Dear Survivor,

As a therapist who treats eating disorders, I have worked with many women, men, and families who fought to overcome their illness and reclaim a life beyond calorie obsessions, food phobias, and irrational fear of weight gain. Often, when they first made the courageous effort to step into my office, they would ask, “What can I do to fix this problem?” For years I struggled to answer this question due to the sheer number of issues involved, and the unique and complex way this illness affects each individual. However, my clients have taught me a great deal about recovery, and my answer is now fairly simple: it involves the concept of the Power of ONE.

Recovery from an eating disorder can be a long and challenging process, so if you are feeling discouraged or overwhelmed about beginning or continuing this journey, just remember the Power of ONE:

to take ONE second, minute, or day at a time,
to set ONE goal at a time,
to have ONE conversation at a time,
to deal with ONE problem at a time,
to eat ONE more bite or meal than you are prepared for,
to resist ONE more binge episode,
to reduce your number of purge episodes by ONE more,
to make ONE more healthy choice,
to establish ONE treatment team that you can rely on,
to find at least ONE passion that gives you the desire to fight for your life,
to reach out to ONE friend at a time,
to take your medicine ONE more day,
to do ONE fun thing you enjoy,
to find ONE more thing you appreciate about your body,
to dream about ONE life worth living,
to take ONE more breath in order to calm yourself down,
to find ONE solution to a problem and then ONE more if necessary,
to get up ONE more time than you fall down,
to remember ONE more person who loves you,
to go to ONE more doctor’s appointment,
to follow your meal plan for ONE more meal,
to talk back to ED ONE more time,
to take ONE more break if you need to
and then continue to put ONE foot in front of the other even when you feel discouraged,
to find ONE more reason to survive this illness,
to remember ONE successful thing you accomplished today,
to remember ONE more good quality you possess,
to create ONE balanced lifestyle,
to trust your body and treat it right for ONE more day,
to set ONE more boundary to protect yourself,
to confront ONE more person if you need to,
to stand up for yourself ONE more time,
to identify and process ONE more emotion at a time,
to defy ONE more myth about eating disorders,
to recognize ONE more unrealistic expectation and re-define it to something that is useful to you,
and to define, reclaim, and embrace the ONE and only you who is good enough, caring enough, attractive enough, smart enough, successful enough, funny enough, healthy enough, and powerful enough to create ONE life worth living with the ultimate goal of being ONE more person who did what it takes each and every day to survive this illness.

Sincerely,
Someone who believes in you

By: Tamara Richardson, Ph.D., is a licensed psychologist, part-time private practice clinician in Stillwater, Oklahoma, and a senior clinical counselor at Oklahoma State

Which of the Harris Center’s recent achievements are you most proud of?

One of the questions that frequently came up [among patients] early on, was, “What is going to happen to my daughter or me in one year or five years or 10 years, whether I get treatment or I don’t. Will I ever recover from this?” In 1987 we were funded by the National Institute of Mental Health, the NIMH, to do a prospective follow-up study of 246 women with anorexia and bulimia. We are now in the 25th year of mapping the course of their disorders, what happens over time. So that’s what’s going on currently.
What findings has the study yielded up to this point?

So far we’ve been able to determine, unfortunately, the severity of this illness. In the first 11 years of the study, 10 of the 136 women with anorexia nervosa died. These were young women. And we wouldn’t have known that they had died if we weren’t following them. They weren’t necessarily in treatment — they might have gone for 3 months or been in psychotherapy or stopped and then started — but we were going to record all of it so at least we would know what [care] they had. It gave us a chance to look at who gets better. What are the factors that predict better outcomes or worse outcomes? I’m not sure we know that there’s a specific treatment for the illness — you take this and you do this, and you so-called “get better.” That is an area that we keep working on.”

This year and in previous years, you’ve invited members of the fashion industry, including Anna Wintour, Diane von Furstenberg and several models, to speak at the Harris Center’s annual Public Forum. What’s your thinking there?

There’s obviously an interest in the fashion world because there is concern that [it] is a factor in the rise of eating disorders. So I was able to make contact with Anna Wintour, and she organized the panel [in 2010] with Michael Kors and [supermodel] Natalie Vodianova to come here and talk about that. To [take on] the issues, [ask], “What’s going on here?” [The discussion] partly had to do with the safety of models and partly had to do with impact of all this on the greater public. Though I’m always concerned about individuals and I don’t want models to suffer more than anyone else, my bigger concern truthfully is the [effect] on the whole society idealizing these figures, these models, these images, which fosters this “too thin” ideal.

