Monthly Archive for July, 2010

Fear and My Bicycle

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When I was a little girl, I suffered a fairly serious foot injury as a result of a bicycle accident at the bottom of my grandparents’ driveway. Fortunately, I healed and have no permanent damage except for a nasty scar, but I spent that entire summer having to soak my foot several times a day. I was miserable being stuck inside with a gaping hole in my foot, and feeling left out that my friends were outside playing or swimming at the pool. So for the next few years, I avoided a bicycle out of fear that it would take me out of commission from everything else that I enjoyed.

As I have gotten older, I have developed a huge fondness for cycling, and my bicycle has actually taught me a lot about fear. For instance, while I was on a recent bike ride, it started to rain. I wasn’t yet that far from home, but worrying about the sudden thunderstorms of summer, I decided to turn back and change my route to circle my neighborhood in case the weather deteriorated. While I was riding, I started to think about how this pattern reflects many other areas of my life. When something slightly different or threatening starts to happen, I often become afraid that something much worse will follow, and sometimes I even change my course to not stray too far from what is familiar and safe. How sad is it when I allow my fear of what might happen dictate my ability to leave my comfort zone? And even sadder, what am I missing by worrying that a storm may come, when a good thunderstorm can actually be fun?

In Thom Rutledge’s book Embracing Fear, he proposes that fear is healthy when it is the rational kind and is warning us of some real and imminent danger, yet unhealthy when it is neurotic and based on the past or our imagination. Healthy fear is quiet unless there is something actually threatening our safety, then it is very clear about what we are to do. Unhealthy fear is that constant chatter in our heads warning us about what could happen, even though we may have no evidence to prove it ever will, and it certainly isn’t at the moment.

Back to my bike. Healthy fear was engaged a few weeks ago when a deer ran out in front of me on a bike ride, and I had to make a snap decision whether to go right, go left, or try to stop. The fear was very clear in its message – watch what the deer does, and do the opposite. Unhealthy fear would be in play if I never rode my bike on that road again, because I was afraid a deer might run out in front of me. I have, and it hasn’t. And besides that, if I handled the situation the first time, I certainly could if it happened again. 

So today I went on a ride, and was listening to that neurotic fear chatting away in my head about a totally different situation in my life. “What if … You better not … You know what’s going to happen if …”  You get the picture.

As is fairly common on my bike rides, I had an epiphany as I started to descend a hill over a section of broken pavement. How much scarier is it for me to go fast down this hill, than it was to climb it about an hour ago?  Translation: Even though nothing in my life is a huge struggle at the moment and I’m basically “coasting,” I am more comfortable when things are hard and I’m forced to climb and claw my way to the top. WOW… there is nothing to be afraid of staring me in the face, and yet I had allowed myself to listen to this neurotic chatter about fear that was taking up valuable space in my head, for no reason. Am I really that afraid of coasting along, allowing things to happen, and enjoying the ride?

The answer is NO. I’m not afraid, and I am grateful for the wisdom that came from that descent. 

Thom begins the first chapter of his book with a quote by Oriah Mountain Dreamer: “There is only one freedom: the freedom from fear.”  Ask yourself this question – do you feel free from fear? Can you listen to your fear and determine if it’s a healthy warning or neurotic chatter?  What would you be doing in your life if you weren’t afraid?

At Southlake Counseling, we understand fear and how to listen to it. If you are troubled by fear and want to take the first step in your personal freedom from it, schedule an appointment with us today.

Be well,

Debbie



Published on Tuesday July 27, 2010 in Uncategorized and Wellness. 0 Comments Tags: , , .

Family-Based Therapy: Three Steps to Anorexia Recovery, Part 2

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As we continue our exploration of the application of Family-Based Therapy for recovery from anorexia nervosa, it might be helpful if we first do a quick review.

In Part 1 of this series we discussed why parental involvement in a child or adolescent’s recovery process is so vital to recovery success. Children need their parents. Parents want and need to be involved. Beyond these simple relational facts, research results have proven that a parent’s active involvement in a child’s recovery process is often a major determinant of a successful outcome.

There are three main stages for implementing a Maudsley or Family-Based Therapy (FBT) approach. The first stage is weight restoration. This phase is nearly guaranteed to strike fear into the hearts of even the most stalwart parents. The basis of this fear and trepidation, accordingly to treating professionals and parents active in the FBT approach, is a simple misunderstanding. Maudsley Parents, another parent support and advocacy organization, explains that the confusion comes in when a parent sees food as different from medicine. FBT treating professionals are able to clear up much of the confusion and fear when they explain to the parents that food is medicine, and as such it is both medically-prescribed and absolutely necessary for the reversal of the anorexic adolescent’s malnourishment.

