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Embodiment and mentalising - new perspectives on eating disorders
This book focuses on how body and mind might interact in eating
disorders, with particular emphasis on anorexia nervosa. It is
based on six scientific articles and an extensive discussion. Three
of these papers describe how people with anorexia nervosa embody
their inner life. Such bodily concretization of emotional life is
described as impaired mentalising. Mentalising refers to the
competence to understand oneself and others, and is considered as a
central psychopathological trait. Mentalising represents a new
intellectual framework for the understanding of such disorders. The
book also presents an outline for mentalisation-based treatment for
anorexia nervosa. A fourth paper describes how shame is central in
the psychopathology of persons suffering from anorexia nervosa. A
fifth paper is based on research among boys and girls in child care
institutions, and concludes with the necessity of increased focus
on male experiences. A sixth paper investigates how adapted
physical activity can move negative attention from the objectified
anorectic body to a more profound experience of oneself and one's
body.
This work presents the adaptation of mentalization-based therapy
for use in Eating Disorders (MBT-ED). The book starts with a
presentation of the theoretical concept of mentalization and
describes eating disorders from this perspective. This is followed
by a discussion of the place of MBT-ED in eating disorders
practice. MBT is first presented as the original model for
borderline personality disorder, and then the model is further
developed to address specific symptoms found in eating disorders,
such as body image disturbance, restriction and purging. The
original MBT model consists of outpatient treatment combined with
individual and group psychotherapy, and psychoeducation in groups.
The book then looks at supervision and training, and how an eating
disorders team can develop a mentalizing focus. It goes on to
describe the training required for practitioners to deliver
individual and group MBT-ED and to supervise therapy. Lastly, it
examines the implementation of the approach in different clinical
settings, including inpatient services, and how management can be
involved in negotiating barriers and taking advantage of enablers
in the system. The authors have conducted a pilot randomized
controlled trial and qualitative research in MBT-ED and have
extensive experience in providing and supervising this novel
therapy. MBT-ED is one of the few therapies for eating disorders
that links theory of mind, and attachment and psychodynamic
therapies and as such will be of great theoretical interest to a
wide variety of clinicians and researchers.
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