by Heather Baker | Jun 1, 2017 | Counseling, Eating Disorders, Mental Illness, Recovery, Relationships, therapy, Trauma, Women
DBT Skill for June: Improve the Moment
Some of the ways we can Improve The Moment Are:
- Imagery
- Meaning
- Prayer
- Relaxation
- One thing at a time
- Vacation
- Encouragement
When practicing this skill, we are not trying to CHANGE the external circumstance, but rather trying to improve the moment to make it more tolerable (or even more enjoyable) for just this moment.
- “Imagery: Imagine very relaxing scenes…Imagine everything going well. Imagine coping well…
- Meaning: Find or create some purpose, meaning, or value in the pain [that’s what I do with this blog, by the way!]. Focus on whatever positive aspects of a painful situation you can find…
- Prayer: Open your heart to a supreme being, greater wisdom, God, or your own wise mind. Ask for Strength to bear the pain in the moment…
- Relaxation: Try muscle relaxing and tensing each large muscle group…take a hot bath…breathe deeply; half smile; change facial expression…
- One thing in the Moment: Focus your entire attention on what you are doing right now. Keep yourself in the very moment you are in; put your mind in the present
- Take a Brief Vacation: Rent a motel room at the beach or in the woods for a day or two. Ask your roommate to bring you coffee in bed or make you dinner (offer to reciprocate)…Get a magazine or newspaper at the grocery store, get in bed with chocolates, and read it…
- Encouragement: Cheerlead yourself. Repeat over and over: ‘I can stand it,’ ‘It won’t last forever.’ ‘I will make it out of this,’ ‘I am doing the best I can do.'”
by Heather Baker | May 5, 2017 | Children, Counseling, Diets, Eating Disorders, Empowerment, Family, Mental Illness, Obesity, Recovery, Stigma, therapy, Weight Loss, Women
We live in a media driven culture with an endless supply of TV shows, internet sites, and phone apps to keep us busy every minute. These platforms are used to deliver messages meant to persuade, inspire, and entertain. Many of these messages contain images of men and women airbrushed to perfection….and it is that very image of perfection that haunts us as we study our own bodies and make comparisons.
To say that the internet has influenced body image is an understatement. In recent years, the rise of pro-anorexia and pro-bulimia websites has glorified eating disorders and praised the behaviors that keep sufferers locked in the illness. The Social Issues Research Centre (www.sirc.org) reports that these “pro-ana” websites target individuals who consider their eating disorders to be lifestyles, something to maintain and celebrate. Users share tips on how to engage behaviors and provide support for each other’s illnesses. For individuals who are in recovery, websites like this can be seriously detrimental. Some people in recovery refuse to engage in social media at all, citing the prevalence of hashtags like #thighgap and #thinspogram as just a few of many reasons to shelter themselves from the social media revolution. USA Today (www.usatoday.com) shares the story of Donna, who is in recovery from bulimia. Afraid to expose herself to the kinds of comparisons that fueled her illness, Donna has decided to stay away from popular social media sites like Facebook and Instagram.
While it’s clear that social media and pro-eating disorder websites have played a part in our global obsession with obtaining perfection, more and more websites dedicated to positive body image and recovery are beginning to pop up. Someone searching for eating disorder tips may stumble upon a recovery website or blog and be drawn into a story of hope….leading to the inspiration to begin recovery. The National Eating Disorders Association (www.nationaleatingdisorders.org) shares the story of one woman who came across the NEDA website in her search for a pro-eating disorder community….a lucky accident that turned out to be the catalyst for her recovery. Nonprofit organizations dedicated to awareness and advocacy use the power of the internet to spread positive body image messages. Eating disorder treatment centers are also getting involved in the awareness movement, offering blogs, webinars, and professional events designed to educate and inspire.
Instagram is also proving to be a powerful recovery tool. An online photo-sharing service, Instagram users can visually communicate their lives to their followers. Some individuals in recovery have turned their Instagram accounts into recovery accounts. The Atlantic (www.theatlantic.com) describes this type of account as a place where users can gain support while maintaining as much anonymity as they would like. Some people don’t use their real names, and others find that it’s easier to open up and share initially in an online environment. Recovery accounts document the progress users are making through pictures of meals, inspirational messages, and even pictures of users’ bodies as they work toward weight restoration. Support from followers during the recovery journey can be motivating and provide comfort during difficult periods.
Although social media can be a positive recovery tool, users must be vigilant and pay attention to their triggers. Any concerning thoughts and behaviors should be taken seriously and addressed with a treatment team.
