Part One: If It Were Cancer…

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Clementine Advisory Board Member Cherie Monarch shares an important series highlighting the seriousness of struggling with an eating disorder. In part one, Cherie begins with a conversation she had with a dear friend who recently found out a loved one was diagnosed with cancer…

To all patients, parents, families, friends, providers, clinicians, teachers, coaches, school personnel, and frankly, everyone, everywhere who has or knows someone with an eating disorder…

Cancer.

It is one word.

One single word.

A powerful word.

When spoken, it’s a word that immediately elicits compassion, empathy, support, understanding, and action. It is one word that immediately garners the support of family, friends, a team of physicians, and will compel people to start walks, fundraisers, galas, go fund me’s, meal support, etc. Cancer will mandate that there be an army of warriors surrounding the family and patient as they walk this journey. And it should.

Cancer. A longtime friend recently posted this on his home page. His daughter is battling cancer. Of course, it immediately elicited my empathy and understanding. Offers of how can I help?

My friend is aware that our family had a loved one that struggled with an eating disorder. He understood that as a parent that this was the worst possible thing that could have ever happened to me. That I would have gladly taken the place of my daughter. That I would have given anything to bear her pain and suffering.  He understood that my journey of a child with a life-threatening illness was worse than my own two open-heart surgeries.

I messaged him and offered support. I shared how very sorry I was for what his daughter and his family were enduring. That I can’t imagine how difficult CANCER has been for them.

I was blown away.  What I was not prepared for was his reply…

“Actually you don’t have to imagine watching your child go through something like this. You lived it. Different disease but just just as deadly, and probably more difficult to treat. The leukemia my daughter has has a very well developed treatment protocol, that is used throughout the entire country, and there is constant collaboration between all of the treatment centers. I know that is not the same with eating disorders. Hell, you still have to fight to get it recognized as a disease, and not just some “silly little girl who won’t eat.” To me your battle seems harder.”

My conversation with my friend caused me to do a lot of reflection. Having a loved one battling an eating disorder is much like battling cancer. It is one of the most challenging and most difficult journeys of our life. Some of us may be battling to get a diagnosis; others of us may have been given a diagnosis but are trying to understand what’s happening.

The difference with eating disorders is …No one is provided with a handbook on how to heal your loved one from an eating disorder. Follow this protocol. Instead we’re left with minimal guidance, minimal support, lots of questions, no direction, a lot of confusion, and no respite care. There are conflicting messages everywhere.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


What Do Ballistic Missile Threats Have to do with Gratitude and Self-Care?

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Becky Henry is trained as a Certified, Professional Co-Active Coach (CPCC) and uses those skills to guide families to let go of fear and panic, learn self-care skills and become effective guides for their loved one in eating disorder recovery. In this week’s post, Becky discusses the healing benefits of gratitude.

Some of you know that I was in Hawaii in January 2018 when the State of Hawaii issued this warning to cell phones on all Hawaiian islands:

Different people react differently to threatening situations. I have, so far observed different approaches and all have various and numerous causes I’m sure. There must be a study somewhere on this…right Kitty Westin?

  1. Stand firmly in DENIAL and go on with our lives – if the threat remains just that.
  2. Walk around completely unaware.
  3. Sheer and total panic rendering the person incapacitated.
  4. Absolute Terror and action.
  5. Fatalistic approach…we are all going to die and it doesn’t matter what we do.

I have experienced most of the above at different times. This time it was #4! I was the most terrified I have ever been in my life. While others were standing at the oceanside blissfully unaware or fatalistically accepting…I don’t know which, I was preparing to die a long slow painful death and attempting to possibly save my own life.

After 3 bliss-filled weeks on the island of Kauai, I got up and watched one of the most beautiful sunrises I’d seen there. Then my husband left for his daily yoga class (during which he did not learn about the missile warning) and I settled in for a relaxing Saturday morning of looking for potential places to stay next year….haha…might just stay in Minnesota out of range of such attacks.

