The 2012 Symposium ~ CED welcomes five distinguished treatment experts from around the world

The Center for Eating Disorders at Sheppard Pratt is proud to present Eating Disorders: State of the Art Treatment, on April 21st, 2012 in Baltimore, Maryland.  This is an exciting opportunity for phsyicians, psychologists, social workers, counselors, nurses, dietitians  and other treatment professionals looking to expand and deepen their knowledge and expertise in the treatment of individuals  with eating disorders.  You can learn more about the 2012 distinguished panel of speakers below.

We hope you’re planning to join us in Baltimore on April 21st.  

 

2012 Speaker Bios

 

Kelly G. Wilson, Ph.D.  ~ Dr. Wilson is an Associate Professor of psychology at the University at Mississippi. He is Past President of the Association for Contextual Behavioral Science, Representative-at-Large of the Society for a Science of Clinical Psychology, and is one of the co-developers of Acceptance and Commitment Therapy (ACT). He is a devoted teacher and winner of the University of Mississippi Elsie M. Hood Outstanding Teaching Award. Wilson has devoted himself to the development and dissemination of ACT and its underlying theory and philosophy for the past 22 years, and has published numerous articles and chapters, as well as 10 books including Acceptance and Commitment Therapy: The Process and Practice of Mindful Change and his newest books Mindfulness for Two, and The Wisdom to Know the Difference: An Acceptance and Commitment Therapy Workbook for Overcoming Substance Abuse. He has central interests in the application of behavioral principles to understanding topics such as purpose, meaning and values, therapeutic relationship, and mindfulness. Wilson is the founder of Onelife Education and Training, LLC and has presented workshops and provided consultancy in 26 countries, and has participated in a wide range of research projects in the U.S., Sweden, Spain, and the United Kingdom.  At the upcoming Symposium, Dr. Wilson will be presenting two talks, including Acceptance & Commitment Therapy for Eating Disorders and Body Image Disturbance as well as a breakout session aimed at helping clinicians to utilize ACT with their most difficult cases.

Timothy Brewerton, M.D.  ~ Dr. Brewerton is Clinical Professor of Psychiatry and Behavioral Sciences at the Medical University of South Carolina in Charleston, where he founded and directed the Eating Disorders Program (1987-2001) and was Medical Consultant at the National Crime Victims Research and Treatment Center (1996-2001). Dr.Brewerton is triple board certified in general psychiatry, child/adolescent psychiatry and forensic psychiatry, and is currently in private practice in Mt. Pleasant. He is Distinguished Fellow of the American Psychiatric Association and Founding Fellow of the Academy of Eating Disorders (AED). He served on the AED Board of Directors and is Past-President of the Eating Disorders Research Society and the South Carolina Council for Child-Adolescent Psychiatry. He is also currently President-elect of the South Carolina Psychiatric Association. Dr. Brewerton has published over 120 articles and book chapters, and is Editor of the text, Clinical Handbook of Eating Disorders: An Integrated Approach(2004). Dr. Brewerton serves on the Editorial Boards of the International Journal of Eating Disorders, Eating Disorders: The Journal of Treatment and Prevention, and Current Nutrition and Food Science. He is a well-recognized expert in eating and related disorders, having presented well over 300 lectures, workshops and symposia in the U.S. and around the world. Most recently, Dr. Brewerton’s work with trauma and eating disorders and his substantial contributions to the field were honored as he was awarded as IAEDP’s 2012 Honorary CEDS (Certified Eating Disorders Specialist).  At CED’s upcoming symposium, Dr. Brewerton will be presenting a keynote presentation entitled Trauma and Eating Disorders: Updates and Advances in Managing the Complex Comorbidity as well as a breakout session for clinicians who work heavily with this patient population.  Hear more about Dr. Brewerton’s research in this Q & A about the intersection of eating disorders & trauma.

