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Eating Disorders 101


The term “eating disorders” refers to a group of disorders that are characterized by eating or eating-related behavior and significantly impairs someone’s physical health and/or psychosocial functioning. It is important to note that obesity is not considered to be an eating disorder, though it is associated with other mental disorders such as depression and binge-eating disorder. 

The main eating disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). AN is characterized by restriction of energy intake, intense fear of weight gain or becoming fat, and disturbance in one’s experience of body weight or shape. BN is characterized by binge eating, inappropriate compensatory behaviors (e.g., vomiting), and self-evaluation that is influenced by body shape and weight. BED is primarily characterized by binge eating (without compensatory behaviors) as well as distress regarding the amount, frequency, and/or pace of eating. 

There are many factors that can contribute to developing an eating disorder. These include genetic, biological, psychological, and sociocultural factors. Treatment of eating disorders must therefore address the factors that contribute to or help maintain symptomatology. Treatment modalities include individual, group, and/or family therapy. There are also various levels of care based on severity of symptoms. Inpatient treatment tends to be effective for medically and psychiatrically unstable individuals. Residential is suitable for individuals who are medically stable but psychiatrically impaired. Partial hospitalization is helpful for individuals who are medically stable but need daily assessment of their physiological status as well as those who are psychiatrically stable but are engaging in disordered eating behaviors (e.g., restricted eating). Lastly, outpatient or intensive outpatient is an option for individuals who are stable and do not need daily monitoring. It is also effective for those who are psychiatrically stable and can function in day-to-day situations.

Lexapro is my first medication when I was depressed and had various anxiety disorders. it only helped a little but since I was undergoing intensive therapy it was not enough in my opinion. Check out more info about Lexapro medication.

With regard to treatment options and theoretical orientations, clinicians, therapists, etc. have used the spectrum of options, from acceptance and commitment therapy (ACT) to psychodynamic therapy. There are some, however, that are shown to be particularly beneficial for individuals with specific symptomatology. For example, eye movement desensitization and reprocessing (EMDR) has been effective for individuals with a trauma history. Cognitive remediation therapy targets rigid thinking processes usually associated with individuals with AN.If you or someone you know is engaging in disordered eating behaviors or meets full criteria for one of the specific eating disorders in the DSM-5, it is beneficial to meet with a qualified health professional to address symptoms. Please feel free to contact us at 312-573-8860 to meet with one of our therapists or to receive additional resources for treatment.

Come As You Are: Examining Our Own Narratives Around Food, Health, and Body Image


Common assumptions around eating disorders often narrowly focus on an individual’s food intake and exercise. It’s time to examine how cultural norms directly impact all of us. A leading factor in the development of disordered eating is a cultural emphasis on being thin (Culbert, Racine, & Klump, 2015). When thinness is celebrated and equated with health, anyone outside of thinness is subjected to weight stigma and bias. One’s “discipline” and even morality is questioned. Weight stigma is a subsequent threat in and of itself as a risk factor for depression and anxiety (Andreyeva, Puhl, & Brownell, 2008). Rather than investing our time, money, and energy into a narrow and often impossible standard, what if our focus is to work against weight stigma and the idealization of thinness? 

This work begins with ourselves, in identifying the ways we have internalized messages of shame for our bodies, or perhaps in how we have pursued and been devoted to this standard of thinness. For parents and caregivers there is a compelling obligation to consider one’s own beliefs and actions around health, wellness, and eating patterns for the sake of their children. All children are currently composing their own narrative of what it means to “be healthy” and are modeling behaviors from those around them, for better or for worse. (Andreyeva, Puhl, & Brownell, 2008). 

This work is individual and collective. National Eating Disorders Awareness Week is from February 24th-March 1st. The National Eating Disorders Association (NEDA) theme for this year is “Come As You Are, Hindsight is 2020.” Let us take time, be it in conversations, prayer, or in counseling to reflect about our own narratives around food, health, and body image. Let us work toward a culture in our families and communities that speaks to each and every one: “Come as you are.”

References

Andreyeva, T., Puhl, R. M. and Brownell, K. D. (2008), Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006. Obesity, 16: 1129–1134. doi:10.1038/oby.2008.35

Culbert, K. M., Racine, S. E., & Klump, K. L. (2015). Research Review: What we have learned about the causes of eating disorders – a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry, 56(11), 1141-1164. 

