Written by: Jenn Burnell MS, RD/LDN CEDRD of Carolina House and CRC
I had the opportunity to attend my first MEDA conference this past week. So many local and national experts shared their insight and knowledge on a variety of eating disorder topics. What a wonderful experience to witness a local non-profit bring together so many wonderful resources!
So what can I share with you from this conference that may help you better understand eating disorders, or make you a better clinician? Unfortunately I could not see all of the sessions, but here are three messages you can take with you even if you weren’t at the conference.
The MEDA conference theme this year was, “Spring into Action: Infusing Creativity and Flexibility into the Eating Disorder Field”. The conference reminded is that we all have different brains that are wired to make us who we are. Some of these wires may cross in a way that can predispose one to an eating disorder, mood disorder, substance use disorder or any combination of these. However, understanding how we all tick and learning the creative, flexible and innovative ways to help others (or ourselves) is key to being an effective practitioner. Our role is to help individuals lead a rewarding and fulfilling life, knowing that everyone’s journey is different.
Working in the eating disorder field is such an amazing thing, and I am proud to have shared time with so many passionate individuals on cold and (dare I say it) snowy Boston days. Looking forward to MEDA 2016 already!
The presentations from MEDA’s Conference are now posted online for those who attended the Conference. Visit http://medainc.org/events/national-conference/ to gain access to the presentations. Also, MEDA will be posting RFP’s soon for their 2016 National Annual Conference. Stay tuned and check www.medainc.org frequently.
Body image VS Self image
By Camille Malecha, MA, LPC
Eating Disorder Specialist at Timberline Knolls
Imagine a completed puzzle that represents a person’s self-image. This picture consists of many pieces, since self-image is linked to personality, social roles (son, daughter, friend, or employee), physical appearance and existential statements. That final component refers to more nebulous concepts such as possessing an important place in the universe and being part of the whole. Now envision the cluster of puzzle pieces that represent body image. This is how a person perceives their physical person, primarily how it looks. Body image is extremely appearance-focused.
Here is what can happen when a person has an eating disorder: the body image pieces become the entire puzzle. Everything else that makes them who they are pales in comparison to the focus that is now placed on the physical person. This individual can become consumed with how they look and the perception is usually about 100 percent negative.
If strongly encouraged to point out a single positive aspect about their bodies, a person might say they have nice hair or a nice smile. But the positive recognition will rarely be below the neck.
The eating disorder can compel the person not to be just body-focused, but body-obsessed. Even if able to recognize positive qualities, or receive compliments from others, they often discredit the positive and immediately return to the negative. This low sense of self-worth is often what drives the eating disorder behaviors and keeps an individual stuck in shame and blame.
The goal of treatment at Timberline Knolls is two-fold. First, we want to move the person into a place of body acceptance, to simply accept their body the way it is. This doesn’t mean they approve, or even like, their body. We want them to embrace the reality that this is the one they have been given. As such, certain behaviors must be embraced to keep this body alive and healthy.
The second goal is to shift focus away from the body and more fully onto the self. We want them to see that they are so much more than what they look like. This realization gradually moves them from the negative to the positive.
We start with a daily practice of challenging negative distorted body image and self-image thoughts and using positive affirmations. We want a person to display gratitude and appreciation for all the body can do and find time throughout the day to say or write affirmations about self and body. Often times someone doesn’t go from hating themselves or their body to love. It is a process that can start with appreciation, move into acceptance, and then shift slowly towards having a love for self and body.
And finally, we want each person to know that they have great value, simply because they exist.
There is a reason they are on this earth; it might not be immediately clear what the role is, but what we know absolutely is their value is not connected to what they look like.
Are you struggling with body image? Would you like to learn more about Timberline Knolls and what is offered for eating disorder treatment? Check out www.timberlineknolls.com or call MEDA at 617-558-1881.
By Amy M. Klimek, MA. LPC
Eating Disorder Program Coordinator, Timberline Knolls Residential Treatment Center
By now most of us are well aware of the possible negative aspects of social media sites. Because these sites are visually driven; even the most savvy or secure people can get caught in the trap of comparing themselves to others, especially when it comes to size.
