Dr. Kimberly Dennis is the Medical Director at Timberline Knolls Residential Treatment Center

Tuesday, December 21, 2010

Jenifer Ringer “Too Many Sugar Plums” Controversy Highlights Dangers of Body Image Obsession and Power of Recovery

A November 28th performance of The Nutcracker by the New York City Ballet inspired controversy after New York Times critic Alastair Macaulay criticized dancer Jenifer Ringer, who is dancing the role of the Sugar Plum fairy, not for her performance, but for perceived issues with her weight, claiming she “looked as if she’d eaten one sugar plum too many.” But I believe the dancer’s eloquent and reasoned response to Macaulay provides a positive story of recovery.

Ms. Ringer spoke with such clarity and confidence, and with not an ounce of resentment in her demeanor. She demonstrates a healthy and rare ability to detach with love from the criticism of the critic. I agree with the ballerina that bodies that are starved cannot perform. The NYC dance troupe, which she asserts celebrates dancers’ bodies of all shapes and sizes, is truly to be commended.

"As a dancer, I do put myself out there to be criticized, and my body is part of my art form,” Jenifer Ringer, told The Today Show’s Ann Curry during an interview Monday. “At the same time, I am not overweight.”

Ringer has openly talked about her struggles with anorexia over the length of her ballet career. Timberline Knolls applauds her braveness. After Macaulay’s article received national attention, both the dancing community and online spectators rushed to Ringer’s defense. The dancer declined to ask for an apology while still firmly insisting her weight is healthy and in no way impedes her ability to dance.

Ms. Ringer nicely highlights how real change happens—by one woman in recovery sharing her recovery with others. That’s what she’s completed in her interviews, that’s what she does each and every time she dances with a healthy body. If we waited for the media and culture at large to initiate the change, we’d be waiting a long time, and the death toll associated with that wait would continue to rise.

Thursday, December 9, 2010

Eating Disorders among Children Rising at an Alarming Rate

A recent report published by the American Academy of Pediatrics shows hospitalizations for eating disorders in children under 12 increased 119 percent between 1999 and 2006. This is an alarming trend because small children develop their foundation of self worth and body worth in their early years (birth to five years old). This increase in hospitalizations show today’s children have distorted body image issues to such a degree it is causing unhealthy, even deadly, behavior.

According to the study, evidence of excessive weight concern, inappropriate dieting, or a pattern of weight loss in children requires further attention. Talking to the parent of a child may also yield information, however parents could be unaware, or even part of, the problem.

If a mother is anxious about eating, hates her body or has an unhealthy relationship with food, this can be directly transmitted to her children in deep, long lasting ways. The child absorbs and internalizes these same beliefs, regardless of whether or not they were ever explicitly communicated.

Often times, the media is blamed for portraying men and women unrealistically. Media is not going to change, but parents can.

The impact that one woman has on her children is exponentially more powerful than anything the media or culture can do to prevent eating disorders. Eating disorders are family diseases, and are best when treated as such.

Early treatment can not only save the individual, but also family members. We see it every day at Timberline Knolls. We are not only helping women save their own lives, but their recoveries have deep and healing influences on their children and other impressionable people in their lives, so recovery reaches more than just one person.

Wednesday, December 1, 2010

Helping Pain with Prescription Painkillers Can Lead to Addiction

With as many as 50 million Americans suffering some kind of chronic pain at any one time, prescription painkillers like Oxycontin and Vicodin have an important role to play in the medical community. But I need to warn you that with prescription painkiller use both patients and doctors must be aware of the risks of addiction.

People who find themselves addicted to prescription medications often deny their disorder with statements such as: "It’s legal, isn’t it?" or "I get it from doctors." But many Americans have come to view pain killers as a harmless treatment for problems that go well beyond the physical pain for which it was originally prescribed.

According to the 2003 National Survey on Drug Use and Health (NSDUH), approximately 4.7 million Americans used prescription drugs nonmedically for the first time in 2002—2.5 million of those were opioid pain relievers like oxycodone, hydrocodone, morphine, methadone, and combinations that include these drugs. 5.0 percent of 12th-graders reported using OxyContin without a prescription in the past year, and 9.3 percent reported using Vicodin (one of the most commonly abused illicit drugs among teenagers).

