Archive for the 'In the News' Category

Utilizing Transference & Countertransference to Deepen the Treatment of Eating Disorders, with Kathryn Zerbe, M.D.

Following an incredibly positive response to her April 2009 presentation on integrated treatment for eating disorders, we are thrilled to welcome Kathryn Zerbe, M.D. back to Baltimore for our 2010 annual professional symposium.  Dr. Zerbe will present, along with 5 other distinguished experts, at Eating Disorders: State of the Art Treatment on Saturday September 25th, 2010.  Her much anticipated  presentation will focus on psychodynamic approaches and the use of transference and countertransference to enhance clinical practice in the treatment of individuals with eating disorders.

Kathryn Zerbe, M.D. is a Professor of Psychiatry and Obstetrics & Gynecology at Oregon Health & Science University.  She also serves as the Director of the Oregon Psychoanalytic Institute and has authored over 60 clinical papers and four books including, Integrated Treatment for Eating Disorders: Beyond the Body Betrayed.  Dr. Zerbe is a Distinguished Fellow of the American Psychiatric Association and a Fellow of the Academy of Eating Disorders. She has been repeatedly selected as one of “America’s Top Doctors” and is a highly sought after speaker both in the united states and internationally.

Find out more about Dr. Zerbe’s work and her upcoming presentation in Baltimore by reading her insightful and thought provoking responses to our questions below.  And don’t miss your chance to attend all six expert presentations on September 25th, 2010. (This event has been approved for 7 CME/CEUs). REGISTER soon!  Space is limited. 

Q & A with Kathryn Zerbe, M.D.

The title of your upcoming talk in Baltimore is “Resiliency, Vulnerability and Growth: Utilizing Transference and Countertransference Reactions to deepen the Treatment of Eating Disorders”.  What specific role does vulnerability play in this process?

KZ: Bewilderment, boundaries, and burnout — these are just a few of the concerns that clinicians are liable to struggle with when treating patients with an eating disorder.  Recognizing that in our quest to be helpful to our patients, we also face a potential undertow because the work to preserve life is taxing in the short run and often takes a commitment of time, energy, and sacrifice in the long run.  Clinicians ‘in the trenches’ know these facts, but what do we do to help ourselves to deal with the hurt feelings that arise when tenacious negative transferences arise, or when we are in a seemingly unwinnable battle with 3rd parties, or experience powerlessness when the patient refutes our counsel?  Awareness to these vulnerabilities, and others, are the first line of defense in staying attuned, steadfast, and nimble in robust clinical practice.

What would you say is the biggest barrier clinicians may face in trying to implement improved strategies for utilizing transference and countertransference in the clinical setting?

KZ: “To know thyself’ and “To be true to thyself’ have been laudable goals since the time of Socrates and Shakespeare, respectively, but such ideals are easier to write about in the abstract than to achieve in real time.  With the daily challenge of managing a lively practice and tending to one’s busy personal life, it is easy to put one’s own needs on the back burner.  Taking a small amount of time weekly to think about the impact of clients is enormously helpful.  In this way, one works on the feelings and clinical formulation one has about each specific person in practice but is simultaneously humbled by what each person teaches us by sharing their unique history and viewpoints.

 

What are the potential consequences of ignoring or ineffectively addressing transference and countertransference issues in the therapeutic process?

KZ: Like most clinicians, I feel extraordinarily blessed to be working in this field where one has the opportunity to witness individuals grow and change over time.  However, burnout is a formidable foe to contend with because change is often difficult, slow, and painful for the patient.  Sensitive clinicians pick up on, or in technical parlance, “contain,” these feelings.  To avoid burnout and to keep the work fresh, invigorating, and growth promoting, the therapist  who ‘knows himself or herself’ best is in a better position to assist the patient, and this is a ‘work in progress’  that is never done until one retires from practice altogether.

In your upcoming presentation, you will discuss strategies for managing “cultural countertransference”. Can you briefly define this term in the context of treating individuals with eating disorders?

KZ: Therapists as well as patients are prone to having conscious and unconscious reactions to media stereotypes, idealized body images, and culture norms as a whole.  We clinicians are in a better position to help our patients by becoming more aware of these potential ‘blind spots’ to  the  prevailing cultural  in ourselves and thinking them through.  Recovery can be enhanced by a timely discussion and critique of noxious cultural norms in therapy.  Both patient and clinician can make use of reading, media, movies, self-scrutiny, and ongoing dialogues with peers or consultants to become more cognizant of our largely unconscious idealization and overvaluation of beauty.   However, as Dr. Catherine Steiner Adair of Harvard University pointed out when she defined the term ‘cultural countertransference,’ in the early 1990s, we must also be wary that too much focus on the culture can be a defense to deepening the patient’s treatment.

Overall, what do you hope symposium attendees will take away from your presentation at The Center for Eating Disorders on September 25th?

