MedWorm.com provides a medical RSS filtering service. Over 5000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'For Professionals' source. Sat, 16 Aug 2008 14:42:16 +0100 http://feeds.feedburner.com/~r/ForProfessionals/~3/285793758/pregnancy-and-e.html I've been thinking quite a bit about the effect of pregnancy on recovery from an eating disorder. I have had clients whose resolve to feed themselves adequately, or stop purging, increases dramatically once the pregnancy is discovered, as would seem to make sense. But I am currently dealing with a young woman whose symptoms have become much worse; she has just been hospitalized in order to stabilize her medical situation, and hopefully, help her gain strength and motivation to continue caring for herself on an outpatient basis. So why is pregnancy a positive motivation for some and a significant stress for others?One factor, I believe, is the extent to which the pregnancy was planned and is welcomed. Nicole, Erin, and Sarah, just to name a few, either desired children and sought the pregnancy, or adjusted happily once the pregnancy was confirmed. They are also in their mid to late twenties, in stable financial situations, and therefore more prepared for parenthood. My client, by contrast, is only 23 and on her third pregnancy in as many years. Although she and her husband seem quite happily married, they have really had very little time to establish themselves as a couple before the children began to appear. Another issue for my client involves her medication. As soon as the pregnancy was confirmed, her OB doctor took her off her psychotropic medications - understandable and likely necessary. However, without the support of the medication she has not been able to control her irrational thoughts. Although she recognizes, at times, that it makes no sense to throw out the food in her house, at other times she is unable to fight back against the paranoia. While in a therapy session she can admit that her slightly rounding belly is a good thing, indicative of the growing life within; at home she can only see that she is getting fat. Finally, I believe my client may be more isolated, lacking the positive support environment that supports and even rejoices in new life. Her own parents offer little encouragement. She has had precious little time to establish her own friends. Perhaps for any eating disorder sufferer, pregnancy is both a positive AND a negative, as it can be for any individual. I would think it would be normal for feelings to range from joy to despair to ambivalence or frustration. If you are a professional who has treated individuals with eating disorders who became pregnant, I'd welcome your thoughts and comments. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1429344 Wed, 07 May 2008 04:00:00 +0100 1429344 http://feeds.feedburner.com/~r/ForProfessionals/~3/263725378/miracles-do-h-1.html I'm very excited to let you know that one of my long term clients, Kathy Christian, has just become engaged. Her fiance', Joe Locke, proposed last weekend over dinner at the top of the Amway Grand, the swankiest restaurant in Grand Rapids, Michigan. Kathy has a lovely ring on her finger and a grin a mile wide. Of course couples become engaged every day - so why am I writing about this one? Well, to really understand the significance of this event you need to know a bit about Kathy's history. She has been my client for fifteen years, and has suffered with her eating disorder for nearly twenty. The fact that she has survived that long of a battle puts her in elite company already. But there is more: Kathy has a severe abuse history, probably one of the ugliest I've ever encountered. About eight years ago she had to cut off all contact with her family in order to keep herself safe. In fact "Christian" is an assumed name, one she chose after she committed her life to Jesus Christ. As is true for all of us who call ourselves Christians, her life did not magically get better once she took the step to commit her life to Christ. In fact it was her family's anger at that decision, and her father's rageful attack of her, that brought her abusive past to light. After seven years of therapy and numerous hospitalizations, I finally understood the reason that she'd not been able to recover. Once the reality of her situation became clear to me she was both ashamed and in fear for her life. What followed is a story we hope to publish one day, because all of the twists and turns read like something out of "Law and Order - Special Victims Unit". Suffice it to say that she is extremely lucky to be alive. She has experienced PTSD, depression, anxiety, and numerous medical complications from her eating disorder. Although she had made steps towards recovery over the past months and years, each step forward was often followed by a half a step back. She despaired of living her life the way it was unfolding, and especially hated the idea of living alone. I often told her that it would take a loving, caring partner in order for her to heal completely from the trauma of her past. And I assured her that such a man existed, at the same time I prayed that I wasn't misleading her in that belief. And then Joe came into her life. He is everything I would have wanted, and that Kathy has needed, to complete her life. She has made unbelievable progress forward just in the past three months, and as she does, her medical complications continue to resolve. Right now they are making plans for a summer wedding; and I'm proud to say I'll be walking her down the aisle. So you see, dreams can come true . . . miracles do happen . . . and when the road seems dark, if you trust in God, he really will bring you through. When Kathy doubted God in the past, I often reminded her of the promise in Jeremiah 29:11: "For I know the plans I have for you . . . plans to prosper you and not to harm you, plans to give you hope and a future". Congratulations Kathy and Joe, and may God give you a long and happy life together. You deserve it! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1349918 Thu, 03 Apr 2008 04:00:00 +0100 1349918 http://feeds.feedburner.com/~r/ForProfessionals/~3/256294207/back-from-the-b.html This past week we hosted Buddy Howard in Grand Rapids, Michigan. His presentation: "Back from the Brink: A Father's Perspective on Recovery from an Eating Disorder" was heard and appreciated by an audience of 75. Buddy was part of a panel of parents talking about their recovery experiences at the NEDA conference in San Diego last September. He is a warm and engaging speaker with a message of hope and inspiration for all; but it truly resonates with the men in the audience. Should you wish to sponsor such a presentation for your event Buddy can be contacted via email at hyddub_1999@yahoo.com. Buddy is heading up the technology campaign for NEDA and we are proud to be making a $300 contribution to this cause. Nicole Tieri Cornell, aka "Scooter Girl", also made an appearance and shared a few selections from her brand new CD, "Tales from Magnolia Drive". Nicole has made several appearances for NEDA and has shared her ongoing recovery story. The newest chapter involves adjustment to pregnancy and the expected arrival of her first born this June. Finally, this event served to launch creat-ed, a brand new non profit organization based in Western Michigan. Creat-ed stands for the Coalition for Research, Education, Advocacy, and Training for the Prevention of Eating Disorders. Creat-ed was founded by myself in association with one of my long term clients, Kathy Christian. Kathy has a history of nearly 20 years of struggling with her eating disorder, and she continues to be saddled with many physical complications. In fact I wanted to wait to launch this until her health was better. But she has a burning desire to be sure that her struggle stands for something, and a determination to keep fighting that is bringing her closer to recovery each day. It was largely due to her persistence that our organization was born. Working together on this has been exciting and challenging. We're both very proud of our first event, and of the hard work that made it happen. