Library
Eating Disorders
Sharon Ridley, Clinical Psychologist
When I was asked to write a post about Eating Disorders I was surprisingly a bit stumped. Caught between feeling like I know a great deal after working with eating disorders for a decade now (a decade?! When did that happen?) and also feeling that I do not know enough.
You see, if we in the field knew enough, people would not still be dying from anorexia-related complications and suicide, children (boys and girls) as young as primary school age would not be reporting negative body image as one of their biggest concerns, there wouldn’t be a life-time prevalence of 1 in 6 Australian females suffering from an eating disorder (look around your next yoga or spin class, statistically someone in the room has had, or is currently battling, an eating disorder). So clearly there is more to be learned, so much more that we have to keep throwing our support and funding behind critical research, and the hospitals (public and private) that work every day to get women and men back to health. I guess what I can share from 10 years of service in this area is that there are many stories of hope, there are little wins and big wins, and there are heart-warming recoveries that remind me we do know a decent amount and it does work in a lot of cases.
What would I tell a loved one that came to me looking for advice to get an eating disorder treated in Perth?
- Go to your GP and discuss referral options, whether that be a referral to a public eating disorder service or a Mental Health Care Plan to access a private psychologist that understands eating disorders.
- Consider seeing a dietitian that has a lot of experience with eating disorders; nutrition will form the cornerstone of your recovery and often people feel more secure with a lot of guidance in the early stages until they can trust their hunger and fullness once more and eat more intuitively. A dietitian can tailor a plan to suit you that becomes increasingly more flexible as your anxiety reduces and confidence increases.
- Consider taking medication as necessary; your GP or a psychiatrist can guide you in the right direction. Whilst there is no medication that specifically treats eating disorders, many people benefit from anti-depressants or anti-anxiety medication while they make steps towards recovery. There is some evidence to suggest certain medications are helpful for bulimia nervosa and binge eating tendencies.
- Prepare yourself for a journey, not a quick fix. Some people can make huge strides very quickly, while others may take months. Some have to have a couple of bites at the cherry, pardon the pun, before they get going. Regardless, do not hesitate to seek help because the sooner you start doing something about it, the sooner you can feel better.
- Eating disorders do not go away by themselves and the longer they are left untreated the more physical and psychological damage is done. Get on it!
- And I would say “you can do this!”. It is not your fault that you have this illness, and it thrives in the shadows of secrecy and shame. By asking for help you are already taking a vital step towards getting out of the grips of your eating disorder and taking back control of your life.
Finally, if your eating disorder therapist doesn’t think adding cheese to your salad is a big deal even though you haven’t touched cheese since the Spice Girls were together, then you need a new therapist because small changes are a big deal! It is when you add up all the small changes that you get a life free of pre-occupation with food, weight, shape, and exercise, a life that is not dictated by the number on the scale or what you see in the mirror, a life where your first reaction when you are invited out to eat is not a panic-stricken one, a life worth living to its fullest.
"Protect" them or let them run wild?
Jennifer Wright, Clinical Psychologist
I am often asked why young adults these days seem to suffer from so much anxiety. Seemingly happy, well-adjusted young men and women present to my clinic puzzled by the fact that they experience regular to intermittent symptoms of panic and anxiety.
I usually say that I am not sure why there seems to be so such a glut of debilitating symptoms of anxiety amongst young people, except that perhaps we are better able to diagnose it.
Psychodynamic Psychotherapy
The essence of psychodynamic psychotherapy is exploring aspects of the self that are the psychological roots of emotional suffering and bringing them into consciousness. Psychodynamic psychotherapy requires self-reflection, self-exploration and self-discovery which takes place in the context of a safe and deeply authentic relationship between therapist and patient. The material that arises provides a rich source of information about how a person views themselves and others, interprets and makes sense of their experience, and interferes with the potential capacity to find greater enjoyment and meaning in life. The goal is not just symptom remission, but to foster positive psychological capacity. Psychodynamic psychotherapy is effective for a wide range of mental health symptoms, including depression, anxiety, panic and stress-related physical ailments, and the benefits of the therapy have been shown to increase after treatment has ended.
Relationship Changes After Birth
The birth of your first child will bring changes to every aspect of your life. One of the most challenging may be the impact it has on your relationship with your partner. It can present enormous changes, as you will need to negotiate differences that may have not arisen prior. Some of these many include:
Finances: Many couple are used to each earning money and having control over how and what they spend their money on. For some couple this may be the first time they have done joint finances and the person no earning (typically the woman for at least some period) may find it difficult to have to ask for money or feel she has to justify what she is spending.
Anxiety Disorders
Anxiety disorders are one of the most common psychological problems, affecting up to 25% of the population at some point in their lifetime. Most anxiety disorders do not tend to go away on their own if left untreated. They tend to stay the same or get worse over time, with an increasing impact on people’s quality of life, work and relationships. There are several different types of anxiety disorders. The most common are Generalised Anxiety Disorder (GAD), panic disorder, social phobia, specific phobias, Acute and Posttraumatic Stress Disorder (PTSD), and Obsessive Compulsive Disorder (OCD).
Coping With Trauma
Julie Watts, Clinical Psychologist
At times in people lives they may experience an event that we would describe as traumatic this is usually an event that involves serious injury or threat to life. It may include an assault, sexual or physical abuse, car or work accident, natural disaster, being a victim of torture or war, a serious medical illness or operation (including labour). It can also include witnessing such events. Some people may also have experienced trauma in childhood that they may never have disclosed that may be re-activated or exacerbated by another traumatic event later in their lives.
