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SYNOPSISPerception of body size, subjective experience of body image distortions and differentiation of body concept in the human figure drawing were assessed in adolescent anorexia nervosa patients and controls shortly after hospital admission, and again 6 months later during the recuperative phase. Size estimation was not found to be a distinguishing variable, as both groups exhibited overestimation tendencies of comparable magnitude at both time periods. By contrast, experiences denoting estrangement from the body, insensitivity to body sensations, and weakness of body boundaries were more prevalent in anorexics, and persisted at high levels after frank symptoms of weight and eating disorder had subsided. Anorexics were also shown to depict the human figure with less differentiation relative to controls. Within the anorexic sample the presence of vomiting was linked to greater subjective experience of body image distortion, and such phenomena appear to be a more enduring feature in this subgroup. Overall, the results were viewed as lending support to the argument that defects in body image formation render the anorexic vulnerable to their manifest pathology, which is itself activated by maturational conflicts unique to adolescence.

The revolution is over! Long live the revolution! The revolution we refer to, in this case, began a half century ago, when a number of leading scientists, engineers, mathematicians, and social scientists proposed a new paradigm -one that emphasized systems, a cybernetic epistemology, and in general an outlook that underscored the role that context and interaction play in understanding individual behavior. Within this new conceptual leap, each person's experiences, attitudes, and sets of problems could now be defined as occurring within a framework such as a family. Rather than seek out the person's intrapsychic problems, clinicians were now urged to direct the attention to the family context in which the behavior occurred and to the interpersonal sequences taking place between family members. Focusing on what was occurring in the present as families interacted, and how each participant influenced (and in turn is influenced by) other family members, began to replace the search for explanations of why problems developed as a result of past trauma. As the outlook of reciprocal causality (or circular causality) replaced linear explanations, clinicians learned to attend to the dysfunctional family unit and not merely the symptomatic person (Goldenberg & Goldenberg, 2008).During its heyday in the 1970s and 1980s, as the family systems outlook gained prominence, a number of seasoned clinicians, formerly psychodynamic in viewpoint, converted to its tenets. They, as well as many fledgling clinicians, were attracted to its basic notion that behavior occurs in context, that problems exist between people rather than within each person, and that seeking to uncover and gain insight into unconscious conflicts was not nearly as therapeutic as helping families change ongoing dysfunctional interactions. Fraenkel (2005) recalls from his student days, after becoming convinced of the therapeutic worth of systems intervention, that "family therapy was an unstoppable revolutionary movement, which would radically change the mental health field, and even our larger society" (p. 33).

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