The Sun and Wind Dispute: Navigating Motivation and Readiness for Change in Adolescents with Eating Disorders

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Treating an adolescent who is resistant and treatment ambivalent can be very challenging for a clinician. In this week’s blog post, Clementine Miami Pinecrest Clinical Director Bertha Tavarez, PsyD offers some strategies to help strengthen the therapeutic alliance and build the groundwork necessary for full recovery. 

“The sun and the wind were having a dispute as to who was more powerful. They saw a man walking along and they had a bet as to which of them would get him to remove his coat. The wind started first and blew up a huge gale, the coat flapped but the man only fastened the buttons and tightened up his belt. The sun tried next and shone brightly making the man sweat. He took off his coat.” – Anonymous

The metaphor of the sun and the wind is an accurate depiction of the challenges that many clinicians face while working with adolescent patients. Although we may have access to the gravity of our patient’s clinical needs, simply communicating our concerns and providing much needed skills can be met with resistance. Our patients remain “locked in” to their emotional experience while simultaneously feeling “locked out” of the insight and motivation needed to increase their receptivity to much needed skills development. The adolescent, preoccupied with exerting and maintaining control and autonomy, may hold tightly to their coat, rendering our intentions to provide care futile.

So how do we, like the sun, create shifts in awareness and influence change?

The power of reflection

It may be tempting to adopt the roll of cheerleader (“You can do this!”) or problem solver (“Why don’t you try this?”). When an adolescent patient presents with resistant talk (“I don’t want to be here”) or talk that inhibits change (“I got straight A’s with ED, what’s the problem?”). Often the simplest and most effective way of building rapport and loosening the grasp of resistance is to simply reflect the patient’s message in your own words. Often, patients are primed for persuasion and direction. Reflection statements can contribute to feelings of validation and interpersonal trust.

Resistance as an interpersonal process / Resistance as developmentally appropriate

It is important to keep in mind that resistance is both developmentally appropriate for adolescent patients and an interpersonal process that occurs within the therapeutic alliance. Although, we may expect a certain degree of resistance on a developmental level, we can provide corrective experiences around resistance that still promote autonomy. A clinician may benefit from awareness about the resistance that is brewing in a session, abstain from engaging in a power struggle, and promote an alliance with the patients’s desire for autonomy.

Highlight intrinsic control

An effective technique that facilitates a shift from resistance talk to change talk is the clinician’s emphasis on the patient’s access to her personal control. A clinician may reflect the pros and cons experienced by the patient:

Patient: “I got straight A’s with ED, what’s the problem? Gosh! That was so hard!”

Therapist: “It sounds like you did well in school this year, but ED made it more difficult.”

A clinician may also reflect a patient’s choice within the constraints of the treatment environment while having the knowledge of the consequences. For example, the patient may be informed of her choice to select what day an exposure is initiated or asked to reflect on her choice to not participate in a group while being aware of consequence of losing a daily privilege as a result.

Shifting focus  

If resistant talk persists, the clinician can shift the focus to another closely relevant therapeutic topic that may tie into the overall theme beneath the resistance. For example, if the patient states, “I don’t want to take medications and that’s final!” the clinician can say, “Ok, how about you tell me how you’re feeling about your overall health today?”

Working with patients experiencing resistance and treatment ambivalence can be challenging. However, there are great opportunities at this treatment phase that can strengthen the therapeutic alliance and build the ground work necessary for lasting change. Motivational interviewing and person-centered techniques are an integral component of the clinical work at Clementine adolescent treatment program.

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.


The Art of Nutrition: the similarities and differences between our three programs philosophies and approaches

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Oliver-Pyatt Centers, Monte Nido and Clementine are three eating disorder treatment programs that operate with the same intention: To support individuals healing from eating disorders and to help them realize their potential of full recovery. That being said, we understand treatment is not a one-size-fits-all formula. Our three directors of nutrition come from the same underlying dietary philosophy that combines medically based research in the treatment of eating disorders with practices that help individuals learn to confidently nourish themselves independently. By understanding the slight differentiators that are practiced in all three facilities, it becomes easy to see that though the day-to-day may differ for clients from facility to facility, the fundamental reasoning for these different practices come from the same place.