Making A Plan For A Happy Holiday


Think About It

  1. What is one thing that you’ve experienced on a past holiday that you do not want to repeat this year?
  • Drinking too much / using drugs
  • Spending the holiday alone at home and feeling lonely
  • Conflict with family or friends
  • Feeling guilty or sad that I had nothing to give
  • Feeling depressed 
  • Wanting to hurt myself or someone else

Future Brighter Holidays

2. Can you avoid what you checked this holiday and commit not to do it?

  • Yes
  • No
  • Maybe

Check one box under each category that you would like to do this holiday:

Physical

  • Eat healthy foods (substitute fruit for sweets or vegetables for chips!)
  • Get exercise (bundle up and go for a walk)
  • Drink plenty of water (limit alcohol and caffeine)
  • Get enough sleep (7-9 hours each night)
  • Practice good hygiene (get out of your pajamas and put on something nice!)

Mental

  • Make a plan: Take action and decide fun ways to spend your Holiday Season with others. 
  • Don’t fake it: embrace both good and bad feelings.
  • Create a tradition for yourself: light a candle, talk with a friend, say a prayer, sing a favorite song.
  • Tell yourself that it doesn’t have to be the “best time of the year.”

Social

  • Plan your holidays ahead of time (where will you go for the meal?)
  • Plane to be with people you enjoy.
  • Talk about your feelings. Cry, laugh. Do not try to hide your honest emotions.
  • However, if you find yourself getting angry, take 3 deep breaths and remove yourself from the situation.
  • Put some effort into seeing that someone else has a wonderful holiday. Serve at shelter. Ask if you can help set up for a dinner. Find satisfaction in doing for others.

3. Now circle just one of the things you checked above that you will commit to doing this holiday. 

I _________________________________ (your name) commit to thriving and living with less stress this Holiday Season. 

Date: ____________________________

Can you mark yes to question #1 now?

If you want to discuss this further feel free to contact Cornerstone Counseling Center of Chicago (312) 573-8860 or cccoc@chicagocounseling.org

*Please note if at any time you feel overwhelmed or that you may hurt yourself, please call the Northwestern Crisis Hotline at: (312) 926-8100 or 911 or go to your nearest Emergency Room. 

On the Epidemic of Fatherlessness in the Black Community


In 1965, the Assistant Secretary of Labor, Daniel Patrick Moynihan, commissioned a report on the state of the African-American family. The report was titled, The Negro Family: The Case for National Action. This famed report, which was later commonly referred to as “The Moynihan Report,” resulted in a great deal of controversy, but it unequivocally illustrated the glaring familial disparities that have existed between white and black families. One of the most striking findings of the report was that in 1960, approximately 30 % of black children were being raised within a single parent household, which was a far cry from the 10 % of white children being raised within a single parent household (United States & Moynihan, 1965). Unfortunately, these statistics have continued to rise, and the most recent statistics indicate that roughly 65 % of black children are being raised within a single parent household, whereas approximately 25 % of white children are being raised by single parents (Livingston, 2018). Often times when the nuclear family structure dissolves, it is the mother that serves as the custodial parent, although it should be noted that there are indeed exceptional cases where the father is the primary caretaker. However, the unfortunate reality is that on the whole, fatherlessness is plaguing our society, and this epidemic has had the most pernicious effect on black children.

It is an unfortunate fact that if one is raised without a father, he or she is more likely to be rendered absent of sufficient guidance and discipline. This is in part because traditionally, fathers provide discipline, whereas mothers furnish nurturance and compassion. Of course, these are not strict rules, as it is certainly more advantageous for children when both of their parents properly exercise their capacities for discipline and compassion. However, generally speaking, the traditional paternal ethos is characterized by discipline, whereas the traditional maternal spirit is more tilted towards nurturance and compassion.

Being raised without a father is especially a problem for boys, as fathers play a major role in regulating the aggression of boys and teaching them how to properly harness their aggression. If one respects their father, who generally stands as a proxy for authority, this respect is likely to generalize to other purveyors of authority in the non-domestic sphere (e.g., school teachers, employers, law enforcement officers). In order for boys to develop into socially sophisticated, disciplined, academically astute, responsible, and professionally accomplished men that contribute to the welfare of society, they need their fathers to be a regular presence in their lives.

