New Anger Workbook Now Available

We have now released our new Anger Workbook.  This along with our other workbooks are very helpful to people trying to overcome their difficulties.

Workbooks Now Available:

1. Eating Disorder
2. Dishonesty
3. Anger
4. Anxiety
5. Depression

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Intermittent Explosive Disorder - A Wicked Problem

Intermittent Explosive Disorder

Uncontrollable episodes of aggression, where the person loses control and assaults others or destroys property.

Persons with this disorder experience episodes of aggressive or violent behavior that result in assault of a person or animal or the destruction of property. These intense episodes occur spontaneously, not in response to provocation or threat, and individuals often express regret as soon as the episode ends. Usually he or she does not exhibit aggressive tendencies between episodes. This disorder can appear at any age, but is more common in adolescence through the 20s, and is more common in males. This disorder is believed to be rare, and reliable statistics on the frequency of occurrence are not available.

Aggression Definition

Aggressive behavior is reactionary and impulsive behavior that often results in breaking household rules or the law; aggressive behavior is violent and unpredictable. 

Frustration, resentment and anger are often generated by what Buddha called desire or attachment, which is the expectation that life will work out as we wish. Dr. Albert Ellis' Rational Emotive Behavior Therapy (REBT) similarly recognized the frustrating nature of irrational cognitions like "life should be fair." And anger can be and is often used by some (not unlike a drug) to cover up painful feelings, fear, anxiety, vulnerability and shame. Popular recovery counselor John Bradshaw refers to such bellicose individuals as "rageaholics." The best defense is a good offense. Certainly, much anger and resentment also stems from an underlying matrix of neurotic narcissism and grandiose sense of entitlement in adolescents and adults. Narcissistic Personality Disorder, is defined by the DSM-IV-TR as "a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy " and commonly includes a sense of entitlement, interpersonal exploitation, and preoccupation with fantasies of unlimited power, fame, brilliance, success,  beauty or ideal love. For the narcissist, it's all about me, my needs, what I want, my ego gratification. Such pathological narcissism and can be seen as a pervasive characterological defense compensating against profound feelings of inferiority, helplessness, sadness, and unlovability stemming from certain fundamental infantile and childhood needs having never been adequately met. When this over-inflated persona is inevitably deflated by stressful life events like divorce, rejection, abandonment, failure, aging and loss, narcissistic rage is triggered, along with other long-buried emotions. The burning desire for revenge, retaliation, and the compulsive need to vengefully repay the hurt, slight or insult no matter what it takes or costs is the central characteristic of narcissistic rage. These fiery, often overpowering emotional reactions can sometimes get so intense as to precipitate a major depressive, manic or even psychotic episode ("madness"), causing clinically significant temporary impairment of perception, rationality, judgment and impulse control. In such extremely debilitating, disorienting and dangerous states of mind, almost anything can happen. And often does.

Who is to blame for this problem? Well, in part, we all are. To the extent our society condemns and denigrates the affect of anger as negative, worthless or evil, ignoring and denying its positive potentialities, we are partially responsible for the subsequent carnage. To the extent mental health professionals continue to avoid confronting anger head on in our patients, choosing instead to try to drug, behaviorally modify or cognitively restructure the demon of anger away, we clinicians too are compounding the problem. Whatever our own complicity in this evil on the part of society, psychology and psychiatry, clearly the primary responsibility for violent behavior falls on the perpetrators shoulders. No matter what his or her childhood circumstances or subsequent traumatic experiences, adults are responsible for how they deal with their own history and their negative feelings about that history. Not addressing an anger disorder by denying its existence or refusing professional assistance is no excuse for the consequences of not doing so.

What can be done to contain the rage epidemic? When it comes to dealing effectively with anger disorders, so-called "anger management" classes are no substitute for intensive psychotherapy. In psychotherapy, the single most powerful, healing and difficult intervention the clinician can offer is to listen to the angry patient, and to acknowledge and accept his or her rage. Anger and rage have to first be validated, expressed, tolerated and understood before the underlying affects or distorted cognitions can be constructively addressed. The dilemma is that most mental health professionals tend to dread, denigrate and demonize anger, dismissing it as an inappropriate, destructive, negative and neurotic emotion. But anger is an appropriate, natural, normal and healthy response to frustration, injury, insult, and anything that threatens one's survival or psychological integrity. We need to be able to get angry at life's obstacles, challenges and assaults. Anger can bestow necessary strength, courage and tenacity in the face of adversity. When we are socialized to view getting angry as negative, evil, immoral or unspiritual, as so many of us have been, we automatically repress our anger--as we repress other impulses or passions of which we are ashamed. This is exactly what Jung describes as the shadow and Rollo May described as the daimonic: those aspects of human experience we find unacceptable, reject, banish and quarantine to unconsciousness. Anger is commonly experienced (if it is consciously experienced at all) as a shameful, frightening, negative emotion which must be hidden from others, and often, even from ourselves. The last thing therapists should do when working with angry patients is to further shame, criticize or punish them for feeling angry.

