WEBVTT 00:00:09.600 --> 00:00:13.460 Welcome to the Call to Flourish podcast sponsored by Divine Mercy University. 00:00:14.085 --> 00:00:15.445 My name is Thomas Kronquist. 00:00:15.445 --> 00:00:19.865 I'm the cohost with father Charles Sikorsky, the president of Divine Mercy University. 00:00:20.085 --> 00:00:21.625 Father Charles, how are you today? 00:00:22.485 --> 00:00:23.685 Tom, I'm doing great. 00:00:23.685 --> 00:00:24.585 How about you? 00:00:24.885 --> 00:00:25.445 Very good. 00:00:25.445 --> 00:00:26.425 Very good, father. 00:00:26.485 --> 00:00:29.785 We have a very interesting podcast scheduled for this afternoon. 00:00:30.540 --> 00:00:40.960 We'll be speaking with doctor Frederica Vyblechka, the director of our counseling program here at the university, on a very important topic, eating disorders. 00:00:41.900 --> 00:00:45.680 Doctor Vyblechka, welcome to the Call to Flourish podcast. 00:00:46.995 --> 00:00:47.735 Thank you. 00:00:48.195 --> 00:00:49.655 I'm happy to be here. 00:00:50.195 --> 00:00:57.255 Well, can you tell us about your background and how you became involved with this, important issue, eating disorders? 00:00:59.010 --> 00:00:59.490 Sure. 00:00:59.490 --> 00:01:01.510 It sorta happened by accident. 00:01:02.050 --> 00:01:09.110 When I graduated with my master's degree in counseling, I went and worked in treatment centers for substance abuse. 00:01:09.650 --> 00:01:22.925 And what I found was I was working with, clients who they would get sober, they would detox, and all of a sudden, they'd come into my office and say, by the way, I have an eating disorder. 00:01:23.625 --> 00:01:37.700 And what I noticed was that the clients in which no care was given for those men and women who had eating disorders, they had a higher relapse rate from the regarding their substance use. 00:01:37.700 --> 00:01:46.105 And so I started in treatment centers providing group therapy for, men and women with substance use disorders. 00:01:46.165 --> 00:01:54.665 And then beyond that, in a private practice, started working somewhat with women with eating disorders, and that's where it started. 00:01:56.460 --> 00:01:58.800 So what and you've been doing that for how long? 00:02:00.540 --> 00:02:03.820 I got my license in 2006. 00:02:03.820 --> 00:02:13.695 So 2006, and currently, I supervise counselors and, I'm starting up a practice again in a couple months to see clients. 00:02:13.695 --> 00:02:23.395 So I had a brief hiatus and was just doing supervision and teaching and then back to clinical work, more hands on clinical work in a couple months. 00:02:23.620 --> 00:02:23.780 Yeah. 00:02:23.780 --> 00:02:25.380 So you've been doing this for a while. 00:02:25.380 --> 00:02:29.640 And, could you tell us what what we mean when we say the word eating disorder? 00:02:30.900 --> 00:02:38.895 You know, someone who, occasionally overeats, I'm wondering what what makes something what what what are we how will we define that? 00:02:38.895 --> 00:02:41.395 What what exactly are we talking about when we say eating disorder? 00:02:42.815 --> 00:02:43.215 Sure. 00:02:43.215 --> 00:02:49.955 So, really, it's any eating behavior or pattern that disrupts normal life. 00:02:50.015 --> 00:03:00.240 And so that's sort of the very easy way to look at it, but there's different ways in which that demonstrates itself in in the client. 00:03:00.240 --> 00:03:05.300 So you have anorexia, bulimia, binge eating disorder, kind of the main three. 00:03:06.035 --> 00:03:10.195 And then from there, there's kind of other specified eating disorders. 00:03:10.195 --> 00:03:21.140 But for some, people tend to restrict to the point where restrict food intake to the point where the they're not getting enough, and there's other criterion that support that diagnosis. 00:03:21.200 --> 00:03:31.760 And then for some, there's and I there's a desire to binge and then have compensatory behaviors, and then for some, there's a desire to simply binge. 00:03:31.760 --> 00:03:40.265 And I think the the main issue is there's a continued, engagement in the behavior despite negative consequences. 00:03:40.485 --> 00:03:43.145 It's impacting many areas of the person's life. 00:03:43.845 --> 00:03:51.420 Is there a common cause for eating disorders, or are the causes very different between these different diagnoses, if you will? 00:03:51.420 --> 00:03:53.420 It's hard to say there's a common cause. 00:03:53.420 --> 00:03:56.960 There's common vulnerabilities associated with them. 00:03:57.180 --> 00:04:01.260 For example, there's a high correlation between substance use and eating disorders. 00:04:01.260 --> 00:04:08.535 There's a high correlation between trauma and eating disorders, and there's a high correlation between mood disorders and eating disorders. 