by Amy M. Klimek, MA, LPC, Eating Disorder Program Coordinator, Timberline Knolls
The new college year is firmly underway. Thousands of young people have left home and started a whole new chapter in their lives. Although exciting and new, these first months can be highly taxing with new social networks, academics and living environment.
The experiences in these pressure-filled months can be a breeding ground for new habits, some valuable, others damaging. Disordered eating can develop long before being noticed by others and sometimes the person themselves. Awareness of disordered eating habits can help friends support those in need before it leads to life-threatening circumstances.
Obsessive or Judgmental Food Talk
Food exists to provide a measure of satisfaction, while fueling the human body. Food is meant to be part of a balanced life – it is not intended to be the measure of value. Obsessive talk about food — what is good or bad, healthy or unhealthy, fat grams, calories, the newest attractive fad diet — indicates that an individual may be moving into an unhealthy, controlling relationship with food. A verbal obsession can be an attempt to find “acceptance” of the new behaviors from others, in the effort to solidify approval for themselves. “I am now on a dairy-free, gluten-free, fat-free, food-free diet. I feel better already.” Or “I binged again last night; I really need to learn how to control myself.” Some of these comments are passive, while others are clear signs of an imminent eating disorder.
Negative Body Talk
College is nearly synonymous with the concept of change; one aspect of this change is the body. Meeting new people comes with new comparisons some flexible and fleeting – others may elicit negative judgments and motive to “fit in.” A rigid relationship with food combined with a negative body image can lead to isolation to avoid the conversations.
It’s important to keep in mind that maladaptive behaviors can manifest in a number of ways, from one extreme to another, yet equally dangerous. For example, both restrictive eating or compulsive overeating may cause a student to withdraw, no longer attending parties or engaging with friends. Altered behavior can also extend to exercise: a student may feel the need to run three hours a day to burn calories, while another might spend inordinate hours in the gym to build excessive muscle mass.
Help with an Open Heart and Open Mind
If the warning signs are apparent, take action. Action comes in the form of honest, heart-felt, compassionate conversations. “I” statements are best used, as in “I have noticed that …” or “I care about you so much that when I see …” Also, serve as a role model by giving attention to a person’s character, not waistline. If you express concern over a friend losing weight, but are also relentlessly dieting, your words will lack meaning. It can help to become familiar with resources available on campus and if needed, be available to go to appointments to support your friend.
By Bertha Tavarez, PsyD
Director of Clementine Adolescent Treatment Program at Oliver-Pyatt Centers
How does the opera singer take care of the voice? The baseball pitcher, the arm? The woodcutter, the axe? The ballerina, the legs and feet? The counselor, therapist, teacher, or heath professional, the self?
-Excerpt from ‘The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers, and Health Professionals 2nd Ed.’ Thomas M. Skovhoh & Michelle Trotter-Mathison
“Experiencing burnout? Who, me? Never!” If you are lucky enough to make it your life’s work to care for others, chances are, you have experienced the burning hot coals of burnout. Burnout is defined as ‘a state of chronic stress that may lead to physical and emotional exhaustion, professional detachment, and perceived lack of effectiveness and accomplishment.’ Burnout can be experienced on a continuum, and, if left unchecked, can negatively impact even the strongest treatment providers.
In a qualitative analysis of job burnout, eating disorder treatment providers were found to be at high risk of burnout due to characteristics of pathology, patient characteristics, and work-related factors (Warren, C. et al., 2012). Work-related factors that contribute to burn out include: lack of structure in the organization, poor support from team members, and difficulty managing large caseloads with multiple professional responsibilities. Although we cannot control the nature of the diagnosis or patient characteristics, we can empower ourselves to create a paradigm shift in how we manage work-related factors.
As the Clinical Director of Clementine Adolescent Treatment Program at Oliver-Pyatt Centers, I wanted to combat the effects of burnout in our staff by crafting team-building opportunities. I developed a plan to engage the staff in daily exercises that would promote practitioner resiliency. I hope these daily exercises act as a fun and dynamic shift in how we relate to one another as well as the clients via a deliberate parallel process.
I presented staff members with individual gratitude jars and a bag of glass pebbles. I encouraged staff members to place a pebble in the jar every time they experienced gratitude for their work. This exercise really encouraged us to find gratitude in the little moments. For most of us it opened our eyes to attend to moments of gratitude. At the end of the week, we counted and reviewed our pebbles (75 total! Woo hoo!) We realized that although we were unable to recall every moment, we had the awareness that they occurred.
The Clementine Staff was given “self-care homework” and asked to spend some time coloring using Valentina Harper’s Creative Coloring Inspirations book after a long workday. The next day, we discussed what the experience was like and how it influenced our ability to find closure in the workday and engage in a soothing activity at home. The response from staff was positive and uplifting! For those who struggled to complete the task, it provided greater awareness about the importance of self-care. Others reported gaining insight regarding a tendency toward perfectionism during the coloring process, and how this may have hindered self-care. A binder of blank pages was placed in the staff office and made available for continued use. These coloring pages were given to clients who shared similar experiences to use as a primary method of coping during difficult times in treatment.
Staff members participated in “adult show-and-tell” during lunch. They were encouraged to bring in a prized possession that proved meaningful in their lives. The purpose of this exercise was to encourage the staff to share aspects of themselves with greater meaning and value and build relationships with one another outside of the typical work-related dialogue. Staff members brought in emotional treasures from their past, and we took turns presenting them and sharing stories. Through laughter and tears, we found a place of greater connection. One of our staff members described this moment perfectly when she said, “I will never forget this work day.”
On Friday, staff members were given bubbles to use in order to encourage a playful mindfulness moment at the end of the week. This simple exercise proved to be a catalyst for joy for all of Clementine. Recovery coaches, therapists, and clients were united in play!
