Wednesday, April 23, 2014

The Reality of Relapse

Relapse can be defined in a variety of ways.  Perception and coming to terms with the reality of relapse is important. These moments are inevitable, but they don’t necessarily mean that a relapse is unavoidable. The key is to recognize when warning signs arise and to take preventive measures. I think that relapse can have a negative connotation at times.  When looking at it through a different lens and honoring that it might be part of your journey or your process, recovery may help you form your own sense of discovery and Self.  As the art therapy intern, I believe this poem can speak visually to the hardships and victories while in recovery.  This poem is written about the journey of recovery.  Becoming aware of our surroundings and emotions that manifest on a daily basis can aid in recovery and trying a new “street.”  The poem is by Portia Nelson and it is from her book, There’s a Hole in My Sidewalk: Romance of Self-Discovery.



Chapter I 


I walk down the street. 
There is a deep hole in the sidewalk 
I fall in. 
I am lost ... I am helpless. 
It isn't my fault. 
It takes forever to find a way out. 



Chapter II 

I walk down the same street. 
There is a deep hole in the sidewalk. 
I pretend I don't see it. 
I fall in again. 
I can't believe I am in the same place. 
But, it isn't my fault. 
It still takes a long time to get out. 



Chapter III 


I walk down the same street. 
There is a deep hole in the sidewalk. 
I see it is there. 
I still fall in ... it's a habit ... but, 
my eyes are open. 
I know where I am. 
It is my fault. 
I get out immediately. 



Chapter IV 


I walk down the same street. 
There is a deep hole in the sidewalk. 
I walk around it. 

Chapter V

I walk down another street.




Source: http://www.lifetrekcoaching.com/poems/bio.htm
Rachel Olszewski
Art Therapy Intern
The Awakening Center 2013-2014

Thursday, April 17, 2014

Just Breathe



Sometimes the best place to begin is to breathe.

So I invite you to take a few deep breaths, inhaling through your nose and exhaling through your mouth and I want you to gently notice how you and your body react.

Notice your belly filling, as if it were a balloon being filled, and the gentle pause between inhalation and exhalation.

Are you feeling a little calmer, as if things slowed down a little bit? Is your heart perhaps beating a little bit softer and at a slower rate? Maybe your limbs are feeling lighter or heavier. Is your posture less rigid and more relaxed?

Take one more deep breath and take notice of your body.

Perhaps by this point you've arrived at a more natural breathing pattern and I want you to try to keep with that as you read this post.

We just took a few seconds, maybe 30 max, to pause and just focus on our breath. Breathing can be a valuable tool to not only calm anxiety, but also to invite yourself to connect with your body, even if it is just for a moment. Taking a few deep breaths allows for the opportunity to clear your mind because you're feeling overwhelmed, or possibly giving yourself the space to sit with an emotion for a few moments before you choose to react. We all use it in different ways, but regardless breathing is a very powerful tool and something that can be done anywhere, at virtually anytime.

So maybe the next time you have a few moments to yourself, you can take a few breaths and focus on your breathing and give yourself the opportunity to reconnect with your body, even for just that moment. You can always find time to breathe. In fact you do it everyday! So what better way to develop the skill, than through practice.


-Jessica Huerta is a Clinical Mental Health Intern at The Awakening Center. Jessica is currently pursuing her Masters of Arts in Clinical Mental Health Counseling at Roosevelt University.

Saturday, April 12, 2014

For the person supporting a friend or loved one with an eating disorder.

“How May I Help You?”
For the person supporting a friend or loved one with an eating disorder.
Michel D. Harris

After greeting each one of my clients, I always ask them, “How may I help you today?”  This simple, open-ended question is one of the most appreciated because instead of telling someone what they should do, I am offering assistance in achieving what my client perceives as important to reach her individual goals.  However, the limited time I have with each client requires an extension of that help from one or several individuals she trusts.  As a source of support to one recovering from an eating disorder, I encourage you to ask, “What can I do to help you?”  What if her reply is always “nothing” or “I don’t know?”  This article will provide assistance with how you can provide support when given minimal or no guidance.

