For Professionals

Especially for Parents

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

Kudos to Marion Bartoli & Father

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

It's Back to School Time!

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