As we both worked on this project, the first thing we made sure of was that we didn’t call it “exercise” recovery, instead, we use the word “movement.”
There are a lot of negative connotations around the word exercise, whereas movement is a more flowy word that gets across what we are calling for in this project.
Movement is a natural state for human beings. It is something that we do in simply breathing every day. Our hope is to encourage that natural engagement rather than forcing the body to do something.
First, let’s introduce ourselves and our specific roles at Timberline Knolls.
I (Maggie) work as the Director of Nutrition Services with Timberline Knolls. In this position, I get to do creative things such as working with peers to come up with what our residents need in the moment.
I (Natalie) am a Dance Movement Therapist (DMT), yoga specialist, and trauma specialist at Timberline Knolls. I lead DMT and yoga groups as well as regular, verbal, counsel and process groups with psychoeducation.
We see a significant overlap between eating disorders and trauma, so, we work to support individuals in working through that. In addition to our jobs, we work with a Dietary Team, a Therapy Team, Physicians, and an Admissions and Discharge Team.
In this article series, we will discuss some practical ways to incorporate movement into treatment.
Function of Eating Disorder Behaviors
Focusing on the functions of eating disorders is essential so that we’re looking at how the disorder formed, and from where the behaviors came. One aspect we see is experiential avoidance, so, maybe an individual is experiencing an external issue, but, the issue becomes internal because it feels like a safer place to put it or cope with it.
As such, disordered behaviors sometimes become the solution to this problem such as restricting, binging, purging, body-checking, obsessive thinking, etc. These behaviors are often compensatory and become compulsive.
We look at these behaviors from the perspective of, the individual thinking it serves a particular function and that gives us a little bit more information and flexibility around what we can do to help them address that need.
Self-awareness can also be an essential function that may play a role in behaviors and be helpful in recovery. We try to support residents in building more self-awareness so that they can start to understand on their own and can have more power over their choices and what they do in treatment.
These are the main functions that we work to learn more about and understand in our work.
Excessive Exercise & Eating Disorders
What is Excessive Exercise?
Defining “excessive” exercise can be difficult because it is viewed as such a “healthy” habit. As a result, there is a lot of misinformation out there. According to the DSM-5, the behavior must be recurring, on average, at least once a week for three months.
That may not seem like a lot, and, many of our Timberline Knolls residents would fit into that description.
With that, it becomes up to use to determine whether it is excessive or problematic, looking at whether it occurs after a binge for example or asking that crucial question above – is it keeping them from engaging in a meaningful life?
I (Maggie) often describe an over-exercise symptom giving the example of a client we worked with that was in high school.
She would carry around 10 to 12 books during the schools days an refuse to go to class, instead just pacing up and down the hallway.
She would share that she wanted to go to school and to class and to do well, but, she had this compulsion, she couldn’t stop moving. Another symptom is not having breaks. We always recommend a minimum of two rest days.
Other symptoms include exercising at inappropriate times, exercise accompanied with intense guilt, rigid scheduling or documentation, exercising solely for weight changes, minimizing their fear of eating, or engaging in exercise without proper nutrition.
The belief that this is sustainable, too, is a symptom because so often it isn’t sustainable for any human being. So, again, creating high expectations that cannot be met.
Exercise and Eating Disorders
The eating disorders that we see commonly paired with over-exercise would be anorexia, bulimia, and body dysmorphia. We often see this associated with the perfectionist attitudes where the function would be being perfect or trying to be “right.”
We find, with this, that there is a cycle of “never enough” and the individual always wanting more. This often leads to individuals exercising excessively despite illness, fatigue, or injury.
Individuals with eating disorders also often try to set and attain unrealistic goals, always reaching for something that is unattainable.
This is true in recovery, as individuals will create goals that may be unattainable not only for a standard human but, particularly, for someone who is trying to recover from an eating disorder.
This mentality of just “pushing through” creates a challenge in recovery because individuals are afraid that, if they let go of that mentality, they just won’t do anything at all.
We try to support them in replacing this all-or-nothing thinking with a more balanced view on what they can achieve.
Complications of Excessive Exercise
Signs that might indicate problematic exercise are exercising despite injury or sickness, avoiding social functions to exercise, or firmly adhering to an obsessive and regimented exercise routine.
An important factor in all of these is that the exercise takes away from the individual’s ability to live a full life.
Continually becoming ill because of overworking the body, missing functions or time with loved ones, or exercising so excessively that time is lost where an individual could be having fun or, even sleeping – all of these take away from an individual living a dynamic and meaningful life.
Engaging in these behaviors is very harmful to the mind and body, resulting in symptoms such as insomnia, depression, fatigue, anxiety, muscular atrophy, bone fractures, or amenorrhea.
It is important to understand that these complications don’t exist in isolation, they often combine to create a really vicious cycle.
For example, an individual may engage in excessive exercise all night, at the expense of their sleep, only to find that they can’t function as they would like the next day and, with perfectionist tendencies, this creates anxiety and depression that worsens throughout the day and as the behaviors continue.
TO BE CONTINUED IN PART II…
Virtual Presentation by Maggie Garrity, RD, LDN, Director of Nutrition Services Timberline Knolls and Natalie Breitmeyer, DMT/Yoga Therapist in the December 8, 2018, Eating Disorder Hope Virtual Conference III: Blasting Through Bias: A Deep Dive into Underserved Populations and Global Issues 2018
Please visit the Virtual Conference page for other presentations.
Margaret Garrity, RD, LDN is the Director of Nutrition Services and her job entails many duties. She oversees the dietitians and diet technicians, carries a caseload of adolescents, supervises the menu and meal planning stages and develops nutrition-related protocols. She also implements current nutrition recommendations, participates in community outreach and trains dietitians. Prior to joining Timberline Knolls, Maggie was the Nutrition Manager at Revolution in Chicago. She started with Timberline Knolls as a diet technician and progressed to a Registered Dietitian. Maggie attended Eastern Illinois University for her undergraduate degree in Dietetics and Nutrition and then completed her dietetic internship at Ingalls Memorial Hospital. She is a member of the Academy of Nutrition and Dietetics, Behavioral Health DPG and South Suburban Academy of Nutrition and Dietetics. Learn More About Margaret Garrity, RD, LDN
Natalie Breitmeyer, MA, LPC, R-DMT, RYT is currently working as a licensed professional counselor, dance/movement therapist, and yoga specialist for Timberline Knolls in Lemont, Illinois. She received her MA in Counseling and Dance/Movement Therapy from Columbia College Chicago and trained as a yoga teacher with Yogaview Chicago. Natalie is a faculty member at Hubbard Street Dance Chicago’s Lou Conte Dance Studio where she teaches yoga and modern dance. Natalie engages with clients from a humanistic, culturally and trauma-informed lens, and incorporates somatic psychology, yoga philosophy, play therapy, and creative arts therapies into her clinical counseling work. Prior to becoming a counselor, Natalie worked as a freelance dance and theater artist in Chicago and Seattle. She received her BFA in Theater with an emphasis in playwriting and directing from Cornish College of the Arts in Seattle. Learn More About Natalie Breitmeyer, MA, LPC, R-DMT, RYT
About the Transcript Editor: Margot Rittenhouse, MS, NCC, PLPC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.
As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on February 1, 2019.
Reviewed & Approved on February 1, 2019, by Jacquelyn Ekern MS, LPC
Published on EatingDisorderHope.com