Book Reviews 181

reconnections of bariatric surgical procedures and a terrific drawing of theinfamous prolonged QT interval. Helpful assessment tools are shown in full,copiable form, including the EDQ, the Boston Interview for Gastric Bypassfor pre-operative evaluations, and the Athletic Milieu Questionnaire toscreen for eating disorders in athletes. Finally, a variety of handouts areincluded, such as Student Athletes and Eating Disorders: A Parents’ Guide,and a list of self-help books and internet sites for patients and families.

Throughout the book, there is a sophisticated clinical integration ofresearch findings. CBT is not just described nor the statistics on its benefitsimply enumerated. Matching treatment to patient is emphasized, with dis-cussion of those not suitable for CBT and those more or less likely to bene-fit. Other approaches are suggested as preferable initially for some(motivational enhancement, for example) along with the caveat that evenmanual-based treatments require individual patient appraisal and adapta-tion. Similarly, clinicians are reminded that EDNOS is not necessarily “lessserious” nor should it be minimized as less deserving of treatment. Similarly,the Sansones have very useful recommendations based on their clinicalexperience sequencing and combining medication for patients with psychi-atric co-morbidity, including those with substance abuse and personalitydisorders—approaches often not used in clinical trials but much-needed inclinical practice. There is also a willingness to challenge accepted mythol-ogy, including Pauline Powers’ apt comments questioning the dictum thatweight loss per se routinely enhances athletic performance.

Read this book from cover to cover, use the handouts or assessmenttools, or check out a particular topic, like pregnancy or diabetes and eatingdisorders. The Clinical Manual of Eating Disorders is clearly the mostcurrent and valuable book of its kind available.

Diane Mickley, MD, FACP, FAEDDirector, Wilkins Center Greenwich, CT Asst Clinical Professor, Dept. of PsychiatryYale University School of Medicine

Hunger for Understanding: A Workbook for Helping Young People toUnderstand and Overcome Anorexia Nervosa, Alison Eivors and SophieNesbitt, West Sussex, England: John Wiley & Sons Ltd, 2005, 172 pages,paperback, $45.00.

In Hunger for Understanding: A workbook for helping young people tounderstand and overcome anorexia nervosa, authors Alison Eivors and

182 Book Reviews

Sophie Nesbitt provide clinicians with an invaluable tool for treating youngpeople struggling with anorexia. Combining psycho-educational, motivational-enhancement, and cognitive-behavioral therapies, this book is not onlyinformative, but also offers concrete guidance, interventions, resources, andsupport to therapists while it engages young people in a treatment that iscollaborative and empowering by encouraging and helping them to play anactive role in their own healing.

The first 32 pages of Hunger for Understanding are geared specificallyto the therapist, clearly and succinctly presenting the framework to combinewith the fully illustrated workbook that follows. The workbook itself—intended for boys and girls ages 11–16 (though certainly appropriate forthose younger and older)—is broken up into 11 sections. Each section buildson the previous ones and starts with concise and easy-to-understand psycho-educational information. A series of tasks and activities follow that help theyoung person integrate the material and connect it to their own experience.These tasks and activities assist young people in linking thoughts, feelings,and behaviors so that they may begin to develop a sense of self and the abil-ity to self-reflect and put words and pictures to feelings. Because the bookitself contains both the material for the therapist and the workbook,I strongly advise clinicians not to give the book to their patients. Instead,they can take advantage of the online option that allows those who havepurchased the book to download and print each section of the workbook.

Eivors and Nesbitt, both clinical psychologists in England specializingin the treatment of eating disorders, bring to this book deep compassionand an obvious wealth of information and expertise. The workbook theyhave created is so clear and straight-forward that, for the unseasoned pro-fessional, it can be misleading. The authors assert several times that theworkbook should be a jumping off place, clinicians should use this as a toolin conjunction with other therapies and other professionals, and therapistsmust be sure to tailor the treatment to the individual: “The workbookshould be administered as part of a treatment package and is not intendedas a ‘quick answer’ to prolonged difficulties” (p. 3). I feel that this point isextremely important and thus bears highlighting. The writers have donesuch a superb job developing this treatment that it can appear, in a mislead-ing way, facile. I fear it could be misused or underutilized by therapistsinsufficiently trained in working with young people who are coping withanorexia. Anorexia and its causes are multifaceted. The seemingly simpleexercises presented in this book are more complex than they might appearand are likely to stir up powerful feelings (and, possibly, acting out behav-iors) in the young people completing these tasks. Good, ongoing clinicalsupervision and continued training will help therapists make the most ofwhat this treatment can offer. I imagine it to be a rare occasion when theworkbook can be followed as linearly as outlined in this text. Therapistsmust be prepared to expect the inevitability of curveballs as recovering from

Book Reviews 183

anorexia is indeed a struggle, and each person struggling with this illness isunique.

In a future edition of this book, I would love to see the beginningsection for therapists expanded. I am particularly interested in the authors’thoughts on common transference-countertransference constellations andways of handling these dynamics. In this type of work, strong feelings canbe triggered in both patient and therapist and therapists need support andassistance in managing those feelings so that they are worked with con-structively and therapeutically and not acted out upon with the patient. Inthe same vein, I would also love for the‘ authors to present case material toillustrate some of the problems that might arise in the course of the treat-ment and how one might work with those problems within the frameworkof this workbook.

All in all, I recommend Hunger for Understanding. Alison Eivors andSophie Nesbitt have created a wonderful therapeutic tool. They understandand appreciate the complexity of helping young people recover fromanorexia, and their empathic attunement to the feelings, struggles, andneeds of these young people is remarkable.

Rebecca Harrington, LCSW, NCPsyAPrivate Practice 49 West 24th Street, Suite 1001New York, NY 10010rebecca.harrington@yahoo.com

Creating Bodies: Eating Disorders as Self-Destructive Survival,Katie Gentile, Mahwah, NJ: The Analytic Press, Inc., 2007, $39.95.

Creating Bodies is a fine example of a published dissertation. Each chapteroutlines theories associated with the developmental and relational experi-ences of “Hannah,” the pseudonym of the book’s subject suffering fromyears of bulimia and self-destructive survival. It is primarily written for thosein the fields of psychotherapy, psychoanalysis, or academia. Clearly,Dr. Gentile has done a thorough job of research. All hypotheses refer backto their sources. And, these sources are well documented. Because of itsscholarly origins, Creating Bodies does not easily accommodate anyoneoutside the professional psychoanalytic realm. Clinical terminology andpsychological lingo are used throughout the text. For instance, starting inChapter One readers learn a great deal about Dr. Gentile’s counter transfer-ence, as well as her analytic approach. Then, as the analysis of the diariesprogresses, the reader is privy to Hannah’s relational transferences, her