Dr. Kim's Lecture at Georgetown University

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By: Dr. Aileen Kim

Last month, I gave a talk to post doctorate clinicians at Georgetown University about Mindful Management of Shared Treatment with Borderline Personality Disorder Patients.

Many patients with BPD see a therapist for psychotherapy and a psychiatrist for medication management. This treatment model is commonly called "split treatment", but I prefer to describe it as "shared treatment" which I consider a more accurate reflection of what is happening when the model is being used effectively.

We examined ways that Dialectical Behavioral Therapy principles can be applied by non-prescribing therapists and prescribing clinicians alike to integrate care for BPD patients. Additionally, we discussed how using our own skills as clinicians can be part of care for caregivers and create an effective professional culture. 

Interview with Alyson Nuno

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Interview with Alyson Nuno


What inspired you to become a mental health clinician?

As a child I was drawn to idea of working in a helping field, such as being a nurse or doctor. It was a natural calling for me, but I didn’t know I would eventually become a mental health clinician until after I graduated from college. In I majored in foreign languages with a dream of working in teaching and translating, but when I entered the “real world” after school I found myself in jobs that did not quite fit where I saw myself long term. At some point I decided to just go for it and pursue a Master’s degree in Mental Health Counseling. To me, it was a life worth living goal.

What do you enjoy the most about working at Potomac Behavioral Solutions?

I really enjoy the team aspect. It is comforting to know that I don’t have to operate alone and that supportive colleagues are always right around the corner. It makes the environment more comfortable, and enhances the work I do so that I can be a more effective clinician to my patients. Additionally, I truly enjoy working with my patients and feel lucky to be part of their journey toward their life worth living. I come to work everyday knowing that I am in the field I love, and it’s a good feeling.

What is your favorite Dialectical Behavior Therapy (DBT) skill, and why?

Checking the facts is my favorite DBT skill because it really helps me to slow down and get out of Emotion mind. Sometimes, it seems like what I’m feeling in the moment is truth or factual, but once I’m able to sit down and objectively examine the data, it makes it easier to think things through and problem solve effectively. Basically, it help me get to wise mind faster since I’m able to detach from some of the emotions that might cloud my view on Wise Mind.

How do you find a balance of acceptance and change in your own life?

Well, I’m very naturally change oriented so I don’t have to work much for that part. However, I carve out time every day to work on acceptance. I make it a daily practice to use mindfulness and radical acceptance to notice when I’m not in acceptance, and pushing for change when it is not effective to do so. Intentionally practicing this helps me find that balance in my own life.

Now, for a bit of fun: What is your favorite hobby, and why?

Crossfit is one of my favorite hobbies and one of my favorite PLEASE skills. I find that the physical activity helps me to unwind, and it’s actually one of my favorite forms of self care as it reduces my vulnerability to stress. Not only that, but I also use it as a mindfulness practice since I focus on what I’m doing in the present moment and increase awareness of what’s going on with my body. The community aspect of Crossfit is something else that draws me to it, because I form relationships with the people I work out with, and we share that common bond. It’s empowering and a lot of fun!

Is there anything else that you’d like the readers to know?

I speak 3 other languages, and I have an interest in art and art history. If you ever want to practice Italian, French, or German, stop on by my office! I learned these languages in high school and actually wanted to be a translator. In college I studied this further and traveled abroad to enhance my foreign language skills. Another fun fact about me is that I have 2 cats and that I love ALL furry creatures! I am hoping to get a dog one day, too, but right now that decision is up in the air.

OCD Awareness: OCD and Anxiety in the Classroom

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Did you know?

“OCD and anxiety are very common in children and can take a tremendous toll on the child’s school performance and social functioning. Approximately 1 in every 200 children in the United States suffers from OCD or a related disorder.

  • Over half of adults with OCD report that their symptoms began before age 18.

  • The National Institute of Mental Health estimates that around 30% of youth have experienced an anxiety disorder.

  • A recent IOCDF-funded study has shown that OCD significantly impairs an individual’s ability to take advantage of educational opportunities.

  • A recent study showed that OCD has a pervasive and profound impact on education across all educational levels, particularly when it has an early age of onset.

Unfortunately, the professionals who interact with youth the most (such as school personnel and pediatricians) are not trained to recognize anxiety/OCD in children. This means that the average child with a mental health condition will wait years after displaying symptoms to receive an accurate diagnosis and treatment.

