The document discusses lenses for viewing and treating eating disorders. Major diagnoses covered are Binge Eating Disorder, Anorexia Nervosa, and Bulimia Nervosa. Each diagnosis is examined through a particular lens - abandonment for BED, control for AN, and trust for BN. Treatment approaches are outlined for each diagnosis and lens, including cognitive behavioral therapy, establishing trust and rapport with clients, addressing underlying issues, and managing symptoms. The document emphasizes that eating disorders cause serious harm and treatment can help.
Poster Review for PTSD:
- Introduction (Definition, Prevalence for adults, children and veterans, the invisible PTSD)
- Types of diseases and symptoms
- Risk Factors
- Complications
- Treatment
- Conclusion
This is a self paced, eLearning module that informs the learner about the symptoms, diagnosis, causes and treatment of Fibromyalgia. Each slide of the original module also contains audio that makes it Section 508 compliant.
Poster Review for PTSD:
- Introduction (Definition, Prevalence for adults, children and veterans, the invisible PTSD)
- Types of diseases and symptoms
- Risk Factors
- Complications
- Treatment
- Conclusion
This is a self paced, eLearning module that informs the learner about the symptoms, diagnosis, causes and treatment of Fibromyalgia. Each slide of the original module also contains audio that makes it Section 508 compliant.
השבוע התקיים f8, כנס המפתחים השנתי של פייסבוק בו הכריזה הרשת החברתית על שינויים דרמטיים.
תמצתנו עבורכם את כל מה שחשוב שתדעו כמי שאחראים על נוכחות הארגון שלכם בפייסבוק.
מה במצגת? Timeline, אפליקציות חדשות, שינויים בניוזפיד, טיקר, רשימות חברים וגם איך לשדרג לטיימליין לפני כולם.
Presentation on Cultural Toolkits aimed at developing audiences of 'family and community focused' and 'dinner and a show' segments of the UK population.
PPM is the best business school in Indonesia. Now under Mr. Andi Ilham Said leadership, PPM is looking forward to be Indonesian landmark of management and business school
Running Head INDIVIDUAL PROGRAMMATIC ASSESSMENT1INDIVIDUAL PR.docxcharisellington63520
Running Head: INDIVIDUAL PROGRAMMATIC ASSESSMENT 1
INDIVIDUAL PROGRAMMATIC ASSESSMENT 11
Individual Programmatic Assessment
Mary Oliver
PSYCH / 630
Mr. Adam Castleberry
January 12, 1015
Individual Programmatic Assessment:
Bulimia Nervosa
Psychological disorders occur frequently. A common psychological disorder selected for the purpose of this paper is bulimia nervosa. Bulimia nervosa has several therapeutic interventions that can help when treating the disorder. Therapeutic interventions can be helpful, but have different measures of effectiveness. The measures of effectiveness consist of validity, efficacy, symptom, behavior management, and recidivism. These measures should be identified, prior to deciding which therapeutic interventions can be most helpful to the individuals diagnosed with the psychological disorder. Many common symptoms are associated with bulimia nervosa. Rates of symptom reduction or management have been reported with the three treatments. Furthermore, the neurophysiological underpinnings of diseases and disorders have to be identified, along with the contemporary attitudes towards the three treatments chosen.
Psychological Disorder: Bulimia Nervosa
Bulimia nervosa is known as an eating disorder. This disorder typically affects females and is most often done by binge-and-purge eating patterns. This eating disorder brings about the effects of bingeing and purging, and using laxative. People, suffering from bulimia nervosa, frequently eat a lot of food at one time. A short period after eating the food, the person, then, attempts to remove the food from his or her system by vomiting, through medication that creates bowl movements, or by working out. Excess working out has been known to lead one to throw up. People diagnosed with bulimia nervosa, often lack self-esteem. Many are self-conscious about their body image and preoccupied by food. Majority of individuals, suffering from bulimia nervosa, have normal weight or believe that they have weight problems. Bulimia is associated with other illnesses, as well. For example, some suffer from depression. Bulimia nervosa shares many characteristics of anorexia nervosa. Anorexia nervosa is a psychological eating disorder that impacts many people, as well. However, instead of purging or bingeing, people with anorexia nervosa, simply, do not eat. People, diagnosed with bulimia nervosa, have a difficult time maintaining a set weight like other individuals. Furthermore, more critically, they are able to hide the fact that they have bulimia nervosa. If bulimia nervosa goes untreated, it can create critical issues, along with a nutritional downfall. “Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions” (NEDA, 2012).
