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Posts Tagged ‘mental health’

Loving someone who is battling an eating disorder (ED) can be quite challenging. You may not know what to say, how to act, or in what way your loved one needs your support. While working daily with individuals with EDs, I get asked a variety of questions from family members who are trying to better understand how they can participate in the treatment and recovery process. There isn’t always information readily available for families, more specifically for spouses, on what things are helpful and unhelpful. Inspired by one of my former patients, I created the following list as a general guide particularly for husbands/wives/partners whose significant other is struggling with an eating disorder and is currently undergoing some form of therapy or treatment. Some things on this list may not work for your relationship so I’d always recommend asking your spouse or partner how you can best support him/her and in what ways he/she is willing to let you participate in their treatment.

  1. First things first, know that at their core, EDs are not about weight. There are many causes for the development of an ED and there are many different reasons why these disorders continue to exist, sometimes for years, before an individual seeks help.
  1. Once your spouse/partner has informed you that he/she has an ED, take time to educate yourself about these disorders before drawing conclusions. This is critical as you begin to navigate the road ahead of you. The more you can learn, the better prepared you’ll be to participate in this journey and to offer support to the person who needs you most.
  1. Reduce or eliminate weight or specific appearance-driven comments. While you may be coming at the subject from a place of love, someone battling an ED can misinterpret such comments and the ED can then utilize this to further the disorder. It may be better to comment on other aspects of your spouse/partner that you like or love. Find non-appearance based topics to talk about and remind him/her of the reasons you fell in love.
  1. Be mindful of the challenges treatment and recovery brings. As if battling the disorder itself wasn’t hard enough, going through this process is daunting, confusing, and anxiety-provoking, among other things. If your spouse/partner is extra irritable in the beginning of treatment, know this may be a result of drudging up many emotional issues that have been buried for years. It may also be a result of stopping the ED behaviors. When the behaviors are ceasing, individuals often don’t know what else to do. They can become easily activated until they learn new skills and new ways of coping with themselves, their lives, and the world.
  1. Respect their personal boundaries. Because those with EDs are dealing with many body image challenges, whether related to past trauma, bullying or another reason, intimacy can be very overwhelming. In addition, individuals can experience several body changes as they are learning to nourish themselves in a new and healthier way. Give your spouse or partner time and space to develop a new relationship with themselves and their bodies without pushing them into intimate situations that may activate a deep emotional wound or trigger an ineffective response. This is an area your spouse/partner will likely be addressing more actively in their therapy sessions and is one way he/she may be able to use their new skills to share with you what they are or are not comfortable with.
  1. Treatment is hard and is necessary. Individuals are encouraged to put as much time and energy as they can on their treatment process. Because of the medical complications that can arise when an ED is present, we as clinicians will often recommend that patients prioritize getting better and work on healing the physical aspects of their EDs in order to do deeper emotional work. As patients progress, they can integrate into their lives more fully and more healthfully. This is particularly important when your spouse or partner is in an intensive treatment program such as residential or partial hospitalization.
  1. Get rid of the scale! Having a scale in your bathroom and readily available can reinforce the urge to step on. We encourage patients to permit their treatment teams to track their weight and to bring their scales to session, destroy it or have someone they trust hide it. If you do hide the scale, it may be tempting to share where it is when your spouse/partner asks. The goal isn’t to exert power, but to assist in limiting the access to a key aspect of the ED, so it is best to refrain from sharing where the scale has been hidden. If you feel you must have a scale for your own purposes, then hiding it may be the best option. Otherwise, I would recommend removing it from the house altogether.
  1. Your spouse/partner wants you to understand. One of the most common things I hear from my patients is that family members “don’t get it.” Some feel like they are being yelled at or told what to do versus being supported. Others feel like they’re not being heard or like their spouse/partner is not making any effort to understand their struggle. The bottom line is that you may not be able to fully understand because you’re not the one with the ED. However, you can educate yourself and follow some of the other suggestions here to at least build awareness.
  1. Recovery is possible and it can take a long time. You may assume that because your loved one has been in treatment or therapy for a few months that they “should be” cured. The reality is that full recovery from an ED can take years. There is no “cure” for an ED. Instead, there are various treatment interventions utilized to assist patients in learning new skills to manage their emotions, experiences, reactions, relationships, etc. without turning to unhealthy coping mechanisms. Implementing these new skills then requires practice.
  1. By being open to providing support, you’re playing a large role in the journey toward freedom from an ED. I’d encourage you to open the lines of communication with your spouse/partner. Ask how they are doing, what challenges they’re having, and most importantly how you can best provide support. Fighting back against an ED on their own makes things much more difficult. If you’re being asked to stay out of the treatment process, I’d recommend asking your spouse or partner in what ways they are willing to let you in. As he/she progresses, you may be invited in more openly.

