anorexia nervosa came up a few times in conversations I had, last week. On one of those occasions an interesting question came up which I will try to summarize here. Clients with anorexia nervosa sometimes get treated in specialized clinics. What I have learned is that in some cases, when the treatment is completed and hospitalization can be terminated, clients are sent home with a prevention plan. The purpose of this prevention plan is to help clients retain their weight and to prevent a relapse. The question which I was asked is whether it is wise to work with a prevention plan in which a negative goal formulation is used, in the sense that something bad has to be prevented. The person asking me this wondered whether it isn't better to work with a positively formulated goal in which something desirable is built and the focus is on achieving growth?
I find this thought quite understandable. How can you speak of progress with such a 'negative' goal? Won't such an approach undermine motivation? Despite this logical sounding objection I think there is another way of viewing this which maybe valid. Progress can mean different things for different people and in different situations. In this article I explain more about this topic. After having read this article you might imagine that getting better at avoiding or preventing negative situations can also be seen as progress in certain circumstances. That people want to avoid negative things is understandable. For example, it makes sense that people want to avoid getting sick, staying out of financial trouble, or losing their their self-control in an argument. It is sensible that people want to develop the skills to stay out of those types of problems. The growth they achieve in these skills can be seen as progress. Once you can view the situation like this you can start looking for behaviors and circumstances which have worked well and have helped you become more competent.
A further thought I have with respect to this topic is that what I have called the optimal zone scale might be useful in working with anorexia nervosa clients. On this scale, the middle area is where you want to end up. Both the lower end of the scale (too thin) and the higher end of the scale (too fat) are undesirable. With a problem like anorexia nervosa (but also with something like assertiveness) it can be helpful to think in terms of the optimal zone scale. This scale visualized that you don't have to get higher and higher on the scale (which someone with anorexia nervosa could associate with getting fatter and fatter) but that you aim at staying in the middle area (neither too thin, nor too fat). When you have found out better and better how to stay in the middle zone, you have made meaningful progress.