Your Say Yes to Life Monday Motivator: Making Peace with Your Body

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When I was struggling through the recovery process to overcome my eating disorder, the word “peace” was never found in the same sentence with the words “my body.”

Yet today, I am able to see and support my body in all ways with a feeling of peace and also with gratitude for all that my body does to support me.

You may be reading this – or may even be tempted to skip reading this – for precisely the same reasons I would have been tempted to skip it when I was in the midst of the recovery process.

“Make peace with my body?” you may be thinking, “Impossible.”

But it is not impossible. You have my word on that.

Now, is it easy? No.

Does it happen overnight? Nope.

Does everybody achieve it? Not by a long shot.

But we all have the potential to make peace with our body, to love our body as it is, for all that it is. In fact, making peace with our body is good practice for making peace with ourselves!

But it is up to us. We get to choose how we will go through this life – how we will feel about all things “us” – starting with the physical expression of our uniqueness that we call “my body.”

In this first of a three-part blog series, we will examine some basic concepts that can be helpful no matter what your current state of health or fitness may be. In following posts we will devote more time to examining special instances where making peace with your body is even more critical – for instance, if you suffer from a health condition like an eating disorder.

But first, I want to share some of my favorite basic self-assessment tools that can help you get started on the path to lasting body peace and acceptance.

In my own experience as both an eating disorder survivor and as a professional working in the field, I have found that it is critical to assess where you are as a measure of what is not working and a tool for defining what you want.

So if, in this moment, you and your body live either completely or somewhat at odds with each other, then take a moment to examine where you fall in relation to the statement, “I accept and love my body unconditionally.” What comes to mind first when you read that statement? Jot it down.

Now you know where you are. You just put a dot on your own map – “you are here.”

Next, you have to figure out where you want to go – not where you think it is reasonable to go, or where you think it is possible to go, but where you would like to go. What are your goals when it comes to body peace? Do you long for total body confidence? Total body acceptance? Total body love?

Take a moment and jot down any goals that come to mind. Now you know where you want to go. You have put another dot on your own map – “your destination is here.”

Next, it is time to take a look at what seems to be standing between you and your goal. In other words – if you do not at this present time totally accept and love your body peacefully and unconditionally, then what could help you to do that safely?

It is also of critical important to be realistic here. Otherwise it is easy to set yourself up for failure by reaching for a goal that is literally impossible to achieve, whether due to genetic body type and features, health needs and requirements, or some combination thereof.

When you are done applying these basic assessment tools, you will have a roadmap of sorts that lays out on paper where you are now, where you want to go, and some of our own ideas about how to get there.

The next step is to identify safe, healthy, and affirming tools to help you get there. While it is possible to do this work on your own, it is always advisable to take help and support from knowledgeable professionals as well as family and friends while you are on the journey. Making the transition from body-hate to body-peace can be physically, mentally, and emotionally challenging, and having a knowledgeable, skilled and compassionate support team in place assures the highest chance of success.

At Southlake Counseling, we have more than two decades of expertise in helping people just like you to meet their recovery, health, and wellness goals, including transitioning from a place of total body non-acceptance and hatred to a space where the body is loved and accepted as a valued friend and protector. If you are having difficulty setting and meeting your body-peace and acceptance goals, contact us. We have been there. We know how it feels. We can help. www.southlakecounseling.com

Be Well,

Kimberly




Published on Monday June 28, 2010 in Body Image. 0 Comments Tags: , , .

My Steps to Recovery – Saying No to ED and Yes to Life!

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I have been asked numerous times over the last twenty years about HOW to recover from an eating disorder and IF it is REALLY possible.  I am here to tell you that Recovery is not only possible, but can become a reality for you, too.

In honor of Mental Health Month I wrote this post to answer that question and to give you some words of encouragement – I recovered from an eating disorder after suffering for over 8 years and now use that experience to help others recover.  My way was only my way and no indication of what will work for you, but my experience may give you some ideas for recovery, as it does contain things I often find useful in working with my clients.  Recovery is a very personal experience, so take what you can use and leave the rest.

