How We Treat
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a solution-focused, evidence-based treatment approach that emphasizes changing behavior through applying specific skills. Developed by Dr. Aaron Beck in the 1960s, CBT has been researched extensively and is the most widely used therapy for treating mood disorders, anxiety, substance use disorders, schizophrenia, and eating disorders. By focusing on the ways our thinking influences our emotions and our coinciding behaviors, CBT identifies, addresses, and teaches us ways to respond to the core beliefs that contribute to the ways we see ourselves, other people, and the world.
Dialectical Behavioral Therapy (DBT)
According to the Linehan Institute, Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT is has been successfully integrated into the recovery process for eating disorders as well. Research has shown that it is effective in treating a wide range of other disorders such as substance use disorders, mood disorders, anxiety, and post-traumatic stress disorder (PTSD). DBT helps clients develop the skills needed to regulate distress and find a balance between thoughts and emotions.
DBT focuses on developing skills, such as engaging mindfulness, becoming more effective in interpersonal relationships, improving emotion regulation, and increasing distress tolerance. DBT can help manage impulsivity, suicidal behaviors/ideations, feelings of emptiness and hopelessness, feelings of abandonment, unstable interpersonal relationships, and engagement in dangerous or life-threatening behaviors. With the combination of commitment, motivation, and practice, Dialectical Behavior Therapy can assist people in becoming more regulated and self-sufficient.
Acceptance and Commitment Therapy (ACT)
Developed by Steven C. Hayes, Kelly Wilson, and Kirk Strosahl, Acceptance and Commitment Therapy (ACT) was founded on the idea that most psychological distress is tied to “experiential avoidance.” This is an attempt or desire to suppress unwanted internal experiences, such as emotions, thoughts, or bodily sensations. ACT focuses on helping an individual learn to observe, recognize, and accept a realistic perception of self while learning to manage thoughts that may exacerbate anxiety or problematic behaviors.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is a therapy approach that enables individuals to heal from symptoms and emotional distress that arise from emotionally or physically threatening life experiences. Through bilateral stimulation and resource development, EMDR helps brains process through threatening events that have taught people they are not safe and assists brains in re-establishing feelings of safety. By processing these events, symptoms such as anxiety, depression, nightmares, numbness, hyper vigilance, isolation, and fears of connection are minimized or eliminated, decreasing the need for engaging in maladaptive behaviors (eating disordered behaviors, substance abuse, excessive exercise, self-harm, etc.) to numb or change feelings.
Many women struggling with eating disorders have statistically also experienced a traumatic event in their past. At Magnolia Creek, we define trauma as anything that physically or emotionally threatens your safety, including physical threats like violence, assault, car accidents, etc. But it also could include relational traumas such as parental divorce, loss of relationship, deaths, attachment wounds, unpredictable home environments, etc.
As Dr. Peter Levine, a well-respected expert on trauma recovery and founder of Somatic Experiencing articulates when we experience traumatic situations, our bodies store that energy by pushing it all down and keeping it contained.
Our bodies are not built to store this energy; this suppression can manifest this energy in other, problematic ways such as:
Anxiety: muscle tension, intrusive images of the traumatic event, nightmares, flashbacks, hyper vigilance-which means being overly alert to your surroundings always, racing thoughts, elevated heart rate, trouble sleeping, shallow breathing/inability to fully catch your breath, etc.
Depression: consistently sad/depressed mood, increase in appetite, decrease in appetite, low energy, loss of interest in activities you used to enjoy, isolation, inability to concentrate, lack of motivation, and/or suicidal ideation.
Physical complaints: aches, pains, ulcers, heart issues, immune issues, headaches, jaw tension, etc.
To find relief from these symptoms, many people seek out ways to numb and cope with the distressing feelings they are experiencing. There are many coping behaviors people may try to manage their distress. Sometimes people turn to eating disordered behaviors or substance use in this attempt to find relief. As effective as eating disordered and substance abuse behaviors can be in giving temporary relief; they do not provide long-term solutions and place people at greater risk for other problems to co-occur. Frequently, what people try to use to numb and gain control over their feelings eventually gains control over them.