KZ: If participants emerge from my talk (which will use art history slides to demonstrate concepts and to provide encouragement for each therapist to bring his/her unique creativity and tenacity to the therapy hour) with permission to ‘take care of yourself’ as you take care of the patient, I will be very happy, indeed.  Perhaps there will be an idea or two that will be new to the ear, but more likely the listener will simply take more seriously the need for ‘time outs’ and the pragmatic and psychodynamic reasons that undergird that need and recommendation.  One of my heroines, Eleanor Roosevelt, said “Do something that is scary everyday!”  I keep that saying on my desk as a reminder that our daily work as clinicians presents us with mysteries and a summons for personal growth that we can’t predict when we get to the office in the morning.  The more tools that we have in our therapeutic hip pocket, the better!  So, I’m looking forward to gaining wisdom from the other speakers who come first and hearing the comments and questions from the audience to, very selfishly, enhance my individual practice!

Our enduring thanks to Dr. Zerbe for taking time out of a busy schedule to provide such thorough answers. Be sure to join us on September 25th for what is sure to be an engaging and enlightening presentation.  Download the Eating Disorders: State of the Art Treatment PROGRAM BROCHURE (pdf) for registration details and deadlines.

If you’d like to order or find out more about Dr. Zerbe’s publications, please click on the links below.  These titles will also be available for purchase at the upcoming symposium.

Published by Kate Clemmer
August 20th, 2010 in CED Events, Editor's Picks, Enhancing Clinical Practice, In the News, Professional Education, Q & A, Therapies, Treatment Providers
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Baby Steps in the Wrong Direction? Increased Anxiety About Weight in the Very Young Child

Have we as a country gone too far in conjuring up a fear of fat?  Most eating disorder specialists and body image advocates would say we hit that milestone long ago – the proof being in our country’s continued and desperate reliance on dieting despite its 95-98% failure rate.  However, recent research seems to suggest a new low – one that we are concerned may spike unnecessary anxiety in new parents and could further distort our country’s relationship with food and eating, beginning with our youngest and most fragile generations.  That being said, we felt it was important to address this topic within our Nurture blog series.

This relatively new research, out of Eastern Virginia Medical School, proposes that a progression toward obesity begins as early as three months old.  Researchers have referred to their findings as a “tipping point”, suggesting we further scrutinize weight during the earliest months of life.  The study’s online abstract states, “that the critical period for preventing childhood obesity in this subset of identified patients is during the first 2 years of life and for many by 3 months of age.”

This raises a lot of serious concerns about how we might be encouraged to interpret these results.  Should worried parents or concerned childcare providers cut down on or restrict breast milk and formula out of fear for an infant’s future weight category?  Will parents of healthy, naturally larger babies be inclined to panic during weigh-ins at the pediatrician’s office or be made to feel they need to enforce low calorie diets to help their baby or toddler lose weight?  Not only do these things not work to prevent children from becoming overweight, they are also incredibly dangerous and can disturb a young body’s natural hunger and fullness cues, setting the groundwork for a harmful relationship with food later in life. The same disruption can happen when infants or children are persuaded to eat when not hungry or made to eat significantly past the point of fullness.  Ellyn Satter, a family therapist, registered dietitian and internationally recognized authority on eating and feeding speaks to this process on her website, stating,

“Children who eat and grow at the extremes make their parents so nervous that they often interfere. It backfires. In our weight-obsessed culture, parents may try to restrict a robust child with a hearty appetite because they assume that enjoying food and eating a lot means she will get fat. It doesn’t, and it doesn’t work. Children who don’t get enough to eat—or fear they won’t—become preoccupied with food and tend to overeat when they get a chance…

…Pressure on children’s eating always backfires. Trying to get a child to eat more than she wants makes her eat less. Trying to get her to eat less than she wants makes her eat more.”

Understanding the paradoxical outcome of restricting early feedings leads us to question the messages sent by this research study as well as those introduced by most childhood obesity prevention campaigns today.  As a country, we should pause and ask ourselves if increasing anxiety about infant and childhood weight might be hurting more than it is helping?  Promoting an even earlier vigilance and stigma around weight and bodies seems only to be muddying the water further, adding to the very “problem” that studies such as this one seem to be trying to address.

Negative messages about food and weight passed from our culture to our infants and children can lead to strained feeding and food relationships, a diet mentality, low self-esteem and negative body image.  All of these things are also risk factors for the development of disordered eating and eating disorders, including anorexia, bulimia and binge eating disorder which is the most prevalent and is often associated with obesity.  For most adults concerned about a child’s weight or well being, the obvious next question would be, “well than what am I supposed to do?”

Consider moving away from a hyper-focus on weight, body type, BMI or any other calculator of weight. Like most efforts involved in parenting, it’s not an easy task to accomplish particularly when it seems like every newspaper article, concerned relative, or public service campaign is telling you to do the opposite.  Do your best to focus instead on your child’s overall health (remembering that weight does not = health).  Honor and accept your child’s natural body size and shape.  Create positive goals around eating that involve paying attention to your baby’s or child’s internal hunger and fullness cues instead of relying on external messages about how much is “too much”.  Positive goals might also include taking steps to decrease the stress related to feeding a family by learning about and adopting Satter’s Division of Responsibility (DOR) in feeding which can be utilized from the earliest stages of infancy throughout adolescence. As  stated on EllynSatter.com, our goals as parents and as a culture with regards to feeding should be to:

“emphasize competency rather than deficiency: providing rather than depriving: and trust rather than control.” *

We would add that providing education rather than stigma; positive goals rather than “tipping points”: and fostering tools rather than anxiety will go a long way in helping to nurture a culture that cares more about health and less about size.

