Kristina Saffran was kind enough to share some insights about her own recovery, as well as the important work she is doing with Project HEAL. Project HEAL offers hope for everyone with an eating disorder, as well as treatment scholarships.
For more information about Project HEAL, please go to http://theprojectheal.org/
Full transcript –
Kathy Cortese: Hello, and welcome to ED Matters. I’m Kathy Cortese, your host, and it is my pleasure today to welcome Kristina Saffran. Good morning, Kristina.
Kristina Saffran: Good morning. Thank you for having me.
Kathy: My pleasure. I’m going to start off with a brief bio. Kristina Saffran graduated from Harvard College with a bachelor’s degree in psychology in May of 2014. She’s currently working as a research coordinator in the Department of Psychiatry at Stanford. Kristina hopes to pursue her PhD in clinical psychology and go on to treat people with eating disorders. In addition, Kristina and a good friend started Project HEAL which we will get into more detail later in our conversation. Kristina, you bring a wealth of personal information and an enthusiasm to the field of eating disorders. And I guess we’ll start at the beginning when you were in the fifth grade, ten years of age, you were diagnosed with anorexia nervosa. What can you tell us about that time?
Kristina: Yeah. Absolutely. I think the biggest thing I realized now is that I am someone with a strong genetic predisposition to developing anorexia. We’ve looked for so long for what was it, what was the trigger, and I really think it was something as innocuous as my babysitter was dieting. I was a small kid, never overweight at all, never really concerned about anything but just saw her and said, “Hmm. Let me kind of try that.” And interacted with my biology in a very negative way when I started to diet and lose weight. Things began to unravel. There’s no specific eating disorder history to my knowledge in my family. But there’s a tremendous amount of anxiety, perfectionism, negative affect that I think would create that perfect storm in someone like me. So yeah, I think that’s how it began at ten.
Kathy: M-mm. Risk factors and then sort of an environmental something. Yeah.
Kathy: You did recover to a degree, and then there was a relapse at age 13. And one thing that I think is not particularly uncommon is that when individuals have an eating disorder, they often adopt that as their identity, and that seems to be part of your experience. And if you could sort of educate our listeners to your understanding of that why it seemed to click and maybe the potential serious dangers of that.
Kristina: Yeah. Absolutely. So I relapsed when I was 13 and ended up–I mean that was a serious period of illness that I remember. In summary was kind of not in freshman year of high school at all. I had four hospitalizations over a total of that whole year, kind of in and out. And I always say that that’s the part where the eating disorder identity really began to take over where I didn’t want to get better. I had doctors tell me you’re going to be a chronic case and I was like, “That’s awesome.” I looked at the older women in treatment who had been suffering for 20, 30 years. Revolving door cases they would call them, and I was like how can I be like them. It was my identity and it really made me feel special and gave me a purpose. I think part of it too was that I was entering high school so I missed my freshman year of high school. I went from being before the relapse as kind of social butterfly type. In middle school, I’ve really thrived. I did really, really well and began to relapse at the end of middle school. And right as I was going into a brand new high school that was going to the largest Catholic high school in America with 3,000 students, and really, little fish, big pond and didn’t want to go back. And so every time I would get out of the hospital, I think it was terrifying to go back and to kind of start fresh all over again in that environment where being sick became easier. And I think added to that, there was a safety and a security in treatment and a sense that people really understood me and got me. I think it was hard to transition back into high school where a lot of my peers and the things they talked about and cared about seemed superficial and shallow to me. And now some of that is a healthy maturity and kind of I was wise beyond my years. But part of that I think is a real danger when you have a disorder like this, and it is hard to re-integrate into a “normal” adolescent life after an experience like this. But you do want to get there because ultimately, I did want to re-integrate back into high school with my normal friends and be able to talk about schoolwork and boys and college.
Kathy: And stuff, yeah.
Kristina: All of those things.
Kathy: Yes. But now on your own, you made a decision to get involved in family based therapy. FBT. Family based treatment or no?
Kristina: On my own? I do credit that as being the smartest decision I ever made. Can I say that that decision was fully my own? Not exactly. Basically, what ended up happening is I got out of treatment for the fourth time within that year, did well for a little bit, began to slip a little bit. And my parents at that time were like, “This is it. We can’t do this anymore. You have a choice. You’re either going out to a residential treatment center out west for a long time. Or we will try this.” It wasn’t called FBT back then. We kind of did a modified monthly approach. And to be completely honest at that time, there was nothing more that I wanted than to go to a long-term treatment center out west. I like the treatment. It was safe, it was comfortable. People understood me, people got me. The thought of really entering, starting high school, sophomore year, terrified me. And that idea was really compelling. But somewhere in my mind, I knew that treatment was easy and every time I came out of treatment, it just got harder and harder and harder, and somewhere I knew that like, “Oh my God. If I go away for many, many months and I didn’t come back. I’ve missed two years of high school, this is going to be really, really challenging. I might as well kind of face this in the moment.” And I think at that point too I had reconciled myself to the fact at least I didn’t want recovery necessarily, and that was actually something that I don’t think I ever woke up any day. I was like I really, really want this. It’s a really slow gradual process. But I had at least transitioned to the point where I didn’t want to be sick forever.
