To better know and understand our feelings few would disagree that insightfulness is helpful. But in and of itself insight changes very little. Unconscious, psycho-biologically driven behaviours are not much influenced at all by how much we know about them.

Clients and patients make this clear to me over and over again in their struggles with eating disordered symptoms.

Many of them say the urge to over-eat and then to purge totally overwhelms them and it does this so quickly and routinely as a response to stress, although it did not start that way, that they come to The Surrey Centre in despair, feeling powerless to resist it despite knowing, i.e., having insight into the fact, that over time succumbing to it over and over again can and does cause awful damage to their bodies. And their minds, already struggling with self-respect, come to feel more and more despair about it. They therefore need to know that I know resisting it is infinitely easier said than done.

At the other end of the spectrum the constant state of being split-off from their emotions and feelings, characteristic of so many people who come with problems of self-starvation, is a much slower, but in many, often more subtle ways, just as overwhelming an experience. If not more so because of how completely it affects their thinking and behaviour so that no amount of insight affects that at all. Their anorexia thrives on starvation and these women, and it is usually women, know, i.e have insight into the fact, that it does. But their insight doesn’t change it at all.

They tell me what makes a difference is feeling they are in a therapeutic relationship. Feeling understood, feeling helped, feeling they can be honest, feeling they can be in a relationship with someone who knows from experience that normal thinking and eating patterns can be recovered.

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