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Publication Date: 
September, 2020
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In this article, the authors assert a need for a new perspective on treatment for adolescents and adults with extreme recurring anorexia, underlying prenatal and perinatal trauma, early childhood trauma (or Adverse Childhood Experiences), and complex multi-problems. Current evidence-based therapies are successful with 66% of patients suffering from anorexia with a BMI higher than 17.5. An approach is suggested that regards the eating disorder as a coping strategy for underlying emotional pain.


There is a need for a new perspective on treatment for adolescents and adults with extreme recurring anorexia, underlying prenatal and perinatal trauma, early childhood trauma (or Adverse Childhood Experiences), and complex multi-problems. Current evidence-based therapies are successful with 66% of patients suffering from anorexia with a BMI higher than 17.5. An approach is suggested that regards the eating disorder as a coping strategy for underlying emotional pain. We advocate this approach, which is based on principles like those from CBT, the Self-Determination Theory, and trauma therapy: Past Reality Integration (PRI). The following initial results of a PRI pilot study with 13 clients appear promising.


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