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1321825 Sat, 22 Mar 2008 04:00:00 +0100 1321825 http://feeds.feedburner.com/~r/ForProfessionals/~3/245261650/happy-20th-neda.html This past week marked the 20th Annual National Eating Disorders Awareness Week. I am proud to say that I've participated with NEDAW almost from the beginning. I remember attending an organizational meeting with Anita Sinicrope Maier and Margo Maine at the NAAS conference in Columbus, Ohio back in 1986. NEDAW has grown exponentially since those humble beginnings. This year there were coordinators across the nation who planned all kinds of events for professionals, students, and the general public, all in an effort to raise awareness regarding eating disorders. We have a wonderful event planned to occur right here in Grand Rapids, Michigan on March 18. More to follow . . . NEDAW always reminds me of my father. Ten years ago I planned events for the week in Michigan, but was unable to attend when I was called home due to my father's death. That fall, when I was present at the EDAP (now NEDA) conference I was presented with an "Outstanding Coordinator" award for my work in helping to pilot the "Go Girls" curriculum. I dedicated my award to my father, "the original 'go girl' in my life." I'm so thankful I was raised by a dad who, in his own unsophisticated way, encouraged me not to take no for an answer. The role of a father in the development of his daughter's self esteem is vital, as is his support and encouragement when she is attempting to recover from her eating disorder. For our event we are bringing in a dad, Buddy Howard, to tell the story of his daughter's recovery from his perspective. Although we believe his messages of hope will be appropriate for all audiences, we are especially encouraging fathers to attend. If you live near Grand Rapids, Michigan please plan to join us at 7 p.m. for this special occasion. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1276122 Mon, 03 Mar 2008 05:00:00 +0100 1276122 http://feeds.feedburner.com/~r/ForProfessionals/~3/235876174/happy-v-day.html Valentine's Day came and went without much fanfare at our house. It was a normal, busy work day - although I did have special calls and messages from my husband and children. Then when I arrived home I picked up the newspaper and was reminded of "V-Day", celebrated with a local production of "The Vagina Monologues" and its theme of halting violence against women. What touched me even more were the messages of support and encouragement sponsored by local businessmen. I thought too of an event earlier this week, described to me by a client, which was held to support Breast Cancer Awareness, and attended by many young men in her community. All of that started me thinking: do we have the same support by men for our cause, Eating Disorders Awareness? Although there have been a significant number of male experts in the treatment and research fields, there have been precious few men championing the cause of awareness and prevention, with Michael Levine being one notable exception. And thankfully, during the past several years, more and more men have stepped to the foreground to become spokespersons about the devastation these diseases can render. Often it has taken incredible courage to do so since their own wounds are still raw from the battles recently fought by their wives, mothers, or daughters. Unless men know someone touched by these illnesses, they can be overlooked or trivialized by them. Perhaps at one time the same thing was true regarding violence against women, or breast cancer. Eating Disorders Awareness Week is just around the corner. Let's be sure we aim our messages at men AND women, because doing so will strengthen our movement. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1236375 Fri, 15 Feb 2008 05:00:00 +0100 1236375 http://feeds.feedburner.com/~r/ForProfessionals/~3/230669151/god-bless-the-u.html I missed posting last week because I was in Norfolk, VA where my husband and I welcomed home our son from a six month deployment in the Persian Gulf. He has been in the Navy for nearly 4 years, but this was his first actual deployment. What an experience it was to stand on that pier, along with about 1,000 other family members and friends, to greet them. First off the ship were the officers, so our anticipation heightened as we saw them hug and kiss wives and children. Next came the 32 new fathers for a first meeting with their 34 new babies born while the ship was away. Lastly came a steady stream of the 800 or so enlisted men and women and soon we had our arms around our son. It brought tears to our eyes and made us swell with pride. All of this has given me a new appreciation for the families who sacrifice so much while their loved ones are in the military. Although I'm not a big fan of this war, I am grateful for those who are willing to serve, and those left behind supporting them. While there we also toured the base, and were amazed and awed by the sights of the largest Naval base in the world. And we were astounded at hearing what it costs to run just one large ship for one day in one conflict. President Bush has again proposed a budget of billions for defense spending while proportionately very little has been allocated for education and health care. So what does this indicate about our priorities as a country? Do we REALLY support "family values"? Frankly I think we can do better. Again I urge you to make your voice (and your vote) count this year! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1213365 Wed, 06 Feb 2008 05:00:00 +0100 1213365 http://feeds.feedburner.com/~r/ForProfessionals/~3/221324249/on-the-issue-of.html I received the following thoughtful response to Carolyn's post, dated 11/8/07: Caroline, you wrote: "The key, for me, is that although there are guidelines, at some point we also have to trust the things that we know. . . . I do my best to keep true to my profession and my humanness at the same time." I almost agree with you wholeheartedly, and now we have evidence based scientific research to back up the use of our humanity in our practices. Appropriate boundaries between patient and psychotherapist are essential in any psychotherapy and particularly in the field of eating disorders. However, the topic is often discussed in terms of content. I believe that when a patient wants to know about my private life or wants to include me in her private life (weddings, funerals, births, graduations, award events, etc.) the patient wants and needs a particular psychological emotional experience from sharing the experience with me. In other words, it’s not the information or event that is the issue. The sharing of our humanity is the point. Again, I agree with you. There's no need to share "dirty details." The value is in right brain to right brain communication, not content. Allan Schore, http://www.allanschore.com/ in his fantastic research on affect regulation, is showing affective neuroscience, neuropsychiatry, trauma theory, developmental psychology, attachment theory, pediatrics, infant mental health, psychoanalysis, psychotherapy, and behavioral biology that right brain communication is received by the right brain and actually changes brain structure to allow developmental progress. The discoveries revealed by the increased sensitivity of neuroimaging validates what many sensitive clinicians have known for a long time. Honesty, caring, empathy, sharing spontaneous imagery, acknowledging physical responses to clinical material make for effective connection, growth and increase possibilities for healing. http://www.biosynthesis.org/html/allan_schore.html My pause in wholehearted agreement with you, Caroline, is a slight shift of emphasis. I believe, with the backing of neuroscience, that we can’t keep true to our profession without keeping true to our humanness. P.S. As part of my practice, I've attended a wedding, but not the reception. I’ve visited a new mother in a maternity ward. I’ve applauded from the audience when a person received a hard won and well-deserved award. I’ve called patients in fire areas during Southern California fires to check on their well being. I ask to be notified regarding outcome of surgery. Joanna Poppink, LMFT, Los Angeles psychotherapist, specializing in adult eating disorder recovery. joanna@poppink.com I'd still love to hear from other professionals regarding this important issue. Write any time! