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Dialectical Behavior Therapy (DBT): a Cognitive Behavioral Approach

GalleryJudy Gurfein Leave a comment

Dialectical Behavior Therapy (DBT): a Cognitive Behavioral Approach

By: Jasmyn Cuate

Dialectical behavior therapy (DBT) is a combination of cognitive and behavior therapy, supported by empirical-based evidence that teaches patients skills to cope with and change unhealthy behaviors. The main goals of DBT are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.

DBT focuses on four key areas in therapeutic skills:

  • Mindfulness: focuses on improving your ability to accept and be present in the current moment, helping you use healthy coping skills instead of using negative impulsive behaviors
  • Distress tolerance: teaches you how to feel intense emotions without reacting impulsively or using self-injury or substance abuse to escape from it. Helping you prepare for intense emotions and cope with a more positive long-term outlook
  • Emotion regulation: teaches you how to identify, label, and change your emotions without judging them– learning how your emotions shape your behavior and what obstacles prevent you from managing your emotions, reducing your emotional vulnerability and helps you have more positive emotional experiences
  • Interpersonal effectiveness: allows you to communicate more effectively with others, become more assertive, maintain self-respect and respect for others, while keeping a relationship positive and healthy

DBT goes through a multistage approach where the therapist first treats the patient’s most self-destructive behavior followed by the therapist addressing quality-of-life skills, then focus on improving the patient’s relationships and self-esteem, with the last stage focusing on promoting more joy and relationship connections. Standard comprehensive DBT is often used in the following settings:

  • Individual therapy: with a trained professional, you learn how to apply DBT skills to specific challenges and situations in your life­– patients agree to do homework to practice new skills and fill out diary cards which are completed daily to keep track of their emotions, urges, behaviors, and skills used throughout the week and brought to weekly sessions for the therapist and client to discuss and see if there’s progress being made. Diary cards are designed to record instances of target behaviors, thoughts and urges, and the use of behavioral skills client’s applied to cope with the problem
  • Group skills training: patients have the opportunity to role-play new behavioral skills and interact with others
  • Phone coaching: with DBT, your therapist is available by the phone for in-the-moment support between sessions if you’re in a difficult situation and need guidance

While your therapist works with you through the DBT approach, it can be challenging to stay motivated. Therefore, therapists have consultation groups,which are a group of professionals who met regularly helping one another to navigate potential stressors, monitor their devotion to treatment, develop and increase their skills, and sustain their motivation to work with high-risk, difficult-to-treat clients.

DBT was developed by Marsha Linehan, originally intended to treat borderline personality disorder (BPD) and suicidal behaviors but has been modified to treat other mental health conditions and have been effective in treating:

  • Borderline personality disorder (BPD)
  • Bipolar disorder
  • Substance use or impulsive behaviors
  • Eating disorders
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Non-suicidal self-injury (NSSI) or suicidal behavior
  • Generalized anxiety disorder (GAD)
  • Attention-deficit/hyperactivity disorder (ADHD)

Overall, DBT offers validation for patients, helping them understand their actions within the context of their personal experiences without necessarily agreeing that their actions are the best approach to solving a problem. This helps patients become more likely to cooperate and work towards self-acceptance and change. The best way to find out if DBT is right for you is to talk with a professional. They will evaluate your symptoms, treatment history, and therapy goals to see if DBT is the best treatment option for you.

If you or someone you know is seeking for dialectical behavior therapy, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources: https://www.webmd.com/mental-health/dialectical-behavioral-therapy https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy

https://www.verywellmind.com/dialectical-behavior-therapy-1067402

https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy

The Relationship between OCD and Eating Disorders

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The Relationship between OCD and Eating Disorders

By: Suzanne Zaugg

Eating disorders are characterized as obsessive, repetitive thoughts, and ritualistic behaviors. Obsessive-compulsive disorder (OCD) is a common, chronic long lasting disorder that characterizes uncontrollable thoughts or behaviors that an individual may feel they need to repeat certain things over and over. Statistics show that people with eating disorders are more likely to show signs of OCD, due to the overlapping traits of both OCD and eating disorders.

