At Monte Nido & Affiliates, we save lives while providing the opportunity for people to realize their healthy selves. One of the ways we want to help provide opportunities for individuals to realize their healthy selves is through our Sea Glass Grants opportunity. We are excited to share our newest Sea Glass Grant recipient, Recovered Living, an organization providing coaching to those who aren’t able to obtain support in underserved locations, providing both in-person support and online. Read more about this amazing organization below!
How did Recovered Living come about?
My own recovery experience inspired me to create a service for people who did not have access to face-to-face support.
After flying home to to New Zealand after 7 months with Monte Nido I realized the ‘Treatment Bubble’ had well and truly burst. The nearest eating disorder therapist was 6 hours drive away so I knew if I wanted to stay in recovery, I needed to get creative in finding a team.
I found a therapist and a dietician that worked online and figured out that lunchtime in New Zealand was dinnertime in California. I would Skype with my recovery friends at mealtimes and in this way created my own virtual IOP. No matter where I was in New Zealand, my entire team was at my fingertips via my laptop. This is how I recovered.
In my recovery journey I saw many people relapse and even die as a direct result of lack of available treatment options. I became determined to bridge the gap for people who did not have access to face-to-face support and create something different that addressed the gap.
How has Recovered Living helped you in your recovery journey?
Recovered Living was a dream of mine years before it was a reality. When recovery was tough for me or the temptation to go back to my eating disorder was strong, I would remind myself that I couldn’t be a role model for others if I went back to my eating disorder. Helping others and being a leader in the recovery field was a very strong motivator for my recovery.
Who is Recovered Living?
Recovered Living is 100% Kristie at the minute! I often refer to Recovered Living as ‘we’…because it truly has a life-force of its own. I have my Kristie life and there is another being in my life called Recovered Living that I am in relationship with.
It is getting close to the time that I need another coach to help meet demand – Recovered Living will soon be ‘us’!
What feeling do you most associate with Recovered Living?
Only one? Hope. The most important thing in the world. Inspiration. Authenticity & Effervescence!
Walk me through the Recovered Living process, how do people currently hear about the services you provide?
Recovered Living provides two distinct services.
Transition Assistance is a 24/7 service where a Recovery Coach will move into a clients home to help them transition. This can be moving from Residential to PHP, from School to Home…or anything in between. When the Recovery Coach leaves, they can continue supporting clients via online sessions. With such a detailed insight into Client’s lives, we have noticed people’s recovery wobbles are more like a dance move than a dive.
The other service Recovered Living provides is online Meal and Snack Support, Recovery Coaching and At-Home Cooking Sessions. This means we have clients all across America, Australia, New Zealand, Canada and Europe.
We recently started a free online ‘Support Space’ group for family and friends of Recovered Living clients. An eating disorder does not just affect one person in the family, it affects every person in the family. We believe families deserve support too!
People have found Recovered Living from all over – we get lots of people from Google searches, word of mouth referrals or from our social media platforms. Something we always offer clients is the opportunity to talk with us first, before making any commitments. We will connect via video call with any new client to hear their story and to talk about how we can help them move forward in recovery. If we seem like a good fit and you want to move ahead – we will design a support schedule that works for your individual needs. We are available nights AND weekends – we get that recovery operates outside office hours – so do we!
What is your favorite part of the day-to-day start up process?
It is not one moment that is my favorite so much as the feeling of a driving and vibrant passion inside me. Sometimes I get so excited I don’t want to close my eyes at night!!
How can people get involved?
If you think Recovered Living is a service that could help someone you know, please spread the word! We have a Facebook and Instagram account, as well as a monthly blog (you can sign up for our newsletter on the website).
Have spare time on your hands? We currently have volunteer opportunities available to help get an upcoming project off the ground. We always welcome support!!!
What advice would you give to someone in their recovery who has a dream?
Do it! Something that helped me in recovery was the mantra, ‘bigger jeans, bigger life’…now I say ‘bigger dreams, bigger life’!
What are your hopes and dreams for Recovered Living?
I hope Recovered Living reaches every corner of the world that has access to the internet.
I dream of a time where treatment for people will be affordable, help is available and support is practical. No matter where you live.
I hope Recovered Living helps to promote the benefits of telemedicine, giving rise to the critical mass that is creating a change in treatment options.
I dream of the client that will one day become a Coach. The client that follows their calling and becomes the person they wish they had in their recovery – themselves.