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1170246 Tue, 22 Jan 2008 05:00:00 +0100 1170246 http://feeds.feedburner.com/~r/ForProfessionals/~3/219560211/class-action-la.html Attention all therapists and treatment providers with clients who reside in Michigan: There has been a class action lawsuit filed in Wayne County on behalf of eating disorder sufferers who have been denied coverage and benefits for inpatient treatment by Blue Cross Blue Shield of Michigan. The denial of coverage must have occurred within the past six years. It does not matter if treatment was to occur in Michigan or in another state. There are currently 19 individuals and their families being represented; others are being encouraged to join. If you as a therapist are aware of clients who were denied needed treatment, or who sought treatment and had to self pay, encourage them to contact Peter Macuga at Macuga & Liddle, PC: 313-392-0015; or his co-counsel, Robert Roether robertroether@cs.com . Although it is certain this process will require some energy, and therefore it would be best if clients contacted are recovered, I believe the process of being "heard" and hopefully, of being vindicated, could help empower individuals toward recovery as well. As professionals treating individuals with eating disorders we are well aware of the tremendous physical and emotional suffering that can be caused by a denial of needed treatment. We don't want to wait until a lawsuit is brought for wrongful death. Let's step up now and make a difference! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1162660 Sat, 19 Jan 2008 05:00:00 +0100 1162660 http://feeds.feedburner.com/~r/ForProfessionals/~3/217058125/the-great-debat.html Today is Primary Day in Michigan. I stopped answering the phone last night because of the onslaught of pre-recorded messages from various candidates, especially on the Republican side. As you may have read or seen on the news, the Democratic primary is only represented by Hillary Clinton, because the state of Michigan broke some rules by moving the primary earlier in the season. As a result John Edwards and Barak Obama withdrew their names from the ballot, and some of Michigan's delegates may not be seated at their respective conventions come fall. This is an election where important issues are being discussed. Topics like the war, national security, abortion, and immigration rights are on everyone's radar. I want to encourage us all to keep national health insurance, and mental health parity also in the foreground. Although it will take more than a supportive president to bring change to the health insurance system, a president who cares about these issues will certainly increase the possibility of insurance for all, and full treatment for all conditions. (That's such a radical sounding statement isn't it?) I currently have a patient who came to the US from Germany just three years ago. She is amazed and perplexed by our fragmented insurance system in the US. Seeing the issue through her eyes, and listening to what the rest of the civilized world provides in countries that truly practice "family values" has reminded me that we can do much better here. I also have a patient who is joining the class action suit being brought against Blue Cross in Michigan for denying appropriate care to those individuals with eating disorders. She is now nearly well, and strong enough to join the fight. She hopes to save someone else from the devastation she experienced when her much needed residential care was denied mid-stay. It seems as if this Presidential Race is all about change. We could be in for a radical change: the Democratic party will likely present either the first African American or the first female nominee for President. And yet there is the fear that, no matter whom we elect, it will be "same old, same old" in Washington, where radical change is often very difficult given the stagnant nature of the system. It's easy to get disallusioned and think it doesn't really matter who becomes President: my voice won't count for anything. But don't we teach our clients the importance of using their voices? And isn't it our responsibility to speak up and speak out on behalf of those who are too depressed, too ill, or too weary to do so for themselves? During this election season, which stretches on for another 10 months, I urge you to remain abreast of the candidates and their stand on health care. We can't afford another season in which eating disorder sufferers are denied the care they so desperately need. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1152890 Tue, 15 Jan 2008 05:00:00 +0100 1152890 http://feeds.feedburner.com/~r/ForProfessionals/~3/212323258/new-years-resol.html It has been some time since my last posting . . . apologies to all, especially my contacts at Gurze, who have been incredibly patient with me. In addition to the extra events and travel during the month of December my family was plagued with some illness. All of this made it difficult to find the time or energy to post. When the time for New Year's Resolutions hit, I thought to myself that "doing better with my blog posts" was an excellent thought. That was six days ago, and the "thought" never crossed my mind again. This led me to reflect for a bit on the process of change. Why do some great resolutions never materialize? I don't think it's for lack of sincerity. Many times I have sat with a client who voices the intention to change which is heartfelt and genuine, who leaves with renewed energy, and returns the following week to report lack of progress. I know my thought was sincere. What helps us translate thoughts into changed behaviors? As we know from the study of Stages of Change Theory, in order for change to occur, the individual must have passed through the "thinking" stages of pre-contemplation and contemplation and be ready for action steps. Then too, change is more likely to occur if goals are clear and measurable, and small steps towards the larger goals are identified. Finally, it can be very helpful to state goals for change aloud and to be accountable to someone regarding progress. So readers, I'm ready for action. I am committing myself to posting on this blog twice per week for the next three months. I hope you will keep me accountable. I would also value your partnership with me - if you have a question or an issue which you want addressed, please let me know. But even if I don't hear from you, I will do my best to meet this goal. Best wishes for a wonderful 2008! