What I would love to see written about EDs
I've seen two publications that have written about progress in two other areas of mental health: OCD and drug addiction. And I hope that this progress is translated into the world of eating disorders.
One is from a publication I received at the Society for Neuroscience Annual Conference from the National Institute on Drug Abuse. It's their latest booklet called "Drugs, Brain, and Behavior: The Science of Addiction" and the image on one of the first pages is this:
Granted, Tom Insel at the National Institutes on Mental Health said as much. But to have it in a handout, a little brochure, the most basic reading material on the subject: that we don't have. I hear a lot more now about how eating disorders are illnesses, not choices- which is good. I just love how in this brochure on addiction, they're not only brain diseases, but treatable ones.
Which is something we can't hear enough.
The other is from a site on OCD, tracing the history of OCD treatment from Freud to current day.
[Freud's] treatment of choice was psychoanalysis, and this was the accepted treatment of the disorder for many decades. Because this approach was met with no success, OCD was considered a rare and intractable disorder...
...Modern psychodynamic treatments, while having similar insight-oriented approaches, involve a more interactive approach by the therapist, with short-term therapy usually being less than 25 sessions. People who suffer from OCD usually have at least some insight into their behaviors, making the ultimate goal of insight less useful; insight alone is not enough to "cure" OCD. We now understand that OCD has, in large part, a biological causation (meaning, for example, that OCD behavior is not simply caused by a bad relationship with your mother), and it tends to run in families. Because of the failure of traditional psychological treatments for OCD, cognitive-behavioral treatments are now used in the treatment of the disorder, with very high rates of success.
Of course, CBT isn't the be-all or end-all of eating disorder treatment, firstly because you have to treat the malnutrition before CBT can really be effective. However, the history of OCD treatment, from an intractable illness to one with a relatively high rate of success, will one day parallel eating disorder treatment.
What do YOU hope will one day be written about eating disorders?
4 comments:
I hope that people realize that it isn't a disease about vanity...and I wish that people would stop saying, "If you just ate, everything would be fine." I would if I could. And it is not a superficial disease. It's serious. I wish that the insurance companies would stop blowing it off and I wish that they would take our pleas seriously to cover it. I wish that people talked about it, instead of trying to cover it up. I wish that it didn't have to be so "shameful." It took me a decade to speak up and even longer to decide that it was alright to talk about. I want people to know that it IS treatable and that unlike what the media typically shows, it isn't hopeless.
Ash,
I love the "if you just ate..." Well the fact that I have an eating disorder means I can't, you dope! Or the "just cheer up" when you're depressed.
And don't get me started on insurance. I've heard Blue Cross/Blue Shield nicknamed "Bull Crap/Bull Sh*t" and I had to agree.
I wish that the good stuff that is already written could somehow get to the "coal face" and that clinicians and the public would actually use it - but I guess that's up to us to get it out there.
I also want to see more studies about long-term outcomes in eating disorders, exploring which variables are predictors for recovery (or what have you) and which might predict remission. I want to stop hearing this drivel that ED are "not curable" just because a few randomized trials show few significant effects in a short amount of time. Maybe not everyone can recover in a year. Maybe not everyone can recover using one particular type of therapy. I want to see researchers get more creative about their interventions -- and more realistic, too. It's a bit crazy to expect that people who have had EDs for years, if not decades, can "recover" during the course of just one intervention. So I'd like to read studies about chronicity, too.
Longitudinal studies, baby! They solve so many problems...
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