Monday, January 31, 2011

Mental Health Interview Specialists Series: Michelle Muezenmeyer, LLP, Eating Disorders Specialist

Let me introduce Michelle Muezenmeyer, LLP, who started working with eating disorders 8 years ago as an inpatient psychotherapist at Forest View Psychiatric Hospital. She continued this work when she later joined Pine Rest Christian Mental Health Services where she led eating disorder recovery groups and provided specialized individual and family counseling. She currently works as a private practitioner at 5060 Cascade Road, Grand Rapids, Michigan. She can be reached at (616) 454-2911 for appointments or questions.

Kerry: “Michelle, thank you for taking time out to answer a few questions. Tell me, what is an eating disorder?”

“Eating disorders are a group of three serious, potentially life-threatening conditions that affect a person’s emotional and physical health. They are: Bulimia Nervosa; Anorexia Nervosa; and Binge-Eating Disorder. People with these conditions use them to ‘numb’ their emotional experiences and to gain a perceived sense of control over their internal world. Eating disorders have been called ‘a disorder of emotions’ since clients are often unaware of their own feelings, see themselves as unworthy of acceptance and love, and tend to focus on pleasing others. It is common for affected individuals also to struggle with symptoms of depression, anxiety, and substance abuse.”

Kerry: “Briefly describe each type of eating disorders.”

“Bulimia Nervosa is characterized by someone consuming a large amount of calories without gaining weight. He or she is able to do this by vomiting after meals, excessively exercising, and/or overusing laxatives and diuretic medications.

Anorexic clients are individuals who have lost a significant amount of their body weight (usually 15% or more of their original weight) and have a distorted perception of their body shape and size. They usually have a rigid determination to become thinner, often at great risk to their health. Both of these first two conditions are accompanied by low self-esteem and an unrealistic drive to be perfect.

Someone struggling with Binge-Eating Disorder will consume large amounts of food while emotionally ‘zoning out.’ He or she may be unaware of the huge consumption and are often surprised by the behavior. This person usually doesn’t purge and, as a result, is overweight or obese. Health risks are associated with this condition, and it is also often accompanied by depression, anxiety, or other substance abuse problems.”

Kerry: “Who usually recognizes the problem first?”

“In cases that involve a child or adolescent, the primary care doctor often is the first person to recognize the problem. Usually parents will have observed a health issue resulting from the eating disorder and will bring their child to the physician for a health assessment. For example, teenage girls will often have stopped menstruating. Parents also might have seen odd or alarming ritualistic eating behaviors or habits. Adolescent clients, however, are very good at hiding eating disorders. Parents are more likely to have noticed that their child seems depressed, angry, or withdrawn. These changes often cause parents to seek professional advice.

Family members are usually the first to identify a problem in adult clients. Often loved ones will confront a struggling individual. Since most people with an eating disorder don’t want help, they will deny the condition until there are serious health issues that force them to get professional treatment.”

Kerry: “What should one expect from treatment?”

“For the anorexic client, the primary goal is weight restoration, and for the bulimic patient, it is the termination of the binge and purge cycle.

Counseling only begins when clients are medically cleared of any serious health concerns. Once that occurs, struggling individuals need to be motivated to participate in the treatment process. Many eating disorder specialists will involve a nutritionist and a psychiatrist as part of the treatment team. Family counseling and/or group therapy might be included.

Therapy will address clients’ fear of being fat, their obsession with body weight or shape, their low self-esteem, and any difficult interpersonal relationships they are experiencing. They will learn to identify and appropriately express their emotional needs. They also will learn new coping skills to address life’s challenges instead of their previous habit of using food.”

Kerry: “How do you know when individual therapy isn’t enough?”

“Each new client comes into treatment with a different level of motivation. Some individuals are not quite ready to give up their dysfunctional behaviors. In such cases, group therapy can help to provide the impetus and support to help that person take the next step.

Some clients have co-existing psychological conditions. For example, they may have an eating disorder and a substance abuse problem. Other clients might be severely malnourished or medically unstable. In these situations, individual therapy may not be intensive enough. These individuals may need a brief stay in an inpatient psychiatric hospital to help jump-start the treatment process.

Kerry: “What other forms of treatment are there and how does one get admitted to those programs?”

“Other forms of treatment besides inpatient hospitalization and outpatient therapy include: Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior Therapy (DBT), and art therapy. Rarely does someone start these forms of treatment unless he or she has been referred by another specialist, such as a counselor.”

Kerry: “What are the most important credentials or personal qualities in an eating disorder specialist?”

“An effective therapist will have plenty of counseling experience with eating disorders. It may be helpful to ask if the mental health professional has received specialized training and supervision in this area. It is also important that this therapist have good working relationships with other specialists, such as nutritionists, psychiatrists, and primary care physicians, since treatment teams can be very helpful.

Effective therapists will also be patient and knowledgeable. They will come across with personal warmth, compassion, and empathy. They also should be good role models in maintaining open line of communication, setting appropriate limits, and practicing healthy lifestyle habits.”

Kerry: “There is a common perception that eating disorders are difficult to treat, is that true?”

“Therapy requires the client to give up a pattern of behavior that has given this individual a sense of control over painful emotions. This is hard work. There is also a fear that recovery may mean becoming overweight and ugly. Clients have to overcome these fears and concerns in order to learn new behavioral habits.”

Kerry: “What is necessary to make treatment successful?”

“It takes an enormous amount of courage for a struggling individual to face the necessary physical and emotional changes needed for full recovery. Recovering individuals will have confronted their fear of food and possible weight gain, learned to deal with emotions differently, and become able to face the world more assertively.”

Kerry: “How does one find an eating disorder specialist in their area?”

“Some weight loss programs have a referral list of eating disorder providers in their area. One’s primary care doctor and health insurance carrier are also an excellent resource for finding a counselor. Probably the best referral source is by word of mouth. Ask colleagues or co-workers, friends, and family members for a recommendation of a specialist.”

Kerry: “Thank you, Michelle, for taking time today to answer questions about eating disorder treatment!”

If you would like to learn more about Michelle, to ask her any questions, or to make appointment with her, she can be reached at (616) 454-2911.

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