VANCOUVER, B.C. – It's hard to know just what to expect–or what to say–when you turn the examining room doorknob for an initial encounter with a patient who has a suspected eating disorder.
“You could have somebody who at best is extremely ambivalent about being there, at worst maybe very, very angry and upset about being there,” psychologist Ronald S. Manley said at a conference sponsored by the North Pacific Pediatric Society.
Dr. Manley begins by offering a simplistic, research-based explanation of eating disorders, including the motivations behind them, their symptoms, and what models have been used to treat them, said Dr. Manley, clinical director of the eating disorders program at British Columbia Children's Hospital.
Using an emotional orientation, he draws on “relatively strong language” to forge a connection with the adolescent that hopefully will assist her in finding the part of herself that does want help. As an example, he might say, “Anorexia nervosa brings something to you that's very important. Why else would you hold onto it? … It's a powerful means of coping with your fears and gives you a sense of being strong and in control. But it is also a cause of suffering and weakness. And a sign of someone deeply troubled.”
In being blunt, “I'm hoping to convey that we do have an understanding of what this patient has been going through and offering her a sense of hope,” he said.