Bad behavior when furious is another matter, and must be firmly confronted. Evil deeds and destructiveness toward self or others cannot be condoned. These are neurotic forms of acting out, and function as a defense mechanism against fully experiencing that which underlies the anger or toward whom the anger is truly directed. Still, it is through first acknowledging, confronting, articulating and accepting the anger that the patient can become more conscious of what truly lies behind it, what drives and triggers it. Anger is not something that can be avoided or circumvented during the psychotherapy process. Anger is the alchemical key to the healing process, the exclusion, suppression or minimization of which impedes rather than promotes therapeutic progress. Without a courageous willingness to deal directly with the daimonic passions of anger or rage in treatment rather than trying merely to manage or defuse them cognitively, behaviorally or pharmacologically, psychotherapists cannot facilitate the deep emotional healing such patients seek. Instead, we unwittingly contribute to the growing epidemic of anger, rage, hostility, bitterness and destructive behavior.

Description

Aggression can a problem for children with both normal development and those with psychosocial disturbances. Aggression constitutes intended harm to another individual, even if the attempt to harm fails (such as a bullet fired from a gun that misses its human target). There is no single theory about the causes of aggressive behavior in humans. Some believe aggression is innate or instinctive. Social theorists suggest the breakdown in commonly shared values, changes in traditional family patterns of child-rearing, and social isolation lead to increasing aggression in children, adolescents, and adults. Aggression in children correlates with family unemployment, strife, criminality, and psychiatric disorders.

Differences exist between levels of aggression in boys and girls in the same families. Boys are almost always more aggressive than girls. Larger children are more aggressive than smaller ones. Active and intrusive children are also more aggressive than passive or reserved ones.

Aggressive behavior may be intentional or unintentional. Many hyperactive, clumsy children are accidentally aggressive, but their intentions are compassionate. Careful medical evaluation and diagnostic assessments distinguish between intentional behaviors and the unintentional behaviors of emotionally disturbed children.

Children in all age groups learn that aggressive behavior is a powerful way to communicate their wishes or deal with their likes and dislikes.

Infancy

Infants are aggressive when they are hungry, uncomfortable, fearful, angry, or in pain. Parents can tell what babies need by the loudness and pitch of crying and the flailing of arms and legs. Crying is an infant's defense, the way to communicate feelings and needs.

Toddlers

Children between two and four years of age show aggressive outbursts such as temper tantrums and hurting others or damaging toys and furniture because they are frustrated. Usually the aggression in this age group is expressed toward parents as a way to get their compliance with the child's wishes. Verbal aggression increases as vocabulary increases.

Preschool

Children between four and five years of age can be aggressive toward their siblings and peers. Because of greater social interaction, children need to learn the differences between real and imaginary insults, as well as the difference between standing up for their rights and attacking in anger.

School-age and adolescence

Aggressive boys between three to six years of age are likely to carry their behavior style into adolescence. In extreme cases, they may show aggression by purse snatching, muggings, or robbery, or in less overt ways by persistent truancy, lying, and vandalism. Girls younger than six years of age who have aggressive styles toward their peers do not tend to continue being aggressive when they are older, and their earlier aggression does not correlate with adult competitiveness.

Common problems

Frustration is a response to conditions that keep children from achieving goals important to self-esteem. Frustration and aggression are closely associated. If children learn that being aggressive when frustrated is tolerated or gives them special treatment, the behavior is reinforced and may be repeated. Aggression may be a way for children to face obstacles or solve problems. It is important not to attribute malice to children who are responding to anxiety, feelings of incompetence, or a sense of low self-esteem.

Through the media, including film, the U.S. culture reinforces violence and aggressive behavior in children. Police brutality, crime-based television programs, and governmental reliance on military aggression to solve political and economic differences all create a climate in which violence is presented to children as a legitimate solution to problems.

Violent behavior in children and adolescents

CULTURAL VIOLENCE Violence includes a wide range of behaviors: explosive temper tantrums, physical aggression, fighting, and threats or attempts to hurt others (including homicidal thoughts). Violent behaviors also include the use of weapons, cruelty toward animals, setting fires, and other intentional forms of destruction of property.

PREDISPOSITION TO VIOLENCE Some children are supersensitive, easily offended, and quick to anger. Many children are tense and unusually active, even as infants. They are often more difficult to soothe and settle as babies. Beginning in the preschool years, they are violent toward other children, adults, and even animals. They often lash out suddenly, sometimes for no obvious reason. When they hurt someone in their anger, they tend not to be sorry and may tend not to take responsibility for their actions. Instead, they blame others for their own actions. Parent should give this behavior serious attention and take measures to correct it.

Children may go through a brief period of aggressive behavior if they are worried, tired, or stressed. If the behavior continues for more than a few weeks, parents should talk to the pediatrician. If it becomes a daily pattern for more than three to six months, it could be a serious problem.

Factors that increase risk of violent behavior

Parents and teachers should be careful not to play down aggressive behaviors in children. In fact, certain factors put some children at risk for developing violent behaviors as adults. These factors include the following:

• being the victim of physical and sexual abuse
• exposure to violence in the home and community
• exposure to violence in media (TV, movies)
• use of drugs and alcohol
• presence of firearms in home
• combination of stressful family socioeconomic factors (poverty, severe deprivation, marital breakup, single parenting, unemployment, loss of support from extended family)
• brain injury

Parents can teach children nonviolence by controlling their own tempers. If parents express anger in quiet, assertive ways, children may follow their parent's example. Children need to understand when they have done something wrong so they can learn to take responsibility for their actions and learn ways to make amends. Responsible parenting does not to tolerate violence or use it in any way.