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*Quotes are copyright © 2010 by Ellyn Satter. Published at www.EllynSatter.com. For more about raising children who eat as much as they need and get bodies that are right for them (and for research backing up this advice), see Ellyn Satter’s Your Child’s Weight: Helping Without Harming, Kelcy Press, 2005. Also see www.EllynSatter.com/shopping to purchase books and to review other resources.

photo courtesy of  pediatrics.about.com

Published by Kate Clemmer
August 13th, 2010 in Body Image, Editor's Picks, In the News, Nurture. Blog Series, Nutrition
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Q & A with Harriet Brown: Part II

On Monday we began a 3-part blog series featuring Harriet Brown, author of the upcoming book, Brave Girl Eating: One Family’s Struggle With Anorexia.   If you missed it, you can go back and read Part I in which Harriet shared about her family’s initial discovery of her daughter’s anorexia and where their journey to recovery began. Today in Part II, we resume our conversation with her about that journey to help her daughter recover, how it affected their family, and what she has learned from it.

Harriet Brown will be speaking at a free community event in Towson, MD on August 25, 2010 – click here for details.

Q & A with Harriet Brown: Part II

You describe your daughter’s recovery as a “slow, painful, infinitely courageous climb back up to health and hope.”  Can you share some of the most important steps your family took along this difficult journey?

HB: The most important step in the journey came when we decided to use family-based treatment and, essentially, empowered ourselves to help her recover. Until then we’d been more or less sidelined; we felt helpless and we didn’t know what to do. We wanted the doctors to tell us what to do and how to cure our daughter. It quickly became apparent that they weren’t going to do that, that they didn’t seem to know much more than we did in certain ways.

When we took on the FBT, we took on both the responsibility and the power to intervene. That was a tremendously liberating step. The worst part of my daughter’s illness for me was standing by helplessly, watching her suffer and starve. The notion that my husband and I could help her required a huge mental paradigm shift—but once we made it, we were much more effective.

Externalizing the disease makes it easier to stay calm, not engage with the eating disorder, and not get angry at what often feels like oppositionality. It helps you understand, as a parent, that your child is essentially being held hostage by an illness, not acting out or being stubborn. It’s very, very helpful.

Another important step was learning to externalize the disease. Anorexia is insidious; it speaks with your child’s voice and looks out of her eyes. It’s natural to think that it’s your child refusing to eat, resisting, raging, or whatever the behaviors are. We made a conscious effort to think of the illness as something separate from our daughter, and that let us see the glimpses of the real her under the savage face of the disease. I characterize the disease as the demon in the book—it’s not that I thought she was literally satanically possessed. Rather it was my metaphor for the way the illness took over her thinking and behavior.

As parents, how did you and your husband manage to take care of yourselves and other aspects of the family while putting the necessary time and energy into supporting your daughter’s recovery?

HB: Well, I don’t think we managed this very well! We made our daughter’s recovery our top priority in the family for many many months. We more or less gave up having a social life, because most social events revolve around eating, and it was a long time before we could eat in public comfortably. We cared for our younger daughter, which mostly consisted of getting her out of the house sometimes so she didn’t have to deal with all the chaos and noise and angst. I went to work sometimes and worked at home sometimes, thanks to a very supportive boss; my husband is a freelancer, so he was home a lot. Other than that we did very little that wasn’t related to re-feeding and recovery. We became very single-minded. And honestly, I think that’s what we needed to do. When you’re engaged in such a full-on onslaught, such an encompassing, overwhelming effort, you have to focus on that as much as possible. In fact that’s advice I would offer families: Don’t think you have to keep up a normal social life during this time. Take care of recovery first, and if you want to fit in other things and they nurture you, great. But don’t feel like you have to. Most families find this process pretty absorbing.

What is the most important thing you learned in the process of parenting and caring for someone with an eating disorder?

HB: I learned the power of love. I know that sounds corny, but the truth is that no one loves your child the way you do. And no one, therefore, has the power you do, the utter commitment, the doggedness, the resilience, to see her through the hell of an eating disorder. And you need every ounce of those qualities as a parent, because this is the most grueling experience your family will likely go through.

We would like to express continued thanks to Harriet Brown for taking the time to address these questions and share her insight and experience with our readers.  Be sure to check back for the third and final Q & A post with Harriet next week.

Interested in hearing from Harriet in-person and getting a signed copy of her book? Download the EVENT FLYER for her August 25th presentation at The Center for Eating Disorders at Sheppard Pratt and find driving directions on our Events page.

