Category Archives: anorexia and bulimia recovery

The Weight of Hope

I’ve been struggling with hope recently. I have two sick loved ones, democracy in America is crumbling before our eyes, healthcare coverage is in a shambles, many of my clients have been in crisis. I have been feeling the weight of this. I’m not going to go into details because, as a wise colleague of mine advises: don’t disclose a story until you can be the messenger of hope. Then it is medicine. Before that, it is spewing more unhealed shit into the world. (For the record: it is wise and helpful to disclose the story that is still in-process in your therapy! That is the place to spew it so you can get to the medicine!) One place I find refuge when cynicism, grief, and despair are fighting to take down hope, is to go to those who are carrying the torch. For me, one of those people is Marianne Williamson. In a Beautiful Writers podcast interview, here is what she had to say about hope:

“Hope is born of participation in hopeful solutions. So when your hope is intimately connected to your own sense of responsibility to provide hope for others, then it’s something beyond optimism. It’s knowledge.

If I want something down on the ground and I let it fall from my hands, gravity will take it there. I don’t just hope that gravity will work; I know that gravity will work.

If you’re an airline pilot and you can’t see the horizon because there is a strong cloud cover, you still know the horizon is there, you just know that today you can’t see it. So the pilot doesn’t just hope that the horizon is there, s/he just knows that s/he can’t see it right now so in that moment, you fly on instruments.”

flight-mountains-sky-flying

What does it mean to fly on instruments in recovery?

It means acting as if the horizon is there. It means following your food plan. It means showing up for your support system: meetings or group, therapy, nutrition, doctor. If you are further along in recovery, it means providing service to the newcomer, your friends, or your clients. Tell them you’ve been there. Be a listening ear. Provide hope for them. Be the message that it is possible. Remind them of the horizon they can’t see.

And in Mommyhood?

Similarly, flying on instruments in motherhood means acting as if, even when you have lost sight of the horizon. Show up for the daily tasks: make breakfast for you and kid(s), pack the lunches, take a shower, get some sunshine and outdoors time, practice gratitude for what you can see in the present. Last night my little one expressed gratitude for the air.

“Thank you for the air, sunshine, mama and papa, and my hamster.”

It is good to be grateful for the air we breathe. It is god to listen to the little ones. They are the carriers of hope. It is good to practice gratitude for loved ones, air, sunshine. This is the fuel that will help us keep going when we can’t see the horizon.

Back to Marianne. She says:

“We are living in an extraordinary time…”

[I know – my pessimistic critic isn’t fully on board with this silver lining either, but let’s just act-as-if the horizon is there]

“…Blessed are those who have faith that cannot see. So hope in things unseen means knowledge of things unseen.”

May you find this knowledge in your daily actions today. May you breathe the air of hope, eat the food of hope, be the message of hope. Hope doesn’t mean pink icing on the garbage. Hope means traveling through the cloud cover, sure and steady, one tiny millimeter at a time.

PS As I was finishing this post, the American healthcare bill that would have taken coverage away from my sick loved one and many of my clients was  withdrawn due to lack of support.

Carry on flying, people. Carry on. Revolutions are built on Hope.

Me too: Feminism and Eating Disorders, No Means No

(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 way, and then I can get rid of it. I can get the trauma and the pain of the assault out of me.
  • Anorexia can become I’m going to show you that you CAN be too thin. I’m so thin that I’m smaller than the 12-year-old girls on model runways that your culture says are sexually attractive or coveted.

At the most basic level, women have the right to say no to abuse and feel safe from sexual and physical assault. But when a woman’s right to say no is laden with cultural ambivalence and minimizing, abuse and rape occur at an alarmingly high level. And rape culture thrives. 

No Means No.

