How To Find A Good Child Psychologist

12 Things you Must know before finding a Child Psychologist

If you are a parent who believes your child might benefit from seeing a child psychologist, first of all, you are not alone. I also know firsthand that the process can be extremely overwhelming. If you have no experience with the process, it can be quite intimidating to think about putting your precious child in the hand of a professional.

As a mother of three girls, I have had several situations where I thought I needed an outside professional opinion. For example, last year, my 10-year-old started hiding sandwiches in her closet and became extremely aware of her physical appearance. I noticed that she had started bringing back most of her lunch home after school and would only eat small quantities at mealtimes. First I told myself to ignore my instincts and just hope that her behavior would subside. However, after finding five sandwiches in her closet and other places, I decided that I should consult a psychologist. Since I suffered from both anorexia and bulimia and was aware of the genetic predisposition, I chose to be extra cautious and make sure there was nothing serious going on with my daughter. I am also fortunate enough to work with colleagues who are experts in eating disorders, so I had easy access to professional who could provide me with the support I needed. I realize, though, that for most parents and other caregivers, the search can be quite daunting and challenging.

If you are seeking a child psychologist, it is most likely because you have either noticed something is not right with your child in terms of behavior or performance, or a professional such as a pediatrician, school psychologist, teacher or a friend has suggested that they see someone for support.

Acknowledging your child needs help can be difficult, but unfortunately, the search can be even more difficult. One of LW Wellness’ child psychologists, Dr. Allison Patterson, a licensed psychologist and certified school psychologist, compiled a list to equip you with some knowledge before you begin your search.

Searching for a child psychologist could be a daunting task for parents.  Many are not sure how to start and what should even be considered. Here are some ideas of things to consider when searching for a child psychologist to be sure they are a good fit for your child AND your family.

Tip #1

Environment– Upon visiting a potential office, take special note of the environment and atmosphere of the office itself. You first want to be certain the psychologist’s office is child friendly and has developmentally appropriate toys or activities to engage your child.

Tip # 2

Experience– Inquire about the experience the psychologist has with your child’s age. A psychologist who specializes in adolescents may not be appropriate for your preschool aged child. Does the psychologist have experience working with schools and other related service providers? Understanding the school setting would be important since your child spends a significant amount of time in that environment. You want to find someone who has significant knowledge about the specific issues you are looking to address.

Tip #3

Theoretical Orientation– There are various theoretical orientations such as behavioral, cognitive behavioral, psycho-dynamic, or family systems. Some approaches provide more concrete strategies to implement and require interventions from the child’s environment. They may focus on the responses of the adults in your child’s life to enact positive changes. Others may be more long term, require more frequent visits, and may not include parents in the process. It’s important to have a brief understanding of the different orientations and be prepared to work with the psychologist.

Tip #4

Location– Consider the amount of time it would take to travel to and from the office.  The amount of time in transit should not exceed the session time. Some psychologists may even be available to work in your child’s naturalistic environment such as their school. This is sometimes helpful in developing skills in the environment where struggles may occur. For example, working on social skills in the context of the child’s peers may be most effective in enacting change and developing skills. Regardless, if getting to and from the psychologist’s office is a major burden on you and your child, it will become too much of a distraction from the work done in the session.

Tip #5

ScheduleBe certain that the time for the session is manageable for your child and your entire family’s schedule. Young children will be more available to benefit from treatment if they are not exhausted during the session. Also, consider availability for parent sessions.  Are evening hours or early AM appointments necessary for your family and if so, is that an option that is available? Find a time where the appointments aren’t disruptive but also can be made a priority.

Tip #6

FlexibilityTalk with your psychologist about his/her various approaches to helping children with their specific problems. Choosing a psychologist who develops a treatment plan based on your child’s specific needs rather than a set formula is crucial.

Tip #7

ConsultationIt is important for the psychologist to be able to consult with all the adults who care for the child to ensure consistency. This could include parents, teachers, caretakers, speech pathologists or occupational therapists.  A multidisciplinary approach to treatment with children allows the psychologist to gain a better understanding of the child’s struggles and provide support in various environments.

Tip #8

Parent involvement and educationFind out how much parent involvement is expected and encouraged. If you are looking for tools to carry over in the home environment, be certain the psychologist is willing to meet with families. Is the psychologist available to answer questions, respond to emails or be available for phone calls? Evaluate your own commitment and willingness to attend sessions independent of your child. Consider the amount of time you are willing to invest.

Tip #9

Fee- It is important to consider the fee, insurance reimbursement possibilities and inquire about what is covered in that fee.  Are consultations with teachers, caretakers, phone calls, team meetings included in the price or do they have a different fee scale.  Some therapists rates may be higher but they include some consultation. For example, they may not bill for a 20 minute conversation with the child’s speech therapist.

Tip # 10

Credentials– The term Licensed Psychologist is a regulated term by New York State.  Other professionals can call themselves psychotherapists, counselors, or behaviorists but the term psychologist is a regulated term that only those who went through rigorous training and supervision are entitled to use. Further, insurance companies often provide reimbursement only to those with the License Psychologist credential. One must achieve a doctorate to be considered for licensure but not all doctors have the license.

Tip #11

Background check- For safety, it may be good practice to inquire about a background check prior to allowing a professional to work with your child

Tip #12

Temperament– Many parents choose to have either a phone consultation or meet the psychologist at the office prior to committing to ongoing treatment for their child. In this meeting, you as a parent could also assess if the psychologist would be a good fit for you and your child. Is the therapist’s temperament one that could fit with your own? Trust your instincts — if you don’t feel comfortable chances are it is not a good fit.

The above tips are important to keep in mind when seeking a child psychologist near you. It is also important to familiarize yourself with prominent figures in the child psychology world, which will help empower you as a parent to make smart decisions and to be an educated consumer when looking for a child psychologist. While there are several figures, the three I find most useful for parents seeking a child psychologist are Adler, Erikson and Piaget.

No worries, I will not be giving you too much information, but only information that I believe can empower you as a parent and as a consumer seeking a child psychologist.

