I began my work as an eating disorder psychologist at Eastern Health almost 12 years ago. I’m Dr. Susan Pardy, and the fact that my entire career has been focused in the field of eating disorders is not because I chose it – it organically chose me!
As I worked towards completing my Master’s Degree in Clinical Psychology at Queen’s University in Kingston, my initial focus was geriatrics where I researched the caregiver role and developed skills in neuropsychological assessment. However, in 2000, the summer leading up to beginning my Ph.D., my thesis supervisor, a geriatric specialist, suddenly announced her retirement. I scurried to find a replacement, and as life would have it, I ended up working with a social psychologist who offered me new and exciting research opportunities – this time outside the area of geriatrics.
With this new direction, my clinical focus began to shift a little, first to adults, and then to young adults. This led me to begin building a practice to treat depression and anxiety. During this time, I can recall that a couple of my clients presented for treatment of eating disorders. The process was for me to refer these patients to more qualified professionals for treatment, which often left me feeling interested to learn more about treating eating disorders.
In 2005, I returned home to Newfoundland and Labrador to complete my post-doctoral internship at the University Counselling Centre at Memorial University of Newfoundland, now known as the Student Wellness and Counselling Centre. This included a four-month rotation at Eastern Health where I chose to work in the Women’s Health Program using my experience in treating depression and anxiety disorders. Things changed unexpectedly, and I ended up in a program called Adolescent Medicine at the Janeway Children’s Health and Rehabilitation Centre.
A natural tendency
In the beginning, I didn’t know much about the specialty of Adolescent Medicine, nor about the treatment of eating disorders. What I did know was that I was naturally drawn to this patient group like no other population that I’ve served before!
It wasn’t long before a vacant psychologist position became available and I was delighted to accept the offer. That is when I began the most intense period of learning in my life’s journey.
Feeling the difficult feelings
In my work with patients, I am trained to use Cognitive Behaviour Therapy (CBT) – an approach that, to risk of oversimplifying it, attempts to change behaviour through changing thoughts and changing thoughts through changing behaviour. I found that my patients were increasingly taking me along their journey of exploring their difficult experiences, difficult relationships, and ultimately, difficult feelings. It became quite clear that eating disorder behaviour was aiding to keep difficult feelings at bay through numbing, soothing and distracting. I found that as long as patients avoided feeling their feelings, the eating disorder continued to serve a purpose in their lives.
I began making “feeling the difficult feelings” in my office a goal of every session. It seemed that the more comfortable patients would get with “feeling their feelings” in my office, the better they were able to “feel their feelings” in their everyday lives as difficult emotions arose.
Bringing parents in
Sometimes eating disorder behaviour becomes more intense as feelings rise to the surface –this would often happen before patients developed a comfort level with “feeling their feelings.”
Yet, I always had faith that the expression of my patients’ most difficult feelings would ultimately bring them relief. I quickly realized the value of bringing parents in on the work I was doing with my patients. I know that parents love their children and would do anything to help them recover. Practically speaking, parents also have more access to their children than I do, and therefore could help my patients through their difficult feelings between our weekly therapy sessions.
One day I attended a training workshop on Emotion Focused Family Therapy (EFFT), offered by the Eating Disorder Foundation of Newfoundland and Labrador, which taught me how to train a parent to be their child’s Emotion Coach, and soon thereafter, I moved into a new position that allowed me to focus my practice on providing EFFT. The next five years I spent working in Eating Disorders Transition, which was inspiring and heart-warming. I can’t say how many times I cried tears of joy after discharging a recovered patient – probably as many times as I’ve been moved to tears while sitting to the side, observing as parents bravely use new skills and acknowledge “old hurts.”
I wasn’t looking for a change when a new Eating Disorders Inpatient Program was announced at Eastern Health. In fact, I felt like I was living my dream job. However, I found myself daydreaming about what this new program needed; what could be achieved; and how I could help make it happen!
In the fall of 2017, I was hired as the clinical lead and program psychologist for this new program. I was thrilled when Leah Bartlett joined the team, a seasoned dietitian who was already doing amazing work with patients living with eating disorders on the Psychiatry Unit at the Health Sciences Centre. Rick Parsons, social worker, brought in his expertise in Dialectical Behaviour Therapy (DBT), which is one of few evidence-based treatments for eating disorders. Finally, Mark Flood, occupational therapist, joined our team with his relevant background in addictions and trauma – which often co-exist with an eating disorder diagnosis.
Our multi-disciplinary team focuses on providing a continuum of services for patients and their families as individuals transition through outpatient, inpatient and follow-up care. We are well connected with a larger group of professionals on the Health Sciences Centre Psychiatry Unit who have many years of experience working with patients living with eating disorders. We also engage Eastern Health’s HOPE Program which stands for Healthy Opportunities for People with Eating Disorders). The HOPE Program is an intensive eating disorder day and outpatient treatment program that is committed to helping people recognize their eating disorder symptoms; challenge thoughts and behaviours; and to help patients develop new means of coping with everyday stressors.
Eastern Health’s new Eating Disorders Inpatient Program provides assessment and specialized treatment for patients who are acutely ill and are not well enough to participate in outpatient or day treatment programming. A beautiful space also exists for family members to participate in their loved one’s treatment and recovery plans.
I can say with confidence that together, we are lighting the way and building an inpatient program within a seamless continuum of care that will provide the structure, skills, experiences and compassion – all of which are required to help a patient navigate through difficult feelings and support the healing process from their eating disorder.
Meant to be
Still to this day, I keep a “thank you” folder that I began while working in Adolescent Medicine Program. In this folder, I save letters and cards of appreciation from patients and their families. The themes of these notes are consistent – patients healed through feeling. With a compassionate bystander, patients are not only learning to tolerate their pain, but also extending compassion to themselves. It is only through this understanding and acceptance that people are willing to explore other options for recovery.
This field is where I belong. To quote a saying on one of my favourite mugs, “Do what makes your soul shine.” I am so lucky to be doing just that, and I am honoured to be a part of a new program that gives patients access to the quality care that they deserve. ■
This article was written by Dr. Susan Pardy, clinical lead and program psychologist for Eastern Health’s new Eating Disorders Inpatient Program.