Managing the chronic, treatment-resistant patient with anorexia nervosa
Article first published online: 11 OCT 2004
Copyright © 2004 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 36, Issue 3, pages 245–255, November 2004
How to Cite
Strober, M. (2004), Managing the chronic, treatment-resistant patient with anorexia nervosa. Int. J. Eat. Disord., 36: 245–255. doi: 10.1002/eat.20054
- Issue published online: 11 OCT 2004
- Article first published online: 11 OCT 2004
- Manuscript Accepted: 15 JAN 2004
- treatment-resistant patient;
- anorexia nervosa;
- weight restoration
To describe the psychopathology of chronic, treatment-resistant anorexia nervosa, as well as a paradigm for its clinical management.
The foundation of the approach integrates clinical experience, empirical psychological findings, and a conceptual understanding of developmental and phenomenologic aspects of the illness.
Elements of the management paradigm take account of the compensatory nature of illness chronicity. The inherent risks of treating these patients in the customary way are described, along with therapist countertransference that must be anticipated and effectively considered.
The chronically ill patient requires a unique approach to care, one that minimizes the risk of iatrogenic effects of rapid weight restoration or failure to appraise the deleterious influences of therapist countertransference. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 36: 245–255, 2004.