To avoid getting caught in rapid fire self-defeating thoughts, try to focus on the intention regarding how you use social media platforms.
The first aspect of intentionality is time. It is very beneficial to decide in advance how much time will be allocated each day to social media. Think about it: in professional life, you may get one hour for lunch; in personal life, you may decide to exercise for 30 minutes or one hour. Why not place a boundary for your time spent on social media? Get on, take care of business, and then get off.
In terms of intentionality, seriously examine your motivation— what purpose do social media sites serve your life? Do you use these platforms to connect with others, stay empowered, and build positive experiences with family and friends? Or do you explore sites that bring up self-defeating, judgmental thoughts about yourself, your body, and your life choices?
Toward that end, try to keep a finger on your emotional pulse. After 15 or 20 minutes of engaging; do you feel depressed and inadequate, or positive and energized? If you are experiencing the former, then intentionally log off. You have the choice to give yourself permission to take a break. Notice if your mood improves.
The intentional act of noticing gives you time to control your focus. Are all your Pinterest pages concerned with topics such as dieting, improving appearance, and weight loss? If so, take this opportunity to notice and make changes to building positive experiences instead of finding ways to change yourself.
If you have someone in your life who is profoundly judgmental, shaming or lacks compassion, consider unfriending them. There is no reason to constantly expose yourself to negative or unedifying input.
Do you only post great photos of yourself? What if you do not receive as many favorable comments as you had hoped?
Intentionality extends to what you put out in the world. Perhaps it is time to focus more on your passions and pursuits—who you are in opposition to what you look like. Can you align your time, pins, and status updates to your values, truths, and self defined beauty? With just a few changes, imagine how your outlook on life and opinion of yourself might improve.
Check out our latest post, courtesy of one of our excellent Partner Facilities, Carolina House (part of CRC Health Group)
Food as Communication
Jenn Burnell MS, RD/LDN CEDRD
CRC Health Group
As the Holiday season is setting on the horizon and a new year begins, it is natural for us all to do some reflection. In thinking of all the meals that were shared over these past few weeks, for most, those memories bring feelings of joy and happiness shared with friends and family. Yet for those struggling with an eating disorder, it may be memories of anxiety or even trauma.
The association between food and emotions is evident for everyone, and often are both positive and negative. Try to think back on your favorite food as a child, and try to remember the taste of it – do you notice any emotions come up? Do you automatically smile? For me, I think of my Nana’s oatmeal cookies, and can literally taste the love in them. But for someone who has an eating disorder, those memories may be clouded by fear or distorted thoughts around that food. If there was constant fighting at the dinner table, or comments thrown in their direction about how much they were or weren’t eating, those connections can have long term effects on those meals or those foods. The simple pleasure of breaking bread with loved ones becomes overshadowed by the haunting thoughts of an eating disorder.
While the phrase, “eat to live, don’t live to eat” may have some validity, I think taking that message too literally can have people indeed miss out of the part of living that involves food. The process of making food, sharing food, and eating food with others is an inevitable part of our culture, and a significant part of living that is missed by those with eating disorders. Thus, when recovering from an eating disorder, it is critical not just to challenge those voices of negativity, but also help make food represent a positive source of emotions and a way to communicate love.
Dani Black, the Chef at Carolina House, plays an integral part of that transformation for those seeking eating disorder treatment in the Durham, North Carolina facility. When first entering treatment, the emotions attached to being in the kitchen may be ones of fear and anger. But over time Dani and the culinary staff witness food become a conduit for sharing laughter, camaraderie and thanks. “Working together in the kitchen is a nice way to put food in its proper place.” Dani says. “ We are learning to give and receive help, to work towards a common goal. So food IS simply nourishment, but our bodies and minds crave much more than ‘just’ food. When we gather with others to bake cookies, or make pasta, or prepare and serve salads, or plan and cook a holiday meal, we are satisfying so many other longings. Emotionally, we long for connectedness, for ritual and tradition, for acceptance and our place in a group. Our physical senses of touch, smell, sight and hearing are engaged and satisfied by the hum and chatter of conversation and work, the warm smells, the many different food textures, tasks done and plates made pretty. Then, tasting what we’ve created is a wrap-up, a celebration of the time we spent together, the work we’ve done.”