For me working with the fashion industry is an opportunity to learn. There’s always this fear that you’re going to be seen as a colluder, but to make change in the fashion world is very much [about] chipping away. You can’t go in with a sledgehammer. The fact that Anna was here was a big step. Sometimes working with the industry is more effective than just purely attacking it.

Do we have a way of measuring the impact of media on rates of eating disorders?

I don’t think if we change the media, that suddenly there aren’t going to be eating disorders. But we’re continually gathering data about the rates of eating disorders whether that’s increasing or stabilizing. Individuals who develop eating disorders are not necessarily glued to fashion magazines. So how do you understand the impact of media?

There’s another piece of this that the new Israeli law [banning underweight models from local advertising and requiring disclosure of photoshopping] kind of got into, the digitalizing of images. Are we going to police every image out there? I’m not pushing for federal legislation. I’m pushing for more information.

Mother Speaks Out After Losing Daughter To Bulimia

April 2, 2012
Like many parents, Judy Avrin didn’t fully understand the gravity of bulimia, until she lost her daughter Melissa. To help shed light on the disorder, Avrin helped make a documentary inspired by her daughter’s journal entries. Avrin speaks with guest host Jacki Lyden about the film Someday Melissa.

JACKI LYDEN, HOST:
This is TELL ME MORE, from NPR News. I’m Jacki Lyden. Michel Martin is away. Coming up, he’s walked the runway in both menswear and women’s wear. He’s even modeled as an haute couture bride. We’ll learn the secret to Andrej Pejic’s unconventional beauty and gender-bending in just a moment.
First, we go behind closed doors, as the program often does on Mondays. That’s where we talk about issues people usually keep private, and eating disorders are that kind of issue.
Up to 24 million Americans of all ages and genders suffer from these illnesses, according to the National Association of Anorexia Nervosa and associated disorders.

Today, we want to focus specifically on bulimia. It’s when people go through frequent cycles of binge eating, followed by purging. Judy Avrin lost her daughter, Melissa, to this illness in 2009, and she helped make a documentary about her teen daughter’s battle with bulimia to help other families and educators and health care workers understand this disease.

In the movie, Judy Avrin admits that she spent some time in denial about her daughter’s condition.

JUDY AVRIN: And then I found, in her drawer – in her dresser drawers – glasses with chewed up and spit out food in it. Melissa was absolutely and totally resistant to even talking about it.

LYDEN: That was Judy Avrin in her film, “Someday Melissa: The Story of an Eating Disorder, Loss and Hope.” And she recently showed the film about her daughter at the National Institute of Mental Health here in Washington, D.C. It’s also being screened at colleges and community groups.
Judy Avrin joins us in the studio now. Thank you so much for coming in, and we’re very sorry about the loss of Melissa.

AVRIN: Thank you. And I’m proud and happy to be here and share her story.

LYDEN: This film was inspired by many things, by this devastating illness within your family, by the writings you found in your daughter’s journal about the arc of her life. There’s one entry that so gets to the heart of the matter. It’s a poem that she wrote. Judy, would you please read it for us?

AVRIN: Someday, I’ll eat breakfast. I’ll keep a job for more than three weeks. I’ll have a boyfriend for more than 10 days. I’ll love someone. I’ll travel wherever I want. I’ll make my family proud. I’ll make a movie that will change lives.

LYDEN: Which is exactly what you’ve done here. How did it feel to find that poem, and was that the inspiration for the film that you’ve made?

AVRIN: The poem, I actually didn’t see the first time I read through the journal. I had finally gotten up the courage to read it about two months after she died. And after I did, I honestly thought about putting the journal in a drawer and forgetting about what she’d written. And it was sometime later when I was speaking to the director, he mentioned someday, and I went back and read the poem, and I got chills.

LYDEN: It isn’t only this poem, which is so remarkable, but her writings in her journals throughout the arc of her illness really got quite profound, and there’s a lot of recognition there, which sort of goes to show the grip of something that she was in. She died in May of 2009, but you start the film, really, with her childhood.

AVRIN: Melissa was a happy, healthy, creative, funny, very normal child. And it was around the age of 13 that she began struggling with the body image issues that ultimately led to the depression and the eating disorder that took her life. It was even certainly harder for my husband to understand it, but I do talk in the film about my own history with bulimia. I battled with it for many, many years. But my eating disorder was not as severe as Melissa’s, so I think it allowed me to minimize the early warning signs.