Violence prevention strategies

Efforts should be directed at dramatically decreasing the exposure of children and adolescents to violence in the home, community, and through the media. Clearly, violence leads to violence. Parents can use the following strategies to reduce or prevent violent behavior:

• prevent child abuse in the home
• provide sex education and parenting programs for adolescents
• provide early intervention programs for violent youngsters
• monitor children's TV programs, videos, and movies

The most important step that parents can take with aggressive children is to set firm, consistent limits and be sure that everyone caring for the children acts in accord with the parents' rules and expectations.

Parents should know the importance of helping children find ways to deal with anger without resorting to violence. Children can learn to say no to their peers, and they can learn how to settle differences with words instead of physical aggression. When children control their violent impulses, they should be praised.

Parental concerns

All children have feelings of anger and aggression. Children need to learn positive ways to express these feelings and to negotiate for what they want while maintaining respect for others. Parents can help their children develop judgment, self discipline, and the other tools children need to express feelings in more acceptable ways and to live with others in a safe way.

Understanding the aggressive child

When children lose their sense of connection to others, they may feel tense, frightened, or isolated. These are the times when they may unintentionally lash out at other children, even children to whom they are close. Parents should be careful not to let children think aggression is acceptable.

When children are overcome with feelings of isolation or despair, they may run for the nearest safe person and begin to cry. They immediately release the terrible feelings, trusting that they are safe from danger and criticism. Effective parents listen and allow the child to vent without becoming alarmed.

Disciplining aggressive behavior

Parents can control the aggressive child in various ways. They should intervene quickly but calmly to interrupt the aggression and prevent the their child from hurting another child. Younger children may need a time-out to calm down and before rejoining a group. Simple rules about appropriate behavior are easier for a child to understand than lengthy explanations. Parents can affirm feelings while stressing that all feelings cannot be acted upon.

Parents can reach older children with eye contact, a stern voice, and physical contact. Older children can be told that they need to learn a better way to handle conflicts. Parents can suggest that, for instance, the child ask an adult to intervene before lashing out at a classmate. Any disciplinary measures should be explained as a simple consequence to the child's aggression.

When parents arrive after conflict occurs, it may be useful to listen to the child's explanation. Having a parent listen can encourage the child to develop trust in the parent.

Parents should not expect the aggressive child to be reasonable when he or she is upset. The child may need time to calm down. Sometimes the child may feel trapped and may need adult support. Parents should encourage the aggressive child to come to them when they are upset, hopefully before violence occurs.

KEY TERMS

Anxiety—Worry or tension in response to real or imagined stress, danger, or dreaded situations. Physical reactions, such as fast pulse, sweating, trembling, fatigue, and weakness, may accompany anxiety.
Consequences—Events that occur immediately after the target behavior.
Misbehavior—Behavior outside the norms of acceptance within the group.
Time-out—A discipline strategy that entails briefly isolating a disruptive child in order to interrupt and avoid reinforcement of negative behavior.

BOOKS

Davis, Jean Q. Anger, Aggression, and Adolescents. New York: Pantheon Books, 2004.
Delfos, Martine F. Anxiety, ADHD, Depression, and Aggression in Childhood: Guidelines for Diagnostics and Treatment. Herndon, VA: Jessica Kingsley Publishers, 2003.
Valkenburg, Pattie M. Children's Responses to the Screen: A Media Psychological Approach. Mahwah, NJ: Lawrence Erlbaum Associates, 2004.

ORGANIZATIONS

Parents Leadership Institute. PO Box 1279, Palo Alto, CA 94302. Web site: .

WEB SITES

"Understanding Violent Behavior in Children and Adolescents." American Academy of Child and Adolescent Psychiatry, March 2001. Available online at (accessed December 12, 2004).

Impulse Control Disorders

A psychological disorder characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.

Impulse control disorders are thought to have both neurological and environmental causes and are known to be exacerbated by stress. Some mental health professionals regard several of these disorders, such as compulsive gambling or shopping, as addictions. In impulse control disorder, the impulse action is typically preceded by feelings of tension and excitement and followed by a sense of relief and gratification, often—but not always—accompanied by guilt or remorse. Researchers have discovered a link between the control of impulses and the neurotransmitter serotonin, a chemical agent secreted by nerve cells in the brain. Selective serotonin reuptake inhibitors (SSRIs), medications such as Prozac that are used to treat depression and other disorders, have been effective in the treatment of impulse control disorders. The American Psychiatric Associationpyromanía, trichotillomania (compulsive hair-pulling), intermittent explosive disorder, kleptomania, pathological gambling, and other impulse-control disorders not otherwise specified. The first three of these disorders are known to affect children and/or adolescents. describes several impulse control disorders:

Pyromania involves the repeated setting of fires for no specific reason (such as sabotage or revenge). Rather, the pyromaniac is someone who tends to have a fascination with fire itself, often expressed as an interest in firefighters and their procedures and equipment. It is not uncommon for a pyromaniac to set a fire, report it himself, and then watch as firefighters put it out, even offering to assist them. Pyromania can occur in a child as young as age three, although it is rare at any age and even rarer in childhood. While children and adolescents account for over 40% of those arrested for arson in the United States, only a small percent of fires set by young people indicate the presence of pyromania. Juvenile fire-setting is usually attributed to more generalized conditions characterized by a broad range of impulsive and/or antisocial behavior, such as conduct or adjustment disorders attention deficit/hyperactivity disorder (ADHD).