Anxiety in the Classroom was developed by the International OCD Foundation to reduce the negative impact of anxiety and OCD on youth.”

For more information, check out Anxiety in the Classroom, an online resource center for school personnel, students, and their families.

OCD Awareness Week: Get UNSTUCK!

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Have you taken a look at the International OCD Foundation yet? If not, what are you waiting for? Their website has tons of information, resources, stories, and videos - and can be a support through one’s journey with OCD.

This week make sure to also check out this wonderful resource to find free screenings of UNSTUCK: an OCD kids movie, which are showing in honor of OCD Awareness Week 2018.

“Thousands of kids, teens and adults with Obsessive Compulsive Disorder (OCD) are trapped in a vicious cycle of worries, intrusive thoughts and rituals. And while families and loved ones are desperate to help them, fighting OCD takes time and specialized therapy. To uncover what OCD is, and what it isn’t, filmmakers Kelly Anderson and Chris Baier focus on an unlikely group of experts: Kids!

UNSTUCK is an award-winning short film that documents OCD strictly through the eyes of young people. The short documentary avoids sensationalizing compulsions and obsessions, and instead reveals the complexity of a disorder that affects the brain and behavior. As the group of resilient kids and teens roadmap their process of recovery, the film inspires viewers to believe it is possible to fight their worst fears and beat back OCD.”

Additionally, take a look at this free facebook therapist chat on Wednesday night, hosted by an OCD therapist who is also a parent of a child with OCD.

OCD AWARENESS STORY: HOPE & Empowerment

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I never pictured myself as a person who would struggle with OCD. When I started treatment, it was because I was at my breaking point. Here is a brief synopsis of my path to recovery (which I am still on), and I hope my words can reach someone who needs to hear them. 

For 3 years, I struggled with terrifying intrusive thoughts. It started a few years ago, after some stressful life events, with a thought I had about taking a knife and cutting my wrist. I was terrified. But I couldn’t get it out of my head, and when I tried, I’d become more obsessed with figuring it out. Was I a suicidal person? No. Did I have any reason to want to hurt myself? No. I felt crazy. I started avoiding knives and having anxiety attacks and googled about it until I started getting other instructive thoughts. Thoughts about sexuality, assault, child molestation, leaving the gas on when I made tea, germs, you name it. My major “compulsion” was reassurance seeking - I spent hours googling the thoughts, and I asked everyone that knew me if they thought I was going to be okay. It was taking over my brain and I could not believe the person I had become. I was sure I was going insane and would end up in a mental hospital. It was rock bottom for me. 

I had struggled with anxiety for years, but OCD was different. OCD feels like a personal attack that you can’t control. It feels like something horrible is in your brain, making you think or imagine terrible things that don’t align at all with your morals or beliefs. Yet you have no control over it. It is the WORST feeling I’ve ever had. However, there is a silver lining to this story. 

When I started going to treatment, I never thought anything would help me. I was ready to give up and live in this anguish forever. OCD had taken my independence, my confidence, my relationship, and any positive beliefs I had about myself. I was DONE letting it take over. I started therapy, accepted an OCD diagnosis, and eventually began ERP (exposure and response prevention) therapy. I won’t sugar coat it - it was torture to face my worst fears head on, but...slowly, IT WORKED. I was amazed. It felt so freeing and empowering to take back my mind. Little by little, I regained my confidence, I stopped googling, I began thinking in a healthier way, and I stopped fearing the intrusive thoughts. I also did an intensive program with PBS for a week, which seriously tested my patience and my endurance, but which rid some of those thoughts for good (or at least for a while).

Now, I have rebuilt myself and feel stronger than I have in YEARS. I truly never thought it could happen. I got on medication, faced the horrible thoughts coming from this disorder (over and over and over again), took care of my self, and worked extremely hard to separate myself from OCD. I may have lost a few people along the way, but I am better for it and now know how much support I have in my life from others. I can honestly say I feel amazing and I am so proud of myself. I have my life back! And I couldn’t have done it without my treatment providers. OCD does not have to take over - and for what it’s worth, it made me realize how strong I am and how resilient we all can be.

OCD AWARENESS WEEK

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The second week of October is OCD Awareness Week!