1.  When recovering from an eating disorder, it is a challenge to be comfortable with weight restoration or accepting one’s current body size.  While you may think comments such as, “your face looks nice and full” or “you’re jeans fit good” are complimentary, the person in recovery may hear this as, “your face looks chubby” or “your jeans are too tight.”  Watching someone transform from a malnourished to healthy state is exciting, but instead of making comments related to body size and image, simply ask, “How are you feeling today?”  This shows you are concerned, yet leaves the chosen topic up to the recipient.  Also, as a source of support, avoid making negative comments about your or someone else’s body.  This is the type of behavior that those in recovery are trying to reverse into positive thoughts, and you can help by verbalizing acceptance of yourself and others.

2.  Have you ever experienced any “bumps in the road” when working towards a goal?  Most likely you have, so why would you expect it to be any different for someone recovering from an eating disorder?  There’s going to be days when she falls short with the meal plan or has a binging episode.  Allow that person to use the set-back as a learning experience, and offer positive feedback.  For example, instead of saying, “You were short two ounces of protein today,” communicate positive thoughts; “You met your exchange goals for four food groups today!”  To follow-up, you may ask, “What is your meal planning goal for tomorrow?”  This rewards the positive behavior, yet challenges the person to take another step forward.

3.  Who wouldn’t want to go out for pizza or ice cream?  Events that used to be enjoyable could be fearful for a person in recovery, and there are many reasons why this is so.  First of all, eating out means loss of control in regards to how food is prepared.  Secondly, the foods usually enjoyed at a restaurant are high calorie/high fat, which are avoided in the case of a person with anorexia or used in binge-purge episodes in those with bulimia.  Even though a person in recovery may have previously enjoyed going to a certain establishment, they will have to re-learn how to eat in social situations.  When presenting an invitation to eat out, ask the person where and when she would prefer to go.  This allows control of the situation, and may increase the person’s comfort level in a challenging situation.  Keep in mind that something basic like coffee or frozen yogurt may seem too safe to you, but serves as a starting point.  Once at the chosen destination, act in a manner that makes the person comfortable; don’t comment on what she orders, the quantity of the food served, or the amount of food she eats or does not eat.  When finished, ask the person how she felt about the event and thank her for her company.


In being supportive, it is also important to recognize when a relapse may or has already occurred.  If you notice that the person you are supporting has gone back to behaviors that were detrimental in the past, offer an ear to listen.  For critical situations in which a person is causing harm to self or others, help her seek medical assistance immediately.

_________________________________________________________________

Michel D. Harris is a Registered Dietitian with 14 years of experience as a clinical and outpatient dietitian.  Her areas of practice include eating disorders, weight loss and management, diabetes, cardiovascular disease, cancer, and food allergies/gluten sensitivity.  As an exercise physiologist, she also assists individuals of all fitness levels in planning exercise programs.

At the Awakening Center, Michel provides individual nutrition consultations, as well as multiple group classes and workshops.  Individual sessions include the development of a comprehensive wellness plan that focuses on establishing a healthy relationship with food and exercise, as well as identifying and changing detrimental eating behaviors/patterns.  The nutrition counseling and mindful eating groups allow individuals to share and receive help with the recovery process via discussion of certain topics and activities.  If you would like to speak with Michel regarding your interest in any of her services, please contact her at 773-929-6262 x24 or meishadivito@yahoo.com.

Wednesday, April 9, 2014

Colon Cleansers: Don't Flush Your Money Away!

Colon Cleansers:  Don’t Flush Your Money Away!!!


Have you ever had a foodborne illness?  When describing the experience, one client said, “I felt like someone beat me up and threw me on the floor after having diarrhea that completely emptied me.”  In severe cases, IV fluids are required to replenish lost fluid and electrolytes.  When a client asks if they should do a colon cleanse for weight loss, I wonder why they would want to put themselves through a re-creation of a diarrhea-causing foodborne illness. 

Colon cleansers promise the following; clean waste and toxins from the digestive system, decrease gas and bloating, and most attractive of all, weight loss and a flat stomach.  Diarrhea for weight loss and a flat stomach-what a worthy trade-off!  Of course, this is stated with sarcasm because similar to most fad diets, cleanses result in a quick, temporary weight loss.  In fact, the lost weight is only from water, and re-gained quickly once rehydrated.

Colon cleansers have been around longer than most fad diets, and come in the form of enemas, laxatives, herbal teas, enzymes, and magnesium-containing formulations.  Products that are labeled as colon cleansers are not regulated by the federal government, and those using them may experience nausea, vomiting, cramping, and dizziness.  Some of the more severe side effects are bowel perforation, infection, a decline in the normal bacteria found in the colon, and mineral imbalances.  Furthermore, there is little evidence to support the belief that colon cleansers improve health or eliminate disease-causing toxins from the body.