However, despite its addictiveness many doctors continue to prescribe these opioids for pain, even though mild to moderate pain can be treated with physical therapy, acupuncture, or biofeedback. Research does suggest that opioids used for non-cancer pain both decreases the pain and causes a moderate improvement in function and quality of life, but this diminishes greatly for people who develop addictions to prescription pain medications – many of whom did not receive any warning of the drug's abuse potential.

Patients with histories of addiction can have a very difficult time distinguishing between taking the medication for the relief of physical pain from the escapist motives that characterized their addictions. Timberline Knolls recommends that patients have support with them when they need to take pain medication, that they not do it alone.

For many people, periodic use can lead to a compulsive need to use, particularly if the person is self-medicating. Any opioid prescribed carries an abuse potential, and patients and doctors need to be and stay aware of this.

Tuesday, November 16, 2010

Alcoholic Energy Drink Sweeping College Campuses, Along with Its Dangerous Side Effects

Nicknamed “blackout in a can” or “liquid cocaine,” alcoholic energy drink Four Loko seems like the perfect cocktail because the combination of alcohol and caffeine can heighten the buzz for those drinking it. The mix can be especially tempting for college students, even more so if they have or are predisposed to alcoholism. But warns the effects can be seriously damaging to one’s health, and even deadly.

Colleges across the country are banning Four Loko after the recent events at Central Washington University, where a group of students "partying" with the drink began to pass out and suffer symptoms of toxicity. Over nine students were rushed to the hospital and more than fifty suffered serious illness.

This incident shows just how dangerous alcohol and caffeine mixes can be when taken rapidly and in excess. Students and college administrators need to recognize the added risks of products like this. One can of Four Loko contains 12 percent alcohol, significantly higher than regular beers, and then it adds high amounts of caffeine on top of that.

The caffeine in Four Loko can suspend the effects of alcohol consumption, allowing a person to consume more than usual without being aware of his or her level of intoxication. When the caffeine wears off the results can be deadly.

The caffeine masks awareness of the effects of the alcohol, even though the blood alcohol level changes with each drink. As a result, those drunk on energy drink and alcohol mixes are able to stay awake, even when their bodies would normally shut down from alcohol intoxication, which makes them more prone to health risks, including death.

A University of Florida study also showed that Four Loko drinkers are more inclined to attempt to drive after consuming the beverage in excess than those who consumed only alcohol. Alcohol poisoning is an issue we take very seriously at Timberline Knolls.

Once the caffeine wears off, the full force of the alcohol content will hit the body, with all of the physical ramifications. And with its low price point ($2.50 a can) the drink seems perfectly tailored to the college-age drinker that may not know when enough is enough. Regulatory bodies need to consider taking this off the market...college students die from alcohol poisoning regularly in this country using standard products alone.

Friday, November 12, 2010

When it Comes to PTSD in the Military, Sexual Trauma Can Cause as Much Damage as Combat

Post-traumatic stress disorder, or PTSD, continues to inflict a mental and physical toll on America’s soldiers, leaving physical, emotional and spiritual scars long after these veterans have left their posts in Iraq and Afghanistan. Additionally, for female soldiers, sexual assault and rape can create similar, and many times more treatment-resistant, symptoms of PTSD.

It has been well-documented in research literature that women are already twice as likely to develop PTSD as men following a trauma. And in the military, women have to deal with increased rates of sexual harassment and assault. Recent studies have shown that even without exposure to combat, our female troops could have increased rates of developing PTSD following rape or sexual assault than they could after combat.

Sexual assault in the military has been a serious problem throughout history. Among those seeking VA disability following the first Persian Gulf War, 71 percent of women reported sexual assault during their military service. At present time, for women in the military, 21.5 percent suffer some kind of sexual trauma while serving, while among men the numbers are closer to 1.1 percent.

Trauma affects the brain’s ability to function and sexual trauma is particularly damaging. Trauma can lead in some cases to psychological reactivity, exaggerated startle response, symptoms of avoidance and numbing, and co-morbid mood, substance abuse and/or eating disorders. Post traumatic stress disorder can have devastating effects on all areas of a sufferer’s life…I see this daily in the girls and women at Timberline Knolls.

A Veterans Health Administration (VHA) outpatient survey discovered that 55 percent of women reported sexual harassment, and 23 percent reported sexual assault. A study of reservists found that 60 percent of female soldiers had been sexually harassed and 13.1 percent sexually assaulted.

Even though the numbers are staggering for our service women, there is hope. PTSD can be effectively treated with trauma informed interventions. By integrating mental health and trauma treatment approaches into counseling, greater improvements can be yielded than by just providing basic psychological treatments or several core therapies separately.

