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Eating Disorders - Bulimia Nervosa Treatment
In this article we're going to cover treatments for Bulimia Nervosa. These treatments actually apply to most eating disorders as they are more or less caused by the same emotional problems. While eating disorders stem from emotional issues in a person's life they are nevertheless still serious health conditions that can do great physical harm to the person as well as the emotional harm that has come before it and will continue long after. Early diagnosis gives a person suffering from an eating disorder a better chance for recovery. Eating disorders can become chronic, debilitating, and even life-threatening. Early treatment is critical. The only really effective and long lasting...
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Eating Disorders: What are they?
Eating disorders are the diseases caused due to the abnormal eating behavior of an individual. Many people suffer from such eating disorders. They indulge in eating more and more food, which is considered abnormal. A normal person cannot have the amount of food, a person suffering from an eating disorder can have. Such abnormal patterns of food are not a result of increased hunger. Person having eating disorders have other problems. These problems are related to their lifestyle. Eating disorders are a sign of a problematic time in a persons life. People eat more food to suppress extreme emotions and depression. There are also different types of eating disorders. Some types of...
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The Trap Of An Eating Disorder
There are many serious health and mental health issues that people deal with everyday in every part of the world. Many sicknesses and diseases are well known and understood by people while others remain mostly undiscussed and misunderstood. Having an eating disorder is one of the conditions that is rarely understood by most people. Struggling with an eating disorder is hard because it is a sickness that is not often recognized until it is fairly serious. People begin showing signs of having an eating disorder for many reasons. Some people are unhappy with their current weight or with the way their body looks. Others suffer the verbal abuse of a spouse or friend that makes hurtful remarks...
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Eating Disorders and the Narcissist

Author:
Sam Vaknin


Patients suffering from eating disorders binge on food and sometimes are both anorectic and bulimic. This is an impulsive behaviour as defined by the DSM (particularly in the case of BPD and to a lesser extent of Cluster B disorders in general). Some patients develop these disorders as a way to self-mutilate. It is a convergence of two pathological behaviours: self-mutilation and an impulsive (rather, compulsive or ritualistic) behaviour.

The key to improving the mental state of patients with dual diagnosis (a personality disorder plus an eating disorder) lies in concentrating upon their eating and sleeping disorders.

By controlling their eating disorders, patients assert control over their lives. This is bound to reduce their depression (even eliminate it altogether as a constant feature of their mental life). This is likely to ameliorate other facets of their personality disorders. Here is the chain: controlling one's eating disorders controlling one's life enhanced sense of self-worth, self-confidence, self-esteem a challenge, an interest, an enemy to subjugate a feeling of strength socialising feeling better.

When a patient has a personality disorder and an eating disorder, the therapist should concentrate on the eating disorder. Personality disorders are intricate and intractable. They are rarely curable (though certain aspects, like OCD, or depression can be ameliorated with medication). Their treatment calls for the enormous, persistent and continuous investment of resources of every kind by everyone involved. From the patient's point of view, the treatment of her personality disorder is not an efficient allocation of scarce mental resources. Also personality disorders are not the real threat. If a patient with a personality disorder is cured of it but her eating disorders are aggravated, she might die (though mentally healthy)

An eating disorder is both a signal of distress ("I wish to die, I feel so bad, somebody help me") and a message: "I think I lost control. I am very afraid of losing control. I will control my food intake and discharge. This way I control at least ONE aspect of my life."

This is where we can and should begin to help the patient. Help him to regain control. The family or other supporting figures must think what they can do to make the patient feel that he is in control, that he manages things his own way, that he is contributing, has his own schedules, his own agenda, matter.

Eating disorders indicate the strong combined activity of an underlying sense of lack of personal autonomy and an underlying sense of lack of self-control. The patient feels inordinately, paralysingly helpless and ineffective. His eating disorders are an effort to exert and reassert mastery over his own life. At this stage, he is unable to differentiate his own feelings and needs from those of others. His cognitive and perceptual distortions (for instance, regarding body image somatoform disorders) only increase his feeling of personal ineffectiveness and his need to exercise even more self-control (on his diet, the only thing left).

