Monthly Archives - September 2018

Plate with sad face (River Centre Clinic)

DBT For Eating Disorders

When people are struggling with binge eating behavior or weight management issues, they are sometimes told to simply eat less and exercise more. This advice, perhaps well intended, will potentially make the situation worse and create an unhealthy diet cycle that focuses on a negative body image and deprivation. People need a sound treatment plan that addresses the complexity of the behaviors, thinking patterns, and relationship with food. This is where a type of treatment known as Dialectical Behavior Therapy (DBT) is helpful. DBT is a type of therapy that combines elements of cognitive behavioral therapy with principles of from Zen Buddhism. DBT has been proven an effective theoretical framework that helps promotes changes that are necessary to treat binge eating as well as other eating disorders.

What is DBT?

Dialectical behavior therapy is a specific type of cognitive-behavioral psychotherapy developed in the late 1980s by psychologist Dr. Marsha M. Linehan. The original goal of DBT was to find better treatment options for people suffering from borderline personality disorder. Dr. Linehan, who is currently a professor at the University of Washington actually developed DBT as a response to her own borderline personality disorder, which had previously not been properly treated. However, since the development of this therapy, it has been used to treat other kinds of mental health disorders.

Dialectical behavior therapy is a type of psychotherapy (talk therapy) that utilizes a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. The main concept behind DBT is the view that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations. These emotional situations are primarily triggered by romantic, family and friend relationships. DBT theory advocates that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation and thereby take significantly more time to return to baseline arousal levels.

Dialectical behavior therapy understands that there are times when people act on emotions that do not match a social situation. This is when a skill from dialectical behavior therapy (DBT) called “opposite action” is invaluable. It’s a skill that helps us to manage our emotions, enhance our relationships and enhance our lives. It’s a skill that helps us make more healthful decisions. DBT would advocate that an opposite action is required in these situations, because it allows people to recognize that their thoughts are not facts. Individuals learn how to experience emotional urges, but take the opposite action and not act on these urges. This provides a level of self-regulation and allows people to have more control over their thoughts, feelings and actions. Not surprisingly, dialectical behavior therapy is an effective treatment approach for people struggling with eating disorders.

A summary of how DBT works:

The term dialectical is based on the principle of blending two key ideas together, acceptance and change. In therapy, both of these ideas produce better results when they are combined together. DBT has patients focus on accepting their experiences, but simultaneously working on changing unhealthy behaviors. A major goal is to provide patients with the necessary skills that allow them to cope with, and change, these unhealthy behaviors. This form of therapy was initially designed to treat people with suicidal behavior and borderline personality disorder. But, DBT has been successfully adapted to treat other mental health problems that threaten a person’s safety, relationships, work, and emotional well-being.

Traditional dialectical behavior therapy focuses on behavioral skills for four domains:

  1. Emotion regulation: Recognizing, labeling, and adjusting emotions.
  2. Interpersonal effectiveness: Navigating conflict and interacting assertively.
  3. Distress tolerance: Feeling intense emotions like anger without reacting impulsively or using self-injury or substance abuse to dampen distress.
  4. Mindfulness: Becoming more aware of self and others and attentive to the present moment.

DBT takes these four domains and applies them in a linear, multistep approach. The first step is to treat the most self-destructive behavior (suicide or self-injury). The next step is to control behavioral response such as emotional regulation, distress tolerance, and interpersonal effectiveness. The third and fourth steps promote better personal relationships and self-esteem while encouraging a sense of happiness and connection.

For additional information or questions about dialectical behavior therapy for eating disorders, contact the staff at River Centre Clinic (RCC). Their programs provide a full range of treatment options for both adolescents and adults. River Centre Clinic is located in Sylvania, Ohio.

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DBT, Eating Disorders,

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Body image and shame

Fat Shaming, Low Body Esteem & Body Positivity

The topic of girls and women’s perception of their bodies, as well as how this topic is portrayed by the society, has long been a subject of discussion. An individual’s perception of her (or his) body has long played a critical role in understanding how to treat eating disorders. Much of this understanding is increasingly looking at the role of media and societal pressures on people’s perceptions. Popular media and the fashion industry appear to actually encourage a culture of fat-shaming and weight stigma. This history of shame and stigma has created devastating consequences.

