Tuesday, November 26, 2013

Using Intuitive Eating During the Holidays

--by Nicole Holt, RD

The holiday season can be a difficult time of the year for those who struggle with an eating disorder. It is a time of the year where family gatherings, work parties, and holiday activities are often centered on food and impressing others. On the other hand, the holidays can be an opportunity to stand up to your eating disorder and practice intuitive eating skills. Let’s go over some intuitive eating concepts to help you feel confident as we enter the holiday season.

As an Intuitive Eater, you know:
  • ·      If you restrict your intake throughout the day to compensate for a dinner party, you are most likely going to be overly hungry at the party and eat until uncomfortably full.

  • ·      If you eat past fullness, do not panic. The feeling of fullness will likely pass in less than a half hour. In the meantime, you can distract yourself with a conversation about gratitude, or a holiday song!

  • ·      It is your right to honor your fullness and say "no thank you" to seconds or dessert.

  • ·      If you want seconds, you are free to eat them without feeling guilt, judgment or the need to exercise, or purge, to compensate.

  • ·      All foods fit in a healthy diet, including stuffing, pie, and whatever else our society labels as unhealthy!

  • ·      You are the expert on your body.  Nobody can feel your hunger and fullness but you.

Being an intuitive eater doesn’t mean you are perfect. Sometimes it means that you eat more because it tastes good. It can also mean creating an escape from an eating situation because you are overwhelmed and need a minute to yourself. Whatever it may be, have faith in your intuitive eating skills this holiday season.

Thursday, November 21, 2013

Equine Therapy in Eating Disorder Treatment

My interest in animal-assisted therapy began with the puppy-love-of-my-life, Shadow. I became the very honored owner of Shadow, a rescued shiba inu, in May 1999. Although we did not know her history, it quickly became evident she was likely neglected, and potentially abused. I was in graduate school at the time, and Shadow was my first dog. She quickly became the (puppy) love of my life and our bond grew to be very strong. During graduate school, once a semester, she was seen in class, helping me to teach learning theory principles to my Intro to Psych students. 

Upon completion of graduate school, honestly, I just wanted to take Shadow to work with me. So, I got her certified as a therapy dog, and over the next few years, she went to work with me at two different treatment centers. I quickly realized that her own skittishness and avoidance of contact was a wonderful conduit for helping those who had experienced trauma to see that their reactions were normal. Shadow never was the cuddly dog one might expect of a therapy animal; many of my clients never really got that physically close to her. But, I was repeatedly told of the major impact that she had, and since have been surprised to hear of the number of past clients who chose to get a shiba inu in adulthood. 

At times in my career, I have been exposed to equine assisted therapy. And I always saw the potential, and was strongly impacted by the ways it could be beneficial for those with eating disorders. I have begun a training program for a specific type of equine assisted therapy, called Gestalt Equine Psychotherapy, and I have a new partner in crime, Daisy (or if we are feeling particularly elaborate: Miss Daisy Mae). I thought I'd talk some about the connections I see between equine therapy and eating disorder treatment, and I'd love to hear others' thoughts about this. Reality is that equine assisted therapy is not a highly researched field. There's not a lot of concrete data to back it, but those who do it know intuitively it's effectiveness, and those who experience it are often blown away by how powerful it is. So, why equine assisted therapy in eating disorder treatment? These are my initial thoughts:

1. In my opinion, "the best" equine assisted therapy is about the relationship with the horse. It is not using the horse as a "tool," but instead as a co-therapist. Eating disorders have the impact of disconnection, from oneself and from others. For various reasons, human relationships can become threatening, yet that with an animal can be safe. The horse as co-therapist can help facilitate reconnection: with one's emotions, with one's physical body, with relationships in general, and with others in the client's life. When one has an eating disorder, they often cut themselves off from the head down. The body is often ignored at best, and rejected at worst. Well, imagine trying to engage on the ground with a very large animal, without being present in one's body. To take it one step further, imagine trying to sit upon a horse, or ride a horse, without being connected. As you can imagine, these things would be very difficult, so interaction with a horse can challenge that disconnection in very real, and powerful, ways.

2. Trust: Let's face it; horses are at least 900 pounds, and taller than us. They physically present a challenge to trust. But they will quickly illustrate the desire and motivation to trust us as humans. And that can be so powerful to those who have learned to distrust others.

3. Mirroring: One of the most powerful things I see in horses is their ability to mirror us as humans. They will physically represent many of our emotions, when they are connected to us. And they often seem to have an uncanny ability to present what we are dealing with. For example, I just recently watched a horse literally push around someone who was talking about feeling pushed around in her life. They present an opportunity to face a challenge that is too scary to face with adults. 

4. Presence: This is very similar to the connection piece. But those with eating disorders, almost without fail, have high anxiety. They are often lost in their thoughts, overwhelmed by their fears and worries. Being in the presence of a horse challenges that. If you don't engage with a horse, and be present with them, they will literally turn and walk away. But, if the client become present, the horse will engage. This can be a powerful illustration of what happens in human relationships in the life of someone with an eating disorder.

5. Communication: Those with EDs often become silent, not saying what they are thinking and feeling. A horse, or a dog, can present a safe environment for beginning to open up again, and then a safe partner for beginning to talk to people whom the client might find more threatening.

I am really interested to hear what thoughts others might have regarding the overlap between equine assisted psychotherapy and eating disorder treatment! This work is being done in inpatient and residential settings a lot, but perhaps is less common outpatient. I am excited to see this area of eating disorder treatment continue to expand.