Understanding the similarities and differences between eating disorders and OCD can help develop a more comprehensive understanding of a patient that presents both of these disorders. People with an eating disorder may experience intrusive thoughts about food and body image, and may develop ritualistic behaviors. Examples of ritualistic behavior pertaining to eating disorders include body checking for any changes in shape or size, frequent weight checking, and skipping meals. An important distinction between OCD and eating disorders lies in the relationship between the thought and action of the individual.  People with OCD are typically interested in ridding themselves of their thoughts and feelings whereas; people with eating disorders may feel more tied to the components of this disorder and feels as if it is a part of their identity.

Since both eating disorders and OCD share overlapping diagnostic characteristics, treatments will look similar. Both exposure therapy and cognitive behavior therapy are very helpful treatments for both eating disorders and OCD. Exposure therapy is a psychological treatment that involves exposing the patient to the anxiety source or its context without the intention to cause any danger. Also, cognitive-behavior therapy is a treatment approach that helps you recognize negative or unhelpful thought patters.

If you or someone you know is seeking therapy for an eating disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.waldeneatingdisorders.com/blog/eating-disorders-and-ocd-a-complicated-mix/

Managing Eating Disorders during the Holidays

GalleryJudy Gurfein Leave a comment
Managing Eating Disorders during the Holidays

By: Suzanne Zaugg

Holidays are a described as being, “the most wonderful time of year” filled with joy and love, it is a time when families to come together. Most, people are gathered around in the season of giving celebrating their holiday cheer, while, people with mental health issues, struggle more throughout the holiday season. According to the American Psychological Association, 38% of people tend to feel their stress increase during the holiday season, which can lead to physical and mental health disorders, such as eating disorders. Signs of an eating disorder include feeling stressed around food, fearful of weight gain, guilt after eating, and missing events that are food focused. These signs tend to increase through the holiday season, so it is important to keep an eye out if you or a loved one start to experience these or similar symptoms. Learning ways to manage relationships with food is a great way to feel better through the holidays, for those who have eating disorders.

Strategies to get through the holiday season:

  1. Show self-compassion. Give yourself compassion through the difficult holiday season.
  2. Ask for help. Find a family member or friend as a support person during meal times.
  3. Have a holiday coping plan. Plan out your “fear” foods (ones that make you feel stressed and anxious) and favorite foods, and then give yourself permission to eat them.
  4. Remind yourself that food provides nutrient value. Holiday foods connect us with culture, heritage, loved ones and traditions. Holiday foods are not considered “unhealthy”.
  5. Give yourself permission to feel satisfaction from eating.
  6. Set healthy boundaries. Choosing not to engage in diet talk or leaving a family function early are important ways to manage food anxiety.
  7. Practice self-care. Whether it is cuddling your pet, connecting with loved ones, or just taking time for yourself. Self-care is beneficial to your overall health.
  8. Take one day at a time. Make short term goals, which are easier to achieve and which will boost your overall mood, in order to make the most of gathering with loved ones.

By learning to understand and recognize the signs of an eating disorder, you can help the people in your life who are struggling.

If you or someone you know is seeking therapy for an eating disorder, please contact our psychotherapy offices in New York and New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Source:

https://news.llu.edu/health-wellness/tips-and-tools-for-handling-eating-disorders-around-holidays

Eating Disorders Part 5: Eating Disorders among Latina Women

GalleryJudy Gurfein Leave a comment
Eating Disorders Part 5: Eating Disorders among Latina Women