Violence against women is still frighteningly common. Here are just a few scary statistics:

  • 22% of surveyed women reported they were physically assaulted by a current or former spouse, cohabiting partner, boyfriend or date in their lifetime. (National Violence Against Women Survey, November 2000).
  • Approximately 1.3 million women are physically assaulted by an intimate partner annually in the United States. [i]
  • Of the American women surveyed who said they had been the victim of a completed or attempted rape at some time in their life, 21.6 percent were younger than age 12 when they were first raped, and 32.4 percent were ages 12 to 17. [ii]

I see many of these women in my practice. (No, not all women recovering from eating disorders have a history of abuse. Eating disorders have a complex and multifaceted etiology.) Sexual assault among women is very common though more common than you may think. Among my colleagues, we talk about how the statistics are more likely to be one in three women.

One in Three

Due to survivors being reticent to report it, the statistics reported are often much lower than the actual numbers. The shame of the abuse is still often carried by the survivor. When assault perpetrated against a woman is blamed on the woman, or not believed, or minimized, there is little incentive to speak up. We need only look at the news of the past few weeks to find evidence for this. And when convictions for three sexual assault felonies, such as in the 2016 Stanford rape case, get reduced from 14 years in state prison to 6 months in county jail, there is little incentive for survivors to pursue legal action.[iii]

If one in three women has been sexually assaulted in their lifetime, that means it is highly likely that you, your spouse, your sister, your mom, your child, your friend, or your colleague has been sexually assaulted. The experience of sexual assault is not limited to women of particular socioeconomic status, ethnicity, or religion. I am probably preaching to the converted here, but just to name a few basic educational points about sexual assault:

  • Sexual assault is an act of violence, not sex.
  • Sexual assault is not caused by what a woman wears, drinks, or doesn’t drink, or whether she is “in the wrong place at the wrong time.”
  • Sexual assault is not consensual. If a woman is unable to consent, that is non-consent. If a woman says stop, then that is non-consent. If a woman has said yes in the past, but is saying no now, that is non-consent.
  • Sexual assault can leave long-lasting impact of the survivor, including but not limited to Depression, Anxiety, PTSD, Flashbacks, Self-Harm, Suicidality, Eating Disorders, STD’s, and unwanted Pregnancy.[iv]

I could go on and on about the work to be done in healing “rape culture.” I am grateful for the education and advocacy work[v] being done currently. And I am grateful for the January 2017 Women’s March “Pink Pussy Hat” movement reclaiming women’s bodies and rights as their own. I am grateful for every survivor doing their healing work. I am grateful for every woman and man who says “No, this is not ok” to rape culture. And I am grateful for 19-year-old Nina Donovan writing her “I Am a Nasty Woman” poem and Ashley Judd reading this poem at the Washington DC Women’s March. In Donovan’s poem she writes:

“I am not as nasty as racism…homophobia, sexual assault, transphobia, white supremacy, misogyny, ignorance and white privilege.”[vi]

Feminism today is being called to become intersectional, addressing the places where misogyny, racism, and socioeconomic status intersect, and where they don’t. Stay tuned for the next post on how eating disorders do not just affect straight, white, adolescent women. And, in the meantime, what can you do? You can be an ally. You can talk about it. Talk about eating disorders and that recovery is possible. Talk about how rape culture is not okay. Be an ally: for yourself, for others. Healing is possible. You are not alone.

 

NOTES

[i] Findings From the National Violence Against Women Survey, November 2000 https://www.ncjrs.gov/pdffiles1/nij/183781.pdf

[ii] Ibid.

[iii] “Telling the Story of the Stanford Rape Case” by Marina Koren, The Atlantic, June 6, 2016

[iv] RAINN.org RAINN stands for the Rape, Abuse, and Incest National Network and is the nation’s largest anti-sexual violence organization. RAINN operates the National Sexual Assault Hotline 800-656-HOPE

[v] Here is one organization working to end rape on college campuses http://endrapeoncampus.org

[vi] Ashley Judd reciting Nina Donovan’s “I Am A Nasty Woman” poem at the January 2017 Women’s March https://www.washingtonpost.com/video/politics/ashley-judd-recites-i-am-a-nasty-woman-poem-at-march/2017/01/21/93205bc6-dffd-11e6-8902-610fe486791c_video.html

 

5 More Ways to Take Care of Yourself Over the Holdays

Last week we looked at HALT (Don’t get too Hungry Angry Lonely or Tired),  Keeping Consistency, Taking a Social Media Break, Introversion Recovery Time, and Looking for Similarities. This week, here are 5 more ways to be mindful of your self-care over the holidays. Remember, the intent is to lean toward kindness to yourself. You are explicitly forbidden to use any of this to beat up on yourself for not doing or being enough.

