Postgrad, IPS Center Excited to Serve Loudoun

Over the summer of 2019, Divine Mercy University (DMU) made its highly anticipated move from Crystal City, just outside of Washington D.C., to its new campus in Sterling, Virginia. In addition to the big move, DMU also brought in some new faces, including Psy.D. graduate Dr. Kristi Stefani. Originally from Montana, Dr. Stefani joined the IPS Center for Psychological Services staff in August as a postdoctoral fellow and resident for the new training year. We caught up with Dr. Stefani to learn more about her experience with DMU, and what we can look forward to for the IPS Center. How did you learn about Divine Mercy University/IPS? Someone from my parish back in Montana recommended and researched the program. So I got connected and spent six years as a doctoral student in the program. As I was discerning future career paths, I knew I wanted a postdoc experience in an academic setting. I wanted one where I was deeply passionate about the mission and benefited from my own formation, but I also wanted to be a part of forming new clinicians and being involved in their training experience.  What has your experience with Divine Mercy University been like so far? I would say that it’s been largely a growing process, both as a student and now as a staff member. We recognize there is an evolution; we’re growing as an institution, and that’s really coincided with both our relocation and my coming on as a staff person. There’s a lot of dialogue about how we can do this successfully. What I’ve appreciated is that the response of the faculty, staff and students here is very generous and they’ve taken a collaborative approach to working through challenges as they arise. For me, no institution is perfect. But I decided to stay with DMU for a postdoc because there is a sense of purpose that goes beyond my occupation or how I make a living. There’s something greater here. And that’s what I enjoy most, this sense of purpose shared amongst the people who work here and come here as students. As a former student, I can share with the students currently in the programs that there’s a lot of emphasis on being formed both personally and professionally; there’s a lot of emphasis on who you are as a person for your professional role to matter. The investment of the faculty and school goes beyond academics to your personal formation, as well. What moment from your time with DMU stands out the most to you? Just pointing at a single moment is hard, because there are so many to choose from! When I was doing my internship--and even at other sites where I’ve worked--I trained alongside people who were in different programs and had a different experience. While working alongside these people, I recognized the perspective I was being offered at Divine Mercy University was very unique, and it comes from incorporating multiple disciplines. It’s not one-way psychology being taught, but a greater vision of the person. I’m very reflective and existential myself, and having those aspects attended to and having people who were actively trying to consider this robust understanding of the human experience--that it wasn’t just limited to psychological research--really impacted me on a personal level. I was learning how to understand myself and the people I work with. I experienced that as a student, too, with faculty who were really invested in me as a person, and wanted to help me grow both personally and professionally. Not all programs are structured in that way.    From your observation, how has the IPS Center impacted the communities in the D.C. area, and now in Loudoun County? The IPS Center is unique in that it meets needs that a lot of other clinics can’t. One is financial access for people. I know that fees present a real challenge for many people and can be a real barrier to receiving therapy.  Another significant component is a willingness to honor and respect a client’s faith, and a willingness to discuss and explore that faith in therapy. We’re very open to everyone who comes in. We don’t place an expectation that faith must be discussed. We have an openness to all aspects of what is important to the client. That openness is part of our professional ethics: that we’re attentive to all facets of somebody’s experience, and we know that in this area in particular, there are a number of different faith communities from various backgrounds for whom having that openness is very helpful. Our mission as a program and a clinic states explicitly that faith and spirituality are a component, and we know that is attractive to people. Research shows this is important to people, but it’s not always highlighted as something that would be attended to in one’s therapeutic work. There’s also been this stigma or even a divide over the questions of faith’s compatibility with psychology, which can lead people to avoid reaching out to mental health services. Instead, they may be more inclined to reach out to their pastor or their church community. But often, the people they reach out to are not prepared or equipped to meet their needs. With that in mind, the IPS Center can provide a great value and serve people in need. Often, we find that clients are looking for something that is Christian-based; they’re looking for someone with a Catholic understanding of the human person; they’re looking for someone that’s respectful of the holistic nature of who we are.  In my clinical work, people often share that they’ve had past experiences where they didn’t feel free to disclose the spiritual part of themselves. And that reaction to stigma hindered the growth that they could have accomplished.             How do you see the clinic impacting the local community? Moving out to a new area and building the clinic in a new location has been a process that takes a fair amount of time. What we’d like to offer the community, through the training that the students receive, is a level of mental health care and compassion that they currently don’t have access to.  

