Monthly Archives: May, 2014

Fat Chat

I remember attending a class postpartum in which all the moms brought their babies in strollers and exercised together. I was in that early phase of exhaustion and urinary incontinence (Who tells you about this prior to having children?!) I was just trying to get out of the house with baby and get some fresh air and exercise. Any exercise. There was this one woman who mentioned taking (__________) the name of a supplement supposedly helpful for losing weight. She desperately wanted to lose the baby weight. (I am deliberately leaving it blank the name of the supplement not give anyone’s ED any ideas. More on “ED” later). I have to admit in that moment I had a dual response. My Healthy-Self thought:

“Uh Oh! Steer clear! Eating Disorder false promise of thin-ness= absence of all discomfort! You know that no supplement is going to take away feelings or give you the nonexistent ‘perfect body’! Lovingly challenge her now! Tell her to love herself the way she is now and ask what else is going on? You know you are talking to yourself when you are talking to her.”

 And my very tired postpartum self, who was subject to “ED” (aka the voice of an “Eating Disorder”ed self-critic) thought:

“Ooh a way to lose weight quickly postpartum! Woo Hoo!”

Did I get that supplement? Of course not. I was 13 years recovered! from an eating disorder at that point and knew better. Did I have a vulnerability to an ED thought during that moment? Of course! I was exhausted and in the huge, life-changing rite of passage of mommy boot-camp! My body was different, my Psyche was different, and I was walking around in a sleep-deprived fog. My Healthy-Self left that group disappointed that my usually strong Eating-Disorder-Psychologist-Feminist-Crusader had not spoken up to what I knew to be true: No supplement will change the difficulty of being and becoming a mom! No supplement will teach you how to love yourself the way you are!  Losing weight is never the answer to complex life difficulties.

This is what I know to be fundamentally true for eating disorder recovery (and cultivating a foundation of love from which to live): Losing weight or trying to change your body is never the answer. The solution is never about hating, punishing, or trying to escape from your body and always about loving and accepting yourself. My clients often ask me: Always? Yes. Always. And yet it is hard to talk about this with women, in groups, where “fat chat” is so common. Andrea Wachter and Marcea Marcus, Licensed Marriage and Family therapists who also specialize in eating disorder recovery, and authors of the book The Don’t Diet, Live-it workbook (www.innersolutions.net) coined this term:

Fat chat is complaining about eating or weight, gossip about who has gained or lost weight, conversations about the latest diets, discussions about cosmetic procedures [Mummy tucks], etc…when we engage in fat chat we are missing opportunities for more meaningful conversations about our lives.

What would a meaningful discussion have been in that moment? Maybe “I feel very alone in this new mom thing. Do you ever feel that way?” Or “I wish my baby weight would go away, too, but I’m also proud I had a baby and of the baby my body grew. My body needs to rest and recover from childbirth more than lose weight right now.” Or maybe if I was being fiercely challenging “I can’t afford the luxury of fat chat right now. I am trying to find my way into who I am as a person, as a Mom, and as a strong woman who has given birth.”

The good news? I can absolutely say that now. Any of those. All of those. My warrior-self is back. Look out ED voice! Look out fat chat! Boot camp is over! And Healthy mama is in the house! Thanks to “How to be a dad” for this beautiful image:

tiger belly

10 Things Moms Say and Do Post Baby… that they said they never would

1. Talk incessantly about their labor and delivery experience.

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2. Talk incessantly about the quality, quantity, and frequency of their baby’s poop.

3. Talk incessantly about the quality, quantity, and frequency of their baby’s eating.

4. Talk incessantly about the quality, quantity, and frequency of their baby’s sleep.

5. Talk incessantly about the (lack of) quality, quantity and frequency of their sex life.

6. Talk incessantly about the (lack of) quality, quantity, and frequency of their social life.

7. Talk incessantly about the (lack of) quality, quantity and frequency of their sleep.

8. Talk incessantly about “the right parenting approach.”

9. Talk incessantly about “the right approach” to childcare, nannies, and working outside the home or not.

10. Talk incessantly about Pre and Post baby bodies.* 

*More on this in next blog

 

P.S. Have I done all of these? Of course! (Well, not incessantly). Did I say I never would? Yep.

