Why Counting Calories is a Crock

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Check out this article from Sunbasket!

“Do yourself a favor and forfeit the fight against millions of years of human evolution. Sun Basket’s Director of Nutrition, Lindsey Kane explains why it’s nutrients, not calories, that matter most. 

The standard advice for losing weight has long been boiled down to “burn more calories than you eat.” While it sounds sensible, researchers are starting to understand that calories don’t work the way we thought they did. The truth is,  everything we know about calories—from the way they’re measured to how they're absorbed by the body to what appears on food labels and nutrition apps—is wrong. Calories, it turns out, are the cracked cornerstone of a flawed structure of understanding food and nutrition, and it’s time we burned that house down. 

What’s a calorie anyway? 

Originally defined as the amount of heat needed to raise the temperature of one kilogram of water from 0°C  to 1°C, a calorie is simply a metric used to quantify energy. It’s measured with something called a bomb calorimeter, a tool developed in the 18th century.  

Here’s a very dumbed-down version of how it works: 

  1. Place food in a secure chamber.

  2. Blow up the food.

  3. Measure the amount of heat released.

The amount of heat released indicates how much energy, which translates to the number of calories, is in the food. While this makes sense in theory, in practice, there are a few problems. The most obvious of these is that your body is not a bomb calorimeter and digestion is not an explosion. 

Humans are living, breathing, digesting beings with genes, hormones, gut bacteria, and environmental conditions that influence energy in ways that can’t be replicated in a lab. In real life, digestion requires a complex orchestration of organ systems, metabolic processes, and biochemistry to convert food into energy and store it for fuel. A meal travels about 30 feettakes about 12 hours to be digested and converted to energy, and anywhere from 30 to 48 hours for waste elimination. It doesn’t combust in a matter of seconds. 

The numbers aren’t real 

Even if the science of calorie counting made sense, the math doesn’t add up. Take nutrition labels, which are calculated using approximations derived from 19th-century lab experiments. The FDA allows for a 20 percent variance on all labels, which means that a 100 calorie bag of pretzels could actually be 80 calories or 120 calories. Someone looking to eat 2,000 calories a day could actually be eating anywhere from 1,600 to 2,400 calories without knowing it. Most calorie-counting apps draw from this flawed data. They also require users to estimate portion sizes, and, as you can imagine, humans aren’t the best portion estimators. 

But even if the numbers were real, they wouldn’t be helpful because the number of calories in a food and the number of calories derived from food are not the same.We digest foods differently based on the quality and the overall “packaging” of the calorie. Each bite of food interacts with our ever-changing biology and environment. So while 1,000 calories of spinach and 1,000 calories of chips give off the same amount of heat in a bomb calorimeter, spinach and chips have unique biological effects that influence weight management in profoundly different ways.

Digestion requires energy, and the amount of energy used up during digestion depends on what you eat. High-fiber foods like vegetables, beans, and whole grains require a lot of chewing and churning, as well as a surge of energy to propel the food through the GI tract, but calorie counts don’t factor in the energy expended during digestion.

Also, we don’t digest and absorb 100 percent of the energy that a food contains. In general, the more processed a food, the more calories are extracted. To accurately calculate the total calories from a given food requires a dizzying array of factors, including how boiling, baking, microwaving, or sautéing changes its chemistry; how much energy is expended breaking it down; and the extent to which the billions of bacteria in the gut aid human digestion and, conversely, steal some calories for themselves.

Value food for what it is, not for what it lacks

It’s time to let go of the soul-sucking exercise of counting calories once and for all and look instead for foods that are rich in the things you actually need, like protein, fiber, vitamins, and other health-supporting nutrients. Instead of playing the numbers game, follow some commonsense rules and listen to your gut. When you eat intuitively, you’ll end up feeling nourished instead of deprived, and you can focus on cultivating healthy habits that you can maintain for a lifetime.”

Artwork by ekströmdesign

Interview with Verity Brown

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What inspired you to become a social worker?

