Working Through Perfectionism in Eating Disorder Recovery by Jessica Gilliland, MS, LAMFT

 

Perfectionism is the pressure to live up to an unreasonably high or perfect standard–no mistakes allowed. For those engaged in eating disorder recovery, combating perfectionism can feel like an uphill battle. Even for individuals who are highly committed to recovering from an eating disorder, the pressure to be “perfect,” whether it comes to body appearance, weight, emotions, choices, or relationships, can be crushing at times. This pressure to be perfect is not something that only individuals in eating disorder recovery feel; almost everyone can relate to feeling the burden of perfectionism at some point in life, especially when it comes to times of life when change and growth are a focus.

Embracing Ambiguity

In working with my clients, I have noticed perfectionism begin to rear its head as recovery starts to gain positive momentum. Suddenly it seems like there is a “right” way to do recovery. The expectation of doing recovery “right” can be just as intimidating as deciding to choose recovery in the first place. Suddenly new ways to fail start popping up, and the questions of self-doubt start getting louder:

“Was I good enough at treating my body kindly, or am I still letting my eating disorder win?”

“Part of me is still afraid of letting go of my eating disorder. Does that mean I’m not really in recovery?”

“I just turned down a lunch date with a friend because I was feeling anxious. Is that a recovery ‘fail?’”

These doubts and fears are a common part of the ambiguity that can surround eating disorder recovery or any type of change or progress. Often it can feel like there is a line dividing what is “recovered” and what is not. The truth is, recovery is not as black and white as it might seem. Sometimes turning down a lunch date in favor of another form of self-care IS the recovery-friendly choice. Another day, choosing to go out to lunch despite feeling anxious might be the next step in moving recovery forward. These grey areas can seem frustrating and even frightening, especially to a person who struggles with the pressure to do things perfectly. However, learning to be flexible and to accept ambiguity and its resulting difficult emotions can be a key part of moving away from a life governed by the strict and unforgiving rules of an eating disorder, and toward a life led by deeply held values that guide a person toward what they truly want most.

Getting in Touch with What Matters Most

Even as a therapist, I am not immune to the sneaky effects of perfectionism in my own life. Recently I realized that I still have some insecurities about my body, despite having been recovered from my eating disorder for several years. Almost without my realizing it, perfectionism started to feed those insecurities until I came to what felt like a bit of a recovery identity crisis. Those questions of self-doubt started to make themselves heard. “I’ve spent years in my own recovery, and years learning about eating disorders and how to treat them, so shouldn’t I have all of this stuff figured out by now?” The pressure to be perfect at recovery started getting stronger and stronger, and my confidence in my identity as a recovered person began to take a major hit!

After a lot of self-reflection and work with my own therapist (and yes, therapists can benefit from therapy, too!), I stumbled upon a truth that I needed to find for myself. It came to my mind as a gentle question:

“What if instead of worrying about whether I’m doing my own recovery ‘right’ or not, I tried doing what feels caring and kind to myself?”

While my day-to-day life looks very different now than it did when I was in the throes of my eating disorder, I have recognized that being intentional about treating myself with kindness is still an essential part of staying committed to recovery. Kindness and compassion are some of my core values, or principles that I want to rely on in guiding my life. Perfectionism started to get in between my values and my thoughts and attitude toward my body. As I have gone through the process of facing my insecurities and getting back in touch with my values, the draw toward perfectionism has seemed less urgent and less appealing. While it has not been easy to accept that I still do have some body image woes, giving myself permission to struggle with them has opened the opportunity for me to grow and gain insight as I have reconnected with what is most important to me.

For me, recovery does not mean suddenly arriving at a place where I always make the “right” choice about food, exercise, my body, or anything else. In most cases, it actually means taking away the pressure of the labels “right” and “wrong,” and instead responding to my physical and emotional needs. It doesn’t mean that I never experience negative feelings about the way my body looks. It does mean that I give myself permission to make loving choices for myself and for my body, despite negative feelings that may come up at times. I can maintain my commitment to recovery even when I feel shaken up by difficult emotions, as long as I can keep my core values in sight.

Breaking Free

While perfectionism can develop a tight grip on us as we try to change and progress, there is hope for breaking free. When we give ourselves permission to struggle and stumble on the journey of change, we open the door for peaceful self-acceptance, wherever we may be on that journey. As we allow ourselves to be guided by what matters most deep down, rather than by the harsh and inflexible rules of perfectionism, we find satisfaction and meaning in our experiences. Letting go of the “right” way to do recovery, or any type of change, can be like taking a breath of fresh air.

Medication Management and Mental Health

In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.  

 What is missing for these patients? Medication management 

Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece. 

When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit.  Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case. 

During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence. 

Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management. 

Originally published on http://utvalleywellness.com/

 

 

A New Start. A New Journey. A New You. How the right therapy, and the right therapist can help get you there by David Nutter, MA, LAMFT

New starts in life often happen when people decide to engage therapy. Whenever I meet new clients as individuals, couples, or even families, I ask them what their goals are in therapy. For some, they have not been asked about what they need, want, or even prefer in their lives for a long time. For others, it often feels that they have never been heard at all, let alone asked. What happens when you go to therapy? What type of model and style of therapy will the person you see provide? What is their level of formal training, how well attuned are they to meet your needs and do they rely on any other resources other than their self-perceived competency? Understanding how much someone knows about your particular issue(s) is a critical step in selecting the type of therapist and style of therapy you will engage.

