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The Chaos of Recovery
Episode 928th February 2020 • Calming the Chaos • Tracy Kenela
00:00:00 00:26:23

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Episode Title: The Chaos of Recovery with Stacy Schilter-Pisano, LMFT, CEDS

In this episode of “Calming the Chaos,” we’ll be talking to Stacy Schilter-Pisano, Licensed Marriage and Family Therapist and Certified Eating Disorders Specialist at The Emily Program in Washington State. The Emily program offers a variety of different ways to help those who struggle with eating disorders find recovery.

Stacy and I are both passionate about treating eating disorders in our local, national and international communities. And so now, during National Eating Disorders Awareness week, let’s listen to Stacy and I talk… as two Certified Eating Disorders Specialists….about the chaos that can happen in the minds and bodies of those who are struggling with eating disorders, and especially in those who decide that they want to enter into a program to find recovery.

Let’s listen in!

Stacy’s Introduction – The Emily Program

  1. The Emily program offers Intensive Outpatient, Intensive Outpatient or Partial Hospitalization services to treat clinical Eating Disorders and Body Image Dissatisfaction.
  2. Their goal is to help those who struggle with food, eating and body image recover from behavior patterns that they have been using for coping with stress, and find recovery.

The steps to recovery: When the environment changes – Chaos Happens!

  1. Intake: Just getting the courage about an eating disorder creates chaos
    1. Their mental health experience, their lived experience and experience with food
    2. Am I sick enough to admit? Or downplaying or minimizing their sickness
    3. People experience some chaos with being vulnerable talking about their behaviors that have been secret
    4. Fear: People might find out about me…is there someone who knows me and find out what I am struggling with?
    5. Is the intake provider judging me? (Racing thoughts)
    6. When feedback or recommendations happens, there is a LOT of chaos

After the recommendation, clients experience:

  • Mental gymnastics - fear of changing, and “what you are suggesting requires me to make some major changes in my life to recover. Overturning life doesn’t seem feasible
  • A Higher level of care (Residential or a 35 hour per week commitment) results in an acceptance of reality and deciding what to do…admit or not?
  • 50-60% Accept the recommendation – Acceptance of reality
  • 20-30% don’t accept, but will do another service (such as outpatient treatment)
  • Motivation is low: on a scale of 1-10 (one meaning not motivated and 10 meaning extremely motivated), most people are usually 2-4…not sure they want to do the things that are required of them to get well.

How to calm the chaos when people admit to the program

  1. Warm, welcoming and calming environment and space
  2. Tour of the space and give them an idea of what to expect / experience
  3. The first day: orientation with Dietician, Medical and Therapist
  4. Describe to them in structure and information in advance – help them feel welcomed and comfortable
  5. Giving them a semblance of what will happens eases the mind
    1. Therapists help them feel grounded in the program
    2. Dieticians and Therapists help them feel grounded when eating
  6. Skills coaching when chaos gets really intense
  1. Prompting to self-soothe using the four senses (the fifth being taste)
  2. Prompting to distract when it gets really difficult
  • Turning the mind away from the chaos that threaten to overwhelm
  1. Checking the facts: “Will that food you eat make you fat?” Dietician can help you check the facts.
  1. Motivational interviewing: “Why did you actually enter this program, anyway?”


Do people get used to it and use skills automatically?

  • Yes, over time they do get used to using


  • How do you help yourself?

Empaths experience people’s distress

Neutrally noticing my own responses (angst within myself)

Notice your own experience


Self-Validating – it deserves honoring

Letting go of things that are beyond my control

Turning mind away from the client that may not be okay, but I can be okay

Experiencing emotions and not judging the emotions or the experiences

Being curious about what is showing up

As a therapist, take no credit for what the people do or not

How Therapists do Self-Care

Stacy: Mind-candy, stories, take me away from the therapeutic experiences, - decompressing tims

Tracy: Audiobooks – hear a story and take me away

Information and links:

The Emily Program is a national program, based in Minnesota, Ohio, Pittsburgh and Washington State. Each location offers individualized care for eating disorders, including assessment and treatment at a variety of different levels of care and within a variety of different disciplines, including Medical, Psychiatric, Psychotherapy, Yoga and Art Therapy and Dietician Assistance.

Find out more information about The Emily Program at

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