Jan 27, 2016
Marion MacDonald

Jenn’s Story: Learning to Put Recovery First

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RECOVERY FIRSTIn 2012, a series of traumatic losses turned Jenn Ryan-Jauregui’s life upside down. Suffering from anorexia and PTSD, she sought treatment at an eating disorder program in Oregon, where she was living at the time.

“I was in a couple of PHP programs there, and also one stint in a residential program,” she recalls. “My husband and I moved here, to Tucson, in April of 2014, because we wanted to be closer to his family and some of my family, and by the time I got here I was already really back into my eating disorder.”

Two weeks later she was admitted to Mirasol’s adult residential program.

It’s Not Just About the Food

“The other programs were helpful in terms of where I was at in my recovery at the time,” Jenn says, “but this program was more helpful because of the body work component and a more individualized treatment plan. I think the thing that helped me the most was being able to work through the trauma through EMDR, and also starting to find ways to be more comfortable in my body. The program I was in before focused so much on how to have a healthier relationship with food, but not with your body. It was amazing that TRE — the trauma releasing exercises — was as helpful as it was, because it was really hard for me to do. I would dissociate completely during the sessions, but staff was very supportive and good at getting me through that part of it.”

Insurance Pulls the Plug

Unfortunately, as so often happens with eating disorder treatment, Jenn’s insurance company pulled the plug as soon as her health began to improve.

“I was only in residential for three weeks, I got stepped down prematurely, I ended up going to PHP and I wasn’t ready for it. My therapist fought and dug her heels in, and they let me go back to residential, but only for another three weeks.”

“When they stepped me down the first time, I was so baffled! I wasn’t thrilled about getting stepped down to PHP the second time, either, but I made the best of it, and I felt like I had a lot of extra support from the staff at Mirasol, and that got me through.”

“I was in PHP from the end of June until the beginning of September, and in IOP until the beginning of December. But when I was in IOP, Mirasol continued to allow me to receive EMDR. Since I was allowed to receive some kind of treatment for seven months, I built up a lot of skills. And I made sure I had a really strong treatment team coming out.”

I think what made the difference this time is that I finally learned how to put my recovery first …. I have learned to recognize what I need for myself at any given moment and to honor that, and not care what other people think.”

“I’ve been at recovered weight now for 18 months. I think what made the difference this time is that I finally learned how to put my recovery first. I ran into a lot of barriers. My family was upset that I was going back into treatment. They didn’t know how to handle it, and I felt really abandoned. So now I have much stronger boundaries. I have learned to recognize what I need for myself at any given moment and to honor that, and not care what other people think. If I think something is going to be overwhelming, I say ‘no’, and I do whatever I need to do to stay healthy.”

Jenn also made careful choices when it was time to go back to work.

“I knew when I went back to work that I wanted to do something related to non-profits or higher education. But I was also very mindful that the amount of stress I was under in my last position, when I was working full-time, was not healthy for me, and it helped contribute to my eating disorder.”

With a strong technical background, Jenn was offered a full-time job as a business analyst, but she convinced her employer to let her work 30 hours a week.

Jenn’s advice for someone who is struggling to recover from an eating disorder?

“Don’t give up!”

“I felt like Mirasol was my last shot. I had been in and out of treatment at that point for a year-and-a-half before I got there, and I would immediately relapse every time I got out. I never had even a few weeks of solid recovery. So I would just say ‘don’t give up, give yourself another chance.'”

“I feel like I’m really blessed that I had the opportunity to go to Mirasol. It’s a really supportive environment. All the staff are really compassionate and invested in your well-being, and there to help, and they treat you as an individual, and that means a lot.”

“I never thought [life] could be this good. My biggest thing for a long time was that I didn’t feel like I had a reason to go on living. But now I have found other reasons, including poetry.”

Jenn started writing poetry — mostly mico-poetry and Haiku — in PHP, and is now very involved in a community of poets on Twitter.

“They have a whole community of poets, I follow them, they follow me, and we inspire each other. I write poetry every day. Some of it is recovery-focused, and some of it is just fun stuff.”

“I feel like I’m really blessed that I had the opportunity to go to Mirasol. It’s a really supportive environment. All the staff are really compassionate and invested in your well-being, and there to help, and they treat you as an individual, and that means a lot.”