Monday, October 25, 2010

The Role of Trauma

The 2010 NEDA Conference, held in Brooklyn, NY earlier this month (Timberline Knolls was one of the sponsors), used the theme of “Building Bridges to Recovery” to create dialogue among its attendees. To match this theme, I presented research on trauma’s role in later psychological damage, in particular its evolution into PTSD. I provided important information for NEDA about the demographics of trauma, how trauma changes the brain structure and the victim’s physical health, and the effective treatments available for PTSD which could help victims of sexual assault who display negative behaviors.

My previous research includes gender differences in the development of psychopathology and use of medication with family-based therapy for adolescents with anorexia nervosa, and during my presentation I outlined how the brain’s reaction to trauma (in particular sexual trauma) can result in the same post traumatic stress disorder that affects combat veterans.

Important topics in the presentation included:

Trauma exposure directly affects how the brain develops, especially in adolescents and children. As a child grows, his or her brain slowly develops different functions such as the regulation of anxiety or the capacity for abstract thought. If trauma occurs prior to one function’s development, then this part of the brain and all that follow may fail to develop in a healthy manner. Trauma in a mature brain can change it, but in children the brain’s entire organization can fail.

Trauma exposure can create a variety of negative mental health outcomes. Depression and substance abuse can follow a traumatic event. Some can develop PTSD, particularly when a woman has been exposed to rape or other sexual assault. PTSD in women can result in psychological reactivity, exaggerated startle response, symptoms of avoidance and numbing, and mood disorder. In the military, sexual assault can give women and men PTSD even if not exposed to direct combat.

PTSD has been treated using trauma informed intervention. A comprehensive, integrated, trauma informed and consumer involved treatment was tested on those suffering symptoms of PTSD. The study noted that after treatment a statistically significant improvement occurred in women’s trauma and mental health symptoms. Alcohol use significantly decreased and drug use trended in the same direction. The study concluded that outcomes for women with co-occurring disorders and a history of violence and trauma may improve with integrated treatment.

If you have any questions at all, or have topics you want me to address, please do not hesitate to email me at Dr.Kim@itsallinthejourney.com.

Wednesday, October 13, 2010

Obsessive-Compulsive Disorder

Many people have heard of obsessive-compulsive disorder or OCD, but many do not know how serious it can be. The term is used lightly and/or as a joke: "Gosh, you're so OCD!" But a person with OCD feels driven to perform compulsive and repetitive acts in an effort to ease distress. Despite his or her efforts to stop them, the distressing symptoms of obsessive-compulsive disorder keep coming back, and this leads to a vicious cycle of ritualistic behavior - and one that is very frustrating for the sufferer.

OCD can consume a person's life, and cause them to do little else but spend time focused on their obsessions and compulsions. Their OCD can cause them to become isolated, as those around them don't know how to deal with the person's actions, and the person with OCD feels they cannot and are not able to stop them. It can become a very lonely situation.

But there is help out there, and it starts with acceptance that there is a problem. I encourage anyone who has OCD tendencies or thinks they do to talk about it. Verbalizing emotions is the first step in getting help. Anyone who has questions about OCD, or wants to understand the condition more, Timberline Knolls has plenty of information on its website. Timberline Knolls treats women with OCD, eating disorders, alcohol and substance abuse, and complex co-occurring disorders.

Thursday, September 30, 2010

NEDA Conference October 8-10, 2010 - New York City

The NEDA (National Eating Disorders Association) Conference is coming up next week (Oct. 8-10) in New York City with this year’s theme being “Building Bridges to Recovery,” and on behalf of Timberline Knolls, I will be presenting at the conference on the topic of trauma.

With this I wanted to educate everyone a little bit on some of the signs and types of trauma.

Signs of Trauma and PTSD:

PTSD symptoms may become disabling, particularly if the sufferer lacks adequate social support to allow them to voice their traumatic experiences. Once a person has experienced a traumatic event, many diverse warning signs of trauma can arise.

* Inability to trust others
* Difficulty concentrating / Easily distracted
* Depression / Anxiety
* Feeling uncomfortable in social situations
* Abuse of drugs
* Eating Disorders
* Self Injury
* Recurring thoughts from the trauma interfering with everyday life

Types of Trauma:

The National Co-morbidity Study recently identified four most frequently experienced traumas:

* Witnessing someone being badly injured or killed
* Being involved in a fire, flood, or natural disaster
* Being involved in a life-threatening accident
* Combat exposure

I encourage anyone and everyone to ask for help and ask me questions they have or voice concerns on this topic or anything else.

