Monthly Archives: October, 2014

PRESCHOOL AS THERAPY: 5 GREAT IDEAS FOR ADULT WELLNESS

IMG_1360(I’m guest blogging this month for a fabulous downtown group of psychotherapists)

1. All feelings are allowed.

At my child’s preschool, they have a saying: You have to get the bad feelings out to let the good feelings in. In therapy, we know there are no “bad” feelings. However, feelings such as anger, sadness and hurt don’t feel good, and they need expression. To express your true feelings within the context of a safe attachment relationship is a deep form of wellness.

“When children [and adults] experience an attuned connection from a responsive empathic adult they feel good about themselves because their emotions have been given resonance and reflection.” 1

If the bad feelings don’t come out, they stay in, which can show up later as…(To read the full article, click:
http://www.psychedinsanfrancisco.com/preschool-therapy-adult-wellness/

Grapefruit, Atkins, Paleo, Pooh: When is it a diet, when is it a disorder, and what is it really about?

bacon-strips-clipart-9Many years ago, when I was in 10th grade, we had to do a “pig lab” in which we dissected a baby pig. As a sensitive 13 year old, this horrified me and I spoke with my Biology teacher about how I would rather not participate. To which he replied, “Do you eat bacon?” The next day I became a vegetarian. By the time I went to college, 4 years later, I became actively anorexic. My concern for others had tipped into self-destruction. I had to spend the next few years sorting out what was helpful and what was not helpful for my recovery in the midst of the concerns I had for others, the world, and the difficult life transitions through which I was travelling. As we say in eating disorder treatment recovery, “it’s about the food and it’s not about the food.”

I recently gave a talk on eating disorders at a bay area hospital and one of the doctors asked me “What do you think of the Paleo diet?” To which I responded:

“I am not a fan of any diet.”

Or, as two of my eating disorder therapist colleagues say, “This is not a die-t; this is a live-it.”

Paleo, Atkins, Vegan

I have spent the past decade and a half working in eating disorder recovery programs and I cannot tell you how common it is for people with eating disorders to be vegan, vegetarian, “Paleo,” “Atkins,” or sugar/gluten free. For the record, there is nothing “wrong” with any of these. And people with sensitive temperaments, physically, psychologically, emotionally, tend to be strongly affected by what they eat. Neuroscience is now showing what we have intuitively known: what, how much, and in what way we eat changes our brain chemistry. Sometimes there are also medical reasons for special food needs. People with celiac disease need to eat gluten free; women with gestational diabetes need to eat in a particular way during pregnancy as a health necessity. However, that being said, from a clinical standpoint, I have noticed a few things:

  • 1) Western culture is obsessed with “good” and “bad” foods as well as diets. The trend changes from Grapefruit, to Atkins, from “juicing,” to Paleo, but there is always one that has the attention of people and the media as the “right” way to eat. Usually this includes moral judgments about how some foods are “good” and some foods are “bad” (with the subtext of how you as a person are “good” or “bad” according to how you are eating.)
  • 2) This same culture of diet-obsession is also obsessed with body sizes/shapes, and how the current “diet” will provide the right body size/shape/weight. Let’s be honest, there is an undercurrent of “The Thin Ideal.” In one 2004 study “Exposure to thin-ideal magazine images increased body dissatisfaction, negative mood states, and eating disorder symptoms and decreased self-esteem, on women.” (Hawkins et al 2004)
  • The thin ideal assumes that thinner is “better” (more attractive, successful, intelligent, young, and on a deeper existential level, provides “freedom” from mortality).
  • 3) People who have a temperamental risk toward internalizing stress, being over-achieving oriented, struggle with anxiety or depression, and are caring toward others (often at the expense of themselves) often obsess about food as a way to resolve complex life problems and issues.

Diets don’t work

This has been proven, again and again. Diets do not work. According to the National Eating Disorders Association (NEDA):

  • 95% of all dieters will regain their lost weight in 1-5 years (Grodstein, Levine, Spencer, Colditz, &Stampfer, 1996; Neumark-Sztainer, Haines, Wall, & Eisenberg, 2007)
  • 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders (Shisslak, Crago, & Estes, 1995)
  • Even among clearly non-overweight girls, over 1/3 report dieting (Wertheim et al., 2009)
  • Girls who diet frequently are 12 times as likely to binge as girls who don’t diet (Neumark-Sztainer, 2005)

Geneen Roth, who has been writing and teaching about the connections between emotions, food, and spirituality for decades, came up with a beautiful fourth law of Physics, which states “Every diet has an equal and opposite binge.”

Diets don’t work. They are a set up for deprivation that inevitably has a backlash. And obsessing about food is never about food.