Joanne Dolhanty, Ph.D. ~ Dr. Joanne Dolhanty has worked in the field of eating disorders for over 20 years. She completed her doctoral studies in Clinical Psychology at York University, and trained and worked in the Toronto General Hospital Eating Disorder Program for 15 years. She currently works as a psychologist in the Eating Disorder Clinic at the Credit Valley Hospital, and at the Mt. Pleasant Therapy Centre, in Toronto. For the past several years she has been working with Dr. Les Greenberg to develop the application of Emotion-Focused Therapy (EFT)to eating disorders and is committed to training other professionals in this approach.  Dr. Dolhanty has facilitated a number of professional workshops on EFT across Canada and the U.S., including presentations for the Academy for Eating Disorders’ International Conference, the World Congress of Behavioral and Cognitive Therapies, and the Eating Disorders Research Society.  At the April 21, 2012 symposium, Dr. Dolhanty will be providing presentation entitled, Fat Is a Feeling: Emotion-Focused Therapy in the Treatment of Body Image Disparagement, as well as a breakout session for clinicians looking  for an Introduction to Skill-Development in Using EFT in the Treatment of Eating Disorders.

B. Timothy Walsh, M.D.  ~ Dr. Walsh is a graduate of Princeton University and of Harvard Medical School, joined the staff of Columbia University Medical Center in 1979 and established the Eating Disorders Research Unit at New York State Psychiatric Institute. Dr. Walsh is currently the Ruane Professor of Pediatric Psychopharmacology in the Department of Psychiatry at the College of Physicians & Surgeons, Columbia University, and Director of the Division of Clinical Therapeutics at New York State Psychiatric Institute. Dr. Walsh’s research group has examined biological and psychological abnormalities which contribute to the development and perpetuation of disturbances in eating behavior, and investigated both psychological and pharmacological treatments for Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Dr. Walsh is a member of the DSM-V Task Force and chairs the Eating Disorders Workgroup for DSM-V. He is a past president of the Academy for Eating Disorders, and of the Eating Disorders Research Society.  On April 21st, Dr. Walsh will be discussing the important topic of Eating Disorders in the DSM-V: Why the Criteria Have Changed and What it Means for You and Your Practice.  He will also facilitate a breakout session focused on Enhancing Recovery from Anorexia Nervosa.

Janet Treasure, Ph.D., FRCPsych  ~ Professor Janet Treasure is Director of the Eating Disorder Unit and Professor of Psychiatry at University College London. She has more than 25 years experience in the treatment and study of eating disorders and is currently director of the Eating Disorders Service. Professor Treasure is also Chief Medical advisor for BEAT and a fellow for the Academy of Eating Disorders. During her career, she has edited seven academic texts on eating disorders and authored multiple books for individuals, families and clinicians, including The Clinician’s Guide to Collaborative Caring in Eating Disorders: The New Maudsley Method. Professor Treasure has been active in research and has over 150 peer reviewed papers in print. Among the numerous awards she has received for her work, are the 1984 Gaskell medal from the Royal College of Psychiatrists and the 2004  Leadership Award in Research from AED. In addition to her considerable research into eating disorders, Professor Treasure has been highly involved in treatment trials for type 1 diabetes through CBT and motivational interviewing. Professor Treasure has trained over 20 PhD students in research on eating disorders and is one of the most highly decorated academics in this branch of research. We are excited to have her as part of the 2012 Symposium where she will present:  Accentuating the Positive and Enhancing Motivation to Change: Essential Tools to Help Patients with Eating Disorders Engage in Treatment.  Dr. Treasure will also conduct a breakout session entitled, Collaborative Care and Skills Sharing with Families to Facilitate Motivation to Change.

There are still a few spots left for the upcoming professional symposium, Eating Disorders: State of the Art Treatment, on April 21, 2012 in Baltimore, MD.  If you’d like to attend, please download the program brochure for details and complete your online registration here.

Trauma and Eating Disorders: Updates & Advances in Managing the Complex Comorbidity

Dr. Timothy Brewerton

On April 21st, 2012 treatment professionals from across the country will gather in Baltimore for a day of advanced training and learning opportunities focused on improving treatment options and outcomes for their patients with eating disorders.  Dr. Timothy Brewerton, one of five distinguished experts presenting at the event, is widely respected for his contributions to the field of eating disorder treatment, particularly regarding his work with co-occurring trauma.  In advance of his presentations, we asked Dr. Brewerton to comment on this complex intersection between trauma and eating disorders.   Read on for his informative responses, and find his full bio here.  

