Recipe For Recovery

Today’s guest blogger was a panelist at the Statistics to Solutions co-hosted by Our Young Addicts and Know the Truth in May 2017. She points out the reality of co-occurring disorders in young adults, such as eating disorders and substance use. MWM

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As a psychologist specializing in the treatment of eating disorders for the past 13 years, we are seeing more and more individuals in eating disorder treatment programs who suffer from both an eating disorder and a substance use disorder. In fact, we know that between 30-50% of individuals with an eating disorder also struggle with a substance use disorder and vice versa. This includes men and women of all ages and backgrounds-eating disorders and substance use disorders don’t discriminate! Often times the substance use disorder and eating disorder are intimately intertwined and if you try to treat one disorder, the other disorder is likely to get worse. This can certainly complicate treatment and it is important to consider this as you navigate your journey to recovery.  

I wrote this piece, “Recipe for Recovery,” a few years ago for eating disorder awareness week. I think it is perfect for not only those struggling with eating disorders but those who may be struggling with a substance use disorder or really any number of mental health disorders. When you see the word eating disorder below, feel free to substitute it with substance use disorder, depression, etc.

When I think about what it takes to recover from an eating disorder, it is really many things working together … it is not just getting treatment, being motivated, or having a good support system.

It actually reminds me more of a recipe. Recipes are something we usually think of when we think about cooking but I would throw out to all of you that we use “recipes” in many areas of our lives. Whether it is getting into college, developing your career, being in a relationship with someone, or parenting a child. These all require several steps or components to be successful.

Webster tells us that the word recipe means:

  1. A set of instructions for making or preparing something
  2. A medical prescription or
  3. A method to attain a desired end

I think this really fits for the journey of recovery, similar to cooking, recovering from an eating disorder takes a cup of this, a dash of that, and a pinch of something else. When you get all of the ingredients in the mix, there is an incredible life of opportunity and experiences waiting for you.

I asked several people that I have worked with over the years about some of their key ingredients to recovery so I could share some of their insights. I wasn’t too surprised to learn that people didn’t feel like it was an isolated thing that got them to recovery but rather several things coming together over time that led them to a life free of their eating disorder.

First, everyone felt like their formal treatment was an important piece. Without that as a foundation, recovery would not have happened.

Another element that people viewed as an important ingredient was willingness. Whether that means trying treatment, doing things that are scary, trying a different treatment approach if things aren’t going well or trying new things in life, willingness played a key role in their recovery. One individual shared: “Maybe you’re not completely 100% on board with getting rid of your eating disorder, and that’s OK, but you have to be willing to learn new things and consider new perspectives on your body, your thoughts, your emotions and the world you live in. I really thought the world was black and white; I either did things wrong or I did them right, and there was only one right way to live your life. Learning about gray areas and the complexities of living life were really beneficial to me.”

Trust was another important item, and it took many different paths. For some it was trusting their treatment providers, for others it was trust in themselves that they could do what they needed to do and it wouldn’t be the end of the world.  Others mentioned learning to trust their body-the idea that if we take care of our bodies, our body will take care of itself.

Another significant item that everyone mentioned was trying new things in order to develop a new identity outside of the eating disorder. One individual shared with me “I was a passionless person and didn’t really care about anything except losing weight and doing everything right. When I was physically healthier, it helped me tremendously to care about something outside of myself.”

Related to this, people found that when they developed new interests outside of their eating disorder, it also helped connect them to people, which played a big role in their ability to move beyond the eating disorder.

Patience and priority were two other items. Patience in that getting to recovery often takes people longer than they ever anticipate with twists and turns along the way.  Priority in that we all live in a very busy world with a lot going on but figuring out how to prioritize recovery so that it gets the time and attention it needs rather than trying to fit it in around other things.

So today I would encourage all of you to think about what are your key ingredients to recovery? What do you already have and what might you need to add to the mix? No matter where you are along your journey, everyone has some of the ingredients they need to start to build their recipe for recovery.       

 

About the Author: Screen Shot 2017-07-11 at 11.37.21 AM

Heather Gallivan, PsyD, LP, is the Clinical Director at Melrose Center. She joined Melrose in 2004 and has helped eating disorder patients recover and realize their full potential in all levels of care from outpatient to residential treatment. She is a passionate leader and teacher concerning the prevention and treatment of eating disorders, and how societal messages impact our beliefs and attitudes about food, weight, and body image.  You may have seen her passion for education and expertise on display in the local media or as a speaker at a state or national conference for healthcare providers. Prior to joining Melrose Center, Dr. Gallivan served 5 years in the Unites States Navy as an active duty psychologist. In addition, she teaches a course on eating disorders at the Hazelden Betty Ford Graduate School of Addiction Studies.

Melrose Center heals eating disorders, with locations in St. Louis Park, Maple Grove and St. Paul. Melrose treats all eating disorders in all genders and ages, through outpatient and residential programs. Specialty programming is available for those struggling with an eating disorder and substance abuse. The program includes individual and group programming focused on treating the eating disorder and substance use disorder together by professionals specially trained to work with both conditions. Visit melroseheals.com.

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

 ©2017 Our Young Addicts   All Rights Reserved.