Karin Lawson is a licensed psychologist, certified eating disorder therapist and writer in private practice. She’s located in Miami, FL. Dr. Lawson is currently the Vice President of the International Association of Eating Disorder Professionals – Miami Chapter, as well as the President-Elect of the Miami-Dade-Monroe Psychological Association. Dr. Lawson discusses strategies for managing the upcoming holidays in this week’s blog post.
The holidays are no easy time of year for most people, much less those who are working on their recovery from an eating disorder. Here are two (note I did not say “easy”) strategies to keep close whether you’re dealing with family dynamics, internal food judgements or binge behavior.
The Power of the Pause. Simply working on pausing when you notice an intensity coming into your body can be a great tool. By “pause” I mean, insert something to slow-down or maybe stop a reaction, so that we’re able to take more consideration into what’s happening for us in the moment, rather than reacting on autopilot. I’m a big fan of creating a pause that also incorporates your nervous system, so that you’re physiologically inducing more relaxation, thus de-escalating the reactive response. So, you’re pause might be to take three slow breaths or do three should rolls forward and then three shoulder rolls backward or maybe your pause is to step outside (no matter the weather) and notice three things (e.g. colors, textures, shapes, sounds) or maybe your pause is to snuggle with your pet for three minutes. There’s nothing magical about the number three. I choose it simply because it feels more doable to most people. Therefore the strategy isn’t off-putting or overwhelming.
Self-Compassion Can Never Go Wrong. Let’s say you do binge, whether you tried the power of the pause or not. Your next strategy in line is to work on evoking a sense of compassion for yourself. Reminding yourself that binge behavior is a coping strategy. You are trying to deal with a difficult moment. How amazing are you to create ways to support your survival in this emotionally challenging world?! Just because you’re trying to let go of this behavior and find new options, doesn’t mean it was bad. Binge behavior was there when you needed it and now we’re working on giving yourself permission to find new freedoms and new options. Let’s be compassionate with that part of your creative self which discovered binge eating as a way to deal with life. Let’s give some understanding that it is hard to create change, even more so in a food-focused, family-focused time of year. Let’s imagine putting our arm around that part of yourself and giving some love and understanding, instead of criticism and shame. Let’s give a bit of gentle compassion to the parts that feel unloved right now. Another way to evoke self-compassion is to look at the behavior with gentle curiosity (again instead of critical and shaming thoughts). Some questions you might say to yourself: “Wow, I must have really be dealing with something there . . . I wonder what was impacting me?” or “That was an intense moment, let me journal for a few minutes to see what comes to mind about what happened.” or “Yowsa, I can’t believe that happened, but it’s an opportunity for information on my recovery. I wonder what I can find out here. Maybe I’ll text a friend or trusted professional to let them know I need to check-in later and process this.” Self-compassion is the antithesis of shame. Shame wants to hide and lurk, but the more we can acknowledge (both to ourselves and to trusted others) the less room shame has to exist.
Here’s to not a perfect holiday season, but one that is sprinkled with light-hearted moments, self-care and gentleness.
Jennifer Kreatsoulas, PhD, RYT is a yoga teacher and yoga therapist specializing in eating disorders and body image. In recovery herself, Jennifer is extremely passionate about helping others reconnect with their bodies and be empowered in their lives. Jennifer works with clients in person and via Skype. She also teaches yoga at the Monte Nido Eating Disorder Center of Philadelphia, is a partner with the Yoga and Body Image Coalition, and leads trauma-sensitive yoga classes. In this week’s post, Jennifer discusses detaching from your diagnosis identity.
When a diagnosis becomes our identity and our identity a diagnosis, we unknowingly become walking, talking containers of illness, pain, and even hopelessness.
We separate ourselves from others in the belief we are different or broken. As we embody the disease we believe precedes us, we disconnect from our unique gifts and passions. Our bodies hurt, our minds become one dimensional, and our spirits wither. Our world narrows to a single dark point chained to the fear of not knowing who we are without our diagnosis identity.
It’s only having lived to come out the other side of shedding the diagnosis identity of an eating disorder that I can say with conviction that you have permission to detach from yours too. I understand the fear, anxiety, confusion, and uncertainty that accompanies even the smallest of steps to let go of that which you believe keeps you safe, in control, and put together. For decades I fiercely resisted detaching from the diagnosis of anorexia. From my hair style to how my clothes hung on my body to the bags under my eyes to the food on (or not on) my plate, I dedicated my every action, word, and thought to fulfilling my identity as an anorexic. That diagnosis was the lens through which I viewed the world and my place in it, and it was a dead end.
