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75 posts categorized "Eating Disorders"


Yoga Therapy – A Personal Note from Sandee

Clients are often curious about what I do when I'm not working at the Center. Like most of you, there are many things that keep me busy – sometimes I joke that I have to go pay to relax. My favorite method of relaxation is yoga, and it's one of the main ways I incorporate spirituality into my life.

As part of a recent yoga teacher training, I wrote a paper called "Better Body Esteem," about how a yoga program I designed can address so many of the body image issues that accompany eating disorders and food addiction.

On the cover of my paper is a photo of my mother in a red one-piece leotard, upside down in a headstand. It was my mother who instilled my love of yoga, and now that she is no longer living, I dedicated the paper to her.

The teacher training was an amazing experience. I met wonderful people I wouldn't have met otherwise (here is a photo of me with some of my classmates), including some that you will be seeing around the White Picket Fence Counseling Center in the coming weeks and months, as we create new programs to bring you the benefits of yoga.

Some people object to the idea of yoga because they feel it conflicts with their religious practice. Our approach will be completely non-religious, and while we believe that spirituality is a key part of the recovery journey, it will be up to you to decide how deep you want to go.

With our limited space, we're going to focus on one-on-one yoga therapy and small yoga groups – including some classes that will be free for the community. So please stay tuned!

For the rest of this month, I'll be presenting more information about how yoga and yoga therapy are uniquely suited to assist people recovering from eating disorders and food addiction.


Books and Resources for the Recovery Stage

Life Without Ed is a book that I recommend to anyone who struggles with anorexia or bulimia. By creating a persona named Ed, representing the eating disorder, author Jenni Schaefer teaches the reader how to separate the person from the problem. I heard Jenni speak at a conference of the International Association of Eating Disorders Professionals (IAEDP) and what a gift it was to be in her presence – she's like a guru in this field and has helped so many people.

At the conference, Schaefer and co-presenter Michael Berrett, PhD spoke about how finding reasons to change helps eating disorder clients to reclaim their lives. Jenni also spoke more about the life she is continuing to build now that she is free of her own eating disorder, including writing a second book called, goodbye ed, hello me.

I also recommend Regaining Your Self, by Ira M. Sacker, M.D. Sacker is Clinical Assistant Professor of Pediatrics, New York University Medical Center and Bellevue Medical Center. He is also the Founder, President and Medical Director of HEED Foundation, Inc. (Helping End Eating Disorders), a not-for-profit organization, and the co-author of Dying to Be Thin. This book helps explain how an eating disorder can be your identity, and so recovery must include a grieving process for the loss of that identity. 


How Relationships May Change in Recovery

As soon as you take your first steps in recovery from an eating disorder, your relationships will start to change. By the time you enter into the maintenance stage of living in recovery, you may focus more of your efforts to dealing with this. By now, you're feeling more comfortable about your day-to-day eating habits and you have many tools and people to reach for when things come up.

With the people who have been in your life for many years, there will likely be communication and relationships patterns that no longer fit with your new version of self. Now that you are more confident and comfortable speaking your mind, people may not know quite how to handle that.

Perhaps you used to be controlled by people pleasing, doing anything to avoid the guilt associated with letting someone down. Perhaps the people around you aren't ready to accept an inter-dependent relationship, rather than a co-dependent relationship with you. As you change and grow, not everyone in your world may jump on board. This is a big adjustment for everyone.

If you're not paying attention to these relationship issues, other people can easily trigger a "lapse" into unhealthy food behaviors, or even a full-blown relapse. Watch for sure-fire signs of relationship struggles, such as talking about other people's faults or wishing they would change. You will have more peaceful relationships if you remember that you can only change yourself. You are lucky enough to have these recovery tools at your fingertips – others are not as well-equipped. Practice compassion for others and healthy communication strategies that protect your recovery.

Your relationships can grow with you, if you give yourself and others the time and attention that are needed for long-lasting change.


Tools for the Recovery Stage of Life

A major part of your recovery will be gaining comfort and acceptance of your body. Whether or not your body size has changed in recovery, you can learn to love and be grateful for who you see in the mirror.

A distorted body image can be deeply embedded in people who are recovering from an eating disorder, whether that's compulsive eating, anorexia or bulimia. The food behaviors they reach for are used to disconnect from the body.

Recovery brings the opportunity – and the challenge – to be present in the body, perhaps for the first time.