00:04:09.075 --> 00:04:29.060 And so we could go down the chicken or the egg road, but at the end of the day, when I see a client that has one of those substance use, mood disorders, etcetera, I always wonder and I always keep in the back of my mind, well, here are some things that could be related, and then vice versa. 00:04:29.060 --> 00:04:34.725 If someone presents with an eating disorder, I wonder about the others that there's a high correlation with. 00:04:34.945 --> 00:04:37.425 How big of an issue are we dealing with? 00:04:37.425 --> 00:04:41.685 Like, what, like, how many what percentage of the population might have an eating disorder? 00:04:42.465 --> 00:04:46.030 And, that you mentioned, bulimia, anorexia, and binge eating. 00:04:46.030 --> 00:04:48.290 Is there one that's more prevalent than the other? 00:04:49.150 --> 00:04:50.130 I don't know percentages. 00:04:50.270 --> 00:04:54.530 I could say from an anecdotal standpoint, it's quite high. 00:04:54.750 --> 00:04:58.235 Maybe that's just because it's what I I see. 00:04:58.235 --> 00:05:00.655 And I I can I can see it in the population? 00:05:00.955 --> 00:05:14.190 I can see it not even in you know, when I'm in supervision and my supervisee is telling me about a client, I can sense symptoms that they're discussing and say, is that what the do you think there's an eating disorder here? 00:05:15.130 --> 00:05:26.745 But I think it's much more common than people think it is, and, especially, there's sort of this new wave of of what eating, you know, what eating disorders look like now. 00:05:26.745 --> 00:05:30.525 It's much different than it was, you know, in 2006 when I started. 00:05:30.665 --> 00:05:37.085 And it kind of follows this environmental trend of what's, for lack of a better word, what's in right now. 00:05:37.360 --> 00:05:42.500 And so, I would say just it's it's it's more common than people think. 00:05:42.960 --> 00:05:47.860 The National, Association of Eating Disorders has great stats on there. 00:05:47.920 --> 00:05:50.240 But, again, I look at the stats and I think, wow. 00:05:50.240 --> 00:05:53.975 I think it's it's it's probably much more prominent than that. 00:05:54.195 --> 00:06:02.515 And then at the same time, there's the diagnostic statistical manual of mental disorders that tells you this is exactly what an eating disorder is. 00:06:02.515 --> 00:06:11.320 And when I work with a client, if they don't fit that criterion, but they're telling me they're having difficulty, it's okay to to address it as such. 00:06:11.320 --> 00:06:13.560 This is this looks like an eating disorder. 00:06:13.560 --> 00:06:15.740 You might not have every single criterion. 00:06:15.880 --> 00:06:17.640 You might not fit the criterion perfectly. 00:06:17.640 --> 00:06:27.155 But if you're having a problem and you identify it as an eating disorder, let's work with it as such so that it doesn't get worse and miss full blown. 00:06:27.775 --> 00:06:32.515 What are the characteristic differences between, for example, anorexia and bulimia? 00:06:33.210 --> 00:06:36.990 You hear these these these, these words a lot. 00:06:37.770 --> 00:06:40.110 What are the differences between these two diagnoses? 00:06:41.370 --> 00:06:41.770 Sure. 00:06:41.770 --> 00:06:46.430 So so with anorexia, it is more of a restrictive type of eating disorder. 00:06:46.765 --> 00:06:50.065 There's a significant focus and fear of weight gain. 00:06:50.125 --> 00:06:55.425 There's a restriction of caloric intake to the point where there's significant weight loss. 00:06:55.645 --> 00:07:02.145 And so to meet that criterion to meet the diagnosis, you have to fulfill those criterion. 00:07:02.900 --> 00:07:08.520 That doesn't mean that you won't see those behaviors in people that haven't met full criterion. 00:07:08.580 --> 00:07:12.100 It just it just in a clinical perspective, it would mean, okay. 00:07:12.100 --> 00:07:14.280 This this person's at risk for anorexia. 00:07:14.835 --> 00:07:25.255 For bulimia, there is a period of time where the person binges on food, and a binge is essentially you eat more than you're supposed to in a short amount of time. 00:07:25.715 --> 00:07:32.030 And that has to happen at least once a week for three months or so. 00:07:32.170 --> 00:07:47.195 And then on top of that, there's a compensatory behavior, which could be fasting, laxative use, use of medication to kind of get rid of that binging episode, and sometimes it's exercise as well. 00:07:48.055 --> 00:07:54.395 So with anorexia, you're not trying to, there there's no binging and therefore no compensatory behaviors. 00:07:54.455 --> 00:07:59.800 It's a full blown avoiding food and not getting the calories you need, essentially. 