During the weight restoration phase, the treating team, which often and ideally includes a medical doctor, therapist, dietician, and psychiatrist, coaches the parents on the proper administration and dosages of “food as medicine.” With coaching and support, parents learn how to empathize with the pain, fear, and anger their adolescent may express, while continuing to insist that the child take in proper dosages of the necessary medicine. Family mealtimes and parental supervision of caloric and nutrient intake is a vital part of the success of this phase. Simultaneously, siblings are taught how to support the patient, and the treating team works to help the patient reintegrate with siblings and with the family unit. Parents who persist and learn the skills necessary to successfully navigate the weight restoration phase find that it is tremendously healing and nurturing for both the patient and for the family unit as a whole.

The next phase is one parents will look forward to during the entirety of phase one, because in phase two parents begin turning control of eating back over to the adolescent. The family unit’s ability to transition to this phase is dependent upon the patient’s continued weight gain, acquiescence to continual increases in food intake, and a positive change in the demeanor and dynamic of the family unit. Often at this phase, everyone from the patient to the parents to the siblings is feeling relief that the eating disorder symptoms are being effectively and consistently addressed, and this relief changes the family interactions for the better, reducing resistance and strengthening resolve. Parents can then begin to give the patient more control over food choice and eating. There is a trust bond that is mutually demonstrated and earned again with each meal as parents see that the adolescent is both willing and medically able to make their own sound and healthy food choices. The patient is also able to eat away from the parents to such an extent as they are able to demonstrate the same healthy choices with friends, peers, and other family members that they do in the home. While this phase can feel stop-and-start especially at first, the entire family is encouraged by the patient’s progress through dependence to interdependence to eventual independence in making healthy nutritional choices and practicing effective body care.

During phase three, the focus moves beyond the food to a re-establishment of a healthy adolescent identity. This is the most exciting phase when parents, siblings, and the patient begin to see the real fruits of persistence with the FBT approach. Here, the adolescent is able to maintain 95% of their ideal weight consistently. Signs of desire or intent to self-starve have abated. The patient has newfound ability to navigate mealtimes with relative ease whether in the home or while out with friends or family. Privileges around food come back into alignment with other privileges that signal a growth from child to adolescent into the teen and young adult years. Often there is a much increased closeness within the family unit and signs of the fear, anger, and resistance that characterized much of phase one and into phase two have vanished (also easing residual parent concerns that phase one and two supervision may somehow irreparably harm the parent-child relationship – research results show that for most families the exact opposite is the case). With weight restoration and stabilization and mealtime autonomy also comes a willingness and ability on the part of the patient to look at some of the underlying triggers and issues that may have contributed to the anorexia. In phase three, the patient can begin or resume work with a therapist and other treating professionals to further discuss healthy life coping skills, identity development, and pursuit of life dreams and goals.

Emergence from phase three shows a young, bright, promising future where the anorexia used to be. The entire family continues to exercise vigilance even amidst beaming smiles and a huge, long sigh of RELIEF.

At Southlake Counseling, we have more than twenty years’ experience with successfully treating eating disorders, disordered eating, body image, self esteem, recovery, health, and wellness concerns in children, adolescents, young and mature adults. Our caring, compassionate, professional and highly trained staff partner with you and your family to smoothly navigate all three phases of the Family-Based Therapy (FBT) process. Discover how rewarding and satisfying it can be to become an active participant in your child or adolescent’s health and wellness by contacting us at www.southlakecounseling.com

Be Well,

Kimberly


Published on Monday July 26, 2010 in Eating Disorders. 0 Comments Tags: , , , .

Family-Based Therapy: Three Steps to Anorexia Recovery, Part I

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When I read the words “three steps to…” I usually think, “Oh, here we go. Someone is about to tell me that something very difficult is really very easy.”

Rest assured, that is not going to happen here. I am a licensed treating professional with more than two decades of experience treating eating disorders, but I am first and foremost a parent too, and I know that all individual or family-based positive change takes persistence, patience, effort, and time.

