On Recovery

TRIGGER WARNING: This post contains information about eating disorder recovery, including eating and exercise. 

 

Eating Disorder Awareness Week 2018 (EDAW2018) wrapped up last week, and I’ve been reflecting a lot on what it means to be recovered from an eating disorder.

 

Throughout EDAW this year (and in year’s past), a lot of the awareness raised comes via those who have survived eating disorders sharing their recovery stories.

 

So, what does recovery of an eating disorder look like?

 

This is going to be underwhelming, but I legitimately don’t have a straight forward answer for this.

 

Eating Disorder recovery is ambiguous.

 

Is recovery the absence of eating disordered behaviours? Of eating disordered thoughts? Of biological measurements? Of negative body image? Of low mood?

 

In a word: yes.

 

But all to varying degrees.

 

One of the main issues with eating disorder recovery is that it hasn’t been concretely defined yet in the research literature, or in practice.

 

Eating disorder research is still in its infancy compared to other mental health research.

 

We need more money. We need more resources. We need more treatment options. Which is why initiatives like Eating Disorder Awareness Week are so important.

 

So, if we don’t know how to measure the thing we’re trying to achieve, can we even do it?

 

Strangely enough, we can!

 

We don’t necessarily have a prescriptive plan of how, but people recover all of the time.

So, it can (and does) happen, but we have not yet identified the specific way that this occurs.  

 

Eating disorder recovery is hard.

 

Another tricky thing about eating disorder recovery is that individuals still need to engage closely with the illness’ symptoms on a daily basis.

 

We need to eat. We need to move our bodies. We probably need to look in the occasional mirror. God knows we have to deal with Instagram, Facebook, and/or Snapchat.

 

This engagement with eating disorder symptoms is distinct from other forms of recovery, such as what we might see in substance abuse.

 

For example, if someone is in recovery from substance abuse using cocaine, the absence of using cocaine is one pretty clear and objective indication that the individual is in recovery.

 

Abstinence from cocaine = recovery

 

Using cocaine = not in recovery*

 

*Obviously this is an oversimplification of substance abuse recovery for demonstration purposes.

 

Now, can you imagine if that same individual was required to use a specified amount of cocaine every single day as a part of recovery, without getting out of control? What about if everyone around him/her/them was also using any amount of cocaine they pleased?

 

This is what eating disorder recovery feels like.

 

You have to stop restricting food in a society where calorie counting is not only encouraged, but regarded as a desirable trait of control and willpower.

 

You have to stop bingeing on food in a society where overindulgence is not only a social pastime, but also an expectation for most social gatherings.  

 

You have to stop the continuous calculator in your head in a society where now even coffee menus display calorie counts next to each item.

 

You have to stop overexercising in a culture of Soulcycle and Crossfit.

 

You have to stop believing that your body is your worth, while being inundated by a beauty industry that profits off of our self-hatred and insecurity.

 

And I’m not even going to get started on social media, because that’s going to be its own post.  

 

It. Is. Hard.

 

But it is possible.

 

Eating disorders are scary.

 

There are recovered people that by all accounts have no physical, psychological, or behavioural remnants of their eating disorder and are recovered.

 

There are recovered people who by all accounts have no physical or behavioural symptoms of their eating disorder, but still experience disordered thoughts.

 

There are recovered people who still experience both behavioural and psychological symptoms of their eating disorder, but much less than they did in the crux of their illnesses.

 

There are people who will die from this.

 

As Blythe Baird says:

 “If you are not recovering, you are dying.”

 

I have to be honest, I really mulled over whether I should include this last section in this post. This topic is a hard one.

 

I’ve seen so many recovery stories that briefly cover “how bad it got” before moving on to the positive feel good part of getting your life back on the other side of recovery, and they should.

 

It is positive, it’s the most positive. Recovery is not only literally life-changing, but it is unimaginably better than anything you can dream of while you’re sick.

 

But something in me was whispering, “Maybe there is also value in exploring the ‘how bad it got’ abyss a little further?”

 

Well, actually that’s not true. There was no whispering. It was more like:

 

Me: “I don’t want to scare people”

 

Also Me: “But eating disorders are scary”

 

Me: “But I don’t want to make people feel sad”

 

Also Me: “I hear you Ash, but isn’t there value in people knowing how serious something is? Remember that time you watched The Cove and you were really upset, but you were also glad you learned about those dolphins, so you could do something about it? Things can’t get better unless people know how bad they are.

 

Me: “Don’t you dare bring The Cove into this”

 

Also Me: “Real talk though: You want people to understand eating disorders and take them seriously. If not now, when?”

 

Me: “…maybe writing out this internal dialogue will help lighten up this very serious topic?”

 

Also Me: "Or maybe you've just finally managed to casually work marine life into a blog post?"

 

Here’s the thing: recovery is scary, hard, and sometimes devastating.

 

Here’s the other thing: recovery is incredible, inspiring, and life-saving.

 

And although I generally like to leave people feeling happier than when we started, sometimes it’s important to focus on things that illicit more difficult emotions in us.

 

One of the reasons I started this blog (and heck, became a Registered Provisional Psychologist in the first place) is because I want people to understand the seriousness of eating disorders.

 

More people die from eating disorders than any other psychiatric illness.

