an Integrative System for the Treatment
of Eating Disorders from Diagnosis to Recovery
As an experienced eating
disorder therapist, I commend Natenshon for
taking on this task of organizing her life's
work and letting other professionals into her
storehouse of knowledge.
Having developed her own system of
treating eating disorders through years of
experience, she has generously taken the time to
methodically detail what she has learned, and
share the experiences that have pointed her in
Natenshon’s personal journey offers solid
guidance in the specialty of eating disorders,
available to mental health professionals in
Works: an integrative system for the treatment
of eating disorders from diagnosis to recovery.
Her writing is thoughtful and
knowledgeable, and her sharing of interesting
anecdotal materials makes the read compelling
and engaging. Her emphasis on the unique
treatment requirements of working with people
suffering from eating disorders is absolutely
A+. Pointing out how exceedingly complex these
disorders are, and offering clinicians
strategies to manage these complexities in
treatment, suggests both the good news, and the
bad....that eating disorders are eminently
treatable all the way to complete recovery, but
only for the therapist with the maturity,
professional skills, patience, creativity, and
inexhaustible empathy required to transform an
irrational, counterintuitive and sometimes
seemingly intractable disorder into the realm of
the understandable and the treatable.
Natenshon’s sensitive and respectful
treatment guidelines lead to significant
improvements in care, setting the stage for
The book speaks to the
beginning therapist as well as to the highly
the Personal Side of Professional Challenges offers personal
assessments, providing readers incentives for introspection and
self-exploration in considering a specialty in this field. "How did you feel
about your body while growing up?"
"What messages did you get from your parents about how people are
supposed to look?" Such questions, and the personal insights that come of
them, offer the kind of personal and professional self-awareness that is
central to skillful management of counter-transference issues.
Natenshon’s inclusion of the
DSM diagnostic materials as they relate to the
associated causes and effects of eating
disorders provides good basic information for
novice practitioners. It points to the
uniqueness and complexity of the eating disorder
diagnostic process, creating an awareness of the
expansive and integrative nature of the disorder
and its impact on lives, and the need for an
equally expansive and integrative perspective on
Natenshon skillfully links
some of the latest information on the relevancy
of neuropsychology and brain plasticity to
eating disorder treatment in Chapter 11,
Brain Learns, People Change: Innovative
Treatment Approaches. As a
practitioner in this field, I am well aware that the most intractable eating
disorders connote lives hijacked by the structure and function of a brain
obsessed with thoughts about food, weight and body image. Mindfully present
therapeutic connections facilitate the creation of new neuronal pathways
which become instrumental in helping patients to change their internal
dialogue and sustainably reclaim cognitive space and healthful behavioral
One of the most helpful and
practicable sections was Chapter 7,
and Managing Eating Disorders, Feeding
Disorders, and Picky Eating Syndrome in Young
Children. Here, Natenshon provides rich information, helping
professionals to recognize issues of frequently misunderstood and vastly
under-diagnosed early childhood eating and feeding dysfunctions that first
appear in infants and latency age children. In offering empowering
diagnostic skills and a wide variety of tools and strategies for parents and
pediatricians, this chapter’s thoroughness is outstanding.
Overall, I most appreciated
how personal Natenshon’s voice is throughout the
She is a clinician and she has filled the
book with information for clinicians.
The personal anecdotes, email exchanges
and case studies she provides are the raw
materials for which every clinician hungers.
Her willingness to include the
conversations that go on, both inside and
outside of the treatment room, is a gift.
These interactions can be heartbreakingly
sad as well as powerfully life changing.
There is no sugar-coating; the reality is
that there cannot always be successful outcomes
in working with these extremely complex
A bottom-line message comes
across clearly; successful treatment has to
include parents and families as part of the
treatment team -- the younger the child, the
more imperative this is.
This essential message cannot be
overstated. No one heals from an eating disorder
Particularly when a child resides in a
parental home, the availability of an
enlightened person to turn to in the next room
is key to a successful outcome. Even when the
patient is an adult, parental support can be a
great asset in achieving recovery.
Though the work of the multi-faceted and
multi-disciplinary professional team is critical,
the life-line to recovery
the patient’s trusting
relationship with the therapist.
The therapist needs to be versatile enough to play the roles of mentor,
educator, liaison, cheerleader and authoritarian case manager, by intention
Natenshon has done an
outstanding job of covering the bases.
For the novice, the book is a great
introduction to this field.
For the experienced therapist, there is
the gift of seeing how it is done by a seasoned
The ideas presented and the people who
have been touched by them have seen outcomes
that have worked.
This book deserves to be used and
appreciated as a basic resource for eating
disorder management and treatment. Though at
occasional points throughout the book, the
reader needs to sift through the publisher’s
poorly edited and formatted text, there is a
quantity of quality pearls buried here that are
truly worth the dig.
Edye Kamensky, LCPC, is
currently a staff psychotherapist at The Family
Institute at Northwestern University and is a
former supervising psychologist at The Renfrew
Read another review
Description by author
Doing What Works is the
first book of its kind to offer novice and veteran practitioners a coherent
and sequential system for approaching, treating, and effectively managing
complex eating disorder cases, from start to finish. Highlighting the unique
qualities that set eating disorder treatment apart from generalist practice,
Natenshon synthesizes evidence-based eating disorder research and
best-practice treatment protocols into innovative and practicable clinical
applications 'that work,' offering a fully integrative approach to eating
disorder care. Bringing the field into the 21st century, Natenshon cites
recent neurobiological research to underscore the significance of a unique
and versatile use of the therapist's self within the treatment relationship.
Her work is also pioneering in explicating the power and significance of
mindfulness in psychotherapy practice, as well as the role of interpersonal
neuropsychology and brain plasticity in enhancing healing.
In the seasoned voice of an expert who has specialized in the treatment of
eating disorders for close to four decades, Natenshon's book speaks to the
entire multidisciplinary treatment team… including nutritionists,
physicians, school personnel and families, filling in extensive gaps in
professional education. The book offers clarity, vision, intention, and
optimism to practitioners striving to meet the rigors and challenges of
managing diagnostic ambiguity, complex transference issues, persistent
patient resistance, and daunting co-occurring conditions within a highly
counterintuitive recovery process. Aside from honing treatment skills, this
reader-friendly treatment guide provides clinicians the opportunity and
confidence they need to become self-starters within a demanding treatment
process--while helping their patients to do the same.