DECEMBER NEWSLETTER

Happy holidays!

I wanted to write a quick note to wish everyone a happy holiday. We realize the holidays can also be hard for many reasons, so we wanted to address one potential difficult reason in the article below, and also try to focus on a spirit of gratitude.  I feel very grateful to work with such a great team of people every day… We have added 3 more great folks this fall, including Samantha Hamby, RD, LDN who is a dietician/nutritionist, Stefanie Murphy M.S., CCC-SLP who is a speech and language pathologist, and Stephanie Pennacchia MS who is a wonderful therapist. Samantha and Stephanie will help us build out our eating disorders treatment program, and Stephanie is excellent with CBT/DBT and treats OCD/anxiety and mood disorders. They join an excellent team of people who do great work with clients, and also support our goal to provide education to the community. In the last year, we have given talks to schools, pediatricians, other clinics, the APA (American Psychiatric Association), and the Nashville Ballet in addition to hosting our own quarterly Wellness Series that has featured topics such as how hormones affect mental health, how acupuncture works, how to help with homework struggles, and why dieting doesn’t work. We also continue to educate ourselves; for example, taking our team to New York to get intensively trained to do family DBT (dialectical behavior therapy). This year we are excited to continue this mission and to expand! More on that soon…

Hope everyone has a peaceful holiday season,

Susanna Quasem MD

TIPS FOR SURVIVING THE HOLIDAYS WITH AN EATING DISORDER

For many, the holidays are full of excitement, joy, and positivity. For those struggling with eating disorders, however, they can be full of anxiety, fear, and avoidance. Holidays typically involve time spent with loved ones, and for most, revolve around meal time, desserts, and sweets. As a result, for those with difficult relationships with food, this can be a particularly challenging time. It becomes even more important then, to plan ahead so you, too, can enjoy the holidays.  Below are some helpful tips for surviving the holidays with an eating disorder, without losing sight of your long-term recovery goals.

1. Schedule sessions prior to the holidays with your treatment team:

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The season becomes busy and it may seem easy to have one less thing on your agenda, such as a therapy appointment. However, because of the potential stressors this time of year can bring, it is critical to have regular appointments with your therapist and treatment team to help prepare for expected and/or potential triggers.

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It is important to think about and prepare for unhelpful comments and conversations that may arise when at group functions such as topics around “good/bad” foods, weight, dieting, compensating behaviors, content/ingredients in food, amount of food consumed, etc.

2. Know how to set boundaries and when to take breaks:

Because unhelpful conversations and interactions may arise, it is helpful to plan ahead with your treatment team, or with yourself, to know when and how to set appropriate boundaries. This can include saying “yes” to some challenges and remaining engaged in some conversations, while also accepting the appropriateness of saying “no” when the situation is no longer helpful or serving to your needs.

It is okay to change the conversation. You can ask about their school or work, a mutually shared or interesting hobby, a significant other, etc. You can also gently inform someone the topic is not helpful to you, or excuse yourself to take a break to allow time for breathing, resetting, reminding yourself of goals, and rejoining the event when you are able.

3. Abide by your meal plan to help avoid over or under eating habits

If you are meeting with a treatment team and have a current meal plan, it is very important to continue compliance with this over the holiday to remain consistent with your overall goals. It can also be helpful to meet with your team and develop a plan of how to meet your meal plan and discuss appropriate challenges to complete. It is important to consider travel plans and eating at different times within your plans.

If traveling, it is important to plan ahead and pack snacks and items you may need before you are able to get to a store. This can also help to ensure you have something to eat at different places. If possible, ask the host what food is planning to be served so you can ensure ability to meet meal plan. Offer to bring an entrée you know is tolerable for you, if needed, to overcome urges to use eating disorder symptoms.

4. Plan ahead to have support before, during, and/or after meals

If exercise is a compensatory behavior, avoid going on walks around meal time.If you struggle with purging behaviors, avoid accessibility to bathrooms after meals. Instead, have other distractions planned and easily accessible.

Know who you can have help at your most triggering times. If possible, arrange someone that you trust at the event to help you remain accountable. However, also have numbers of people you can reach stored in your phone. The National Eating Disorder Hotline is available: 800-931-2237 or you can text “NEDA” to 741741 to be linked to a trained counselor through Crisis Text Line.

5. Be creative and ensure time can be spent with loved ones outside of triggers.

Think about a list of activities you can engage in with family and friends outside of meal time or around other triggering behaviors within the eating disorder. Perhaps play a board or card game, going to or watching a movie, talking about past shared memories, etc. This can help maintain overall well-being and help preserve your mental health during an otherwise very challenging time.

BENEFITS AND QUICK PRACTICE OF GRATITUDE

“Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend.” ― Melody Beattie

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It’s the season of giving, being merry and kind. Most of us hope the season bring feelings of gratitude and joy, however this is not always the case. Difficult and complicated relationships, generational gaps, differing opinions, sour many family gatherings. Living in the company of others is not easy. Gratitude is one social remedy that can encourage cooperation, maintain social harmony, and build relationships. The presence of gratitude has been linked to a wide variety of benefits, including health, emotional, and relational well-being. Gratitude helps us to acknowledge the importance of and strengthening close relationships. So how can we increase this much needed skill and shift our mood from being stuck in negativity into a place of thankfulness and acceptance?

One simple practice of finding joy and balance in the moment can be achieved by trying the G.L.A.D. technique (Altman, 2014). This technique works by giving attention to positive aspects of life that are around us all the time, nevertheless frequently overlooked. Use a journal, your phone, or a sticky note to write down a quick answer to every letter of the acronym. Each letter stands for a specific item to notice: G – Gratitude: that you’re thankful for today (e.g. having food, shelters, sunlight, a body that works well, a meaningful relationship, caring friend); L – Learned: a new thing you learned today (e.g. new insight, fact, perspective); A – Accomplishment: one small accomplishment you did today (e.g. getting enough sleep, not skipping meals, getting dressed, attending school or work); and finally D – Delight: a delight that touched you today, something that made you laugh, smile or brought you joy, a thing of beauty that you noticed (e.g. a bird chirping, a funny joke, the feel of the water on your hands while you wash the dishes). To really get in the practice, try to do this each day for the next week. The important thing is that you write these down, so that you keep them to look at in the future (at times when you might need them most!).