Thursday, October 25, 2012

Secret Sins and Much Much Worse

I recently reserved two books from our local library. The first was a light detective novel of no great merit. It was called "Secret Sins". The second was a venerable (28 year old) text book on an important medical subject that I openly campaign about. Naturally on leaving the library and walking onto the main street I tucked the textbook behind the novel and while I have read the novel in public and openly at home, except when reading it in total privacy I have kept the text book pretty well hidden ever since.

I have though, managed to get through quite a bit of it. It is Jill Welbourne and Joan Purgold's "The Eating Sickness" and it IS incredibly dated. There is no talk of randomised controlled trials or evidence based medicine. The clinicians have learned by observation and discussion and hope to impart their wisdom through the medium of case studies and persuasive argument rather than via graphs and statistics. They thought Marjorie and Violet were reasonable names to give their case study patients. The Family Therapy they talk of as being so trumpeted as cure all (which they doubt) was probably Minuchin's rather than Dare and Eisler's. I personally think that, particularly in the case of the anxiety they observe in families, they may have confused correlation with causation and their assertion that this is a disease of the middle classes is frankly laughable. I know that many of my friends would be cross at the slow pace of treatment and recovery suggested and the emphasis on restoring mood before restoring weight and physical health.

All these drawbacks aside, I'm going to be able to finish reading the book in time to get it back to the library without a fine and without getting caught. Unlike other publications it's not going to be found in my bed as I fall asleep  in boredom over chapter 8 AGAIN and I'm not going to be found trying to throw it out of the window in a fit of guilt and shame. All in all I like it. It's readable and despite the addition of poetry the prose isn't as flowery as some. The case vignettes are realistic and detailed rather than simplistic and infuriating and the the observation of both patients and their families is done with care, consideration and compassion. Oh, and yes, this quote resonates in buckets with me "more than one attempt to help families by formal, albeit legitimate, means have in our experience been ineffective because of the additional unhappiness caused in the anorexic by her guilt at being the cause of further trauma for her parents".

I will of course be tucking it firmly behind the detective novel when I go back to the library. I may even deposit them both through the "returns" letter box under cover of darkness.


Batty Matty said...

"Her" guilt... No mention of males of course..

marcella said...

No, no mention of males at this point or throughout much of the book but they do include one in the "medical horror stories" chapter and reflect quite early on that clinics who specialise in males tend to see a higher proportion of them. That's why I wonder how it can have escaped their notice that maybe they only saw middle class girls because they weren't looking for immigrants or poor boys. A problem with using observation instead of scientifically gathered evidence and a small self-selecting (as in those who made their way to the doors of a specialist clinic in the days when there were NO developed clinical pathways for carers or GPs to follow) population to observe.