Oliver-Pyatt Centers in Miami offers comprehensive, day treatment, transitional living and intensive out-patient programs for women seeking eating disorder recovery. Our program uses thoughtfully planned, supported food exposures to challenge food rituals, beliefs and judgments while building skills and laying the foundational understanding of the role hunger, fullness and satiety play in self-nourishment.  We work with a variety of mindful eating techniques, paying particular attention to hunger and fullness cues, while implementing a medically indicated and individually structured meal plans. Our hope is that this combination lays the groundwork for a future of intuitive eating as our clients move toward full recovery after discharge.

Monte Nido treatment centers offers residential, day and intensive outpatient programming and transitional living for clients seeking eating disorder recovery. At Monte Nido treatment centers, we work with our clients to support their nutritional, physical, and emotional health and wellbeing.  With treatment of the whole person as our guide, our initial goal is to build rapport with our clients, to gain an understanding of an individual’s challenges and to formulate an individualized treatment plan that promotes movement away from eating disorder ideals and towards whole health. Using thoughtfully planned, supported exposures to a variety of food and eating environments, active challenging of eating disorder behaviors, and individualized, structured meal plans, we work with our clients to support the development of the skills required for a life of conscious eating.

Lastly, Clementine is strategically structured for the treatment of adolescents with philosophies that pull from both of its parent programs. Our dietary practices are no exception; nutritional practices are based on research that is aligned with adolescent growth and development. We practice mindful eating techniques before and during meals and reflect after mealtime. There is an emphasis placed on healing the whole family through education, family food exposures and individual work with the family.

While on paper all three programs appear somewhat different, our objectives remain the same. In the next few weeks we’ll dive into the specifics of each program to reveal some more key similarities and differences between the three programs. Our first in-depth look at nutrition will be focused on Monte Nido programs and can be found here.

 

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.


Treating Eating Disorders in Adolescents: Complexity, Connection and the Course to Full Recovery

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Monte Nido & Affiliates Chief Clinical Officer Doug Bunnell, PhD, FAED, CEDS, Monte Nido & Affiliates Senior Director of East Coast Clinical Programming Melissa Coffin, PhD, CEDS and Clementine adolescent programs Director of Nutrition Services Amanda Mellowspring, MS, RD/N, CEDRD-S will present “Treating Eating Disorders in Adolescents: Complexity, Connection and the Course to Full Recovery” on March 29th and March 30th.

To be effective, treatment of eating disorders has to reflect the complexity of these illnesses. Treating eating disorders in adolescents adds another layer of complexity that requires a deep appreciation for the influences of cognitive, emotional and physiological development. It also requires a thoughtful and systematic approach to helping families support their adolescent’s recovery. This comprehensive model provides a roadmap for helping teens and families establish a quick remission of the acute impact of eating disorder symptoms and behaviors so they can work their way to a full and lasting recovery.

Through this presentation, participants will be able to accurately explain the role of temperament, traits and neurobiology in the etiology maintenance of eating disorder symptoms in adolescents, as well as the psychiatric, psychological, nutritional and medical issues that are unique to this age group. Participants will learn to identify at least three developmental aspects of addressing motivation and readiness for change in the treatment of adolescents and be able to list and explain four skills families can implement to help adolescents develop strategies for managing anxiety and fear. Lastly, participants will learn to define and describe emotional response and attunement, communication and meal support—skills families need to develop when managing the challenge of their teen’s recovery.

Join us on Wednesday, March 29th in New York City at 3 West Club or on Thursday, March 30th in Westchester Country at the Doubletree by Hilton Hotel. Registration, networking and breakfast will begin at 8:30 and the presentation will take place from 9:30-11:30am. 2 CEUS will be provided! RSVP to Regional Outreach Manager Jenn Vargas at jvargas@montenidoaffiliates.com.