 Q & A with Timothy Brewerton, M.D.

Q: There is a lot of conflicting information about the co-occurrence of trauma and eating disorders.  From your experience with the research regarding this population, what is the prevalence of trauma disorders among individuals who have an eating disorder?  And conversely, what percentage of individuals who’ve experienced trauma, struggle with eating disorders? 

Dr. Brewerton:

There has been enormous variability in the quality of methods in studies that have assessed trauma and eating disorders, including the size and nature of samples used and the assessment instruments employed. How and when a clinician assesses a trauma history is crucial to the outcome. Using behaviorally specific language, rather than vague, open ended questioning, is much more preferable. More importantly, most studies have not assessed for lifetime and current histories of PTSD and partial or subthreshold PTSD, the presence of which appears to be a crucial mediator between a prior history of trauma and the subsequent development of an eating disorder.  

Trauma histories and PTSD are exceedingly common in subjects with eating disorders. The National Women’s Study found that 54% of a non-clinical, representative sample of women in the U.S. with BN had lifetime histories of a major crime victim event, including rape, molestation and/or aggravated assault. In addition, 38% of this same sample of women in the U.S. with BN had lifetime histories of PTSD. In the more recent, National Comorbidity Replication Survey, 100% of men and women with BN reported a major traumatic event, most of which was of an interpersonal nature, and 45% of both women and men with bulimia nervosa (BN) had lifetime PTSD. 

When lifetime partial or subthreshold PTSD is factored in, the great majority of individuals with BN meets criteria for partial or complete PTSD. And it is these individuals with PTSD or partial/subthreshold PTSD that have the highest rates of comorbidity and have the highest rates of treatment refractoriness. Conversely, most traumatized individuals do not develop eating disorders, although in traumatized individuals with PTSD the odds ratio (OR) for developing BN is 10.2, for binge eating disorder (BED) it is 5.1 and for any binge eating it is 4.0.

Q: We know there is some positive correlation between eating disorders and trauma.  When broken down into anorexia, bulimia, binge eating disorder and EDNOS, do we see any trends in terms of their associations with trauma?

Dr. Brewerton:

Yes, there is a fairly consistent association between trauma history and all of the eating disorders that involve bingeing and/or purging, but not pure restricting. This link has been most clearly established for bulimia nervosa (BN) and secondarily for anorexia nervosa, binge-purge subtype. There are also several well-done studies showing higher rates of trauma history and PTSD in individuals with binge eating disorder and EDNOS associated with binge eating and/or purging, e.g., “purging disorder.”

Q: We know eating disorders can arise from a complex combination of factors.  How do you conceptualize and explain the role of traumatic life events in terms of its roll in eating disorder etiology?

Dr. Brewerton:

Eating disorders are highly heritable conditions in that genetics appears to account for 0.5 to 0.8 of the variance, regardless of the type of eating disorder. Given our increasingly expanding knowledge of gene x environment interactions, the old adage coined by George Bray holds true: “Genetics loads the gun, and environment pulls the trigger.” Traumatic life events presumably trigger gene expression in susceptible or predisposed individuals, which in turn leads to a cascade of events in brain that is associated with trauma-related thoughts, feelings, memories and behaviors, as well as associated symptomatology of anxiety, depression, and dissociation. In other words, traumatic experiences overwhelm the person’s internal (neurobiological) and external (psychosocial) resources such that there is a failure of integration of these experiences. In turn, behaviors typically associated with experiential avoidance develop, such as bingeing, purging and/or substance abuse, and represent attempts to not only avoid trauma-related thoughts, feelings, and memories but to reduce emotional arousal as well.   

Q: On April 21st you will be presenting Trauma & Eating Disorders: Updates and Advances in Managing the Complex Comorbidity.  What general questions can symposium attendees hope to have answered during your presentation? 

Dr. Brewerton:

Following the talk, attendees will walk away with the following questions thoroughly answered:

  • What are the best self-report and interview-based assessments for screening for trauma, PTSD and comorbid psychopathology?  
  • What is the research evidence from both female and male samples of all ages that supports the conclusion that traumatic experiences are significant yet nonspecific risk factors in the development of eating disorders and other related psychiatric conditions?  
  • What are best-practice, integrative treatment approaches for patients of all ages with both eating disorders, PTSD, and other comorbid conditions?