00:07:59.860 --> 00:08:01.960 Whereas, bulimia, it's a back and forth. 00:08:02.580 --> 00:08:11.825 With anorexia, a lot of times, you know, you you typically you see the person who who feels like they're overweight or fat and yet tend to be really skinny. 00:08:13.085 --> 00:08:23.425 What kind of dynamic or what are some examples, I guess, of of, like, if you if you're concerned someone might be heading in that direction, like, what what might you watch out for? 00:08:24.980 --> 00:08:30.260 I think it's the uncharacteristic fear of gaining weight. 00:08:30.260 --> 00:08:38.280 It's it's this they don't have a the person does not have a rational perspective of what they look like. 00:08:38.775 --> 00:08:44.555 It's and, in turn, the response to that is the restrictive behavior. 00:08:45.015 --> 00:09:01.800 And so you would notice restrictive behavior in in the person regarding food, and there it would kinda sometimes it starts with picky eating or overly healthy eating to the point where, as I mentioned, it starts to be a restriction significant restriction of calories. 00:09:01.940 --> 00:09:07.720 Not a not a diet, but a very a very significant restriction of calories. 00:09:08.355 --> 00:09:08.595 Okay. 00:09:08.595 --> 00:09:20.195 So some kind of, they don't fully under they, you know, there's misunderstanding what they really look like, and then they can be picky, or you or just sort of fasting or something. 00:09:20.195 --> 00:09:22.455 You see those kinds of things, that that's an issue. 00:09:22.810 --> 00:09:37.365 And I would say that kind of the big thing what you'll notice first is probably a significant weight loss, which, you know, from an outsider's perspective who doesn't understand, they might compliment the person. 00:09:37.365 --> 00:09:41.305 Oh, I've I've noticed you've lost weight, and that sort of fuels it even more. 00:09:41.525 --> 00:09:50.885 The then there's more restricting to the point where, you know, they're barely eating anything all day, a piece of lettuce, an apple, that sort of thing. 00:09:50.885 --> 00:09:55.460 And and there is a fear of of of eating. 00:09:55.520 --> 00:09:56.740 There's a fear of eating. 00:09:56.880 --> 00:10:01.380 When the eating happens, a lot of anxiety occurs as the eating is happening. 00:10:01.600 --> 00:10:05.220 And so it's just a it's just an avoidance after at that point. 00:10:05.665 --> 00:10:08.325 When I hear the word anorexia, I think of Karen Carpenter. 00:10:09.025 --> 00:10:22.510 And maybe I'm dating myself here, but, if you if you see, videos of the Carpenters, performing, you can see in the the latter part of her life, she was getting very, very thin. 00:10:22.970 --> 00:10:24.030 It was very noticeable. 00:10:24.730 --> 00:10:27.850 And I'm just wondering, it's always been kind of a mystery to me. 00:10:27.850 --> 00:10:30.750 Did she not realize where this was going? 00:10:30.810 --> 00:10:41.775 Or do do people with anorexia just not not realize what what effect they're having on their body, the negative effect effect they're having on their body, or is it is it how does that work? 00:10:42.715 --> 00:10:54.830 There isn't a realization that there is a negative impact on their body, and part of it is there's sort of I'm not a biologist, but there's there's a or a doc well, I am a doctor, but not a medical doctor. 00:10:54.890 --> 00:10:57.630 There's there's a brain chemistry change that happens. 00:10:58.170 --> 00:11:07.505 And as a result, there there is no kind of volition goes away, and there they cannot see the negative impact they're having on themselves. 00:11:07.505 --> 00:11:10.005 They do not see what everybody else is seeing. 00:11:10.145 --> 00:11:28.530 And so it's sort of this, this dynamic where the the anorexia started somewhat from a decision, albeit part of that is a might might be a a genetic predisposition, maybe some environmental predisposition. 00:11:28.670 --> 00:11:29.650 So it starts. 00:11:30.095 --> 00:11:35.555 The person engages in the behavior, and then they get so far down the line that it changes their brain chemistry. 00:11:36.175 --> 00:11:40.035 And in a sense that, for example, they truly aren't hungry. 00:11:40.175 --> 00:11:41.535 They're just not hungry anymore. 00:11:41.535 --> 00:11:44.430 They've learned their brain has learned to shut that off. 00:11:44.670 --> 00:11:55.330 And so part of undoing that is is very difficult trying to get the brain chemistry kind of back from being essentially out of whack because they've lacked nutrients. 00:11:56.110 --> 00:12:05.025 And then I would argue there's such a strong dynamic of denial involved that and then the brain chemistry changes. 