With time, persistence, willingness, and a whole lot of support, my eyes opened to the shadow I was living in, the shadow of my diagnosis identity. Once I spotted this identity as a menacing shadow and not the entirety of who I was, I realized I had the power to walk out into the light. As I inched away from the shadow, new possibilities for healing came into my life as did new relationships and opportunities. Slowly but surely, I began to resent the shadow for holding me back from embracing more and more of the world around me and the food, people, and sensations in it. The stronger my resentment grew, the more willing I became to detach from the diagnosis identity and replace it with the gifts, talents, and passions that were buried but by no means dead.
It took practice giving myself permission to detach from the eating disorder identity. Every morning for months I asked myself Who are you? until the words anorexia, anorexic, and eating disorder were not my first answer. Little by little, more answers surfaced in my mind, like mother, daughter, wife, yogini, writer, creative soul, kind person, etc. I did this exercise over and over until the words related to my diagnosis identity moved down the list and one day slid right off it. Getting to this point took perseverance, and it wasn’t a straight line, just as recovery is not.
With the help of a therapist, other supports, and my Yoga practice, I was able to arrive at complete permission to detach from the diagnosis identity. Now the words anorexia and eating disorder do not define me, nor do I strive to embody them. Rather, I respect and honor these words for the profound experiences in my life they represent and the gifts they provided: self-awareness, empathy, resilience, compassion, and ultimately my life’s purpose to support others healing from eating disorders through yoga.
My friend, you are capable of detaching from any identity that keeps you trapped in shadows. Once you give yourself permission to do so, the possibilities for goodness to fill your life are endless. Take a few moments and reflect on these questions:
How would your life change if you shed your diagnosis identity?
What dreams would become possible?
How much more fulfilled would you be?
How much more connected would you be?
How much more whole would you be?
Don’t be afraid to ask yourself who you are. Let the answers come as they are in this very moment. Ask again tomorrow, and the day after, and the day after that until new words bubble up. With permission, they will. Be patient and gentle with yourself as you step away from the shadow, but trust you can do it. I fiercely believe you are more than a diagnosis. You have permission to detach from your diagnosis identity. You have permission to explore who you are without it. You have permission to move through this world as an whole, vital individual.
Monte Nido Manhattan Primary Therapist Temimah Zucker, LMSW dives into the difference between disordered eating and an eating disorder in this week’s blog post. Temimah shares ways to discern between to the two, and warning signs to be aware of.
One of the most common questions I’ve received as both a clinician and an eating disorder survivor is how to know whether someone truly has an eating disorder. In this day and age, when food fads and diets come and go quickly and people so regularly, casually discuss the manner in which they “eat their feelings” as a means of coping, it can be hard to discern when one’s eating practices morph from disordered eating into an eating disorder.
Normalized, non-disordered eating is when one mindfully consumes food when hungry and is able to stop when full. Additionally, they incorporate variety into their diet. Now, according to this definition, many people I know, who consider themselves to have a terrific relationship with food, may be classified as “disordered eaters”: they eat when they’re bored, have the same thing for lunch each day, cut out a main food group, etc. Societal standards and pressures, as well as preoccupations with weight loss and exercise, may lead individuals to alter/manipulate their food intake. For many people, this “works.” It does not interfere with their lives; they are able to find food they’re comfortable with at any restaurant, and there is no desire to change.
For others, this way of eating can be a precursor to a full-fledged eating disorder, and in many cases, it is hard to distinguish when an individual is struggling with disordered eating versus when an eating disorder is at play. From a clinical perspective, all who have a non-normalized relationship with food have an opportunity for introspection and reflection around their patterns and behaviors in relation to food and exercise. This being said, the essence of this piece will focus primarily on the distinction between this type of disordered eating and an eating disorder.
“How do I know if I should be worried? What if this gets worse?” These are the thoughts and questions, not only for those concerned for their loved ones, but also for individuals who are unsure about what type of help they might need. There are three key factors: behaviors, obsession, and functionality.
When an individual is struggling with an eating disorder, they generally engage in multiple behaviors. These behaviors can involve food or may relate to body image or mood. Judging by these behaviors alone would be insufficient: many people eat health foods or consume large quantities of food and do not have eating disorders. The quantity of behaviors may be an indication; for instance, this person engages in behaviors multiple times per week or even per day. This being said, many people keep their behaviors a secret and it is therefore difficult to gauge based on behaviors alone.