Low Body Esteem:

According to studies performed by the Dove (Unilever Corporation), feelings of low body esteem impact the majority of both women and girls. The report states that 85% of women and 79% of girls say that they purposely skip major life activities and events due to the fact that they do not feel good about the way they look. Shockingly, 69% of Women and 65% of girls state that pressure from advertising and mass media pushes them to reach an unrealistic standard of beauty. On a worldwide scale, the report states that out of the 13 countries in the study, Japan ranked lowest, with only 8% body confidence among respondents, followed by the UK and Canada at 20%, the US at 24%, and South Africa topping the list at a modest 64% of women who feel confident in their bodies.

The Body Positivity Movement:

Reports like these have inspired a growing empowerment trend known as body positivity movement. This movement is quickly gaining popularity on the internet and in mass media. The concept of body positivity evolved as a way to counteract feelings of poor body image in society at large. Generally, body positivity asserts that all bodies are good bodies. How people’s bodies physically appear should not determine their worth as a person. “In Western society, this idea fights against long-held valuations of physical appearance, primarily as portrayed (or conspicuously not portrayed) in the media. Body positivity proponents across social media, therefore, seek to make diverse body types more visible, partly as a reminder to rethink our cultural conceptions of what it means to be beautiful, and that such concepts are not fixed.”

Fat Shaming as Entertainment:

Whether the body positivity movement able to create permeant societal change is still unclear. The entertainment industry still produces shows that seem to send the opposite message. For example, for the last few months controversy has been swirling around the new Netflix show Insatiable. Described as a dark comedy set in the Southern world of beauty pageants, the show is labeled as a “coming of rage” story. The series follows the actions of a vengeful teenager who was called “Fatty Patty” by school bullies. However, this character loses a substantial amount of weight, after having her jaw wired shut; and then teams up with a disgraced pageant coach in order to seek revenge against the people who once tormented her. The show’s creator argues that the Netflix series draws from her own experiences dealing with bullies and an eating disorder while growing up in the suburbs. Critics have called the show “an offensive mess,” “almost unwatchable” and “obscenely cruel” for perceived fat shaming.

One of the actors from the series, Alyssa Milano, defended the series arguing that the show is not engaging in fat-shaming behavior. “We are addressing (through comedy) the damage that occurs from fat shaming.” Milano explains that she hopes the show is a conversation starter, since the series explores body images issues, rather than sweeping it “under the carpet.” Insatiable’s main star Debby Ryan agreed with Milano and argues that the subject matter is difficult, but she hopes that the show serves a purpose by “stirring conversation” about fat shaming and low body esteem.

Critics of the show have not agreed with Ryan and Milano’s analysis. As of August 31st, 2018, a Change.org petition has garnered more than 200,000 signatures to have the show canceled. The originators of the petition state that the shows central plot is not an isolated case, but part of a much larger problem every single woman has faced in her life. The Netflix series “perpetuates not only the toxicity of diet culture but the objectification of women’s bodies.”

Other critics have agreed with this analysis and have called the show dangerous. Behavioral health professionals have noted that the U.S. society has made significant improvements in advancing the body positivity movement. However, fat-shaming and body weight stigmas are still a problem. Netflix’s show Insatiable only proves there’s still a lot about the way body image is portrayed in the media that needs to improve. The show’s core premise displays a plotline that is based on some ugly body image ideas. Body Positivity activists have pointed out that series shows that “a fat girl could never stand up for herself while fat and of course she has to be assaulted and have her mouth wired shut before she becomes her best self, her skinny self.” Other news sources have raised the question that perhaps the series is just misunderstood.

Whether the show is deemed offensive or is actually secretly progressive, the judgment that people feel about their physical appearance will continue. As a social trend and topic of conversation, River Centre Clinic will monitor this story as it unfolds. Our trained staff understands the complexity and sensitivity surrounding these issues. For additional questions or comments about this or other related topics – please contact us.

The River Centre Clinic’s primary purpose is to provide high quality, cost-effective, specialized care for patients with eating disorders in a state-of-the-art treatment environment. The clinic follows a treatment philosophy designed to provide an affordable treatment alternative to inpatient care. Our innovative approach to treatment is designed to reduce costs without compromising our high quality of care. The River Centre Clinic provides state-of-the-art treatment located in a modern, spacious and tranquil setting in Sylvania, Ohio — an historic suburb of Toledo, Ohio. The facility was designed to provide an attractive, and safe alternative to hospital or hospital-based programs. Living facilities are located in the main building to comfortably accommodate adults and adolescents in separate units.

Follow on Twitter:  @River_Centre

Body positivity, Body Image, Weight Stigma, Low Body Esteem

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