00:12:05.025 --> 00:12:06.565 It's hard to undo that. 00:12:06.705 --> 00:12:08.725 It's not hopeless, but it is difficult. 00:12:09.265 --> 00:12:10.865 So not hopeless, but difficult. 00:12:10.865 --> 00:12:11.105 Yeah. 00:12:11.105 --> 00:12:16.000 That sounds quite quite, quite a challenge there. 00:12:16.000 --> 00:12:24.820 What what so what what kind of techniques or therapy have you seen that help people, overcome that or or, you know, the reason for that hope? 00:12:25.335 --> 00:12:29.035 When you have someone that's very severe, you have to hospitalize them. 00:12:29.095 --> 00:12:38.615 Many times, I I would have this because a lot of my work with the with more severe, clients with eating disorders was in substance use treatment. 00:12:38.615 --> 00:12:46.950 And they would come in, and they could not address the substance use because the the eating disorder had to be addressed first. 00:12:46.950 --> 00:12:53.530 They were so either malnourished that they needed to be hospitalized or go to treatment for an eating disorder. 00:12:53.750 --> 00:12:58.105 And it's it's it takes, you know, all day, everyday sort of treatment. 00:12:58.325 --> 00:12:59.785 Family needs to be involved. 00:13:00.725 --> 00:13:19.810 However, when you have a client that comes in that is not at the level of hospitalization yet, You can still work with them in private practice or just on an individual basis, but the but a really good approach with working with someone with anorexia is group therapy and family therapy. 00:13:19.810 --> 00:13:25.245 It's it's found to just be very, it allows for accountability and support. 00:13:25.705 --> 00:13:36.710 Now that being said, I I don't usually recommend family therapy when there is a history of, eating disorders in the family that haven't really been addressed, so it doesn't that doesn't help. 00:13:36.710 --> 00:13:40.150 But if you have a supportive family, you need to bring them in. 00:13:40.150 --> 00:13:48.890 And I would, you know, I would say that goes with any disorder you're working with, but it definitely helps with eating disorders and anorexia. 00:13:49.715 --> 00:13:56.275 How often do you find an underlying trauma in in your counseling with these people with eating disorders? 00:13:56.275 --> 00:14:00.375 Is there often an underlying trauma that that began this process? 00:14:01.475 --> 00:14:08.200 They're they're reacting to that trauma in some type of, some type of way maybe beyond their control? 00:14:08.660 --> 00:14:12.200 I would say eighty percent of the time, the client had sexual trauma. 00:14:12.900 --> 00:14:14.920 Eighty percent of the time, sexual trauma. 00:14:15.060 --> 00:14:15.560 Wow. 00:14:15.780 --> 00:14:17.140 Now this is my number. 00:14:17.140 --> 00:14:18.600 This isn't you know? 00:14:19.275 --> 00:14:25.055 I I don't know if you could Google that, but my experience was eight out of ten times the client had sexual trauma. 00:14:25.915 --> 00:14:26.415 Okay. 00:14:26.475 --> 00:14:30.415 And that's from abuse or Mhmm. 00:14:30.715 --> 00:14:39.240 So, usually, it was some sort of trauma that happened in childhood, but at the same time, it not all the time, I should say. 00:14:39.240 --> 00:14:49.565 I I would say that the sexual trauma could have happened at any time, and then it sort of triggered this identity around one's body and sense of self. 00:14:50.105 --> 00:15:00.280 And it was a way to cope with the pain, cope with how to handle what happened, and almost in many times, a way to attack the body. 00:15:00.280 --> 00:15:04.600 It was sort of, I'm gonna blame the body on what happened, my body. 00:15:04.600 --> 00:15:07.740 And so if I can control that, I can undo what happened. 00:15:08.120 --> 00:15:12.220 So it really just recapitulates what happened until it gets addressed. 00:15:13.035 --> 00:15:13.355 Wow. 00:15:13.355 --> 00:15:22.415 Is there a particular demographic or characteristics of age groups, or so forth that that struggle with this more than others? 00:15:23.115 --> 00:15:28.930 I mean, women definitely struggle with, I would say, but it looks different in men and women. 00:15:28.930 --> 00:15:30.470 So there's that piece. 00:15:30.850 --> 00:15:32.470 I mostly worked with women. 00:15:32.850 --> 00:15:38.450 And, you know, I've I never worked with children with eating disorders, young young girls. 00:15:38.450 --> 00:15:47.595 I worked mostly 18 and older, but it was, you know, with the women that came in, like I said, well, I said eighty percent of the time sexual trauma. 00:15:47.595 --> 00:15:51.375 Ninety percent of the time, the women that came in had an eating disorder. 00:15:51.915 --> 00:15:56.575 And and it was interesting how it was correlated with their drug of choice. 