Eating Disorders Do Not Discriminate. Neither Should Feminism. Or Recovery.
Despite the myth that eating disorders only affect straight, white, thin, adolescent girls, women and men of all sizes, skin colors, and sexual orientations develop eating disorders. I remember one African-American client (details changes for confidentiality) I saw who was struggling with an eating disorder. She was a bright young woman who struggled with severe bulimia that could not get her family to support her in her recovery because “that’s a white girl’s disease.”
Here are just a few statistics:
African-American girls aged 11-14 consistently scored higher than white girls of the same age on all Eating Disorder Inventory (EDI) scales measuring features commonly associated with eating disorders except for body dissatisfaction and drive for thinness (Striegel-Moore et al, 2000).[i]
A study conducted by Robinson et al, found that among the leanest 25% of 6th and 7th grade girls, Hispanics and Asians reported significantly more body dissatisfaction than did white girls. [ii]
Chamorro & Flores-Ortiz (2000) found that second-generation Mexican-American women-those born in the US to foreign-born parents-were the most acculturated and had the highest disordered eating patterns.[iii]
Acculturation can be defined as the shifting of values from host culture from culture of origin (Kemp & Thomas). This can be one of many intersecting factors in the development of an eating disorder. One woman I worked with in an eating disorder treatment center was a first generation bilingual immigrant. Because her mother didn’t speak English, she had to spend her therapy time translating for her mother. This repeated the dynamic of being “the hero” for the family, and kept the burden of parenting
her mother on her, not allowing her to get the care and attention she needed to heal from her eating disorder. Although the mental health team I worked with attempted to find a translator to lift this burden from the client, we were unsuccessful. Another “miss” in treatment and recovery for eating disorders is the shortage of bilingual therapists and therapists not trained in cultural competence.
Eating Disorders have complex etiology and don’t occur in a vacuum. There is a cultural context in which they occur. I often explore with clients what was going on in their own life, in their family, and in a larger cultural context during the time they developed an eating disorder. There is a reason that eating disorders DO affect many adolescent girls: this is the time during which they are developing into a woman! When we look at how the rite of passage of becoming a woman is held culturally (OR NOT), this make sense. Mary Pipher, PhD in her 2005 book Reviving Ophelia explores the phenomena of how girls entering womanhood begin to collapse inwardly against themselves in a culture that doesn’t support their rite of passage into womanhood:
Why had these lovely and promising human beings fallen prey to depression, eating disorders, suicide attempts, and crushingly low self-esteem? Crashing and burning in a “developmental Bermuda Triangle,” they were coming of age in a media-saturated culture preoccupied with unrealistic ideals of beauty and images of dehumanized sex, a culture rife with addictions and sexually transmitted diseases. They were losing their resiliency and optimism in a “girl-poisoning” culture that propagated values at odds with those necessary to survive.
Similarly, when other rites of passage (pregnancy and postpartum, midlife, coming out as bisexual, lesbian or gay) are not welcomed, there is a cultural compost heap fertile for eating disorders to develop. Eating Disorders do NOT only affect straight women and the research is beginning to reflect that (All research stats from the National Eating Disorders Website, NEDA.org):
- Beginning as early as 12, gay, lesbian and bisexual teens may be at higher risk of binge-eating and purging than heterosexual peers.
- In one study, gay and bisexual boys reported being significantly more likely to have fasted, vomited or taken laxatives or diet pills to control their weight in the last 30 days. Gay males were 7 times more likely to report bingeing and 12 times more likely to report purging than heterosexual males.
- Elevated rates of binge-eating and purging by vomiting or laxative abuse was found for both males and females who identified as gay, lesbian, bisexual or “mostly heterosexual” in comparison to their heterosexual peers.
- Gay men are thought to only represent 5% of the total male population but among men who have eating disorders, 42% identify as gay.
At the intersections of misogyny, racism, homophobia, and classism are implications for where we can become curious and fierce about advocating for women – and men, and transgender people – in their recovery and their rights. Feminist theory has a history of, among other intersectional misses, not addressing the experience of women of color. Intersectionality addresses how, when more than one aspect of discrimination intersects, something else altogether emerges that is missed.
“Intersectionality simply means that there are lots of different parts to our womanhood,” Brittney Cooper, an assistant professor of women’s and gender studies and Africana studies at Rutgers University, explained. “And those parts — race, gender, sexuality, and religion, and ability — are not incidental or auxiliary. They matter politically.”[iv]
Many people, including myself, believe that this intersectionality is the next wave of feminism– and recovery.
[i] National eating Disorders Association (NEDA) website
When I work with clients recovering from eating disorders, part of the work is identifying and challenging the voice of the Eating Disorder (sometimes called “ED”). And then the work is to develop a new “Recovery voice,” one that has rainbow (instead of black and white) thinking.
This “Recovery voice” is both compassionate and fierce. It can call your eating disorder on its shit and have compassion for the part of you that is struggling.
Though I recovered from the eating disorder I had twenty years ago, I still have an “ED-like” voice that shows up as a critic. This voice has many black-and-white, non evidence-based directives. Here below are some of the obstacles the critical voice said while writing my book. (Exciting news: it was just accepted by Jessica Kingsley Publishers!)
Following what the Critic said are the challenges that helped lovingly guide me through obstacles. Feel free to try this journal exercise dialogue-ing between the parts of yourself and see what emerges for you.
Critic : You should do it alone.
Fiercely Compassionate Voice:
(The short version): Why?
(The long version): It’s easier with help, honey. Every hard thing you have ever done – recovery, graduate school, writing the dissertation, passing your licensure exams, marriage, having a baby, postpartum – has been done with help and support. Ask your community to help you with this. You do not have to do this alone!
