By Joseph Wolpe
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Dr. Kari Palonen ist Professor am division of Political technological know-how der Universität Jyväskylä, Finnland.
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Therapy 6, 211-218. MORTON R. (1694) Phthisiologia Or A Treatise of Consumptions, Smith and Waiford, London. SCRIGNAR C. B. (1971) Food as the reinforcer in the outpatient treatment of anorexia nervosa, / . Behav. Ther. & Exp. Psychiat. 2, 31-36. (First received 28 November 1971 in revised form 13 March 1972) SYSTEMATIC DESENSITIZATION OF ANOREXIA NERVOSA SEEN AS A WEIGHT PHOBIA ANTHONY T. SCHNURER,* RICHARD R. RUBIN The Johns Hopkins University School of Medicine and ALEC ROY Maudsley Hospital Summary—A case of anorexia nervosa in which phobic components appeared to be a primary factor in the maladaptive behavior, showed a marked response to systematic desensitization.
A Case example The patient, a 21-yr-old male, had marked difficulty carrying on a conversation and com municating his desires to other patients and staff. He affected a silly grimace whenever he spoke to anyone. He had particular difficulty in standing up for himself, as the grin belied whatever annoyance he was trying to express verbally. A 3-min role-playing situation was constructed requiring the patient to deny some unjust charges. He had formulated what he was going to say and was told that the other roleplayer in the situation would disagree with him but he was to insist that he was unjustly accused.
At the same time, the patient was being trained with Paul's (1964) modification of Jacobsons' (1938) relaxation technique and instructed in the basic strategy of systematic desensitization. Four days were set aside for baseline observa tions of eating behavior and of activity level measured by a pedometer on the patient. The staff were told that the patient could engage in all regular ward activities, and requested not to reinforce any behavior related to her weight or to eating. The caloric intake during this period was 600 cal per day.