According to The International OCD Foundation (IOCDF), “OCD Awareness Week is an international effort taking place during the second week in October each year to raise awareness and understanding about obsessive compulsive disorder and related disorders, with the goal of helping more people to get timely access to appropriate and effective treatment. Launched in 2009 by the IOCDF, OCD Awareness Week is now celebrated by a number of organizations across the US and around the world, with events such as OCD screening days, lectures, conferences, fundraisers, online Q&As, and more.”

Check out the International OCD Foundation for more information and for resources.

OCD International Foundation & Mental Health Advocacy Capital Walk

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According to the OCD International Foundation, “One out of 100 people live with obsessive compulsive disorder (OCD) — a serious mental disorder affecting not only the lives of those who struggle with it, but also those of their family, members, friends and loved ones. OCD is one of many mental health conditions, which altogether impact 1 in 5 people in the US alone.”

International OCD Awareness Week is October 7–13, and TOMORROW kicks it off with the Mental Health Advocacy Capital Walk in Washington DC!

Check out this link for more information.

BFRB Awareness Story: A Journey towards Acceptance and Freedom

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I’ve tried for a long time to feel “perfect.” I’m not perfect. I make mistakes. I yell at those I love, I eat when I’m not hungry and sometimes I’m too tired to brush my teeth before I go to sleep. When I’m stressed, I pull my hair. When I’m bored, I pull. Or excited. Overwhelmed. Highly caffeinated, or not caffeinated enough. I frequently wake up in the middle of the night, subconsciously pulling my hair. But I’m not writing this to tell you how I pull my hair (or used to) all the time. I’m writing to let you know how I don’t let it control my life.

Pulling makes me feel out of control. When I first started pulling, I had dreams about cutting my hands off. I felt like a monster with a broken brain. For some reason, my brain urged me to pull hair from my own body, look at it, play with it, and discard it. Something must be terribly wrong with me.

There were times when I wished I had a different condition, something more socially acceptable. Hair pulling felt so obvious. At the peak of my pulling, people asked my boyfriend if I was sick. Like, my hair was so thin people wondered if I had cancer. It felt awful to know that I had done that to myself.

I would spend hours getting ready to go out with friends, styling my hair in 100 different ways to cover the bald patches. Often, I would decide at the last minute to stay in. Or, I would go out, have fun, only to feel punched in the stomach when I went to the bathroom and looked in the mirror. “You look stupid,” I would say to myself. “You are so ugly.” “You are embarrassing.”

Here’s the truth that I have learned: I am not a monster. My brain is not broken, nothing is wrong with me. I am not stupid or ugly, nor do I need to be embarrassed by who I am. I pull my hair out, and though, through self-acceptance, I’ve significantly reduced my pulling - I may always pull my hair out. And that’s okay. I am not defined by my hair.

Who am I? I am a kind and caring friend. I am an accomplished teacher, a loving fiancé. I love ice cream, college football, and playing board games. I’m not perfect. I am not my hair.

Singer/songwriter India.Arie writes:

“Does the way I wear my hair make me a better person?

Does the way I wear my hair make me a better friend?

Does the way I wear my hair determine my integrity?

I am not my hair.

I am not this skin.

I am the soul that lives within.”

Let me be clear - it took me a long time to work through self-acceptance. It’s something I continue to work on every single day. It’s not easy. But it’s so, so worth it.

So I smile when I look in the mirror, even though I wish my hair was thicker. I carry fidgets with me everywhere, and when people ask, I let them know that I’m working on not messing with my hair. I ask friends and family to tap me on the shoulder or say my name when I’m lost in pulling, because it’s not embarrassing to have those who love you help out. It’s so much easier for me to be honest. For me to recognize, “I have a big deadline coming up, so it makes sense that I’m pulling more.” “I’m sitting down to watch a movie, so I should grab a hat.” “I pull the most right when I get home from work, so I’ll leave a fidget by the door.” And I celebrate the times I’m a few steps ahead. When we took a road trip and I wore a bandanna the whole time - including on gas station bathroom breaks. When I take the time to go to yoga so I’m more calm going into a stressful week at work. When I leave myself notes on the bathroom mirror like, “comparison is the thief of joy.”

I learned my truth by embracing the parts of me that I love: by rewarding myself for love, not punishing myself for pulling. By working through the stress that causes me to pull. By being honest about who I am.

