A Rethink: Part Two
A quick recap of Part One of this series on some concepts we are looking at right now:
Eating disorders are very difficult to treat successfully and the best of the best have struggled for decades to unlock a path to better outcomes, and
Having our hearts in the right place is still leading to significant ongoing trauma and ultimate relapses for up to two thirds of all patients with eating disorders who undergo any treatment, whether evidence-based or unconventional.
And what shall we make of China’s Yang Jingru and her amazing speed skating win at the 2024 Youth Olympics ?
Perhaps the takeaway is that sometimes an unusual combination of cleverness and luck turns an entire professional field on its head.
Luck is always part of the equation. Had the competitors pushed a bit to keep up with Yang’s initial burst away from the pack, then it would have ended up as yet another hard race where Yang may or may not have been able to hold her lead to the end.
Every one of us enters our professional field with enthusiasm and a not insignificant amount of optimistic exceptionalism. One of the most deflating things for a new practitioner is to sit across from a 30-year veteran who has tried it all, done it all and is confident there is nothing new under the sun.
But it will never be the veterans of any field who will truly move the field in a new direction. I knew one physician who had always wanted to pursue a career in research. He specialized in medical malpractice expert witness reviews for legal cases. He felt he was too old, at 30, to pivot into research. He said that beyond 30 you will not have the intense creativity and focus to truly find the breakthroughs.
I suspect that it is not age based so much as it is how new you are to the field. It is feasible for a 70 year old who is only a few years into a brand-new-to-them research field to figure out something that all the other experts have missed.
Is it possible someone new to the field of eating disorder research is on the cusp of a breakthrough that has been long overdue for decades, maybe centuries? I do not know. But what I do know is that the medical, academic and research industrial complexes are so heavy and overburdened with the defense of their own existences, the chance that a clever and lucky person laps them before they know what has happened, has never been less likely in the history of modern civilization.
I would be extremely happy to be proven wrong on that, but at present there is nothing on the horizon. While we can all hope, the reality of an existing patient population with few options and only a minority who will navigate themselves to remission (often in spite of the expert treatment they receive and not because of it) we need a plan for the now.
3. While new and clever people with luck at their backs may give us the breakthrough for eating disorder treatment like nothing we have seen to date with shockingly good remission rates, the systems that train and groom new and clever people have never been more capable of squashing innovation than they are today.
I have painted a bleak landscape where experts are stymied, breakthrough cleverness is suppressed and patients have very poor outcomes for remission.
We are now going to wrap ourselves in the Stockdale Paradox to move to the next instalment where I will try to get into what to do with this reality.
“You must never confuse faith that you will prevail in the end—which you can never afford to lose—with the discipline to confront the most brutal facts of your current reality, whatever they might be.”
James Stockdale was once asked how he coped in a POW camp in Vietnam and who was not likely to make it out. His response was that the optimists did not make it out. They died of a broken heart. And the above quote wrapped up his thoughts on what successful survival looked like in those circumstances.
Armed with the faith that you will prevail and the discipline to face the brutal facts of the current reality of eating disorder recovery we move forward to the next instalment in the series soon…
Next Up: Part Three
