Guest: Dr. SooMi Lee-Samuel MD, MA
Presenter: Neal Howard
Guest Bio: As the Medical Director at Timberline Knolls, Dr. Lee-Samuel supervises the medical staff and sets the overall vision and direction for the treatment program. She had a private practice for several years and was an Assistant professor at the University of Chicago. She also served as the Director of Psychiatric Services for DCFS of Illinois. Doctor Lee-Samuel attended Wellesley College, the University of Cincinnati College of Medicine and the University of Chicago–Harris School of Public Policy. She is a member of the American Academy of Child and Adolescent Psychiatry.
Segment overview: Dr. SooMi Lee-Samuel, medical director of Timberline Knolls Residential Treatment Center, talks about the treatment of women and adolescent girls struggling with eating and mood disorders.
Health Professional Radio – Getting Help With Eating Disorders
Neal Howard: Hello and welcome to the program today. I’m your host Neal Howard here on Health Professional Radio, thank you so much for joining us. Our guest in studio today is Dr. Soo Mi Lee Samuel, she’s a board certified psychiatrist and Medical Director of Timberline Knolls Residential Treatment Center, specializing in treatment for women and adolescent girls who are struggling with eating disorders and much more. Welcome to the program Dr. Lee Samuel.
Dr. Soo Mi Lee Samuel: Thank you for having me.
N: Thank you. Tell us about Timberline Knolls.
S: Sure. Well Timberline Knolls is a residential treatment facility, we are located in Lemont, Illinois which is about 30 minutes outside of Chicago, Southwest of Chicago and we are a treatment center that specializes in treating adolescent girls and women with eating disorders, substance use issues, and addiction behaviors as well as mood and anxiety disorders.
N: What else do you involve yourself in there at Timberline?
S: Yes. Well, I obviously as Medical Director, I have administrative duties and then so I oversee the staffing for the nurses, our mental health specialists. I assist our Director of therapy services with her staffing as well and then I have my own caseload where I work with individuals and work with patients directly as well too. I feel that it is very important as a Medical Director to continue to have direct patient care and contact so I can stay up to date on what’s going on, on our lodges that’s where our residents stay and what’s really going on with the treatment teams and how things are working clinically.
N: Obviously in the field of psychiatry there are so many, many specialties. What is it that drew you to working with women as far as eating disorders are concerned?
S: Right. Well I think that as a woman, all young girls and women, we struggle in some capacity – it may not be to the point of full blown diagnosis of anorexia or bulimia, but I don’t know any woman who has not struggled in some point in their lives about eating issues. Whether it’s just maintaining healthy eating habits, understanding nutrition, and then being self-conscious about their body image and how they look and this in turn plays a part into developing you own self-esteem and you own self-worth. So for me, I attended an all women’s college and so I became very much interested in women’s issues since college, but to the idea of working with adolescent girls and women who struggle with eating issues and with mental health issues, where I personally know what that’s like and I think a lot of women just generally in the population know what it’s like. Especially around the holidays, ‘am I eating too much’, ‘am I eating healthy’, all of that, even though it may not be in the forefront of your mind, we have these thoughts that play a part in our society and so, I think that is something that is true, not only in myself, but a lot of our staff members into wanting to work with this patient population.
N: You mentioned two eating disorders. I’m going to assume that those are the two most, we hear about them more – anorexia, bulimia – are those the only two types of eating disorders?
S: No, there are other eating disorders. There’s binge eating disorders as well too and there’s a category of what we call eating disorder not otherwise specified and actually that is the most common diagnosis that we see. And so the women that we see may not have the strict criteria needed by the DSM-5 for anorexia, they may not be 85% body weight, they may not be overweight restricting, but they have disordered eating habits. And so we call it as a more general diagnosis of an eating disorder, where you really have eating disorder behaviors, so you may not be 85% of your body weight, you may be 95% of your ideal body weight so you may be normal with the normal limits, but you may be still struggling with restricting and calorie counting and wanting to exercise. And that is what we most commonly see is this eating disorder not otherwise specified. We definitely also see our women with bulimia who actively purge, by overly exercising or by making themselves throw up and we also see the anorexic diagnosis as well too.
N: Do you find that women are affected more severely than adolescents or is it kind of a case per case basis?