Dr. Brewerton recommends the following sites for additional information regarding the impact of trauma as well as resources for research and treatment:

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Many thanks to Dr. Brewerton for taking the time to respond to our questions and for discussing this important topic. Dr. Brewerton will be presenting the following sessions at the 2012 symposium, Eating Disorders: State of the Art Treatment, on April 21, 2012:

  • Morning Keynote ~ Trauma and Eating Disorders: Updates and Advances in Managing the Complex Comorbidity
  • Afternoon Breakout SessionChallenges to Therapists in the Long-term Psychotherapy of Traumatized Eating Disorder Patients

Interested in attending this professional event?  Please Note: there is limited space available as we approach the event.  View the full program agenda, download the program brochure and register online today to ensure your space at the symposium.  Questions?  Call (410) 938-4593.

www.eatingdisorder.org

 

 

 

Social Networks ~ Building a Body Positive Presence Online

Developing a positive body image isn’t necessarily easy and often takes a lot of work.  Creating a body positive Facebook page, however, can be easy with a few simple steps…

If you haven’t done this yet, start by recognizing any negative or positive effects that  your Facebook use may be having on your self-esteem or body image.  How often do you publicly or privately criticize your own body while on Facebook?  How much time do you spend comparing your body to other people’s bodies online? Do your comments on other people’s photos regularly focus on weight or appearance?  Do you ever get overwhelmed by this?

If the answer to any of these questions has you concerned, you’re not alone.  As we’ve been discussing here on our blog, the resultsof a recent public survey indicate that Facebook and other online social networks can be a tumultuous environment when it comes to body image.  Many survey respondents shared that seeing photos of themselves and others on Facebook often makes them more self-conscious about their own body/weight, even to the point that they often feel sad about it.  It seems that a lot of Facebook time is spent comparing, criticizing and lamenting our bodies, so today’s post is all about changing this online culture of negative body image. 

Read on for tips and ideas that can help us as individuals, and as a community, move towards building a body positive presence online.

Remember the basics while on Facebook:

  • People often go to great lengths to create a ”perfect” image of themselves online – be wary of comparing your real life or your real body to someone else’s online persona. 
  • There are many benefits of online social networks. Most importantly, they offer an incredible way to connect with and learn from other people and organizations.  That being said, do your best to present your authentic self instead of a “perfected” or fake online persona (see above).  Be mindful that you are using Facebook and other social networks for purposeful, real, positive connections with people and organizations that you respect and that give you respect in return. 
  • Don’t forget – people tend to be mostly focused on themselves; your Facebook friends are never looking at photos of you as critically or as closely as you are of yourself.  

Interrupt the body negativity  in your social network feeds by subscribing to some body positive organizations.  These are just a few great body image advocates on Facebook, many of them are also on Twitter and Pinterest: 

Proud2BmeUS -   Making it cool to be body positive! An online community for teens who want to change the way teens talk about food, weight, and body image. Written by and for teens but great messages for adults too!

The Illusionists - A sophisticated look at body image across the world and the global effects of the beauty industry… uncovering how mass media, advertising, and industries manipulate and exploit people’s insecurities about their bodies for profit. 

Linda Bacon HAES -  Shifting the focus from weight to health, giving people of all shapes the tools to achieve better fitness, health and even happiness – all without ever dieting again.

Adios Barbie - A daily dose of beautiful. Their mission: to promote healthy body image and identity in folks of all races, sizes, ages, sexual orientations and abilities.

End Fat Talk  - Eliminating fat talk, changing the conversation about body image.

By subscribing to at least a few of these organizations, you set yourself up for a boost of daily body positivity – when is the last time you set yourself up to succeed?  Read their posts and click on their links.  Over time, you will begin absorbing these positive messages, and it can help you shift your own focus away from weight, back to health and holistic well-being. 

Take a stand  and make a conscious decision NOT to engage in weight obsession or “fat talk” within your online communities.  Here’s your challenge: try only posting about or commenting on friends’ non-physical accomplishments and successes instead of immediately zeroing in on how they look or what they weigh. 