The level of obsession around eating disorder thoughts and behaviors can distinguish disordered eating from an eating disorder. It can be normal to think about food when hungry or what one might have for the next meal. For those struggling with an eating disorder, however, the thoughts are generally all-consuming; the individual thinks about calories, taste, food avoidance, or where to buy food, etc. This level of obsession can impair focus, the ability to stay present, and sleep, among other things. While it’s difficult to judge how much time and energy another person is spending thinking about food or using behaviors, the individual may offer this information or it may be evident that they spend more time in the grocery store, or perhaps isolate more frequently, and their general behaviors and patterns have changed.
Finally, the level of functionality is a distinguishing factor. When someone’s eating patterns take them away from normal functioning, this can be a strong indication of an eating disorder. This can include a woman who will not go out with friends because of the fears around their judgment while she eats. Or perhaps an individual does not attend work or school on more than one occasion due to behavior use like a compulsion to exercise. While these examples may sound extreme, those struggling often cite impairments of their social functioning as well as other obligations, due to their eating disorders.
The distinction between an eating disorder and disordered eating is one that takes practice in order to achieve understanding. Oftentimes, those struggling report that their eating disorder began as disordered eating. This by no means indicates that all who engage in disordered eating will have an eating disorder. Rather, it is a reminder to practice reflection and support for those around us about whom we have any type of concern.
I do not encourage diagnosis of others without involving a professional and yet, perhaps this piece sheds light on the type of warning signs that may present themselves and will plant the seed not only for further discussion around this important distinction, but also call to mind the need for methods of prevention and help not only for eating disorders in general, but for disordered eating. With further understanding and curiosity, we can rise up and provide support to all those struggling.
This blog originally posted on the National Eating Disorders Association website.
Individuals struggling with the aftermath of a traumatic experience require an effective protocol ensuring long lasting results. It is important to specifically ask treatment centers to provide detailed descriptions of their trauma protocol and how they offer this important and sensitive support. At Monte Nido & Affiliates, we offer a clear methodology that will treat trauma patients with care, compassion and practices that work.
Cognitive Processing Therapy (CPT) is the chosen model we use at our locations because it has strong empirical research and outcomes. This type of therapy is manualized but still leaves room for flexibility based on the patient’s needs. Features of this treatment include targeting perceived cognitive distortions and challenging the patient through socratic questioning. This type of questioning allows patients to reach conclusions themselves and promotes inner reflection. Somatic experiences, such as mindfulness and yoga, are incorporated into the program as well, although it is not our direct method for treating trauma. The CPT process is also integrated with other modalities such as Dialectal Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR).
At every location that offers this programming, there is a trained staff member on call. These treatment plans are administered through certified therapists that have undergone extensive training by Dr. Patricia Resick. She has administered national two-day training programs at locations in Malibu, Miami and Briarcliff. Additionally, Dr. Resick continues to check in with supervision calls with the clinicians at our locations to ensure each patient is receiving the best care possible.
Knowing your loved one is struggling with the aftermath of a traumatic experience can be a devastating process and we are here to help ease your pain. If you are ready to take a step toward healing, please visit our admissions page here.
Dr. Stacey Rosenfeld is a clinical psychologist specializing in eating disorders and body image concerns. She also works with substance misuse, anxiety and mood disorders, infertility, and relationship difficulties. A certified group psychotherapist and certified eating disorder specialist, Dr. Rosenfeld has worked at various treatment centers and universities and now directs the Gatewell Therapy Center in Miami, Florida. Dr. Stacey Rosenfeld is the author of “Does Every Woman Have an Eating Disorder? Challenging Our Nation’s Fixation with Food and Weight”, based on her award-winning blog of the same name. She is committing to helping people develop healthier relationships with food and their bodies. Check out Dr. Rosenfeld’s podcast on Life Unrestricted where she discusses disordered cultural messages, compulsive exercise and co-occurring issues.
The road to recovery for individuals facing an eating disorder takes strength, stamina and perseverance. Those who are coping often benefit from a team of professionals that truly care about their patients. They require a team that has developed a comprehensive, personalized and intimate treatment plan for them to follow. That team can be found at Oliver-Pyatt Centers. Our team understands every individual comes from a different background bringing unique challenges and traits along with them. Our professionals work one-on-one with patients to provide a treatment catering to their specific needs and maximizing their chances for a full recovery.