I first became interested in social work as an undergraduate student. I went to school in rural Ohio and volunteered once a week to meet and mentor local juvenile offenders. Getting to know these teens and their daily struggles with mental health, addiction, trauma, and systemic oppression truly changed my perception of the world. After college, I landed an internship with a group of lawyers offering services to low-income families in DC. They put me in charge of connecting families with resources. This work was so difficult but so rewarding that I decided to go back to school for my Masters in Social Work.

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

It’s an ongoing process and some days are easier than others! I’ve found that slowing down and noticing my thoughts, emotions, and sensations in a particular moment can clue me into 1) what is present and 2) what might be missing.

For example, a common morning vignette in my house: I’m frantically trying to get out of the door, lost in self-talk about my disorganization, and feeling chaotic. A moment of awareness clues me to take a breath and practice acceptance of the current moment.

In my practice, mindfulness of the present moment is key to balancing acceptance and change.

What do you enjoy the most about working in this field?

My patients and my co-workers, no question! My week is spent interacting with such brave, smart, and interesting individuals. My days fly by because I am constantly challenged and learning something new.

What is your favorite hobby or leisure activity?

Cooking, traveling, spending time with friends and family, reading or listening to audio-books, and snuggling with our dog, Fiona, while watching scary movies with my husband.

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

Both my parents are from the UK. As a child, I lived in Hungary and Poland. The most exotic places that I’ve traveled to are Kazakhstan and Malaysia. I have two older brothers; one lives in DC and one lives in London.

The Art of Non-Productivity

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Check out this informative article on the topic of Radically Open (RO) DBT!

Author: J. Nicole Little, Ph.D., R.C.C.


“When I teach skills class, I will confess I kinda cringe when we get to lesson 5.  Week 5 is dedicated to Engaging in Novel Behaviour and includes a discussion of the art of non-productivity.  For someone who leans toward over control (OC), my brain automatically switches the term “non-productivity” to “laziness.”  I cringe because despite the personal work I have done through my involvement as a RO DBT therapist, supervisor and trainer, “the art of non-productivity” remains my albatross.

For those unfamiliar with this lesson, let me walk you briefly through it. For our OC clients, they are biologically hardwired to be risk adverse and as a result, often engage in rigid and rule governed behaviours.  This can be as seemingly benign as driving the same route every day to work or more intrusive as seen with rituals associated with anxiety or Anorexia Nervosa. We teach engagement in novel behaviours through the skills Flexible Mind VARIEs where we ask clients to:

V– Verify one’s willingness to experience something new

A – Check the Accuracy of hesitancy, aversion, or avoidance

R – Relinquish compulsive planning, rehearsal or preparation

I – Activate one’s social safety system and the Initiate new behaviour

E – Nonjudgmentally evaluate the outcome

Novel behaviours also require a willingness to be a bit silly or non-productive; mammals are innately capable of play and playfulness is no laughing matter!  Play serves to reinforce both cognitive and social emotional skills, and allows us to deepen our intimacy with others.  But for our OC clients (and therapists!) this can be challenging.  We know this and as such, supply a list of self-enquiry questions (see page 133-134 of the skills manual) to help elicit the “edges” that may arise. For my clients I often tell them this story:

So I want you to imagine a woman who lived in an 800 square foot apartment with one cat.  She had a rule that work always came before play.  So she would make sure the house was clean, the cat box taken care of, emails answered and inbox to zero, dishes washed and put away, and all errands were run. She often caught up on her paid work after hours and prided herself on her work ethic.  Only when everything was done could she relax and maybe watch a movie or go out to see some live music.  Often, though, she noticed that her “relaxation” was centred on gaining her next personal best time on her bike or watching Ted Talks that could be included in her teaching. 

Normally, my clients see this as perfectly acceptable behaviour.  It kinda makes sense, doesn’t it?  Get the “to do” out of the way so you can get “to be.”  However, the story continues:

Now imagine this same person gets into a romantic relationship, complete with aging in-laws, ends up with 3 cats and 3 dogs and moves into a 1500 square foot house with a yard. Her work ethic has gained her a promotion at work requiring much more responsibility. Wow, so much to do! Can you imagine how much email, house cleaning and poop that translates to?

I then ask my clients:

Does her rule of work before play or rest seem to make sense in this context?