BFRB Awareness Week

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The first week of October is BFRB Awareness Week.

Did you know?

“Body-focused repetitive behaviors belong on the list of MOST common mental health disorders. At least 3-5% of the population is affected by a body-focused repetitive behavior (BFRB), a general term for a group of related disorders that includes hair pulling (trichotillomania) disorder, skin picking (excoriation) disorder, and nail-biting (onychophagia). These behaviors are not habits or tics; rather, they are complex disorders that cause people to repeatedly touch their hair and body in ways that result in physical damage.”

Read more here!

Educational Series on Suicide: Part III of III (Help for Survivors of Suicide Loss)

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By Aileen Kim, MD


In part I and II of my educational series on suicide, I discussed how to recognize suicide risk, and identified actions that laypersons can take if they suspect a loved one might be suicidal. 

Taking action to help someone who is suicidal matters, but the reality is that suicide is not 100% preventable. I imagine that we all hope this post is something that we will never need. I know I did. However, a few months ago, a physician colleague of mine took her own life, which left my professional community feeling sad, shocked, confused and devastated. 

Since suicide is a relatively uncommon event, most of us had never experienced this kind of loss before. Many of us were unsure of what we could do to help and support each other after this loss. As we wrap up National Suicide Prevention Month, in this third and last installment of my educational series on suicide I will share some guidance on how to help a survivor of suicide loss. 

  • Simply listen. Being present is in of itself a form of validation. 

  • Give accurate refection ("I can see that losing  ____ has you feeling shocked/sad/confused) if you feel you are able to do so. If you don't know how, or don't what to say that is OK. 

  • Let survivors of suicide know that you radically accept their feelings about the loss as they are, without trying to change the distressing feelings or problem solve. Let survivors take the lead in sharing and talking about the loss. 

  • Used the loved one’s name instead of ‘he’ or ‘she’. This humanizes the decedent; the use of the decedent’s name will be comforting.

  • Refrain from judgmental language about the suicide, the person who died by suicide, or preconceived notions about suicide.  A subtle but significant example: many of my colleagues expressed objection to the use of the phrase "committed suicide" which can be potentially stigmatizing and shaming to survivors. Consider instead saying "died by suicide". 

  • Ask if survivors would like connection to professional help and support resources before offering; again, practice acceptance before promoting change. Give survivors the chance to move through changes at their own pace and on their own terms. Practice patience and acceptance of differences in how individuals grieve and process the loss. 

It's OK to ask survivors what they need. It can be an open ended question, or you can offer suggestions for them to accept or decline. 

There is nothing "wrong with you” if you feel uncomfortable with feelings and discussion about suicide. Suicide is a harrowing event. Do your best to accept your own discomfort and refrain from self-criticism and assumptions that others are judging you for it; I've observed that fear of such judgment can inhibit people from reaching out to offer support. Survivors of suicide will likely appreciate your positive intentions and the fact that you are consistently making an effort to offer your support and caring. 

References: 

http://www.suicidology.org/portals/14/docs/survivors/loss survivors/hepling-survivors-of-suicide_what-can-you-do.pdf

https://www.speakingofsuicide.com/2017/09/21/suicide-language

https://themighty.com/2015/07/why-you-shouldnt-say-committed-suicide

https://www.borderlinepersonalitydisorder.com/.../ValidationandBPDNEApresentation...

Contents of this blog are intended as general educational material and are not a substitute for advice from a healthcare professional in the context of a treatment relationship. If you or someone you know is suicidal, call 1-800-273-8255, 911 or use the nearest Emergency Room. 

Hello Beautiful Fall!

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Our team went apple picking together over the weekend, to welcome the new season and to spend valuable team-building time together. It ended with a bonfire and s’mores!

This season brings to mind a quote by an unknown author:

"The trees are about to show us how lovely it is to let things go."

It is never too late to decide to let go of behaviors, ideas, patterns, judgments, attitudes, or assumptions from the past that no longer serve us. Is there something you might consider working on letting go of, changing, or accepting? Are there new ways of doing things that might be more effective going forward? With a new season of life comes the possibility of change, if one is willing to explore that path.

National Recovery Month

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We are celebrating National Recovery Month in September! Prevention works, treatment is effective, and recovery is possible.