Totally In Control: The Rise of Pro-Ana/Pro-Mia Websites. Social Issues Research Centre, www.sirc.org
Rojas, M. (2014). Social Media Helps Fuel Some Eating Disorders. USA Today, www.usatoday.com
Kay, J. (2014). How Social Media Led Me to Recovery. National Eating Disorders Association, www.nationaleatingdisorders.org
Mirhashem, M. (2015). Overcoming an Eating Disorder with Instagram. The Atlantic, www.theatlantic.com
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by Heather Baker | Jun 2, 2016 | Children, Counseling, Eating Disorders, Family, Mental Illness, Recovery, Relationships, therapy, Women
When an eating disorder strikes an individual, his or her entire family is affected. According to an article by Abigail Natenshon, MA, LCSW, GCFP, 87% of eating disorder patients are children and adolescents under the age of 20. As many in this age group still live at home, the eating disorder develops and plays out within the family dynamic. It often takes on a life of its own and can be the cause of many battles at meal times, family gatherings, holiday events, and can even affect extended family and school environments. Family therapy is an essential part of eating disorder treatment and is necessary to ensure everyone who is a part of the family system is cared for.
The Family System Theory
Developed by Dr. Murray Bowen, family systems theory posits that the family is a unit and the emotional connections fostered by thoughts, feelings, and actions create an interdependent environment. This interconnectedness helps the family to become cohesive and supportive of its members. If there is unrest and tension, emotional connections can become more stressful. If there is a member of the family who tends to take on the emotions of the other members and may take on an accommodating role, leading to overwhelm and isolation. This is the family member who may become more susceptible to addictions, depression, anxiety, eating disorders, and illness.
There are eight concepts to the family systems theory:
- Triangles: A three-person relationship system
- Differentiation of self: Variation in how people are susceptible to pressures to conform to the group
- Nuclear family emotional system: Four basic relationship patterns (marital conflict, dysfunction in one spouse, impairment of children, emotional distance)
- Family projection process: The way parents transmit their emotional issues to children
- Multigenerational transmission: Differences in differentiation across generations
- Emotional cutoff: Managing emotional issues by cutting off family members
- Sibling position: Impact of sibling position on behavior and development
- Societal emotional process: Emotional systems govern behavior on the societal level
Family systems theory can be used to help clinicians understand the dynamics of the family presenting to work through one member’s eating disorder.
Family Involvement in Eating Disorder Treatment
Comprehensive treatment plans at all levels of care will involve family therapy. Center for Discovery residential programs involve the family weekly in a therapeutic way, not only in family therapy but also at meal times by facilitating therapeutic family meals. The purpose of these activities is to observe family dynamics at meal times and in social situations in order to best prepare the family for realignment and a return to balanced interconnectedness.
Some clients benefit from a type of family therapy called Family Based Therapy (FBT, also known as Maudsley). This outpatient approach, which places the refeeding process in the hands of the parents and moves the family through phases of treatment as recovery develops, has proven to be very successful for adolescents with anorexia.
In outpatient settings, family therapy is usually recommended in conjunction with individual therapy, nutrition services, and group work. As the eating disordered member reintegrates back to the system after being away at treatment, therapy is needed to help the family adjust once again. An eating disorder has the potential to isolate family members from one another, create discord in the system, and indeed can be either sustained or eliminated depending on the dynamics of the family system. It is important for clinicians and parents to know that parents do not cause eating disorders. The entire system needs attention and support to thrive again.
Natenshon, A. Family Treatment is Cornerstone of Effective Care for Eating Disordered Children. Treating Eating Disorders, www.abigailnatenshon.com
The Bowen Center for the Study of the Family. www.thebowencenter.org
by Heather Baker | Sep 6, 2015 | Counseling, Diets, Eating Disorders, Empowerment, Inspirational, Mental Illness, Recovery, therapy, Women
I have seen so many of my own patients with Eating Disorders (ED) struggle with how to move beyond the Stage of Change in recovery : “I know I have a problem but not willing to do anything about it ” and get to the Stage of Change: ” I know I have a problem and I am willing to do everything I can to get better”.
With my patients who tell me that they can’t get better, they won’t get better or they don’t even really have a problem, I have noticed a few things:
- GREY MATTERS: The majority of people that have the disease of an eating disorder think in absolutes. Black and White. I am either fat or thin. I have no control or I am in total control. I have to do everything perfectly or not at all.
- They feel they can not survive life without their Eating Disorder. They believe that if they choose to start recovery they will lose all control, their voice, their protection, their identity and their purpose in life.
- They believe that if they do not have their ED they will no longer be successful, fulfilled, special and worthwhile.
So to be able to get to the next stage in recovery, one must believe:
- That they are capable of anything they put their mind to. Someone with an eating disorder is a very determined and capable person. Perseverance is key.
- Their ED has begun out of some form of unmet need. They need to learn to be able to fulfill their wants and needs out of assertiveness, determination, perseverance and creativity.
- They are capable of change. They are not made of stone, but of soft clay that they can continue to mold, sculpt and make into their best selves.
As a therapist, my role is to never give up on finding a way to communicate these truths, to motivate them to take risks and to take one baby step at a time.
I think of the “little engine” who despite it’s limitations, never gave up, believed in it itself and always had someone cheering him on.
Heather Baker, LCSW, CEDS