Tuesday, September 21, 2010

Illinois Governor Pat Quinn Recognizes Timberline Knolls Residential Treatment Center with Statewide Proclamation

In recognition of National Recovery Month, Timberline Knolls Residential Treatment Center has received a proclamation from the Illinois governor, Pat Quinn, recognizing the month of September 2010 as Alcohol and Drug Addiction Recovery Month. I encourage everyone to use this time to celebrate the continued success of the many people in Illinois who have turned their lives around and achieved recovery, and a time focused on bettering the lives of those who are in need of treatment.

We want to express our deep gratitude to Governor Quinn for acknowledging the importance of Recovery Month among the citizens of Illinois. We urge all citizens to express support for those who are courageous enough to seek alcohol or drug addiction treatment and encourage and support others who search for help.

Approximately 23 million Americans are dependent on illicit drugs or alcohol, and of those 23 million Americans, less than 10 percent receive treatment. Recovery Month is sponsored annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment to raise awareness of both the scope of the problem, and the effectiveness of drug and alcohol addiction treatment.

We want the message to be clear: substance and drug abuse is preventable, addiction is treatable, and recovery is possible. The journey to recovery requires not only great fortitude, but also a supportive network. As we celebrate Alcohol and Drug Addiction Recovery Month, we also express our appreciation for the family members, mutual aid groups, peer support programs, health professionals and community leaders who provide compassion, care and hope.

Thursday, September 2, 2010

Yoga Therapy

At Timberline Knolls, we've incorporated a new form of therapy into our treatment program, yoga therapy, known to help bring balance to the body and mind through an awakening of the spirit.

Here are some of the different kinds of yoga we are using:

Fitness Yoga - aims at working toward fitness related goals utilizing breathing techniques and yoga postures.

Yoga Therapy - facilitates the experience of a mind-body connection through yoga postures, relaxed breathing techniques, guided relaxation, breath and movement coordination and meditation.

Gentle Yoga Elective - while similar to Yoga Therapy, the movements are gentler and slower, the postural holds are longer and there is a greater overall emphasis on restoration, self-exploration and breathing techniques.

Yoga Therapy for Individuals - helps develop mind-body connection, increase body-awareness and self-awareness and learn proper breathing to regulate reactivity and self-control.

Has anyone used yoga as a form of therapy? I would love to hear your experiences.

Friday, August 27, 2010

Going Back to School Met with Mixed Emotions

Millions of students at all grade levels, from elementary to high school to college, will head back to school – and many times this is met with mixed emotions. Not because the “summer fun” has ended, but because school adds new pressures into the mix, with many kids focusing on trying to be popular, and some just to even fit in.

Many times these pressures can manifest physically, with young men and women trying to be an ideal body size and weight, just like they see in the people they idolize in magazines and movies. I want to educate students and parents about potential problems and let them know assistance is available.

As many as 10 million females and one million males are fighting a life and death battle with anorexia nervosa or bulimia and another 25 million are fighting a binge eating disorder, according to the National Eating Disorders Association. And because of this, body image and eating disorders are growing concerns in schools around the country.

This is an especially critical time to be aware of potential problems and watch for warning signs. During this time when schedules change drastically with the start of school, and new pressures are added into the mix, children and young adults can be more susceptible to body image issues and concerns.

Warning signs that there could be a potential problem in a loved one include:
•refusal to eat
•difficulty concentrating
•denial of hunger
•obsession with body size and shape coupled with low self esteem
•skipping meals and making excuses for not eating
•eating only a few certain foods considered safe, usually those low in fat and calories

Recognizing these signs and symptoms in a loved one can be a critical first step in working to improve body image distortions. Through early intervention, treatment and therapy, a positive body image can be restored and a life free from the obsession of reaching an “ideal” body size and shape can be achieved.

Wednesday, August 18, 2010

Animal Assisted Therapy

I wanted to share with you some ways in which Timberline Knolls involves animals to facilitate healing and rehabilitation. As a collaborative effort between Timberline Knolls staff and a professional handler, Timberline Knolls residents work with animals to realize individual treatment goals by addressing a variety of mental health and human development needs, including behavioral issues, attention deficit disorder, substance abuse, eating disorders, abuse issues, depression, anxiety, relationship problems and communication needs.

