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Wasatch Family Therapy Idea

Cindy sat in my office, seeking relief from the intense psychological anguish that she had been experiencing for the several months since having survived a fatal head on collision with an SUV. The driver of the other vehicle was intoxicated, swerved into Cindy’s lane of traffic and impacted her vehicle head on. That driver was pronounced dead at the scene. Since that time, Cindy had been experiencing insomnia, nightmares, flashbacks, panic attacks and difficulty functioning – classic symptoms of Post Traumatic Stress Disorder.

From a neurological stand point, her brain was essentially “stuck” in a primitive survival mechanism known as “fight or flight” – a protective measure that is designed to identify a dangerous situation and put the entire system on the defense at warp speed, all in an effort to ward off any threat to survival. Fight or flight is a mode of defense that operates on a “better safe than sorry” mentality. In Cindy’s case, even though the threat to her safety had ended months ago, her system was still stuck in that defensive posture “just in case” the threat, or anything like unto it, resurfaced. Although Cindy understood on a rational level that the threat had long since passed, her neurology was reluctant to let it’s guard down in the event that there was a mistake and the danger had not really passed.   Scenes from the event were relived again and again in her mind because literally that memory had been loaded into her neurological network in a manner that caused the rewind button to be continuously pushed by anything in her environment that even slightly resembled the near fatal accident – riding in a moving vehicle, the sound of a car’s engine, sirens in the distance, flashing lights, etc….

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Ask A Therapist: Is My Eating Disorder Serious?

Q: Hello. About four months ago I diagnosed myself with possible anorexia. I skip about 2 meals a day but I eat try to eat a full meal for dinner. I exercise for at least an hour daily. I am 16, my height is 5 foot 9 and my weight is 123 pounds. I want to ask for help from my parents but I am too scared they will be disappointed in me. I also do not think that my disorder is that serious. Should I ask for help?

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Ask A Therapist: I Think I’m Depressed

So five months ago, I moved from Chicago to a new school. I thought it would be great to move to a new school, but I was wrong. It isn’t and I’m still not making any close friends. Everyone already has all their groups and best friends, so it’s really hard for me. I still haven’t found anyone to fit in with. And now, I’m starting to have self esteem issues. I was already having suicidal thoughts a little before I came to this school, but then they kind of died off. But about a month after being in my new school, the thoughts came back and stayed with me for another good 3 months. Even though these thoughts are gone, my self-esteem isn’t as great as it used to be. I cry a lot more often just thinking about my life, and I’m a lot more sensitive than I used to be. I also used to have an eating disorder, where I made myself throw up a few days a week. I barely read anymore, which is something I used to do all the time.
 From this, do you think I’m depressed?

A: The short answer is yes, your symptoms do sound like depression. I suggest that you seek help immediately. The social isolation and low self-esteem, frequent crying, and your history of suicidal thoughts are serious symptoms that need to be addressed. While I can’t diagnose you in this forum, I suggest that you get a thorough mental health evaluation to find out exactly what’s going on, and what treatment you need so you can start enjoying your life. Watch the video below for my complete response. Thanks for writing in.

Take good care of yourself,

Julie Hanks, LCSW

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5 Ways to Help a Loved One with an Eating Disorder

Do you suspect that one of your friends or family members is struggling with an eating disorder, but don’t know how to reach out to them? If so, my heart goes out to them and to you, because I understand that it is a heart wrenching experience. It is very difficult to watch someone you care about go through something so difficult, and it is even more frightening when you don’t know how to help them. Here are 5 suggestions that might help you approach the situation:

Recognize the Problem

It is helpful to recognize the signs of an eating disorder. The following are some of the things you may notice if your loved one is truly struggling with this issue:

Anorexia Nervosa
• Dramatic weight loss
• Wearing baggy, bulky clothes to hide weight loss
• Preoccupation with food, dieting, counting calories, etc.
• Refusing to eat, especially certain foods, such as carbs or fats
• Avoiding mealtimes or eating in front of others
• Preparing elaborate meals for others, but refusing to eat them
• Exercising excessively
• Poor self-image/Making comments about being “fat”
• Stopping menstruating
• Complaining about constipation or stomach pain
• Denying that extreme thinness is a problem

Bulimia Nervosa
• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics
• Skipping meals or avoiding eating in front of others, or eating very small portions
• Exercising excessively
• Wearing baggy clothes
• Complaining about being “fat”
• Using gum, mouthwash, or mints excessively
• Constantly dieting
• Scarred knuckles from repeatedly inducing vomiting

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Ask A Therapist: How Do I Open up Emotionally to my Therapist?