6 Tips for Handling Holiday Stress

We always look to the holidays as a time of celebration; a magical time of good cheer, warm traditions, and being with family and friends. We think of it as a time of rest and relaxation, filled with joy and gratitude for all that we have. Despite the surface magic and positivity, the holidays are often accompanied by even busier schedules and events that can seem daunting. For many people, the mere idea of attending large family gatherings, numerous holiday parties, and all the traveling can produce anxiety, stress, and depression. According to the Anxiety and Depression Association of America (ADAA), three out of four people surveyed reported feeling anxious and/or depressed during the holiday season. Holiday parties in particular are a common stressor, especially for those with a social anxiety disorder. For some, they’ll try anything to avoid activities that involve larger groups. For others, the problem lies in attempting to have the “best” Christmas ever, where the thought of something being out of place or decorations falling short can cause significant feelings of distress, as well as fears of disappointing others or feeling that everything they do is being scrutinized and judged.  “There’s just so much that goes into the holidays,” said Dr. Alexis Melville, co-director of the IPS Center for Psychological Services, an outpatient mental health facility located on the campus of Divine Mercy University. “We’re rushing all over the place just trying to tie up loose ends and get everything prepared for the celebrations, but we also tend to self-evaluate how we did throughout the year. There are perceived societal pressures throughout the holiday season that can amplify expectations for ourselves or others, and those expectations can induce a greater anxiety during these times.” You don’t have to succumb to the holiday stress. Here are some ways to help manage the stress this holiday season:
  1. Plan
The holidays may feel like one gigantic party, where everyone is invited and you’re the host. Like with all parties, planning for it is a key practice toward success. Plan your menus, make your shopping list early, and set aside specific days for shopping, baking, visiting friends and other activities. This will help prevent last-minute scrambling for forgotten ingredients. And make sure to line up help for party prep and cleanup so that you’re not doing EVERYTHING.
  1. Be realistic
We love our traditions, but the holidays don't have to be perfect. In fact, they’re never the same. Life changes. Families grow and traditions will change. You can try to hold onto some old traditions, but try starting new ones too.
  1. Set aside differences
It’s no secret that some family gatherings can be tense, but chances are that everyone is feeling the same holiday stress. Try to accept family members and friends as they are and set aside old grievances. Try to be understanding if others get upset or distressed.
  1. Set healthy boundaries
It is easy to feel pulled in many different directions over the holidays, but don't be afraid to make the choices that feel right for you; overindulgence, especially with alcohol, only adds to the stress. Try to get plenty of exercise and sleep during the holidays. Also try eating a healthy snack before the parties so that you don't go overboard on cheese, drinks, and candy canes.
  1. Take a breather
Make some time for yourself. Spending 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.
  1. Just say no
It’s okay to turn down invitations. We may want to be involved or feel pressured to be involved. Saying yes when you should say no can leave you feeling overwhelmed. Friends and colleagues will understand if you can't participate in every activity. If it's not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time. Following these tips and strategies can help you reduce anxiety and take control of the holidays. Despite your best efforts, you may find yourself still feeling persistently anxious, stressed, or sad. Perhaps there was a change in your life that altered how you approach holidays -- a good friend may have moved far away and can’t celebrate with you, or a loved one passed away. If you lost someone dear to you, it’s normal to feel their absence; it’s normal to feel grief in their absence.  If these feelings last for a while and manifest physically and if you’re feeling irritable, hopeless, unable to sleep or unable to perform routine chores, then you should seek out a mental health professional. The IPS Center at Divine Mercy University offers psychological services on a sliding scale basis. Services are offered by supervised doctoral students and are available to both adults and children. For more information, call (703) 418-2111 or email ipscenter@divinemercy.edu.

Suicide Among Leading Causes of Death in U.S.