What did it take to stop?  Honesty, openness, and willingness. And a lot of hard work and persistence.

Has it been worth it? Absolutely. Today I am free of being controlled by unconscious urges with food and compulsive exercise.  I know how to respond so I don’t have to engage in the behavior. I am more self-aware, healthy, and centered. I also realize that food is just food and weight is just a number on the scale.  Neither can bring me true happiness. And I have finally accepted people don’t like me or dislike me because of my body, but because of who I am as a person.

Is it perfect? No, because perfect doesn’t exist, and I live in a world where focus on body, diet, and perfection is idealized. I need to maintain a certain acceptance, willingness and awareness. But this is such a small price to pay for having freedom.

How did I do it? I am actually working on writing the story of my recovery, but to give you the shortened version, this is what I did and the steps I took.

1)     I accepted that I had an eating disorder and I needed help.  I also came to realize it was not my fault, and I had no need to feel ashamed. An eating disorder is a real medical condition. I didn’t ask to have one, I just developed it due to a combination of many factors; genetics, triggering events, family issues, and peer pressure.

2)     I retired my “Cinderella Complex” and came to accept and realize that no one was coming to save me.  I would have to develop responsibility for saving myself.  Looking outside myself was not the answer, I had to look within and discover my true self.

3)     I came to understand that although it was not my fault, it was my responsibility to do whatever it took to learn to control the urges I had and the actions I took. Thus, I needed to make a decision on how I was going to approach the problem and then begin to do it.

4)     I decided that I would do whatever it took to reach recovery and regain my life. I reached a point where I realized that living with an eating disorder was really no way to live. I could learn to eat in a healthy way, manage my urges, and learn to tolerate my feelings without necessarily acting on them. As Goethe once said, “The moment one definitely commits oneself, then providence moves too. All sorts of things occur to help one that would never have otherwise occurred. A whole stream of events issue from the decision, raising in one’s favor all manner of unforeseen incidents and meetings and material assistance which no man could have dreamed would have come his way. Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it. Begin it now.”

5)     I took the time to educate myself and learned all I could about eating disorders and what was needed to live without one.  I fully accepted it wasn’t about the food or the weight. I accepted that I couldn’t do it alone and that I needed to practice humility and ask for help.  Being responsible for my recovery didn’t mean I had to do it on my own.  I could be vulnerable, admit my imperfections, and live to tell about it.  I could also allow people to help me.

6)     I did self-monitoring for 6 months, an average of five days a week. I learned SO much about myself, my patterns, and my responses to situations, whether I was tired, lonely, angry, or feeling anything else.

7)     I took medication to moderate my anxiety and depression – it didn’t help me to eat, but it enabled me to lift the depression and anxiety I had experienced since childhood, so I could stay motivated with my practice of all the tools I had learned from others, and developed on my own.

8)     I began to focus on the things in my life that were the most important to me and surrounded myself with positive and encouraging people. I learned to identify my true feelings, and noticed that if I expressed myself in appropriate ways, and set good boundaries, I was less likely to be triggered.  Self-care became a huge part of the process.  I learned how to put myself and my needs first and let go of feeling guilty when I said NO. I practiced  meditations, relaxation techniques and learned to enjoy exercise as a way to move my body rather than punish myself for what I had eaten.

9)     I decided that I was willing to accept that this might take a while, but what did I have to lose?  I could either keep living the way I was, which was in misery, or I could begin to practice all the things I was learning and take some risks.

10) I Learned not to beat myself up when I did slip. I came to realize that we DO slip on the road to recovery, or most of us do. So learning to be a little(or a lot)  more compassionate and accepting with myself was a big part of the process.

11) I Learned to measure my recovery not by the scale, but by how fast I got back on track with my life, how little I berated myself, how much I was able to congratulate myself and enjoy all of my accomplishments.

