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jamie-morrisAs a treatment provider, working with female athletes can present an additional set of unique factors that need to be considered. Oliver-Pyatt Centers Clinical Director Jamie Morris, MS, LMHC dives into the treatment of female athletes, particularly those participating in the collegiate level, in this week’s blog post. 

In all instances of eating disorders, an individual’s relationship with exercise is one of many facets that call for assessment and consideration in developing a treatment plan. When working with female athletes, particularly those participating in collegiate level sports, there are an additional set of vulnerabilities to consider. It is important that as treatment providers, we are aware of the demands that often exist at this level of competition to help discern when a client is simply working to meet the competitive demands of her sport versus when she is acting on behalf of her eating disorder.

The special considerations for athletes may be more relevant than one may think. Athletes are at higher risk for developing an eating disorder than individuals not participating in sports; that, combined with the increased risk of eating disorders among college students places NCAA/collegiate athletes at the highest risk of eating disorders than any other group. Additionally, student-athletes may experience more stress than non-athletes because they deal not only with the transition away from home and stressors related to academic and social demands of college, but also the pressures associated with sport participation and sport performance.  Focus on eating, exercise, and/or body often become a way for individuals to cope with such stressors.

While the complex nature of disordered eating in female athletes is not different than in the non-athlete population, the specifics of genetic, psychological, environmental, and behavioral factors differ between the two populations. Environmental factors, for example, may include family or peer pressure about athletic performance or coaching that encourages sole focus on excellence in sport.. Additionally, an individual identified as an athlete often gains self-esteem through praise offered from sport performance.  Psychological factors may include the sole focus on success and performance without the ability to assess how fatigue/overtraining influences performance, or the belief that body modification will influence enhanced performance.  Athletes tend to face pressures to lose, maintain, gain, or otherwise manipulate their body weight, shape or size on some level due to the technical or aesthetic demands of the sport, rules or conventions, media portrayal of athletes in their sport, or societal demands.  Though this pressure is higher in some sports, such as dance, than others, it is likely that all athletes grapple with weight and body size/shape pressures in the athletic environment on some level.

Despite the numerous additional risk factors, female athletes do have some protective factors on their side.  For instance, they tend to show more self-efficacy and have less negative views on life than their non-athletic counterparts. They also show a greater use of approach coping- a “take the bull by the horns approach” to dealing with life’s stressors. Some athletes with eating disorders even show less psychopathology compared to non-athletes.  This may be observed in the clinical setting to have better/more effective emotion regulation, fewer negative arousals, more consistent reports of happiness, and higher self-esteem compared to non-athletes.

With a better understanding of athletic demands and the particular protective/risk factors that high performing athletes bring the table as eating disorder clients, there are a few treatment considerations that are important for us to keep in mind throughout evaluation and treatment. Try to assess how much pressure is placed on the client to return to their sport; it is possible that parents and coaches have turned a “blind eye” to the athlete’s issues in order to preserve competitive placement within a team.  This information can guide focus in individual and family therapy. Another thing worth exploring with a client might be how she describes herself outside of being an athlete. Is she able to identify other talents, strengths or interests? Medically, it is particularly important with female athletes to assess risk for injury through DEXA scan and bone mass density evaluation. Many athletes can buy into the myth that amenorrhea is an expected part of rigorous training or that birth control/hormone replacement therapy will maintain bone mass.  It is important that we work to debunk these myths and instead focus on educating our clients about what is needed from a caloric and nutritional standpoint to fuel and sustain training expectations when they return to sport. When medically indicated, allow for engagement in some training activities they would do if they return to sport to further evaluate psychological and medical readiness to return to sport.  It is so important that we are able to process sensations that come up around training and work with them so that their approach to training involves ample self-awareness and self-care.

Working with athletes and eating disorders may be an intimidating task, these women are entrusting their recovery and a very strong part of their identity with us when they come through our doors. No matter the outcome of their athletic career, whether they choose to return to their sport or not, we will be able to guide them with careful assessment and consideration, ultimately empowering them to make decisions from a place of health and ease rather than force.

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

alyssa-mitola lissaFor November’s edition of First Wednesdays at OPC, Oliver-Pyatt Centers Director of Food Services Lissa Garcia, RD, LD/N and Clementine adolescent treatment program Nutritionist Alyssa Mitola, MS, RD, LD/N will present “The Kitchen’s Perspective: Creating a Safe Place Through Supported Exposures and Skill Development in the Treatment of Eating Disorders”. The presenters aim to enable the modern eating disorder clinician to empower clients using cooking and kitchen exposures. Through hands-on supported experiences, unaddressed issues can be revealed, allowing for moving corrective experiences and true peace with food. Discussion will include how co-occurring conditions impact the planning and approach for successful experiential activities. Attendees will learn different ways the eating disorder presents in the kitchen setting and key points of exposure support.

Through this presentation, participants will be able to identify three different kitchen exposures that can be utilized in the treatment of eating disorders, name two interventions to reduce anxiety during cooking exposures and define two co-occurring conditions that impact approaches to cooking exposures.

Breakfast begins at 9 am and the presentation will be from 9:30-10:30. 1 CE hour will be offered for: PhD, PsyD, LMFT, LMHC, LCSW, LPCC, and RD. If you would like to join OPC’s First Wednesdays on November 2nd, please RSVP to Florida Outreach Manager Callie Chavoustie at callie@oliverpyattcenters.com or RSVP here by October 31st.

 

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Fear Busters

Posted on July 28, 2016 by StayConnected

KarinL_blogKarin Lawson, PsyD is a licensed psychologist who is passionate about helping people create change in their lives through self-reflection, self-compassion, new perspective and new ideas. In her writing, Dr. Lawson offers some useful tips to help combat the fear you might be facing.  

 

Fear is a feeling, but it’s one that is incredibly powerful and can stand in our way like no other. It is not always rational . . . most of the time it’s not, yet it is all too real and intense none the less. When someone is struggling with an eating disorder, may times common everyday fears are ramped up and intensified. Reasons for this amplification can include co-morbid anxiety disorder(s), poor sleep and malnutrition both of which impact our physiological experience of fear, faulty core beliefs, history of trauma (both big T and little t) to name a few. If you’re set up for a major battle with fear, take heart, because there are some choices you can engage in to help make it a little less overwhelming.

In the recent Ghost Busters remake, it wasn’t a lone person but a group of kick butt, like-minded women who faced their fears together. So find your recovery-oriented tribe. Join a psychotherapy group, find a pro-recovery Facebook group or reconnect with those who have supported you in the past. When people are standing together, there’s more courage, less fear. You don’t need to do this alone.

Find your safe space. Whenever we’re venturing out of our comfort zone, facing fears and taking risks, we also need that nurturing, soothing safe space to rejuvenate and recover. This could be a comfy chair with headphones and blanket nearby or a spot under a tree where you take your journal and your dog. Your safe space is yours, so only you know what makes sense, but take some time to recognize it and make it happen. Many times in therapy we talk about an imaginary safe space, which is still legit support, but I also encourage you to find that literal space where you can let your hair down and relax in a tangible way.

Find inspiration from risk takers out in the world. Find those people those are conquering their fears. These don’t always need to be related to eating disorder recovery. Look for those people out there in life. Whether it’s conquering the fear of traveling alone or applying for a school that has always tugged at their heart, people are out there doing it and writing about it. Find them and hear their truth. My bet is that they were not fearless, but balancing the opposing concepts of fearfulness and courage. This is another way to recognize that you are not alone in this. The exact fears may be different, but the feeling is the same. Know that it can be done. Fear does not have to lead.

Here are some of my favorite fear busters when I need a courage boost.

Brene Brown’s Courage Works http://www.courageworks.com/

The Courage 2 Create Blog  http://thecourage2create.com/

100 Days Without Fear http://100dayswithoutfear.com/

 

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Mary Dye_MPH RD CEDRD LDN_Director of Nutrition Services

Mary Dye, MPH, RD, CEDRD, LD/N oversees all nutrition across Oliver-Pyatt Centers as the Director of Nutrition Services. In this weeks blog, Mary offers her unique perspective on the relationships between dieting, disordered eating and eating disorders.

What are some signs you should be aware of that a strict diet is turning into an eating disorder?

Isolation & Secrecy:

If counting and measuring food, only eating in a certain way or at a certain time starts to take priority over relationships and social opportunities then we have a problem. Think of that friend who used to meet up for brunch. If she’s now suddenly not available or comes but “has already eaten” these could be warning signs. If you realize she doesn’t seem to eat with you anymore and is always full, these could be signs that her eating is so rigid it can only be done at home, likely alone.

