Healing Injuries that have Occurred “Around the Table”

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Amanda MellowspringClementine Director of Nutrition Services Amanda Mellowspring, RD/N, CEDRD 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. She shares how the food exposures and challenges at Clementine help clients in their recovery process.

Most often by the time an individual admits to one of Clementine’s residential treatment programs, the client, the family, and their peer group are afraid, frustrated, and exhausted. Oftentimes, many emotional injuries have occurred along the way. Many of these have occurred surrounding food.

With eating disorders, food is the vehicle through which feelings are expressed that otherwise may not be spoken or heard. For this reason, food symbolically consumes the family and the peer group for these individuals. Family meals become tense if not obsolete because of the frustrations and anxieties associated with food selection, preparation, quantity, and behaviors at the table. Dining with friends is no longer a fun way to catch up, laugh, and share stories. It becomes a terrifying task of eating enough of the “right” things to seem “normal enough” and not ruin everyone else’s fun as her mind races with thoughts of hidden calories, special orders, and comparisons.

In healing these injuries, it is vital that each client at Clementine, not only achieves a state of health and wellness with appropriate food intake and nutrient balance but that she also begins to experience freedom in her experiences with food.  Food exposures and challenges with staff, with family, and individually are all important ways of doing this. This aspect of recovery takes practice in self-confidence with nutritional needs and honesty in honoring all of the aspects of food that make it enjoyable in our lives. Being able to cook a meal with mom and dad, go on a picnic, order in for a movie night, or go out for ice cream on a pass are all examples of ways that Clementine clients have practiced this healing.

During these exposures clients are not only practicing eating foods they like and desire in appropriate quantities to support their body’s needs, they are also challenging messages regarding comparisons with others, seeing calorie information posted in restaurants, managing herself while others around her may feed themselves differently, and working to be present in the moment socially and emotionally to enjoy the opportunity to be with friends or family.

The Clementine dietitian works closely with the entire treatment team and family to ensure that the dynamics surrounding these injuries at the table are acknowledged and approached with compassion for both the client and her family members.

Obtaining a state of health and awareness of how to nourish one’s body appropriately is vital in recovery, while healing the injuries that have occurred around the table offers peace and serenity for these individuals allowing them to move forward in their life and recovery without the wounds of the eating disorder.

 

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.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.


Bright Yellow Beach Ball

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BerthaTavarezClementineBlogDr. Bertha Tavarez, Clinical Director of Clementine adolescent treatment programs, speaks to the benefits of experiential therapy techniques to be utilized within a therapeutic relationship as well as among professional colleagues. 

I was recently invited to present at the 10th annual Latin American Eating Disorder Conference in  Mexico. I was encouraged to present a clinical topic that was “different”, “new” and “cutting edge.” I decided to create a presentation on experiential therapy techniques and how to incorporate them into eating disorder treatment. Soon, my creative wheels were turning, and I planned on several therapeutic demonstrations, work samples, and props that may facilitate warm up therapy exercises.

I combed through a labyrinth of Walmart aisles looking for the perfect prop that I could use as an ice breaker. The prop needed to be accessible enough to quickly flow through a large audience with the power to break the monotony of hours of lecturing. Did I mention my presentation was at the end of the day? In a moment of inspiration I saw it! Among a myriad of seasonal toys I spotted a bright yellow beach ball with a large smiley face stitched on. The plan was to throw the ball at a person in the audience, asking them to state their name and one word that best represented their inner self before passing it to another person, and another, and so on.

The next morning, I boarded an airplane with my bright yellow beach ball safely stowed. After the beach ball was scanned for explosives residue (true story!) I was on my way to the conference, softly whispering talking points to myself as I took in the sights of the bustling city of Monterrey. I arrived in time to sit in on a presentation on the epigenetics of eating disorders. As I marveled at the research studies being presented, I stared down at the bag containing my ball, and became flooded with thoughts about how my bright yellow beach ball paled in comparison to talks of ventricular enlargement.

After a welcoming introduction, I approached the podium with a mixture of trepidation and resolve. I stated that no presentation on experiential therapies can be devoid of experience and action, and with a brief explanation, and a flick of the wrist, I tossed the bright yellow beach ball into a sea of audience members. Soon, the room lit up with a choir of voices. “Ana, Intelligent!”, “Carmen, Loving!”, “Sandra, Patient!” For days these people were introducing themselves by their titles and affiliations, but for one moment they connected on a universal human level with the help of one unsuspecting prop.

 

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.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.


An Open and Informed Medical Approach

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LaurenOzboltClementineBlog

 

Medical Director of Clementine Lauren Ozbolt, MD is board certified in adolescent, adult and child psychiatry and oversees the psychiatric care and attending psychiatrists at all Clementine locations. Dr. Ozbolt explains how she uses a systematic approach in order to establish a strong rapport with the adolescent and the family in order to recommend the use of psychopharmacology.

After years of treating patients with eating disorders, I know the word “psychiatric medications” often sends chills down one’s spine.  Furthermore, the idea of using psychiatric medications in adolescents is frequently the stuff of parental nightmares. It is true that some adolescents have been scarred by memories of taking psychotropic medications without explanation or have felt “bullied” into taking medications.  I find that many teens are terrified of psychotropic medications and have false preconceived notions about how medications work.  As one young girl timidly told me, “I will be a zombie.” (Cue Walking Dead episode)

Thus upon meeting a new adolescent at Clementine, I typically don’t introduce the idea of taking psychotropic medications for the first few weeks of treatment (provided they are psychiatrically stable).  I find it is much more valuable at this stage of the game to establish rapport.  I really want to take the time to get to know the patient, focus on the nutritional aspects of treatment and try to gain a better understanding of the function of the patient’s eating disorder.

After seeing the adolescent daily for several sessions and establishing rapport, I then may make medication suggestions.  Psychotropic medications can be very helpful in the treatment of certain eating disorders targeting such symptoms as anxiety, depression, obsessive thoughts and food preoccupations.  I spend a great deal of time providing education about the medication, how it works in the body, risks, benefits and side effects.  I will often tell the adolescent what they will find if the “google” the medication and why or why not this may apply to them.  I never push a medications though, and often suggest that they take a few days to think about the medication and discuss it with their parents.  I similarly, give the parents the same extensive psychoeducation and rationale for my recommendation.  If the adolescent decides not to take psychiatric medications, again, I never push or try to convince her to take medication. I don’t believe in trying to convince people to take medication they don’t want to take—especially an adolescent who is in the separation-individuation stage of development where opposition is the rule.  Instead, I support the adolescent in their decision all the while, leaving the option for medication open.  I find this open approach coupled with a relationship that fosters trust and mutual respect sets a firm foundation for change.

 

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.

To visit or tour a Clementine locations with one of our clinical leaders please reach out to a Clementine Admissions Specialist at 855.900.2221.