12) I kept a gratitude journal.  In the deepest darkest days of my depression, anxiety, and ed behaviors I didn’t think there was anything to be grateful for.  I was wrong.  When I began to focus on all that I was and everything that I had, a small light started to shine.  As Helen Keller said “Keep your face to the sunshine and you will not notice the shadows.”

13) Even after my symptoms subsided, I stayed in therapy to discover my true self, who I was without the eating disorder.  How could I be myself if I didn’t know who I was? Look for my upcoming book… How can I be myself when I don’t know who I am TM.

14)            I found a passion and purpose for being- my career and helping others recover and focusing on having my own family. Finding a reason to recover was important.

15) Today I live with the full understanding that yes, my eating disorder could come back at any time. However, this way of life has become an opportunity for self-growth, centeredness, awareness, and acceptance. Today, I have the tools I need and the commitment to use them.  Every day, I Say Yes to Life !

The good news is there really are pathways out of being controlled by ED and other compulsive behaviors. The challenge is that it takes time, commitment, awareness and practice. But then, to be good at anything usually does. I have lived many years free from Ed behavior and am lucky enough to work every day with amazing people who are also on this journey.  If you are on this path, struggling, or just need someone who really understands, give me a call.

To your success and happiness,

Kimberly

Kimberly Krueger, MSW, LCSW is a therapist and the founder and director of Southlake Counseling and The Center for Self Discovery in Davidson, NC. Kimberly may be reached at kkrueger@www.southlakecounseling.com

Southlake Counseling is Lake Norman’s leading behavioral health treatment center, providing a full range of clinical services to children, adolescents, and adults. Southlake services include therapy, psycho-educational and psycho-social assessment, consultations, health education, nutrition, wellness and coaching programs for those suffering emotional, behavioral, health, and educational challenges.


Published on Monday June 21, 2010 in Eating Disorders. 0 Comments Tags: , , .

Your “Say Yes to Life” Monday Motivator: Staying Away From the Borderline

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May is Borderline Personality Disorder Month. This month, in honor of this important topic, we began a new blog series that focuses on the nuts and bolts of borderline personality disorder (BPD), and each week in May we will address a different aspect of recovery from this highly treatable disorder.

This week, we look at the role of the professional in the recovery process.

Perhaps no other disorder has been so extensively misunderstood, misdiagnosed, or misrepresented as BPD, so much so that mental health professionals are often reluctant or downright resistant to working with BPD sufferers. “I stay away from the borderlines,” one professional was heard to say at a recent conference.

Three decades ago, before the creation of Dialectical Behavioral Therapy (DBT) by Dr. Marsha Linehan, a response like this would have been more than understandable. However, in light of all the resources professionals have at their disposal today to treat BPD sufferers, hearing this at a conference in 2010 is puzzling.

BPD is essentially a disorder of relationships. As such, understanding the nuts and bolts of how the disease arises and what sufferers need to overcome its effects can go a long way towards reducing stigma and offering sufferers the type of professional treatment they need to get better.

According to the National Education Alliance for Borderline Personality Disorder (NEA for BPD), representative BPD symptoms include:  fears of abandonment, intense mood shifts, impulsivity, problems with anger, recurrent suicidal behaviors or self-injurious behaviors, and patterns of unstable and intense relationships that often create chaos in the lives of sufferers and their families.

In short, individuals with DBT can’t stand to be with themselves, inside their own intensely emotionally-charged skins, but through their behaviors they often recreate the very relational abandonment they fear, which exacerbates their symptoms, and so on and so on. It is thought that the stage is set for BPD, which is often diagnosed in early adulthood and primarily in females, through early emotional invalidation with a possible genetic biological component.

What is most important for professionals to know, however, is that it is highly treatable.