 

Which is why recovery is so important to talk about, learn about, and understand.

 

Eating Disorders are serious, but recovery is possible. Recovery is so possible.

 

I will leave you all with an excerpt from an email that I wrote years ago to an acquaintance who was on her own path towards recovery:

 

Recovery is such a bizarre thing. It reminds me of a quote from Prozac Nation, about depression, about how it's "gradually and suddenly", and in my experience, that's really how it happened. It's little moments and steps forward (and sometimes backwards) every day, and sometimes you aren't sure that you're moving at all, but then one day you realize that your days are measured less by symptoms and numbers, and more by people and experiences; and that living a real life as a full person is actually pure gold.

 

Take care of yourselves and each other out there.

 

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

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How (Not) to Support Someone With An Eating Disorder

Well, Eating Disorders Awareness Week 2018 kicks off tomorrow here in Calgary, so I thought I’d write a little something about how to support someone who might be struggling with an eating disorder (ED).

On second thought, in the spirit of keeping things interesting, let’s actually focus on how NOT to support someone with an eating disorder (ED).

1. Don’t Talk About Appearance

 

Often when we suspect that someone might be struggling with an eating disorder, our instinct might be to make some comment related to our loved one’s appearance. Examples include:

 

“You’re so skinny!”

“You’ve gained so much weight!”

 

This is not helpful. Not only will commenting on someone’s appearance risk making them feel bombarded/attacked/super awkward, but these statements can actually reinforce the eating disorder, by acting as a trigger or even motivation to engage in further eating disorder symptoms.

 

This also includes anyone who was/is in recovery from an eating disorder. Saying things like:

 

“You look so healthy!”

“You look so much better!”

 

You guessed it: not helpful. I know it seems counterintuitive, but comments like this can be devastating for someone working hard towards recovery.

What can you do instead?

A good rule of thumb in both of these scenarios is to focus on feelings, or in some cases behaviours:

 

Instead of saying: “You have lost so much weight!”

 

Try: “Are you okay? I feel really worried about you.”

 

Instead of saying: “You look so much healthier!”

 

Try: “I am so happy we get to spend time together, I missed you! How are you doing?”

 

2. Don’t Accuse or Interrogate

 

Spoiler Alert: Yelling at someone who has an eating disorder will not scare the disorder away.

 

I get it. Watching someone you love or care about propel into the depths of a serious mental illness is incredibly frustrating, heart-wrenching, and frankly - terrifying. Yelling or getting angry at the person who is struggling with an ED is not the answer.

Eating disorders are a group of illnesses that thrive off of isolation, secrecy, and shame. Yelling at the person struggling risks embedding the illness further.

 

With that said, you are allowed to feel frustrated, angry, and terrified.

Instead of taking out your anger on the person struggling, find ways that you can manage your own emotions (and there will be a lot of them!) whether it’s talking to a friend, family member, or mental health professional.

Caregiver burnout is real, and you cannot support your loved one’s if you are not okay yourself.

 

Try: “Are you okay? How can I help?”

 

3. Don’t Minimize the Disorder

 

Fact: Eating disorders have the highest mortality rate of any psychiatric illness. 

 

Do NOT tell someone to:

“Just go eat a sandwich.”

“Just go to the gym.”

“Just stop watching Keeping Up with The Kardashians.”

“Just stop going on Facebook/Instagram/Snapchat/newer social media that I don’t understand.”

 

This is not helpful. Eating disorders are serious psychiatric illnesses. Eating disorders are not a choice. Eating disorders are not about vanity.

 

And you know what else? Eating disorders are not about food or weight (I know, I know, just stay with me here); they are merely symptoms of much deeper struggles.

As Carrie Arnold says:

“This only reinforces the idea that EDs are an expression of vanity, or just a bunch of beauty-obsessed kids who need to stop reading magazines. And they’re not. Focus on this does everyone a disservice.”

 

You tell em' Carrie! Preach! 

Try: “What can I do to better support you?”

 

4. Don’t Make It About Yourself

 

Examples include:

“If you think that about your body, what do you think about mine?!”

“Do you know how hard this is for me?!”

The truth is: people’s eating disorders aren’t about anyone but themselves.

Eating disorders affect the way individuals think, feel, talk, and treat themselves, but chances are they would never think, feel, talk, or treat anyone else in the world the same way.

Try: “I see you are struggling, and I know this is hard, but I am here for you.”

 

5. Don’t Play Therapist

 

All together now! Eating disorders are a serious psychiatric illnesses!

Which means, they require professional support from a registered mental health professional, who specializes in eating disorders (ahem).  

Don’t get me wrong, support systems = great/amazing/necessary.

But if you are someone’s parent/sibling/spouse/co-worker/friend you cannot be their therapist. You are too close.

 

Eating disorders are really hard, so let’s not mess around okay?

 

Let’s help each other get the most appropriate kind of help/support/treatment, so that we can start to change the statistics regarding eating disorders for the better.

 

Want to learn more about eating disorders?

 

Great timing! Eating Disorders Awareness Week starts tomorrow.

There are a whole bunch of events happening all over the city, one of which is the screening of the amazing documentary Straight/Curve  at Fort Calgary on February 2nd 2018!

