mirror, mirror on the wall

by Jenny Bryan

Looking at themselves in a full-length mirror for increasing amounts of time each week can help young women who are recovering from anorexia to improve their body image. Results of a small study recently carried out at St George's NHS Trust, in London, showed that women who included the mirror treatment in their body image programme felt better about their body six months later, while those who didn't have the mirror treatment felt no better about themselves.

© Getty

Professor Glenn Waller, head of clinical psychology at St George's NHS Trust, explains that 30 to 60 per cent of women who are successfully treated for eating disorders still have a problem with body image, and this can affect whether they make a full recovery.

'One of the biggest predictors of relapse is disordered body image. Women who come out of treatment with a good body image will probably have benefited from treatment, but those who still have body image problems will probably be back,' he says.

standard therapy

In the recent mirror trial, all the women who took part had the binge/purge form of anorexia and they had reached their target weight (body mass index 20.5-21.5). One group had standard treatment to help improve their body image. This consisted of eight weekly sessions of 90 minutes, during which they talked and wrote about their body image problems and sexuality. They were encouraged to wear items of clothing and to take part in a range of social activities that they might otherwise avoid.

mirror treatment

The second group also had this programme but, in addition, they were asked, each week, to stand fully clothed for increasing periods of time in front of a full length mirror. At first, the women did little more than walk past the mirror. But gradually, they spent longer looking at themselves and, as they felt comfortable with what they saw, wore more figure hugging clothing. At each stage they talked with their therapist about what they saw and how they felt. The mirror exposure brought strong emotional responses from many of the women.

desensitisation works

At the start of the study, at the end of the group sessions and at six months, all the women in the study completed a range of questionnaires related to body image. Those who had taken part in the standard programme for improving body image showed no significant changes in body image at the end of treatment or at six months, compared to the start of the programme.

But those who had the mirror treatment were less dissatisfied with their body at six months than at the start of the study and scored higher on other tests related to anxiety and awareness. A few did not respond well to the mirror therapy; they had a history of sexual abuse and the researchers agreed that, in some cases, mirror treatment may not be the answer.

help and info

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organisations

Anorexia and Bulimia Care (ABC)
PO Box 173
Letchworth SG6 1XQ
Tel: 01462 423 351 (Mon-Fri 9.30am-12.30pm)
E-mail: help@anorexiabulimiacare.co.uk
Website: www.anorexiabulimiacare.co.uk
A Christian organisation offering support to sufferers of any eating disorder, their families, carers and professionals. Provides a befriending service, online resources, advice and the chance to share experiences with others who have been through the same.

beat (formerly Eating Disorders Association)
103 Prince of Wales Road
Norwich NR1 1DW
Adult Helpline: 0845 634 1414 (Mon-Fri 10.30am-8.30pm and Sat 1-4.30pm)
E-mail: help@b-eat.co.uk
Youthline: 0845 634 7650 (Mon-Fri 4.30-8.30pm and Sat 1-4.30pm)
E-mail: fyp@b-eat.co.uk
Website: www.b-eat.co.uk
Campaigning organisation that provides information, advice and publications on all aspects of eating disorders. Operates a UK-wide telephone helpline and a youthline for information, help and support if you're aged 18 years and under. There is also a webzine, message board and chat room on the website.

Careline
Cardinal Heenan Centre
326 High Road
Ilford IG1 1QP
Tel: 0845 122 8622 (Mon-Fri 10am-1pm and 7-10pm)
E-mail: info@carelineuk.org
Website: www.carelineuk.org
Provides confidential telephone counselling for children, young people and adults on any issue including eating disorders, depression, loneliness, anxieties and phobias. The website has a forum and an online counselling portal.

First Steps to Freedom
PO Box 476
Newquay TR7 1WQ
Helpline: 0845 120 2916 (Mon-Thurs 10am-10pm; Fri-Sun 10am-midnight)
E-mail: first.steps@btconnect.com
Website: www.first-steps.org
Offers a confidential helpline, counselling and befriending, telephone self-help groups plus leaflets and audio tapes.

Mental Health Foundation
Sea Containers House
20 Upper Ground
London SE1 9QB
Tel: 020 7803 1100 (Mon-Fri 8.30am-5.30pm)
E-mail: mhf@mhf.org.uk
Website: www.mentalhealth.org.uk
Aims to improve the support available for people with mental health problems and people with learning disabilities. Offers information and literature on all aspects of mental health, including where to get help, information about specific mental health problems, treatments and rights.

websites

Eating Disorders Resources
http://edr.org.uk/
Informative website with resources on eating disorders including anorexia nervosa, bulimia nervosa, compulsive eating and binge eating, with details of organisations, publications and links to other websites.

National Centre for Eating Disorders
www.eating-disorders.org.uk
Contains information available to download, for those eating disorders such as compulsive or binge eating, anorexia, bulimia and dieting. Offers information, counselling, and professional training.

The Site
www.thesite.org/healthandwellbeing/mentalhealth/
eatingdisorders/anorexiaandbulimia
Advice on why people develop eating disorders and guidelines on helping yourself or others with an eating disorder.

Something Fishy Website on Eating Disorders
www.something-fishy.org
Pro-recovery website dedicated to raising awareness about eating disorders, providing support and information for those with eating disorders, and their family and friends.

Weight Concern
www.weightconcern.com
A new charity which aims to support the physical and psychological health needs of overweight people and to speak out on behalf of overweight people against prejudice and discrimination.

reading

	'Body Image Treatment within an Inpatient Program for Anorexia Nervosa: The role of mirror exposure in the desensitization process' by A Key and others, in International Journal of Eating Disorders, vol 31 (March 2002), pages 185-190.
	All About Anorexia Nervosa (Mental Health Foundation, 2000) A booklet for those wanting to know more about anorexia nervosa. Available to download here.
	Breaking Free from Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers by Janet Treasure (Psychology Press, 1997) This book includes sections for parents and other carers alongside a section for the sufferer herself. In her work with patients and families Janet Treasure has tried to ensure that family and professionals collaborate and co-operate in order to overcome the power of the illness. Get this book
	Conquering Anorexia by Clare Lindsay (Summersdale Publishers, 2000) Provides an insight into anorexia and offers reassurance for those with the disease, and their families, with advice on steps to overcome the emotional and physical problems of living with anorexia. Get this book
	Skinny by Ibi Kaslik (Walker and Co, 2006) Novel that gets inside the head of a young woman with an eating disorder and which has had rave reviews. It's also about a whole emotional world where anorexia can hatch and flourish. Sibling love/rivalry, family dysfunction, the confusion of sexual awakening, the identity questions at the heart of the immigrant experience - all these and more converge on an early twenty-something former medical student. Get this book

(May 2002, resources updated March 2005)