Canine Therapy
By building on the bond between dogs and humans, residents receive unconditional love and patience provided by special therapy dogs, which help increase the residents’ self esteem and motivation. Whether emotional or physical, goals are oriented toward growth on an individual level.

Equine Therapy at TK Ranch
Timberline Knolls offers equine-assisted psychotherapy, a powerful and effective therapeutic approach providing residents with an opportunity to work and care for horses. Certified by the Equine Assisted Growth and Learning Association (EAGALA), TK Ranch helps residents develop non-verbal communication skills, assertiveness, confidence, creative thinking, leadership and problem-solving skills, as well as teamwork and relationships.

Has anyone found that animal therapy helped them in their recovery? I would love to hear your stories.

Thursday, August 12, 2010

Adderall a Miracle Drug to Students But Highly Addictive Nature Ignored

Another issue I want to talk about with kids going back to school is adderall use. Adderall is a drug widely reported to increase alertness, concentration and overall cognitive performance, while decreasing fatigue – but it is also a drug widely abused across college and high school campuses. During exam time and throughout the year, students are consuming this highly addictive drug in order to study, as well as in many cases to lose weight due to the loss of appetite realized when adderall is taken.

It’s prescribed on a regular basis to treat ADHD and ADD, but adderall is being sold and handed out in mass quantities to individuals with no prescriptions. The problem is getting worse and the harmful effects and addictive nature of this drug ignored.

Adderall is over prescribed to all populations, by general psychiatrists and even addiction psychiatrists, without informed consent or understanding by the psychiatrist of dependency risks. Many people with addictions and eating disorders seek out psychiatrists who will give them adderall prescriptions with little to no therapy, diagnostic detail or consideration of non-medication alternatives.

The problem has been researched by The National Survey on Drug Use and Health, specifically with college aged kids, who in a 2009 survey found that, “full-time college students aged 18 to 22 were twice as likely as their counterparts who were not full-time college students to have used adderall non-medically in the past year.”

I believe the best medication for attention deficit disorder is ongoing, consistent and loving therapeutic attention. Due diligence must be done by professionals to decrease the amount of these prescriptions handed out, and subsequently decrease the amount of abuse widely seen on college and high school campuses. And education to students on the drug’s addictive nature is key to stopping the severity of abuse being seen.

Thursday, August 5, 2010

Back to School: While a Fresh Start, College Also Can Trigger Harmful Lifestyle Choices

I wanted to let everyone know about a book my colleague here at Timberline Knolls Residential Treatment Center, Jena Morrow, recently published: Hollow: An Unpolished Tale. This book details a battle with anorexia that begins in early childhood, and also one where college gave her the perfect opportunity to delve deep into her disease.

College is supposed to be an exciting time in a young woman’s life; a chance for a fresh start, the opportunity to make decisions that will impact the rest of her life. But for Jena, college life brought negative and harmful lifestyle choices into the forefront.

Jena found college to be the most opportune time to really elope in harmful behavior, a sickness that almost killed her – anorexia.

In college, Jena hid her disease because she was no longer under the watchful eye of her parents, high school teachers or long-time friends. She was able to lie and deceive those who did not know any better.

She even recounted this story for me: "At the beginning of college, my parents bought a meal card for me, but there was one catch: I had to sign a paper upon arrival to college to activate it. I just never signed the paper; my parents never knew, and I played it off as a dumb mistake to my new friends. It was easy to hide my disease from people at college because they didn’t know I ever had a problem. I would avoid social situations where I knew food would be present, and in a way, isolated myself.”

With help, she’s had the strength to recover, and one of her messages in the book is a powerful one: the stresses, freedom and autonomy of college combine to create the perfect opportunity to practice life skills, but it’s also an ideal time for negative influences to have an impact and cause unknown internal triggers to show up for the first time.

Jena did relapse later in life, but after becoming a mother she realized she had more to live for – and is now happily in recovery. Currently working as a behavioral health specialist at Timberline Knolls Residential Treatment Center, Jena wrote her book to give hope to others struggling with an eating disorder, as well as create awareness and open people’s eyes to the impact and prevalence of these diseases.