Clients resonate with this story  and tell me of course the woman should chill out a bit– they see themselves in it, on the treadmill of “to do” without pause and often experiencing resentment because of how hard they work.  I then tell my clients that this is not fiction but my own experience, and learning to balance work and play is a work in progress.  So I do not smuggle in that this is the “hardest” skill (because it is for me, tee-hee) but rather “out” myself in relation to this module.

Of course, as I write this, I recognize it is Friday night.  A friend has invited me to see a band later on and still I am perseverating on how to fit the vacuuming in!  So I will close here, practice Flexible Mind Varies and continue to walk the talk.  And maybe dance a bit.”

Nicole is a therapist specializing in eating disorders and other conditions of overcontrol in Victoria, B.C., Canada.  She has also taught for 13 years at Universities and colleges. Her passions are RO DBT and animal assisted therapy. 

Check out the blog post for more information!

DBT for Complex Eating Disorders

We know that eating disorders are complex and serious illnesses and traditional treatment does not always resolve symptoms adequately. In these instances, Comprehensive DBT can be another option. Take a look below to get a general idea of what the program would look like.

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Individuals can benefit from comprehensive DBT for an eating disorder when:

  • Traditional treatment for the eating disorder has not yielded desired results

  • Emotion dysregulation is central to the eating disorder symptoms

  • Significant co-morbidities such as substance use, mood disorders, self-harm, or suicidality impacts standard treatment

  • There is a history of significant therapy interfering behavior(s)

Please contact us for more information about this program option!

Interview with Dr. Marino

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What inspired you to become a psychologist?

Both my father and my uncle were psychologists and my mother was a psychiatric nurse.

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

I use my team for phone coaching in my real life! That's right, I call up my teammates for phone coaching when I need help with skills in my life :) 

What is your favorite hobby or leisure activity?

I'm a Pilates instructor at a local studio and love spending time with my 3 doggies.

What is your favorite thing about evidence-based practice?

I enjoy evidence-based practice because I hear so many patients say they can see a difference in their behavior fairly rapidly compared to other treatment they have tried.

What are you most proud about achieving in 2018?

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From the amazing folks at “Before5am”…

Take a moment to just reflect on all that you have achieved & accomplished this year.

You have achieved a lot so far in your life and taking time to think about those achievements will energize you and give you a great sense of confidence and pride.

It doesn't matter how big or small those achievements are, the main thing is that deep within your soul, you feel a sense of pride for having overcome or created or achieved something that is meaningful to YOU!

When you start to see, feel and appreciate your own achievements you will start to see and feel your potential and your own ability to achieve great things!

So, here is my question to you:
What are you most proud about achieving in 2018?

For more information, check out their team.

The Holidays, Cue Reactivity, and Cravings

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By: Dr. Fischer

Over the past few weeks, I have found myself surrounded by cookies, alcohol, gingerbread houses, candy, and advertisements for holiday dinners. I’ve also been thinking about what to write about for our PBS blog post on eating disorder research.

As I ate another cookie that someone brought in to work, I realized that it might be helpful to discuss cue reactivity and cravings!

Most humans like the taste of fat and sugar, and our brains have evolved to motivate us to approach foods that are high in fat. You may have learned about dopamine (a neurotransmitter) and the reward system in the brain at some point.

What a lot of people don’t realize is that dopamine doesn’t necessarily give us pleasure, but it does push us to approach things that are high risk/high reward. Getting a surge of dopamine in your brain is like getting a surge of motivation to approach or act. We just often act to get things that are rewarding.

At some point in your life, I’m guessing that you learned that you liked the taste of ice cream or cookies or cheese, all foods that are high in fat and/or sugar. When you eat these types of foods, you may experience a reaction in your brain; a surge of dopamine to areas in your brain that motivate you to act. Eventually, this surge of dopamine gets paired with even the image of food. Imagine coming home from work and seeing a junk mail advertisement for pizza. You may not have even been thinking about pizza, but the image of that food is a cue that sets off a whole host of reactions in your brain and gut. You may end thinking “Pizza sounds really good tonight,” even if you had not thought of pizza all day.