LYDEN: In this arc of her life, things start to change, and she’s withdrawing in school and she’s about 14. So what were some of the things you were seeing?

AVRIN: She would start wearing baggy clothes, and that’s a really classic sign of somebody who’s just not comfortable with their body. Large amounts of food would start to disappear, but we were the house that a lot of the kids would come to. So both of my kids had, you know, friends in and out of the house and then the really, really classic sign that I didn’t know until much later was she developed really severe constipation. And if the food is – and if it’s going in and coming out, or if it’s not going in at all, you’re not going to have a normal digestive system. And we had many, many visits to doctors and gastroenterologists before anyone ever uttered the word eating disorder.

LYDEN: And what was your husband’s reaction when that diagnosis was made?

AVRIN: He did not understand, as many people do, that it’s something really serious.

LYDEN: And people also think it’s a choice?

AVRIN: Which is one of the biggest misconceptions there is. It’s not a choice, and as hard as this is to understand, it’s not about the food. It may start as wanting to lose a couple of pounds, but it can transform very quickly into disordered eating and turn into a full-fledged eating disorder. And at that point, it is a mental illness.

LYDEN: I want to talk about that aspect of its being a mental illness, because I don’t know much about bulimia, but I will say here that I grew up very much with – in the presence and with – and love – a mentally ill mother. And there’s a clip in this film that I think really links it to the profundity of mental illness itself and how someone becomes someone else.
And this is where your son, Melissa’s brother, is talking about seeing your daughter out on the sidewalk in front of the house at night.

UNIDENTIFIED MAN: In the bitter, freezing cold, she’s going through the garbage out on the curb looking for something to eat. And I went outside, and I yelled her name. Just the way she looked back at me was so empty, vacant. It was a deer in headlights, but that doesn’t explain it.

LYDEN: At this point, even you say she’s in the grip of something that feels like a demon.

AVRIN: She really wanted to get healthy and get well, but it would so control her and she wouldn’t be able to eat moderate amounts of food.

LYDEN: You had to lock up food. You couldn’t leave anything in the house. The cupboard had to be either bare or, you know, have a lot of shots in the film of a lock over a trunk of food. And that made the house – the fact of you locking the food, Judy Avrin, was like it made the house less of a home.

AVRIN: It did. And what I want you to understand, that came years into her illness, and it would be at times when she was, as I said, so in the grip of this eating disorder that she would consume anything. And if she did, it meant she would have to purge it.

LYDEN: If you’re just joining us, this is TELL ME MORE, from NPR News. I’m Jacki Lyden. We’re talking with Judy Avrin about her documentary about her daughter, “Someday Melissa: The Story of an Eating Disorder, Loss and Hope.”

One of the things that you did for Melissa was send her to a kind of self-confidence camp in Idaho, and that becomes kind of a celebration, in the end, for your family. Let’s listen to how that goes for her in Idaho.

UNIDENTIFIED WOMAN: (as Melissa Avrin) Dear Mom and Dad, I finally made it through my first week here, and so far what I’ve worked on is realizing what I do and why I do it. I’m not going to justify my past actions. They were wrong and dangerous and careless, and I’m so sorry I hurt you.

AVRIN: It’s a wilderness program that works with kids with all kinds of problems, drinking and drugs and eating disorders. And by the end of – I believe it was six weeks – she was so incredibly proud of what she had accomplished. She rediscovered the joy of being healthy.

LYDEN: Which is one of the things you show in this film, and I think that’s so great, Judy Avrin, that we don’t only see her as a collection of symptoms. Did you feel, after the wilderness camp, that you’d turned a corner?

AVRIN: Absolutely did. And she was about to turn 18. And, generally, kids who come from programs like this need a transition, and it’s better not to come right back home. And we had selected a therapeutic boarding school for her to go to. And while she was there, she truly rediscovered the joy of her brain. She was incredibly bright, an amazing writer. She tutored other kids. So in that sense, that next stage was positive, but the eating disorder came back in full force.

LYDEN: But she would eventually get into even the college she wanted.

AVRIN: Yeah. She wanted to be a filmmaker, and Emerson College was her dream school. And a week before she died, she got a phone call. And then a week after she died, the big envelope came.

LYDEN: Why did you want to make this film? You must think that there are many misconceptions about bulimia.

AVRIN: There are so many misconceptions. The general public, I think – to them, the face of an eating disorder is somebody with anorexia, extremely underweight, malnourished, the bones protruding. A typical bulimic generally will be within normal weight ranges, and that makes the eating disorder invisible.