(Note: If your critic says, “I don’t have a community,” that’s not true. Do you go to work, church, yoga, dance, music events, your child’s school? Do you have recovery friends and/or colleagues? Are you in a support group? Do you have a therapist? Do you know other writers? Pay attention to where you go and who you see every day. There’s your community. Join them. If you don’t have a community, ask people who have one how they connected into one.)
Critic: Don’t share about it until it is perfect or done.
Fiercely Compassionate Voice:
How do you feel when someone else shares about being in-process with something? Do you feel judgmental and shaming toward them? Of course not. You feel excited, empathic, and wanting to help. Just like when you are watching a movie, you know the main character will encounter obstacles, and you are rooting for them. You are on the journey with them. You want them to cultivate resilience through the hardships they encounter. You want the movie to end well.
Share about your visions and the obstacles you encounter along the way. The people who cheer you on are your tribe. Cheer them on, too. Those are your people. Keep them close. Share your “movie writing” with them and support them in theirs.
Oh, and, as your little one often repeats back to you, “There is no perfect, mama.”
Critic: The writing process should occur daily. At the same time. In a perfect leather chair (or, if in the bay area, a vegan version of leather). At the perfect desk. With a perfect cup of tea.
Alone. (Did I mention that already? Because if I haven’t, you should definitely be doing this alone. I know you are a mom with children hanging off of you most of the time. But you should still have this perfect alone-place.)
Fiercely Compassionate Voice:
First of all, you don’t really like tea, honey. If you don’t like something, you don’t have to drink it. And you could write daily, but you don’t have to. Write when you can, where it works in your life. If you are a mom with a toddler that only goes to sleep at nap time in a moving car, write in your car (once you pull over, of course)! You “should” (change all shoulds to coulds) write where and when and how it works for you. Maybe it will be twice a week. Maybe it will be every day. Maybe it will be different on different weeks, depending on the rest of your life. Flexibility and the slow, consistent, practice of showing up are much more sustainable than Rigid Must-Look-Like-This plans.
Critic: This should be done and published in 1 year.
Fiercely Compassionate Voice:
Remember your “Birth Plan” for Labor and Delivery? Remember how you told the baby how and when it was supposed to come out? And, in response, that baby clung to your womb like it was was going to stay there forever? And then the baby came out in exactly the way and time that was right for the baby? That’s the process here. The baby (book) will be done when it is done. Your job is to show up for the writing, and surrender the results. Be Anne LaMott and write lots of “shitty first drafts.” Be Dory finding her way home through the unknown: Just keep swimming. You don’t get to decide when this baby (book) comes out, and in what way. Your job is to make the baby (book). Write.
This “ED” critical voice, though annoying, is actually a great teacher. Just like my eating disorder twenty years ago gave me an opportunity to grow in ways I might otherwise have not, this critical voice lets me know when I am suffering and need to write. How do I know this? Because when I don’t write, the critic gets louder and when I do write, the critic becomes silent. Isn’t that interesting?
As a friend of mine loves to say “What’s in the way IS the way.”
What do you notice about your ED or critical voice? What emerges when you talk back with fierce compassion? What else helps you challenge it? What visions are you working toward?
May you keep swimming, keep surrendering the results, and keep traveling through the obstacles toward your happily (good-enough) ever after.
I got a new pair of glasses. Suddenly, the world is super clear. I keep looking around marveling at all I can see, the distinctness of colors and edges. Suddenly, there is focus. I didn’t realize until now how blurred my seeing used to be.
It’s kind of like depression.
Many women with whom I work struggle with depression. They often realize it after they emerge. When in a depression, the blurry fog tainting things feels like reality. Beliefs just under the surface color your experience. Beliefs like:
This is the way it is. It won’t ever change.
Why try? It won’t make a difference.
I should be better. If I just tried harder, I wouldn’t feel this way.
Other people are functioning – and thriving – so if I’m not, it must be my fault.
There are all kinds of environmental stressors that can trigger depression: work stress, losing a job, moving, divorce or marital difficulties, seasonal changes (lack of light during the winter months), having baby. Here are two surprising ones: recovery from an eating disorder and planning for a wedding. Yep. Even “positive” changes in one’s life can trigger a mood shift and/or a full-blown mood disorder.
Change is scary. Even the “good” changes! And if you have a temperament that tends toward “turtle-ness” (risk-averse, anxious, cautious, slow to warm up) then depression can emerge to “help.” Depression can help slow you down when parts of you are afraid of moving quickly. Depression can help you feel “grounded” when you feel “out of control.” Depression can mute anger or make it feel less scary. Depression can provide a source of constancy or familiarity, when it felt as if everything else is changing.
But what are the “glasses” for depression?
Just in case you think I am advocating for depression, I’m not. I am aware that depression signals something (or many things) need attention, need tending. Let’s look at some of the tools, if you are struggling with depression, that may help.
Meditation is a simple (but not always easy) tool that can assist in bringing compassion and grounding to parts of you that are afraid, angry, or overwhelmed. It can help slow down the anxious thoughts. It can help “turtles” navigate change with more ease. It can provide a tiny bit of distance away from depressive thoughts of things always being like this or things that are uncomfortable or not ok being my fault. The compassionately objective voice that can emerge in meditation might say something like:
“Huh. Have things always been like this? I can see a bigger picture…”
I can feel your struggle right now and there is nothing wrong with you.
I can see a part of you that is hurt. It might help you to tend to, and speak up for, that part.