Guilt & Obsession:

Strict diets and/or exercise regimens can require so much time, counting and focus they can feel like a part time job. When adhering to an exercise or meal plan replaces pleasurable activities and breaking the plan results in guilt, shame and anxiety, or requires compensatory behaviors there is a problem. It’s tricky because often in our culture we praise people’s devotion to dietary rules but it can be a fine line between an interest and an obsession.

Self-worth based on diet, exercise and/or weight:

Many people on diets like to talk about their diet, exercise and weight. When this becomes the basis of a person’s identity, it can be a sign of a larger issue.

Rapid weight loss & continued loss:

This may or may not occur. But if it does, consider it a warning sign. Losing over two pounds per week can resulting in negative health consequences. Often people start a diet with the goal of losing a few pounds, but once they get into the obsessive mindset and receive positive reinforcement for losing weight (which we do a lot in our culture) the diet can spiral into something more serious.

Pre-occupation with food:

If all your friend is talking about is food and living vicariously through your eating while she claims to be full: warning sign. She’s probably really hungry and is struggling to allow herself to eat the foods her body needs.

Use of food rituals:

These can vary but might include: taking tiny bites, not eating in public, breaking foods into little pieces, drinking loads of water before meals, eating only at exact times, using excessive calorie free condiments, etc. They usually have to do with extending the eating experience and filling up on low or no calories.

Compensation:

Statements like “I have to go for a run because I ate a brownie” can sound benign, but they can be a major red flag. If a person is having to compensate for their food with exercise, purging behaviors or forms of self punishment or if a person is reducing or altering their food intake and denying their hunger cues to compensate for missing a workout, these may be reasons to be concerned.

What is the difference between having an “eating disorder” and having “disordered eating?”?

There are specific criteria for the four diagnosed eating disorders in the Statistical Manual of Mental Disorders-V (DSM-V). While many people don’t meet the full criteria for a diagnosed eating disorder, many do have an unhealthy relationship with food and weight that may put them at risk both physically and emotionally. The difference has to do with the degree or frequency that a person is engaging in the disordered behaviors. A person with disordered eating would engage in the behaviors with less frequency or with a lower level of severity, yet are at risk of developing a full blown eating disorder in the future. Disordered eating is dangerous in itself, and many times goes undetected until it is a full blown eating disorder because the warning signs are less severe and the person is often highly functional in other areas of their life (this high functionality can be the case in eating disorders as well). Sadly, we live in a culture that promotes a degree of disordered eating, so many people feel uncomfortable addressing these warning signs and write them off as normal.

How has our focus on healthy eating (especially on Instagram and Facebook) contributing to eating disorders? Could they be eating disorders in disguise?

Social media certainly has intensified the pressure to “eat right” – whatever that happens to mean on a particular day. It can fuel the false idea that perfection is attainable. Since social media is accessible 24/7 – it can be visited when people are feeling most vulnerable and looking for a way to fix themselves by scrolling through photos and getting ideas on how to “self-improve”. As registered dietitian doing private food recalls for over 10 years, one thing I can say with certainty is that what people are actually eating and what they present themselves as eating, are often pretty different. I tell my clients all the time: comparisons get you no-where.

Strict regimens are fueled by reinforcement, and what better way to motivate than to get countless “likes” for a way of doing something. It can also intensify the guilt and shame that are experienced if the regimen is broken both for the person in the social media post (a sort of dual identity) and for the person viewing it (I’ll never be like her, I just ate dessert and don’t have time to go running). We also have loads of people giving nutrition and fitness advice on social media that don’t have backgrounds in these fields, so that can lead to a lot of confusion and misinformation.

I think the social media stars that have recently come forward and disclosed their eating disorders has been a wake-up call that some of what we see is an illness in disguise.

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Posted in Body Image, Recovery

GretaGreta Gleissner, LCSW is a NYC-based psychotherapist specializing in eating disorders. In recovery since 2001, Ms. Gleissner has firsthand knowledge of the challenges individuals face in the eating disorder recovery process, particularly during transitions. In her writing, she offers ways parents can help support their child with an eating disorder.

When a healthy child gets sick, parents can usually find a fairly simple answer: Tylenol, amoxicillin, cough medicine. But when your child is diagnosed with an eating disorder, parents face a problem for which there is no immediate fix. Caring for and supporting your child with an eating disorder can be confusing and scary.

Parents attempting to support their child with an eating disorder may struggle with a sense of helplessness and frustration when unable to quickly restore their child’s health. While responsible for your child, you are not fully in control. Ultimately, it is up to your child to choose recovery. As parents, your task is to create an environment of support and information for your child, so they can begin to take responsibility for their own well-being.

But what if your child is not ready to self-motivate, and their health is in critical condition?

Sometimes the priority must be stabilizing a child at a treatment facility or medical providers, to manage the dire physical repercussions of starvation or purging. But medical stabilization is only the first step in the healing process.

Once your child’s physical health has been addressed, a long road still lies ahead. Psychological and emotional healing does not necessarily happen in tandem with the physical restoration. Parents often feel an understandable impatience at this point, and an urge to accelerate and steer this stretch of the journey. But you must accept what they cannot do–i.e. “fix the problem”–while recognizing all the ways you can be supportive as their child undertakes one of the most challenging and scary tasks: letting go of their eating disorder.

One parent with adolescent recovering from an eating disorder took refuge in the serenity prayer: “Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

What You Can Do:

Get Informed: It is hard to have empathy about something that feels foreign, so familiarize yourself with eating disorders. Seek out information, get educated. Research the experts in the field. Find approaches that resonate with you. Then share this information with your child so they can understand the ramifications of the eating disorder. If they hear it enough, they may begin to understand, and decide to turn towards health.

Connect: Turn to your co-parent, or another family member or loved one, to discuss decisions and vent. The irritability, explosions, despair, and/or silence that your adolescent may exhibit when in the throws of their eating disorder can be baffling, heartbreaking, and infuriating for you as a parent. It is important to have someone to talk with about your feelings, as well as to feel a sense of partnership in making decisions.

Prioritize Self-Care: Remember the oxygen mask on an airplane technique: you can only effectively care for your child when your own needs are being met. Eat balanced meals. Get appropriate amounts of sleep and exercise. Engage in activities that feel nourishing and joyful for you. Model a healthy lifestyle for your child.

Practice Compassion: Offer yourself and your child compassion. Guilt, blame, and shame do not create the gentle conditions that best serve healing. Frame the unhealthy behaviors your child engages in not as “bad behavior” that warrants reprimand or punishment, but as symptoms of a disorder that reflect the pain they feel inside, and call for love and solace.

Cultivate Trust: Give your child every opportunity to trust you. Your child is likely experiencing tremendous shame about their eating disorder, which compels them to retreat into silence and not speak their truth. Let your child know they can tell you when they purge or are feeling fear about eating, and that you are trying to understand–even if you cannot ever fully understand. It is so important for a child to feel safe to describe aloud their fear and pain. Speaking truth takes the power away from the eating disorder, which thrives in secrecy and silence.

Believe in Recovery: It is imperative for parents to believe recovery is possible. While it is not going to be easy or linear–your child likely will make progress and then fall into unhealthy patterns again–that is just part of the long journey of recovery. Model for your child an unwavering faith that they have the courage and strength to attain health, and that stumbles are not signs of failure. Especially in times of setback, it is crucial to offer unconditional support and emphasize your belief that recovery is within reach.

Supporting your child with an eating disorder can be challenging. If you are struggling to help your child suffering with an eating disorder, please consider reaching out to us for help. We offer support for parents. We help care for your child – in college, still at home, even as young as 12 years old.

Resources:

Parent “Tool Kit” from the National Eating Disorder Association:

http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf

Your Dieting Daughter: Antidotes Parents can Provide for Body Satisfaction, Excessive Dieting, and Disordered Eating by Carolyn Costin

8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

What’s Your Power Pose?

Posted on June 30, 2016 by StayConnected

Jennifer_Yoga-9076Jennifer Kreatsoulas, PhD, founder of Chime Yoga Therapy, is a yoga therapist specializing in eating disorders. Recovered herself, Jennifer is exceedingly passionate about helping others connect with their natural gift of resilience through yoga. In addition to her private practice, Jennifer is also a yoga therapist at the Monte Nido Eating Disorder Center of Philadelphia. In her writing, Jennifer tells of the power of yoga in eating disorder recovery.

The other day I had the powerful experience of leading four women through a yoga practice at a retreat. The women had come together to strengthen their eating disorder recovery journey. I was inspired by their grit and dedication. After all, attending a retreat is voluntary. These individuals participated purely out of choice, knowing they were going to do some seriously hard work.