Motherhood, Body Image, and Disordered Eating in Middle Age

I remember going to my first ObGyn visit when I was pregnant. The Doctor put “AMA” in my chart. Having worked in treatment settings for eating disorder recovery for many years, I thought she meant “Against Medical Advice,” the term clinicians use when a client is choosing to leave treatment despite their providers’ recommendations. I quickly said to my Doctor:

“I just want you to know am willing to implement any medical advice that you give me regarding my pregnancy!”

She gave me a blank stare.

I explained that I noticed she had written “AMA.”

She smiled. That means “Advanced Maternal Age.”

“Oh.” Long pause. “Oh.”

Being a mother of “advanced maternal age” is becoming more and more common in developed nations, as women work toward completing higher education, solidifying their careers, finding the right partner, and doing personal growth work prior to having children. The Center for Disease Control and Prevention reports:

Delayed childbearing in the United States is evident in the 3.6-year increase in the average age at first birth between 1970 and 2006…The dramatic increase in women having their first birth at the age of 35 years and over has played the largest role in the increased average age of first-time mothers…many other developed nations have observed increases in average age at first birth with some now averaging near 30.0 years of age. 1

What does this phenomena have to do with disordered eating and body image?

Although data regarding body image in middle aged and older women remains sparse, a study published just this past month in the International Journal of Eating Disorders suggests that body dissatisfaction and drive for thinness do not diminish with age. In a survey of 715 women just out, of which 76.5% were married with children, 4.6% met full diagnostic criteria for an Eating Disorder and 4.8% met criteria for Subthreshold Eating Disorder (SED). 2 Together, that makes roughly 10%. So that means 71 of those women with children are suffering with disordered eating.

And yet the myth persists that eating disorders primarily affect adolescents. Why?

There is a reason why the myth that eating disorders affect young women in adolescence exists. According to the National Association of Anorexia and Associated Disorders (ANAD): Over one-half of teenage girls…use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives.3 Adolescence is a huge rite of passage for a woman. When a rite of passage is not celebrated, ritualized, or supported, the growth required to complete crossing the threshold of this rite of passage goes underground. Mary Pipher, author of Reviving Ophelia: Saving the Selves of Adolescent Girls (2005), writes:

“I think anorexia is a metaphor. It is a young woman’s statement that she will become what the culture asks of its women, which is that they be thin and nonthreatening…Anorexic women signal with their bodies “I will take up only a small amount of space. I won’t get in the way.” They signal, “I won’t be intimidating or threatening. (Who is afraid of a seventy-pound adult?)” 4

Similar to adolescence, both parenting and middle age are rites of passage in a woman’s life. When not honored, seen, and embraced, these can also turn into eating disorders and body image distress. Ageing women also face the cultural taboos of not taking up too much space, speaking too loudly, or being seen and valued. They face the task of loving themselves and embracing aspects of the beauty of mortality, power, and wisdom that western media culture is terrified of in women: wrinkles, thick middles, saggy boobs, gray hair. I remember reading one article on “objectification theory” in my doctoral research that linked media and female body image obsession with western culture’s fear of mortality. Female body objectification may veil unconscious existential fears. 5 Other stress factors that affect women in middle age that are similar to adolescence are hormonal changes. However, middle age women also face different stressors such as: medical scares, death of a parent or a spouse, divorce, and career challenges. 6 Margo Maine, co-author of The Body Myth: Adult Women and the Pressure to be Perfect, writes:

Women in their 30s, 40s and beyond face increasing pressure to look slender and youthful despite years of childbearing, hormonal changes at menopause and the demands of careers, parenting and caring for aging relatives…Some researchers call it the ‘Desperate Housewives effect,’ referring to the cultural influence of the hit TV series, in which improbably thin women in their 40s prance around in short shorts. 7