LYDEN: Melissa was within normal ranges?

AVRIN: Absolutely. You know, her weight varied from time to time, but people would tell her she looked so great, you know, not knowing that she was purging and…

LYDEN: And I think perhaps another thing that’s not known is the devastating toll that it takes on the internal organs. The lack of potassium weakens the muscles. This is really not precisely starvation as we may think of it, but you are doing devastating things to your organs.

AVRIN: Right. And that’s ultimately what took Melissa’s life. She had a heart attack because her body chemistry was so out of whack. And you also don’t have to be sick for a long time. All it takes is one time that you purge and your electrolytes or your potassium are out of whack, and you can have a heart attack.

LYDEN: Had you worried – I want to ask you frankly, Judy Avrin – that she might succumb? That she might die?

AVRIN: Never. Never. I always believed she would recover. Even as difficult as it is to go through this cycle, I always believed she would recover.

LYDEN: So what has been the most helpful thing? She passed away May the 6th, 2009. What do you think – as you’ve had some time now, several years, nearly, to live with this?

AVRIN: Making the film, first of all, was an incredibly therapeutic way for me to channel my grief. And what has come from the film – and I say I would trade it all in a heartbeat to have her back.

LYDEN: Obviously.

AVRIN: But she is so inspiring others around the world, and I get emails, truly, on a daily basis. I got one the other day from a young woman in Texas. I’m 26 and I realized months ago, after hearing Melissa’s story, that I have so many somedays I still want to live, and I’m fighting for my recovery. Or I’ll hear from people – from families who say watching this film made me understand my child’s eating disorder unlike anything else has.
And therapists are using it for treatment and intervention. And she’s giving other people hope.

LYDEN: You’ve really made her live again.

AVRIN: Thank you.

LYDEN: Judy Avrin is the co-executive producer of the documentary about her daughter, “Someday Melissa: The Story of an Eating Disorder, Loss and Hope.”
Thank you so much for making this documentary about your late daughter and for coming in and sharing your story with us.

AVRIN: Thank you. It’s been an honor.

Copyright © 2012 National Public Radio®. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

Yoga, meditation, massage, acupuncture, and herbal remedies; these are just some of Eastern medicine’s contributions to our decades-long search for ways to live well with fewer pills and less-invasive health care. Toward that end, I’m excited to report that there are promising new findings in the field of energy psychology, specifically about a practice called Emotional Freedom Technique (EFT), or tapping, that is taking our search for holistic solutions to an exciting new level.

What’s unique about EFT is how it combines Eastern wisdom about acupressure, or “meridian points,” in our bodies, with traditional Western psychotherapy. The practice consists of tapping with your fingertips on specific meridian points while talking through traumatic memories and a wide range of emotions. “Acupoint tapping sends signals directly to the stress centers of the mid-brain, not mediated by the frontal lobes (the thinking part, active in talk therapy),” explains Dr. Church, Ph.D., who has been researching and using EFT since 2002. Because EFT simultaneously accesses stress on physical and emotional levels, he adds, “EFT gives you the best of both worlds, body and mind, like getting a massage during a psychotherapy session.”

In fact, it’s EFT’s ability to access the amygdala, an almond-shaped part of your brain that initiates your body’s negative reaction to fear, a process we often refer to as the “fight or flight” response, that makes it so powerful. “By reducing stress,” adds Church, “EFT helps with many problems. There’s a stress component to sports performance, business and financial pressure, and most disease. When you reduce stress in one area of your life, there’s often a beneficial effect in other areas.”

Church estimates that 10 million people worldwide have used tapping, and what’s so exciting is how incredibly quickly it’s alleviating issues like depression, anxiety and insomnia, as well severe PTSD, physical pain, even illness.

At this point you’re probably thinking what most intelligent and sane people are — how is that possible? How can tapping on “meridian points” resolve serious health issues? As an EFT practitioner and the producer of the movie The Tapping Solution, it’s a question I’ve been asked repeatedly over many years. In fact, you’ll often hear me refer to EFT as “this strange tapping thing.” Fortunately, there’s very real science (and results!) behind it.