September is Suicide Prevention Awareness Month, and you may have seen the videos on the news, YouTube, Facebook, LinkedIn, Instagram or other media platforms that are meant to raise awareness of suicide, especially that of suicide by veterans with the 22 Push-up Challenge. But suicide affects everyone and sparks many different emotions among the living. Whether that person was a veteran who saw combat, someone who made you laugh, someone with gifts and creativity that you admired, or someone who’d smile and nod at you while on a walk in a quiet neighborhood, the death of that person by their own hand is bound to leave you sorrowful, sympathetic toward the family and, overall, incredibly confused. In March of 2019, Dr. Melinda Moore Ph.D., presented a lecture at Divine Mercy University entitled "How to Understand Suicide and its Aftermath: From a Scientific & Faith Perspective."  She is a licensed clinical psychologist and an assistant professor of psychology at Eastern Kentucky University. She also sits on the board of the American Association of Suicidology. She shared her first-hand experience of suicide -- when her husband killed himself -- and how it affects the living. At the time, her husband was a chemist and grad student at Ohio State University. “This was, without a doubt,” she said, “the most emotionally and physically painful experience of my life, and it changed me in a very profound way. What I experienced was an incredible professional and personal rejection. I realized that, when I returned to work, that something different was going on. There was something about this experience I shared in the taint of what he had done.” During her presentation, Dr. Moore referenced the article “Struggling to Understand Suicide” by Fr. Ron Rolheiser, a priest in the Missionary Oblates of Mary Immaculate (OMI) and the president of the Oblate School of Theology in San Antonio, Texas. “All death unsettles us,” writes Fr. Rolheiser. “But suicide leaves us with a very particular series of emotional, moral, and religious scars. It brings with it an ache, a chaos, a darkness, and a stigma that has to be experienced to be believed. Sometimes we deny it, but it’s always there, irrespective of our religious and moral beliefs.” We all know the great actor and comedian Robin Williams, who brought so much laughter and joy to us from the stage and the silver screen, left the world shocked when he commited suicide. Chester Bennington -- the voice of Linkin Park, one of the most successful rock bands of the new millenium -- took his own life at his California home while his family was away on vacation nearly a year after his good friend Chris Cornell (Soundgarden and Audioslave vocalist) committed suicide, and fashion designer Kate Spade fashioned a suicide note before committing suicide at her apartment in Manhattan, New York. Even in a small town like Warrenton, Virginia, an elderly couple was discovered deceased in their home when their home healthcare provider discovered a note on their front door saying not to enter because of their suicide in the residence.  In each of the cases just mentioned -- like many others -- there were symptoms and warning signs that went unnoticed or neglected. Williams and Bennington had both battled addiction and depression throughout their lives. Williams was even being treated for depression and anxiety before his death, and had been diagnosed with Parkinson's disease months before. Bennington’s widow admits today that she’s more educated about the warning signs leading to her husband's suicide: hopelessness, changes in behavior, and isolation. Neighbors and friends of the couple in Virginia, including Sadia LaRose who had lived across the street from them, compared them to Romeo and Juliet despite their health and financial burdens. But LaRose admitted that she would have intervened in some way had she been aware of their plan. “If any of us knew, we would have gone over there to try to stop it,” said LaRose, as reported by the Fauquier Times. And it’s not just adults, veterans and celebrities. Children also struggle with suicidal thoughts and impulses. In 2018, a new study released by the American Academy of Pediatrics showed that more kids are either contemplating or attempting suicide. That study was followed by the August death of 9-year-old Jamel Myles of Colorado, who committed suicide after telling his fourth grade classmates that he was gay. In May of 2016, Billy Sechrist discovered his 15-year-old daughter, Shania, after she committed suicide in their Pennsylvania home. A freshman in high school, Shania had left a note explaining that, while she loved her family, she couldn't bear the pain of being bullied any more. The following winter, an 8-year-old boy, a third grader in Cincinnati named Gabriel Taye, was beaten by bullies at school and, two days later, young Gabriel ended his life in his own bedroom Suicide is the 10th leading cause of death in the United States. It is also the second leading cause of death in the world for those aged 15-24 years and is often considered a public health emergency. In the aftermath of suicide, we are often left with the hopelessness of hindsight, telling ourselves, “if we had only known, we would have done something to stop it.” According to a recent report released by the Centers for Disease Control and Prevention, the suicide rate in the United States has jumped 33 percent since 1999, with over 47,000 Americans ending their own lives in 2017. The report also showed that public funding to research, prevent, and combat suicide is far below that of research of other leading causes of death and conditions with lower mortality rates. The National Institute of Health spent about $68 million on suicide last year. The NIH spent nearly twice as much researching indoor pollution, over three times as much on dietary supplements, five times as much studying sleep, and ten times more on breast cancer.    "What I’m just painfully aware of is that all of the areas where the top 10 causes of death in the United States have gone down have received significantly more attention," said John Draper, director of the National Suicide Prevention Lifeline, in an interview with USA Today. "There’s been so much more put into every one of those causes of death than suicide ... If you didn’t do anything for heart disease and you didn’t do anything for cancer, then you'd see those rates rise, too." Dr. Moore experienced a similar disconnect from suicide by the people around her. At the time of her husband’s death, she was a policy analyst and a speechwriter for the director of public health in Ohio. People were normally happy to see her, but she noticed a real change when she returned to work after burying her husband in his home nation of Ireland. “When I would see people after I came back,” she said, “they were clearly not interested in me coming to their office, and they were certainly not coming to mine. When I would see people in the hallway, they would turn and walk away in the opposite direction. There was an enormous professional isolation and rejection. Also my family and friends had no interest in talking about this, so there was enormous personal rejection and isolation.” But just as it was the worst experience of her life, Dr. Moore also looked at her experience with suicide as the best experience of her life. “That may seem absurd,” she explained, “but it really took the blinders off and changed me on a profound level. It made me more compassionate, it certainly changed my vocational interests. I was the first researcher to look at post-traumatic growth among suicide bereaved parents and, when considering my dissertation at CUA [Catholic University of America], I understood that nobody knows more about the inside out than me. Now my primary research is in primarily post-traumatic growth, and I embed it in everything I do.”   Watch the entire recording of the suicide lecture to learn how a faith-based approach to mental disorders can help save lives.  If you or someone you know may need help, here are two suicide prevention resources:
  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Crisis Text Line: Text HOME to 741741
You can also equip yourself with the skills to recognize and help those on the dark, slippery slope toward suicide.  In DMU’s psychology and counseling programs, we teach students how to act effectively in situations where de-escalation, negotiation, and crisis intervention are needed, such as suicide attempts. The courses also train students on the best ways to diagnose and treat common psychological problems to prevent severe disorders from developing. Sign up to learn more.  

50 Percent of Marriages End in Marriage

About four years ago, my brother-in-law (before he was my brother-in-law) said something to me that I still think about today. We were sitting in the kitchen of his home in Plainfield, NJ, with his wife standing at the stove prepping a dinner that I’ve long forgotten--except that it was delicious--discussing topics ranging from homeownership and jobs to the adventures of marriage and raising kids. A former seminarian from Brooklyn, he felt compelled to lay down some knowledge and inform me that “There are some things they don’t warn you about in marriage.” I married his wife’s sister anyway. We married knowing fully well that there are no perfect marriages. Although we would’ve loved to be like the Fredricksens from the movie Up--where the opening scenes and montage doesn’t show them arguing at all--the real adventure is knowing that that is not the reality of marriage. Meetings with our priest and our conference for engaged couples in our preparation helped us understand that, and further developed our understanding of marriage as a commitment into the unknown future that a husband and wife vow before God to take together; a lifelong journey side by side, hand in hand, towards the sunset. But like all commitments--and all ventures into unknown futures--things happen. Obstacles arise that can throw married couples into odd, difficult and even tense situations. Some couples may just need help creating good communication patterns in their marriage. Others may feel distant from each other and aren’t sure why, or find themselves in a rut and want to find a way to start over. Obstacles like finances, home and car repairs, family matters, emergencies and unexpected occurrences can lead to tense discussions, heated arguments or a distancing silence, leaving the couple frustrated, in pain, and looking for ways to heal and move forward. That lifelong journey towards the sunset is not without a lifetime of obstacles to face. On March 9th and 10th, married couples will have the opportunity to address those obstacles head on at Our Lady of Bethesda Retreat Center in Maryland, where faculty members from Divine Mercy University (DMU), led by Associate Professor Dr. Lisa Klewicki, will host a retreat for couples looking to reconnect, repair and re-energize their marriage. “This retreat is primarily aimed at helping couples deepen their relationship, their level of communication, and emotional connection,” said Dr. Jonathan Marcotte, a Licensed Psychologist for Catholic Social Services of Southern Nebraska. “It’s based off of scientifically validated psychological studies on ‘Attachment Theory’ that have been heavily researched for over 50 