Stop Treating Symptoms and Start Addressing the Underlying Issues

‍What if the key to lasting recovery isn't found in meal plans or coping strategies, but in understanding the story behind the eating disorder?

After years of working with clients who seemed to make progress only to plateau or relapse, I began to notice a pattern. The clients who achieved lasting, transformative recovery weren't just changing their behaviours - they were connecting their eating disorder to their deeper story.

The limitation of surface-level treatment:

Traditional eating disorder treatment often focuses on the "what" - what behaviours to change, what skills to learn, what meals to eat. While these elements are important, they miss the crucial "why" that drives lasting change.

When we only address symptoms without exploring their origins, we're essentially asking clients to abandon coping mechanisms that have served a purpose without fully understanding what that purpose was. It's like asking someone to throw away a life jacket without first teaching them to swim.

Behavioural focused intervention (CBT-E, FBT, etc.) can work brilliantly for some folks, but for others it leaves out something crucial. For some, the most profound moments in therapy happen when they suddenly understand the connection between their current struggles and their past experiences. That moment when they realise their perfectionism around food connects to growing up in a chaotic household. The insight that their body image struggles link to early messages about worth and appearance. The recognition that their eating disorder emerged as a way to cope with trauma or loss of control.

These connections don't just create understanding - they create the motivation for deep, lasting change.

Moving beyond "what happened" to "what it means":

Exploring eating disorder origins isn't about dwelling in the past or assigning blame. It's about helping clients understand the logic of their symptoms within the context of their life story. When clients can see how their eating disorder developed as an understandable response to difficult circumstances, shame often transforms into compassion.

This understanding creates several powerful shifts:

• Behaviours that seemed "crazy" or "irrational" suddenly make sense
• Self-criticism transforms into self-compassion
• Motivation for change comes from within rather than from external pressure
• Recovery becomes about reclaiming their authentic self, not just changing behaviours

The framework that creates breakthrough moments:

Effective exploration of eating disorder origins involves examining four key areas:

Life experiences that shaped their worldview - particularly around food, body, safety, and worth. This includes family dynamics, cultural messages, traumatic events, and experiences of marginalisation or discrimination.

Core beliefs that developed as a result of these experiences - about themselves, others, and the world. These often unconscious beliefs become the lens through which they interpret new experiences.

Protective strategies they developed to cope with distressing beliefs and feelings. These adaptive responses made perfect sense in their original context, even if they've become problematic over time.

Current behaviours that stem from these earlier adaptations. When clients can trace their eating disorder behaviours back to their protective origins, they often feel less broken and more empowered to change.

Creating the conditions for deep work:

This level of exploration requires safety, trust, and the right timing. Clients need to feel secure in the therapeutic relationship and have adequate emotional resources before diving into deep work. It's not about rushing to uncover trauma, but about creating space for clients to explore their story at their own pace.

The goal isn't to pathologise their past or find someone to blame. Instead, it's about helping clients understand the wisdom in their survival strategies while supporting them in developing new ways of meeting their needs.

When clients connect with the deeper story behind their eating disorder, recovery often shifts from feeling like an imposed task to a natural evolution. They're not just following a treatment plan - they're reclaiming parts of themselves that got lost along the way.

This kind of work often leads to recovery that goes beyond symptom remission. Clients don't just improve their relationship with food and their body - they often experience improvements in relationships, self-esteem, life direction, and overall well-being.

Supporting clients in this exploration:

Having structured tools to guide this exploration can make the difference between surface-level insights and profound transformation. When clients have a framework to examine their story, they often make connections that surprise even experienced therapists.

The most powerful tool is often the client's own wisdom. Our role is to provide the structure and safety for them to explore their story and make their own connections.

The ripple effect of understanding:

When clients understand the origins of their eating disorder, it doesn't just change how they view their symptoms - it often transforms their entire relationship with themselves. They begin to see their struggles not as personal failings but as understandable responses to difficult circumstances.

This shift in perspective creates space for genuine self-compassion, which becomes the foundation for sustainable change. Recovery stops being about fixing what's "wrong" with them and becomes about honouring their resilience while building new ways of thriving.

Your role in facilitating this transformation:

As clinicians, we have the privilege of witnessing these profound moments of connection and understanding. By providing the framework and safety for deep exploration, we help clients access their own wisdom about their healing journey.

The most lasting changes often come not from what we tell clients, but from what they discover about themselves when given the right tools and support to explore their story.

Ready to facilitate this level of transformation?

Download our free handout: Stop Treating Symptoms and Start Targeting Core Issues: How Exploring Origins Creates the Breakthrough Your Clients Need
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Or see our alternative version for when the eating differences are primarily due to neurodivergence rather than disordered eating

To dive deeper, check out our online training: https://training.exhalepsychology.com.au/

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When we help clients understand not just what to change but why change matters to their deeper story, we create the conditions for transformation that goes far beyond symptom management. We help them reclaim their authentic self - which is, ultimately, what recovery is all about.

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