 

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.


How Are You Teaching Others to Treat You?

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Clementine South Miami Primary Therapist Josephine Wiseheart, MS contributed to an article published on PsychCentral, “What It Means To Teach People How To Treat You.” The full, original article can be accessed here. The article explores the importance of and your own role in teaching others how to treat you. Please enjoy an excerpt of the article below…

Start with yourself.

“[T]o teach people how to treat you, you do not begin with them, you begin with yourself,” said Wiseheart. Morgan agreed: “The way you believe about and treat yourself sets the standard for others on how you demand to be treated. People learn how to treat you based on what you accept from them.”

Wiseheart regularly tells her clients to “Be the pebble.” In other words, “to create even a seemingly small amount of change will ripple out and create more change.”

Teaching others how to treat us starts with self-awareness, Wiseheart said. She suggested asking yourself these questions: “How do I treat myself? What do I value? What do I want? What do I think I deserve?”

Remember that you can’t change anyone else. But we can “create a different reaction in others if we change ourselves,” she said.

Talk about your “rules of engagement.”
One of the biggest misconceptions Wiseheart’s clients have about relationships is that others should know how they want to be treated. However, “in order for people in a relationship to be on the same page, they need to have access to the same instruction manual,” she said.

She calls this manual the “Rules of Engagement.” She suggests having “business meetings” to discuss the “rules” of your relationship. Have these meetings when people are at their best: They aren’t in an emotionally heightened or vulnerable situation, she said.

Rules might include no name calling or yelling during a conversation, and taking a break when tempers flare.

Communicate your needs clearly and compassionately.
For instance, many couples criticize, yell, or give each other the silent treatment to communicate their needs, said Morgan, who practices at Wasatch Family Therapy. This not only is ineffective, but it also hurts your relationship.

“Rather than scream ‘you never listen to me,’ it is more helpful to express ‘I feel alone right now and I would be very grateful if I could have your undivided attention for 10 minutes,’” he said. Another example is: “I am feeling overwhelmed right now and would love it if I could get a few ideas from you.”

In other words, we teach people how to treat us when we can identify a need and then express it in a clear and comprehensible way, Morgan said.

“If we use pouting, desperation, or even abuse, people do not learn how we want to be treated. All they hear is pouting, desperation and screaming. The message does not get across.”

Model how you’d like to be treated.
Wiseheart also often tells clients to “Be the person you want other people to be.” That is, treat others the way you want them to treat you, which is reminiscent of the Golden Rule, she said.

“If you want your children to be kind to you, be kind to them; if you want your sweetheart to be romantic and affectionate with you, be that way with them.” If you want others to listen to you, listen to them. Focus your full attention on the person, maintain eye contact, ask questions, validate their feelings and be empathetic, Wiseheart said.

Reinforce behaviors you like.
Reinforcement simply means expressing appreciation when the other person makes the effort to change their behavior, Wiseheart said. For instance, you might say: “I appreciate that you listened to me so intently yesterday.”

“Reinforce [behaviors you like] at the time, 5 minutes later, 10 minutes later, an hour later, a day later, 10 days later. You cannot reinforce a positive behavior enough.”

Pick a role model to emulate.
“Find a role model of someone who demands respect and appears to have a strong sense of worth,” Morgan said. This person might be a parent, peer, friend, teacher, coach, therapist, mentor or even a well-known celebrity, he said. “The important component of a role model is that they are emulating the desired beliefs and behaviors that you would like to adopt or integrate.”

Have realistic expectations.
According to Wiseheart, “You don’t teach people how to treat you in a day, or a week, or a month; it probably takes many months at a minimum to really get someone to treat you the way that you want to be treated.” This process takes lots of practice and patience. And sometimes, people are too caught up in being rigid and defending their own reality to try to act differently, she said.

When you start clarifying what you will and won’t tolerate there’s also a risk that some people won’t stick around, Wiseheart said. “At that point, you need to ask yourself what’s in your best interest — a relationship at the cost of you, or making room for the future relationships that you deserve?”

