Making the decision to seek treatment for trauma, anxiety, depression, anorexia, bulimia or any other eating disorder or mental health disorder isn’t easy. First, it can be hard to acknowledge that you have a problem. Second, you have to be willing to at least consider making a change. On top of that, you need to figure out where you want to go for help, as well as making room in your life to participate in treatment.
In the third part of our interview series, Galen Hope Co-Founder Dr. Wendy Oliver-Pyatt shares why she encourages individuals struggling with their mental health to embrace getting well, and how Galen Hope can help even those who have not found lasting healing in other treatment centers.
Choosing an Eating Disorder or Mental Health Treatment Program
What are some of the worries that individuals and their families have when they decide to seek treatment for an eating disorder or mental health disorder?
It is hard to make the decision to come to treatment because you’re making a decision that says, “I trust you. I’m relieving myself of my autonomy. I’m going to follow your schedule. I’m going to allow you to be very involved in the details of my day-to-day life.”
So, it’s important for people to recognize that when they’re making the decision to come to treatment, they’re making a sacrifice of time and money and energy. They’re putting hope back into the possibility of healing.
There’s a lot that a person coming to treatment really invests in. And I think it’s important for people to recognize that it feels hard because it really, really is hard.
I think myself, if I was needing to go to treatment, I would probably be somebody that it would take a lot of work and time and energy to convince me to go somewhere to treatment. I know myself, and I know that the idea of giving up autonomy would be something that would be very, very difficult for me, just because of my personality.
So why? Why do that then? Why make such a big decision and take those steps?
One of the things I like to help people think about when they’re coming to treatment is, as hard as it is and as much time as it takes, I’ve literally, in these 20 years, never ever met somebody who said, “I stayed in treatment for too long.” Never.
And I try to help people think of their life as almost like an encyclopedia with lots of books and chapters. Within that whole encyclopedia of life, the amount of time that we’re asking somebody to dig into this process of treatment is a very small amount of time. It’s a big sacrifice. But it’s a small amount of time.
And why I’m so committed to this, and why I feel so passionate about doing this work, is because not only do I have what Emerson calls “an advanced experience” in being able to be a provider and be a healer and work with a team which is very special to me. But also to be able to be a witness to a person who’s come into treatment in pain, and to see their future take such a different direction.
So when you come here, you’re making this investment. And what we want to see after that period of time is a very different life trajectory, where there’s more peace.
If you have an eating disorder, a peaceful relationship with food and your body is a part of that. If you have a mental health disorder as a primary disorder, it’s where you’re feeling lifted and relieved of that pain, and hopeful and with clarity in your thinking process.
Seeing the trajectory of the person’s life, the quality of life is what really matters. And seeing that shift in the trajectory is so powerful and meaningful. I’ve had the benefit of being in contact with so many different people I’ve worked with for the past 20 years. Receiving those notes and letters and emails or text messages, or seeing somebody maybe at a conference or in some other situation, is really, really powerful. For me and for the whole team at Galen Hope.
Let’s talk about outcomes.
It’s very important to pay attention to objective measures of outcome during the patient’s time in treatment.
So not only do we have our own qualitative experience, just working with a patient day after day, seeing a person individually, individual therapy, meals, groups, etc., but also actually looking at outcome measures that really help us see how we’re doing more objectively.
Whether it’s a PHQ-9 that helps us understand where the person is along mood symptoms, we look at that and we frequently measure that throughout the course of treatment.
The EDE-Q helps us look at the eating disorder questionnaire to understand very specific symptomatology that the person might be experiencing, and that helps us look at domains of the person’s eating disorder that might need more attention.
It could be body image, or it could be intrusive thoughts about weight and shape. But by doing the objective measures, we’re able to assess where the person is on the continuum.
And we’re also able to provide families and other providers and insurance companies with the information that they need to see, to be assured that while we’re working with their loved one, that their loved one is, in fact, getting what they need to heal.
One of the things that’s so difficult about a person who is struggling with a mental health condition or an eating disorder is that the pain the person may be experiencing can be very, very hidden.
In fact, many people with eating disorders and mental health conditions can be what we call very high functioning, if you will. The person may say, “I’m fine.” A person may be receiving accolades for their work or their school life or even movement and exercise and being at a gym, being a trainer.
So, there’s a lot of different ways that these conditions can manifest that are very hidden and not known to others.
This can be especially also true with men who are even more taught to not show their pain. Depression in men can sometimes come out as irritability and anger, for example, because they’re not really kind of socially allowed to say, “I’m in pain. I’m hurting. I have needs.”