This is called cue reactivity, and craving is that urge to eat or drink or ingest something when you are faced with a cue. That urge may feel really strong because you get a dopamine surge when you view the cue, which really pushes you to act and go get the food or alcohol or drug.

In my research lab, we conduct studies on how stress and other emotions impact binge eating. We’ve been really interested in the past few years on how individual differences in brain activity when faced with food cues or stress influence vulnerability to binge eating. What we have found is that even though a lot of people with binge eating symptoms experience craving at the sight of food (a cue), not everyone experiences craving right before a binge. Some people have really strong reactions in their brain to food cues – their blood flow increases to regions of the brain involved in approach and reward when they see those food cues. Those people might be the ones feeling really strong urges to order pizza when looking at the junk mail. Other people don’t have the same type of reaction in their brain to food pictures.

We’ve found that women with bulimia nervosa who have those strong reactions in their brain to food cues tend to experience increasing levels of craving before binges, and the craving tends to go down following a binge. Women who don’t experience that same type of brain reactivity don’t seem to report craving before binges.  

Back to the holiday season – We are surrounded by food cues! And stress! You may be working really hard to eat regular meals, not feel out of control with eating, and then feel as though it is incredibly difficult to manage those things at this time of year. Some people start feeling very self-critical and have judgmental thoughts about themselves. Well, I think it is really hard to feel in control when your brain is pushing you to go get some food every time you turn around at work, or at a family gathering, or at your school. You are probably in an environment during the holiday season which is flooding your brain with dopamine and hence urges to eat. It is the way our brains were designed to push us to get enough fat to survive. Stress reactions also influence reactivity to food cues in some people, so the combination of family stress and being surrounded by food can make it difficult to feel grounded during the holiday season.

Hopefully you can remind yourself that your brain is working the way it is supposed to when you crave food, and not feel as though you are lacking willpower. And, we at PBS (of course) are also hoping that you just eat what you want when you are hungry!

I wish you health and peace of mind during the next few weeks!

Eating Disorders and the Holidays

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The National Eating Disorder Information Centre offers a valuable resource about how to cope with eating disorder recovery during the holiday season. Read below for ideas from this great article!

“Coping with the Holidays”

NEDIC Staff, Maria Jacobsen and with thanks to our volunteers

The holiday season is often a very stressful period for individuals with food and weight preoccupation issues. The emphasis on spending time with family and celebrating with food can be very distressing. This article will focus on exploring ways in which individuals may make this time less difficult. It is not an exhaustive list, but may get you started on generating ideas that are adaptive to your own situation.

You don’t need a crystal ball to be able to predict some things about family and friends! Based on past experience and an understanding of the people close to you, you may be able to avoid or cope constructively with uncomfortable situations.

The holiday season is a time when you may find yourself overwhelmed by commitments. It is easy to overlook your own needs while fulfilling others’ expectations.

  • Predict high stress times and places

  • Plan which events you will attend and which you won’t attend.

  • Plan to have restorative time for your own needs: Go to a movie, unplug the phone, or take a walk. Visit a trusted friend. Buy yourself a present.

  • Plan and carry a phone list of friends and crisis lines.

  • Plan to do volunteer work or join an interest or support group if you are without many friends or family as the holiday season may be a time of loneliness, emptiness or pain.

For example, make time available for pleasurable activities between visits to family. Say that you will attend one big family gathering and make plans for other fun alternatives or smaller, more manageable celebrations. Find a listing of local activities and join in those that appeal to you.

Predict which people might make you most uncomfortable, and in which ways

  • Plan as to whether you want to, or can, avoid these people.

  • Plan appropriate ways of excusing yourself from their company.

  • Plan ways in which to shift the focus of attention from you.

For example, X and Z always demand that you sit next to them. It makes you feel as though they are monitoring or restricting your behaviour. Say that you will only spend a few minutes with them as you want to visit with Y; say you will sit with them a little later, but you first need/want to do something else. There is no need to apologize for satisfying a need or desire that you may have.

Predict what people might say to you that would lead you to feel uncomfortable

  • Plan and practice verbal responses.

  • Plan to set boundaries ahead of time: Ask that people not comment on your body, appearance or eating habits.

