Linking Self-States in Eating Disordered Patients: Multiplicity in Multidisciplinary Teams

Novack (this issue) provides opportunities for clinicians working with patients with eating disorders to think of the various team members, including additional therapists, as representing and helping to bring to the forefront the patient’s various self-states and expands the idea of multiple self-other configurations to a multi-person configuration. However, the complexity of this multi-person field can be fraught, as the clinician is pulled into engagement with these various team members, while simultaneously containing multiple self-states and body-states, and working internally to link an awareness of each of their functions. In this commentary, I address how the expression of dissociated self-states across a multi-person system can serve both defensive and expressive unmet needs for both patient and therapist. Is linkage with others external to the treatment dyad as therapeutically useful as linkage from within the dyadic field? Holding the tension of what is gained and what is lost in expanding the idea of multiple self-other configurations from the analytic dyad to a multi-person field requires careful consideration.