Instead of a cutting off or lifting away from the experience of depression, meditation can assist in being with it from a larger space. It can help you not get swallowed up by it. It can be the “new pair of glasses” that brings clarity to the blurry-ness. It can help you see a bigger picture, and personalize less. It can gently place you back in the experience of being human rather than the suffering of humanity being “my fault.”
I am not a Psychiatrist. I do not prescribe antidepressants. I do know that many of the women I see are hard-working, conscientious, sensitive beings that believe they “should” be able to “just get over” depression or anxiety without medication. Shame and stigma color their vision. They believe that they should just be able to function and thrive by “eating the right food” (that is a whole other blog, but let’s just say for the record, that you are not “bad,” “dirty,” “clean,” or “good” for eating or not eating any particular food), “doing the right spiritual practice,” and working super extra hard. They compare-and-despair what they are feeling on the inside, to sleek, put-together look of other people’s outsides. They think there is something inherently wrong with them. They think they “shouldn’t” need glasses. They “should” be able to just see!
I’m here to tell you that no matter how hard I worked at being good enough, or eating the “right” food, my eyesight did not get better without glasses.
Just in case you think I am pushing antidepressant medication, I am not. Medication, like meditation, is a tool in the recovery tool box. Some people choose to use this tool and some do not. I work with women who make many different choices in this area. I am erring on the side of offering medication as a tool to – hopefully – offer a stigma free zone for people who struggle with depression to make a choice. There is no right answer for everyone. There is the right answer for you, at the right time for you. If you are considering medication, you will need to explore that question with your doctor.
Important caveat: If you are considering medication for depression, and you also have an eating disorder or are a new mom, it is wise to see a psychiatrist who specializes in those areas. There are particular needs for women recovering from eating disorders (ex awareness around how medication can affect appetite and weight, risk of seizures with certain medications if you have a history of purging) and perinatal mood disorders (ex awareness around safety of different medications during pregnancy, postpartum, and breast-feeding) that your doctor needs to have in mind.
I offer you the possibility of clarity. As it says in A Course In Miracles, a miracle is a shift in perception. If you are struggling with depression, may you find, and put on, your new pair of glasses. May you see that hope is possible. May you put one foot in front of the other (or tuck them into seated meditation position) and keep looking for a compassionate space inside yourself. May you find exactly the right therapist and tribe of friends that treat you with compassion when you forget. May you feel that change is possible and you are enough. It is. You are.
Twenty years ago, I vision-ed what it would be like to no longer have an eating disorder. I wasn’t sure it would be possible for me. But I was ready to vision the possibility. I discovered, by visioning the possibility, and then taking the actions steps into that vision, that it was possible. Every year since then I have made a vision board. Fifteen years ago, I started facilitating others in this process.
What is a Vision board?
Vision boards (also called vision collages or treasure maps) are just what they sound like: a collage of your vision! The word “board” is used when you make it on cardboard or other thick material for backing. You can also use paper or posterboard. When making this collage, you can be very specific with putting what you want 1-year-from-now as well as choosing images that make you appeal to you without knowing why. You can make sections of your collage for different areas of your life such as family, health, career, and spirituality. You can also have a “theme” for the year. For example, the theme of the year for the collage on the left was “Flow.” My most favorite option is to just glue your images on the paper as you go. As one client of mine stated “you can just slap images on the paper and trust that it’s going to mean something.” Here are some more specific suggestions.
Pick the right images (only you know what they are)
You do not need to know why an image speaks to you. Listen to your gut. Trust what wants to stay on your vision board and what doesn’t make the cut. Years ago, I had an image of a sacred family and a pregnant woman on my vision board. At that point, I was still in the “no kids” camp, and it was a metaphor for other aspects of my life wanting and needing to be born. In addition, it was an image of family healing that I needed.
However, the beauty of images is that they can hold multiple meanings. A newborn baby can mean taking good care of yourself and your new recovery, giving birth to a new business/creative endeavor, grieving the loss of a child, the desire to have a baby, or all of these.
I have had people come back, year after year, again and again, saying “I don’t know why I put that image (of Italy, or a Balinese woman, or a Hawaiian flower, or…) on my collage last year but guess what happened?” and then telling me about the synchronicities that emerged.
The person who made this collage went to Hawaii and got engaged after image-ing this on her vision board.
Make it In Real Life. With Real Supplies
For your vision collage, use actual paper, actual scissors, and actual images. Pinterest is great, but it is not a vision board. You need to be a be able to move things around, use your hands, and decide what feels right on your collage. The boundaries of your paper/board are important. You want your vision to be clear. Some things will not make the cut to being on your vision board this year. That is important to honor. Holding those boundaries for your board, (and in your life), will create the space you need for your vision. (Also, notice if you have trouble leaving any space on your board- is this true in your life? There is usually a parallel process with how you make your board and how you live your life.) Post your vision board on your actual wall, so you can see it in your actual life. Look at it throughout the year, so your body and mind can take in your vision. This will help you make it real!
Make it with Other People.
In my experience, vision boards are best made with other people. Just like recovery and motherhood, you don’t have to do it alone, and it is easier if you do it together. When you do it with other like-minded people, the experience has the opportunity to become much more ease-full and meaningful. When you run into obstacles (as happens in recovery, motherhood, and vision board making), it can be helpful to have support around you. When I facilitate the process for groups, we give each other feedback on what we see in their vision collages. Often, you are so in-the-thicket-of-your-own-trees (or your collage/life), you can’t see the beautiful forest you are in! Having other people reflect back to you what they see can be eye-opening. Ten people looking at the same images see ten different things. That can feel abundant! Remember, you as the artist of your vision board and of your life always get to decide what it means to you.