With yoga mats, grounding stones, and paper and pens, we set off to share a yoga experience. I began by asking the women to write down a word that described how they wanted to feel that day. Words like “thin,” “empty,” “numb,” or other eating disorder associations were off limits. This exercise was about imagining another way of feeling and drawing out their “healthy voice.”

As we flowed in and out of poses, I cued the women to recall the word they wrote down. I asked them to hold their word in their mind as we breathed, balanced, twisted, folded, backbended, and inverted.

At the end of the practice, I asked the women to give their word a pose. You see, I believe we can wire in a feeling that we want to cultivate through our bodies. In other words, we can embody a feeling by creating a pose that expresses that very feeling. For example, in the same way that hunched shoulders, clenched hands, and a frown can embody (and even create) a sense of depression, anxiety, or loneliness, an open stance, with feet firm on the floor and shoulders back (like mountain pose) can embody a sense of grounding or confidence. We can call on a pose to literally shift our mood, thoughts, and demeanor. This is a powerful tool I’ve been practicing in my own healing journey.

Certainly, a pose isn’t a permanent fix, but when done with purpose, strong intention, and often, yoga poses can be a powerful way to cultivate the qualities we want to create more of in our recovery and life in general.

I was so impressed and inspired by how willing and open the women were to this exercise. For one woman, “peaceful” took the form of tree pose, and for another woman this quality was felt in mountain pose. Half moon pose represented “alive” for another participant. All five of us were smiling by the time we finished sharing. The room was lighter, and my perception was that the women felt lighter in their bodies as well.

It was quite a moment for me to watch the women combine their word with a pose. In fact, one of them brilliantly named the exercise “Power Pose.” How perfect, right? When we realize that we can interrupt an eating disorder thought or behavior simply with a word and a pose, we have gained immense power. We show ourselves that the very thing that we believe controls us can be quieted and even conquered, if even just for a moment. That single moment is the gateway to many, many more moments one word and one pose at a time.

I invite you to discover your Power Pose for today. First, ask yourself how you want to feel today. Next, imagine a shape that connects you to that quality. You don’t need to be in a “real” yoga pose either. Just simply shift into a shape that takes you out of the eating disorder slump (in mind and body) and into a more positive space.

There’s no right or wrong. Feel your way into your Power Pose. Get used to having the power again.

Many thanks and blessings to those four special women for gifting me with the beautiful idea of Power Pose and sharing their yoga practice with me. Many thanks and blessings to you, too, for taking the time to read this post and opening your mind and heart to healing.

Keep going!

 

For more information about Oliver-Pyatt CentersClementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedInTwitter, and Instagram.

Article Inspiration

Posted on June 09, 2016 by StayConnected

Join us in reading inspirational and informative articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

Article-Inspiration-3

Anxiety, Fears, and Things That Go Bump in the Night Psychology Today

How Weight Information Can Increase Overeating/Binge Eating Dr. Stacey Rosenfeld

Yoga May Be Good for the Brain The NY Times

If We Treated Ourselves The Way We Treat Our Children Kantor & Kantor Law

How Anorexia Causes a ‘Starved Brain’ Dr. Jen Gaudiani

Understanding Anorexia Nervosa in Males Psychology Today

Binge Eating and Binge Drinking: Same Origins  BEDA

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on FacebookLinkedIn, Twitter, and Instagram

The Power of Our Storytelling

Posted on June 02, 2016 by StayConnected

KarinL_blogKarin Lawson, PhD is a licensed psychologist who is passionate about helping people create change in their lives through self-reflection, self-compassion, new perspective and new ideas. In her writing, Dr. Lawson offers some thought about the power of storytelling both in and outside of therapy.  

Feeling incredibly honored to be a contributor for the OPC Blog, I am jumping in this week with a reoccurring theme for me these past few months . . . storytelling. While this has actually been a theme in much of my life, more recently it has been popping up consistently. As a psychologist, I have the privilege of hearing people’s stories. In that work, it’s important to note the stories that they were told, the stories they tell themselves and the new stories that we create together. While I have never been formally trained in narrative therapy, I have used it without realizing it. Being someone who naturally has gravitated toward journaling and creative writing in my early life, that thread continues on in my blogging and the talk therapy that occurs in my office. My recent run-ins with reflections on storytelling have clarified some incredibly important aspects to why storytelling in our life matters. I’d love to share them with you.

In his University of Pennsylvania commencement speech on May 16, 2016, Lin-Manuel Miranda, the creator of the wildly successful Broadway musical Hamilton, says this:

Every story you choose to tell, by necessity, omits others from the larger narrative. One could write five totally different musicals from Hamilton’s eventful, singular American life, without ever overlapping incidents. For every detail I chose to dramatize, there are ten I left out…This act of choosing—the stories we tell versus the stories we leave out—will reverberate across the rest of your life.

To me, this speaks to a couple of things that we can look at more closely and gain insight. Take any story of your life, maybe the one you have told yourself or your therapist most recently and take note of what details you were pulled to emphasize versus which ones didn’t seem as interesting to you. Why are those details so important to us? This question isn’t meant to be a judgment that someone has chosen the wrong details to signify, but rather an opportunity for gentle curiosity to explore and understand better how we work and what’s important to us. Then we get to play around with perspective and think of the story we’ve recently told and tell it from another perspective. Was there someone else in the story? Can we tell the story from the imagined perspective of that person? Or can we tell it as if someone had been looking in from a far, but wasn’t a part of the story, as much as an observer? What is it like to think about this life experience as a “story”, not a made-up story or a fiction story, but a story, none the less?

My second recent run-in with the concept of storytelling was in the May-June 2016 issue of Psychotherapy Networker, in which the editor Richard Simon writes about The Moth. The Moth is a international phenomenon started by a poet in New York City, in which average people  (i.e. people who don’t necessarily professionally write or perform) gather in groups, in cafes and theaters and tell true stories, as remembered by the storyteller, 5-minutes in length. There’s always a theme for the story night such as fathers, food, grudges, life in the fast lane, etc. The piece of Richard’s discussion of The Moth that struck me the most was the sense of connection that people feel in the shared experience of hearing stories. There is often tears, laughter and a knowing that even though the audience’s experience doesn’t mirror the storyteller’s experience, there is a relatable emotion at the heart. That’s the hard-part though for most of us, allowing ourselves to be revealing rather than omitting, self-editing and trying to keeping the rawness at bay.

In the spirit of knowing that our true stories are healing and connecting, I encourage you in the journey of recovery to share your truth, to know that others want the truth and to give yourself that gift of not being alone with it. That may mean that you reveal yourself to your family, your group therapy, your individual health care providers, your friends . . . whoever is safe and deserving of hearing your stories.

You can watch Lin-Manuel Miranda’s speech on YouTube here https://www.youtube.com/watch?v=ewHcsFlolz4

 

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us onFacebook,LinkedIn, Twitter, and Instagram

Carolyn_Costin_LtGreen_Portrait_CircleMonte Nido Founder and Eating Disorder Expert Carolyn Costin, MA, MEd, MFT is renowned for being an advocate and activist in her field.  After recovering from her own eating disorder, Carolyn became a therapist and began treating people suffering from eating and body image problems. She went on to open Monte Nido in Malibu, California because she wanted to create something different.  “I wanted to create a center for healing in a home like environment, surrounded by nature.”  She has authored numerous books, and most recently released her fifth book. “Yoga and Eating Disorders” bridges the knowledge and practice gaps between mental health providers and yoga practitioners who work with clients suffering from disordered eating.  It is an invaluable resource for mental health and yoga professionals, as well as individuals and family members struggling with eating disorders.

Fifteen years of treating eating disorders prior to opening Monte Nido taught me the importance of incorporating healthy exercise. Taking away all exercise, as was the general practice, did not work. In private practice a no exercise rule is almost impossible to enforce. When enforced under 24-hour care, clients go right back to unhealthy exercise habits after discharging. Monte Nido has a gym, exercise equipment and a fitness trainer, but it is yoga that profoundly transforms our clients’ approach to exercise in a new and healthy way. Of course, many clients are initially interested in yoga because it purports to provide some kind of exercise. Yet, whatever clients come in the front door expecting, yoga provides a back door into teaching them much more.

My knowledge of the history of yoga barely scratches the surface. I am not adept at any particular form of yoga. I don’t call myself a devotee of any kind of yogic philosophy. What I know is that yoga, as a practice and philosophy, helped me embody what I already cognitively understood was true. It helped me live in my body with awareness, respect, non-judgment, harmony and honor. It enhanced my ability to be still, go inside, maintain balance, avoid comparison and be in the moment, yet not totally disconnected from the past or future. Practicing yoga taught me to accept where I was while, at the same time, guiding me to improve. If yoga did all this for me, how could it not be beneficial for my clients? I began recommending yoga to certain clients in my private practice. At the hospital eating disorder unit, where I served as clinical director, I lobbied to hire a yoga teacher for the patients. I was denied. Then, in 1996, I decided to open my own program, Monte Nido, the first residential eating disorder facility licensed in a home setting.

