January 1, 2013

People to know

Well, this is cool. Really cool!


Dr. Janet Treasure, an advisor and greatly valued friend to F.E.A.S.T. has just been named by the Queen as OBE (Order of the British Empire) "For services to People with Eating Disorders."

A lot of us who don't have crowns, or proper hats for the ceremony, would also like to give her honors, honours, and an enormous hug!




20 comments:

  1. It IS really cool. If all was equal she would be at least a Dame, but then again if all was equal she'd be practising out of the William Gull Hospital rather than Thomas Guy's. We have a long way to go until it is common to recognise the field publicly, but this is a real step forward. We'll all need to don our hats and wave our flags when the ceremony happens even if we're doing it remotely via the TV.

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  2. Being named on the Queen's Honour list with an OBE for our beloved Dr. Janet Treasure is certainly well overdue and ever so well deserved. It is an honour to know her, have her on our team as parents, patients and above all, in the UK. I do hope this will have an impact on our policy efforts in the UK and become a shining example, globally, of homegrown talent, compassion, intellect, commitment and a driver of change for the field of eating disorders. Thank you again, Dr. Janet Treasure, OBE for all your years of hard work for so many in need.

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  3. It is truly wonderful and delightful and I couldn't think of anyone more deserving or more modest about it.

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  4. A well deserved honor, I am sure.

    For us rubes on the other side of the pond - this doesn't makes her now Dame Janet Treasure? And do we bow, or just throw rose petals (jk!) How does that all work?

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  5. Ms. Treasure has published more than 300 papers since 1985 on the subject of eating disorders.

    Have any of these papers demonstrably improved treatment outcomes?

    If so, which ones?

    CB-US

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  6. No sorry Irish, she's still plain old PROFESSOR Janet Treasure, the honorary letters OBE go at the end of the name, along I suspect with loads of others that she already has. Mind you a few rose petals never did any harm

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  7. The reason I asked the questions, above, is that I have some serious reservations about Ms. Treasure's work on anorexia nervosa. First, she, like many eating disorder professionals, has had a tendency to write books and papers giving specific advice about how to treat AN without providing objective evidence that her ideas are effective. For example, the book on the New Maudsley method contains no experimental evidence at all. How do we know that if the parents act like a "dolphin," as she suggests in the New Maudsley book, it will actually help their daughter or son who suffers from anorexia nervosa either gain weight or resume normal eating patterns? For decades the field of eating disorders has been plagued with too much theorizing and not enough experimental research. I think Ms. Treasure's writings reflect this problem.
    Second, I have read many of the 300 articles Ms. Treasure has published since 1985 and I am, frankly, appalled at how much parent-blaming there is. If her stance toward parents were backed up with scientifically-reliable evidence, I'd be satisfied. But over and over again she, in my opinion, distorts the research evidence to fit her preconceived notions about parents. Overall, I think her writings about parents are, frankly, pseudoscientific. I am very surprised by the expressions of admiration she receives from some members of the parents commumity. I wonder how many of these parents have actually read what she has written over the years, including very recently.

    I would be willing to overlook these issues if Ms. Treasure had developed "the cure" for anorexia nervosa, or even a treatment method that has been tested in rigorous studies and found to be an improvement over the status quo. Unfortunately, I have not found any such methods or studies in her published works, and her negative stance toward parents makes me less than enthusiastic about her record of publications on the subject of anorexia nervosa.

    CB-US

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  8. CB, your reservations about Professor Treasure are well known here and elsewhere. I suspect my personal admiration of and affection for her are too. I could write a long post countering the arguments you've given here, and you could then reply but I don't think it would advance either of our causes and much more importantly I don't think it would help one single person suffering from an eating disorder one iota.

    Suffice to say I celebrate this award to the PERSON because I admire her. In a much wider sense though I celebrate this award to the FIELD of eating disorders which I think is a first (I may be wrong, please contradict me if you know otherwise).

    As this link https://www.gov.uk/honours/overview explains, our honours system "recognises people who’ve made great achievements in public life and people who’ve committed themselves to serving Britain". There are various categories of worthy activity that are recognised and health is one of the main ones. In more widely praised medical fields there will be several individuals at any one time who hold such honours. I hope that in time this will also be the case with eating disorders. It's an archaic and odd way of getting awareness and help but we're an archaic and odd country! If any UK citizens have any other people they'd like to see get an award, get nominating https://www.gov.uk/honours/nominate-someone

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  9. CB,

    CB, you're milking a cow and expecting orange juice. You're cutting down the orange tree because it's not producing cheese. I'm sure your myopic and dogged critique of Treasure is a crucade you view as shining light on important issues for unsuspecting fellow parents but I just see it as silly and lacking context.

