All eating disorders are characterized by an inability to properly feed oneself. Difficulties in eating, body image, and digestion are largely rooted in neurobiological and metabolic factors and complicated by sociocultural influences. Avoidant/Restrictive Food Intake Disorder (ARFID) was officially recognized in the DSM5 in 2013, although researchers had been studying it for several decades prior, so this is...

Is suffering inevitable? Is pain inevitable? In DBT, we teach that pain in life is inevitable but that suffering is not. Suffering, from this perspective, happens when we experience “ordinary life pain” and then reject that pain or the circumstances causing it. This concept has been a focal point in therapy and in my consulting practice...

  Not sure if you are ready for this post, or if I am, but its been brewing….so here it is.   Over the past twenty years as a psychologist I have worked with and through so much. I have spent my career studying emotion regulation, trauma, eating disorders, and personality disorders (the overlap unmistakable)...

  When you restrict your eating in any way, your body adapts by entering starvation mode. Starvation mode is an evolutionary and biologically driven physiological mechanism designed to keep you alive. In cave person years, when food was not plentiful, the body would adapt by slowing down metabolism and digestion, reducing heart rate, and conserving...

    Despite the leaps and bounds the field has made, in large part due to the life work of people like Marsha Linehan, I am still disappointed (and concerned) by the prevalent judgement and emotion dysregulation that persists among healthcare practitioners when they hear the term borderline personality disorder (BPD). Eyes roll, sighs suddenly...

Dialectical behavior therapy (DBT) is guided by a number of core assumptions about the nature of human behavior and about the process of treatment. Over the next few weeks, I will describe each in turn. One that is high on my list right now, however, is the treatment assumption that clients cannot fail DBT. People often...

A mother sent me the attached “holiday song” stating the following: “these are the lyrics of a song that (my grade 3 child) is learning to sing for their Christmas concert. It doesn’t sound right to me and I wanted your professional opinion.” So I read the lyrics. And then I read them again. And...

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