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I have struggled with my decision to contribute to this debate. I have questioned my motives and worked to clarify my purpose for writing and my intended audience. What I have realized is that these are all things that you, Ms. Poppink, failed to do before you submitted this article. I have read a number of your various posts and blog entries across the Internet and find most of them to be well written and positive contributions to the Internet community. However, this article and particularly this article on this site which claims to be "a unique online resource dedicated to helping women improve their health and well-being. We provide up-to-date medical information, access to leading medical experts...." is extremely dangerous.

I'm unclear as to who your audience is--is it ED patients themselves? is it treatment professionals? is it friends and caregivers...the "hundreds of people (who) have asked (you) why someone develops an eating disorder"? Are you posing a new theory asking for dialog and feedback? What you fail to make clear to your readers is that this is a new theory, without any research base. That's fine if you are honest about it, but your writing is so over-the-top with broad, sweeping generalizations and black and white thinking that it couldn't help but polarize readers. The headline is not "One Reason for Developing an Eating Disorder" it's "NUMBER ONE Reason for Developing an Eating Disorder."

You write "from my exploration of this field over the years, I have concluded that there is one outstanding theme that runs through every person with an eating disorder whom I have encountered. Early in their lives, people with eating disorders have experienced, on a sustained basis, relentless boundary invasion on every level." Your word choice leaves no room for discussion; "one outstanding theme," "every person," "sustained basis," "relentless boundary invasion," "every level" are all extremely aggressive, all-or-nothing phrases that don't belong in a serious scientific discussion. If they had been supported with evidence from the literature and research, the hyperbole might be forgiven.

On your Twitter page you express surprise to have generated such a violent response, but your own emotionally charged words have set up this response. To use the language of DBT, this "black and white" thinking has led to a response that comes from readers' "emotional mind." If you had proposed your theory a bit more cautiously, the discussions might have come instead from readers' "wise mind."

But here's my personal concern. For the past 15 years I have worked as a teacher and librarian with students and their teachers, helping them to become savvy internet users. We are fortunate to have access to a wealth of peer-reviewed research articles in various commercial databases, but many students still take the easy path of Google and Wikipedia and often rely on this kind of questionable scholarship. In this case, if they had followed my advise and checked out the Empowher "Terms of Use" link, they might have read the following statement "content is created by experts in the medical community or submitted by members of the site. The Content we write or commission is written by medical and health experts and reviewed by medical experts before it is posted." They would be led to believe that this is a reliable source of information. Of course, they would be wrong, since clearly no such peer review of this article took place. (I emailed Empowher about this and as yet have received no response.)

In consideration for the information needs of young women and men struggling with eating disorders, I would strongly recommend that you withdraw this article, re-craft the first three to four paragraphs, and then re-post it on your own blog.

I would also like to briefly comment on two generally excellent articles that you've posted elsewhere. I found the article "For Parents of Children with Eating Disorders" (http://www.trans4mind.com/life-coach/life-challenge5/poppink.shtml) very helpful, though it did concern me that you don't remind parents to think of the eating disorder as separate from the child. And finally in your otherwise excellent article "For Teens: When You Discover a Friend is Bulimic or Anorexic" (http://www.something-fishy.org/doctors/doc_article015.php) you neglect to encourage teens to tell a trusted adult. This is standard advice for dealing with suicide, should an eating disorder be treated any less seriously?

Best of luck with your book project.

-Peter

June 14, 2009 - 9:19pm

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