The warning arrived on my phone and after some frantic scurrying around and searching (along with thousands of others) “How to Survive a Ballistic Missile Attack” on the internet and found an article on Business Insider , I began preparing to try and survive inside while fallout rained down.

In addition to shutting windows, blinds and doors (yes it got very warm very quickly) and filling every container I could find with water, I called my mom in Minnesota to say, “Goodbye.”

During all of this my mind was going a million miles an hour; “Will I ever see any loved ones again? Will Jay stay put at the yoga studio? Will we die instantly or be sickened by fallout? Where are Jay’s passwords? How long with the food in the fridge be safe to eat? Will I run out of water? How will I tell my daughter what was happening? And a thousand scarier thoughts.

While talking to my mom; who was in reaction #1 above, I looked on Twitter and thankfully saw the Governor’s message that this was a mistake…never in those minutes did I envision this potential outcome! We were still going to be healthy, safe, able to eat safe food and drink clean water and breathe clean air!! And see our loved ones again!

Gratitude barely begins to describe how grateful I felt then and still do. It was a mind bender. About 30 minutes of sheer terror and sadness and suddenly back to normal. My good friend in Chicago helped me breathe over the phone until my husband returned. He was in a state of yoga bliss and didn’t even know what had happened…Guess that says a lot about the benefits of yoga, but that’s another article. Check out what Forbes has to say about scientific benefits of GRATITUDE!

After calming down I went to see the waves at the lighthouse with my friends who were also visiting the island from Minnesota. They had watched a football game while this was going on. Both had grown up with air-raid drills and weren’t phased at all. Blew me away, this wasn’t a drill, but they had learned to not trust these things. It was surreal to be outside breathing clean, safe air and watching the waves and whales after thinking my life as I knew it was over…talk about second chances!

The next day as I watched another gorgeous sunrise I was
filled with gratitude and joy! I had thought I may never see
another sunrise…that whole day I walked around in
amazement at all that I still had. Clean air, clean water to
drink, safe food to eat and a healthy body still. This was
amazing. Weeks later I am still incredibly grateful for all of these things.

One of the self-care tools I teach to parents of kids with eating disorders is to practice gratitude. Often parents will tell me there is nothing to be grateful for when they have a child at death’s door. Being grateful for clean air, clean water, enough food and good health are some of the things I’ve suggested that they feel gratitude about. It’s hard to grasp what a powerful antidote to suffering that gratitude can be.

It takes doing it regularly to get into the habit of practicing gratitude so that it can become a go-to tool to cope with all that eating disorders challenge a parent with on a daily basis. This is why we teach how to practice gratitude during the self-care training at the SHIFT HAPPENS Retreats. The next one is September 22-25 – in the Mid-Atlantic Region for all of the East Coast folks who’ve been after me to host a retreat out there, watch my website for updates.

I would love to hear what you are grateful for, how you practice gratitude and what it shifts for you. Please share your comments. Thanks!

Still not convinced that gratitude can reduce your distress while being the caregiver of someone with an eating disorder? Check out the “7 Scientifically Proven Benefits of Gratitude” published in Psychology Today in 2015.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

 

 


Part Two: Feeding Our Warrior Daughters

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Clementine adolescent treatment programs Director of Nutrition Services Amanda Mellowspring, MS, RD/N, CEDRD-S is a Certified Eating Disorder Registered Dietitian with over a decade of experience in program development and clinical application working with eating disorders at various levels of care. In part two of her series, Amanda dives into just how Clementine supports adolescents to be empowered in their eating disorder recovery. 

Check out Part One of Amanda’s series HERE.

