What is your name and what are your credentials?
My name is Giulia Suro and I am licensed clinical psychologist.
Please give us a brief description of your background.
I completed my undergraduate degree, receiving a BA in Psychology at University of Southern California and went on to pursue my Master’s Degree in Mental Health Counseling at Colombia University in New York City. It was during this program that I exposed myself to a wide range of clinical experiences including non-profit community mental health, inpatient psychiatric settings and even spent two years working in Rikers Island Jail. I realized I most enjoyed working with individuals experiencing severe symptoms of psychological distress and pursued my Doctorate of Clinical Psychology at University of Miami. I spent my third year as a doctoral student working in OPC’s Intensive Outpatient Program as a “prac” a few days a week. I really fell in love with OPC as a setting, its treatment philosophy as well as the meaningful work we’re able to do with the women who come here for care. I returned as a Postdoctoral Resident and spent two years as a primary therapist in the Comprehensive programs before transitioning to Clinical Director of IOP/TLP.
What does a typical day look like for you at OPC?
One of the things I love most about my job is that there is no real typical day. Time is divided between running groups, individual client sessions, supervision, family calls, seminars and administrative meetings. I recently established a weekly Acceptance and Commitment Therapy (ACT) consultation group with the other clinicians conducting ACT groups, and that has quickly become my favorite hour of the week.
In your own words, please describe the philosophy of OPC.
I think there are several threads that come together to create the OPC philosophy. The first is a commitment to individualized care and treating the unique needs of each woman who comes here for help. Along these lines, I believe we are very open to thinking outside the box in our effort to fully eradicate the eating disorder. This may include specialized therapeutic approaches, passes and exposures. Additionally, I believe all of our providers convey the message that the women are deserving of a meaningful life free of shame and suffering. This is conveyed in therapy, groups, meals and all interactions with staff.
How does your team work together? How do your roles overlap and differ?
I am constantly blown away by the IOP team. We are small but mighty! Each of the therapists, dieticians and recovery coaches are so very passionate for and committed to their job. We are consistently discussing how we can creatively continue to support our clients in their recoveries and I love that every member of the team sets a bar of full recovery for each woman we treat. We often come together as a well-oiled machine in multidisciplinary treatment teams to tackle the ED from all angles and push our clients toward recovery as a united front.
What is your favorite thing about OPC?
What first inspired me about OPC was the staff who work here and the culture they created. It is a daily gift to be able to work alongside brilliant, bold, women who are dedicated to helping those with eating disorders. We support one another in achieving our professional goals as well as in having a healthy work-life balance.
What are three facts about you that people do not know?
I usually wake up before the sun comes up to do yoga and meditate.
I love tomatoes so much I designed a garden where I could grow my own.
I have dog named Jack and he is truly magical!
Oliver-Pyatt Centers Director of Nutrition Services Mary Dye, MPH, RD, CDN, LD/N shares about the Intuitive Eating Model in this week’s blog post. Mary gives insight into how OPC supports clients to lay a foundation of intuitive eating so that they are able to improve their relationship with food on their recovery journey.
Sometimes, when eating disorder professionals hear of intuitive eating, they aren’t sure how this method can be incorporated into treatment at higher levels of care. The concept of listening to the body’s internal cues sounds like an ideal long-term goal for a person who has imposed strict and maybe even aggressive dietary guidelines on themselves. However, the reality for an individual living with an eating disorder, requires nutritional structure to ensure adequate nourishment and re-engagement of cues while working through all aspects of treatment. Oliver-Pyatt Centers’ nutrition programming, often referred to as an Intuitive Eating model, utilizes individualized, structured meal plans while assisting clients in increasing their awareness, understanding and ability to appropriately respond to innate cues with increasing autonomy over time. Throughout treatment, mindful eating practices and participation in thoughtfully planned, supported food exposures serve as the basis of each client’s journey toward the goal of full recovery, freedom and flexibility with food.
