In and out of anorexia : the story of the client, the therapist, and the process of recovery

Interleaving the stories of therapist and client, this is a positive and helpful book for people with anorexia and those who care for them. Ayelet describes her experiences of this life-threatening illness, her repeated hospitalizations and eventual successful recovery, and includes examples of drawing and writing made when she was ill. Tammie, her therapist, outlines the progress of the cognitive constructivist therapy and the rationale behind her decisions and treatment considerations. Also included are an overview of current research into anorexia and its treatment and a glossary of key terms that make this book a comprehensive as well as inspiring resource. Doody Review Services Reviewer: Gina M. Caputo, MA, LCPC(Cermak Health Services) Description: This book uses a different approach to explore the disorder anorexia and its treatment. The client tells her story as she knows it, and the therapist hers. Literature summation is presented at the end of the book, including illustrations by the client, a glossary and references. Purpose: The client initially wanted to tell her story in order to achieve closure and the therapist believed the process could be beneficial. The process itself, however, resulted in much more than a book and the insights gained by both client and therapist were much more than they anticipated. Objectives included providing an approach to anorexia from two different points of view and life after anorexia. The objectives are noble and accomplished. Audience: It is hoped that this book proves helpful to mental health professionals, hospital staff, private clinicians, school counselors, and pediatricians as well as young women suffering from similar problems, their parents, and other family members. The book is very easy to read and honest. The author is very credible since she is the therapist and her background and experience in child clinical studies is appropriate. Features: The book is covers three areas. Parts I and III portray the client's own story of her life, illness, and therapy; Part II is the therapist's account of the treatment; and Parts IV, V, and VI contain a summary of current literature, the therapist's approach, and guidelines for other clinicians. There are illustrations by the client throughout the book and a glossary. Assessment: The book is very useful due mainly to its unique presentation. So often clinicians fall prey to the therapeutic rut. This book reminds us of the client's experience and also gives a "happy ending" after a long and arduous trek through therapy for client and author. Laypersons will find this book easy to read and understand. I have quite a collection of books on eating disorders and this is a welcome addition. In and Out of Anorexia......Page 4 Contents......Page 6 List of Illustrations......Page 9 Dedication......Page 10 Acknowledgement......Page 11 Prologue Before We Begin: An Overview......Page 12 I. Ayelet’s Story: On Becoming Anorexic......Page 20 1. Introduction: Was I Ever a Normal Child?......Page 22 2. Childhood: Exploring the Roots of My Anorexia......Page 27 3. Between Me and Myself and My Social Relationships: Finding Creative Expression for My Loneliness......Page 42 4. The Stage is Set: From Healthy Child to Anorexic......Page 55 5. Flowing with the River: Learning to Act Anorexic......Page 57 6. Receiving the Diagnosis: Yes, I Am an Anorexic; My First Experience in a Psychiatric Hospital......Page 73 7. My First Hospitalization (Second Hospital), Or: Who is Stronger – The Illness or Me?......Page 83 8. Is There Anyone Who Can Help Me?......Page 87 9. Meeting the Big Black Hole: My First Attempt to Commit Suicide (Third Hospital)......Page 90 10. In the Cuckoo’s Nest: Behind Closed Doors......Page 104 11. Fifth Hospital: Will I Ever Be Normal?......Page 111 II. The Therapist’s Story: The Challenge of Treating Ayelet......Page 132 1. Getting Acquainted......Page 134 2. Family History......Page 137 3. Collecting an Inventory of Ayelet’s Problems and Establishing an Initial Treatment Contract......Page 143 4. Rationale for the Decision to Treat Ayelet Using Multi-Targeted Cognitive-Constructivist Therapy......Page 148 5. Specifying Target Behaviors and Measuring Baseline Functioning......Page 150 6. Family Intervention......Page 154 7. Parent Counseling......Page 157 8. Beginning Individual Therapy with Ayelet......Page 159 9. The First Problem Area: Treating Her Obsessive-Compulsive Disorder (OCD)......Page 161 10. Treating Her Anxieties and Fears......Page 164 11. Urging Ayelet to Start Studying......Page 167 12. Social Skills Training......Page 170 13. Starting the Journey toward Self-Acceptance......Page 172 14. Incorporating Ayelet’s Creativity Imagination and Talent......Page 180 15. Couple Therapy......Page 182 16. Interim Summary......Page 184 III. Ayelet’s Story: Life after Anorexia......Page 186 1. Feedback......Page 188 2. And What Now? And What Next?......Page 190 IV. Literature Review......Page 198 1. The Anorexia Disorder......Page 200 2. Treatment of Anorexia......Page 203 3. Cognitive-Constructivist Intervention......Page 211 4. Self-Control Therapy with Children and Adolescents......Page 221 V. Guidelines for Therapists: Cognitive Creative Intervention with Anorexic Clients......Page 226 1. Making Decisions about the Need for Therapy......Page 228 2. Making Decisions about the Appropriate Setting(s) for Change......Page 233 3. Treatment Considerations and Adaptations......Page 235 4. Applying Constructivist Creative Intervention......Page 240 5. Focusing on the Therapeutic Relationship......Page 242 6. Incorporating Emotional Processes into Cognitive-Behavioral Therapy......Page 244 7. Challenging Clients to Open Up to New Experiences......Page 247 8. Designing the Process of Intervention......Page 250 9. Applying the Self-Control Model for Change......Page 255 10. Fostering Maintenance and Generalization......Page 258 11. And Last But Not Least......Page 260 VI. Closing Remarks......Page 262 Glossary......Page 267 References......Page 274 Subject Index......Page 281 Author Index......Page 287 Ayelet spent six years of her adolescence in and out of hospital, having been diagnosed as suffering from a severe anorexia disorder. She is now a special needs teacher. In the first part of this book Ayelet describes her personal experiences of the illness, the repeated hospitalisations and her ultimate recovery, illustrated with examples of her drawing and writing from when she was ill.Tammie Ronen, her therapist, outlines the step-by-step progress of the therapy from the professional angle, describing in detail the decision-making and treatment considerations specific to Ayelet's life and context. She also includes comprehensive overviews of contemporary research into anorexia and of cognitive constructivist methods.This interweaving of theory, practice and personal experience offers the reader unique insight into the reality of the illness and demonstrates the effectiveness of integrative and creative methods, and the central importance of a good relationship between the client and the therapist. The book is a rich source of inspiration and guidance for therapists and other professionals, as well as for people with eating disorders and their families. People who knew me as a child, as well as those who met me later on, throughout my years at university or as I started working as a teacher, keep wondering: Could it be true?