exposure therapy Archives

Lactose, Dairy, and Eating Disorder Recovery

April 13, 2023November 5, 2022 by drmuhlheim

Dairy and Eating Disorder Recovery in Los Angeles, California [Image description: a person driving a bottle of milk through a straw] Illustrating a potential person in eating disorder recovery incorporating milk

The Milky Way: Why We Encourage Inclusion of Dairy in Eating Disorder Recovery by Shelly Bar, MD, KatieGrubiak, RDN, and Lauren Muhlheim, Psy.D. Dairy is tasty and good for you. Despite this, there are a lot of folks who are scared of it. You may have eliminated dairy from your diet in pursuit of better …

Supporting a Loved One with Emetophobia

July 28, 2023September 4, 2022 by drmuhlheim

Supporting Someone with an Eating Disorder or Emetophobia in Los Angeles, California

What is Emetophobia–Fear of Vomiting? Emetophobia is an extreme fear—or phobia—of vomiting that significantly impacts a person’s life. People with emetophobia may be afraid of vomiting, or seeing or hearing another person vomit, or seeing vomit. In an attempt to avoid vomiting, these people often end up avoiding many situations, activities, and even people they …

Seven Reasons You Should Eat When You’re Not Hungry

June 11, 2023April 30, 2019 by drmuhlheim

Joyful Eating in Los Angeles, California [Image description: drawing of 2 females joyfully eating ice cream] Represents potential eating disorder counseling clients in Los Angeles, California challenging diet rules and eating even when not hungry

In my work with clients with eating disorders and disordered eating, I often find that the fear of eating when not hungry is one of the most difficult bits of dogma to overcome. One of the cardinal rules of dieting is “Eat only when you’re hungry.” People with eating disorders and good dieters everywhere have …

FBT Treatment Team Members

February 17, 2024April 14, 2019 by drmuhlheim

FBT Treatment Team Including Therapist, Dietitian, and Medical Doctor in Los Angeles, California [Image description: Purple scrabble tiles spelling "FBT Treatment Team"]

Family-based treatment (FBT) is the leading evidence-based treatment for teens with anorexia nervosa and bulimia nervosa. In an ideal world, every person with an eating disorder would have access to a full treatment team. This team could include a therapist, a dietitian, a medical doctor, and a psychiatrist. However, manualized FBT calls only for a …

This Halloween, Serve Candy to Your Teen in Recovery

October 5, 2023October 15, 2018 by drmuhlheim

A Family-Based Treatment (FBT)-approach Halloween can be scary for teens with eating disorders for the wrong reason: the candy! Most teens with eating disorders are only willing to eat a restricted range of foods. Expanding this range is an important goal of treatment, with the reintroduction of fear foods being a key step. Candy tends …

FBT Meal Strategies Gleaned from Ziplining

January 4, 2020December 30, 2013 by admin

Understanding and Responding to Your Youngster’s Fear: A Metaphor I often explain to parents that for a youngster suffering from an eating disorder, a meal can feel dangerous – like jumping out of an airplane. A couple of years ago I had the opportunity to (almost) live out this metaphor on a family vacation. This …

Exposure in the treatment of Eating Disorders

March 27, 2012 by admin

Exposure therapy is widely recognized as a necessary (and sometimes sufficient) ingredient of treatment for most of the anxiety disorders including phobias, panic disorder, and obsessive compulsive disorder. Anxiety is a core psychological feature of anorexia nervosa and bulimia nervosa. However, instead of being afraid of heights, speaking in public, having a heart attack, or contamination, individuals with eating disorders are primarily afraid of food, eating, and shape and weight.

Both cognitive-behavioral therapy and family based treatment, two empirically validated treatments for eating disorders, employ exposure techniques. Exposure works through the process of habituation, the natural neurologically-based tendency to get used to things to which you are exposed for a long time. During exposure, habituation occurs as people acclimate to their fear and come to realize that nothing actually dangerous is occurring. Habituation promotes new learning of safety, tolerance of fear feelings, and extinction of the fear avoidance urge.