For the full article, written by Margarita Tartavosky, MS who writes her own blog, Weightless, please visit here. Marriage and Family Therapist Michael Morgan, of Wasatch Family Therapy, also contributed to the article.

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

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


Diagnostic Dilemmas: The Nutritional and Medical Interface in Treating Eating Disorders and Co-morbid Illness

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Clementine Director of Nutrition Services Amanda Mellowspring, MS, RD/N, CEDRD and Chief Medical Officer Joel Jahraus, MD, FAED, CEDS will be sharing some of their expertise in an upcoming professional seminar. “Diagnostic Dilemmas: The Nutritional and Medical Interface in Treating Eating Disorders and Co-morbid Illness” will be held in Princeton, NJ at the Westin Princeton on Friday, March 10th from 9:00am-11:30am. Breakfast and 2 CE hours will provided.

Contemporary medical illnesses including celiac disease, food allergies and irritable bowel syndrome often confound the treatment of eating disorder patients and need careful consideration as to a true medical etiology. Often in the course of treatment the nutritional aspect of care becomes front and center as individuals fear the worst with food exposures that they have long avoided. This presentation will discuss these issues and put forth our model of care in appropriately assessing the comorbidities as well as the collaboration of medical and nutrition in treating not only the co-morbid illness, but the eating disorder as well.

In this presentation, participants will learn to describe three basic medical and nutritional issues inherent to co-morbid medical issues in eating disorder treatment and accurately explain the current medical approach to the treatment of comorbid illnesses. Participants will also learn to describe the interaction of medical and nutritional team members in the assessment and treatment process. Lastly, participants will learn at least two appropriate nutritional approaches that correct nutritional deficiencies while addressing food fears and eating disorder behaviors.

To join the professional seminar, please RSVP to Regional Outreach Manager Tamie Gangloff (tgangloff@montenidoaffiliates.com). Seating is limited.

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

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

 

 


Seven Key Developmental Needs: Creative Expression and Structure

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In this fourth and final post on the seven developmental keys series, Senior Director of East Coast Clinical Programming Melissa Coffin, PhD, CEDS discusses the final two keyscreative expression and structure. Read on to learn how Clementine adolescent treatment programs incorporates both keys in treatment…

The Center for Early Adolescence has defined fundamental developmental needs during adolescence as the following: Self-Definition, Meaningful Participation, Competence, Creative Expression, Physical Activity, Social Interactions and Structure. Today I want to write about the combination of Creative Expression and Structure and how they are integrated in the treatment of adolescents with eating disorders.

In adolescence, the prefrontal cortex is still continuing to develop. As a result, adolescents are able to think more creatively during this time. This flexibility of thought allows them to see things in a different way than we do as adultsthey are great “outside of the box” thinkers. We enjoy this quality of adolescence and encourage our adolescents to use creativity and flexibility to challenge their eating disorders or other areas of life where they are stuck.

At Clementine, we integrate time for both creativity and expressive therapies to appeal to their cognitive flexibility. Being able to teach and talk about important concepts in treatment through a creative modality helps to enrich our programming. It is also a non-threatening way to therapeutically approach more sensitive or challenging topics. For example, having a client create a collage of their goals rather than writing them down in a list helps them visualize goals in a different way. This activity can perhaps bring to light some goals that were not at the forefront of their mind when they started the assignment.

Coupled with honoring their creativity and flexibility, Clementine programming and staff naturally provide structure for our teens. With our multidisciplinary Level System, and structured programming, we provide a safe container in which our teens can flourish during this special time in their lives. We have found this balance of structure and creativity to be the perfect blend for our adolescents. 

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

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

 


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.

 

5 Ways to Self-Care During Difficult Times NEDA

Friends of Teens with Eating Disorders Unsure Where to Turn Psychology Today

6 Key Steps to Getting Back on Track after a Relapse in Recovery Angie Viets

Cultivating a Positive Relationship with Food MEDA

Disordered Eating Patterns to be Aware of Among Adolescents ED Hope

 

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.