Even with this awareness however, one initial challenge treating professionals will face is to separate out BPD symptoms from other frequently co-occurring disorders. As the NEA for BPD reports, borderline symptoms rarely occur in isolation, and are frequently exacerbated by other concerns such as substance abuse, eating disorders, depression, anxiety, and bipolar disorder. While individuals suffering from BPD symptoms are often medicated, it is also important to know that no medication has been specifically approved for use to treat BPD symptoms as of yet.

Additionally, there are many ways in which the core symptoms of BPD can manifest, and those symptoms may vary based on each individual’s background, life experience, and prior treatment experiences. With an estimated 2% of the population suffering from BPD symptoms, it can quickly become a source of professional frustration to find one method to treat so many individual cases.

This is where Dialectical Behavioral Therapy (DBT) comes in. Dr. Marsha Linehan, the founder of DBT, categorized the six major categories of BPD symptoms into four skills-building modules. These four core modules include Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. DBT, while used today to treat a variety of mood-based disorders, was created specifically to treat individuals with borderline symptoms, and is scientifically proven to be a highly effective and lasting treatment approach.

Dr. Linehan’s goal when developing DBT was not to separate out, categorize, and individually address all 200+ permutations of the core BPD symptoms. Rather, she aimed to – and succeeded at – identifying instead the four core areas of coping skills that were missing from each BPD sufferer’s internal life coping toolkit. BPD sufferers all struggle to maintain mindfulness about who they are and how they fit in with others. BPD sufferers all wrestle with regulating their emotions and managing feelings of distress. BPD sufferers all have trouble developing trust-based, healthy relationships with themselves and with others in their lives.

In summary, BPD sufferers can all benefit from the four core modules taught through DBT.

For sufferers, loved ones, and referring or treating professionals, DBT is a bright light of practical hope amidst the darkness of a struggle against BPD symptoms.

At Southlake Counseling, we have more than two decades of clinical expertise in treating individuals with BPD symptoms through our DBT outpatient programs. Our combination of individual and group support, with additional phone support if necessary, puts BPD sufferers on the road to lasting recovery. We are happy to talk with loved ones and referring professionals about how DBT skills-building treatment can positively intervene in the life of someone struggling with BPD. We have expertise with adolescents, females, and males and offer individual and group support for individuals at each stage of the recovery process. Visit us at www.southlakecounseling.com – we look forward to hearing from you.

Be Well,
Kimberly

Published on Monday May 24, 2010 in Borderline Personality Disorder. 0 Comments Tags: , , , .

Your “Say Yes to Life” Monday Motivator: Making It Across the Borderline

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May is Borderline Personality Disorder Month. Last week, in honor of this important topic, we began a new blog series that focuses on the nuts and bolts of borderline personality disorder (BPD) and each week in May we will address a different aspect of recovery from this highly treatable disorder.

This week, we look at the role of the family in the recovery process.

If your loved one has been diagnosed with borderline personality disorder (BPD), you probably reacted initially with equal parts relief and consternation.

The relief? “Well thank goodness we at least have a name for ‘it’ now!”

The consternation? “What can we do to help?”

The good news is that effective treatment is available. Two decades ago Dr. Marsha Linehan developed a (then) new therapeutic process known as “Dialectical Behavioral Therapy” or DBT. DBT was specifically created to effectively interrupt the BPD emotional cycle and replace those thoughts and behaviors with new coping skills. Students of DBT learn new skills in four core modules – Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. While DBT is used to treat a variety of mood-based disorders today, it was specifically designed to dramatically improve the lives of those diagnosed with BPD.

Family members and loved ones are also an important part of the individual’s recovery process, and knowing how to effectively participate can go a long way towards ensuring eventual full recovery.

In the absence of guidance, it can be tempting for family members and loved ones to pull away, thinking that less is more, and at least the person will not be harmed by the wrong kind of support.  However, this will be perceived by the individual suffering from BPD as yet another instance of abandonment, exacerbating symptoms and delaying recovery.