Published by Kate Clemmer
August 12th, 2010 in CED Events, Celebrity Topical News, In the News, Recovery, Therapies
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“Brave Girl Eating” – Q & A with Harriet Brown, Part I

On August 25th, 2010, The Center for Eating Disorders will welcome Harriet Brown – journalist, professor and parent of a child who almost died from an eating disorder.  Harriet Brown will be traveling to Baltimore to speak about her oldest daughter, Kitty’s difficult struggle with anorexia and  how their family used love, persistence and Family-Based Treatment (FBT) to help her recover.  In anticipation of her presentation and the upcoming release of her new book (left), we asked Harriet to share a little bit about her family’s experience in this three-part blog series. Her strikingly honest and insightful responses are sure to resonate with and empower countless other families who’ve been impacted by an eating disorder.

Harriet Brown’s presentation on Aug. 25th at The Center for Eating Disorders is FREE and open to the public. More information is available on our Events Page.


Q & A with Harriet Brown: Part I

Before your family went through this very personal experience with anorexia nervosa, what knowledge did you have of eating disorders and the treatment process?

HB: Probably about what most people know, which is basically nothing. I bought into all the usual myths: Anorexia affected white girls from rich families. Anorexia was a bid for attention, a way to act out in a dysfunctional family. I had no idea what I thought about treatment—I probably never gave it a thought, honestly.

When and how did you first become aware that your daughter was struggling with an eating disorder?  What were your initial reactions?

HB: We’d been aware of the possibility for a while—Kitty was a gymnast, and she’d always been on the thin side. I’d even asked her pediatrician about six months before she was diagnosed whether Kitty was maybe too thin; she’d grown half an inch and not gained any weight in a year, at age 13. The pediatrician reassured us, which in retrospect was a mistake; all adolescents need to be growing and gaining weight, and failure to gain can be as much a symptom as losing weight.

My husband and I first noticed an uptick in anxiety, but no weight loss. That’s why I was confused—I thought there had to be sudden dramatic weight loss. Kitty developed some obsessive tendencies around food and other areas, and her anxiety bloomed to the point of interfering with daily life. By now my husband and I were very alarmed. Around then Kitty lost a few pounds—4 or 5—and suddenly we put 2 and 2 together and realized we were dealing with anorexia.

Our first reaction was to push her to eat. That’s when we began to understand what we were dealing with. The harder we pushed her to eat, the more she resisted, and that was not like Kitty. By the time she was formally diagnosed, three weeks later, we were in a state of utter shock and panic. That sense of panic persisted for several months as we tried and failed to get her to eat, as her physical condition deteriorated; she landed in the hospital for dehydration and bradycardia at one point. That hospitalization was a turning point for all of us. We’d been trying to get her to eat, and failing; she was insisting she wasn’t hungry, she’d already eaten, her stomach hurt, all the excuses an individual with an eating disorder offers up. And part of us believed her, because we’d always been able to believe her. I think I was in denial. I know I was, actually. There was a moment, in the hospital, when after 4 hours of re-hydration, her heart rate still didn’t come up. The doc transferred her to the peds ICU. I remember distinctly running alongside the bed and arguing with the doctor about why she didn’t need to be in the ICU. I look back on that moment with horror, because it shows how much in denial I was that this was a life-threatening illness. No parent really wants to think that. And in retrospect I think all families pass through a stage of denial like this, and the best thing you can do is hurry them through it so they can get to the hard work of helping their child recover.

We flailed around unsuccessfully from June to August, when we stumbled on the notion of family-based treatment and decided immediately to try it. That’s when we started to make progress.

…to be continued.

Check back to read more of Harriet’s incredibly poignant account of her daughter’s illness and recovery.  In part II, Harriet talks about the most important thing she learned in the process of parenting a child with anorexia and the critical steps her family took along the way.

If you’d like to comment on this blog, or you want to receive updates when Parts II and III of this blog are posted, please join in the discussion and become a fan of CED’s Facebook page.

You can learn more about Harriet Brown and the upcoming release of her book, Brave Girl Eating: A Family’s Struggle With Anorexia, by visiting her website, www.harrietbrown.com.


Published by Kate Clemmer
August 9th, 2010 in CED Events, Celebrity Topical News, Editor's Picks, In the News, Nutrition, Recovery
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National Men’s Health Week, June 14th – 20th, 2010

Reality and research have shown us that eating disorders do not discriminate based on age, race, ethnicity, or gender.  No one is immune, yet males who struggle with eating disorders – sons, husbands, fathers, grandfathers - can often feel extremely resistant to asking for help or seeking treatment for an illness which, for so long, was viewed primarily as a women’s issue.  In recognition of National Men’s Health Week, we want to help men, and the people who support them understand the importance of pursuing recovery  and remind everyone that seeking help is a sign of incredible strength, regardless of gender.  

Over the last ten years, the number of males in the U.S. with serious eating disorders has grown to more than one million.  This rising number is likely representative of our culture’s ever intensifying focus on appearance, bodily perfection and the relatively newer trend of  diet, exercise and fashion industries heavily marketing to men.  Societal body pressures for males might be different in shape – for example, muscular for men versus thin for women - but the intensity of these messages is often just as pervasive.  However, eating disorders are not 100% about body image, and its important to remember that men are just as emotionally impacted by these illnesses as women.  Acting on symptoms of an eating disorder becomes a way to cope with stress, discontent and difficult or uncomfortable emotions which may be exacerbated by a trauma history, co-occurring substance abuse or interpersonal problems.   Likewise, men’s bodies are just as susceptible to the serious physical health repercussions of eating disorders including cardiac irregularities, electrolyte imbalances, bone loss, serious gastrointestinal problems, dental erosion, infertility and even death.  These are just a few of the consequences that make it an important topic for discussion during National Men’s Health Week 2010.   