Let’s start with my favorite psychiatrist who is also trained in psychotherapy: Alfred Adler. He worked closely with Sigmund Freud, whom I am sure many of you are familiar with, but Adler is best known for his approach of looking at the individual as a whole. Adler believed that when children feel that they are not loved and don’t belong to this world they develop feelings of inferiority (what he called an inferiority complex). According to Adler, what people, particularly children, need most is a kiss and a hug and to be empathetically seen for who they truly are. Only then will they be able to be what they were truly meant to be in this life. Think about this for a moment. Think about yourself as a child or as an adult. How would you feel if your parent or friends saw you for who you are and loved and accepted you unconditionally and supported you throughout your journey? What are your passions? What would you have truly done if you could have choices without the social, parental or other societal constraints that might have pressured you? You don’t have to answer at this moment, but when it comes to our children, it is important to be aware of this. Now, think of this in the context of seeking a child psychologist. Are you seeking a child psychologist because you think your child is performing according to your expectations? Are they realistic? What are they based on? It might be a good idea to write these down and share with the child psychologist you choose. We often project our own anxieties and insecurities onto our children and as a result they develop anxieties and take on some of the parents’ fears, insecurities, etc.   

The next theorist that I think you will appreciate learning about is Erikson, who is best known for his psycho social theory. Erikson developed eight stages of development and a virtue associated with each of these stages. His stages are age appropriate trust vs. mistrust (age 0-18 months, virtue = Hope). Autonomy vs. shame and doubt (18 month- 3 years, virtue = Will), initiative vs. guilt (3-5y years, virtue= Purpose), industry vs. inferiority (5-13 years, Virtue = Competence), Ego identity vs. role confusion (12-18 years, virtue= Fidelity), intimacy vs isolation (18-40 years, virtue = Love), generativity vs. stagnation (40-65 years, virtue= Care), ego integrity vs. despair (65+ years, virtue= Wisdom). He focused on how people’s sense of identity develops and how people develop or fail to develop abilities and beliefs about themselves, which allows them to become productive, satisfied members of society.

Thinking about my three girls (ages 8,10 and 13), I found it helpful to think about their development in the context of Erikson’s stages because it helped me as a parent put things in perspective. For example, my daughter Shiloh, who is 8 years old, for the most part feels a sense of competence. During this stage of her development (Stage # 4 Industry Vs. Inferiority) I encouraged and reinforced her to take initiative and achieve her goals. However, if a child at that age is not encouraged, or restricted, then the child will begin to feel inferior and therefore will not reach full potential.

I also have great respect for Piaget because he was the first psychologist to make a systematic study of cognitive development. He was able to show that young children think considerably different than adults. Here are Piaget’s stages of development:. Sensorimotor (Birth-24 months), Preoperational (2-7 years) Concrete Operational (7-12 years) and Formal Operational (12 years-Adulthood).

Why are these important?

Piaget noted that all children shared certain developmental patterns. This can be helpful for you whether seeking a child psychologist or just curious about child development. They are easily understood. Back to the example of my 8-year-old, Shiloh, who is in the concrete operational stage (Age 7-12). I found it to be extremely helpful to read that Piaget found this to be a MAJOR turning point in the child cognitive development because it marks the beginning of logical or operational thought. This is good news for us parents! Because it means that the child can now work things internally in his head rather than physically try things out in the real world.  

You might think this is going too deep and you don’t need to know all of this, but the truth is, as a parent you have to be an active participant in your child’s therapy, so educating and empowering yourself with the basics of child psychology will help you be an educated consumer, ask the right questions and ultimately help your child succeed!

If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!

Overcoming Fear: Dealing With Anxiety

5 Actions to Take When Anxiety Is Near

 

Action # 1 : Normalize Your Feelings

The first and most important thing to do when experiencing anxiety is not to freak out and let it overcome you — this is easier said than done. However, a good first step is to tell yourself that it is normal to experience anxiety. Sometimes, letting yourself feel anxious is the best thing that you can do to help yourself overcome it. Before I continue, I want to convince you that anxiety can be a positive and constructive thing. (Yes! You read that right…don’t worry — I’ll explain more, so keep reading.)

Anxiety is a feeling characterized by intense fear, worry, and apprehension. So far, all of this sounds negative, scary, and overwhelming — and it can be. When you feel anxiety, it is expressed not just emotionally, but also physically. For many, this can be debilitating. These symptoms are typical for millions of people who are diagnosed with an anxiety disorder, including panic disorder. In the DSM 5 (considered the bible of psychology) there are 12 types of anxiety disorders. I will not include them all, but will briefly mention the criteria that is required to be diagnosed with Generalized Anxiety Disorder (GAD).

Before you tell yourself that you have a “disorder,” you might find it helpful to know that, in order to be diagnosed with a psychological disorder, you have to experience the following symptoms for a certain amount of time. Of course, you will need a professional to help with the diagnosis, but I am including this here so you can understand that what you are experiencing might not necessarily be a disorder, but rather a feeling that many experience. If you allow yourself to experience the anxiety, it may actually dissipate.

When should I seek a professional depression and anxiety therapist near me?

  • You experience excessive anxiety more days than not about several topics, events, or activities for at least 6 months.
  • The anxiety and worry that you experience is accompanied by seeking reassurance from others.
  • The anxiety can be related to work, health, financial matters, or other life circumstances.
  • The anxiety and worry are associated with at least THREE of the following symptoms:
  1.  Edginess or restlessness
  2. Tiring easily; more fatigue than usual
  3. Difficulty concentrating
  4. Irritability
  5. Increased muscle aches or soreness
  6. Difficulty sleeping

It is important to note that one can be diagnosed with GAD only if his disorder is not better diagnosed as a different disorder. Also, GAD cannot be diagnosed if the individual is abusing medication or alcohol.

Action #2 : Practice Mindfulness

Before you go any further, I challenge you to try the following exercise. Read the following instructions, and then pause for 60 seconds while completing the task:

  • Look at the palm of your hand.
  • Focus on your breath while looking at the palm of your hand.
  • When you feel that your thoughts are distracted by the many things you have to do (or whatever else you might be thinking about) gently bring your thoughts back to the palm of your hand.
  • DON’T judge yourself for being distracted. Simply notice the distraction, and bring your attention back to your hand.