There is often a lot of discussion related to feeding, meal planning, weight goals, etc, so in this discussion, let’s focus instead on how to plant those strong roots (ie. how to empower an adolescent in recovery while also providing structure and guidance). In working with adolescents, it is not uncommon that our girls are still trying foods for the first time EVER! This rarely has to do with the eating disorder, yet can have everything to do with being an adolescent. Supporting girls in trying new foods or combinations of foods with structure and expectation that their warrior hearts can manage it, allows for an empowering experience of increasing food variety, enjoying new flavors, and even learning that they enjoy different cuisines. This can also be an individuating experience for some girls. A common example of this includes supporting our girls in trying new fruits or veggies for the first time; perhaps even meals prepared differently than how mom or dad does at home. This may include new seasonings or spices, sauces, and even preparation methods – a great Indian chicken tikka masala dish may be a new love for someone in treatment, while another girl may develop a new love of grilling outdoors with our chef. Oftentimes, these new experiences for our daughters also may challenge mom and dad to explore new foods and our cooking experiences at home also. Healing involves the whole family and creativity can be a big part of the process.

Another important example of planting these roots involves tolerating dislike – yes, exactly, asking and expecting that a warrior heart can manage to do things that she doesn’t absolutely LOVE! I know – tough adolescent stuff! Our world is busy and it is often easier (and less frustrating) to just pick up or serve whatever we know everyone will eat, so that we can all try to get a bit of relaxation in before another busy day. Allow us to support both your daughter and your family in shifting this. In our work, we devote the time to tolerating the experience of pushing through the dislike and acknowledging that doing so actually translates into an important lifeskill – how many times do we all as adults have to do things we don’t LOVE?…often! Being able to tolerate these experiences and move through them without getting stuck in them, or demanding ONLY our preferences from the world, strengthens those roots. I still remember bursting in the door from high school, frantic to know what was for dinner, only to hear something I didn’t want to hear…say meatloaf. I also remember that I would wash up, sit down and eat the meal, chat with my family, focus on the time together, and then move on with my evening. Meatloaf nights were an important part of creating strong roots to tolerate that life is often different than what we would prefer, but the value in that holds great opportunity for us. A strong theme in our work with adolescent girls is acknowledging their warrior strength, rather than backing down to the eating disorder or fearing that their young years somehow limit their ability to challenge themselves. Treating our adolescent girls as the warriors of recovery that they truly are, allows for growth, change, empowerment, and wisdom. These are aspects of healing that are vital to true, longterm recovery.

The balance of accountability and expectation with compassion for the sometimes confusing experiences of adolescence holds endless opportunities for supporting recovery and normalized adjustment into adulthood. Avoiding the fear, the challenges, and the fight serves no one in recovery. After all, warriors grow from the fight!

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Part One: Feeding Our Warrior Daughters

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Clementine adolescent treatment programs Director of Nutrition Services Amanda Mellowspring, MS, RD/N, CEDRD-S is a Certified Eating Disorder Registered Dietitian with over a decade of experience in program development and clinical application working with eating disorders at various levels of care. In this week’s blog post, Amanda shares the importance of empowering adolescents in eating disorder recovery process, and just how Clementine supports adolescents to do so. 

In the treatment of adult women, we often hold discussion on these powerful women being “warriors” in recovery, having overcome the trials of an eating disorder and likely other hardships.

In my work with adolescent girls, I often hear others comment on how “sweet” the work of our younger girls must be by comparison, or sometimes even how “sad” it must be to see our younger girls’ struggle. In response, I must say that these girls are the truest warriors – a path less refined by age but sometimes with just as many battle marks.

So, how do we empower our adolescent girls to be warriors in their recovery while also holding space for them to stay at a developmentally-appropriate place in their life and recovery work? One of the ways that we manage this at Clementine Programs is to strike a fine balance in our work with food. Feeding our warrior daughters is a mighty task!

