Joanna Lee Haase, Ph.D., MFT

Dr. Joanna Haase recently gave a workshop designed to assist clinicians develop an understanding of how to work with highly gifted individuals who suffer from eating disorders.  The roles of overexcitabilities, giftedness and asynchronous development in eating disorder etiology and treatment was discussed through lecture and clinical case examples.  Participants learned how treatment of highly gifted individuals with eating disorders can differ from traditional eating disorder strategies and how to work more effectively with this population.

Treatment of eating disorders traditionally focuses on the “need to be perfect”, body image distortions, sexual themes and fears of adulthood.  While these themes may indeed be relevant to highly gifted individuals, they are also more likely to be complicated by overexcitabilities, asynchronous development, ability to intellectualize, not only, treatment strategies but their emotions, lack of peers, and anxiety.  In order for treatment to be effective, a clinician must understand how to integrate these elements into their formulation of the client and treatment plan.

Because many highly gifted individuals have or had sensory issues such as “tag” intolerance, they come into therapy with a very different relationship with their body.  It isn’t just that they want to be “thin and beautiful”, it is that they have already spent years trying to tolerate being “in” their body.   Traditional eating disorder treatment would address this as part of the “disorder” and not understand that for some, starving can lessen the experience of sensory overexicitablity just as being overweight can help others feel more grounded in the world.

Unfortunately, highly gifted children are often expected to “not be children” by adults and themselves.   Their advanced ability to “understand” is often mistaken for an advanced ability to “manage” complicated and intense emotions.  While they may look like they are “managing”, many of these children feel like they are drowning and develop anxiety that can be bound, at least temporarily, by eating disorder behavior.   The therapist must be aware of this and carefully assist the client in developing an emotional understanding and connection with their body and self.

The workshop outlined possible issues with overexcitabilities, asynchronous development, intellectualization, and anxiety and eating disorders with highly gifted individuals.  Participants then discussed therapeutic interventions in cases of anorexia nervosa, bulimia nervosa and compulsive overeating.