How was this experience for you? (If you didn’t actually take 60 seconds to do this, please do it now…:-) )

I must say that when I first tried this exercise, it was extremely challenging for me. When I was first asked to do it in school, I found it difficult to focus my full attention on staring at the palm of my hand. (Who has time to do that?) Besides the fact that I had never actually looked at the palm of my hand or realized how many lines existed (kind of fascinating, no?), I was surprised to find out how challenging it was for me to just be mindful and quiet my mind for five very long minutes.

So, before I continue, it might be helpful for me to define mindfulness in a very simple way: Mindfulness is a state of active, open attention on the present moment without judging your thoughts and feelings. Instead of letting your life pass by, mindfulness means that you are living in the moment with full awareness of your current experience, rather than dwelling on the past or anticipating the future.

Many people practice mindfulness meditation to help with the reduction of stress and anxiety. There is a lot of evidence about the effectiveness of mindfulness, but I will include some studies that may convince you to be curious about mindfulness if you are not already familiar with it. My wish for you is that by the time you finish reading this section, you will have practiced at least 60 seconds of mindfulness exercise.

Can you think about the last time you experienced anxiety? What was the anxiety about? What was your first instinct to do when you felt it?

I have worked with many clients who, for a variety of reasons, are terrified of being anxious. We will all experience anxiety at some point in our lives. When we think about the word anxiety, we are most likely to associate the word with something negative that we must remove from our lives. While anxiety can create challenges for many people, it is important to also remember that anxiety serves a purpose to help and protects us in certain situations.

Action # 3 : Write Down Your Thoughts and Feelings

If I told you that writing down your thoughts and feelings would reduce your anxiety, would you at least try it? Many studies have shown that writing down your fears eases overall stress, and helps you perform better in life’s stressful situations.

A University of Chicago study that was published in the journal Science found that test takers who wrote down their worries before the test had higher scores than students who did not write down their anxieties and fears before taking the test. The researchers concluded that identifying and getting out all of their concerns helped to ease tension, and allowed them to free up brain power for more important things, like actually responding to the questions on the test!

Writing in a journal every day or two is a great way to release some of your tension. Write about happy things, as well — write about whatever you want! The important thing is to write. You may be happy to have those journals years down the road. Or, if you’re worried about leaving a paper trail, write things down and recycle the paper — it doesn’t have to be a precious keepsake! The point is, write down what’s bothering you, what scares you, what makes you nervous, and then move onto more important life things! Stop letting it take up space in your brain.

Action # 4 : Know That You Are 100% In Charge Of Your Thoughts And Feelings

This one took me a long time to actually understand, believe, and practice! Once I understood that I had the power to control my thoughts, though, my life changed and I was much happier. Let’s assume that you are reading this and believe that you INDEED have the power to change your thoughts and feelings. First, can you acknowledge how awesome it would be if you could have full control over your thoughts and feelings? So? What would you actually do with that? Understanding/awareness is only the first step towards achieving the desirable behavior (=reduction in anxiety). Basically, some event happens and you tell yourself something that it is causing you to feel/experience anxiety.

I am going to include some psychology terms, but feel free to ignore the terms and just understand the ideas behind them. Cognitive Behavior Therapy (CBT) and Dialectical Behavior Therapy (DBT) are the two treatment modalities that helped change my life and many of my clients’ lives. The simplest way to explain CBT is that our thoughts affect our emotions and behavior, so if you can change your thoughts or learn to redirect them, you will feel better and will be able to change your behavior. DBT is a specific form of CBT that emphasizes acceptance of what cannot be changed.   

Cognitive-behavioral therapy (CBT) is one of the most commonly practiced forms of psychotherapy today. Its focus is on helping people learn how their thoughts color and can actually change their feelings and behaviors. It is usually time-limited and goal-focused as practiced by most psychotherapists in the U.S. today. DBT seeks to build upon the foundation of CBT, help enhance its effectiveness, and address specific concerns that the founder of DBT, psychologist Marsha Linehan, saw as deficits in CBT.

DBT emphasizes the psychosocial aspects of treatment — how a person interacts with others in different environments and relationships. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations — primarily those found in romantic, family, and friend relationships. DBT was originally designed to help treat people with borderline personality disorder, but is now used to treat a wide range of concerns.

The basic logic is that your thoughts affect your emotions and behavior. So, if you take the example of you looking at yourself in the mirror and thinking that you are fat and ugly, the associated emotions will be sadness, anxiety, and other negative emotions.

Now, let’s remember that you have the full control of your thoughts and the ability to redirect your thoughts to a more positive place. With this in mind, you will look at yourself in the mirror and tell yourself, “I am ugly, fat, and I have the worst sense of style…” Then look at yourself again, this time with love and compassion, and tell yourself that you are a beautiful, healthy looking individual who is doing the best you can in order to be happy (or any other positive things you want to say to yourself). How do you imagine you will feel telling yourself these positive things? I am hoping better than you feel when telling yourself that you are ugly and fat. This might take some time and practice, but once you learn how to redirect your thoughts to a more constructive place that helps change your behavior and drives you to a more desirable behavior, your will feel so much more happy and healthy. It’s not about lying to yourself, it’s about acknowledging your thoughts and redirecting them to a positive place.

Action # 5 : Reach Out For Professional Help

Should I look for a therapist near me for depression and anxiety?

Asking for help is not always easy, but there is nothing wrong with asking for support. Whenever possible, I suggest that you use whatever resources you have to get the support that you need. It might help you to know that there are over 43 million people in the U.S. suffering from anxiety (that’s 1 in 5 adults!!!). Unfortunately for many people, there is a stigma associated with seeking support for mental health, which prevents them from getting the support they need. Many also wait until things get worse, which makes it more challenging to treat. Seeking and finding the right therapist near you to help with your anxiety issues can also be anxiety-provoking, but it doesn’t have to be. Prior to finding the right therapist, you can educate yourself and find out the best treatment for anxiety. There are also self-help books that you can read to help you better understand what you are experiencing.