  • Plan ways of desensitizing yourself to the comments. 

For example, “You eat like a bird. Come on, have another helping…You need to gain weight.” Response: “Thanks for your concern, but I won’t get into a debate about my weight. Please leave it up to me to decide how many helpings I eat.”

Use coping statements:

  • Before events: “I am within my rights to say no. ”During events: “I can handle this. ”After events: “I did… very well” or “I can see that X is upset; however, it was important that I take care of myself.”

  • Remind yourself that you are a worthy individual and are entitled to respectful behaviour.

  • Put the value of the other person’s position and power in your life into perspective.

Predict negative thoughts that you might have during the season

  • Plan how you could challenge these thoughts; Try to be realistic about events and your own behaviours.

  • Plan and practice alternative, positive thoughts. Write them down. 

For example, you might think, “She gave me a bigger gift than I gave her, she must think I am cheap.” It is important to think in a way which would be more realistic, helpful and adaptive. A challenge to the above thought could be: “People will understand that I can’t afford expensive gifts but give thought to what they would enjoy.” A way to expand on the use of coping statements is to look at events as having three parts: before, during and after.

You can prepare three sets of statements:
Before: “I’m entitled to…”
During: “I can handle this.”
After: “I did… very well.” 

Complimenting yourself on your actions may be difficult. It may help to focus on individual steps you have made. It is important to come up with coping statements that work for you.

Predict how you might respond to the thought of a banquet of food

  • Plan to consistently eat three meals a day to help avoid the desire to binge.

  • Plan ways to feel more comfortable around food: be realistic in your goals. Dispel myths of “good” and “bad” foods. Think of how you can distract yourself if you find yourself counting calories.

  • Plan to allow yourself to eat “treats” and “extras.” This is socially and psychologically healthy!

  • Plan for possible discomfort around feelings of fullness: distract yourself by engaging in a pleasurable activity, e.g., singing.

  • Plan to be compassionate towards yourself. If you binge or purge, remember this is a behaviour that will decrease in regularity with healthier attitudes and eating behaviour rather than punishing yourself for relapses.

  • Plan to hide or throw away your scale to avoid sabotaging yourself.

For example, you may have a close friend with whom you can review strategies for remaining in control during stressful occasions at which food is a focal point…review deep breathing techniques, hold on to a magical, comforting thought, seek out someone who is affirming of you.

For some people it is helpful to realize that the picture-book holiday scene is not a reality for many people. Some cannot afford it, there are many single people who are not close to their families or do not have a family and there are many families that do not fit into the nuclear family model. Don’t blame yourself for family/friendship conflicts. People are no different during the holidays than any other time of the year. Remember that you are responsible only for your own actions and for taking care of yourself.

Places you may want to explore for things to do during the holidays

  • Women’s centres

  • Community centres

  • Parks and recreation department

  • City hall

  • College and university campuses

  • Community newspapers and websites

  • Social media, blogs and message boards

© NEDIC 1992; reviewed and updated 2015  www.nedic.ca

Some Teens Hospitalized for Anorexia are Not Thin

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We are so glad to see more articles emerging about Atypical Anorexia. This article from Psychcentral sheds light and awareness on this serious disorder:

Some Teens Hospitalized for Anorexia are Not Thin

By Traci Pedersen

“A new Australian study finds that 31 percent of adolescents hospitalized for anorexia nervosa exhibit all the cognitive and physical complications of the disease without being underweight.

Dietitian Melissa Whitelaw at the University of Melbourne is calling for a change to the diagnostic criteria for the disorder after finding that patients with “atypical anorexia” suffer serious health concerns despite being within or even above the healthy weight range.

“What we are seeing now is that you can have a healthy body weight but be just as sick as someone with typical anorexia nervosa, including having the same thoughts about eating and food,” said Whitelaw.

“We need to redefine anorexia because an increasing proportion of anorexia nervosa patients are atypical and more difficult to recognise. The definition should refer to weight loss, not just underweight.”

For the study, Whitelaw looked at 171 anorexia patients, ages 12 to 19, who were admitted to the Royal Children’s Hospital’s eating disorder program in Melbourne, Australia between 2005-2013.

