Helping People with Eating Disorders
Bob Palmer is Honorary Professor of Psychiatry at the University of Leicester, UK, where he spent much of his career as an NHS clinician and consultant psychiatrist. Over the last 40 years, he has become a leading figure in the field of eating disorders and has been involved in innovative research, clinical practice, education and administration. He is a recipient of Lifetime Achievement Awards from the Academy for Eating Disorders and Beat, the UK eating disorders charity. He is also the author of numerous articles and the author or editor of several books.
Helping People with Eating Disorders
PREFACE TO THE FIRST EDITION
I have written this book to provide an introduction for clinicians to the eating disorders, anorexia nervosa and bulimia nervosa – conditions that have become increasingly salient over recent years. More and more people working in various health professions have been confronted with the need to try to help sufferers to escape from what can be miserable and life-blighting disorders. Some professionals find themselves with the additional task of organising services for people with eating disorders, and in doing so, they may get caught up with the ambivalence of the general public who often seem to hold contrasting attitudes to the eating disorders, viewing them at times as the trivial fads of silly young women and at other times as mysterious and deadly diseases lurking in their midst and picking off young people at the threshold of promising lives. Those who plan and fund health care may share these extreme views – albeit less openly – but almost everywhere provision is patchy and often inadequate.
Those who would seek to do better face a variety of obstacles. Not least amongst these is the wide range of advice and opinion about the nature of these disorders. There is a lot to sift through, and at times, it seems that there is a more dirt than gold. This book is designed to do some of that sifting and sorting for the reader. I hope that it may be useful to have some help from someone who has been panning this particular stream for many years. However, I would warn you that although I have tried to give a balanced account, I can present things only as they appear to me. Even an experienced eye may miss what is important or be sometimes misled by 'fool's gold'. The enthusiasm that we all need in clinical practice may at times distort judgement. It is important to be confident about what we do and for that confidence to rest on as sure a foundation as possible. Where possible, I have tried to include discussion of, or reference to, the sources of the views that I put forward. However, in the end, you must judge for yourself – and for the people whom you are trying to help.
I have tried to make the book practical in orientation. It is about trying to help people with eating disorders. Whenever I was faced with a decision as to whether to include something or leave it out, I decided on the basis of clinical utility. Consequently, some topics which might have made the book more interesting may have been omitted in favour of some which are less fascinating but more useful clinically. This book does not set out to be a theoretical treatise upon the nature or wider significance of eating disorders. Such books can be of great interest and may even be important, but something different is required to support the professional confronted by a sufferer asking for help as the professional needs to be able to put the person seeking help into wider context, to assess her problems, to know what others have found useful to offer and to avoid making things worse. Most of all, the professional needs a measure of confidence. Of course, such competence and confidence cannot come just from a book, but the right kind of book could help, and I have tried to write such a book. I cannot be the judge of how useful it will be in practice. Only time, and those who read the book, will tell.
I shall, of course, be delighted if as many people as possible read – and buy – this book. These might include the student, the sufferer, perhaps the families of sufferers and even that fabled figure 'the interested general reader'. However, it is not written with them in mind. I have written this book for people who have chosen – or find themselves chosen – to offer help to those suffering from clinical eating disorders. My guess is that they may come from a variety of the so-called 'helping prof