Of those persons diagnosed with pyromania, the vast majority—some 90%—are male. Pyromaniacs have feelings of sadness and loneliness that eventually give way to rage, for which setting fires serves as an outlet. Some researchers have linked pyromania to victims of child abuse. Persons affected by this disorder often suffer from other behavioral problems and also tend to have learning disabilities and attention disorders. Often, children who set fires also have a history of cruelty to animals. Some common biological characteristics have been discovered in pyromaniacs, including abnormalities in the levels of the neurotransmitters norepinephrine and serotonin, which may be related to problems with impulse control, and low blood sugar levels.

Pyromania has responded to behavioral treatment designed to increase a person's awareness of the emotions that lead up to a fire-setting episode and provide alternate ways of dealing with them. Often this type of therapy is followed by a more psychodynamically oriented approach that deals with the deeper underlying problems that arouse the negative emotions associated with the disorder. Family therapy has been particularly successful with children, as have community-based intervention programs, some of which have the youngsters spend some time with firefighters who can serve as positive role models and help build their self-esteem. Selective serotonin reuptake inhibitors (SSRIs) are also used to treat pyromania. Childhood pyromania responds well to treatment and is eradicated in about 95% of children who demonstrate signs of the disorder.

Trichotillomania is the name given to compulsive hair-pulling not caused by any other condition, such as schizophrenia. In children, it occurs equally among males and females; in adults, it is much more common in females. Statistics on the incidence of trichotillomania are scant, for most people affected by it do not seek professional help. However, a well-documented survey taken on a college campus found between 1-2% of students affected by this disorder, with the incidence in females as high as 3.4%, more than twice that in males. Another study found trichotillomania to be about one-fifth as prevalent as nail-biting, a habit practiced by 20% of Americans, which would place the incidence of trichotillomania at 4% of the population. The primary ages of onset are between 5-8 years of age and 13. Many young children exhibit harmless hair-pulling (often in conjunction with thumb-sucking) that stops by the age of six. However, some continue to revert to this habit in times of stress, a tendency that can eventually lead to trichotillomania. In some individuals the condition is episodic, while in others it continues steadily for long periods of time.

In trichotillomania, hair is most often pulled from the scalp, resulting in bald patches, but it can also be pulled from the eyebrows, eyelashes, beard, torso, armpits, or pubic area. The hair may be pulled in short repeated episodes or for hours at a time. Hair-pulling is often accompanied by other actions, including chewing on or swallowing the pulled hair, called tricophagia. Trichotillomania has been associated with depression, anxiety, and obsessive-compulsive disorder (OCD), but it is still recognized as a disorder distinct from these conditions. It has been linked neurologically to distinctive patterns of glucose metabolization and is thought to have a genetic component. Effective drug treatments include selective SSRIs (particularly Prozac), lithium, and SSRIs in combination with the drug pimozide (Orap), which affect the brain chemical dopamine. Psychotherapy has proven more effective in children with the condition than in adolescents or adults. In some cases, hypnosis is used to break the habit and explore any underlying emotional problem that may be at its root.

Intermittent explosive disorder was only recently recognized as an impulse-control disorder. It is characterized by violent and aggressive outbursts of temper that are significantly disproportionate to the events that trigger them. These outbursts often result in property damage and/or personal injury. Occurring mostly in teenagers and young adults, it is four times as common in men as in women and appears to have a genetic component, as evidenced by multigenerational family histories of violence. The outbursts of temper that characterize intermittent explosive disorder, like the symptoms of other impulse control disorders, are often followed by feelings of relief and eventual remorse. Treatment consists of both therapy and medication. Antipsychotic drugs, anticonvulsants, betablockers, lithium, and benzodiazepines have all shown to alleviate the symptoms of this disorder.

A condition not listed by the American Psychiatric Association that some experts consider an impulse-control disorder is repetitive self-mutilation, in which people intentionally harm themselves by cutting, burning, or scratching their bodies. Other forms of repetitive self-mutilation include sticking oneself with needles, punching or slapping the face, and swallowing harmful substances. Self-mutilation tends to occur in persons who have suffered traumas early in life, such as sexual abuse or the death of a parent, and often has its onset at times of unusual stress. In many cases, the triggering event is a perceived rejection by a parent or romantic interest. Characteristics commonly seen in persons with this disorder include perfectionism, dissatisfaction with one's physical appearance, and difficulty controlling and expressing emotions. It is often seen in conjunction with schizophrenia, post-traumatic stress syndrome, and various personality disorders. Usual onset is late childhood or early adolescence; it is more frequent in females than in males.