00:15:56.970 --> 00:16:08.350 And so many times, women who struggled with cocaine dependency were anorexic and, alcohol abuse or alcohol dependence, bulimia. 00:16:08.905 --> 00:16:35.450 And so but it was shocking to me how how correlated the two were, that it was once there was once the drug and alcohol was taken away, the eating disorder would come up within three or four days after, you know, kind of this sense of, oh, I'm sober, and I'm working on being sober, but now I'm binging and purging three times a day. 00:16:35.450 --> 00:16:36.570 It was like, oh, okay. 00:16:36.570 --> 00:16:37.390 This is interesting. 00:16:37.530 --> 00:16:42.355 This is this there's there's no way we can say these aren't correlated. 00:16:42.495 --> 00:16:45.715 And a lot of times, it was in an effort to avoid pain. 00:16:46.335 --> 00:16:48.915 So That can happen with all addictions. 00:16:48.975 --> 00:16:49.375 Right? 00:16:49.375 --> 00:16:53.840 You you you get over one and you fall into something else. 00:16:54.060 --> 00:16:55.120 Is that Mhmm. 00:16:55.260 --> 00:16:55.760 Yeah. 00:16:56.860 --> 00:16:57.360 Yes. 00:16:57.420 --> 00:17:07.295 It's, they call it process addictions and and or at the same time, you have clients who have a history of just both since the beginning. 00:17:08.235 --> 00:17:17.215 But there there's many times, you know, we are we have a tendency in in human nature to be selfish and to avoid suffering. 00:17:17.675 --> 00:17:21.855 And so in a sense, it's this normal response that's gone haywire. 00:17:22.330 --> 00:17:25.530 So that's kind of how I I viewed it. 00:17:25.530 --> 00:17:27.630 It was a way for me to put it into perspective. 00:17:27.690 --> 00:17:33.790 We all have this tendency to be selfish, and we all don't really enjoy suffering. 00:17:33.850 --> 00:17:50.005 And you've got these people who have significant trauma and pain in their life and were not, for whatever reason, given appropriate coping skills, learned appropriate coping skills, didn't have enough resiliency factors to get them through it, and this was sort of a default. 00:17:50.630 --> 00:18:10.335 With anorexia, I've heard that there one of the factors contributing to it is, the perception of beauty for especially for young women looking at, maybe models or actresses, who tend to be thin and, you know, whatever. 00:18:10.555 --> 00:18:15.775 And they and they compare themselves to those those people, and they try to be like those people. 00:18:16.395 --> 00:18:19.055 And, how much of a factor is that? 00:18:19.590 --> 00:18:28.010 I think it's a it's a significant factor, and especially in the world we live in today, where you can you can see it within seconds. 00:18:28.230 --> 00:18:32.570 You immediately compare yourself, especially in the world of social media. 00:18:33.015 --> 00:18:37.655 I really encourage people not to do social media for that reason. 00:18:37.655 --> 00:18:39.995 It's sort of this unrealistic expectation. 00:18:40.775 --> 00:18:55.100 And but, truly, when when you work with this population, there there usually is some sort of comparison, and there's no sense of truth as it relates to who they are and what they look like. 00:18:55.100 --> 00:19:03.385 It's just completely skewed, which is sad because as the clinician, you see who the person is, and they cannot see it themselves. 00:19:03.925 --> 00:19:21.200 And that's a that's kind of a significant focus of therapy is getting the client to kind of see themselves as who they truly are and not this idea of what they should be and be and kind of accept them as is because the standards are unrealistic. 00:19:21.980 --> 00:19:29.495 We all know this from a cognitive level, but it's in our face constantly, so it's hard to address that cognitive dissonance. 00:19:30.275 --> 00:19:30.515 Yeah. 00:19:30.515 --> 00:19:44.550 And then you mentioned to this natural tendency to selfishness and, you know, to seek pleasure, so to speak, which kinda reminds me, you know, we have our here at DMU, our our Catholic Christian model of the person. 00:19:45.010 --> 00:19:50.150 And that's one of the points is that we're we're subject to what Christians call original sin. 00:19:51.650 --> 00:20:02.945 What kind of insights from from that model of the person can be held for for FELPA for someone who's struggling, with a knee disorder? 00:20:03.725 --> 00:20:09.505 I think the most important piece is that, you know, we we do want good. 00:20:10.130 --> 00:20:11.270 We all want good. 00:20:11.490 --> 00:20:17.030 But at the same time, like like I said earlier, we're all prone to selfishness. 00:20:17.650 --> 00:20:23.030 And a lot of times, there would I would have clients who would get very down on themselves for relapses. 