In order to achieve this balance, we support our girls in feeding themselves with foods they enjoy, nourishing themselves with a variety of foods, and support them in re-engaging with internal awareness of hunger, fullness, and satiety. The combination of these empowering messages of personal safety with food and body trust, alongside the structure of guidance around quantity, food flexibility, and normalized developmental experiences of food exposure and trials allow for a firmly rooted warrior of recovery.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Article Spotlight

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Join us in reading inspirational and informative articles we have cultivated from across the web. If you have found an article you feel is inspirational, explores current research, or is a knowledgeable piece of literature and would like to share with us please send an e-mail here.

 

10 Things People With Anxiety Need to Do Every Day Psych Central

How I’m Living My Best Life with Mental Illness This Year The Mighty

What to do When Your Child is at College and Tells you They Have an Eating Disorder More Love

MythBusters: The Binge Eating Disorder Edition Proud2BeMe

6 Turning Points That Were Essential To My Recovery Recovery Warriors 

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Part Two: An Inside Look Into Treatment at Clementine

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Dr. Lauren Ozbolt, MD, CEDS, FAPA is a board certified Adult, Child and Adolescent Psychiatrist who specializes in the evidence-based treatment of mood, anxiety and eating disorders. She currently serves as the Medical Director for Monte Nido & Affiliates. In part two of her series, Dr. Ozbolt continues to share an inside look into a day in treatment at Clementine adolescent treatment programs.

While our adolescents are quite busy in programming throughout the day, we also recognize the need and benefit of appropriately scheduled breaks and downtime. Downtime is often difficult for our adolescents in that unstructured time allows the eating disorder thoughts more freedom. At Clementine, downtime is interspersed with opportunities for relationship building, recreational time and fun. Our recovery coaches are no strangers to fun and it is not unusual to see them engaged with the girls in an intense game of banana-grams or an elaborate art project.

 One aspect unique to Clementine is our use of a multi-dimensional Level System. Upon admission, adolescents are assigned to Level I, which corresponds with certain goals, assignments, challenges and privileges. When these goals and challenges are met (determined by the treatment team and milieu), then the adolescent advances to the next level of challenges and privileges. By using this system, the adolescent, parents and treatment team are all clear about the client’s progression in treatment. This eliminates uncertainty on the part of the adolescent, fosters mastery and facilitates trust.

After a full day of clinical programing, meal support and countless opportunities to practice recovery-oriented choices, adolescents are ready for bed. Recovery coaches are present to support bedtime routines and prepare for lights out. Recognizing that separation from parents and loved ones can be difficult for adolescents, Clementine staff are there to comfort and encourage. It is only at night, when your daughter feels safe, supported and loved that our job for the day is complete. It is perhaps in these quiet moments, that the beauty of the Clementine program is most visible.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Part One: An Inside Look Into Treatment at Clementine

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Dr. Lauren Ozbolt, MD, CEDS, FAPA is a board certified Adult, Child and Adolescent Psychiatrist who specializes in the evidence-based treatment of mood, anxiety and eating disorders. She currently serves as the Medical Director for Monte Nido & Affiliates. In our new series, Dr. Ozbolt walks us through a day in treatment at Clementine adolescent treatment programs to share an inside look of how Clementine supports adolescents on the path to full recovery.

Adolescents who come to residential treatment at Clementine are battling truly horrific illnesses. Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorders not only rob individuals of their health, but also their freedom and their life. Though the path leading to treatment is scary and the road to recovery is a challenge, staff at Clementine understand that it is often the difficult times that lead way to true healing. At Clementine, we meet your daughter where she is at and align our goals with hers. Clinical programming in our residential, home-like setting is designed to promote security, allow for camaraderie/support and remind your daughter what living is all about.

In the morning, adolescents start their day at 7am as a nurse greets them and assesses vital signs and other medical parameters. Recovery coaches are present to assist the adolescents with activities of daily living, bathroom safety and orient them to the daily schedule. Breakfast is served at 7:30 am and is eaten with peers and recovery coaches in an elegant dining environment. Intentions and goals are set before the meal and discussed post-meal. Recovery coaches, serve as a major source of support during meal times and model appropriate mealtime behavior.