Are you wondering, “Is it time to find a therapist for depression and anxiety near me?” Then why not talk to someone? Why not make your life less anxious? Hold yourself accountable for asking for help. Especially in today’s fast-paced world, it’s entirely normal to feel stressed, worried, and anxious, but we don’t have to live this way.

Search for a therapist near you who treats anxiety, ask friends and family for a recommendation, and if you have any questions, please feel free to call us for a free consultation!  At LW Wellness, we help match you with the right therapist who fits your needs and provides you with the care and attention that you deserve.

Pediatric Dietitian Advice From The Pros

How YOU Can Help Your Picky Eater By Not Jumping To Conclusions!

 

Whether you have a toddler or a teen, nutrition is extremely important for your child’s physical and mental development. I’m sure you’ve seen the research stating that one in every three children is obese. But what are we supposed to do with this information? As parents, all the information and oftentimes conflicting advice on what constitutes “healthy and nutritious” for your child can be overwhelming. And what if we have a kid who just won’t eat nutritious foods?

As an eating disorder specialist and a mom of three girls, I know the challenges that parents and caregivers go through when raising children and trying to feed them healthy foods, while promoting a positive and healthy body image. For some parents, this is not such a big deal, and they allow their kids to eat whatever it is they want without paying attention to the nutritional value. Other parents end up getting in the way of their children by worrying too much about what they are (or aren’t!) eating. Which end of the spectrum do you fall on? To what extent can you actually help your child? Advice from an expert pediatric clinical dietitian — someone who has seen it all! — may help you realize that you aren’t alone, and that your kid isn’t different! Many children experience difficulty eating, and it’s completely normal. However, as a parent you do play a vital role in guiding your child down a healthy path.

It’s important to recognize that picky eating isn’t your fault, it isn’t your child’s fault, and it is completely manageable. Children are growing creatures who experience new senses every single day in their bodies, and that includes in their taste buds! You wouldn’t expect a child to understand what a word is until they are taught to read it (and even after that it takes some time to recognize it on their own), so why would you expect them to understand their sense of taste immediately? Children are sensitive, and they are constantly learning about the world around them. Remember, it’s brand new for them! Our anxieties only worsen the situation. Read on for some advice from professional pediatricians and specialists on how YOU can help your child overcome the boundaries of picky eating and lead them on a lifelong journey to healthy eating!

Normalizing Picky Eating and Learning to Manage Anxiety from your Child’s Fussiness

Below you will find several findings from various pediatricians, eating specialists, and therapists who have either conducted studies on or worked personally with children who are extremely picky eaters. These doctors and therapists have worked closely with stressed and anxious parents who live in fear that their children suffer from eating disorders. The specialists assure these worried parents that excessively picky eating is more normal than you may think in children. Doctors and therapists also stress the importance of remaining calm and not making a huge deal out of a very common childhood trait. They outline the importance of not jumping to conclusions, and not labeling your child’s fussiness. What we as adults may see as being “picky” is often actually just a child experiencing and growing in the world around him or her.

Kristen Lee Campbell, MD is a Pediatrician at St. Louis Children’s Hospital & Instructor of Pediatrics. She is also a mom herself and has a picky eater of her own. Findings from her thesis on fussy eating in children is outlined below.

It’s Completely Natural

According to Dr. Kristen Lee Campbell, children are stubborn creatures by nature, and sometimes they simply decide their mind/body doesn’t want something. This is natural, and can be conditioned and worked with without too much cause for alarm. Just because a child is selective with his or her eating habits, it doesn’t necessarily mean he or she has a disorder. Being an overly picky eater is actually congruent to biology and the natural development of a child’s taste buds and tolerance for certain foods. “It does take time for children to develop the sensory tolerance for certain flavors, spices, textures, and temperatures,” Campbell says. Therefore it is totally natural for a child to be extraordinarily picky and selective with food. You also shouldn’t continually compare your child’s progress with eating habits to others because “the definition of age appropriate foods varies with culture, and a myriad of contexts,” Dr. Campbell explains.

Keep Calm And Keep Cool

Dr. Campbell also encourages parents to keep calm, and keep cool! Children are unbelievably impressionable. Believe it or not, if they sense your anxiety in a situation, they are more likely to experience their own anxiety. It is important to not project your own fears and misconceptions of possible eating disorders onto your child. The last thing that is going to help your little picky eater is a mealtime full of tension, worry, and fear. Children will often do as they see. They are little mimics by nature. Remaining calm, encouraging, and optimistic will only help ease your child’s picky tendencies. They also respond well to visually appealing and fun foods! Dr. Campbell personally knows how difficult this can be for parents, but she urges them to be patient, and remain optimistic.

Dr. Lee Hudson is a Consultant Pediatrician with expertise in feeding and eating disorders. His findings with picky eaters among children are outlined below.

You Are Not Alone

Dr. Lee, first and foremost, points out that parents with picky eaters are not alone! “Picky eating is very common,” he states with confidence. Dr. Lee relays that a study in the Journal Appetite, released in January 2016, evaluated the eating habits of well over 100 children ages 3 to 11. Overall, 39% of children were identified as very picky eaters. It’s common among children, and of course common among parents, to jump to conclusions and begin labeling. However, Dr. Lee stresses the importance of parents remaining calm, and not overanalyzing during a child’s “finicky phase”.

Dr. Faye Powell is a developmental psychologist at the University of Bedfordshire specializing in children’s eating behavior. Dr. Jacqueline Blissett is a reader in childhood eating behavior. Natalie Morris is a lead therapist at Integrated Therapy Solutions’ Feeding Clinic. All three specialists have worked together to study children with picky eating habits, and to assuage anxious parents. Some of their findings and thoughts on picky eaters are below.

Every Child Develops At A Different Pace

Dr. Powell believes that every child is different, and just because your child is not eating as much as his or her sibling or friend did at a certain age, there is no need to jump to the conclusion of an eating disorder. “Child fussiness is largely down to innate differences between kids.” For instance, Dr. Powell mentions that, “Children who have ‘heightened sensory sensitivity’ are much more likely to be fussy eaters. These children are sensitive to different sensory aversions and textures – it can be rather overwhelming. Kids with tactile defensiveness, where they have high oral sensitivity, will be fearful of and not accepting of foods that are different — crunchy, for example.” This doesn’t mean there is something wrong with your child, it doesn’t mean your child has an eating disorder. It simply means every child is innately different, and every child will develop his or her eating tendencies at a different pace. As long as your child is not malnourished or severely underweight in any capacity, this fussy phase is normal, and patience and optimism are key!

