ANOREXIA NERVOSA: Resolving The Root Cause in Treatment
ANOREXIA NERVOSA
The main symptoms of anorexia nervosa are substantial loss of body weight
and deliberate restriction of calorie intake. It is therefore sometimes called
the "slimmer's disorder." The diagnosis is not accorded unless the individual
has lost 25 percent of normal body weight (or, if the person is under eighteen,
the actual weight loss and the weight that would have been gained as a
result of ordinary maturation combine to meet the 25 percent criterion).
The central feature of anorexia nervosa is an intense preoccupation with
body size and image. Even when they are emaciated, individuals with this
disorder feel fat. About 95 percent of those suffering from the disorder are
women. Moreover, its prevalence appears to be rising (Bruch, 1978; Yule,
1980), such that as many as 1 in 200 females between the ages of twelve
and eighteen succumb (Crisp, Palmer, and Kalucy, 1976). Often, the disorder is
accompanied by a variety of other physical changes. Amenorrhea-that is,
loss of the menstrual period-is a common occurrence in women anorexics.
Blood pressure may be lowered; sleep patterns. may be disturbed, with early
morning insomnia common; there may be noticeable hyperactivity and a
general loss of interest in sex. The salient symptom, however, remains the
persistent determination not to eat, a determination that is so powerful that,
in nearly a fifth of the cases, it results in death.
The following case illustrates this disorder:
Frieda had always been a shy, sensitive girl who gave little cause for concern at
home or in school. She was bright and did well academically, although she had few
friends. In early adolescence, she had been somewhat overweight and had been
teased by her family that she would never get a boyfriend unless she lost some
weight. She reacted to this teasing by with drawing and becoming very touchy. Her
parents had to be careful about what they said. If offended, Frieda would throw a
tantrum and march off to her room- hardly the behavior they expected from
their bright and sensitive fifteen-year-old.
Frieda began dieting. Initially, her family was pleased, but gradually her parents
sensed that all was not well. Mealtimes became battle times. Frieda hardly ate at
all. Under pressure, she would take her meals to her room and later, having said
that she had eaten everything, her mother would find food hidden away untouched.
When her mother caught her deliberately inducing vomiting after a
meal, she insisted they go to the family physician. He found that Frieda had
stopped menstruating a few months earlier. Not fooled by the loose, floppy clothes
that Frieda was wearing, he insisted on carrying out a full physical examination.
Her emaciated body told him as much as he needed to know, and he
arranged for Frieda's immediate hospitalization.
Theories of Anorexia Nervosa
Anorexia nervosa is a bizarre and worrisome condition. Why should any
young woman starve herself to death? And what is the source of these strong
fears of obesity that support an iron-willed determination to eat as little as
possible? Unfortunately, there are many suggested explanations, but too little
confirmatory evidence (Van Buskirk, 1977).
Psychoanalytic theory offers two views on anorexia. In one, eating is
equated with sexual instinct and social role. Women who cannot face up to
the demands of a full adult social and sexual role, starve themselves. In so
doing, they avoid menstruation and the possibility of becoming pregnant. A
second view holds that such patients often have fantasies of oral impregnation.
Confusing fatness with pregnancy, they unconsciously believe that
eating may result in pregnancy, and therefore they starve themselves. These
hypotheses are difficult to confirm. The fact that amenorrhea precedes
rather than follows weight loss seriously damages the first view. The second
view may well be weakened by the fact that fantasies of oral impregnation
are common in women of this age, but most of these women do not become anorexics.
Anorexia nervosa may result from faulty communication within the family.
In Frieda's case, for example, anorexia seemed related to the way her
family dealt with what was already a sensitive issue: the fact that she was
slightly overweight. In turn, the daughter recognized how she could solve
her weight problem and simultaneously retaliate against her family-for
nothing mobilizes greater despair within a family than a child who is wasting
away. The intense struggle between parents and child that subsequently
took place maintained the anorexia. Recent efforts have aimed at reducing
the family conflict by opening new avenues and styles of communication
(Liebman, Minuchin, and Baker, 1974).