The film starts at 6:30 pm, and is followed by a panel discussion, moderated by yours truly. So, come hang out, watch a great film, and let’s talk about it! Click here to get your tickets

Click here for more details on all of the events happening throughout Calgary as a part of Eating Disorders Awareness Week!

 

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

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What is Body Image?

With Eating Disorder Awareness Week (EDAW) just around the corner (don’t pretend it’s not marked on your calendars), I thought it would be helpful to talk about something topical that affects us all*: Body Image!

*Unless you don’t have a body, in which case: 1) I’m sorry, and 2) please explain.

What is Body Image?

 

Body Image is composed of two things:

1) The mental representation of our own physical body (e.g., size, shape, appearance), and

2) Our attitude towards our physical selves (e.g., thoughts, feelings, beliefs).

Body image is fluid and changes over time, based on things like culture, mood, societal norms, and interactions with family and friends.

Sometimes the concepts of body image and self-esteem can get confused, which is fair because they are closely related, but distinct ideas.

For the record:

Body image focuses on our attitude about single aspect of ourselves (a.k.a our physical body), while self-esteem relates to our evaluation of our overall worth (a.k.a our whole damn self).

Why is body image important?

 

Well, the way we think about our physical selves affects how we exist in the world. Poor body image can contribute to a whole host of issues, including depression, anxiety, eating disorders, relationship issues, and substance abuse.

Not surprisingly, poor body image often leads to lower self-esteem, which can cause problems in any area of life that requires confidence (e.g., work, school, relationships, performing ukulele songs in public, etc.), and usually equals not liking ourselves very much (which is the opposite of a good time).

So, should I start eating more kale then, or…?

 

Okay, brace yourselves:

You can have the body of a supermodel, and have terrible body image. You can look like Gollum, and have great body image. Body image is not dictated by physical measurements, it’s dictated by how we feel about our physical measurements.

 

Body image is composed of attitudes, not tangible measurements or sizes. So even if our attitude is momentarily improved because we altered our body in some physically recognizable way, it is probably not going to last because we still haven’t addressed the underlying attitudes and beliefs about why we feel the way we feel about ourselves.

Which is why going on a diet or working out to improve your body image is not effective.

 

Plus, doing so can lead to a really exhausting cycle of believing that if we just change our body x amount more, then we will feel happy with ourselves. The problem is we quickly discover that once we’ve achieved our initial goal, the aforementioned happiness doesn’t arrive, and so we begin the cycle over again of “just a little bit more.”

In other words, body image programs that focus solely on exercise and diet are missing 90% of the body image pie, and in some cases are downright dangerous.

Plus, who only wants 10% of a pie?

So, what can we do?

1)    Media Consumption!

Does the media effect our body image? Yes. Are we going to get into the intricacies of all of my feelings on this right now? No. It’s complicated, and reserved for a whole other blog post.

But! One thing we can do is to be mindful about consuming diverse media. Are you only following Gisele Bundchen look-a-likes on Instagram? Then, you are doing your body image a disservice (spoiler alert: even if you are a Gisele Bundchen look-a-like).

Why? Because we internalize the images around us (a.k.a internalization of the appearance ideal), whether we like to or not.

Which means, if we are only used to seeing emaciated airbrushed goddesses, giant muscular hulks (also airbrushed), or insert other unrealistic socially-perpetuated imagery here, in our media our reflections become a lot more difficult to feel good about (because airbrushing in life is not a thing).

In other words, the unrealistic images that we are constantly bombarded by become the new norm, creating impossible expectations that human beings will never be able to physically meet.

Even Kate Moss doesn’t look like Kate Moss in real life.

 

Which means: it has never been more important to consume diverse media. Consume media that is created by and representative of people of all colours, sizes, creeds, abilities, and genders.

2)    Accept Yo Self! (Can we make this a hashtag?)

There are all kinds of archaic beliefs floating around that suggest that fat-shaming ourselves or others will somehow motivate us to change our bodies in a way that brings us closer to the socially-determined appearance-ideal. This is a lie.

Research shows that commenting negatively about others’ (or our own) bodies actually increases the incidence of binge eating, depression, anxiety, and low-self-esteem. You can read more about that here.

A general rule of thumb here is: don’t be a jerk. To yourself or anyone else.

 

One way to start moving towards body acceptance is to start saying nice things to your body every day. This can be as serious or silly as you want, but every sincere effort makes a difference. Some of my favourites include:

“Hey feet! Thanks for giving me the ability to tap dance. It makes me laugh and is a great party trick.”

“Hey legs! Thanks for helping me run, walk, and cartwheel my way through life. You da real MVP!”

“Hey body! Thanks for waking up today. I am really glad that we get to be alive.”

Rather than beating your body up for all the things it’s not, start thanking it for all of the things it does for you every day (because it’s a lot).

For those in the Calgary area: I would be remiss if I did not mention at this point that I will be facilitating an awesome body image group called The Body Project starting Feb 3rd, 2018. If you want to change the relationship you have with your body alongside a bunch of other rad ladies, click here.

3)    Start talking!

Talking about how we feel about our bodies and ourselves can be an important starting place to improve things.