Wednesday, July 28, 2010

Successful Addiction Treatment is a Family Affair

Active family engagement and commitment is one of the most underappreciated aspects of recovery from substance abuse and chemical dependency. From supporting a loved one in staying committed to treatment, to addressing rifts among other family members and building an atmosphere of healing that continues once their loved one returns home from an inpatient or residential treatment center, the family is an integral part to ensure lifelong recovery for those suffering from addictions.

Having a family member involved in the recovery process can often mean the difference between temporary and life-changing treatment. Family members are able to learn about and support a resident’s treatment goals, and patients learn about and support their families' goals, forming a shared mission.

At Timberline Knolls, we begin family treatment and therapy by phone almost immediately. This occurs in a variety of settings, including individual psychotherapy sessions, group therapy sessions for residents, and multi-family group sessions via conference call. Across each of these venues, family therapists work to increase awareness of ways that family dynamics may influence a woman’s behavior in ways loved ones don’t appreciate, and to enhance the woman’s confidence to voice her feelings about how the family affects her.

•Individual Family Therapy sessions are often conducted separately with the resident and with members of her family in order to allow all parties to speak openly and honestly. They provide perspective on the key family issues to address during residential treatment.

•Multi-Family Group is an educational forum for adult family members of all Timberline Knolls residents. Conducted by leading family therapy experts, it meets three times per month in order to increase family awareness of about how family dynamics can impact their loved one's illness and develop strategies for managing it. Given that most Timberline Knolls residents come from outside the Chicago area, this forum is conducted via conference call.

•Family Dynamics Group, for residents only, provides a similar in-person forum for residents to explore the 'inner workings' of their families. Residents hear the experiences of their peers and learn that they are not alone in their struggles. This group can often spur insight and breakthrough for addressing their family dilemmas.

Some rehab centers and treatment programs address family issues primarily in a single, on-campus family week. At Timberline Knolls we believe this short-changes the process that the family must go through while their loved one is in treatment. Over the course of several weeks, the examination of family roles and the process of clarifying boundaries and improving communication skills shows residents how to enhance their freedom and find joy within the family even during times of dysfunction or turmoil.

Because families are a part of their loved ones struggle with addiction, illness and problematic behaviors, they also need to engage in their own recovery and healing process. Research indicates a higher probability of their loved ones recovery when family members are a part of the process.

By integrating loved ones into focused family treatment sessions, patients and their families are able to increase communication and work together towards understanding and tolerance of each other's perspective, a major step towards an individual's acceptance of herself and a vital component to the healing process.

Thursday, July 22, 2010

Mommy Not Always Dearest During Treatment For Eating Disorders

One underlying cause that surprises many women during treatment for an eating disorder is the relationship an adolescent girl has with her mother. Young girls suffering with eating disorders often think the physical aspects of their disease call for the most healing, but in most all instances, girls have to recognize the psychological and emotional damage caused by anorexia or bulimia, too. It’s during this process that they often uncover unexpected root causes of their disease.

This happens because the mother-daughter relationship can be a complicated one. While relationships with friends and husbands begin in adolescence and adulthood, a mother's love begins before a child is born, and can create an unrealistic expectation that the connection between mothers and daughters will be as strong and free from limitations in adulthood as it was in early infancy.

At Timberline Knolls we endorse an introspective look at this unique relationship and believes temporary distance from family members allows many adolescent and teenage girls to feel safe exploring the mother-daughter relationship in ways they haven’t been able to during prior treatment for anorexia or bulimia. We work together to foster a nurturing environment that helps teen girls gain a realistic view of their relationship with their mothers. In turn, the girl and her mother are better equipped to support each other on their path to recovery.

Exploring relations with her mother in a residential setting also equips a young woman to place the relationship in a healthier social context. Because in reality, an individual's needs and fears are often informed by society's needs and fears, making this one of the most maligned of all human relationships. By identifying societal myths commonly found in these relationships, mothers and daughters can begin to build a stronger foundation – and one of recovery for those suffering from eating disorders and substance abuse.

There are several “perfect mother” myths that can create unrealistic standards for behavior that often strain the relationship and trigger feelings of shame:
•the measure of a perfect mother is a perfect daughter
•constant nurturing comes naturally to all mothers
•mothers are born knowing how to raise children
•mothers and good daughters don't get angry
These ideas contribute to mother-blaming when mothers don't match the myth and can create distance between mothers and daughters.

