Anorexia and Obesity: Two of a Kind?

anorexia Dr Nicola Davies is a health psychologist, counsellor, and writer specialising in raising awareness about health, wellbeing and weight loss. She is a member of the British Psychological Society and the British Association for Counselling and Psychotherapy. Nicola also keeps a health psychology blog and runs an online forum for counsellors. She is the author of I Can Beat Obesity! and I Can Beat Anorexia! and the co-author of the Eating Disorder Recovery Handbook.

While generally regarded as two separate, very different issues, anorexia and obesity actually share many similarities – not only in terms of risk factors, but also psychological, behavioural, cognitive, genetic, and neuropsychological similarities.

Continue reading

Pooky Knightsmith: Three good reasons to write bad poetry

You don’t need tKnightsmith_Using-Poetry-to_978-1-78592-053-0_colourjpg-printo be a poet to write poetry, and you don’t need to write ‘good’ poetry to get a lot out of it.  I’ve found that the very act of writing and reviewing poetry can be incredibly therapeutic regardless of what we might produce.  Letting go of the idea that we need to be in some way talented with words to write poetry can open the door to a truly engaging, interesting and meaningful way to explore and express how we’re feeling.

In this blog post I’m exploring three key reasons why I’m an advocate of writing even the most terrible poetry – I hope it inspires you to give it a go (if so, you may find the fifty poetry writing prompts in my new book, Using Poetry to Promote Talking and Healing a good starting point).  Continue reading

Download a therapeutic resource from Pooky Knightsmith’s new book ‘Using Poetry to Promote Talking and Healing’

Knightsmith_Using-Poetry-to_978-1-78592-053-0_colourjpg-printThere are five poems in this extract from Pooky Knightsmith’s new book Using Poetry to Promote Talking and Healing. Each poem, written by Pooky, is the subject of a common mental health issue borne of her own experiences in the field of mental health.  They address panic attacks, anxiety, depression and anorexia and are accompanied by supporting questions and activities to help open up difficult discussions.  They are an ideal resource for therapeutic, classroom and family settings.

“Unlike so many stereotypes about poetry, this book is practical, unpretentious and heartfelt, with applications for helping people- young and old- way beyond mental health settings.”                                                                                                              -Nick Luxmoore, school counsellor and author of Horny and Hormonal

>>Click here to download the extract<<

Helping young people to build a positive body image

Check out this free activity from bestselling author Kate Collins-Donnelly’s upcoming book Banish Your Body Image Thief. Collins-Donnell_Banish-Your-Bod_978-1-84905-463-8_colourjpg-print

This activity will help young people to be more aware of, and to understand, their own body image and how to develop this in a healthy way. Examples of poems, drawings and songs from other young people will help them get started and show that they are not alone in how they feel.

Download the activity here

Read more about Banish Your Body Image Thief

Read more about Banish Your Self-Esteem Thief, also coming soon from Kate Collins-Donnelly.

C’mon everybody – get writing!

Vanessa Rogers is the author of Working with Young Women, Working with Young Men, Let’s Talk Relationships, 101 Things to Do on the Street amongst others. In this article she gives her writing tips for aspiring authors. And, if you’re feeling inspired feel free to send in your proposals to post@jkp.com


They say that there is a book in all of us, and judging from the number of emails and Tweets I get from people in the youth work and social education field inspired to write their own, it would certainly seem to be true. So this is a collective response to those of you who have asked me for ideas of how to start writing, and to share my personal experiences of writing a book. I hope it is useful – but please remember this is only my way, which I made up as I stumbled along the way.

When I start a new resource book it is because the subject holds a compelling fascination for me. For example, Working with Young Women (Jessica Kingsley Publishers ISBN 9781849050951) came out of lots of girls’ groups that I was facilitating at the time. The young women came to the group because they had been identified as at risk of offending and aggressive behaviour, but the more I got to know them the more I thought that a lot of their behaviour was actually a response to the bad relationships they had with their peers, parents and boy/girlfriends. It seemed to me that their anger and aggression was a coping mechanism that until now had worked for them. So, this made me question how young women can build a sense of self, gain confidence and assertiveness, look at the role models they have and their aspirations for life – in a way that is interesting, non-judgemental and fun. After all, through the group work I was basically asking them to change their existing coping behaviour, (which whilst not necessarily socially acceptable to all, gave them the kudos and ‘respect’ they sought), to take a chance of being vulnerable and exploring things that hurt to find a better way with me. But it seemed that this was the foundation for everything else – e.g. if you value yourself and your body you are more likely to respect it and look after it.