The patient does not trust himself in the slightest. He is his worst enemy, a mortal enemy, and he knows it. Therefore, any efforts to collaborate with HIM against his disorder are perceived as collaboration with his worst enemy against his only mode of controlling his life to some extent.

The patient views the world in terms of black and white, of absolutes. So, he cannot let go even to a very small degree. He is HORRIFIED constantly. This is why he finds it impossible to form relationships: he mistrusts (himself and by extension others), he does not want to become an adult, he does not enjoy sex or love (which both entail a modicum of loss of control). All this leads to a chronic absence of self-esteem. These patients like their disorder. Their eating disorder is their only achievement. Otherwise they are ashamed of themselves and disgusted by their shortcomings (expressed through shame and disgust directed at their bodies).

There is a chance to cure the patient of his eating disorders (though the dual diagnosis of eating disorder and personality disorder has a poor prognosis). This and ONLY this must be done at the first stage. The patient's family should consider therapy AND support groups (Overeaters Anonymous). Recovery prognosis is good after 2 years of treatment and support. The family must be heavily involved in the therapeutic process. Family dynamics usually contribute to the development of such disorders.

Medication, cognitive or behavioural therapy, psychodynamic therapy and family therapy ought to do it.

The change in the patient IF the treatment of his eating disorders is successful is VERY MARKED. His major depression disappears together with his sleeping disorders. He becomes socially active again and gets a life. His personality disorder might make it difficult for him but, in isolation, without the exacerbating circumstances of his other disorders, he finds it much easier to cope with.

Patients with eating disorders may be in mortal danger. Their behaviour is ruining their bodies relentlessly and inexorably. They might attempt suicide. They might do drugs. It is only a question of time. Our goal is to buy them time. The older they get, the more experienced they become, the more their body chemistry changes with age the better their prognosis.


Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 .
Until recently, he served as the Economic Advisor to the Government of Macedonia.
Visit Sam's Web site at http://samvak.tripod.com

palma@unet.com.mk




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If you like the article above, you may be interested in the following article which is also related to Eating Disorders...

How We Rescued Our Child from Anorexia, Effecting a Complete Recovery in Just Six Months
In March 2003 our then 13 year old daughter, Helen, was diagnosed with anorexia nervosa, at which point she was on the verge of being emaciated. Her BMI was approximately 15. My initial reluctance to accept this diagnosis was dispelled towards the end of the month when Helen became severely dehydrated and suffered a complete nervous breakdown as the anorexia finally took total control of both her mind and body. It may sound melodramatic, but it was as if she had become possessed. Helens reaction, when encouraged to drink a glass water in order to ease the stomach cramps caused by the dehydration, was uncharacteristically aggressive and resulted in an hysterical screaming fit which unnerved both myself and Fiona, my ex-wife. Helen flew into a rage and began to scream: IT'S WEIGHT, IT'S WEIGHT, IT'S WEIGHT! At this point, we realised that we had no control over Helen whatsoever. However, by June 2003, only three months later, Fiona and myself had broken the illness and Helen was able to return to school. By September 2003 Helen had attained her perfect weight and the illness had been completely eradicated from her psyche. By January 2004, Helen was signed off by the adolescent mental health unit, her psychiatrist commenting that it was one of the quickest recoveries from mental illness that he had ever seen. In order to break the anorexia, my ex-wife and myself devised a radical treatment programme which was contrary to the advice of the medical specialists and which, for a number of weeks, put us in direct confrontation with them. Throughout this period, I rigorously maintained the validity of our approach and predicted that the anorexia would be done and dusted by Christmas. Helens psychiatrist was extremely sceptical and was clearly concerned by what he...
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