(And, as I say to my new mom clients, the caveat/abbreviated version for Moms is: Take a Shower, Get Support.)

  1. Practice Loving Kindness  OLYMPUS DIGITAL CAMERA

Lovingkindness is both a Buddhist and Hebrew term that is associated with mercy, dignity, compassion, and benevolent affection. Practice this kindness and softening of judgment with yourself and others. I was recently at Mindful Self-Compassion training with Kristin Neff, PhD, author of Self Compassion: The Proven Power of Being Kind to Yourself (HarperCollins, 2011). She led us through a meditation in which we imagined a person who we easily love such as a young child, a pet, or a spiritual teacher. We sat with sending them love for a moment. Then we took a posture in our body-imagination of sending and feeling love such as holding this person in a hug or putting your hands on your heart. Then we transitioned to sending that love to ourselves. Try this. Try sending the love you give freely to others to yourself. In the lovingkindness practice, there are also components of sending the wish to be happy and healthy, free from suffering to a person with whom you feel neutral and with whom you feel hostile. Feel free to try this as well. If you feel your heart closes at this prospect, stay with yourself. You yourself most need your own lovingkindness. If you feel resistance toward self-compassion, watch Dr. Neff’s TED talk: Overcoming Objections to Self Compassion.

 2. Practice Gratitude

I just finished reading the book The Gratitude Diaries by Janice Kaplan (Dutton, 2015). In it, she interviews Dr. Martin Seligman, the founder of Positive Psychology, who states:

“Of all the positive strengths we’ve looked at, people who are highest in gratitude are also highest in well-being.”

It was also shared that if you don’t come by gratitude naturally, “gratitude interventions” can have a big effect. I love that. The founder of positive psychology has a brain that doesn’t naturally turn toward gratitude! Can you relate? It’s ok to have a mind that keeps going back to “bad alleyways.” The work is to train it differently, with compassion and perseverance, like you are training a puppy.

Gratitude interventions include: keeping a daily gratitude journal, writing a letter of gratitude to a friend or loved one and reading it to them, taking pictures of things you are grateful for throughout your day. I’m not talking being Pollyanna here. It has to be authentic or it has no effect or meaning. But it can be simple. Some of my recent examples include: being warm and dry out of the rain, making paper snowflakes with my little one (turn toward the fun and away from the scraps all over the floor), talking with a friend.

3. Be of Service

Being of service can be one of the most benevolent AND personally rewarding things you can do. If you can do something big, by all means DO IT NOW. But it doesn’t have to be big. Mother Teresa said:

“There are no great acts. There are small acts done with Great Love.”

Many, many, many people took very small steps (and many took very large ones as well) together to preserve Missouri river at Standing Rock recently. You may find that healing others with similar struggles helps heal your own. If you are a person recovering from an eating disorder or alcoholism, you have the unique gift of being able to understand someone else struggling with the early stages of healing in an empathic, helpful, and non-condescending way. (Keep in mind that you can’t keep it unless you give it away but you can’t give it away unless you have it. So if you are struggling with your own recovery, find another way to be of service right now and let others be of service to you for your recovery.) The feeling of doing something helpful for someone else has a way of providing meaning that no other gift can.

Here a few other examples:

  • Return a grocery cart or pay the bridge toll for someone in the car behind you.
  • Smile or make eye contact with someone you wouldn’t normally.
  • Let someone else get on the train/bus first.
  • Open the door for someone with a stroller.