Talk to your friends. Talk to your Family. Talk to a mental health professional (ahem). Talk to your cat. Just talk to someone who is ready and willing to listen and support you on the road to accepting yourself.

For those in the Calgary area interested in engaging in a larger discussion about body image, I am so excited to announce that the documentary Straight/Curve will be screening as a part of Eating Disorders Awareness Week this year at Fort Calgary on February 2nd 2018.

The film is incredible and starts at 6:30 pm, followed by a panel discussion, moderated by yours truly. So, come hang out, watch a great film, and let’s talk about it! Click here to get your tickets

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

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Intentions > Resolutions

Oh hey 2018!

We are three days into a fresh year, and I have been hemming a hawing more than I’d care to admit over what to write to kick off this new year.

My brain immediately went to “Duh! Resolutions, obviously. It’s January, keep up Wanamaker.”

The problem is that I kind of cringe at the thought of resolutions. This is not because I’ve jumped on the anti-resolution bandwagon of no-one-even-keeps-them-anyway-so-why-try-isms, but actually because quite the opposite is true.

I actually really love New Years. I love the idea of reflecting on the past year. I love the idea of setting intentions for the year to come. Blame it on my very brief stint as a Lemonhead (lululemon employee, not the candy), but I’m a sucka for goals.

Real talk: I even have the original version of my goal to become a psychologist framed and hanging in my office as I type this.

Goals are my friends, without which I would never leave my natural state of existence: in a blanket cocoon with Netflix looping for eternity.

So, what’s my deal with resolutions then? In my experience, I think that resolutions tend to evolve from a place of “should”, which if you have worked with me, you know I am not a fan of. 

Spoiler alert: I regularly tell people to stop shoulding all over themselves.

 

My issue is when people make resolutions from a place of should, they are often setting goals based on the expectations of others, rather than from their own values. Now, it’s not breaking news that when we strive to make changes for things that we don’t actually care about/value/want, we aren’t usually successful.

So, when we inevitably don’t keep our new year’s resolutions, we add another dose of failure to the already unrealistic/boring/weird expectations we originally set, which usually manifests in feeling even worse about ourselves. Thus, perpetuating the cycle of shoulding all over the place.

What’s worse, supposing we actually manage to stick to the resolution we thought we should set, only to achieve it and feel absolutely nothing. All because we didn’t stop to ponder if the resolution was actually something we value/like/want in the first place.

It’s just a whole cycle of doom that I am not down with. I just don’t believe it’s particularly helpful to hate ourselves and/or feel miserable.

 

I was having a conversation recently with a friend about new year’s goals, and she talked about the goal of wanting to work out at a gym.

Now, it's important to note that for the entire duration of our friendship, I have never known this friend to walk into a gym, and yet this is not the first I’ve heard about this resolution. I’m even gonna go so far to say that this friend doesn’t even particularly like gyms or gym-related culture, and that gyms on the whole probably make her feel weird and gross.

But, like many of us, this friend has set this same intention before, only to not keep it, feel bad about it, and tell herself she just needs to try harder/be better/blah blah blah next time. During this conversation I asked, “Do you really want that?” to which my friend chuckled and said “I don’t actually know.”

Long story short: my friend had the insight that at some point in her life she had associated people who have time to work out at a gym with success. Thus, if she was consistently working out at a gym every day, then she would know that she was successful.

The problem is, if you don’t like going to the gym (I mean who does), or value what going to the gym does for you or how it makes you feel, then you are setting a goal to do something every day that makes you feel miserable.

This is an excellent recipe to feel terrible.

 

For everyone who is about to get all up on the comments asking what kind of monster I am for supporting someone in not going to the gym because don’t I know the importance of physical health and mental health and all of the health?! 

First of all: cool it.

Second of all: yes, moving our bodies is good for us, for so many reasons.

Fun fact: we can move our bodies at places that aren’t the gym.

 

Heck, I do it almost every day (even in a gym sometimes)! But wouldn’t it make more sense to find ways that we actually enjoy doing these really important things to take care of ourselves, rather than beating ourselves up for not doing how we should be? For my friend, this was realizing that she actually wanted to start taking dance classes, versus going to a place that she hates every day.

Which is where the glorious concept of intention comes in!

(Sorry not sorry if you thought the conclusion of this was going to be “Boo resolutions! Boo goals! Don’t do anything ever again!).

Intentions are similar to resolutions, except that they make us stop and think about what we value, before putting a specific plan or goal into action.

Intentions force us to consider the bigger picture.

 

Once my friend was able to identify her belief that gyms = success, she was able to:

1) Ask herself if she thought this belief was true (no), and

2) Reassess to see if she actually valued anything about working out.

What she discovered was that moving her body more positively affects her mental and physical health, which is something that she does value. Fortunately, this friend also is super interested in taking dance lessons, so voila! A goal that actually resonates (and thus is more likely to be successful) is set.

Here’s the thing: you don’t have to do anything.

 

I mean, I’m just gonna say it’s probably in your best interest to stop at stop signs and pay your taxes, but ultimately you are the boss of you. Which is why it’s so important to stop and ask yourself what you actually like, how you want to spend your time, and who you want to be.

You get to decide that.