In the same way, there are “bad mother” myths that can lead mothers and daughters to feel like they are walking a tightrope where too much or too little love will push them over the edge. Damaging assumptions include:
•mothers are inferior to fathers as authority figures
•only experts know how to raise children
•mothers and daughters are bottomless pits of neediness
•mother-daughter closeness is unhealthy
•assertion of a woman's power is dangerous or unseemly
The impact of beliefs like these can keep a teenage girl from seeking support from her mother when she needs it, or from accepting her mother’s efforts to build a normal, healthy bond that will help her through adolescence.

Relationship myths can be particularly perilous for young girls who are struggling with body image issues. Given that a mother is often the first person to recognize signs and symptoms of an eating disorder, any reluctance to address her concerns in an open and honest way can impact her daughter’s chances of avoiding long term medical complications.

Through residential treatment and therapy this relationship can be explored and these young girls can come to better understand its affect on their diseases – and in turn help build a foundation for lifelong recovery.

Friday, July 16, 2010

Heroin Addiction Deaths Might Have Fallen, But Still A Problem

A new study by Roosevelt University’s Illinois Consortium on Drug Policy shows deaths from heroin overdoses in Chicago’s Cook County fell 16 percent during the last decade, but the Chicago metropolitan region still ranks among the worst in the nation for heroin use. I see the use of heroin regularly from girls I treat at Timberline Knolls and know the importance of awareness and seeking help to overcome this addiction.

Heroin is exquisitely addictive, especially when injected, because the effect is euphoric, profound and immediate. There is a great need for individuals suffering from heroin addiction to seek treatment, and that many times starts with the family and loved ones of these individuals intervening when they suspect a problem.
Loved ones may notice a number of signs of heroin use, which are visible during and after heroin consumption:

•Shortness of breath
•Dry mouth
•Constricted (small) pupils
•Sudden changes in behavior or actions
•Cycles of hyper alertness followed by suddenly nodding off
•Droopy appearance, as if extremities are heavy

But the above signs are not unique to heroin abuse. More definitive warning signs of heroin abuse include possession of paraphernalia used to prepare, inject or consume heroin, including:

•Needles or syringes not used for other medical purposes
•Burned silver spoons
•Aluminum foil or gum wrappers with burn marks
•Missing shoelaces (used as a tie off for injection sites)
•Straws with burn marks
•Small plastic bags, with white powdery residue
•Water pipes or other pipe

Loved ones must watch for these warning signs and for paraphernalia used in heroin abuse – and seek help immediately. Heroin use is associated with high risks of overdose and death, hepatitis and HIV transmission. But through treatment and therapy, lifelong recovery can be achieved.

Tuesday, June 29, 2010

Prevalence of Eating Disorders in Female Athletes Exacerbated by Need to Masculinize One’s Body

Eating disorders and disordered eating are commonly experienced by female athletes, and are many times brought on by the pressure female athletes feel to masculinize one’s body. Right now, as the World Cup is going on and baseball is in full swing, I want to make young athletes and their coaches aware of this growing problem.

As I’ve seen in my own experience treating eating disorders in young women, the prevalence of these disorders in female athletes occurs at an even higher rate than the general population. They can be spurned by denial, perfectionism and psychosexual implications. Most athlete role models are men, with the exception of aesthetic sports such as dance, cheerleading and synchronized swimming and because of this many females think their bodies must match a male physique.

The psychosexual implications of being a female can contribute to this increased prevalence and risk of disordered eating among female athletes. Because most athlete role models are men there may be pressure to masculinize one’s body and become more muscular. They might also seek to avoid menstruation, with its inherent cyclical fluctuations affecting bodies and moods, since stability, consistency and control are important for athletic performance and success.

Early detection is key to fighting this deadly disease, which has a death rate twelve times higher than the death rate of ALL other causes of death for females between fifteen to twenty-four years old, and coaches and school administrators are sometimes the first line of defense in noticing key changes that could signal an eating disorder. There needs to be education around prevention and recognition of eating disorders, particularly to staff and coaches for female athletes and to the female athletes themselves. Coaches and school administrators must foster a culture of safety around the athlete so that they feel comfortable asking for help and expressing concerns about weight, as well as be able to make appropriate treatment recommendations. It is only through a combined effort on all fronts that we can stop this deadly disease and help young women find lifelong recovery.

As always, I encourage you to email questions you have about eating disorders or topics you would like me to address in an upcoming column to Dr.Kim@itsallinthejourney.com. I look forward to hearing from you.

