When Doing Is Not Enough

Abstract

The prevalence of ,anorexia nervosa is increasing throughout the world, both clinically and subclinically (Crisp, 1976; Jones, 1980). Occupational therapists are often involved in the treatment of these women, especially with regard to development of the sense of effectiveness. Aonlication of fundamental occuoationd therapy principles suggests (hat the prescription of activity' should help anorexics to develop individual competencies, which would subse@ ently generalize inio a sense of effktiveness over time (Fidler, 1981). However, experience with anorexics in an inpatient treatment unit has challenged this basic assumption. The paper is an attempt to understand and explain the relationships among three factors: anorexia, the sense of ineffectiveness, and the use and meaning of activity. Attempts are made to explain the development of the sense of effectiveness in healthy people, and discussion targets the areas where this process may break down in the anorexic. A detailed discussion of activity and past research on activity demonstrates the state of knowledge on this topic within the field of occupational therapy, and pinpoints the need for further research to more appropriately utilize activity in the remediation of the sense of ineffectiveness, particularly with anorexics.