Those who consider self-mutilation an impulse control disorder do so because, like the other conditions that fall into this category, it is a habitual, harmful activity. Victims often claim that it is accompanied by feelings of excitement, and that it reduces or relieves negative feelings such as tension, anger, anxiety, depression, and loneliness. They also describe it as addictive. Self-mutilating behavior may occur in episodes, with periods of remission, or may be continuous over a number of years. Repetitive self-mutilation often worsens over time, resulting in increasingly serious forms of injury that may culminate in suicide. Treatment includes both psychotherapy and medication. The SSRI Clomipramine (Anafranil), often used to treat obsessive-compulsive disorder, has also been found effective in treating repetitive self-mutilation. Behavioral therapy can teach persons with this disorder certain techniques they can use to block the impulse to harm themselves, such as spending more time in public places (because self-mutilating behavior is almost always practiced secretly), using music to alter the mental state that leads to self-mutilation, and wearing protective garments to prevent or lessen injury. In-depth psychodynamic therapy can help persons with the disorder express the feelings that lead them to harm themselves.

Books

Gaynor, Jessica, and Chris Hatcher. The Psychology of Child Firesetting: Detection and Intervention. New York: Bruner/Mazel, 1987.

Koziol, Leonard F., Chris E. Stout, and Douglas H. Ruben, eds. Handbook of Childhood Impulse Disorders and ADHD: Theory and Practice. Springfield, IL: C.C. Thomas, 1993.

Rider, Anthony Olen. The Firesetter: A Psychological Profile. Washington, D.C.: Federal Bureau of Investigation, U.S. Department of Justice, 1984.

Stein, D. J., ed. Impulsivity and Aggression. Chichester, NY: Wiley, 1995.

Rise In Children Under 12 Developing Eating Disorders

Rate of Eating Disorders in Kids Keeps Rising

MONDAY, Nov. 29 (HealthDay News) -- Eating disorders have risen steadily in children and teens over the last few decades, with some of the sharpest increases occurring in boys and minority youths, according to a new report.

In one startling statistic cited in the report, an analysis by the Agency for Healthcare Research and Quality found that hospitalizations for eating disorders jumped by 119 percent between 1999 and 2006 for kids younger than 12.

At the same time as severe cases of anorexia and bulimia have risen, so too have "partial-syndrome" eating disorders -- young people who have some, but not all, of the symptoms of an eating disorder. Athletes, including gymnasts and wrestlers, and performers, including dancers and models, may be particularly at risk, according to the report.

"We are seeing a lot more eating disorders than we used to and we are seeing it in people we didn't associate with eating disorders in the past -- a lot of boys, little kids, people of color and those with lower socioeconomic backgrounds," said report author Dr. David Rosen, a professor of pediatrics, internal medicine and psychiatry at University of Michigan. "The stereotype [patient] is of an affluent white girl of a certain age. We wanted people to understand eating disorders are equal-opportunity disorders."

The report is published in the December issue of Pediatrics.

While an estimated 0.5 percent of adolescent girls in the United States have anorexia and about 1 to 2 percent have bulimia, experts estimate that between 0.8 to 14 percent of Americans generally have at least some of the physical and psychological symptoms of an eating disorder, according to the report.

Boys now represent about 5 to 10 percent of those with eating disorders, although some research suggests that number may be even higher, said Lisa Lilenfeld, incoming president of the Eating Disorders Coalition for Research, Policy and Action in Washington, D.C.

Most studies that have been focused on prevalence were based on patients in treatment centers, who tended to be white females, Lilenfeld said. "That does not represent all of those who are suffering," she said. "It's hard to say if eating disorders are on the rise in males, or if we're just doing a better job of detecting it."

Rosen and his colleagues pored over more than 200 recent studies on eating disorders. While much is unknown about what triggers these conditions, experts now understand it takes more than media images of very thin women, although that's not to say those don't play a role, Rosen said.

Like other mental health problems and addictions, ranging from depression to anxiety disorder to alcoholism, family and twin studies have shown that eating disorders can run in families, indicating there's a strong genetic component, Rosen said.

"We used to think eating disorders were the consequences of bad family dynamics, that the media caused eating disorders or that individuals who had certain personality traits got eating disorders," Rosen said. "All of those can play a role, but it's just not that simple. All young women are exposed to the same media influences, but only a small percentage of them develop eating disorders. So what is different about those 1 percent that develop an eating disorder compared to the 99 percent who don't?"

At the same time as eating disorders have risen, the obesity epidemic has also exploded. Concerns about overweight and obese children have prompted some physicians to counsel their young patients about nutrition. That's an approach that can backfire when not handled correctly, however.

"There are lots of kids in my practice who say their eating disorder started when their family doctor told them, 'You could stand to lose a few pounds,'" Rosen said. "As physicians, we need to make sure our conversations are not inadvertently hurtful or impact their self esteem."

For people who are genetically vulnerable, dieting itself is a risk factor for eating disorders, while strict dieting is even a bigger risk, Lilenfeld said.

Parents and pediatricians should look for signs of eating disorders, including a child whose progress on growth charts suddenly changes, very restrictive eating, compulsive overexercising, making concerning statements about body image, vomiting, disappearing after meals or use of laxatives and diet pills.

Eating disorders, especially anorexia, can have long-term consequences for health, including leading to early osteoporosis and death.

"We know the sooner they get some evidence-based treatments, the better the outcome," Lilenfeld said.

"The good news is eating disorders can be 'cured' -- that is to say, the person isn't merely keeping the condition at bay but can actually get over it," Rosen said. With treatment and maturity, many kids move beyond the eating disorder.