While its certainly not a positive sign to see eating disorders on the rise in any segment of the population, its quite possible that part of the increase we’ve seen in males with eating disorders may actually not be an increase at all but just a more accurate sample as a result of decreasing stigma.   Improved treatment options for males has helped lessen stigma and the subsequent secrecy and isolation for those with the disorder.  As a result, it’s meant more males are speaking out about their struggle and more are being counted.  We are encouraged to see more boys and men seeking treatment for their eating disorders - overcoming  internal and societal resistance  to find their way into support group circles, therapy sessions and nutrition appointments in an effort to move towards emotional and physical health.  

As National Men’s Health Week culminates with the celebration of Father’s Day on Sunday, we encourage you to take time to recognize the men in your life.  Remind them to schedule regular check-ups, sreening tests and follow-ups with specialists as necessary.  Educate yourself and others on the signs and symptoms of eating disorders.  If you or someone you know is struggling with an eating disorder and you’d like to ask questions or find out more about treatment, please call us at (410) 938-5252.

 

Visit The Center for Eating Disorders on the web:
Homepage:  www.eatingdisorder.org
Facebook: http://facebook.com/eatingdisorderhelp 
Twitter: http://twitter.com/CEDSheppPratt
Published by Kate Clemmer
June 18th, 2010 in Body Image, In the News, Males, Recovery
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What is Reality?

 

A plethora of news stories developed overnight, placing “Real Housewife”  TV Star, Bethenny Frankel in the media spotlight for her drastic post-pregnancy weight loss three weeks after giving birth to her daughter via cesarean section.  Most sources are speculating that these rapid changes to her body are unrealistic, are the result of unhealthy behaviors and set an undeniably dangerous and negative standard for everyday, non-celebrity moms.  Even while suggesting the danger in this, magazines and news shows continue to flaunt photos of her in a bathing suit, promote her books and products, and proclaim her diet, exercise and weight loss to the world as though it is something to emulate.  Subsequently, the public is greeted with more mixed messages about health and weight loss that are confusing and difficult to sort through.

Our questions amidst this media frenzy differ from the slew of inquiries into how much weight was gained and lost or what Bethenny was eating or not eating.  We would rather ask why reporters and news media feel its appropriate to provide readers and viewers with the specific details of Bethenny’s weight loss regimen while simultaneously questioning its safety?  And why would someone who has publicly discussed a “former” unhealthy obsession with food, weight and exercise, support a publicity storm focused on weight just three weeks after the premature birth of her child? 

Its time to focus on reality instead of reality TV and on healthy moms and babies instead of weight loss.  Want some real-life tips for avoiding “the numbers game” of pregnancy and post pregnancy weight? Check out our newest guest blog from the authors of Does This Pregnancy Make Me Look Fat? The Essential Guide to Loving Your Body Before and After Baby.  Click here to read, “Adding Up, Weighing In, and Counting Down: Five Ways to Cope with the Numbers Game of Pregnancy,” by Claire Mysko and Magali Amadei

Published by Kate Clemmer
June 4th, 2010 in Celebrity Topical News, In the News, Nurture. Blog Series, Nutrition
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Eating Disorders in the Jewish Community

Tackling issues often wondered about and little discussed…

Eating disorders are amongst the most serious of medical conditions with high rates of morbidity, including the highest death rate of any psychiatric illness.  It is important to note that within diverse populations, the stressors that may exacerbate an eating disorder can vary greatly, as can unique cultural factors which may serve as preventive or protective factors.  In recent years, more attention has been paid to these issues within the Jewish community specifically, as concerns continue to surface about increasing numbers of Jewish girls and boys struggling with eating disorders such as anorexia nervosa and bulimia nervosa. 

An increasing rate of eating disorders is certainly not unique to the Jewish population – numbers are rising across the country regardless of ethnicity, religion or race.  However, the effective prevention, early identification and treatment of eating disorders within the Jewish community is dependent upon education and discussion that is socially and culturally relevant to those who are affected.  For example, the centralized role of food in Jewish heritage and traditions, including celebratory feasts and fasting, as well as stressors associated with the shidduchim, or traditional Jewish matchmaking, may influence one’s relationship with food and weight.

Research around eating disorders in the Jewish community has been done but studies regarding the prevalence are somewhat conflicting. According to one study, eating disorders affect one out of every 19 girls ages 14 – 16 in the Orthodox and Syrian communities, a rate that is 50% greater than in the general population.  Other studies have shown that while the incidence of eating disorders among the Jewish population may not necessarily be greater than that of the general population, Jews are often part of a demographic that would be more susceptible to eating disorders.  Orthodox women were found to have similar rates of eating disorders as secular Jewish women, however Orthodox women may be less likely to seek treatment given the cultural stigma that exists around the issue.  This stigma is a key reason why it has become so important to shed light on the topic of eating disorders in the Jewish community.   

