Anorexia Nervosa: Defenition of Eating Disorder Essay Example
Anorexia Nervosa: Defenition of Eating Disorder Essay Example

Anorexia Nervosa: Defenition of Eating Disorder Essay Example

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  • Pages: 7 (1864 words)
  • Published: October 14, 2021
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Although the section on eating disorders in the DSM-IV-TR (APA, 2000) is subsumed under the broad category of Adult Disorders, many eating disorders have their origin in the early years of life or the adolescent stage. Approximately 5 to 10 million people in the United States have one form of the many eating disorders. Among the common chronic illnesses in teenage women, Anorexia Nervosa ranks third. The prevalence rate of anorexia among teenage women ranges from 0.5 to 3 percent of the total number of teenagers. The problem and incidences of eating disorders have been on the rise for the last part of the 20th century and the 21st century with the problem estimated to have increased threefold.

Most of the females between the ages of 11 and 13 years view themselves as overweight. A high percentage of this number often attempt to lose weight and th

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e remaining small percentage engage themselves in self-induced vomiting. The death rate for people suffering from anorexia is estimated to be 5.6 percent in every 10 years.

Anorexia Nervosa is a disorder characterized by significant weight loss because individuals with this disorder engage themselves in excessive dieting. The BMI of anorexic individuals is often not ideal. These individuals are also characterized by unreasonable fear that they will become fat regardless of their low body weight. This notion/idea makes them to focus on losing weight thus, distorting their body image. This means that, anorexic individuals perceive their body weight and shape to be greater than what they actually are. For females who have begun menstruating, there has been a cessation of menstrual periods for at least three consecutive cycles (APA, 2000).
There are

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two main types of Anorexia Nervosa. These types are restricting type and purging or binge type. Persons who have Anorexia ‘restricting type’ severely restrict their food intake without engaging in bingeing or purging behaviors. Persons with the binge or purging type of Anorexia maintain their weight at abnormally low levels not only through restricting themselves from food but also engaging in binge eating and purging behaviors. These behaviors may either include one or a combination of self-induced vomiting, laxative, and diuretic abuse (APA, 2000).

In their study, Voriadaki, Simic, Espie & Eisler (2015) examined the intensive multi-family therapy for teenagers with anorexia nervosa and the experiences of adolescents and their parents. These researchers examined the experiences of six families with adolescents who are anorexic. These families were required to complete daily records of their experiences. The participants were then engaged in separate group discussions. The findings of the study indicated that changes in behavior were more facilitated through sharing of experiences with families going through the same problem, being more able to express their deep emotions, role play activities, and the perceived mutual support and learning. The emergence of family therapy in the 20th century offered a new way of thinking about families and by 1970s a growing number of the pioneers in the field had started applying this new conceptualizations to eating disorders (Sexton & Lebow, 2012).

In their book, Family Therapy for Adolescent Eating and Weight Disorders, Loeb, Grange, Lock & Lock (2013) have shared the same findings in one of the studies in their book. Multi-family therapy was found to be very effective in the treatment of anorexia eating disorder. In this study, there

was notable satisfaction by the families of the adolescents with anorexia eating disorder. However, Loeb et al. (2013) observed that the mechanisms through which multi-family therapy might bring about a change are still poorly understood. One of the studies discussed in this book suggests that the intensive multi-family therapy approach provides an environment with rich experiences from others that promotes profound understanding of the illness within a setting that is perceived as safe, supportive, and organized to disclose their feelings, discuss each other ideas, and try and test new behaviors. “The sharing of experiences with other families was felt to promote insight into the illness and a major shift in the adolescents’ motivation toward recovery” (Loeb et al., 2013, 131).

Teenagers reported a major increase in understanding of the disorder gained from Day 1 to Day 3 of multi-family therapy that was assisted by the group’s shared externalization of the illness. It appeared that when young people in the group were faced with not being able to avoid observing other’s anorexic behavior, seeing their own symptoms from an outsider perspective with all the similarities they mutually shared brought a greater awareness of their own illness behaviour and of the barrier that was standing between them and their families and life. In Voliadaki et al. (2013) study, multi-family therapy was found to enhance motivation for recovery for 4 of the 5 participating teenagers and improve self-efficacy for 7 of the 10 parents. This shows that the benefits in the former study were realized in the latter study. The latter study concluded that sharing of experiences in intensive multi-family therapy improves helps adolescents to understand the disorder and

instills hope.