00:20:24.115 --> 00:20:39.830 And it part of it was saying, you know, this is just I I don't wanna say it's part of the process because the goal isn't to relapse, but the goal but you do have to recognize you're human and you're gonna make a mistake, and your mistake is to fall back in something that you've done before. 00:20:40.290 --> 00:20:44.770 And so kind of putting that into perspective and helping them understand, okay. 00:20:44.770 --> 00:20:45.570 Now you know. 00:20:45.570 --> 00:20:50.210 And if if the client was Christian or Catholic, I would say, now you know your cross. 00:20:50.210 --> 00:20:52.425 This, unfortunately, is your cross. 00:20:52.425 --> 00:20:53.645 Everybody has one. 00:20:53.705 --> 00:20:55.245 This is what yours looks like. 00:20:55.545 --> 00:20:59.145 So now you know you're gonna fall sometimes, and you just gotta pick up. 00:20:59.145 --> 00:21:03.245 And rather than be mad at yourself, that's that's not helpful. 00:21:03.385 --> 00:21:05.010 That's not what you're called to do. 00:21:05.090 --> 00:21:07.510 You just acknowledge you made a mistake and move forward. 00:21:07.890 --> 00:21:19.365 And know that those those tendencies to be selfish, which usually end up hurting yourself, will get fewer and small and they will have less of an impact. 00:21:19.365 --> 00:21:26.345 And soon, when you get into recovery, it won't be the eating disorder you're falling into as your kind of MO. 00:21:26.405 --> 00:21:29.045 It it'll be something less hurtful to yourself. 00:21:29.045 --> 00:21:30.325 I mean, we do it every day. 00:21:30.325 --> 00:21:31.445 Everybody does it. 00:21:31.445 --> 00:21:34.810 Everybody is selfish and makes a mistake based on selfishness. 00:21:35.030 --> 00:21:40.170 So It seems like part of this, is, involves self esteem. 00:21:40.230 --> 00:21:46.585 The the people who are suffering from these eating disorders have a have a low self esteem. 00:21:47.205 --> 00:22:00.090 And I think from our perspective, DMU's perspective, you know, we we, we base our our our dignity, our worth upon our our relationship with God being created in the image and likeness of God. 00:22:01.290 --> 00:22:08.730 Is does it help in counseling and therapy to, focus on the the self esteem aspect? 00:22:08.730 --> 00:22:09.550 Is that helpful? 00:22:10.170 --> 00:22:10.490 Yes. 00:22:10.490 --> 00:22:11.390 But I understand. 00:22:12.675 --> 00:22:21.335 I I speak of self esteem in the sense of in order to gain self esteem, you have to be other oriented, which means you have to not be selfish. 00:22:21.635 --> 00:22:25.255 The more selfish you are, the lower your self esteem is gonna be. 00:22:25.340 --> 00:22:35.980 And the more other oriented you are, selfless, the higher your self esteem will be because you find there's value in being of service to others and not focusing on self. 00:22:35.980 --> 00:22:49.465 And when clients do that, anybody does that, their self esteem is rate goes up, essentially, when they are you know, part of the reason why we're called to work is to be of service to others. 00:22:49.845 --> 00:22:58.730 And so, especially, with this population, you have to approach that subject delicately because you don't want to say you're just selfish. 00:22:58.790 --> 00:23:00.890 That's not that's not my point here. 00:23:01.110 --> 00:23:33.650 But when there is a treatment approach that focuses on undoing this lie they have about themselves and who they are and and kind of addressing that with another piece of being other oriented, being of service to others, there tends to be, in my experience, a lot more success because the shift leaves themselves, which is a big piece of what anorexia and bulimia is, a focus on self and goes outward away from self and towards others. 00:23:34.615 --> 00:23:41.915 You know, I I think a lot of people have experienced either through families or or friends, people they know who have an eating disorder. 00:23:42.695 --> 00:23:45.755 Maybe you touched on this before, but we could touch on again. 00:23:45.895 --> 00:23:57.670 What are some of the the the signs that that somebody you know, a loved one, has more than has has an eating disorder that needs, you know, intervention, professional help? 00:23:58.210 --> 00:24:10.025 You you mentioned loss of weight, but are there behavioral other behavioral changes that, you can pick up on and and and, be a signal that, someone needs help? 00:24:11.285 --> 00:24:11.685 Sure. 00:24:11.685 --> 00:24:18.180 So, for example, someone who, after they eat, disappears is always a red flag. 00:24:18.180 --> 00:24:21.720 That usually means some form of purging behavior is happening. 