The therapist's voice

Hope has long been recognized as a vital element of the therapeutic process. We know that a fair percentage of clients do not recover, yet, to do our work effectively, we must balance acceptance of a person "as is" with the hope for change. Learning to bear the unfinished chapters is perhaps one of our most difficult lessons, as is indicated in the following vignette.     

Questions and Answers

Abstract

As a therapist using a cognitive-behavioral approach to treating eating disorders, I devote a significant part of my work to changing irrational ideas that perpetuate the disordered eating and related behaviors. Typically. part of each session is devoted to helping the patient recognize her irrational thoughts and encouraging her to substitute more realistic ideas. Like many cognitive-behavioral therapists (e.g., Fairburn, 1985, Hsu et al., 1991), I use cognitive restructuring techniques, such as asking questions, encouraging hypothesis testing, and offering information, that counter irrational beliefs about food and weight. One problem I have encountered with this approach is that frequent repetition may be required. Issues such as body image, dieting, emotional coping, and self-esteem reemerge in almost every session. Yet I become uncomfortable if I feel that I am repeating the same cognitive restructuring techniques too often. As a partial solution to this problem, I find that the following analogies and comparisons are helpful. They make it easier for the patient to identify her own thought patterns and to recognize the illogical assumptions in these thoughts. As therapy progresses they can serve as a shorthand that reduces the necessity for didactic discussions about irrational thinking.     

Reproductive Immunology Issue One： Cellular and Molecular Biology

It is estimated that immune system evolution commenced more than 600 million years ago （Mya） when ancestral forms of MHC and CD45 appeared establishing innate immunity. By 500 Mya, RAG gene evolution had occurred, founding adaptive immunity.The first mammals appeared much later （220 Mya） and reproduced by laying of eggs. Placental mammals with internal gestations and live born offspring have existed for only 100 Mya, with humans and mice being relatively recent mam- malian evolutions.