The ups and downs of FIFO
Jennifer Wright, Clinical Psychologist
The ups and downs of fly in, fly-out (FiFo)
(Also known as drive-in, drive-out (DiDo) and bus-in, bus-out (BiBo)
What are the stressors and health implications for travelling shift workers?
In Western Australia, we hear a lot about the Fly-in Fly-out (FIFO) lifestyle, where people are required to travel to their jobs and live for extended periods of time on site during rostered work time. FIFO contracts require employees to live and work away from their family and friends, and return to a location of choice when off duty.
The Bear is in Your Head
Jennifer Wright, Clinical Psychologist
Anxiety and the Fight/Flight Model
In primitive days, the biggest stressors we had in our lives were physical dangers such as enemies from other tribes, snakes, lions, and bears. We are biologically adapted to manage these physical dangers generally by running from them, or fighting them.
Stress
Jennifer Wright, Clinical Psychologist
Individuals have different tolerance levels for stress, but most of us know when we are going through a stressful period. Our muscles become tense, our hearts beat faster and our palms can feel sweaty. Emotionally, we might feel intolerant, irritable and unpredictable. The effects of stress are evident in our physical reactions, our emotions and our behaviours. Stress is created by the way we see the world (internal sources of stress), and the stressful events in our lives (external sources of stress).
Social Engagement - A Pathway to Relaxation
Jennifer Wright, Clinical Psychologist
My clients wonder why, in some situations, they behave like calm, loving, enlightened human beings towards their partners, and at other times, they scream and shout at the person they love, surprising even themselves.
Older Adults and Psychology
It is never too late in life to obtain assistance for psychological / mental health problems that you are unable to sort out by yourself or with friends or loved ones.
Mindfulness - A Stress Management Strategy
Jennifer Wright, Clinical Psychologist
Mindfulness is a way of paying attention that originated in Eastern meditation practices, where attention is brought to the present moment. Mindfulness can occur whether you are sitting in meditation, washing the dishes, watching television, or running a marathon. It is the opposite of mindlessness, where you feel out of touch with yourself and your mind is elsewhere.
Hakomi Psychotherapy
Jennifer Wright, Clinical Psychologist and Certified Hakomi Therapist
Hakomi is a form of body-centred psychotherapy which focuses on using mindfulness to enable positive and lasting changes in the client. The basis of the relationship between the client and the therapist in Hakomi is based on loving presence which hopefully will lead to mutual trust and respect, creating a space where deep emotional work and consequent changes in core beliefs can occur. Hakomi is also called assisted self-study, where the client is seen as the expert of their own processes. The therapist is there to support the client in accessing material which may have been repressed, and help the client to better understand his or her behaviour and become more loving to the self.
Grief and Loss
Julie Watts, Clinical Psychologist
Intense emotional reactions are common in the first few weeks following a bereavement and can include shock, disbelief, crying, anger, guilt, insomnia, difficulty concentrating, loss of interest in activities and social contact. Everyone varies in how they grieve. Many people may want to talk a lot about their feelings and others may want to grieve more privately. For most people the frequency and intensity of these symptoms will decrease within a couple of months however, it can be a prolonged process.
Resources
Therapists at Chelsea Psychology are often asked to recommend authors, books and websites. Below are some of the resources we have found most helpful. Articles in our Library were written with the guidance of some of these authors, books and links.
Postnatal Depression and Anxiety
Julie Watts, Clinical Psychologist
Although becoming pregnant and giving birth are amazing experiences women it is also an enormous time of transition which impacts on every aspect of your life. For some it can be a time when they experience symptoms of depression and / or anxiety that can significantly interfere with the enjoyment of this time. Estimates of depression and anxiety vary depending on the assessment used, overall about 9% will have depression in pregnancy and about 15% postnatally. Rates of anxiety have been found to be about 20% with 2/3 of those also having depression.
Acceptance and Commitment Therapy (ACT)
Julie Watts, Clinical Psychologist
ACT is a new type of cognitive behaviour therapy. It teaches clients to accept thoughts and feelings with compassion and develop new ways of relating to them rather than struggling with or trying to avoid them as this usually unworkable and leads people to restrict their lives. This enables them to instead focus on what really matters in their lives, what they want their life to stand for and take action towards achieving these valued life goals and living a full, rich and meaningful life.
What is Dialectical Behaviour Therapy?
Dialectical Behavior Therapy (DBT) is an evidence–based treatment approach developed by Dr. Marsha Linehan for people who have emotions they are unable to manage in constructive ways. People who have difficulty in regulating emotions typically suffer from intense and painful emotions from which they may feel there is no escape. They may also experience quick shifts from one emotion to another and may feel like emotions are controlling their life.
Depression
Jennifer Wright, Clinical Psychologist
A major depressive episode is a very confusing and debilitating illness, which can leave previously high functioning people floundering on the couch, feeling totally inadequate and unable to complete simple tasks.
Depression has been described as the common cold of mental disorders, and most people will be affected by the illness directly or indirectly. Depression and its diagnosis is very confusing - what is depression exactly and what makes it different from feeling low for a few days?
Bipolar Disorder
Jennifer Wright, Clinical Psychologist
Bipolar Disorder can be difficult to diagnose. Some sufferers struggle with unpredictable mood swings for years before they receive appropriate treatment. They find everyday situations difficult to confront because of their internal emotional havoc, and they don't understand why life seems so hard. People with Bipolar Disorder can be very high functioning, but their bouts of debilitating depression and occasional manic episodes confound their lives.
Changing Bad Habits
Jennifer Wright, Clinical Psychologist
Habits are a choice, no matter how addicted to them you might feel. You may well be addicted to staying in bed on a cold winter morning, but would prefer to stay healthy, so you rise at 5.30 and go to your yoga class. Your preference for health and fitness is stronger than your need for warmth and comfort.
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