Check out SAMHSA’s website to learn more. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

How Mindfulness Empowers Us

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Have you ever considered that mindfulness can actually be a tool that empowers us?

Happify Daily has a wonderful film on this topic. “Through a short animated tale of two wolves fighting in our hearts, meditation expert Sharon Salzberg explains how mindfulness allows us to see our thoughts and feelings as they are, freeing us from old ways of thinking and being”.

Watch the video now!


National Suicide Prevention Month

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Did you know that September is National Suicide Prevention Month?

To read stories from people who have been through a crisis and found hope, click here. The National Suicide Prevention Lifeline toll-free number is 1-800-273-TALK(8255).

If you are seeking help for suicidality and self-injury, please call us at 571-257-3378 or email us at info@pbshealthcare.com to schedule an intake assessment. To find out more about our services, click here.

 

The content of this blog is not a substitute for medical evaluation or advice in the context of a healthcare relationship. If you are in imminent danger, seek immediate medical attention by calling 911.

 

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Putting the Pieces Together: Is an Intensive Program for you?

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Navigating mental health treatment can often be confusing. You may be wondering what level of support you need, and what that looks like in terms of treatment. We know that sometimes, once weekly individual therapy may not be enough support to manage the symptoms of what you may be experiencing. In those cases, individualized intensive programming may be another option to explore with your team here at PBS. 

Our programming offers evidence-based practices in a weekly structured way to provide maximum exposure to interventions, skill development, and symptom amelioration. Programming often runs as a week-long program, however, can be offered over the course of multiple weeks. Just as every individual's needs are different in weekly therapy, this will dictate how your personalized intensive is set up.

We offer individualized intensive programming for:

  • OCD
  • Anxiety
  • Over-control
  • Body image
  • Eating disorders and disordered eating
  • Food exposures
  • Phobias
  • Emotion dysregulation
  • General mental health issues

Please call us at 571-257-3378 to learn more about individualized intensive programming.

RECOGNIZING SUICIDE RISK FACTORS AND WARNING SIGNS: PART II OF III (How to Help Someone Who May Be Suicidal)

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By Aileen Kim, MD

 

Part I of my educational series about suicide addressed how risk factors and warning signs for suicide can be recognized. In Part II of my educational series about suicide, I will address what a loved one of someone who may be suicidal can do to help.

The first step is speaking up. Speak about your feelings and observations. Ways to start a conversation about suicide:

  • "I have been feeling concerned about you lately."

  • "Recently, I have noticed some differences in you and wondered how you are doing."

  • "I wanted to check in with you because you haven’t seemed yourself lately."

Gather information about the situation.

Questions you can ask:

  • "When did you begin feeling like this?"

  • "Did something happen that made you start feeling this way?"

  • "How can I best support you right now?"

  • "Have you thought about getting help?"

Support the person who may be suicidal. Here are examples of what you might say that could help:

  • "You are not alone in this. I’m here for you."

  • "You may not believe it now, but the way you’re feeling will change."

  • "I may not be able to understand exactly how you feel, but I care about you and want to help."

  • "When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage."

What if you’re not sure if someone you love is in immediate danger? The following questions can help you gather more information about the immediate risk for suicide:

  • Do you have a suicide plan? (PLAN)

  • Do you have what you need to carry out your plan (pills, gun, etc.)? (MEANS)

  • Do you know when you would do it? (TIME SET)

  • Do you intend to take your own life? (INTENTION)

People who answer “yes” to all four of these questions and have details in mind, as well as intend to take their life, are at very high risk of attempting suicide. Now, that being said, there are a lot of gray areas regarding answers to these questions. Negative answers to some or all of these questions do not guarantee someone is immediately safe from suicide. There are many other variables influencing immediate safety that these four basic questions do not address. The immediate risk of suicide may be unclear especially to someone who is not a mental health professional.  Suicidal persons may not always be forthcoming even with those they trust and love, or be capable of thinking and communicating clearly when they are experiencing suicidal thoughts. For these reasons, if you are unsure or your intuition tells you the feedback from your loved one may not be accurate, ask a healthcare professional for advice.

Source: https://www.helpguide.org/articles/suicide-prevention/suicide-prevention.htm

Do:

  • Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.

  • Listen. Let the suicidal person unload despair, vent anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.

  • Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.

  • Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.