    First of all, the standards you set are meaningless. There is so little research on such small scales, that there are no oranges to compare with apples. The ONLY treatment outcome research of any quality (the FBT RCTs) is still so small-scale that it can't be used to compare to much. It is 'proof of concept' and shows that research can be done on this population but doing large-scale research on EDs requires more money and access than anyone currently has - and to expect any treatment provider or researcher to have that money and access to that number of patients is a great goal but perhaps your energy would be better spent raising that money to get it done?

    What you see as "parent blaming" is deliberate mis-reading. We've had these debates, you and I, and you seem to delight in doing it in public so I feel free to say publicly that I read the same things as you do and despite my fine-tuned sensitivity to parent-blaming think your statement is bollocks.

    But more to the point, you're choosing targets that bring your judgement into question. Treasure is one of a very small handful of clinicians/researchers who even pay attention to parents and ED care. And she isn't selling a treatment, anyway, she's offering tools to parents on how to understand, cope, and care for terribly ill kids. To compare that with a treatment modality, as you continue to do, is either deliberate obfuscation or uncharacteristically unintelligent.

    Of the ED clinician/researchers, she is the one I've found most compassionate, most thoughtful, most open to working with parent activists, most eager to respond to questions, most willing to continue to learn from families, and most creative in getting her work from page to people. I know countless parents who love her work and find it very, very helpful to them in caring for their kids. Treasure is especially caring and understanding of people who suffer from black and white mindsets, I note. Although the animal analogies usually leave me personally cold, I'm thinking of quite a few of them right now as rather brilliant, especially the ostrich and the rhino. Of all the people that you love to attack, this choice makes you look the most out of touch.

    Treasure has done far more for eating disorder patients, their parents, and for the field, than you or I could dream of. I am very proud to cheer for her recent honor.

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  10. Oh dear, CB. This continued campaign against Professor Treasure is becoming very boring. I have read your endless ranting emails, both to her and to others and listened to your same old, same old deliberate misinterpretation of her work for years now.

    Firstly, she remains a Professor and, if you are unable to spell that, at least afford her the courtesy title of Dr. I find your juvenile insistence of not according her her proper title reminiscent of a teenager "whatever" attitude, not of a grown up professional debate in an open forum. Manners don't cost anything.

    I concur with Laura. I have failed to find another clinician who is so readily available and listens to what parents are saying and incorporates feedback into her work so swiftly.

    I have to (yet again!) remind you that Professor Treasure is not selling anything. You cannot buy Professor Treasure's services, however much you offer.

    Not only have I read, but I have also contributed quite heavily to a number of her projects recently. Do you have a problem with that?

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  11. PROFESSOR Janet Treasure OBE is one of the most inspiring people I met in 2012 and I am sure many, many people would agree with me, and with Charlotte, Laura and Marcella etc above.

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  12. When I have met Prof Treasure, I have found her to be, amongst many other qualities, questioning, interested, observant, willing to listen, and patient. She is probably one of a kind. It is very apparent, CB, that you have reservations and are unenthusiastic about her work, but really, in this particular instance, in this slightly odd honours system that persists in the UK and raises so many mixed feelings amongst so many of us Brits, but also seems to be supported by many of us when those who are recognised by it deserve to be honoured in a public way, nobody really needs or wants to know about your view. She has been nominated and selected and is being recognised by her own country for the work that she does in it, fittingly for this particular system whatever else you may wish to hold her to account for, and I too am thrilled and gladdened to hear it.

