Interview with Carolyn Costin

Contributor: Carolyn Costin, Founder and Prior Chief Clinical Officer Monte Nido & Affiliates

What drew you to the field of eating disorder treatment? Why?

Interview Photo - Carolyn CostinI began treating eating disorders by a duke actually. I was a young therapist treating adolescents and someone I knew said, “There is this girl across town that has that thing you had maybe you should try seeing her.”

I had been recovered from anorexia nervosa for a while and my friends knew this so when a young girl with anorexia needed help people sought me out. When I saw this person it was like I knew the inside of her mind. She felt understood and she got better. Then I got another referral and she got better too. Soon people all around my town and the surrounding cities started referring to me. It was only then, that I knew I had to do this work

What keeps you in this work, day after day?

Every person is unique and has something valuable to offer. I love people and I love helping people see all that they can be. I find it extremely satisfying to talk to someone and give the hope that they too can become fully recovered from an eating disorder.

Most people I meet don’t think they really can be, they don’t think it will happen for them even if they believe others can do it. I love showing them in little ways how in fact they can. I don’t judge people and don’t get frustrated when they are having a hard time or even if they say they don’t want to get better.

I really don’t let things get to me too much and continue to express love and caring in every situation and I really think that helps me get through it day after day. I also have treated so many people who are recovered now and that has been a big inspiration to keep going. Many people think eating disorders are hard to treat. I don’t think they are I just think it takes patience and dedication and a therapist or treatment team who knows what they are doing

What is your philosophy on eating disorder treatment?

My philosophy is pretty eclectic. I use evidence-based practices like CBT, but in fact, have been doing that before CBT was ever given a name. I think having recovered myself I knew you had to talk about the client’s thoughts and behaviors around food and you had to weight them.

I’ve done this for over 30 years now. I also knew I had to bring in the families and I had to eat with clients and help family members eat with the clients as well. For every client who walks through my door, I treat them as though they have a healthy self and an eating disorder self that has developed over time. The eating disorder self has gained control and repressed the healthy self.

I see my job is to strengthen each person’s healthy self and that this healthy part of them will get back in control and take care of the eating disorder self. This kind of understanding helps me to collaborate with clients because rather than trying to take away something I am making their healthy self-stronger.

I also openly disclose my own eating disorder history and talk about how I recovered. I do not discuss how sick I was or details about my illness but I constantly give clients strategies for getting better, dealing with body image, eating their meal plans etc., And really important I am a role model I eat with clients, take them clothes shopping etc.

I did this in private practice and we do this at Monte Nido. I say to every client, “If I got better so can you.” I believe my clients can become fully recovered and that has contributed to my success and the success of Monte Nido.

What tools would you like your participants to gain while working with you?

  • Strengthening their healthy self
  • Being able to talk back to their eating disorder thoughts
  • Being able to recognize they have a soul self and they are not just a body
  • Realizing the eating disorder cannot be stronger than they are because it is a part of them and they give it its power
  • Being able to reach out for support from others, use people rather than the eating disorder
  • To come up with behavioral rewards and consequences for themselves to help them change habitual behaviors that are hard to break
  • Visualization skills, as this technique is a way to practice skills through using one’s mind which has been proven to work on the brain just like practicing the behavior
  • To become a “conscious” eater, putting together nutrition knowledge with one’s body awareness

What do you envision the future of eating disorder treatment to be like?

I think we will be using a lot more recovered people and that will make it less costly. I think residential and day treatment programs will be more useful than hospitals and people need to go to those long before reaching the point where they need hospitalization. I think more therapists will eat with their clients and realize that this has to be part of the treatment and that talk therapy is not good enough for an illness like this.

I think there will be more self-help manuals like my book, 8 Keys to Recovery From an Eating Disorder. I wrote this book with a former client Gwen Grabb who then recovered and became a therapist. This book gives clients strategies and assignments to work through in order to get better and offers hope as it is full of quotes from people who recovered.

I think people will get diagnosed earlier and treated earlier. We will for sure use families more and include them more often and earlier on.

I don’t think we will ever find a pill to eradicate eating disorders. I do think we might find better treatment for the underlying anxiety so many people with eating disorders suffer from.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 27th, 2014
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