So from here, as for every other book I have written, I devised a series of questions that I wanted to answer. These help me keep focused and distill the essence of what I am trying to do.

After that, I spend about 3 months researching the topic. I do this by reading around the subject and trawling the Internet for ethical and correct data and statistics, but also by speaking with other practitioners and as many young people, or in the example above as many young women, as I can, to ask my questions and test out some of my theories. By now I usually have at least one box file filled with clippings and stuff, as well as my trusty notebook (I always have at least one hardback notebook on the go) filled with points to remember and ideas for games, quizzes or activities.

One thing; all of my session plans have to be tried out with young people before I will include them. For me, this part is one of the rules of my work to keep it ethical and grounded – it has to have been tried and tested and I have to know that young people will learn from it and more importantly enjoy doing so.

As I write constantly this means that I often have ideas stashed on my computer that are developed later when the opportunity presents itself. I try my best to include lots of learning styles in the activities and this might mean that I write the same learning outcomes three times, with three different ideas for delivering them. So, as I try them out with young people I use the one that goes best and dump the rest. I also ask young people to give me feedback as the book comes together, which I value as they don’t hold back if they think it won’t work!

Once this is done, I stick my main points on bits of paper around my desk and tell everyone that I am going to be ‘writing’. To my family this means that I am likely to be distracted, a bit bad tempered and the dinners will be rubbish for a while – but the good news is that I will be in the house for days on end and easily tempted to buy take-aways!! To my friends it means that if I do see them I am probably going to bore them witless by obsessing over my blossoming (or not) book. All training and other work is put on hold. And then – I write it.

I tend to write ‘all over’ my books – meaning that I might write part of the intro, then get a bit stuck so move on to one of the later chapters.  It may look chaotic but it isn’t – more like putting a jigsaw together, because by this stage I know exactly what I want to write and how it will look at the end. I tend to really get into this bit so write day and night, with no adherence to office hours – I actually prefer working through the night so it is pretty usual for me to be writing between 2 and 5 a.m.

Once it is done – which usually takes about 7 days end to end – I put it away for at least 3 days before getting it out and editing / doing the final writing.

Then it is off to Jessica Kingsley Publishers …… and I miss it like mad …… get a bit sad, like at the end of any relationship …… do any edits or re-writes asked of me by the editors and proof readers ….. and leave the printers to get on with it. In my head it is over.

I try and build a break in at this point so that I can have fun with friends and family and shake off the topic that has been all consuming for what might have been up to a year. And then, just when I think that I have had enough of writing, something sparks my interest – and the whole cycle begins again.

I hope this helps – but as I say all writers are different and I am sure you will find your own way of working. My only advice would be, write for you and choose a subject you feel passionate about – if you aren’t at the start, you definitely won’t be at the end! My very best wishes and good luck with it – let me know how you get on.

 

JKP author Linda Ciotola discusses the Societal Standard of Beauty and Eating Disorders

JKP author Linda Ciotola, M.Ed., TEP, co-author with Karen Carnabucci of Healing Eating Disorders With Psychodrama and Other Action Methods – Beyond the Silence and the Fury, discusses American culture and its impact on eating disorders in women.

Anorexia is both the result of a protest against the cultural rule that your women must be beautiful.  In the beginning, a young woman strives to be thin and beautiful, but after a time, anorexia takes on a life of its own.  By her behavior, an anorexic girl tells the world, ‘Look, see how thin I am, even thinner than you wanted me to be.  You can’t make me eat more.  I am in control of my fate, even if my fate is starving.’” – Mary Pipher, “Reviving Ophelia”

Many people believe that the young woman who suffers anorexia epitomizes our culture’s definition of what it means to be feminine:  thin, passive, and eager to please. The metaphor is that she will become what our culture asks of its women:  to become non-threatening, taking up little space while being decorative and not intimidating and non threatening.

Beauty is a defining characteristic for women.  Girls worry about clothes, makeup, skin and hair – but mostly about weight. In our book, Healing Eating Disorders with Psychodrama and Other Action Methods: Beyond the Silence and the Fury with co-author Karen Carnabucci – we  talk about how this societal standard for beauty influences our image of ourselves and is one of the many contributors to the rise of eating disorders and chronic dieting struggles with girls and women.  Sadly enough this emphasis on appearance is quickly spreading to boys and men as well – and eating and body disorders are growing with them as well as we discuss in our book along with specific interventions for these populations.

Why is appearance so important?

