Discovering our clients with a lifeline


I hear on the grapevine that someone has taken exception to NCFEDs method for assessing a client’s story via a lifeline. The lifeline tracks their life experiences alongside changes to their eating and body size or weight with colours and pictures.

Someone claiming to be a psychotherapist has taken exception to our understanding the client’s weight changes during their lifespan (alongside their story) by calling this “fat phobic”

The apparent purpose of tracking a client’s weight, is not to shame or judge them. It is to see how life experiences and transitions have changed a person’s eating habits and weight status. The weight is important only as it serves as a communication of deeper issues that may be unspoken.

It was Freud who first identified the mind-body as a single energy system and both behaviour and body weight may symbolise issues that are either hidden from understanding or for which the client cannot find words to express or explain what is happening to them. As Van de Kolk explained, “the body keeps the score”.

Just as we understand that weight loss in the anorexic is the only way they know to experience an emotional pain for which they lack a language, it may be the same for weight change in the opposite direction. It is our sacred duty to identify ALL the signals in the client’s narrative to understand what is important to them, what has been lost or is missing, what is the communication that we need to hear. What have they been unable to cope with, and what can we learn about the deficits that therapy can address.

It can also be said that clients tend to like and find safe the lifeline process; in 40 years of work we have had no complaints. If anything, it shows that I am interested in who they are rather than simply their eating disorder symptoms. During the process they become curious rather than defensive. They start to make their own connections about a problem that has not been understood and that has plagued them  And they engage with me because they sense that I have seen them, and what is important in their life OTHER than food and body shape.

Some people are so wedded to their activisms that they are blind to reason. I am reminded that just because you have a loud voice you may not be right. They are passionate militants without fully understanding why.  Should they be let loose on vulnerable people?

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