Cultural systemic therapy on the kibbutz: community and family-based treatment of anorexia nervosa

A cultural approach to therapy assumes that community organization and social ideology can contribute to the genesis and maintenance of mental health problems, and also to their resolution. Cultural systemic therapy applies this insight to all relevant levels of the family-community ecosystem. This is demonstrated by focusing on the treatment of anorexia nervosa in the Israeli kibbutz. We analyze the confluence of cultural characteristics with the anorectic syndrome and then illustrate in a case study of how these characteristics can be employed in therapy. Two particular interventions are delineated to document the powerful impact that can be achieved when this approach is applied to severe and long-term disorders: the establishment and ongoing collaboration with an expanded community/family team and a home confinement program.

Psychogenic cough tic: a case report

A case of psychogenic cough tic is presented to demonstrate the problems and complications that can arise from misdiagnosis of this dramatic and disabling disorder. It can be confused with TS and may be treated more aggressively than is beneficial. A single case with a recurrent course is described with the hypothesis of a possible autoimmune contribution. The combination of organic precipitants and emotional maintaining factors suggests that psychogenic cough tic is a condition that lies between somatization and transient tic disorder.