We have moved from communities of primary relationships in which people know each other to communities of secondary relationships where appearance is the only dimension available for the rapid assessment of others.

Today’s media portrays desirable women as thin. In 1950, models averaged five feet, four inches in height and weighed 140 pounds.  Today, the standard is five feet, ten inches and 110 pounds!

A recent study found that 11 percent of people in the United States would abort a fetus if they were told it would grow into a child that would have a tendency toward obesity.  Elementary school children have more negative attitudes toward obese children than toward bullies. Obese students are less likely to be granted scholarships.  Being fat means being left out, scorned, vilified, and often bullied.

In order to help our young people value their true selves and grow into healthy adults, we recommend the need for love from family and friends, meaningful work, respect, challenges and physical and psychological safety.  They need identities based on character, talent, interests instead of appearance, popularity and sexuality.  Instead of scales and diets, we do better to promote healthful meals, family exercise, and a value system that de-emphasizes the importance of looks.

Psychodrama and related action methods, through role play and other explorative tools, provide an important route to discovering how to find and sustain these connections and identities in their lives.  These methods can be used in education and in community settings as well as in therapy.

As a psychodramatist and psychodrama trainer, I often ask my clients:

If you were living on a magical island where weight, size, shape, appearance had no value and, instead were neutral, what would you find yourself focusing on?

This question is a perfect question to think about – and, better yet, to act out in the psychodrama room. With these actions, we can experientially discover another reality, one that is healthy – and through the power of action methods old roles based upon body obsession can be transformed into new roles based upon character.

In Search of Youth Work by JKP author Vanessa Rogers

An interesting and thought provoking article from JKP author, Vanessa Rogers on what it is to be a youth worker today. Vanessa is the author of a number of titles on working with young people including, Working with Young Women, Working with Young Men, Let’s Talk Relationships, 101 Things to Do on the Street, and new from JKP the Little Books on Alcohol, Drugs and Tobacco Set.


What is Youth Work?

Today I realised that I have been a youth worker for over 15 years, yet I still struggle to explain exactly what that means, especially to someone outside of the profession. It is not a simple answer and I have even been known to say, ‘social worker’ in certain social settings just because it is easier.

The irony is not lost on me; that I am prepared to betray my profession, even though I feel so passionately about it, because I can’t be bothered to explain what I do and that it involves more than playing pool and sorting out squabbles about which track to play next on the iPod in the youth club. Explaining detached youth work is even harder, and has even been met with snorts of laughter at the thought of being paid to wander the streets talking to unknown young people. ‘But what is the point?’ is a constant refrain.

It has not always been so. There was a time not that long ago when it would be hard for me not to weigh in with my views. In fact, many of my ex-students could stand testament to the fact that, ‘what is youth work?’ is one of my favourite assignment titles, and the 500 words produced in response are a constant source of interest and heated debate.

Then it dawned on me that perhaps the sinking heart I get whenever someone asks me what I do for a living is not merely personal apathy, but because I have had the conversation one too many times. The sense of justifying what youth work is, why it matters and the unique place it has in supporting young people – not only amongst friends, family and strangers but also with youth workers and other professionals – has become habitual. I realised that I am a bit tired of the struggle and don’t want to spend time any more time analysing the process at a cost of actually doing it less.

It hasn’t always been so difficult, although I am in no way harping back to some mythical golden age of youth work. I am simply pointing out that if you had asked me 15 years ago what I did my answer would have been pretty easy – an area youth worker for the Youth & Community Service responsible for developing girls work, work with young parents and managing a large and busy youth wing on the site of a school in an area described as ‘deprived’. So far, so clear.

The role of a Youth Worker

Fast forward and my role, but not my professional title, has changed so many times that writing a CV can be a daunting thing. Terminology for the young people, or ‘client group’, has changed from young people ‘at risk’ through ‘vulnerable’ to ‘targeted’; youth services have dropped the ‘ & community’ tag and been variously part of the education, leisure, Connexions and social care departments.

Responsibilities have changed to include meeting parents, undertaking social care assessments, creating community profiles and measuring work by the number of accredited outcomes achieved.
What constitutes ‘youth work’ has changed so many times that it can now be tagged on to virtually any service that works with young people.

But is this a good or bad thing? Is the increase in those using traditional youth work skills to engage with young people something to be celebrated or lamented? All I know is that ‘youth work’ is a notoriously difficult term to describe, and it isn’t getting any easier. The task of trying to find a pithy one-liner to sum up the collective aims of so many different clubs, societies and detached projects is almost impossible.