Or men may be particularly programmed to feel that an eating disorder is a women’s condition, that it is not a men’s condition, which is also untrue. Because 40% of individuals with binge eating disorder are actually men. And binge eating disorder is more common than anorexia nervosa and bulimia nervosa combined. So, in fact, the most prevalent eating disorder, binge eating disorder, is 40% men.
We have to break through some of some of the myths about eating disorders and struggling and mental health conditions and struggling.
And this is a little bit different than a physical condition or even some of the substance abuse conditions where the symptoms are much more obvious and clear and glaring. Because a person with a substance abuse condition may have a quicker deterioration in psychosocial functioning than somebody with an eating disorder or a mental health condition.
There’s even something called high functioning depression where the person can be in a great deal of pain, and nobody even knows it.
A person with an eating disorder could be malnourished, have amenorrhea, be developing osteopenia and osteoporosis. And nobody recognizes the existence of what is actually a life-threatening illness. Eating disorders affect every single organ system. There’s no organ system that is spared. Yet on the outside, the disease itself may not even be obvious. And in fact, because our society is so caught up in weight and so associates – unfortunately – thinness with health, the person could be very restrictive and have deteriorated health while receiving positive reinforcement in a variety of different environments, even in medical environments.
When people have tried to get help for their mental health or eating disorder but nothing quite worked, they can start to lose hope that they’ll ever get well. What is your message to them?
One of the things you hear out in the world, and in the field of mental health and eating disorders, is that the patient was “treatment refractory” or “treatment resistant”, or they weren’t “ready.”
I like to turn that around and say, “Are they treatment refractory or did they just not get good treatment?”
I think someday, we’ll be able to look back and realize that when we missed doing the trauma treatment, when we missed the co-occurring illnesses, when we missed doing the community integration, when we missed putting those pieces of the puzzle together, we actually haven’t really done treatment. So instead of the person being treatment resistant, maybe they really weren’t even treated. Conversely, when the person has really found their place in life, where they feel a sense of connection and purpose and attachment, that is when we see healing.
Relationships with the professional community
How does getting patients in the right the level of care for their condition affect outcomes?
What I like to teach to people I’m working with, whether they’re clinicians or future psychiatrists, is that the most important decision that we make about working with a patient is what level of care they actually need.
For example, if somebody had cancer and needed chemotherapy and they thought they should take vitamin D to get rid of the cancer, I mean, the vitamin D could potentially be helpful. However, vitamin D isn’t really going to get rid of the person’s cancer.
So, it’s important, as painful as it is, to be able to ascertain what level of care is appropriate.
It is hard to see people with mental health conditions and eating disorders receiving care at a lower level of care than what is truly indicated, because sometimes the care does need to be stronger and more wraparound than just going to an outpatient office.
Now, again, that is a big decision to make, the decision to come to treatment, which is why treatment needs to be thoughtfully designed so that the person will receive something useful and therapeutic.
We all have this one life to live and time is precious. So sometimes it’s important to work with families and providers to help make that decision, to figure out objectively what level of care is really working or not.
I believe that the relationships with the community of providers is vital to a good outcome.
There are inevitably, during the course of treatment, bumps in the road. Times when the person is upset with the team, or doesn’t like what they hear, or feels a need to move on, or they have to get back to school, or they have to get back to work. All of those things are pressures that are very real that our patients or clients are experiencing.
It’s through those relationships with others in the professional community that we can objectively look at the person’s whole life and figure out together the timeline that’s needed.
We don’t want to lose the opportunity for the person to develop those aspects of their life that are reinforcing of healing. At the same time, if people leave treatment too early, it can really backfire.
When the outpatient providers really know what’s going on in treatment and we get the information from them about what’s real in the person’s life and important to consider, it’s a great model where we all look together, with the patient or the client, sometimes the family, to try to make a cohesive plan for that process of returning to the person’s home environment.
With those strong connections with the community, where we really are learning as much as we can and we’re collaborating as much as we can, that we can design care that lasts in a meaningful way and helps mitigate against the potential of a person relapsing after they leave.
THE ROAD TO WELLNESS STARTS BY SEEKING HELP. TODAY.
Built on the principles of assertive community treatment, Galen Hope is an eating disorder and mental health treatment center offering individualized treatment options that include Intensive Outpatient (IOP) and Partial Hospitalization Programs (PHP). As a “Community of Integrated Wellness,” we pride ourselves in fostering a thoughtful and meaningful care experience that can guide our clients on their road to recovery and increased quality of life, regardless of diagnosis. Galen Hope currently offers separate, age-specific programming for female and transfeminine adolescents ages 12-17 and adults 18 and up, as well as a gender-specific programming for males and transmasculine individuals with eating disorders and primary mental health diagnoses.
To learn more, or to join our community for integrated wellness, please contact us today.
Belong. Heal. Grow.