years.” Dr. Marcotte, a graduate of DMU’s Psy.D. program in 2017, ran this two-day workshop with Dr. Klewicki and her team last year. Modeled from the “Hold Me Tight” workshop format for couples developed by clinical psychologist and founding Director of the International Centre for Excellence in Emotionally Focused Therapy (EFT), Dr. Sue Johnson. Dr. Klewicki and her team immersed the Catholic faith into its structure to help guide couples through the first phases of EFT and improve their ability to experience God’s love within their marriage. Dr. Kathleen Musslewhite, also an alumna of DMU, will be a part of Dr. Klewicki’s team this year. She’s a licensed psychologist who practices in Frederick, Maryland. “The purpose is to help couples who are married to recognize some common obstacles in marriage through the lens of EFT,” she said. “I’ve used EFT for three years now and find it really kind of amazing. It takes the pressure off the couple and puts it on the reactive attachment cycle.” This workshop is not a replacement for marriage therapy. According to Dr. Musslewhite, it is in the context of programs for marriage enrichment. The couples spend the weekend engaging with each other--talking to each other--and no therapeutic relationship is created. The therapists are there to present information and opportunities and help the couples with the exercises, but they do not speak with the couples. There are some couples who may end the weekend realizing that they need more extensive therapy.     “Couples from all sorts of situations have come on past retreats,” said Marcotte, “ranging from newlyweds to couples who are so distressed that divorce is on the table. This retreat is specifically for couples who feel like they’re ‘stuck’ in a constant state of negative interactions with each other. It’s for couples who feel disconnected and want to rekindle feelings of closeness with each other. This retreat certainly pushes each individual to dig deeper into their own roles regarding negative interactions with their spouse, as well as to put aside their frustrations in order to hear each other’s pain.” “I remember at the last one I attended, there were couples who expressed to me ‘ah ha’ moments,” said Musslewhite. “They expressed that they were in the middle of reactive cycles but couldn’t see the pattern. Once they saw the patterns, they felt more empowered. Another couple was able to recognize the behavior that had previously felt critical and judgemental now felt like a cry for closeness, a need for secure attachment.” In addition to the workshop being immersed in Catholic theology, the workshop is immersed in the sacraments. Confession will be offered throughout the day and Mass will be offered in the evening. “This is a wonderful reason why this workshop is so effective,” said Marcotte. “Integrating the sacraments allow more opportunities for God’s grace to pervade into the couple’s experience. It is incredibly important as couples become more vulnerable and take advantage of this opportunity to allow God’s love to give courage and solace to the one being vulnerable, as well as giving grace and peace to the one receiving and responding to the other’s vulnerability.” The workshop takes it a step further by allowing the couples, at the workshop’s conclusion, the opportunity to renew their marriage vows. It’s optional and the couples are not obliged to partake, one may think that there’s extra pressure on the couples that attend knowing that’s available at the end. “The sacraments and the renewal of vows are all offered, but certainly not compulsory,“ said Musslewhite. “Some couples don’t stay for the Mass and renewal of vows at the end of the weekend. For other couples, it’s the highlight of the weekend.”   “Well, it might!” Marcotte exclaimed when asked if couples attending may feel the pressure of the renewal of vows. “A lot of couples get into some deep places if they take this workshop seriously, and while it’s a place to do some deep healing and restructuring, it can take couples to places they never wanted to go. If a couple feels unresolved in some difficult parts of their relationship, they might feel forced to do marriage vows.” “However,” Marcotte continued, “renewing vows is also symbolic of the element of love that is a choice, and this opportunity allows them to make a conscious choice to love each other and continue fighting for a positive relationship.”           No marriages are perfect, and the world is full of obstacles that can dissuade a couple from keeping the fire of their love lit. But within that commitment to each other is the love and hope to acknowledge when those obstacles are affecting our relationship, and to make every effort toward identifying and remedying those obstacles toward rekindling that love that originally brought them together. For more information about this workshop and future workshops, click here: https://ourladyofbethesda.org/healing-your-love-tools-overcoming-obstacles-marriage#panel--2   

Fostering Inclusivity in Eating Disorder Awareness

