Tag Archive for 'Eating Disorders'

If you want recovery, then CHOOSE it!

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If you won a free shopping spree to your favorite store, would you hesitate to redeem your prize? Absolutely not – you’d head right on over to the store, award in hand, to start shopping away!

But what if you were handed a free pass to recover from your eating disorder? Would you turn it in to collect your winnings or just leave it sitting on the kitchen table?

You are intelligent. You are resourceful. You are creative. You are determined. In other words, you already possess the winning lottery ticket of recovery.

But it avails you nothing until you redeem it.

Today’s affirmation: I can and DO choose recovery today!

From Frozen to Fantastic: Ten Tips for Tackling a Child’s Eating Disorder as a Family

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Eating disorders are bio-psycho-social illnesses. They are also very treatable. With the right treatment, in appropriate doses, at appropriate times, and for an appropriate length of time, they are even curable.

But medical limitations, patient reluctance, or even media messages are not the primary deterrent to recovery.

The number one reason patients do not get better faster is a plain and simple deficit of information.

In my more than two decades of treating and supporting both eating disordered patients and their loved ones, I have learned a great deal about the type of information that is needed to effectively mobilize a family around a child who is suffering. This article addresses ten key learnings that can take your family from frozen to fantastic in how you collectively band together to combat a child’s life threatening illness.

The first key learning is – do not blame yourself. And do not blame your child. It is nobody’s fault when the biologically-based illness that is an eating disorder arises, in the same way that it is nobody’s fault when a child develops leukemia or autism, or an adult woman develops endometriosis. What is needed and effective is not blame, but rather action in the form of appropriate professional care and informed family and community support.

The second key learning is – an eating disorder is a bio-psycho-social illness with genetic links. Eating disorders have their underpinnings in a biological brain imbalance that results in the affected individual processing the presence of nutrients differently than someone without that imbalance would. As the National Eating Disorders Association states, “biology loads the gun, and environment pulls the trigger.”  In the thin-obsessed culture we live in today, there is a clear biological reason why not every exposed individual develops a diagnosable eating disorder. Not everyone is at risk, because not everyone carries the genetic linkages that predispose an individual to develop an eating disorder. Those who develop an eating disorder are life-threateningly ill and require prompt and comprehensive care.

The third key learning is – do not panic. Instead, learn all you can.  Getting educated by reading high quality books and visiting nonprofit and medical websites that contain accurate information about eating disorders will help you and your family understand what you are dealing with, in the same way that a diagnosis of breast or prostate cancer might prompt the affected individual and their family to carefully review current treatments, options, success rates, and risks involved. In the case of an adolescent who is affected, the responsibility clearly rests with the parents to do the homework necessary to pick the best course of care. The more you are able to learn about what to expect, the timeline involved in recovery, what works better in which kinds of cases, and who in your area has expertise in treating eating disorders, the less energy you will waste in fear, indecision, self doubt, and frustration with the recovery process.

The fourth key learning is – get help. Do not attempt to self-diagnose or self-treat an ill child or loved one. Eating disorders are the most lethal of all psychiatric-based diseases. They are treatable and even curable – with appropriate professional care. For adolescents in particular, learn as much as you can about newer cutting edge protocols such as Family Based (Maudsley) Method (FBT) or Dialectical Behavioral Therapy (DBT), both of which have shown excellent results in improving symptoms and returning the affected individual to a healthy state.

The fifth key learning is – don’t forget about your own self-care needs. Supporting your child will take an incredible amount of time and energy. There will be times when you will feel hopeless, exhausted, frustrated, confused. To avoid burning out during each leg of the recovery process, remember that you can accept support and you deserve support . You are working as hard as your child, albeit from a different perspective, and you need to apply good self-care or you will not have the stamina you need to see the recovery process through to its successful conclusion. Seek out supportive groups online or in your area – for example, FEAST-ED.org is an excellent parent support site that offers parent-to-parent mentoring via an online forum called “Around the Dinner Table.”

The sixth key learning is – shame has no place in recovery from any illness, including an eating disorder. We have come a long way from the “don’t ask – don’t tell” generation our parents and grandparents labored under. We know so much more now about what causes psychiatric illness and how to help affected individuals and their loved ones navigate the recovery process. Whether it is cancer, loss, unemployment, divorce, or another personal tragedy, no one is a stranger to the need to recover from life’s unexpected challenges. With your acceptance and validation of your child’s illness, you strengthen your child and your entire family to own the challenge ahead as a learning process and a chance to grow stronger. Don’t let shame rob your child and your family of that energizing and motivating gift.

The seventh key learning is – remember that your child and your child’s illness are not one and the same. Your child is a unique, wonderful individual with endless promise and potential. Your child’s illness is something that he or she struggles with that requires appropriate treatment to overcome. They are two different things. It is important to start immediately to emotionally separate out who your child is from what your child is struggling with. Love the child, treat the disorder – they are not one and the same.

The eight key learning is –DO NOT WAIT.  An eating disorder will not suddenly get better or go away if ignored. Pretending the disorder is not there may cause the child to hide the symptoms out of shame or fear, but disappearance of symptoms is cause for increased rather than decreased concern. Act immediately the moment you see the first sign of symptoms. Research has shown that the sooner an eating disorder is intervened upon, the faster and shorter the recovery period will be.

The ninth key learning is – make sure the treatment you choose is evidence-based. What this means is that, with the wealth of options available today, it is easy to get confused about what is the best choice for your child. Go with where the evidence is. Interview medical professionals and ask for success rates. Contact nonprofit and professional organizations and ask to read recent medical journal and research reports concerning treatment protocols you are interested in pursuing.  Talk with other families about what worked for them. Ask medical professionals for references and call those references to find out what their experiences have been like. Most of all, seek a treatment protocol for your child that is well researched and shows consistent positive results. Treatment is expensive no matter what route you choose, so go for what works.

The tenth key learning is – never discount the transformative power of unconditional love. As the disease takes hold, you may find yourself thinking, “Is this my child?” The answer is “No.” The voice of the disorder at work within your child’s brain may create a different relational dynamic for awhile, as her relationship with food and fear changes and then changes again throughout each phase of the recovery process. Fear is a powerful agent, and may produce bouts of rebellion, resistance, even rage. But underneath any show of resistance, bravado, or anger is a frightened child who is doing her best to understand what is happening and figure out what to do about it. It is no different than the brain changes a bout of chemotherapy or radiation might cause – it is temporary, and reversible with application of proper nutrient levels that produce brain re-balancing with a corresponding return of emotional stability. Love your child, treat the disease, fight it together as a family.

At Southlake Counseling, we have more than two decades of expertise in treating adolescents and families affected by eating disorders. Our specializations include Family Based (Maudsley) Training (FBT) and Dialectical Behavioral Therapy (DBT). Our founder and staff received training directly from Dr. Nancy Zucker, the director of the Duke University Eating Disorders Program, which incorporates both FBT and DBT protocols in their highly successful family-based treatment program. Our clinical director has also received training directly from Dr. Locke and Dr. Le Grange, authors of Helping your Teenager Beat an Eating Disorder. At Southlake Counseling, we have seen firsthand how families that recover together grow closer and stronger together. We encourage you to reach out for help and experience the difference expert, compassionate professional care can make in your family’s life. Visit us today at www.southlakecounseling.com to learn more.

Be Well,

Kimberly

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


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

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