General Medical Guidelines for Eating Disorder Treatment

The following general rules are the underlying basis of our experience and structural interventions are based.

• Hide Family System

It is important, if possible, to take families in treatment, but the family is far much dysfunction and unhealthiness. It is important to find resources within the family to meet the needs of the patient. It is important to help the patient to emotional relationships within the family, to increase empathy and sympathy for the family, and to help the patient individuate from the family in a healthy way that family ties remain intact.

• Be Directive and Specific

It is important for the therapist to take more responsibility to be active in treatment, to create energy in the meetings, and direct the process in ways that help the patient, who has less experience to draw on and whose life style has be more externalized, approval and peer acceptance-based, rather than mounted in a self-definition and within the law.

• Use activity-based Sessions

It is good to use more activity-based sessions and fewer “only talk” session with the treatment of patients eating disorder. Activities based sessions provide an opportunity for the therapist to participate in patient their world, where many eating disorder patients spend much time externa virtualization as their approach to life – seemingly constant search for external approval. This project-based approach is especially important for teenagers who have difficulty learning from the experience of others and seems focused on creating and learn from their own experience only. Experience interventions teach lessons that are more easily internalized, and set the stage for later learning from the insights and experience of others.

• construction of treatment

invisible and unguided treatment can create more confusion and insecurity in patients with eating disorders. It is useful to give the patient information about the process of treatment and process changes. It is useful to predict the struggle and help them to see the ups and downs of recovery and to prepare for these times. Tell the patient what is going to happen, a series of events, why you’re doing what you’re doing, what they can expect, and the changes that they will go through. This increases their trust in your understanding of the ability to help them.

• provide immediate encouragement and support

of hope to defeat this terrible disease, movement of recovery is minimal at best. It is the therapist’s job to try to provide, create and nurture hope in the patient. Tell the patient about your vision of the future, because they often can not see this for themselves. Remind them that their illness can be temporary and that their feelings of hopelessness create are temporary. Point progress and performance. Help them find and mark improvements as such, no matter how small they are. Help them to set short-term, sometimes very short-term goals, and help them find evidence of progress. Teach the concept and value of small steps of change, and help them to see the progress in the special moments along the way. Help them to see not only what they are doing differently, but the internal processes taking place within them as well.

• See the difference between love and approval against approval

Those who have eating disorders so often learned to sincerely believe that “approval and disapproval of all, end all.” They often have minimized and compartmentalized in one or two clear part of themselves – their bodies and external performance. It is important to focus on what they do and who they are, are not the same. Acceptance “all herself,” take the focus off what other people think, and help them to turn to the inside to find values ​​are important themes. Help them find the language and signs and help them understand the difference between love, recognition and acceptance can help them to take these different experiences.

• Focus have feelings without self-judgment

help patients feel, logo, understand, accept, and express their own feelings without making emotional judgments about who they are and what kind of person they are is important to create an environment of self-acceptance for themselves. Many people with eating disorders are the merciful, willing and vulnerable people who have “shut down” and become numb and personality shift, allowing their emotions to lead to secondary and, consequently, guilt, shame, selfishness, or “evil.” Helping patients to expand their ability to notice and experience the feelings without self-judgment is critical of the treatment process.

• Make Honesty and consistency of persistent theme

help patients become honest and congruent without self-criticism is necessary for recovery. Stress the need to stop all the pretending, hiding, or lying, and emphasize the need for a genuine and open with themselves and others. Honesty and openness in the therapeutic relationship is by building trust and creating security in connection with helping the patient to understand the expectations of integrity. This honestly does help them reveal secrets so that they can process thoughts and feelings out loud, start to allow help from others in overcoming shame, and break the cycle childlike “hiding under a blanket of shame.” Secrets to say may be past trauma and abuse from long ag: there may be mistakes made, thoughts or feelings that seem the unthinkable and unforgivable, as well as tell the whole truth about their eating disorder. Telling secrets helps to be “grown up” instead of feeling fear “a little”, and “sweeping out all corners” in a private stash misery can bring relief and peace.

• teach patients to avoid only one-get

Eating disorders are disorders of reach. Help patients learn about access, many of her face, damaging consequences, seductive yet ephemeral rewards and its relationship to eating disorders and other addictive patterns. Help clients understand their fears, unhealthy react to fear, and the need to “feel the fear and do it anyway”. Discuss with the patient the fear of failure and all-too-common pattern of flaws, beware. Patients challenges and encourage them to take risks and to deal with their pain. Teach and help them experience vulnerability healthy precursor growth within himself and emotional intimacy in relationships.