It is an interesting journey being “advanced maternal age.” Sometimes I look at young(er) women or young(er) mothers and I think You look so not tired. Or Wow your stomach looks so not stretched. I remember that. That feels like a long time ago. Or I envy younger moms who are more likely to have their grandparents be present for their children’s growing up. My child will already never meet one of his Grandpas. He died before my baby was born. However, there are gifts I have being “middle aged” that I couldn’t have come by earlier in my journey. I had not yet solidified my eating disorder recovery in my twenties. I had not earned a doctoral degree in Psychology in my twenties. I had lots of ideas and lots of difficulty with follow-through. I thought being earnest would pay the rent. The concept of income needing to match or be greater than outgoing expenditures was not a concept I truly understood or felt applied to me. Because I now have financial clarity, I don’t have to “deprive,” “restrict” or  “binge” or “purge” with money, like I used to do with food in my twenties. Interestingly, though I hated my (flatter) stomach in my twenties, I now love my (stretched) stomach in my early middle age. I also have much more capacity to pause and come back to difficult interactions in relationships rather than avoid, hide, or leave. I would not have been ready for marriage in my twenties. I would not have had the “distress tolerance” skills to go toward a young child and stay emotionally present through individuation-attempting tantrums. I would have been inadvertently shaming or stuffed the discomfort with food. I can tolerate it now. I would not have been a good, or frankly even good-enough, mother in my twenties. I wasn’t ready. I remember studying for the Psychologist licensure exam learning that the executive function of the brain (the part that fully understand cause and effect and is able to therefore pause impulsive actions) is not fully developed until the late twenties, or even 30. Does that mean all women should only have children after age 35? Or that only women over 35 are good (enough) mothers? Of course not. And not all women are able to. One always has the potential to become a good (enough) mother. In fact, the eating disorder recovery process mirrors the journey of becoming a good enough mother to one’s self: allowing and embracing imperfection, listening to and honoring emotions, communicating clearly, getting enough sleep, eating in a balanced way, practicing mindfulness or spirituality, connecting with support. And THAT is always possible and always a work-in-process, regardless of one’s chronological age.

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Dr. Linda Shanti McCabe is a Mom and Licensed Clinical Psychologist who works with women recovering from Eating Disorders, Body image difficulty, Depression/Anxiety, Perinatal Mood Disorders, and New Mommy “boot camp.”You can read about her work professionally at www.drlindashanti.com

Resources:

1. T.J. Mathews, T.J. and Brady E. Hamilton, “Delayed Childbearing: More Women Are Having Their
First Child Later in Life,” Center for Disease Control NCHS Data Brief, Number 21, August 2009. http://www.cdc.gov/nchs/data/databriefs/db21.htm

2. Mangweth-Matzek, Barbara, Hoek, Hans W. et al, “Prevalence of eating Disorders in Middle-Aged Women,” International Journal of Eating Disorders2014; 47:320-324.

3. National Association of Anorexia Nervosa and Associated Disorders websitehttp://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

4. Pipher, Mary, Reviving Ophelia: Saving the Selves of Adolescent Girls (2005).

5. Grabe, Shelly, Routledge, Clay, Cook, Alison, Anderson, Christie, and Arndt, Jamie “In defense of the Body: The Effect of Salience on Female Body Objectification”, Psychology of Women Quarterly, Vol 29, 2005.

6. Harding, Anne Eating disorders: Not just for the young, CNNHealth.com, June 27, 2012. http://www.cnn.com/2012/06/26/health/mental-health/eating-disorders-not-just-for-young/

7. Barton, Adriana, “Are middle-aged women succumbing to ‘Desperate Housewives syndrome’?” The Globe and Mail, March 6, 2013.http://www.theglobeandmail.com/life/health-and-fitness/are-middle-aged-women-succumbing-to-desperate-housewives-syndrome/article578178/

8. Tiggemann M., “Body image across the adult life span: Stability and change,”Body Image 2004; 1:29-41. 9. Slevec JH, Tiggemann M., “Predictors of body dissatisfaction and disordered eating in middle-aged women,” Clinical Psychology Review 2011; 31: 515-524.

