Student ID: 18104894
CNS ED 6000
November 12, 2012
Counseling Women Diagnosed With Bulimia Nervosa
This literature review will introduce bulimia nervosa and discuss research that pertains to counseling women who seek treatment for this particular eating disorder. The information included will be helpful for counselors and those seeking help for bulimia or for a loved one. This paper addresses matters that cause and compound bulimic pathology, such as exposure to western culture and deficient emotional regulation. It also outlines several counseling modalities that benefit the population. Cognitive Behavioral Therapy (CBT) and its variants, Interpersonal Therapy (IPT) and Dialectical Behavioral Therapy (DBT) are therapies that benefit female bulimics, as evidenced by empirical support. This paper touches on two Mindfulness-based adjunctive interventions. Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Eating Awareness Training (MB-EAT) also benefit the female bulimic population, as evidenced by phenomenological research. Introduction
Bulimia nervosa is characterized by episodes of binge-eating behavior followed by compensatory behaviors (such as self-induced vomiting, laxative abuse, restrictive eating and/or excessive exercise), which are designed to control the body and the emotional internal world (Broussard, 2005; Johnson & Connors, 1987; Wilson & Shafran 2007). The disease primarily affects “urban, upper- and upper-middle class, mid-to-late adolescent white females,” living in the context of “western industrial, capitalist nations,” (Bendfeld-Zachrisson, 1992). Clinical trials reflect a prevalence of bulimia in women between 1 and 20 % of the entire population (Bendfeld-Zachrisson, 1992). While men suffer from bulimia, the disease is principally associated with females (Johnson et al., 1987). Research reflects that bulimia presents as a chronic and self-perpetuating condition (Fairburn, 2008; Wilson et al., 2007). Wilson et al (2007) studied women who seek treatment for bulimia and found that bulimia is among the most difficult psychological disorders to treat. He explains that remission is commonly transitory and relapse happens frequently. Even the most successful treatment modalities fail to offer a female client long-term healing from her eating disorder (Wilson, 2007). Nevertheless, research shows that an enhanced form of Cognitive Behavioral Therapy (CBT-E), Interpersonal Therapy (IPT) and Dialectical Behavioral Therapy (DBT) each illustrate empirical effectiveness in the context of treating the distorted thoughts, interpersonal struggles and emotional distress that maintain bulimic behavior (Fairburn, 2008; Kristeller, Baer & Quillian-Wolever, 2006; Mitchell, Agras & Wonderlich, 2007). Furthermore, pieces of mindfulness-based phenomenological research underscore the significance of cultivating awareness within the bulimic population, which can be integrated by means of Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Eating Awareness Training (MB-EAT) (Kristeller & Wolever, 2011; Kristeller et al, 2006). Causality and Features that Influence Bulimia Nervosa
Johnson et al. (1987) conducted research on the etiology of bulimia; they state that any conceptualization of causality is much too limited a view on the etiology of bulimic behavior. Still, research shows that exposure to western culture and emotional dysregulation are two significant causal features that perpetuate the disorder (Bendfelt-Zachrisson, 1992; Schupack-Neuberg & Nemeroff, 1992; Stice & Shaw, 1994). Societal and Cultural Influences
Bendfeldt-Zachrisson (1992) discusses how culture is an agency responsible for bulimic behavior. He deliberates that a woman’s preoccupation with her ability to force her body to conform to western culture’s “dominant beauty [norm]” can cause bulimic reactivity. Conversely,...