Include specific goals and intentions
(AND surrender the timeline and the way these come to fruition)
It is ok, even fabulous, to have specific goals and intentions for the year ahead. A goal is a realistic, tangible and measurable outcome. An intention is a desire and a deep orienting of the self toward a direction. Both are important. When I was pregnant and approaching my first year of motherhood, I had a “comfy, dry and sleeping like a champion” baby displayed largely on my vision collage. This was an intention. This didn’t happen for either myself or my baby very frequently the first year.
If you, like me, have a left-brain that is a bit obsessed with accomplishing goals, by all means put them on your vision board. (Important side note: Diets are not allowed in any of my vision board workshops. Diets don’t work. Diets suck your energy away from your real visions. This is not a die-t. This is a live-it.) If you struggle with impatience or perfectionism, you may need to give your self more time than originally planned to accomplish your goals and intentions. I had the goal completing the doctorate and getting licensed as a Psychologist on my vision boards for many years. It was important to keep setting the goal, again and again, with patience and perseverance.
In addition, vision boards often manifest your visions in Soul-time, which can be nonlinear and surprising in how they come to fruition. Sometimes an image you originally thought meant one thing when you put it on your collage, becomes something else entirely. That is part of the magic. Which leads to a question I often get asked:
Isn’t it magical thinking to make a collage and then expect these visions to happen in your life?
No. Let yourself dream big. And then, TAKE ACTION on it!
There is a famous quote attributed to Goethe, “Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it.” I like how the words dream and do are both here. Dream, and then DO. Obviously you have to take action to make your visions come true. But image-in-ing it is often the first step. What is most threatening, fearful and truly exciting to imagine yourself accomplishing, having, being? You have to imagine it is possible before you walk your way into it.
Because the truth is, it’s not about the collage. It’s about you letting your vision turn into the imperfectly beautiful surprise of your life. YOU are the vision you are creating.
What’s your vision? If you haven’t made your 2018 Vision Board yet, now is the time!
Dr Linda will be facilitating a Vision Collage workshop in San Francisco on January 7, 2018. For more information, go to DrLindaShanti.com or email Linda@DrLindaShanti.com
In the last blog, I introduced you to Lindsay Stenovec, Registered Dietician, and her experience healing disordered eating and becoming a dietician. Lindsay is now a Mom who works with women recovering from disordered eating. Here is some of the fabulous insight she shared with me during her interview:
What are some of the things you work with that are specific to moms recovering from eating disorders?
Something that has become more and more apparent to me is that there’s a lot of shame when a mom who’s in recovery has an increase in disordered eating. They could be in recovery for 2 years, 10 years, 15 years, but if they start to realize during their perinatal journey, they’re struggling, it brings up shame. They forget to take into account that this is actually one of the riskiest times for recovery. And a small or large amount of eating disorder behaviors or thoughts that can come back into the mind are not uncommon.
When I get initial calls for support, a lot of the self-talk I hear from recovering moms is “I feel so stupid,” or “This shouldn’t be happening,” or “I can’t believe this is happening again. I thought this was far behind me.”
I’m always really quick to say:
“This is actually something that a lot of women in recovery experience. It’s one of the riskiest times for recovery. And it doesn’t say anything about your recovery or how much work you put into it. And look here you are on the phone with me! You have totally recognized what’s going on. You’re getting support. That’s you taking care of yourself. This is exactly what you need to be doing: reaching for and getting support!”
Right off the bat it’s important to make sure that they know they didn’t do something wrong; that there is nothing wrong with them. A lot of the times disordered eating thoughts and behaviors come up as a result of the hormonal changes that women experience. And pregnancy/postpartum, are big life changes. It isn’t surprising that disordered eating “coping skills” come up.
I also see that there’s a lot of worry around body changes during pregnancy and postpartum. This is a big time of change, not just physically, but also emotionally. What I have noticed is, for women in recovery, it may take a little while to open up about that. I’ve notice a trend with not wanting to say out loud or fully express the distress around body changes, because they don’t want it to be there. They don’t want to be feeling this way about their bodies. They feel shame about feeling bad about the change in their body. And so keep that really close to their vest. But over time it starts to organically come out. For moms in recovery, just know that this could be a risky time, and seeking support can help.
(Side note: shame is such a big obstacle for recovering women. I tell my clients shame stands for the false message of SHAME= Should Have Already Mastered Everything. Let’s challenge that message, again and again. You get to be human and in-process, just like the rest of the world. And you deserve compassion, just like you offer your little one.)
How can pregnant and postpartum women sort through all the food recommendations that are in magazines, doctor’s offices, and diet-culture and find what works (and doesn’t) for them?
We do have some changing nutritional needs during the perinatal period. However, oftentimes they are presented in a way that reinforces diet culture. And so there’s some work to be done regarding how we consider nutrition. How do we incorporate that into our own bodies’ wisdom? For example, if I’m working with someone who is early in pregnancy, the first trimester is often survival mode for many women who have pregnancy nausea. The cues from your body are so strong, they are very chaotic, and they are not to be messed with. So if I were to say, as a dietician
“Hey you know you should really more broccoli during your first trimester because vitamin C is very important and broccoli has lots of vitamin C,”
and then you go home and you can’t even look at broccoli because you’re going to be sick, that nutrition information is not that helpful for you! You have to say to yourself:
“OK, vitamin C might be important, so I could probably take a vitamin supplement to help myself during this time.”
And then, in the meantime, you might be eating saltines and apples. It’s a really interesting time to explore, because the cues from your body are so strong. You have really very little choice other than to go with the flow of what your body is asking for. This level of intuitive eating- of listening to your body’s cues- can be very scary or it can be very empowering. I’ve seen it go both ways.