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  13. Here's what Ms. Treasure has written about mothers of people with anorexia nervosa. I'll quote her directly, in her own words:
    "Both clinical and empirical studies suggest that insecure attachmnet is common in eating disordered populations. Clinical studies have addressed mother-daughter interactions, but there has been little empirical research into the mother's own attachment patterns and whether there might be intergenerational transmission of these patterns. We aimed to examine the attachment status of patients with severe anorexia nervosa and their mothers, using the 'gold standard' Adult Attachment Interview (AAI). We predicted: (1) a high level of insecurity among the patients (women with anorexia nervosa with or without bulimic behaviors); (2) that the mothers would show a higher rate of insecurity than predicted by population norms; and (3) that there might be attachment style associations within mother-daughter pairs. Twenty consecutive in-patients with a DSM-IV diagnosis of anorexia nervosa were interviewed using the AAI, as were 12 of their mothers. The mental state of daughters was rated by experienced clinicians, and that of mothers by the Clinical Interview Schedule (Revised). AAIs were transcribed and rated by expert raters. Nineteen (95%) daughters and 10 (83%) mothers were rated insecure on the AAI. Of these, 15 (79%) daughters and seven (70%) mothers were dismissive in type. We did not find an association between mothers' and daughters' attachment style. The incidence of unresolved loss was high among the mothers (67%). Idealization scores were high and reflective functioning scores low in both mother and daughter groups. Women with anorexia nervosa and their mothers commonly have a dismissive attachment style. Low levels of reflective functioning and high idealization scores are found in both groups, and may be learned (or transmitted) from mother to daughter. A difficulty in emotional processing, exemplified by unresolved loss, may be transimitted to daughters, and act as a risk factor for the development of anorexia nervosa."
    Treasure, et al, "Attachment in Anorexia Nervosa: A Transgenerational Perspective" Br J Med Psychol 2001 Dec; 74(Pt 4): 497-505 http://www.ncbi.nlm.nih.gov/pubmed/11780797

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  14. Oh, pshaw: is that your worst? A 12 year old paper by Treasure's student of a tiny study testing the security hypothesis?

    I know you know this, but for those who may not, this is how academic papers work. A research question is posed, not as an accusation or an independent idea but as null hypothesis testing. In this case, it is testing the hypothesis "Parenting style does not correlate with anorexia diagnosis"

    It's a good, if slow, way of doing things because the idea is to find out if the ideas being used in practice have validity. Each study question is assumed to be untrue unless proved otherwise. In the case of eating disorders, there was an operating assumption out there that mothers were doing something wrong that could be fixed and applying the scientific method to that premise is a good idea. As it turns out, there are correlations in some studies and not in others.

    Treasure herself has been consistent, loud, and often alone in publicly saying that parents do NOT cause eating disorders. I don't know how often or in what venues she would have to say that, but she is actually the only one of her stature who does so often and strongly and for so long. To choose HER of all people as parent-blaming says more about the accuser than anyone!

    I'm not saying that I agree with all the research questions that are being asked, or were asked, but in science one does not generally start with fresh questions and in one's literature review one is obliged to draw from the existing literature -- not opinion and what one wants to be true.

    As a grad student I myself had marvelous new questions I wanted to ask for my thesis but my advisor was obliged to rein me in to certain parameters: I had to study something I had access to without incurring costs that were not already funded, I had to start with a study question that built on something already established or sought to test something already out there. My literature review had to be comprehensive and not simply support my hypothesis. And my advisor, poor thing, got to and had to have authorship (at end of list of other students) on his students' published work.

    But to stay on topic here, I am not afraid of research into the topic of attachment: I welcome it. I'm not afraid of any well-designed research as I want to know the truth and have even bad research out there to discuss - rather than let these ideas fester. I welcome bad research, too, as then we can discuss it.

    Reading and commenting and being part of the larger discussion means I need to be able to tell the difference between strong and weak research, between correlation and causation, between 2001 and 2013, and between open discussion amon equals and random bomb-throwing far from the field of battle.

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  15. Great reply, Laura.

    CB - the comments that have been posted on Facebook about this blog post include cognitive inflexibility and difficulty set shifting. I believe that you believe you are doing a GOOD THING by these vitriolic and (to my mind) totally unjustified attacks on Professor Treasure. Just to let you know, you are totally alone out there in cyberspace, in this assumption.

    Probably the thing I find most irritating is your singular lack of courtesy. I set store by good manners and your continued sophomoric refusal to accord Professor Treasure with her proper title is mind-numbingly puerile.

    Act your age, not your shoe size.

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  16. Here is another quote from Ms. Treasure, taken from the same paper. She writes:

    "In terms of the older clinical literature, a dismissive stance would limit a mother's response to an infant's emotionally based attachment needs, particularly when these stir up negative feelings. Infants of such mothers may be adequately cared for physically, and even attended to emotionally up to a point, but certain experiences (mainly negative) would be likely to remain unprocessed. In Bruch's terms, such a mother superimposes her own needs on those of her infant, who then grows up unable to differentiate its own needs/wants. Such an infant remains dependent on the mother to supply a sense of self, yet having to defend against the mother's intrusiveness. Bruch (1974) describes the evolution of such an infant into the eating disordered adolescent. Thus, our findings provide a plausible empirical link to this literature." Treasure, et al, Attachment in Anorexia Nervosa: A Transgenerational Perspective,Brit J Med Psych (2001), 74, 497-505.