What is needed instead is a two-pronged approach beginning with the realization that no family member or loved one, no matter how well-intentioned, is equipped to manage the recovery process of an individual diagnosed with BPD. BPD is a serious, potentially fatal disease, and is worthy of both the highest respect and comprehensive professional treatment. BPD is not a self-willed disease – in other words, the sufferer cannot help their behavior outside of the intervention of trained professionals who know how to help break through the emotional gridlock inside and guide the sufferer to safety.

So the first step to take as a concerned family member is to ensure your loved one is receiving appropriate and adequate professional medical treatment.

Once this first step has been addressed, family members are now able to join in to support the individual through the recovery process. The National Education Alliance for Borderline Personality Disorder (NEA for BPD) has issued specific guidelines to help family members and loved ones participate effectively and constructively. A brief overview of these guidelines is found below and more information can be obtained on the NEA for BPD website at www.borderlinepersonalitydisorder.com.

The first recommendation is to “go slowly”. In other words – in the initial stages, fear of change and fear of abandonment through change is very high in the mind of the sufferer, who may exhibit resistance to treatment and change for precisely these reasons. This is not unique to a BPD sufferer – family members can build their “patience muscles” by considering areas of their own lives where change is both needed and feared. The NEA for BPD also advises family members to refrain from encouraging the sufferer with “you can do it” messages – these may increase anxiety and slow actual progress. Rather, family members are encouraged to eschew overt praise at noticeable progress and instead validate the hard work involved while still empathizing with how difficult the change process must be. Wrapped in with this is an encouragement to avoid discussion of achieving big goals – again, family members can flex their patience muscles by contemplating how desired change has happened in their own lives, and by setting small, realistic goals for the sufferer with the help of the professional treatment team.

The second recommendation is to modify the home environment in any way necessary to achieve what the NEA for BPD calls a “calm and cool” environment. This may mean something as simple as maintaining predictable daily family routines. Other ideas that are effective are making efforts to moderate intense emotional displays (whether positive or negative), minimize defensiveness in response to the individual’s thoughts and behaviors, and set limits on what will and won’t be tolerated to preserve the sanity and safety of the family unit.  Becoming educated about BPD symptoms and fears – for example, intolerance of being left alone, inability to discern “grey” emotional areas, and inability to self-sooth – will also assist family members with developing patience, compassion, and appropriate responses throughout the recovery process.

Finally, the NEA for BPD urges family members to seek prompt professional attention for BPD-related behaviors, such as self-harming, self-medicating through alcohol or other substances, or suicidal thoughts or behaviors. These behaviors are serious and reflect an intolerable inner environment that requires immediate professional intervention. Getting the sufferer prompt attention preserves not just safety and sanity but paves the way for development of secure emotional bonds that lead to eventual full recovery.

At Southlake Counseling, we have more than two decades of clinical training and experience implementing DBT-based treatment programs. Our wealth of individual and group support for males and females, adolescents and adults is unique in the Davidson area. If you or someone you love is exhibiting borderline personality disorder symptoms, contact us today at www.southlakecounseling.com to find out how DBT-based treatment can help.

Be Well,

 Kimberly

Published on Monday May 17, 2010 in Borderline Personality Disorder. 0 Comments Tags: , .

Your “Say Yes to Life” Monday Motivator: On the Borderline

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May is Borderline Personality Disorder Month.  In honor of this important topic, we will spend the month of May addressing different aspects of recovery from this highly treatable disorder.

This week we will focus on the nuts and bolts of what borderline personality disorder (BPD) is, what treatments are available, and recommendations for finding support for yourself or a loved one.

Just hearing the phrase “borderline personality disorder” can strike fear into the hearts of the most resilient loved ones.

But for the individual who is diagnosed with borderline personality disorder (BPD), there is probably just a question mark where comprehension should be. This person is probably thinking, “BPD? What is that? This is just how I am!”

