sarah (_blueingreen) wrote in ed_ucate,

Excerpts from article on potential therapy for anorexia

Hi! This is my first post -- been lurking for something over two years. I'm not posting the whole thing because I can't find the article online, so I've just put the parts related to eating disorders:

Here's a link, but you only get a preview (I have the magazine): here .

Fantasy Therapy: Steeping patients in computer-created virtual worlds can help heal a multitude of psychiatric ills, including phobias, eating disorders and implacable pain

By Nikolas Westerhoff

Jonah is inching upward in the glass-walled exterior elevator of a 70-story skyscraper. For each story he ascends, he rates his fear on a 100-point scale. At the top, he peers out over a microcosm of office towers, streets and gas stations—that are not really there. While donning a headset that produces three-dimensional images, Jonah is receiving an experimental therapy for a debilitating fear of heights.
The goal of the treatment is habituation, a form of learning in which a response to a stimulus diminishes with repeated exposure. Traditionally this exposure is done in real-world settings -- in an actual skyscraper, or on an airplane (for fear of flying) or with a spider (for spider phobia). But in a new twist, clinicians are increasingly replacing reality with 3-D computer simulations...

Such virtual reality (VR) technologies can also help combat anorexia, post-traumatic stress disorder and pain, among other psychological ailments. Moreover, studies of virtual therapies are accumulating apace...

... Recent applications of such technologies include therapy for obsessive-compulsive disorder and outpatient treatment of bulimia. The American Psychological Association (APA) estimates that some 2 percent of U.S. therapists are using virtual reality and other media-based modes of treatment. In Europe, pioneers of a venture called VEPSY Updated are developing digital media for psycholtherapy tailored to disorders as diverse as social phobia, male sexual dysfunction and obesity.

In some VR programs, a patient's profile can be incorporated into a simulated scene, a technique that Riva has applied to the treatment of anorexia. In Riva's programs, a computer uses a person's physical dimensions to generate an animated version of that person. The patient then guides her virtual image through a house with many doors in which she meets figures of various shapes and sizes, including some she had previously judged as ideal.
Eventually the patient encounters her own figure behind a door. The encounter, according to Riva, causes many patients to realize that they are slimmer than the people they had considered perfect. "The sight of her own body often triggers strong emotions," Riva says. In this way, the computer-generated image can help anorexics start to form more accurate mental pictures of themselves.
Riva and his colleagues have tested a similar approach in obese individuals, for whom dieting alone is often ineffective in diminishing their body dissatisfaction. In addition to receiving body-image therapy like that used in anorexic patients, the obese subjects enter virtual environments to learn how to cope with eating triggers at home or at a supermarket, pub or restaurant. In a study of 211 obese patients published last year, the researchers fount that virtual-reality therapy was superior to cognitive-behavior or nutrition therapy alone in improving obese subjects' body satisfaction and eating behavior. Perhaps as a result, significantly more of the patients who receive the VR treatment had lost 10 percent of their body weight after the study, and more of them had maintained that weight loss six months later.
Meanwhile other researchers are testing cell phone text messaging as a means of preventing relapse in bulimia patients. In a study at the University Hospital of Heidelberg in Germany, headed by psychiatrist Stephanie Bauer, patients send a text message to a computer once a week in which they rate their body perception and indicate the frequency of behaviors such as binge eating and self-induced vomiting. After a computer calculates the patient's progress, or regression, from the previous week, a therapist offers support and advice. For instance, if a patient has a low body-image rating but a positive eating report, a therapist might reply: "Don't let negative body perception get you down. You've got your eating disorder under control. That's something to be proud of!"

Thoughts on this type of treatment? Anyone encountered it? How do you think such a program (the bodies-behind-doors) would differ from the typical body-image therapy? I've never been in therapy, but I've seen many clips of the whole "draw-yourself-as-you-think-you-are," followed by a true body trace. Do you think that this 3-D virtu-body-tour would be much more effective than that, or does it depend on more than fancy graphics? Surely even though most of treatment depends on the relationship between the patient and doctor, the patient's willingness to recover, etc., this does seem like it may at least advance the technology of it all ... not sure what that means for treatment effectiveness. It may seem more "real," seeing your body perfectly reconstructed to "surprise" you. If anyone here is recovered, with the help of techniques to eradicate poor body image, what types of treatments helped you? Did nothing? I wonder what else could be done with this kind of therapy. It really does seem to depend, though, on a patient really taking it seriously and going into the treatment really really wanting to recover. But given that, maybe it would be very effective? It does seem to work, from the little data there is, for some obese patients. There's not much data on how well it works, but I found it interesting anyway.

And since it's my first post I just want to say I really love this community and how intelligent and honest all of the discussion, comments, everything is, blah blah blah cliché, but it's true.

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