To begin, you can use the following tools to discover your personal image and your connection to your body. Then you can start to learn where this story has come from. That way you can release any hurtful or unhealthy perceptions, and move into compassion and full acceptance.

I teach a model called "The Five A's" to guide people through this process:

  1. Awareness (includes acknowledgement and anticipation) – Build your awareness of your current body image beliefs by journaling, meditating and talking about what you discover. Acknowledge your positive, healthy perceptions and anticipate the benefits of moving more and more into this new perspective.
  2. Appreciation (includes achievement and abundance) – Practice self-caring and self-loving rituals that celebrate your body and all of its gifts.
  3. Action (includes attention, amends, aspiration and accountability) – Take the necessary steps to care for and heal your body. You may have spent many years making unhealthy choices, but you can repair that damage one day at a time. Build and use a support team for this process (e.g., therapist, dietician, exercise buddy, therapy group).
  4. Acceptance – The sooner you can accept yourself and your body as you are right now, the sooner you will be able to evolve into the next stages of recovery.
  5. Affirmations – Talk to yourself kindly and positively, always choosing the perspective that everything you want is already on its way.


Learning to Live in Recovery

According to the Transtheoretical (Stages of Change) Model developed by Prochaska and DiClemente, once someone has passed through the active stage of recovery they enter a maintenance phase. As I wrote about in 2009, a big area of focus in this stage is on how to prevent relapse.

But there has to be more to life than just the absence of your eating disorder. Otherwise it's still controlling you and your life. I encourage people to learn how to live in recovery, to build a life where you're dealing with the realities of preventing relapse, but also open to new discoveries and growth beyond what you've ever imagined for yourself.

The truth is that the stages of change and recovery are fluid, and you will move back and forth between them. Part of the challenge is that life will continue to throw stressors and unpredictable things at you – the difference is that now you're not using food or eating behaviors to deal with them. That may seem scary, but it's actually really great.

Imagine just how proud you'll feel the first time get through a tough time on your own – without the old crutches that you used to use. It doesn't mean you're doing it alone, it means you're reaching out for help in a healthy way, from healthy people, and you're receiving and using that help.

Living in recovery requires a totally different way of being. At the White Picket Fence Counseling Center, we talk about this with our clients right from the beginning, so they can practice the tools they can tap into later. Otherwise, they may not know how to handle it when, let's say, people stop noticing or commenting on their new healthy body weight, or when it's time to replace their mealtime habits of calorie counting or deprivation.

We pride ourselves on equipping our clients with the tools, confidence and self-assurance to be strong in their recovery, and to be aware of potential issues so they can talk about them instead of reaching for old, unhealthy behaviors. We remind them, "This too shall pass," and it always does!

Life in recovery brings the chance to develop healthy relationships with food, with your body, with yourself, and with others. When you're using food behaviors, if you have a problem, then automatically you have two problems. In recovery, when you have a problem, you have one problem, and infinite tools and resources to solve it. That is true freedom.

At the White Picket Fence Counseling, we will be continuing our series of Recovery Stories in the Living Room events, where clients share about their journey to recovery. We're looking for volunteer speakers for this series. Please contact us today if you would you like to share your story. We'll also be doing some specialized workshops on this topic, so stay tuned for details. In the meantime, watch the blog and newsletter for additional articles about tools, resources and relationship guidance for the recovery stage.


The Evolution of Compassion

Once you have gotten more comfortable with having compassion for yourself, having compassion for others and accepting compassion from others, your self-care can evolve to the level where you create your own source of compassion.

This is the ultimate in self-care, because these positive feelings come from within, rather than being dependent on what anyone else does or says. By making the commitment to self-activate, you can create a beautiful sense of balance between your physical, emotional mental and spiritual health. You will let go of harmful thought patterns, food and exercise behaviors, or alcohol and drug use.

You can activate this soothing system within the body through practices such as deep breathing, singing or humming. You can use visualization by developing the image of a place where you feel safe, emotionally, mentally and physically. Then visualize yourself in that place.

You can also visualize yourself as a compassionate self, or use a vision board to create a physical reminder of what you're working towards.

Looking within for compassion won't come naturally at first. You can develop your sense of self-trust by making a list of your successes and accomplishments; this is evidence that you can be trusted – you can achieve your goals and overcome your challenges. Write these things down every day until this self-trust becomes a part of you. You can also write about the times when you felt most compassionate towards yourself or others, or when you felt the most compassion from someone else – and you were able to receive that compassion.

