Effective Treatment of Anorexia Nervosa: The Recovered Patient's View (original) (raw)

1985, Transactional Analysis Journal

The existing outcome research on the efficacy of treatment of anorexia nervosa yields minimal insight regarding the nature of the recovery process and the quality of life pursuant to recovery. A primary problem is the omission of direct inquiry of recovered patients. This study, utilizing intensive interviewing of 25 recovered anorexics, finds that few who received formal treatment believe it was essential to their recovery. Many experience the therapeutic experience as duplicating the dynamics and problems leading to the illness. Citing insufficient attention to eating behavior, body image, and family dynamics, the interviews alsoreveal that factors essential to a therapeutic relationship are more often found in relationships outside of treatment. Recovery occurs over time as the anorexic accepts and adapts to the problems in the systems around her and in turn accepts herself. Findings validate the need for an existential, systems-oriented approach in the treatment of anorexic patients. Recovery from anorexia nervosa, a complex biopsychosocial disorder characterized by lifethreatening deficits in interoceptive awareness, necessitates dramatic changes in selfawareness, cognition, and perception. Because this disorder may lead to death or to severe physical sequelae, treatment is often multimodal, with many interventions (medical, psychotherapeutic, nutritional, behavioral), initiated at the same time. Smith, Glass, and Miller (1980) point out that delaying treatment or utilizing controlled comparative studies of treatment effects is inconceivable and unethical. Thus, assessment of the value of various treatment effects is difficult as combinations of factors inside and outside of treatment may be 48