Thursday, 30 December 2010
Thursday, 23 December 2010
Motivation Is Not An Infectious State: More Top Treatment Tips
Prof Glenn Waller offering top tips in CBT Today, December 2010 points out that our enthusiasm for the client's recovery will not rub off on the client. He suggests that we should keep focusing on whether change is actually happening rather than expecting it to happen because someone says they are about to change or because we believe they should.
So how will you learn if recovery is actually happening? Perhaps you cannot be sure so you have to suspend your expectations and wait.
I have learned to be patient. When you have a partner, home, lifestyle or eating disorder it is really hard to change. One of my NLP mentors once told me that he takes the following line with addicts - "I insist absolutely that you keep your addiction until it has been replaced by something more useful".
For this reason, I don't reward what people expect me to reward. I don't reward weight loss in people who want to lose weight and I don't reward weight gain in people with anorexia and I don't pat someone on the back when they have had a good eating week. I prefer that people keep doing what they are doing and help them find some helpful options for thinking and doing things differently now and then. People simply cannot recover until they have reclaimed what their eating disorder has stolen from them or when they have build a resource which, by being absent, led them into the eating problem in the first place. This resource might be confidence, compassion, or a feeling of belonging. Whatever.
Recovery from an eating disorder does not happen on the therapist's agenda. It is like a baby learning to walk. You can't force it. When the baby is ready, he or she will just take off. If you try to hurry her, she will fall.
So how will you learn if recovery is actually happening? Perhaps you cannot be sure so you have to suspend your expectations and wait.
I have learned to be patient. When you have a partner, home, lifestyle or eating disorder it is really hard to change. One of my NLP mentors once told me that he takes the following line with addicts - "I insist absolutely that you keep your addiction until it has been replaced by something more useful".
For this reason, I don't reward what people expect me to reward. I don't reward weight loss in people who want to lose weight and I don't reward weight gain in people with anorexia and I don't pat someone on the back when they have had a good eating week. I prefer that people keep doing what they are doing and help them find some helpful options for thinking and doing things differently now and then. People simply cannot recover until they have reclaimed what their eating disorder has stolen from them or when they have build a resource which, by being absent, led them into the eating problem in the first place. This resource might be confidence, compassion, or a feeling of belonging. Whatever.
Recovery from an eating disorder does not happen on the therapist's agenda. It is like a baby learning to walk. You can't force it. When the baby is ready, he or she will just take off. If you try to hurry her, she will fall.
Wednesday, 8 December 2010
Assessing Eating Disorders Properly: A Commentary.
Prof. Glenn Waller, eating disorder expert, has written a bunch of top tips for people working with the eating disorders in the Journal of CBT, December 2010. His first tip is “Monitor and work with physical and psychiatric risk.”
He points out that there is no substitute for a good assessment of such risk. Many psychotherapists don’t do this if they aren’t trained to work properly with these problems. They may say “it’s not about food, it’s about feelings”.
But many people have serious health risks associated with their eating behaviour. Bulimics risk heart and kidney problems. Binge eaters might be suffering from diabetes. Food is chemistry not just calories and ingesting large amounts of sugar puts enormous pressure on the pancreas. Purging leaches potassium from the cells, stopping them from burning energy. Being very thin can cause the inside of your bones to turn to jelly, interrupting the supply of the cells that keep your blood from flowing and your heart from beating properly.
People with anorexia are 57 times more likely to commit suicide than people of any age who do not have the illness. We have to consider them at psychiatric risk. We have to test them for clinically active trauma, for hidden cases of self harm, for depression or for exercise activity that may cause them to collapse.
People do not start developing eating disorders because they are vain or stupid. Losing or controlling weight starts off as a solution for feeling better; and most of us are delighted if we look slim or lose a little weight. But if dieting and weight management goes out of control, the solution becomes the problem that can kill you or ruin your well-being.
Prof Waller recommends you to be a good Assessor. Check out www.iop.kcl.ac.uk/IoP/Departments/PsychMed/EDU/downloads/pdf/RiskAssessment.pdf
But why not come on our specialist training courses. For expert CPD visit http://www.eating-disorders.org.uk/professional-training.html or call us on 0845 838 2040 to discuss your training needs.
He points out that there is no substitute for a good assessment of such risk. Many psychotherapists don’t do this if they aren’t trained to work properly with these problems. They may say “it’s not about food, it’s about feelings”.
But many people have serious health risks associated with their eating behaviour. Bulimics risk heart and kidney problems. Binge eaters might be suffering from diabetes. Food is chemistry not just calories and ingesting large amounts of sugar puts enormous pressure on the pancreas. Purging leaches potassium from the cells, stopping them from burning energy. Being very thin can cause the inside of your bones to turn to jelly, interrupting the supply of the cells that keep your blood from flowing and your heart from beating properly.
People with anorexia are 57 times more likely to commit suicide than people of any age who do not have the illness. We have to consider them at psychiatric risk. We have to test them for clinically active trauma, for hidden cases of self harm, for depression or for exercise activity that may cause them to collapse.
People do not start developing eating disorders because they are vain or stupid. Losing or controlling weight starts off as a solution for feeling better; and most of us are delighted if we look slim or lose a little weight. But if dieting and weight management goes out of control, the solution becomes the problem that can kill you or ruin your well-being.
Prof Waller recommends you to be a good Assessor. Check out www.iop.kcl.ac.uk/IoP/Departments/PsychMed/EDU/downloads/pdf/RiskAssessment.pdf
But why not come on our specialist training courses. For expert CPD visit http://www.eating-disorders.org.uk/professional-training.html or call us on 0845 838 2040 to discuss your training needs.
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