How did you get involved in treating anorexia? Both of my daughters suffered from anorexia. The condition was particularly severe in my second daughter, Nicole. Initially, I took her to a myriad of professionals who worked in the field. I was told many different things but the theme of all responses was unrelenting in its negativity: "she will be a statistic within months"... "she is spoiled and vain"... "she is a selfish girl, trying to get attention, and you, as her mother, are to blame"... "try to get therapy for yourself and accept the fact that she is going to die". I knew my daughter well, and therefore, I knew that what I had been told was not the truth. Presumably, this disorder had a psychological premise which I realized I had to unravel in order to save her life. This I was determined to do. I was completing undergraduate work in psychology when Nicole became ill. I decided it was necessary to emotionally distance myself by objectifying her as a case study. It was a slow, difficult process but the alternative was unfathomable. And how are your daughters now? Following their complete recovery they pursued various interests for several years. Their deep sensitivity and commitment to this cause is now realized in their integral involvement with the treatment of other victims of this insidious disorder. Today they are essential members of the counselling and teaching team at the Montreux Clinic. Many people think about anorexia as a disease about food, but you disagree with that. Yes, I certainly disagree. I have come to understand that "eating disorders" are the symptom, not the disease. We have coined the phrase "Confirmed Negativity Condition" from which anorexia springs. Food is involved, only in that it is synonymous with self worth. These sufferers do not recognize that they have any value. They have assumed that they are not worthy of life and deny themselves food in order to fulfill that belief. Every new patient arrives in such dire need. How can you be so sure that you can succeed where others have failed over and over again? I know that eating disorders are completely reversible for anyone who follows the appropriate steps. I have seen this confirmed innumerable times. The best way to cure patients afflicted with eating disorders is to envelope them with positive caring 24 hours a day until reason and logic take the place of the negative mental construct. To truly effect this requires the united efforts of an extended care team, as well as the patient's family and wider social support structure. It is essential that everyone involved understands that the responsibility for recovery must be placed on their shoulders--not the patient's. For those of us who have never known someone with the disease of anorexia explain a little bit about what is going on with the patient. Well, you're lucky if you haven't seen it. The suffering that they go through is something that nobody can relate to. Anorexics worry about everyone else--not themselves--and when they realize that they can't fix everything, then they begin to feel worthless. That negative self-image is so powerful that victims simply stop eating. These unusually sensitive people realize that they cannot solve the world's problems and collapse into self-loathing. Anorexia is really an unconscious attempt at suicide because the victims don't believe that they deserve to live. There is a negative mind-set that convinces them that they have to die. It is a complex and devious, deep mind-set. The victim's mind is able to construct such negativity against themselves so that the patient actually has a civil war going on in their head. Before a patient enters Montreux, you talk to them about how you and your staff will take responsibility for them. What do you mean by this? Shouldn't these victims work on taking responsibility for themselves? This is one of the most profound misunderstandings concerning this condition. Putting responsibility on the victim is the antithesis of what is required. These are sensitive, caring individuals who have already placed immense burdens upon themselves in their perception of society's need. Patients in the acute stage of an eating disorder manifestation are emotional infants who are generally incapable of allowing themselves any favors. It is therefore incumbent on us to provide the nurturing and support that has become vital to their survival. How have traditional approaches failed in the treatment of anorexia? If one is attempting, merely, to treat the symptom (and anorexia and bulimia are only symptoms), then the task becomes very difficult indeed. Traditional approaches generally assume that the patients can do it themselves and the onus of the responsibility is put on a patient who is too weak to assume it. Focussing only on increasing weight for release from the hospital invites recidivism. Many programs focus on behavior modification--improving the self-esteem--but when the negative mind is in control, there is no self to esteem. To say, however, that traditional approaches have failed is perhaps unfair. Certainly many people must have been successfully treated elsewhere. What I have come to realize is that, perhaps, there are gaps in traditional programs that make it much more difficult, and often impossible, to effect complete recovery. We are attempting to fill some of these. The patients need a map, a guide to show them through to a point of possibility. Someone has to convince them that they deserve to live. Once these victims know that there is hope in the world--they can make it--they hold on. They're so incredibly tenacious. It's amazing to watch them follow through. Hopefully we will all share what we have learned about this negative mind state and grow together. All people who attempt to tackle this condition should be commended. But isn't this 24-hour care you provide at Montreux expensive? What is very expensive is the endless cycle of hospital programs. Also and think most importantly of the expense of human life that is wasted in the interim. Why not take longer and treat the condition more thoroughly the first time? There's a great demand for what you do but there are limits to how many patients you can care for. You are obviously a very caring and compassionate person saving the lives of so many. How can you bear to turn patients away? It is difficult and often devastating to have to make these choices. I have written this book with the hope that it will give parents and other care givers a deeper understanding of how to effectively care for those in need. Our next project is the development of a professional training centre. Employing a small teaching hospital format, we hope to be able to intensively train several hundred individuals per year in all aspects of our treatment model.