Monday, March 24, 2014

From Survive to Thrive Guide

Why did I take on the project of creating a Guide for recovering from an eating disorder? And why did I want it written by those with lived experience? Because I know from personal experience that there are some pieces to an eating disorder that cannot be explained. There is an overwhelming sense of comfort and ease knowing that someone else out there has gone through the same struggle.

With over 200 responses from people who have struggled with body image and eating issues themselves, this Guide provides an abundance of insight and advice to those who are currently struggling with an eating disorder. In a sense, this Guide remembers what it was like to think that everything depends on weight and appearance. This Guide remembers what it was like to feel you could never be smart, attractive, or interesting enough. This Guide remembers what it was like to watch your friends and family feel completely powerless in how to help.

But more importantly, this Guide knows what it’s like to recover.

It can help you find a will to change, help build up a strong sense of self with a new, healthy way of coping that does not involve an eating disorder. By reading this, I want readers to feel empowered, confident, and understood.

You are not alone.


Here's a sneak peak of what you'll find inside the Guide! 
Available for FREE online here:
***Also available in ebook format on iTunes and Indigo books!***

Monday, March 17, 2014

Reflection on my PEDAW Clothing Drive, by Julie Sweeney

My experience with the PEDAW clothing drive was fantastic. Even while shlepping bag after bag after bag into the building where the charity was, I felt joy. Running around collecting bags and bags of clothing from various VIBES FITNESS locations and then taking them to WEAR 2 START was the highlight of my week - a couple of times. There was so much donated that I had to make 3 trips! People were generous and willing to participate. The wonderful owners at each VIBES FITNESS location took in the clothes from their members, but they also wanted education on what PEDAW is and about the charity I chose to make the donation to. I was encouraged by both their willingness to help with the clothing drive and their desire to learn more about both PEDAW and WEAR 2 START.
I felt led to get the word out and to have a clothing drive because so many people keep clothing "just in case". Just in case they lose weight and finally reach their elusive "goal weight," or clothes that are too big for fear motivation. Having a closet or drawer full of clothing that doesn't fit just serves as a reminder that you are not worthy. You are not worthy dressing your body as is, right in this very moment. Clothing that serves no purpose other than to frustrate you has to go to a better home. 

This clothing drive also had a personal meaning to me. I spent many years prior to my own recovery with the desire for a leather jacket. I would tell myself when I hit a certain size that I would allow myself to buy a cute black leather jacket. This went on for many years. Now that I'm secure in my body and who I am, yet no different in size than all those years I waited, I have a RED leather jacket and 2 fabulous pleather jackets which I love just as much! 

There is no more waiting for the "perfect" size or weight. You deserve to be comfortable and feel your best every day - not a certain number of pounds from now.  There is only today. Today is what matters, and you are beautiful. 

Insight to Action Counselling Services
(250) 889-3444

Wednesday, March 5, 2014

Emotion Focused Family Therapy for Eating Disorders (EFFT), by Natasha Files

Emotion Focused Family Therapy for Eating Disorders (EFFT)
EFFT seems to be the new buzzword in the BC eating disorders field, but let me assure you it is more than a trend. Initially hearing about it at the 2013 NEDIC conference, something about Dr. Adele Lafrance Robinson’s presentation caught my heart. Any therapy that believes in the healing power of parents as monumental for change wins my vote.

Developed as an adjunct to care and specifically for treatment resistant cases, EFFT views low self-efficacy and emotion avoidance as foundational culprits in the development and ongoing struggle with eating disorders. As presented in the below example, eating disorder symptoms are maintained as an attempt to quiet emotion, and individuals who lack the ability to fully express and have their emotional needs met, will continuously find themselves in a state of overwhelm. 

Imagine functioning in the realm of extreme emotion. Feeling another’s sadness, anger, fear or shame before they even express it. Believing you need to be the one to reduce the burden because tolerating it feels like too much. Each time someone looks at you the wrong way means they are thinking the worst – not to mention your whole existence is wrong; therefore, your actions are driven with a desire to avoid further shame. The sub-theme to your existence is about repaying a debt to humanity.

Now, imagine finding a way to dull that emotional intensity. Realizing that you can trade the discomfort and cocoon yourself behind a protective layer – much like the quieting of a busy city during the peaceful dark of a snowy night. You know the chaos still exists, but have found a refuge that feels unfaltering. Even if for a moment, hiding in this place promises a form of relief.

Then, imagine everyone in your life franticly demanding you come out from behind that protective fortress. People insisting your hiding space is bad. That you must stop, and change, and shatter the very thing that has promised you escape…

How do you convince someone to give up the one thing that helps them feel safe?
The short answer: you don’t. The long answer: you help them find a new definition for safety.