4. Practice Radical Acceptance.

Carl Rogers said:

“The curious paradox is that when I accept myself as I am, then I can change.”

This is a beautiful quote that sums up the environment within yourself that can help ease suffering and, if you want, create change. For the holidays, try practicing “It is what it is.” Look around you, notice and describe what you see, what you smell. Use your senses to bring yourself directly into the present moment. If you can be with that, you will most likely be okay. It is just this moment. Try practicing adding “right now” to aspects that you find difficult to accept and see if that helps soften the suffering of wanting it to be different. This is my body right now. This is my family right now. This is the cabinet of the President elect right now. You don’t have to like it. And accepting is not the same thing as agreeing with or condoning. It is acknowledging that this is what it is right now. The artist Richard Stine is attributed to saying:

“It’s simple. We are where we should be, doing what we should be doing. Otherwise we would be somewhere else, doing something else.”

There can be great relief, power, and spaciousness is the right now. You are right where you are supposed to be. Right Now.

5. Ask yourself what you need.

Only you know what you truly need. Ask the part-of-you-that-knows. Listen and respond.

What do I Need right now? (Only YOU know!)

Whatever it is, be kind with yourself. “You yourself, as much as anybody in the entire universe deserve your love and affection.” – Buddha

Amen (and Women)!

5 Ways to Take Care of Your Self During the Holiday Season

The holidays can be hard. They can be especially difficult for people recovering from disordered eating, alcoholism, depression, or anxiety. The intention of this blog is to help you be a bit more fierce with your own self-care and a bit more compassionate with yourself and others. This is not a list to use to beat up on yourself for not doing enough or being imperfect! May it be helpful, useful, and ease some of your suffering during this time.

  1. HALT

Try not to let yourself get too Hungry, Angry, Lonely, or Tired. Getting too tired, hungry/hypoglycemic, resentful, or isolating is a recipe for addictive behaviors and/or haltdepression. Imagine yourself to be a little one (this will not be hard for you parents to imagine) who needs regular meals and snacks, regular emotional understanding, and regular sleep. If little ones get too tired/hungry/emotionally not heard, there will be meltdowns. Be a kind parent to yourself. Pack a self-care bag with protein snacks, water, get to bed on time, make plans with friends and/or providers that “get” you so you can feel nourished and grounded. Practice what a friend of mine calls “aggressive self-care.”

2. Keep 1 Thing Constant

Choose one thing – morning meditation, weekly support group, your meal plan, sobriety, journaling, daily inspirational reading… To read more, go to EDBlogs

Just as a reminder, the intention here is to help you be a bit more fierce with your own self-care and a bit more compassionate with yourself and others… not to beat up on yourself for not doing enough or being imperfect.

Stay tuned for part two next week!

 

Embody: Learning to Love Your Unique Body (and quiet that critical voice)

I have been following and quietly cheerleading the work of The Body Positive for years. Created by Connie Sobczak and Elizabeth Scott, LCSW, in 1996, The Body Positive is a community offering freedom from societal messages that keep people in a struggle with their bodies. Connie’s experience with an eating disorder in her teen years and the death of her sister Stephanie inspired her life’s work to improve the self-image of youth and adults. She founded The Body Positive in honor of her sister, and to ensure that her daughter Carmen and other children would grow up in a new world—one where people focus on changing the world, not their bodies.

Like Connie, my work is inspired from the desire to break the intergenerational legacy of eating disorders. I want eating disorders to stop with me, and I want my child to be free.

So it was with great pleasure that I read Connie’s book, Embody (Gurze books, 2014), which outlines the work of body positivity beautifully. Early in the book, Connie outlines how the Body Positive model differs drastically from not only dieting, but also a self-help model or cultural message around “arriving” at a static end point in order to be “done” (and therefore not need to grow, feel, work or explore anymore).

