The March edition of the Bariatric Bulletin is live NOW! Check it out by clicking the link below to download OR head over to our Linked In where it is available to share!
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By Meghan Shapiro
The pride I feel about being a part of the Chrysalis Team is not something I keep close to my chest. I am so proud to be a part of such a knowledgeable, compassionate, conscientious team. Every day I experience renewed excitement about the potential for growth and healing within a safe environment that exists at Chrysalis. The truth is, however, that there is an underrecognized part of our treatment team. 
This weekend, while reflecting on the week before, I found myself filled with gratitude for our administrative staff and I realized that they are way overdue recognition for the contributions they make to the Chrysalis Team. They regularly, daily, go above and beyond to ensure clients at Chrysalis receive the care they need. Not just by scheduling appointments and working through insurance/payment questions but by paying attention and caring. They really do care and their contributions are too often taken for granted.
Last week, I was able to support a client who needed it because an administrative staff member recognized this client’s need and reached out to me without being asked to do so by the client. Intuiting client needs is not part of their job description. It is a reflection of commitment to Chrysalis Clients.
Clinicians can be pretty needy with schedule changes that sometimes come without much forewarning. Our administrative staff responds to those needs with patience and thoroughness, ensuring both the clinician and client needs are met. I know that is not an easy task and am so thankful for the grace with which they do it.
Despite the daily hassles we cause for them, the administrative office at Chrysalis is always a place clinicians are greeted with kindness and genuine interest in how we are doing. I hope our administrative team knows how much that can impact clinician’s days in a positive way.
I want our administrative staff to know that we see their commitment and hard work. That we know they are an integral part of the Chrysalis experience. That we appreciate them every day.
The first edition of our monthly bariatric newsletter is out now! Chrysalis dietitians, Madelyn and Jennifer, collaborated to bring you a bite-sized publication chock full of tips, tricks, and interesting tidbits to help you make the most of your bariatric experience.
Click HERE to download and read!
By Katie Baker
Communication with loved ones, especially with romantic partners, can influence how we feel about other parts of our lives (such as our holiday plans) and can either add to or reduce stress. This blog includes tips for communicating with your partner to help minimize tension during the holiday season (and throughout the year). These tips come from the highly researched and popularized Gottman Method for couples therapy, created by Drs. John and Judy Gottman.
Research shows that the following characteristics of communication are predictors of relationship decline when used regularly: criticism, defensiveness, contempt, and stonewalling. Called the “Four Horsemen,” when we give or receive these negative reactions, we make it almost impossible to reach a solution. Gottman offers antidotes to the four horsemen, which can prevent a breakdown in communication, emotional disconnection, and stress.
Criticism involves attributing your partner with a negative trait. Instead of using criticism, Gottman suggests stating what you are feeling with neutrality followed by sharing your needs. An example of a critical comment is, “You never offer to help me with anything, all you think about is yourself.” Instead, try, “I’m feeling a little overwhelmed with everything I need to do. Can you help me with the meal tonight?” This takes out the blame and lets your partner know what you would like.
Defensiveness is used to protect ourselves from attack. It can show up as acting like the victim or righteous indignation. An example of defensiveness is, “It’s not my fault the gifts didn’t arrive on time.” An antidote to defensiveness is accepting responsibility for even just part of the problem. This could look like, “Well, part of this is because of me. I need to order gifts earlier next time.” Even a simple, “good point,” or “fair enough,” can defuse an otherwise negative and stressful interaction.
Contempt is the #1 predictor of relationship demise, according to Gottman. Contemptuous statements come from a place of superiority. An antidote to contempt is to cultivate appreciation, respect, and openness in the relationship. An example of contempt might be, “You’re so stupid. What were you thinking?” An antidote could be, “I feel anxious when you make plans for us without telling me. I need to be a part of making these decisions.” There’s no name-calling or blaming here, instead, focus on your feelings and what you need.
