Articles & Guides

Eating Disorders

DBT for Binge Eating: What Safer, Telch, and Chen Built for the Affect-Regulation Pattern

Beginning in the late 1990s at Stanford, Christy Telch adapted Marsha Linehan's dialectical behavior therapy for patients whose binge eating was driven by affect dysregulation rather than by cognitive over-evaluation of shape and weight. The RCT lineage that followed, culminating in the Safer, Telch, and Chen treatment manual published by Guilford in 2009 and revised in 2017, established DBT-BED as the evidence-based intervention of choice for the affect-regulation presentation. This post traces what the protocol contains, how it differs from standard DBT, and when it is indicated over Christopher Fairburn's CBT-E.
Eating Disorders

Why Dieting Causes Binging: Restraint Theory Explained

In 1985, Janet Polivy and C. Peter Herman published the experimental work at the University of Toronto that demolished the willpower model of binge eating. Restraint theory proposes that cognitive dietary restraint, not hunger or lack of discipline, is the proximal cause of the disinhibited eating that follows a breach of a self-imposed rule. Four decades of subsequent research, including Eric Stice's dual-pathway confirmation, have substantiated the basic mechanism and informed why Christopher Fairburn's CBT-E drops dietary restraint early in treatment.
Eating Disorders

The Obesity Clinic That Discovered Trauma: Vincent Felitti, the ACE Study, and What Your Binge Is Holding

In the late 1980s, Vincent Felitti ran the obesity clinic at Kaiser Permanente in San Diego. He could not understand why his best-outcomes patients were the ones who quit the program, until he began following them up and discovered what his liquid-diet protocol had been treating without knowing it was treating. The ACE Study grew out of those interviews. What the study found about the relationship between adverse childhood experiences and adult health outcomes, including binge eating and body size, reorganized the epidemiology of trauma in the United States and has not yet reorganized most of the treatment the culture offers.
Eating Disorders

The DSM-5 Criteria for Binge Eating Disorder, Read Plainly

In 2013, the American Psychiatric Association added binge eating disorder to the DSM-5 as a standalone diagnosis, closing a three-decade gap between what clinicians were seeing in the consulting room and what the diagnostic manual permitted them to name. This post reads the DSM-5-TR criteria plainly and answers the three questions patients ask most often when a primary-care referral form prints the criteria in front of them.
jungian

The Transcendent Function: Jung's Actual Mechanism of Psychic Change

The transcendent function is Jung's term for the psychic mechanism by which conscious and unconscious positions, held in tension long enough, produce a third thing neither alone could generate. Active imagination is the practice that creates conditions for the function to operate. The mechanism is not mystical. It is specific, structural, and often foreclosed by the ego's preference for quick resolution.
jungian

Type-Adequate Therapy: Why the Same Framework Needs Different Delivery for Different Cognitive Profiles

The same therapeutic framework lands differently on different cognitive profiles. A Thinking-dominant client needs interventions framed through Thinking. A Feeling-dominant client needs them framed through Feeling. Type-adequate therapy is not 'different therapies for different types.' It is the recognition that the client's auxiliary function is the door through which mature change can enter.
dreams

The Independent Dream: When the Dreamer Acts

The Independent configuration in Structural Dream Analysis names a dream ego that decides, shapes, and acts rather than flees or watches. Christian Roesler's 2018 replication in the Journal of Analytical Psychology found that the movement of dream-pattern agency scores toward this end of the spectrum predicted symptom change on standardized outcome measures, which makes the Independent dream a biomarker of therapeutic work rather than a reward at the end of it.
dreams

The Dream Ego Who Watches: What Roesler Named and What It Means

The Observer dream ego is the position in which the dreamer watches events rather than participating in them, a pattern Christian Roesler's Structural Dream Analysis identifies as one of six recurring dream ego positions. The position carries different clinical meaning depending on whether it arises from dissociation, neurotype, or depressive depletion, and distinguishing the Observer ego from the cultivated mindful observer is the first move in any honest clinical conversation about it.
dreams

The Survivor Dream: Why Nightmares Recur and What the Psyche Is Trying to Do

The Survivor is one of six structural dream archetypes catalogued in Christian Roesler's 2018 replication study, the one in which the dream ego manages threat without resolving it. This post synthesizes Roesler's structural dream analysis with Ernest Hartmann's contextualization theory and Rosalind Cartwright's longitudinal work to explain why post-trauma nightmares recur, how they compress rather than replay, and what their shift across treatment indicates clinically.