Friday, March 26, 2010

NEDA Young Investigator Grants

Young Investigator Grants
The National Eating Disorders Association is announcing the opening of our Young Investigator Research Grants Program for 2010. The Call for Submission process will begin Friday, March 26, 2010.

Submissions are due April 21st, 2010.
 

General Information
The National Eating Disorders Association (NEDA) is pleased to sponsor this small grants program to support research in the areas of eating disorders etiology, prevention and treatment. Through the grants, the organization seeks to expand innovative eating disorders research while supporting investigators in the early stages of their careers in the eating disorders field.

Requirements
Any junior investigator worldwide who works in the field of eating disorders and has completed their terminal graduate level degree and training is eligible. Trainees (e.g. students, grad students, residents) are not eligible and investigators must be within seven years following the end of their training. Individuals who previously served or currently serve as a principal investigator on a substantial externally funded grant (e.g. RO1, RO3, or K award in the U.S.) are ineligible. 

Terms of Support
There are three research grants available for 2010 totaling $30,000.
    • Three (3) NEDA Young Investigator Grant in the amount of $10,000 each
For more information about research grants, please visit our website.

If you have any questions, please send them to research@myneda.org.

Best Wishes,
Laurie Vanderboom
NEDA
Director of Programs
James Mitchell, MD, NEDA Research Committee Chair
UND School of Medicine and Health Sciences

NYT: Ask the Expert: Is it Anorexia, or Body Dysmorphic Disorder?

Dr. Katharine A. Phillips, a professor of psychiatry at Brown Medical School, is perhaps the best known authority on Body Dysmorphic Disorder (B.D.D.) and the author, most recently, of “Understanding Body Dysmorphic Disorder: An Essential Guide” (Oxford University Press, 2009).  Dr. Phillips answers reader questions at the New York Times in this week's Ask the Expert column. 

Q:  Hello Dr. Phillips, thanks for answering questions. Could you clarify the distinction between body dysmorphic disorder and the severe distortion of weight and shape experienced in eating disorders?



I had severe anorexia for years but worked very hard toward recovery. I have seen a psychologist weekly for the past six years, and in that time, I’ve gone from a 15.7 B.M.I. to about a 22.3.


The thing is, although my eating behaviors and weight have changed and I’m now able to live an energetic life that I truly am able to value at this point, I still wake up every day horrified by the hugeness of my “normal”-sized body. I avoid mirrors, malls, shopping, magazines, tight clothes and even touching or looking down at my body (as much as possible) to avoid triggering feelings of complete revulsion and self-hatred that often lead to self-harming.

It’s actually more of a relief to try to believe that I am crazy (as my friends kindly remind me) than to face the “fact” of the body I see and feel. Needless to say, my body shame (over my bone structure, shape, everything) is a huge hindrance to intimacy and a social life. It seems as if B.D.D. is, like eating disorders, genetically and physiologically embedded. So what is the distinction between eating disorders and B.D.D.?

I also wanted to ask this question because the following comment in the New York Times article accompanying the blog post really bothered me. Jane Brody writes:
                "One presumed factor — societal emphasis on looks — is far less important than you
                  might think. Dr. Phillips said the incidence of B.D.D. was nearly the same all over the
                 world, regardless of cultural influences. Also, unlike eating disorders, which mainly
                 affect women seeking supermodel thinness, nearly as many men as women have body
                 dysmorphic disorder."


Point taken — the demographics for B.D.D. are indeed more evenly distributed across gender lines than those for eating disorders (although eating disorders are found in both males and females of all ages and all cultural and environmental backgrounds, it’s still true that women vastly outnumber men with these diseases). But the statement that eating disorders affect women “seeking supermodel thinness” is just plain ignorant, and suggests that people get eating disorders through a kind of vain willfulness. I’m sure this sentiment is found in your work as well. So how do you convince people who don’t know anything about B.D.D. that it’s not just a condition prompted by vanity and narcissism?

A: Dr. Katharine Phillips responds:
Thank you for your question about the distinction between body dysmorphic disorder and eating disorders -– this is a common question.

