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Tables of Contents for Anorexia Nervosa and Bulimia
Chapter/Section Title
Page #
Page Count
Acknowledgements
xiii
Introduction
1
6
Part I
7
76
Beginning to unravel the problem
9
17
Mysteriousness
10
2
The illness as a category problem
12
2
The physical illness category
14
2
The deliberate action category
16
1
Recognizing the condition that is anorexia nervosa
17
2
The importance of the `anorexic attitude'
17
2
Distinguishing the food/body control that is characteristically anorexic
19
3
Informal observation
19
2
Formal measures
21
1
The similarities between anorexia nervosa and bulimia
22
1
Some medical and other objections to taking the two conditions as one problem
23
3
A path through the theories
26
19
Two types of theory
26
1
Theories and how they relate to what is seen as needing explanation
27
2
The practical significance of the theoretical divide
29
1
The psychological effects of starvation
29
4
Intellectual change
30
1
Sexuality
31
1
Moods and feelings
31
2
Theories that build on the psychological effects of starvation
33
2
Starvation as avoidance of sexuality
34
1
The starvation whirlpool
35
3
Decision making
35
1
Food preoccupation and the idea of self
36
1
The condition naturally intensifies
36
2
Positive ideas about food and body regulation
38
4
Fasting
38
1
Dieting, slimming and exercising
39
3
Professional objections to the idea of starvation effects
42
1
The idea of illness
43
2
Control by any other name
45
17
The dangers of authoritarian intervention
47
3
The anorexia nervosa/bulimia board game
50
3
Progression around the board
53
1
`Advantages' of a bulimic pattern of control
54
2
Completing the board game
56
4
The helper's dilemma
60
2
Bad medicine
62
21
False leads: appetite and mood
62
2
Treatment objectives
64
1
Additional medical interventions and their limitations
65
2
Insulin therapy
66
1
Electroconvulsive therapy
66
1
Surgery
66
1
Drug therapy
67
1
Taking control of the anorexic patient
67
2
Behaviourism: a theoretical rationale for taking control
69
2
Legitimating coercion
70
1
When black-and-white thinkers meet head on
71
2
The use of legal powers to detain and treat the anorexic
73
1
The anorexic's alienation from the medical profession
74
1
The doctor's point of view
75
1
How much weight gain?
76
2
The tyranny of assumptions
78
5
Sex roles
78
1
Thresholds
79
1
Overlooking male sufferers
80
3
Part II
83
66
The picture at low weight and foundations for help
85
20
The move to low weight
86
1
Different approaches and how weight gain is implicated
87
2
Weight gain as a prerequisite to psychotherapy
87
1
Gradual weight gain and psychotherapy in parallel
88
1
Different meanings of the same words
89
2
`Opposing food control'
89
1
`Weight' and `weight gain'
90
1
Low weight and non-medical help
91
2
Monitoring physical safety
92
1
A stepladder for recovery
93
2
Mapping low weight
95
7
100--85 per cent, and viable weight
95
1
The 83--82 per cent AEBW band: alteration
96
1
The communication threshold: 81--78 per cent AEBW
97
1
Moving towards the classic picture: 75--69 per cent AEBW
98
2
Emaciation and danger: 68--50 per cent AEBW
100
2
The sufferer's response to the experience of starvation
102
3
Viable weight and the picture that is hidden
105
14
. . . but ever more came out by the same door as in I went
106
1
Being invisible
107
1
The key to the self-starvation whirlpool
108
1
Morality
108
3
Public rules and personal rules
109
1
Public rules from two sources
110
1
Worthlessness
111
3
Throwing self away
112
1
Humiliation in the guise of help
113
1
Sensitivity
114
2
Responding and responsibility
114
1
How sensitivity becomes a burden
115
1
External control
116
1
Hidden feelings
117
2
The culture of control
119
15
The female role: only part of the explanation
120
1
The Protestant or `work' ethic
120
3
The `therapy culture' in conflict with the sufferer's culture
123
1
Social standing
124
1
Circumstances that intensify commitment to the work ethic
124
2
Social mobility
125
1
`Missing' people
126
1
The transmission of values
126
2
Creating the symptoms
128
3
The moralization of body regulation
128
1
How moral imperatives fit extreme actions
129
2
Moving the spotlight away from women
131
3
Worst little boys -- or not
131
3
On becoming a person: through food control
134
15
Being . . .
