What if only one person wants therapy? Couples therapy edition (Copy)
If you are struggling with food, your body, or the relentless noise of both, you have probably been told, explicitly or implicitly, that the problem is you.
Your behaviors. Your thinking. Your lack of willpower or self-control.
The clinical world has a long history of locating eating disorders inside the individual, as though they emerge from personal failing rather than from something far more complex.
I want to offer a different frame.
Eating disorders are not random. They are not character flaws. In many cases, they are coping mechanisms; intelligent, if painful, responses to an environment that felt unsafe, uncontrollable, or unaccepting.
Food restriction, bingeing, purging, and obsessive thinking about the body are often ways of managing something that feels unmanageable. Fear of rejection, unbearable uncertainty, grief, or the exhausting performance of being enough, which on the surface, looks like the problem. But beneath it is usually a question: am I loveable as I am? — that never got a satisfying answer.
This is not an excuse. It is an explanation. And explanations matter, because they change what healing looks like.
When we treat eating disorders purely at the level of behavior; tracking intake, restoring weight, challenging thoughts — we can miss what the behavior is actually communicating. A more complete approach asks: what is this protecting you from? What would it mean to let it go? These are not easy questions, but they are the right ones.
In my work, I draw on psychodynamic therapy and Internal Family Systems to help clients understand the parts of themselves that developed these strategies, and why those parts made sense given what they were navigating. The goal is not to eliminate those parts, but to understand them well enough that they no longer need to work so hard.
If you are struggling, we want you to know; your eating disorder is not who you are, it is information. And with the right support, that information can become the beginning of something new.
Julia works with individuals navigating eating disorders, anxiety, identity, and life transitions. She sees clients in Manhattan and remotely.