These disorders do have some overlapping features. Both involve dissatisfaction with one’s appearance and distorted body image. In fact, studies have found that people with B.D.D. and those with eating disorders have equally severe body image preoccupation, dissatisfaction and distress. And some people with B.D.D. are distressed by their weight or the belief that some parts of their body, such as their stomach or hips, are too fat, and they may diet or exercise excessively.

But there are some important differences between B.D.D. and eating disorders. Most people with B.D.D. aren’t preoccupied with their weight -– rather, they most commonly focus on their skin (such things as perceived acne, scarring or skin color), hair (for example, a belief that they’re losing their hair or have too much body hair), or nose. In fact, they can dislike any part of their body, thinking it looks ugly or abnormal, even though it looks normal to others. And B.D.D. doesn’t involve behaviors like binging on food or inducing vomiting to lose weight.

Another difference, as you noted, is that B.D.D. appears to affect nearly as many men as women, whereas most people with an eating disorder are female. There are also some differences in effective treatment approaches. Research studies that have directly compared people with B.D.D. to people with an eating disorder have found, among other things, that those with eating disorders have more psychological symptoms on a scale called the Brief Symptom Inventory, whereas those with B.D.D. have more negative self-evaluations and lower feelings of self-worth because of appearance concerns, more avoidance of activities because of self-consciousness about appearance, and worse functioning and quality of life because of appearance concerns.

Indeed, B.D.D. usually has very negative effects on people’s daily functioning and quality of life. Some people are unable to work, go to school, socialize or have relationships because of their B.D.D.

This brings me to your last question -– B.D.D. is definitely not a condition prompted by vanity and narcissism. It is a serious, and usually treatable, disorder. Typically, people with B.D.D. suffer tremendously, and those with more severe B.D.D. find that their lives are devastated by their symptoms. Some even commit suicide. This brings home what a serious disorder B.D.D. is. The good news is that most people get better with the right treatmennt. 

Wednesday, March 24, 2010

Consumerist: How To Find Affordable Therapy

*Note:  I edited the orginal article to post here to remove some unnecessary lines.  See the whole article at the link above*

The problem is that therapy sounds expensive, but there are actually affordable options out there if you know where to look. Here are some tips.

Look for a training institute.

If you live in a large city, there's a good chance there's some sort of training institution in your area. It's where you'll find post-graduate therapists getting real-world experience before opening up their own practices, and the fees will be a lot lower than what you'll find in a private practice. Many institutes will offer a sliding-scale fee structure and work with people who don't have insurance.

To find these places, do a Google search in your city for the phrases "pyschoanalytic institute," "psychoanalysis institute," or "psychotherapy institute."

Check with the local university.

If there's a school with a psychology department in your town, there's a chance they offer a sliding-scale fee structure for therapy to the student body, or sometimes to the community at large.

Call private therapists in your town and ask for advice.

Some therapists reserve a couple of slots in their patient roster for people who can't afford their normal rates, so it's worth asking directly if you can pay less. Even if the therapist says no, he or she might be able to refer you to someone who you can afford.

Check whether your insurance covers mental health treatments.

Many policies do, although usually they stipulate a specific duration for the treatment (n number of sessions and that's it!). If there's a specific issue or crisis dragging you down, a shorter-term engagement may be enough to help get you back to a productive state again.

Check whether your workplace has an "Employee Assistance Program."

Our commenter speedwell, avatar of snark points out below that your employer might foot the bill for some visits to a therapist: "I went to an excellent therapist who straightened me out and got me functioning in just six sessions. For 'acute' issues, that's often just right, and may work for some 'chronic' depressions and anxieties too."

Don't feel you have to settle for the first person you talk to. There's no predicting how well your personalities will match up, and if it doesn't feel like you can trust or open up to the therapist, it's perfectly okay to try someone else.

It's okay to ask the therapist if he or she is in therapy. Some won't answer because that's not how they roll when it comes to the patient-therapist relationship, but it's not offensive or inappropriate to ask. You may feel more comfortable with a therapist who is also exploring what makes him or her tick.