134
1
. . . and nothingness
135
1
How is an existential problem to be recognized?
136
5
Dither and indecisiveness
137
1
Lack of spontaneity
138
1
Controlling others . . .
139
1
. . . or follow-my-leader
140
1
Food/body control: a solution to confusion
141
1
The difficulty there is in expressing nothingness
142
2
The significance of indecisiveness
144
1
Sources of confusion
145
2
Gender roles
145
1
Trying to make bricks without straw
146
1
The danger in resolving sufferers' conflict for them
147
2
Part III
149
110
Perspectives that maintain the ability to help
151
15
Food/body control and the use of alcohol compared . . .
151
1
. . . and contrasted
152
1
Symptoms of excessive virtue
153
1
The preference for physical explanation
154
1
Seeing what is there
155
2
From praising control to imputing madness
156
1
Admiring the anorexic
157
2
Becoming drawn in and ineffective as help
159
1
Intervention: problems and strategies
160
3
Justifying intervention
162
1
Self-interpretation and virtue
163
3
Different languages and their implicit values
163
3
Getting through
166
15
Acknowledging the sufferer's style of thinking
167
2
Returning to the stepladder
169
1
Adjusting for the centrality of food control
170
4
Adjusting for altered thinking
174
2
Adjusting for low self-esteem
176
2
Adjusting for different physical experiences
178
1
Adjusting for different implicit values
179
1
Nurturing a sense of self
180
1
Good medicine
181
19
50--65 per cent AEBW: emaciation and medical help
182
2
How much time do we have?
182
2
50--65 per cent AEBW: communication
184
1
Refeeding the anorexic in hospital
185
2
Intravenous feeding
186
1
Nasogastric-tube feeding
186
1
Liquid diet
187
1
Ordinary food, with or without liquid supplements
187
1
Moderate aims for weight increase
187
1
Helping the sufferer feel safe
188
3
Refeeding and the need for predictability
191
4
Food as medicine
193
1
Avoid offering choices
194
1
Making hospital staff comfortable
195
1
The use of sedatives in hospital
196
2
Help: dividing the task: providing continuity
198
2
Turning around
200
16
How to begin working together?
201
2
Working with rather than against control
201
1
Offering an experiment
202
1
Discovering anorexia nervosa is in control
203
1
The inescapability of choice
204
2
Allowing the necessary time to choose
206
3
Calculating safety: recognizing danger
207
1
Anxiety in the helper
208
1
Choosing to change
209
4
Practical planning for experiment
210
3
Learning points
213
3
Transition
216
20
Catching the sufferer on the way down
218
1
Holding the sufferer on the way up
219
2
Getting better feels like getting worse
221
1
Giving sufferers the appreciation they need
222
1
The constructive use of crisis
223
2
Further learning points
225
1
Withdrawing from therapy too soon
225
2
Acting out the chaos
227
1
Help and care at viable weight
228
1
Patterns of food and body control
228
1
Stealing
228
1
Seeking oblivion
228
1
Self-harm
229
1
Using sexuality
229
1
Practical responses to the consequences of chaos
229
7
Mixed addictions
230
1
Giving control back to the sufferer
231
1
Overdosing and potential suicide
232
1
Stealing
233
1
Debt
234
1
Sexuality and `relationships'
234
2
Moving towards a real sense of self
236
23
Choice, decision and selfhood
238
1
Constituent parts of choosing and deciding
239
1
Learning to live in the present
239
1
Discovering personal rules and core beliefs
240
4
Acknowledging the rest of the iceberg
242
2
Allowing feelings and emotions
244
2
Relating to the world
246
2
Integrating the experience of self
248
3
Signs and sounds of recovery
251
2
Further experiment, self-discovery and real development
253
6
Appendix
259
6
Index
265