Patients are the number one priority at Oliver-Pyatt Centers. They are treated in an intimate environment with a high staff-to-patient ratio. Treatment plans are highly customized and include thorough medical and psychiatric care to patients, individual psychotherapy, daily exposure therapy and extensive aftercare planning. Each particular program acts as a catalyst to the patients healing process and brings hope for their future following treatment.
In 2008, Oliver-Pyatt Centers opened Casa Rosada; as the first Casa (house) welcoming young women struggling with eating disorders to begin their holistic road to recovery. Clinical Director, Dr. Casey Fields, oversees the multidisciplinary team here that ensures sustainable recovery for patients.
“It is difficult to choose one part of my experience at Oliver-Pyatt Centers that was most meaningful. I can’t speak highly enough of Oliver-Pyatt Centers. I have grown more here in the past four months than I have in the past few years. Oliver-Pyatt Centers as a whole has made me a better person and for that I am incredibly grateful. However, if I had to choose one part of my experience I would deem most meaningful, I would have to choose my experience with my primary therapist in Casa Rosada. I can’t thank her enough for her part in my growth.” – Client Testimony
Neighboring Casa Rosada is Casa Verde, Oliver-Pyatt Center’s second house which opened its’ doors in 2011. Clinical Director, Dr. Benaaz Russell oversees the team at this location and ensures the philosophy of collaboration is held among team members and outpatient providers.
Casa Azul is the most recent center established in 2013. Dr. Tali Yuz-Berliner acts as the clinical director at this location and works collaboratively with a team to create a personalized, attentive experience for each patient.
Each Oliver-Pyatt Centers’ home has no more than 12 patients attending at a time, allowing us to implement consistent care and personalized programming for all. We provide a safe space for each patient to reside while focusing on their own unique recovery. Patients are treated with the utmost of care and follow a particular treatment plan designed just for them. This is no ordinary treatment center, this is The Oliver-Pyatt Centers difference.
Join us for First Wednesdays at Oliver-Pyatt Centers! For our June edition, board-certified art therapist and licensed mental health counselor Annie Hoffman, MA, LMHC, ATR-BC will present “The Use of Art and Creative Methods in Eating Disorder Treatment” on Wednesday, June 7th!
Annie will present on specific areas related to the introduction of art materials and creative methods when working with individuals in a therapeutic setting for the treatment of eating disorders. She will also review some considerations that are unique to eating disorder treatment and the use of creative methods. Participants will gain an understanding of how to safely use these materials and methods while remaining in their respective scopes of practice.
Through this presentation, participants will identify when to consult with and/or refer to an art therapist and name three considerations for safety in the use of art materials. Participants will also be able to identify three therapeutic areas of focus that are common when using art materials in the treatment of eating disorders.
Registration, lunch and mingling begin at 12 pm and the presentation will be from 12:30-1:30pm. 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 May 3rd, please RSVP to Luisa Benda at LBenda@montenidoaffiliates.com or RSVP here by Monday, June 5th.
In this week’s blog post, Oliver-Pyatt Centers Founder Wendy Oliver-Pyatt, MD, FAED, CEDS shares her personal perspective on being in recovery versus being recovered. Read on to learn more from OPC’s Founder and eating disorder expert…
Recovery is a process. Recovered is more like an outcome. Both are possible. They are connected, but they are different. On one hand, the recovery process begins to unfold when you have started to really develop the conviction that the eating disorder is no longer an option, and you are willing to do whatever it takes to recover. This is when the process of recovery really begins. However, you can also be in the process of your recovery, even before you have truly decided you have “had enough,” or when the conviction to recover has not fully set in; examples of when this may come up are when you are in treatment and are beginning to engage with another human being in a truly meaningful way, but are uncertain of your conviction to actually become recovered. Or perhaps you don’t really have the vision, the hope and the confidence that you can really become recovered; but you are willing to give it a shot, you are willing to step outside of your isolation and allow a new way, or new people into your world. During this phase you may have a lack of intention, or a lacking of strength to behave in a fully recovered way, but you are willing to engage in the process. In this case, you are in a healing phase, and you are recovering (even if you are very ambivalent about it!)
