The first thing you notice when you walk through the door of the Finchley Clinic for Eating Disorders is that it is anything but clinical.

Entering the Edwardian house in Victoria Avenue, you could be forgiven for thinking it is someone's home. Indeed behind the closed doors at the rear of the house lives Barbara Pearlman and her family.

But at the front of the house Barbara has established the first independent clinic in Britain for people with eating disorders.

The main room at the front has been turned into a group therapy area. A circle of comfy-looking chairs, a large Victorian dresser full of ornaments and an antique dining table set off the room.

In her office, where the one-on-one therapy takes place, the furniture is Viennese -- "Keeping faith with Freud", says Barbara. There is the pyschoanalyst's couch, of course, but also a couple of inviting armchairs for clients who prefer the less clichéd approach.

Since qualifying as a clinical psychologist and group analyst some 20 years ago Barbara has worked at all the major hospitals in the area, setting up eating disorder clinics in both private and NHS hospitals.

An impressive set of credentials follows her: Barbara is presently supervisor for the Eating Disorder Service for North East Essex; a member of the European Council for Eating Disorders; and a member of the Independent Psychology Service for Central and North London and Hertfordshire.

In March last year she opened the Finchley clinic, with two colleagues specialising in family therapy, Naomi Shragai and Bill Radmall. It treats people with obesity, compulsive over-eating, bulimia nervosa, and recovering anorexia nervosa.

The timescale of the treatment is determined by the patient's need and it consists of individual, group and family therapy.

Barbara explained family therapy was vital because eating disorders could be described as a 'lack of voice'. The sufferer has difficulty expressing needs.

So he or she shows the family what is wrong rather than telling them, which manifests itself in an eating disorder.

When, through therapy, they find their voice it can send shockwaves through the whole family and this is why the supportive therapy is so important. "It's a way of controlling their emotions," Barbara explains. With bulimia, when people make themselves sick it is a "metaphor for emptying the contents of the mind".

Frequently the sufferer will have been very self-effacing, while at the same trying to take control over the chaos inside, says Barbara. "The family are not used to hearing her true feelings so it can be quite a shock when she begins to voice them."

Barbara uses the word 'she' a lot. But these are the statistics: only one-tenth of the people suffering from eating disorders are male. With anorexia and bulimia it is often girls or young woman who are affected. There is a misconception that anorexia is about image. It isn't.

"You are dealing with two realities -- an internal and an external reality. The internal reality is nothing to do with weight and fashion. You are not going to look gorgeous if you look like a skeleton.

"When they look in the mirror they see the external reality but they disregard it. They think they are full of fat feelings. It is a fight inside to be themselves and we have to help to find a strong sense of self," says Barbara. "In a sense the eating disorder is only a symptom. It's about 'Who am I ? Am I lovable? If I open my mouth what will come out?' If it is not vomit, what might it be?'."

Obesity, which tends to manifest itself in a slightly older age group, is also a disorder of voice and space. But whereas anorexics try to make themselves disappear, obese people, who may externally appear confident, even agressive, use their size as a form of protection, Barbara explains.

"In all the eating disorders it is a disturbance of self," she says. A disturbance, which, with enough time and help, Barbara and her team believe they can rectify.

This is no "fly by night clinic" says Barbara with determination. "I want this to be a centre for excellence."

o The Finchley Clinic for Eating Disorders can be reached on 0181 343 4681.

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