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It’s holiday time again where we were flooded with excessive goodies, tempting aromas and multiple food-focused commitments.  Let’s brainstorm a few ways to make this wonderful time a year pleasurable and nutritious!

Choose to focus your attention on friends and family; they are some of the most important gifts in our lives.

Choose to socialize away from the sight of food.  This will help you not graze and avoid mindlessly munching during the event.  Change your environment by stepping outside, putting your napkin on your finished plate or sitting with your back to the food table.

Choose to bring a healthy dish to the gathering; it can still be seasonal and fun such as pumpkin dip made with yogurt, shrimp cocktail or a veggie tray arranged as a turkey or Christmas tree. Pinterest has ample ideas to help you be creative.

Choose to be mindful.  Appreciate the smells, textures and flavors; savor each bite.  Pay close attention to your body’s signals.  Our holiday foods are special, eat them that way.

Choose to say “No thank you” to food pushers.  Eat the type and portion of food that makes you feel good physically.  Don’t feel obligated to eat it because it’s left on your plate or someone made it for you.

Choose to keep your normal routine with eating before and after events.  This will help you feel more in charge of portioning and getting the right amount that makes your pouch feel comfortably full. It will also help maintain healthy blood sugar levels and metabolic function.

Most importantly, choose to embrace your body through the holidays.  Celebrate all your successes, non-scale victories and the best gift of all, your health!

“The moment you start acting like life is a blessing, it starts feeling like one.”


15/Nov/2017

“People are disturbed not by things, but by the views they take of them.” Epictitus.

“There is nothing either good or bad, but thinking makes it so.” Shakespeare.

One of the key ingredients to living well is thinking well.  Our perspectives about ourselves, others and life in general will influence what we feel and what we do.  Our perspectives are our lens to the world.  This lens is shaped by our life experiences-which in turn shapes how we experience life.  All of us has a different lens to the world which will impact our experience of the world.

Issues with our experience of life however may occur due to distortions in this lens. These distortions may skew how we view ourselves, others and life. At times, we may not view things in a healthy, realistic or accurate manner due to these distortions.  In many of these cases, this may result in unhealthy emotions and/or behaviors.  Every emotion has a central core element that should be identified if you are experiencing unhealthy emotions-these are summarized below:

Anxiety=fear of a certain outcome occurring

Anger=the perceived violation of expectations

Depression=perceiving ourselves as hopeless, helpless and worthless as well as perceiving others and life in an unfounded negative manner.

To overcome unhealthy emotions and/or behaviors, it is important to reflect upon our perspectives.  We need to step back and objectively evaluate how we are thinking about things in our life. We need to identify any possible distortions on our lenses that may be creating our negative experience of life.  Once these have been identified, it is not effective to simply focus on “not thinking about it.”  It is important to identify healthier, more realistic or more accurate ways of viewing your world.

If you would like assistance with exploring these concepts as they apply to issues with which you may be struggling, contact the Chrysalis Center at 910-790-9500 and schedule an intake with one of our clinicians.



Each year on the fourth Thursday in November, Americans gather for a day of feasting, football and family. While today’s Thanksgiving celebrations would likely be unrecognizable to attendees of the original 1621 harvest meal, it continues to be a day for Americans to come together around the table—albeit with some updates to pilgrim’s menu.

With so much emphasis on the fat, calories, and potential dietary pitfalls of Thanksgiving dinner I thought I’d put a positive spin on the indulgent meal. I mean, with all the eating you’ve got to be getting some kind of nutrients, right? And, with the exception of canned cranberry sauce, (Uncle Joe insists on having it) everything on the table at my families’ Thanksgiving is homemade, and that has got to count for something!

Read on to see the HEALTH BENEFITS of Thanksgiving dinner!

  • Just 5oz of turkey provides half the recommended daily allowance of folic acid and 32g of protein.
  • 5oz of mashed potatoes pack 27mg of vitamin C—that’s 45% of the RDA.
  • String Bean Casserole made with frozen or canned vegetables maintains most of the nutrients including beta-carotene and B-vitamins
  • A half-cup serving of sweet potatoesprovides 330% of your recommended daily allowance of vitamin A!
  • One half-inch slice (about 1/8th of a can) of cranberry sauce is only 86 calories and .1g of fat. Even better, make your own for the full antioxidant, and infection-fighting benefits of cranberries!
  • Traditional stuffing doesn’t offer much but cook it in a separate dish, outside the turkey, to save yourself 70 calories per tablespoon!
  • A 5oz glass of wine is packed with the antioxidant reservatrol, which reduces bad cholesterol and prevents blood clots.
  • 1/8th of a 9” pumpkin pie packs 4.2g of fiber and 288mg of potassium, which helps counteract the high levels of sodium in a traditional Thanksgiving meal.