How do I open up to my therapist? I am constantly worried that he might think I’m trying to get attention. I have an eating disorder and I’m slightly overweight according to my BMI. I’ve overexercised, took laxatives, and most recently diet pills. I ended up giving my therapist one session because I was taking so many that it made me fell terrible. I’m just not able to be truly open and honest. He really is a great therapist, and I have a deeper connection with him than most others in my life. I have these feelings outside of therapy, but when I go in, I put on a face that everything is ok. How do I work on this to communicate better?

A: Great question! The emotional pattern of guarding your feelings is likely part of the reason you’re in therapy in the first place. Watch the video below for complete answer.

Take good care of yourself!
Julie Hanks, LCSW

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Ask A Therapist: Eating Disorder, Depression, Insomnia, & Cutting

Q: I have an eating disorder, depression, insomnia, and now I’ve started cutting. No one cares. My mom said things could be worse. My dad ignores it. My boyfriend says its in my mind and I can get over it on my own. I’ve started cutting and no one knows and it’s embarrassing. I need help. What should I do? (24 yr old female college student)

A: Click the arrow below to hear my response to your question…

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Click here to find a therapist in your area

Take good care of yourself!

Julie Hanks, LCSW

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Ask A Therapist: I Deal With Abusive Boyfriend By Cutting And Binging

Q: Hi, I am 19 year old girl in my 2nd year of college. I currently live with my boyfriend of 4 years who is 25 years old. Our relationship used to be really good, but now all we do is argue. A few years ago I was flirting with other guys and he has never forgiven me for it. He constantly tells me he doesn’t trust me, and when he gets mad he tells me he hates me, that I should crawl in a hole in die, that he can’t stand to look at me, and many profanities. He spends no time with me so I spend the majority of time home all alone, which is the main issue because that gives me all the time alone I need to self-destruct.

I can’t stand myself, I hate everything about me. I’m fat and ugly, sometimes I don’t even know why I bother trying to make it through life nothing ever goes as planned. I feel like I am constantly starving myself or if not eating ridiculous amounts of food and then feeling guilty so that I either make myself puke or cut myself. I can’t control it, I feel like if I can make myself attractive my boyfriend will love me again but I can’t even take care of myself. The worst was when he caught me binging and freaked out along the lines of “No wonder I’m always starving, you eat all the food. For once I wish you would save some for me instead of stuffing your face all the time.” And despite hearing that I still continue to stuff my face… I can’t help myself… maybe I deserve to be fat. I can’t even decide what is worse, the purging or the self-harm. Both cause me discomfort and to feel like a failure, but in the end neither make me prettier…they just make me uglier. This also causes me to spend way too much money on food…I am $20,000 in debt with my bank because of all the money I waste on food. I eat too much so now I cant even barely afford anything…which my boyfriend also blames me for…rightfully, it is my fault.

I just don’t know what to do. I have thought about trying to see a therapist regularly but I’m too embarrassed. I don’t want to make known just how disgusting I am. I don’t want anyone to know how much I eat. I don’t want anyone to know how my boyfriend treats me. I just want to be a normal person… I want to be happy, and loved…what do I have to do to be okay?? 🙁

A: Even though you’re embarrassed, please go see a therapist ASAP. Licensed therapists are trained to help individuals and couples in crisis resolve your problems and help you, not to judge you. Just by reading this letter I can sense the depth of your pain, I have empathy for you,  and I want to help you. This is how your therapist will feel too when you meet with him or her face to face. If you’re not sure where to find a therapist in your area click the Find Help tab at the top of this page for a listing. There are likely earlier roots to your self-destructive eating patterns, cutting, and dysfunctional relationship that can be explored and healed in therapy and are beyond the scope of what I can offer here.

