"Live your questions now, and perhaps even without knowing it, you will live... into your answers." - Rainer Maria Rilke
Common Questions
Do I, or does my son or daughter, have an eating disorder?
Eating disorders come in every possible size and shape. There is no such thing as the "look of an eating disorder." That is why they can be so difficult to detect... The most common eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. All eating disorders can occur in both males and females and at any age. Anorexia is best described as a fixation on body size, shape or weight and accompanies severe and significant weight loss. Refusal to eat, strange or odd eating habits, eating rituals and/or an obsession with food are all common. Further, hiding food, over-exercising and use of diet pills or laxatives is seen in many individuals with Anorexia. A person struggling with Anorexia may or may not purge, or throw up after meals. Bulimia differs from Anorexia in that individuals are not of a significant low body weight. An individual with Bulimia engages in frequent and repeated binge and purge cycles. A binge occurs when a person eats a very large amount of food in a small period of time. Purging is any kind of behavior that serves to rid the body of calories- such as vomiting, over exercising or using diuretics or laxatives. Individuals struggling with Bulimia may be underweight, average weight or above weight. Binge Eating Disorder is defined when someone feels an uncontrollable urge to eat and may binge for long periods of time without any compensatory purging behaviors. Additionally, "orthorexia" is a term that is being used more recently to describe individuals who are overly focused on only eating "healthy" foods- this can take the form of strict adherence to diets and avoiding all "non-healthy" foods. Orthorexia is often accompanied by obsessive thoughts, high anxiety and may result in significant weight loss.
While it is easy to focus on the food-aspect of a person's eating disorder, it is essential to remember that "it's not just about the food." People engage in eating disordered behavior as a way to handle or cope with emotions, stressors or fears. It is very common for individuals struggling with disordered eating to experience high anxiety, panic attacks, depression, low self-esteem and social withdrawal. Diagnosing an eating disorder is a complicated and careful process, requiring a initial psychological evaluation and often a trip to see a medical doctor, dentist and/or nutritionist to confirm the diagnosis.
Outpatient treatment can be highly effective and it is best to start treatment as early as possible. It generally includes individual as well as family therapy and often requires nutritional and psychiatric services as well. If you are struggling with an eating disorder or suspect a family member is, please contact Dr. Bush to set up this initial evaluation.
For more information on eating disorders, support groups or to get involved to help out- please check out The Alliance for Eating Disorders, located in downtown West Palm Beach.
Do I have OCD?
Obsessive-Compulsive Disorder is a very "popular" diagnosis today and it is not uncommon to hear people casually talk about "being OCD" or having OCD symptoms. However, the actual anxiety disorder of OCD is not as common as it may seem. OCD is diagnosed when a person experiences either obsessions or compulsions, or both, that consume a significant period of time in the person's life and cause significant impairment or distress. Obsessions are persistent thoughts, ideas, urges or images that are unwanted and that the individual is unable to ignore or get away from. Compulsions are behaviors or mental rituals that a person engages in in an attempt to reduce anxiety or to quiet obsessions. Obsessions and compulsions may be illogical, odd or "impossible" or they can be common place in content.
Many people enjoy order, symmetry and routine within their lives. It is only when the need to maintain this routine or sense of order overrules one's life to the detriment of other things, or becomes distressing, that an actual diagnosis will be made. Outpatient treatment can be highly effective for OCD, as well as for other anxiety-related disorders. Through the use of specific interventions designed to break habits, increase coping tools and quiet the mind, many individuals find significant relief from their symptoms.
Do I really need therapy?
You have successfully overcome many obstacles in your life and feel you can handle this on your own, too. However, the ability to be self-aware and to realize you may need outside help is a significant strength and is the first step towards creating real change. Everyone, no matter the situation, has the ability to develop greater insight and awareness, improve relationships, decrease negative habits or just "live better." Dr. Bush is committed to hearing your individual goals for yourself and will work with you towards those goals.
How can therapy help me or my family?
Dr. Bush's form of treatment focuses on fostering insight, improving real-life coping skills and learning how to take control of your thoughts so that you can successfully live your life and achieve your goals. Therapy can be an opportunity to allow you to face stressors, explore emotions, set intentions and learn how to best interact with the world. A psychologist can help you to achieve personal growth, improve relationships and better handle every day hassles. Finally, a psychologist can provide a unique, outside perspective to help you to better see new solutions. The benefits of therapy depend on your commitment and the time and energy you put towards your session and using the skills outside of sessions.
Do I get a say in my treatment?