By: Abby Erasmus

Latina women are caught between two cultures and are therefore at risk of experiencing acculturative stress (a term discussed in “Eating Disorders: Part 4”). As mentioned previously, increased acculturative stress is linked to an increase in eating- related pathology, thus disordered eating patterns are not uncommon among Latina women. The rate of occurrence of eating disorders among Latina women is equivalent to the rate of the general population of U.S. females; however, anorexia nervosa (AN) is rarely noted in Eating Disorder (ED) studies in regard to Latina women. This does not mean AN does not exist among Latina Women, AN is just thought to be the least prevalent in the community. Researchers have found that bulimia nervosa (BN) and binge eating disorder (BED) are the most common, with lifetime prevalence rates of 2% to 2.3-2.7% respectively. Further, researchers have identified key differences in the presentation of both dietary restriction and drive for thinness in comparison to European- American white women. Latina women are less likely to engage in dietary restriction, and if they do, it is often followed by a binge- eating episode. Latina women also find themselves caught between the thin ideal belonging to Western culture and the curvy but flat- stomached ideal belonging to the Latinx community, and these conflicting body image ideals can result in disordered eating behaviors. Additionally, and quite similarly to Asian American culture, food is the love language of the Latinx community, yet, similarly to Asian American women, these women will be scrutinized for gaining weight. Latina women also experience the paradox, and providers should keep this paradox in mind to understand root causes of EDs within the Latinx community.

Binge eating within the Latinx community is associated with significant levels of distress as well as psychopathology, and is often accompanied by obesity. Despite reporting significant levels of distress, the majority of Latina women do not seek treatment, and when they do, they often refer to primary care doctors in which obesity is the only thing that gets identified. Their ED goes unnoticed. In order to correctly diagnose EDs among Latina women, providers must understand the high prevalence rates of BED, BN, and binge- eating behaviors within the population which, in turn, can result in obesity. Once the ED is addressed, obesity can be addressed. Again, with cultural competency added into the equation of treatment, Latina women’s EDs will be correctly diagnosed and they will receive proper treatment.

If you or someone you know is seeking therapy for an eating disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://yourlatinanutritionist.com/blog/eating-disorders-among-latinas

Identifying Eating Disorders in Latinas

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680162/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078895/

Eating Disorders Part 1: More than Just One Narrative

GalleryJudy Gurfein Leave a comment

Eating Disorders Part 1: More than Just One Narrative

By: Abby Erasmus

Eating disorders don’t discriminate; about 1 in 7 male individuals and 1 in 5 female individuals experience an eating disorder by age 40. Girls as young as 8 or 9 are walking into the doctor’s office with cases of anorexia nervosa, bulimia nervosa, and other types of eating disorders. Individuals regardless of race, class, gender, religion, and sexual orientation can suffer from an eating disorder (ED). EDs are an extremely serious matter; they have the highest mortality rate of all mental illnesses. Keeping all of this information in mind, it is extremely important to understand and acknowledge that EDs affect all demographic groups and can manifest differently within these groups. Different demographics have complex histories with different cultural backgrounds that can affect how one displays an ED, and why a group develops one. Because people are unaware that different demographic groups experience EDs, stigma often surrounds their diagnosis by both people within their community as well as outside the community. Knowing that EDs have the highest mortality rate, it is our responsibility to reduce the stigma by disseminating information about how EDs affect a wide variety of populations.

The typical narrative of an ED tells the struggle of a white, straight, cis- gender woman. This population does experience EDs, and it’s extremely important to provide them with appropriate help and support; however, this typical narrative leaves out the experience of many other groups of people with EDs and why different demographics might development them. In reality, the rates of EDs are about the same across demographic groups in the United States, but because one narrative is told, other groups are significantly less likely to receive treatment. In a series of blog posts, I will discuss how EDs affect different populations: Black women, the LGBTQ community, Asian American women, Latina Women, and men in general.

If you or someone you know is seeking therapy for an eating disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.state.sc.us/dmh/anorexia/statistics.htm

https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2752577

https://www.webmd.com/mental-health/eating-disorders/anorexia-nervosa/features/changing-face-anorexia

https://www.nationaleatingdisorders.org/people-color-and-eating-disorders#:~:text=Eating%20disorders%20have%20historically%20been,help%20for%20their%20eating%20issues.