"The conventional wisdom is eating disorders are incurable. You have them for life, you never get better and the best you can hope for is to keep it under control like alcoholism," Rosen said. "That's not the reality, particular for children and teenagers with eating disorders. The majority of children and adolescents get all better."

More information

The U.S. National Institute of Mental Health has more on eating disorders.


SOURCES: David Rosen, M.D., M.P.H., professor, pediatrics, internal medicine and psychiatry, University of Michigan, Ann Arbor, Mich.; Lisa Lilenfeld, Ph.D., incoming president, Eating Disorders Coalition for Research, Policy and Action, Washington, D.C.; December 2010, Pediatrics

Body Dysmorphic Disorder - When the Mirror Lies

No matter how much weight is lost, or no matter how much food is thrown up, the person with anorexia or bulimia will constantly see the same overweight, vile, failure in the mirror. This typically leads to very destructive and even deadly methods of weight loss in a desperate attempt to lose the distorted perception - in this case, fat (failure). It is very hard, though, for anyone that does not have an eating disorder to be able to understand just how someone could do this to themselves - go through hospitilizations and near death experiences even - but continually see themselves so distorted. Even though Body Dysmorphic disorder isn't just shown in cases of eating disorders (someone afflicted with BDD can obsess not about weight, but instead about their hair, nose, chest, etc.), it still hurts and ruins the lives of whoever is afflicted with it.

At one time or another we all worry about our appearance, but when you wake up degrading your nose, hair, chest, WEIGHT, etc. and then continuing to have these thoughts all day, that's when there is a problem. Closely linked to other disorders and psychiatric conditions, Body Dysmorphic Disorder (termed shortly BDD) is a serious disorder that is growing fast. People that suffer from BDD not only dislike some aspect of how they look, they're preoccupied severely with it. Most get to the point where it is very hard to go outside or sit down comfortably, or go to work and talk to others, without thinking the No Iframes self-degrading thoughts about their flaws. The thoughts soon over take the person's mind and it is all he/she can think about.

The problem, though, is that all of these self-degrading thoughts about a perceived flaw are distorted. Many, many times the supposed flaw doesn't even exist, or an "imperfect" body part is blown entirely out of proportion. However, the person themselves cannot see that what they believe is distorted. Many hold the belief that they are seeing all of this, therefore it MUST be true. This is one of the main reasons that it is so hard for people on the "outside" to try and convince even the most severely emaciated people with anorexia that they are not fat or failures - the people with anorexia and/or bulimia themselves literally cannot look in the mirror and see the same person that everyone else sees.

Kinda like a cloud i was up way up in the sky
and i was feeling some feelings you wouldn't believe
Sometimes i don't believe them myself
and i decided i was never coming down
Just then a tiny little dot caught my eye
It was just about too small to see
but i watched it way too long
...and that dot was pulling me down-NIN

It's estimated that Body Dysmorphic Disorder affects 1 in 50 people, mostly teenagers and 20-somethings with either a gradual or abrupt onset. Often the person is a perfectionist, like most people with eating disorders. Nothing is good enough because the person cannot see that what they have done is absolutely fine, or that they are on the border of near death (in the case of anorexia and extreme weight loss). Low self-esteem is a trademark of those with BDD as they feel like colossal failures for their perceived physical flaws.

BDD can lead or take after other psychiatric problems as well. Depression, obsessive compulsive disorder, eating disorders, anxiety issues, agoraphobia, and trichotillomania (hair pulling) are all problems that commonly follow or trigger BDD.

One person that I know that is in treatment for BDD and other issues became afflicted after a rape. Although she doesn't fit the common statistics in that she is 32 and Latino, the BDD immediately showed itself after the incident. She felt that the rapist was "inside of her" somehow and making her "ugly and disgustingly horrid from the inside out." She began to check her face and nude body in the mirror. At her worse, she was doing this about 5 hours a day. She felt degraded and disgusting from what happened to her, believing that only something that was disgusting and worthless and ugly could be raped. Eventually, the isolation and weird habits pushed her family to convince her to get help (thankfully). It took a lot of persistence, though, since she did not believe there was a problem, even in her most severely depressed times.

treatment

Often Body Dysmorphic Disorder is mis-diagnosed because doctors tend to have a lack of familiarity with the disorder. Many times those afflicted feel so ashamed and worthless that they down-play the problem or do not even recognize that they need help, so they end up staying in hiding. Families may even trivialize this problem, not realizing that this extreme distortion cannot be resolved through "getting over it" or calling it a "phase." However, when you or someone you know is ready to accept help and is willing to get it, there are therapists out there that specialize in treating distortion cases while new methods of treatment for Body Dysmorphic Disorder are currently being studied.

One recent study was made where 17 individuals, all diagnosed with BDD, spent 4 weeks of daily 90 minute sessions with therapists. Cognitive behavior therapy was used to treat their conditions. Further treatment for Body Dysmorphic Disorder included having them exposed to their perceived physical defect, and they were prevented from engaging in any behaviors that increased the discomfort and triggered the BDD more. In the cognitive behavior therapy the individuals were also taught how to resist compulsive behaviors and face avoided situations. At the end of this study, a significant decrease was found in the individuals' pre-occupations and time spent engaged in destructive behaviors and thoughts.

