Application of Psychodrama and Object Relations Psychotherapy – An Integrated Approach to the Treatment of Bulimia Nervosa Based on Selected Elements of the Theory and the Author’s Own Experience

Bulimia nervosa is an eating disorder characterized by self-destructive behaviours which gradually affect the sufferer’s mental well-being and lead to body emaciation. The results of the scientific research conducted in the past few decades point to a multitude of determinants of this disorder, including biological, familial, socio-cultural and individual factors [Mikołajczyk, Samochowiec, Kent,Waller, Dagnan, Hartt, Wonderlich , Rorty, Yager, Rossotto, Lacey, Evans]. Chronic stress and traumatic events which the person experiences in his or her life (e.g. acts of violence or sexual abuse) are considered to be significant triggering factors for bulimia nervosa [Mikołajczyk, Samochowiec, Kent, Waller, Dagnan, Hartt, Wonderlich, Rorty, Yager, Rossotto]. Traumatic experiences which bulimia sufferers are exposed to, and their emotional deficits affect the recovery process. In the therapeutic process, the patient needs to develop a cognitive and emotional insight into psychological mechanisms underlying the disorder which he or she suffers from, and to undergo a corrective emotional experience in the contact with the other person. This points to the significance of an “encounter with the other person and establishing a positive emotional bond (the therapeutic alliance) with this person”. Thus, psychodrama is the therapeutic method which allows to intensify reactive actions and facilitates positive changes in the emotional structure of the patient’s personality, and proves to be an effective technique of reducing bulimic symptoms. Eating disorders belong to the category of psychopathology which is characterized by various levels of personality dysfunctions which range from neurotic disorders to psychosis. The choice of diagnostic and therapeutic interventions applied in the process of treatment should then be determined by the kind of a personality disorder identified in the given individual. Developing insight into psychological mechanisms underlying eating disorders, as well as establishing a therapeutic bond, constitute a crucial element of therapeutic interactions which can be supported by such methods as psychodrama and object relations technique. Integrating psychodrama, which allows to gain insight into psychological mechanisms underlying bulimia nervosa, with the approach that focuses on corrective interactions in