 

Now you know what you stand to gain from a traditional Thanksgiving dinner—aside from pounds.  Happy Thanksgiving!

 



“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” – Theodore Roosevelt, the Man in the Arena. Delivered at the Sorbonne (Paris) on April 23rd, 1910.

I wanted to dedicate a blog post to a topic I have encountered numerous times in sessions with clients, as well as wrestled with myself as a developing therapist continuing to explore her therapeutic style and sense of self; external and inner criticism. When covering this ground, I turn to the work of Brene Brown. Brown is an American scholar, author, and public speaker, who is currently a research professor at the University of Houston Graduate College of Social Work. She has spent over a decade researching courage, vulnerability, shame, and empathy and is the author of four #1 New York Times bestsellers and her labor has been featured on PBS, NPR, TED, and CNN.

In one of her presentations entitled, “Why Critics Aren’t the Ones Who Count” delivered in front of an audience at the 99 Conference, she covers this topic and highlights:
• Why (creative) human beings must embrace their vulnerability
• How to handle (external and inner) criticism and public scrutiny that accompanies exposure
• Which feedback matters, and which does not, in the “public arena”

Criticism can stifle creativity and can anchor people from daring greatly and taking risks. Brown poses the question: What would you try if you knew people wouldn’t say ___ (fill in the blank) about you? She explores the benefits of not allowing fear of criticism to inhibit the display of one’s own work. Brown conceptualizes this through “the arena.” When a person is thinking about or preparing to enter the arena, there is fear, self-doubt, comparison, anxiety, uncertainty, and shame. People tend to “armor up” emotionally and psychologically and when they do, they shield themselves from vulnerability. Vulnerability is the birthplace of love, joy, belonging, trust, empathy, creation and innovation.

When a (courageous) person chooses to enter the arena, they are greeted with rows of seats and people. The three seats that will always be filled in the arena are: shame, scarcity, and comparison – 1). Shame (which Brown describes as a “universal human emotion”), 2). Scarcity (Does this matter? Is this important or original?) and 3). Comparison. The fourth seat is reserved for a teacher, ex-coworker, family member. Brown summons the audience to recognize that the critics will be there and to invite them in, however one may not be interested in their feedback. Brown believes by taking the stance that unless your critics are also exposing themselves and exhibiting vulnerability, their opinions and feedback are extraneous – using the dialogue: “I see you, I hear you, but I am going to show up and do this anyway.” In addition, Brown shares that we are often our own worst critic, so she advises us to save a seat in the arena for ourselves. Brown says, “We orphan the parts of us that don’t fit the ideal… leaving only the critic. On the contrary, the person (or the part of us) who believes in what we are doing and why we are doing it should be in that chair.”

Choosing to be seen in the arena is no easy feat. Brown encourages a clarity of one’s own values and having a support person that is willing to pick them up and dust them off when they fail or make mistakes. Brown notes, “if one isn’t making mistakes, then one isn’t really showing up!” She explores why “not caring what people think” sends a huge red flag as human beings are “hard-wired for connection.” However, when a person becomes defined by what their critics think, they lose their willingness to be vulnerable.

Is it petrifying to show up and be seen? Yes, absolutely. But remember to make space in the arena for the people and part of you that values courage and creativity.