On weekdays, breakfast is followed by 2 ½ hours of school held onsite in our Clementine classroom. Clementine employs state-certified Math and English teachers to assist with school assignments and liaison with the adolescent’s home school. While our focus is always on treatment, daily school hours do allow the adolescent to maintain their academic progress and eliminates the anxiety of “falling behind.”

Following school, our clinical programming is built around specialist-led groups, including adolescent DBT, Process, Cooking, Relapse Prevention, Body Talk, Family and Relationship, Nutrition, Mindfulness, Creative Arts and Yoga or Tai Chi. Additionally, each adolescent meets with her primary therapist three to four times weekly for individual therapy. She will also meet with her nutritionist, clinical director, family therapist, family practice practitioner and psychiatrist weekly. Primary therapist and nutritionist routinely join the adolescents and recovery coaches for meals and snacks to identify and address unique struggles and further offer meal support. Mealtime is often difficult for adolescents with eating disorders and we anticipate this. If and when your adolescent struggles with a meal, we believe in immediate and timely feedback. This is accomplished in a very private and supportive way with 1:1 staff interaction.

 

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Part Two: Eating Disorder Treatment and Recovery

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Chief Clinical Officer Doug Bunnell, PhD, CEDS is an expert clinican and leader in the eating disorder field. He is passionate about research and the latest advancements in the field, and equally committed to individualized client care. In this week’s blog post, Dr. Bunnell shares part two of an overview of treatment and recovery and how Monte Nido & Affiliates supports clients along their path to full recovery. 

Transitions to Day Treatment (DTP) and Intensive Outpatient (IOP)

These programs are intensive group based therapy programs. Eating disorders are serious, potentially chronic and life threatening illnesses, requiring your full focus. It is essential that each patient make a full commitment to attend all scheduled sessions. Our experience shows that patients and families who make their treatment and recovery their primary focus have the best outcomes.

Many patients who begin treatment of their eating disorder in outpatient therapy may require higher levels of care as their treatment progresses. Patients often need more structure to support them in their nutritional and psychological recovery. As their need for structure and support decreases, patients can step down to lower levels of care. The research on the treatment course of patients with anorexia nervosa indicates that many patients will require some degree of psychotherapeutic treatment for two years or more.

It is important for you and your family to look at the full course of recovery. Many insurance policies cover only an acute phase of treatment, whereas the clinical, or treatment, recommendations are more likely to address the issues involved in maximizing the chances for full recovery. The gap between covered care and recommended care, between medically necessary care and clinically indicated care, is important to consider as you plan for your, or your child’s, treatment needs.

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.

 


Part One: Eating Disorder Treatment & Recovery

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Monte Nido & Affiliates Chief Clinical Officer Doug Bunnell, PhD, CEDS is an expert clinican and leader in the eating disorder field. He is passionate about research and the latest advancements in the field, and equally committed to individualized client care. In this week’s blog post, Dr. Bunnell shares an part one of an overview of treatment and recovery and how Monte Nido & Affiliates supports clients along their path to full recovery. 

Eating disorders are complex illnesses with biological, genetic, psychological, social and developmental roots. There is never a single cause for someone’s eating disorder and effective treatment must address this entire range of factors.

The treatment of eating disorders is equally complex. It involves a number of different treatment disciplines, and usually a number of different levels of care. Effective treatment and recovery involves an ongoing collaboration between patients, their families and loved ones, and clinicians. Families, especially for younger women with eating disorders, are essential partners in the treatment team.

Treatment teams often include:

Physicians and psychiatrists

Psychotherapists

Individual, Family, Group

Experiential therapists

Art, movement

Nutritionists

Nurses, Educational consultants, …..(residential)

Levels of care include:

Residential

Day Treatment and Transitional Living

Extended Care

Outpatient Day Treatment

Intensive Outpatient

Outpatient Individual, Family, Group, Nutritional and Psychiatric therapies

Recovery takes place in phases or steps. Monte Nido & Affiliates’ continuum of care provides a way to gradually move from a highly structured and intensive residential treatment program to increasingly less structured levels of care. The transitions between levels of care are important moments in the process of recovery but this gradual “step-down” process helps minimize the risk for relapse.