Super-feelers are highly sensitive to the emotions of others’, have an extreme degree of emotion perception, and experience their own emotions very intensely. Combine super-feeler status with the various known contributors to the development of eating disorders (genetics, cultural, social, life stressors, coping style) and you have the perfect storm. No wonder eating disorders develop.

Viewing the eating disorder as an adaptive way to manage emotion has transformed my clinical practice. I increasingly find myself saying, “that makes so much sense!” and no longer struggle to outwit or outsmart a seemingly relentless opponent.

This model values individuals as doing their absolute best, and challenges a deeper look whenever motivation is in question. Your child adamantly demands you stay out of her care? I can almost guarantee that she is really saying “I desperately want you involved, but am so worried it won’t go well, so I feel safer pushing you away.” Your client is convinced she is not ready to recover? I wonder if she is really admitting, “I am so scared and don’t know how to do this.”

The Role of Carers
So where do carers come in? EFFT teaches carers (any loved one who is in a caregiving role) to become their loved ones recovery coach and emotion coach, invites family members to participate in relationship repair, as well as offers an opportunity for carers to work through their own fears related to offering support.

Previously avoiding the word good in any therapeutic conversation, I have recently found myself saying good and very good more regularly. Why? Because each time we uncover the fear behind a behaviour – also known as speaking the unspoken – we have found a clue:

If I give her too much support she may never become independent.
Now we understand why you are not loving this approach. Good. We can work through that.

If I make her eat she may run away or kill herself.
 So now we know why you freeze each time she complains about meal support. Good. We can work through that.

Anyone can be taken hostage by emotion, especially fear, and EFFT invites carers (and therapists) to work through their fears in order to become more grounded in the recovery process. EFFT views care as “going back to get on track” and highly values a carers ability to soothe their child. How much more are we able to soothe when we don’t have the devil whispering core fears in our ear?

Recovery Coaching
Family members are taught how to support re-feeding and symptom interruption. Strategies for various situations are taught and practiced (including meal supervision, coaching phrases, asking direct questions, and even how to support someone through text message).

Emotion Coaching
Family members are also taught skills to support the processing of emotion, specifically around targeting bodily felt sense, emotional needs, and action tendencies.

Feels- heavy and slow
Needs- comfort
Action Tendency- reach out for a hug

Each emotion has a need, and it is by experiencing the full follow through of emotion that individuals come to rely less on the eating disorder symptoms. Emotion coaching supports the child to internalize emotion regulation skills and helps re-shape their experience of previously overwhelming feelings. It also enhances relationships.

Where to go from here?
EFFT balances empathy and compassion with firm limits that support symptom interruption, behavioural change, and an overall transformative experience of emotion. With preliminary data showing significant positive changes, this approach offers carers tangible skills in order to fully engage in and support their child’s recovery process.

1) Pay attention to how you and your child express and process emotion. Does it always feel safe to “go there”? Do you find yourself walking on eggshells for fear of something “worse” happening?

3) Consider attending the EFFT Carers Workshops in April. Carers, as well as clinicians (as observers) are invited to register:

About Natasha:
Natasha Files, MSW, RSW
Natasha holds a Master of Social Work (Clinical Specialization) from the University of Calgary, is a Registered Social Worker, and has specialized training in Dialectical Behaviour Therapy, Narrative Therapy, and more recently, Emotion Focused Family Therapy. Currently working in private practice, as well as being the Transitional Care Coordinator and an Individual and Family Therapist at Woodstone Residence, Natasha is passionate about facilitating a therapeutic experience that is both tangible and sustainable. 

Sunday, March 2, 2014

Dear Anorexia, by Kim Ratcliffe

September 8, 1998

I have come a long way since the first day we met. I don't need you nearly as much as I did before, and that's a good thing. For so long I have hated you, and now the hate has lessened. I think I am beginning to understand you and why I needed you so much. I also feel that we are both trying to trust each other and believe me I know how difficult that is. That "TRUST" word does not come easily to me or should I say it didn't come easily to me. I am beginning to see that you can trust people in this world, have relationships where people don't abandon me, or leave me. I don't want you to be a part of my life anymore, but I don't know if that is possible. I will have to deal with that. I realize that for the past 20 years I really needed you. You never left me, you made me feel safe, I could always count on you, you gave me power and control when I needed it, but you did this in a very DESTRUCTIVE AND HARMFUL way to me. That's where the anger comes in and why I hated you so much. The arguments we would have in my head nearly killed me. I could no longer take them which is why I got help!! You made me do things that are DISGUSTING like, abuse laxatives, loose a lot of weight, lie to everyone (including myself, be secretive, isolate from everyone (and the one that hurts the most from isolation is my kids, they never had a mother for a long time), I was always angry and hungry, you made me starve myself, you made me have medical conditions from the eating disorder (some I still have), I felt worthless, had no self-esteem, and my recovery has been one of the most hardest things in my life to go through. I nearly lost everything because of you, including my life!! How could you do this to someone? ME or ANYONE for that matter. You take lives away and don't even care because you are still out there grabbing on to someone else. YOU should be ASHAMED of yourself, not "us" feeling guilt and shame.