Canaries in the Coal Mine:

So if diets don’t work and disordered eating is not about the food, what IS it about? That is the (hopefully less than) 10 million dollar therapy question that takes rigorous and compassionately curious work. I often think of people with eating disorders or people practicing disordered eating (including dieting) as canaries in the coal-mine. They are the ones that are extra sensitive to family, cultural, and environmental toxicity. If there is something not right in the family system, in the environment in terms of treatment of other sentient beings, or in the balance of power culturally (Have you ever wondered why women and GLBTQ people often struggle more with body image distress than straight men? And what they do and do not have access to?), then the person who develops the eating disorder is going to be the one saying (or acting out) “Something’s not right here! There is suffering! We’re not all going to survive!” They are the ones that are showing things are out of balance.

I share with my clients recovering from compulsive eating that putting a sign on their fridge stating “Its not in there” can be helpful. If you are looking for something in the food or a diet that’s not in the food, I invite you to ask the question what are you truly looking for? Is it kindness toward yourself and others? A feeling of well being? Is it to be seen or feel loved? Is it comfort or companionship? Relief from disappointment, embarrassment, resentment, jealousy? Is it a friend to be with you during grief? Connection with your family or community? Food can’t provide any of these. It’s not in there. I want to invite you, the next time you are considering going on a diet or eating ice cream in order to resolve any of these, to turn toward the discomfort of what is going on within you. Try not to fill it up with the distraction of food. Imagine

“…feelings like disappointment, embarrassment, irritation, resentment, anger, jealousy, and fear, instead of being bad news, are actually very clear moments that teach us where it is that we’re holding back. They teach us to perk up and lean in when we feel we’d rather collapse and back away. They’re like messengers that show us, with terrifying clarity, exactly where we’re stuck. This… [how to stop protecting your soft spot, how to stop armoring your heart] is the perfect teacher.”

―Pema Chodron, When Things Fall Apart

 

Resources:

The Don’t Diet Live it workbook, Wachter and Marcus, 1999

Neuroscience

http://www.anad.org/news/binge-eating-disorder-affected-by-brain-chemistry/

http://www.ncbi.nlm.nih.gov/pubmed/21350434

Scott E. Moseman, MD Medical Director, Laureate Eating Disorders Program Investigator, Laureate Institute for Brain Research, “Neurobiology for Clinicians” 2014 International Association of Professionals Treating Eating Disorders (IADEP) conference

The Thin Ideal:

Hawkins N1, Richards PS, Granley HM, Stein DM. “The impact of exposure to the thin-ideal media image on women,” Eating Disorders: The Journal of Treatment and Prevention, 2004 Spring;12(1):35-50.

Your Dieting Daughter (Chapter 7 “The Thin Commandments”) By Carolyn Costin

Dieting Stats:

National Eating Disorders Association (NEDA) website

https://www.nationaleatingdisorders.org/get-facts-eating-disorders

Compare and Despair

Identifying, Naming, and Taming the inner critic

I am your Critic: I protect you from vulnerability, but I feel alone and uninvited.

I am your Critic: I protect you from vulnerability, but I feel alone and uninvited.

Many women compare themselves to others. Women recovering from food, weight, and body image issues and, often, new mothers, have often honed this skill to an excruciatingly sharp pointed edge that goes right back into the self. As a colleague of mine has put it “an eating disorder is an over-developed superego,” and “Supermom doesn’t exist, but we all keep desperately trying to be her.”

Some common self-judgments for women in eating disorder recovery that I often hear include:

  • If [insert body part such as stomach, thighs, or arms here] was different, I would be more successful in my career, lovable in romantic relationships, and not have these feelings (ex: anxiety, depression, anger, sadness, shame).
  • If I were not eating this [insert “bad food” here], then I would be “better,” “good,” not feel this way (see above list).
  • “She’s thinner, and therefore more attractive, lovable, worthy, than me.”
  • “She’s sicker than me, and therefore deserves treatment/to get better more than me.”
  • “She has a real/valid reason for an eating disorder (ex history of abuse) and I don’t.”
  • “There is something wrong with me that can never be fixed or healed.”
  • “She’s in a romantic relationship and therefore more lovable than me.”
  • “None of my romantic relationships have worked, so none will ever work.”
  • Her eating disorder (whether it be starving, bingeing, or purging) is more dangerous than mine. I don’t deserve to tend to my recovery and self-care because it’s not that dire or important.
  • I’ll never be a Mom if I can’t even take care of myself.