On January 31st2010, the Center for Eating Disorders and the Orthodox Union will host a workshop in collaboration with Jewish Community Services and Hadassah of Greater Baltimore to address the topics identified above as well as the importance of self-esteem, body image and family communication in the Jewish community.  The free community event, Promoting Self Esteem & Healthy Body Image: A Program for the Jewish Community, is intended to help people develop a better understanding of the seriousness of these illnesses and help them identify risk factors and utilize prevention techniques.  This program is focused on addressing these concerns as they uniquely affect the Jewish Community and is geared toward educators, clinicians, parents, lay persons, and family members of affected individuals.

With a large Jewish population in the Baltimore area, we hope to provide the community with education about prevention strategies, risk factors for early identification, and the effective treatment of individuals with eating disorders. This workshop will include a plenary session from Catherine Steiner Adair, Ed.D,Director of Education and Preventions at the Klarman Eating Disorders Center at McLean Hospital in Belmont, MD.  Dr. Steiner Adair is a leader in the field of eating disorder treatment and the author of Full of Ourselves: A Wellness Program to Advance Girl Power, Health, and Leadership. She has also published a supplement to this guidebook, titled Bishvilli- For Me, specifically to assist those in the Jewish Community to utilize these activities in a way that compliment their lifestyle.

The program’s keynote address will be presented by Rabbi Dr. Tzvi Hersh Weinreb, Executive Vice President, Emeritus of the Orthodox Union.  He will be focusing on the issues of self esteem and eating disorders as they affect those in the Orthodox Jewish Community.  Eight other workshops will be facilitated by eating disorder professionals and mental health providers who have an understanding of the concerns of the Jewish Community.  For a full listing of presenters and workshop titles, download the Event Program.  Those who attend the program will have an opportunity to learn about and discuss the following subjects:

  • Recognize the signs and symptoms of eating disorders
  • Identify early warning signs and risk factors of eating disorders
  • Become aware of the effects of eating disorders and related issues in the Jewish community
  • Understand how modern therapeutic techniques can be applied while maintaining respect for traditional Jewish culture and values
  • Utilize Jewish tradition, culture, spirituality, and rituals as resources for health and protective factors against the development of negative body image and eating disorders

Attendance at this event is free but pre-registration is required. Please call 410-938-3157 or email rsvp@sheppardpratt.org to reserve your seat. Download the FINAL PROGRAM BROCHURE for complete details and share the promotional event flyer with others who may be interested in attending.

photo courtesy of jewishharlem.com

Published by Kate Clemmer
January 7th, 2010 in Body Image, CED Events, Editor's Picks, In the News
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Parties and Presents and Resolutions, Oh My!

The end of a calendar year brings with it endless conversations of new year’s resolutions.  Setting these notoriously lofty goals is often an attempt to pull oneself out of the seasonal funk that can settle in with shorter days, colder weather and a barrage of holiday stressors.  When people make resolutions, it is often with the intent to completely overhaul their life.  They look to make a sweeping change that will fix all that is wrong, and get them back on the “right track”.  Unfortunately, this particular type of goal setting usually backfires – as evidenced by the fact that most people end up making the same exact resolutions year after year.  

New year’s resolutions also send a message that today doesn’t count – it gives us permission to stay unhappy or unhealthy ”just a little bit longer” until January 1st rolls around. This could mean different things for different people depending on whether you are working towards recovery from an eating disorder, still struggle with chronic yo-yo dieting or are trying to quit smoking.  So, how do you pull yourself out of the winter blues without jumping on the resolution bandwagon?  Here are a few ideas to get you started…

1.  Don’t wait.  Start making small adjustments today that have nothing to do with food, eating, or your weight. Creating small but positive disruptions in your daily routine can help you stay grounded and may even help to break a cycle of negative thoughts or eating disorder symptoms that are associated with certain places or a time of day.

  • Try taking a different route to work or school.  This small change could open up new possibilities, even if its just observing the new scenery or discovering a park along the way that you never knew existed!  Who knows, you may even find out that your new detour involves less traffic or fewer lights.
  • Do some interior designing.  Consider rearranging some furniture or updating a picture wall inside your house or apartment.  Visible changes such as these can offer a sense of renewal without the obligation or pressure.
  • These are just a few examples…you can come up with your own ideas for “minor adjustments” and share them on our Facebook page.

2. Setting goals is a great thing but not if the goal is unrealistic, unhealthy, too vague, or involves intense pressure to succeed.  All of these charactersistics can make it very difficult to follow through with a resolution.  Instead, focus on taking small, concrete steps forward in the direction of balanced living.    