Kristina: I knew that. I didn’t want be that person who had been in the hospital 20 times anymore. And I was like when I’m 40, this won’t be my life. I don’t know when I’m going to turn it around, but I didn’t want that. And so that was at least enough motivation to kind of give this a try.
Kathy: I think that’s a great point for people who are listening to hear that you were not like super gung-ho, some people are like I choose recovery. But you were sort of on this balanced beam. There’s a part of me that’s in this direction, there’s part of me that’s in that direction, but I think I’m going to hang over on this direction.
Kathy: I think that kind of interesting spot really is active for many, many people. And the good news is where that took you. So the shift, let’s continue to talk about how things shifted and continue to shift.
Kristina: Yeah. First, to just follow up on your point there, I think that’s so true and it’s so important. I think there is a myth that still is out there that you will wake up one day and really want this. And for most people, that doesn’t happen. For most people, recovery really is ambivalent at best and the biggest motto of my recovery honestly was autopilot. Like I made a conscious choice that I was going to do it and I went on autopilot for a year, and really, really hated myself throughout the process. Like recovery sucks. It’s a really, really hard challenging process where you honestly hate yourself every minute of everyday and then it gets a little better, a little bit better. But you just kind of got to go on autopilot and have this blind faith that it will get better and the end result will be better. And I think people need to hear that because if you’re going in expecting that recovery, the process of it is going to be wonderful and butterflies and rainbows. They’re going to be like oh my God, what is this? This is horrible.
Kathy: You call it autopilot. I tell my clients it’s mechanical.
Kathy: It does not feel like it’s you.
Kathy: So don’t expect it too. But I’m not being true to myself. Right.
Kristina: Yeah, exactly. That’s your eating disorder. You can’t give your brain a minute to think because ED will come in and manipulate. So that was really important. I think where did the shift begin to happen…Family based treatment was incredibly important for me. And I say that that was a pivotal, pivotal turning point in my recovery because I wasn’t ready to do all the behaviors alone and so it’s really important for my parents and actually my best friend in high school supervised my lunch during school, and for them to come in and do that. I think about six months in, my parents started to hand back control of the food intake and it was incredibly tempting to relapse and to go back to behaviors. But at that point, I had already built up enough good stuff. I was starting to make a good friend group of my own that I was hanging out with on weekends. I was really into acting in high school so I just got a role in a school play which was really exciting. I was starting to do very well academically and kind of flourish in my classes. And so there was enough there that I was like let me just stay a little bit more. I mean a good analogy that I used for a lot of my recovery was put your eating disorder in a box in a closet away. And you can always go back to it. It can always be there. But let’s keep going and let’s keep staying, and it was as gradual. Yeah, let’s keep trying this a little bit more. It’s not so bad. And life began to take over. It was incredibly slow and incredibly gradual. I mean I don’t know where that point was where I was like, “Oh my God, this is great.” But I know it took–I would have told you a year after getting out of the hospital, after I was really like weight-wise behaviorally recovered and doing everything right, that I was fully recovered because I was doing so much better. I mean a year after, I really did feel like that. It wasn’t until two years after that to three full years after I was fully weight restored and behaviorally okay, that I was like, “Oh, this is really full recovery.” I think it takes a really long time to get into that. Or at least three years at that point seemed like a really long time. But in the scheme of things, it happens. You just have to hold on.
Kathy: Right. And I think that’s our great segue to something that you began when you were 15 years old. Is that accurate?
Kathy: And I’m going to read a little something about Project Heal. Project HEAL, Help to Eat, Accept, and Live is a 501(c)(3) non-profit organization that raises money for people with eating disorders who are not able to afford treatment and promotes healthy body image and self-esteem in hopes of preventing future eating disorders. The co-founders met while undergoing treatment for anorexia nervosa when they were just 15 years old, helped each other to reach full recovery, and then wanted to help others achieve it as well. And the co-founder is your dear friend Liana Roseman.