OUCH! Obviously they all fall into the categories of Great-Palace-Lies and Cognitive Distortions such as personalizing, emotional reasoning, and globalizing. New moms, like women in early eating disorder recovery, are also in the terrain of developing a new self identity. Growth periods such as these are often when the critical voice is loudest. Below, I have named a few of the many critics that attack many moms internally:

  • The ecological critic: That mom has never used any kind of plastic in her child’s lunch, even if it is BPA free. All her food has been made from scratch and the vegetables have been grown in her organic backyard garden. If I use plastic, have anything not made from scratch in my child’s lunch, I suck as a Mom.
  • The Body-image critic: She lost the baby weight sooner (or at all) and is therefore a more attractive, functional, lovable successful career woman/mom/wife.
  • The stay-at-home-mom critic: I am mommy-tracked and my skills are not valuable/outdated/my sleep-deprived brain-body doesn’t remember how to have a career. I can’t move ahead with my career, because people won’t take me seriously anymore.  
  • The work-outside-the-home-mom critic: My kid(s) are more attached to the nanny than me. I should start saving for therapy now, as I’ve probably already damaged them with abandonment issues/insecure attachment.
  • The Attachment-parenting critic: I stopped wearing and co-sleeping with my baby, and therefore they feel traumatized and insecure. I should breastfeed at all costs for the first three years. Moms who leave their kids in daycare are bad.  
  • The Feminist Mom critic: I should be able to bring home the (vegan organic) bacon, fry it up in a pan, while simultaneously playing with my non-screen watching child after writing an updated introduction and research study on The Second Shift and presenting it to the National Association of Feminist Sociology conference.

OK, so I have an overdeveloped Superego (Critic). What do I DO about it?

Here are some strategies for combatting the critic and assist yourself in arresting the Compare and Despair Trap.

  1. NOTICE IT.

In eating disorder treatment, it is often encouraged to notice “ED” (the voice of the eating disorder). You can also think of this as “Inner Critic.” Although this can be painful (it is not a kind voice), it is important to notice that this part of your self is just that- PART of you, not all of you. And as you start to notice it is not all of you, you can then begin to cultivate other parts of you that are more fiercely kind and compassionate rather than shaming and harmful toward you.

  1. NAME IT.

Naming the “ED” or “Critic” voice can be helpful in continuing to separate and dis-identify from it. It can be fun to make a collage, picture, or funny character name for it. Though this may sound silly, it can actually help take some of the power away from it. Sometimes I think of my critic as a Spikey haired teenager: it looks fierce, but really it is a soft mollusk inside and the spikes are trying to protect its vulnerability. This allows me to invite the scary-looking critic back into my larger Self rather than try to cut off from it.

  1. GET SUPPORT

It can be hard to develop a fiercely compassionate voice within yourself to assist in combatting the critical voice and making peace with/tolerating distressing emotions. Sometimes a wise therapist, person further along in recovery or motherhood can be helpful to verbalize kind, discerning support until you can cultivate strengthening this voice within yourself.

  1. IF YOU ARE GOING TO COMPARE, BE FAIR.

For example, if you are a newly postpartum mom, when you wear a bathing suit, it is NOT fair to compare yourself to an airbrushed image in a magazine or even a woman’s body who hasn’t given birth. Your body is different. If you MUST compare, then compare to another newly postpartum mom (though my recommendation would be to talk about what is really going on regarding the stress of being a new mom!)

  1. FIND AND CULTIVATE A REGULAR CREATIVE AND/OR OR SPIRITUAL PRACTICE 
I am your Heart. If you listen to me, your critic will soften.

I am your Heart. If you listen to me, your critic will soften.

Fighting the critic needs to include rather than cuting off from your feelings and your body. This can be sitting meditation, moving meditation, writing, collage-ing, art-making. It is usually an activity that includes the right (creative) brain and somatic (body) awareness such as movement or following the breath. You will know that you have found a practice that works for you when you discover (usually after the fact when it returns) that your inner critic was quiet for a time. Cultivate that activity, whatever it is for you. Keep returning to that Big Mind, Big Self, Coonected-ness again and again. Your critic will start to lose its power when it is invited into a larger, more spacious creative and enticing place to be. I will end with an affirmation borrowed from 12-step program reading: Just for today, I will not compare myself to others. I will accept myself and live to the best of my ability. Don’t compare—identify. Don’t intellectualize—utilize. To keep it, you have to give it away. You can’t give away what you don’t have. May the growth continue!

Resources:

Self-Help: Taming Your Gremlin: A Surprisingly Simple Method for Getting Out of Your Own Way By Rick Carson 8 Keys to Recovery from an Eating Disorder By Carolyn Costin and Gwen Schubert Grabb Creativity and Spiritual Practice: Women, Food and God By Geneen Roth The Artists’ Way and The Artist’s Way for Parents By Julia Cameron Soulcollage Evolving: An Intuitive Collage Process for Self Discovery and Community By Seena Frost Sweat Your Prayers By Gabriel Roth Buddha Mom: The Path of Mindful Mothering By Jacqueline Kramer Humour: Shitty Mom: The Parenting Guide for the Rest of Us By Laurie Kilmartin, Karen Moline, Alicia Ybarbo and Mary Ann Zoellner Ketchup is a vegetable and other lies moms tell themselves Robin O’Bryant

%d bloggers like this: