Treatment in anorexia nervosa.

A discussion of "Anorexia Nervosa and the Psychotherapeutic Hospital," by Ian Story Ph.D. "Anorexia Nervosa" is a misnomer. "Anorexic" patients do not suffer from loss of appetite but actively pursue self-starvation and are frantically preoccupied with food, and even more with their size and shape. It is not an illness of weight and nutrition but a desperate effort to establish a sense of control to counteract deficits in the sense of effectiveness and the self-concept. After a childhood of overconformity, these patients are ill prepared to meet the demands for independence and self-assertion that growing up implies. Traditional treatment has emphasized the restitution of weight, which, however, is insufficient for cure. For effective treatment, reparation of the underlying personality deficits is essential. Story's paper on the therapeutic hospital describes the desperate plight of chronic anorexic patients in whose early treatment this important factor had been neglected.