 

The thing is, unless we’ve done some deep self-reflection (what up therapy!), most of us aren’t taught how to do this. Not-knowing ourselves, coupled with the fact that Westernized society bombards us 24/7 with what we should be doing, usually leaves a lot of us working really hard to achieve things that will never bring us whatever it is that we are actually seeking.

So, what does this look like?

Well, there are a few ways to check in with yourself so that you can set intentions (if you choose that you want to. I'm not the boss of you.) that will actually fulfill whatever it is you are wanting to achieve:

1)    Get to the why.

Ask yourself "why" like a toddler hopped up on curiosity. You want to eat more kale. Why? Because you know leafy greens are good for you. Why? Because they provide all kinds of important nutrients to your body. Why does this matter? Because you want to nourish your body so you can be the best version of yourself. Why? So you can do sweet dance moves and solve math problems. BOOM.

2)    Ask yourself what lessons you are taking with you, and what you are leaving behind.

Rather than telling yourself to stop doing something (don’t think of a purple hippopotamus. See, doesn’t work), reflect on what you have learned, and what thoughts/beliefs/behaviours you may have outgrown, or no longer fit. Recognize where you have been, and dream up where you’d like to go. Shout out to Meg Hasek-Watt for reminding me of this gem this year. 

3)    Go to therapy.

I mean, I had to say it. Some people say going to therapy is like getting a PhD in self-reflection. I don’t know who these people are, but I do know that therapy allows us to get to know ourselves on another level. So, if you’re reading this and are like “Ahhhh! Ashley, I don’t know what I value!” or “Do I even like spinach? Or do I feel like I’m supposed to like spinach because society tells me too?!*”, then giving therapy a go is probably a really great idea. Heck, it's probably a good idea even if you are confident in your spinach-related feelings. People in the Calgary area who are interested in checking out therapy can check out resources in this post, or book a free consultation with me here.

*Just kidding, nobody likes spinach.

So whether it is to spend more time with family, eat more broccoli, or learn all of the words to No Diggity, go into this new year setting intentions that resonate with who you are, or who you'd like to be. Or don't. After all, you're the boss. 

happy 2018 people! I am so glad to be here with you. 

 

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

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What is Atypical Anorexia?

When most people think about eating disorders, the terms anorexia and bulimia tend to come to mind. 

Today we're going to focus on a lesser-known eating disorder diagnosis: Atypical Anorexia.

 

What is atypical anorexia you ask?

 

Well, according to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5; a.k.a. THE diagnostic bible for psychologists and psychiatrists), Atypical Anorexia falls under a diagnostic category called Other Specified Feeding or Eating Disorders or OSFED.

 

So, let’s back up for a moment. For reference, there are several eating disorder diagnostic categories including:

  • Anorexia Nervosa
  • Bulimia Nervosa
  • Binge Eating Disorder
  • Avoidant or Restrictive Food Intake Disorder (ARFID)
  • Other Specified Feeding or Eating Disorders (OSFED)
  • Unspecified Feeding or Eating Disorders (UFED)
  • Pica
  • Rumination Disorder

 

We’re going to focus on a diagnosis from the OSFED category, which include feeding or eating behaviours that cause clinically significant distress and impairment to areas of functioning, but do not meet the full criteria for any other eating disorder. Atypical Anorexia falls under this category. 

So, this means that in the case of atypical anorexia, an individual would meet all of the same diagnostic criteria as anorexia nervosa, but the individual’s weight remains within a normal or above normal weight range.*

*Sidenote: I use the phrase “normal weight range” because it is used within the DSM and not because I agree with it philosophically or think it is particularly helpful. 

Why does this matter?

Well, the introduction of the diagnosis atypical anorexia is a big deal for a few reasons.

Until 2013, if you were someone who was:

1)Restricting your food intake (a.k.a. skipping/limiting meals)

2)Pre-occupied with you weight and/or shape (a.k.a. you and your body are not friends),

3)Had an intense fear of gaining weight (a.k.a. you are constantly worried about gaining weight), 

but were not (yet) clinically underweight, you could not be diagnosed with anorexia nervosa, and in many cases, would not be able to access eating disorder treatment to get help.

Heck, you could even be losing weight rapidly and experiencing all of the same psychological and physical complications that come along with having an eating disorder, but if you had a BMI of 18 or over, you technically weren’t “sick enough” to qualify for eating disorder help, by DSM-IV standards. 

I want to be clear that I write “sick enough” in quotations because of course if anyone is experiencing the above symptoms they are sick enough for help and what a ridiculous notion to be perpetuated for literally decades.

Fact: I know people who have had physicians/nurses/parents say to them “You are not sick enough yet” when attempting to seek help.

Another fact: By the time an individual is “sick enough” by DSM-IV standards, they often have had an eating disorder for years, making the illness more entrenched and treatment more difficult and complicated.

Most important fact: If someone is struggling at all, they are sick enough for help.

Maybe it was because more people die from eating disorders than any other psychiatric illness, or that the majority of people who were presenting with eating disorder symptoms didn’t meet the strict criteria of anorexia nervosa and bulimia nervosa, but at some point, someone was like:

Hey! What if, instead of waiting to help people until they are emaciated, we intervened earlier, you know, to help them before their body starts shutting down?

And the diagnosis of atypical anorexia was created. Hallelujah.