She found the following:

  • 51 of the patients were “atypical” with significant eating disorder psychopathology, but not underweight;

  • Rather than being underweight, greater weight loss was associated with life threateningly low pulse rates, a complication of starvation in anorexia nervosa that requires admission;

  • Patients with atypical anorexia also suffered low blood pressure and deranged blood electrolytes;

  • Importantly, no complication was independently associated with being underweight, the typical hallmark symptom of anorexia;

  • None of the patients in the study were being monitored by a health professional for weight loss, their relationship with food, or their methods of losing weight.

Atypical anorexia patients might have lost about a quarter of their body weight, but the body can go into “starvation mode” if as little as 10 percent of weight was lost quickly, causing the heart rate to slow in order to preserve energy.

According to Whitelaw, atypical patients may have been encouraged by family or health professionals to lose the weight. This frequently results in praise and encouragement about how good they look, re-enforcing even more weight loss.

“If adolescents lose weight, it doesn’t matter what weight they are, a health professional should monitor them to check that weight loss is appropriate and if so, that it is done gradually,” said Whitelaw.

“They should also monitor the adolescent’s dietary intake and relationship with food and exercise for signs the patient was spiralling into an eating disorder. Following large amounts of weight loss, careful medical assessment is also recommended.”

Once a person goes into starvation mode the only way to increase the heart rate is re-feeding and weight gain, which in this cohort, required hospitalization.

Whitelaw said people can understand an extremely thin patient needing to gain weight, but it is often a shock to patients and families when someone within or above the healthy weight range needs to gain weight.

And while atypical anorexia nervosa is often seen as less severe than anorexia nervosa, the new findings show that the health consequences can be just as dangerous. Whitelaw believes it is time to change the current diagnostic criteria which states that those with anorexia nervosa must be underweight.

“The face of eating disorders is changing against a backdrop of increasing prevalence of overweight and obesity. Families, teachers, sports coaches and others interacting with young people should not delay seeking help for adolescents with worrying eating patterns if they have lost weight, even if they are not underweight,” said Whitelaw.”

The new findings are published in the Journal of Adolescent Health.

Source: University of Melbourne

Family Based Treatment for Teen Eating Disorders

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Does your child or teenager struggle with an eating disorder? This is a helpful article from the National Eating Disorders Association (NEDA) on the topic of Family Based Treatment for eating disorders.

Just what is Family Based Treatment (FBT)? According to NEDA, FBT (also known as the Maudsley Method or Maudsley Approach) is a home-based treatment approach that has been shown to be effective for adolescents with anorexia and bulimia. FBT doesn’t focus on the cause of the eating disorder but instead places initial focus on refeeding and full weight restoration to promote recovery. All family members are considered an essential part of treatment, which consists of re-establishing healthy eating, restoring weight and interrupting compensatory behaviors; returning control of eating back to the adolescent; and focusing on remaining issues.

Potomac Behavioral Solutions offers this evidence-based treatment for families. Contact us to learn more!

Community Education

On Wednesday, November 14 Dr. Marino presented on the topic of “A Parents’ Guide to Evidence-Based Treatment” at a county sponsored event. Participants learned about the latest and most robust evidence-based treatments for a variety of behavioral issues.

If you are interested in scheduling Dr. Marino for a professional or educational event, please contact us here. Additionally, we offer professional consulting services to the following (including but not limited to):

  • DBT Consultation Teams

  • Clinicians

  • Professionals

  • Universities

  • Organizations

You can learn more about our consulting services here.

Interview with Laura Cusumano

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Interview with Laura Cusumano


What inspired you to specialize in eating disorder treatment?

In college, I double majored in psychology and theatre. Throughout my life, I encountered a number of people in the theatre community who struggled with body image and disordered eating, and I wanted to help promote a culture of listening to and loving one’s body. I joined a group on campus called CARES, which stood for Collegiate Awareness Regarding Eating Smart. We did outreach on campus to build awareness about eating disorders, to educate about eating disorder prevention, and to inspire body positivity. Ever since then, I have been drawn to the topic of eating disorders. During my graduate studies, I focused a great deal of my research on eating disorders, and I was fortunate to complete my internship at an eating disorder treatment facility in the Midwest. I love helping people who are struggling with physical, psychological, and emotional challenges move toward healing and flourishing.