As I think back at these activities, I can say they greatly benefited us individually and collectively. The most rewarding aspect was that, as we took better care of ourselves, we were able to spread this loving energy to those we serve.
‘In dealing with those who are undergoing great suffering, if you feel “burnout” setting in, if you feel demoralized and exhausted, it is best, for the sake of everyone, to withdraw and restore yourself. The point is to have a long-term perspective.’ – Dalai Lama
Warren, Cortney S.; Schafer, Kerri J.; Crowley, Mary Ellen; Olivardia, Roberto; Eating Disorders, 2012 May-Jun; 20 (3): 175-95.
By Sydney Keller, Mental Health Worker at Monte Nido Eating Disorder Center of Boston
I have come across handfuls of clients that feel the only way they have ever identified themselves is through their eating disorder. The number on the scale, the size of their jeans, the amount of times they have been in treatment, the list goes on and on. When I have asked clients in group settings to talk about themselves, I have been shocked when their opening statement is, “I’m Mary and I’m anorexic” or “I’m Linda and I’ve had bulimia for the past ten years.”
Your onhealthy fosamax eating disorder gives you nothing. It takes and takes and will never stop taking. It robs you of your health, your happiness, your relationships with family and friends, and it will continue to take from you. Your eating disorder is not and will not ever be your friend. You are not defined by your eating disorder and your eating disorder will never be your true identity.
On your journey of recovery, your eating disorder identity will begin to diminish and your true identity will resurface. In many instances, clients feel they do not know who they are without their eating disorder and feel they need to relearn the facets that include their healthy soul and self. This is your time to explore. Recognize your role among your family and friends, rediscover your passions, re-establish your self-worth, and redefine your abilities and attributes.
Pat yourself on the back for all you have done and all you will continue to do on your journey of recovery. Now will the real you please stand up?
By Amy Klimek MA, LPC, Eating Disorder Program Coordinator, Timberline Knolls
When individuals leave treatment they are often asked to write a letter to themselves in recovery. As a clinician, this would be my letter to such a person:
Your eating disorder once was considered a friend, a protector, a shield to guard you; it may have navigated your actions and narrated your thoughts. Today and each day that you choose to show up to life in a new, different way, you are breaking down the barriers that limited your growth and potential.
Whether you sought treatment yourself, or you were “strongly encouraged” to do so, is irrelevant. You went and you showed up. Somewhere along the way, you committed yourself to recovery.
You worked hard then, and you will work hard in the days and months ahead.
The voice of the eating disorder that whispered in your ear from the minute you woke up to when you laid down to rest was infused with judgments and fear. That voice will soften with time. As you become more intently mindful, you will learn to listen to a new voice, a voice that may not be as loud, but a voice that will become familiar and safe. You may still hear the whispers, the critical voice telling you to give in; the difference now is how you will respond to that voice.
Eating disorders simply do not give up without a fight.
It would be ridiculous to say just don’t pay attention to these thoughts, onhealthy lexapro since they remain convincingly real. But here is what you can do: widen the lens of your mind. When you had an eating disorder, the lens with which you observed the world was very narrow; now it is time to expand that lens, inviting new possibilities into your awareness. In the midst of terrible thoughts, it is possible to create additional space for new observations, perspectives and experiences. While mindfully noticing the critical thoughts, you can still mindfully notice the recovery thoughts, the ones that help you to show up to recovery each day.
This is not a battle to fight alone. You need supportive people around you; you need a community of family and friends to turn to for help – an army of encouragement and validation. Don’t give excuses why your recovery isn’t working. Instead, give reasons why it is. Give space and attention to change.
It is natural to gravitate to what was known as familiar and comfortable. With time you will recognize recovery as your own.
Here is all that truly matters: right now. Although who you are today is a culmination of previous events and experiences, the past is absolutely gone. It cannot and should not be revisited. The future has yet to happen; the choices you make today can help the possibilities for tomorrow. The present — where you are, what you are doing, right now – is what matters. Living one day, one thought, and one breath at a time.
Someone who cares for you
By Rogers Memorial Hospital
Night eating syndrome, or repeatedly waking up to eat food, even after an evening meal, shouldn’t just be shrugged off as your “midnight snack.” Regular night eating can upset social or occupational relationships, or even impair your daily functioning due to lack of restorative sleep. Night eating can also disrupt your daytime eating schedule, making you not hungry enough to eat breakfast until much later in the day or eat less throughout the day.
Although this eating practice sounds similar to the excessive consumption commonly associated with binge eating, the two are not the same. People with night eating syndrome snack repeatedly throughout the night hours, while people with binge eating disorder eat a large amount of food in a single sitting. People who binge eat also do not typically over-consume during the night.
While people that have night eating syndrome are fully aware that they are waking up to eat, people with a sleep-related eating disorder are not. A person that has this disorder often sleepwalks, or has diminished consciousness while onhealthy cipro they roll out of bed, prepare food and eat it— that is until they find wrappers, opened containers or other evidence the next morning.
This disorder can easily become dangerous since a person may unknowingly harm themselves with kitchen appliances, flames from a gas stove or utensils while preparing food. People with a sleep-related disorder have also been known to consume non-edible materials or frozen food, all while in their unconscious or impaired state.
Even though a person isn’t fully conscious when they are eating, a person with this disorder may still feel tired throughout the day. There are also potential medical concerns that could arise from this disorder, including weight gain, diabetes and dental decay.
Although its name is deceiving, sleep-related eating disorder is not a type of eating disorder. Rather, it is a type of sleep disorder. Sleep-related eating disorder is not as prevalent as sleepwalking is and is also more common among women.
If you are experiencing disordered eating, contact Rogers at 800-767-4411 and request a screening or request one online at https://rogershospital.org/.