So what I am about to share with you is not easy at all – but it is very possible, and it is highly effective. In this two-part blog series on implementing Family-Based Therapy (also called the Maudsley Method) for recovery from anorexia nervosa, we will examine the reasons behind the newfound acceptance and popularity of a family-based approach to treatment, as well as the three steps every family will follow to implement family-based therapy in the home.

The role of the parent in eating disorders recovery has long been a controversial one. In the past, treating professionals have commonly regarded parents as, if not the main culprits, at the very least a large part of the problem. Parents have been cordoned off from the treating area, banned from the therapy room, locked out of the kitchen.

Today that thought process is changing. Efforts from concerned parents such as Laura Collins, the author of “Eating With Your Anorexic” and founder of the F.E.A.S.T. parent support and advocacy group, and treating professionals like Dr. James Lock, co-author of the “Treatment Method for Anorexia Nervosa: A Family-Based Approach,” have reassured parents that they do have a place in the treatment process – and a vital role that only a parent can fill.

Additionally, there is a growing body of scientifically-sound research that highlights the efficacy of involving the parent in the adolescent’s recovery. The message is clear – parents can learn, parents can help, parents are needed.

For parents of an anorexic child or adolescent, this is very, very good news!

For single parents who are concerned that the process won’t work without a parental team, there is even more good news. Recent research has shown that the FBT approach can work equally well with a single parent head of household. The main determinant of success is not dual parenting but rather parent education, commitment, and involvement in the process.

Stay tuned next week for Part 2 when we examine the three phases of FBT, what a parent can expect during each phase, and a big picture look at a typical outcome for families who adopt the FBT approach.

At Southlake Counseling, we have more than twenty years’ experience with successfully treating eating disorders, disordered eating, body image, self esteem, recovery, health, and wellness concerns in children, adolescents, young and mature adults. Our caring, compassionate, professional and highly trained staff partners with you and your family to smoothly navigate all three phases of the Family-Based Therapy (FBT) process. Discover how rewarding and satisfying it can be to become an active participant in your child or adolescent’s health and wellness by contacting us at www.southlakecounseling.com

Be Well,

Kimberly

Published on Monday July 19, 2010 in Eating Disorders. 0 Comments Tags: , , , .

Your Say Yes to Life Monday Motivator: The path to body peace is paved with good intentions

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In this final post of our three part series on examining body peace, it is time to acknowledge that our intentions have always been good.

Your intentions have always been good.

Not a one of us, when we were small, dreamed of growing up to hate our bodies. I know I didn’t!

While in other blogs I may write from a more objective, clinical space to help you better understand medical complexities in layman’s terms, in this series I am speaking to you directly from the heart.

I want you to know that I, too, had great intentions even while my eating disorder was getting worse and worse, and even when I feared I wouldn’t survive it. At no time in my journey to where I am today was I trying to develop a life threatening disease. I wasn’t trying to kill off my body. I wasn’t trying to worry those around me. I wasn’t trying to fail at life or destroy my potential to live it.

I developed my eating disorder for two reasons. One, I had a biological predisposition to do so. And two, I experienced a variety of environmental triggers that in turn triggered my own inner survival mechanism to  control what was within my power – my own body.

The path to body peace often makes several detours along the way, but there is never a lack of good intentions. In fact, after more than two decades of serving and supporting individuals to move from the dangers of an eating disorder and low body esteem back to the holistic health and wellness they desire and deserve, I can state with the utmost confidence that I have not yet met a person struggling with body dissatisfaction and eating disorders who didn’t have good intentions.

We mean well. We truly do. We are trying to make sense of a complex world full of complex choices and complex people. We are incredibly strong, and even while enduring experiences that might level others, we survivors have found a way to survive.

Now, it may be that the way we survived such experiences in the past no longer works for us now, but that does not take away from the fact that we survived them – somehow.

Again, we had the best of intentions.

So now, to seek and achieve body peace, it is time to re-examine our intentions in light of the new information we have that what we did yesterday or last year or ten years ago to survive is no longer the only or best option we have. It is no longer the path we wish to choose to get to where we want to go.

We are ready to try something new.

Knowing this, we can now make a new intention to choose a different path than an eating disorder or body dissatisfaction to manage life’s stressors.

Wow!

For instance, we can choose to seek help, and in so doing we can choose to work on the intentions beneath our intention to survive, which may include our intention to thrive, to love, to succeed, to connect, to experience, to accept ourselves and others as we are, to serve and give and also receive and appreciate all that life has to offer.