  • Take the person seriously. If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.

But don’t:

  • Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.”

  • Act shocked, lecture on the value of life, or say that suicide is wrong.

  • Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.

  • Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.

  • Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

Source: Metanoia.org

The content of this blog is intended as general educational material and is not a substitute for medical evaluation or advice in the context of a healthcare relationship. If you or someone you know is suicidal, call 1-800-273-8255 or seek immediate medical attention by calling 911.

Interview with Dr. Rebecca Hardin

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Interview with Dr. Rebecca Hardin

What drew you to develop a career in the field of psychology?

I took a psychology class in high school which initiated my interest. I initially started pre-med studies in college, and after a while realized that I wasn’t enjoying much of the content except for the psychology courses. When I was exposed to a health psychology class, I had an “aha moment” related to learning about the mind-body connection and applying the biopsychosocial model to chronic illness - it was the perfect blend of medicine and mental health. I ended up switching majors and completed a degree in Psychology and have continued to focus on Health psychology through my studies and training.

 

Tell us about your special interest in Type 1 diabetes and co-occurring eating disorders:

For me, my interest in this field is two-fold. On one hand, I’ve always been interested in the severity of these conditions and the impacts on physical and mental well being, and on the other hand, having Type 1 Diabetes myself, I recognized the vulnerability that went along with it and realized how pervasive that vulnerability is to those with these co-occurring conditions. I have also had both personal and professional experience with the occurrences and did a lot of personal reading and research based on those experiences - it was interesting to think about the bi-directional impact on recovery, or on lack of recovery in these cases. Oftentimes, specialists may be pigeon-holed in the way they provide treatment or are not necessarily trained for these co-occurring disorders - when a patient suffers from the co-occurrence, it adds a substantial layer of complexity to the case.  Fortunately, there is some training starting to emerge regarding the overlap of these two disciplines; although more is needed.

 

What is your favorite part about being Director of Program Development and Outreach?

With program development, I really enjoy looking at things from 30,000 foot view and then identifying ways that we can improve as a team and as a mental health clinic. I like being able to find where the deficits of service are and helping plan where we can be more helpful and improve or integrate evidence-based practice into these needed areas for the community. On the outreach side of things, having opportunities to travel to other facilities and learn about what services are offered helps me develop a top referral network for our patients. We develop relationships with other providers that we trust to ensure that patients receive good continuity of care. It’s comforting to know that we can stand behind our choices of where and who we refer individuals to. Overall, I value being part of and enhancing the services available to the community and being a resource to them.

 

Describe what your favorite therapeutic skill is:

With regard to DBT, identifying the dialectic of a situation if one of my favorite skills because it helps me slow down when a situation brings up strong emotions. Some of my other favorite skills are opposite action, behavioral activation, and taking a moment to check the accuracy of my thoughts (eg: cognitive reframing in CBT or checking the facts in DBT).

 

What is your favorite thing about evidence-based practice?

It works! I like that there is both anecdotal evidence as well as research evidence of its effectiveness. At PBS I like that we also use outcome measures with patients, which provides us with objective data to share with them and show them that treatment planning is working, or that treatment may need to be adjusted or updated. It allows us to accommodate what is needed for the patient in order to provide the most effective care.

 

Now, for a bit of fun: What is your favorite leisure activity and why?

I really enjoy kayaking because water is very peaceful to me. Hiking is another favorite leisure activity because I find the mountains to be serene and peaceful. Overall, being in nature is a relaxing and quiet escape from daily life in a noisy city. Spending time with friends is also one of my favorites...sometimes we simply hang out at the fire pit, and other times we even go on vacation together. It’s my way of accumulating some positive experiences in my life.

 

Is there anything else that you’d like to share with readers?

Yes. Although I can appreciate that I’m a bit biased, I truly enjoy working at Potomac Behavioral Solutions because of our team approach. We operate like a family and genuinely care about one another, as well as our patients. I believe that we are an effective team and that we are able to pass that onto the individuals we serve - and as both a professional, individual, and consumer of services, that means a lot to me.

Intuitive Eating Program

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Did you know that Potomac Behavioral Solutions offers a dedicated program for individuals who want to learn how to eat intuitively? Intuitive eating is referenced as a “dynamic process – integrating attunement of mind, body, and food". To learn more about intuitive eating, see our information page.