But anorexia nervosa is such a powerful disorder, one that results in death
in 15 to 21 percent of the cases (Halmi, 1978), that we are inevitably led to
suspect that there is more than faulty communication or misguided sexual
identity at work here. Some suggest that there is a fundamental disorder in
the hormonal and/or endocrine systems. Others postulate hypothalamic
malfunctioning (Gelfand, Jenson, and Drew, 1982). Yet others believe that
anorexics have not learned to label the hunger sensation and, as a result,
simply do not eat (Agras, Barlow, Chapin, Abel, and Leitenberg, 1974).
Treatment
(For out-patient treatment see my recommendation below)
Quite often, hospitalization of the anorexic is recommended because the patient
is dangerously ill and can be carefully monitored in the hospital. Even
at the point where hospitalization is required, however, some anorexics will
protest that they have no problem, that they are not ill, and therefore that
they do not require treatment. As a result, they are often difficult patients.
The more successful hospital treatment regimens combine sympathetic
counseling with contingency management, which makes various privileges
contingent on positive changes in eating habits and on weight gain (Bemis,
1978; Yule, 1979; Palmer, 1980).
The main symptoms of anorexia nervosa are substantial loss of body weight
and deliberate restriction of calorie intake. It is therefore sometimes called
the "slimmer's disorder." The diagnosis is not accorded unless the individual
has lost 25 percent of normal body weight (or, if the person is under eighteen,
the actual weight loss and the weight that would have been gained as a
result of ordinary maturation combine to meet the 25 percent criterion).
The central feature of anorexia nervosa is an intense preoccupation with
body size and image. Even when they are emaciated, individuals with this
disorder feel fat. About 95 percent of those suffering from the disorder are
women. Moreover, its prevalence appears to be rising (Bruch, 1978; Yule,
1980), such that as many as 1 in 200 females between the ages of twelve
and eighteen succumb (Crisp, Palmer, and Kalucy, 1976). Often, the disorder is
accompanied by a variety of other physical changes. Amenorrhea-that is,
loss of the menstrual period-is a common occurrence in women anorexics.
Blood pressure may be lowered; sleep patterns. may be disturbed, with early
morning insomnia common; there may be noticeable hyperactivity and a
general loss of interest in sex. The salient symptom, however, remains the
persistent determination not to eat, a determination that is so powerful that,
in nearly a fifth of the cases, it results in death.
The following case illustrates this disorder:
Frieda had always been a shy, sensitive girl who gave little cause for concern at
home or in school. She was bright and did well academically, although she had few
friends. In early adolescence, she had been somewhat overweight and had been
teased by her family that she would never get a boyfriend unless she lost some
weight. She reacted to this teasing by with drawing and becoming very touchy. Her
parents had to be careful about what they said. If offended, Frieda would throw a
tantrum and march off to her room- hardly the behavior they expected from
their bright and sensitive fifteen-year-old.
Frieda began dieting. Initially, her family was pleased, but gradually her parents
sensed that all was not well. Mealtimes became battle times. Frieda hardly ate at
all. Under pressure, she would take her meals to her room and later, having said
that she had eaten everything, her mother would find food hidden away untouched.
When her mother caught her deliberately inducing vomiting after a
meal, she insisted they go to the family physician. He found that Frieda had
stopped menstruating a few months earlier. Not fooled by the loose, floppy clothes
that Frieda was wearing, he insisted on carrying out a full physical examination.
Her emaciated body told him as much as he needed to know, and he
arranged for Frieda's immediate hospitalization.
Theories of Anorexia Nervosa
Anorexia nervosa is a bizarre and worrisome condition. Why should any
young woman starve herself to death? And what is the source of these strong
fears of obesity that support an iron-willed determination to eat as little as
possible? Unfortunately, there are many suggested explanations, but too little
confirmatory evidence (Van Buskirk, 1977).