You can find Jenn’s poetry on Twitter at twitter.com/jennfel. Here are a few samples:

Desperate, alone
Staged her own intervention
Showed up for herself

No longer imprisoned
In a cage made of sharp bones
Curves become her saving grace
Path to liberation

Jan 23, 2016
Marion MacDonald

“Reflections:” A Powerful Tool for Healing Relationships, Developing Personal Responsibility, and Moving Forward in Recovery

“People who continue to do their work, stay out of their behaviors and stay in recovery do ultimately get to a place of freedom. And that’s really the goal, it’s about freedom. But if you’re going to be free, you have to be responsible for your reality.”

That’s how Mirasol Executive Director Diane Ryan introduces a staff workshop on “Reflections”, a form designed to help clients analyze their reactions to triggering events, so that they can make choices about how they respond.

“We developed this form several years ago to facilitate communication at Mirasol’s family program,” says Ryan, “and since then it has expanded to become one of the primary tools that we use here at Mirasol.”

The form begins by inviting the subject to describe a neutral event and explore their reaction to the event, including how they experience it in their bodies. Gradually, they examine the narrative they attach to the event based on their core beliefs, and the cycle of self-destructive behaviors that can result from that narrative.

Mirasol Primary Therapist Katie Klein provides a concrete example:

“Suppose when you walked in the door this morning, you didn’t say ‘hello’ to me. Based on my perception of that event, I might conclude you’re mad at me. That’s just my perception, but I’m adding meaning to it. So where do I feel that in my body? I feel tightness in my chest, because I think, ‘you don’t like me, probably because I’m not worthy of being liked’. And that makes me feel hopeless. So I might isolate or act out in an eating disorder, or use drugs. This is what happens a lot with eating disorder clients.”

Ryan says the “Reflections” form is the philosophical foundation of the work that we do at Mirasol.

“One of our core values is to encourage our clients to take responsibility for their thoughts, for their feelings, for their actions, for the decisions that they make, for their lives, and for their recovery.”

Some Mirasol staff members actually keep copies of the form in their notebooks.

“If you use them regularly,” says Klein, “you will definitely see a pattern. It all comes back to your core beliefs.”

Mirasol Staff Workshop on Using the “Reflections” Form — January 22, 2016

The “Reflections” Form

The only thing we can truly know is ourselves, and yet we all have to interact with others to discover who we are.

“I would like to share some thoughts and feelings with you. I understand that these are my perceptions and mine alone, and that you may see things differently.”

“Certain events, circumstances and situations create strong emotional reactions within me (“triggers”). For example …”

“In my body, I experience this as …”

“Then, I think …”

“Because I believe …”

“This causes me to feel …”

“And as a result I …”

“Which creates impacts on my life and my relationships in these ways …”

“I can see that this reminds me of other situations and events in my life, such as …”

“As I focus on you and the event, I can see the reflections of myself in you in this way …”

“In my desire for recovery and improved connections to myself and others, in the future I will …”

“I am deeply grateful for the opportunity to share my perceptions with you and to learn more about myself. I love and respect you just the way you are.”

© 2016 Mirasol Eating Disorder Recovery Centers

Dec 16, 2015

The Best Present: The Neurobiology of Giving

giving back

As it turns out, what every six-year-old knows about the holidays turns out to be true: when it comes to the meaning of Christmas, it IS all about the presents. Or, at least about the giving. Numerous longitudinal studies provide compelling evidence that acts of giving, kindness and generosity improve physical and emotional health across the lifespan. Volunteering stimulates a release of oxytocin, producing feelings of well-being, warmth, and even euphoria. The effect of volunteering on cortisol levels decreases stress, with its well-documented relationship to health.

Steven Root, in his book “Why Good things Happen to Good People,” reports that — controlling for other lifestyle factors — older individuals who volunteer an average of four hours a week experience a 44% reduction in mortality. Similar results have been reported for individuals with chronic pain and chronic illnesses such as cardiovascular disease, cancer and multiple sclerosis.

Giving is also a gift that keeps on giving. Watching a video of Mother Theresa and orphans in Calcutta stimulates similar impulses to give and to be kind. The act of observing others volunteering appears to have a contagious effect, perhaps inspiring others to act through the agency of mirror neurons.

Interestingly, this effect does not follow a straight line. It is not true that the more giving, the greater the effect. Too much giving, like too much of most things, has a negative effect, throwing the individual’s system out of balance.