00:24:22.020 --> 00:24:28.235 Someone who eats in secret, so you're you're never able to have a meal with someone. 00:24:28.235 --> 00:24:33.375 That would be in because, typically, people who binge wanna do that alone and by themselves. 00:24:33.915 --> 00:24:35.515 So that would be a red flag. 00:24:35.515 --> 00:24:37.055 Obviously, weight loss. 00:24:37.595 --> 00:24:46.180 Sometimes, just kind of a presentation of kinda dull skin, very just brittle looking is a good example. 00:24:46.400 --> 00:25:02.285 And I think the key is you never tell someone who might possibly have an eating disorder you don't look like you have an eating disorder, because women with, and men with bulimia, they are average weight. 00:25:02.585 --> 00:25:11.090 You wouldn't they're average weight, so that's not gonna be the the the factor in knowing whether or not they have bulimia. 00:25:11.470 --> 00:25:21.890 With anorexia, you can spot the symptoms of the avoidance of spit of food, excuse me, the restriction, and then the weight loss comes later. 00:25:22.275 --> 00:25:26.115 What so bulimia and binge eating, like, what what would be the difference? 00:25:26.115 --> 00:25:28.135 And what what's like could you give an example? 00:25:28.435 --> 00:25:29.575 Like, what's a binge? 00:25:31.235 --> 00:25:37.015 A binge is eating a very large amount of food in a very short period of time. 00:25:37.110 --> 00:25:40.890 I believe the DSM says two hours. 00:25:41.750 --> 00:25:46.250 So within two hours, you consume three or four meals. 00:25:47.430 --> 00:25:49.030 Three or four meals in two hours. 00:25:49.030 --> 00:25:49.455 Okay. 00:25:49.615 --> 00:25:52.195 So that's different from bulimia in some way. 00:25:54.015 --> 00:25:55.395 What how would you distinguish? 00:25:56.495 --> 00:25:59.715 So with bulimia, you would have to have binging and purging. 00:26:00.015 --> 00:26:02.915 Once a week, I believe within a three month period. 00:26:02.975 --> 00:26:03.475 Okay. 00:26:04.000 --> 00:26:10.000 So the cause for binge eating, is it often trauma also, or is it something else? 00:26:10.000 --> 00:26:13.940 It seems like a very different manifestation, different symptom. 00:26:14.960 --> 00:26:19.005 What what what what's the primary or primary causes of binge eating? 00:26:19.245 --> 00:26:27.025 I would say a lot of it is trauma, and then also there's a high correlation between, say, mood disorders, personality disorders as well. 00:26:27.245 --> 00:26:35.750 If someone has a family member or maybe, you know, I know I think this can be an issue on college campuses and different schools or something. 00:26:37.650 --> 00:26:38.530 What would you recommend? 00:26:38.530 --> 00:26:44.390 How would someone what would they do to turn for help if they they suspect someone has a an eating disorder? 00:26:45.625 --> 00:26:45.945 Sure. 00:26:45.945 --> 00:26:54.345 So I would recommend going to either having maybe an evaluation done or just calling a therapist that specialize in it. 00:26:54.345 --> 00:27:01.530 The other option is, National Association of Eating Disorders has a page of signs and symptoms. 00:27:01.590 --> 00:27:07.370 But, usually, you'll have someone call a therapist and say this is what I'm seeing. 00:27:07.830 --> 00:27:15.165 And then going from there, they might give an approach for how to work with the person until they're more willing to come into therapy or not. 00:27:16.205 --> 00:27:19.505 But first, to start off with what are the signs and symptoms. 00:27:20.045 --> 00:27:20.285 Okay. 00:27:20.285 --> 00:27:26.625 What could the non therapist do, to help and not hurt someone in the situation? 00:27:28.210 --> 00:27:30.610 Like, without because I sometimes I I yeah. 00:27:30.610 --> 00:27:31.410 I get all these ideas. 00:27:31.410 --> 00:27:37.670 Oh, I could really help this person, but I'm afraid I don't want I'm not a professional in in mental health or counseling. 00:27:38.690 --> 00:27:40.930 But are there things I could do? 00:27:40.930 --> 00:27:47.965 Let's say, you're in the case that you just mentioned where person doesn't wanna go and get any help or they're just not ready for that. 00:27:48.505 --> 00:27:50.445 I think the key is relationship. 00:27:51.065 --> 00:28:00.980 I mean, that is the predictive factor in counseling anyways of the curative factor essentially is the ability to form the relationship. 00:28:00.980 --> 00:28:10.795 So if your relationship is with good is good with the person and your goal is for them is for their well-being, if you can approach them from that from that perspective. 00:28:11.575 --> 00:28:19.755 And then just saying, I'm worried about you, and I'm here, rather than harping on what you're seeing. 00:28:20.215 --> 00:28:21.575 So I see you've lost weight. 