Sunday, January 22, 2012

Jessica Setnick Blog Interview

This is the second in my blog interview series. This time it is Jessica Setnick, MS, RD/LD, CSSD who was a guest professional on one of our tele-classes in November.

Jessica Setnick Blog Interview
  1. Your website, shows your passion for helping folks with eating disorders.  Where does this passion come from?

It is a combination of wanting to help others and wanting to understand the human condition in some way that would help me understand myself. I learn so much from my patients, and the continuing education that I have pursued has been as applicable to myself as it is to my work. The other aspect is that I feel that I have been given a gift, a gift that I may not have identified on my own, but that the incidents of my life brought to my attention. I am grateful to have found the intersection of what I like to do, that I am good at, that helps people, that I can do for a living. It is my mission and I wouldn’t feel complete if I didn’t act on it. Over time my mission has evolved into helping other professionals to help solve eating disorders, and most recently into helping build a treatment center, Ranch 2300, to do the same.

  1. What is your philosophy on effective eating disorders treatment?

Ah, my philosophy. My philosophy on effective treatment starts with my philosophy on eating disorders themselves. I believe that the nomenclature we use for eating disorders stinks. I think it was developed to facilitate research and description but it does not describe the human experience. So we are not treating individuals with eating disorders as well as we could be because the research is based on artificial distinctions. Anyone who is familiar with the field realizes that two people with “anorexia” might have very different situations – different causes, different skill deficits, different needs – but yet we continue to look for the one “best” treatment. There might be two people whose eating disorders look very different, but they have a lot in common. The treatment must be individualized to what each person needs. But I think that if we did a better job of describing eating disorders, such as “Depression-related eating disorders” and “Anxiety Spectrum Eating Disorders” and “Post-traumatic eating disorders” instead of the way we do now, we could also do a better job of recommending treatments rather than the trial-and-error approach.

The most important factor in treatment that lasts is recovery protection, ie the systems and skills that someone needs in order to thrive outside of a treatment setting. That has been the most fun part of designing Ranch 2300 – thinking of all the skills that someone needs to “make it” in recovery, and figuring out ways to teach those skills in the safe environment of treatment.

  1. What is your opinion on full recovery?

I prefer to use the word “remission,” since it seems to fit the paradigm of eating disorders better than recovery. I feel recovery can begin the very day someone realizes their eating disorder is killing them and they want to change, but that is no guarantee of a change in the parameters we tend to measure. On the other hand, an individual may be weight-restored and seem to be “in recovery” while internally they are not recovered at all.

Remission indicates that while bodies heal faster than minds, both the body and mind have recovered to the point that eating disorders stay in the thought stage only and do not transmit into behaviors that are problematic. In other words, I believe that I am in remission because when I have eating disorder thoughts, I am able to manage them before they lead to behaviors, and on occasion under extreme duress when I have an eating disorder behavior, it is no more severe nor lasting than the average American. It does not lead to guilt or shame, or a repetitive cycle, and I use it as a clue that life is not in balance and a cue to re-evaluate my situation.

My opinion on Remission is that it takes up to 7 years of compliance with treatment from the day an individual with an eating disorder enters treatment to advance to the stage of Remission, where the eating disorder is genuinely and for all practical purposes “in the past.”
  1. How have people used your boot camp to treat their eating disorder?

Well I did not intend it for that purpose, it is a training program for professionals treating eating disorders. But after some of the workshops, professionals who attended would come forward and tell me that after attending the weekend they recognized their own eating disorder, or recognized that it was no longer congruent with their lives, and they asked me to help them find treatment in their area.
  1. What do you tell people who care about someone with an eating disorder to say to encourage their loved one to seek treatment?

I care about you is a good start. I care about you and I would like to help you find treatment is even better. I care about you and I have made an appointment with a counselor to talk about how hard it is to watch someone I love hurt themself is the best way of all. Because then you are not only expressing yourself, expressing how deeply this is important to you, and how you are willing to stick by this person “in sickness and in health,” but you are also role-modeling self-care and reaching out for help, two things that everyone with an eating disorder needs to see more of.

1 comment:

lindah said...

Jessica is one of the finest and "daring"-est registerd dietitians in the field of eating disorders. I'm so glad to hear her speak her "truths"; this spectrum of disease is ruining lives, creating so much pain, and denies joy in living to anyone touched by this disease. I believe we need more options in addressing this disease and have not been happy with the "assembly-line" treatments offered by the centers who believe they are the experts. What other disease tricks the host in helping them kill themselves? Linda Hachfeld, MPH, RD