Tag Archives: insurance

carnival of eating disorders, november 2008 edition

here is the november edition of the carnival of eating disorders!

anorexia and “becoming unspecial”
lola snow has a thoughtful post on the notion of being special, something very important for a lot of people who are in the throes of anorexia. some would say that being anorexic is about being special, about showing the control that results in standing out. in 12-step circles, this attitude is referred to as “terminal uniqueness”, a sometimes literally life-threatening attitude of being different: needing to be different, suffering from being different and the “no-one understands me” syndrome. there are a lot of interesting conversations about what it means to become less terminally unique and still remain the unique one-of-a-kind specimen that each and every one of us is. here’s lola’s contribution to that conversation: becoming unspecial.

anorexia, bulimia, NaNoWriMo
since i’ve participated again in NaNoWriMo this year, of course we have to have an entry here from someone who worked on a novel in november, too. here is a novel excerpt by someone who actually made it and wrote the 50,000 words (not something i can say about myself, unfortunately):

in the eighties, i saw an article in a magazine about a man who eats and then takes 50 laxatives. he weighs 5 stone (about 70 pounds) and looks like he’s going to die any minute. these pictures repulsed me and i thought to myself, ‘how can a person be so foolish? how can he lose control like that? how can he take all those laxatives? doesn’t anyone know what he is doing?’

of course, i didn’t see myself.

read more of soulbrush’s story here.

pro-anas on facebook
there was quite a bit of fanfare last week about pro-anorexia sites on facebook. one of the more intelligent treatments of this topic comes from my friends at PsychCentral:

so what does all of this do for people? isn’t allowing people to discuss their pro-ana needs just plain harmful and potentially dangerous? not necessarily:

marcia herrin, a dartmouth professor who has written several books on eating disorders, finds the public nature of the discussions of anorexia on facebook encouraging, because it shows that teens are less afraid of confronting eating disorders.

the more “out in the open” these kinds of concerns become, the more society learns and can answer the kinds of information (or mis-information) they promote.

insurance companies pay to help with eating disorders
this november edition seems to be the “news” edition. good news, then, from new jersey, where eating disorder treatments were recognized to be treatments for a mental illness, and therefore “worthy” of being covered by insurance. we have similar successes with that here in canada. here is ED bite’s article about it.

anorexic girl expelled from school
all is not well, though. the F-word discusses the case of a girl who was expelled from school because of her anorexia.  i know nothing about the particular circumstances of this case but two things that the post mentions are worth thinking about:

unless a client is extremely disabled, kincaid said, “it’s hard to prove you’re qualified. the more i make it negative, the more i pile on about how ill you are, the more the other side argues, ‘well, you’re not otherwise qualified to be here.

and

at the pinnacle of my eating disorder, i was carrying a 15-18-credit hour course load. school was my saving grace – if i didn’t have the structure and support of my studies to rely upon and motivate me just to get up each day, i might be just another eating disorder suicide statistic. in fact, it was my education and the accompanying encouragement to self-examine both the world and myself that factored greatly into my own recovery.
would the school expel a student undergoing chemotherapy to treat cancer or lymphoma? are new hampton students suffering from depression or who are obese up for expulsion, also? eating disorders are a certifiable mental illness and in some anorexia cases, represent a disease of the brain. it’s time that they receive the same respect that any other medical condition would receive.

big people in the air
another piece of news was the court ruling here in canada that overweight people can ask for two seats on airplanes. here are two reactions, one from the big fat blog, who endorses the ruling, and another one here, symptomatic of how some people who don’t understand eating disorders think about people with weight issues:

the courts in the great white north have ruled that the human chunks eh must be allowed to have 2 seats for the price of 1 on flights within canada. as if airlines don’t have enough problems nibbling at their bottom lines they now have to have to allow the big bottoms to chomp on the airline profits.i have to say i earnestly hope this idiocy doesn’t come to the states since i don’t believe in fat rights. about the only right i think tubbies have is the right to either stuff their faces or not.

body beautiful
wilhelmina has a lovely, inspiring post about looking at our bodies:

all of a sudden, you catch sight of yourself in the full-length mirror. and you look. for once, you aren’t staring because you’re thinking of all the things you don’t like, and all the things you want to change. you’re staring because you notice curves, and tapering lines, and grace.

read here for the rest.

mindful eating – thinking about buddhism
the word “mindful” is often connected to buddhist ideas. it’s interesting, then, to read “exceptionally fat” ‘s post about mindful eating because it demonstrates how to put the “middle way” (an important buddhist concept) into practice.

intuitive eating was absolutely invaluable when it came to ‘legalizing’ those foods i had once completely banished from my house. i couldn’t bake because i wasn’t to be trusted around baked goods. i couldn’t order packages of liz lovely cookies because i would eat them all in a week and then feel terrible *and* have no cookies. i saw complete avoidance of these foods as the only option. don’t get me wrong, i could have a cookie or a brownie, but only when i could go out and buy just one. this was less problematic when i lived in atlanta and had easy access to all sorts of vegan goodies. here, it involves an hour long drive which would make it completely ridiculous to just buy one treat.