Disclaimer: Some profanity is used in the following video.
Brene Brown; Why Your Critics Aren’t the Ones Who Count:

Brene Brown’s Official Website: http://brenebrown.com/

Home

 



Me Too! The social media phenomena of women announcing that they too have been subjected to sexual harassment has taken the world by storm. Yes, the world. This is not hyperbole, women from Germany, Italy, the Arab countries even Nairobi have been posting Me Too! Not that anyone should be surprised that women all over the world are subjected to sexual harassment. This abuse extends way beyond celebrity casting or factory work. However, in addition to the global Me Too! response is something that is different. Men are responding. And men are responding positively: not with rationalizations or minimizations. With tweets of “I hear you! “or even “I was guilty!” Guilty of not standing up, of not saying something when they observed another man making a lewd comment, of shaming the victim who dared to say stoop. This is not just the celebrities rallying against Harvey Weinstein. Everyday men are saying “I understand.”
Women have long been united in trying to empower other women. In the marches, the protests or gatherings there is always a small percentage of men who will stand up for women’s rights. Is this a change to more global activism? We can only hope that men and women unite against all forms of abuse. The message needs to change. One recent article noted that we have depersonalized violence to being out there, as if the perpetrators are some alien force, not human. It’s domestic violence not significant others attacking their loved one What if we read, there was X number of men raping women or X number of teenage boys impregnating teenage girls. Can men join women in standing up to other men or calling expressing their own victimization without shame. Can we hope that someday it will not be Women’s empowerment but Human Empowerment? Well, we just might have taken a step. I look forward to the day it is not about men, women, or any other group. May the next blogger be able to comment “We treat all living being with respect”
Sexual harassment is abuse. Often the dynamics are the same as with more physical forms of sexual violence. The same power differential and the same intimidation. Unfortunately, it can lead to the same lasting PTSD difficulties as well as loss of employment, opportunity and potential. Disclosure can be as difficult as the harassment and lead to even further difficulties. Reading the stories of Me Too posts expose harassment for what it is… simply a longer word for abuse.



I thought that I would change up my tune a little bit and write about something seasonal. No matter how much I want to believe that the summer is still here, the Christmas decorations at Cotsco tell me otherwise. Sigh. But I’m not going to talk about Christmas or any other winter holidays today. Confused? So was I when I saw those fake Christmas trees in September. I digress… Today I am writing about something very… Fall: Pumpkins. Pumpkin patches have popped up all over Wilmington and I thought I’d provide some ideas of what to do with these stinkers other than paint, carve or smash them.

Eating pumpkin is underrated.

Growing up I was taught to scoop out the pulp and seeds and throw those away (which I never minded since it was all kind of smelly.) We would occasionally toast the seeds, but my pillowcase full of candy always won over the Ziplock bag of dry seeds and I never would have considered taking a bite out of Jack (O’Lantern). Yet, I wish I would’ve been taught that pumpkin pie wasn’t the only way to enjoy pumpkin. In adulthood I learned to be open minded and curious about pumpkin – well about all food in general – and I’ve found out that I like it…a lot.

For a little background: pumpkins are a Fall veggie and if you are selecting one it should feel firm and heavy for its size. One serving of pumpkin provides 130% of the average person’s Vitamin A needs for the day and 15 % of their Vitamin C needs. Talk about vitamin packed and a clever way to add some variety into your meals!

Canned pumpkin or whole pumpkin can both be used in a multitude of ways.

  • If you use canned pumpkin please you double check if you are need pumpkin puree (only pumpkin) or pumpkin pie mix (sweetened and spiced for convenience). Depending on what you are making this could make a significant difference for your end product.
  • If you have a whole pumpkin on hand, spoon out the seeds and stringy pulp and cut the pumpkin into large pieces. Roast it until fork-tender (about 350 for 45 minutes) and then remove/peel the skin off. You may need a knife for this. Next, mash the pumpkin flesh up with a potato masher, put it in your blender or food processor. Voila. Fresh pumpkin puree that you can use or freeze.

I am a big proponent of eating a variety of foods and of adding foods, not taking foods away. I hope that these ideas help you branch out and see if pumpkin is something you enjoy in your meals and/or snacks! Pumpkin (Spice) up your life!

Pumpkin Smoothie:

1 cup milk, 1 medium banana, ¼ cup pumpkin, 1 dash of cinnamon, maple syrup to taste, 4 ice cubes. Blend. Drink. Yum.