If considering a colon cleanse to eliminate the “waste and toxins” in your body, let me tell you a little well-known secret that is actually ancient news:  the human body has a unique method of eliminating waste that costs nothing, and is very natural.  What is this secret method?  A bowel movement!  Along with bowel movements, the liver has the ability to neutralize toxins and the colon contains bacteria that detoxify food waste, sheds its old cells every three days, and its mucous membranes prevent harmful substances from re-entering the blood and other body tissues.  How’s that for efficiency!  Drinking adequate amounts of fluid, and consuming foods high in insoluble fiber keeps this unique system “regular.”  Valuable sources of insoluble fiber include whole wheat and whole grain products, wheat bran, nuts, seeds, barley, couscous, brown rice, bulgur, and most fresh fruits and vegetables.


There are a few parting thoughts to keep in mind regarding colon cleansers and weight loss.  Frist of all, some products may contain components that interact with prescription medications and cause serious side effects.  Secondly, focus on a high-fiber, low-fat meal plan for weight loss instead of dangerous quick fixes.  A registered dietitian can help you plan meals according to a calorie level that would promote weight loss.  You know the saying “waste not want not;” don’t waste your hard-earned money on products that are potentially  harmful, especially when healthy eating habits are more effective!

Friday, March 28, 2014

What's the Deal with Emotions?



If I Google emotions chart I can choose from over 11 million results that will most likely contain more options for happy, sad, angry and scared than most people can wrap their minds around. It makes sense that deciphering the minute differences between fearful and afraid, or elated and overjoyed can be confusing. Keeping them all straight when we have so many options can feel overwhelming. Consequently, when in therapy you may be asked about your feelings so much that you would rather not having emotions at all!

Most often we embark on therapy not because of the emotions that fall under the happy category, but due to those that are associated with sad, scared, or angry. It makes sense when clients wish away their emotions altogether. If one feels melancholy the majority of time, not having emotions may seem like an ideal solution. Life may be easier without the complications that emotions can provide. We could move past struggles without anxiety, depression or having to develop coping mechanisms to numb out the emotions that feel too great to overcome.

Consider life without emotions though. Even in a depressed state many individuals are able to identify that something is not right, that they do not feel well. As I’m writing this I’m trying to imagine what my day would be like without even the most mild emotions. I wouldn’t have felt reluctant for more sleep this morning. I would not have felt content sipping my morning coffee, reading today’s news. I would not have felt. The moments during our days would be purely intellectual with no deeper meaning to them. There would not be that feeling that fills out the thought, action or reason for why. Thinking about this, I can only describe it as robotic, hollow.

So then why do we need the full range of emotions? Couldn’t we just have happiness and forget about the rest? Typically when I ask clients this, they laugh envision a world where everyone would be constantly happy. It may be fun for a bit, but after a while it may become draining or even as drab as a world with no emotions. Without the full range we miss out on the positive things that having a complex set of emotions brings to our lives. We are able to know when we are happy because we are also able to know when we are sad. Having a wide range of emotions provides a comparison point to distinguish one from the other. And from these differences we can then work on uncovering the degrees of an emotion to gain better insight into our lives.

Having a wide range of emotions provides our days with more meaning. It’s why when we remember a moment of elation we can often tap back into how we felt in that moment. Emotions fill out those moments, planting more complex memories deeper in our minds. Additionally, we can become mindful of our emotions to become more insightful about ourselves. Recognizing that certain situations bring hope to our hearts or panicky thoughts are ways we can learn who we are. With this knowledge we can take control of our lives, and supply our toolboxes with the skills we need to manage any moment or emotion.

Still skeptic? Do the Google search I mentioned at the beginning of this post. With over 11 million results surely there is evidence that better articulates the importance of our emotions. And maybe you will discover a new one that resonates with you!



Katie Infusino is currently finishing her Masters work in Community Counseling at DePaul University. As an intern at The Awakening Center she sees clients for individual sessions, co-leads the Monday Narrative Therapy Body Image Group, as well as the Tuesday evening support group. Katie loves sharing the emotions charts she finds and working with clients to better understand the positive intentions behind each emotion. 

