This scientific essay aims to more closely study how to best arrange a context that subtly conveys that change is possible in the treatment of patients who starve themselves. By describing a number of situations during the first weeks of a girl´s therapy, this essay focuses on some central themes in the initial stage. The essay is mainly aimed to explore the conditions for a meaningful communication with a patient who has a low BMI value and who quitted the nutrition-oriented care in her clinic. The essay is a form that allows for reflection on one´s own considerations about the wisest line of conduct in various situation. The work is based on an existential understanding of the starvation as a fragile person´s one and only way to reconcile with herself in the world that is hers. This approach provides a hopeful perspective on two difficulties that are often associated with this population; namely a negative attitude to the possibility of getting well, and a lack of motivation to change anything. What seems to be useful in this kind of treatment is the therapist´s participation in the girl´s phenomenon world and a conjoint exploration on the meaning of her self-starvation. The activity and presence of the therapist is considered important, and the basic assumption is that the starvation is connected to a persons need to feel her personal value, which in the long run serves contributes to remove deeply rooted perceptual and cognitive blockages.

Syftet med denna kvalitativa studie är att närmare undersöka den fronetiska kunskapen kring vad det är iterapeutisk behandling som hjälper människor i riskzonen att utveckla eller redan har utvecklat långvariganorexi. Genom tre material – min teoretiska och praktiska kunskap och tidigare kvalitativa forskning, enfallstudie från den kliniska verksamheten vid Anorexiamottagningen i Stockholm samt en fältstudie medintervjuer med en forskare och fem terapeuter från två olika enheter. Denna studie utforskar gemensammanämnare i behandling med särskilt fokus på vikten av terapeuternas perspektiv. Informanterna har ett holistisktperspektiv och arbetar med olika existentiella, integrativa och systemiska modeller. Det som står ut iinformanternas svar, och som bekräftas av familjen och klientens egen röst, är att personen bakom symtomentonas fram – särskilt inför sig själv – och att sjukdomen tonas ner. Viktigt är också att terapeuterna kan förmedlabåde sin tro på att det är en mänsklig möjlighet att bli fri från anorexi och att det även finns anledning att tro påden enskilda klientens möjligheter att återhämta sig. Andra teman av betydelse är hur man hanterar ångest,negativa självbilder, ambivalens och rädsla för förändring och hur man inviterar till reflexion över alternativasätt att komma vidare i livet utan sin ”bästa” vän Anorexia. Denna studie föreslår mitt material och familjernasberättelse och informanternas bidrag tillsammans frambringar en kollektiv fronetisk kunskap. Det öppnar för attfortsatt forskning går vidare med de aspekter som diskuteras i slutreflektionen. / The aim of hisqualitative study is to examine more closely the fronetic knowledge of what it is in a therapeutic treatment thathelps people who are on the edge to develop, or already have developed, long term anorexia. Through threematerials –my own theoretical and practical knowledge and previous qualitative research, one case study fromthe clinical praxis at the Anorexiamottagningen in Stockholm and one field study where one researcher and fivetherapists from two different unities are interviewed. The study has explored common denominators in treatmentwith special focus on the importance of the therapists ́ perspective. All informants have a holistic view and workwith different existential, integrative and systemic models. What stands out in the answers of the informants, andis confirmed by the family and the voice of the client, is that the person behind the symptoms is tuned up –especially for herself – and the illness is downplayed. It is also important that the therapists can mediate boththeir belief that it is a human possibility to become free from anorexia and that there is also good reason tobelieve in the possibility for the individual client to recoup. Other themes of importance are how to deal withanxiety, ambivalence, negative self-images and fear of change, and how to invite to reflection on alternativeways to proceed in life without their “best” friend, Anorexia. This study suggests that my material together withthe account of the family and the contribution of the informants at the treatment units and bring forth aconsiderable amount of collective phronetic knowledge. This suggests that future research look further into someof the aspects discussed in the final reflection.