A patient’s motivation to recover is a critical element in the recovery process. Healing and motivation are sustained and nurtured through involvement in a community. The treatment approach stresses these essential connections. As patients gradually regain their physical and nutritional health, treatment begins to focus on other aspects of successful recovery such as self esteem and broader aspects of the quality of life.

Most patients will fully recover from their eating disorders. Full recovery, however, often takes considerable time and effort. Patients with anorexia nervosa who are able to restore their weight to healthy levels have a much lower relapse risk than those who regain some, but not all, of their lost weight. Patients with bulimia nervosa who are able to completely eliminate their binge and purge behaviors have a lower risk of relapse than those who continue with even sporadic episodes.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Part Three: Don’t Look in My Lunchbox! An Open Letter to all teachers, coaches, school personnel, educators, parents, and frankly, everyone, everywhere…

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Clementine Advisory Board Member Cherie Monarch conludes her important letter from a mother’s perspective in this week’s blog post. Cherie continues with an “open letter to all teachers, coaches, school personnel, educators, parents, and frankly, everyone, everywhere”.  

10 Things you need to know before you speak (read 1-4 HERE and 5-7 HERE).

8. Even if your words do not trigger my child to have an eating disorder or disordered eating, they may haunt them for the rest of their life. They may burden my child with thoughts every time they take a bite … they may question every food choice. They may analyze  every bite they take, every meal they choose, for the rest of their life. Your instruction may make my child afraid to eat wheat, chips, cookies, ice cream, or other foods they used to love and were celebratory. Please consider your words carefully. Please don’t make my child afraid of birthday cupcakes!  

9. As my child’s mother, I know best what to pack in my child’s lunchbox. There are reasons my child’s lunchbox contains the foods it does. My choices may be driven by medical, mental, or financial needs. If you have questions regarding the food in my child’s lunchbox please contact me directly. Please do not discuss this with my child or shame them.

10. It is important that my child eat the lunch I have packed. If you notice my child is consistently not eating their lunch, is giving their lunch to other students, or is throwing it away or you have concerns regarding the amount of food my child is eating, please contact me directly. There may be a serious health concern. Please do not address this with my child. Please do not comment on the amount of food they are/are not eating. I count on you to be my eyes and ears when my child is at school.

I encourage you in the future to NOT monitor any child’s lunch or food choice. To reconsider and re-examine any school-based, anti-obesity, healthy living campaigns. To consider the fact that there is little research on the effectiveness of these programs. Is the potential risk of harmful effects on children’s physical and mental health and adoption of unhealthy behaviors worth the potential gain?

So, before you speak, please think carefully about your words. You see, my child respects you. They look up to you as their teacher. Imposing your beliefs and your nutritional needs on my child may compromise their health and mental state. Please teach them that all foods fill a need – always nutritional, sometimes celebratory and always nurturing.

Please understand, I know your intentions are pure and good. For that I will be forever grateful. But in the future I would appreciate it if you do not monitor my child’s lunchbox. Please leave that to me, their mother. I know their nutritional and emotional needs better than anyone.

Warm regards,

Mothers Everywhere

P.S. This article is not about monitoring lunch boxes because a child in the class may have an inadequate food supply in their lunch box or may have life-threatening food allergies. It is about the negative food talk happening in classrooms and lunchrooms, and how it affects our children. It is about food judgments and how programs that are intended to promote health sometimes have big unintended consequences.

 

We are exited to share the opening of Clementine Malibu Lake. Learn more about the program by visiting our website or calling an Admissions Specialist at 855.900.2221.

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.