In partnership with Dr. David Feinstein, Dr. Church has been able to confirm that tapping on specific meridian points has a positive effect on cortisol levels. Cortisol, known as the “stress hormone,” is integral to our body’s “fight or flight” response. Originally designed to help us survive life in the wild, the “fight or flight” response was essential when our ancient ancestors were faced with sudden, brief danger like, let’s say, a tiger. However useful in short bursts, releasing cortisol too frequently, as we seem to be doing in response to the ongoing or “chronic” stress of modern life, may have serious, even scary, impacts on our physical, mental and emotional health. In fact, living in this kind of biological “survival mode” may be making us more vulnerable to everything from cancer to heart disease, and more.

In Dr. Church’s study, 83 participants were separated into three groups. One group was guided through an hour-long EFT session, the second group received an hour of talk therapy, while the third, the control group, received no treatment. The group that did an hour of EFT demonstrated a 24 percent decrease in cortisol levels, while the other two groups showed no real change. The EFT group also exhibited lower levels of psychological symptoms, including anxiety, depression, and others, as measured by the Symptom Assessment-45 (SA-45), a standard psychological assessment tool.

Research suggests that EFT may be so effective because of its perceived ability to balance out the nervous system, leveling off the activity of the parasympathetic and sympathetic regions. Responsible for promoting cell regeneration and relaxation, the parasympathetic region helps to slow your heartbeat, support digestion, and more. The sympathetic system, on the other hand, prepares you for vigorous physical activity by speeding up your heart, constricting your pupils, and so on. As noted in Church’s study, imbalance between these two regions is associated with a long list of health issues, from high blood pressure and heart problems (most often seen in those with an overactive sympathetic region), to depression, fatigue, and weakened immune response (in those with excessive parasympathetic activity).

In his study findings, Church asserts that EFT, which he refers to as “acupoint treatments” produces “a neutral emotional state,” which, biologically speaking, is the gold standard of health and wellness. It’s also the state of well-being people have sought to achieve for millennia through meditation, prayer, yoga, and other mindfulness practices.

Dr. Feinstein, a clinical psychologist who uses EFT in his own practice, adds that EFT is an “unusually precise, rapid, and direct for shifting the neurological underpinnings of a range of psychological problems.” In fact, he adds, “the number of therapists using EFT has been rapidly increasing over the past decade, and now peer-reviewed research is showing that their instincts have been right. Surprisingly rapid outcomes with a variety of disorders are being documented.”

The results of that documentation can (and will!) impact millions of lives in incredibly powerful ways, which is why I’m excited to share a host of new studies with you here, in future posts. In the meantime, I look forward to hearing your feedback. Are you familiar with tapping? Do you use it yourself, or know others who do? Are there specific topics you’d like me to focus on in future posts?

Nick Ornter is the creator and executive producer of the hit documentary film, “The Tapping Solution.”

Did you answer yes to any of these questions?

If you answered yes to any of these questions, you need to know that bullying leads to children’s eating disorders or other dysfunctional behaviors. More and more children are finding they need treatment for an eating disorder who are younger than 12.

Bullying is dangerous and can even lead to suicide. The internet has exposed the terrible truth about the effects of bullying. Remember, Phoebe Green, who hung herself at age 15 because of cyber bullying.

Only recently have we as health care professionals begun to look at the seriousness of bullying particularly after reported teenage suicides. Does your child use the internet? If so, be alert. Know that the internet has exposed the terrible truth about the effects of bullying, severe enough to drive some kids to self-harm or suicide.

Bullying effects millions of students but parents and teachers don’t understand the serious outcomes. When professionals or parents tell kids to ignore teasing, or to just get on with it, this not the kind of advice or understanding they need.

What does bullying looks like?

1. Emotional or verbal abuse looks like “Fatty fatty two by four, can’t get thru the kitchen door” or Piggy, piggy!
2. “Hey Jew boy.”
3. Cyber abuse is on Facebook where everyone from your school can see it.
4. Cruel emails can be sent from anywhere.

A person can be picked on by an individual or group with more power. Someone with more power may be peers, older kids, even teachers or parents. Bullies choose their victims because they look different, have a different religion, or are disabled. Bullies pick on a person simply because the person is shy or is gay or is a lesbian.

We must never forget that bullying is a severe form of abuse, i.e. emotional abuse, verbal and sexual abuse. Being excluded socially is a form of abuses. Verbal bullying, cruel email, or cyber-bullying (posting insults online) are forms of abuse.

Bullying like most forms of abuse is ongoing, like water dripping on a stone. The person being bullied lives in a constant state of fear. Everything in his or her life is affected. School work and health are both affected. A person being bullied can get stomach-aches, diarrhea, and headaches from the stress.
Kids abused by peers or family members can suffer from depression, low-self-esteem, and anxiety occasionally or a great deal of the time. They might even consider suicide!

