Jul 29, 2015
Marion MacDonald

“Kick Your Eating Disorder’s Butt!”

We have just received an incredible letter from a 15-year-old describing her descent into anorexia, and her recovery at Mirasol. This very courageous young woman and her family have generously allowed us to reprint her letter in the hope that it will inspire other struggling teens to “Kick Your Eating Disorder’s Butt”.

a teen's eating disorder recovery

By MA

When my parents told me that I had to go into a residential treatment center, I was not happy. But I’m so glad I did. And this is why.

I am 15 years old and have suffered with anorexia nervosa for the past year. Let me tell you, though, that year was HELL. I can’t pinpoint the time it exactly started, but I can say the time where I started my diet. That was in March of 2014. I started wanting to eat healthier. At first, it was like that. I incorporated more vegetables and I would try new food. I had days where I would get dessert and eat a little more. I did that for about two months. Then, I slowly started going downhill. The thing is, I didn’t even know I was going downhill until I realized I was so deep down into “the hole” (which is what I would call it). I was NEVER fat to begin with. It’s just that perfectionism part of me always wanted me to be this really unrealistic human being. I kept going on this “diet” and slowly started to cut out chocolate, cereal, desserts, pasta, pizza — all of the foods that I once loved.

In August of 2014, I moved to Arizona and that’s when it got REALLY bad. I could see every bone there was in my body and quite frankly, it disgusted me. I wanted to get better so badly. I just didn’t even know where to begin. My eating disorder was telling me to stay eating the way I was so that I wouldn’t gain weight, but all I would do was lose weight. I didn’t want to lose weight, I just wanted to maintain my weight. Overall I had lost a total of 32 lbs. and for my height, and how active I was, that was not acceptable. I was on a cross country team until my doctor pulled me out of the team. I was very upset.

In September, my parents decided to get me a pediatrician who specializes in eating disorders, a nutritionist, and a therapist. I would see them all once a week. Whenever I would see them, I would get really motivated and excited to get through this, but then when I would leave, I would just go back into that mindset.

Months passed and I got admitted into Mirasol at my lowest weight. It was very challenging and the most definitely the most difficult time of my life. But it was so worth taking some time for myself to help me get back on track and straighten up my life. I loved how we all had our own individual meal plans, and the food was AMAZING. We would get a variety of foods and even though I am an extremely picky eater, I managed to get through it 😉

If you’re reading this, and you’re thinking about going to a treatment center, or your parents are already making you go to one, PLEASE COME. You will be the happiest you will ever be, trust me. I am in recovery and even though it’s been tough, it’s been so worth it. And I would recommend this place to ANYONE for help. You are worth it. Kick your eating disorder’s butt and choose recovery… because it’s amazing… :-)

You’ll find more recovery stories on Mirasols’s web site.

Jul 21, 2015

Take-Aways from Our Time in the Wilderness

Photo of orange mushroom with a bugWe have just returned from another weekend of camping and hiking with Mirasol’s teen clients. We’ve done it many times now, so we have the packing pretty much down to a science, even with the special requirements of camping with clients who are in various stages of recovery from an eating disorder.

What is less predictable, and much less subject to planning, is what we bring home once the tents are folded and the chairs are stacked. What special moments, new understandings, or closer connections will become part of the story of recovery for a struggling client?

High in the Catalina Mountains above Tucson, it’s all about connection: to self, to each other and to the larger world. Clients often report a clearer sense of self, and a yearning to be themselves without the barrier of their eating disorders. Being on a trail, moving through space, time and terrain — those elements combine to create a powerful yearning to be who we really are, without the smokescreen of the eating disorder, and its attendant anger, disappointment or depression.

This realization may strike with a clarity that derives its power from an environment that challenges them to do more than they thought they could, and to see themselves as “more” — more capable, more brilliant and more worthy.

Photo of a horny toadThe physical demands of hiking, setting up camp, reacting to the weather and spending the night outdoors often create a stronger connection to others. This magnifies the relationships clients were already building with each other and with staff. Clients often report that they had no real friends before coming to Mirasol, but they now recognize true friends among their fellow clients, and they are beginning to understand the value of friendship. This sense of bonding and shared experience not only follows them back to treatment, but may form the foundation for life-long friendships.

As we take our clients from all over the globe from the desert floor to the summits of ancient mountain ranges, we move through a landscape which may be novel and full of surprises. Flowers, butterflies, trees, birds, wildlife of all sorts, intimate woodland alcoves and sweeping desert vistas inspire a profound appreciation of the beauty and wonder of the natural world. Around a blazing fire and under a canopy of stars, we experience emotions that have stirred humanity since the dawn of time. Clients are often surprised by the suddenness and power of those feelings. Returning to Mirasol, they have the opportunity to express themselves through art, music and writing. Some clients may discover passions that will enrich the rest of their lives.