Yoga fit right in as a way to enhance and physically concretize what I was trying to do: help clients realize that the eating disorder self is ego/ mind out of control. Help them understand that they are not their eating disorder self. Help them separate from it and re-connect with their true nature or soul. Once connected to soul, things like weight get into proper perspective, where a number on a scale is no longer a matter of consequence.

Yoga can decrease eating disorder symptoms while not decreasing BMI. In a study of eating disorder clients, ages 11 through 21, the control group received “standard care” (physician and dietitian visits), while the test group received standard care along with individualized yoga. The yoga group demonstrated greater decreases in eating disorder symptoms a month after their treatment, while the control group showed some initial decline but then returned to baseline levels. 9 Food preoccupation dropped significantly after all yoga sessions. Both groups maintained BMI levels and experienced decreased anxiety and depression over time. The researchers conclude: “Results suggest individualized yoga therapy holds promise as adjunctive therapy to standard [eating disorders] care.”

People with eating disorders are disconnected from, even at war with, their bodies. Their minds are in a state of constant comparison. They are judgmental of themselves and others, out of balance, caught in habitual behavior patterns, and living in the past or future. As a yoga teacher said in class just this morning, “Our bodies live mostly in the past and our minds in the future; yoga helps us bring both into the present moment.” While yoga facilitates awareness, connection and unity of mind and body, we do not claim that yoga alone can heal eating disorders. Instead, Yoga and Eating Disorders: Ancient Healing for a Modern Illness demonstrates an important role for yoga in an overall treatment strategy aimed at transforming body dissatisfaction, disordered eating, addictive exercise, sabotaging thoughts and self-destructive behaviors.

 

All excerpts above reprinted from “Yoga and Eating Disorders” with permission. Read more about the use of yoga in therapy buy purchasing Carolyn’s book, “Yoga and Eating Disorders”To learn more about Monte Nido and the programs it offers, visit their website: www.montenido.com or call 888.228.1253.

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook,LinkedIn, Twitter, and Instagram

Posted in Body Image, Recovery

World Eating Disorders Action Day

Posted on May 19, 2016 by StayConnected

Stacey Rosenfeld - 2

Stacey Rosenfeld, PhD is a licensed psychologist who specializes in eating disorders, addictions and group therapy. In her writing, Dr. Rosenfeld shares about World Eating Disorders Action Day, a day to help educate and raise awareness about eating disorders.

 

What Is It?
A wealth of misinformation surrounds the eating disorder field; we hear these myths all the time. Ideas such as “Only young, rich, Caucasian girls get eating disorders,” “You can tell if someone has an eating disorder by looking at him/her,” or “True recovery is impossible” cloud the eating disorder conversation.

The inaugural World Eating Disorders Action Day (World ED Day), happening on June 2nd, 2016,  seeks to dispel these myths, raise awareness and understanding around eating disorders, and unite activists around the globe toward much-needed policy change.

World ED Day promotes the “Nine Truths about Eating Disorders”, a collaboration between the Academy for Eating Disorders, Dr. Cynthia Bulik (the truths are based on her 2014 talk of the same name), and other key eating disorder associations. The mission/vision of World ED Day is  to “advance understanding of eating disorders as serious, treatable illnesses” and “unite eating disorder activists, professionals, parents/carers and those personally affected to promote worldwide knowledge of eating disorders and the need for comprehensive treatment.”

On June 2nd, activists around the world will come together to promote the “Nine Truths,” highlight the need for evidence-based treatment, increase funding for eating disorders research, and advocate for broad-based policy change that enables greater access to care.

Why Is It Important?
Eating disorders have the highest mortality rate of any psychiatric illness, but that does not mean they are untreatable. Recovery is possible, but we need to make sure that those who struggle have access to quality treatment. Too often, those who suffer aren’t able to access good care due to lack of sufficient resources, insurance limitations, limited information, or other interfering variables. For many others, treatment is based on an outdated understanding of eating disorder etiology. We now know that eating disorders have genetic, biological, and environmental influences. We know that parents can play a critical role in the treatment and recovery of adolescents with eating disorders. Unfortunately, these truths have not been adopted by all.

World ED Day seeks to reduce barriers to care, particularly in underserved populations, and supports increased diversity in narratives and in the media. Have you ever noticed that most eating disorder articles in mainstream media are accompanied by a stock image of a low weight, Caucasian woman? This needs to change. Eating disorders affect men and women of all shapes and sizes, races, and socioeconomic statuses. These illnesses cut across age, class, ethnicity, sexual orientation, and gender identity in a way that media, research, and policy do not adequately convey.

How Can You Get Involved?
World ED Day is calling for significant social media presence and engagement in the days leading up to, and including, June 2nd. The hope is that those who suffer from eating disorders (and their families), treatment professionals, healthcare organizations, and policy makers will take note of World ED Day’s key messages. The easiest and best way to get involved is to promote World ED Day through your own social media platforms. You can use the hashtags #WeDoAct and #WorldEatingDisordersDay and like/follow these World ED Day accounts:

Facebook: https://www.facebook.com/WorldEatingDisorderDay/

Twitter: https://twitter.com/WorldEDday

Instagram: https://www.instagram.com/worldeatingdisordersaction/

There will be a 24-hour Tweetchat-a-Thon, accessing folks in all timezones, on June 2nd. Various organizations will present on topics such as Binge Eating Disorder and evidence-based treatment. Follow the hashtags to join the conversation. You can also participate in the Instagram project, which highlights images of diversity and challenges myths surrounding eating disorders (@worldeatingdisordersaction). Finally, please read and share the blog posts on the World ED site. Professionals, patients/carers, and advocates have written critical content begging for dissemination.

The inaugural World Eating Disorders Action Day is in our hands. We have the power, by raising our collective voices, to challenge misinformation, target underserved populations, increase research funding, and remove obstacles to care, toward the goal of treatment and recovery for all.

 

This article written by Stacey Rosenfeld, PhD.

For more information about Oliver-Pyatt Centers, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Kelli_Malkasian_PsyD CEDS_Director of AftercareDirector of Aftercare for Oliver-Pyatt Centers Kelli Malkasian, PsyD, CEDS helps to prepare clients to reintegrate back into their lives in a sustainable way. In her writing, she shares the importance of aftercare planning in the recovery process.

“Aftercare planning needs to pay reverence to all aspects of a client’s life and recovery.” When I heard Dr. Wendy Oliver-Pyatt say those words, I thought there were never truer words spoken.  Even if a client makes amazing changes to her eating behaviors, has full medical and physical restoration, is motivated and attends the best program in the country, they still run a high risk of relapsing without a comprehensive aftercare plan.  We, as clinicians, have to understand what needs, triggers, and barriers to recovery exist in our clients and their environments, as well as, think about what we can do to prepare them for reintegrating back into their lives in a sustainable way.

Seeing firsthand the difficulties that clients face when they step out of residential treatment was very eye-opening for me.  I considered Dr. Oliver-Pyatt’s statement heavily throughout my time working in the IOP/TLP program and took that statement into my current role as the Director of Aftercare.  Now I work with our clinical teams to keep the aftercare plan in mind throughout treatment, both as a guide for treatment planning and for considering important factors to be addressed as a client prepares for and finally discharges from our programs.  Further, we work together with the outpatient teams, families, and the clients to help everyone see beyond the goal of symptom cessation and to look at recovery as an all encompassing process.  Factors such as school/work, relaxation, fun, socialization, environment, access to resources, family support, spiritual restoration, and support for co-occurring disorders/struggles all need to be considered in the treatment and aftercare planning.

It is my objective to make sure that each client has a full wrap-around aftercare plan that meets their unique needs and takes into consideration barriers that may exist.  Understanding and addressing these barriers early on is necessary.  Such barriers may be a lack of understanding of the complexity of the illness or treatment process, lack of access to services or financial resources, lack of willingness to participate in treatment, barriers to motivation or recovery, or lack of an appropriate support system.    We address these barriers and incorporate exposures to assess and practice their skills, build additional multi-faceted support into the aftercare plans, and help clients create a meaningful life that is congruent with their recovery needs.