• constantly Show Nurturance, Kindness and Caring

Those who suffer from eating disorders usually have had the absence of nurturing and care, at least during the eating disorder, where they have reduced it to primary relationships, and where they feel most unworthy of love and it is difficult “to let her in. ” Some lack nurturance lifetime and have actively resisted concern to them because they have considered himself undeserving of it. It can help to make this pattern clear by pointing out the reality of care, love, compassion and acceptance within relationships and help them to see that it is available to them in life-not their only from the perspective of the therapist’s point of view, but from many others who love them as well. As they learn to take it, mark it, and are encouraged to get to it, they prepare to take back and nurture relationships with other important for the social and family circle.

• Do unhealthy behaviors and relationship Patterns Explicit

As the pattern of dishonesty, manipulation, pushing others away, justification for unhealthy choices, patterns of helplessness and powerlessness and assessment and behavioral rituals meet the recommended connection with the report or observation, making the issue of treatment. This can be done by pointing it out, meaning it for what it really is, dismantling justify negative pattern, having them look at the negative impact on the board, and help them to reflect and then split to choose “new ways” to live. The self-deception, justification and rationalization of eating disorders based strong wall that needs to be addressed directly and carefully apart.

• Help patients to abandon their Disorder

the later stages of an eating disorder, it becomes identity of the patient. They begin to feel and live in accordance with the perception – that they are eating disorder them. This self-definition brings with it fear, disgust, self-contempt, helplessness, withdrawal and feelings of guilt. In the later stages of the disease, the patient truly miss some conscious control over their behavior and choices. They need help to understand that much of their behavior is due to the illness of an eating disorder, and it is not the result of personal failure or faulty willpower. Again, the theme here is, “you are not your illness and you are not implied in your behavior, thoughts or feelings.” As they begin to see their illness related to well-intended yet independent harmful coping strategies, and begin to understand and even sympathize painful journey of eating disorders, they can feel a sense of hope and self-empowerment in their lives. They can expected increase in personal responsibility for their choices and have the power to change the negative selection.

• Help patients actively use Spirituality their recovery

help patients use their own sense of spirituality or religiosity, or both, the recovery can be very useful for many customers. In the first meetings of food and during treatment, it is important that the patient should teach spiritual therapist and their faith. It is then for the good therapist to help the client live congruently with the inspections, and to help them to actively use their beliefs in the healing process, including their belief in a higher power, God, or divine influence. There is no more powerful faith, hope, love, service, the purpose and other principles that are spiritual in nature. Research has shown the value of spirituality in recovery, and ignorance of such neglect is a powerful healing resource. Caution must be used to allow patients to lead this process and to help customers to use their own framework of values ​​without imposing faith therapist on the patient. Respect is the key.

experience, knowledge and structural interventions

The following interventions will provide you with a few examples of how to incorporate the experience and structured process in relation to the group, family and individual therapy. This intervention can generate emotional energy, verbal processes and reactions and behavioral reenactments that can be very useful in the ongoing treatment of the patient and recovery.

Group Therapy

• Hiding behind a wall

This group activities can be done with a few members of the group within the larger group round or it can be done by having each group within the room. Facilitator can bring in large pieces of 3’x4 ‘cardboard or large pillow pad to use as props – figurative wall. Group members are asked to break up the dyad and sit before a spouse with one worker dyad holding cardboard or pillows in front of them the protective and self hiding fashion. However, they are asked to honestly tell their partner why they are hiding what they are hiding, what they do not want other people to see why they are afraid to show real selves, what they are trying to protect themselves from, why they put on the wall in the first place, so their partner can ask clarifying questions and give feedback on how it is to be on the outside of the wall. Facilitator can process the experience, observations and feelings during the project as a whole group. Sometimes, the instructor can have individual members of the group create the first scenes relationships with family and friends in front of the group, where they interact while hiding behind a wall. Participants are then asked to return to the dyad and explore ways to put down or keep the wall down while showing up honestly to their partners. Specific questions can be asked again to facilitate personal sharing without the wall.

• handling negative note

In small groups of three people, each patient is struggling with a strong negative voices in their minds is served in the middle triad. When cued, start the other two members to speak in the opposite ears of the patient in focus. One voice is the “negative side” or the negative mind and the voice of the “positive side” or confirm mind. The patient in focus is given the opportunity to listen and experience an intense internal conflict that comes with conflicted voices, and to express their feelings, explore the power and capacity to silence negative mind, and embrace the message in a positive attitude. The group can process impact messages, listening and the power of choice in recovery.

• sculpture Group About Commitment

One well on the road to recovery and with some leadership responsibility and the ability of the group is asked to make a sculpture of a group around a central focal point in the room, and the customer sculpts each member of the group in close proximity to the central focal point based on their perception of the commitment of each person to “change” and wants to give up eating disorders and related self-destructive behavior and attitude. It is a great structure and experiential way to give feedback and allow for self-studies and “looking into emotional mirror”. Each group member is invited to respond by sharing feelings and feedback about where they were placed in the sculpture and is also given the opportunity to put themselves in the place they think is accurate to their commitment to change.

