A retrospective view of psychodynamic treatment: Perspectives of recovered bulimia nervosa patients

Detailed case studies from the clinical literature suggest the efficacy of psychodynamic psychotherapy for bulimia, yet few empirical studies examine the aspects of psychodynamic intervention identified as helpful to the recovered patient. In-depth interviews were conducted with fourteen recovered female bulimic patients, ranging in age from 22–46, who had been in individual psychodynamically-oriented treatment for at least two years and had terminated this treatment no less than six months ago. The findings included five major thematic categories that recovered patients identified as beneficial to recovery: 1) engagement and building the therapeutic alliance; 2) decoding the adaptive and psychological meaning of the symptom; 3) the nature of the therapy relationship; 4) signs of progress as the therapy work deepened; 5) adjunctive treatment approaches. These findings underscore the relational field in psychotherapy and suggest that recovered bulimia patients may perceive psychodynamic treatment as effective when integrating adjunctive and behavioral treatment interventions, such as medication, journaling, and keeping food diaries.