  • If you tend to make resolutions that are unrealistic and unhealthy…“I have to get myself to the gym.  I’m going to purchase a membership and force myself to go everyday, no matter what.”
    • Try this instead: “I will commit to going to one or two community yoga classes by the end of the month and work on developing a positive and supportive relationship with my body.”
  • If you tend to make resolutions that are vague and counterproductive… “I need to lose weight by the summer so I’m really going to stick to my diet this year!”
    • Try this instead: “I give myself permission to stop dieting and to trust my body. If I need the help of a professional nutritionist to do this, I will seek one out.”
  • If you tend to make resolutions that leave no room for error and put a lot of pressure on you to succeed…“As of January 1st, I am never going to act on my eating disorder symptoms again.”
    • Try this instead: “Before the week is over, I will call and schedule an appointment to begin seeing a therapist.” This is an example of a small but very meaningful task that can result in long-term change.  If you already see a therapist, consider this instead: “In the next week, I will use at least one new support or coping skill that I’ve never tried before.”  Examples include: attending a support group, journaling, or enrolling in art therapy.

3. Now that you’ve resolved NOT to make a resolution, how are you going to cope with everybody else who feels inclined to talk about resolutions, weight loss and diets all of the time? 

  •  Be the bearer of accurate news.  When your friends start discussing the new diet they will begin on January 1st, inform them about why diets don’t work.  If you’re not sure why, stay tuned for our upcoming blog that will convince you once and for all that dieting is NOT the way to go.
  • Try out the “shock and awe” technique. As others start to bemoan their hips and curse their thighs while resolving to change their bodies in the new year, employ the element of surprise – say something  NICE about yourself and your body. Body bashing has become such an accepted form of conversation (especially around the holidays) that when someone (You!) is able to reflect positively on their own body, people are seriously caught off guard and may think twice about their own statements.  Try one of the comments below or come up with a few of your own!
    • “I am so grateful for all of the things my body allows me to accomplish.” 
    • “I’m much more concerned about feeling strong and healthy than I am about fitting into a particular size.”
    • Even if you are not at a point in your life, or in recovery, where you actually believe these statements, say them anyway!  Saying them out loud helps move you in the right direction toward real change.  You will not only have helped yourself, but you will steer the conversation away from a negative place and become a role model for positive body image.  This is particularly important if children and adolescents are within earshot of the conversation.

Here’s to a happy and balanced end of 2009 and continued hopefulness in 2010! 

If you have any questions about eating disorders, please call our admissions coordinators at (410) 938-5252 to speak confidentially about your concerns and treatment options.  Additionally, you can visit our website at  www.eatingdisorder.org for more information, including an interactive on-line quiz that can help determine whether you, or someone you care about, might have an eating disorder that requires professional treatment.   

Photo courtesy of grandhoteloceancity.com

Published by Kate Clemmer
December 22nd, 2009 in Body Image, Celebrity Topical News, Editor's Picks, In the News, Nutrition
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Time for BODY POLICY in the UK?

   ”Media images that depict ultra-thin, digitally altered women models are linked to body dissatisfaction and unhealthy eating in girls and women, and there is also recent evidence of the detrimental effects of unrealistically sized dolls and toys which present role models to children… as well as the impact of muscular media models on boys and men.”   - excerpted from, The Impact of Media Images on Body Image and Behaviours: A Summary of the Scientific Evidence

While research has repeatedly shown the negative impact of media images on the perception of our own bodies, to date, little has been done to counteract these falsified images. In a move that is the first of its kind, the United Kingdom’s Liberal Democrat party is attempting to regulate these harmful marketing tactics with newly proposed public policies.  Recently, they requested a compilation of scientific research to indicate whether or not people were really negatively impacted by looking at airbrushed-to-perfection pictures in the media. In response to the request, scholars and researchers from around the world came together and created a consensus on how idealized images in the media impact the way individuals feel about their bodies and how those feelings translate into behaviors.

The international group of scientists and researchers provided an overwhelming amount of data supporting the relationship between exposure to idealized images and increased body image dissatisfaction. Their final report, The Impact of Media Images on Body Image and Behaviours: A Summary of the Scientific Evidence, discusses the effects of media images and outlines five proposed policies that could help to empower and protect individuals from the cultural obsession with thinness and perfection.  The research clearly shows that looking at images which have been unrealistically and excessively airbrushed can lead to poor personal body image and low self-esteem, both of which can lead to many physical and mental health problems.  Most notably, these problems include disordered eating and eating disorders, anxiety and depression, and even sexual dissatisfaction.  Using data from over 100 studies, researchers linked idealized media images to the increasing numbers of people with negative or distorted body image. In their paper, they concluded that, while these images do not have a universal impact, they do have a negative effect on the majority of those who see them.

The effects of media exposure begin very early in life and have been documented in girls as young as five and a half years old.  Furthermore, the images were found to have the greatest impact on some of the most vulnerable populations, including 1) adolescents, 2) those who are of a different body weight or shape than the ones being depicted, and 3) those who have internalized the cultural body ideals presented for men and women. The research goes on to suggest that the images have an “immediate and cumulative impact”, meaning that a negative self-evaluation occurs immediately following the viewing of such images, and with continued and repeated exposure, self-evaluation continues to decline and/or be distorted.  The paper points out that, although most people are aware that images they see have been retouched, many do NOT know just how extensive the airbrushing and “revisions” actually are.   

