Conversations at Selah House

Darlene: Eating disorders are very complicated. And when someone addresses an observed behavior head on, it usually shuts the person down. So instead, what we recommend is softer language. It sounds like this. I just wanted to check in, is there anything I can do to support you? Is there anything you need?

Host: That’s Darlene Graham, lead therapist at Selah House, explaining one tactic that you can use to support a loved one with an eating disorder. My name is Clark and I’m your host of Conversations at Selah House, a new podcast. We’re covering topics like the importance of comprehensive treatment and some of the unique types of therapy used to help women and girls recover from eating disorders. Selah House is the only licensed inpatient, residential, and partial hospitalization program eating disorder treatment center in the state of Indiana. It’s also part of the larger Odyssey Behavioral Health Network, which includes 20 locations that are committed to helping individuals reach their optimal levels of health. In this episode, Darlene explains how the team at Selah House focuses on treating the whole person. She also offers advice to those who are looking to better support a family member and eating disorder recovery. To learn more about Selah House and Odyssey Behavioral Health Care, visit odysseybehavioralhealth.com. Now let’s get started.

Darlene: Hello, my name is Darlene Graham, and I am the lead therapist at Selah House. And I’ve been with Selah House for about seven and a half years. And in that time, I’ve worked at both of our facilities. We have two facilities. We have a teen house and an adult house. The facilities are actual houses and they’re huge. We have a teen house where we house teens from 12 to 17, and we have an adult house where we treat women from 18 and up. The whole idea behind the treatment focus was to have a very homey environment. So it’s not very sterile nor it doesn’t have an institutionalized feeling. It’s very homelike. There are comfy couches. There’s wide, open space. There’s a living area. There are bedrooms that are just like your bedroom might be at home, but there might just be a couple more beds in the room, but it has a very homey feel.

Host: And I’m curious too, again as I’m learning more about this, there’s a lot of different ways– different activities and different ways for therapy. There’s a lot. There’s a lot happening there.

Darlene: There is a lot. There is a lot. Selah works on a treatment team approach. So, there’s a whole big team that’s filled with therapists, dieticians, and medical people. When a client comes to our facility, they get their own little, what I like to call, mini team. So, they have a dietician assigned to them, an individual therapist assigned to them, and a family therapist assigned to them to support them in their recovery because recovery from an eating disorder is a multifaceted approach. It’s not just a single approach.

Host: I want to talk about the recovery process a little bit. And there’s a lot of things. I know we have limited time for this particular conversation. But one of the biggest things that I want to hear your views on is quite simply, how can a loved one be supportive to someone who is struggling with an eating disorder? Maybe it’s someone who is in recovery from an eating disorder. You and I are having this conversation, it’s actually around the holidays. And there’s social gatherings all throughout the year, and I know this year has been a little different with the social distancing and all that, but we’re still able to see people and be around folks. What’s your message around people when they are in social gatherings and they’re trying to navigate all of the complexities around this? Is there a way to begin by just thinking about social gatherings?

Darlene: Absolutely. So, for the person recovering from an eating disorder, any type of event that involves food or any type of event where there’s a moderate to large number of people is often avoided. And that’s because the pressure to eat is too great. Oftentimes, the person will think that all eyes are on them. There’s a lot of pressure for them to get a plate, to consume their food in front of others. And the person in recovery thinks that everyone’s watching them, and they have to prove to the person that everything’s okay. So typically, a person struggling with an eating disorder will avoid social gatherings, will avoid going to places where there’s food being served. However, around the holiday season, that can become more difficult to do.

Host: So around the holidays is, of course, that is going to be harder to avoid. And there’s also holidays throughout the entire year. And no matter what event, there’s probably food involved. That’s just part of the culture. So I want to stay here for just a moment. What else do you normally like to make sure people know about this challenge that someone is thinking about that’s really heavy on their mind and heavy on their heart as we know food is involved with so many different events?

Darlene: Absolutely. What ends up happening for the person who is struggling with an eating disorder is that they find themselves with experiencing a lot of anxiety. They often come up with very creative ways in which to avoid eating. And so that could be sharing that they’ve already eaten, that they’re not hungry, that they’ll eat later. So they have to be very, very imaginative around how they can get out of eating. That’s very important for those who interact with those struggling with an eating disorder to remember is that comments asking about what they’re going to eat, why don’t they eat, can be very triggering- and to stay away from those would be helpful.

Host: And they may not even realize what they’re saying is actually triggering and really challenging and really painful for someone. So, what you’re saying here is maybe they’re giving an excuse, “Hey, I already ate,” or– and then maybe as a response they’re hearing, “Hey, you actually– hey, you should– you’re going to love this. Just have a plate of this.” Is that kind of what you’re describing?

Darlene: Exactly. Exactly. And those comments are unintentional, but to the person in recovery, they can be very anxiety provoking. Host: Okay, so now we’re to the point where– and this is one of the biggest things we really want to talk about. And it’s simply put, how can a loved one be supportive to someone who is struggling with an eating disorder? In no particular order, what are some of the ways a loved one can be thinking about ways to navigate this?

Darlene: This is a really important question. And one of the first answers is planning ahead is awesome. When the person in recovery knows what to expect and knows that they have the families to support, it can be so comforting and that can boil down to knowing where they’re going to sit. It can be coming up with an escape plan. If there’s that particular aunt that has the person in the corner and they’re barraging them with questions, having a plan where someone just goes and taps aunt on the shoulder and says, “So-and-so would like to see you.” So, planning ahead is very helpful.

