Studies have shown that eating disorders (EDs) and obsessive-compulsive disorder (OCD) have a high rate of comorbidity. Childhood anxiety disorders have been found to predict the onset of EDs. Researchers propose that OCD and EDs are part of the same spectrum of disorders, with AN being a specific type of OCD similar to body dysmorphic disorder. Malnutrition is a primary factor leading to complications in this presentation as it can compromise medical safety, worsen cognitive functioning, hinder insight and perception of reality, and increase obsessionality. Both groups experience symptoms such as intrusive cognitions, perfectionism, avoidance, and ritualistic behavior, which require specific interventions and complex clinical expertise for positive treatment outcomes. Maladaptive perfectionism is common in both disorders, leading to self-defeating behavior and daily impairment. Avoidance and ritualistic behavior are common in both disorders and are motivated by maladaptive cognitions related to catastrophic outcomes and beliefs about morality, achievement, and identity. These behaviors serve to alleviate anxiety associated with these cognitive domains.

The treatments with the strongest evidence base for EDs use collaborative weighing at the beginning of each session, but this may be challenging for patients with comorbid OCD due to their increased tendency for rigidity, reassurance seeking, perfectionism, and a decreased tolerance for uncertainty. Personalized interventions should be devised to target the specific factors that maintain the patient’s disorder, such as addressing the core fears and how this impacts weight exposures (e.g., blind or viewed). Collaborative weighing is appropriate and needed for most patients. It is important to be mindful that certain aspects of providing weight information can become obsessive with this comorbidity, and engaging in hidden weighing can be useful in increasing tolerance of uncertainty related to changes in weight. Identifying and addressing compulsions and escape behaviors and encouraging the patient to abandon these behaviors and face the possibility of relapse can be beneficial for treatment in the long term.

Chapter 6 highlights the roles of personal and situational factors on metaphoric interpretation through a focused exploration of the interpretation of McGlone and Harding’s (1998) Next Wednesday’s meeting question.

From a mentalizing perspective, in attachment trauma an individual’s experience of adversity is compounded by the sense that they have to be able to bear that experience alone. An overwhelming experience cannot be calibrated and managed within an attachment relationship. Normally another mind provides the social referencing that enables an individual to frame and reframe a frightening and potentially overwhelming experience. In the absence of this, the person cannot process the experience, and further development of mentalizing is disrupted. This chapter describes MBT-Trauma Focused (MBT-TF) work, and it illustrates the three phases of treatment by presenting clinical examples. Intervention focuses on mentalizing, avoidance, mental and behavioral systems, managing anxiety and dissociation, and trauma memory processing. An MBT intervention for complex PTSD that uses psychoeducation, group intervention, exposure, and looking to the future is outlined, and is illustrated with clinical examples.

After assessing a client a treatment plan is required. The chapter outlines the practical steps in proceeding from a case formulation to a treatment plan. Since many techniques are modified for application in many different clinical problems and psychological disorders, we will concentrate on providing a description of particular procedures that are broadly applicable. The chapter provides practical illustrations of treatment planning with outlines of behaviour therapy, dialectical behaviour therapy, cognitive therapy, and interpersonal psychotherapy. It includes specific examples of clinical cases and explains how these approaches can be subsumed under a transdiagnostic framework of treatment planning. Consideration of transdiagnostic interventions involves targeting negative affect, intolerance of uncertainty, anxiety sensitivity, avoidance and safety behaviours, emotion regulation, and metacognitve therapy.

Questions of authority, legitimacy, and meaning emerge in Cavell’s essay on King Lear, “The Avoidance of Love,” with reference to “Music Discomposed” and “A Matter of Meaning It.” Shakespeare raises these themes in peculiarly poignant ways, exposing them through testing the resources of theatre itself. Early in Must We Mean What We Say? Cavell is pondering problems of theatricalization, where they are related to the “all but unappeasable craving for unreality.” This puts into question the nature of the everyday and the ordinary, and the human tendency to drift into a state of “exile from our words.”

