In the case of Laura, she seems to have developed an eating disorder that includes purging rather than refusal to eat. Has she in the past been anorexic? Does her family history offer any clues to her eating disorder, such as a history of such disorders, alcoholism, depression, etc? Do you believe these factors support a biological predisposition? Do you see this particular instance of an eating disorder as influenced at all by societal factors such as a desire for thinness? How has this disorder impacted her physical health, if at all? And lastly, do you view the sexual abuse, along with unmet developmental needs as a crucial part of Laura's problems including her relationship with her mother and her confusion about herself as a sexual person? I am also interested in your relationship with Laura and wonder about the role of establishing a "different" type of relationship thus providing her with a different experience with a significant other. In short do you believe that experiencing a different reaction, response, and by having someone BE THERE contributes to therapeutic change? If you might address these questions in future postings perhaps I could develop a better picture of Laura and her present situation. I am intrigued by the multiple aspects of eating disorders and the vast variety of issues that can contribute to the development of an eating disorder. I am also interested in how one can conceptualize the nature of the disorder and work with the client to provide a corrective experience or facilitate meaningful changes.