Disturbances in the functioning of the upper gastrointestinal (GI ) tract have been described in both Anorexia Nervosa (AN) and Bulimia Nervosa (BN). Patients with AN experience substantial delays in gastric emptying as well as constipation. These problems may give rise to significant medical complications and may contribute to increased difficulties with refeeding and weight restoration. Reported GI disturbances in BN include increased gastric capacity, diminished gastric relaxation, delayed gastric emptying, diminished release of cholecystokinin (CCK) and abnormalities of enteric autonomic function, all of which may play a role in perpetuation of the syndrome. This article reviews evidence for the most common disturbances of GI function in AN and BN and discusses potential GI targets for therapeutic intervention.
A driving force in an eating disorder like anorexia nervosa has been a distorted body image. The psychobiological dynamics of eating disorders have demonstrated significant hypnotic phenomena such as forms of dissociation, hallucination, time distortion and catalepsy, and therefore, pose hypnosis as a good fit for particular parts of treatment. Presented here are four hypnotic approaches designed to inspire the establishment of a reality based body image in the eating disordered individual. Conditional prerequisites for application of these interventions are described and case examples illustrate each approach. A discussion on some of the rationale for formulating these strategies is offered.
An alternate framework for thinking about anorexia treatment is presented with a treatment approach that results in prompt remission of anorexia symptoms. Prior treatment of eating disorders using hypnosis is reviewed. A case example illustrating the method is followed by a discussion. The process is described for teaching clients how to nullify the anorexia symptom complex when it is reactivated.
This article presents a substance abuse treatment method that acknowledges and accommodates the personal needs that are being addressed by substance. This method, Utilization Sobriety, bypasses perceived resistances and employs idiosyncratic psychobiological learning to achieve a body-mind gestalt that is complementary to the client's sobriety. It develops a safe framework for addressing any subsequent mental health themes directly or indirectly related to substance misuse. A treatment protocol for the use of Utilization Sobriety as well as relevant clinical material illustrating its application and a discussion of its implications are offered.
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