What you’re describing in relationship with your boyfriend is verbal and emotional abuse. No one deserves to be told by their lover “I hate you” or “You should just crawl in a hole and die.”  That is heartbreaking to hear and needs to stop if you are ever going to gain self-esteem and confidence to change your life. Your therapist can help you to build  relationships skills and to help you come up with a plan to stand up for yourself when your boyfriend becomes verbally abusive.

In addition to meeting with a therapist regularly, I suggest you start seeking out books, blogs, and other resources and start arming yourself with more knowledge and tools to help you feel stronger and more competent. Here are some excellent resources right here at Psych Central to help you get started:

Weightless Blog
Eating Disorder & Binge Eating Info
Self-injury Forum
Relationship & Communication Forum
Eating Disorder Community Forum

Take good care of yourself!

Julie Hanks, LCSW

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Ask a Therapist: I’m scared to see a therapist for my eating disorder

Q: I started out with anorexia but now am bulimic/anorexic and have been this way for about 3 yrs now. I am on a binge/purge cycle and have purged everyday at least since November. One person knows about my ED and I am so scared to get help even though I know that I need it. I am fully aware of the dangers of bulimia. I am being treated for one of the symptoms of bulimia, which is passing out because of malnutrition. However, the doctors did not figure out that it is due to an ED. I’m 18 so I can get help without my family knowing which is a big deal for me because I can not let them know. They have a lot to deal with right now plus my mother does not really understand how to deal with things. Shes Bipolar and every once in a while has a Schizophrenic episode. I am scared of my father and stay away from him so I can’t tell him either, my whole family dynamic is screwy. However, I am considering getting help for my ED. What should I expect if I do decide to go to a therapist? What kind of questions will they ask me. Thanks for your help.

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Ask a Therapist: Tips To Help Control Bulimia

Wasatch Family TherapyQ: I have been suffering from bulimia for four months now. I realize the health risks and I know I have a problem. I have been trying to stop for a month now with no success.  Before this problem I was healthy and now I fear that all my hard work I have completed over the years to be a healthy person are going down the drain. To be honest I am not sure what started my ED, but my main focus is to overcome it. I know that I have some self esteem issues and I will continue to work on that, but do you have any advice or tricks to stop these behaviors that have seemed to become habitual and uncontrollable. I know that getting professional help is probably the best way to go, but that is not me. I have always dealt with my problems in the past and I would like to give this a shot. So if you have any suggestions or tips to help me slowly stop these bulimic behaviors I would appreciate it so much.

A: I commend you for recognizing that you have a problem, for acknowledging the health risks, and for reaching out for help. While I can give you suggestions to try and change your behavior, it’s important to recognize that overcoming eating disordered behavior is much more than controlling your actions. Recovery also requires learning new skills to manage your thoughts and emotions, and learning to get comfort and soothing in relationships, instead of in food.

Out of control behaviors often serve as “relationship substitutes”. Consider that your symptoms may be signaling that it’s time to shift from doing things on your own to learning to ask for and accept help. When you feel the urge to binge or purge call a friend or family member. Even if you’re not ready to openly share your struggle with them reaching out to a trusted loved one can delay the urge to engage in self-destructive behavior and provide you with emotional support.

It can also be very helpful to journal your emotions before and after binging and purging to become more aware of the feelings driving your behavior, and to identify which emotions are most difficult for you to tolerate. You may find the book Mindful Eating and the workbook Overcoming Bulimia helpful in gaining awareness of the emotional and psychological roots of your behavior.

I urge you to seek an assessment with a psychotherapist specializing in eating disorders, and to schedule a physical with your doctor. To find a therapist in your area click here. If you do indeed have bulimia, your chances of recovery are higher if you seek help now instead of months or years down the road.

Send me your relationship and mental health questions here!

This post originally appeared in my Psych Central Ask the Therapist column

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Self & relationship expert Julie de Azevedo Hanks, LCSW is wife of 22 years and mother of 4, a licensed therapist, a popular media contributor, and director of Wasatch Family Therapy. Listen to Julie’s podcast You and Yours , on B98.7 radio as the Bee’s Family Counselor, and read her national advice columns on Psych Central! and Latter-day Woman Magazine

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