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1132754 Sun, 06 Jan 2008 05:00:00 +0100 1132754 http://feeds.feedburner.com/~r/ForProfessionals/~3/212323255/new-years-res-1.html It has been some time since my last posting . . . apologies to all, especially my contacts at Gurze, who have been incredibly patient with me. In addition to the extra events and travel during the month of December my family was plagued with some illness. All of this made it difficult to find the time or energy to post. When the time for New Year's Resolutions hit, I thought to myself that "doing better with my blog posts" was an excellent thought. That was six days ago, and the "thought" never crossed my mind again. This led me to reflect for a bit on the process of change. Why do some great resolutions never materialize? I don't think it's for lack of sincerity. Many times I have sat with a client who voices the intention to change which is heartfelt and genuine, who leaves with renewed energy, and returns the following week to report lack of progress. I know my thought was sincere. What helps us translate thoughts into changed behaviors? As we know from the study of Stages of Change Theory, in order for change to occur, the individual must have passed through the "thinking" stages of pre-contemplation and contemplation and be ready for action steps. Then too, change is more likely to occur if goals are clear and measurable, and small steps towards the larger goals are identified. Finally, it can be very helpful to state goals for change aloud and to be accountable to someone regarding progress. So readers, I'm ready for action. I am committing myself to posting on this blog twice per week for the next three months. I hope you will keep me accountable. I would also value your partnership with me - if you have a question or an issue which you want addressed, please let me know. But even if I don't hear from you, I will do my best to meet this goal. Best wishes for a wonderful 2008! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1132753 Sun, 06 Jan 2008 05:00:00 +0100 1132753 http://feeds.feedburner.com/~r/ForProfessionals/~3/192715938/holiday-tips-fo.html Our Thanksgiving is over, and in a few short weeks, we'll be celebrating Christmas. As we all know, this season brings special challenges for those individuals struggling with eating disorders and their families. Lots of activity and family togetherness, along with special holiday meals, can raise anxiety as they are anticipated and depression when they are over. Each year my staff and I spend extra time on the importance of good self care during this stressful period. But how about those of us who are the helpers? Do we follow our own prescription for healthy living? Do we eat and drink in moderation? get enough rest? watch our spending? stop trying to "do it all" and focus instead on doing the things we really enjoy? Have we simplified with decorating, entertaining, and celebrating? Do we share our material wealth with those who have very little? Do we seek to deepen our spiritual selves and reconnect with those most important to us? If you are like me, an occasional reminder of "the reason for the season" provides important perspective. I wish for happiness, contentment and peace for all of you - until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1061229 Thu, 29 Nov 2007 05:00:00 +0100 1061229 http://feeds.feedburner.com/~r/ForProfessionals/~3/181934812/response-from-c.html Carolyn Costin, Director of Monte Nido and Affiliates, and author of The Eating Disorder Sourcebook and !00 Questions and Answers About Eating Disorders responded to my last post about Professional Boundaries with these words: "The topic of our relationship as clinicians to our clients is always a hard one to discuss. There are so many reasons for us all to be concerned about this dynamic. From the very beginning in my work with eating disorder clients I found that they needed to hear from me as a person, not just as a therapist. Although I am careful, I do talk about myself and share from my experiences . . . I do not share the horrors and dirty details of my illness. I discuss strategies for overcoming it that worked for me. I also maintain contact after clients have left treatment . . . if a client emails or calls I respond; I also occasionally reach out to them to see how they are doing. It is possible to maintain boundaries: it is the nature of the relationship that is important. They always know they are clients or former clients, not friends.. . take the client who called after 7 years of recovery who was in town with her new baby and wanted to see me. Should I say 'Make an appointment"? For me my humanness overrides that silly thought and I agree to a cup of coffee together. . . The key, for me, is that although there are guidelines, at some point we also have to trust the things that we know. . . . I do my best to keep true to my profession and my humanness at the same time." Thanks Carolyn, for your wise and thoughtful response. I'm looking forward to hearing from other colleagues. Until next time, blessings! Gail Hall (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=1015079 Thu, 08 Nov 2007 05:00:00 +0100 1015079 http://feeds.feedburner.com/~r/ForProfessionals/~3/177732604/professional-bo.html I had lunch recently with a couple of colleagues who do not work primarily with eating disorders. We were discussing the issue of whether it's appropriate to keep in contact with ex-patients. Both of my colleagues seemed quite clear in their position, that it's never appropriate: "once a patient, always a patient"; "our ethical guidelines indicate we don't create dual relationships". We also discussed the pros and cons of attending events, such as graduations or weddings, on the invitation of a patient. Again they were both of the opinion this would not be acceptable. I shared with them that my experience as a therapist has been quite different. I have, in fact, attended events when invited by patients. I do, in fact, keep in contact with some of my patients, at their initiative: although I have also contacted patients to encourage them to participate in a survey, or to invite them to a special event involving Eating Disorders Awareness Week. A few of my patients have gone on to become therapists or dietitians, and we have even allowed one young woman to shadow the dietitian at our practice. My style as a therapist has always been to be somewhat accessible about my own life. I share from my own experiences: although I have never had an eating disorder, I have had the struggle with self esteem and body dissatisfaction that is common to most women. I don't mind talking about what's "normal" during adolescence, or my experiences as a professional juggling career and family, or ideas about child raising that worked for me. I believe one of the most powerful avenues for healing is the modeling we bring to young women who are confused and overwhelmed with their life choices. In fact, whether we acknowledge it or not, our behavior is being watched closely. I see no harm in allowing questions and opening ourselves up to mentoring. NEDA is also a unique professional organization in that families and sufferers are invited to attend our national conference. Many professionals in this field have themselves recovered and appear to draw from their recovery when helping others. We stand shoulder to shoulder with families and sufferers as we work to bring change to our culture. Involvement with NEDA has likely also encouraged my thinking in this regard. I know I've been "changed for the better" as a result. I'd love to hear from other professionals about this issue. Your thoughts? Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=995157 Wed, 31 Oct 2007 04:00:00 +0100 995157 http://feeds.feedburner.com/~r/ForProfessionals/~3/168741194/a-follow-up-que.html I received the following comment from Geri in response to my most recent post: "This was my first year at NEDA, and I too was impressed by how accessible professionals were and what a compassionate, helpful environment it was. I met a woman who had brought her anorexic, adult daughter with her, in the hopes of finding her help. I was struck by how upbeat and positive the girl was after speaking to several treatment professionals. It really goes to show that recovery is all about hope opening a door to a positive chapter of life. Do you find that most people who seek help from you are hopeful, or feel wrangled into treatment by parents or friends?" Actually my clients come into my office in all stages of readiness for recovery. Some are still in deep denial; some are angry and resentful because they did not come to treatment on their own. Many are ambivalent or conflicted about making changes; a few are completely ready to leave the eating disorder behind; and ALL are frightened. But I really believe that even the most angry or ambivalent client has a part of herself that wants to recover. It's my job as a therapist to search for and connect with that part; to strengthen resolve; and to instill hope. Recovery is never easy, and it can take significant time, energy, and resources. But it IS possible!! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=945580 Thu, 11 Oct 2007 04:00:00 +0100 945580 http://feeds.feedburner.com/~r/ForProfessionals/~3/166396085/neda---still-fa.html I'm on my way home from the annual National Eating Disorders Association conference. I'm proud to say that I've been involved with NEDA since it was EDAP (Eating Disorders Awareness and Prevention) and have attended all but one of their conferences since 1986. NEDA has remained true to its roots in that it is an organization dedicated to awareness and advocacy efforts. At the same time it manages to put on one of finest conferences for professionals in the field, where the latest and greatest information on eating disorders treatments is available. One of the things I've always appreciated most about this conference is the accessibility of the presenters. I can walk up to some of the biggest names in the field and have my questions answered while being greeted as an old friend. But what has set NEDA apart from other organizations is the welcome it has extended to family members, friends, and eating disorders sufferers; and we have all been made richer for it . This morning's panel presentation by family members sharing their trials, joys, and ultimate hope for recovery was one of the most inspirational I have ever heard. Finally, NEDA continues to inspire and energize us towards a world where eating disorders no longer exist. I'm going home with a renewed appreciation for what we will collectively be able to accomplish, and I've been energized to continue the fight. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=933040 Sun, 07 Oct 2007 04:34:46 +0100 933040 http://feeds.feedburner.com/~r/ForProfessionals/~3/162244906/especially-for-.html I just received my copy of The Parent's Guide to Eating Disorders by Marcia Herrin and Nancy Matsumoto. Although I haven't had time to digest it completely, my initial quick read suggests a wealth of important information for families and the therapists who are trying to help them. It also appears to be appropriate for parents of both young children and teenagers. There are three chapters devoted entirely to discussion of the Maudsley method of treatment for eating disorders, a family based treatment which has had amazing success; and this author's adaptation of that method, Parent Assisted Meals and Snacks (PAMS). There is a very helpful, non judgmental chapter on assessing the parents' relationship to food, their own body image, and how that can impact their children. I intend to use this book as a guide as I continue treatment with my youngest patient, age 7. I will also recommend it to all parents who are interested in preventing eating disorders and developing healthy body image in their children. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=912219 Thu, 27 Sep 2007 04:00:00 +0100 912219 http://feeds.feedburner.com/~r/ForProfessionals/~3/154854157/kudos-to-marion.html The U.S. Open Tennis tournament has just drawn to a close, and almost everyone knows that Justine Henin and Roger Federer continue their dominance of the women's and men's fields, advancing as champions, both in straight sets. But I want to tell you about a lesser known player, her unorthodox style, and her father's unique coaching methods. Unless you are a pretty avid tennis fan you may not have heard of her. Marion Bartoli is a 22 year old from France who blazed into focus by appearing in this year's Wimbledon final. At the U.S. Open she lost in the 4th round to American Serena Williams. She uses both hands on her forehand and her backhand; she serves from an unusual tip-toed stance; and apparently her father/coach has her practice service accuracy by casting with a fishing rod. It's rumored that he's a bit of a tyrant with his protege; but as John McEnroe noted, his unusual methods may come into vogue now that she is achieving some success. But it was not her tennis training which caught my attention. Rather it was the discussion re: her weight, and the questions around her level of fitness, which the commentators tossed around during her matches. There were subtle (and outright) suggestions that she'd be better if she just took off a few pounds . . . As therapists we know full well the power of those words. Just such a suggestion from a coach, trainer, or parent has launched many a young woman into a diet which spiraled into an eating disorder. Tracy Austin set the record straight. She noted that Marion's father engaged the services of a trainer for her this year; but when she changed her training regimen and lost weight he felt she became weaker on the tennis court; so he wisely stopped the process and encouraged her to return to her previous (healthy) weight. What a concept: GAINING weight in order to improve athletic performance. I wish all coaches - and fathers - understood this principle. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=862251 Mon, 10 Sep 2007 04:00:00 +0100 862251 http://feeds.feedburner.com/~r/ForProfessionals/~3/153258641/its-back-to-sch.html Earlier this summer I wrote about the summer months as an opportunity to catch up with former patients who are back in the area, dropping in for "wellness checks". Now that fall is around the corner most of my patients are beginning a transition back to school, with all of the stresses and opportunities this change brings. Since many eating disorder sufferers are prone to anxiety and risk-avoidant, they often experience significant anticipatory anxiety as they wonder: will I like my new teacher? Can I handle the work load? Will I have any friends? What if I don't keep my perfect 4.0 record? Will I make the cross country team? How different is high school from elementary school? How can I keep up in marching band when I missed band camp? And many, if not most, of these fears, can be translated into food, fat, and body phobias. Therefore some of the important work of therapy at this time involves decoding the fat fears and translating the underlying fears into words. As we all know, fears translated and expressed become much less powerful; and then the focus can turn toward problem solving skills. It's also true that school can present some real obstacles. Often we've had to be creative with a client's meal plan when she has to leave for school by 7 a.m. and has been assigned to "first lunch" at 10:50. Frequently teachers prohibit eating during classes which calls for some advocacy to allow time for snacks. And although we work very hard to teach our clients not to value themselves based solely on their appearance, an ill-timed comment from a peer can undo a great deal of progress in this area. On the other hand, a return to school can be of positive benefit for some of my patients. Sometimes there is comfort in the return to the routine that summer cannot always provide. Other times the incentive of returning to participation on the fall sports team can provide motivation to gain and maintain weight. For some college-aged individuals coming back to campus represents a return to their most supportive environment. I'm certain all of you who work in the field are aware of the potential benefits and pitfalls of the return to school season. Please write and share your thoughts. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=848565 Thu, 06 Sep 2007 04:00:00 +0100 848565 http://feeds.feedburner.com/~r/ForProfessionals/~3/145217635/update-on-first.html I've received a few comments and suggestions re: my last post. Meanwhile, I've continued to see this child and her family. They are scheduled to see one of my staff dietitians next week, then we hope to meet together to decide on next steps. I will continue to post as our process unfolds. Your advice to date has been helpful; no one suggests that leaving out the child and focusing exclusively on her parents makes sense. All are in agreement that parents are a vital part of the process; but at least one professional who has worked with young children is encouraging me to see her alone occasionally as a way to hear her thoughts and feelings without her parents present. Parents and I have already agreed that a more consistent schedule and a plan to approach mealtimes will be helpful; it seems too often now eating gets delayed, or squeezed in between the pick up from day care and after work errands. Parents also tend to approach the struggle around eating in slightly different ways, and I've encouraged them to use the strengths of each approach to find a more consistent model. We also see that their daughter has some nutrition myths which will need to be challenged by more accurate information. I've been reminded that young children can sometimes develop medical complications, and therefore need hospitalization, more quickly than our older patients. I plan to have the dietitian monitor weight here, and have the pediatrician monitor other vital signs as needed so that we avoid the need for emergency intervention. It's still my hope to be able to help this family without inpatient treatment. I will welcome ongoing comments from other professionals; and from parents who've had a young child in treatment. What was most helpful to you? Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=806100 Fri, 17 Aug 2007 04:00:00 +0100 806100 http://feeds.feedburner.com/~r/ForProfessionals/~3/134791600/first-do-no-har.html I'm eager for some input from my fellow therapists. Yesterday I saw my youngest patient to date, a seven year old. I suppose this isn't breaking news - I've been hearing and reading more about eating disorders in children, and I've attended presentations given by specialized treatment facilities for patients younger than 10. I've also treated several 11 year olds and currently have a 9 year old on my caseload. Still, I found it a bit unsettling to sit across the room from a young girl so tiny her feet dangled over the edge of my easy chair, never reaching the floor. I wondered if I am up to the challenge of helping someone so young. I am determined to intervene slowly and carefully, and above all, to do no harm. In the interests of protecting the confidentiality of this little girl and her parents I do not want to describe the situation in too much detail; and in fact I have not yet gathered enough information to have a clear picture. But so far I can say there is anxiety about eating and distortion regarding body image. There is a strong fear of fatness, both re: becoming fat herself and being near others she sees as far. Although there has been no weight loss there has been failure to gain such that she has dropped from the 50th percentile to the 25th over the past year. There were no feeding difficulties as an infant or toddler. She describes herself as a very "picky" eater and parents confirm she has eliminated many foods she was eating a year ago. I would welcome input from anyone experienced with treating children this young. Obviously her parents are important allies in the process; they are clearly invested and capable. Should the primary focus be with parents, supporting them and empowering them to help her? Should we keep her out of the process entirely? Would a family focus be best? Or are there indications for individual therapy as well? I will welcome your thoughts. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=741550 Tue, 17 Jul 2007 04:00:00 +0100 741550 http://feeds.feedburner.com/~r/ForProfessionals/~3/129383118/sink-or-swim.html I live in a beautiful area surrounded by lakes; so maybe it's for this reason that when I use metaphors in therapy they often involve water. When my clients express surprise at the difficulty involved in changing their behavior I will explain that doing so is like swimming upstream - intially it will take much more effort to swim against the current of established routines. They may also feel as if they are expending great effort without marking much progress forward; but if they continue, eventually the current will change and their new, healthier coping mechanisms will now carry them forward. Another metaphor I've referred to frequently is the eating disorder as a life jacket. Imagine you are out alone in a large lake and your boat sinks. You jump from the boat just in time to avoid going under; and initally, you are panicked. You have no idea if anyone knows where you are; and you don't know in which direction to swim to find the shoreline. Suddenly a life jacket floats towards you; and of course, you grab the life jacket and put it on. Although it's bulky and awkward, you are grateful for it's support and even its warmth. It allows you to float and rest in the water as you survey your situation. As hours pass and no one comes to your rescue to cling tightly to this inanimate friend, knowing you would not have survived until now without it. But as more time goes by, you notice the heaviness of the jacket; and now the water soaked vest is cold, rather than warm. You are beginning to realilze that it's getting dark, and no one is likely to come for you; so if you hope to survive you are goind to have to swim for shore. As you try to move through the water you discover that the life vest is making it difficult, if not impossible, to make headway. Although it's frightening to consider you think about striking out without the vest. Hesitantly, you slip it off and paddle away a few yards, just to see how it feels. But it feels too scary to head out without it, so you swim back to it and put it back on. The next time you strike out without the jacket you go farther, but once again, return to the safety of floating in the vest. One day you swim so far without it that it's almost lost on the horizon; and although you now know which way to swim for shore, you can't bring yourself to leave the jacket completely behind. Finally you realize you have wasted too much time returning to the jacket over and over, and you make the bravest decision of your life. You decide to head for shore and not look back. Of course there are some rough moments, but as the shoreline comes closer and closer you find your confidence and strength only increasing; until at last, you reach your destination, safe, sound, and full