After a recent culinary group where the participants made pasta from scratch, Dani asked the women how they felt. Where there were surely challenges, there was also a huge sense of accomplishment, and they said, “but it was FUN, and the people who made the pasta for us really CARED about it!”.
Being in treatment during the holidays can leave its own emotional stamp, but the Culinary Team make every effort to bring the joys of Holiday meals into Carolina House. Take a look at the Christmas cookies they made- all I see in this picture is joy. Joy in making, joy in sharing, and for many actually enjoying them.
To ring in New Year’s Day the ladies staying at Carolina House created a menu, including: Paula Deen’s French Toast Casserole, Quiche Popovers, Lentil Walnut Pate with Pita Toasts, Curried Butternut Squash Soup, and Sparkling Juices. These collaborations help bring back the joy into meals.
There is nothing more rewarding than seeing someone “come back to life” in the recovery process. Learning to use one’s voice is often a crucial skill learned while recovering, not just in words but in actions. When one can see how preparing and sharing food can be an expression of those thoughts and emotions in a mindful and balanced way, one’s path in recovery truly is more alive.
To learn more about Carolina House, check out their website here:http://carolinahouse.crchealth.com/
Here at MEDA we are often asked “How do I know if my son/daughter/friend/partner is just a picky eater, or if it’s an eating disorder?” While we always recommend an assessment by an eating disorder specialist if there is a concern of a potential eating disorder, there are some ways to ascertain whether or not there is need for concern or if the behavior is developmentally normal.
With picky eating, an important component to consider is “why?” There needs to be information gathered beyond just observing the behavior. There is a big difference between someone who simply prefers certain types of food and is “picky” and someone who has developed anxiety and obsessions that are causing the selective or restrictive eating.
Questions to consider:
Why are they selective in their choices?
Is it cultural? Is it medical?
Is the person anxious in other areas?
What is their response to food and eating? Do they enjoy it, or just tolerate it? Will they find excuses to skip meals all together?
Picky eating alone is not enough to develop an eating disorder, and may dissipate due to normal aging, development, lifestyle or environmental changes. However, if there is a genetic predisposition to eating disorders, a co-morbid mental illness like anxiety or OCD, or a trauma history, it is something to be aware of and monitored. In particular, picky eating can develop into an eating disorder around periods of high stress or transition, as in when parents separate, losing a loved one, a career change, moving, or progressing from middle school to high school or high school to college.
Again, if you are concerned that a friend or a loved one may have an eating disorder, we at MEDA always recommend an assessment by an eating disorder specialist. MEDA offers many services to those struggling with an eating disorder including clinical assessments, support groups and education on eating disorders. For more details on our clinical services, please click here. In addition, if you would like advice on ways to start the conversation with your friend/loved one regarding seeking help or getting an assessment by an eating disorder specialist, one of MEDA’s clinicians would be able to offer you guidance and support.
MEDA’s clinicians and staff members can be reached by phone: 617-558-1881 or by e-mail: Info@medainc.org. For your convenience, listed below are some tips that you might find helpful.
Tips for friends and family:
How does the individual act around food? Are they anxious, obsessed, or isolating? Do they get irritable when around food or at meal times? Do they engage in negative self-talk, count calories, refuse whole food groups, or have compulsive exercise habits? There are some individuals who get so involved in their work/family life/hobby that they can simply forget to eat. Encouraging family meal times and assisting loved ones with finding balance, or encouraging snacking can be helpful for these individuals. If you become concerned about a loved one’s selective eating, ask them if there are ways you can support them in eating more or trying new foods. Also note if there are changes you notice in their mood or behavior, and ask them how you can be helpful or compassionate to them. If you believe that they are struggling with an eating disorder, recommend they visit MEDA or give us a call for a confidential assessment and support.