If She Were Your Daughter, What Would You Do?

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LaurenOzboltClementineBlogClementine Medical Director Lauren Ozbolt, MD is board certified in adolescent, adult and child psychiatry. She oversees the psychiatric care and attending psychiatrists at all Clementine locations. In her post, Dr. Ozbolt shares some the work being done at Clementine and the commitment the staff has to each adolescent’s recovery.

I can recall first wanting to become a physician when my mother would take me to the pediatrician’s office when I was feeling sick as a child. Often times my doctor would sit next to me and calmly explain what he felt was going on and all the options for treatment that were available. My mother would always reply in the same way whether I had the flu or needed hospitalization. She would say, “If she were your daughter…what would you do?” To this day, that is how I think about the adolescents we treat, and that is the approach that permeates the air at Clementine. With each adolescent we think, “If this was my daughter, what would I do…”

Here’s what we would do…

At Clementine, your daughter’s psychiatrist takes the time to get to know the girl underneath the eating disorder. We empower and equip her with the tools – whether they be therapy, medication or both – to help her overcome her eating disorder. We feel the best kind of care is collaborative care and we invest a great deal of time in making parents “experts” on the most innovative treatments, neurobiological causes and the latest research in the field of eating disorders. We feel in order to treat a disease it is important for you and your daughter to fully understand the illness and our rationale for treatment. At the heart of Clementine program is a commitment to your daughter.

 While education about treatment of eating disorders is invaluable, it is only a part in what makes out treatment unique. We truly delight in knowing her and your family and take pride in aligning ourselves with you. At Clementine, your daughter’s future goals, become our goals and hence starts a beautiful restorative process of getting her back on track to become the amazing young woman she is destined to become.

 

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

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


Our Clementine Family: Megan Hamann

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megan-hamann-20171Clementine Academic Liaison Megan Hamann has been working in the education field for over ten years. In her role, Megan ensures that the adolescents are able to stay on track with their school work while on their journey to full recovery. Learn more about Megan and her work at Clementine in this week’s “Our Clementine Family”…

What is your name and what are your credentials?

My name is Megan Hamann. I hold a Bachelor’s degree in Early Childhood Education from Asbury University in Wilmore, Kentucky and I also have my Master’s degree in Special Education from Florida Gulf Coast University, in Fort Myers, Florida. I am looking forward to beginning my Specialist degree in Education leadership in the Fall here in Miami.

Please give us a brief description of your background.

Surprisingly, teaching was something I never thought I would do! School definitely was not my favorite thing growing up. However, after a decade of being an educator, I wouldn’t have it any other way! I decided to pursue education, to make it a fun and enjoyable experience for my students.

I have had the privilege to teach in amazing schools, focusing on grades 1st – 6th. I hold certifications in ESOL, Elementary K-6, English 6-12, and Special Education. Having taught in Georgia, Naples, Florida, and Miami, I have had a wide experience in different public school systems, as well as Charter Schools. However, one of the best experiences was teaching at Ada Merritt in Miami – one of the top International Bachelorette schools in the country! I love all the experiences I have had, especially the wonderful students & administrators I have worked with, which has thoroughly helped in the position I hold today!

I began working for Oliver Pyatt Center in 2015 after I was looking to step back from the public school system to spend more time with my children. I started OPC as the English teacher and after a few months of working with the clients, I was asked to fulfill the role as the Educational Liaison. I love to work with the adolescents, parents, school counselors and principals on a daily basis to ensure the adolescents are able to stay on track with their education while they focus on their recovery.

What does a typical day look like for you at Clementine?

Typically, my day begins by checking my email to make sure I can connect the adolescents with the teachers or counselors who have emailed assignments or tasks. On the days I am in the classroom with the adolescents, I check in with them to see how their work load is. We aim to maintain a healthy balance of school work with their treatment. If adolescents are overwhelmed, we cut back, if they can handle more work, we add more. When adolescents first admit, we create a personal plan for each. We look at their work load, course requirement for graduation and the reality of what can be attained during our school hours at Clementine to find the best fit for each adolescent in treatment.