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Taking an AND instead of OR perspective: The Minnesota Model 2.0

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Melrose Center, an eating-disorder specialty clinic in the Twin Cities, was a generous sponsor for our addiction-prevention conference in May 2016. Today’s guest blogger is Jason Reed, one of our panel experts who addressed solutions to co-occurring disorders, which are common among young people with addiction.He’s prepared an encouraging and thought-provoking perspective on why we need to find the best approaches to treatment rather than being pressured into a rigid acceptance of just one way. MWM

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.” Scott Fitzgerald

 

 

Minnesota is the land of 10,000 lakes, and some would say, the land of 10,000 substance abuse treatment centers. The actual number of treatment centers is actually more like 500. Regardless, Minnesota put addiction treatment on the map by developing the very first formal treatment approach for alcoholism and other substance use disorders. It’s called The Minnesota Model and has been replicated across the world and has helped millions of people. The 12-step philosophy of AA and NA is an integral component of the Minnesota Model.

As a psychologist working primarily in the area of addiction, I often hear 12-step programs pitted against evidence based treatments such as Cognitive Behavioral Therapy (CBT).

It’s as if as a clinician, I have to somehow choose a side, and then stick to it. It’s 12-steps or CBT.

At this point in my career, I’ve grown weary of the word or. In CBT the tendency to think in either/or terms is called “black and white” or “dichotomous” thinking. This can lead to a lot of mental and emotional suffering. Modern American society is full of examples of headline-driven questions that make us feel forced to chose a side: do guns kill or do people kill? Are you a Republican or Democrat? We get put in an either/or dilemma.

Most rational and reasonable people would likely concede that when trying to understand a phenomenon, it’s best to take an approach that can account for multiple variables and potential influences. However, we as humans seem to have a natural tendency or desire to align ourselves with a particular side or “camp”.

In the field of psychology, our camps are based on different theories of the mind and human behavior. Theories are useful and necessary, and serve as a framework for trying to understand these things.

However, holding onto a particular theory too tightly can sometimes cause us to miss the forest for the trees.

The field of psychology has also at times fallen victim to dichotomous thinking when trying to understand the origins and treatment of human suffering. This has led to questions such as: is it nature or nurture? is early attachment or temperament more important? Are mental health problems best described in categories of symptoms or better understood on a continuum? Is it the technique or the skill level of the clinician that produces change? The list goes on and on. Intuitively we know the answer is probably somewhere in the middle, but we still feel pressure to cling to one particular camp.

 

During graduate school I felt pressure, mostly from myself, to come up with my own unique theory of human behavior and treating mental health disorders. And I thought I had it figured out by the end of my training. Now over a decade into my career, I’m realizing that I know much less now than I did back then. My theory is much less clear. And I think that’s a good thing.

I now teach at the school I graduated from. For one of the courses I teach, Counseling and Personality Theories, I intentionally start the semester off by discussing some of the existing research that indicates the theoretical principle you pick makes less difference than other variables such as the therapeutic relationship and client factors.This forces students to sit with the frustration of not having a simple, clear answer, and to instead appreciate the complexity of human behavior and the process of change.

Addiction, and in particular the behaviors that arise from addictions, are among the most complex and confusing of all human phenomenon.

The addiction field has to grapple with some of its own often befuddling questions:

Is addiction a chronic, progressive disease that requires intervention or do most people get better on their own, without treatment?

Are substance use disorders caused by genetic factors (biomedical model) or are they the result of trying to cope with difficulties in life (self-medication model)

Is complete abstinence necessary for full recovery or can people live a quality life while still using substances?

Should family members detach and protect themselves as not to enable the addiction, or can they influence the behavior of their addicted loved one?

Do you need a personal history of struggling with addiction to be able to understand and treat it, or do you need a high degree of training and professional licensure?

We have some big questions facing the addiction field and how we are going to evolve our understanding, prevention and treatment of addiction. Perhaps the least helpful response to this profound conundrum would be to fall back into black and white thinking and look for simple answers and then divide into camps.

In many ways there is still a lot we don’t understand about addiction. Most experts can’t even agree on a shared definition of addiction. And there are many, many different pathways to addiction.

One of the greatest advances in behavior therapy over the last several decades has been Dialectical Behavior Therapy (DBT). Created by Marsha Linehan and now disseminated and used all over the world, DBT has been shown to be effective for a variety of difficult to treat conditions. The philosophy of the approach is based largely on the idea of a “dialectic”, which assumes everything has its contradictions or opposing forces. In essence it involves the art of holding two opposing ideas in mind; specifically with DBT, balancing change with acceptance. Approaches like DBT have taught us the importance of balance, and the power of the word and.

The ultimate dialectic in addiction treatment may be that you need to treat the addiction as a primary disorder and the underlying factors that drive it to keep going. When we can’t prevent it, people suffering from addiction deserve the best possible treatment we have available. And we will only arrive at the most effective treatments by bringing everyone together from all the various camps and disciplines.

It may be time to take a step back from what we think we know about addiction, and come together to better understand it.

We will need to have some difficult conversations and we will need to bring people together who have very different ideas about addiction and how to treat it. Going through this process will be a good thing for the addiction field, but more importantly, for the individuals and families at risk for, or currently struggling with addiction. We owe it to future generations to put in this difficult, messy work, so we can come out with something even better.

Then, from our combined efforts, we can build a truly integrated treatment approach and we can call it The Minnesota Model 2.0.

Dr. Jason Reed is an Addiction Psychologist, Adjunct Professor and founder of the Minnesota Integrative Treatment and Recovery Enterprise (MinCARE). MinCARE is a consulting, training and advocacy organization committed to improving the quality of care and outcomes for all individuals struggling with addiction and co-occurring disorders in the state of Minnesota.

www.mincare.com

info@mincare.com

©2016 Our Young Addicts   All Rights Reserved.

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.