Wednesday, March 26, 2014

HCG: The Ugliest of Fad Diets


HCG:  The Ugliest of the Fad Diets

When it comes to fad diets, as long as weight loss is promised, people will follow it, even if they have no idea what they are injecting or swallowing.  This is definitely the case with the HCG diet; ask someone whom is following this fad diet what HCG is, and they will probably respond with a vague or clueless response.

Before discussing the harm this diet can cause, let’s outline the details of how it’s supposed to work.  HCG, Human Chorionic Gonadotropin, is a hormone that supports normal egg development in the ovaries, and stimulates the release of eggs in one phase of a women’s menstrual cycle.  It is also present in the placenta during the first trimester of pregnancy.  How in the modern world of science does this relate to weight loss?  It has been proposed that HCG can tell the brain to use body fat as a fuel source when on a Very Low Calorie Diet (VLCD), instead of breaking down muscle mass, which normally occurs during inadequate calorie consumption.  The use of body fat for energy “tricks” the body into thinking it is receiving adequate calories.  In addition to HCG injections or the ingested droplet form, one must follow a diet that is 800 or less calories per day.

The HCG diet poses a double risk, the first from the hormone itself, and the second from the VLCD.  HCG is prescribed for fertility issues, but in some cases, the following side effects have been reported; fatigue, low energy levels, constipation, blood clots, numbness, tingling, confusion, dizziness, headaches, ovarian hyper-stimulation and cysts, vaginal bleeding, and decreased sperm production and breast enlargement in men.  VLCD’s provide less than 800 calories per day, and may cause gallstones, irregular heartbeat, electrolyte imbalances, and low energy levels.  It is also impossible to meet daily nutritional needs at such a low calorie level.

If the proposed side effects have not sent followers running in the opposite direction, consider the fact that the FDA (Food and Drug Administration) has not approved HCG for weight loss, and it has not been proven that its use results in weight loss.

Those on the HCG diet may lose weight, but this is solely from the VLCD.  When considering the VLCD separate from the HCG, it is a quick fix that often leads to the person gaining all, or even more weight that was lost.  Several doctors believe VLCDs are safe when medically supervised, but as a dietitian, the writer of this note, in most cases, never recommends meal plans that provide less than 1500 calories per day.

Weight loss is more successful and long-term when clients are taught how to create well-balanced meals, and incorporate an exercise program as part of a healthier lifestyle.  Off-and-on use of VLCDs causes one’s metabolism (the ability to use food for energy) to become less effective, and weight loss more difficult.  When thinking about it, a body that is frequently starved wants to hold on to everything possible in order to survive.  Finally, the diet component of the HCG plan is chock-full of rules and regulations; only 2 meals per day, no butter or oils, 1 tablespoon of milk per day, 1 protein/1 vegetable/1 bread/1 fruit per meal, and each food group has a minimal list of “allowed foods.”  It makes one wonder, who made these lists, and what is the logic behind the chosen and unchosen foods?


In considering all of this, the smart consumer is the educated consumer.  If effortless weight loss is promised, treat it like a stop sign; before proceeding do the research!  Advertised weight loss products and diets often fail because their restrictive nature leads to frustration, many possible side effects, and a rapid weight loss that is temporary and unhealthy.

Michel D. Harris, RD, LDN, CDE!

Michel D. Harris is a Registered Dietitian with 14 years of experience as a clinical and outpatient dietitian.  Her areas of practice include eating disorders, weight loss and management, diabetes, cardiovascular disease, cancer, and food allergies/gluten sensitivity.  As an exercise physiologist, she also assists individuals of all fitness levels in planning exercise programs.


At the Awakening Center, Michel provides individual nutrition consultations, as well as multiple group classes and workshops.  Individual sessions include the development of a comprehensive wellness plan that focuses on establishing a healthy relationship with food and exercise, as well as identifying and changing detrimental eating behaviors/patterns.  The nutrition counseling and mindful eating groups allow individuals to share and receive help with the recovery process via discussion of certain topics and activities.  If you would like to speak with Michel regarding your interest in any of her services, please contact her at 773-929-6262 x24 ormeishadivito@yahoo.com.

Saturday, March 22, 2014

Eat, Don't Drink Your Calories!

Before you read this week's post, I'd like to introduce you to The Awakening Center's newest nutritionist, Michel D. Harris, RD, LDN, CDE!

Michel D. Harris is a Registered Dietitian with 14 years of experience as a clinical and outpatient dietitian.  Her areas of practice include eating disorders, weight loss and management, diabetes, cardiovascular disease, cancer, and food allergies/gluten sensitivity.  As an exercise physiologist, she also assists individuals of all fitness levels in planning exercise programs.


