"New Directions for the Home Treatment of Eating Disorders"

This is the title of a lecture given by Janet Treasure at Gresham College in the UK. The entire transcript is online, and so is the audio file. I didn't listen to the audio version, and so I can't tell you what the quality is.

But it is an enlightening lecture, and I'm really glad the folks at Gresham put it up online.

Several interesting parts:

What we now need to do, very urgently, is to try and find treatments for people who are treatment-resistant: people who have had treatment for a long time, or had the family treatment, and it has not really helped. The most important thing though is that we tailor our treatments, rather than just taking off-the-peg treatments, therapies, that are used for other conditions, because if we can know what is keeping the illness going, we might be able to specifically work on that and produce change.

We try and help people with anorexia nervosa develop these traits and behaviours that go against some of the things that make them at risk, and so help them to be more flexible, help them to be more emotionally intelligent, help them to be less rigid, and not to focus on detail or to avoid emotions.

I hope I have shown you how we can now be developing new treatments for eating disorders by focusing on these factors that can keep the eating going, and we are now developing workshops where we can teach carers the skills that we have learnt in the specialist units, so we hope that family members can deliver early interventions which we know are so important, because once the illness has progressed for a long time, you get a lot of secondary effects, changes in the brain, for example, that make change difficult. We need to concentrate not just on the content of what people say, but how they think; to try to enable them to have different strategies of thinking, and use remediation in this, and show them how to use their emotions. Culture does shape the form and behaviour of discontent, and that very much has shaped the development of bulimia nervosa that started mainly in women born after the Fifties. It can have a big impact on the maintenance of anorexia nervosa, but what we now think is that the main mechanisms causing these eating disorders are interactions between the genes and the environment that can interact with brain mechanisms, or produce brain mechanisms, that can keep the illness going.

This is thinking that is very clear and very holistic. Not holistic as in sniff-some-patchouli-and-go-home-dear, but holistic as Treasure looks at the problem of eating disorders from a personal, psychological, biological, and societal viewpoint. It's a fairly quick read, and I had to restrain myself from posting the whole thing verbatim.

Off to bed!

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Jane said...

Very nice. Thanks for posting this.

Tracey said...


Thanks for sharing this excellent transcript.

I have only skimmed thus far-- will dig in more later, but I really resonate with Ms Treasure's metaphorical descriptives and utility within working with both patients and assisting families. Makes it very user-friendly for parents and caregivers-- which is always a plus.

The idea of being "more like the Sun" vs the North Wind (well, I know I've blown quite a few gusty winds, but have also let the Sun shine too!)

"Motivational Interviews"... I like that, but since I haven't fully read the article, did I miss what specifically what is meant by this other than the Columbo analogy? Hmmm... like it!

Isn't it both interesting and annoying that this transcript is from '06 and you really don't hear, read or see the majority of this being offered up to parents and families in a much wider and broader scope? Either I'm living under a rock (not!) or many of us have been doing much of this on our own regardless of the lag.

Clinicians need to be working with families much more and making sure the resources, literature and info is amply available. It's not going to do much good if all the researchers are merrily going about publishing to only peer reviews, etc. and basically only circulating within narrow and limited audiences/readership. It doesn't stop there...

Some things are always the most basic though:

as well as plenty of nutrition.

Oh... I sense my North Wind is blowing again!


carrie said...


Why you're welcome.


I'm the queen of metaphor. I don't believe that anorexia itself is a metaphor for anything, but that the use of metaphor can be so beneficial to helping sufferers and their families.

I was wondering about the motivational interviews, too. Maybe I'll email Stephanie about that, and troll through PubMed.

(...wait...did I feel a breeze?)


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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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