And you know what? Research studies have not found a difference in the medical and psychological impacts of anorexia and atypical anorexia. Both are serious psychiatric illnesses, and both require professional help. Which means, thanks to the DSM-5, people can get help sooner now, which (not surprisingly) is linked to better treatment outcomes

Which brings me to another important point: anyone can have an eating disorder.  

That’s right, anyone. And you know what else?

You can’t tell who is struggling with an eating disorder by looking at them.

 

Eating Disorders Come in all shapes and sizes.

The notion that eating disorders only affect skinny wealthy white women is archaic/incorrect/boring. 

Overweight? You can have an eating disorder. Underweight? You can have an eating disorder. Totally normal weight as defined by our messed up societal beauty standards? You can have an eating disorder. Man? You can have an eating disorder. Woman? You can have an eating disorder. Trans? You can have an eating disorder.

You get it: Literally anyone can have an eating disorder.

So what can we do about it?

Well, a few things.

1) If you suspect you may have an eating disorder, reach out for help here or here

2) If you suspect someone you know is struggling with an eating disorder, let them know that you care about them and encourage them to reach out for help here or here

2) Stop engaging in Fat Talk. You don’t know who may be struggling with an eating disorder, and real talk: the only body that is your business is your own. Engaging in this type of talk about ourselves and others is damaging. For everyone. Let’s change the culture that contributes to the development of eating disorders in the first place.

And now, a moving and poetic personal account of atypical anorexia by the magnificent Blythe Baird:

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

 
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How To Find The One

We know that people should be taking care of their mental health like they take care of their teeth: all day, every day (if you didn’t know, now you know).

So, how do you choose a psychologist to work with? 

Here are some things to consider:

1. What are you called?

While there are a variety of mental health professionals that hold different titles, this post is going to focus primarily on psychologists because it’s:

a) A regulated profession

b) My jam (you know, as a Registered Provisional Psychologist).

 

What is a regulated profession? In Canada, some professions are regulated to protect the health and safety of the public, and psychology is one of them. This means, that you cannot call yourself a psychologist in any way, shape, or form (Psychologist, Registered Provisional Psychologist, Best Psychologist Ever*) unless you have been approved and granted this title by your provincial regulatory body (in Alberta, this is the College of Alberta Psychologists; CAP).

*CAP has yet to appoint this title to any individual to my knowledge.

Why does this matter? Well, because when you’re searching for someone to work with, you want to ensure that they are competent and appropriately trained in what they say they do. Choosing a registered professional (such as a psychologist), ensures that this person has been vetted by a qualified group of people.

It’s important to note that:

just because a psychologist is a regulated professional, does not mean that all psychologists will be the right person for you.

However, if someone holds the title of psychologist it does mean that they have had to meet a minimum set of standards outlined by a governing body, which is a really nice safeguard to have when you are considering working with someone on something as important as your mental health.

For example, in Canada the term therapist is not a regulated title, which means that anyone can call themselves a therapist without meeting any specific requirements or standards.  

Does this mean that all therapists are bad at what they do? Of course not, don’t be ridiculous. We already talked about how education alone doesn’t make someone good at their job. However, it does mean that there are no checks and balances on the qualifications, training, or experience for that individual calling themselves a therapist*.

*This does not apply to occupational or physiotherapists, which are regulated professions in Alberta.

2. Who do you work with?

Another important consideration when looking for a psychologist is knowing what their specialization is. Do they work with children, adolescents, adults?

What kind of concerns does this psychologist typically work with?

In other words, if you are an adult female looking for someone to help you with depression, it would be good to know if the psychologist you are talking to specializes in play therapy for young children with Autism Spectrum Disorder.

3. What is your approach?

This can be a tricky one. Like most things in life, there are many schools of thought in psychology. Typically, psychologists will draw from at least a few different theories to inform how they work with their clients. For example, if you’re lying on a couch and are the only one speaking during your sessions, chances are your psychologist is heavily (if not entirely) influenced by Freud’s psychoanalytic theory.

In my own work, I draw from a variety of theories, including (but not limited to) narrative, feminist, client-centered, and trauma-informed. With that said, I would describe my approach as eclectic, which means: I do what works best for each client. For example, cognitive-behavioural techniques may work for some clients, while narrative approaches are best for others.

There is no-one-size-fits-all approach to therapy.

Okay, that’s not true, there are lots of one-size-fits-all approaches to therapy, but in my experience these approaches are not always helpful for everyone.

Human beings are dynamic, unique, and complex, so it makes sense that each person’s mental health needs would be equally as dynamic, unique, and complex.

If you do come across a psychologist who strictly adheres to a single approach, my advice would be to make sure you understand the approach being used, and be sure that it is one that resonates with who you are and what you are trying to achieve.

In my practice, I feel it’s the responsibility of the psychologist to have a variety of tools and approaches to utilize, and then to work with the client to decide what is going to work best for them. In my opinion, this is good therapy, but many people may not share this view.

4. Accessibility?

Let’s be serious, going to see a psychologist can be pricey. The Psychological Association of Alberta currently lists the recommended fees here.

I have said it before, and I’ll say it again: I wish everyone could have access to mental health services all of the time. Unfortunately, I’m not in charge of the world (yet), so this is not the case (also yet).