Perhaps it is that so many people now describe themselves as ‘youth workers’, whilst working in areas more traditionally associated with social workers or youth justice? I have even spoken with police officers that say they do ‘youth work’. Really? Are the professional boundaries so completely enmeshed? Please note this isn’t about professional qualifications, or even the lack of them, more a questioning of how the ethos of voluntary participation and the gradual process of building positive relationships and engaging and empowering young people fits within a law and order or social care framework.

The ethos at the heart of Youth Work

Historically, youth work did not develop just to ‘keep people off the streets’ or to provide aimless amusement, it has always offered social and political education in an informal environment. Good youth work may look as if it just ‘happens’ but the success of it actually depends on good planning, clear aims and measurable outcomes. This ethos should be at the heart of all youth work – especially detached projects. Surely an exciting detached project that motivates young people to get involved should result in more, not less, youths on the street? And that should constitute success?

Put simply, providing young people with a ‘good time’ is not enough. Effective youth work should offer young people the opportunity to meet, socialise, develop new skills, explore the world around them and learn to question and challenge what they see effectively. Detached projects should not be about forcing young people off the streets and away from adult eyes, but more about building trust and developing interesting projects that are relevant to their needs, reflecting the things of importance to them. Which is unlikely to be the same as the media focus on demonizing young people as part of a lawless counter-culture.

As I see it the need to build two-way respect between young people and other members of their community is paramount – after all it is hard to encourage young people to take up their responsibilities and become active citizens if they are treated like social outcasts. Why would you want to be part of something that clearly doesn’t want you?

Perhaps the answer is purely financial. In the struggle to chase funding and secure projects we have been forced to chase the pound, rather than offer what young people truly want. Or maybe as numbers dwindle in traditional old-style youth clubs what’s on offer is simply outdated and no longer meets the needs of teenagers. In that case let’s stop hanging on to the solutions of the past and try new ideas.

Listening to Young People

Young people can be innovative and visionary, with energy and enthusiasm to shape and change the world. To do this they need to find ways to get their voices heard and be able to see that their participation in things like youth councils, forums and consultations actually makes a difference. To be honest, as an adult I am happy to give my opinion on things that matter to me but I get disheartened and then disinterested if nothing ever comes of it and I don’t receive any feedback. Too often I think young people are let down because although they are told that their opinions count, when it comes to money and budgets, they don’t. Participation has to be more than a paper exercise or a way to ‘tick boxes’.

Reclaiming Youth Work

So I think it is time for youth workers to stand up and reclaim youth work by celebrating how different it is to other work with young people. It should be seen as a whole, not as a useful pick’n’mix to compliment other services, and defined in our own terms – whether that is through a Youth Work Academy or some other collective process – before someone else does it for us.

In another 15 years time I don’t want to still be ducking the question, ‘what do you do for a living?’ – I want to be able to say (still with pride), ‘I am a youth worker’, and for that to mean something.

Using analogies and metaphors to understand and help defeat a child’s eating disorder – An Interview with Ahmed Boachie and Karin Jasper

Dr Ahmed Boachie is Program Director of the Eating Disorder Program at Southlake Regional Health Centre in Newmarket, Ontario, Canada, and Staff Psychiatrist at The Hospital for Sick Children in Toronto, Ontario. Dr Karin Jasper is Clinical Mental Health Specialist and Research Co-ordinator of the Eating Disorder Program at Southlake Regional Health Centre, and Assistant Professor in the Department of Psychiatry of the University of Toronto.

Drs Boachie and Jasper are co-authors of the new book, A Parent’s Guide to Defeating Eating Disorders: Spotting the Stealth Bomber and Other Symbolic Approaches. Here, they discuss their unique approach to helping parents and professionals get to grips with the challenges faced by young people with eating disorders and, ultimately, help overcome them.


How did you each come to work in the field of eating disorders?

AB: I trained as a child psychiatrist in Great Britain with extensive developmental pediatrics background knowledge. With eating disorders there is always a need to understand the child from both perspectives. Bringing this integrated perspective also really helps parents appreciate the need to intervene without delay, and to understand how indispensable their role is in helping their child recover. Eating disorders are among the most common causes of morbidity and mortality in children and they have a high potential for becoming chronic. Yet, in comparison with other illnesses they are paid little attention. It is still very common for an eating disorder to go undetected until it has become entrenched and is affecting a child or teen’s physical, psychological, and social development.