The cause of bulimia nervosa has not .
השבוע התקיים f8, כנס המפתחים השנתי של פייסבוק בו הכריזה הרשת החברתית על שינויים דרמטיים.
תמצתנו עבורכם את כל מה שחשוב שתדעו כמי שאחראים על נוכחות הארגון שלכם בפייסבוק.
מה במצגת? Timeline, אפליקציות חדשות, שינויים בניוזפיד, טיקר, רשימות חברים וגם איך לשדרג לטיימליין לפני כולם.
Presentation on Cultural Toolkits aimed at developing audiences of 'family and community focused' and 'dinner and a show' segments of the UK population.
PPM is the best business school in Indonesia. Now under Mr. Andi Ilham Said leadership, PPM is looking forward to be Indonesian landmark of management and business school
Running Head INDIVIDUAL PROGRAMMATIC ASSESSMENT1INDIVIDUAL PR.docxcharisellington63520
Running Head: INDIVIDUAL PROGRAMMATIC ASSESSMENT 1
INDIVIDUAL PROGRAMMATIC ASSESSMENT 11
Individual Programmatic Assessment
Mary Oliver
PSYCH / 630
Mr. Adam Castleberry
January 12, 1015
Individual Programmatic Assessment:
Bulimia Nervosa
Psychological disorders occur frequently. A common psychological disorder selected for the purpose of this paper is bulimia nervosa. Bulimia nervosa has several therapeutic interventions that can help when treating the disorder. Therapeutic interventions can be helpful, but have different measures of effectiveness. The measures of effectiveness consist of validity, efficacy, symptom, behavior management, and recidivism. These measures should be identified, prior to deciding which therapeutic interventions can be most helpful to the individuals diagnosed with the psychological disorder. Many common symptoms are associated with bulimia nervosa. Rates of symptom reduction or management have been reported with the three treatments. Furthermore, the neurophysiological underpinnings of diseases and disorders have to be identified, along with the contemporary attitudes towards the three treatments chosen.
Psychological Disorder: Bulimia Nervosa
Bulimia nervosa is known as an eating disorder. This disorder typically affects females and is most often done by binge-and-purge eating patterns. This eating disorder brings about the effects of bingeing and purging, and using laxative. People, suffering from bulimia nervosa, frequently eat a lot of food at one time. A short period after eating the food, the person, then, attempts to remove the food from his or her system by vomiting, through medication that creates bowl movements, or by working out. Excess working out has been known to lead one to throw up. People diagnosed with bulimia nervosa, often lack self-esteem. Many are self-conscious about their body image and preoccupied by food. Majority of individuals, suffering from bulimia nervosa, have normal weight or believe that they have weight problems. Bulimia is associated with other illnesses, as well. For example, some suffer from depression. Bulimia nervosa shares many characteristics of anorexia nervosa. Anorexia nervosa is a psychological eating disorder that impacts many people, as well. However, instead of purging or bingeing, people with anorexia nervosa, simply, do not eat. People, diagnosed with bulimia nervosa, have a difficult time maintaining a set weight like other individuals. Furthermore, more critically, they are able to hide the fact that they have bulimia nervosa. If bulimia nervosa goes untreated, it can create critical issues, along with a nutritional downfall. “Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions” (NEDA, 2012).
The cause of bulimia nervosa has not .
Let's Talk About It: Breast Cancer - Our Quality of Life as Long-term Breast ...bkling
Many of us who are 5+ years in our survivorship are still having to navigate through the damage from our toxic treatments and multiple surgeries that impede our quality life. Our guest speaker, Emily M. Beard from Northside Hospital Cancer Institute in Atlanta, GA will discuss things we can actively do as long-term survivors since many of us are at different life stages from our original diagnosis and active treatment days.