While the above is not an exhaustive list, these may good starting points. By letting you into the ED world, you’ve been given an immense amount of trust from someone who may have much difficulty trusting people – guard this with all of your might and simply do the best you can. There is no perfection in the journey to recovery.

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So what does downsizing your wardrobe have to do with mental health? A lot actually. For some, shopping for new clothes can be an attempt to satisfy a part of their lives that feels unsettled or having a closet full of variety can calm anxiety about not having the right thing for the right event. For others, clothing has an appropriate place in their lives and their closets are not crammed with unnecessary items.

The reality is that often the needs we have cannot be fulfilled with a closet full of clothes. While it makes sense to have some variety in your closet, having an excess of clothing (or other belongings) could signify a deeper issue, most notably an anxiety disorder.

When I was in my early 20s my house was on the UPS delivery guy’s daily schedule. I had fallen prey to the credit card trap and found myself ordering from any and all catalogs that came in the mail. There was something about looking through these catalogs, writing down everything I wanted, narrowing it down (or sometimes not), and placing an order that fulfilled my young life in a way nothing else could at the time. I suppose you could say I had a “problem” with buying too much and it took years for me to find a workable solution.

In my late 20s I moved out of my mom’s house and into my own apartment. By this point I had stopped ordering clothing via catalogs, though I did still frequent the local department store on nights when I was bored. A few years later I got married and moved in with my husband and it was then that I counted just how many pair of jeans I’d accumulated. Let’s just say I could have gone nearly a month without ever needing to repeat. And even though I’d gotten rid of many clothes over the years, I still had too much. I began to place clothes in trash bags, filling four total, and either threw them out or gave them away.

My love for, or perhaps obsession with, clothing didn’t necessarily stop there. It was around then that I realized I was buying clothes for reasons beyond necessity and I’d spent many days and much money that didn’t need to be spent trying to satisfy something I still don’t fully understand. For me, clothing provided a sense of comfort and calm when other areas of my life felt out of control. I loved being able to mix and match items and create a new outfit, but I would find myself spending hours, and I mean hours, sifting through my closet to see what I could put together. By the time I was 30 I recognized that what I said was just “a love for fashion,” was actually a manifestation of my anxiety about various aspects of life.

The difference now is that I know this about myself and I work through it in healthy, less costly ways. And being married, I’m learning more about how to manage finances, a household, relationships, etc. I have other things on which to focus my attention despite still owning more clothes than I truly need. In the past three years, however, I’ve worked to reduce the closet clutter and organize my wardrobe and my life.

But how?

Well, it has taken a lot of reading and a whole lot of talking differently to myself about needs versus wants. The feeling of freedom that has come throughout the process is very welcome and I encourage you to find your own freedom from the clothing trap.

Step 1: Assess

Before you even look in your closet or dresser, or both, consider what you do most days. Are you a stay-at-home mom who rarely goes to social events? Are you a career woman who is required to dress up 5 days per week with church on Sundays taking that total to 6 days? Are you someone who wears whatever you prefer or wears a uniform? Do you do a lot of yard work, painting, or other dirty jobs?

Once you consider what you’re doing with your time, you can determine your basic clothing needs. This will include the types of pants, tops, and shoes you need on a regular basis, as well as a few extras for odds and ends projects or outings.

Step 2: Organize

After you have an idea of your basic clothing needs, it’s time to take inventory and organize. Pull out everything you haven’t worn in a year and put it in a “donation” pile. With what’s left, determine what you wear most often. Do you have a pair of black dress pants you wear 1-2 times per week? Do you wear the same pair of shoes with most outfits? If so, lay these items in an “everyday” pile. Any items you wear less than weekly, but more than monthly, can go in an “extras” pile. Create a fourth pile for your “special occasion” attire. This may include clothing worn on dates or to the occasional wedding. Lastly, create an “as needed” pile for clothing items that don’t fit in another pile (casual wear, housework clothes, etc.).

