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Female inpatients aged 28\u201359 (<jats:italic>M<\/jats:italic>\u2009=\u200940.2,<jats:italic>SD<\/jats:italic>\u2009=\u20095.0) from a randomised trial comparing Compassion Focused Therapy for EDs (n\u2009=\u20093) with Cognitive Behavioural Therapy for EDs (n\u2009=\u20093) were interviewed with video-assisted recall about a self-selected session. Data were analysed through Interpretative Phenomenological Analysis (IPA) with Grounded Theory (GT) elements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Covert patient strategies included self-effacement, regulating therapeutic distance to open up, and engaging with reflective rather than experiential interventions. First, self-effacement included submissive, passive or pretend responses to perceived criticising or violating therapist behaviours as well as other orientation and submission for approval. Second, some preferred a close patient\u2013therapist alliance with therapist self-disclosure and reciprocity was a\u00a0requirement for opening up; others required distance. Third, informants detached from experiential trauma work while engaging in joint reflection on post-trauma responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Informants were preoccupied with calibrating the emotional\u2013relational landscape in session; we hypothesized that psychological insecurity and affective intolerance from CT limit their freedom to explore own in-session experiences.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40337-022-00566-1","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T11:03:30Z","timestamp":1647860610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Covert therapeutic micro-processes in non-recovered eating disorders with childhood trauma: an interpersonal process recall study"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1477-9249","authenticated-orcid":false,"given":"Malin E.","family":"Olofsson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KariAnne R.","family":"Vrabel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asle","family":"Hoffart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne W.","family":"Oddli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"566_CR1","first-page":"40","volume-title":"Clinical handbook of complex and atypical eating disorders","author":"JG Trim","year":"2018","unstructured":"Trim JG, Galowski TE, Wagner A, Brewerton TD. 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