of self confidence. I hope this metaphor is useful to you and your clients. Sometimes identifying the positive benefits of a very dangerous and dysfunctional behavior, and thereby, normalizing ambivalence, can act as a catalyst for change. Until next next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730834 Sat, 30 Jun 2007 04:00:00 +0100 730834 http://feeds.feedburner.com/~r/ForProfessionals/~3/124094071/the_obesity_epi.html Last week I attended a one day workshop entitled "Obesity and Compulsive Eating - Helping Without Harming" taught by Jonathan Robison, PhD, MS. Jonathan is an engaging and knowledgeable presenter who is a strong advocate of the Health at Every Size movement. He suggests that the effects of weight on health "have been dramatically overblown, and have done more harm than good". Over the course of the day long workshop he gradually dismantles the position of the traditional medical community re: obesity and advocates instead the Health at Every Size paradigm. HAES has three main tenets: 1) thinness is not intrinsically healthy and beautiful nor is fatness intrinsically unhealthy & unappealing; 2) people naturally have different body shapes and sizes; 3) dieting usually leads to weight gain, decreased self-esteem, and increased risk for disordered eating. HAES also advocates self-acceptance; movement (rather than 'exercise') and normal eating (based on internal cues) as its three main objectives. All of this should be "music to the ears" of us as professionals who treat eating disorders. But as Jonathan so wisely pointed out, in order to practice this we have to be this - we cannot advocate self acceptance to our clients and continue to disparage our own bodies, or obsess about our weight or eating habits. Nor can we talk about the evil of weightism while secretly passing judgment on obese individuals. Attending this workshop should be required for all health care professionals. I urge you to check out Jonathan's web site: www.jonrobison.net :and to attend one of his seminars when you get the chance. You'll leave inspired and equipped to challenge the myth of the Obesity Epidemic. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730835 Mon, 11 Jun 2007 04:00:00 +0100 730835 http://feeds.feedburner.com/~r/ForProfessionals/~3/119463880/mental_health_p.html The (Michigan) House parity bills HB 4390, 4391, 4392, and 4393 were scheduled for a hearing in the House Insurance Committee but that hearing has just been postponed. It will be rescheduled just as soon as the Michigan Legislature reaches a budget agreement. If you live in Michigan it is still an excellent time to send an email, a letter, or make a telephone call in support of this legislation to a member of the House Insurance Committee. If the bills make it out of committee with favorable support a full House vote could be scheduled within a week. For the most current information please check out (and bookmark) this page: michiganparity.googlepages.com/parityactionalerts. As those of us treating eating disorders are all too aware, treatment can be a long and challenging process. We cannot afford to have that process interrupted by an arbitrary limit to benefits, or a cap on inpatient stays, which has been designed to contain costs. If there is no limit to treatment for cancer, there can be no such limit to treatment for eating disorders under parity legislation. Many states have enacted parity bills. Call or write now to support these bills in Michigan. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730836 Thu, 24 May 2007 04:00:00 +0100 730836 http://feeds.feedburner.com/~r/ForProfessionals/~3/116473976/congratulations.html This weekend I was in New York attending the wedding of Nicole Tieri (popularly known as Scooter Girl to American Idol fans) and Julian Cornell. It was a wonderfully festive, witty celebration full of all kinds of special touches. Nicole and Julian's family and friends were there of course, along with some representatives from NEDA. It was fun to connect again with Lynn Grefe, who has encouraged Nicole to use her story and her talent to be an ambassador for eating disorder prevention. Also present were Buddy and Kathy from Raleigh North Carolina, who have generously underwritten the production of Nicole's first CD. Buddy and Kathy are also involved with NEDA, and met her at the NEDA conference in Denver two years ago. I couldn't help but think the guests represented Nicole's past, present, and future; and in many ways, it was a living testament to the "village" it takes to help someone with an eating disorder find health and healing. I'm honored to have been a part of that community. God bless Nicole and Julian! until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730837 Sun, 13 May 2007 04:00:00 +0100 730837 http://feeds.feedburner.com/~r/ForProfessionals/~3/113771243/passages.html The months of May and June seem to be "transitional" months at our practice. Many of our clients are finishing a semester of school, leaving on summer trips, heading for camps, or coming home for the summer. There are proms, graduations, and weddings to attend. Some of our older clients are becoming pregnant, having babies, or even watching their children leave home. Each of these transitions from one life stage to another, normal as they are, create stress for our clients. As a result many times the eating disorder symptoms flare up, and therapy is needed until the passage can be navigated safely. Summer is also a time when some of our former patients come in for a "visit" or "check-up". The visits with those former patients are some of my favorite sessions. It's so good to see young women and men progressing on their paths towards maturity. As therapists we have the chance to assist our clients not only in overcoming an eating disorder; but also in helping to shape their futures. I consider that a great privilege. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730838 Wed, 02 May 2007 04:00:00 +0100 730838 http://feeds.feedburner.com/~r/ForProfessionals/~3/112985197/calling_all_pro.html It has again been a couple of weeks since I posted on this blog. Spring tends to be a very busy season at both my home and my practice, and this year has been no exception. But I also find myself struggling just a bit with continuing to post -- when I was asked to host this blog I envisioned a forum in which professionals could exchange ideas. But in fact it's been more of a monologue, and my creative juices are running a bit dry. So I would LOVE to hear from you if you have ideas for subjects that you would enjoy discussing with others. Please write soon! Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730839 Sun, 29 Apr 2007 04:00:00 +0100 730839 http://feeds.feedburner.com/~r/ForProfessionals/~3/108171192/equity_for_fema.html It's been awhile since my last post. There is a phenomenon in Michigan called "Spring Break" and I was enjoying mine. While I was out of the country there was a long awaited decision by the US Supreme Court not to hear the case re: gender equity in high school sports in Michigan that has been winding its way through the system for the past nine years. This decision means a lower court decision stands, and as a result, there are eight sports seasons which must be switched next school year to promote equality between girls and boys. This case was initially filed by two Grand Rapids mothers of female athletes claiming that the schedule as it existed cut down on opportunity for exposure, and therefore, for college scholarships, for female high school athletes. Supporters of the change are overjoyed, although obviously the change comes far too late to benefit their daughters; while opponents raise other questions. Will having both boy's and girl's basketball played in the winter, which will mean competition for gym time, coaches, and referees, really result in better equity? Or will girls' sports be overshadowed by the boys? Sadly, even with all the steps forward with gender equity in my lifetime (my clients can scarcely believe that I went to high school before Title XIX), no one seems to think that the girls can go head to head with the boys and come out on top. And another sad note for female athletes is in the news - Don Imus is being called on the carpet, and rightfully so, about his racist and sexist comments towards the Rutgers Women's Basketball Team. Such comments about their male counterparts would never be tolerated. Somehow a two week suspension doesn't seem like more than a slap on the wrist . . . Is it any wonder that our clients don't feel validated as young women, and fall into the trap of turning their frustration towards their own bodies? As my friend Michael Levine has so wisely said, all of this will continue until we learn to take girls seriously for their ideas, not their bodies. Until next time, Gail Addendum: as the whole world knows by now, Don Imus was subsequently fired for his comments. Congratulations CBS on taking the right position on a very important issue. (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730840 Tue, 10 Apr 2007 04:00:00 +0100 730840 http://feeds.feedburner.com/~r/ForProfessionals/~3/103486130/theres_no_place.html My husband is a high school music teacher, and it's musical week at our school. Because he's the orchestra conductor his presence is required at all dress rehearsals and performances. So several years ago I decided I might as well be there too, and I volunteered to serve as stage manager. It's fun mixing it up with high school kids in this way; and I get to live out my fantasy of being involved in a Broadway production. (By the time the week is over I know why the life of a Broadway musician or actor is only for the young and hearty!) This week we are doing one of my all time favorite shows, "The Wizard of Oz". I vividly recall watching this movie as a child when it was televised, year after year, often on Thanksgiving night. I was afraid of the witch and the flying monkeys; but I delighted in the land of Oz (in color!) and the ultimate victory of Dorothy and her friends over the Wicked Witch of the West. And I celebrated with Dorothy when she made it back to Kansas, safe and sound. Now that I'm an adult I think Dorothy is a pretty plucky heroine. After all, she has the courage to face the Wizard and ask for what she needs. She leads her friends on the journey through the enchanted forest in their quest for the witch's broom; and she faces her fears and stands firm when her friends are threatened. When she and Scarecrow, Tinman and Lion return to the Wizard in triumph, expecting to be rewarded, they learn instead that what they were searching for was actually within each of them. I have a plaque expressing that sentiment on my office wall. Along with a picture of Glinda the Good Witch it says: "You don't need to be helped any longer. The power was yours all along." It's been my privilege to encourage that sense of empowerment in the clients I see. Until next time, Gailwmicted@aol.com (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730841 Wed, 21 Mar 2007 04:00:00 +0100 730841 http://feeds.feedburner.com/~r/ForProfessionals/~3/101546515/thanks_zoe_you_.html Recently I had the privilege of writing a letter of endorsement for a former patient, Zoe, who is a semi-finalist in a college scholarship program sponsored by Discover Card. Zoe was asked to write an essay about "Overcoming Obstacles" and she chose to describe her recovery from anorexia. Zoe was a high school freshman when she was my patient. Typical of so many who suffer from this disease Zoe is an extremely bright, capable, gifted young woman with incredible drive. What began as a simple diet in an attempt to better herself spun out of control and became deadly. When I first began seeing her she was just beginning to accept the fact that she did, in fact, have anorexia. As someone who had prided herself in not being susceptible to peer pressure or societal expectations re: beauty, she was openly asking the question "How did this happen to me?" And although she recognized that she needed to make changes in order to recover she struggled mightily to be able to make those changes. All of this probably sounds quite familiar to those professionals and family members reading this post. Zoe's struggle, like the struggles of so many sufferers, strongly suggests a genetic predisposition and susceptibility to a brain disorder brought on by dieting. In the right individuals that's all it takes. Fortunately Zoe's story has a very happy ending. She did recover; in fact, she states she is seldom troubled by obsessive thoughts re: weight or food. Her course of treatment was quite brief by national standards, less than a year from start to finish. She avoided hospitalization, recovering through a combination of outpatient approaches. She credits a spiritual experience at a summer camp as the beginning of her recovery process; and she is fortunate in that she has a committed, caring family with the means to support her treatment. I hope Zoe's story brings inspiration and hope to others who are looking ahead at what seems like a mountain they must climb. Trust me, you can do it - and one day you may look back at your recovery with the same sense of accomplishment and pride that Zoe has. It may even bring you a college scholarship! And thanks for asking me to write that letter, Zoe. It was great to reflect back on our work together. Until next time, Gail (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730842 Tue, 13 Mar 2007 04:00:00 +0100 730842 http://feeds.feedburner.com/~r/ForProfessionals/~3/99614419/congratulations.html The National Eating Disorders Association (NEDA) has just celebrated the 20th annual National Eating Disorders Awareness Week (NEDAW). I'm proud to say I've been a member of NEDA since 1986, and served as a State and Local Coordinator for most of that time. This year clinical responsibilities prevented me from sponsoring any events but it sounds like NEDAW was bigger and better than ever. This organization has grown from a relatively small, grass roots organization to a large international consortium of public and professional members. Check out their web site at www.nationaleatingdisordersassociation.org. Yet as far as we've come, we have far to go. There is still massive public ignorance about the prevalence and the dangers of eating disorders. (When I tell casual acquaintances that I treat individuals with anorexia and bulimia the most common response is often nervous laughter, followed by "Guess it's obvious I don't have that problem"; or worse, "I wish I could have that for a little while") We have too few professionals who are adequately trained in the assessment and treatment of eating disorders. We are still dealing with an insurance payment system that arbitrarily limits benefits and gives patients and their families more obstacles to negotiate. And we know precious little about real "prevention". More and more individuals continue to develop the illnesses at younger ages. Still, I have hope for the future. We've learned so much about eating disorders during my professional lifetime; with the genetic research project which is drawing to a close we are learning more than we even dreamed possible. Perhaps I'll live long enough to "work myself out of a job". Until next time, Gail wmicted@aol.com (Source: For Professionals) For Professionals blogs http://www.medworm.com/rss/comments.php?id=730843 Mon, 05 Mar 2007 05:00:00 +0100 730843