In your own words, please describe the philosophy of Clementine.

Education, as well as recovery, is something that effects the adolescents for the rest of their lives. While their recovery and focus on treatment is the number 1 priority, education is also an important part of their lives as well. Our goal is to maintain the appropriate balance to keep the adolescents on track for graduation, while they focus on recovery. However, this is different for each adolescent that comes in, which is why communication is a key factor in the success.

How does your team work together? How do your roles overlap and differ?

Teamwork is key at Clementine! Education is just a piece of the puzzle that we all bring to the table. Without that piece, there would be a big hole in the picture! As our team brings together information, it is amazing to see how certain parts of the Eating Disorder can affect school, learning capabilities and also social aspects as well. As an educator, I aim to bring my knowledge together with the doctors and therapists to help understand why the school situation is impacting the clients positively or negatively.

What is your favorite thing about Clementine?

My favorite aspect of Clementine has been working with schools and adolescents all over the country! I have learned a lot about the school systems and medical leaves, school & state requirements, and have met so many wonderful people who are also focused on wanting the best for our adolescents. Guidance Counselors and principals play a key role in helping the girls attain success as well, it has been such a joy to work with such caring people!

What are three facts about you that people do not know?

When I was in college, I was a nanny for a family who had four kids under the age of three in SoHo, NYC! That was an experience! I also backpacked Europe after I graduated college with only a couple hundred dollars! My biggest secret is – When I was in college I had a major intestinal surgery that took a year to fully recover from, I know that is odd to share here, but I have seen that it has helped me connect with the girls in a very intimate way. I had to take a semester off my college classes and felt it was the end of the world, however, to get better and recover was actually what I needed. I was able to continue to finish school, I finished just a little later than I first anticipated. However, that ended up being the best thing for me. I love to share this with the clients, so they know I completely understand how hard it is to stop their ‘plan’ for school and focus on the quality & health of their own life. I understand it is hard, but we will work together to get them to a place where they can be successful!

 

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

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


Fat Chat is No Light Matter

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andrea-wachter

Andrea Wachter is a Licensed Marriage and Family Therapist and author of Getting Over Overeating for Teens. She is also co-author of The Don’t Diet, Live-It Workbook and Mirror, Mirror on the Wall: Breaking the “I Feel Fat” Spell. She is an inspirational counselor, author and speaker who uses professional expertise, humor and personal recovery to help others. In her writing, Andrea shares strategies to help parents foster a positive relationship between their children and their bodies.

As an eating disorders therapist and woman who spent the majority of my life in the grip of a weight and food obsession, I walk around with my antennae tuned in to whatever might help me understand how we got ourselves into this mess. Obesity is now considered an epidemic. My young bulimic clients tell me, “Vomiting is no big deal.” Every day, people die from anorexia-related complications. And let’s face it, folks: Even many Americans of average weight are preoccupied with food and body image.

Recently in a grocery store check-out line, I stood behind a thirty-something mom and her little girl. The mother was chatting on her cell phone while the daughter was clinging to her mom’s leg with one hand and sucking on the thumb of the other.

The mother’s side of the conversation went like this: “Oh, I was so bad yesterday! I had a whole piece of chocolate cake at the party. I am not eating any carbs today. I feel as big as a house.”

I wanted to hand the daughter my business card right then and there! I refrained, though, since the kid, still in diapers, was a little too young for therapy.

My point is that your children are listening. They are listening when you partake in what I call “fat chat.” They are listening when you say you feel “fat” (which, by the way, is not a feeling). They are listening when you say you were “bad” or “good” or “evil” or “sinned” because of a food you either ate or passed up. They are listening when you say you need to go to the gym to work off your dessert. They are listening when you comment on other people’s bodies or your own. Your children are listening and learning and following suit. And what they often end up thinking is: “I better watch out. I might get fat. Maybe I am fat. If I am, then people are judging me. I better control my eating. Uh-oh, I can’t stop eating. Hunger is bad. Fullness is worse.”

