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What Eating Disorder Treatment and
Psychotherapy Are About
Successful treatment for eating disorders puts
an end to food restriction and to bingeing and purging behaviors.
It normalizes food intake as it resolves the underlying emotional
issues driving the dysfunctional behaviors.
Common Myths About Eating Disorder Treatment
and the Psychotherapy Process—And What the Facts Are
Myth 1. A person can recover from an
eating disorder through willpower alone, through behavioral
changes alone, or through self-esteem work alone. A person
recovers from an eating disorder through behavioral and emotional
changes, made simultaneously.
Myth 2. People in therapy are mentally
ill or emotionally weak and are generally at an advanced stage
of disease. In fact, people in therapy are seeking an opportunity
to define and solve problems. This is a demonstration of strength,
not weakness. Moreover, people who enter therapy early in
the disease, before habits have a chance to become ingrained,
have a better chance for a quick and complete recovery.
Myth 3. Eating disorder treatment never
leads to complete recovery. Eating disorder treatment can
lead to varying degrees of recovery, including complete and
total recovery.
Myth 4. You can determine whether the
therapy process has the potential to be successful only after
months of treatment or by how your child feels about the therapist.
The first meeting with the therapist should suggest the potential
for success. Other indicators of productive treatment are
the emotional and behavioral changes your child makes.
Myth 5. When a child is dealing with
several therapy issues at once, it is not necessary to deal
directly with food behaviors; they will improve as emotional
issues are resolved. The dysfunctional food behaviors should
be treated simultaneously with the emotional issues. They
are intractable habits that will not disappear unless specifically
addressed.
Myth 6. By bringing an eating disorder
out in the open, one risks making the problem worse and the
child more unhappy. As discussed earlier, confronting problems
can create productive controversy and can give clarity and
definition to an already existing issue, increasing the chances
for problem resolution.
Myth 7. A truly strong family never
has fights and should not have problems that require therapy.
All families have disagreements and problems. A strong, successful
family is one in which family members can discuss anything
together without fear, resolving problems as they arise.
Myth 8. The therapist best qualified
to treat an eating disordered child is one who has recoveredfrom
an eating disorder herself or himself or who has psychoanalytic
training. The therapist best qualified to treat an eating
disordered child is one who works actively, purposefully,
and with deep caring, experience, and expertise in this area.
Myth 9. In family therapy the child's
therapist runs the risk of breaching the child's confidence
if she or he also works with the family. The therapist who
works effectively with both individual and family strengthens
and quickens the recovery process. She or he can avoid breaching
anyone's confidence by enforcing clear boundaries, understanding
the parental role in recovery, and promoting family therapy.
Myth 10. In family therapy there is one
patient only—the person with the eating disorder. Because
family members typically share issues with the patient, their
needs and responses also must be addressed; otherwise everyone
stands to lose. Every family member is of equal importance
in the context of family therapy and the family systems approach.
Myth 11. In family therapy the child's
dependence on his parents becomes greater. When this is the
case, it is temporary. The security, bonding, and trust developed
in family therapy increases the child's ability to separate
healthfully and comfortably from the family and ensures his
desire and capacity to return to the family with the same
degree of comfort. Therapy teaches your child the skills he
needs to become an independently functioning adult.
Myth 12. Your relationship with your
child may not survive the jolt of bringing him to treatment
against his will. If it does survive, it may become more hostile
later, asfamily treatment brings problems to light. In fact,
family therapy improves family relationships by reinforcing
sound communication and increasing mutual trust. Bringing
problems to light is a prerequisite to solving them.
Myth 13. The best time for your child
to enter treatment is when he feels ready, when his physical
health is compromised, or when you've reached your wit's end.
The ideal time for your child to begin therapy is as soon
as either of you detects a hint of an emotional problem that
needs resolving or of an eating dysfunction of any kind.
Myth 14. The eating disorder treatment
should continue until your child begins to eat normally or
the insurance runs out. There are several cues for concluding
the therapy: your child's weight returns to normal, his dysfunctions
with food subsides, and either all the emotional issues driving
the disease are resolved or you and he are capable of resolving
the remaining issues without assistance. Eating disorder therapy
helps the patient to manage his symptoms as he regains sufficient
control of his life to ultimately outgrow and eliminate his
need for those symptoms.
Reprinted from When Your Child Has An Eating
Disorder, A Step-by-Step Workbook For Parents And Other Caregivers,
Jossey-Bass, 1999.
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About the Author:
Psychotherapist Abigail H. Natenshon has specialized
in the treatment of eating disorders with individuals, families,
and groups for the past 31years. She is the author of When
Your Child Has An Eating Disorder, A Step-by-Step Workbook
For Parents And Other Caregivers, Jossey-Bass, 1999. Based
on hundreds of successful outcomes, this book shepherds concerned
parents step-by-step through the processes of eating disorder
recognition, confronting the child, finding the most effective
treatment for patient and family, and evaluating and insuring
a timely recovery. A guide to eating disorder prevention,
this book is useful to parents, health professionals and school
personnel alike in countering the pervasive epidemic of unhealthy
eating and body image concerns, and destructive media and
peer influences. Her work can be reviewed further at www.empoweredparents.com,
www.empoweredkidZ.com
and www.parentingbookmark.com.
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