Clients want to improve: This is one of several central treatment assumptions in DBT and not one that is widely accepted or believed in general mental health settings. When I present the DBT assumptions in my clinical trainings, it is inevitable for some clinicians to question the validity of this statement: “I don’t think all...
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Author: Anita (Anita Federici)
For anyone who wonders why I advocate so hard for those with eating disorders (EDs), especially in the context of treatment access and with respect to Medical Assistance in Dying (MAiD), this article, in a nutshell, is it: In August 2022, Dr. Davia Barzdaitiene (Consultant Psychiatrist, Norfolk Community Eating Disorders Service) wrote an opinion piece...
We know that eating disorders (EDs) are not choices, but is recovery a choice? I spend a lot of time thinking about this because it has everything to do with how I design treatments and how I work with people in general. What you believe about human behaviour impacts how you engage with others....
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...
Binge eating and purging can be present in both anorexia nervosa (AN) and bulimia nervosa (BN). In both disorders, the individual may engage in objective binge episodes (eating a large amount of food in a short period of time accompanied by a sense of feeling out of control) and engage in compensatory behaviours. ...
This post was originally written for FEAST on Dec 28th, 2020: Given very high rates of suicidal and self-injurious behaviours among adolescents with eating disorders, it is crucial that families receive training and support to manage these complex behaviours. Rates of suicide are 12 times higher in those with anorexia nervosa and almost 8 times...
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...
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