It May Just Be How The Food Looks!

r. Powell & Dr. Blissett also say that innately, children are fussier about foods because of how the food may look, such as toast being burned. “As they grow older, food fussiness may be because they are associating that food with something they find ‘disgusting’,” Dr. Blissett says. “If they see worms in the mud, they may associate them looking like spaghetti.” Therefore, it is actually  more normal than you think for a child’s fussy eating habits to develop past the age of 5 or 6. Believe it or not, this shows positive cognitive development, and cognitive function. It just so happens that if your child is a picky eater, their cognitive development is influencing their food fussiness.

Repeated Exposure

Dr. Powell, just like Dr. Lee, stresses the importance of remaining calm throughout your child’s picky eating days. “The key thing to bear in mind when encouraging your child to eat something is to not put any pressure on them,” Dr. Powell says. And that includes the pressure of a hypothesized eating disorder. “All research into food behavior points to putting pressure (including the projection of eating disorders and your own anxiety) on children to eat having a negative impact,” Dr Powell says. “For children who are fussy, ‘repeated exposure’, where you offer the food repeatedly without the pressure to eat it, is really important. Over time, that child will typically begin to accept the food.” The key is remembering that this is something that will happen over time.

Model Behavior

Moreover, Dr. Powell and Dr. Blissett discuss how impressionable children are. They talk about the importance of modeling while coping with your child’s picky eating. “Watching other people and learning through modeling other people’s behavior is so important,” Dr. Blisset says. “In all of our studies, we’ve shown if your child is fussy, the most effective way of getting them to try something new is if you’re eating the same thing and modeling it enthusiastically.”

Be Patient

Most importantly, Dr. Powell and Dr. Blissett encourage parents of picky eaters to be patient. Excessive fussy eating is more normal than many parents believe it to be, and widely affects children up to the age of 11. Even science explains a child’s fussy eating, and how it will eventually begin to cease, as Dr. Powell explains that, “With age, we lose sensory capacity and foods will be tasted less intensively. This is one factor reducing a child’s pickiness.” Therefore it is naturally common for young children to be exceedingly picky. It makes complete sense for a child to be very picky when it comes to foods because of their heightened sense of taste, so don’t stress!

Dr. Blisset and Dr. Powell also relay several cases of parents believing their child’s fussy eating days would never end. However, with patience and a calm demeanor, these parents overcame their fears and anxieties of their children’s projected conditions.

Don’t Project Your Anxiety

Natalie Morris, lead therapist at Integrated Therapy Solutions’ Feeding Clinic, is yet another therapist to stress the importance of parents remaining calm and optimistic throughout a child’s (very natural) journey with picky eating. Natalie explains how she has seen parents get worked up and anxious thinking their child has an eating disorder, and in turn the parents’ anxiety may be hindering a child’s appetite.  Natalie states: ”Feelings of fear and the need to control are significant. When the brain is in this heightened state of anxiety, adrenaline is released and this suppresses the appetite, making the child even less likely to eat.” When these feelings of fear are projected from parent to child, a child’s appetite can be suppressed even further.

Dr. Powell, Dr. Blissett, and Dr. Morris all assure parents with picky eaters that they are not alone, and that, despite their hardships with fussy eating, what they are experiencing is actually a very normal and natural phase for numerous children. They encourage parents to try as best they can to eliminate anxieties and simply “take each day as it comes.”

How Can I Find a Great Pediatric Dietitian Near Me?

A pediatric registered dietitian can be hard to find if you don’t know where to look. Let us help you in your search to help your child! After thorough research and interviews, we match clients with the perfect fit for their needs, whether it is a registered dietitian pediatric specialist, a nutritionist, a coach, or something else entirely. We have a fantastic base of specialists, including, of course, professionals who work in clinical dietitian pediatric nutrition! Check out our website to view our many professional specialists, or email or call us to chat about connecting you to someone who can help change your and your child’s life for the better.

 

Eating Disorder 101: A Mental Health Therapist Answers Your Most-Asked Questions Part II

Part II – Effects & Finding a Dietitian

Note: There are two parts to this article. For “Part I – Stress and Society,” click here.

I’m Limor Weinstein, founder of LW Wellness Network, and I am going to answer some of your most-asked questions about eating disorders. My background, experience, and education as a licensed mental health therapist are centered on personal and family well-being. As a mother, wife, and psychotherapist, my goal has always been to provide emotional support and knowledge that may be absent due to a variety of variables. I myself am an ED survivor. I am also an Eating Disorder Specialist who works with clients to help them find their way to better health.

What health risks are related to ED?

There are many health risks related to eating disorders. Each eating disorder has its own health consequences due to the nature of the disorders. As anorexia nervosa is characterized by self-starvation, the body is forced to live without the essential nutrients it needs for normal functioning. Anorexia can lead to abnormally slow heart rate and low blood pressure, which increases the risk for heart failure, reduction of bone density, muscle loss and weakness, severe dehydration, which can result in kidney failure, fainting, fatigue, overall weakness, dry hair and skin (hair loss is common). It is also possible that there is a growth of a “downy layer of hair called lanugo” all over the body to keep the body warm (NEDA).

With the binge-and-purge cycle of bulimia, the entire digestive system becomes affected, which leads to electrolyte and chemical imbalances of the body. These electrolyte imbalances “can lead to irregular heartbeats and possibly heart failure and death” (NEDA). This is because electrolyte imbalance is caused by “dehydration and loss of potassium, sodium and chloride” from the body each time the individual purges (NEDA). Gastric rupture can occur during binging. Frequent vomiting can lead to inflammation and possible rupture of the esophagus, tooth decay, and staining from stomach acids. Abuse of laxatives can lead to “chronic irregular bowel movements and constipation” (NEDA).

The consequences of binge eating disorder are similar to the health risks associated with clinical obesity. These include high blood pressure, high cholesterol levels, heart disease due to elevated triglyceride levels, type II diabetes mellitus, and gallbladder disease (NEDA).