 

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Giulia Suro_PhD_Primary TherapistPrimary Therapist Giulia Suro, PhD shares three specific strategies that can be integrated into the therapy process. In her post, she explains how Acceptance and Commitment Therapy (ACT) can be a useful approach to help clients with eating disorders.

Acceptance and Commitment Therapy (ACT) is a creative, mindfulness-based therapy that hinges on acceptance and values-driven action. You do not need to be well-versed in the theory of ACT to integrate ACT techniques in to every day sessions. Below are three core concepts to ACT that can be brought in to therapy when you might feel like changing things up.

Functional Contexualism, or, “How did this serve you?” Imagine a chair that has a leg that gives out every time you sit on it. What words would you use to describe this chair? Broken? Faulty? Garbage? What if this chair was being used as an educational tool in a furniture-making class? Or as prop in a circus act? In these contexts, the chair would be serving its purpose, or function, perfectly well. Eating disorders also serve a function in the specific context each individuals’ life. This may be to provide a sense of control, safety or distraction. Yet, our clients are very quick to label their own behavior as dysfunctional or wrong. Focusing on the function of behaviors given their context can shift clients to examine their eating disorder from a more compassionate stance and help them move away from guilt and self-blame.

Experiential Avoidance, or, “Feelings won’t kill you.” Eating disorders, like most mental disorders, are characterized by avoidance. This may be avoidance of specific foods, settings, people and often life in general. From an ACT perspective, it’s truly not the external stimuli that are being avoided. Instead, it is how these things make us feel internally. Family therapy would not be difficult if it did not bring up feelings of anger or guilt. Fear foods would not be threatening if they did not incite terror or disgust. In this way, acts of avoidance are really an attempt to escape some internal experience. From this framework, discussions about exposure can center on the emotions that are truly at the heart of avoidance.

Defusion, or, “You are not your thoughts.”A common frustration in the recovery process is that eating disorder thoughts continue to persist despite progress being made. This can be scary and discouraging. When this comes up, ACT offers the skill of defusion. When we defuse from our thoughts, we see them from an objective stance and are better able to hold them lightly. A quick exercise in defusion entails identifying a powerful thought such as “I’m worthless,” and noticing how it feels to buy in to it. Adding the phrase “I’m having the thought that..” to the beginning of the sentence (“I’m having the thought that I am worthless”) immediately provides some space and allows us to and observe the thought from a distance. While the thought itself doesn’t change, we decrease its power and increase our clarity.

 

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Grieving the Thin Ideal

Posted on April 28, 2016 by StayConnected

Tali_YuzPrimary Therapist Tali Yuz Berliner, PsyD has run a body image group at Oliver-Pyatt Centers for almost three years. In her group, she works with clients on accepting their bodies and letting go of the “thin ideal”. In her writing, she shares about her use of cognitive fusion in aiding clients through this process.  

After almost three years of running body image group at the comprehensive level of care, I have learned a lot from the many incredible clients I have had the pleasure to sit with. One significant theme that is revisited time and time again in my group is the need for the women to “grieve the thin ideal.” It has been important for these women who suffer with eating disorders to not only accept that they cannot strive for thinness any longer but also to accept that the body that they have been chasing will not bring them the fantasy life they envision. I often use the ACT(Acceptance and Commitment Therapy) term cognitive fusion, to explain this concept to the group. Cognitive fusion proposes that certain attachments are made through verbal interactions that people spend endless amounts of energy trying to prove or disprove. People will do so despite the thought not being accurate in the present moment or having evidence to the contrary.

The way we (I say “we” since the process is always collaborative with the clients) tackle this theme in my group is two-fold. First, it is imperative to challenge the distorted thought that a specific body type will lead them to happiness. This is done through a variety of exercises from several modalities, such as:

Looking for evidence that challenges the thought

Exploring body image development

Identifying and connecting other values

Challenging the media

In addition to the exercises, it is important to openly process and review the topic of body image acceptance and how it occurs on a continuum. We explore how it begins with tolerating the body, then accepting the body, then liking it, and eventually one day learning to love it. Exploring where the woman is on the continuum and moving them through it allows the loss of the thin ideal to be less painful.

Second, it’s important that we validate the loss of this ideal. The work can often mirror general grief and loss work whereas the women can experience similar emotions to the loss of a loved one. It is necessary that they process how this void has and will impact them in the future. We continuously reinforce the significant need to strengthen and connect to other roles and values outside of the body/appearance and the eating disorder. The women explore the integration of values to replace what is lost and to reinforce the message that the idealized body will not bring them to a happy life but instead being connected to others and immersed in their values will lead them to life satisfaction. The above is a snapshot into a very complex process that is inherent in both group and individual sessions. My hope is for these women to start to trust their values and their healthy voice to come to the understanding that there is more to life than the thin ideal.

 

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Angie

Angie Viets, LCP is an eating disorder specialist who has dedicated her career to helping her clients recover. In her writing, Angie shares her personal journey with an eating disorder as well as her professional experience in the field. She offers a unique perspective to the view of exercise and whether it can be an act of self care or self harm.

“Strong is the new skinny.” “Nothing tastes as good as skinny feels.” “Suck it up now and you won’t have to suck it in later.” Sound familiar? You can’t spend five minutes on Pinterest or any form of social media without seeing these catchy little quotes layered on top of images of whatever the latest absurd mandate is to be considered beautiful or sexy…

Sometimes I wonder who the puppeteer is behind this charade. I imagine if we saw who is making up these insane standards it would be like the big revelation in the infamous Wizard of Oz. Just an ordinary man behind the curtain playing clever tricks on us (probably while eating Cheetos and drinking grape soda, laughing at us while we run around in circles eating egg whites).

Are you so lost and unsure of yourself that you’ve bought into this craziness? Once upon a time, I was, for sure.  My life felt controlled by getting in my next workout. I adopted the belief that a day was only as good as the workout completed. Fear pressured me into working out while sane people slept. Dark streets stretched before me, lonely and cold, yet mile after mile I ran and ran until my heart told me to stop, yet even then I kept going.

I felt so superior to my peers and colleagues; I burned seven trillion calories while they drank coffee and watched the Today Show before heading into work. People probably thought I was crazy, but instead, they said things like, “Wow, I wish I had your motivation.” (“See, you’re superior!  You have something they want but don’t have the willpower to achieve,” the eating disorder that ruled my life at the time said, reinforcing my efforts.) I failed to let them know that I was seeing a cardiologist over the lunch hour, due to becoming increasingly more convinced that my irregular heartbeat might be a sign of an impending heart attack at the premature age of 22.

I hold images of that girl in my head, and I just want to pick her up off of the dark curb where she sat, fearfully timing her pulse, instead of her miles, and tuck her into bed while secretly burning her running shoes. She was a lost soul, running away from the very thing she was so desperate to find – herself. Looking back now it just feels sad; certainly not superior. My identity was wrapped up in an all-consuming eating disorder, and excessive exercise was just one part of my obsessive and disordered life. Until…

Until the day, I walked by a yoga studio and observed people in odd postures. They looked really…well, serene, unlike me and all of the other treadmill junkies. I found the practice of yoga fascinating; it kept calling to me softly, “just one class,” as I walked by each day. But I waited a long time to have the courage to attend a class because it meant rebelling against my eating disorder and its insistence that running was the Holy Grail. My addiction to running was much louder than the gentle whispers seeping out from under the yoga mats, following me home.

The night I finally entered the sacred space of that yoga studio is forever burned into my mind. Something shifted in me that night as I laid in savasana (corpse pose). I reconnected with a part of myself while lying on my yoga mat and I heard a quiet voice softly whisper, “You can eat now.” This voice is my most compassionate self who is loving, infinitely wise, and deeply invested in nurturing me. I chanted Om three times, bowed my head while saying Namaste, rolled up my mat and walked back out into my life forever changed.

Unfortunately, I didn’t abandon compulsive exercise that night; I needed a remedy much greater at the time. But little by little I started giving myself permission to listen to my body and its desire to attend a yoga class instead of torturing my injured knees on a treadmill. At some point, I laid down running entirely. Moving my body stopped feeling abusive and slowly felt like an act of self-care. Over time, I let go of the core belief that if I didn’t exercise in an ‘acceptable’ way that something horrific would happen.

Exercise is kind and loving and very much a source of self-care when used in moderation and in ways that feel good to you. For some, that could be running, for me, it’s a long walk on a sunny day with Mosley, our Golden Retriever, a bike ride with my kids, or a walk with a girlfriend where our legs try to keep up with our words. My body craves a gentle yoga class with incense burning and Sanskrit music playing; I feel at home in my body on a yoga mat.  Sometimes it’s a quick cardio workout with my favorite audible book playing. And many days, it’s rest, because I don’t need to run away from myself anymore.