If you desire to understand and change your relationship with food, our Intuitive Eating 12-Session Individualized Program may be for you. Our Registered Dietitian will work with you through the principles of Intuitive Eating on a one-to-one basis in a guided and supported fashion. Please call us at 571-257-3378 or contact us for more information.

7 Reasons NOT to Compliment Someone on Weight Loss

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Our culture focuses so much on weight, which can perpetuate the dieting mentality for many people. We know that eating according to diets or external cues, rather than internal cues, can lead to disordered eating. This article in The Washington Post discusses why it can be harmful to comment on an individual's weight, and provides options for what you might say instead.

You can read the full article here.

Recognizing Suicide Risk Factors and Warning Signs: Part I of III

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By Aileen Kim, MD

 

Recent current events may be bringing up some thoughts and questions about suicide. This is part I of III of an educational series that addresses some common questions and concerns about suicide.**

What are the differences between suicide risk factors and suicide warning signs?

Risk factors are characteristics or conditions that increase the chance that a person may try to end his or her life. For example, we know that people who try to end their life are more likely to have these variables present:

Health Factors

  • Mental health conditions

    • Depression

    • Substance use problems

    • Bipolar disorder

    • Schizophrenia

    • Personality traits of aggression, mood changes and poor relationships

    • Conduct disorder

    • Anxiety disorders

  • Serious physical health conditions including pain

  • Traumatic brain injury

Environmental Factors

  • Access to lethal means including firearms and drugs

  • Prolonged stress, such as harassment, bullying, relationship problems or unemployment

  • Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss

  • Exposure to another person’s suicide, or to graphic or sensationalized accounts of suicide

Historical Factors

  • Previous suicide attempts

  • Family history of suicide

  • Childhood abuse, neglect or trauma

Warning signs are new or different behaviors in an individual person who might be at risk for ending his or her life in the near future. An individual who demonstrates these signs may be at risk:

Talk

If a person talks about:

  • Killing themselves

  • Feeling hopeless

  • Having no reason to live

  • Being a burden to others

  • Feeling trapped

  • Unbearable pain

Behavior

Behaviors that may signal risk, especially if related to a painful event, loss or change:

  • Increased use of alcohol or drugs

  • Looking for a way to end their lives, such as searching online for methods

  • Withdrawing from activities

  • Isolating from family and friends

  • Sleeping too much or too little

  • Visiting or calling people to say goodbye

  • Giving away prized possessions

  • Aggression

  • Fatigue

Mood

People who are considering suicide often display one or more of the following moods:

  • Depression

  • Anxiety

  • Loss of interest

  • Irritability

  • Humiliation/Shame

  • Agitation/Anger

  • Relief/Sudden Improvement

What causes suicide?

There is no single answer to this question. For any individual whose life ends in suicide, any combination of the risk factors listed above can play a part. People who commit suicide may genuinely believe that their survivors are better off without them or that their death would not have a negative impact on others. Conditions that create risk for suicide can affect a person’s perception, reasoning or judgment.

Is suicide always foreseeable and preventable?

Unfortunately the answer is no. People who attempt suicide can sometimes do so impulsively. They may not necessarily tell others that they want to end their life or intend to do so. Additionally, people with multiple risk factors and warning signs may not attempt suicide. Even when people with risk factors and warning signs seek and receive appropriate treatment, suicide is not always foreseeable and preventable. That doesn’t mean it is futile to try to help someone in your life when you are concerned they might have risk factors or warning signs for suicide, and it does not mean getting help from a professional cannot make a difference.

 

**Disclaimer: The content of this blog is intended as general educational material and is not a substitute for medical evaluation or advice in the context of a healthcare relationship. If you or someone you know is suicidal, call 1-800-273-8255 or seek immediate medical attention by calling 911.

 

References:

https://afsp.org/about-suicide/risk-factors-and-warning-signs/ accessed June 11, 2018

http://www.allianceofhope.org/blog_/2014/07/a-few-weeks-ago-i-noticed-a-young-survivor-who-wrote-in-school-we-are-told-that-suicide-is-100-preventable-but-when-m.html accessed June 11, 2018

Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk

Cheryl A. King, Adam Horwitz, Ewa Czyz, Rebecca Lindsay J Clin Psychol Med Settings. 2017 Mar; 24(1): 8–20.