Are there any ED withdrawal symptoms? What are they?

Withdrawal from an eating disorder is similar to withdrawal from other addictions. According to a study done by Indiana University, symptoms of withdrawal typically include irritability, cravings, and general restlessness.

Why do people fear overcoming ED?

Fear comes with this decision to recover from an eating disorder because until this point, the eating disorder has helped the individual to feel safe and secure. The eating disorder has given this individual a sense of control and identity. This is why it becomes difficult to stop an eating disorder. But, it is possible. The person affected by the eating disorder must overcome their feelings of helplessness, guilt, shame, and self-disgust to seek help. Once they do this, they will still fear letting go of their eating disorder and going through a change. These fears should be acknowledged and discussed to help in the road to recovery.

There is, of course, always the fear of relapse. The final stage of recovery, maintenance, is about new experiences and adjusting to new developments. With this there is the chance of relapse. But this cannot be the focus of recovery. This is why recovery is an ongoing process, involving asking for help and communicating through thoughts and feelings.

You’ve said that, “While it might not be easy to stop ED, it can be enjoyable.” Can you elaborate?

Although it is not easy to stop an eating disorder, it can be enjoyable. Depending on the type of treatment that one goes through, he or she will likely be surrounded by other people in treatment (which can be both good and bad as discussed earlier). By being surrounded by like-minded individuals, one can see that they are not alone, that there are people out there going through the same thing as them who are also looking to get help.

As August McLaughlin discusses in “The Silver Lining: 5 Happy Truths About Eating Disorder Recovery,” there are positive aspects in the road to recovery. Recovery leaves people “feeling lovelier, inside and out.” Individuals with eating disorders have distorted views of themselves both physically and mentally. They want to lose weight to fix their physical appearance, and they take these drastic measures to make them feel better internally. Treatment, however, teaches people how to appreciate themselves for who they are and to love each and every part of themselves. Treatment leads to greater energy. Eating disorders take an extreme amount of physical and emotional energy to sustain. By letting go of an eating disorder people will gain back this energy to do things they love physically and to think about something other than the eating disorder.

Treatment also brings enjoyment back to food. Food is no longer as scary as it once may have seemed. By mending one’s relationship with food, he or she can enjoy their favorite foods without feeling the extreme guilt before, during, and after. Treatment leads to freedom. Eating disorders have such control over people’s lives. By not letting the eating disorder dictate every life decision, individuals are surprised to see how much they can freely live their life, by their own rules. Lastly, treatment leads to gratitude. Living with an eating disorder can be extremely challenging and detrimental. People in recovery, living without an eating disorder, will learn to be thankful for their bodies and minds. It may be scary to think about what one’s life would be like giving up this eating disorder that has had so much control, but there is nothing to lose by giving up an eating disorder, just a beautiful life to gain.

I’m sick of people focusing on why I shouldn’t maintain my ED (health risks, etc.)! Can you tell me why people do continue their ED?

It is easy to list all of the reasons why clients should try and get rid of their eating disorders. There are health risks involved, the eating disorders take over the individual’s life, there’s dramatic weight loss as well as damage to the digestive system and potential organ damage. Sometimes it is not enough to express to the client the negative effects that an eating disorder can have. Rather, we should focus on why people maintain their eating disorders. People with eating disorders become comfortable with their eating disorders. They begin living a lie and don’t know how to get out of it, or if they even want to. As stated earlier, the eating disorder that has such control over their life becomes a sense of security and control. The eating disorder begins making life decisions that the individual does not have to make. Further, the eating disorder becomes his or her release. The willpower not to eat, the binging, purging, or excessive exercise gives the individual a way to relieve stress.

By teaching clients alternative ways to have control in their daily lives or new ways to cope and calm themselves, clients can hopefully give up the detrimental ways in which they achieve this through their eating disorders. If a client can begin to enjoy these alternatives they may be more likely to give up the harmful techniques they were using and transition into recovery.

Is it a myth that the ED person “sacrifices” something or deprives themself when they stop their ED?

Many people believe that when they quit something they are addicted to they will be sacrificing something. In the case of eating disorders a client may feel that they are missing out on something by giving up their eating disorder. To help with recovery we must show how positive it can be to live a life without an eating disorder. There should be “nothing to fear, nothing to ‘give up’ and absolutely everything to gain” (Carr, 2011).

Why do eating disorders provide people with a feeling of safety and security?

Life with an eating disorder provides people with a feeling of safety and security. This is because eating disorders are started out of instability, with the hope that the eating disorder will create stability or some kind of control. Eating disorders hold great control over individuals lives that they grow accustomed to over time. It can be scary to let go of this sense of control and comfort that they have been living with.

Is there a link between boredom and ED?

Yes, many people eat out of sheer boredom. It is important to differentiate between biological hunger and boredom. When we develop negative eating habits, we become unaware of why we are eating. An individual may try to fill themselves up with food when they do not feel like their lives are full. Eating becomes a mindless activity, similar to when one emotionally eats.

What is going on the brain of an eating disorder client?

In addition to the other emotional, physical, and social effects that eating disorders have on an individual, eating disorders can lead to neurological damage (Emilyprogram.com). A client’s nervous system is negatively impacted when they engage in restrictive behavior. This leads to disruptions in neurotransmitter behavior, structural changes, and abnormal activity during anorexic states, a weakened response in the reward regions of the brain, and potential shrinking of the brain. Nerve related conditions such as seizures, disordered thinking, and numbness or odd nerve sensations in the hands or feet are also possible effects. Eating disorder clients may become depressed, irritable, or isolated due to the adverse effects on the emotional centers of the brain. An individual also could have difficulty thinking, switching tasks, and setting priorities due to the disruption in the brain’s normal functioning.

Is it an illusion that I can overcome my eating disorder?

In some cases body dissatisfaction does not change once an individual has “recovered” from an eating disorder. Even when the physiological and behavioral aspects return to status quo, mentally a client may still feel negatively about their body. This is why recovery from an eating disorder is an ongoing process that involves overcoming daily triggers that an individual may encounter. However, it is not an illusion. There can be a light at the end of the tunnel.