Tuesday, March 23, 2010

NYT: When Your Looks Take Over Your Life

"Is there a part of you that you hate to look at and perhaps try to hide from others? Do you glance at your image in distress whenever you pass a reflective surface?


"Many of us are embarrassed by or dissatisfied with some body part or other. I recall that from about age 11 through my early teens I sat in class with my hand over what I thought was an ugly bump on my nose. And I know a young woman of normal weight who refuses to sit down in a subway car because she thinks it makes her thighs look huge.

"But what if such self-consciousness about a perceived facial or body defect becomes all consuming, an obsession or paranoia that keeps the person from focusing on school or work, pursuing normal social activities, even leaving the house to shop or see a doctor? What if it leads to attempted suicide?

"Such are the challenges facing tens of thousands of Americans who suffer from body dysmorphic disorder, or B.D.D., a syndrome known for more than a century but recognized only recently by the official psychiatric diagnostic manual. Even more recently, effective treatments have been developed for the disorder, and its emotional and neurological underpinnings have begun to yield to research."

Read the rest of the article here!

ABC News: Obsession with 'Pure' Food Leads to Eating Disorder

"Can too much of a good thing actually be harmful?


"When it comes to eating healthy foods, the answer may be yes.

"Patients with orthorexia eat healthy food to the point of malnutrition.We are all encouraged to follow a healthy diet, but some people take it too far, limiting their diets to food that they consider to be pure to the exclusion of everything else. Some of them end up with orthorexia, a severe eating disorder.

"Kristie Rutzel, a Richmond, Va., woman in her mid-20s, said she nearly died because of her obsession with healthy food."

Read the full article here!

Updated Treatment Providers List

New Jersey

Pennslyvania

Treatment Providers - Pennsylvania

PENNSYLVANIA


Allentown

Linda Brownback
*Welcome for free advice*
Brownback, Mason and Associates
1702 West Walnut Street
Allentown, PA 18104-6741
Phone: (610) 434-1540
Fax: (610) 434-6775
http://www.brownbackmason.com/
brownbackmason@choiceonemail.com
Treatment Models: Individual sessions, couples sessions, family sessions, nutritional, neuro feedback, bio feedback, biopsychosocial, christian, 12 step, CBT, psychodynamic, family systems, DBT.
Clients Include: Alcohol and drug addiction, adolescents, athletes, body image, children, college students, eating disorders, males, medically ill, self injury, sexual abuse, co-morbid psychiatric disorders, dissociative identity disorder.


Bala Cynwyd

Karyn Scher, PhD
*Welcome to call for free advice.*
1 Presidential Blvd., Suite 113
Bala Cynwyd, PA 19004-1207
Phone: (610) 668-9189
Fax: (610) 668-4089
Treatment Models: Family sessions, individual sessions, couples sessions,group sessions, family systems, feminist, cognitive behavior therapy, biopsychosocial.
Clients Include: Adolescents, college students, and athletes, males and females, who suffer from eating disorders, alcohol and drug addiction, and body image issues.


Chester Springs

Geraldine Toland, MSS, BCD
1832 Art School Rd.
Chester Springs, PA, 19425
(610) 827-7812
Treatment Models: Individuals, Couples, Biopsychosocial, CBT, Psychodynamic, DBT
Clients Include: Adolescents, Body Image, College Students, Self Injury, Sexual Abuse, Co-morbid psychiatric disorders.


Hershey, PA

Penn State Eating Disorders Program
*Welcome for free advice*
Penn State M.S. Hershey Medical Center
905 W. Governor Rd. Suite 250
Hershey, PA 17033
Phone: (717) 531-7235
Fax: (717) 531-0067
mkeener@hmc.psu.edu
http://www.pennstateeatingdisorders.com/
Treatment Models: Individual sessions, family session, group session, nutritional treatment, psychodynamic, biopsychosocial, cognitive behavioral therapy, psychopharmacology therapy, medical/nutrition stabilization treatment, IPT, and research.
Clients Include: Adolescents, children, and college students, males and females, who are medically ill, and suffer from eating disorders.