For example, as I write this article I am thinking of the many different styles of therapy available. I can immediately think of 11 different styles: structural family therapy, strategic therapy, the Milan systemic approach, the Mental Research Institute (MRI) approach, Satir’s communication approach, symbolic-experiential family therapy, intergenerational family therapy, collaborative therapy, narrative therapy, cognitive behavioral therapy and solution-focused therapy. That’s a lot of different styles of therapy, all with empirical research associated with their model and experts in each field.

Added to this list of styles of therapy are the therapists themselves. Who are you going to see and what you are likely to experience is largely dependent on the type of education they have and the experience they have with others. There is a vast difference in the education requirements to become a life coach, mental health counselor or a marriage and family therapist (MFT). There are differences in approaches and emphasis, even within the same style/model of therapy. You and the particular issues you bring to therapy may be weighing on you. The therapist fortunate enough to have you as a client should work as hard on your issues as you do.

There are resources such as books, workbooks, films, music and other sources that might resonate with you that are not particularly useful or preferred by others. You have decided to make a new start and that new start needs the support of the developing relationship of trust you are building with your therapist of choice. That relationship is essential for discussing what you want to achieve and the ways you plan to address the changes or goals you want for yourself and your relationships. Your new journey starts with a decision about what you want to experience in the future. Often this gets accomplished by a review of the past and current life experiences you have survived or thrived from. The therapist caring deeply about your experiences and your strengths will celebrate what you have achieved and where you are going. Aspects that you bring to the therapy effort are elements of the way you might describe yourself—the many facets of who you are. When people describe their experiences in therapy, I hope they include feeling heard, challenged, respected, validated, encouraged and celebrated. Their experience should feel welcomed like a friend, with a serious focus in a nurturing manner. Sometimes people cry, reflect and reconsider critical directions or attitudes they have adopted. Sometimes they laugh and release tension in a light-hearted way. New beginnings are often encouraged by a therapist going the extra mile along side of you, so you can keep going more miles, confidently forward. Welcome to your new start.

 

About the Author:

David Nutter is an Associate Marriage and Family Therapist at the St. George Center For Couples & Families. His career experience includes military service, management and executive positions and international business consulting. He received his undergraduate degree from BYU and his Masters in Marriage and Family Therapy from Northcentral University, a COAMFTE approved program. David was inducted into two honor societies for academic and clinical excellence and is enrolled in NCU’s PhD/ MFT program. During his Master’s program he was mentored by Steve Allred, with a broad range of client ages and issues. He served as the SGPD Chaplain (board certified) to reduce the impact to personnel and citizens from significant trauma experiences. He is adjunct faculty at DSU. He has lived in every U.S. time zone and abroad, and appreciates diversity. David is married to his “girlfriend” Diane. Together, they call their 7 children, their spouses/partners and 5 grandchildren their immediate family.

Why Should Couples Consistently Set New Year’s Resolutions Together? By Dr. Matt Eschler, Ph.D, LMFT

I have counseled couples for twenty-five years. Panicking, anxiously pacing, wringing hands, couples have wandered into my office, hoping to find some peace in their relationships. In the counseling arena we explore some very principled foundation ingredients that, when mixed together, produce peaceful, passionate relationships.

There are three fundamental ingredients that all of us need to exercise for a shot at a sound relationship. My challenge to you is to sit with your lover and assess the following three principles, and set specific goals to learn a little more, stand a little more firm, and increase your skills in these three areas:

The first foundation principle is friendship. Friendship is unilateral. Increase your friendship with your lover every couple of hours. You do this by sharing information, being trustworthy, and being transparent—without conditions.

The second principle that relationships will not survive without is influence. You must accept your lover’s influence. Men seem to have a slightly more difficult time with this, but both partners will benefit from allowing influence. Think about a time when there was disagreement in direction of relationship or activity. Did you allow your lover to have influence? Did you argue until one of you gave in? Was their healthy negotiation until a mutually satisfying result occurred? The hope is always influence and no competition. Get a little better at this in 2018!

Finally, the third principle is generating a governing purpose for your marriage. This is the North Star that holds you both accountable to a result that is desirable and cherished. If you are seeking the same purpose, you won’t go after hostile results. For example, my wife and I want to travel the world. If I sneak out and spend our travel money on a new truck and lots of clothes, we won’t have resources available to travel. That causes issues. If I save and we put our travel fund together and watch it grow together, we will eventually accomplish our common goal.

I invite you all to accept this challenge: In 2018 be a little bit better in all three of these areas. Sit with your lover and map out a specific strategy to accomplish these three goals to improve your relationship.

 

About the Author: Matt lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Simple Ways to Improve Mood by Alberto Souza, MSN, APRN, FNP-C

We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.

Be With People

Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.

Get Out

Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.

Enjoy Yourself

When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.

Talk to a Professional

Feeling sad or moody are normal human emotions that we all experience from time to time.  Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.

Source: Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.