 Here’s a few common Facebook examples:

~ Your cousin just had a baby and posts a picture of herself with her new bundle of joy.   A  common [weight-focused] Facebook comment would be:  “Congrats! You look great – You don’t even look like you just had a baby!”  Instead of focusing in on her body, consider adding something to the online conversation that honors her feelings and her role as a new mom without drawing attention to her waistline:  “Congratulations! You are radiating the happiness of a new mom! Can’t wait to see you and meet the baby.” 

~ An old high school friend posts something about meeting his weight loss goal and is receiving tons of compliments for it in the comments below his post. Instead of joining in the chorus of, “Wow- you look amazing!…Congratulations!…I’m so jealous!”comments, think about what you might be condoning by doing so. Would you still leave a celebratory comment on someone’s Facebook page if you knew their weight loss was a result of fasting, obsessive exercise, purging or other behaviors that were putting their health at risk?  Hopefully not.  The truth is, you can’t tell a whole lot about some one’s health from a picture on Facebook so you may want to abstain completely from commenting on people’s weight.      

Unfortunately, we hear from individuals with eating disorders all the time who get a lot of positive feedback for their weight loss - online and offline – from friends, family and even health care providers who don’t know what they’re really doing to lose the weight.  This positive reinforcement often promotes an escalation of  unhealthy behaviors and can strengthen a person’s reliance on weight loss for maintaining self-worth.  As columnist Yashar Ali wrote for The Current Conscience,   Think Twice Before You Praise Someone for Losing Weight, becuase you just never know what’s going on behind the computer screen. 

Draw the line when it comes to protecting your own well-being while online.  If you find yourself continually triggered by a certain Facebook friend, do not be afraid to unsubscribe from their Facebook updates.  It can be very empowering, and beneficial to your body image, to hide comments or unsubscribe from people if they continually focus in unhealthy ways on weight, dieting or superficial definitions of beauty. 

Take a break if you find yourself unable to escape feelings of jealousy, sadness or comparison while online.  Experiment by logging off temporarily and see how your mood and body image respond.  Use the time that you would have spent on Facebook to acquire a new hobby, connect with body-positive friends by phone or in person, or engage in other activities that honor your body and mind in a healthy way.

Are you willing to ditch the diet and weight obsession online?  Ready to make the change to a body positive page? Please join us on Facebook and share your suggestions for promoting a positive body image within your online social networks.

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If at any time, you are engaging in disordered eating or dangerous behaviors seek professional help right away.  You can visit www.eatingdisorder.org for information about treatment and support or call us at (410) 938-5252.

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What’s Really Going On with Facebook & Body Image?

The results of our recent survey regarding the intersection of Facebook use and body image have been highlighted by various news outlets over the past two weeks.  We discussed the implications of the survey results here (and as a guest post over at The Illusionists), drawing attention to the fact that 51% of the 600 survey respondents said they often compare themselves to others while on Facebook and that seeing photos on Facebook makes them more self-conscious about their own body and weight.  Additionally, 32% endorsed feelings of sadness when they compare their body to other people’s photos on Facebook which, for most people, is at least once a day if not more.

Facebook: Body Image Friend or Foe? at The Illusionists.org

We originally set out to do this survey because we were finding that patients with eating disorders were meeting with great difficulty in the recovery process when it came to logging into their Facebook accounts.  In fact, before we released the full survey results, one user on our Facebook page left the following comment:

Facebook definitely played a role in fueling my eating disorder symptoms and behaviors.  Most people only post pictures that glamorize their bodies and social life…There have been multiple times throughout my recovery that I have deactivated my account because the things I was seeing online were fogging my view of reality.  Realizing that the site was doing more harm than good for me has made me more aware of the things I post on my account.  I think it’s important to make sure we are trying to foster a safe and healthy community and we can only do that if we first change the way we act… .” -  Facebook User

While some media outlets have gone as far as to say that Facebook is a cause of negative body image and eating disorders, others have dismissed the significance of the results as par for the course in our  image and weight-obsessed culture.  Others, including this editorial assistant over at Allure Magazineonline, have spoken up in a personal, and humorous, way about the modern realities of  this pressure-to-be-perfect in Facebook photos. Despite the varied reactions, one thing became clear to us following the survey;   Individuals with eating disorders are not alone in their battle with body-obsession on Facebook.   