Absolutely! Dr. Bush is highly collaborative and will spend time to hear your goals as well as your concerns. Treatment will be geared towards your stated objectives. Dr. Bush believes it is essential that the therapeutic relationship is strong and feels "balanced"- she encourages feedback about herself, about what you are liking and about what you are not liking. You are the only expert on you and therefore, it is essential that you are an active participant throughout all stages of treatment!
How can I help my family member who is struggling?
It can be heartbreaking to watch a loved one struggle with a mental health issue and as a parent, caregiver or spouse, it is important that you, too, are supported! Stress-related illnesses are on the rise in our country and in order to best provide for others, you need to be healthy! There are many simple and effective stress reduction techniques that you can learn to help you to be your best for your loved one.
How long do I have to be in therapy?
Given that all treatments are individually tailored to each person, treatment lengths vary significantly. It is possible for some people to see significant changes in as little as 6 -10 sessions. There are also some people who choose to remain in therapy for longer periods of time. Dr. Bush is always open to talking about your expectations for treatment length and will work with you throughout the process to revisit your initial goals, assess progress and openly collaborate on future goals.
Isn't there a medication that I can take for this instead?
Research has consistently shown psychotherapy to be as effective or more effective than medication in the treatment of many disorders. While medication may be very helpful, or even necessary, for some individuals, it should not be used instead of therapy. Medication addresses some symptoms, while therapy addresses the causes of your symptoms to promote long term relief. That being said, Dr. Bush works closely with respected psychiatrists, and there is even a psychiatrist within her office suite for your convenience should you desire or require a psychiatric consultation.
Is what we talk about in therapy kept confidential?
Confidentiality is one of the most important elements of the therapeutic relationship between the therapist and client. Successful therapy requires a significant amount of trust between the therapist and client. Nothing discussed within therapy sessions can be shared with anyone without prior written permission from the client. In order for Dr. Bush to speak to your doctor, your nutritionist or even your husband, you will need to indicate, in writing, that she is allowed to do so. In the case of work with minors (anyone under the age of 18), the parents retain legal rights to information about what goes on during the course of treatment. In the case of individual therapy with minors, Dr. Bush will discuss confidentiality and its limits with both the patient and the parents/guardians to determine what information will be shared and what will remain confidential.
However, there are a few exceptions to confidentiality that are required by law. Exceptions are in the case of:
Do I, or does my son or daughter, have an eating disorder?
Eating disorders come in every possible size and shape. There is no such thing as the "look of an eating disorder." That is why they can be so difficult to detect... The most common eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. All eating disorders can occur in both males and females and at any age. Anorexia is best described as a fixation on body size, shape or weight and accompanies severe and significant weight loss. Refusal to eat, strange or odd eating habits, eating rituals and/or an obsession with food are all common. Further, hiding food, over-exercising and use of diet pills or laxatives is seen in many individuals with Anorexia. A person struggling with Anorexia may or may not purge, or throw up after meals. Bulimia differs from Anorexia in that individuals are not of a significant low body weight. An individual with Bulimia engages in frequent and repeated binge and purge cycles. A binge occurs when a person eats a very large amount of food in a small period of time. Purging is any kind of behavior that serves to rid the body of calories- such as vomiting, over exercising or using diuretics or laxatives. Individuals struggling with Bulimia may be underweight, average weight or above weight. Binge Eating Disorder is defined when someone feels an uncontrollable urge to eat and may binge for long periods of time without any compensatory purging behaviors. Additionally, "orthorexia" is a term that is being used more recently to describe individuals who are overly focused on only eating "healthy" foods- this can take the form of strict adherence to diets and avoiding all "non-healthy" foods. Orthorexia is often accompanied by obsessive thoughts, high anxiety and may result in significant weight loss.
While it is easy to focus on the food-aspect of a person's eating disorder, it is essential to remember that "it's not just about the food." People engage in eating disordered behavior as a way to handle or cope with emotions, stressors or fears. It is very common for individuals struggling with disordered eating to experience high anxiety, panic attacks, depression, low self-esteem and social withdrawal. Diagnosing an eating disorder is a complicated and careful process, requiring a initial psychological evaluation and often a trip to see a medical doctor, dentist and/or nutritionist to confirm the diagnosis.
Outpatient treatment can be highly effective and it is best to start treatment as early as possible. It generally includes individual as well as family therapy and often requires nutritional and psychiatric services as well. If you are struggling with an eating disorder or suspect a family member is, please contact Dr. Bush to set up this initial evaluation.
For more information on eating disorders, support groups or to get involved to help out- please check out The Alliance for Eating Disorders, located in downtown West Palm Beach.
Do I have OCD?