An individual with an eating disorder typically has little to no awareness, connection or ability to appropriately respond to their bodily cues. A key characteristic of the eating disorder is disassociation- a person comes to disregard their body’s hunger and fullness cues for so long that they forget what it feels like to be comfortably hungry for a meal and what it feels like to be satiated after eating. Our work is to reorient our clients with their own body’s language. As they work towards making peace with food, movement, and their bodies, we continually draw their attention back to their own experience- we ask them over and over again to describe what is happening in their body in the present moment. We do this first by having them assess their hunger and fullness on a scale of 0-10; zero being empty, and ten being painfully full. We also ask them to explore how these cues equate to emotional hunger and fullness. On empty, a person is experiencing cognitive deterioration or numbness, while when painfully full, the sensation is profound and distracting. During the initial phases of nutritional restoration, a client’s hunger and fullness cues are all over the scale and this can be confusing and quite anxiety provoking for the individual. However, as the body is restored to health and becomes accustomed to the routine of the meal plan laid out by the nutritional team, these cues start to fall in a less extreme and more comfortable range where hunger and fullness are experienced more gently and predictably. By noticing hunger and fullness in more comfortable, and less distressing ranges of sensation, clients learn to better recognize their body’s physical needs and address them before they become unmanageable.
Another key aspect of nutritional philosophy at Oliver-Pyatt Centers is the way we incorporate the Principles of Exposure Response Prevention Therapy to guide our client’s supported interactions with food. Because of our intimate staff to client ratio, we are able to provide a high volume of exposure experiences in a controlled and safe setting. We remind clients that exposures must be repeated and while there is a peak in shame, anxiety, and disassociation, we find that overtime maladaptive responses decrease. To support our clients through daily exposures, meals are reported in a safe setting just prior to exposure experience and intentions for that specific meal are set in a focused and supported environment. These built in, habitual exposures are paired with individualized challenges to address specific eating disorder behaviors and beliefs. We work with clients to quell their anxieties in the moment to work through challenges early on as they continue towards the goal of mindful connection to their experience in the moment.
Throughout each client’s treatment stay, we work to lay a foundation of mindful, and eventually intuitive eating, with the goal of reconnecting mind and body. We believe that after following treatment recommendations and continuing to work toward full recovery, our clients are capable of making peace with food through intuitive eating.
1. What is your name and how long have you been with Oliver-Pyatt Centers?
Mary Dye. I have been with Oliver-Pyatt Centers for two years. Prior to working here, I had the pleasure of knowing Oliver-Pyatt Centers as an outpatient dietitian. I was so impressed by their work I had to move down and join the team!
2. Provide a few sentences about your role at Oliver-Pyatt Centers.
I oversee all of the nutrition services at Oliver-Pyatt Centers. I supervise the nutrition work in all levels of care and across our various programs. Additionally, I meet individually with all of the women participating in our Transitional Living Program. I also have the pleasure of meeting many providers around the country and speaking with family members about the treatment their loved ones receive at Oliver-Pyatt Centers. A big perk of my role is the ability to educate professionals and the public about eating disorders.
3. What is your favorite thing about working as the Director of Nutrition Services at Oliver-Pyatt Centers?
My team. I could not ask for a more passionate, dedicated, loving, creative, and smart group to work with every day. The entire OPC team, from our graphic designer and human resources department to the clinicians, chefs, and recovery coaches, has such a high level of dedication to patients and their families and true passion for helping our women succeed. The team puts a smile on my face every day and reassures me that every woman who enters our doors is in the best hands possible.
As a mother of two young girls, I feel a real obligation to help create a culture I want them to live in. Whether advocating against school BMI screenings, pointing out the dangers of photoshopping, or fighting for insurance coverage for eating disorder treatment, I have the pleasure of working on a team devoted to the same causes. For so many of us the work we do speaks to larger cultural issues we feel a personal obligation to change. This passion inspires and motivates my work.
4. Tell us three things nobody knows about you.
I grew up surfing and feel so blessed to have been raised near the ocean. I grew up in a family of pilots so many weekends were spent doing take offs, landings, and stalls in the air. It has resulted in a real love of spontaneity, travel, and roller coasters! The ice cream cone was invented in my hometown of Norfolk, VA (I am particularly proud of this one!)