Pavel G. Somov, Ph.D., Licensed Psychologist
Author of "Eating the Moment: 141 Mindful Practices to Overcome Overeating, One Meal at a Time"
"7 Stars on a 5-Star Scale: an Excellent Continued Education Cross-Trainer!, October 9, 2008
As a psychologist in practice, in picking up this book on nutrition counseling by a nutrition expert, I was expecting psychotherapy to be accorded its usual short shrift and after-thought status that seems so common for the nutritional literature on eating disordrs. I was pleasantly surprised. Not only is the book calling for a non-nominal coordination of nutritional and psychological disciplines, the nutritional angle itself is presented with an extraordinary degree of psychological savvy.
Case in point: in addition to the coverage of various psychological treatment paradigms, the book offers process suggestions for nutritional counselors on managing self-disclosure, splitting, idealization, countertransference. The first two chapters are smartly subdivided into basic nutritional counseling (more educational in scope) and advanced nutrtional counseling that integrates nutritional counseling and psychotherapy.
While empirically authoritative and technically comprehensive, the book is also highly pragmatic. Dr. Herrin continuously offers direct speech suggestions of how to pitch a certain educational theme or tid-bit to a prospective client. Throughout the book, the reader keeps stumbling upon highly practical counseling gems that begin with "explan this" or "you might want to say this." This pragmatic refrain helps the reader to pause and translate the material into hypothetical counseling exchanges.
I particularly appreciated the no-nonsense harm-reduction orientation of the book: this is most evident in the discussion of normalizing the relationship with "fun foods," as well as in the discussion of managing binge-eating through paradoxical harm-reduction binge-schedulng alternatives.
The "intervention" core of the book, consisting of the following five chapters, is impeccable: "Weight Management," "Managing Weight Restoration" (a euphemism for "weight gain/weight normalization"), "Managing Binge Eating," "Managing Purging," and "Exercise Management."
Herrin's amazingly effective: page for page she offers tremendous informational density - without (!) creating a sense of informational satiation. Her narrative style feels light but never superficial. Her handling of the medical repercussions of purging is a wonderful example of that: in the span of just a few pages, Herrin manages to provide a panoramic overview of dental, electrolyte, cardiac, GI and other types of medical complications that can result from purging.
She offers a similarly effective overview of misuse of veganism/vegetarianism (as a socially sanctioned cover for restrictive eating), of eating pregnancy, and of other "special issues." She offers an extensive Appendix with forms, tables and handouts (check out Appendix E - "Recovery Plan" for binge-prevention and post-binge damage control).
In sum, the book seems to round out the respective educational-professional fortes of nutritional and psychological counselors. Nutritional counselors stand to learn more about the counseling aspect of nutritional counseling and psychologists working with eating disorders stand to learn more about the nutritional nuts and bolts of the eating disorder presentations that might otherwise be left unattended in the guilt-shame shade of client's ego-saving defenses.
Herrin's "Nutrition Counseling" is an excellent continued education cross-trainer!"
Dr. Marcia Herrin
(Brunner-Routledge, 2003, ISBN 1-58391-031-X, 284 pages)
Eating Disorders Review
Joel Yager, M.D.
Within a brief time, the eating disorders field has been gifted with several fine books by registered dieticians. Now Marcia Herrin, RD, founder and co-director of the Dartmouth Eating Disorders Center (and co-author of The Parents Guide to Childhood Eating Disorders: A Nutritional Approach to Solving Eating Disorders, previously reviewed in EDR) has written an excellent book that all nutritionists working with eating disordered patients will want to own and study. The book takes practitioners through the clinical processes necessary to establish and maintain friendly and effective clinical rapport and appropriate professional boundaries. Early chapter focus on relationship building, and offer nutritionists who may not be very familiar with psychiatric syndromes information about common developmental and psychopathological findings in these patients. Readers are provided with an informed introduction to the premises and conduct of the psychotherapeutic and psychosocial treatments, including counseling, cognitive behavior, diatical behavior, psychodynamic, and family therapies, they"re likely to encounter in the care of eating disorder patients. The major ģeducational themesī clinicians need to understand and to discuss to increase motivation and to have impact on gaining trust and adherence are laid out, including issues such as the impact of under-nutrition and purging on bones, brains, menses, and other physiological functions. Common myths held by eating disorder patients are also debunked. The middle chapters on food planning and establishing, maintaining and revising the food plan, and on the use of food plan templates are, pardon the pun, the bread and butter of the book. The sections on managing weight restoration, binge eating, purging, and exercise are all thoroughly and intelligently written. The large number of appendices include very helpful details on weight calculation (including BMI tables), energy need calculation, details on nutrition components of meals, several excellent patient handouts, and a number of professional tools, including food plan templates, self-monitoring diaries and other assessment tools.
This book will be an exceptionally helpful source of information for those entering the field, and will be a useful and an informed sensible review for veterans as well, including non nutritionist clinicians who wish to learn more about these essential aspects of our work.