Describe what your favorite therapeutic skill is, and why:

I enjoy helping my patients learn how to validate others and how to recognize when others are validating them. I think it is so important to feel understood and to feel like one’s experiences matter and make sense. Validation is an excellent skill to achieve those goals.

What do you enjoy the most about working in this field?

I love being able to meet a variety of people from all different walks of life and to be part of their journeys. I feel really privileged to have the opportunity to be an important and trusted person in my patients’ lives.

What is one of your favorite Radically Open Dialectical Behavior Therapy (RO DBT) skill, and why?

One of my favorite RO DBT skills is “Flexible Mind is LIGHT.” It can be so easy to become fixed in cynicism and bitterness and to have blinders on that prevent us from seeing things that are uplifting in the world around us and in our everyday relationships. “Flexible Mind is LIGHT” helps us to go opposite to the bitterness we experience so that we can move outside of ourselves to practice kindness, help others, and practice gratitude.

Now, for a bit of fun. What is your favorite hobby or leisure activity?

My favorite hobby is singing. I have been performing for most of my life, and I love musical theatre. Whenever I have time, you can find me belting out songs around my house. Singing is something that has been part of my life for as long as I can remember, and something that I enjoyed with my mom growing up. It was an important part of our relationship, so I value it a lot. It’s a healthy way for me to express my emotions.

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

My favorite color is hot pink, and if you come to my office you’ll pick up on that very quickly! I also really like sequins and glitter!

The Holiday Season is upon us

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By: Verity Brown

Somewhere between back-to-school shopping and snacking on Halloween candy, I blinked my eyes and suddenly, the weather was colder and the trees were colorful.

For many people, winter brings excitement and nostalgia. The smell of pumpkin pies and fir trees can evoke feelings of gratitude and warmth as we gather with loved ones and reflect upon the year. Socks get thicker, blankets get cozier, and fires get crackling! Picture-perfect, right? Not always. For all the joys that the holidays can bring, they also bring stress, conflict, overwhelm, and sometimes grief.

If the thought of standing in mile-long lines at Best Buy or facing a dinner with the relatives leaves you with dread… fear not!  Here are some tips and techniques to keep the most magical time of the year from becoming a full-blown nightmare.

Observe

Mindfulness practices are the key components to changing our instinctual (ahem- impulsive) behaviors. Pause and notice when challenging emotions arise within yourself; paying close attention to the thoughts that start firing and sensations that start brewing. Perhaps the car honking behind you is increasing your heart rate… perhaps thoughts of “why me?!” are flooding in as you’re waiting for another delayed flight.

Regardless of the context of the situation, observing what is happening internally gives us useful information about the present moment. And, just by observing, we mentally secure a little cushion between ourselves and the emotions, thoughts, and/or sensations we are feeling.

Come to Your Senses

If we find ourselves battling overwhelming emotions, distraction can be a great short-term option. Where we go, our five senses come too (sight, hearing, taste, touch, smell). Take time to pause and notice your surroundings, searching for small pleasures in large crowds.

Maybe it’s the sweet taste of your hot cocoa or the spicy smell of peppermint. Perhaps it’s the feeling of your favorite sweatshirt, or the sounds of falling snow. Find what lifts your spirits and enjoy it with as many senses as you can!

Use a Gentle Manner

The holiday season usually means increased contact with other humans. When stress is running high, it can be tempting to snap, scold, or scrutinize others. Keeping a sense of humor and a gentle manner with others increases the likeliness that both people will walk away from interactions feeling positively about themselves. Relaxing our posture, using an easy tone of voice, and staying aware of our body language can help cue our brains to release tension.

Comprehensive DBT for Complex Eating Disorders

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Are you struggling with a severe eating disorder and don’t know where to turn? If you have been through traditional treatment for your eating disorder and are still suffering, read more about our newest program that is coming in Spring of 2019.

Eating disorders are complex and serious illnesses and traditional treatment does not always resolve symptoms adequately. In these instances, Comprehensive DBT can be another option.