    The conclusion of Ms. Treasure's paper -- that "Women with anorexia nervosa and their mothers commonly have a dismissive attachment style" -- was based on interviews of merely 12 mothers carefully chosen, not selected at random. The mothers were subjectively "rated" by the authors of the paper, who therefore had a conflict of interest because they hoped for results that could be published to advance their careers. Unfortunately, however, the paper was statistically insignificant. It generalized subjectively-developed data from a non-representative sample to an entire population and therefore was pseudoscientific. I doubt many scientists would defend it. I doubt many other anorexia nervosa researchers were quoting Bruch in 2001.

    Ms. Treasure has continued to make similar assertions. See, for example, Treasure, et al, "Factors of Risk and Maintenance for Eating Disorders: Psychometric Exploration of the Cross-Cultural Questionnaire (CCQ) Across Five European Countries, Clinical Psychology & Psychotherapy, Vol 18, Issue 6, pages 535-552 (Nov/Dec 2011); Treasure, et al, "Gene-Environment Interaction in Anorexia Nervosa: Relevance of Non-Shared Environment and the Serotonin Transporter Gene," Mol Psychiatry 2011 Jun; 16(6): 590-2 Let me know if anyone would like me to post quotations from these two papers, both of which have been published in the past two years and cannot be explained away.

    Most eating disorder researchers have rejected these assertions about parents, mothers in particular, because of empirical studies published in the past decade. Ms. Treasure continues to make them. If you don't believe me, read her papers (above).

    Many people now doubt that the kind of psychology research performed by Ms. Treasure is a real science rather than mere speculation and bias. The official investigation into the scandal involving Diedrik Stapel concluded that there is evidence the field of research psychology exhibits a "general culture of carelessness, selective and uncritical handling of research and data," and a "general neglect of fundamental scientific standards and methodological requirements." See press release by Tilburg University issued November 28, 2012 and final report attached thereto. These problems were also discussed in an article in the Guardian on September 13, 2012, entitled "False Positives; Fraud and Misconduct Are Threatening Scientific Research; High-Profile Cases and Modern Technology are Putting Scientific Deceit Under the Microscope."


    For these reasons, I think it is reasonable to approach Ms. Treasure's ideas with a certain amount of caution.

    CB-US



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  17. It is ALWAYS reasonable to approach ANYONE's ideas with caution. And you have my complete agreement about the state of psychology research in and out of eating disorders: its shameful and actively harmful. But you're not approaching with caution or with any seeming purpose either except to be the last man standing on a lonely outpost of indignation. There: you have it. Enjoy.

    All you have to do is ASK Dr. Treasure or talk to any family that has worked with her or read her books or listened to her talk or work with families. But you don't do that -- you dig up old academic papers whose context you don't seem to understand in which your enemy du jour has been listed. Your targeting and harassment of individuals, taking them out of context and assuming ill intent, is inexplicable even to my highly sensitive affront to anti-parent messages. I have a long list of people whose current publications disturb me and here's what I do: I contact them and engage with mutual respect.

    Even your allies, and I used to be one, can't figure out what you are on about.

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  18. Laura,
    If you want to give "hugs" and "honours" to someone who disparages parents, engages in pseudoscience and questionable research practices, quotes Hilde Bruch in 2001 as a reliable source of information, and admits she has never developed any evidence that helps treat patients with anorexia nervosa
    (http://www.ncbi.nlm.nih.gov/pubmed/22995632) you are free to do so. As you know, I actually brought my concerns to Ms. Treasure in a cordial fashion several years ago, but she persists in her behavior. I'm now disclosing facts. You have not disputed any.
    I don't know what you are about, although it seems you are an apologist for some quite unhealthy practices by eating disorder professionals, detrimental to parents and sufferers alike.

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  19. I don't know about Laura but I for one would far rather give hugs and honours to a clinician who has personally brought hope and understanding to my family, than continue to debate the finer points of what one of her research students may or may not have said 12 years ago with you CB.

    Laura has created an international movement of parents willing and able to take their part in pushing the field of eating disorders forward. Here in the UK this is greatly facilitated by those clinicians who are interested in parents and put back by those who have little or no experience of or interest in family caregivers. Professor Treasure is one of the leading lights in studying, including and welcoming family carers and by working with her and people like her parents can really make a difference, not to some academic and legal argument, but to LIVES

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  20. "Anger and intolerance are the enemies of correct understanding."

    Mahatma Gandhi

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