Again, these intentions have never changed – and they never will.

All that has changed is the path we now choose to get there.

At Southlake Counseling, we have more than two decades of experience with guiding and supporting individuals just like you to achieve and exceed your recovery, health, and wellness goals. We offer the full range of professional support services, from dietary and nutritional coaching to group support to wellness consulting to individual therapeutic sessions. Visit us to learn more about how you can put your wealth of good intentions to work for you in a positive, nurturing, self-respecting way as you say “no” to body hate and YES to life! www.southlakecounseling.com.

Be Well,

Kimberly


Published on Monday July 12, 2010 in Body Image. 0 Comments Tags: , , .

Your Say Yes to Life Monday Motivator: Without war, we wouldn’t know peace

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I know what you are thinking – where there is a will to avoid war, there is always a way.

I couldn’t agree more.

However, after more than two decades working in the clinical field as a trained health professional, it is clear to me that sometimes we are at war before we realize what war is.

At that point, it is time to call a spade a spade and take the steps necessary to return ourselves to the peaceful state we prefer.

For instance, I see many individuals who are suffering from an eating disorder. Anorexia, bulimia, eating disorders not otherwise specified, and binge eating disorder are increasingly common in today’s “War on Obesity” thin-obsessed culture.

Here is the problem we are facing – the world we live in glamorizes declaring war on our own body for the purposes of making peace with other dreams we hold dear – like the dream to be accepted, to be loved, to be successful. Somehow, without our probably even realizing it (I know I didn’t realize it when I was in the early stages of recognizing my own battle with an eating disorder 30 years ago!) we have adopted an internal belief system that states that where we desire peace, we must also accept war.

There is another way.

But for those of us who are suffering with an eating disorder, it is both useless and unproductive to spend time beating ourselves up for what we could have or should have done differently.  An eating disorder is a lethal psychiatric disease for which there are effective treatments, and just like any other disease it deserves our highest respect and the full complement of professional care.

So for those of us who are suffering from an eating disorder, or from other forms of body-war such as low body-based self esteem, poor body image, disordered eating habits, and reluctance to engage in life’s opportunities due to how we believe that we look, we must simply acknowledge that for reasons we may not even fully understand, we have declared war on our body, and we now instead desire war’s opposite – body peace.

Body peace IS possible. I know that it is possible because I too at one time declared war on my body, and I was able to turn my own ship around and instead declare first a truce, and then a state of peace, with my own body.

It is no one’s fault when an eating disorder develops. No one single factor causes an eating disorder to unfold. Eating disorders are a complex dance of biology, psychology, and sociology, and just like for any other disease, when all the causal elements are present in one place, an eating disorder is likely to arise.

What is then important is to turn our attention from focusing on the problem – the war we were waging on our body that we now must wage against our eating disorder – to the opportunity. The opportunity is the chance to get better, and in the process to fully understand our own weaknesses, strengths, motivations, dreams, beliefs, judgments, expectations, needs, and desires at a deeper level than we ever dreamed possible.

In short, we get the opportunity to examine what it feels like to be at war, and to use that example to try on a different state for size – a state of peace. We can literally use the feeling of war to remind us of what we do not want more of, and instead turn our attention to anything that feels unlike war – and use that as a guide to explore moving closer to a state of peace.

In that way, the war can even be a gift. It is a clear sign from within telling us that something is wrong and needs our attention. It is a flag of warning trying to get our attention, and we should thank it for its devotion to warning us now, before it is too late.

If you are suffering with disordered eating, low self esteem, low body esteem, poor body image, or unwillingness to engage in all that life has to offer due to how you perceive yourself in the mirror, you both need and deserve help and support.  I am living proof that there is a different way to live life – before I became a health professional, I experienced what it felt like to stand in those shoes, and that is how I know it is possible to break free.

I started Southlake Counseling, the first comprehensive eating disorders care facility in the Davidson area, for precisely this reason. At Southlake Counseling, our staff is more than just skilled, trained, and experienced. We are compassionate. We can empathize. We have been there and we know how it feels. We can help you say “no” to the precariousness of living life side-by-side with an eating disorder and instead say YES to life!

Don’t let another day go by where you live at war with the skin you are in. Remember, without war, we wouldn’t know peace. To learn more, visit us at www.southlakecounseling.com

Be Well,

Kimberly


Published on Monday July 5, 2010 in Body Image. 0 Comments Tags: , , .