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Friday 8 March 2013

Not a fan of CBT......

I belong to various groups on Linked In, some of which I participate in, some of which scare me but I love to read and some of which I generally ignore because they are full of s@$t.  Recently, I did notice that one group, whom I generally ignore, have been commenting a lot on this particularly good article from a couple of weeks ago, so I thought I would investigate.

In some ways, I wish I hadn't because it is full of, quite frankly, prehistoric guff and self-righteous indignation all rolled into pseudo-scientific justification - or as I like to call it, casting slurs on someone you have never met's parenting and then trying to defend the indefensible.  One of the loudest voices actually advertises herself thus:

My treatment approach is "object relations" which focuses on gaining insight into how we've internalized important people in our lives, and how we use food to deal (or not) with these people in our internal worlds

What the heck does that actually mean?

Anyway, the joy of this whole thing is that you do not have to be a member of Linked In to read this discussion.  You can Google:

Eating disorders in very young children: good piece on ABC news

or just follow this link.

What I am interested to know is:

  1. Do you think that the child's eating disorder had anything at all to do with her adoption?  
  2. Do you think the child's parents had something to do with her mean voice? 
  3. Does Stockholm Syndrome have anything to do with eating disorders?  
  4. Does psychoanalysis really deal with the unconscious?  
  5. Does psychoanalysis have any useful function in this day and age or is it so damaged by the blatant misuses and transgressions in the past, that it is a tainted therapy? 
  6. Is leaving the unconscious unattended damaging? (And what does that even mean?) 
  7. Does a 9 year old really communicate her defence against the loss of her biological parents through controlling her nurturing?
  8. Is anorexia a choice for a 9 year old?
  9. Is evidence based science a reductionist concept?
  10. Should we be relying on clinical observations to find an answer for eating disorders?
  11. Am I projecting my own issues on to this discussion?

Before answering these questions, it is well worth reading this because I like cherries....


  1. Good grief. My head about exploded reading those comments.

    Thank God for Laura and people like you, Charlotte. Nothing like sunlight for wonder they got their panties in a bunch for allowing an 'outsider' to publish 'outsider' who happened to be the mom they were so busy making assumptions about.

  2. Colleen

    I have moved on to this particular subject in the same group

    I have to say that Dr C is a real pistol - all his gun analogies and him such a fan of Freud and psychoanalysis......

  3. I feel really badly for Sophie's mom for getting picked apart. Truth is there are many younger set ones. Ohhh ahhh, its all about professional branding. Isn't that pretty aparent? Keeping the co pays going? I grew up in an academic community so am all too familiar with the PHD puffery bluffery publishing blah blah.
    Truth is my young girl is doing fine now thanks to FBT. In fact she left for school, her light was on, paper all over the floor, bed unmade, grabbed a brownie for snack. How's that for insight. Whatever....

  4. truth is our family struggled mightily with FBT, but that doesn't mean that I feel it's OK to dismiss the most effective evidence based treatment yet found for a killer illness just because it doesn't work easily for everyone, try to dismiss the whole concept of evidence based treatment out of hand because it isn't perfect and doesn't fit with what they are trying to sell and accuse the organisation of which I happen to be the UK Chair of being totally biassed towards FBT. I'm on linked-in but don't know how to join discussions and have decided that if this is the quality of discussion I'll give it a miss.

  5. The truth is there is openess and compassion on FEAST for the large umbrella that supports all parents of eating disordered children. No matter who and what they are able to treat with. We learn every day on there...There is a wide spectrum of presentation. Funny, i talk a lot about how i benefitted with a young one from not just from FBT but from a structured course of behaviorist EXRP. How I am forever grateful to the clinician who did this with a young one. How it helped. I personally welcome clincians coming to read FEAST daily and over time learning a little more....developing a little more compassion for those they treat...and less self agrandizing professional puffery.

  6. Hi,

    This is Jill Cohen Lcsw. I thank you for your support in what was a very difficult discussion. Again I think it is so important for professionals to be able to agree to disagree and exchange ideas so that we can learn from each other. "It is the mark of an educated mind to be able to entertain a thought without accepting it."
    Greek critic, philosopher, physicist, & zoologist (384 BC - 322 BC)

  7. "Be as you seem"

    Thank you Dr. Cohen.

  8. Hi, I am not a Doctor but thanks for the upgrade ; )

    Jill Cohen Lcsw

  9. "Be as you wish to seem."


  10. I wish the discussion on the thread could return to that of the original post: Early onset and the subject of the ABC News piece. There is very little attention paid to early onset....

  11. Thanks for drawing my attention to this discussion C! I like to keep tabs on which therapists are see family dysfunction as a major component of eating disorders as well as those who outright say "parents cause eating disorders".

    When parents in different cities around the world call me and ask for effective treatment providers I like to let them know what the beliefs and perspectives of each provider happens to be and let them choose whom they would like to hire...or not.

    After having encountered a psychotherapist in NYC who told me to my face, "If it weren't for pathological parents, we wouldn't have eating disorders." I began keeping a detailed spreadsheet that clearly lays out the different perspectives so parents choosing a treatment team can be well informed.

    I don't recommend one provider over another just as I don't promote any type of treatment over another. I know parents are smart and can take the information and make the decision that works for them. I give the information and let them decide.

    So glad to have a few more names to add to my spreadsheet with lots of good information on each one.
    Thank you,
    Becky Henry