Once you have created these piles, you can now move on to the next step.

Step 3: Eliminate

It’s time to go through the items in each pile and determine what you love, like, dislike, hate. If you dislike or hate an item, put it in the “donation” pile. If you are unsure if you like it, you probably don’t so into the “donation” pile it goes. This will leave you with only items you like or love.

Through all of my reading, I’ve also learned two additional ways to go about the elimination process. One is to ask yourself “If I was shopping today, would I buy this?” If not, it’s time to toss, donate, or give away.

The second way is to turn hangers around or backwards in your closet and after wearing and washing each piece, place them back in the closet with the hanger facing the right way. If after a year you have several hangers that are still facing backwards, eliminate those items from your wardrobe.

Step 4: Simplify

The final step is to once again look through the items in each pile and, considering what you determined your needs to be in step one, shrink these piles to 7-10 everyday outfits, 3-5 as needed outfits, 2-3 special occasion outfits, and 2-4 extras. Hang these items back in your closet or fold them and put them back into your dresser. Anything that remains should be considered for donation.

Be honest with yourself as you go through this process. If you think you are hanging onto an item because you might need it someday, chances are you won’t! Trust me on this! I was the queen of holding onto clothes that I would never wear, some still with tags. Second guessing yourself will likely cause you to hang everything back up! If you notice yourself becoming overwhelmed, take a few deep breaths and walk away for 5-10 minutes. Come back and continue the process. For those items that have sentimental value to you, consider placing in a tote and storing for a period of time.

Organize your closet based on your current lifestyle and simplify the process of getting ready. When you have less to choose from, it not only takes less time select what you’ll wear, but you may even notice a reduction in your level of stress each morning. Not to mention that the items you keep will be items you like or love!

*As with other areas of life, if you are experiencing strong emotions or attachments to items in your wardrobe and are finding this process unbearable, it might be helpful to seek out the assistance of a professional. See Psychology Today to find someone in your area.

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Guest Post By Camille McDaniel, LPC, CPCS

I didn’t know exactly which topic I wanted to share with you initially. I wanted it to be relatable and at the same time hold your attention. Then it hit me. A voice said, “Just write what you see.” So I’m listening.

This is something I’ve helped so many people with over the years and this is a road that I travel regularly. Logically, you may know that you need boundaries with friends and family in order to keep your emotional and mental wellness intact. However, it can be difficult to put these boundaries into action when the time comes. Why? Why can’t we just do what we know we need to do and say what we need to say in order to maintain emotional and mental wellness? It has a lot to do with our perception of what it means to be assertive, how we want people to see us, and how we feel about ourselves.

Today, I want to give you three tips for creating the foundation of healthy boundaries. I also want to provide support for that part of your brain that may hold tight to the idea that it’s not worth the risk to try these three tips.

  1. Give yourself permission to be okay. Everyone is not interested in being healthy emotionally and mentally. Sometimes staying in what is familiar, even if it’s toxic, is more comfortable than trying to change for the better. When you decide to start creating a healthier space for yourself, some people may try to use manipulation as a way of getting you to just accept their poor behaviors, as if you’re the one who is wrong for trying to create boundaries for yourself. My advice? Don’t try too hard to make them okay with your changes. Let them own their own feelings. Boundaries are okay and YOU are okay for wanting to create a healthier life for yourself.
  1. Let people know how you feel when it happens. When you don’t advocate for yourself by speaking up, something happens. You sit and think about the event over the next few days and instead of actually saying what is wrong, you may let your body language speak for you or you may act like everything is fine and start resenting the person for “not knowing better” than to act that way. Letting the person know how they affected you will give that person an opportunity to learn more about you and understand how their actions are impacting you. What if they don’t care you ask? Well let me refer you back to the last part of #1: “Boundaries are okay and YOU are okay for wanting to create a healthier life for yourself.”
  1. Know when to let go. Sometimes you just have to love people from a distance. It’s not because you don’t care about them. It’s because you care about them and yourself enough to know when to stop toxic cycles from continuing in both of your lives. In time, that person may change or maybe they won’t. Either way, you must know when it’s time to put space between you and them.

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Camille McDaniel, LPC, CPCS is the founder and director of Healing Psychotherapy Practices of Georgia, LLC in Kennesaw, Georgia.  She is also the creator of an online business called The Counselor Entrepreneur. You can find more about her work at http://www.CamilleMcDaniel.com.

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