Through journaling you can develop an ideal of what you're looking for in yourself or someone else. Then you can use imagery and even affirmations to call forward these ideals. 


Accepting Compassion is Not Always Easy

For people who are recovering from an eating disorder, compassionate support from others can be unsettling. You may not know how to receive that support, and you may not feel like you deserve it.

Have you ever heard the expression that "we teach people how to treat us"? What happens in this case is that this discomfort can lead you to send out the message that you want to be left alone – and then you will be.

The first step in practicing receiving compassion is to clarify what help you need. Do you need someone to keep you company while you eat a meal? Do you need to talk about something that's bothering you? Or do you need to forget about something that's bothering you by getting out and doing something fun?

Once you have an idea of what you might need, it's time to ask. Before you think about asking specific people, make a list of the qualities you would like them to have, for example:

Challenges in a gentle way
Feels safe

There may also be people with qualities you want to avoid, such as:

Unreliable, untrustworthy (opposites of all the qualities above)

Now, make your list of the people in your life who have the qualities you want, and who don't have the qualities you don't want. Leave off the list anyone who brings up feelings of co-dependence, confusion or anxiety.  Strive for relationships that are interdependent – equal – rather than dependent or co-dependent.

Start with safe people.  Sometimes it's easier to practice with professional supporters, such as a therapist, dietician or clergy, or friends from a more structured setting such as a 12-step program or a therapy group. Over time, if you keep practicing, then receiving compassion will become more familiar. Though it may still be challenging, once something is familiar it usually feels more comfortable as well.


How to Have More Compassion for Others

When you're struggling with your own body image and self-esteem issues, it's common to also be more judgmental of other people (especially people with food and weight issues). The reverse is also true – the more you can love and accept yourself, the more accepting you can be of others.

Stephen R. Covey wrote, "We judge ourselves by our intentions and others by their behavior."

A lot of times we judge people's physical appearance or outward actions, without any idea of what's going on underneath. We only see the tip of the iceberg. We don't know their family history or how they've been hurt by other people.

That's why it's really important to suspend judgment of others, and instead practice acceptance and neutrality and compassion. Understand that everybody has their own stuff going on. It's like we discussed in an earlier article, that "your first thought is a freebie." We may have judgmental thoughts about others, or ourselves, but we can revise those into more loving thoughts.

The more we can suspend judgment of others, the more we will learn to do the same for self – peace within extends to peace with-out, and vice versa.

Who can you practice being more compassionate towards today? 


Three Ways to Have More Compassion for Yourself

The world can be a harsh and confusing place for people who are dealing with an eating disorder. What might be a simple task for other people, such as a trip to the grocery store, can be daunting when you are surrounded by mixed messages.

Standing at the checkout counter, a quick glance at the magazine rack shows photos of celebrities caught in unflattering poses, details of the latest quick-fix diet, while on the same cover there is a photo of a decadent dessert with the promise of the recipe inside. Every aisle is adorned with displays meant to entice us into buying things we weren’t planning to buy or to eat. This type of temptation can lead to unhealthy behaviors, which then set into motion a cycle of self-blaming and self-loathing.

When it seems like everything in the grocery store is against you, it becomes even more important to cultivate an ongoing sense of compassion for yourself. When you can acknowledge what you’re going through and every small victory you accomplish, you can help yourself heal and grow.

While I disagree with how defines compassion as "a feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering," I do appreciate these synonyms they offered: "tenderness" and "heart".

Compassion is more about validation than pity; "I see how challenging this is for you," rather than, "You poor thing." Feeling compassion is not about feeling sorry for oneself or someone else. It's about looking at self and others through a tender heart.

Here are three ways you can add compassion into your life: 

  1. HALT – This powerful slogan stands for "Hungry, Angry, Lonely, Tired," which are feelings that can make people more vulnerable to act out in their addictions. When you become more aware of whether you are feeling one of those things, you can choose to act on that feeling, or address it using a healthier tool. It takes courage to look with integrity and truth at what’s really happening within yourself. This awareness gives you the compassion and perspective to see why you might be feeling or acting a certain way, and ask what you need to do to take care of yourself in that moment.
  2. Think twice about giving in to your compulsive behavior – It's easy to feel sorry for yourself when you focus on the list of things that may not be going your way, "My friend isn't talking to me," "I had a struggle at work," "I'm not talking to anyone in my family," etc. The next thought might be to "treat" yourself or repeat a harmful behavior. Yet is it really a treat if it will damage your health and you'll feel bad about it later?
  3. Question your self-talk – Notice the mixed messages and give yourself compassion for reacting to them. Release the self-criticism, shame and self-loathing that undermine your self-esteem and confidence and make you feel bad. This all just leads to wanting to eat more or restrict more.

