anorexia

Posted by on Sep 17, 2016 in | 0 comments

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  • From ‘disorder’ to political action: conversations that invite collective considerations to individual experiences of women who express concerns about eating and their bodies — Kristina Lainson

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    This article describes an interweaving of narrative practices which has proved helpful for a number of women experiencing concerns about eating and its effects on their bodies. Through the stories of two young women, this paper illustrates how, by inviting collective ideas to individual experiences, and by recognising and naming their own commitments and agentive responses to societal expectations, the women became able to move away from ideas of ‘stuckness’ towards a sense of themselves as influential both in their own lives and possibly in the lives of others similarly concerned.

  • Every Conversation Is an Opportunity: Negotiating Identity in Group Settings— Ali Borden

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    Therapy within the context of a treatment centre can spread and confirm stories of deficit, or it can be an opportunity in which preferences and skills reverberate within a community and enable preferred reputations to be born. In a group setting, every conversation is an opportunity to negotiate meaning, and every group provides a stage for the performance of identity. This paper describes some ways that we at the Eating Disorder Center of California day treatment program guide some of that performance, including how we seek to take apart assumptions about eating problems and recovery, what is relevant to share, and what people have in common. Our intention is to open space for women to share their experiences as rich and complicated; their preferences as diverse, varied, and dynamic; and at the same time encourage points of connection, camaraderie, and community.

  • A Service-user and Therapist Reflect on Context, Difference, and Dialogue in a Therapy for Anorexia— Tracy Craggs and Alex Reed

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    This article was co-authored by the participants in a therapeutic process which occurred within a specialist eating disorders service in a hospital setting. One of us was seeking assistance in their struggle with anorexia, and the other was a therapist working in this field. In addition to our encounters in the therapy process, we share in common a background in research and an orientation towards postmodern research methodologies. We became interested in how this shared research interest might provide an additional resource towards creating new knowledges and change. Through a process of shared inquiry, we sought to explore, from our different positions, the therapeutic process that we were engaged in by attending to the different narratives that shaped our experiences, understandings and actions. In particular, the influence of the clinical context on our respective experiences of the therapeutic process was examined. Some tentative reflections are offered regarding the potentially fruitful inter-relationship between therapy and research activities, and the transformative potential of this kind of shared inquiry.

  • Bringing Narrative Practices to Psychopharmacology— SuEllen Hamkins

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    This paper considers how narrative therapy practices can be brought to the field of psychopharmacology. Specifically, the paper explores how clients’ evaluations of medicine – including negative and positive effects, as well as their preferences for its use – can be brought more to the centre of medicine consultation. The various discourses that surround pharmacology during practice are also considered, including how to proceed when these discourses are in conflict. A discussion of the relevant issues in theory and practice is complemented by two examples from the author’s practice.

  • Narrative Therapy with Boys Struggling with Anorexia— Rudi Kronbichler

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    The work described in this paper took place in Salzburg, Austria, within a psychotherapeutic outpatient department for children, adolescents and their families. It is based on meetings with eight young men and their families over the last couple of years. The young men’s ages ranged from twelve to fifteen and their diagnoses were that of ‘anorexia’. This paper discusses the growing incidence of anorexia amongst young men and boys and proposes narrative ways of working that have been experienced as helpful and effective.

  • The Interplay of Substance Misuse and Disordered Eating Practices in the Lives of Young Women— Christine Dennstedt

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    Many young women struggle with problems of substance misuse and disordered eating practices. However, programs and ways of working when both issues are present are not common. This article explores the similarities and interplays of substance misuse and disordered eating, drawing on interviews with young women, and discusses some implications for therapy and residential programs.

  • Narrative Therapy, ‘Eating Disorders’, and Assessment: Exploring Constraints, Dilemmas, and Opportunities— Mim Weber

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    This paper is a work in progress. It is an exploration of the usefulness of an eating disorders assessment and referral service to the people who consult it; and whether such a service can avoid practices which could be experienced as reinforcing of the eating disorder, pathologising, or blaming. It also looks at the possibility of working with narrative therapy ideas in an environment which does not necessarily subscribe to those ideas.

1,972 Comments

  1. Listening to Tileah I was provoked to contemplate my own use of language when working with clients. I enjoy the narrative model of practice and I am aware that for some there is definitely stigma attached to the process of counselling or therapy. I have only had one experience of working with an Indigenous person as a client and I will be sure to look at my use of language. I like the idea of it just being a yarn, it takes the pressure and onus off of the client to do something.

  2. Hello:

    This is Andrea from Toronto.

    I found particularly helpful the discussion in the FAQ around the use of metaphors of conflict and combat. I expect to be working in healthcare settings with critically ill patients and their loved ones (mostly children and parents), and I anticipate hearing them use these kinds of combative metaphors during our conversations. I also anticipate meeting many people who are mentally, emotionally, and physically exhausted from “fighting” these problems. I appreciated the comments in the FAQ about combative metaphors, and the suggestions around exploring other kinds of metaphors which may be less conflict-laden and draining on their emotional resources. Thanks again for making this material available!

  3. I have started to use collaboration with clients when I am asked to write a report. I ask clients what they see as the areas of change and challenge of which they want others to be aware. I also at times share my report with the client first to be sure it accurately reflects their experience. In this way they are both acknowledging their ongoing journey and being acknowledged for the work they have done.