Turkey Pumpkin Chili:

Courtesy of www.WholeFoodsMarket.com *

Ingredients:

  • 2 tablespoons extra-virgin olive oil
  • 1 small yellow onion, chopped
  • 1 green bell pepper, chopped
  • 2 jalapeño peppers, seeded and finely chopped
  • 2 cloves garlic, finely chopped
  • 1-pound ground white or dark meat turkey
  • 1 (14.5-ounce) can diced tomatoes, undrained
  • 1 (15-ounce) can pumpkin purée
  • 1 tablespoon chili powder
  • 1 teaspoon ground cumin
  • 1/2 teaspoon fine sea salt
  • Ground black pepper, to taste
  • 1 (15-ounce) can kidney beans, rinsed and drained

Instructions:

Heat oil in a large pot over medium high heat. Add onion, bell pepper, jalapeños and garlic and cook, stirring frequently, until tender, about 5 minutes. Add turkey and cook until browned. Add tomatoes, pumpkin, 1 cup water, chili powder, cumin, salt and pepper and bring to a boil. Reduce heat to medium low and add beans. Cover and simmer, stirring occasionally, for 30 minutes more. Ladle chili into bowls and serve.

Pumpkin Apple Doggy Treats:

Courtesy of http://munchkinsandmilitary.com/2016/10/pumpkin-apple-dog-treats.html *

Ingredients:

  • 4 – 4.5 cups oatmeal, plus additional
  • 1 medium apple
  • 1 egg
  • 1 cup canned pumpkin

Instructions:

Preheat oven to 400 degrees F. Grind the oatmeal down in a food processor or blender. Transfer to mixing bowl. Core apple, being sure to remove all of the seeds. Grate apple, and add to bowl with oatmeal. Add egg and canned pumpkin to bowl and mix well to combine. The mixture will be thick and slightly sticky. On a surface dusted with oatmeal (ground or not, your choice) roll the dough out to approximately 1/2″ thick. Use a doggy bone cookie cutter to cut dough into shapes, and transfer to a lined baking sheet. Bake for approximately 12-15 minutes, or until golden and crispy. Allow to cool to room temperature, then store in an airtight container for up to a week.

 

* I am not endorsing these sites, I just like the recipes! I posted the full recipes here to filter out any diet talk or mention of numbers.  But please be aware that these sites may include this information.



This Monday, October 9th, a years long dream will become a reality. Chrysalis will begin offering our IOP for adults 18 and older with all forms of eating disorders. IOP is considered a step up from outpatient care and a step down from partial hospitalization, residential, or inpatient eating disorder treatment. It is appropriate for those who are able to live independently, but require more structure and support than typically achieved by attending once weekly individual and nutrition therapy. It is also a useful way for those who’ve been at a higher level of care, with nearly constant supervision, to transition back to “the real world”. For those who’ve been away at treatment, IOP serves to help prevent relapse and sustain recovery.

Our mission is to offer expert level, evidence-based treatment to our clients dealing with all types of eating disorders (including anorexia, bulimia, and binge eating disorder), while also addressing co-occurring issues such as anxiety, depression and other mood disorders, trauma, and substance use. Our goal is to provide individualized care that targets every aspect of the client’s well-being in order to improve medical, nutritional, psychological, and interpersonal functioning. We seek to understand and challenge the underlying and maintaining factors of the eating disorder in order to achieve and sustain lasting recovery. It is our desire to restore hope and health to clients by empowering them to fulfill their goals, make positive changes, and prevent relapse. We believe that collaboration amongst the treatment team, clients, families, and the community will facilitate a path to successful outcomes.

Our program will be offered Monday, Wednesday, and Thursday from 3pm-7pm and will include a variety of group therapies, ending each day with a supportive meal led by a registered dietitian. These meals will rotate between catered options, “brown bag” or potluck dinners, and restaurant outings so that clients experience a variety of exposures to food challenges in different environments. Therapy groups include the ACT/DBT informed Mindful Living, Staying Open about Recovery, Motivation for Change, and a general Process Group. Additional specialty groups for trauma survivors and those dealing with substance use will be available dependent on the needs of the clients enrolled at any given time. Yoga and art therapy groups will also be incorporated into our programming.

Those clients interested in IOP can self-refer or have their treating provider (therapist, dietitian, or medical doctor) make a referral. Pre-screening with our clinical director will be required to determine if IOP is the appropriate level of care. All clients will have to undergo a medical evaluation to ensure their physical stability prior to being admitted into the program. If a client is already connected with a therapist or dietitian, they can maintain their current treatment team while also attending our IOP program. Close communication and collaboration between the IOP team and the referring provider will occur. If a client does not have a treatment team (i.e. therapist, nutritionist, or psychiatric provider) in place, Chrysalis will offer those individual services as well to round out the treatment experience. As we are the only eating disorder specific IOP within a 130 mile range, we will also accept clients from out of town. Our director of professional relations will work with those clients to attain affordable lodging options.