Jenkintown

Gail Post, PhD
711 West Ave. Suite 2
Jenkintown, PA 19046
(215) 884-9260
gkpost@verizon.net
Treatment Models: Individual, Family, Couples, Group, CBT, Psychodynamic, Family Systems, Feminist.
Clients Include: Adolescents, Athletes, Body Image, College Students, Eating Disorders, Males, Medically Ill, Self Injury, Sexual Abuse, Co-morbid psychiatric disorders.


King of Prussia

Ellen Davis, PhD
Woodland Forge
3001 Valley Forge Circle G-11, King of Prussia, PA 19406
Phone: (610) 337-7434
Fax: (610) 948-1037
drdavis@woodlandforge.com
http://www.woodlandforge.com/
Treatment Models: Individual, Family, Couples, Group, Consultations, CBT, Psychodynamic, Family Systems.
Clients Include: Adolescents, Children 8 years and up, Co-morbid psychiatric disorders.

Alex Goncalves, PhD
Woodland Forge
3001 Valley Forge Circle G-11
King of Prussia, PA 19406
Phone: (610) 337-7434
Fax: (610) 948-1037
info@woodlandforge.com
http://www.woodlandforge.com/
Treatment Models: Individual, Couples, Group, Support Group, CBT, Psychodynamic, Family Systems.
Clients Include: Alcohol and drug addiction, females, males, Co-morbid psychiatric disorders.


Philadelphia

Belmont Center for Comprehensive Treatment

4200 Monument Rd
Philadelphia, PA 19131
Phone: (215) 581-5489
http://www.einstein.edu/facilities/belmont/article9780.html
Belmont Center for Comprehensive Treatment is a 147-bed private psychiatric hospital offering a full array of services for the treatment of behavioral health and addictions disorders in adolescents, adults and older adults.

Programs include: Inpatient, Intensive outpatient, Outpatient, Partial and residential
Capabilities include: Dual diagnosis (substance abuse with behavioral health problems), Alcohol and drug addiction, Eating disorders, Women's health, Crisis intervention, Triage and evaluation

The Renfrew Center
475 Spring Lane
Philadelphia, PA 19128
1-800-RENFREW
Fax: (215) 482-7390
http://www.renfrewcenter.com/
Treatment Models: In-patient, out-patient, groups, events

Deborah Reeves, MG, PGP,LPC, CGP
*ANAD Support Group* *Welcome for Free Advice*
1528 Walnut Street
Philadelphia, PA 19102
(215) 732-1612
dr@healingminds.com
http://www.healing-minds.com/
Treatment Models: Individual sessions, group sessions, support groups, psychodynamic biopsychosocial, cognitive behavioral therapy, dialectical behavior therapy, and feminist.
Clients Include: people who suffer from eating disorders, issues related to body image, self-injury, co-morbid psychiatric disorder, trauma spectrum disorders and sexual abuse.

The Renfrew Center of Radnor
320 King of Prussia Road
Radnor, PA 19087
1-800-RENFREW
http://www.theren/
Programs: Day Treatment, Intensive Outpatient, Outpatient Services
The Renfrew Center is JCAHO accredited. Treatment programs and services are covered by most insurance policies.
Groups: Radnor Outpatient Groups, Adolescent Eating Disorders Group, Young Adult/College Age Eating Disorder Group, Thirty-Something and Beyond Group Emotional Eating Group


Spring House

Lucy S. Raizman, MSW, LCSW, LMFT
*Welcome for free advice*
921A Bethlehem Pike Suite 205B
Springhouse, PA 19477
Phone: (215) 345-4854 ext. 2
Fax: (215) 345-1699
http://www.councilforrelationships.org/
runningthere205@comcast.net
Treatment Models: Individual sessions, couples sessions, family sessions, psychodynamic, biopsychosocial, cognitive behavioral therapy, family systems, dialectical behavior therapy, feminist, EMDR.
Clients Include: Adolescents, college students, who suffer from body image issues, eating disorders and sexual abuse issues.