Whatever a client’s individual experience, a trip to the wilderness provides many valuable jewels to pack in the backpack and call upon as the journey into recovery continues.

Jul 20, 2015
Marion MacDonald

Beyond “He” and “She”: Teens and Gender Identity

teen gender identityGender identity has become a hot topic in the mental health field. It’s of special concern for eating disorder professionals, since new research indicates a far higher incidence of eating disorders among transgender and gender fluid young adults.

The Gender Spectrum

Individuals are typically assigned one of two genders at birth, based on external genitalia. However, gender is multifaceted, not binary, and many individuals fall somewhere in between.

Gender Identity Terms:

  • Gender fluid: Gender identity that may change over time
  • Non-binary: Used to describe people whose gender in not strictly male or female
  • Transgender: For people whose gender identity differs from the sex or gender they were assigned at birth.

There are many possible explanations for the high correlation between gender fluidity, negative body image and eating disorders. For example:

  • Rejection or fear of rejection by friends and family members
  • Negative self-image based on non-conforming gender expressions or transgender identity
  • Violence or bullying can contribute to development of post-traumatic stress disorder, which sharply increases vulnerability to eating disorders
  • Lack of body acceptance or desire to have a body appear differently
  • Lack of support from family and friends

“Sensitivity to concerns about gender identity is important to us,” says Jodi Tudisco, Clinical Director for Mirasol’s teen eating disorder treatment program. “We’re recognizing that we need to adjust some aspects of our program, for example, the gender identification section on our intake form and the use of gender pronouns.”

Mirasol therapist Jenna Jarrold agrees. “We’re very open to not labeling clients by gender. It takes time for staff to learn to use gender-neutral pronouns, but it’s important to show clients that we are making an effort.”

There’s some helpful information on the use of gender-neutral pronouns at genderneutralpronoun.wordpress.com.

Exploring Gender Identity in Treatment

“Clients admitting to treatment have lost themselves to their eating disorders,” says Tudisco. “Our job is to help clients find themselves. As part of the process of self-discovery, teen clients are likely to look at all aspects of themselves, including gender identity and sexuality.”

Tudisco advises parents of children and teens exploring their gender identity to focus on providing support. “The most important thing parents can do is to be open to learning about their children while they discover who they are. This kind of validation from parents can become a powerful tool in helping clients accept and love themselves.”

If a client chooses to inform family members about gender identity during the course of treatment at Mirasol, therapists work to support both the client and the parents through this process. As Tudisco explains, “We don’t treat gender neutral or gender fluid clients any differently than other clients, because ultimately treatment is about acceptance and self-love.” Tudisco goes on to say, “Rapidly changing attitudes toward gender identity create an opportunity for staff to improve the way we role model. The behavior I want to model focuses on the individual rather than a gender label.”

Jul 14, 2015
Jenna Jarrold

My Child is Coming Home. Now What?

If you’re nervous about your child’s return home after residential treatment, you’re not alone. Transitioning to life in the real world can be very challenging. You want to recreate everything that worked during treatment, but how do you do that and still live a normal life?

It might help to remember that a big part of your child’s successful treatment began with a solid plan. The same holds true for life after treatment. Your loved one needs a recovery plan that incorporates realistic goals and ongoing support.

At Mirasol, we do everything to make the transition as easy as possible, for both the child and the parents. Prior to discharge, Mirasol’s aftercare coordinator will assemble a team of specialists in your home town who can provide the services you need to help your child stay in recovery. As the discharge date approaches, your treatment team will make a recommendation regarding the next level of care, be it PHP, IOP, or outpatient care.

  • Partial Hospitalization Program (PHP): Typically involves full days of programming (4-7 days per week) while the client lives at home or in a peer-supported residence.
  • Intensive Outpatient Program (IOP): Programming can be anywhere from 10-15 hours per week, consisting mostly of groups and individual counseling.
  • Outpatient Care: Minimum level of care typically includes individual therapy 1-2 times per week, a weekly support group, individual nutrition counseling and other modalities (acupuncture, Reiki, etc.).

Continuity of care is extremely important, so your teen will go home with a full record of the stay in residential treatment, including meal plans, weight progression, medical notes and psychiatric evaluations. The Mirasol team will stay in touch with the new treatment team, sharing information regarding the client’s overall progress, challenges, barriers to recovery, specific interventions and goals.

As parents, you are the most important members of your child’s recovery team! Your ability to support your child will depend on your ability and willingness to seek support for yourself. Mirasol often offers referrals for parents as well, such as therapy, Al-Anon meetings or support groups where you can hone the healthy coping, emotion regulation, and improved communication skills introduced during our family therapy program.

Red Flags

Before your child goes home, the Mirasol team will make sure you are aware of any “red flags” or warning signs that may signal a return to eating disorder behavior.