Our bodies crave movement. Exercise has tremendous benefits for our mental and physical well-being, but when abused it does far more harm. It’s not intended to be our only method of coping with the stress we experience in our lives.

Listen to the infinite wisdom of your body, it has all the answers you need.

Love + Light,

Angie

If you are concerned exercise has shifted from self-care to self-harm, I would recommend taking a minute to consider a few common symptoms:

-Working out when sick or injured

-Irritability if you can’t exercise

-Becoming depressed if you are sick/injured to the point of being unable to work out

-Fearful of weight gain if not exercising

-Arranging your entire day around a workout

-Working out more to compensate for eating certain foods or skipping a workout

 

This article originally published on The Angie Viets site. 

 

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Melanis Rivera-Rodriguez_PsyD_Primary Therapist

Primary Therapist Melanis Rivera-Rodriguez, PsyD co-facilitates a weekly process group at Oliver-Pyatt Centers. She shares about the use of Yalom’s therapeutic factors in her work with group therapy.

When it comes to the treatment of eating disorders at a residential level of care, a sense of community and ways of one patient relating to another can be weaved into the daily focus of treatment and recovery. The concept of community and relationships dates back to our ancestors, and from a scientific perspective speaks of the gregarious nature within the instincts of survival and collaborative work that humans possess. From a therapeutic stance, Irvin Yalom, an existential psychiatrist, speaks of 12 therapeutic factors defining them as “the actual mechanisms of effecting change in the patient” (Yalom, 1995) in a therapeutic community and/or group therapy setting.

In my experience as a primary therapist, and in co-facilitating process group once a week at Oliver-Pyatt Centers, a sense of community can be observed being established among the women in which several of Yalom’s therapeutic factors can be identified in the group dynamics. Being attuned and aware of these factors has aided in facilitating not only the group process but the individual process as well. Yalom’s therapeutic factors consist of:

  1. Universality – feeling of having problems similar to others and not being alone.
  2. Altruism – helping and supporting others in their recovery process.
  3. Instillation of hope – encouragement that recovery is possible.
  4. Guidance – nurturing support and assistance.
  5. Imparting information – teaching about a problem and recovery.
  6. Developing social skills – learning new ways to communicate about feelings, concerns, and new ways of relating.
  7. Interpersonal learning – finding out about themselves and others through group feedback.
  8. Cohesion – feeling of belonging to the group and valuing the group.
  9. Catharsis – release of emotional tension.
  10. Existential factors – life and death are realities.
  11. Imitative behavior – modeling another’s manners and recovery skills.
  12. Corrective recapitulation of family of origin issues – identifying and changing the dysfunctional patterns or roles one played in primary family.

From the previously listed therapeutic factors, universality seems to inherently facilitate connections in which possibly the treatment experience creates an exchange among the women that may enhance empathy, compassion and self-awareness. Additionally, the elements of time (length of stay) and environment (24/7 care) seem to play crucial ingredients as the women begin to navigate treatment for their specific struggles with an eating disorder and/or other co-occurring issues. Change can be identified not only cognitively and behaviorally, but also holistically, in which the integration of these factors, insight of recovery and relationships might parallel the woman’s circumstances outside of treatment possibly facilitating change in deeper, consistent and meaningful ways in the path of recovery from an eating disorder.

 

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Posted in Body Image, Recovery

Thaimi Fina_LMHC_Primary TherapistPrimary Therapist Thaimi Fina, LMHC is the facilitator of the Body Image Group for women at the Oliver-Pyatt Centers. Through her work, she has learned various strategies to help battle negative body image thoughts. In her post, she shares five effective ways to establish a more positive relationship with your body.

Whether they struggle with an eating disorder or not, most women (and men!) experience negative body image thoughts throughout their day-to-day life. Unfortunately, this has become our norm. Despite the automatic nature of these thoughts, it doesn’t mean that we have to be bound by them and allow them to impair our daily functioning. As a Primary Therapist in Casa Verde at Oliver-Pyatt Centers, one of my most valued tasks is facilitating the Body Image Group for our adult women. Throughout my time facilitating this group, I have had the privilege of learning a lot from our women about which strategies have proven most effective in battling their negative body image thoughts. In this post, I will be sharing 5 of these tips with you in hopes that they will assist you in managing these thoughts and making peace with your body.

Tap into your values and determine the most values-oriented actions you could take. During one of my groups, I provide clients an expansive list of potential values and ask them to prioritize their top five values. These values may include honesty, family relationships, spirituality, independence, health, etc. Clients are then asked to identify a situation that would likely trigger negative body image thoughts and brainstorm as many different actions they could take in that moment to manage these thoughts. Then, they are asked to reference their list of top values and identify the most values-oriented actions they could take. For instance, say you experience negative body image thoughts while getting dressed to go to work. You could decide that these thoughts are too strong, they are impacting your mood, and you should just stay home and avoid being seen today. However, you choose to reference your list of top values which include family relationships and independence, and identify values-oriented actions you could take instead. You decide to call a loved one to share your frustrations or maybe just distract with small talk. You also remind yourself of the importance of showing up to work in order to continue striving for financial independence, and commit to going to work. These thoughts may still be present, but you are not allowing them to control your life.

Write a letter of gratitude to your body and read it when negative body image thoughts arise. During another body image group, our women begin by participating in a gratitude meditation. There are many wonderful gratitude meditations available on youtube if you’re interested! Then, they are asked to write a letter of gratitude to their bodies, choosing to suspend criticism for just a moment, and taking the time to honor their bodies. As they write this letter, clients are encouraged to reflect on all the ways that their body serves them and enables them to live a life worth living. This letter could serve as a powerful reminder of your body’s amazing resilience and value, when you find yourself criticizing its appearance.

Commit to doing one to two random acts of kindness for your body each day. These acts of kindness could vary significantly from person to person but should include any action that makes your body feel good and honors your body’s needs. These acts of kindness could include (but are certainly not limited to): resting when your body is tired, taking a mindful walk, taking a warm bath, putting on a favorite scented lotion, getting a massage, wearing a cozy sweater, honoring your body’s hunger and fullness cues, stretching, meditating, etc. Create your own list of acts of kindness that resonate the most with you and commit to trying 1-2 of these acts each day. Building a better relationship with your body doesn’t just involve battling the negative, but also actively creating positive interactions with your body.

Practice self-compassion. You can’t control that these negative body image thoughts pop up in your head, but you do control whether or not to beat yourself up for having them. Instead, it is important to gain awareness of how these thoughts became so embedded in our heads. We live in a society where women are constantly given the message that their worth is determined by their appearance and body size and that they must never be satisfied with either. It’s no wonder that we feel compelled to criticize our bodies and compare them with unrealistic ideals of perfection. As you work towards building a better relationship with your body, practice self-compassion and be patient with yourself. Choosing to honor and accept your body exactly as it is, is truly revolutionary in our society. Rather than beating yourself up when these negative thoughts arise, speak to yourself with the same loving kindness that you would to a loved one.

Actively seek and create body-positive messages. Be creative and find ways to surround yourself with body-positive influences. This tip could include following body-positive blogs or Instagram accounts. Create your own pro-recovery and/or body-positive Pinterest board. Join organizations and participate in events that promote body acceptance and health at every size. Create and display a collage of images and quotes that inspire you to be kind to your body and honor it. Spend more time with friends and loved ones who do not engage in negative body talk. Serve as a role model for others and avoid criticizing your body in conversations with others. The options for carrying out this tip are endless. Our society, mass, and social media are full of images and messages that promote body shaming and/or unrealistic body ideals. Actively work towards surrounding yourself with very different messages and avoid following accounts that reinforce your negative body image thoughts.

These are just a few of the strategies that the women in our program have found most helpful in battling negative body image thoughts. As you begin trying some of these tips, I encourage you to remember that the goal is progress and not perfection. These thoughts are common and likely to pop up from time to time but you can become more effective in how you manage them and choose to respond. Remember that a thought is just a thought. It does not determine fact or how you must respond. I hope that you find these tips to be helpful and encourage you to brainstorm your own strategies for building a better relationship with your body. To end, I will leave you with one of my favorite poems from Nayyira Waheed. “And I said to my body. Softly. ‘I want to be your friend.’ It took a long breath. And replied ‘I have been waiting my whole life for this.’”

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Practicing Gratitude

Posted on March 31, 2016 by StayConnected

Jessica_Genet_Pic MonkeyAssociate Director of Clinical Recruitment and Resources, Jessica Genet, PhD shares how practicing gratitude can be an effective treatment tool in body image work.  She explains how the use of gratitude in the recovery process can help heal the clients relationship with the body, and offers seven different ways to begin doing so.