I believe it’s very helpful to have that dietitian with you to say something like this:
“Oh, you got this piece of nutrition information. Let’s look at whether it’s supportive or not supportive to you and how could we use it in a way that honors what your body is telling you right now.”
We really have to learn what intuitive eating calls gentle nutrition. We have to learn how we can incorporate that gentle nutrition into our lives. We have to think about the different stages someone’s at, and to realize that healthy eating doesn’t mean rigidity. Healthy eating doesn’t mean restriction or not allowing yourself to enjoy food. There is no such thing as a right way to intuitively eat. There’s only listening to your body and going by what it needs. Your body does have wisdom, and it is going to be giving you different information every day. The only way you’re going to know what it needs is to is to pay attention to it and just do the best that you can.
In conclusion? Pregnancy (and postpartum) are great times to practice:
*letting go of perfectionism and shame,
*eating intuitively and listening to your body’s needs,
*being present what what-is (rather than what your fantasy wants it to be) and
*receiving support and practice being good enough.
To connect with Lindsay’s Nurtured Mama podcast, Facebook group, and resources, click HERE
In continuing with the fabulous interviews for the forthcoming book Good Enough Mama: Taking Care of Yourself and Your Recovery During Pregnancy and Postpartum, today I want to introduce you to Lindsay Stenovec, Dietician, Mom, Recovery advocate, and host of The Nurtured Mama podcast
What made you want to become a dietician that specializes in eating disorder recovery?
My own journey definitely led me to this area of specialty. Having suffered from disordered eating and body image distress informed it. In college, as a nutrition major, thought I was doing the “right thing,” eating “healthily” when really it was diet mentality. I thought I was being a good nutrition major. I was following the rules that were given to me. I genuinely thought there was something inherently wrong with myself in my body for not being able to adhere to these recommendations that just weren’t realistic or appropriate for my body. And that would send me into these cycles of struggling with disordered eating. So, long story short, I hit this point in late in my senior year of college where I said:
“Enough is enough. I just I have to let myself eat enough food!”
I started to experiment with this, and realized I could relax around food! And I found it was actually not so scary. And shortly after that I was introduced to intuitive eating as well as the world of eating disorder treatment.
(Intuitive eating can be defined as a nutrition philosophy based on the premise that becoming more attuned to the body’s natural hunger signals is a more effective way to attain a healthy weight, rather than keeping track of the amounts of energy and fats in foods. For ten principles of intuitive eating from authors Evelyn Tribole & Elyse Resch, go to: Ten Principles )
Intuitive eating – and using this approach to eating disorder recovery – fit in very nicely with my own personal experience. I realized there was this whole world of people practicing intuitive eating and “Health At Every Size” (HAES) who were saying not only “It’s OK to eat,” but also “It’s ok to eat enough and enjoy it! You have permission to do this!” I realized, Oh these are my people and this is my jam! There was no going back.
What is diet-mentality and how did you break out of it?
Diet mentality says that a variety of body shapes and sizes are not OK and that you can’t trust yourself around portions. In my nutrition program at school, they were teaching us that you’re going to have to really work hard to help people not eat too much. It was fear-based: one wrong moved you are going to be out of control.
I remember having a discussion in my nutrition program about portion sizes and all of a sudden I realized “Oh my gosh, the ‘serving size’ on the box is just the unit of measure! Under no circumstances is this like the right amount for everyone to eat, every time they sit down to eat that food.” All of a sudden I had so much validation for myself in struggling with trying to stick with a cereal box recommendation, feeling so hungry, and thinking there was something wrong with me. I could eat more than one bowl of cereal because, even though it said one bowl was a “serving size,” one bowl didn’t fill me up!
I remember raising my hand in class and saying:
“I just realized that this is the unit of measure not the perfect amount everyone is supposed to eat! This is just a unit of measure that manufacturers picked and put on the boxes. It helps their product look good within diet culture, but it really has nothing to do with what you need in that moment.”
Everyone including the teacher just looked at me strangely, and went back to the lecture. But it was a revelation for me. Back in the day, they used to always say a bowl of cereal was part of a complete breakfast. Not your whole breakfast. And if you want to choose to have a cup of cereal, fine. But make sure to give yourself unconditional permission when you get hungry an hour later.
Stay tuned next for part two of this interview, when Lindsay discusses some of the ways she helps moms with the massive food and body changes during pregnancy and postpartum!
This week, I will share Part Two of Recovering Women and Advanced Maternal Age: A Story of Hope (and Grace, who you will meet at the end of this blog).
To read Part One of Sheira’s story, click here.
Last week, Sheira shared about some of the obstacles she worked through in order to have a baby at age 50. Here is the final excerpt of the interview in which she shares the obstacles she worked through, and the miracle that she birthed, at age 50:
There was all this evidence stacked up supporting the fearful belief that I couldn’t have a baby. It was important to go in there, make conscious those fearful beliefs, and express them. When I touched in those beliefs, I felt like throwing up. I had just tried an embryo donation that had fallen through. I touched into this very deep grief about my family life not working out. And I really felt like throwing up. That’s what my body really wanted to do. This sounds strange, but I let myself dry heave and tear up and cry all at the same time. And it was cathartic! It was a layer of grief that was so unconscious. It felt good for it to be out. So that was one of the turning points.
I had another turning point when I was deciding between two sets of embryos. I didn’t know if either one would work out. I had reason to believe I wouldn’t be able to carry a child. I was afraid there had been too much damage done. I was telling this to a friend who’s had three children. I was explaining how it doesn’t get to work out for me and I have evidence supporting this belief. She turned her around and she said:
“This sounds like depression.”