The Effect of Social Media and Eating Disorders

GalleryJudy Gurfein Leave a comment

    By: Sarah Cohen

    Eating disorders are extremely serious and often deadly illnesses that include severe disturbances in eating behaviors and related thoughts and emotions. There have been numerous studies in which mass media consumption of the “thin ideal body” has been linked to eating disorders among women. Pressure from media has led to women and men internalizing the “thin ideal body” and led to extreme body dissatisfaction which can then lead to eating disorders. While the effect is smaller among men, they are still being subjected to pressure.

    Studies have shown “significant change in the weight and size of female and male models portrayed throughout the media in western society and the concept of the ‘perfect or ideal body’.” This explains “why many adolescents are preoccupied with their bodies and dissatisfied with their body image and are willing to try a variety of dangerous weight-loss practices in their quest for the perfect body.”

    Most people are usually not aware the amount of manipulation and digital editing done in the fashion industry to create ‘ideal’ female and male bodies. These false images encourage unrealistic and unhealthy standards that are impossible to attain. One study focused on body concerns in girls 16 years old and tried to understand the underlying motivations to be skinny. The element that exerted the largest pressure to be smaller was the media. Another study measured indicators of eating disorders in a population of young Fijian girls after the addition of Western television to their routine. The indicators of eating disorders were exceptionally more prevalent after extended television viewing, demonstrating a negative impact of media. A large component of the data recorded was the theme of subjects describing a new interest in weight loss as a method of modelling themselves after the television characters they viewed.

    In order to prevent the effect of social media on disordered eating, here are three tips: choose what media you view and participate in carefully, limit the amount of exposure you have, and test each media’s message for body positivity by asking critical questions about what information they are attempting to spread.

    If you or someone you know needs support with their marriage, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

    https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792687/

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792687/

    https://www.nationaleatingdisorders.org/media-eating-disorders

    Tiggemann M, Gardiner M, Slater A. “I would rather be size 10 than have straight A’s”: A focus group study of adolescent girls’ wish to be thinner. J Adolesc. 2000;23:645–59.

    Becker AE, Burwell RA, Gilman SE, Herzog DB, Hamburg P. Eating behaviours and attitudes following exposure to television among ethnic Fijian adolescent girls. Br J Psychiatry. 2002;180:509–14.

    Orthorexia Nervosa: an eating disorder in disguise

    GalleryJudy Gurfein Leave a comment

    By Argie Dabrowski

    Eating disorders are characterized by unhealthy relationships with food, whether it be excessive or restricted intake or cycles of binging and purging. The most common eating disorders today are anorexia nervosa, bulimia nervosa, and binge eating disorder. Orthorexia nervosa is a proposed eating disorder that, paradoxically, revolves around healthy eating. Orthorexic people are not focused on losing weight. Instead, they are trying to achieve the perfect diet, which they believe will be the solution to all of their problems.

    Although not officially recognized by the American Psychiatric Association, orthorexia nervosa has been the topic of many studies and can still be as dangerous as more well-known eating disorders. Those with orthorexia only eat food that fits their standards, such as only containing whole grains or being vegan. This means that they avoid many foods that they see as unclean or unhealthy. Some orthorexic individuals also avoid foods they believe they are allergic too, without actual advice from medical professionals.

    At its core, orthorexia is an obsession and those who suffer from it are not simply eating healthy but revolving their entire lives around what and when they eat. Those who have orthorexia have described being completely fixated on food, making it difficult for them to maintain healthy social relationships. These people often avoid social events that involve eating, such as parties, because the food served may not meet their criteria for “healthy” eating. They connect their rigid diet to mortality, as well. Because of this, when failing to meet the standards of their rigid diets, these people feel immense guilt and anxiety.

