Nicole Garber & Jenni Schaefer – PESI – Addicted to Exercise: When Movement Takes a Dangerous Turn

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Nicole Garber & Jenni Schaefer – PESI – Addicted to Exercise: When Movement Takes a Dangerous Turn

Whether on its own or in collision with another mental health problem, pathological exercise is a serious and debilitating condition. Similar to substance use disorder, compulsive exercise can serve as a maladaptive coping strategy in response to increased arousal, hypervigilance, cognitive ruminations, and other trauma-related symptoms. Yet, in a society that glorifies more as better, movement that takes a turn to compulsive—and dangerous—is far too often missed and dismissed. Further, the assessment, diagnosis, and treatment of pathological movement—a process addiction—can be complicated by the fact that balanced exercise provides clear health and healing benefits. From both a professional and patient perspective, this presentation discusses the intersection of exercise, trauma, substance use disorders, eating disorders, posttraumatic stress disorder, and suicide.

Utilizing neuroscience findings, the personality and temperament traits that increase an individual’s risk of developing compulsive exercise in response to trauma will be described. This unique presentation discusses evidence-based as well as alternative treatment approaches.

Speakers

Nicole Garber, MD

Nicole Garber, MD, is triple board certified in general psychiatry, child and adolescent psychiatry, and obesity medicine. in addition, Dr. Garber is a certified Dialectical Behavior Therapy (DBT) therapist and has also completed advanced trainings in psychodynamic therapy, mentalization based therapy, and Acceptance and Commitment Therapy. She is a fellow of the American Psychiatric Association since 2015.

Dr. Garber began her career at the Menninger Clinic, where she developed the adolescent eating disorder track. She is the former chief of the pediatric and adolescent eating disorder program at Rosewood Centers for Eating Disorders. Dr. Garber is the former medical director at Arizona Children’s Association and currently is a board member. She is currently the Vice President of Psychiatric Services at Meadows Behavioral Health and Chief of Psychiatry at The Meadows Ranch where she provides comprehensive individualized treatment for adolescents and adults with eating disorders, supervises the medical team, writes and implements policies and procedures, and facilitates DBT groups. Dr. Garber speaks nationally on the diagnosis and treatment of eating disorders, addictive disorders, and self-harm.

Nicole Garber, MD is not affiliated or associated with Marsha M. Linehan, PhD, ABPP, or her organizations.

Speaker Disclosures:
Financial: Nicole Garber has an employment relationship with Alsana and Eating Recovery Community. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Nicole Garber is a member of the American Psychiatric Association, the International Association of Eating Disorder Professionals, the National Eating Disorder Association, and the American Medical Association.

Jenni Schaefer
The Meadows

Jenni Schaefer is the author of several books, including the breakthrough bestseller Life Without Ed: How One Woman Declared Independence from her Eating Disorder and How You Can Too. An Ambassador with the National Eating Disorders Association and a Meadows Behavioral Healthcare Senior Fellow, she is a sought-after presenter on eating disorders, trauma, and posttraumatic stress disorder. Harper Collins will release Jenni’s next book, Facing the Invisible Monster: How I Came Back from Trauma and How You Can Too. For more information visit www.JenniShaefer.com.

Speaker Disclosures:
Financial: Jenni Schaefer receives royalties as a published author. She receives a speaking honorarium from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Jenni Schaefer is a senior fellow of The Meadows and an ambassador for the National Eating Disorders Association. She is a member of the International Society for Traumatic Stress Studies, the Academy for Eating Disorders, and The International Association of eating Disorders Professionals Foundation.

Objectives

1. Distinguish the brain changes associated with trauma that increase an individual’s risk for developing substance use disorders and pathological exercise.
2. Assess the personality traits and temperaments that increase an individual’s risk for developing pathological exercise in response to trauma.
3. Evaluate the association between the aberrant emotional regulation that often occurs in posttraumatic stress disorder, pathological exercise, and substance use disorder.
4. Investigate the association between pathological exercise, substance use disorders, and the increased risk of suicidal behaviors.
5. Distinguish both evidence-based and alternative treatment approaches for individuals impacted by trauma-related disorders and pathological exercise.

Outline

Introductions

​Professional Perspective

• Setting the Stage: How trauma can change the brain and how exercise, other process addictions, and substance use can become maladaptive coping strategies.
• Define compulsive exercise; address underlying temperament and history traits that make it more likely that someone will develop compulsive exercise.
• Discuss diagnostic criteria for compulsive exercise, including screening questions and specific assessment tools.
• Describe neuroscience findings: trauma effects reward and habit circuitry that may contribute to compulsive exercise and other addictive disorders.
• Discuss the increased risk of suicide with both addictive disorders and compulsive exercise.
• Describe treatment approaches for compulsive exercise.

Patient Perspective

• Share personal story of seeking treatment for posttraumatic stress disorder after recovering from anorexia nervosa (binge/purge type)—complicated by pathological exercise.
• Explain the positive and negative experiences of treatment with a succession of providers and modalities.
• Identify practical skills for developing a balanced relationship with exercise within the realm of both eating disorder and PTSD recovery.

Questions and Answers

Target Audience

• Counselors
• Social Workers
• Psychologists
• Physicians
• Addiction Counselors
• Therapists
• Marriage & Family Therapists
• Nurses
• Case Managers
• Other Mental Health Professionals

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