Common anti-depressants were also used to help further the treatment. Prozac, Zoloft, Paxil, Luvox, and Anafranil are all common anti-depressants that are used to treat this disorder (as well as depression), and they have all been show to help stop the behaviors associated with Body Dysmorphic Disorder.

New Podcast - Cognitive Distortions

Our newest Podcast on Cognitive Distortions is available!

Sorry I have found myself with quite the sinus infection so my voice is pretty bad but this is an important show none-the-less!

http://www.addictions.net  

Listen to internet radio with EDRC on Blog Talk Radio

WOW I have alot to learn

Whew!  Well I'm definately on a learning curve with all this new stuff.  I'm not very computer savy!  But I'll learn. Anyway -  I hope all the information I posted is helpful.  Looking forward to this new process!
Deb

All About Prader-Willi Syndrome

What is Prader-Willi Syndrome?

Prader-willi syndrome is a disorder in which someone has a compulsive desire to eat. People with this condition are often short in stature, have light skin, poor muscle tone, suffer from mental retardation and are frequently obese. They are typically very friendly, but frequently find it hard to control their emotions if frustration or stress occurs.
The insatiable appetite those with prader-willi syndrome have is a genetic disorder present at birth. Due to a defect found in the hypothalamus, a person with prader-willi syndrome can never achieve a state of complete fullness and will always have an uncontrollable urge to eat. Excessive eating habits of those with prader-willi syndrome are often monitored to prevent severe health complications. Eating disorder treatment may be available for people suffering from this disorder and several others.

Who has Prader-Willi Syndrome?

Prader-willi syndrome can affect people of all ethnic backgrounds and is common in both boys and girls. This syndrome affects one person out of approximately 12,000 to 15,000 people.
It is uncertain as to whether this syndrome is genetic or not, but it is confirmed that this disorder is congenital, meaning it begins at birth. This condition is brought about by the lack of genes in chromosome 15.

Ten Common Signs of Prader-Willi Syndrome

1. Constant eating
2. Stealing food
3. Picking at the skin
4. Abnormal eating patterns, such as eating garbage, pet food and frozen foods
5. Difficulty sleeping
6. Never completely full after eating
7. Hiding food
8. Frequent loss of temper
9. Strict eating rules are in place
10. Difficulties with learning

Risks/Complications of Prader-Willi Syndrome

The following are a few complications that can occur with the presence of prader-willi syndrome:

• Obesity
• Mental retardation
• Almond-shaped eyes
• Speech impairments
• Short stature
• Type 2 diabetes
• Weak muscles
• Infertility
• Poor sexual development
• Obsessive compulsive disorder
• Hypotonia
• High narrow forehead
• Fair skin, easily bruised
• High tolerance for pain

Complications of obesity as a result of an eating disorder can be damaging to the health of a person. Eating disorder residential centers offer treatment for obese individuals seeking treatment for an eating disorder. These eating disorder treatment centers desire to give full recovery to their residents and prevent further complications from arising.

Diabulimia: A Diabetic’s Struggle

Diabetes & Eating Disorders

Type 1 Diabetes

When someone has type 1 diabetes, the insulin producing cells in their pancreas are attacked by the immune system in the body. Due to this problem, the body no longer has enough insulin because the pancreas has stopped making it. Insulin is needed to survive. Someone with this form of diabetes must use an insulin pump or take insulin injections numerous times throughout the day in order to stay healthy.
Insulin is important to the body because it processes blood glucose in the body and glucose is needed in the cells for energy. Without insulin, the body would suffer and glucose levels would rise to unhealthy levels. Specific problems associated with a lack of insulin include hypoglycemia, nerve damage and kidney failure. Vision problems are another side effect of a lack of insulin in the body. In fact, out of all the reasons for blindness in the United States, diabetes is listed as number one.
Most cases of type 1 diabetes occur among children and young adults. When this disorder first begins in the body, weight loss takes place. However, once the problem is fixed with insulin supplements, weight is put back on the body. When this occurs in a young adult, body image problems easily take place due to the constant pressure to be thin and the numerous changes of adolescence. An eating disorder is often one of these problems. If you or a loved one has an eating disorder it is important to seek eating disorder treatment at an eating disorder residential center as soon as possible. These centers have been proven beneficial to the recovery process.

Diabulimia

The condition known to many as diabulimia is a form of eating disorder. This condition exists when someone with diabetes reduces or completely eliminates the amount of insulin they need as a way of loosing weight. This method is extremely bad for one’s health as it causes the blood sugar levels to overflow, causing the kidneys to work harder in an effort to eliminate excess glucose from the body through urination.
Most cases of diabulimia occur in those with type 1 diabetes. Diabulimia is not yet recognized as a medical condition but seems to be very well-known amongst diabetics and the American Diabetes Association. Teenagers are the most common age group in which diabulimia occurs. Diabulimia is often compared to the common eating disorder bulimia because in bulimia a person purges the food they eat and in diabulimia a person metaphorically “purges” sugar from the body.
On average, about 30% of women who have type 1 diabetes say they have skipped and/or entirely eliminated insulin doses in an attempt to lose weight. Weight loss can also be blamed on diabetes because it can be used as a way to hide the eating disorder, diabulimia. Eating disorder treatment is often helpful to those struggling with an eating disorder such as diabulimia. Diabulimia therapies, anorexia treatment and bulimia programs can be found at most eating disorder residential centers.