Stonewalling happens when one person emotionally withdraws from the conversation. This could look like silence or the absence of cues that let the other person know you are listening. When you feel yourself wanting to withdraw it’s okay to let your partner know that you need a few minutes before you can continue the conversation. Take a break and do something that calms you down and does not have to do with the situation. This could look like going for a walk or taking some deep breaths until you feel emotionally calmer. The important thing here is to communicate to your partner how long of a break you need (ideally no longer than 30 minutes) and assure them that you will return to talk about it when you feel calmer.
Another thing to keep in mind around the holidays is that many of us, including our partners, have high expectations for how things should go, which can increase stress. It’s important to cultivate friendship within your partnership so you two can lean on each other during high-stress situations. One way to do this is to have what Gottman calls a “Stress Reducing Conversation.” These conversations are meant to help the two of you feel like you are on the same page. Let your partner vent about something without placing judgment on them or offering advice. Take your partner’s side in these conversations, which helps your partner feel less alone. Even if you don’t agree with your partner, that is not the time to reveal this, instead, stay empathetic towards why this is hard for your partner. And again, postpone problem-solving, just be a friendly ear to listen and empathize.
If you’re interested in learning more about how to have effective conflicts and communication with your partner, our new clinician, Katie Baker is currently taking couples and would like to hear from you! Katie has completed Level 1 Gottman training and uses the Gottman Method Couples Therapy in her work.
Health Equity News Volume 2 is live now! November’s issue is all about neopronouns.
Enjoy!
https://chrysaliscenter-nc.com/wp-content/uploads/2023/11/Health-Equity-News.pdf
Health Equity News October 2023
Riley and Megan here! We are so excited to bring you the first volume of Health Equity News! We are going to have monthly installments covering different topics within the LGBTQIA+ community. This first edition is centered on supporting trans youth. We sincerely hope you enjoy!
According to a 2020 literature review (Eskander et al.):
- Women with eating disorders are more likely to abuse substances than those with no eating disorders.
- Approximately 12% to 18% of adults with anorexia nervosa (AN) and 30% to 70% of adults diagnosed with bulimia nervosa (BN) have substance use disorders.
- One-fourth of individuals with binge eating disorder (BED) reported substance use disorders.
There are many shared risk factors between substance use disorders and eating disorders. Both are much more common in people with a history of traumatic experiences. They often occur in times of transition or stress. The biological underpinings and genetic profiles are very similar, with both sets of disorders highly correlated with low self-esteem, depression, anxiety, impulsivity, and compulsivity.
The symptom profile of both substance use and eating disorders overlap as well, involving obsessive preoccupation, craving, compulsive behavior, and rituals. Both substance abuse and eating disorders are steeped in secrecy, shame, and social isolation. They are chronic, potentially fatal diseases with high relapse rates, which means they require intensive, specialized, and long-term therapy.
While the statistics may seem daunting, the good news is there is hope for recovery! As with any blog for recovery month, I asked a brave and inspirational client to anonymously share their story. “Sandy” (not her real name) is approaching her six year sobriety date and is in full remission from severe binge eating disorder. Here is what she had to say:
Good old Merriam Webster states a journey is “travel or passage from one place to another”.
I lived a vicious cycle of bingeing and drinking for comfort when I felt “less than” or someone made me angry. Unfortunately, this happened frequently – people’s actions really got on my nerves sometimes. Why couldn’t they act like they had some sense? Why were people so mean and unthinking? Why didn’t situations seem to go my way?
I frequently needed the sense of ease and comfort that came with eating those sugary bites or that first few drinks – I promised myself I could learn to only use my disordered behaviors for comfort when needed – that would be it. The problem was I stayed angry or hurt most of the time because life frequently did not go my way.
It took therapy and another recovery program to teach me about ego, letting go, and prayer. I had to succumb to the fact that there was something in this universe that was more powerful than I was. My job was to accept what I could not control and treat others with love and respect. That’s it. Acceptance and Love.