Here are 8 tips to help you protect yourself from bullies. What advise will help if you feel bullied or know someone who is being bullied?

1. Tell someone about it, a teacher, a friend, a parent — tell anyone but tell right away.
2. Stick together with your friend who is being bullied — never leave him or her alone.
3. Learn to ignore the bully. Don’t add wood to the fire.
4. Don’t get physical (or angry) with the bully.
5. Practice feeling and looking confident. Posture is a give-away.
6. take small steps to be in charge of your life. This is where a good coach can help.
7. Talk about the bully and bullying to anyone and everyone. The more public you are, the bully will hide out.
8. Find true friends, friends that can offer you unconditional friendship.

If you’re a kid, find an adult who can guide you step by step through the process of taking charge of your life.

As you grow in confidence, you’ll stand taller knowing that no one will bully you again.

I have always tried not to use another person’s material when writing my blog, but this article is so exceptional, I need to share it with everyone!! It comes from a website, www.eatingforlife.org.

What to do if you think someone may have an eating disorder
Eating disorders are not about the food. There is always a deeper problem that is causing the person to focus so intently on food. The eating disorder is the outward manifestation signaling that there is an inner problem (e.g. self-esteem, family issues, depression, anxiety). An eating disorder is a person’s attempted solution to that problem. The eating disorder will begin to go away when the inner problem is addressed, and usually counseling is helpful in this process.

Make sure you approach the person one-on-one. If a group of you is concerned, it is very important that one person be chosen to talk with the friend. Group confrontation can make a person feel “ganged up on” and can cause a friend to feel betrayed, as if everyone has been talking about them. The goal is to support your friend, and often a group confrontation can leave a person feeling like they have been betrayed by their support system.

Make a plan to approach your friend in a private place. Try to choose a non-stressful environment where you will have time to talk at length, if necessary.

Present what you have observed and what your concerns are in a non-confrontational, caring way. Tell him or her that you are worried because of what you have noticed and that you would like to offer some help. Stay away from saying “we’ve been talking and are worried” – focus on what you yourself have seen, it is less threatening. (Friends who are too angry or hurt to talk supportively should not be the ones to confront.)

Offer human company and empathy. You don’t need to agree with the person’s feelings or stance. There is a place for challenge, advice, information, pep talks, jokes, and confrontation. Generally, that place is after she or he feels her or his experience is understood and accepted for what it is.

Listen carefully and non-judgmentally. Give the person time to hear what you have to say and to verbalize their feelings. Ask clarifying questions and then accept whatever they have to say without judgment. Encourage him or her to talk about their feelings.

Do not argue about whether or not there is a problem. Power struggles are not helpful. You could say, “I hear what you are saying and I hope that you are right and that this is not a problem. But I am still concerned about what I have seen and heard because I care about you.” (It is best not to say what other people feel or what they have noticed. Speak with “I” statements.)

Do not lay guilt trips, like “Look what you are doing to your family or roommates”. We are each responsible for our own feelings. Bear in mind that people with eating disorders yearn to know that someone could both know the worst about them and love them and care about them anyway.

If the person denies the problem, becomes angry, or refuses treatment, understand that this is often a part of the illness. They have a right to refuse (UNLESS their life is in danger). You may feel helpless and angry. You might say, “I know you can refuse to go for help, but that won’t stop me from being concerned. I may bring this up again later – maybe we can talk about it then.” Follow through on this, and other promises you might make. Your friend may need time to process what you have said to them. Don’t expect an immediate positive response, the important thing is to follow through and be consistent.

Provide information and resources for treatment. Make sure that you brush up on your knowledge of eating disorders before you talk to your friend, and be sure to offer resources to your friend. Encourage her or him to see a counselor, nutritionist, or physician and offer to go with them to the first appointment. Remember that recovery is a long process. It may take a while before your friend is feeling better and it is important for you to remain supportive throughout the entire recovery process.

Do not try to be the hero or rescuer – you may be resented. If you do the best you can to help on several occasions and the person does not accept it, stop. This does not mean stop being aware of their behavior, but you have done all it is reasonable to do. Eating disorders are stubborn problems, and treatment is most effective when the person is truly ready for it. You may have planted a seed that helps them get ready.

Make sure you get support for yourself. It can be difficult to live with someone who is dealing with an eating disorder. Get the information and support that you need.

