Posts Tagged “DBT”

To those in eating disorder recovery, it can often feel like triggers are all around. It seems they can’t be escaped and they can’t be ignored—they come, unasked and unannounced, in the sounds and sights of everyday life.

You overhear one in the mall dressing room: “You look great – have you lost weight?” You see another on your coworker’s plate, a conspicuously small serving of the company lunch. You find yet another on your favorite restaurant menu, calorie counts in bold black font on every page.

For many, triggers are even louder and more glaring during the holidays. They may come in the form of a family get-together, where a difficult relative sidles up alongside you, or a fear food is passed around the dinner table. They may come when Grandma prepares your favorite dish differently this year, or your schedule is thrown off by holiday travel. Triggers can turn the most “wonderful” time of the year into the most overwhelming.

This article talks about the health repercussions of eating disorders. Please use your own discretion. And speak with your therapist when needed.

By Lucene Wisniewski, PhD

The harsh reality of eating disorder mortality rates

Eating disorders kill. This is a harsh reality. Our clients are reminded about this fact from their loved ones, doctors and therapists. Yet, many of our clients believe that it will be someone else who dies and not them.

Eating disorders impact about 30 million people in the United States. They are associated with high levels of premature mortality, including an increased risk for suicide. Without treatment, up to 20 percent of people with a serious eating disorder will die. These are sobering statistics.

Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

By Dr. Lucene Wisniewski and Dr. Mark Warren

Over the last 15 years, Dialectical Behavior Therapy (DBT) has gone from being virtually unknown to being a term utilized by many treatment programs. DBT is an evidence-based therapy, initially designed for Borderline Personality Disorder, and more lately for other diagnoses including eating disorders (Wisniewski, L., Safer, D., & Chen, E.Y., 2007). With its increase in popularity among treatment providers it is important to be clear about what it means to “do DBT” so an individual knows if they’re receiving evidence-based care.

Comprehensive DBT treatment, initially described by Marsha Linehan, has four components: Individual therapy, skills group, 7-day week phone consultation availability, and consultation team for therapists known as “therapy for therapists”. Unless all four of these components are present, a program is not providing comprehensive DBT treatment. Additionally, in order for a therapist to be capable of providing DBT, a significant training process is generally required. This training process necessitates a therapist taking a non-judgmental stance, the ability to encourage motivation and commitment with their client, extensive knowledge and understanding of the DBT skills and therapeutic techniques, and the balance of accepting where a client is while moving them toward change.

By Lucene Wisniewski, PhD

Without effective treatment, eating disorders can be chronic and life-threatening. Therefore as patients, we should be well-informed consumers of the treatment we receive. In fact, being armed with accurate information about what constitutes best practices in treatment could be the difference between life and death.

What is the best treatment at any given time when recovering from an eating disorder? This is one of the great questions providers, clients, and families alike struggle to answer.

We know there are significant scientifically based therapies that deliver positive outcomes, including weight restoration and behavior cessation. In fact, The Emily Program incorporates these therapies in our programs — Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Family-Based Therapy — and has experienced much success through them.

Having said that, however, we also know that many clients who are able to cease behaviors and achieve weight restoration may continue to experience physiological distress, urges, body dissatisfaction, and anxiety, among other eating disorder symptoms.

Further complicating the issue, eating disorders often occur in secret and many clients may not reveal the intensity of their behaviors, thoughts, and feelings during treatment.