From red vegetables to sexuality: Resymbolizing the meaning of concrete thought in eating disorders

Abstract

This paper introduces and describes the theory and practice of a novel treatment approach to eating disorders—internal language enhancement therapy (ILET)—illustrated with a case study. This treatment approach is informed by the neurobiology of emotional processing integrated with elements of psychoanalytic theory and practice, early maternal preoccupation, development of the self, early right hemisphere language development, and techniques from cognitive behavioral therapy. ILET is based on the Discontinuous Model of Neural Emotional Processing, which means that emotions are processed in the brain either symbolically or concretely. The aim of ILET is to open up and reinforce the underused brain pathway to the symbolic functions by forensically working back to and accurately identifying the emotional material that triggers the concrete state. When the emotional trigger is identified it is explored using symbolic and metaphoric language that reconnects the patient to the symbolic state. ILET posits that eating disorders only appear in the concrete state.