For this holiday season, give yourself the gift of giving. Focus on others — family, friends, coworkers, strangers. Giving to a cause that moves you is an invitation to expand your joy and increase your feeling of belonging to those around you. For those in recovery, the mindfulness and connection these opportunities provide are precious gifts, not just for the holidays but for a lifetime.

Dec 11, 2015
Marion MacDonald

Having Faith: A Mirasol Client Video Testimonial

In this video testimonial, a recent alumnus of Mirasol’s teen eating disorder program speaks frankly about her initial concerns, and how she overcame her fears and learned to trust her therapist, her fellow clients, her family and herself.

“I didn’t really choose to come here,” Faith confides. Having never been in treatment before, she was surprised to find herself in a comfortable, home-like environment. And while she was initially very wary of her fellow clients, she was ultimately inspired by their successes.

“I was very self-conscious, but they didn’t really care that I was struggling, because they knew what it felt like,” says Faith. “It was very inspirational, because at the the time, I didn’t care. I didn’t want to do anything to help myself, but I saw others achieve being happy, and living life. It took me a while to realize I could be happy like them.”

Experiential activities helped Faith discover that there were ways to exercise that weren’t just about burning calories.

“I’d never been hiking before, and it was such an amazing experience. I grew bigger relationships and had a stronger bond with the girls that were here. Seeing them achieve so much and go through so much with me was just amazing.”

It wasn’t easy, but Faith learned to trust her therapist, and Mirasol’s family program helped her open up to her family.

“I felt comfortable with my family, and I told them things I had never told them before. It was scary! I thought it would change the way they thought about me, but it didn’t, because I had people here supporting me when I opened up, says Faith. “If I wouldn’t have come here, and gone through this experience, my family would probably be normal, but we wouldn’t be that happy.”

Faith closes with a beautiful poem she wrote about her passion for living.

Dec 7, 2015
Marion MacDonald

Suggestions for Surviving — and Maybe Even Celebrating — the Holidays

Holiday Survival Guide

The holidays are supposed to be the most joyful time of the year, but they bring with them a long list of unrealistic expectations that create a lot of stress and anxiety, especially for anyone who suffers from an eating disorder. Mirasol staff members met to share their thoughts on healthy ways to celebrate the holidays. We found out that successful strategies run the gamut from diving in head first, to head-long flight! In between are many helpful suggestions for minimizing the stress and maximizing the joy of the holidays, however you choose to spend them.

Diane RyanMirasol Executive Director Diane Ryan is a big fan of diving into the holidays, but she worries about clients in early recovery who want to go home for the holidays.

“When you go home, it’s like you become six years old again. Those are the initial roles that we learn, not only about the holidays, but about how to relate to one another. And then you put a frame around it that says ‘everything must be perfect,’ and it creates a lot of pressure.”

Diane’s strategy is to use tools to “keep the joy part and reduce the stress“.

“I concentrate on my breathing, and I focus on the heart-warming stories, the acts of kindness and the opportunities to serve.”

Anthony Hackworth“I’m all about the Christmas spirit,” says Dietitian Anthony Hackworth. “It can get stressful, and it’s easy to get locked into the drama, but I realize as I get older you don’t have to be there 100% of the time. You can remove yourself, go do the things you want and come back for the fun stuff. So that’s what I recommend to clients.”

Jodi TudiscoClinical Director Jodi Tudisco grew up in an Italian family with strong holiday traditions.

“So much of the holidays in our family was about the food — preparing the food together, certain foods for specific holidays, sitting down for a big meal together. All the colors and the textures of holiday food are very artistic and beautiful to me. And I want our clients to be able to appreciate the holidays in that same way, but there’s a lot of fear and hesitation around food. How can we help them bridge that gap?”

Jamelynn EvansPrimary Therapist Jamelynn Evans suggests that one way to manage expectations around holiday traditions is to remember that “we are meaning-making machines” who have the power to attach new and different meanings to the holidays. She recalls fondly one year when her brother was living in Florida and couldn’t fly home until a few days after Christmas. The family decided to postpone Christmas until he arrived – at midnight – and they all stayed up until 3:00 or 4:00 in the morning, talking and opening presents. “It was so spontaneous,” says Jamelynn, “and I have such a fond memory of what that turned into.”