Letting go of what I could not control is a daily; sometimes hourly practice. But it can be done and you don’t have to do “this” alone. Reaching out for help was the most humiliating, frightening, empowering, self-saving, action I have ever taken. I was coached to give myself the gift of honoring my true needs and wants while learning to have real relationships with other humans.
To those on their journey to recovery, please know that help and support is out there. Chrysalis Center has therapists who are trained in both eating disorders and co-occurring substance use who are here to help.
Eskander, N., Chakrapani, S., & Ghani, M. R. (2020). The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus, 12(9), e10309. https://doi.org/10.7759/cureus.10309
(with throwback photos!)
It’s truly hard to believe that today marks two decades since Chrysalis Center opened its doors. At that time, we were 2 psychologists in a small 3-room office in Oleander Office Park and now we are incredibly grateful to be in a sprawling 4-suite office space in Burnt Mill Business Park employing 12 therapists, 4 dietitians, 1 prescriber, and 4 administrative support team members.
We are also exceptionally proud of the training programs we offer, having precepted numerous interns over the years in a variety of disciplines from several different universities who are able to provide pro bono counseling in our community. We are also a behavioral health rotation for the family medicine residents in our area, teaching future doctors about eating disorders which are highly complex disorders wrought with potential medical complications. Both Kelly Broadwater and Terri Mozingo are approved supervisors for the International Association of Eating Disorder Professionals (IAEDP) and we have several clinicians on staff who are able to supervise associates for their respective licensing boards. In addition to teaching, supervising, and supporting the next generation of clinicians, our ambitious team shares a love of learning and have (or are currently) pursuing various specialty certifications. Most recently, Jen Myers became a licensed Be Body Positive facilitator, Aiereal Lloyd earned her Perinatal Mental Health certification, and Terri Mozingo is a newly minted certified Intuitive Eating counselor.
Outreach is another area we proudly focus on, feeling it’s important to give back to the community, as well as share our knowledge base with other professionals in our disciplines. Since our last anniversary, we have assembled a team that participated in the Cape Fear Heart Walk, we were sponsors of the Wilmington Out of the Darkness Walk associated with the American Society for Suicide Prevention, we collected and donated items to the Good Shepherd Center which supports the unhoused in our area, and we held a networking event for perinatal health professionals and will have a resource table at the upcoming Climb out of the Darkness walk which benefits the NC Chapter of Perinatal Support International.
Our team has also been busy with professional presentations this year. Kelly Broadwater has shared her bariatric expertise with the Carolinas Bariatric Society, the Obesity Action coalition, and in a few weeks will speak at the American Society for Metabolic and Bariatric Surgeons annual meeting. Terri Mozingo and Riley Burns co-presented at the 2023 SEAHEC Pediatric Symposium in March and Alaina Van Gelder led a four-hour training at the 2nd Annual Southeastern Behavioral Health Summit in May.
Another exciting development in the past year is our Health Equity Initiative, headed up by Riley Burns and Megan Vaughn, focusing on providing affirming care to LGBTQIA+ clients. Understanding that this population has unique needs when it comes to mental health support and eating disorder recovery, we are striving to better meet those needs via staff training and providing more inclusive programming. This year we launched an Embodying Queerness group led by Kaelin Kennedy for LGBTQIA+ clients, focusing on building trust and pride in their bodies.
Hopefully this synopsis demonstrates just how committed we are as an organization to our values of quality and teamwork! Speaking of quality, we’d be remiss not to acknowledge and honor the memory of one of our founders who passed away in 2022, Dr. Kiersten Nash (Okine) Andersen. Kayj was a counseling psychologist and eating disorder specialist who took both our executive director and clinical director under her wing early in our careers and taught us so much during our time as our supervisor. Her passion for teaching and love of learning was truly foundational to key members of our team and we hope that her legacy lives on as Kelly and Meghan both supervise future clinicians and eating disorder specialists.
I am humbled to be writing this blog and reflecting on the growth of Chrysalis over the past 20 years and the amazing accomplishments just in the time since our last anniversary. I hope that we continue to embody our mission, vision, and values and “Restore Hope” and “Empower Change” for many years to come.