Since the survey, we’ve been asked multiple times about how body-pressure from online social media differs from the toxic messages we’ve been getting for decades from fashion magazines, commercials and weight-focused friends?   The answer: the content itself is nothing new to us as a society - conversations that are hyper-focused on weight loss, diets, bikini bodies, and who looks ”hot or not” – but the delivery and dissemination of it is new.  We’ve noticed the following characteristics of online communities are unique in how they can potentially affect the relationship we have with our bodies: 

  • Accessibility - Online social networks never turn off.  Even when you’re by yourself you’re often not far from your laptop, iPad or Smartphone and the lure of logging in to Facebook.  In the past, waiting in line at the store might have included…waiting in line.  With a smartphone it could easily be spent browsing Facebook pics from your old college roomate’s beach vacation or reading about Aunt Sally’s 37th time going on a diet.  For better or worse, we have a lot more visual information at our fingertips than ever before. 
  • Immediacy – your status update or photo can literally be seen (and commented on) around the world in a matter of seconds.
  • Lack of control over what other people post and how people comment on it.
  • Two-way street- unlike with magazines or commercials, Facebook not only allows you to see photos of other people, but allows them to see photos of you.  Maybe even more importantly, YOU are seeing public photos of you which can sometimes create the most body anxiety, especially if your instinct is to zero in on all of your supposed “imperfections” in each picture.
  • Business or Pleasure? – there’s a unique mix between the personal and business realms on Facebook.  Users often use one account to stay connected with friends/family but also occasionally promote a product or business in their posts and photos.  This means we get advertisement-like messages about beauty, exercise and weight-loss products from people we like and/or trust.  Confusing? Definitely.     
  • The sheer number of people you are connected to on Facebook is more than you would ever casually socialize with on a Friday night. The thought of hundreds or even thousands of people zeroing in on what you imagine to be “imperfections” can be overwhelming when it comes to body insecurities.  (It’s important to remember that no one else is ever looking at you or your body in photos as closely as you are!) 
  • Body Comparisons while on Facebook take on new meaning because you’re seeing real people.  Unlike magazines and advertisements which feature [heavily photoshopped]models and celebrities, photos of Facebook friends may, unfortunately, feel like a more realistic or welcoming comparison.  

The truth is, when you get caught up in comparing yourself and your body to other people (online or off) you can’t win.  Blogger, Margarita Tartakovsky, shares her journey out of this comparison trap in How To Stop Comparing Yourself To Others, in which she reflects:  

When you’re rarely satisfied with yourself, your self-worth is shaky, and you see others’ lives as almost perfect – or definitely better than your own. You  constantly search outside yourself, and as a result, you knock yourself down. For many of us, comparing ourselves just changes stripes from time to time. One day, we want someone else’s abs, biceps or hips. Another day, we want their smarts or style. A few days later, we want their family life or financial situation.  Until we can truly believe in ourselves, the comparisons will swirl and sabotage…It’s interesting that now that I accept, appreciate and believe in my body, the physical comparisons have mostly quieted.

The trap of body negativity and comparisons on Facebook can certainly be difficult to avoid, especially if your online social atmosphere includes a lot of people who place a high value on appearance-only qualities or happen to be caught up in the diet mentality themselves.  The impact can feel much more powerful if your body image is already in a fragile state as is often the case for individuals with eating disorders and those recovering from eating disorders.  

The great news is that you can mold a more positive online experience for yourself.  If you’ve reflected on your Facebook use,  assessed its impact on your body image and realized that too much of your social networking time is spent feeling worried or sad about how you look, than it may be time to set some changes in motion.

You can start by vowing to maintain a body positive Facebook profile - this means not engaging in fat talk, self-criticism, diet discussion or body snarking while on Facebook. Once you’ve made the decision to do so, you can find tips and suggestions for incorporating body positivity in our post, Social Networks ~ Building a Body Positive Presence Online.

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