2023/10/29 Tutorial and Dragon Dan

This week, we had Dragon Dan. On Monday, my tutor, Cynthia, helped us to prepare the pith. She mentions the pitch has diverse audiences, purposes and commercial value. So we need to clearly and quick point out our idea and the marketing value is essential. So the three mins pitches, can include :

  • Introduction: Name and where I am from.
  • Research question: I am looking at…
  • Why this is a problem: Presentation of data.
  • Expert: Public interest organisations and institutions.

The dragons of the Wednesday Dragon Dan are Dominic Stone and Emily Zak. Dominic is an academic coordinator at Central Saint Martins. And Emily is a Founder of Consultancy. It’s a mix of academic and commercial.

So, on the presentation day, I printed my work as a zine for Dominic and Emily and described the project to them in the following structure-“introduction, research question, why this is a problem in China, and what experts I cooperate with.”

I prepared a PDF for the presentation, but it didn’t show on that day due to a technical issue.

My speech was still overdue, but the central part has been stated. According to my project, Dominic and Emily give serval suggestions:

  • At the moment, my zines look like two separate and distinct pieces of content that could be combined in the next step.
  • The content seems too broad. It could be more specific and targeted, more suited to the eating disorder group.
  • A daily schedule can become a weekly schedule, and it can go on forever.
  • It’s important to think about how the voices of more people with eating disorders can be heard, such as platforms, associations, and other avenues. And, if you’re building a platform, think about why people should trust your platform.

The day after Dragon Don, I had an online meeting with Qinwen, founder of the nonprofit eating disorder organisation “ED HEALER” in China. I showed her the draft zine. She suggested that I focus on the eating-disordered person’s own emotions first. So, I decided to reduce the “external connection” part and first concentrate on the patient’s positive thinking. We decided to enter into a partnership to place my zine in international schools in Shanghai, signalling the attention currently being paid to the issue of teenage eating anxiety.

The Draft Zine

UK eating disorder statistics

  • Between 1.25 and 3.4 million people in the UK are affected by an eating disorder
  • Around 25% of those affected by an eating disorder are male
  • Most eating disorders develop during adolescence, although there are cases of eating disorders developing in children as young as 6 and in adults in their 70’s.
  • Eating disorder are most common in individuals between the ages of 16 and 40 years old
  • Around 10% of people affected by an eating disorder suffer from anorexia nervosa
  • The average age of onset for anorexia nervosa is 16-17 years old
  • 40% of people affected by an eating disorder suffer from bulimia nervosa
  • The average age of onset for bulimia nervosa is 18-19 years old
  • The rest of sufferers fall into the BED or OSFED categories of eating disorders
  • Research suggests that individuals who have family members with eating disorders are more likely to develop eating disorders themselves when compared to individuals who have no family history of these illnesses
  • Eating disorders have the highest mortality rates among psychiatric disorders
  • Anorexia nervosa has the highest mortality rate of any psychiatric disorder in adolescence
  • The earlier that eating disorder treatment is sought, the better the sufferer’s chance of recovery
Eating disorders data from China Acdamic Journal.

2023/10/21 Structure of the guidebook/ the content

Appearances

This week, I’d start to think about the structure of the zine. So, a zine has 16 pages in total, including double-sided paint. And each page is A6 paper size.

Process of making zine

A4 paper in total, folding and tailoring

Paper size guide

Each page is A6 size

I set up a 16-page A6 Indesign document.

The content structure includes:

  • Coverpage – Page 1
  • Foreword – Page 2
  • Characters – Page 3
  • Day 1 – Page 4
  • Day 2 – Page 5
  • Day 3 – Page 6
  • Day 4 – Page 7
  • Day 5 – Page 8
  • Day 6 – Page 9
  • Day 7 – Page 10
  • Day 8 – Page 11
  • Day 9 – Page 12
  • Day 10 – Page 13
  • Postscript – Page 14 to Page 15
  • Backpage – Page 16

Content

Before starting the content part, I watched a documentary by researchers from the Eating Disorder Centre of Shanghai Mental Health Centre.

From the WeChat subscription “Lok Hong Wai Ai”, for academic use only.
This short documentary film, “Bon appétit” (Eat Well), was co-produced by the SMHC Eating Disorder Clinic and Ivy Ding, a senior in high school. From Ivy’s point of view, the film focuses on people with Eating Disorder (ED) and tells the story of their journey of physical and mental recovery with the help of the Shanghai Mental Health Centre (SMHC) and the community. No man is an island, click on the film, one click public service, care for the ED people around you and me.

In this video (7:28), I find out that Dr. Chen-Director of the Eating Disorder Center, has mentioned:” A relatively effective treatment for eating disorders in adolescents called Family-Based Therapy (FBT). This method leverages the closeness and cohesion inherent in Eastern cultures, making family intervention particularly suitable in China. Parents often maintain a relatively close relationship with their children before marriage, a cultural aspect from the West.”