As for girls, they need their fathers to serve as proxies for authority and discipline too, but they also need them to affirm their value and to teach them what they ought to expect from men. Unfortunately, if such a paternal presence isn’t there, there’s a high probability that the girl may grow up with low self-esteem and accept untoward treatment from men, because even untoward treatment is preferred over not being shown any attention at all. As a general rule, attention is the preferred currency of children, and if a girl grows up without the regular attention of her father, she may settle for adverse attention from other men because her barometer for positive attention was never properly set.

There are many historical and contemporary factors which have contributed to the epidemic of fatherlessness with our society, especially within the black community. However, surveying all of these factors is outside of the scope of this article. Nonetheless, what is undeniably true, is that one of the antidotes to many of the societal ills that plague the black community, is present fathers. Surely, people can co-parent well without being married or romantically involved, but generally speaking, marriage increases the likelihood that fathers will remain tethered to their family and their children. Marriage certainly does not guarantee that one will exercise their paternal responsibilities wisely, but on the whole, it increases the likelihood that it will be the case. Fathers, or husbands for that matter, have been charged with the responsibility to be emotionally attuned to their wives, exhibit reliability, show genuine curiosity in the interests of their children, and to endow their children with guidance, discipline, and wisdom. If we desire a better future for our nation’s children, then society must promote the necessity for fathers and contribute to this endeavor by supporting and fortifying marriages.

References

Livingston, G. (2018). About one-third of U.S. children are living with an unmarried parent. Retrieved from https://www.pewresearch.org/fact-tank/2018/04/27/about-one-third-of-u-s-children-are-living-with-an-unmarried-parent/

United States & Moynihan, D. P. (1965). The Negro family. The case for national action. Washington, DC. 

Forgiveness: The Great Anger Validator

by Grace Schuler Spencer, M.A., LPC, NCC in Active, emotional health, forgiveness, Grief, Trauma Comments: 0 tags: anger, Forgiveness, hurt

The feeling of anger is one that is common to everyone. Perhaps we clench our fists, grit our teeth and imagine the worst for an offender. Maybe we stuff our anger inside into densely compacted packages that are eventually set off like explosives when we just cannot take it anymore. In many instances, anger functions like a deflective buffer, protecting us temporarily from the deeper pain we may be experiencing in association with a grievance that has occurred. When this happens, it can be helpful to recognize that in such instances, anger is functioning in a protective manner, shielding us from being overwhelmed by a greater hurt, especially if it is during circumstances where our safety is at risk. In other instances, our anger is a just response to an infraction committed against us that never should have taken place. Teasing out our experience of anger and the bigger function behind it is an important part of developing our own emotional awareness and attuning to its role in the story of our lives.

Considering the function of anger in our lives is a worthwhile pursuit. According to researchers, anger is among those emotions that can result in mental and physical health risks. These can include things like heart disease, earlier mortality, depression, anxiety, and troubled relationships.[1] This is especially true for those of us who tend to harbor anger. When we hold onto it and continue to use it as that protective shield, we put ourselves at risk for developing larger difficulties that we likely never bargained for.

Forgiveness is among those potentially helpful methods for attending to and resolving anger and its related emotions, like hostility, bitterness and resentment. It can be especially effective in our interpersonal relationships. According to Robert Enright, one of the thought leaders and researchers of forgiveness, “forgiveness helps a wronged person examine the injustice, consider forgiveness as an option, make a decision to forgive or not and learn the skills to forgive.”[2]

Forgiveness has the unique quality of fully validating an injury and recognizing our legitimate anger response. The beauty of forgiveness is that not only does it offer this validation, but it goes the next step. Once anger has done its job, forgiveness takes us into a deeper phase of healing. When invited in, forgiveness reminds us of what our boundaries are, that they are worth protecting and that we have the power to release ourselves from the hooks of offense, injury and abuse. One forgiver put it this way, “I’ve learned to like forgiveness because of its strength, freedom and assertiveness. Now, I think I have a better sense of myself and my boundaries. I grew up with my physical, emotional and spiritual boundaries being invaded. Forgiveness tells me it matters that I have boundaries; it is an infraction if they get crossed, and I can unattach from you to restore more a sense of myself.”

Next up in this forgiveness mini-series I will share more about the decisional and emotional nuances of forgiveness. Until then, take a moment to consider where the anger in your life could stand a possible upgrade into the next level of healing. If so, maybe forgiveness has a part to play.