Erin McGinty presented at our preferred provider conference on Obsessive Compulsive disorders, Anxiety Disorders, and how they relate to Eating Disorders. She explored the current research regarding these disorders and their co-occurrence with Eating Disorders. She also shared current treatment approaches addressing both eating disorders and OCD spectrum disorders.
The essentials of comprehensive eating disorder treatment presented by Katie Thompson & Erin McGinty. Katie and Erin presented on the goals and objectives when developing a comprehensive treatment plan.
The problem of infertility comes as a shock to people. It is an issue we want nobody to face in real life. Counseling a friend suffering from the issue and recommending the required help is what can be done, in order to share the load.
Is bulimia considered a mental illness Ellern Mede
If you want to get rid of the eating disorder quickly and effectively, you need to get in touch with highly trained eating disorder recovery specialists. They will not only improve your physical health but also help you live a healthy life again. If you want to try self-help version of CBT to treat Bulimia, dedicated therapist can also help you in this.
OBJECTIVES:
If I were starting an adolescent treatment center what would I want to make sure adolescents and families learn?
Identify and Describe How Families Arrive at your door.
To Demonstrate the Power of Family Mapping and the Art and Science of Portraiture.
Clinical and Reverse Interventions - what are these and how to do?
Share Standard Vocabulary Families need to know Family Change Agreements - What are these - when to use?
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
3. Terry Schiavo
Ice Tea
Bulimia
Medical Negligence
1 Million Dollars
Friday, March 13, 2009
4. Major Diagnoses
BED - Binge Eating Disorder
AN - Anorexia Nervosa
BN - Bulimia Nervosa
Friday, March 13, 2009
5. BED - Depression, anxiety, adjustment disorder,
dependency issues.
AN - Obsessive Compulsive Disorder. Family
frustrations and fears, physician’s referral due to
weight loss. Client feels nothing is wrong.
BN - Personality disorder, extreme depression.
Referral from therapist colleague, self-referral. “I
believe you are the only person who can help me!”
Friday, March 13, 2009
10. Binge Eating Disorder
ABANDONMENT
Pleasant & compliant.
Distorted Body Image
Use Eating as Source of
Comfort & Distraction
Friday, March 13, 2009
11. Binge Eating Disorder
Diagnosis - Depression, anxiety, dependency issues & weight issues bring the
client to treatment.
Referral
Nutritionist
Overeaters Anonymous (12 Step group for compulsive eating)
Group therapy addressing BED.
Medications from Primary Care Physician or Psychiatrist
Exercise Classes for Large Bodied People
Friday, March 13, 2009
12. BED Treatment through the lens of
ABANDONMENT
Weight History to identify pertinent themes.
Teach methods of postponing a binge and becoming more aware of feelings.
Encourage engaging in activities of interest that one is putting off until thinner.
Cognitive Behavioral Therapy to challenge distortions.
Trauma therapy.
Process the client’s efforts to be compliant and agreeable with the therapist.
Teach emotional awareness, acceptance, containment and communication.
Give permission to client to experience and express anger.
Friday, March 13, 2009
13. BED Treatment through the lens of
ABANDONMENT
Cognitive Behavioral Therapy to challenge distortions.
Trauma therapy for dissociative symptoms.
Solution Focused Therapy.
Process the client’s efforts to be compliant and agreeable with the therapist.
Challenge compliance gently as a wish to maintain what the client experiences as a
fragile connection.
Teach emotional awareness, acceptance, containment and communication.
Create a predictable safe therapeutic environment while encouraging client to
differentiate, express anger and declare expectations.
Friday, March 13, 2009
14. BED Treatment through the lens of
ABANDONMENT
Teach the use of mirror work to recognize and accept body as it is not as client
imagines it is.
Encourage involvement in exercise.
Encourage forms of bodywork with appropriate practitioners such as massage and
yoga.
Teach the use of the hunger scale.
Teach methods of limiting food, such as choosing small portions of three types of
food and eating them slowly then choosing more.
Doing a food history with foods a person feels is an inevitable binge food.
Friday, March 13, 2009
15. Anorexia
CONTROL
Severe Restricting or Cessation of
Eating
In Therapy Against Their Will
Terrified of Eating and of Gaining
Weight
Distortion Believing They Are Fat
Despite Emaciation
Friday, March 13, 2009
16. ANOREXIA
Diagnosis - client usually comes with suspicion of diagnosis from referring source.
