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The Sound of Silence:"If I could say it in words there would be no reason to paint." Edward Hopper, American artist


Thursday, March 22, 2018: 2:00 PM-3:30 PM
Royal Dublin (Omni Championsgate)

Background: This presentation is offered to heighten awareness of current ED language research including the neuroscience that drives language inhibition under stress, to demonstrate the power of communication and to assure that the clinical interventions are grounded in supportive knowledgeable script. Discussion will focus on current understanding, development and application of communication skills. Clinicians will learn how to guide patients to safely express what they are hearing, understand what words, language, and /or delivery provide the most recovery-focused support, and how to tolerate “disturbing noise”.

Objectives: 1) Recognize current “miscommunications” that encompass and challenge the treatment of eating disorders and the current research addressing this concern 2) Understand the validity of non-verbal expression and language consistency as necessary elements to create an authentic therapeutic relationship 3) Explain the importance of using consistent language, communication and agreed-upon definitions with the team, support staff and families at each level of care and for the prevention of relapse in behaviors and mindset

Content Outline:

Introduction:

Today we are definitely moving beyond the “basic “ skill development for ED treatment. Your knowledge of this illness, is what serves as the foundation for the conversation of ED language that we are going to share today. Our intent in the design of this workshop is to adhere to the commitment of the iaedp symposium in providing topic directed current research and widespread clinical practice in conjunction with suggested directives for improved clinical work. In addition, we are hopeful that you will experience the powerful emotional response, both disturbing and comforting, that is inevitable with a topic so compelling. Language: existing in our constant experience. So, with a deep quiet breath, let’s begin the dialogue.

1) Definition of Language

  1. Power of silence
  2. Power of words
  3. Power of non-verbal language

2) Script of the Illness

  1. Self Talk
  2. Neuroscience studies
  3. Metaphoric language
    1. Regarding body image
    2. Regarding food
  4. Past learned messages
  5. Messages of media and current dietary trends and beliefs

3) Larger the “team”, more complicated the conversation; more susceptible to contradiction

  1. Patient encouraged to use “voice” has to assume responsibility to make needs known
  2. Physician or physician staff may or may not be trained in basic knowledge of illness
  3. Therapist
  4. Dietitian
  5. Teachers, coaches, friends

4) Balancing/ tolerating the major areas of complications

  1. Splitting
  2. Lack of communication among tx team and family members
  3. Lack of clear and precise definition of recovery

5) Review of the proposed current language approaches and dialogue

  1. Guidelines from
    1. Academy of Nutrition and Dietetics
    2. American Academy of Pediatrics
    3. Int J of Eat disord publication
    4. iv. iaedptm white papers
  2. Published programs for discussions in physicians offices regarding weight
  3. Several other review articles on suggested terminology etc

6) Conclusion

Hopper’s message reflects not only the gifted artist’s need to have an avenue for expression but, now, many decades later, it is a reminder of the needs of our eating disorder clients who struggle to articulate and make known the emotions, experiences and energy embedded deep within them. Critical to a positive recovery outcome is the manner in which we, as health care professionals, listen, understand and respond to those for whom words alone cannot fully articulate their distress. Clinicians in the eating disorder (ED) field are challenged to understand the neuroscience that drives language inhibition and its impact on the relational experience of clinical work. Through emotion (right hemisphere) and cognition (left hemisphere), brain plasticity is stimulated so that what we say, how we say it and even what we do not say contribute to a new inner-voice narrative for the client. We propose a directive focus on an examination of clinical terminology, the importance of the unspoken script of the ED and an exploration of metamorphic as well as internal self-talk regarding food and body image.

ED language evolves through repetition and reinforcement when clients’ internal “translator” transforms what is being said into a script that feeds and confirms their negative default mode beliefs. Understanding the process of this unique internal translation and its impact on the client is essential to prevent well- intentioned commentary from leading to shame, misinterpretation or relapse. This presentation is offered to assist attendees in heightening awareness of current ED language research, demonstrate the power of communication and assure that clinical interventions are grounded in supportive knowledgeable script. Discussion will focus on current understanding, development and application of communication skills. Clinicians will learn how to guide patients to safely express what they are hearing, understand what words, language, and/or delivery provide the most recovery-focused support, and how to cope with tolerating “disturbing noise”. The importance for clinicians to listen and hear will be emphasized for “to truly listen is to risk being changed forever.” Native American Elder,Sa’k’ej Henderson

Primary Presenter:
Karen Beerbower, MS, RDN, CEDRD, LD, F.iaedp

Karen Beerbower, MS, RDN, CEDRD. LD, F.iaedp is a licensed registered dietitian and a certified eating disorder dietitian. She holds a Master of Science degree in Medical Science and a nutritional pediatric fellowship from the Indiana University School of Medicine. She is the president of Nutritional Guidance, Inc. Karen presently serves on the Senior Advisory Board for the International Association of Eating Disorder Professionals (iaedp), is an iaedp Fellow and Approved Supervisor for certification. Using her experience from various medical facilities serving eating disorder patients at all levels of care, Karen strives to bring her experience to others through clinical service and education.



Co-Presenter:
Adrienne Ressler, LMSW, CEDS, F.iaedp

Adrienne Ressler, an ED and body image specialist, is VP of Professional Development, The Renfrew Center Foundation, and past-president/Fellow of iaedp. With extensive training in gestalt therapy, psychodrama, bio-energetic analysis and Alexander Technique, her work is published in The International Journal of Fertility and Women’s Medicine, Social Work Today, and the Journal of the International Spa Association. She has contributed chapters for 2 ED textbooks and an entry, Experiential and Somatopsychic Approaches to Body Image Change, in the first Encyclopedia of Body Image and Human Appearance. Adrienne is Co-chairperson of the AED Somatic Therapies Special Interest Group.



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