Obsession with Health & Perfection

One reason eating disorders so often occur in those with diabetes is because each of these complications have a common obsession with food. In someone with diabetes, strict attention must be focused on what is eaten, how much is eaten, when it is eaten and of what quality it is. These individuals must also focus on their level of blood sugar or serious mood swings can occur. Diabetics need to maintain this diet in order to stay as healthy as possible. When so much time and energy is placed into the control of food and health, diabetes can become a leading cause for having an eating disorder.
Weight control is another important factor in both diabetes and eating disorders. Just as a diabetic strives to perfectly control various aspect of their health, someone with an eating disorder desires to find and maintain the “perfect” weight. Because of these similarities diabetes is often used to hide an eating disorder. Recovery for an eating disorder such as diabulimia can be found by taking a look at the programs of many eating disorder treatment centers. Eating disorder treatment has proven helpful to a variety of people and many programs are successful in preventing relapse.

Symptoms of Diabulimia

The symptoms of diabulimia can be very harmful to one’s body. If this process of insulin restriction continues death may even result. Symptoms of diabulimia include:

• Increased levels of blood sugar
• Low energy levels
• Failure of one’s kidneys
• Dehydration
• Damage to nerves
• Tiredness
• Retinopathy (damage to the eyes)
• Complications in the heart
• Quick weight loss
• Frequent urination
• Death
• Amputations (caused by a vascular disease)
• Hypoglycemia
• Grouchy, moody
• Coma
• Diabetic ketoacidosis
• Poor body image
• Depression in which help from a depression treatment facility may be necessary

Eating disorder treatment is often recommended for those struggling with anorexia, diabulimia or bulimia. Bulimia help, anorexia treatment and therapy for diabulimia is available for those willing to seek treatment at one of many eating disorder treatment centers. Team treatment is one of the many therapies often strongly recommended for those who have diabulimia. A dietician is another important aspect of recovery which is crucial to eating disorder treatment.

Top 20 Famous Athletes With Eating Disorders

Well-known Male & Female Athletes with Eating Disorders

Many athletes, past and present, have dealt with an eating disorder. These eating disorders have caused great turmoil in their lives, and consequently, have had a negative impact on their athletic careers. In many of these people, perfectionist behavior and a competitive nature exist. These are personality traits common in eating disordered people as well. Anorexia and bulimia are the two most popular forms of eating disorders among athletes.

Certain types of sports or the presence of a demanding coach increase the possibility of an eating disorder. If you are an athlete and find that you have an eating disorder, seeking eating disorder treatment at an eating disorder treatment clinic is often beneficial to recovery. Which famous athletes have struggled with eating disorders that eventually had a negative impact on their athletic ability? The following list includes a variety of athletes who have struggled with anorexia and/or bulimia.

11. Nancy Kerrigan – A winner of 2 Olympic medals for figure skating, Nancy also struggled with an eating disorder. Her eating disorder may have been triggered in part by being purposely injured in the leg by a hired attacker.
12. Kelly Masey – Masey was a gymnast who also suffered from an eating disorder. She is thought to have begun this disorder as a result of high pressure to succeed in the sport.
13. Martina Eberl – Martina, a German golfer, struggled with the eating disorder bulimia. This disorder began when the golfer was about 14 years old. She had the illness for over ten years before she finally sought out treatment. Today, she is recovered and has since returned to golf.b
14. Stefan Zund – This Swiss ski-jumper dealt with an eating disorder that eventually ended his sports career. During his career, he won several victories at the World-Cup.
15. Christy Henrich – This U.S. gymnast eventually developed anorexia and bulimia, eating disorders which plagued her for several years. The story frequently mentioned is that she was told by a United States judge that she was too fat to excel in gymnastics, and thus developed an eating disorder to lose weight. Eventually, multiple organ failure (caused by her disorder) killed her at the age of 22, she was 47 pounds.
16. Megan Neyer – Megan, a professional diver, struggled with bulimia for approximately 7 years. This may have been due to her perfectionist and competitive nature.
17. Laffit Pincay – This jockey dealt with the eating disorder anorexia. During his career he was named the leading jockey of the United States 7 times, he also won a variety of other awards.
18. Jamie Silverstein – After 5 years of struggling with anorexia, Jamie, a pairs figure skater, sought help for her disorder. She took four years off from ice skating and after her recovery was once again able to compete and perform in competitions such as the Olympics.
19. Kathy Johnson – This gymnast developed anorexia after harsh criticism about her weight from a coach.
20. Heidi Guenther – Heidi was a ballet dancer who struggled with anorexia after being advised by her ballet company to lose 5 pounds. She died at the age of 22 because of the complications associated with her disorder. After her death, a program was created to raise awareness and reduce eating disorders in dancers.

Specialized programs offered at eating disorder treatment centers can be very helpful to anyone dealing with an eating disorder. Therapy sessions offered in anorexia treatment facilities and bulimia clinics may be especially helpful to perfectionists and those dealing with large amounts of stress. Full recovery is an option at an eating disorder residential center and been proven effective in numerous cases. Don’t let an eating disorder hinder your life and ability to succeed as an athlete, as it did many of these famous athletes.

Top 20 Famous Athletes With Eating Disorders

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