I utilize my own shared recovery experience to provide compassionate recovery care and empower clients to a life of health and wellness.
Well, I think something we just talked about off-camera is technology, and how now we have these options to deliver care through these different mediums. And I will say for myself as a clinician, I was already using Zoom even before COVID. But I think for myself and a lot of my colleagues, we started using Zoom even more. And so, in some ways, it’s a great service to offer people. I find sometimes more and more people are like, “Oh, I’d prefer Zoom. It kind of works better with my lifestyle.” Using technology to deliver services can be very effective. In the FAB program, we started using the MyClearStep scale, which I think was also kind of born out of COVID-19 because clinicians wanted to find ways to monitor clients. The MyClearStep scale is a Bluetooth scale. We don’t always want clients to be overly focused on numbers. So they step on the scale and their information such as weights, and for some people, you can do vitals. We just monitor the weights and then the person doesn’t have to overly focus on the number. Then, our team gets that information. Technology is this really interesting way to deliver care–even our nutrition team uses a private Instagram story to take pictures of food and then to have this accountability with food in this private way, and it’s easier for our clientele. It’s technology used for the greatest good, because we know sometimes some of these things can also be detrimental to people, but we are using it for the greatest good. I think the other thing that we’ve seen is more and more men accessing care. So when we first started FAB, (the Food and Body program that offers wraparound services for clients in an outpatient setting), we were only treating women, and then we started getting referrals for men. And we said, well, why wouldn’t we look at working with men as well? And it has worked well to also deliver services to men. So that’s something that I think more and more men are identifying with–having some level of problematic eating and accessing services. And I would say the other thing we are seeing is a younger age of onset. There was an article that just came out not so long ago that unfortunately proves we are seeing younger and younger people, even kids, with these eating issues.
That’s such a beautiful question, Merrit. It was interesting when I started my career working at a treatment center. So the first half of my career was working in the treatment center, and it was the first treatment center in the country that treated eating disorders. Now there are hundreds of these programs. And we were working in lots of different modalities at the treatment center, but I think the piece that we were not addressing was the spiritual piece. And it was something I was really committed to. There was a group of us at the treatment center who said, “Let’s form a committee, and let’s start looking at, well, what does spirituality mean? Because spirituality can mean so many different things for different people.” And our clinical director, who was really like my mentor, was amazing. Dr. Gayle Brooks was really open to all these different modalities of healing. We had this very diverse committee and we started looking at what we would want to offer our clients. We came up with a spiritual assessment that clients started doing. We started offering some different spiritual modalities. We actually had a spiritual, very open service that we were doing with an interfaith minister who would come in. We also created a healing garden. So we had all these different ways. That was my first real foray into working with people with eating issues and treating them in different ways, like the healing garden. Nature can be really healing and that might be somebody’s path for spirituality.
So I was starting to see that the clients, for lack of a better words, we’re hungry for “beyond the mind, beyond the body.” I don’t always say this in a first session with a client, but I do feel in some ways that these are not only emotional disorders, but they’re kind of these Dark Nights of the Soul. Eating issues don’t just come out of the blue. There are usually converging factors, and there are usually some pretty big precipitants that happen before the eating disorder starts. And so people are longing for something. They’re trying to figure out how to deal with themselves and these very difficult things that they’ve gone through that are usually, for some people, very life-altering. So why wouldn’t we be going beyond just the mind or just the body? Sometimes there’s a bigger thing that people are looking for. So that’s why I certainly am committed to a more person-centered holistic way of working with people in FAB.
I was very much committed to making sure it was like a mind-body-spirit, mind-body-soul. However, we were looking at all aspects of the person. And for some people, this is a really new area. Like, they’ve never looked at that in their lives. I’m thinking of somebody who’s in FAB right now and he’s been so open to this. He’s never had that in any of his treatments, and he was at a place where he was really curious to explore that. There are other people who are not quite as open and that’s also okay because we’re trying to meet people where they are on their own healing journey. And again, that can mean a lot of different things for different people.
The first half of my career was really in the treatment center kind of world, that space. And I feel so grateful for what I learned from my mentors there and the clients. And then I stepped out into private practice. I was finding that there were clients who were coming into my office and I would work with a multidisciplinary team, even outpatient. And some clients needed more than traditional outpatient, but they maybe didn’t need a treatment center. They were not medically or physically unstable, but they needed something different than the treatment center or the traditional outpatient. And that was how FAB was born. I saw that there was a need for something else in the staircase of treatment of eating disorders. It felt like there was a gap in care. The second thing that I found in working with a multidisciplinary team, (a doctor here, a nutritionist here, maybe a psychiatrist here), we were all doing the best we could in terms of communicating with each other and tracking the client. But it was sometimes still taking years for people to really seem to shift their relationship with food and body and get through the eating disorder. And so what I started imagining was, what about if there was a different step in the staircase where we were providing wraparound services in that client’s home environment if they were stable enough to stay outpatient? And we were working with a team who had a similar philosophy model. We were all communicating. We were all on the same team. And, could we potentially shift things quicker with four hours of treatment, but maybe not as much as say like a day program or an intensive outpatient program, but more than the traditional? And would that make a difference in terms of their healing journey and potentially have people get better quicker? So that’s really where FAB was born.