Okay cool Ashley, I can’t afford to even take care of my super important mental health.  GREAT POST.

Everyone calm down, here are some ways that therapy can be more accessible for people who aren’t Bill Gates:

-       Insurance!

If you have insurance, chances are you have some kind of mental health coverage to see a psychologist. In fact, if that insurance coverage is from Blue Cross, most psychologists in Alberta can actually directly bill to them.

-       Sliding Scale!

Some private psychologists operate on what’s called a sliding scale, meaning you pay for services based on how much money you do (or don’t) make. This is a great thing to ask prospective psychologists about. See contact info at the bottom of this post for more info. 

-       Public Services!

In Alberta, this would be anything offered through Alberta Health Services. It’s important to note that there is typically a much longer wait to access publicly-funded services than seeing someone privately, but the upside is that they are almost always free! See contact info at the bottom of this post for more info. 

-       Agencies!

Depending on who you are and what kind of mental health goals you have for treatment, there are a variety of organizations that offer subsidized and/or sliding scale services. In Calgary, some of these agencies include Wood’s Homes, Calgary Counselling Centre, Hull Services, and the YWCA.

5.THE FINAL AND MOST IMPORTANT POINT:CONNECTION.

If you are reading this, then it means you made it to the last and most important point of this post, high-five!

The single most important consideration when finding a psychologist to work with is connection. I cannot stress this point enough. Research shows that the quality of the therapeutic relationship is the most important factor in therapeutic outcomes.

In other words, if you don’t like your psychologist, therapy is not going to work.

You can be working with a psychologist with 50+ years of experience, who is an expert in their field, and trained in every technique in existence, but if you do not trust, respect, and connect with her/him/they, chances are therapy is going to be a bust.

In my practice, this is one of the main reasons that I offer an initial complimentary consultation. It gives the client and myself both a chance to get to know one another, discuss the therapeutic goals, and get a sense if we are each other’s people.

And you know what? If I am not someone’s person, that’s totally cool. I have no interest in wasting my time or my client’s, because I want people to get what they actually need.

If there is anything to know after reading this post:

1)    It is most important to find a psychologist you connect with.

2)    If the first psychologist you meet is not your jam, it’s your right to request/find/talk to another one.

3)    If you don’t feel that the approach or technique that your psychologist is using is helping you, tell her/him/them so! In fact, this is paramount to effective and meaningful therapy.

Good luck and godspeed on all of your therapeutic adventures.

 

Need help getting started? 

Contact Access Mental Health at  (403) 943-1500 for help navigating public services offered through AHS. 

Interested in private services? Search your area or mental health concern in the Psychology Today listings.

Interested in booking a complimentary session with me? Click here.

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

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What's The Deal With Therapy?

It’s really encouraging to see conversations around mental health and stigma finally happening on a more regular basis (it's about time, pals!), but one of the most misunderstood things about mental health care is therapy itself.

Wait. What is therapy and/or counselling and is there a difference?

Firstly, yes there is a difference.

While both counselling and therapy involve meeting with a mental health professional, there are a few important differences. Counselling typically involves resolving issues in the here and now, and tends to be more short-term in nature.

Comparatively, therapy tends to address more longstanding emotional, psychological, or behavioural patterns, often involves working through both past and present concerns, and typically occurs over a longer period of time.

This past week, I was talking to a family member who said “I thought about going to therapy, but I don’t think I feel that bad.” What followed was a conversation about what exactly therapy is (and can be) for, but this sentiment is one I hear all of the time.

Therapy is not just something to consider once you’ve shame-spiraled into the dark and scary corners of your psyche (or the Internet), it is a tool that you can access at any point in time.

Most people think about going to therapy as something we only do while we’re in crisis, like when experiencing serious depression, substance abuse issues, or unexpected stressful life events. You know, when things have gotten “bad enough.”

Here’s the thing: should you see a mental health professional if you are in crisis and struggling? Absolutely. 100%. Get help immediately or sooner.

But are these the only times when therapy is helpful? Definitely not.

Thinking that mental health care is only useful when things are “bad enough” is like avoiding dental check-ups until your teeth have fallen out of your head.

Should you go see a dentist if all of your teeth fall out of your head? Definitely. Would it have been helpful to intervene with whatever was happening before you became toothless? Probably.

The point is, if we can collectively start thinking about taking care of our mental health in the same way that we take care of our physical health, we would be able to move towards actually maintaining good mental health, rather than waiting to intervene once things get severe (A.k.a. “bad enough”).

So, what are some non-crisis reasons to go see a psychologist?

1.     You want to understand yourself better

2.     You want to make a good relationship great

3.     You want to let go and forgive

4.     You want to excel in your career

5.     You want to be a better parent/spouse/human

6.     You want to engage in self-care

7.     You want to learn about and practice life skills (healthy boundaries, assertiveness, communication, etc.)

8.     You want to win the Olympics.

Did you know there is a whole area of psychology that focuses on how to thrive, rather than just on how to resolve what might not be going well?

The theory of positive psychology largely focuses on the importance of positive beliefs, emotions, and strengths in an individual or a community.

In other words, positive psychology focuses on what is right with people.