I was 16 when you came into my life, you had no right to! I was just a kid! Now, for the past 20 years of my life, I have done nothing but live with you, fight with you, and not even know who I am. You have taken 20 years of my life, and I had no choice about it. Now, for the past 4 years, I have been trying to get rid of you, so you can't hurt me anymore, (I have had enough hurt in my lifetime.) I would like to do this in a positive way, not a destructive way like you did. I can't say I forgive you completely, but I am trying to understand you and why I still need you at times. I am NOT a bad person (like you said I was), and if you would only let yourself see that, along with all the wonderful people I have met thru my recovery process. They really do care about ME, not what I look like or how much I weigh. It's "ME" they care about. The INSIDE stuff. And do you know what a wonderful feeling that is, to have someone care about me, for ME. I don't have to be THIN to be LOVED!! I don't need your protection anymore, nor, do I have to pretend to be someone else. I know in the 20 years you have been around, that through that time, I needed you to protect me, let me feel safe and worthy of myself, but I don't need that anymore from you. I can protect myself (in a healthy way), and I am beginning to love myself and find out who I am. I know I will continue NOT to need you as much, because even when you do come back in my life for a while, you don't stay around long enough to do any damage, a choice that is mine!! I won't give back to you all the hard work I have done in letting fo of you. You can't have it. It's mine. I guess this letter is GOOD-BYE!! Please leave me alone, I don't need you anymore or want you in my life! You have hurt me 20 years too much. This is now my life, not yours! One I have worked VERY HARD to build. I deserve a happy, healthy, ANOREXIA FREE LIFE!!

When I began writing this, I had no idea it would turn out to be a good-bye letter, but it did, and it was much needed for me to do.  I can see that now. I have done a lot of healing from writing this, one that's been a long time coming!!

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Saturday, March 1, 2014

The Heart of the Matter, by Deborah Grimm

She leaned in eyes wild and body tense. “Tell me,” she said, her halting words revealing the desperation within. “Tell me what I need to do to prevent my child from having an eating disorder?”

Having met with so many mothers this was not an unfamiliar question. I sighed, for I knew how badly she wanted the “golden nugget” that was at the heart of the matter. Those magic words that would save her child from a life threatening experience.

She wanted to be a knowledgeable mother.
She wanted to be an informed mother.
She wanted to be any mother, other than me.

My daughter, despite my best efforts, had found herself lost in the grip of an eating disorder so, oddly, that made me an expert in how NOT to create one.

“Well,” I began and she sat straighter in her chair, “the first things to know would be the facts.”

“The facts. Yes,” she replied, scribbling notes on a mental note pad.

“The tell tale signs of skipped meals, oversized clothes, anxious outbreaks and isolated afternoons.
Of sunken cheeks and glazed over eyes.
The fact that there is a genetic predisposition.” At this she flinched much as I knew she would.

And then the truth came next.

“I don't know exactly how to prevent an eating disorder but I have some ideas. You ready?”

She nodded yes.

“An eating disorder is not a choice, but rather a coping mechanism that seeks to manage a hideous inner dialogue with a fella named Ed. A dialogue that promises wonders, but delivers only broken dreams and heartache.

It is a mental illness. It is not a whim or a phase ones goes through. It is most definitely not just an attempt to get attention.

And prevention? Well I have big ideas on that.

To me it means that, as a culture, we would need to create a dialogue of understanding. To tease out the truth from the fiction and fear about one another. To raise our young men to bear witness to beauty that comes from within and young women to know that they are perfectly imperfect, just like the rest of the human race. That magazines are just magazines and the players in them, well, they have been played because in reality they are meant to be background to the clothing rather than the main event. We need to ask who you are rather than what. To hold the space for hurt and sadness and joy for each other and to learn how to sit in the emotion of all of it.”

I watched as she absorbed what I had said, coming to terms that there wasn’t an easy solution.

"And that ~ that’s what might help us get to the heart of the matter."