Imagine the following: “You are driving your car to the store. Up ahead, the road is closed and road workers redirect you towards an alternate route. Once you arrive, you walk into the store and are greeted by a store employee with a friendly smile.”

Take a moment to reflect on how you would respond to this scenario. Would you focus on the hassle of the road closure? Or would you notice the small act of kindness shown by the store employee?

It is easy to take for granted the small “gifts” that occur in our daily lives as well as the more substantial blessings and silver-linings. It is also unfortunately easy to fall into a pattern of focusing on hassles, irritations and life stressors. However, research has shown that taking the time to actively practice gratitude – acknowledging goodness in ones’ life and recognizing the contribution others (people, animals, higher power) have made for the sake of our well-being– can be incredibly beneficial to our emotional and physical health. Research has shown that gratitude increases happiness and feelings of optimism, joy and pleasure. Gratitude also encourages us to “pay it forward” and be more helpful, altruistic and compassionate. A grateful focus helps us feel more connected to others and less lonely, and improves our health, strengthens the immune system and encourages us to take better care of our bodies.

At the Oliver-Pyatt Centers, we regularly incorporate practices of gratitude into our treatment. For individuals with an all-consuming eating disorder, moments of gratitude are often overshadowed by obsessive thoughts, anxiety and sadness, isolation, and other hallmarks of the disorder. We also know that the journey to recovery is often challenging. By teaching our clients to practice gratitude, we can help build their resilience to the challenges of recovery and move towards a life that feels more joyful, meaningful, and connected to others.

One area of treatment that especially benefits from the practice of gratitude is body image work. Many of our clients enter treatment extremely critical of their bodies and preoccupied with body shape and size. By encouraging our clients to take a moment to reflect on the gifts and miraculous functions of the body – such as appreciating arms because they allow us to hug a friend and our eyes which allow us to see a summer sunset – we can slowly begin to heal the relationship with the body.

Below are some suggestions for how you can start a practice of gratitude (from the book “Thanks!: How Practicing Gratitude Can Make You Happier” by Robert Emmons, Ph.D.)

Keep a Gratitude JournalEstablish a daily practice of reminding yourself of the gifts, benefits and good things you enjoy. By writing each day, you magnify and expand upon these sources of goodness.

Buddhist Meditation Technique of Naikan – This practice involves self-reflection on three questions that can help address issues or relationships. It involves recognizing the gifts we receive and what we give to others, and acknowledging how we may cause pain in the lives of others.

What have I received from__________?

What have I given to ____________?

What troubles and difficulties have I caused _______?

Pay Attention to Your Five Senses – By paying attention to the ability to touch, see, smell, taste and hear we connect to what it means to be human.

Use Visual Reminders – Visual reminders (e.g., post-it notes on our bathroom mirror, reminders in our phone) serve as cues to trigger thoughts of gratitude.

“Breath of Thanks” (by Dr. Frederic Luskin) – Two or three times a day, slow down and bring attention to your breathing. Notice the flow of your breath. For each of the next five to eight exhalations, say that words “thank you” silently to remind yourself of the gift of being alive. Practice at least three times a week.

Learn Prayers of Gratitude – Spiritual traditions are universally filled with prayers of gratitude. If you identify with spiritual tradition, incorporating these prayers into your daily life can heighten gratitude.

Go Through the Motions – If we go through grateful motions (e.g., saying thank you, writing letters of gratitude) we can trigger the emotion of gratitude. Psychological evidence has shown that attitude change often follows behavior change.

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Dawn Theodore BlogDirector of Day Treatment Services at Monte Nido & Affiliates Dawn Theodore, MA, MFT, CEDS discusses the unique challenges that arise when treating a middle-aged patient with an eating disorder.

When I treat clients with eating disorders, I always talk to the person about the “fork in the road”, which is the choice they have as to whether to choose their life in that moment or their eating disorder. Every decision that is made moves them closer to one destination or the other.

The Fork in the Road
As I sat across from a woman in her 50’s who has been struggling with her eating disorder for 40 years, I have to wonder why she has chosen her eating disorder and not life. After all, she is working and functioning in life, but she continues to struggle with her eating disorder and is sitting in treatment yet again after many failed attempts.

I had a lot of empathy and compassion for this woman who had developed her eating disorder at age fifteen, about the same age I had developed Anorexia Nervosa. We were approximately the same age and yet we had chosen a different fork in the road.

In the past, eating disorders would be seen at developmental transitions such as middle school to high school, high school to college, college to life and before and after pregnancies. Now there are additional transitions that are leading to an increase in eating disorders in individuals 40 and above.

Many clients being seen for eating disorders in the 40 and older range could have had an eating disorder for many years, but it was never recognized or treated. The person was functional in their life and able to keep their eating disorder a secret for many years.

A client may also have had recovery from their eating disorder at an earlier time in their life and a life event has triggered a relapse.

The Pressures of Aging
Some of the possibilities as to why the 40 and older population is developing their eating disorder now could have to do with transitions associated with the age. At this age, the person may be beginning to recognize the societal pressure to look younger as the aging process begins. Their children are developing into beautiful adults as they begin to see the signs of aging.

Children are leaving the home and the empty nesters are being asked to reevaluate their lives after raising a family. This is a time when the couple has to look at their marriage or relationship and divorce is a distinct possibility as they rediscover life without their children.

There may also be financial concerns as they have children in college and they are preparing for retirement. Women may be forced back in to the work force after years of being removed if they were a stay at home mom. Seeking treatment may be costly and they feel shame to take money from college funds and/or retirement.

The sandwich generation is stressed by the pressures of raising their own family while caring for ailing parents. The loss of parents is another developmental transition which can cause someone to begin looking at their own mortality and aging fears.

As young girls transition from childhood to adolescence, they receive attention for their new body. Women who are going through menopause are also going through a transition with their body, but this time they are not receiving the positive reinforcement they had as an adolescent. In fact, it is a time when they may really be dissatisfied with their body.

Treating this Population
When treating this population, it is important to look at the current stressors in their lives. Being able to identify what has gotten them to treatment and actually be able to talk about it without shame and guilt.

If they have had an eating disorder in the past and have relapsed or if they have secretly had an eating disorder for a long time, they may feel hopeless and as though they will have their eating disorder forever.

Teaching the client how to be authentic and congruent may be healing as they take off the mask they have presented to the world. This may be the first time they actually have the time to focus on themselves and their well being.

What they were presenting to the world and how they actually have felt were not the same. The person will need to identify their feelings and learn how to communicate their feelings to their support system.

The support system for this population may include their children, husband, friends, and siblings. Helping the client identify what she or he needs from their support system and how they can be supportive. The more educated the families are about the clients eating disorder, the less this client will be able to act out in their eating disorder.

Communicating Concerns
Helping the family communicate their concerns can be difficult. The children may have to be honest about how their parent’s eating disorder has impacted them.

The roles may be reversed and the child may be the one setting limits with their parent(s). Teaching families to be loving, empathetic and communicating without judgment is key through the process. Also important is being able to speak their truth without being attached to the results.

The belief system of the eating disorder will need to be challenged. If the client has had their eating disorder for a long time, the belief system will be rigid and it will take a lot of support from the therapist, dietitian, family and friends to begin to shift the distorted cognitions.

As I sat across from my client, I was aware of how her eating disorder had pushed the support system away with its relentless demands on her. She had no relationships in her life and she was returning to an apartment she shared with her cat. As she made the transition out of treatment and back to her life, I held the hope for her journey in to recovery, but also knew it was her choice and she had the tools to choose life.

How do you think eating disorder been impacted by age? How has age impacted recovery?

This post originally published on the Eating Disorder Hope blog

 

To read a past article about eating disorders and aging, please visit here. For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programs, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Posted in Recovery

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A heartfelt thanks goes out to Emily for sharing some insight into her path of recovery, including a journal entry at the completion of her time at Oliver-Pyatt Centers. We hope this provides encouragement to those working toward recovery, strength to those struggling, and a reminder that you can do this.  

For the longest time, I was my body’s worst enemy. I was constantly consumed by my thoughts obsessing over my body and food. This began when I was fairly young. I can still vividly remember being in 2nd grade when I was forced to wear a dance costume for my recital that consisted of pleather pants and a hot pink fuzzy sweater. To this day, I can remember how much I hated my body in that outfit – the thoughts were inescapable. That was the first time I became aware of how much I disliked myself.

I grew up thinking that hating my body was normal; I truly believed that everyone was struggling with the same thoughts. I started to live my life convinced if I lost some weight, all of my problems would disappear. I would be happy, popular and live a life people would be envious of.

