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Newsletter #8: The Treatment of Eating Disorders The Treatment of Eating Disorders Selfmatters.org wants you to know about the new book... Effective Clinical Practice in the treatment of Eating Disorders: The Heart of the Matter A new book, Effective Clinical Practice in the treatment of Eating Disorders: The Heart of the Matter will be published this fall..... an important contribution to the field of eating disorders edited by our Jane and two of our colleagues. Very exciting is the forthcoming publication of Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter edited by Jane Shure, Margo Maine and William Davis with a chapter by Jane and Beth, "Shame, Compassion and the Journey Towards Health". About the Book This book is the first to address what really happens behind closed doors during eating disorders treatment, as most writing has only addressed theoretical approaches and behavioral strategies. The field has long needed a book that describes the heart of the matter: the therapeutic interventions and interactions that comprise life-changing treatment for this life-threatening disorder. In response to this need, the authors have created a book that reflects the individual therapeutic skills and the collective wisdom of senior clinicians, all of whom have years of experience treating anorexia, bulimia, and binge eating disorder. Intended to be a deeply thoughtful and instructive volume, Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter demonstrates the depth, complexity, and impact of the therapeutic process. In particular, the book articulates and explores essential points of information, issues, insights and unresolved questions about eating disorders treatment. Effective Clinical Practice in the Treatment of Eating Disorders describes and explicates important treatment issues and themes in a nuanced, highly contextualized and qualitative manner. The book offers a significant reference for both novice and seasoned therapists, and it includes specific information that will serve to inform and mentor future generations of eating disorders clinicians. The Book's Table of Contents Maine, Beyond the Medical Model: A Feminist Frame for Eating Disorders. Shure, Weinstock, Shame, Compassion and the Journey Towards Health. Emmett, Wholeness and Holiness: Understanding and Treatment of Eating Disorders from a Psychospiritual Perspective. Davis, Individual Therapy for Anorexia Nervosa and Bulimia: What Seems to Make a Difference. Rabinor, Treating Eating Disorders: The Healing Power of Guided Imagery. McGilley, Sacred Circles: Feminist Oriented Group Therapy with Adolescent's in Recovery. Ressler, BodyScript: Unlocking Memories Imprinted in Time. Burgard, Moments of Body Loyalty: Achieving Body Trust and Learning to Defend It. Wingate, Blending: Holistic Integrative Psychiatry and the Treatment of Eating Disorders. Bunnell, Countertransference and Attunement in the Psychotherapy of Patients with Eating Disorders. Bloomgarden, At the Precipice: Managing Therapist Fear and Self-doubt. Whitehead-LaBoo, Connecting Through Difference: Therapeutic Use of Self to Promote Eating Disorder Recovery. Zimmer, Tess: Therapy Redux. Costin, The Embodied Therapist. Publication information: Edited by Margo Maine, William N Davis, Jane Shure, Whitehead-LaBoo List Price: $39.95 ISBN: 978-0-415-96461-6
About our chapter: "Shame, compassion and the Journey Towards Health" In this book chapter we define shame and explore how it is both an outcome of, and a driving force behind eating disorders. We explore the many ways that shame shows its face emotionally, physically and behaviorally, and reveal how self compassion can become its antidote. The chapter includes discussion on the origins of shame, trauma-based shame, culturally induced shame, attachment deficits and shame, familial shame, shame and its relationships to dissociation and eating disorders, how therapists works with shame in the treatment room, mindfulness and the brain, and working in the therapeutic relationship where shame is present. In addition it includes case examples. See an excerpt of the chapter below. (Some of you will recall the newsletter we wrote on "The Power of Shame", Fall, 2006. In that newsletter we explain shame as it appears and manifests from a wide range of human challenges and give you 'tips' for diminishing shame's toxic effect.) Here is an excerpt from the introduction to our chapter: (p.163) Shame is a mighty force. It can make one feel inherently flawed or defective, invalid as a human and essentially unlovable. At its most extreme, it is experienced as an internal and ultimate truth about one's core being. Shame takes one prisoner, inhibiting spontaneity and draining life's energy, creating emotional paralysis and an impulse to disappear. Women with eating disorders are often consumed by their shame, living under its spell and tormented by its power. Shame affects mind, body, and behavior. Physically, shame draws the body inward and manifests in symptoms like blushing, sweating, nausea, and a racing heart. Cognitively, shame appears as severe and constant self-criticism, causing the belief that one is never good enough, smart enough, nice enough, or thin enough. Behaviorally, shame is reflected in patterns of withdrawal, secrecy, avoidance, deception, and self-destruction. Shame acts like a thief, robbing one's spirit and injuring one's soul. Despite its powerful and potentially crippling impact, shame has not been a focal point in psychological literature until recent decades (Karen, 1992). Freud, for example, focused on guilt rather than shame. He saw shame as a cover for deeper emotions (Lewis, 1992), acknowledged it as self-evident, but did not attempt to explore its vicissitudes and dynamics (Karen, 1992). Contemporary theorists, however, have begun to name shame as an important element in modern psychology. One author described shame as "fluid, diffuse, indeterminate, complex and evasive" (Edelson, 1988, p.33), while another says that shame is like "a wound made from the inside out by an unseen hand... stalk(ing) one's being, inflicting an unconscious self-loathing" (Kaufman, 1992, p.5). Karen (1992) believes that shame is a major cause of emotional distress in our time while Nathanson (1987) sees attention to shame as the missing factor for success in psychotherapy. The addictions recovery movement has educated people about the relationship between dysfunctional families and children who carry shame (Bradshaw, 1988; Fossum & Masson, 1986; Kaufman, 1983) and twelve-step programs have consciously helped to diminish the shame related to addiction through acceptance and acknowledgement. Confusion remains over the essential nature of shame, as well as its etiology and primacy as an emotion. Some writers claim that there are healthy degrees of shame that contribute to the creation and maintenance of social norms (Scheff, 1988) and that a well-integrated person's self-reflection about recurrent shaming behaviors can spur personal growth and development (Lynd, 1958). There is also debate over the age at which shame develops (Lewis, 1971). Some theorists say that shame is a primary emotion that develops within the first seven months of life, independent of interaction, introspection or self-consciousness (Plutnik, 1962). Other theorists maintain that shame is a secondary emotion that only appears after a child observes herself in relation to how she is seen by others (Karen 1992). Object relations theory points to shame as a result of deficits in patterns of interpersonal interaction (Kohut, 1971). Nathanson (1992), on the other hand, views shame as an innate biological mechanism, hardwired in the brain and genetically determined. Another perspective comes from existentialist writers who speak of shame as a permanent and inescapable aspect of "being in the world" (Edelson, 1988). There is no question but that shame has become an important point of interest in contemporary psychology. Although theorists differ in how to conceptualize and understand it, they agree that shame is a powerful, often unconscious force, with significant clinical and personal implications. Click here to subscribe to this free newsletter |
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