We have a beautiful clinical team that is multi-disciplinary, and we’re working with a five-stage model. This model came out of years of doing this work with clients across all these different levels of care-residential, day, and IOP. I’ve done almost every single level of care. So the five stages that we see are people launching into their treatment. And for some people, they’re launching again. Maybe they come to FAB and they’ve already done treatment. For some people, this is their first introduction to treatment. Then they’re discovering what their eating disorder is really about. Or perhaps they relapse, so they’re trying to understand what happened. They’re integrating all that they’re learning from their individual sessions, their group sessions, their family work, and the curriculum that they’re working on. So they’re integrating all these skills into their lives to then be able to sustain themselves without the eating disorder ideally, to then move into thriving. So, FAB is really about not only helping people transform their food and body struggles, but our bigger aim is to have people live their joyful fulfilling lives, because as you certainly know, when people are in these eating issues, it’s hard to focus on the things that really matter.
We’re working with their eating disorder symptoms and whatever else they’re dealing with, depression, anxiety, or all the host of things that people are dealing with, like the comorbid issues, but we’re also trying to have them start looking at what fulfills them. What is their life about? What is their purpose? What are their values? And having people walk towards that, because I think sometimes without having that focus, this is where the eating disorder has so much more power. And so we’re helping them create this new future for themselves as well. Those are our five stages and once people go through those five stages, and we say on average, it takes people about a year to go through those, some people it’s a little more, some people a little less, but on average about a year. And then after that, some people participate in our mastery program. So then they’re perfecting some of those skills that they’ve learned. And then they also want to give back to other people, so that’s another part of our mastery stage.
Our primary client is somebody who is identifying that they have a problem and are motivated to get themselves help. Because it’s outpatient, there does need to be some level of internal motivation. Different than a treatment center where it’s like it’s so in your face that it’s almost like you cannot not get the treatment.
We have these wraparound services and we’re very focused on the people we work with. It’s almost concierge. But there does need to be some level of “I’m pulling the treatment towards me.” So somebody who is identifying that they have a problem that they may not understand where it comes from or how to solve it. That’s why they’re accessing treatment. Somebody who’s motivated for care, and I would also say somebody who is committed to putting themselves in a process because, for most people who come into our space, this didn’t start a few months ago. So if it didn’t start a couple of months ago, it’s typically going to take a period of time to get through this. So it’s also somebody who’s committed to their healing and willing to engage with the team, with our process, and dedicate a portion of time each week, even with everything else they go on. We have a lot of college students who come into our space. We have professionals who come into our space. And men, women, or however people identify on that spectrum.
We’ve had from teenagers to up to seventies in our program. If they’re younger than teenagers, right now we don’t work with the younger ones. We would make referrals to great providers who specialize in working with children.
I think at one point in my career, I used to think you had an eating disorder, or you don’t have an eating disorder. I don’t think about it in categories anymore. I think about it in terms of a spectrum. Because we’re all dealing with relationship with food, relationship with body. So all of us fall somewhere on a spectrum. But yes, we do have some people on our team who are very open about that and appropriately disclose. I do think that there’s something unique about that. Because I think that they can really understand the clients from the inside out in a different way. I do think you also have to be mindful of that because if I’ve learned anything through all these years of working with people with eating issues, it’s that sometimes there are similar themes, but I think what keeps this work so interesting and challenging to me is that no two people are alike.
There is always hope. No matter how long you’ve been struggling, no matter how much treatment you think you’ve had, there is always hope. So if somebody is reading this struggling and thinking, “Nothing worked. Oh my gosh, why am I in this dark place again?” What I would say is “Pick yourself up, and find the help that you need.” Because there are so many options now for people, and perhaps you just didn’t have the option that clicked for you. At one point, not even that many years ago, there weren’t so many options. And I think sometimes we’re ready for something different. We have somebody right now that we’re working with who has had a lot of different treatment, but this has been the first time for her that something is clicking differently.
And maybe there was a readiness that wasn’t there. Maybe it’s the combination of providers and the approach. So what I would say is don’t give up. There is hope and it’s worth fighting this. It’s worth working on this and working through this. I think my clients who have gone through the eating struggle and are on the other side will say, “This was the toughest thing I’ve ever done. But I wouldn’t give up the journey because it has given me so many gifts going through all that I went through to get to the other side.” So to me, that is the spiritual way to conceptualize these problems. There is a reason that you’re going through this dark time and you want to have the right help, the right guides. Same thing for me. When I’m going through a hard time, I want to get the right guides. There are so many great healers and providers and ways to help ourselves these days. So don’t give up. There is hope. Find the approach that works for you.
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Merrit Elizabeth is an Eating Disorder Recovery Coach certified by The Carolyn Costin Institute. She holds a master’s degree in Health Promotion Management and has years of experience working with women with eating disorders.