I was 15 when I was diagnosed with an eating disorder, but it didn’t hit me that it was a real problem then. It wasn’t until last year when I spent the holidays in panic over the food that I realized things were not okay. Needless to say, my eating disorder had taken over my life. On some days, I was able to recognize things had gotten out of control, but a majority of my days were spent listening to the thoughts that shouted I wasn’t sick enough. I believed them because I never thought I was enough. Sick enough, pretty enough, smart enough, talented enough – it was never enough.

A few days after ringing in the New Year, I found myself having had enough of my eating disorder. Ironic isn’t it? I sat in my therapist’s office and agreed that maybe it was time to really recover. She mentioned Oliver-Pyatt Centers (OPC) might be the right fit for me. I looked at her like she had four heads, ME, in residential treatment? My eating disorder panicked and I went right back into denial. I swore I was fine even though I was the furthest thing from that.

I did not understand how this could happen. How did I end up with an eating disorder? How did it get this out of control? Why couldn’t I stop?

Everything felt like a blur. I very reluctantly agreed that to go. I packed my bags and began my journey. I left New York City and went home to my parents the days before I boarded the plane to Miami. I cried a lot – I was leaving my favorite city, my beautiful family and my eating disorder. I knew logically there was no reason to miss something that was killing me emotionally, physically and spiritually. But we had spent so many years together that I did not know how I’d survive without it.

I will always remember the devastating feeling I had walking away from my family at the airport to fly to Miami by myself. I landed in the MIA airport and was greeted by one of the OPC recovery coaches. She tried her best to comfort me about being there and reassured me I had made one of the strongest choices I’ll ever make in my life.

I walked into the Verde house where I would spent the next few months and took a deep breathe. I tried my hardest to remember why I was there. Not just to lose my eating disorder, but to gain back my life. I, of course, missed my family, but something told me I had just found my new family. The way I was embraced in hugs with girls I barley knew, and staff that only wanted the best for me – I felt at peace for the first time in a long time.

It is so hard to put into words the experience I had at OPC. The five months I spent there were unforgettable. I became Emily again, and god it felt so good. I think the following journal entry when I ‘graduated’ from residential is the best way to share how much it meant to me. I will always remember sitting outside in the tranquil backyard of the house reading this to all the girls I had been with on this journey and crying. Not because I was sad, but because I was so happy about how far I had come.

May 17th, 2015

I can hardly believe this day has come. That all my hard work has paid off. The past three and a half months I spent in treatment here has meant the world to me because I feel so differently than I ever have in my entire life. Prior to getting here, waking up in the morning felt like a never ending nightmare I couldn’t wake up from. I was emotionally, physically and spiritually exhausted. I was miserable and living a life filled of shame and pain. The most awful feeling in the world was wanting to call my body home but never having the strength to.

I dreaded each day knowing I would have to deal with the tiring dialogue and war happening inside my head. What is so special and rewarding about spending time here at OPC is that I’ve regained my life back. I realize now that there is not enough time for hating myself. There are too many places to go, to see and people to meet. There are too many things to make. It’s time for me to go live my life. A vibrant beautiful life – filled with joy and sometimes sadness.

I realize now that there is nothing more important than being happy and healthy. I realize now that there is nothing more precious than learning to embrace the skin and body I live in. Waking up excited about life and it reminds me how beautiful this process is. I am becoming the truest version of myself the one I had been looking for for so many years. I can look in a mirror now and recognize that I am so much more than just my outward appearance and accomplishments.

I am a beautiful girl with likes and dislikes, with opinions and feelings. Who I am is never going to be reflected on my outer appearance. Who I am is never going to be dependent of the number on a scale. One of the most important things I’ve learned here is that I am a combination of what I love rather than what I hate in the mirror.

For the first time in my life I am loving and nourishing my body more and more everyday. I am able to accept love and compliments for the first time. I have never felt more honest and true to myself and I feel so lucky to have the opportunity to learn how to do that. I can finally say I deeply and completely love and accept myself. The time spent here at the Oliver-Pyatt Center was worth every tear shed and every uncomfortable feeling I have had to sit through. I am becoming Emily for the first time and I am using my voice once and for all.

At the end of the day I am also grateful for my eating disorder because it helped me sit through the unspeakable. Even though the comfort of my eating disorder came with a heavy price, I am able to recognize how much I have learned from this illness. I can say now that I deserve more than dedicating my lifes work to losing weight. I feel no shame now for having used my eating disorder to cope with my life, because it doesn’t make me a bad person – my presence still can light up a room.

Thank you to everyone at OPC for teaching me how to love and live again. You saved my life.

I know thinking about going to treatment is scary, even terrifying at times, but I hope this reminds you what you could gain in the process. If you’re struggling with an eating disorder, call Oliver-Pyatt Centers at 1-866-511-HEAL or visit their website for more information. I wish you well on your journey of recovery. YOU can do this.

This article was originally published on the Project Heal website. We thank them for allowing us to re-post and share with our readers. 

Posted in Recovery

Melissa_Orshan_Spann_withborderDirector of Admissions Dr. Melissa Spann, co-hosting with the Alliance for Eating Disorders Awareness, will be exploring the spectrum of treatment options for trauma in eating disorders throughout treatment at a presentation tomorrow, Friday December 11th from 9:00am – 12:00pm in West Palm Beach, Florida. If you are interested in attending, please register here. For additional information, please scroll to the bottom of this post. 

Trauma is an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives.” 

In this presentation, participants will gain knowledge regarding specialized tools and techniques used to effectively engage clients throughout treatment. From an initial point of inquiry, clients with a co-occurrence of trauma and eating disorder require a specialized approach to treatment in all levels of care. Various treatment techniques and evidences-based practices have proved to have significant results for effective treatment of trauma; however, in the intersection of trauma and eating disorders, specialized consideration of nutritional, medical and eating disorder goals must be given prior to use of trauma techniques.

This presentation will address how to initiate specific trauma-informed therapies according to client background, eating disorder diagnosis, and stage of recovery. During an initial point of inquiry, the use of trauma-informed motivational interviewing provides the client with an opportunity to feel more connected, engaged and as an active participant of their own recovery. This presentation will highlight specifically tools of trauma-informed motivational interviewing as a means to initiate treatment and provide a framework to treatment progression. Additionally, the presenter will provide examples from other clinicians on most challenging trauma eating disorder cases and best practices used.

About Melissa Spann, PhD, CEDS
Melissa Orshan Spann, PhD, CEDS is the Director of Admissions at Oliver-Pyatt Centers. Dr. Spann has presented nationally on topics related to adolescent development, trauma and body image. Her clinical interests include experiential therapies, healthy body image, and women’s issues across the lifespan. Previously, she served as a primary therapist at OPC, The Renfrew Center and Life Counseling Services. Dr. Spann also worked with Moving Traditions, whose premier program, Rosh Hodesh: It’s a Girl Thing! is dedicated to proactively building for health. She received her doctoral degree from Drexel University, Master’s degree from University of Miami and undergraduate degree from University of Florida.

Event Details
Friday, December 11, 2015
9:00 am – 12:00 pm (8:30 am – Light Breakfast and Registration)
West Palm Beach Event Hall | 2223 Palm Beach Lakes Boulevard #101 | West Palm Beach, FL 33409
3 Free CEUs and Light Continental Breakfast!

Registration Fee
In lieu of a registration fee, we are requesting a donation to benefit our organization and the free services we provide community wide.

Items Requested
Donations: Cash/Check Accepted (made out to The Alliance for Eating Disorders)
Gift Cards: Office Depot, Home Depot, Staples, Target, Publix, Amazon
General Supplies: Copy paper, Correction Tape, Clear packing tape, Trash bags-large black, Paper Towels, Tissues, K cups, Postage stamps, Tyvek 8.5×11 mailing envelopes

CEU Information
The Alliance for Eating Disorders Awareness is approved by the Florida Board of Psychology to provide continuing education courses to psychologists (Provider # 50-11298, expires 5/31/2016), Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling (Provider # 50-11298, expires March 31, 2017) to provide continuing education courses to LCSW’s, LMFT’s, and LMHC’s, Florida Board of Nursing to provide continuing education courses to RNs, LPNs, and ARNPs (Provider # 50-11298, expires 10/31/2017), and Florida Council of Dietetics and Nutrition to provide continuing education courses to RDs, LDs, and LDNs. The Alliance for Eating Disorders Awareness maintains responsibility for this program and its content. This course offers 3 credits.

For more information about Oliver-Pyatt Centers and Clementine adolescent treatment programming, please call 866.511.HEAL (4325), visit our websitesubscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram

Posted in Recovery
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