online conference transcript
Bob M is the moderator.
Bob M: Good evening everyone. For those of you who are new to the Concerned Counseling Website, welcome. I'm Bob McMillan, the moderator for tonight's conference. Our guest is Dr. Steven Crawford, Associate Director of the St. Joseph's Center for Eating Disorders. Our topic tonight is: What does the word "recovered" really mean when it comes to an eating disorder. And coping strategies for families and friends and how they can best help the eating disorder sufferer. I want to welcome Dr. Steven Crawford back to our chat site tonight. Before we get to the questions Dr. Crawford, maybe you can tell us a bit more about your expertise in the area of eating disorders?
Dr. Crawford: I am currently the Associate Director for the Center for Eating Disorders. I have worked closely with Harry Brandt, MD for the past ten years treating individuals suffering with eating disorders. I appreciate the opportunity to be here this evening to discuss the process of recovery.
Bob M: What exactly does the word "recovered" mean when it comes to eating disorder patients?
Dr. Crawford:Eating Disorders Recovery is not easily defined. It is individualized in many ways. Recovery is a process and not an event. Eating disorders do not develop overnight and are not "cured" overnight. Simply stated, eating disorders recovery is most likely achieved when an individual is able to not have food dominate their every waking moment. Individuals moving toward recovery are able to engage in social activities, work, school, etc. without having their concerns with eating decrease their functioning.
Bob M: So are you saying, "recovered" is not the same as "cured". Even if you have "recovered," you will still have eating disordered thoughts or behaviors, you will just be able to control them better than before?
Dr. Crawford: Yes. Many individuals have told me that they see eating disorders recovery as a daily choice to not act on their symptoms and that they are never completely free of concerns about their weight and appearance. However, they have learned to live with these concerns in such a way that they do not limit their lives.
Bob M: Is that why even someone who has "recovered" is always at risk for a relapse?
Dr. Crawford: Yes. Individuals who have moved toward recovery remain at risk for relapse throughout their lives. This is because they have learned to use their eating disorder symptoms as their means of coping and during times of stress, people tend to revert to comfortable means of coping.
Bob M: We have many people in the audience tonight, so I'm going to get to some audience questions on this part of the conference early. Then we'll move on to helping family and friends cope and how they best can help someone they know handle their eating disorder.
Bry: Is the recovery process the same for all Eating Disorders?
Dr. Crawford: In many ways, yes. Treatment is essential to recovery from all eating disorders. Individuals need to take a two-track approach to recovery. The first track is learning to block eating disorder symptoms. The second track is beginning to understand what is underneath the eating disorder. Both tracks are important and necessary. Developing control over the symptoms usually entails nutritional counseling, with moving towards normalization of eating. It can also include medication management. At times, partial hospitalization and inpatient treatment are necessary to assist individuals in symptom blockade. Understanding what is underneath the eating disorder involves psychotherapy, either individual, group, family or a combination of the above. Support groups are also helpful.
windwood: Dr. Crawford, I have managed to keep from binging and purging or complete restricting for at least 7 years now (after having been anorexic and bulimic for nearly a decade). But I must admit, I still have thoughts of wanting to be thinner. I am in no way overweight. Is it truly possible to stop this nonsense thinking?
Dr. Crawford: As I said earlier, learning to live with the thoughts, and not acting on them, can be a lifelong process. It sounds as though you have achieved this. I sometimes suggest to patients that their eating disorder can actually be helpful. When the thoughts feel stronger and more difficult to control, it can be a red flag that there are stressors building in one's life that need to be tended to.
Elora: When is it imperative to get help?
Dr. Crawford: I suggest that when the eating disorder is interfering with one's lifestyle that it is time to get help.
Bob M: I want to take the time to mention here, that one of the people who frequently visited our website and chat rooms died last week from her eating disorder. She suffered a heart attack. I want to encourage everyone here tonight, that if you are suffering from an eating disorder, please get professional help. This is not something that you will be able to beat by yourself. And I want to stress, as so many of our previous guests have, the longer you wait, the harder it is to recover.
Cie: I heard that in St. Joseph's you almost "force" patients to socialize and keep out as much private time as possible to patients. Is this crucial to recovery and what is the theory behind it?
Dr. Crawford: During hospitalization, patients need to be monitored closely to assist them in not acting on their eating disorder. "Private time" may leave vulnerable individuals with an opportunity to act on overwhelming eating disorder impulses.
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