KJ: At first what caught my attention was the impact of our culture’s obsession with dieting and body shaping as solutions to nearly every life challenge. I saw that this obsession was particularly stifling to the lives of girls and women. It has intensified and today increasingly affects males as well. Specializing in the area of eating disorders, what I see is that children and teens who are caught in the grip of the disorder and whose lives and development are at stake, are able to recover. When they first come for treatment their personalities and voices are muffled and muted by the eating disorder. As their parents help them get well, their individuality returns. It’s the most beautiful thing!

Tell us about the new book – what is unique about the approach it takes?

Our book is innovative in that it uses analogies and metaphors to crystallize an understanding of eating disorders and crucial aspects of their treatment, which can improve the therapeutic alliance among professionals, parents, and children. Children and teens with eating disorders think that no one understands them and find it difficult to trust anyone, which presents a major obstacle for recovery. Parents often try to calm their children’s anxieties about food and weight-gain by minimizing expectations for food intake. The analogies and metaphors in our book help parents understand eating disorders in a way that allows them to ally themselves with treatment rather than with the eating disorder. Children who believe that others grasp their experience find it easier to open up. They feel understood, respected, appreciated, and supported, thus decreasing their guilt and improving their listening. Professionals may find the book increases their understanding of the complex presentations of eating disorders and thereby find it easier to explain them to parents. It can help everyone to work together effectively.

Why is the use of metaphor so effective in helping young people with eating disorders and their parents understand eating disorders and treatments?

Just as comedians make us laugh about things that are difficult to talk about and help us focus on the right rather than the wrong things, with metaphors and analogies we can make eating disorders understandable, reduce parents’ self-blame, and help them focus their strengths in a way that facilitates their child’s recovery. Children or teens may be unable to appreciate the real danger they are in because they are focused on the perceived “benefits” of the eating disorder and are fearful of being without it. Analogies and metaphors can help them shift their focus and see that there is a way out.



The 911 Call

A young person with an eating disorder may ask for help and then deny that she wants it, like someone who has an intruder in her home and calls 911 but, when help arrives, finds that the intruder is standing at her back with a gun, forcing her to say everything is all right after all. After some time living with the illness and giving up hope of being rescued, the young person may also start thinking of the intruder as her protector, believing that it is better to live with the eating disorder than to give it up for some other coping mechanism which may not work. When parents bring the young person for treatment, she experiences the professional who treats her as an unhelpful or dangerous alternative to her protector, the eating disorder.

– from Chapter 1: Rationale for Anologies and Metaphors



What are some common obstacles that parents face when trying to help their child overcome an eating disorder, and how will this book help?

The most important obstacle is that parents have traditionally been put to the sidelines in the treatment of their children with eating disorders. More recently it has been demonstrated that parents have a central part to play in helping their children get well. Our book will help by making eating disorders and their treatment transparent to parents in a way that empowers them to take the key role in their children’s recovery.

There are many myths about eating disorders that contribute to delays in identifying and treating them – for instance, that a girl who eats candy, chocolate, and chips cannot possibly have an eating disorder, or that boys don’t get eating disorders at all. Once recognized, thinking that an eating disorder is just a phase and that the child will just grow out of it, can contribute to delay in treatment. Because eating disorders also resemble other illnesses like depression or digestive problems, especially in the earlier stages, it can be difficult to get a diagnosis that leads to appropriate referral for treatment. Illnesses like pneumonia are not like this – it is straightforward to get a diagnosis and treatment. Specialized treatments for eating disorders may be available, but can also be expensive or difficult to access because of location or long waiting lists.

Eating disorders are a-motivational illnesses, which is to say that the person with the eating disorder does not feel motivated to change or is unable to sustain a motivation to change that would see her through treatment. There are perpetuating effects of the eating disorder related to semi-starvation – for example, depression – that contribute to the child or teen’s a-motivation for treatment.

A child or teen with an eating disorder needs her parents to understand the nature of the illness, to persist through systemic barriers, and to guide her firmly but compassionately through the process of recovery. Our book helps by using analogies and metaphors to inform parents about this process and to help motivate them through it.



Parents are the Priceless Resource

What is the most priceless thing to human beings? Air. It’s everywhere and it costs nothing. It comes to you even if you make no effort to find it. Just because we take it for granted, doesn’t mean it isn’t priceless. Parents may ask: “Is there any other facility I can take her to?” thinking that a more specialized or better hospital will be the answer. This is not the answer. It is you helping her to eat that will make the difference. The key is your own presence and involvement, at whatever stage of the illness your child may be.

– from Chapter 1: Rationale for Anologies and Metaphors


Copyright © Jessica Kingsley Publishers 2011.