Insurance typically covers IOP level of care with prior authorization. Our helpful administrative team will assist clients to determine their benefits and to obtain the authorization required to attend IOP. If we are not in-network with a particular insurance company, our utilization review department will strive to negotiate a single case agreement with the individual’s carrier. Once enrolled in the program, our hope is that at least 6 weeks of continuous care will be approved.

Our staff is a friendly, knowledgeable mix of experts in the field. Our clinical and nutrition directors are a certified eating disorders specialist and a certified eating disorders registered dietitian, both with previous experience working in higher levels of care for eating disorder treatment. Our IOP therapists and dietitians have specialized training and experience in the groups that they facilitate. Chrysalis’ program is licensed by the NC Department of Health and Human Services and accredited by the Joint Commission.

Making the decision to pursue IOP care is a big step in the recovery process and should be applauded. Visit https://chrysaliscenter-nc.com/iop/ for more information about the schedule, specific descriptions of the groups offered, and to meet our leadership team. If you have further questions about our program or to request a screening, please contact us at 910-790-9500 or iop@chrysaliscenter-nc.com.

Kelly Broadwater, LPA, LPC, CEDS is the founding executive director of Chrysalis Center. She is extremely grateful for the IOP leadership team who has put in countless hours of blood, sweat, tears to develop the program (and write more policies and procedures than she ever thought imaginable) and excited to see what the future holds as the IOP “takes flight”.



There are a lot of different methods and theories of couples therapy. One of the best ones for treating couples, is the Gottman method. John Gottman, PhD and his wife Julie Schwartz Gottman, PhD have been studying couples’ behavior in Washington State, teaching clinical and direct workshops for therapists and clients, writing books, and providing couples’ therapy for over 40 years. They are internationally recognized for their contributions to what can be a very tricky area for therapists and clients. If you want to know more about them or the Gottman Institute, please check out https://www.gottman.com/.

The Gottman Method

Since becoming a Gottman Certified Educator in 2015, I have been running workshops and working with couples using their methods (as well as all of my other clinical experience). This method takes you beyond active listening and conflict resolution to focus on friendship, respect, and acceptance that not all problems can be solved – but they can be managed.

This is a very difficult thing for a lot of people to process – that problems need to be managed and compromised on, that they cannot always be solved. And it is just one of the seven principles of a “Sound Relationship House” that form the core of their treatment philosophy.

Why Couples Come to Therapy

Couples come to therapy for a myriad of reasons. It is a difficult and stressful thing to do – to recognize that your relationship needs work and that you cannot solve all of the problems in your relationship between the two of you.

Some couples come because they don’t really interact with each other anymore – maybe they are empty nesters, maybe they have had family crisis(es) that leave them having to put out fires all the time instead of nurturing their relationship. Whatever the case, a lot of couples who come into my office do not know each other very well anymore – sometimes after only a few years of marriage! It takes energy to keep up with people – in our busy lives, we all know how difficult it is to keep in touch with friends and relatives – but you also need to keep up with your spouse, your partner, the person who you (hopefully) have some downtime with.

“Love maps” are the Gottman method’s way of getting to know each other again – drawing a map of what makes your significant other tick and keeping up with it as it changes. I also like Table Topics to generate discussions in couples or families.

Couples also come to therapy when there has been infidelity. There are a lot of potential reasons for this, but infidelity (emotional or physical) is the opposite of “Turning Towards” your relationship. When one partner is unfaithful, they have turned away from their partner and towards someone else. A “sound relationship” is one where each party can rely on and trust the other. That means that if one person is struggling with something, they turn to the other for support, guidance, opinions, or a port in their storm.

If you love, respect, and admire someone and you have a disagreement, you try to see their side and validate their point of view even when you don’t agree. You do not give in (which will just cause resentment), you do not turn away, and you do not blame the other person. Forgiveness is an aspect of “fondness and admiration” as well as “turning towards” and the “positive perspective.” You do not always have to forgive, but if you want to stay in a relationship after infidelity, you both have to forgive each other for whatever transgressions have brought you to that point.