How do I stop?

Unfortunately, this is not as simple as reading a response. However, I’ve put a list of things I have my clients ask themselves:

  1. What does the ED really do for me?
  2. What purpose does it serve?
  3. Do I really enjoy it?
  4. Do I really need to go through life playing with my health just to maintain my eating disorder?
  5. What am I getting out of maintaining this eating disorder?
  6. Would my life be incomplete without it?
  7. How could I make my life more complete so I can get rid of my eating disorder? How can I use the resources and people around me to help?

Where can I find a dietitian?

If you are trying to figure out where to find a dietitian, chances are, there is someone not far from you. There are fabulous nutritionists, dietitians, and eating disorder therapists all around the country who are qualified and ready to help you. Your doctor may have some good recommendations if you want to find a local dietitian. Do you want someone who is uniquely matched with you? Give us a call. We will learn about you — from your personality, your history, your health past, your struggles, and your goals — and we will find someone in your area who fits you best. We have many fantastic providers whom we trust and adore to help guide our clients on their path to recovery.

If you or someone you know is struggling with an ED, it’s time to take the necessary steps to change life for the better. You can grow into the best version of yourself, starting right now.

If you would like me to connect you with one of our expert therapists or dietitians, contact me or book an appointment with me. I look forward to hearing from you!

Eating Disorder 101: A Mental Health Therapist Answers Your Most-Asked Questions Part I

Part I – Getting Familiar With Eating Disorders

Note: There are two parts to this article. For “Part II – Effects and Finding a Dietitian,” click here.

OK. To get you into the right frame of mind, I want you to really listen up. If you or someone you know is struggling with an eating disorder, you probably have a lot of negative thoughts on the subject. You may be plagued by feelings of gloom, misery, and even depression. Put those thoughts on hold for a moment and picture yourself in a state of elation. Imagine being cured from a terrible, life-threatening disease. Because the truth is, eating disorders are terrible, life-threatening diseases, but you don’t have to fight them alone. We’re here for you!

I’m Limor Weinstein, founder of LW Wellness Network, and I am going to answer some of your most-asked questions about eating disorders. My background, experience, and education as a mental health therapist are centered on personal and family well-being. As a mother, wife, and psychotherapist, my goal has always been to provide emotional support and knowledge that may be absent due to a variety of variables. I myself am an ED survivor. I am also an Eating Disorder Specialist who works with clients to help them find their way to better health.

The following questions are questions that people have been asking me for the past 15 years over and over again, so I have decided to compile a list of answers and include some evidence as support. Since I had too many questions, I have decided to break this blog into part A and B, but if you have any other questions related to eating disorders that you want answered please feel free to email me and I will answer them for you! (limor.w@limorweinstein.com).

What is an ED?

An eating disorder is an illness that includes extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders can have serious emotional and physical consequences on an individual’s life. Although the majority of people with eating disorders are female, this illness does affect males as well. In the United States, 20 million women and 10 million men suffer from an eating disorder at some time in their life (Wade, Keski- Rahkonen, & Hudson, 2011).  

There are eight types of eating disorders including Anorexia Nervosa, Binge Eating Disorder, Bulimia Nervosa, PICA, Rumination Disorder, Avoidant/Restrictive Feeding Disorder, Unspecified Feeding or Eating Disorder (UFED) and Other Specified Feeding or Eating Disorder (OSFED). I am not going to go over all the eating disorders, but I will focus on the main three (Anorexia, Bulimia & Binge Eating Disorder). This is not to say that the other eating disorders are not important, but I promise to write about the other disorders as well in later blogs!  

Anorexia is characterized as inadequate food intake leading to a weight that is too low for that individual, intense fear of weight gain, self-esteem overly related to body image, and an inability to appreciate the severity of the situation. Within this categorization, there are two types of anorexia: binge-eating/purging type that involves binge eating and/or purging behaviors during the last three months; and restricting type, which does not involve these behaviors.

Binge Eating Disorder is characterized by frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting, a feeling of being out of control during the binge eating episodes, strong shame or guilt regarding the binge eating, and indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame of this behavior.

Bulimia Nervosa involves frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting, feelings of being out of control during the binge-eating episodes, and self-esteem overly related to body image.

Is ED an addiction?

In short, the answer is yes. Growing research suggests that there are several similarities between eating disorders and addictive conditions. The American Society of Addiction Medicine now has a more comprehensive definition of addiction, which includes “process” addictions, such as food, in addition to drugs and alcohol. This is because the effect that these substances and behaviors have on our brain is similar across “substances.” The reward centers of our brains can be activated by food in a similar manner as by drugs and alcohol. Once this reward center is activated, an addictive cycle is created. Therefore the stimuli, such as drugs, alcohol, or food, become a desperately desired substance. This is when addiction and dependency occur. Abuse of any substance creates a false sense of temporary happiness or relief, but of course, has its long-lasting consequences. (Eating Disorder Hope, 2016))

In fact, research indicates it is the restriction that becomes addicting, rather than the excessive food. Restrictive behaviors like starving and even exercising increase endorphin levels in a similar way as opiates — which is both fascinating and scary! However, this helps explain why people can’t simply STOP having an eating disorder. It also reinforces why you shouldn’t try to go it alone.

Is there a brainwashing component to ED?

Yes! Individuals who develop an eating disorder frequently tell themselves that eating less is better, eating more is bad, eating will make them gain weight, and gaining weight is bad. They repeat these ideas over and over throughout their daily life. These individuals can be compared to those who have been brainwashed. As explained in “Recovery from Eating Disorders: A Guide for Clinicians and Their Clients,” “they brainwash themselves to prevent weight gain: their feelings of hunger are felt as positive and safe and they are proud of being able to resist hunger, which gives them a feeling of control and self- esteem.” Feeling hungry is not the “norm,” but these individuals strive for that feeling. They also are brainwashed to believe that the image they see when they look in the mirror is not an attractive image, that even at a below normal weight they are still fat.

What do stress and society have to do with my ED?