Yardley, PA

Rachel Millner, PsyD
*Welcome to call for free advice*
301 Oxford Valley Suite 402B
Yardley, PA 19067
Phone: (215)932-9885
Fax: (215) 321-4205
http://www.rachelmillner.com/
rachel@rachelmillner.com
Treatment Models: Individual, and couples sessions. CBT, IPT, Psychosynamic and Feminist.
Clients Include: Adolescents and college students who suffer from eating disorders, body image issues, self injury and co-morbid psychiatric disorders

Friday, March 5, 2010

WaPo Family Almanac: Treating daughter's eating disorder must involve entire family

Q:  My lovely daughter, now 24, is bright and personable and she graduated with excellent grades from a private high school and a well-known college, but for the past eight years she has suffered from anxiety, has been in therapy and has struggled with an eating disorder.


She now works full time at a job she loves, shares an apartment with a college friend and lives near us, so we see her often. She is close to us and her siblings and gets support at home and at work, but she seems more anxious and weighs less than she ever has.

We have discussed residential treatment since the beginning, but her doctors thought she would recover and it was never something she wanted to do. It is heartbreaking to watch her decline and we are feeling more and more desperate. How can we help her get over anorexia nervosa?



A:  Any parent of an anorexic child would be desperate, because anorexia nervosa is a dangerous illness with the highest death rate of any psychiatric disorder -- if it is, indeed, a psychiatric disorder.

Doctors first documented AN, as it's called, 125 years ago, and knew that it usually struck in the early or mid-teens and that nine out of 10 anorexics were girls, but they didn't know the cause. Nevertheless, they called it a psychiatric illness, put the blame on parents and said that only doctors could make it go away.

Now doctors still don't know the cause, but they aren't blaming parents anymore because most of them think AN is a biological illness because it runs in families; because anorexics often have relatives who are depressed, bipolar or have mood disorders; and because they are usually anxious, like to be in control, are perfectionists, have a shaky self-confidence and are fearful.

Most people with these characteristics can diet easily, but they switch a trigger in others. Suddenly they become terrified of getting fat and they remain terrified, even when their heart rate slows down, their blood pressure drops, their energy sinks, their minds get foggy and their arms and legs look like twigs. None of that matters. They simply can't see themselves as others see them.

With help, your daughter can turn off that trigger, but she'll probably turn it off sooner if you can find a Maudsley-certified therapist who uses family-based treatment (FBT), which was developed to treat anorexic teenagers in London and is used at some of the best U.S. hospitals.

Studies show that anorexics in this intensive outpatient program can usually overcome AN in six to 12 months -- instead of several years -- and that 80 to 90 percent of them will still be fine five years from now. This is a much better outcome than patients have in other therapies, perhaps because parents are part of the treatment, as parents of sick children always should be.

In this three-phase program, the therapist will first assess your family and then teach your daughter how her dizziness, her cold hands and feet, her depression and irritability are actually signs of starvation, although she won't believe it at first. At the same time she will teach you how to use sympathy and compassion -- but not criticism -- to get your daughter to eat three meals and three snacks a day, and to sit beside her until she does, even though she will object vociferously while you're firmly repeating the Maudsley mantra: "Starvation is not an option."

When your daughter begins to eat more and gain some weight, you'll move into phase 2. Here the therapist will encourage you to give your daughter more control over her eating, and when she is about 95 percent of her ideal weight -- and isn't trying to starve herself anymore -- you'll move into phase 3, where she'll help your family correct any lingering problems you might have. After living with AN for eight years, you're bound to have a few.

If FBT doesn't help your daughter, however, you'll have to seek residential treatment. You'll have no choice.

To learn even more about AN than you already know, read "Demystifying Anorexia Nervosa" by Alexander R. Lucas (Oxford, $15) and "Life Without Ed" by Jenni Schaefer and Thom Rutledge (McGraw Hill, $17), a big favorite with recovering anorexics.

And for more about FBT, go to http://www.maudsleyparents.com/ and read "Help Your Teenager Beat an Eating Disorder", by James Lock and Daniel leGrange, (Guilford; $18); "Skills-Based Learning for Caring for a Loved One With an Eating Disorder" by Janet Treasure, Grainne Smith and Anna Crane (Routledge, $25) and "My Kid Is Back" by June Alexander and leGrange (Routledge, $18), which comes out in May.




