Did you know that an eating disorder is a physical AND mental illness that affects people of ALL backgrounds? Instead of pigeonholing this condition to one particular category of people, National Eating Disorders Association's Awareness Week (February 25-March 3) is fostering inclusivity this year to show how this disease impacts "individuals at all stages of body acceptance and [to emphasize that all] eating disorders recovery .... stories are valid." This message matches the association's 2019 theme: Come As You Are. To gain more insight on eating disorders for this week of awareness, we reached out to clinical psychologist Laura Cusumano, Psy.D., who specializes in eating disorder treatment. She is also an alumna of Divine Mercy University and currently provides treatment through Potomac Behavioral Solutions in Arlington, VA. Dr. Cusumano has extensive experience working with people suffering from eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID). In her 2017 dissertation for the Psy.D. program, she integrated the virtues of humility and temperance into Radically Open Dialectical Behavior Therapy (RO DBT) to develop a Catholic adaptation of RO DBT for those with anorexia nervosa. "I found the RO DBT material to be well suited for this adaptation," she said "and I would like to expand upon it in the future." In an email response, she shared detailed answers to questions about eating disorders, their causes/effects, stigmas still associated with them and more! Read on to gain a deeper understanding of the disease that's estimated to impact 20 million women and 10 million men in America at some point in their lives. Q - How can someone detect if their friend or loved one has an eating disorder, and how do you safely address it? Dr. Cusumano - There are several subtle signs that may indicate that a person is struggling with an eating disorder. You may notice that your friend or loved one has started to talk about eating "clean" or going on a diet. The person may make negative comments about his or her body, express a desire to lose weight, and/or compare his or her body to other people's bodies. You may observe your friend or loved one making changes to his or her exercise routine, and the person may become anxious or upset if he or she misses a workout. Your friend or loved one may decline invitations to go out to dinner or prepare a separate meal when eating with others. During a meal, your friend or loved one may engage in unusual eating behaviors, such as cutting food into very small pieces. The person may also stop sharing meals with others altogether. You may also notice a change in your friend or loved one's mood and energy level. If you are concerned that your friend or loved one may have an eating disorder, I encourage you to share your concerns privately with that person. Spend some time doing research on eating disorders so that you have information to share. Use "I" statements to express that you feel worried and to share things that you have observed about the person's behavior (e.g., "I'm worried about how frequently you're going to the gym."). Your friend or loved one is more likely to be receptive to what you have to say when you phrase things in this way. Having this discussion may feel awkward and uncomfortable for both of you, and that person may have a negative reaction or deny that something is wrong. Let your friend or loved one know that you are here to talk whenever he or she is ready and offer to provide the person with resources. Encourage your friend or loved one to seek professional help. Q - What are common resources that you are confident in providing to men and women with an eating disorder? Are any resources gender specific? If so, why? Dr. Cusumano - I really like the National Eating Disorder Association's (NEDA) website: www.nationaleatingdisorders.org. It has a wide breadth of information about the spectrum of eating disorders and how they typically manifest. The information on the website ranges from general (e.g., "What are Eating Disorders?") to specific (e.g., the "Identity & Eating Disorders" section). It is important to note that eating disorders can affect people of any race, ethnicity, sexual identity, or gender. There is gender-specific information on the NEDA website. This is because eating disorders manifest differently across different populations. For example, most women with eating disorders desire to have bodies that fit our culture's thin ideal. In contrast, many men with eating disorders have a drive for increased muscularity. Body image distress varies between men and women, and this should be taken into consideration during treatment planning. The Academy of Eating Disorders, a professional association dedicated to eating disorder research, education, treatment, and prevention, also has a variety of useful resources available on its website: www.aedweb.org. Q - How are therapists currently working with physicians to diagnose and prevent eating disorders? Dr. Cusumano - When a patient starts therapy with me, I refer him or her to a dietitian for nutrition counseling and a physician for medical monitoring. Eating disorders can be life-threatening, so it is extremely important for the patient to work with a treatment team. Medical complications can include dizziness, fainting, dental problems, electrolyte imbalances, arrhythmia and other heart problems, muscle weakness, organ failure, and menstrual irregularities in women. It is essential for therapists to consult regularly with physicians about their mutual patients to ensure that patients are being treated at the correct level of care. A patient may underreport symptoms, and if medical stability is not assessed, he or she may not receive the proper intensity of treatment. With regard to prevention, therapists encourage physicians to promote positive body image when talking to their patients and to educate them about nutrition and healthy amounts of physical activity. I have worked with patients who have reported that the only strategy their physicians recommended to address their health problems is to lose weight. Even though physicians may have good intentions when they make this recommendation to patients, the recommendation could backfire and trigger body image distress and an eating disorder in people who are predisposed to develop them. Therapists work to educate the physicians with whom they share patients in order to craft an approach that is both empathetic and direct about the dangers of eating disorders in an effort to prevent them. Q - How can someone with an eating disorder reframe their thinking patterns so they do not consider themselves overweight or undesirable?  