For continuing support of your friend:
Remember that she or he is more than the eating disorder. Don’t let it become an identity – focus on his or her other characteristics that make them great. The more you help him or her identify his or her positive attributes, the easier it will be to let go of the “eating disorder” identity.

Don’t be afraid of conflicts or problems. These areas need to be brought out into the open, not hidden. Be sure to keep lines of communication open.

Do not focus on weight gained or lost. Focus more on their mental state. If you say, “you look thin” you are focusing on appearance and feeding into their behavior. If you say, “you look healthy” she or he may think you are saying, “you look fat.”

Don’t focus on achievements – grades, promotions, etc. Instead, talk about his or her inner qualities and strengths. Set an example – be good to yourself and she or he will see that it is possible.

Stay positive! People do recover from eating disorders. Many people who recover acknowledge the importance of friends who believed in them and kept trying to reach out to them.

Women’s Resource Center
Boston College

This article hit me on two different levels.

1- In our struggles with insurance companies I often find myself wondering how they fail to realize that investing in solid treatment will not only lead to lowering the suffering of the individual we are working with, but also in the long run save insurance companies money in the long term health problems which result from eating disorder behaviors.

2-This study states “that obesity prevention programs that stigmatize obesity or create a sense of blame can actually contribute to eating disorders.” Goes along with awareness of weight bias.

Dear Jeanne,

I am a former Mirasol client from back in 2007. After a lifetime of sickness with an extreme case of anorexia, I finally found a treatment center that not only worked for me, but gave me my life back and allowed me to flourish since I left four years ago. In those four years I have earned my master’s degree in advanced practice nursing and am now a family nurse practitioner.

Words cannot adequately express how much my time and experience at Mirasol meant to me, and there has not been a day that has gone by since I left where I haven’t thought about it. Not only was it the beginning of my recovery and healing journey, but it introduced me to the world of holistic and alternative medicine, reignited my interest in health care, and was the inspiration for my application to nurse practitioner programs.

I felt accepted, understood, nurtured, and most of all LOVED by the people I encountered at Mirasol, and that is why I was able to heal there. I firmly believe that everything I’ve been through with my eating disorder has been for a reason, and has led me to a path of wanting to give back what was so generously given to me. No matter where I end up working I know that I will carry my Mirasol experience with me forever, and it will always be there guiding my approach to patient care.

All my love to you,

J. S.

—Howard Thurman

By Dr. Sharon Meglathery

I am a traditionally trained, East Coast physician with board certification in both internal medicine and psychiatry. However, when I arrived at Mirasol, I knew little about complementary, alternative or naturopathic medicine, and essentially nothing about holistic treatment of eating disorders. I had been taught that eating disorders were very dangerous and difficult to treat, and that other than fluoxetine (Prozac) for bingeing and purging, off-label use of atypical antipsychotics for irrational thinking and appetite stimulation, and topiramate for appetite suppression, no medications have proven very effective for treating these dangerous conditions.

Arriving with an open mind, I was greeted during my first psychiatric evaluation by a very guarded, hostile young woman who quickly informed me that she had chosen Mirasol because she never again wanted to be controlled or tortured by psychiatrists in a “so called treatment center,” and that there was no way she would take any medication. My floundering attempt to extract any useful information — I had given up on any chance of prescribing anything — was dramatically interrupted by the screeching of another patient who had accidentally sprayed liquid soap into her eye. My attempt to help by providing a bowl of water for irrigation of the eye was immediately rejected as a reckless attempt to cause further harm by infecting the eye. Caring attention from both staff and other patients had little effect on the inconsolable crying which was punctuated by demands to be taken to the emergency room. As I cycled through feelings of helplessness, anger, and frustration, I remembered what had been repeated over and over during my psychotherapy residence: the emotions provoked in the provider by the patient often reflect what the patient is experiencing. My initial impulse to retreat was replaced by intrigue and a sense of challenge. It was going to be very enlightening to see how the other providers worked with these women. It was going to take more than behavioral modification and 15-minute med checks to effect lasting change.

My first two patients had demonstrated several fundamental truths about people with eating disorders:

• They are in tremendous — and not easily consoled — psychic pain which is expressed in a variety of primal and harmful ways.
• The behaviors of the patients themselves, and the relationships they form with the doctor, staff and other patients, are fraught with transference (which can be a powerful tool).
• The medical establishment’s use of coercive and punitive measures with these patients (ultimatums, feeding tubes, medication to affect appetite, etc.) does little to promote healing while eroding whatever trust the patient may have initially had.

