Accelerated experiential dynamic psychotherapy (AEDP) is an attachment-oriented, emotion-focused model of psychotherapy and trauma treatment. AEDP is grounded in the belief that we are all innately resourceful and driven toward health and wholeness. When given the care and attention of an attuned, responsive caregiver, we will naturally flourish. According to Diana Fosha, developer of the model, “The roots of … resilience are to be found in the sense of being understood by and … existing in the heart and mind of a loving, attuned, and self-possessed other” (2003, p. 228). In contrast, the roots of psychopathology—or the problems that bring our clients to treatment—lie in the painful experience of “unbearable aloneness” with overwhelming feelings or events (Fosha, 2000b). Eating disorders (EDs) and dissociation are symptoms of this plight of aloneness. They are self-protective strategies to quell anxiety and manage the distress associated with unsafe or unwelcome emotions, and they are self-reliant in design. As AEDP therapists, we assert ourselves as safe and secure attachment figures for our clients with EDs, undoing their aloneness and offering a warm and reliable relationship to hold and explore feelings previously experienced on their own.

The ethos and metapsychology of AEDP are organized around change—and change for the better. Current research on attachment and neuroplasticity suggests that new experiences of emotion and connection wire and rewire the brain (Siegel, 2003). In this chapter, we detail the course of AEDP treatment for clients with active EDs. We use vignettes and a transcript from a live therapy session to highlight salient concepts and illustrate AEDP interventions in action. From our initial clinical assessment to the moment-to-moment processing of affect and, ultimately, trauma healing and integration, we seek to offer our clients a new, embodied emotional experience within the context of a new, authentic, relational experience. We invite our clients to connect with us and to reestablish contact with their feelings and bodies, embarking together on small rounds of focused experiential work that we follow with shared and explicit reflection and processing. Developing the capacity to “feel and deal while relating” is the hallmark of mental health in AEDP and the foundation for sustained ED recovery (Fosha, 2000b).