COMPREHENSIVE DBT FOR COMPLEX EATING DISORDERS

Individuals can benefit from comprehensive DBT for an eating disorder when:

  • Traditional treatment for the eating disorder has not yielded desired results

  • Emotion dysregulation is central to the eating disorder symptoms

  • Significant co-morbidities such as substance use, mood disorders, self-harm, or suicidality impacts standard treatment

  • There is a history of significant therapy interfering behavior(s)

If you are interested in learning more about Comprehensive DBT for Complex Eating Disorders, please contact us.

Rock Climbing - Team Building Event

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At a recent team building event, members of the PBS team went to Earth Treks in Crystal City for an afternoon of team building. Staff participants had the opportunity to practice individual climbs as well as trust exercises as a team. The team activities in particular helped staff to tap into their skills of communication, listening and observation in order to meet challenges. 

Not only did this experience help to build trust and rapport among the staff, but some staff members who were afraid of heights did their own mini-intensive exposure to help them overcome their fears!  

What is a true friend?

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Have you ever wondered about a friendship in you life? How do you know what a true friendship involves? According to Goodnet.org, you choose your friends, not your family, and in many ways, the people we bring into our lives intentionally can mean just as much, if not more. Our friends help us live more meaningful, joyful lives in so many ways, and we should never under-appreciate the value of a true friend who supports us through thick and thin.

1. Good Friends Accept You for Who You Are

A truly supportive friend will love you for the person you are, flaws and all. That doesn’t mean friends have to agree with each other all of the time. In fact, different outlooks can help expand our horizons. Still, a true friend will accept you and even find beauty in your quirks and imperfections.

2. Friends Stick Around During the Good Times and the Bad

Life has its ups and downs. Having supportive friends can help us get through the hard times. A true friend, because they love you, will stand by to help overcome obstacles. That could mean giving a shoulder to cry on, listening to our problems, or finding ways to cheer us up. Those small gestures can mean a lot especially when times get tough.

3. A Real Friend Celebrates Life with You

In going through life, a friend’s support not only matters during the hard times. A friend means someone who genuinely wants to see you succeed. Unfortunately, disingenuous people may feel insecure and want you to fail. But a true friend celebrates your accomplishments and feels happy to see things go well.

4. True Friends Will Make the Time to See You

Sometimes our hectic schedules make it difficult to see our friends as much as we would like. A best friend will treat you as a priority and set aside quality time to catch up, whether through a phone call, stopping by the house, or even hopping on a flight to see you.

5. A Real Friend Will Tell You the Truth, Even If You Don’t Like It

If you choose your friends the right way, you’ll surround yourself with people who share your values. In this way, you can always rely on friends to give good advice and help guide you through life. Sometimes, we may not notice ourselves falling off track. A good friend will help us make the right choices even if that means saying something we don’t always want to hear.

6. A True Friend Encourages You to Achieve Your Goals

We should all work to become the best version of ourselves, and a good friend will support you in working toward personal improvement. Whether it means cutting out unhealthy habits, pursuing a dream job, or cultivating a creative outlet, friends will give us the motivation to help follow through with the things we want to achieve. 

7. A Real Friend Helps Us Feel Comfortable in Our Own Skin

Sometimes we just can’t force that special connection between friends. It just happens. Two people come together and feel completely at ease being themselves. Whether it means laughing at silly jokes for hours or talking the night away, a long-lasting friendship involves an effortless connection in which two people understand each other when simply being themselves.

Do you know of a special person who shows all the signs of a true friend? Don’t forget to be a good friend in return and show how much you care. Even if you haven't talked in a while, remember to reach out to the important people in your life who love and support you.

Gratitude

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“Gratitude turns what we have into enough.” – Anonymous

One of the DBT Distress Tolerance skills is that of distraction with Comparisons. You can practice this by comparing yourself to individuals who are less fortunate, or to a time when you felt different. As we approach the holiday of giving thanks, consider taking some time to reflect on what you are grateful for in your life. Perhaps even start a gratitude list!

SPIRIT WEEK: DAY 5!

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Today was the final day of spirit week 2018...today the team celebrated 80’s day!