The sub-plot amplifies the questions of legitimacy and succession, democratizing these through its focus on bastardy and baseness. The problems of inheritance raised in Cavell’s discussion reverberate through ordinary language philosophy and through political settlements in the modern world. With some acknowledgment of the manner of Cavell’s participation in the “drama of the nation’s conscience,” in Ralph Ellison’s phrase, around the time he was writing the essays in this volume, the essay assesses Cavell’s contribution to the nation’s “painfully slow advance toward true equality” (again, Ellison).

There is compelling evidence supporting the use of cognitive behavioral therapy (CBT) to treat depression and anxiety disorders; furthermore, recent evidence supports the use of CBT to treat attention-deficit/hyperactivity disorder (ADHD) in adults as well. High comorbidity among these conditions requires healthcare providers to recognize and treat problems with anxiety and depression in adults with ADHD, or ADHD in adults with anxiety and depression. This chapter reviews relevant research on the comorbidity of internalizing conditions in adults with ADHD and provides three guiding principles for tailoring CBT to treat depression and anxiety disorders in adults with ADHD: comprehensive case conceptualization, addressing therapy-interfering behaviors, and a functional approach to cognitive and behavioral avoidance.

This chapter focuses on types of emotional strategies that students are using to deal with negative emotion. It links back to Chapter Three by clarifying that dyslexic student negative emotion is an issue not only because of its prevalence; in fact, the students interviewed did not have any productive strategies to cope emotionally. Consequently, the chapter themes negative emotional coping methods under the actions of avoidance, getting stressed, worrying and crying, panicking, and withdrawing from social interaction. It confirms these themes by providing recollections from voices of students who have employed these methods. Although this may initially seem rather defeatist, the sharing of these experiences by students with dyslexia is in fact positive for dyslexic readers of the book, as they can identify with the scenarios. The second part of the chapter is themed around more productive emotional coping methods that some of the students discussed as mechanisms they found useful: talking to someone, planning and using strategies, implementing breaks, participating in exercise, seeking comfort, and using mental resilience, such as persistence and determination. Specific examples are provided through articulations of dyslexic students, and the dyslexic reader of the book is invited in to consider these approaches.

This chapter compares the U.K. and U.S. approaches to fiduciary duty and clawback as they relate to transactions when the firm is in the vicinity of insolvency. Historically the U.S. and the U.K. have balanced directors’ duties and trustee’s avoidance powers in opposite ways. In the U.K., officers and directors have a duty of fairness to creditors in the vicinity of insolvency; in Delaware no such duty to creditors arises. The U.S. takes a strict approach to avoidance of preferential and fraudulent transfers; the U.K. requires culpability. This chapter suggests that, on both sides of the pond, the duty and clawback regimes are under stress due to their failure to appreciate the importance of equitable treatment in the vicinity of insolvency and that the current emphasis on insolvency and pre-insolvency regimes oriented toward “rescue” highlights this shortcoming. The chapter concludes, that both jurisdictions fail to appreciate that duty and clawback serve complementary functions in the vicinity of insolvency—equitable treatment of creditors; and that a more balanced approach would be better than either of the lopsided approaches taken by the U.S. and the U.K.

This chapter describes the primary interventions for the fear of aversive consequences presentation of ARFID, including:

• Examples of how avoidance of feared food or eating situations keeps the problem going

• Examples of how facing fears through exposure can actually reduce anxiety

• Creating a hierarchy of feared food and eating situations

• How to design and implement at-home exposures to these feared food and eating situations

Sex is a powerful way for couples to enhance their bond and promote the success and happiness of their relationship. Yet, maintaining sexual intimacy and passion is a challenging endeavor in romantic relationships, making it crucial to understand the role of sex in relationship maintenance. This chapter focuses on the role of sexuality in enabling couples to maintain satisfying relationships, focusing in particular on how couples can maintain sexual desire and satisfaction over time and as they navigate important relationship and life changes that may result in partners experiencing differences in their sexual interests, such as in the transition to parenthood. We begin the chapter by describing the ways that sex can benefit relationships, focusing on the roles of sexual frequency, physical affection, and sexual satisfaction in shaping the quality and maintenance of relationships. Then, we review research on how couples can prevent declines in sexual desire, or remain satisfied in spite of these declines, with a particular focus on sexual goals, sexual communal motivation, sexual communication, and sexual expectations. We conclude the chapter by highlighting several promising directions for future research on sex and relationship maintenance.