Abstract
In the most severe forms of eating disorders (especially in anorexia nervosa), when the patient do not have insight and refuses life-saving treatment, compulsory treatment can be necessary. However, there are strategies which diminish the resistance and enhance motivation. The therapist can reframe the compulsion, or turn the vector of it, or with the technique of splitting can form an alliance with the healthy part of the patient. The involvement of the families is always essential during the treatment of eating disordered patients.
The issue of control is a central phenomenon in eating disorders. The anorexic overcontrol can sometimes be observed paradoxically, this is the control paradox. Other paradoxes are also described in anorexia, i.e., the body weight paradox and competency paradox. In this study the importance of provocative behaviour of anorexic patients in the family is discussed. The provocation has a positive message with challenging important family issues, and in this aspect a coercion paradox can be conceptualized.
Key words: eating disorders, anorexia nervosa, bulimia nervosa, compulsory treatment, provocation, coercion paradox