She had a word for it. It was a relief to name it as depression, as it had only ever been the truth to me. And then she said:
“Having children came really easily to me. Give your depression to me. I can help you with that.”
And she did. She put her hands out and we kind of held on each other’s forearms and I just closed my eyes and I said “OK, I’ll give it to you. I give you my depression about family.” And she just accepted it, and it ended in her unafraid psyche.
My fears finally had someplace safe to go. There was another human being who got in there with me. After, that I would still get fearful thoughts sometimes, but they just didn’t have the same hold. And then some events happened that went counter to the (fear-based) evidence.
After my second marriage ended, I knew I was going to have to do it on my own. So I got my mind around adopting the embryo and I went on an embryo donation web site. I knew two people who had embryos, and they both came forward and offered them to me. Then it became a question of what the requirements and wishes of the donating families, and which was a better fit. I decided on a certain set of embryos. Then there was a very expensive legal transfer of the embryos to my posession. There was no legal precedent for transferring embryos, so my lawyer had to do original scholarship on it. The lawyers fees and transferring the embryos from one physical location to another took a lot of time and money. But finally, I was able to move forward.
Happily (Mostly) Ever After
And then I met someone who basically was a much better suited partner for me than the other two I had chosen. For me that really settled and we entered into a long honeymoon period. I was having all this evidence that contradicted the fearful belief that I wouldn’t be able to have a family. (NOTE: Finding my partner was a very important piece, But I had already made the decision to have a baby. I know many single mothers, and anyone who wants to be a single mother, I would encourage you to do that. I made the decision to have a baby first, and then the right partner came.)
The embryos were transferred and then I began the medical procedures that I needed to do. I was in full menopause in 2009 and in 2014, I got pregnant.
I was 45 when I went to through menopause. I think it was related to my eating disorder. Eating Disorders mess up your hormones. That’s probably why I went into menopause early. My mother was 55 when she was in full menopause and I was 45. If you have had an eating disorder, the good news is you can have a baby. There’s so much help now, in so many ways, to get pregnant.
So once we had the embryos in the right place, I started doing the medical procedures. I got the green light from the head of the fertility department that we could implant. It was an amazingly easy procedure. I had a very mild dose of the pain medication and I was completely awake. There was a teeny tiny tube that had the embryo in it and they had to look at it with a magnifying glass to make sure the embryo was in it. And then they put it into me and checked with their magnifying glass that there was nothing in the tube. The they said:
“That’s great, it must be in there.”
What I want people to know is: it felt like a conception. One of the members of the embryo donation family was there, and my partner was there, and a very dedicated acupuncturist. It seems futuristic and scientific, but that’s how my baby got conceived! It was love. It was different, but it was still love. It was not anything like I pictured, but it was still great.
I was afraid to get my hopes up. My whole world had been turned around as far as what I thought I knew about finding a partner, the kind of partner that I thought would be a good partner, and what I thought I knew about how I would make my family. So I didn’t want to get my hopes up. Looking back, I realized that there was a knowing, but it wasn’t like fireworks at all. Then I went to the doctor for a real pregnancy test. And I was pregnant!
How was the pregnancy?
I have terrible insomnia and I have had terrible insomnia since I was born. I didn’t sleep through the night till I was three years old. When I was pregnant, I slept great. I could sleep anywhere. I could fall asleep in 10 seconds, get woken up, and go right back to sleep. My experience of being pregnant was I was never so calm. I still feel that way when I hold my daughter. My whole system just goes calm. And I feel her system going like that. You know we just got lucky on that.
But in other ways, the pregnancy was very difficult. One way I had recovered from my eating disorder was to learn to eat when I was hungry and stop when I was full. But I didn’t feel hungry. I actually lost weight in the first trimester. I was getting worried because I thought the baby wouldn’t get enough nutrition. People were saying I looked funny. I was at my goal weight of what I wanted to be when I was in high school. I was so skinny. Why did I ever think that was attractive? I had to require myself to eat. As the pregnancy progressed, people said the sickness was going to go away. It didn’t for me. It kept going. I was worried I was carrying small. I had an ultrasound and the technician stopped the appointment to call the doctor and say:
“We have a 6th percentile here.”
My baby was only in the in the sixth percentile of growth. I became very worried. I was instructed to stop working. I had to stay at home. I was instructed to stop exercising. Then I had to come in every week, just to make sure the baby was growing.
By about a week before she was born, my baby was in the normal range. It’s very unusual if you start out at the sixth percentile that you would get back into the normal range. I can’t say exactly what happened. The doctor thought it was because I was working at home and stopped exercising. Clearly that helped. But it’s still a mystery to me how she could have grown that much.
Labor and Delivery
10 days before the baby was born, I found a doula to interview. We met on a Friday and we planned to meet again on the following Monday. Well, on the Sunday night before I had to lay down for a nap. And I felt all this wetness. Throughout the night the fluid that was coming out was pink, and then it came out brown and the doula said:
“You have to go to the hospital now.”
My friend drove me and I got there and they wanted to give me pitocin. I had heard that there was a cascade of interventions that they give you from there. I wanted to have a childbirth with as few interventions as possible. But an hour later, I still wasn’t progressing and they gave me a drip of pitocin.
I dilated very, very quickly. I pushed with no pain medication, doing everything with the help of the doula. I pushed and her head crowned. I could feel her. I did tear, and it really hurt. I’m never going to forget how painful it was. It’s not fair to women that you don’t remember it. This should be remembered. My beautiful baby came out and she was strong. She was five pounds eight ounces at five pounds seven ounces, they take the baby into the NICU. She just made it. When they sewed me up, they were singing songs to her. It was very sweet.