• Let’s see what is most important to you

The team members are asked to bring in a group of a few items from their homes or rooms that represent or symbolize what is most important in their lives. Each member puts the items in front of them that all group members sit in a circle on the floor. Each member, one by one, says the group on the issues, their symbolism or what they represent and shares the feelings associated with each object. After this share, each participant is asked to turn his back on these treasures by turning around and facing the outside of the group and by the turn of the inner circle where these important points are set. The group is asked to process their feelings of loss, hurt, anger and fear about the loss of these important things in their lives, and to talk about how eating disorder them is something that turns them away, or take them out of the is most important to them. Functionality can also discuss the commitment and congruence or incongruence between stated his message “What is important” and incongruent behavior. Treatment discussions may also consider grieve the loss and make promising plans for the future.

• What Is Line mean for you

therapist uses masking tape to make a 10-foot line in the center of the group room floor. Individually, each member of the group is asked to stand up to the line, one by one, and they are asked what the line means to them. The line can have many different meanings and can open up discussions about the emotional boundaries, take risks, to take a stand, stay back, take a leap of faith, open to others, etc with the therapist and the group members give feedback and reaction to individual line can also open therapeutic interactions can lead to play a positive movement in relation to the line.

Family Therapy

• Blind walk through a mine field

A large room is ready with the obstacle course books, chairs, and other obstacles strewn randomly further good rates. The patient is brought into the room blindfolded and family is also brought into the room. The family is asked to take selected locations around the outside edges of the room. The patient is placed on one end of the room with instructions to find their way to the other side of the room without touching any object on the floor with any part of her body. She further said that any touch object will result in the beginning of it over the original site and the activities will take as long as necessary, up to four hours. The family is said to help her over with only words and they are instructed to stay in their outside obstacle course. As a patient and family go through this experience, issues arise including frustration, anger, helplessness, confidence, control, handle style, help style, leadership and the role of the family. A patient can be guided to discuss what it is like browsing through a recovery, and the family can talk about their wishes to help, their feelings of powerlessness and their style or methods to support and whether they are useful or not useful to the patient .

• Stacking books: ownership, responsibility and Barriers

The treatment of family issues personal responsibility for eating disorders as well as other issues and emotions, such as marital happiness, individual happiness and a choice of health and wellness may arise. In this intervention treatment is done around the table. A large stack of books five feet tall on the table. Therapist or family members can replace books based on the responsibilities of the various components of the family and given a stack of related to the size of each family member. Stacks of books can also be used as a symbol of the obstacles in communication, where sometimes family members can not see each other obstructions. Emotion of obstacles and responsibility, or barriers to each other in an objective form and experience these things not only emotionally, but physically as well, coming up.

Individual Therapy

• Carrying the Burden

It may be useful to help the patient experience what it’s like physically carry a heavy burden to help them get in touch with deeper feelings about the implementation inside burdens. The burden could be eating disorders, their guilt for some action in the past, shame, self-hatred, or responsible for someone else’s life or happiness. The customer may be stone, boxes or other heavy or awkward object, and asked to carry it with her wherever she goes in the next few days or weeks. Motivation to notice effects of interference from stress in her life and to speak honestly about what she is learning and feeling the way is very important (load items can not be so heavy that it could cause physical harm by carrying it).

• Wearing Sign Making Implicit Explicit

As themes emerge in the treatment of the core message the patient may “send out” in their relationships with others, which either push the other off or prevent it from allowing the love and support in her life, these and other messages can to put on a big map and worn by the patient façade with a prominent place (ie worn as a necklace). Processing therapy sessions can focus around the message, what she really wants to say, direct communication, the reaction of others to clear the message, new ways to meet the needs of a healthy way and her wishes to change. As she becomes acutely aware of the messages and “gets tired” to give the same old message, she can begin to replace it with a new positive message. Val use the signal can then be done to help change the inside message to clear positive or confirmed messages it wears off in a few days.

Conclusion

We make use 40-50 different structured and experiential interventions to help eating disorder patients understand, experience and reinterpret different factors that promote disease. For the sake of brevity, we have only mentioned a few of these interventions in this article. We recognize and appreciate the need for different therapeutic styles and strategies, and the need for a comprehensive and multidisciplinary program of treatment of eating disorders. What we have also discovered that physical therapists over many years of working with patients eating disorder, is the power and impact realistic and structured interventions to one aspect of their treatment. These interventions often by-pass a special analytical or emotional ways avoidance defense patients, giving them a “new look” or “emotional vision” to their problems, as well, “taste” of new solutions may be available for those in recovery.