Eating disorders are a prevalent issue in today’s society, related to the constant pressures to be thin. Whether this is in the media or from our friends and family, the pressures placed on people lead them to develop eating disorders. Those who suffer from eating disorders not only have issues with their eating behaviors, but these issues spread to other aspects of their life. There is no single cause for developing an eating disorder and it can be a combination of factors related to an individual’s social, psychological, interpersonal, cultural and/or biological influences.

Yes, we need to change the way that beauty is portrayed; being thin should not be equivalent to being healthy and beautiful. Society over-emphasizes appearance and sets unrealistic goals when it comes to weight loss. It also associates a thin body with success and love, therefore convincing members of society that if they want to be successful or find love they must first meet this body type. Society also puts labels on food, labeling them as inherently “good” or “bad,” which perpetuates feelings of guilt for eating a “bad” food.

The diet industry spends billions of dollars each year to promote diet pills and magic tricks that will make people lose weight instantly. If these “tricks” really worked then why are there so many of them? The reason that there are so many options out there is because diets don’t work.  

With the increased access to celebrities’ lives it is easier than ever to know what our favorite celebrities are doing to keep their “perfect bodies.” Between this and fad diets we are susceptible to developing body issues and disordered eating.

Is it a myth that people use ED to relax and calm/soothe themselves?

No! It’s not a myth. Eating disorders aren’t always just about wanting to be thin. In addition to striving for some body image ideal, individuals may use unhealthy behaviors such as dieting, starving, binging, and purging to cope with unpleasant and overwhelming emotions and stressful situations. For someone who doesn’t suffer with an eating disorder, this can seem like an unusual concept, but for many people these restrictive and controlling behaviors in regards to food actually bring some sense of peace. While these behaviors may relieve anxiety and stress in the short term, however, in the long term they actually increase anxiety and stress — in addition to creating other serious complications (ULifeline.org, 2016). It is important to note, though, that binging and purging can feel like the only way the individual knows how to receive pleasure.

Do you have an example of an extreme ED case that made news?

Today many people are showing symptoms of orthorexia nervosa. While this disorder is not currently recognized in the DSM-5, due to the “clean eating” phenomenon it is becoming popular. These individuals have an “unhealthy obsession with otherwise healthy eating,” meaning they have a “fixation on righteous eating” (NEDA). While orthorexia may start out as an individual looking to eat better, it can turn into an unhealthy obsession. Individuals look to eat perfectly each day, sometimes taking drastic measures to overcompensate if they “mess up,” which could lead to bulimia. This obsession can also take over their lives, taking joy out of everyday activity and making it difficult to have a social life. Rather than anorexia or bulimia, which focuses on calories and weight, orthorexics focus on healthy eating.

Why do people with ED feel intimidated?

People with eating disorders may feel intimidated by everyone around them. They could feel intimidated by the really “skinny” woman on the street because of the way she looks. They could feel intimidated by the “heavier” woman who is smiling, wondering how she could be so content living like that.

Individuals with eating disorders may feel intimidated to let their secret out. For so long it has been kept a secret between that person and their eating disorder. Letting someone into that secret can be overwhelming and scary.

Another aspect of intimidation can be within the eating disorder community itself. A person may feel intimidation from those who have “worse” cases then them, those who eat less calories, or those who have seemingly more self-control. On the other hand, they could also feel intimidated by those in recovery.

It seems like the ED person has already “programmed themself to fail.” Does our society encourage that?

Recovery from an eating disorder is hard, but it is definitely possible. One of the most important aspects of recovery is willingness to recover. If a person goes into treatment and recovery with the attitude that they do not want to recover, they do not want to gain, and that they are happy with how they are currently it is very difficult for treatment to be successful.

Those who have recovered are always in recovery, which is because there will always be those little triggers and thoughts that could have potential effects on an individual. Similar to how our society can influence the start of an eating disorder, society can also help someone to fail in his or her recovery. The messages about being thin and getting the best body are still out there. Granted there are now stories about feeling good at any weight and plus size models are being featured, but those do not stand out as much as the “5 easy tricks to drop 10 pounds in a week” articles.

Society reinforces eating disorder related behavior. Unknowingly, others who are unaware that an individual has an eating disorder may give positive reinforcement. They could tell their friend how skinny they look and they admire how they can control themselves in front of food or go to the gym for so long. For people who have friends who do know about the disorder, they probably offer care and support. The client may feel that without the eating disorder they would not get the same care and attention from those around them. Whether it’s negative or positive attention that an eating disorder brings to an individual, they likely appreciate this attention and it becomes an additional “plus” to the eating disorder.

What population of the USA has ED? How about the world? Is there any country where ED is not prevalent? Why?

In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life (Wade, Keski-Rahkonen, & Hudson, 2011). Eating Disorders affect 70 million individuals worldwide (The Renfrew Center). A study done by Medscape’s General Medicine (2004) shows that prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in females. Prevalence rates for bulimia nervosa in females ranges from 0.3% to 7.3% and from 0% to 2.1% in males. In non-Western countries, prevalence rates for bulimia nervosa ranges from 0.46% to 3.2% in females. Disordered eating in non-Western countries, though lower than in Western countries, have increased, likely due to the influence of Western culture (Makino, Tsuboi & Denerstein, 2004).

Is an eating disorder an oral satisfaction? Is there any evidence relating it to our early child development?

Oral satisfaction is a strong biological urge in every human being. It is common for an infant to suck on his or her thumb for self-soothing. As people get older they may smoke cigarettes or chew gum to get this satisfaction. Overeating and chewing nails has also become common practice when an individual is nervous. We know that “eating disorders are centered on fixations on food, which go beyond mere satisfaction of hunger” (Urdang, 2002). An eating disorder is not just about food or an unhealthy relationship with food, but about something deeper within the individual. There must be something else that is “unsatisfied” within the individual that the client tries to fix with the disordered eating behaviors.

What else should I know? And where can I find a mental health therapist near me?

This topic is so broad and we have so much to write about that we made it two blog posts! To read more about the effects of eating disorders, as well as how to find a mental health therapist or a dietitian, read Part II of this article here.

If you would like me to connect you with one of our expert therapists or dietitians, contact me or book an appointment with me. I look forward to hearing from you!