At the Awakening Center, Michel provides individual nutrition consultations, as well as multiple group classes and workshops.  Individual sessions include the development of a comprehensive wellness plan that focuses on establishing a healthy relationship with food and exercise, as well as identifying and changing detrimental eating behaviors/patterns.  The nutrition counseling and mindful eating groups allow individuals to share and receive help with the recovery process via discussion of certain topics and activities.  If you would like to speak with Michel regarding your interest in any of her services, please contact her at 773-929-6262 x24 or meishadivito@yahoo.com.

 Eat, Don’t Drink Your Calories

Liquid nutrition in the form of juices and smoothies has grown in popularity over the past few years.  Many popular fast food facilities have added what they claim to be, “fresh-squeezed” juices, and thick, blended produce concoctions to their offerings.  One particular chain, Jamba Juice©, specializes in this juicing and smoothie craze.  Sales for juicing appliances have also risen. 

While some use these beverages for pure refreshment, many have alternative reasons for their use, in which the most common is for weight loss.  In addition, clients that seek nutrition counseling services have shared that they feel “better”, “natural”, or “clean” when going on a “juice fast,” or using it as part of a weight loss plan.  Then there is the handful of clients that use juices and smoothies for extra calories when trying to gain weight or as post-workout fuel.

The big question is, do these beverages really help with weight loss, and deliver the promised antioxidants and other health benefits?  Ideally, a food or beverage that is part of a weight loss meal plan should include fiber and protein, with a reasonable amount of calories.  Therefore, a person following a 1500 calorie meal plan would allow 400-500 calories per meal.  Fiber expands when it enters the stomach to provide a feeling of “fullness,” while protein provides satiety, a.k.a., the sense of satisfaction.  Researchers suspect that protein slows or stops the activity of ghrelin, a hormone that communicates to the brain that we are hungry.

Another consideration: several recent studies have shown that calorie-containing beverages, when provided with a meal, do not promote satiety because subjects consumed similar, or in some cases more calories, when compared to those who drank a zero-calorie beverage at the same meal.  From this, we can question if a juice or smoothie as a “meal” would lead to early hunger pains, and actually promote excess snacking or over-eating at meals.  Doesn’t this also support the fact that the process of chewing contributes to the satisfaction of the eating process?

So how does this apply to our liquid nutrition?  Juicing and blending processes break down the fiber in fruits and vegetables, reducing their effectiveness as a stomach-filler, and neither is a significant source of protein.  Calorie-wise, it may take four pieces of fruit to make one glass of juice for a total of 240-480 calories, depending on the size, and type of fruits used.  Smoothies usually contain yogurt, peanut butter, and other add-ins that provide protein, but additional calories.  After investigating, it was found that a fresh-squeezed juice from a popular establishment contained 210 calories, 3 grams of protein, and 1 gram of fiber, while a medium smoothie had 410 calories, 4 grams of fiber, and 6 grams of protein.

In the case of juicing, adding the pulp back into the juice for fiber and protein powder, as well as substituting vegetables for less calories, will make an improved drink.  The smoothie example may sound reasonable in regards to calories, fiber, and protein, but instead of these liquids, one can do much better with one of the following solid breakfasts…

A Greek yogurt parfait with 1 cup of plain yogurt, 1 cup of fresh blueberries, and 1 ounce of slivered almonds provides 370 calories, 6 grams of fiber, and 30 grams of protein.

A breakfast sandwich made with 2 egg whites, 1 tomato slice, 1 turkey sausage patty, and one whole wheat sandwich thin with a side of fresh berries provides 325 calories, 9 grams of fiber, and 18 grams of protein.

As far as antioxidants, fresh produce when blended or eaten whole contains these valuable nutrients!

To conclude this debate, from a dietitian’s perspective and experience, consuming solid foods provides more satisfaction than drinking calories, especially when trying to lose weight.  Many clients try the liquid meal approach to lose weight, but quickly abandon it because they feel hungry hours before their next meal.  Also, people with diabetes often experience high blood glucose levels with either juices or smoothies because of the high carbohydrate content.  For both of the solid meals above, one gets a significant amount of fiber, protein, and antioxidants, with more satisfaction and flavor variety.

The jury agrees…Eat, don’t drink your calories!!!