Tips for school staff or parents:
If you notice that a child is a consistent picky eater, alert the parents. This may be something that they are very well aware of and compensate for in other ways- perhaps they know their child is picky about lunch but eats a hearty snack when they get home from school. Also discuss the eating habit with the child’s teachers as they may notice academic or social issues that may be related to the eating behavior, or notice changes in the child’s behaviors (i.e. falling asleep in class or hyperactivity from eating lots of sugar, etc.) Additionally, many children have trouble eating if they are under stress during the school day or are dealing with a stressful situation at home. Parents should always have nutritious snacks (perhaps paired with a snack the kid really loves) available after school or even a late lunch, particularly for picky eaters.
Tips for clinicians and other professionals:
Assess the individual for anxiety, obsessive compulsive thoughts and behaviors, trauma, or depression. With anxiety, OCD, or trauma, selective eating can give the client a sense of control or comfort when they otherwise feel overwhelmed or chaotic. With depression, selective eating could be because of loss of appetite, general malaise, or a general apathy towards food. With thought disorders or psychosis, food can seem scary or bizarre to clients experiencing delusions or hallucinations. Note how these behaviors may have changed for the individual and whether they may coincide with distressing situations in the individual’s life. Take care not to immediately assume the behaviors are an eating disorder- eating disorders are far more complex than just “picky” eating, but “picky” eating can develop into an eating disorder if there are other factors that are contributing such as co-morbid mental illness, stress, transition, trauma, or a genetic pre-disposition to eating disorders or mental illness in general. Refer to a medical professional to ensure there are no medical concerns for the selective eating, such as a virus, acid reflux, or thyroid issues. A referral to a registered dietician is also helpful, as these clinicians can assist in helping individuals think creatively and find foods they enjoy while also ensuring nutritional balance.
We have some awesome advice from one of our partnering treatment facilities, Timberline Knolls. Take a look at what they have to say…….
Reducing Stress in the Holiday Season
The holidays are just around the corner. Thanksgiving is only days away, and in the blink of an eye, it will be Christmas Eve, followed in short order by New Year’s.
What the holiday season is intended to be, and what it actually turns out to be, is often quite different. The season is typically defined by words such as peace, happiness, joy, warmth, and blessing. For an individual who had an eating disorder in the past, or struggles with one now, this time of year can be anything but joyful.
There are myriad reasons as to why this is so, not least of all the fact that food is such an extreme focal point of most holiday-related activities. Thanksgiving is nearly synonymous with food—an enormous turkey is traditionally flanked by an assortment of side dishes and pies. Christmas parties and events are rife with cookies and candy. Coping with this constant onslaught of food can prove extremely challenging.
Perhaps the most difficult aspect of the season is stress. This results from doing too much, whether it’s spending, shopping or simply expecting too much. Stress can lead to exhaustion and fatigue, which negatively impacts health. It can prove very triggering to those living with an eating disorder.
The following are a few tips for decreasing stress and increasing enjoyment of the season:
Take Care of Yourself
Do not use holiday busyness as a convenient way to relax your commitment to healthy exercise, good nutrition and adequate sleep. Avoiding any one of these will disrupt balance.
Try to remember that Hallmark cards are created with magic in mind; they are rarely reflective of real life. Try to be realistic regarding expectations about friends and family members, celebrations or gifts. If you have an idealized version of how things will transpire and how people will behave, you are setting yourself up for disappointment. Additionally, adjust the expectations you place on yourself.
Focus on the Reason For The Season
Cultivate and practice gratitude. Be intentionally thankful for all the good in your life. Look for the good, then tell someone about it.
Try to make peace in advance with the concept of holiday-related food. If support is needed, attend holiday celebrations with a friend who can be there for you.
So often, those with disordered eating also strive to be perfect in any number of areas. The problem is, there is no such thing as perfect—it doesn’t exist. Therefore, if the Christmas tree doesn’t resemble a magazine photo, that is absolutely fine. Take the burden of perfection off of your shoulders. While you’re at it, eliminate guilt from your emotional playlist. If you can’t be all things to all people, if you can’t attend every holiday party, do not feel guilty about it. Guilt is counterproductive—serving no purpose.
Remember, the holidays are a season, not a lifetime. They come, they go. Do the best you can to make them a positive, stress-free experience!