Dr. Cusumano - Enhanced cognitive behavioral therapy for eating disorders (CBT-E) is an evidence-based treatment that has demonstrated to be effective in treating a transdiagnostic range of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder. Treatment consists of helping a patient establish a regular pattern of eating and challenging the factors that maintain the person’s eating disorder, such as dietary restraint and overevaluation of shape and weight (i.e., body image distress). Through the use of cognitive reframing, patients learn how to challenge their unhelpful thinking patterns in an effort to develop a more balanced way of thinking about themselves. The process of challenging one’s cognitive distortions about body image is often difficult, and it can take a while for patients to recognize that their worth is not dependent on their appearance. It is often helpful for patients to participate in group therapy that focuses on body image so that they can support one another through this process. Q - What is a misconception about eating disorders you'd like to be dispelled? Dr. Cusumano - Most of the time, when people think of anorexia nervosa, they imagine that all those who suffer from anorexia are underweight. Anorexia nervosa is diagnosed when a person restricts his or her energy intake to less than what his or her body needs to function (based on factors including age, height, and gender), resulting in low body weight. Anorexia is also characterized by an intense fear of gaining weight or becoming fat, and body image disturbances are also present. Despite the diagnostic criterion regarding low body weight, anorexia can affect people of all shapes and sizes. The intense fear of being fat and body image distress can occur in people who restrict their energy intake and remain in a normal weight range or above average weight range. This is known as atypical anorexia nervosa. Many of my patients who struggle with restriction have a formal diagnosis of atypical anorexia. It is a myth that a person must be underweight to suffer from anorexia. Q - After getting your Psy.D. degree, what other training did you seek to specifically treat clients with eating disorders? Dr. Cusumano - My primary training in treating people with eating disorders actually took place while I was still enrolled in the Psy.D. program in the Institute for the Psychological Sciences at Divine Mercy University. I completed my internship at The Emily Program in Minnesota. The Emily Program is dedicated to providing treatment to those suffering from eating disorders. During my internship, I worked at the outpatient, intensive outpatient, and partial hospitalization levels of care. I had wonderful supervisors who guided me through learning evidence-based methodologies for treating eating disorders. I learned how to support patients during therapeutic meals and to challenge them to use skills effectively so that they could work toward recovery. My time at The Emily Program was extremely valuable to my development as a therapist specializing in the treatment of eating disorders. Currently, I work as a postdoctoral fellow at an outpatient practice that specializes in providing evidence-based treatment of eating disorders. I have gained training in family-based treatment (FBT) for anorexia nervosa, which is the primary evidence-based treatment for adolescents. I hope to continue my training and may pursue certification as an eating disorder specialist later in my career. Q - What advice would you give to parents who think their child or teenager has an eating disorder? Dr. Cusumano - As a parent, recognizing that your child is exhibiting signs and symptoms of an eating disorder can be frightening and leave you feeling helpless. If you suspect that your child has an eating disorder, it is important to discuss your concerns with your child in a compassionate, not critical, manner. Remember, your child is suffering from an illness, and he or she is not completely in control of his or her behaviors. When you talk to your child, focus on the behaviors you have observed, rather than your child’s appearance. Use “I” statements when sharing your concerns. Gather information from resources such as the NEDA and AED websites, and seek professional support. Many parents will find FBT to be the best treatment option for their child. From an FBT perspective, parents are the best equipped at providing the care that their child needs to recover from an eating disorder. An FBT therapist will guide and empower parents to take control back from their child’s eating disorder so that their child can recover. If your child is struggling with an eating disorder, know that recovery is possible! Treatment outcomes are generally positive when eating disorders are detected early. Learn more about the Doctor of Psychology (Psy.D.) in Clinical Psychology program offered at Divine Mercy University to gain skills to treat those who suffer from eating disorders.
About DMU
Divine Mercy University (DMU) is a Catholic graduate university of psychology and counseling programs. It was founded in 1999 as the Institute for the Psychological Sciences. The university offers a Master of Science (M.S.) in Psychology, Master of Science (M.S.) in Counseling, Doctor of Psychology (Psy.D.) in Clinical Psychology, and Certificate Programs.