Jamelynn recommends shifting some of the emphasis away from food: going for walks, singing, playing music, wrapping gifts, decorating. “We’re working toward being more okay with the food, but we don’t need to force that to be okay right now.”

Of course one of the cornerstones of recovery — especially in early recovery — is following a meal plan.

“To do well, and to feel good about the holiday experience, the client needs to follow the meal plan as closely as possible,” Diane says, “but it’s very challenging to stay on your meal plan when there are so many different activities, most of them involving food. Families can help by just being understanding and supportive of what the client needs to do.”

Anthony also recommends “keeping it simple”.

“If you serve traditional holiday foods, talk with family members about their preferences, and serve simple meals — one protein, one starch, one healthy fat and a desert — instead of a whole table full of food.”

Anne GanjeFellow dietitian Anne Ganje concurs. “There is so much hustle and bustle, and so much going on during the holidays. This is not the time to experiment or challenge ourselves. Even if you don’t come from a dysfunctional family, you can be triggered by the anxiety of those around you. If a client needs to just follow the basic meal plan during the holiday season, that is 100% okay. There will be plenty of time after the holidays to process everything that happened and to offer opportunities to challenge meal plans, or to do things differently.”

“Food aside, it’s important to recognize that this is a stressful time of year for most people — even those who don’t have an eating disorder,” says Jamelynn. “This may not be the best time to engage in deep discussions about future plans for career or school. It might be better to keep it a bit lighter and simpler when you do come together.”

Maeve ShaughnessyAt Mirasol, we talk a lot about the importance of setting intentions, and Clinical Director Maeve Shaughnessy thinks this may be the key to getting the most out of the holidays.

“Before going to family events, take some quiet time to think about your priorities and about what’s important to you, so you don’t get overwhelmed.”

Rachel NelsonArt Therapist Rachel Nelson offers the following tips for how to take care during the holidays:

· Since it can be a stressful time around family, I’m going to make an intention to have fun, and to stay focused on that.

· I will find three positive aspects of family members to focus on.

· I think having those things to focus on will relieve my mind from bringing past frustrations forward.

“Spending time outside is also a really good thing to do,” says Diane, who championed the development of Mirasol’s robust adventure therapy program. “I like to take the clients hiking during the holidays. It’s a nice time of year here in the desert.”

Marion MacDonaldMany embrace the spirituality of this season, and spirituality can take many different forms. For Webmaster and Wilderness Guide Marion MacDonald, this time of year is all about the change of seasons and the return of the light.

“The holidays usually find us camped somewhere in the desert, watching the sun rise on the shortest day of the year, and enjoying the smell of a crackling mesquite fire and a little crispness in the air. What I like most about the holidays is the quiet. Everything seems to slow down between Christmas and New Years – people are calmer, the traffic slows down. It’s a time to think about where you’ve been this past year, and where you want to go in the next one.”

Maeve was surprised to hear the words “holidays” and “quiet” in the same sentence!

“I thrive on that quiet and reserved peace, but I can really get caught up in the hustle bustle, and it’s important for me to set that intention and remind myself that it can be a quiet time as well.”

Ann is fascinated by the different ways that people recharge. For her, this time of year is when most other people are ready to be social and connected.

“There’s a solid month where people who would usually say ‘no” are saying ‘yes’ to invitations to do something socially – so I love this time of year!”

At the far end of the spectrum, Diane confesses that in her younger days she used to get a temporary job at the mall. “I loved the chaos,” she says, and she recommends planning some activities for early January to avoid a post-holiday let-down.

What about clients who are spending the holidays in treatment?

“Many people might think that it would be the worst thing in the world to be in treatment at this time of year,” says Diane. “But my experience over the years is that it’s really quite special for the people who are. Anybody who is in treatment has had some challenging family interactions, so being in treatment takes all of the difficulties of being in early recovery off the table and allows them to continue doing their work.”

“It can be a big relief to clients to be in treatment, because we can validate what they’re experiencing,” Jamelynn concludes. “The truth is that it’s okay to be sad, and we all do think about certain things that we may be missing. But oftentimes what we want and what we need are different. We may want to be home, but treatment may be the best place for right now. I tell my clients that they’re setting themselves up for future holidays that will look much different from the way you’ve spent your holidays in the past.”