    Besides weight loss, orthorexic people often experience isolation due to the aforementioned social strains. This can lead to depression and further anxiety. Orthorexia nervosa is often clinically treated in a similar manner to anorexia nervosa and obsessive compulsive disorder, which is through exposure to avoided foods.

    If you or someone you know needs support for an eating disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com

    Sources:
    pro.psychcentral.com/3-warning-signs-that-a-patient-might-be-struggling-with-orthorexia/
    psychcentral.com/blog/understanding-orthorexia/
    pro.psychcentral.com/orthorexia-nervosa-disease-that-masquerades-as-health/
    nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

    Image Source:
    ojo.pe/mujer/el-color-de-los-vegetales-280442-noticia/

    Health and Weight

    GalleryJudy Gurfein Leave a comment

    By Zuzanna Myszko

    “Healthism” is a new term that has been coined because of the social link that has been created between morality and health. Because health is seen to be heavily related to weight, people who are overweight are often seen as “lazy” and “over-indulgent,” which are extremely harmful generalizations that make overweight people seem immoral.

    Research has shown that the connection between health and weight is not as clear as we once thought. One may participate in health-promoting activities and still be overweight because of metabolic rate, genetics, biological influence, and environmental factors. Therefore, healthism stigmatizes the overweight individual and affects his or her self-image in all aspects of life.

    Some specific factors that may be promoting weight gain include:

    • Increased accessibility to high-calorie foods and drinks.
    • Lower prices of high-calorie foods and drinks.
    • Increased prices of fruits and vegetables.
    • Living in food deserts, which are areas where affordable and nutritious food are hard to obtain.
    • Lack of public transport to get to grocery stores.
    • Low safety in some areas.
    • Environmental toxins.

    Also, dieting, usually touted as the solution to obesity, has shown to be ineffective. People usually bounce back to the weight they were before beginning the diet. More importantly, dieters do not usually experience an increase in well-being and health outcomes.

    Additionally, the judgment of others based on their weight implies that they should not be allowed to be responsible for their own bodies, which is an absurd assumption. All people have the right to autonomy when it comes to their bodies.

    In the end, healthism has an excessively negative effect on the mental health of those impacted starting at a very young age. Many experience eating disorders as a result. Therefore, people who are generally termed “overweight” must focus on the facts and create a positive relationship with their body.

     

    If you or someone you know appears to be suffering from issues related to weight or eating disorders, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/.

    Image: https://playzoa.com/book-of-womens-exercise-pants-petite-in-spain.html

    Source: https://www.psychologytoday.com/us/blog/real-healing/201901/health-and-weight

    Group Therapy

    GalleryJudy Gurfein Leave a comment

    Alice Cordero

    According to psychcentral.com, Group therapy is a form of psychotherapy treatment where several people meet together under the supervision of a therapist in a particular setting. Group therapy is a form of therapy that can be used in conjunction with individual therapy and medication.  The benefits of group therapy include:

    • Modeling
      • Patients are able to witness how others in the group cope with their problems in positive ways and apply it to their lives.
      • Patients learn from other group member’s mistakes.
    • Helps improve social skills
      • In group therapy, most of the time each individual has to share something about themselves and how they are doing; this helps improve the patient’s interpersonal relationships and understand that they are not alone in this particular process.
    • Increased feedback
      • Provides patients with different perspectives/ coping methods
      • Gives patients a view of how others handle their particular situation
      • Provides individuals with personal feedback through other patients perceptions of themselves
    • Support Network
      • Having multiple individuals who are going through the same gives each patients the opportunity to build a support system that they can use

     

    Group therapy involves members expressing their feelings, problems, ideas, and reactions towards other members. Studies have shown that group therapy has been effective in addressing countless problems, including: anxiety, depression, addictive disorders, substance abuse, death, lifestyle issues, and relationship issues.

    If you or someone you know is suffering from any of the conditions listed above or think you/ they could benefit from group therapy, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/.