For me, establishing rapport is the essential first step. I often think of the life-saving advice that one should not swim toward shore perpendicular to a riptide, but rather parallel to the shore until the riptide has passed. Butting heads with the patient is like swimming against the riptide; finding some commonality allows you and the patient to eventually swim together toward the shore.

As the provider who assesses patients when they arrive and then when they depart, I have been amazed at the changes I have observed firsthand. Why do so many patients who have “failed treatment” at the “best” of treatment facilities finally succeed at Mirasol? I believe it’s because we establish ourselves as trustworthy, caring and competent providers with a wide range of skills. We look for the deep-rooted cause/meaning of the eating disorder and help the patient process this as part of her life narrative. We enhance personal, positive development and empower patients to surrender their eating disorders and enjoy the natural and normal bodily sensations associated with food. The clients leave Mirasol as more developed, competent women who are able to experience their emotions fully and safely, and who are better equipped to handle life’s challenges. And, from now on, because they will choose to eat in a healthy manner, they will attain long-term medical and psychiatric balance.

]]> http://edrecovery.com/swimming-in-the-rip-tide-an-eating-disorder-psychiatrists-journey/feed/ 1 http://edrecovery.com/neurofeedback-the-king-of-holistic-treatment/ http://edrecovery.com/neurofeedback-the-king-of-holistic-treatment/#comments Thu, 03 Dec 2009 19:38:18 +0000 jrust http://edrecovery.com/?p=180 This is the second article in a series about holistic treatment.   In this article I will discuss neurofeedback which — probably more than any other modality — dramatically illustrates the mind/body connection.

By Dr. Jeanne Rust

Thousands of people have benefited from neurofeedback, a therapeutic training tool that is very effective in the treatment of ADD, ADHD, epilepsy, fibromyalgia, head injury, substance abuse, eating disorders and chronic pain. Not only does neurofeedback alleviate a variety of emotional problems and physical ailments, but it does so without invasive procedures or the need to take expensive and potentially addictive medications.

Neurofeedback improves the formation of essential neuro-pathways in the brain, actually reconditioning and retraining brainwave patterns. Psychological testing and brain mapping (QEEG) show any abnormalities in brain function. During the training sessions, clients learn to normalize their brainwave patterns through feedback, coaching and practice.

During typical neurofeedback training, sensors are placed on the scalp and/or ear lobes. An EEG unit provides instantaneous audio and visual display of brain wave activity. This “feedback” allows the individual to alter brain activity, increasing or decreasing certain frequencies in order to function most efficiently for the task at hand. The client literally learns how to train the brain to function with greater control and stability through self-regulation.

Frank H. Duffy, M.D., a Professor and Pediatric Neurologist at Harvard Medical School, stated in an editorial in the January, 2000, issue of the Journal of Clinical Electroencephalography that scholarly literature now suggests that neurofeedback “should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used. It is a field to be taken seriously by all.”

Neurofeedback can also be used for performance enhancement, improving memory skills and increasing concentration, and focusing abilities. When combined with conventional treatments, neurofeedback results in very low relapse rates as it seems to function as a form of “mental antabuse.” The overall success rate of neurofeedback training is reported to be more than 85% for some disorders, including eating disorders and substance abuse.

Neurofeedback has been used in the treatment of alcoholism, helping clients achieve relaxed states by increasing alpha and theta brainwaves and reducing fast beta brainwaves. A 1990 study by Peniston and Kulkosky found that after four years, 80% of alcoholics treated with traditional methods had relapsed, whereas 80% of the experimental group who received neurofeedback in conjunction with regular treatment were still sober. Since over 40% of all eating disordered patients also have issues with substance abuse, neurofeedback is an extremely effective treatment modality.

For the treatment of ADD and ADHD, Rossiter and LaVaque (1995) found that 20 sessions of neurofeedback produced the same improvements in attention as taking Ritalin. A 2002 study with a one- year follow-up by Monastr, et al, discovered that neurofeedback was far superior to Ritalin.

Neurofeedback’s time has come, and more and more treatment centers and pain clinics are confidently offering neurofeedback to their clients. Mirasol pioneered the use of neurofeedback in the treatment of eating disorders and remains a center for research on the use of neurofeedback as an alternative to psychotropic medications. Not all medications need to be eliminated – indeed, they are absolutely necessary in many cases. But we have also found that people can actually retrain their brains so they may use much lower dosages of medication and even in some cases none at all.

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