At Magnolia Creek, we use Somatic Experiencing to help our clients regain their freedom and control by releasing this trapped survival energy that is causing these distressing symptoms. In addition to providing each person’s body the opportunity to release this suppressed energy and process the events that led to the initial development of this energy, Somatic Experiencing also aids in ultimately eliminating the need to engage in these coping skills that have started to control them. At the very beginning of the process and throughout their work together, therapists assist clients in developing alternative coping skills that will reinforce safety and assist the body in regulating its energy.
One commonality among individuals with eating disorders is the avoidance of the body and body sensations. When we ask our clients to explain what they are feeling, many are unable to articulate it (or are even aware of it). Our clinicians have found that Somatic Experiencing can foster integration of mind and body. Clients taking part in Somatic Experiencing often voice a deeper connection to the body assisting them in being able to improve awareness of their own emotions as well as physical cues that have frequently been ignored in the past. By improving mind and body integration, allowing a release of suppressed survival energy, and developing skills to assist bodies in maintaining regulation, we see our clients experiencing healing in mind and body.
Mindfulness involves developing awareness of what is being experienced at the moment, including thoughts, feelings, and the environment around you. It is also the practice of accepting thoughts and emotions, and not passing judgment on the present. Mindfulness-based therapy can be helpful in learning how to manage external stressors that may trigger desires to find a quick relief for distress through binge eating, restriction, purging, excessive exercise, self-harm, substance abuse, etc. Therapeutic techniques can help an individual learn to be more observant instead of reactive in the present moment and can aid people in developing skills to allow emotions to and thoughts the space to process.
Psychodynamic therapy believes that our experiences from the past influence the way we see and interpret the world. By offering a safe space and a healthy therapeutic relationship to identify and process through events, relationships, and patterns throughout life, we can gain insight on present-day problems, beliefs, and thoughts. Once we gain insight, we can develop coping mechanisms to implement to manage distress and engage in different behaviors moving forward to inhibit the continuation of distress-inducing experiences.
Narrative therapy functions from the belief that our experiences contribute to our narrative or story if you will. The story that we develop about ourselves is based primarily on our interpretation of what we have experienced in life. Narrative therapy utilizes the power of people’s stories to discover life purpose. Because narrative therapy sees people separate from their problems, it works towards transforming the effects of the problematic experience instead of working towards changing the person. Through narrative therapy, individuals are empowered to re-define their stories.
Exposure and Response Prevention (ERP)
Exposure Response Prevention Therapy (ERP) is used to treat anxiety disorders, exposing the individual to the feared object or circumstance in the absence of danger to desensitize fear and distress while reinforcing safety. ERP helps the brain re-conceptualize the threat by gradually increasing the exposure to the fear at mild to moderate levels while reinforcing safety through affirmation and experience.
For those suffering from an eating disorder, particularly bulimia nervosa or anorexia nervosa, ERP can aid in helping individuals overcome fears of consuming certain foods and can also assist with anxiety provoking experiences like being weighed, grocery shopping, or looking at oneself in the mirror.
Experiential therapy is a category of therapy that includes multiple approaches such as role playing, group sculpting, use of props, guided imagery, art therapy, etc. Instead of traditional talk therapy, experiential therapy encourages individuals to address and hidden and sometimes subconscious issues through experiential activities and interactions.
Motivational interviewing is a therapy technique that encourages collaboration between client and therapist to identify internal motivating factors to enact change. Motivational interviewing is commonly used in the treatment of substance use disorders, health disorders, and eating disorders.
Internal Family Systems
The theory behind Internal Family Systems is we each have different internal components filling the needs we have for love, attachment, belonging, achievement, survival, etc. With the support of a trained therapist, we can identify the roots of conflict and ways to navigate the conflict in ourselves and others by developing a deeper understanding of these components, their experiences, and their needs. Identifying and meeting the needs of these components dissolves our tendencies of meeting needs in other ways and equips us to identify and navigate conflict more effectively.