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Dr. Rachel Kramer, PhD is a psychologist in San Francisco, CA specializing in psychology. Dr. Rachel Kramer, PhD is affiliated with Cincinnati Children's.
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Anorexia
Anorexia nervosa, commonly referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. People with anorexia have an extreme fear of eating and gaining weight, and may perceive weight loss as a way to achieve happiness. They may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a normal amount of it, resulting in symptoms such as:
-Abnormally low BMI (body mass index)
-Vitamin deficiency
-Fatigue
-Fainting
-Amenorrhea (lack of menstruation in women)
-Emaciation
-Poor wound healing
-Anemia
-Irregular heart rhythms
Anorexia may also cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). These physical symptoms are frequently accompanied by altered behaviors and emotions. Those with anorexia may feel compelled to hide their weight and actions from others. For example, someone with anorexia may wear oversized or baggy clothing to conceal weight loss or may deny hunger or lie about the amount of food that he or she consumes. Some people with anorexia may withdraw from social activities and may experience irritability and depression.
People of all ages, genders, and races may be diagnosed with anorexia; however, the condition affects more women than men. There is no single known cause for anorexia, but biological, psychological, and environmental factors may play a role. Athletes who participate in certain sports that emphasize body shape and size (such as ballet, figure skating, and wrestling) may be more likely to develop anorexia.
Anorexia has two subtypes that are referred to as the restrictive type and binge-purge type.
Restrictive type is the more frequently represented form of anorexia, involving the extreme restriction of food. Binge-purge type anorexia is food restriction accompanied by episodes of binging (eating large quantities of food) and purging (vomiting). Binge-purge type anorexia differs from bulimia as people with this type of anorexia severely limit calories and purge most of what they eat and are generally underweight, while those with bulimia are in a normal weight range. Left untreated, both types of anorexia have severe and life-threatening effects on health. Anorexia can lead to heart failure and even death.
Many people do not consciously develop anorexia, and have difficulty seeking treatment. For this reason, early detection and treatment helps with long-term recovery outcomes. Treatment for anorexia can vary from therapy visits to inpatient treatment, depending on the severity of a person's anorexia. Severe anorexia is typically treated in inpatient rehabilitation facilities, where patients increase their food consumption and gain weight under medical supervision. Eating disorder specialists provide therapy sessions and oversee a physical and mental treatment plan. Outpatient programs help patients return to a healthy weight through frequent talk therapy or cognitive behavioral therapy (CBT) sessions, specialized nutrition plans, and eating disorder support groups. Anorexia treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy, or CBT, is a form of psychotherapy or treatment for mental illness. It comes in a variety of methods, but the basic concept behind all CBT is the same -- thoughts cause feelings, which cause actions. If someone wishes to change problematic behaviors or emotions in their lives, they need to start by changing their thoughts. CBT examines ideas and looks for patterns that may be causing harmful actions. The therapist helps patients modify those thought patterns and, in doing so, helps them feel better and cope more effectively.
CBT is one of the most widely studied forms of psychotherapy, and it has been shown to be extremely effective for a variety of mental illnesses. Some of the issues that respond well to CBT include mood disorders, personality disorders, eating disorders, substance abuse, sleep disorders, and psychotic disorders. In some cases, CBT has been shown to be as effective or even more effective than medication. One of the interesting things that the scientific study of CBT has shown is that CBT actually changes the way the brain works, physically improving its function.
CBT differs from traditional psychotherapy in a few key ways. One of the most important distinctions is the emphasis on the power and responsibility of the patient in CBT. The patient will be encouraged to be the one asking the questions in CBT therapy, and most patients are assigned homework to complete outside of therapy sessions. There is a concept in CBT that everyone has power the power to change how they feel, even if they cannot control the situation, and this can be very empowering for patients. Because of this power shift, the therapist-client relationship is not as critical to success in CBT as it is in other modes of therapy. Patients should still get along well with their therapists, but they do not need a deep, dependent emotional connection to them. Finally, because CBT often treats a specific issue or problem, it is usually shorter in duration than traditional therapy. While some therapies may continue for years, CBT lasts on average just 16 sessions.
Dialectical Behavior Therapy
Dialectical behavior therapy, or DBT, is a form of cognitive behavior therapy (CBT) that was originally developed to help the most severely mentally ill and depressed patients accept therapy. It relies on the same concept in CBT that examines the relationship between thoughts, feelings, and actions, but in DBT the emphasis is first on acceptance rather than change. There is also an emphasis on mindfulness, 'being in the moment,' and relaxation techniques such as yoga. These are combined with a great deal of validation and encouragement from the therapist.
The word 'dialectical' means acting through opposing forces, and this word refers to a few different opposing concepts in DBT:
Dialectical behavior therapy was developed when therapists attempting to use CBT techniques on the most seriously ill patients ran into a problem. When they suggested that a patient change their thoughts, these very vulnerable patients would become overwhelmed and turn aggressive or suicidal. DBT was developed to support these patients with acceptance and validation while still guiding them towards changing problematic thoughts. Although also used for suicidal and self-harming patients today, these days, DBT is mainly used to treat borderline personality disorder. It is one of the few effective interventions for this serious illness.
DBT has been shown to be very effective at reducing self-destructive behavior. It can also be used to teach new coping skills and increase a patient's self-esteem and motivation to become healthier.
She has a state license in California.
Licensed In: California
Dr. Rachel Kramer, PhD is associated with these hospitals and organizations:
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Dr. Rachel Kramer's specialty is child psychology. In her practice, Dr. Kramer focuses on cognitive-behavioral therapy (CBT), dialectical behavior therapy, and anorexia. Dr. Kramer is affiliated with Cincinnati Children's.