Therein lies the difficulty in accurately diagnosing, assessing, and treating BPD. To the professional untrained in BPD treatment, a sufferer can seem like an exercise in unpredictability, not to mention a source of continual professional self-doubt and frustration.

To the loved ones, often unwittingly caught in the disease’s trap along with the sufferer, BPD can appear as a nightmare of confused interpretations that never ends.

To the sufferer, it is just another day in a life filled with emotional pain.

Statistically-speaking, studies indicate that 2% of the population is thought to suffer from BPD. Additionally, up to 20% of all psychiatric hospitalizations stem from BPD. It is thought that nearly three-quarters of all sufferers are female, which is why current research and treatment continues to focus on females.

But what is it? What does “borderline personality disorder” even mean?

Simply put, BPD places the individual at odds with her own emotions. Emotional ups and downs are experienced as equally painful, chaotic, and unmanageable. Any other symptom traditionally associated with BPD can be traced back to this internal emotional war. Because the emotional instability is so severe, BPD is considered both serious and life-threatening. Self-harming and suicidal thoughts and behaviors are common. Relationships are a continual challenge due to continual mood swings and poor sense of self-identity. Treatment is a must – for the sufferer’s sake, and for the sake of those around them.

What causes BPD? While research is not yet able to pinpoint the exact causes, one thing is clear – it is not a self-willed disorder, and it is not the sufferer’s fault. Newer scientific evidence strongly points to a dual dance of biology and environmental triggers. For instance, while studying the brains of individuals diagnosed with BPD, researchers noted higher activity in parts of the brain that control emotional expression and experience, including the limbic system, the brain’s emotional processing center. For these and other reasons, it is widely thought that BPD-predisposed individuals’ brains differ not just in function but also in structure. This evidence also illuminates one possible reason for the tendency the disorder has shown to run in families.

Environmentally, an individual is considered at higher risk for developing BPD after experiencing childhood trauma or an invalidating emotional bond with early caregivers – or both. Since the disorder tends to first show itself in early adulthood, environmentally it appears that an earlier experience of traumatic emotional invalidation is a key factor in determining who is at risk for BPD later on in life.

But while it can be tempting to spend vast amounts of time digging into a sufferer’s past for clues as to why BPD has developed, the most important call to action is to get that person HELP.

Up until a few short decades ago, treatment options were scarce. But thanks to the pioneering work of Dr. Marsha Linehan, the founder of Dialectical Behavioral Therapy (DBT), there is much hope for successful treatment of this persistent and often resistant disorder. Dr. Linehan developed DBT specifically for the treatment of individuals suffering from BPD after studying their symptoms extensively and determining a range of four core building blocks needed to successfully overcome the disorder.

This is good news for sufferers, loved ones, and professionals. Sufferers who become students of DBT learn key coping techniques in Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. These four core modules are introduced over a period of time in an atmosphere of comprehensive individual and group support, including extra phone support if needed. The end result is an individual who is equipped with all the tools and resources she needs to combat her tendencies toward emotional overextension and self invalidation. Since the instruction is done in a nurturing and emotionally-validating environment, the individual is repairing old hurts while learning new skills, and emerges a stronger, more confident person within herself and in her interpersonal relationships.

If you or someone you love is exhibiting signs and symptoms of BPD, it is important to seek help immediately. BPD is a serious disorder and deserves the highest respect. Do not attempt to manage symptoms of BPD for yourself or a loved one. The professionals at Southlake Counseling have dedicated more than two decades to proficiency in supporting individuals with borderline symptoms through the recovery process. We are here to help. Southlake Counseling offers a wide variety of DBT-based individual and group support, including phone support. Our support groups are offered for both females and males, adolescents and adults. Our comprehensive DBT outpatient program is designed to make immediate, measurable progress in reduction of symptoms and improvement in emotional functioning. Visit us at www.southlakecounseling.com to learn more.

Be Well,

Kimberly


Published on Monday May 10, 2010 in Borderline Personality Disorder. 0 Comments Tags: , , , , .