Let me be clear, positive psychology isn’t merely the idea that if you just think positively, everything will be great (I see you, The Secret), it’s based off of the scientific study of what makes individuals and communities truly exceptional. Click here to learn more about positive psychology.

In fact, many professional athletes, musicians, and performers work with psychologists as a way to optimize their performance, agility, and resiliency, in their respective profession. Shout out to Emma Stone, Jon Hamm, Kerry Washington, Brad Pitt, Brandon Marshall, and Ron Artest, to name a few.

So, what does this mean?

Well, it means that you don’t need permission to take care of your mental health! You aren’t wasting time. You are not a burden. You aren’t taking away resources from people who need it more. You are making sure your proverbial teeth don’t fall out of your head.

If you or anyone you know in the Calgary area is experiencing a mental health crisis call the 24-hour Distress Centre line at 403-266-4357 or 911.

 

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Real Talk: Friends don’t let friends Fat Talk.

What is Fat Talk? I'm so glad you asked. 

Definition
fat-talk [fat-tawk]
adjective & verb
1. describes any statement that reinforces the thin-ideal standard of beauty and contributes to men and women's dissatisfaction of their bodies. 

According to Mimi Nichter (the glorious professor who coined the term), Fat Talk refers to negative body-related comments that often occur during conversation with others.

You know the scenario: a friend/family member makes a self-deprecating comment about his/her/their body and then we respond by uttering an equally – if not more- self-deprecating statement about our body, and eventually we somehow find ourselves in a really messed up (but somehow socially acceptable?) body-shaming standoff in the Wild West of hating ourselves?

For those of you not well-versed in the ancient art of Fat Talk Fast Draw, infamous examples may include:

“Do I look fat in this?”

“You look great, have you lost weight?”

“I’ve really been doing well on this diet, you should try it”

“I can’t eat that - it will make me fat!”

“She/He/They are too fat to be wearing that!”

“You’re so thin! What is your secret?”

So why do we do this?

Well, there are a few reasons.

The short answer is we’ve been taught to.

In Westernized societies, Fat Talk has become a means for individuals to bond with one another, an opportunity to express personal concerns about one’s weight or shape, and gain reassurance from the people around us.

*We’ll save diving into the why we’ve been taught to for another post coughthepatriarchycough

In fact, Fat Talk has become so normalized that one could argue that it’s actually become an expectation.

You know that scene in Mean Girls, where Regina George (Rachel McAdams) tells Cady Heron (Lindsey Lohan) that she’s “like, really pretty”? Due to the fact that our glorious Cady has spent the majority of her childhood growing up in Africa with her zoologist parents (aka relatively unexposed to these Westernized ideals), she replies with a sans-self-hating “Thank You.”

Regina, intrigued by Cady’s shockingly simple response, presses further, asking “So you agree, you think you’re really pretty?” as if interacting with a moderately confident female is the most fascinating experience of all time (and priming her for a full on bully experience, but that’s another post).

The point is: Women (not only, but often) tend to have such a hard time talking nicely about themselves, that uttering a simple “thank you” in response to a compliment can feel actually impossible sometimes.

And Fat Talk is bad because?

Fat Talk has been linked to a whole host of negative outcomes, including increased negative body image, low mood, depression, anxiety and increased body dissatisfaction and internalization of the thin-ideal (you know, the two of the greatest risk factors for developing an eating disorder).

As if that’s not enough, Fat Talk not only reminds you how badly you feel about yourself, engaging in it actually contributes to feeling worse!

Okay, so what can you do about it?

I’m so glad you asked! Here are 3 tips to fighting fat talk:

1)    When someone gives you a compliment, say “Thank you.”

I know, some cutting edge psychological advice being offered up here, but seriously, uttering these two simple words is powerful and can stop negative self-talk before it starts (not to mention contributing to changing pervasive body-shaming culture).

2)    Don’t let your friends/family/random strangers off the hook when they engage in Fat Talk about themselves.

My personal favorite* is to respond in the third person to any kind of Fat Talk going on by saying, “Don’t talk about my best friend/mom/bus driver that way!” This is my favorite for two reasons:

a.     It confuses the person engaging in Fat Talk why you are suddenly referring to them in the third person.

b.     It lets them know that you care about them enough to not let them say messed up things about themselves.

*Shout out to my husband for teaching me this one.

3)    Don’t let your friends/family/random strangers off the hook when they engage in Fat Talk about others.

My go-to response to hearing someone comment negatively on another person’s appearance is to affirm their comment in the completely opposite (positive) way. Example:

Fat Talk: “OMG, look what he/she/they are wearing”

Anti-Fat Talk Response: “OMG he/she/they are killing it! YAS! SLAY!”

Look, the bottom line is: life is already hard enough. In a world of 24-hour news cycles and videos of screaming goats, there is a lot to worry about all of the time.

So maybe we take feeling obligated to negatively talk about ourselves and others off the table? Just for a minute? Maybe instead we experiment with taking a break from body-shaming ourselves and others, and instead use that energy to lift each other up/high-five/cure cancer/do anything else?

After all, loving yourself in a world that tells you not to is basically the most punk rock thing of all, and who doesn’t want to be punk rock?

TLDR: Friends don’t let friends Fat Talk.

 

 

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