The Maudsley Method, also known as Family-Based Treatment, can be characterized by an intensive outpatient treatment where parents are integrated as an active and positive role.  The primary purposes of including parents in this approach are to incorporate and encourage participation in their child’s recovery journey.  This therapy method was originally formulated by Christopher Dare and his colleagues at the Maudsley Hospital in London in 1985.  Formerly proposed as a method for the treatment of anorexia nervosa in adolescents, it was devised as therapy that would occur in the home environment with therapeutic supervision by a trained professional.

Since then, the Maudsley Family Therapy approach has been adapted for bulimia nervosa, binge eating, and for older patients as well.  Generally, this treatment has three phases which occur over a period of 6-12 months, directed by a family-based therapist, and which involve the entire family in weekly sessions.  Parents are guided in the fundamentals of helping their loved one eat (and/or prevent purging and over-exercising) and siblings are supported in collaborating with the patient.  Sessions periodically entail a family meal under the guidance of a therapist who can assist in recognizing the various dynamics of the family around the meal.
The Three Phases of the Maudsley Family Approach are as follows:

Phase I – Weight Restoration:  In Phase I, a professionally trained therapist concentrates on the various effects associated with anorexia nervosa, particularly physiological, cognitive, and emotional.  A major focus of this phase is the restoration of the patient’s weight and the “re-feeding” component.  A crucial psychological feature of this primary phase is substantiating the illness.

Phase II – Returning control over eating to the adolescent:  Phase II encompasses the patient learning to progressively regain control over their individual eating habits again.  This typically commences when the patient’s weight has reached approximately 87% of their ideal body weight.

Phase III – Establishing healthy identity:  This phase is initiated when the patient is sufficiently able to sustain their weight above 95% of ideal body weight independently and refrains from engaging in restrictive eating behaviors.  Focuses of treatments are primarily on the psychological consequences the eating disorder has had on the patient and the establishment of a healthier identity.

So, how do we make a change? According to the Transtheoretical Model and Stage of Change, TTM, also known as The Stage of Change Model,

The zine will focus on the Phase III of FBT. Of course, a small zine will not wholly change people, but I hope that zines can bring positive thoughts and warmth to people. It mainly focuses on “right mindfulness” (Buddhism), which means developing an accurate and precise awareness of the present moment uncoloured by ideas, memories, beliefs, expectations, etc., just the experience.

Venerable Nyanaponika Mahathera explains in The Road to Inner Freedom:

Right Mindfulness is the quality of awareness. It ensures complete awareness of all activities of the body as they occur, complete awareness of all sensations and feelings as they occur, complete awareness of all activities of the mind as they occur and complete awareness of all mental objects when the appropriate situations arise. This attitude of complete awareness brings about powerful results. It sharpens to the finest degree man’s powers of observation, induces the deepest calm and ensures that nothing is said or done or thought unguardedly or hastily, mechanically or without deliberation. He who develops this factor is able to take count of every single and minute activity of the mind, even such activities as are generally considered to occur when the mind is passive and receptive; so penetrating and powerful is his sense of awareness. (70)

Guide

Based on the above research, the zine’s content is divided into two parts: internal thinking and external connection. I set a ten-day journey with readers. The internal thinking part helps readers to focus on the right mindfulness. The external connection parts encourage readers to reach out to the outside world and build a comfortable, trusting external environment.

Diagram of the content

Characters

For the characters in the zine. I created six gentle and friendly animal characters. Have these characters lead the reader through self-healing activities

Lop rabbit
West Highland Terrier
Ducks
Capybara
Brown bear
Hedgehogs

I got in touch with the Chinese eating disorder charity “ED HEALER,” and I will have a videoconference with the founder Qinwen and other members of the organisation on the 26th of October to discuss the zine. I will also participate in a painting exhibition about eating disorders in cooperation with Shanghai Mental Health Center at the end of this year or the beginning of next year. At the end of this year or next year, I will also participate in an exhibition of paintings about eating disorders in collaboration with ED HEALER and Shanghai Mental Health Center.

2023/10/13 Interview with Ding/ Thought about family treatment

For the next intervention, I am going to make an digital zine to assist people with eating disorders to establish good habits in their daily lives.

So far, my experts include a sociologist from Tsinghua University, a psychiatry researcher from Sun Yat-sen University, and an expressive arts therapist in Macau. Volunteers team leader of Eating Disorder Centre of Shanghai Mental Health Centre.

Interview with Hux Hexiao Ding

Background of Ding:

Fellowship in Psychiatry in Sysu

Sun Yat-sen University (SYSU)- Public Health- 2020

The Hong Kong Polytechnic University (PolyU) – Medical Physics Lab- 2024

Ding was preparing to carry out research on eating disorders as opening material for his PhD. He came across my personal website through an internet search and therefore contacted me to express his interest in my project and to collaborate afterwards.

