Table 4.

Treatment needs from the wisdom of SE-AN experience

Therapeutic Stance
The therapist sees the person:
▪ as a unique individual
▪ outside the illness
▪ without preconceptions of how AN is for them
▪ struggling to find value in themselves and their life
Therapeutic Relationship
▪ allows time to build trust
▪ recognises relational struggles
▪ instils trust in self-efficacy, helps me to trust myself
▪ accepts me for who I am, especially the bits I ‘disown’ and see as unacceptable
▪ provides security with a boundary of treatment non-negotiables that prioritise my safety, and includes me in the process
▪ recognises that food may be a literal manifestation of being starved, a red herring
Treatment
▪ Helps me to understand my illness before I am expected to give it up
▪ Recognises that my illness really works for me and is the best way I know how to survivea
▪ Recognises my illness is compatible with the low value I place on myselfa
▪ Helps me to build meaning about what AN is in my life
▪ Allows space in treatment, to address my unique concerns beyond the treatment manual
▪ offers me choices and maximises my autonomy so I can build my own self-efficacy
▪ Measures me not by my weight
▪ Allows me the freedom to create the terms for my life
▪ Helps me to connect to all aspects of my being and offers a variety of treatment adjuncts
▪ If I need to go to hospital, offers me emotional support as well. Recognising when I am terrified and that I may have past trauma from previous admissions too
▪ Recognises the broader context of living with SE-AN, including;
- Judgement and misunderstanding of my illness
- Being enslaved to AN, it is the ‘master’
- Appreciation of my profound losses to SE-AN
- Helps me to make peace with my life I have made alongside AN
- Offers me the care that I need in line with my stage of my illness. I’m not an adolescent

^arecognising the broader aspects of ego-syntonicity beyond control of body image and weight