Tummy Troubles

Dear Followers:

This will be the last podcast of Dietitian Seasonings & Therapist Reasonings......we have served our community for two years and are ready to close this chapter of our work in the eating disorder community. 

We hope this podcast was helpful in your journey in understanding eating disorders through the encouragement and process of supervision concepts (vs just education).

You can still find us! Through A Collaborative Approach we will continue to offer dual sessions to clients that desire to have both a dietitian and therapist in session: www.acollaborativeapproach.com.

Meredith Riddick is continuing to provide supervision and webinars (with even continuing education credits by 2021) at www.harmonytherapygroup.com

Jill Sechi is continuing to provide supervision as well as offering a residency program at www.wcandnt.com or www.jsechinutritiontherapy.com

Jill and Meredith review basics about digestive issues that one often sees when working with clients that are struggling with an eating disorder. 

There are some great podcasts that cover more in depth- stomach issues- which often clients want to focus on food to change or eliminate. Do you have clients with "IBS" or "constipation, diarrhea, or vomiting" or perhaps struggle with sleep? 

Today Jill and Meredith discuss how these digestive issues might come up in session and are more often than not due to handling emotions in effectively (ie, not actually dealing with them but attempting to numb or distract from emotions one feels challenging). 

Meredith encourages looking at the client as a "whole" person and not just seeing their issues as "all in their head." Jill discusses the nutritional issues that impact digestive issues. Often digestive issues (up to 40% of IBS cases) are due to the "mishandling" of emotions through eating disorder behaviors and or malnutrition through elimination of foods, food groups over and under eating. Often this process and helping clients "connect the dots" can take up to a year or longer. 

We're back! Yes, right before Thanksgiving Day to boot!

Today Jill and Meredith discuss countertransference. This information is from Lisa Ferentze. Check out her resources at the Ferentze Institute .

Have you ever seen a movie or TV show that had a therapist role. Were they ethical? Would YOU do this in session? Lisa Ferentze discusses Wilson and Lindy's models of countertransference. Listen on as Meredith and Jill will highlight a few areas from this training. 

What is countertransference? How can it be helpful and perhaps hurtful in sessions. KNOW YOURSELF and use SUPERVISION to process your countertransference when it comes up!

Watch this clip from Good Will Hunting for a little background or go watch the movie. 

We will cover these aspects of countertransference:

1-Empathic disequilibrium: Feel a little ineffective with clients?

2-Empathic withdrawl: Feeling distant from your client for your own safety? 

3-Empathic enmeshment: Feeling highly related to a client's story leading to inappropriate boundaries? 

4-Empathic repression: Feeling overwhelmed with a client's emotional experience by rationalizing or minimizing or not coming back with a follow up session? 

Jill takes the stage this week to discuss the importance of understanding macronutrients. The current "diet" trend is for clients to be "counting macronutrients." What are macronutrients? What do you mean by "counting them?" Jill discusses the very basics of macronutrients. What they are and how they are described in nutrition and dietetics. She also goes through basic functions of macronutrients. 

Here are a few links/resources for your clients:

Having difficulty getting your client to see a specialized dietitian (ED RD): https://www.jsechinutritiontherapy.com/post/why-is-it-important-to-see-a-dietitian-that-specializes-in-eating-disorders

Yep, we are a bit behind on recording but have several new episodes coming up! We decided to repost this important episode. Enjoy! Be tuned in to next Monday for a new episode.

Meredith and Jill discuss the words one uses in conversation with clients and also in conversations between colleagues and professionally. 

What words are we talking about? For example saying "completed suicide" vs "committed suicide." Calories vs energy? How about "obesity" which is often referred to as the "O" word within the ED community. 

Listen on as Meredith and Jill discuss the WORDs we use and how they can hold deep meaning. Do you want to be "right" or do you want to be "effective?" Know your audience and work on strong skills of communication and persuasion. 

Jill goes on a rant and Meredith goes in more detail about the importance of not crowd sourcing to get support with clients on social media.

There are many issues about posting detailed information to seek consultation on difficult cases on social media platforms!

What's available instead? Paid consultation with a supervisor (who you get to determine level of of experience and expertise). We encourage you to form a peer consultation group within your community of ED professionals. There are also many resources on iaedp that provide monthly supervision (have to be a member): peer consultation group and also one for a focused BIPOC perspective. Another resource more specifically for dietitians is EDRDPRO. And of course there are supervisors (like Meredith and Jill) and others that provide paid consultation groups throughout the United States. 

Meredith and Jill review higher level of care recommendations presented by the American Psychiatric Association guidelines. 

There are basically 5 levels of care ranging from out patient to inpatient. The chart helps reflect on key points to consider. 

As always, seek supervision or peer consultation when you need more support with the client or understanding the complexities of helping a client with this decision. 

We are reposting a past season episode as we are preparing for several new episodes coming down the pike! 

Meredith and Jill discuss the challenge of treating clients with eating disorders. How do you hold support and understanding yet also provide accountability during the eating disorder recovery process?

If you have not heard this episode, listen on or listen again as we discuss how to not align with the eating disorder which may bring about difficult discussions and uncomfortableness in the room. 

Jill takes the wheel this week with the focus of metabolism and how eating disorders effect the metabolism process of the body. 

Jill goes through very basic concepts of metabolism, function and how eating disorders can lower or "rev up" the body's metabolism (during refeeding). 

Is metabolism as simple as "calories in vs calories out?" Mmmmm, no. Listen on!

As you listen to this episode, Jill hopes you understand the importance of using a dietitian. If you struggle getting a client to see a specialized dietitian, this article may help. 

Dr. Guadiani also has some great articles on metabolism to share with clients or understand more details about our amazing machine: the human body.