Obsessive-Compulsive Disorder is a very "popular" diagnosis today and it is not uncommon to hear people casually talk about "being OCD" or having OCD symptoms. However, the actual anxiety disorder of OCD is not as common as it may seem. OCD is diagnosed when a person experiences either obsessions or compulsions, or both, that consume a significant period of time in the person's life and cause significant impairment or distress. Obsessions are persistent thoughts, ideas, urges or images that are unwanted and that the individual is unable to ignore or get away from. Compulsions are behaviors or mental rituals that a person engages in in an attempt to reduce anxiety or to quiet obsessions. Obsessions and compulsions may be illogical, odd or "impossible" or they can be common place in content.
Many people enjoy order, symmetry and routine within their lives. It is only when the need to maintain this routine or sense of order overrules one's life to the detriment of other things, or becomes distressing, that an actual diagnosis will be made. Outpatient treatment can be highly effective for OCD, as well as for other anxiety-related disorders. Through the use of specific interventions designed to break habits, increase coping tools and quiet the mind, many individuals find significant relief from their symptoms.
Do I really need therapy?
You have successfully overcome many obstacles in your life and feel you can handle this on your own, too. However, the ability to be self-aware and to realize you may need outside help is a significant strength and is the first step towards creating real change. Everyone, no matter the situation, has the ability to develop greater insight and awareness, improve relationships, decrease negative habits or just "live better." Dr. Bush is committed to hearing your individual goals for yourself and will work with you towards those goals.
How can therapy help me or my family?
Dr. Bush's form of treatment focuses on fostering insight, improving real-life coping skills and learning how to take control of your thoughts so that you can successfully live your life and achieve your goals. Therapy can be an opportunity to allow you to face stressors, explore emotions, set intentions and learn how to best interact with the world. A psychologist can help you to achieve personal growth, improve relationships and better handle every day hassles. Finally, a psychologist can provide a unique, outside perspective to help you to better see new solutions. The benefits of therapy depend on your commitment and the time and energy you put towards your session and using the skills outside of sessions.
Do I get a say in my treatment?
Absolutely! Dr. Bush is highly collaborative and will spend time to hear your goals as well as your concerns. Treatment will be geared towards your stated objectives. Dr. Bush believes it is essential that the therapeutic relationship is strong and feels "balanced"- she encourages feedback about herself, about what you are liking and about what you are not liking. You are the only expert on you and therefore, it is essential that you are an active participant throughout all stages of treatment!
How can I help my family member who is struggling?
It can be heartbreaking to watch a loved one struggle with a mental health issue and as a parent, caregiver or spouse, it is important that you, too, are supported! Stress-related illnesses are on the rise in our country and in order to best provide for others, you need to be healthy! There are many simple and effective stress reduction techniques that you can learn to help you to be your best for your loved one.
How long do I have to be in therapy?
Given that all treatments are individually tailored to each person, treatment lengths vary significantly. It is possible for some people to see significant changes in as little as 6 -10 sessions. There are also some people who choose to remain in therapy for longer periods of time. Dr. Bush is always open to talking about your expectations for treatment length and will work with you throughout the process to revisit your initial goals, assess progress and openly collaborate on future goals.
Isn't there a medication that I can take for this instead?
Research has consistently shown psychotherapy to be as effective or more effective than medication in the treatment of many disorders. While medication may be very helpful, or even necessary, for some individuals, it should not be used instead of therapy. Medication addresses some symptoms, while therapy addresses the causes of your symptoms to promote long term relief. That being said, Dr. Bush works closely with respected psychiatrists, and there is even a psychiatrist within her office suite for your convenience should you desire or require a psychiatric consultation.
Is what we talk about in therapy kept confidential?
Confidentiality is one of the most important elements of the therapeutic relationship between the therapist and client. Successful therapy requires a significant amount of trust between the therapist and client. Nothing discussed within therapy sessions can be shared with anyone without prior written permission from the client. In order for Dr. Bush to speak to your doctor, your nutritionist or even your husband, you will need to indicate, in writing, that she is allowed to do so. In the case of work with minors (anyone under the age of 18), the parents retain legal rights to information about what goes on during the course of treatment. In the case of individual therapy with minors, Dr. Bush will discuss confidentiality and its limits with both the patient and the parents/guardians to determine what information will be shared and what will remain confidential.
However, there are a few exceptions to confidentiality that are required by law. Exceptions are in the case of:
- In the case of suspected or known child abuse, disabled adult or elder abuse.
- If a client is threatening serious bodily harm to another person.
- If a client intends to hurt or kill himself or herself