Psychoanalytic theory offers two views on anorexia. In one, eating is
equated with sexual instinct and social role. Women who cannot face up to
the demands of a full adult social and sexual role, starve themselves. In so
doing, they avoid menstruation and the possibility of becoming pregnant. A
second view holds that such patients often have fantasies of oral impregnation.
Confusing fatness with pregnancy, they unconsciously believe that
eating may result in pregnancy, and therefore they starve themselves. These
hypotheses are difficult to confirm. The fact that amenorrhea precedes
rather than follows weight loss seriously damages the first view. The second
view may well be weakened by the fact that fantasies of oral impregnation
are common in women of this age, but most of these women do not become anorexics.
Anorexia nervosa may result from faulty communication within the family.
In Frieda's case, for example, anorexia seemed related to the way her
family dealt with what was already a sensitive issue: the fact that she was
slightly overweight. In turn, the daughter recognized how she could solve
her weight problem and simultaneously retaliate against her family-for
nothing mobilizes greater despair within a family than a child who is wasting
away. The intense struggle between parents and child that subsequently
took place maintained the anorexia. Recent efforts have aimed at reducing
the family conflict by opening new avenues and styles of communication
(Liebman, Minuchin, and Baker, 1974).
But anorexia nervosa is such a powerful disorder, one that results in death
in 15 to 21 percent of the cases (Halmi, 1978), that we are inevitably led to
suspect that there is more than faulty communication or misguided sexual
identity at work here. Some suggest that there is a fundamental disorder in
the hormonal and/or endocrine systems. Others postulate hypothalamic
malfunctioning (Gelfand, Jenson, and Drew, 1982). Yet others believe that
anorexics have not learned to label the hunger sensation and, as a result,
simply do not eat (Agras, Barlow, Chapin, Abel, and Leitenberg, 1974).
Treatment
(For out-patient treatment see my recommendation below)
Quite often, hospitalization of the anorexic is recommended because the patient
is dangerously ill and can be carefully monitored in the hospital. Even
at the point where hospitalization is required, however, some anorexics will
protest that they have no problem, that they are not ill, and therefore that
they do not require treatment. As a result, they are often difficult patients.
The more successful hospital treatment regimens combine sympathetic
counseling with contingency management, which makes various privileges
contingent on positive changes in eating habits and on weight gain (Bemis,
1978; Yule, 1979; Palmer, 1980).
For the out-patient treatment I recommend this therapy.
Click Here: http://www.TheLiberatorMethod.com
AVAILABLE IN the USA CANADA UK AUSTRALIA
Inpatient Treatment Residential Treatment Partial Hospitalization Day Treatment Outpatient Individual Therapy/Private Practice Medical Evaluation Nutritional Counseling Family Therapy Couples Therapy Group Therapy Support Groups Phone Counseling and Phone Therapy Distance Counselling
FOOD ADDICTION?
Learn why Impulse Control Treatments Counselor/Therapies may FAIL and discover a new Cutting Edge Method that WORKS...
You may not-yet-have-experienced…
…YOUR POWER TO CHANGE!
I’ll explain the Empowering Counseling Method—with a proven success rate.
Click here to learn more:
http://food-addiction-treatment-cure.webs.com/
Click Here: http://www.TheLiberatorMethod.com
AVAILABLE IN the USA CANADA UK AUSTRALIA
Inpatient Treatment Residential Treatment Partial Hospitalization Day Treatment Outpatient Individual Therapy/Private Practice Medical Evaluation Nutritional Counseling Family Therapy Couples Therapy Group Therapy Support Groups Phone Counseling and Phone Therapy Distance Counselling
FOOD ADDICTION?
Learn why Impulse Control Treatments Counselor/Therapies may FAIL and discover a new Cutting Edge Method that WORKS...
You may not-yet-have-experienced…
…YOUR POWER TO CHANGE!
I’ll explain the Empowering Counseling Method—with a proven success rate.
Click here to learn more:
http://food-addiction-treatment-cure.webs.com/