Compassion is about being fully present with yourself, just as you are, without condemning or judging any part of your whole self. Compassion isn't a free pass or letting yourself off the hook; it's a way to focus on the solution and get yourself to the physical recovery that is so important.

The compassionate choice isn't always the easiest one. Another 12-step axiom is that "the first thought is a freebie." You don't have to act on that first thought, which will often take you back into old, unhealthy patterns and habits. You can let that first thought go and revise it into one that will lead you towards recovery.

For some, compassion can be love. For others it can be grace. What is compassion for you?


Weaving in Other People's Words

At the White Picket Fence Counseling Center we offer informational sessions for the friends and families of people with eating disorders. We teach them about what's helpful to say – and not to say – to their loved one who is in recovery. As much experience as I've had myself in working with clients with these struggles, I know that it's reassuring if I can also provide resources from organizations and agencies. 

Sometimes other people can just say things better. 

If you're someone who tends towards negative, self-harmful thinking, you can practice using other people's words until they become more natural to you. Here are a few ways you can do this: 

  • Word-a-Day – Create a pile of cards or pieces of paper that each contains one positive word or principle, e.g., commitment, acceptance, freedom, comfort, adaptability, abundance, progress, harmony, detachment, non-attachment or security. Each morning, choose a word and strive to weave it into your thoughts, words and actions for the rest of the day. If that seems too long, try it just for an hour. I use this with my clients, and sometimes we'll just try it until the end of the session.
  • Meditation books – There are meditation books based on topics, methods of recovery, types of goals and more. Find one that inspires you and read it every morning or whenever you think of it throughout the day. Take a moment to write one line in your journal about how you personally interpret the reading. Or just write down your favorite word or phrase from the reading.
  • Professional help – One of my most important roles as a therapist is to help people reframe their language as a way of reframing how they see themselves and their situation. For example, you may find it a relief to see your sadness as grief rather than depression. This kind of help can be very valuable and can help you take more initiative for choosing your own experience of life. 

We have many resources that can help you continue this work. Please contact us for more ideas and recommendations.



What Your Language is Really Saying

Changing the words you say to yourself and others is a long process that requires time and practice. It also requires you to be focused on the present moment so that you are choosing your words with intention.

Language can also be a barometer – if you learn how to read it. For example, whenever we use the phrase, "I'll try to . . ." what we're really doing is giving ourselves permission to not do something. In other situations we may slip into polarized thinking and use words such as good/bad, right/wrong, all/nothing, always/never, success/failure, either/or. Noticing these words provides the opportunity to change your perspective and choose thoughts and words that grow your recovery and build your self-esteem.

Body language is another important tool for communicating with others. If you can become more aware of the messages your body is sending, it can help you to ensure that you're delivering what you're intending.

The Center for Nonverbal Studies has an online dictionary where you can look up gestures, postures or body parts to learn what studies have shown about what unintentional language you might be using.

Changing your language requires you to tune in and notice your words and gestures, to make sure they're sending out the right messages.


Choosing the Words to Share

"Oh my gosh, I'm so stupid!" 

Self-deprecating statements like this can harm your self-worth and affirm negative beliefs that may have been planted earlier in life. It's a worthwhile goal to begin a practice of using different words that are more self-loving

The words we choose don't just affect us; they affect the people we're speaking to. Harsh statements such as the one above can have different effects. The other person may feel uncomfortable, or may want to rush in and reassure us. Either way, it creates uncomfortable tension in the conversation and in the relationship as a whole. 

Another phrase that can have a troublesome impact on relationships is, "I'm sorry." Ideally, when we make a mistake we recognize it right away, apologize and then move on. 

The difficulty starts when you don't consciously recognize you've made a mistake, or you recognize it but don't feel willing to apologize. Either of those scenarios can damage relationships and create emotional turmoil that can lead to unhealthy body image and eating behaviors. 

Another challenge is when we apologize for something that's not our fault, such as the fact that else is experiencing a loss or struggle. Or we spend too much time apologizing or explaining something that really wasn't a big deal to begin with. (For more insights on this topic you can read the article, Make Amends to Make Your Guilt Disappear.) 