Kathy: The philosophy for Project HEAL is recovery is possible. When people who suffer from an eating disorder are able to receive comprehensive treatment, they can regain a healthy relationship with food and live full and happy lives. Project HEAL knows this is true through the firsthand experience of its founders, supporters, and volunteers, as well as through the testimonials and success stories of the organization’s grant recipients. So take us on this fascinating and remarkable journey because we’re only talking, what, nine years into Project HEAL?
Kristina: Eight years.
Kathy: Eight years, okay.
Kristina: We’ve grown a lot. It’s crazy. So we started Project HEAL really naively as 15-year-olds. Liana and I had been in treatment as I just told you. Not incredibly motivated to get treatment and we’re lucky that we had parents who pushed us in and insurance would pay for it and parents who could cover one insurance wouldn’t pay for. And we saw so many people being kicked out of treatment before they were ready or released. And that’s not talking about any of the people who weren’t able to get treatment at all. We got out treatment and realized oh my God, 30 million Americans suffer from an eating disorder and only 10% get treatment? That’s absurd. And we needed to do something about it. And so that was the initial driving force of Project HEAL. I think additionally, some factors that went into it is we got better and talked and helped one another in recovery. We realized that God, we come out of treatment with all these healthy coping skills and affirmations and this is how you should eat and interact with your body. And realized that it wasn’t just our eating disorder peers who had issues, but a lot of our friends in high school who also were dealing with these issues. And then third, I think that when we were in treatment, we really lacked a role model of recovery. Somebody who we could look to and be like, one, this is possible, and two, this is really worth it. To go through that hellish process, you want to have a role model to look to. Like wow, their life looks pretty good. Like this looks like they’re having fun, they’re enjoying themselves and it’s worth it. So we wanted to service those role models. And so Project HEAL was born through that. And yeah, we’ve grown tremendously in the past eight years. Our major mission is to fund-raise for treatment like I told you.
Kathy: Roughly when you started, one scholarship, two scholarships, how did it start and where did it grow from there?
Kristina: We were doing like one or two scholarships. Really, one scholarship a year for beginning of it because treatment is about $30,000 per month, and often not covered. So it’s very expensive. We started in the past two or three years. That’s when our massive growth has been. We started partnering with treatment centers across the country. So we partnered with 16 across the country that basically agreed to provide a minimum of one free treatment per year for our applicants. And so this is amazing because it enabled us–I mean I think last year, we funded 18. This year, we’re on track for over 20. So it’s a lot of exponentially increasing amount of people that we fund. And also, because we tried to send most people who need residential to our treatment center partners, we’re able to now fund a much more comprehensive recovery process from obviously travel there and back, family visits, but also that critical step down after care. The partial programs and then the outpatient for many months after to really make sure you get a full recovery.
Kristina: Some people need a round two and we really make a commitment to stay with our applicants to help them really, really achieve full recovery.
Kathy: Applicants. Okay. Because not everyone is familiar with how one would go about this process. So how does one go from I need help, we don’t have the money, to perhaps being a candidate.
Kristina: Yeah. They can apply directly on our website. It’s all online. We have a rolling application process that we review quarterly with a clinical advisory board of the experts in the fields. It’s a hard process because we’re getting about 600 applications per year. So that’s a huge need. Our number one criteria is motivation which is obviously a fuzzy criteria but one that I think we do a really good job of trying to nail down. We ask a lot of questions about motivation to get better, what do you view as recovery, what are your views, your strengths and weaknesses, what are the assembling blocks, how do you plan to overcome them, etc etc. And really, because it’s online, we’ve relied on how much people really get into it and write and tell us about their hopes and dreams. Additionally, because we do have such limited resources and there is such a huge need, we do prioritize applicants who were likely to do well in treatment based on predictors of success, shorter length of illness, younger age, fewer co-morbidities. That being said, it’s not an exclusion criteria. And we’ve had applicants who do not fit those categories, who go on to be successful recipients. They just really need to articulate like have you been in treatment three times before? Why is this time different? What happened? And have that real insight and motivation to recover. And that’s what’s so amazing to me about our applicants. And so in just about the fact that they don’t get healthcare is because such a huge part of recovery from an eating disorder is ambivalence about recovery. And so we’re really getting those applicants who already passed that or just like “I want treatment, get me somewhere and I’m ready to hit the ground running.” And they really do.
Kathy: Yeah. A wonderful inspirational story. You are setting the world on fire, I think, you and Liana with your passion and your wonderful intentions. And I’m sure there are many, many people who are very grateful to you. I am. And I want to thank you so much for your time and also for the work that you do in the eating disorder community.
Kristina: Thank you so much.
Kathy: Thank you, Kristina.
Kristina: Thank you for having me.