S: Yeah. I think that we definitely are seeing adolescents who start with their disordered eating behaviors and the youngest I’ve seen someone starting to really engage in dieting behaviors was that aged 6 or 7. You pick it up very early, and then we see adolescents who have it and who have the disordered behaviors and that’s why we have two adolescent lodges so we can definitely address those issues relating specifically to the adolescent population. But then a lot of our women who are coming in are women who’ve been struggling since adolescence or since their early 20’s and they just struggle with it all their life and it’s just very hard for them and the difficult thing with eating disorders is that it’s not something that you can avoid. We need to eat to maintain our life, it’s not like alcohol where we can avoid alcohol or we can avoid a substance like heroin to live. We need to eat to live and so you have to learn to develop this healthy relationship with food and so being in a facility where you cannot only regain healthy eating habits, but learn to have this healthy relationship I think is really important.
N: In your experience, do you find that there is a high level of picking it up early? Are these eating disorders that you encounter usually a result of someone, an outside influence say, watching someone, how they live, or the advertising on television, or peer pressure? Or is it usually something from within that person that they just can’t seem to let go of this disorder?
S: Right, yeah. I think it can come from a number one of many different places. So we see about a large number of our women actually have a history unfortunately of some kind of sexual abuse or trauma. So the eating disorder develops as a response to some trauma that has happened that they’ve not been able to manage or they’ve not been able to process properly and so the behaviors turn into controlling your eating and restricting what you put in your body because it’s a way that control that part of your life. You cannot control what happened to you as a child when you were sexually abused but you can control what you eat and you can control how you look. To take it a step further, some of our women will do this so they don’t develop their menstrual cycles, they maintain a very boyish figure so they do not become sexually attractive. Again, this is in response to their sexual trauma history, they do not want to be seen as growing women because they were abused when they were younger. And then we have some women who have an undiagnosed depression, or anxiety, or maybe obsessive-compulsive disorder, so they have some psychiatric issues going on. And so in order to maintain control over that, they developed these disordered eating habits that then become very restrictive or they may purge as a response to cope with their undiagnosed and untreated mental illness. So it can come from a number of different places and that’s why I think it’s really important when you’re working with these young women who are presenting with disordered eating to really try and figure out well where is this coming from. Is there something else going on that’s contributing and making these behaviors worse? Because if you have a history of sexual trauma, you can do all the work that you can for the eating disorder, but if you don’t get at the underlying sexual trauma history and really work to resolve that, then there’s always going to be that hanging around and there’s always going to be that influencing your behaviors.
N: Now based on what you’ve just told me and based on the fact that you have in-house residential facilities, what type of support does Timberline Knolls offer to the family members of these young women and adolescent girls when it comes to dealing with not only the disorder but the underlying cause be it sexual abuse, or a physical trauma, or something like that, sometimes not known to the family member.
S: Right and so we really take that into account. Everyone who comes into our facility, all the adolescents get assigned an individual therapist and a separate family therapist, and then the adult women get assigned depending on their history, either a separate family therapist or they may have one person who does both roles. And what we really try and do is engage the families very early on and have family sessions with the individual in our center, most a couple of times a week. So we offer individual therapy for our residence, but then we also offer family therapy for our family members, and then in addition to that, we will also offer courses and classes on how to sit with their daughters or their loved ones when they’re eating a meal, how to manage the behaviors while they’re eating and how to be present with them. And so it’s almost like a parent training and a family training that we offer but we feel that’s very important and necessary because we need to not only give support to our individuals who are with us, but they’re going home to their family members after they leave our facilities, so we need to make sure that we support the families and give them support systems as well too, so they know how to manage what’s going on.
N: Great. Where can our listeners go online and get more information about Timberline Knolls and help with eating disorders in general?
S: Absolutely. Our website is www.timberlineknolls.com, we’re available 24/7, we’re really here to help the individual and even if we’re not the right fit for that particular person who calls us needs, we have enough resources on our belt that we can probably refer them to somewhere in their state or in their country, so they can pursue and get the services that they need that’s going to be appropriate for them.
N: Thank you so much for coming in today.
S: You’re welcome, thank you for having me.
N: Thank you. You’ve been listening to Health Professional Radio, I’m your host Neal Howard, in studio with Dr. Soo Mi Lee Samuel, board certified psychiatrist and Medical Director of Timberline Knolls Residential Treatment Center. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm, and you can subscribe to this podcast on iTunes.