Every year, my clients get younger. I have seen six-year-olds who are already dieting and know about carbs, fats and calories. I worked with a seven-year-old girl who was spitting up her food because she was convinced that calories were bad for her. Last year, I had a nine-year-old client who had to change her school clothes several times each morning till she found something she didn’t feel “fat” in. Most often, though, people don’t get to my door until they have been entrenched in food and weight struggles for many years. While an eating disorder is possible to overcome, the longer it goes on, the harder it is to heal. We need to do prevention at the ground level. We have a choice: We can teach our children to relax, listen to their bodies and love themselves, or we can teach them to be anxious, controlling, and out of touch with their own hunger and fullness.

My message here is not to blame or to shame, but merely to highlight the fact that unless we model a healthy, balanced, and loving relationship with food and our own bodies, children are at risk for developing disordered eating, poor body image, and/or weight problems. Take a look at the messages you are teaching. Learn to enjoy food again. Stay conscious of your body’s hunger and fullness levels and act on them. Get help if you can’t. Treat your body with respect and appreciation. After all, isn’t this what we want our kids to do?

Tips for Helping Your Child with Body Image

• If you find yourself “feeling fat,” explore a little deeper to see if there’s something else going on in your life. Model for your children that “fat” is not a feeling, but rather “feeling fat” can be a distraction from more difficult issues.

• Try not to label food as “good” or “bad.” Some foods are more nutrient dense than others, but morally all food is equal — it’s fuel! Talk with your kids about the nutritional value and variety of different foods, the art of cooking, and the fun and the pleasure of eating.

• Talk to your kids about the difference between emotional and physical hunger and how the two often get mixed up. Physical hunger is a feeling in the belly that the body needs fuel. Teach kids to notice degrees of hunger and fullness as well as how to eat when they are hungry and stop when they are full. Emotional hunger is usually a need to express feelings or have feelings acknowledged. When kids are sad, they might need to cry, talk about it, or draw a picture. When they are mad, they might want to write, draw, punch a pillow, tell you about it with gusto, and have you really hear them.

• Along these same lines, talk about the role of feelings: that they are signposts for living, and not to be “stuffed” or “starved” away. Teach them that just like there are no “good” or “bad” foods, there are no “good” or bad” feelings.

• Do not comment on other people’s bodies. This sets up a comparison mentality that is harmful and hard to give up. Talk about how everyone is beautiful in their own way, and that beauty is an inner quality that can be expressed in outer characteristics such as kindness and enthusiasm.

• Exercise with your kids for the joy of movement, not for how many calories you might burn.

• Look at family photos and talk about where your size and shape came from.

• Watch TV together and discuss the emphasis our culture places on looks, image, and thinness. Help them to notice special qualities in themselves like compassion and humor as well as things that interest them beyond their appearance. Teach them that they are enough just by being who they are — on the inside. (While you’re at it, think about yourself that way, too!)

• Do de-stressing activities together, like: listening to music, walking, spending time in nature, playing games, doing a hobby or craft, or reading and discussing a particular book.

• Help them to foster love for themselves when they look in the mirror. Teach them to “see” themselves with the same love that they feel for other people or animals in their lives.

• Make a list together of all the things that our bodies do for us. Help them to appreciate their various body parts rather than criticize them.

• Talk about what makes a good role model. Ask for an example of a person who seems to be a healthy, balanced eater with a positive body image. Discuss what qualities that person has that demonstrate good health. Ask your child to imagine having those same qualities inside.

• Teach your child that weight fluctuations are normal and healthy and that we all have a natural weight range just like we have a natural eye and hair color. Help them prepare for weight changes, especially girls approaching puberty.

• Role model and practice all of these things along with your child so they can experience you as a healthy eater with loving body image!

 

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

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