so i took the advice in this book and filled my kitchen to the brim with all kinds of formerly forbidden foods. it was honestly terrifying at first, but eventually it worked and those foods ceased haunting me with their very presence. i now keep ‘bad’ foods in the house with no problem.

disciplined eating – christian thoughts
these two attitudes – disciplined and mindful eating – came together quite by accident, and so did the fact that there are connections to buddhist and christian thoughts. healthymahma mentions a book by elyse fitzpatrick, author of love to eat, hate to eat, who uses the acronym D_I_S_C_I_P_L_I_N_E_D E_ating to “remember whether your eating is sinful or not”. as you might imagine, i find the idea of sin not overly useful. however, if we can free ourselves from the fundamentalist tone, some of fitzpatrick’s points could serve as interesting models, for example:

11. D_istract: will preparing or eating this food distract me from something better that god has for me to do? for instance, would i do better by ministering to the lord or my guests rather than spending excessive amounts of time cooking some elaborate meal and being frustrated that others aren’t as impressed about my cooking as i am? (does it really matter if the gravy is lumpy? will anyone remember that you spent hours cooking, or will they remember that you loved them and spent time ministering to them in conversation, prayer, and fellowship?)

a few months ago, i wrote a guest post on my friend alexander’s blog, transcending the murmur, where i talk about “translating” such texts. for example, “ministering to the lord” could be translated into “remembering my values”, and “ministering to them in conversation, etc.” could be “being present to them”.

emotions and recovery
the “E” in fitzpatrick’s acronym stands for emotions. jen talks about this in her post more on anger and recovery, which, the way i read it, is mostly about negativity and recovery from unhelpful eating. (anger, in my book, is not necessarily synonymous with negativity). i really appreciate this image:

there’s a difference between looking for the hidden reasons we do things and clinging to them as some sort of badge of honor and excuse. as easwaran said in the yoga journal article, “can you imagine a sculptor scurrying to pick up the slivers that fall from his chisel, hoarding them, treasuring them, ignoring the statue altogether?”

do you have, or do you know, a post that would be a good addition to this carnival? if so, please submit it here or drop me a line, and we can enjoy it next month, at the carnival of eating disorders on december 31.

more on professionalism: insurance, education and organizations

i’d like to follow up on evan’s guest post yesterday, entitled, why professionalism is of the devil. evan blogs at wellbeing and health – this is a topic he’s passionate about.

evan says that his problem lies with professionalism, not with professionals. they lie with professional organizations and all that comes with them.

i think evan raises a number of interesting points. i’m going to address three here.

professional organizations

professional organizations are made up of professionals. granted, the professionals who actively participate in professional organizations are usually just a very small fraction of the professionals they represent. but then this is really similar to democracy, isn’t it? there are only a few people who bother to get involved. and yes, a good portion of those who do get involved are power hungry, busybodies or control freaks.

but not all of them are. many of the people who get involved seriously care about the issue, and seriously want to make something really good happen for the constituency. almost always, there are not nearly enough people to make it all happen, and things turn out to be less-than-ideal.

insurance

insurance is a double-edged sword and i keep dancing around it all the time. we’re talking about risk here. here are the categories i see:

mitigating loss and suffering through making prudent provisions for adverse events

  • that do not happen often but do happen once in a while (car insurance and health insurance are good examples) and which carry small to very large costs
  • that happen very rarely but when they do occur they carry enormous costs (e.g. malpractice suits)
  • that happen very rarely and when they do, they carry small to very large costs (e.g. many forms of home insurance)

of course insurance is much more complicated (just think of all the mind-boggling small print that excludes a myriad of circumstances) but i think the above can be a good first guideline.

i think the operative word above is “prudent”. going without professional insurance that is the equivalent of the first instance is silly. but reaching for insurance in all categories will often hamper the delivery of good service to the patient – simply because often, for all intents and purposes, the client has ceased to be the patient. the client is now the insurance company/companies. we hear a lot of horror stories about that from the U.S. i’m glad i live in canada, where it’s a bit better.

continuing education

evan says, “professions prevent the learning of practitioners.”

i’m not sure about that. all the professional organizations i know require continuing education. this is a topic i’ve often thought about, to a large degree, i think, because of my work with people with chronic conditions (e.g. chronic pain, or depression). medical doctors tend to be quite ill-informed about these health issues. the question, however, is how to help them learn more about it. doctors are helplessly overworked (one could say that being a doctor is in itself a chronic health condition). like anyone else, they want to have leeway in terms of what they do for continuing education. the things they CAN learn more about are endless. so they’re going to pick their battles. and if one of the continuing education courses comes sweetened by a conference – literally sweetened, with rum and cakes – who can blame them for going for it?

what i would like to see there is more patient groups that aggressively go out and find ways for professionals to get continuing education.

is that a pipe dream?