Assemble treatment team.
Nutritionist, IMMEDIATELY!!!!!
Psychiatrist & Primary Care, SOON!
Evaluate for immediate hospitalization in eating disorder unit.
Eating disorder group, if one is available.
Continue evaluating need for hospitalization throughout treatment.
Friday, March 13, 2009
17. AN Treatment through a lens of
CONTROL
Establish rapport using Motivational Interviewing strategies.
Explain relationship between restricting and an effort on client’s part to establish
control over something.
Wonder about what she feels out of control of together.
Weight History to begin the detective work of understanding.
Establish and maintain an aura of acceptance of the symptoms and recognition
that others are freaking out about her eating.
Friday, March 13, 2009
18. AN Treatment - Continued
NEVER pressure her to eat.
Assist her in understanding why others are frightened for her.
Invite family members in for family therapy and extract their commitment to not
pressure her in her presence.
Conduct ongoing family therapy to assist the family in learning appropriate
communication strategies and boundaries.
Friday, March 13, 2009
19. AN Treatment - continued
Needs - help the client to realize it is acceptable to have needs.
Needs - help the client to sort out how to get some of their needs met.
Fear of Being Fat - This fear exists at delusional proportions.
Discuss meanings client has attached to body size.
Explain that angst about life has gotten displaced onto body size.
Cognitively challenge this as a distortion and teach client to do the same.
Friday, March 13, 2009
20. AN Treatment - continued
MOST IMPORTANT
DON’T PANIC!!!!
Working with anorexics is frightening.
The therapist will feel overwhelmed and experience extreme helplessness.
Reach out to knowledgeable colleagues.
Persevere. As you learn to contain your helplessness and hopelessness and
proceed your client will learn to do the same and you will be on your way to
recovery.
Friday, March 13, 2009
21. The devestation of eating disorders.
http://www.youtube.com/watch?v=I6e98OlDclU
Friday, March 13, 2009
22. Bulimia
TRUST
Bingeing & Purging
Inconsistent
Unreliable
Risk of Premature End to Therapy
Loathing of Body, Emotions and
Need for Closeness
Friday, March 13, 2009
23. BULIMIA
Diagnosis - Client will come from other therapists and have seen many therapists.
Client will present as personality disordered, borderline, histrionic or even bipolar.
Referral
Nutritionist.
Medication consult with psychiatrist.
Primary care physician.
Couples therapist.
Possible need for referral to inpatient trauma unit.
Friday, March 13, 2009
24. BN Treatment through a lens of
TRUST
Establish rapport. Remember this person has extreme issues with trust. Do an
extended and careful history of all previous treatments and predict that the client
will have a strong impulse to prematurely terminate this treatment.
Obtain client’s promise to discuss this impulse with you before acting on it.
Explain and educate that bulimia develops when certain individuals are subjected
to extremely untrustworthy people or environments.
Pay careful attention to issues of timing, phone calls, and other contact.
Development of trust is built on therapist acting in predictable ways.
Friday, March 13, 2009
25. BN Treatment continued
Prescribe not bingeing, with permission to binge.
Prescribe not purging, with permission to purge.
Refer to nutritionist and maintain regular contact with the nutritionist to discuss
client progress and compare notes.
Develop an understanding that bingeing and purging are symbolic for how
difficult it is for client to take good things in and keep them.
Friday, March 13, 2009
26. BN Treatment continued
Recognize client’s loathing of her body.
Recognize client’s suspicion about caring.
Weight History to understand weight fluctuations and changes in eating behaviors
along with stresses and betrayals in life.
Encourage physical self care: appropriate exercise, massage, use of lotions, and
safe, nonsexual touch.
Friday, March 13, 2009
27. BN Treatment continued
Teach emotions 101. Dialectical Behavior Therapy is helpful. Clients have been
traumatized by emotions of others and are often fearful of their own emotional
experience.
Trust is the belief in another person’s integrity.
Help client hope that as they integrate they will choose more trustworthy people
to relate with.
Conduct limited family sessions for the purpose of education about the eating
disorder and refer to colleague for more extensive work.
Friday, March 13, 2009