Psychopathology of Eating Disorders According to Neurobiology of Attachment: An Instrument to Overcome Resistances to Treatment?

Eating disorders are still challenging mental disorders and encourage psychiatrists to wide-range reflections on their psychopathology which are addressed to copy with the persisting difficulties in offering an effective treatment. The current development of the treatments for EDs is still unsatisfactory, in particular for Anorexia Nervosa (Zipfel et al., 2013) [1]. More or less one half of subjects affected with bulimia nervosa and one fourth of those affected with anorexia nervosa reach a complete and lifetime stable recovery from their disease. The resistances to treatment (e.g. difficulty in engaging in the treatment, in being compliant to therapies, and in concluding the therapeutic programs in agreement with the therapists) which are common to all mental disorders are expressed at their highest degree in ED subjects (Fassino and Abbate Daga, 2013 [2]; Abbate Daga et al., 2013 [3]). The psychopathological models of the eating disorders, which are the basis of worldwide validated treatments (Fairburn et al., 2015 [4]; Zipfel et al., 2013) are still far from effectively explaining the dynamics underlying the resistances to treatment and offer effective solutions. Thus the resistances to treatment are worldwide challenging the current clinical practice concerning EDs since they impair treatment search and compliance, foster dropout, obstacle recovery, and in general delay healing.