  4. Mike here, in London. I too was interested in “We were unwittingly adjusting people to poverty or other forms of injustice by addressing their symptoms, without affecting broader social and structural change.” It’s a really difficult question. I was involved for about 10 years in working with people suffering from homelessness. Sue Mann’s story really rang true for me. One thing I was involved in was a choir for marginalised people, literally helping them find their voices. That, I felt, was useful, and collaborative. But I have always been suspicious of things like distributing left-over sandwiches to people sleeping rough on the street, as if that made it OK for them to be there as long as we give them some stale sandwiches. Or giving them tents or sleeping bags. What message does it send? Even though it may be well-meaning.

  5. Hi, I’m Mike. I work as a couples counsellor in London, England. My main training was 50% psychodynamic and 50% systemic. Narrative work was touched on briefly, for one module, and I am looking forward to learning more. Couples certainly do bring stories, often rather thin stories. “My partner is selfish.” Or “My partner had an affair”. Full stop. That’s all there is to know. Even in happy couples, people seem to get shaped into rather thin roles: this partner is the one who’s good with people, that partner is the one who’s good with money, this one cooks, that one drives. If the relationship ends, they may discover, actually *I* also can drive, cook, manage my money, make friends, I am a complete person.

  6. I think it will be an important part of my practice to investigate with clients which elements of our systems (social, cultural, political, economic) that are contributing to or mitigating their problems and suffering. I was particularly struck by the following sentence from the Just Therapy article: “We were unwittingly adjusting people to poverty or other forms of injustice by addressing their symptoms, without affecting broader social and structural change.” I think it is incumbent upon those of us in helping professions to work with the people we are helping to begin addressing the systemic issues that are contributing to (or creating) their problems. Otherwise, we may fall into this trap of “adjusting people to injustice.”

  7. Hello! My name is Andrea and I am a Masters student in a spiritual care program located in Toronto.

    After reviewing this chapter, I’m reflecting upon the question that was raised: “how do we respond to grief when that grief has been caused by injustice?” and thinking about it in the context of working with seriously ill children and their families in a hospital/hospice setting. Patients and families in that setting also face grief that has been caused by injustice (in the form of incurable illness), and I see how the narrative metaphor can be used to help those families begin to reclaim their own lives in the face of tremendous loss caused by uncontrollable circumstances. I can see how the Articles of the Narrative Therapy Charter of Story-Telling Rights would be tremendously helpful when working with patients and families as a framework for telling and receiving their stories about their lives and their problems.

    For me, the material in this chapter also raises the question of how we can help to facilitate healing in a world where systems are seemingly becoming more unjust and creating deep suffering. My initial thought is that we continue to listen to each other’s stories with deep compassion, and the teachings of this course will help to provide us with new ideas and skills on how to do this.

  8. Chimamanda Adichie’s TED talk was incredible. The one line where she said “a single story creates a stereotype. And the problem with stereotypes is not that they are untrue but that they are incomplete”. This blew my mind. I am ashamed to have ever participated in the single story belief of anyone let alone whole cultures, communities and countries , continents and so on. I know that moving forward I will endeavour to hear more stories and to encourage others to tell their story. I am about to run a photovoice narrative project to do just this, give a whole community the opportunity to change their stereotype.

  9. “Narrative therapy doesn’t believe in a ‘whole self’ which needs to be integrated but rather that our identities are made up of many stories, and that these stories are constantly changing.”

    I like this, I find it very compatible with my beliefs as a Buddhist. In Buddhism, as I understand it, mistaken beliefs about a solid, fixed “self” are the source of our suffering.

    I work with couples using EFT for couples, and in that approach, there is a big emphasis on externalising the problem as “the cycle that you get trapped in”, and encouraging couples to come up with their own name for it.

  10. Thank you for this. I am a counsellor, and trying to make as much as possible of my notes “in quotes”, that is, writing down things that the clients said. And not my own opinions.

  11. hello

    I the ED of a Friendship Center in Terrace, BC where were mostly target the indigenous population in our city of 12,000. I found your video interesting and something that we may want to try. Havee you been able to to do any follow ups studies to gage the long term effect of your program?

    Regards

    Cal Albright
    ED
    Kermode Friendship Center
    http://www.keremodefriendship.ca
    Terrace, BC
    Canada

    • Hi Cal, thanks for the interest. At this point the only followup has been through conversations with with people who return to volunteer on additional walks or engage with our other programs.

      However, a group of fourth year medical students at a local university have offered to run a pre and post measured study / report in 2020 as part of their studies which should be interesting.

      Let me know if you would like more information.

      CD

  12. Thank you for this overview of Narrative Therapy. I am returning to practice after some time away, and these reminders are timely and appreciated.

  13. Hi Chris

    I really enjoyed watching your video about Narrative Walks. My project is based in Blaenau Gwent, in South Wales, Uk. I’m wondering whether I might use such an approach in my work with our Youth Service, who support young people between the ages of 11 and 25. Have you any thoughts on this? Are there any resources available, either free or to purchase?

    Best wishes

    Paul

    • Hi Paul, m

      Much of my early attempts of the program were with the 15-20 year old age bracket and I found it worked really well. When I recently had an opportunity to run the program again with this age bracket – I extended the finish time so that could spend more time at the stop points and have a fire at the last resting place to talk about our intentions after the walk. This meant that we used head torches for the 2km which added a bit of a sense of theatre to the day. It was pretty cool.

      If you email me on hello@embarkpsych.com I can send you the manual. Or ask any other questions via this page so others might share in the answers.

      CD

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