Monday, March 1, 2010

FREE Webinar: The Transformative Power of Self-Love

The Transformative Power of Self-Love
A FREE Webinar for Those in Recovery


Tuesday, March 23, 2010
12:00pm - 1:15pm EDT

or

Wednesday, March 24, 2010
7:30pm - 8:15pm EDT

What would your day be like if you lived it completely from a place of self-love? Would you hide away from life or would you step out and take risks? Would you engage in eating disorder symptoms or would you be kind and gentle to your body? Would you wear masks or would you reveal your authentic self?

In this webinar, we will explore the topic of self-love and the powerful difference practicing self-love can make in how we experience life. You will have an opportunity to reflect on where you are on your journey to self-love and what it is that may be blocking your way. In addition, you will have the chance to set personal goals for integrating practices into your day that tap into the source of all change in your life—self-love.

This webinar will feature Mary Curtis, Renfrew alumna and founder of Authentic Communication Techniques—a company focused on assisting people in enhancing their interpersonal communication skills from the inside out. She will share personal insights and experiences, as well as tools that continue to support her on her journey to an authentic life.


**Please note that this webinar is for those who are recovering from an eating disorder.**


To register for the Tuesday, March 23rd webinar, visit:




To register for the Wednesday, March 24th webinar, visit:

Psychology Today: What we don't want to know about eating disorders

Five studies. That's the complete scientific literature about the effectiveness of different treatments for eating disorders. The largest of these studies had 165 participants. No wonder patients, parents and professionals flail around when presented with the options.


Dr. Jim Lock presented these and other findings at a Feb. 27 workshop for the public at Lucile Packard Children's Hospital at Stanford.

The good news was that there were sixty people there - and they asked good questions. It's hard to get people to attend a discussion that includes the horrifying list of chronic and acute effects of eating disorders.

I learned a new one, parotid gland swelling, from Dr. Cynthia Kapphahn, who concluded her descriptions with this fact: "Parents and friends don't want to know this." Indeed, we would much rather have been home watching the Olympics.

We don't want to be blamed, a tradition that started with the first doctor to label a condition as anorexia nervosa.

Sir William Gull set the standard of blaming the parents, which just about always means the mother. Later researchers piled on "refrigerator mothers" and "double-binding mothers," Lock said. When Dr. Lock arrived at Stanford in 1993, parents were at best considering a nuisance in the treatment of eating disorders.


From the skimpy available evidence of five studies, Dr. Lock gleaned that family-based treatments are most effective and that cognitive behavioral therapy is "possibly useful." There was no evidence favoring antidepressants, save one small case series involving ten people that came out "possibly useful." Nutritional counseling was of limited usefulness. Psychiatric hospitalization showed "no specific benefit" in treating anorexia. There have been no studies about psychiatric hospitalization and bulimia, nor any documenting day programs and residential facilities.

In the question period, a man whose daughter has been hospitalized three times wondered how much he could push treatment on an unreceptive patient.

Parents must find the place between making threats and not doing anything at all - for fear of making things worse.

Dr. Kara Fitzpatrick attacked that dilemma. "If your child was drinking vodka before school to relieve anxiety, no question you'd intervene," she said. If your child is not eating, again, there should be no question.

Another question was about dual diagnoses, common with eating disorders. What do you treat first? A young adult has a psychotic break and is anorexic. Anorexia trumps even that, Dr. Lock said. It is life-threatening.

He concluded by quoting German philospher Arthur Schoepenhauer: "All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

As an aside, Sir Gull himself got a little confused.

On Friday, October 24, 1873, at a meeting of the Clinical Society of London, Sir William Gull achieved a coup de maitre by delivering two seminal reports. The first was called, "Anorexia Nervosa, (Apepsia Hysterica, Anorexia Hysterica)". The second was entitled, "On a Cretinoid State supervening in Adult Life in Women." The manuscript on anorexia was regarded by Gull's peers to be significant, but of lesser importance. The essay on hypothyroidism was generally regarded to be Gull's chef d'oeuvre. One hundred and twenty-four years later, the situation has reversed itself: the anorexia paper is heralded, while the other manuscript is all but forgotten.