One of this year's conference workshops is ran by Fran Weiss, LCSW-R, BCD, DCSW, CGP, a well-known expert in group therapy for those struggling with weight regulation. She offeres her workshop on Sunday, June 12, 2011, from 9:15 am to 12:15 pm. This is what Ms. Weiss has to say about her workshop:
Patients who come to your practice with over eating, weight regulation, and body image problems defy classical DSM IV diagnosis from an eating disorder perspective. They present daunting biochemical as well as self-regulatory problems. Although daunting, they come for our help and we are challenged to treat them.
Overeating and weight regulation are not considered eating disorders. Binge eating disorder (BED) has recently become a proposed diagnosis to be admitted to the DSM. However, all patients with eating issues do not quality for BED. Those who eventually come into a psychotherapist’s office have probably “failed” at institutional and commercial programs for weight loss.
Conceptually, I have moved from thinking about these patients from a strictly psychoanalytic and psychodynamic viewpoint, and begun unraveling their issues in line with the paradigm shift away from drive theory to interpersonal neurobiology and modern attachment theory. This shift incorporates development of self, attachment patterns, and development of self-regulation. In this shift, the symptom, overeating, becomes a high caloric regulatory and compensation mechanism. The resultant weight problem, which ensues, has a bio-chemical life of its own.
In the treatment realm, group psychotherapy had been vastly underutilized and has essentially been put in the background. Currently, cognitive behavioral therapy is considered to be the gold standard of treatment. But, sole use of cognitive behavioral therapy has been shown to have its limits. Most patients lose, 5-10% of initial weight, the current standard of criteria for success. However, patients usually regain 30-35% of their weight loss in the year following treatment and many return to their baseline weight within 5 years. Success rates in obesity programs are grim.
What is missing in treatment? Looking at this cluster of patients from the traditional psychodynamic psychoanalytic model has its restraints. New technology has allowed us to access the brain, which has shown us that the development of regulation starts long before the drive models that Freud conceptualized. It is important not to throw out the baby with the bath water, so to speak, but add on to what we already know, and upgrade our work in current thinking. The current work in interpersonal neurobiology and modern attachment theory gives clarity to what is missing and can only add to the repertoire of a traditionally group trained psychotherapist. It is time that we begin apprehending these patients from a different model. Modern attachment theory and interpersonal neurobiology lends to a different conceptualization and thinking about them clinically. These can be incorporated into group psychotherapy adding to the richness of this model. Group, utilizing these newer concepts, can be a regulatory mechanism for those challenged with regulatory problems. Active engagement in this newer thinking, can lead to developing fresh group strategies for those with these daunting problems.
About Fran Weiss, LCSW-R,BCD,DCSW,CGP, DPNAP
Fran Weiss is an expert clinician with over three decades of experience in the treatment of weight regulation and body image among the obese and disordered eating population. Her subspecialty is in women's health issues, emotional issues surrounding a cancer diagnosis, trauma, interpersonal issues. She is known for her work in the health professions as a bridge, developing interdisciplinary teams. She is in Private Practice in New York City in, Individual, Couples, and Group Psychotherapy. She also developed a time limited workshop BITE® The Body Image Transformation Experience focusing on body image and weight regulatory issues. Her training and background is from a psychodynamic and psychoanalytic psychotherapy perspective. Her current practice is informed by interpersonal neurobiology, modern attachment theory. She is also a trained Sensorimotor Psychotherapist.
She is an Associate Clinical Professor at Mount Sinai School of Medicine and has been the Senior Psychotherapy Consultant to the New York Obesity Research Center, St. Luke's Roosevelt Hospital Center, since 1979. She is also is the eating disorder book reviewer for The American Journal of Psychotherapy as well as a blind reviewer of articles. In addition she has been a blind reviewer for Social Work in Mental Health.
She was awarded Distinguished Practitioner by the National Academy of Practice (NAP) 2011. She is a Board Certified Group Psychotherapist (1994), Board Certified Diplomate (1988); Board Certified Diplomate in Clinical Social Work (1987); Diplomate, the Former American Board of Psychotherapy (1988-1993); Board Certified Specialist with Children and Their Families. American Board of Examiners in Clinical Social Work, (ABECSW); Member of the Book Review Staff, American Journal of Psychotherapy (1986), Member of the Academy for Eating Disorders.
For over three decades she has acted as the senior psychotherapy consultant to the New York Obesity Research Center at St. Luke's Roosevelt Hospital Center (ORC) in their various clinical arms. One of which was the world renown Theodore B. VanItallie Center for Nutrition and Weight Management. The New York ORC is one of the first NIH funded Centers studying metabolism and obesity in the United States. Throughout her consultancy she has made numerous presentations; taught and supervised psychiatric residents, psychologists, social workers, nutritionists and nurses the psychodynamics of patients with weight regulation problems. She also developed and conducted a six month seminar series for premedical students from the Institute of Human Nutrition affiliated with Columbia Presbyterian, “Psychosocial Behavior Approach to the Treatment of Eating Disorders”. Her current involvement is with the NIH research studies Look Ahead Study and the Diabetes Prevention Program.
Her unique and pioneering work has been the clinical integration of recent advances in psychology, modern attachment theory, and neruoscience research with innovative clinical application in the treatment of the overweight disordered eating patient. This has been exemplified by her peer reviewed articles; her on-line articles; her book reviews; her presentations to Faculty at Mount Sinai School of Medicine. She has been a guest lecturer at NYU Medical Center, Teacher's College, Columbia University CUNY Sophie Davis School of Bio0Medical Education. She has been a resource person for NBC,CBS, and the New York Times in Body image of women and obesity. She has given presentations, run workshops, and taught courses at the national meetings of the American Group Psychotherapy Association, AGPA; the Eastern Group Psychotherapy Association, EGPS; and the Northeastern Society for Group Psychotherapy, NSGP. Her most recent contribution has been an on-line PsyBC Seminar Series, Mind Body Integration of the Self in Treating Weight Regulation: The Hollow Victory of Weight Loss which due to its popularity has become a continuous course.
Mike Devlin,MD, past president of the Academy of Eating Disorders has said “Fran's publications on body image assessment and treatment of body image disturbances are seminal. As far back as 1986, her American Journal of Psychotherapy paper on “The evaluation and treatment of body image disturbances among obese individuals” paved new ground and served as a major inspiration for experiential body image work. As it became clear that traditional psychodynamic and cognitive-behavioral approaches had limited ability to deeply impact body image, Fran and others began to mine the potential of combining traditional psychodynamically-based approaches with more powerful techniques that address the development of body self and the need for mind-body integration in order to bring about lasting change.”
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