Another reason couples come to therapy is that they argue all the time – I call it “kitchen sink” arguing when you start arguing about one thing (usually something minor in the scheme of things) and end up throwing all your other resentments, hurts, problems, and unhappiness into the argument. There is no way to win that kind of argument. You know that you are there when you do one of the “Four Horseman” of relationships. These are criticism, defensiveness, contempt, and stonewalling (see left). Whenever you get to the point of complaining about unrelated things, arguing about semantics, name calling or just not talking at all, you have done one of these.

There are a lot of other behaviors that you do with each of these, but it is important that every time you do one, you have to do at least five positive things to counter the damage to the relationship. With contempt, it is 20 to 1! Relationships cannot survive constant arguments like this. There are a lot of things – Gottman calls them “repair attempts” – that you can do to try to fix it, but it is MUCH easier not to do these in the first place. No one wins in these situations.

The average couple comes to counseling six years after the problem begins in their relationship – that is a lot of negativity to counter. There is no quick fix or shortcut to building a healthy relationship. Everyone argues, everyone disagrees, and everyone has to figure out the best way to manage their relationship. It is a puzzle that requires both partners be interested in change. It requires that both people be willing to learn and grow to make a relationship healthy. There is no shortcut to learning to listen, argue well, compromise, and value each other.  But sometimes, there is help along the way.

 

Kendra Wilson, LCSW, CEDS

Kendra is a Gottman Certified Educator and teaches Couples Enrichment Seminars at Chrysalis Center periodically. If you are interested in attending a seminar, please email Chrysalis and we will let you know when the next set of seminars will be scheduled.


22/Sep/2017

 

A Tale of Two Changes (ish)

A couple of months ago, I was talking to a friend about my yoga practice. I am hardly an aficionado, but I really enjoy practicing yoga, and when I regularly do yoga, I notice my mood is so much better, I feel better in my body, and my distress tolerance increases significantly. And yet, I think the last time I did yoga was at least a month ago with the previous time being a month or two before that.

On the other hand, I used to be someone who was chronically late. I used to joke that it was in my DNA to be late because I was even born late. Then, one day, someone said something to me, and it stuck with me in just such a way, that over time, I have shifted out of the pattern of being late to being on time (I do think I should clarify, though, that I’m still not an early person).

How can I enjoy doing something so much and still not follow through with actually doing it? How was I able to make the change with becoming more on time even though doing so was physically painful at times?

Breaking It Down

Both of these questions have to do with the question of motivation and sustainability. Why are we sometimes able to make change and keep it going, and other times, it feels like a constant struggle or something that we try and fail to follow through with?

In brief, it is our motivation to change and how we approach the change process that makes a difference.

Next Steps

Starting in September, there will be a Motivation to Change group that explores the change process, strategies to make and maintain change, and focuses on goal setting and follow through to meet goals.

By breaking down the steps it takes to make change, becoming aware of our individual values, and increasing our skills and supports, each of us has the capacity to make significant changes.

To be fair, though, it’s both exactly what I said and also more complex. I still am not doing yoga the way I wanted to several months ago, but I also have shifted my focus towards being more flexible with the activities I am incorporating and being less rigid about it necessarily being yoga where I find my peace and tranquility. As a result, I have made change, continue to make efforts at change, and also have further clarified my values to better match up with my goals for change.

Putting It Together

Clearly, as outlined above, I am still human- just a person who is able to make some changes but struggles with others. However, through this group, I am confident that you can gain better understanding of what motivates you in the moment, keeps you motivated over time, and helps you maintain progress towards your goals.

Wishing everyone wellness, flexibility, and motivation during this season and moving forward!

 

For Follow Up

If you are struggling to make change, or if you just want to know more about the process, please reach out, and I am happy to follow up with you. Also, if you would like to work through a group focused on change (and flexibility and self-care and all the things), then please let me know, and I am happy to discuss options for that, as well!

 

 

Rachel Hendricks, LCSW is a new addition to the clinical team at Chrysalis and has been working on the topic of motivation to change for the entirety of her clinical practice. She also specializes in working with clients who have had their eating disorder for ten or more years, clients with co-occurring substance use behaviors, as well as working with couples and families. She is excited to be making the transition to Wilmington from the Center for Eating Disorders in Baltimore, Maryland and looks forward to becoming more familiar with the area as well as continuing her reputation for providing excellent clinical care in the field of eating disorders.