Is yoga actually good for treating eating disorders? If so, why? And which style is the best for recovery? As a yoga practitioner myself, these are questions I’ve set out to answer by combing through studies that asked the same questions. Lucky for me, in recent years, yoga has been empirically explored as an intervention for treating eating disorders (ED) such as bulimia nervo
sa (BN), binge eating disorder (BED), and anorexia nervosa (AN) (Brennan et al., 2020; Diers et al., 2020; Pizzanello, 2021). The following are highlights from recent research that indicate yoga’s effectiveness in ED treatment.
The Mindfulness Movement: A Catalyst for yogic interventions
In more recent years, mindfulness-based interventions such as meditation have come on the psychotherapy and ED recovery scene. Mindfulness has proven to help with many biological and psychological functioning including emotional regulation and body awareness – two big factors in EDs and ED recovery (Diers et al., 2020). Yoga as an intervention for ED comes from the recent implementation of mindfulness techniques in treatment and recovery (Brennan et al., 2020).
Eating disorders are associated with a disruption in emotional regulation, poor body image, and the inability to experience emotions and body sensations, including hunger and fullness cues. The mindful movement aspect of yoga can help people begin to feel body sensations, become more aware of emotions, and tolerate emotional distress as they learn to tolerate the body positions experienced in yoga practice (Brennan et al., 2020; Diers et al., 2020; Pizzanello, 2021). The idea that body sensations accompany most if not all emotions (Pizzanello, 2021), provides a strong argument that body-based interventions for ED can help patients increase emotional awareness as they mindfully awaken to their bodily sensations through yoga (Brennan et al., 2020). Equally important is the fact that body awareness also helps people experience hunger and fullness cues which is an important element of ED recovery (Pizzanello, 2021).
Which style of yoga is best for recovery?
Yoga practices that emphasize awareness of internal experiences including physical sensations, thoughts, and emotions can be most helpful for ED recovery. One research study used Kripalu yoga, which invites practitioners to accept these internal experiences without judgment (Brennan et al., 2020). Mindfulness and self-compassion were encouraged in each class.
Finding a studio that is non-competitive is important for ED clients. Starting yoga in recovery could trigger over-exercising or the inclination to engage the “yoga lifestyle” (i.e., strict diet and exercise regime), which can mirror ED behaviors for those with EDs. Thus, having an instructor and yoga community that is non-competitive and encourages participants to listen to and be gentle with their bodies is key for those in recovery. Research shows that practicing yoga in a recovery group with processing afterward is ideal, especially for those newer to recovery (Brennan et al., 2020). For those who choose to do yoga outside of a treatment center or group, it is advised to process the experience with your therapist.
Bottom-line
Yes, yoga has been found to be a potentially beneficial intervention for treating EDs. Yoga’s focus on mindfulness of the body and emotions can help those with EDs to begin to feel and appreciate their body. Doing yoga as part of recovery should be processed with a therapist and should be sought in a safe, non-competitive environment. The Chrysalis Center offers gentle yoga for those in recovery for EDs. If you are interested in incorporating yoga into your recovery, speak with your treatment team about the best way to start your yoga practice.
References
Brennan, M. A., Whelton, W. J., & Sharpe, D. (2020). Benefits of yoga in the treatment of eating disorders: Results of a randomized controlled trial. Eating Disorders, 28(4), 438–457. https://doi.org/10.1080/10640266.2020.1731921
Diers, L., Rydell, S. A., Watts, A., & Neumark-Sztainer, D. (2020). A yoga-based therapy program designed to improve body image among an outpatient eating disordered population: program description and results from a mixed-methods pilot study. Eating Disorders, 28(4), 476–493. https://doi.org/10.1080/10640266.2020.1740912
Pizzanello, H. C. (2021). An exploration of yoga’s potential to incite feelings of aliveness and authenticity in women recovering from anorexia nervosa. Smith College Studies in Social Work, 91(4), 324–363. https://doi.org/10.1080/00377317.2021.1976698