Red Flag Examples:

  • isolating from friends and family, or events
  • more prominent or obsessive exercising
  • becoming secretive, especially about food or meals
  • increasing criticism of their body or others’ bodies

If you notice these (or other) red flags, contact your teen’s new treatment team and alert them to your concerns. Additionally, parents and other family members can always reach out to Mirasol’s aftercare coordinator, who will remain in contact with your child for one year after discharge, with any questions or concerns they may have regarding their child’s eating disorder recovery.

Don’t Panic

An occasional return to maladaptive behavior — skipping a meal, engaging in a binge or purge episode, or over-exercising during a workout — is often part of the recovery process, and it doesn’t mean your child is relapsing. Mirasol clients leave treatment with a “Slip Plan,” which includes steps to take immediately following a slip:

  • exploring why the slip happened
  • reaching out (telling someone)
  • getting back on track (back on meal plan, exercise plan, etc.)
  • forgiving yourself

For parents, it’s important to support your child during this tough time. Be careful not to shame your child. And remember, if you have questions, contact your child’s new treatment team or the Mirasol team!

Dos and Don’ts

As a parent, you want to make your child’s transition home as smooth as possible. Every client is unique and each transition is different, but there are a few things that parents should keep in mind:

  • Make sure your child has agreed to a daily routine/schedule (this can include school, activities, therapy appointments, chores, leisure time, etc.)
  • Identify the difficult times of day for your child and the supports can you put in place.
  • Determine the level of independence you should give your child (ask the Mirasol treatment team if you need help).
  • Discuss your own fears about your child’s transition with the Mirasol treatment team.
  • Make sure you have adequate support systems for yourself.
  • Most importantly, talk with your child about what you can do, and how you can make coming home easier.
  • Make sure you have contact information for the aftercare coordinator in case you have questions or need assistance.

Reduce Mealtime Stress

Mealtimes can be one of the most stressful times for families with a child returning home from residential treatment. However, preparing yourselves in advance for potential difficulties can reduce the stress level.

  • Establish and maintain a routine around mealtimes, especially in the early weeks of recovery.
  • Plan meals in advance and invite your child to grocery shopping with you.
  • Try to eat with your child to demonstrate that eating a meal is a normal and necessary part of the day. Try to normalize the act of sitting down to a meal.
  • Avoid any comments on calorie content, weight and portion size.

Build Your Relationship

Building a better relationship with your child is the key to long-term recovery. Here are simple things you can do to establish and maintain a healthy relationship:

  • Spend time with your child, doing things the child enjoys.
  • Listen when your child is speaking, and show that you value your child’s opinions.
  • Acknowledge abilities and talents your child has, particularly ones that aren’t “physical.”
  • Focus compliments on your child’s personality and individuality rather than on appearance.
  • Work with your child to identify friends who can provide support and respect. Encourage your child to spend time with those friends.
  • Examine your own attitudes to body image, and to yourself (your child will pick up on these).
  • Keep lines of communication as open as possible.
Jul 8, 2015
Marion MacDonald

Backpacking and Recovery

Backpacking is lot like recovering from an eating disorder. It’s a long uphill climb with a lot of baggage. Sometimes things get pretty hot, and you may experience an occasional breakdown.

And so it was the day we left for Mirasol’s second backpacking trip with clients. This time of year, going anywhere outdoors means traveling to higher ground, since temperatures in mid-June here in Tucson were topping 110 degrees. We set our sights on Arizona’s Mogollon Rim, a 200-mile-long wall of sandstone and limestone that slices diagonally across the northeast corner of the state and divides it into two distinct regions. The Rim is home to North America’s largest stand of Ponderosa pine, and also gives birth to dozens of permanent streams that tumbles over the cliffs and water the canyons of southern Arizona. Between the generous canopy of trees and opportunities to splash in an icy stream, we figured we’d be okay to hike, even with temperatures in the mid-90s.

About 100 miles out of town, one of the vehicles broke down, so we sheltered everyone in the shade with plenty of water while we ordered a tow truck from Tucson and made a mad dash into nearby Globe to rent another SUV. I think most people would have given up and gone home at that point, but we pushed through, and we were rewarded for our perseverance with a delightful weekend in the mountains.

More challenges — and more lessons — lay ahead. In an open pasture under a full moon that night, we were all reminded how important it is to stay close and take care of one another. The next day we trekked to a shady campsite next to a gushing spring. Sometimes the solution is flowing right there at your feet, but you still need to pump it up and take it in!

It was a great trip that gave us many opportunities to practice the skills we learn in treatment, including controlling anxiety, being prepared, overcoming obstacles and taking care of ourselves and others. I hope the memory of that sparkling cool stream will serve as a reminder that there’s a big payoff for perseverance, patience and teamwork.

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