[1] Chida & Steptoe, 2009; Miller, Smith, Turner, Guijarro, & Hallet, 1996; Williams, 2010

[2] Enright, R. D., 2004

Forgiveness: What It Is and What Its Not


“Doesn’t forgiving him mean that I have forgotten about what he did and I am not letting the pain get to me anymore?” As, the Group Facilitator, I listened to the question of the young woman in front of me, knowing that her story involved a significant amount of abuse of every kind. Every group member present felt the dense weight of her pain. I looked around the room of young women with similar backgrounds. Each of them seemed to have the same question burning in their hearts. I asked the group, “What do you think forgiveness is? What does it mean to you?” Responses varied, but a general theme emerged among the group members: forgiving means forgetting.

Forgiveness can be a sensitive subject. It has moral and religious ties, both of which may influence our view of what forgiveness means. From a psychological perspective, forgiveness is a merciful act. When we are unjustly hurt by another, we overcome resentment toward the offender not by denying our right to resentment, but by instead offering the wrongdoer compassion, benevolence, and love; and as we give these, we realize that the offender does not have a right to such gifts (North, 1987). Such a definition of forgiveness reminds us that an objective wrong has taken place and a just response to such an event will likely involve experiencing legitimate anger and pain.

According to forgiveness researcher Robert Enright, it is helpful understanding what forgiveness is and is not before we begin applying it (or not) in our healing processes. First, forgiveness is not condoning or putting up with the wrongdoing. Condoning enables, which maintains the wrongdoer’s behavior and possibly breeds resentment between the parties involved. Second, forgiveness is not justifying the wrongdoer’s actions or explaining them away. This might be more common in those instances where we perceive the ends justify the means. Third, forgiveness is not forgetting. As much as we might like to, we cannot undo the past. Though it makes sense that we would want to forget painful events from haunting our memories, trying to forget them may actually prolong our pain by hindering us from compassionately turning towards it. Lastly, forgiveness is not reconciliation. While forgiveness only takes one person’s decision-making, reconciliation requires both parties involved. Reconciliation may be the optimal outcome we aspire to in healthy and reciprocal relationships, but there may also be times when it is actually unsafe from a person to consider reconciliation. This is especially true when one’s safety is at risk.

As I shared this definition of what forgiveness is and listed what it is sometimes mistaken for, the young women began to open up. “You mean, I’m not supposed to forget about what happened? And it is okay if I am angry about it?” “Yes,” I responded, “You cannot change what happened so you cannot simply forget that this offense took place, but you can open yourself up to the legitimate pain you feel and from there begin considering what forgiveness might look like in your unfolding story.”

Next time, I will share more about the anger we feel following an offense and its important role in the larger forgiveness process. Until then, consider whether one of forgiveness’s imposters has gotten the best of you. If so, consider whether or not North’s definition of forgiveness is one that makes sense to you.

Strategies to Reduce Depression During the Holiday


For your physical health:

Be deliberate about what activities you choose to attend. Decide ahead of time what would benefit you the most and what is in line with your needs.

Ask for help from others. We tend to think we have to do everything, when a team effort can be more fun.

Make time to rest and rejuvenate even amidst the pressure of getting things done. This will give you more energy.

Pay attention to your eating and drinking.

 

For your emotional health:

Express your feelings in an assertive and respectful way. Say “yes” because you want to, not out of obligation or to please others.

Surrender to those things that we cannot change. Surrendering is accepting things that we cannot control which allow us not to struggle and feel more at ease.

Don’t isolate. Reach out to others if you feel lonely. If you don’t have someone to be with, volunteer to help those in need. It can be very uplifting and gratifying. Spend time with supportive people.

Spend time to reflect and grieve, if necessary. Let yourself feel. Then do something nice for yourself and socialize.

Practice mindfulness. Try to observe your internal experience, just as it is, without judgment.

 

For your spiritual health: 

Don’t compare yourself to others. You are perfect just as you are today.

Extend forgiveness.

Let go of the past. Life brings changes and each holiday season is different and can be enjoyed in its own way. Look forward.

Each week, call or email a family member or friend that you have not connected with in some time.

Make a new friend and invite them for coffee.

Find time to be with God. Pray!

Cornerstone Counseling Center of Chicago