00:28:21.575 --> 00:28:22.135 I see this. 00:28:22.135 --> 00:28:22.710 I see that. 00:28:22.790 --> 00:28:23.430 Starting there. 00:28:23.430 --> 00:28:34.890 Now the severity also, if you have a child who's, you know, 19 years old and they've lost 20 pounds, you you kinda have to bypass that and worry about their health. 00:28:35.145 --> 00:28:37.965 So I think you have to take that into consideration too. 00:28:38.265 --> 00:28:38.345 Mhmm. 00:28:38.345 --> 00:28:38.845 Severity. 00:28:38.905 --> 00:28:39.065 Yeah. 00:28:39.065 --> 00:28:44.365 If it's really severe, you need it, yeah, quicker immediate help. 00:28:45.065 --> 00:28:49.085 In some cases, do you need, like, a family intervention? 00:28:50.560 --> 00:28:52.500 The family gets together around somebody. 00:28:52.720 --> 00:29:04.100 If if they're not, as you say, connected with reality in a certain way, would a family intervention help, or would that that exacerbate the problem? 00:29:04.655 --> 00:29:07.455 I don't believe it exacerbates the problem. 00:29:07.455 --> 00:29:09.155 The problem has been exacerbated. 00:29:09.455 --> 00:29:18.115 If if you're at the point where you have to if you're considering an intervention, it typically means the client's health is in danger, and you're worried they're gonna die. 00:29:18.175 --> 00:29:21.930 And so at that point, you you need to do whatever it takes. 00:29:22.630 --> 00:29:23.130 Mhmm. 00:29:24.870 --> 00:29:29.290 All the while knowing the person, if they're over the age of 18, gets to decide. 00:29:30.950 --> 00:29:48.070 Does Divine Mercy University have, particular classes or, focuses in the counseling program that, you know, on this on this problem, on this issue, help prepare therapists, counselors to to deal with it? 00:29:48.370 --> 00:29:53.170 We don't have classes specifically for eating disorders to treat them. 00:29:53.170 --> 00:30:04.755 That being said, what we encourage our students to do is to if they're interested in the population, we encourage them to seek out a practicum or internship site and start there. 00:30:05.375 --> 00:30:12.915 Most students, when they go through the program, they're gonna learn the foundations for how to work with clients no matter the issue. 00:30:13.190 --> 00:30:19.510 And then when they graduate, if there's a specialty, then they go towards the specialty after that point. 00:30:19.510 --> 00:30:22.250 And sometimes they start that in practicum and internships. 00:30:22.310 --> 00:30:27.725 So sometimes you can have a student who wants to specifically work with people with trauma. 00:30:27.785 --> 00:30:30.365 They'll go to a place that focuses on trauma. 00:30:31.065 --> 00:30:41.565 So they can do that, and then they get supervision through practicum and internship from, our instructors to work with that population as well as supervision at the site. 00:30:42.420 --> 00:30:46.500 Doctor Vyvilechka, we're we're coming, we're running out of time here. 00:30:46.500 --> 00:30:51.000 This is a very, very important issue and a very interesting topic for the podcast. 00:30:51.460 --> 00:31:00.315 If somebody has, more questions or would like more information, can they contact you, or is there a, are there resources? 00:31:00.615 --> 00:31:05.355 Maybe you can give an email address or a website that people can go to if they want more information. 00:31:06.135 --> 00:31:06.455 Sure. 00:31:06.455 --> 00:31:11.030 If they can email me, they can go go to the website, National Eating Disorder Association. 00:31:11.730 --> 00:31:20.310 If their goal is to have a Catholic therapist, they can go to Catholic Psychotherapy Association and find therapists and email addresses there as well. 00:31:21.425 --> 00:31:23.205 Your email address is there, you said? 00:31:23.585 --> 00:31:24.085 Sorry. 00:31:24.385 --> 00:31:29.195 My email is f v u y v l e c k a. 00:31:29.195 --> 00:31:39.220 And fvuyvlecka@divinemercy.edu. 00:31:39.760 --> 00:31:40.160 Very good. 00:31:40.160 --> 00:31:40.640 Thank you. 00:31:40.640 --> 00:31:53.035 That I'm sure people, will have some, interesting questions for you, but wanted to thank you very much for this very, very interesting podcast and look forward to having you on again, in the future. 00:31:54.135 --> 00:31:57.755 Father, is there anything else you would like to say as we finish here? 00:31:57.975 --> 00:31:58.455 Well, no. 00:31:58.455 --> 00:32:00.935 I I would just reiterate what you just said, Thomas. 00:32:00.935 --> 00:32:04.155 It's been very informative and, learned quite a bit. 00:32:04.420 --> 00:32:10.040 And thank you, thank you, doctor Veflechka, for this, for your time. 00:32:10.500 --> 00:32:12.280 Have a wonderful day, doctor Veflechka. 00:32:13.300 --> 00:32:14.120 Thank you.