This posts shares some information about a supportive, evidence based treatment for trauma and PTSD symptoms: Prolonged Exposure.

What is PTSD?

Post traumatic stress disorder is a common mental health problem following trauma. Individuals with PTSD often have difficulties with emotion regulation, managing symptoms of arousal, and other related symptoms. Co-occurring problems such as eating disorders, substance use disorders, depression, and self-injury are also common. You can read more about PTSD in my prior Chrysalis blog about PTSD.

What is prolonged exposure?

Prolonged exposure (PE) is a well established evidence based treatment for PTSD. It has been shown to yield long term improvement in PTSD symptoms.  PE can be applied with individuals who have co-occurring problems as part of a comprehensive treatment plan.

PE s a form of Cognitive-Behavioral Therapy (CBT) for PTSD, developed by Edna Foa, PhD. PE typically takes 8-12 sessions with at home practice in between sessions. Before working on traumatic memories, the PE therapist teaches the patient various safe techniques for relaxation from anxiety and arousal.  After the patient learns theses techniques, the PE therapist helps the client begin to work on traumatic memories. As part of this process, the trauma survivor intentionally recalls a traumatic memory that is contributing to PTSD symptoms. This is done through the use of verbal or written narratives while under the careful supervision of the PE therapist. These memories are recalled and then the safe relaxation techniques are employed. This is done long enough and often enough to experience a reduction in PTSD symptoms.

Working in this careful manner with a PE therapist, the patient learns new ways for the brain and body to respond to traumatic reminders. This allows the traumatic memories to lose their power to elicit PTSD symptoms. To be successful, PE needs to target the traumatic memories that are most related to PTSD symptoms. However, individuals can experience improvement  without discussing every trauma or all aspects of their trauma.

How does prolonged exposure work?

PTSD can be seen the inability of the brain to stop the fight-or-flight response. Reminders of the trauma trigger distressing thoughts, feelings, and harmful behaviors, even when there is no current danger. Escape and avoidance behaviors develop to provide temporary relief; unfortunately, over time they can lead to PTSD and co-occurring problems.

By intentionally approaching traumatic reminders safely under the therapeutic guidance of a PE trained therapist, new learning can happen to decrease PTSD symptoms. Over the course of PE, the brain starts to learn that traumatic memories and reminders are not dangerous, that anxiety does not last forever and that it is possible to have some power and control over traumatic memories.

What if I feel too afraid to start prolonged exposure?

It is natural to feel afraid at the start of PE. It is common not to feel quite to start PE or even feel afraid. All of that is totally okay. In fact, the first steps of PE address these concerns and give patients tools to decrease these anxious feelings, relax and regain control before working on traumatic memories.

PE should only be done in the context of a strong therapeutic relationship with a licensed clinician who has received formal training in PE. PE is a gradual process where the patient is in control and works collaboratively with the PE therapist. As part of this collaboration, fears about PE should be discussed about openly with your PE clinician throughout the process. This should help decrease initial fears and keep later fears manageable. It is okay to feel afraid and PE will help you gain strength and confidence.

What if I am ready to start prolonged exposure?

If you think you may have PTSD and that PE might be helpful, talk with your primary clinician or  contact Chrysalis to set up an initial evaluation. PE is compatible with ongoing therapy for other difficulties. PE can be added for 8-12 weeks in conjunction with your primary therapist in a collaborative approach to your treatment. At Chrysalis, we offer PE by a licensed psychologist who has been intensively trained in PE.  You can contact Chrysalis for more information about getting started. Recovery from PTSD is possible and within reach!

Dr. Kate Brody Nooner is a licensed clinical psychologist and associate professor of psychology at UNCW. She also holds an adjunct appointment at Duke University and is the principal investigator of NIH-funded grants aimed at reducing child and adolescent trauma and preventing alcoholism.


About Us

At Chrysalis, we believe that a supportive, healing environment is essential in order for change and growth to occur. We seek to offer such an environment to clients and help them create that in their lives and relationships. Read More

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Mon: 8AM – 6PM
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Wed: 8AM – 6PM
Thu: 8AM – 6PM
Fri: 8AM – 4PM
Sat: CLOSED
Sun: CLOSED

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