The strange part was I thought I was going to have a completely empowered expansive experience when I was giving birth. I thought it was going to be like the earth mother would come through me and I would feel so competent. But it wasn’t like that. My inner critic was huge and loud every minute. It said I was doing it wrong. That’s the only voice I heard in my head. I was so surprised. I was so pissed off!
After the birth I heard them talking about me at the nurses station. They said “No pain medication?” Then the nurse came into my room and she said:
“You are my queen. I’m going to give you a tiara. All other all the other girls on this floor are 25 years old and they’re asking for epidurals. And you came in here with your doula and you did your thing.”
That was exactly what I needed to hear. I could not undo my own critic and this lovely nurse did it for me. It prompted a healing where I realized I am complete in all of my body. I can’t believe I ever rejected it. I realized I had thought the hardware was flawed. But the hardware was not flawed- it never was. The software was flawed. I had
believed that my body was incompetent and wrong. But It wasn’t my body. My body knew what to do. My actual body is like a strong and powerful tree, or a flower in its infinite wisdom.
Her name is Gracie. It’s my way of thanking the family who donated the embryos and thanking God for finally giving me what I what I had so much.
Sheira Kahn, MFT, is a marriage and family therapist in the bay area who gave birth to a beautiful baby girl at age 50. To read more about her professionally, you can visit her website here
I’m in the process of interviewing professionals and recovering women for my book, Good Enough Mama: Taking Care of Yourself and Your Recovery During Pregnancy and Postpartum. And I’m being blown away by the amazing women I am meeting. So I’ve decided to share some of the experience, strength, and hope they are offering in their stories.
But first, a bit on Advanced Maternal Age (and how it relates to eating disorders):
There are many reasons why women are delaying having a baby until later in life, including: effective contraception, gender equality, women reaching higher educational
levels, cultural value shifts, divorce or partnering later in life, lack of childcare support, an absence of supportive family policies in the workplace, economic hardship, job instability or work in male dominated fields that are not supportive of or understanding of motherhood.*
Along with reaching higher educational levels, many recovering women want to do personal growth work and solidify their eating disorder recovery prior to becoming a parent. However, delaying childbirth until after age 35 can further inhibit fertility for women that may already have fertility problems leftover from their eating disorder history.
Twenty million women and 10 million men have an eating disorder at some point in their lives, according to the National Eating Disorders Association. Fertility problems, though they can be overcome, are among the potential long-term consequences of such conditions, with some studies suggesting that eating disorders account for about 18 percent of patients seen in infertility clinics, says Dr. Leslie A. Appiah, associate professor in the University of Kentucky College of Medicine’s Department of Obstetrics and Gynecology. **
OK, enough with the stats. I’d like to get to the stories of hope because the purpose of this blog (and the upcoming book) is sharing hope: hope that recovery is possible, hope that motherhood is possible, hope in the knowledge that you are not alone.
So without further ado, let me introduce you to Sheira Kahn, MFT. Sheira is a marriage and family therapist in private practice with two decades of experience in treating eating disorders and three decades of her own recovery. For those of you struggling with hope that you can still be a mom later in life: She had a baby at age 50.
Here is her recovery story:
When I was a teenager and I was bulimic. The house where lived was filled with turmoil that I literally couldn’t stomach. Thankfully, when I moved out, I stopped purging. However, hatred of my self and my body persisted. I still hated my body and I hated every bite of food that I ate. The mental part of the disorder persisted. I was in pain and I knew that I didn’t want live that way. So I joined a meditation school where they taught us about how to work with the critic. And since my critic was always criticizing me about my body, I did what they said to reduce your critic. Every time my inner critic was loud and mean, I practiced. And my relationship with my body changed, because there was less hatred being channeled from a critic toward myself. Then, a book on hunger and fullness signals taught me how to listen to my stomach, not my critic, when making food decisions.
What inspired and motivated you to get into recovery?
I was in so much pain. I wanted the pain to be reduced. I think with some people, the coping mechanism (of the disordered eating) works to keep them numb to the pain, so they keep doing the coping mechanism. But for me I was in pain. It wasn’t a hard decision for me. I felt so bad. I thought recovery was going to make me feel better, so I threw I threw myself into it.
Did you always know that you wanted to be a mom or did that desire come later?
I always did growing up and then, in my 20s, I thought I didn’t. And then it came back. And then it came back very, very strongly. I assumed that would happen for me, as it seemed to happen so easily for other people. I had no idea that it that I would have to go through a lot actually to become a mom.
For me it was a combination of factors. I wanted to be partnered. I married someone that I had fallen in love with when I was 21. He wanted to have kids, and I didn’t. Then I changed my mind, but then he had changed his mind! That relationship wasn’t working out for several reasons. Then I got married again. I was in my I was 40’s when we started trying, so I was on the late side as far as far as fertility. It might have happened if I had felt safer in the relationship. However, I didn’t feel safe in the relationship to bring in a child. I believe this influenced my already shaky fertility. However, I knew I really wanted to have a baby, and I was ready to do whatever I needed to do. I was ready to have a baby or have a family, even without a partner who is willing to do it. I just knew that I had to go for it.
By that time there were some things in place that showed me I could be successful being a mom. I felt healed enough in myself. I had a sense of inner strength and I had support. I was making good livelihood on my own at that point, so I knew I’d be able to provide for a baby.
What happened in the decade between 40 and 50?
Three things during that decade: internal readiness, emotional clearing, and practical steps.
