To the Bone Abnormal Psychology

TO THE BONE

Abnormal Psychology: To the Bone

Part 1: The Character

The character that I elected to focus on in this case is Ellen, who later on changes her name to Eli. She is a 20-year old who finds herself confronting an eating disorder. From the presenting symptoms, the eating disorder in this case happens to be anorexia nervosa. A college dropout, Ellen is constantly confronted by a myriad personal fears and familial problems. After failing to make progress in earlier in-patient programs and practices, Ellen joins another group program managed by a rather unconventional doctor by the name of Dr. William Beckham. The other persons that she finds in this particular program are young adults who also happen to be struggling with disorders that are more or less similar to hers. It is from this point onwards that Ellen embarks on what could be described as a self-acceptance and discovery journey. She is able to find herself before it becomes too late to do so. To a large extent, Ellen, and others depicted in the film, are able to project an image of true perseverance.

As I have already pointed out, the character described above is ailing from anorexia nervosa, which, according to Gorwood et al. (2016), happens to be an eating disorder. In the movie, a number of presenting symptoms of the eating disorders are showcased. Further, the challenges that persons diagnosed with the said disorders encounter from time to time are highlighted.

Part 2: Diagnosis

It would be prudent to note that to be diagnosed with this particular disorder, an individual must meet the DSM-5 criteria set out. To begin with, food intake restriction should be apparent – resulting in the loss of significant weight to the extent that the said individual has body weight that happens to be significantly lower than that which would be ideal for a person of similar height, sex, as well as age. Secondly, a person has to have an unusual or extreme fear of weight gain. Third, a person’s perspective of self as well as that of their circumstances (i.e. in as far as weight is concerned) ought to be distorted. For instance, in this case, a person could perceive themselves as being ‘fat’ whereas in the actual sense they are underweight. Collectively, and from a professional perspective, such thought patterns are referred to as distortions. It would also be prudent to note that under DSM-5, anorexia nervosa could be placed in two sub categories. The said categories are; restricting type and purging type.

From my own observation, Ellen meets the diagnostic criteria for anorexia nervosa. This is more so the case given that she severally restricts her food intake – with the result, over time, being the all too apparent loss of body weight. Further, Ellen has also on several occasions been shown to have intense fear of weight gain. For example, in one instance, at time 00:47:52, she makes this statement: “I get all panicky even thinking about it, like, the world is gonna fall apart.” This is in reference to her need to maintain her weight by ingesting small food portions. Also, at first instance, Ellen does not consider her condition to be a problem. As a matter of fact, during her earlier engagement with other treatment programs (before enrolling for Dr. William Beckham’s program), it is all too clear that she does not even desire to get better. It is for this reason that she is sent home.

Ellen feels neglected and is largely lonely. The divorce of her parents also contributed to her denial of attention and affection. These, in my opinion, are the internal and external factors that could have triggered the condition. The other diagnoses which could be present could, thus, be inclusive of, but they are not limited to, major depressive disorder. Further, Other Specified Feeding and Eating Disorder (OSFED) could be considered.

Part 3: Treatment

If Ellen were my patient, I believe that the best treatment approach would seek to address not only her physical, but also her psychological problems. For this reason, efforts to treat her condition ought to be team effort – ideally bringing together a primary care doctor, a nutritionist, and mental health professional. This is an assertion collaborated by Takakura (2019) who is of the opinion that the relevance of team effort cannot be overstated in seeking to promote better treatment outcomes. With this in mind, I am confident that Ellen would benefit from nutritional counselling (nutritionist), therapy (mental health professional), and continuous medical care (primary care doctor). The primary care doctor would be instrumental in the assessment of Ellen’s blood electrolyte levels as well as bone loss. It would be prudent to note that at present, I do not see the need to put Ellen on any medication. There is also need to make an observation to the effect that FDA is yet to approve any medication to treat the disorder (Gorwood et al., 2016). However, in the past, as Gorwood et al. (2016) further point out, treatment approaches have incorporated antidepressants. In the present case, I would be focused on a long-term recovery route, as opposed to short-term fixes. Ellen would also need adequate social support to make meaningful progress throughout the recovery process. At present, however, she does not have a strong and reliable social support network.