Aggressive Self-Care

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I just bought myself a book light. Yes, I still read actual books. Every night, while lying next to my child (resorted to this- see Confessions of a Failed Sleep Trainer) I read. I have been using a flashlight that is slowly wearing its batteries down and I have to shake it to get it back on. My eyes have begun to strain. Every night, before going to sleep, I have had the thought “I should get a book light.”

Why is it so difficult for Moms to take care of themselves? It is a given that I bring my child to all of his doctor visits, dentist visits, haircuts. I make sure he gets plenty of playtime, fresh air, exercise, organic food, sleep, baths. We have special time during which he gets to decide whatever he wants to do. We play games and make up stories for all of the themes that he is encountering in growth opportunities. The cars learn how to say goodbye and then come back together, share racetrack time, use their words to say when they feel MAD or SAD. The part of me that is just-trying-to-survive-as-a-Mom, however, has no time for being playful, kind, or patient with my own feelings and needs. This part wishes they would “just go away” because I don’t have time! And yet they don’t. We all know what happens when you try to rush a young child to get through feelings quickly because we don’t have time: they get bigger! Time doesn’t exist in the emotional world. Grown-ups need to care for their feelings, too. Or they get bigger. (Or turn into depression, resentment, eating disorders, alcoholism, etc)

I am in a moms-who-are-therapists group in which we spoke about aggressive self-care recently. We shared about our “ideal, but realistic” days as moms. What would we do? The answers weren’t huge changes. They were little shifts internally and externally that made a big difference: getting up ½ hour early in order to write, enjoying cooking instead of trying to just-get-everybody-fed, going OUT to dinner to have a night off from cooking, going for a family hike on the weekend instead of spending so much time on laundry, getting a haircut or a pedicure.

Why the term “aggressive”? I like this because it expresses how much it truly is an opposite action to take care of one’s self first (or at all) for many moms. As moms, we often defend and protect our child/dren’s well-being. How often do we turn this energy toward our own care? It requires attention, intention, and yes, some level of aggression. Because the cultural messages for moms are often about martyrdom and loss of self. And so turning toward, back to the self, honoring and tending to one’s self, requires fierceness. In case you didn’t notice the quote that my new book light is illuminating:

 …every day, the world will drag you by the hand, yelling, “This is important! And this is important! And this is important! You need to worry about this! And this! And this!

And each day, it’s up to you to yank your hand back, put it on your heart, and say, “No. This is what’s important.”

-Iain Thomas

PS By the way, just to name the obvious, you don’t have to be a Mom to practice aggressive self-care. It absolutely applies to eating disorder, codependency, and recovery general good self-care as well. Put on your own oxygen mask first.

 

Free Gift: Mother’s day Affirmation card

Recovery Mama’s sole purpose is to provide inspiration and hope to women recovering from Eating Disorders, Body Image difficulty, Postpartum Depression/Anxiety, and “New Mommy boot camp.” In celebration of all mothers, your mother, you as a mother, you re-mothering yourself, I am offering the following affirmation for anyone that signs up to follow this blog!   Please email your snail mail address (contact form below) so I can send you (and/or your mother) a hand-made customized affirmation card. It is ok to request a card for yourself, even if you haven’t given birth. We all have the Great and Good-Enough Mother archetypes within us.

Heart-Mother, LS McCabe, All rights reserved

Heart-Mother, LS McCabe, All rights reserved

 

 

I listen to my intuition.
There is a still, small light in me. It is the part of me that knows. It has always been there and is an intuitive awareness. It doesn’t come from books. It is inside me. I have a Mommy-intuition. It is based on connection with myself, with the part-of-me-that-knows. When I listen deeply to that connection, I know. I know what to do and not to do. I know the next right step.
I listen to my intuition.

 

lightofintuition, LS McCabe, All Rights Reserved

Light, LS McCabe, All Rights Reserved

 

When filling out the form below, Please write which image you would like

(Heart-Mother, Light, or Blue-Mother) and if you would prefer I write “Happy Mother’s Day” instead of the affirmation.

Many Blessings,

(Dr) Linda

 

 

Blue-Mother, LSMcCabe, all rights reserved

Blue-Mother, LSMcCabe, all rights reser

 

 

 

 

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