Monday, June 14, 2010

Timberline Knolls Helps Repair, Rebuild and Restore Health, One Meal at a Time

At Timberline Knolls, incorporating nutrition therapy into an individual’s personal treatment program is not an option – it is critical to recovery success, and it follows the position of the American Dietetic Association (ADA) which states that, “nutrition intervention, including nutritional counseling, by a registered dietitian is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care.”

At Timberline Knolls, registered dietitians are skilled counselors who conduct a complete dietary evaluation in relationship to an individual’s physical needs and act as a bridge from the unknown to a new education about what food and drink must be to physically meet the body’s needs. During treatment, residents are given personal meal plans, designed to repair, rebuild and restore a resident back to health. Registered Dietitians work with residents to come to an honest understanding of current food intake and emotional associations with foods – which is one of the most important steps in finding recovery.

Normalizing nutrient intake is critical to allow recovery to occur. Without a minimum intake of calories and nutrients, making the simplest decision can prove difficult and this can impede recovery because the human body can’t function properly.

Through a combination of meal support and planning, support groups and family involvement, Timberline Knolls’ registered dietitians are able to work with residents to provide encouragement in order to begin on the path to recovery. Our goal here at Timberline Knolls is to bring honesty and caring communication about eating to our nutrition therapy program, because it is only through this safe environment that recovery from eating disorders can happen.

I encourage all of you to ask questions about proper nutrition intake – and watch the behaviors of loved ones around you for disordered eating. Don’t be afraid to seek help or information. As always, I encourage you to email questions you have about eating disorders or topics you would like me to address in an upcoming column to Dr.Kim@itsallinthejourney.com. I look forward to hearing from you.

Monday, June 7, 2010

Summer Weather Aggravates Negative Body Perceptions

Summer is upon us - and this is a time we need to be especially aware of our own body image. During the warm weather season, negative body perceptions are aggravated for many people. Clothing is thinner and less substantial, increasing feelings of inadequacy which manifest as poor body image. It is during this time that men and women sometimes take drastic measures to try and get their bodies to an “ideal” size they feel comfortable showing off in the summer – and these drastic measures can lead to serious eating disorders.

People begin the warm-weather season thinking they need to lose a few pounds to look good. They may go on a crash diet or begin a cycle of binging and purging. Positive reinforcement of this sudden weight loss by peers could cause a person to feel like he or she must maintain that type of body to feel good about him or herself, and this can trigger or reinforce eating disorder behaviors.

But we must remember that even when someone does lose weight to fit into that swimsuit, if he or she is not comfortable from the inside out they will never feel good in anything they wear. As people continue to lose weight and receive praise, they feel they need to keep going and keep losing weight – which quickly turns into a full-blown eating disorder. Watching for warning signs of an eating disorder during these months leading up to the summer is crucial for loved ones and friends – and not being afraid to talk to someone if you suspect they have a problem. Anorexia nervosa has the highest premature mortality rate of any psychiatric disorder, so the earlier it is addressed, the more likely the individual is to find recovery and begin to work on their own self esteem and body image issues.

Many people who suffer from eating disorders are not clinically overweight – they simply see themselves in a distorted fashion – so it is best to consult with a doctor if you want advice about losing weight. Eating healthfully one day at a time is the only way to maintain consistent and healthy weight loss if a doctor determines you have a weight issue. Crash dieting because you have to fit into a swimsuit this summer is not healthy, nor is it safe. Just remember, it’s not about what you eat, but rather, what is eating you. You can learn by visiting the Timberline Knolls website.

As always, I encourage you to email questions you have about eating disorders or topics you would like me to address in an upcoming column or on this blog to Dr.Kim@itsallinthejourney.com. I look forward to hearing from you.

Dr. Kim

Thursday, May 27, 2010

Hello It’s All in the Journey Readers

Thank you for coming to check out my blog and welcome! Due to the overwhelming support and attention to my Food Fight columns in It’s All in the Journey, I wanted to have another outlet to quickly and easily respond to feedback I receive from you all, the readers. I wanted to be able to offer additional advice and provide information for people to learn more about eating disorders and substance abuse and how to find help.

Please feel free to leave comments to items I post on here. I hope for this to be an interactive forum for people to engage and ask questions and seek out information. If there is a topic you want more information on, please let me know and we can discuss it here.
I look forward to hearing from all of you and educating along the way.
Please don’t hesitate to email me at DoctorKim@ItsAllInTheJourney.com.
Dr. Kim

Timberline Knolls