Host: The second thing is not overemphasizing the focus on food. As you mentioned earlier, when people come together for social gatherings, it’s usually around food. But instead, I invite families and friends to talk about family and friends and hobbies and passions and things aside from food to help lower the anxiety of the person struggling with an eating disorder. What we found in the world of eating disorder is that the natural, intuitive thing that comes up for someone in order to be supportive is usually the very thing not to do or say.

Darlene: Eating disorders are very complicated, and when someone addresses an observed behavior head on, it usually shuts the person down. So instead, what we recommend is softer language that sounds like this. “You know, I just wanted to check in. Is there anything I can do to support you? Is there anything you need?” Because that’s a softer approach that will help. It’s not 100% but will help prevent the person from feeling confronted or attacked.

Host: And that’s a one-on-one conversation. That’s not hollering at someone, yelling at someone across the room, “Hey–“

Darlene: Absolutely.

Host: –“Why have you eaten yet?” That’s terrible. No wonder that would make someone feel–

Darlene: It is.

Host: –isolated. And then they stop going to the event. They stop being around a support system.

Darlene: You’re exactly right. And in fact, some of the other examples of things people might say unintentionally, not meaning to be harmful or hurtful, but some of the comments are, “Why aren’t you eating?” Or, “Is that all you’re going to eat?”

Host: Oh, right, right, right.

Darlene: Or, “You eat like a bird.” When someone hears these comments, it feels like pressure. It feels very judgmental. And it can be really difficult for the person in recovery.

Host: I appreciate you sharing the examples and I’m sure there’s a whole list you could go down of how a loved one is maybe trying to show support. But what they’re saying is just not– it’s not landing the way it should. So, what I’m hearing you describe is it really is a full effort, a full family effort, a team effort. There’s a lot that goes into this. If someone’s getting the help they need, I would imagine there’s a lot of coaching and support that loved ones around them would ideally be receiving, right?

Darlene: Absolutely. And so that’s why at Selah House, there is a family therapy component built into the treatment process, because, as I mentioned earlier, it’s very difficult to know what to do. And part of what we offer at Selah for families is the coaching around how to support the loved one who is in recovery. And that consists of what to say, what not to say, what could be triggering, oh, and how not to be what we call the food police. At Selah, we also help families with eating disorder education in general. Eating disorders are not logical, so they can be very difficult to understand. We provide some education around that. We also provide education around the loved one in particular, because there are nuances related to their struggle with the eating disorder that we want them to understand, and that’s how we help them at Selah, but it’s also very helpful for the family to understand that. So again, they can provide some really effective and helpful support.

Host: While we still have a few moments left, I want to ask you something I– which I saw on the website about Selah. It was, the programs and physicians focus on the individual, not the symptoms, and consider the whole person. In your own words, what does that mean to you and the work that you and your team is regularly doing?

Darlene: Selah House does provide a faith-based approach, and what that means is that it allows us to focus on the whole person, on their emotional needs, on their mental and psychological needs, but also on their spiritual needs. And we find that often times many clients want to incorporate God as a resource in their recovery. And Selah House is equipped to do so. We have a chaplain on site. We have a chapel that happens every week. We have opportunities for our clients to stream church services and just wanted to provide– we just want to provide an all around approach to help the person recover and meet their needs.

Host: At the beginning you were telling me you’ve been doing this for a little over seven and a half years. Tell me about your heart and your passion on this. What’s your why with the work that you get to do?

Darlene: Well, first of all, I love what I get to do. I’m grateful every day for the opportunity to be here at Selah and to support women and teenagers and going from a place of literally bondage to a shift towards freedom, because recovery from an eating disorder is a journey. And when our clients are with us at Selah, our key focus is on helping them make those small shifts that accumulate over time and become those major changes. And so at Selah, we have learned not to downplay those small shifts because they can make a difference. I appreciate the opportunity to help a client who struggles with self-acceptance to learn to accept that they have these beautiful brown eyes, and that’s a shift. It’s a small shift, but it’s a shift towards the path of recovery that they can build on at Selah and once they discharge from Selah.

Host: It sounds like it’s the small things, they really matter. Small things equal big things over time. What are some of the other small things that you see at Selah House that help contribute to the path to recovery?

Darlene: Well, yes, we have a number of different groups that we offer our clients, including equine therapy, and that’s a chance to do therapy work with our horses. We have body image work that we do here. We actually have an ask a nurse group and a client-led group where clients get the opportunity to share what they’ve learned and what’s been helpful for them in their recovery with their peers. And one other thing that we do to continue to support them in these shifts is we definitely provide aftercare planning. So, to make sure that the clients go from the work and the progress that they’ve gained at Selah and that they have continuity of care is what it’s called, that they have a place to continue that recovery work after they leave Selah.

Host: Darlene, thank you for taking the time to share some of your stories and experiences. I know there’s a lot we could continue talking about, but I know you’re also a very busy person. So thank you for sharing a bit about your experiences and the passions that you have at Selah House.

Darlene: Absolutely. I appreciate your questions and thank you so much for having me. Host: Hey, thanks so much for listening to Conversations at Selah House. Please be sure to follow, rate, and review the show wherever you get your podcasts. If you or someone you love is looking to turn second chances and to new beginnings, start your journey at odysseybehavioralhealth.com.