The collection of this information led the research team to the question, what will be effective in changing these negative outcomes? While media literacy education has been shown to have a beneficial impact, the real long-term solution is the changing of the images themselves. The researchers recommend that, instead of using distorted, caricatured versions of people, that real people and real images be used. In addition, they developed these five policies to target the areas in most desperate need of change.  

  • Policy 1. No digitally altered models in advertising aimed at under 16s
  • Policy 2. Clear labeling of digitally altered models in all other advertising.
  • Policy 3. Models used in Fashion Weeks to have a health certificate from an eating disorder specialist, in order to protect their health and well-being.
  • Policy 4. Encouragement for use of diverse and healthy body sizes in all media models.
  • Policy 5. Media literary programmes about ‘perfected’ models as part of school curricula to encourage critical awareness and resilience in children and adolescents.

The hope is, that by including pictures of real people and identifying when digital retouching is used, everyone can become more informed, and therefore, more realistic in their assessment of  media images. While there is much debate about whether or not these policies will actually have an impact on body image and eating behavior, it is important to note that the relationship between policy and individual change is cyclical.  As more individuals become aware of a problem, there is a greater push for policy change, and as more policies are implemented, they impact even more people, leading to greater awareness and more effective, long-term change.  If approved in the United Kingdom, these changes could positively impact an entire generation of girls, boys, men and women and, perhaps, the United States will consider following suit.  

On the home front, Darryl Roberts, Director of the documentary “America The Beautiful”, is spearheading a drive to challenge advertisers and media in a different way.  He is currently leading a campaign to boycott Ralph Lauren until the company apologizes for it’s photoshopped ads and makes a personal commitment, (without being mandated by law), to stop using such drastic levels of photo manipulation to sell products.  If you support this idea, you can join the campaign by becoming a fan of the  ATB Action Network on Facebook.   

photo courtesy of  www.photos.igougo.com

Published by Kate Clemmer
December 11th, 2009 in Body Image, Celebrity Topical News, Editor's Picks, In the News
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Tips for Overcoming Holiday Stress & Anxiety – Part II: The Stress

Thanksgiving, a holiday of gratitude and hopefulness, can also come with a large dose of frustration, worry and woes.  In an attempt to make this Thanksgiving a positive one, especially for those who are also struggling with an eating disorder, we’ve offered some ideas for overcoming and embracing the holiday season.  Yesterday, we posted Part I: The Food, the first in a holiday blog series that addresses unique challenges associated with eating and socializing during the holidays. Today, Part II in the series offers even more constructive ideas and concrete steps you can take to make your Thanksgiving a success, while still prioritizing your recovery.

Part II: When it comes to the STRESS…

If the place where you are staying is particularly stressful or triggering, carving out time for yourself is a necessity.  Try finding a quiet room to be alone for several minutes in order to clear your head and re-energize yourself for encounters with others around you. Taking five minutes out to breathe and re-center can make a big difference in your ability to maintain your composure and keep you focused on your goals of having a healthy and positive holiday experience.  If you’re worried that you will seem rude if you leave or have a hard time finding the time to be alone, consider offering to pick up or drop off elderly family members who can’t drive themselves.  

  • Depending on your preference, try to let those around you know what is helpful and what isn’t. The holidays are an important time to practice being assertive.
  • Reach out - we all know one or two people who can’t travel to their own family’s Thanksgiving event or just don’t have a place to go for the holiday – invite them along to share in your festivities.  
    • Bonus - An extra support person for you before, during and after the meal!  
  • Focus on the kids!  Get the younger generation involved in your support plan.  Round up the youngest family members for a post-dinner game of  Pictionary or puzzles.  Often, kids can be the most positive and least triggering family members.
  • In the event that someone makes a triggering food/body comment to you, have a plan for ways to quickly shift attention away from you in a positive way…respond strategically to the comment and then ask your cousin how her new job is going, or mention that your parents should tell everyone about their recent vacation.
  • Just because it is a holiday doesn’t mean you have to clear your social calendar – think about making plans with a friend to see a movie right after your holiday gathering so you can have something to look forward to regardless of how well your Thanksgiving meal goes. 
  • The same goes for your pre-meal schedule.  Sitting around, smelling food and just waiting for the meal to be ready can be a very triggering or anxiety-provoking time.  Consider offering to run a last minute errand or employ yourself as the family photographer!  Make it your goal to snap some great pictures of your family members arriving and socializing together. 
    • Bonus – The resulting photos could make great gifts when the next holiday rolls around!

Although the holidays can be difficult, try to place them in perspective and remember that no single day determines your worth, value, or potential as a person.  Regardless of what you hear from others, keep in mind that this is a season of hope and thanks-giving, so try to focus less on the stressors and more on the ability that you have to give thanks and receive joy this holiday season.

Find even more holiday coping skills by reading last year’s blog, Thanksgiving with an Eating Disorder: 10 Tips to Help You Get Through the Holiday.

photo courtesy of bhg.com/holidays

Published by Kate Clemmer
November 24th, 2009 in CED Events, Editor's Picks, In the News, Nutrition
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