Alternatively, a person may have full conviction, intention, and determination to recover, and they may even be certain they will recover. This does not guarantee immediate results. So often, patients and families are confused. We live in a society that says, “Just do it!” When we try this, we do expect results! Nothing can be more difficult than to have the expectation if we just try hard enough, and want something enough, we are going to be able to “do it.” Time and time again, patients, families, and even providers are attached to this concept. This can lead to very difficult and even dangerous experiences for a person with an eating disorder. A frequent time we hear this mindset is when a patient or family says, “I am going to college in the fall, the structure will really help me” only to find that the stress, the demands, and the nature of a potentially triggering environment make things worse not better. Another situation this comes up is when a patient is willing to do everything expected of them in treatment, but not all the components of recovery are not integrated. Perhaps they will do as they are told, they will try and try and try. But this does not mean the person is fully engaging in treatment, or that they are aware of, sharing, and/or confronting the struggles in their life. Intention to recover does not equate with a guarantee that you are in a healing phase, or that all of the pieces are intact to lead to being fully recovered (the person may in fact underestimate their needs in general – a hallmark of all forms of eating disorders, and may underestimate what they need in order to recover.)
In some of my presentations I create a slide that reads: “Intention to Recover vs Healing Process.” What I am trying to point out is that one can have an intention to recover, yet not be engaging in a vulnerable and open relationship with others, or be developmentally able to process the emotions that leave them locked in the eating disorder and one can be in a healing process, even when they have very little, if any intention to recover.
Becoming recovered is when you have both healing process and intent operating simultaneously, to some extent. For me, personally, I became recovered when I was truly sick and tired of my eating disorder ways, and was willing to do whatever it took to recover. It was still trial and error, but I refused to be controlled by a mandated weight or size, and furthermore, I fully rejected the idea that restriction of my calories would ever bring me happiness, peace or fulfillment. I abandoned the pursuit of weight loss, and instead pursued the practice of mindful eating, and ultimately mindful living. I continued on the trajectory of healing, despite set backs and struggles.
To me, this is a little bit like learning to play the piano. When you first begin, you have to practice measure-by-measure, line-by-line, sometimes right hand alone, sometimes left hand alone. You mistake the F sharp for an F over and over, and have to re-do certain parts of the piece over and over. It seems like it will never work! This is the recovery process. The amount of time and energy this takes is individual to each specific person and their circumstance. What shockingly happens when you are committed to the process is the most amazing. Through this intention, and this process, eventually you play this music “by heart”…meaning no written music is necessary. Isn’t that kind of funny? When you master a piece, and play it without any music, we call it playing “by heart.” That is a little bit what it feels like to become recovered. Over and over you practice and fail at mindful eating. Just like over and over you fail to play that piece of music without errors. But you keep coming back to it. And eventually the song comes out of you, versus being forced. The piece is played without the written music, and when you are playing it, you are not fighting your way through it. It flows.
I think this is why it is so important to remember the distinction between the terms “recovery” and “recovered.” Here is what my friend, Carolyn Costin says about being recovered: “Being recovered, to me, is when the person can accept his or her natural body size and shape and no longer has a self destructive or unnatural relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life and what you weigh is not more important than whom you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size or reach a certain number on a scale.”
A person may not yet have the strength, conviction, confidence or trust needed to leave the eating disorder paradigm. This process cannot always be “willed.” It is an uncertain and mysterious process for a person to develop a sense of trust with self and/or a connection to self that really allows you to be exposed and vulnerable, or be open to a new way of experiencing food (and life.)
Recovery is when you are able to combine the process of recovering, with a willful intention to recover, and you are willing to do whatever it takes for as long as it takes to train or retrain yourself to live a life guided by mindfulness.
Being recovered means that I am not living my life based on weight, shape, or being focused on food. Being recovered is not “white knuckling” it. It is like playing the piano from heart. I am living life based on my heart, by intellect, and my “inner compass.” This also means I am not attached to outside approval, and am not wed to avoiding all conflict. I am thankful I stumbled across Mindful Eating/Intuitive Eating when I did in my life. Had I not, I don’t know if I would have ever recovered. What is most important to me now is that my attention and energy are actually available to me to live according to my values and according to what really excites me. Being recovered is not something I think about a lot – but deep down it is always something I have gratitude for.
As 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 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 email@example.com or RSVP here by October 31st.
Karin 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 Centers, Clementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our website, subscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram.
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.
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 Centers, Clementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our website, subscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram.
Greta 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.
Parent “Tool Kit” from the National Eating Disorder Association:
8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb
For more information about Oliver-Pyatt Centers, Clementine adolescent treatment programs and Monte Nido, please call 866.511.HEAL (4325), visit our website, subscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram.
Jennifer 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.
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.
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
Karin 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
Monte 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.
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:
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.
Director 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 website, subscribe to our blog, and connect with us on Facebook, LinkedIn, Twitter, and Instagram.