Second, intensive multi-family therapy was also found to involve the parents of the adolescents and this was found to be the most useful strategy. In the former study, confidence that recovery was possible usually increased gradually, first among parents who mostly, from the beginning of the group, appeared ready to do something different for their children to recover, followed by most of their children showing the first glimpses of positive motivation for recovery while designing the family timeline on the fourth day of multi-family therapy. In another study, multi-family therapy was integrated into Day Programs at the Maudsley Hospital. The researchers dedicated one afternoon per week to parent skills for all the parents of the adolescents that attended the program. In parent skills group, parents shared experiences of obstacles in managing their children’s eating and all-encompassing effects of the disorder.

Even the pioneer of “treating the families together” model, Laqueur recognized the importance of the multi-family therapy in helping adolescents to recover. The 20th century was an era of restricted resources multi-family therapy was almost accidental in formation, offering a solution to staff shortages. What transpired was the potential of seeing several families together to create a different context in which alternative behaviors and different relationship patters could emerge. Laqueur and his co-workers saw the multi-family setting as a useful context for trying out different behaviors and new relationships. Here, the family members are considered to be good resources and one that can be used more successfully, with a number of families receiving treatment together in one group. The major aim was to improve communication within and between families with an aim of improving and

helping the families of anorexic children to gain deeper understanding into the troubled behaviors of the anorexic adolescent. At first, Laqueur worked with schizophrenic patients and their families in health care facility ward – alongside insulin-shock treatment. He saw this as a practical response to the need for improving ward management.

The multi-family therapy deals with the complexity that exists in families and affects their relationships and the health of the family members. This model acts as the cornerstone of the caregiving system and is a replacement of the traditional medical model in which the sick person was the only focus of treatment. It gives a patient and his family ability to adapt and cope with the medical situation. The family systems are armed with inner strengths and different families combine their strength to eliminate a common problem. From a fresh perspective, psychosocial factors in addition to biological interventions play an important role in healing (Rolland, 2003).

Relationship Enhancement Programs

There are other researchers who have developed programs to enhance the relationship within and between families. Barry Ginsberg, a student of both Bernard and Louise Guerney, husband and wife colleagues, has recently described the contemporary practices of the RE approach as combining psychodynamic, behavioral, communication, and experiential systems perspectives (Ginsberg, 1995).

The Guerneys' early psychoeducational endeavors go back to the filial therapy program they developed during the 1960s to help parents with problem children deal better with their emotionally disturbed children. In this therapeutic undertaking, usually conducted in groups of six to eight parents, the Guerneys explained how Rogerian principles are used to enhance the relationship between children and their parents and instructed parents to use this technique in

developing structures and limit-setting skills. Weekly play therapy sessions at home augmented the process. In general, the technique was devised to help children who were found with behavioral, emotional, and developmental problems to better understand their conditions develop ways of communicating their feelings and ways of controlling their actions. At the same time, if the approach was successful, parents developed more realistic expectations, became more receptive to the children's feelings and experiences, and learned to communicate their new understanding and acceptance. This RE approach later was supplemented by the Parent-Adolescent Relationship Development (PARD) program (Ginsberg, 1995) to foster trust, empathy, genuineness, intimacy, openness, and satisfaction in parent and adolescent relationships.

For a multi-family therapy to be effective, there are several ground rules, interpersonal safety and group engagement that must be involved. A key ground rule that has been found to be useful; for multi-family therapy groups is that each participant decides for him- or herself how actively that person wants to take part in any exercise or discussion. Observing and listening are as important as doing and talking. Families and their individual members become consultants to each other through observing various interactions that are both similar to and different from their own. Most of these multi-family groups are very successful with the presence of therapists as facilitators. As facilitators, therapists encourage the families to own their expertise and strength in fighting the anorexic problem. Gradually, the families become proactive in exploring avenues for change within a group atmosphere that is predominantly informal but also draws on the professional expertise of the therapists when apposite.

Appropriate use of humor plays an important role in lifting group spirit and

dispelling tension. This is often an organic process led by the families and therapists. Therapeutic intensity is generated quickly by bringing together a number of families and is further increased when multi-family therapy meetings continue over several consecutive days. Such an impact creates an immediacy of therapeutic contact, which brings about expectations of rapid yet achievable aims; injecting hope and fostering an expectation that deeper, longer-term change can be in the hands of the family members.

Interventions and Therapeutic Techniques

The multi-family therapy program makes use of a wide range of therapeutic techniques derived from family and group therapies, and families soon become accustomed to respond with comparative ease to a number of tasks and exercises. These may include circular questioning to encourage family members to develop varying perspectives of meaning; externalization to mobilize individual and family resources to challenge the problem and reduce feelings of guilt and blame; and enactment and intensification, which make specific aspects of problems more visible and can interrupt mechanisms that maintain problems. There are other exercises dubbed ‘reflecting team ideas’ which can be used in a number of ways in family group settings; both therapists and families can offer reflections, observed by other members of the group, who then change places in order to reflect their own thoughts (Grange & Lock, 2012).

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