There was an internal readiness that I didn’t achieve until I was 48 years old. I came from a family where there was emotional trauma. There was extreme disconnection: fighting, antagonism, conflict, and fear between my parents. That set me up to have very few skills for building long term relationships. It gave me a layer of fear. When there are emotional injuries like this, it’s like a layer in your body. It felt like a layer of beliefs that went along with this fear. I thought that I would never be able to have a family. Or that it could happen for other people, but not me. I saw it happening for other people, and I believed it couldn’t exist for me. There was all this evidence that had confirmed the belief I held: Sheira doesn’t get to have family. I had been divorced once and then was getting divorced a second time. I had miscarried…
(Don’t worry! Remember this is about hope. The story doesn’t end here! Stay tuned next week for part two where we get to the Hope part of Experience, Strength, and Hope)
Sheira Kahn, MFT, is a marriage and family therapist in the bay area who gave birth to a beautiful baby girl at age 50. To read more about her professionally, you can visit her website here
*Mills M, Rindfuss, RR, McDonald P, Te Velde E,“Why do people postpone parenthood? Reasons and social policy incentives,” ESHRE Reproduction and Society Task Force: Hum Reprod Update, 17(6):848-60, Nov/Dec 2011.
** Medaris Miller, Anna “The Lasting Toll of An Eating Disorder: Fertility Issues,” US News and World Report, March 31, 2016.
(Reposting in honor of #Metoo)
It’s National Eating Disorders Awareness Week. And the theme this year is “Let’s talk about it.” Talking about eating disorders isn’t necessarily comfortable. Or pretty. Last week I wrote about women having all of their feelings, including anger, and having the right to assert their boundaries. This means a woman has the right to say no. She has a right to say no to unsolicited comments about her appearance and her body size.
When women aren’t allowed to directly express these boundaries or when there is trauma such as sexual assault, an eating disorder can become unconscious expression. For example,
- Binge eating or starving can become I’m going to make my body sexually unattractive so I can be protected from ever having to go through the trauma of sexual abuse again.
- Bulimia can become I’m going to take this food in, in a violent, self-harming…
View original post 885 more words
Since I live in an area where wildfires have been devastating communities, this is some of what I’m hearing in therapy this week:
“I’m having trouble breathing.”
“Should I keep my child home from school or make them wear a face mask?”
“Three of my friends just lost their houses.”
“I can’t seem to focus.”
“I was just starting to get my head around the Las Vegas shooting and now this.”
“I don’t even know how to take care of myself right now.”
“Donating bags of supplies doesn’t seem like enough.”
“I’t’s just one disaster after another- I’m not sure I want to bring my children up in this world.”
These are from people living near the wildfires. Not the ones who directly lost their houses, schools, churches in the fire. So you can only imagine the trauma for those impacted even more directly.
A Little About Trauma:
What is trauma? According to the APA (American Psychological Association) trauma can be defined as:
“an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and… physical symptoms like headaches or nausea. While these feelings are normal, some people have difficulty moving on with their lives. Psychologists can help these individuals find constructive ways of managing their emotions.”
Secondary trauma can be defined as “the stress resulting from helping or wanting to help a traumatized or suffering person.” (Figley, C.R., Ed., 1995).
According to Secondarytrauma.org, some of the symptoms of secondary trauma include:
- intrusive thoughts
- chronic fatigue
- poor concentration
- second guessing
- emotional exhaustion
Many caregivers, therapists, nurses, firefighters, emergency providers, and what I call “senstives” or “empaths” experience secondary trauma. Secondary trauma can result from working directly with people who experienced trauma.
But what can we do about it?
If you are feeling the effects of trauma, here are some thoughts on self-care.
- Physical self-care
A friend of mine said recently, “I feel like a baby. I don’t even know how to take care of myself during this.” Actually, thinking of baby self-care is a good clue as to what you may need. Babies need physical care and tending. If you are able to, keep regular routines of sleep, meals/snacks, hygiene (showers and baths), and stay hydrated. Obviously, physical self-care also includes staying in a safe house or shelter. In the bay area, many hotels, air b and b’s, and nearby friends/family members/colleagues are offering shelter for those who have lost their house or residence due to the fires.
2. Emotional Self-Care
When thinking about a time when you have felt grounded, ask yourself what you were doing? It may have been journalling, meditating, or spending time with a dear friend. Although tempting to NOT do these things during times of crisis, it is actually even more important to do them. This is the directive of “put your own oxygen mask on first.” You cannot be of service to others of you are unable to breathe yourself.
3. Help others
Note this comes third on the list. After you make sure you are taken care of and resourced, then you can give, whether it be through providing housing, volunteering, donating supplies, or emotionally supporting people affected by the disaster.
If you are a parent:
Here’s a beautiful acronym/summary of ways to support your child during/after a disaster or emergency from Alberta Health Services:
Remove yourself and your loved ones from danger. During an emergency or disaster, finding shelter, water, and food is the first step. Staying safe and keeping calm is important in helping you and your child in an emergency.
Eat nutritious food and drink water.
Activity. Return to your normal routine as quickly and much as possible. Try to do what your family normally did before the event (e.g., eat meals together, walk together, play games, read).
Take care of yourself! One of the gifts of both recovery and of disasters is that it forces asking questions such as: What is most important? And what do I need to take care of myself right now? Here’s to living our way into those answers.
As always, this blog is not intended to provide or replace psychological treatment.
Mentis in Napa county is one of many mental health centers in the bay area providing mental health support at low fee currently for victims of the California wildfires. 707-255-0966 ext 132 http://mentisnapa.org/our-services/#mental
The National Center for PTSD is a good resource for information on trauma recovery: https://www.ptsd.va.gov