The following is my interview with Ding.

S: Hey, my name is Shuang Zheng. Currently, I am studying MA Applied Imagination at Central Saint Martins. I'd like to ask you about localised research on Eating Disorders (ED) in China.

D: Hey Shuang.I'm Ding. Unfortunately, China's research in this area is almost nil. I see you have art therapy workshops on your site, which is something that has been done and researched in other mood disorders, but Eating Disorder is still very much in its infancy and there is very little research on it, so to speak.

S:Yes, in fact, by the end of the day I felt that there were industry barriers to doing art therapy, after all, I was not educated in professional psychological research. Moreover, the information I have read so far is all interpreted in the context of Western psychology. I did a questionnaire during the summer holiday, and I felt that the word "eating disorder" is not well understood in China. There are regional differences, for example, developed cities on the southeast coast know more about it, but inland cities know very little about it.

D:Yes, this disease was also included in the disease code the year before. (2021) It can be said to be in its infancy worldwide.

S:I feel that "art healing" has gained a lot of attention on the internet in China, but very few people are actually doing it for the purpose of helping patients, and basically it's all about making a profit. That's why I'm taking a step back and trying to popularise eating disorders.

D: Yes, this kind of PROGRAM needs money to start. We are usually get funds from the university. I think doing a QUALITATIVE RESEARCH and getting it published is a great POINT, and I've read that you've done a lot of interviews, which are actually still pretty good, and totally worth writing about.

S:I understand that Shanghai Mental Health Center opened an eating disorder clinic the year before last.

D:Yes, the country is still in its infancy, and many of us are at our wits' end when it comes to diagnosing eating disorders. The prevalence rate is still high, and it's hard to detect.I think sociologically you should interpret his symptoms, for example, the interviews you do can be written as qualitative research. for their motivation, is there a psychological model that can be quantified, that's what I'm thinking about. Sociological and psychological research methodologies are similar. I think, if you have an idea, you can start by putting together the interviews, many medical journals will accept qualitative research. that is, qualitative research. I think, if you have an idea, you can start by putting together interviews, and many medical journals will accept qualitative research. I think this makes a lot of sense, and I'm very encouraged by what you've written. Mainly I want to promote eating disorder in China.

According to experts and online resources, establishing healthy eating habits in a family environment, especially within a group that includes individuals with eating disorders, requires a sensitive and supportive approach. Here are some strategies that eating disorder support groups can consider to promote a healthier eating environment within families:

  1. Education and Awareness:
    • Start by educating both individuals with eating disorders and their family members about the nature of eating disorders, their triggers, and the importance of healthy eating.
    • Raise awareness about the emotional and psychological aspects of eating disorders to foster understanding and empathy within the family.
  2. Professional Guidance:
    • Encourage families to seek professional help from therapists, nutritionists, and dietitians who specialize in eating disorders. These experts can create personalized eating plans and provide guidance on recovery.
  3. Open Communication:
    • Promote open and non-judgmental communication within the family. Encourage family members to express their concerns, feelings, and needs related to food and eating habits.
  4. Family Meals:
    • Reintroduce regular family meals as a supportive and bonding activity. Ensure these meals are relaxed, enjoyable, and free from food-related stress.
  5. Meal Planning:
    • Collaborate with a nutritionist or dietitian to create balanced meal plans for the entire family. Emphasize variety, moderation, and balanced nutrition.
  6. Model Healthy Behaviors:
    • Parents and caregivers should model healthy eating behaviors themselves. Children often learn by observing adults, so setting a positive example is crucial.
  7. Eliminate Trigger Foods:
    • Remove or limit access to foods that trigger eating disorder behaviors. Discuss these changes with the individual who has an eating disorder to ensure their comfort.
  8. Avoid Food Comments:
    • Encourage family members to avoid making comments about body weight, appearance, or food choices. Negative remarks can contribute to anxiety and exacerbate eating disorders.
  9. Supportive Environment:
    • Create a supportive atmosphere where individuals with eating disorders feel safe and understood. Encourage them to share their feelings and struggles without fear of judgment.
  10. Gradual Changes:
    • Understand that change takes time. Progress may be slow, and relapses can occur. Be patient and continue to offer support and encouragement.
  11. Seek Group Support:
    • Consider involving the family in support groups or therapy sessions tailored for families of individuals with eating disorders. These groups provide a safe space to discuss challenges and learn from others.
  12. Celebrate Achievements:
    • Acknowledge and celebrate small victories and positive steps toward healthier eating habits. Positive reinforcement can motivate individuals in their recovery journey.
  13. Set Realistic Goals:
    • Work with a therapist or counselor to set realistic goals for recovery. These goals should be achievable and adapted to the individual’s progress.

Each individual’s journey toward healthy eating habits is unique, and there is no one-size-fits-all approach. Professional guidance and a supportive, understanding family environment areessentialf recovery from eating disorders.