Dying to Please: Anorexia, Treatment and Recovery, 2d ed.
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This article was submitted to Eating Behavior, a section of the journal Frontiers in Psychology. Received Jul 21; Accepted Dec The use, distribution or reproduction in other forums is permitted, provided the original author s or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Abstract A serious problem faced by clinicians treating anorexia nervosa is the egosyntonic nature of the illness, wherein individuals with anorexia nervosa value their disorder, thereby hindering motivation for recovery and engagement with treatment.
Keywords: anorexia nervosa, treatment, recovery, engagement, motivation, egosyntonicity. Introduction Anorexia nervosa AN is an illness which is often chronic in nature, wherein sufferers experience a multitude of detrimental effects in various domains of their life as a result of their low weight and restrictive nutritional intake.
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Understanding the Egosyntonic Nature of an Researchers and clinicians have debated how to understand the meaning of anorexic behavior, with some suggesting that AN functions as a way of reclaiming control of psychobiological maturing Crisp, or as a self-punishing defense when fearing loss of control Bruch, Perceived Burdens of an Serpell et al. The Egosyntonic Nature of an and Ambivalence Toward Recovery Understanding Ambivalence toward Recovery In an attempt to understand ambivalence toward recovery in AN, a study investigated the experiences and understandings of those suffering with AN who desired to maintain their eating disorder and examined how these understandings may impact upon treatment experience Williams and Reid, The Egosyntonic Nature of AN and Stages of Change A framework for understanding ambivalence about change is put forth in the transtheoretical model of change TTM , wherein individuals are grouped into distinct stages of readiness to change, including precontemplation not thinking about change , contemplation thinking about change , action actively making changes , and maintenance working to prevent relapse Prochaska et al.
The Egosyntonic Nature of AN and At-risk Populations Understanding the egosyntonic nature of AN, and its links to attitudes toward recovery and illness severity, a pertinent question arises regarding the origin of pro anorexic attitudes, specifically, whether such attitudes precipitate the disorder as a risk factor, or develop as an artifact of the illness. Methods for Overcoming the Egosyntonic Nature of an Our emerging understanding of specific perceived advantages of AN which patients may endorse and how these weigh up against perceived consequences, potentially playing a role in ambivalence and illness severity, highlights the need to develop methods to counteract this theorized barrier to recovery.
Current Treatments With respect to current treatments, the degree to which they target the ambivalent nature of the illness varies across treatments.
Author Contributions EG conceived of the presented idea. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Footnotes Funding. References Abelson R. Tomkins S. New York, NY: Wiley; , — Psychotherapy in anorexia nervosa. Treatment principles in anorexia nervosa. Psychiatry 10 — The development of a decisional balance scale for anorexia nervosa. Decisional balance in anorexia nervosa: capitalizing on ambivalence.
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A cognitive behavioural theory of anorexia nervosa. Resistance to treatment in eating disorders: a critical challenge. BMC Psychiatry 13 : Factors associated with dropout from treatment for eating disorders: a comprehensive literature review. BMC Psychiatry 9 : Promoting mentalization in clinical psychology at universities: a linguistic analysis of student accounts.
Understanding anorexia nervosa through analysis of thematic content of letters in an adolescent sample. The pros and cons of change in individuals with eating disorders: a broader perspective. A cognitive-behavioral approach to anorexia nervosa. Durham: Duke University Press; Acceptance and commitment therapy: model, processes and outcomes.
Dying to Please: Anorexia, Treatment and Recovery
Motivational Interviewing: Preparing People for Change. How well does anorexia nervosa fit with personal values? An exploratory study. Reluctance to recover in anorexia nervosa. Stages and processes of self-change of smoking: toward an integrative model of change. In search of how people change.
Applications to addictive behaviors. Measuring processes of change: applications to the cessation of smoking. Stages of change and decisional balance for 12 problem behaviors. Health Psychol. Paradox, persecution and the double game: psychotherapy in anorexia nervosa. Psychiatry 31 — The use of the pros and cons of anorexia nervosa P-CAN scale with children and adolescents.
The development of the P-CAN, a measure to operationalize the pros and cons of anorexia nervosa. Anorexia nervosa: friend or foe? London: Sage; , — Hove: Psychology Press.
She illuminates the anorexic's paradox—self-annihilation in service of self-preservation—and the central task of recovery: development of a Self. The author addresses the origins and attributes of anorexia and accompanying disorders, the use and misuse of the Internet, and the concept of recovery. She addresses different therapies in detail, as well as therapies for families and interventions. A directory of organizations, a list of resources for information and referral, a bibliography and index are included. More about Avis Rumney.
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