I experienced being on the other end of this, when someone was apologizing repeatedly for a simple mistake that was already dealt with. I'd been double-booked for a radio interview, but everything turned out perfectly because the other person was late anyway. But the host just couldn't seem to move on. When I spoke up and let him know that he didn't need to keep apologizing, he said he really appreciated it because he had no idea how it sounded to the other person when he was doing that. 

I always encourage people to find a way to speak your truth to others in a kind way that feels honorable to you and aligned with your values.


Words Carry Weight

Words are vital to personal growth, recovery and sense of self-worth. It's not only about the words said out loud, but the messages behind the words. Even having those messages in your mind can affect behavior in many situations, years after the messages were implanted. 

In her book Learning to Love Yourself, Sharon Wegscheider-Cruise teachers her readers to recognize some of the "garbage messages" that may have been heard as children, and what is taught through those messages. For example: 

  • "You can do better than that!" (meaning: "What you are doing is not good enough.")
  • "Family business is private business." (meaning: "Don't trust.")
  • "Don't speak unless you're spoken to." (meaning: "Being spontaneous is wrong.")

If you continue to hear those messages or repeat them, it can make you feel bad and unloved, affecting self-esteem and contributing to unhealthy food behaviors. 

On the other hand, there are positive messages that help people feel good about themselves – phrases such as: 

  • "That is a great idea!"
  • "I like you just the way you are."
  • "I'm proud of you." 

Consciously choose to spend more time with supportive people who say these types of things, and also make a habit of saying them to yourself. 

People in 12-step recovery programs often use slogans as a way of reprogramming hurtful self-talk and unhelpful messages. Slogans are short phrases that are easy to remember and can instantly evoke the principles of healthy recovery. There are sample slogans with explanations on this page: 

You can also create your own slogans or mantras. Start by thinking about the values, principles or phrases that you consider important and sacred. Then try on different wordings until you find the ones that feel good. After you've been using them for a while, you may notice that your enthusiasm has faded, or that you've begun saying or thinking the words by rote. If that happens, switch them for some new words in order to stay fresh. 

Also consider which words you want to let go of. For example, we often use violent terminology for everyday activities without even realizing it, such as:  "I'll shoot you an email later." 

Other words may not be violent, but they de-motivate instead of being motivating, such as telling yourself that you need to exercise (exert) or work out (work), instead of inviting more movement into the day. 

Another example is how marketing experts teach business owners to use only positive language in any materials. Instead of, "Please do not hesitate to call me," you'd want to say, "Please feel free to call me." Can you feel the difference? 

Changing your wording is not an overnight project – it takes time and practice. As a much-loved 12-step slogan reminds us, it's about "progress, not perfection."


IAEDP™ Symposium 2012: A Perspective

(IAEDP is the International Association of Eating Disorder Professionals)

As a licensed clinician, supervisor of interns, and adjunct professor of psychology working in and focusing on the field of Eating Disorders and Food Addiction, I have to say, I love my job. I love helping people work on recovery from conditions and often debilitating eating disorders that preclude them from leading their happiest, healthy lives. This field of study is uniquely gratifying, and even more so when the work we do on a daily basis is not only validated, but enhanced by experts in our field who pose not only the very problems and concerns we routinely encounter as therapists, but who also offer the kinds of innovative solutions we seek.

What I found particularly exciting about this year’s symposium, entitled Journey Through the Looking Glass: Complex Issues/Creative Solutions, is the number of conference sessions that focused on Food Addiction education, which included not only presentations by researchers, but by treatment professionals who offered some inspiring perspectives, studies, and methods of treatment. The impressive number of presentations with supportive research maintaining that FOOD ADDICTION is a very real problem is extremely important in today’s world and one worthy of being further addressed and researched.

In addition to sharing my enthusiasm about these remarkable professionals, their sessions, and the ideas they shared with the professionals in attendance, there are some particular highlights worth mentioning:

  • In his keynote address, Dr. Mark Gold, Distinguished Professor, Eminent Scholar, Chairman McKnight Brain Institute, University of Florida College of Brain Medicine, presented comprehensive research on the cause and potential treatment of addictions to foods and eating. His presentation was supported by Dr. Nicole Avena, PhD of University of Florida College of Medicine and Princeton University, who, like Dr. Gold, presented compelling research about the brain’s reward centers and the preference in rats for sugar -- over anything else!
  • Joel Robertson, PharmD, explored the relationship between potentially problematic brain chemistry and one’s body image. In addition to a variety of non-medicating options and methods of treatment, Robertson presented his idea that brain chemistry is affected by disordered eating, posing the notion that healthy eating can improve brain chemistry and become a successful treatment option.  
  • Kevin Wandler, MD and Elizabeth Dizney, PsyD, representing University of Florida’s Eating Disorder Recovery Center, presented  ideas about the relationship between eating disorders and a variety of today’s most prevalent addictions. They noted the importance of treating ALL addictions (food, drugs, alcohol, and shopping) in order to prevent behavior relapse.
  • Similar research was included by Carolyn Coker Ross, MD of the Ranch, and Dr. Kimberly Dennis, of Timberline Knolls, in their break-out sessions, Addiction, Food Addiction, Obesity and Binge Eating Disorder. Dr. Dennis provided insightful information about 12-step recovery programs to clinicians who may have received feedback from clients, but haven’t experienced these kinds of benefits directly.

Each of these outstanding presenters affirmed not only the importance of addressing the relationship between the brain and eating behaviors, but the relationship between the brain AND addiction, relative to specific foods and volume eating.

Beyond emotional recovery work (therapy), exercise, and eating at a slower pace, I would like to have seen more innovative treatment-related ideas. That being said, I feel a certain hope that if we continue the open dialogue about food addiction, discuss and share the effects it has on so many lives, talk about what has been helpful in the past and what we can do today and in the future, we can continue to improve the probability and success rate of the recovery process.

When the conference was over, I felt a wave of satisfaction that Food Addiction was addressed at such depth at the IAEDP conference this year, reaffirming confidence in my treatment approach and our work at White Picket Fence Counseling Center.

To address your questions, request information, or to schedule speaker engagements for Sandee S. Nebel, MS, LMHC, please contact her via the White Picket Fence Counseling Centre website.


Why a Team Approach?

JakiBy Jaki Hitzelberger, MA, Registered Mental Health Counselor Intern

Surrounding yourself with a team of people who are knowledgeable, who support you, who understand and care, and who work towards helping you help yourself to a better, healthier life – that is an important part of our approach at White Picket Fence Counseling Center. 
One of the trainings on the treatment of eating disorders I recently attended featured Cynthia M. Bulik, PhD, FAED, Director of the University of North Carolina Eating Disorders Program. Dr. Bulik has published over 400 scientific papers and chapters on eating disorders. Her new book is The Woman in the Mirror: How to Stop Confusing What You Look Like with Who You Are (Walker, December 2011). She is also author of Crave: Why You Binge Eat and How to Stop (Walker). Her research includes treatment, laboratory, epidemiological, and genetic studies of eating disorders. I found the information presented to be very applicable in my work with clients.
Dr. Bulik touches on many ways to make treatment more effective, including the importance of a team approach for recovery. In addition to meeting with the individual who has eating concerns, it is necessary to include participation of the counselor, physician, psychiatrist, dietician, family and friends in the course of treatment. All members of the team must work together to support the individual through communication and understanding. I believe in Dr. Bulik’s team approach philosophy and think it is important to work closely with the client and other practitioners in the field (my colleagues).
Depending on the individual in therapy, working with the family is another important piece of our team approach atWhite Picket Fence Counseling Center. We understand that the home environment and support from family provides the individual with strength throughout treatment. We also acknowledge that the word “family” is not always meant in the traditional sense. For some, family encompasses different important people in their lives, such as friends, extended family, or mentors.
Dr. Bulik’s research shows that couples counseling is also highly effective in the treatment of individuals who have eating concerns. Part of recovery involves helping couples re-build the connection that may have been damaged due to ongoing and sometimes secretive eating disorders. The UCAN (Uniting Couples in the Treatment of Anorexia Nervosa) approach involves re-teaching the couple relationship skills such as sharing thoughts, expressing feelings, and problem solving. I find it helpful to add working to break through the barriers shame and guilt unduly provide.
Dr. Bulik’s research sheds light on many significant issues with eating concerns. It supports and affirms our approach at White Picket Fence Counseling Center, where our goal is to provide a holistic experience to recovery. We believe in the importance for all individuals with disordered eating patterns to receive the holistic support and treatment that will allow them recovery, both physically and emotionally, as well as socially – with fulfilling relationships.
I invite you to take advantage of our workshops and counseling services and utilize them as part of your support team through your personal journey.  We know that this is YOUR journey and we are honored to be a part of it. 
My best to you,
Jaki Hitzelberger, MA
Registered Mental Health Counselor Intern