Body Positive:                                                          Not Body Positive:

Tools for a lifetime of exploration A static goal-oriented view of life
A definition of health that is based on balanced self-care and self-love An idealized external image of a ‘healthy’ person
No Double binds Conflicting messages that leave people confused or frustrated
Attuned self-care “Rules” about eating and exercise
A foundation of self-love and forgiveness “Shoulds” and punishment
A celebration of diversity as beauty A limited definition of “ideal” beauty
The development of positive communities Connecting with others through negative self-talk

There are so many things that stood out for me in this book. Here are a few that I celebrated in particular:

* Exploring your Body Story through creatively using expressive arts and writing

*Turning your critical eyes toward discernment of negative messages you may have received from your family of origin (without blaming your mother) and culture rather than turning them against yourself.

*Defining and supporting Intuitive eating

*Re-defining exercise as a way to have fun and pleasure in your life (walking, dancing) and release brain chemicals to keep our moods stable rather than a way to punish ourselves or shape our bodies differently

* Including tools for quieting the Critical Voice

*Declaring your Authentic Beauty

Throughout the book, personal stories from Connie, Elizabeth, and people who have participated in Body Positive community are shared. There is a feeling that you are not alone in the struggle, and your are not alone in your journey to re-find (or find in the first place) joy and peace in your body and your life.

It isn’t often that I would recommend a book to friends, colleagues, and my clients! This is that book.

 

Creativity, Recovery, and Fear

big magic.jpg

I’m reading Elizabeth Gilbert (Eat Pray Love author)’s new book Big Magic. It is a fabulous journey exploring the relationship between fear, creativity, inspiration, and life. Here is an excerpt of a letter she wrote to fear.

Dearest Fear,

“Creativity and I are about to go on a road trip together. I understand you’ll be joining us, because you always do. I acknowledge that you believe you have an important job to do in my life, and that you take your job seriously…But I will also be doing my job on this road trip, which is to work hard and stay focused. And Creativity will be doing its job, which is to remain stimulating and inspiring. There’s plenty of room in this vehicle for all of us, so make yourself at home, but understand this: Creativity and I are the only ones who will be making any decisions along the way…You’re allowed to have a seat, you’re allowed to have a voice, but you’re not allowed to have a vote…above all else, my dear old familiar friend, you are absolutely forbidden to drive.”

It can be hard to talk back to fear, to allow it, without letting it run the show. Fear likes to be dictatorial. It lives in the land of cognitive distortions, so it is full of globalizing, catastrophizing, shaming, and emotional reasoning. “This will never work,” “If you do this, you will never have enough money to live on,” “Who do you think you are?!” “You are a fraud, and they are going to find out eventually, so why even pretend you’re not?” “This is the way things have always been, so this is the way they should be.”

In my own recovery I had to learn to identify the voice of fear, like a subtle click of the clock, tick tick tick, always whispering in the background of my mind. I had to notice this was part but not all of me. In my work with clients, I help facilitate separating out the voices of fear and also of the eating disorder (sometimes shortened to “Ed”). They are often quite similar in tone. This is an important aspect of recovery, and of cultivating the courage to be your full self, because it allows you access to the other pats of you. Fear and Ed do not like you to be aware that you have other parts to yourself. They speak loudly, and try to run your life.  OK, sometimes they speak quietly. Actually, they’re quite sneaky that way: they morph. Sometimes they are so quiet that you can’t even hear them talking to you, because it is more of a niggling, silent belief that colors your whole world view. For example, it might not say this, but rather imply strongly as a silently pervasive belief, don’t even try because you are going to fail. Before you act on this belief, it is important to take opposite action. Jenni Schaeffer, in her book Life without ED, writes about the importance of learning to Disagree and Disobey the Ed voice:

When you are trying to begin your separation from Ed, it is important that you first recognize Ed’s rules in your life. You must be able to distinguish between standards that Ed holds for you and healthy boundaries that you set for yourself. You must realize that Ed’s rules do not make sense. For instance, many of Ed’s rules contradict each other. On one day, Ed tells you not to touch that ice cream or dare drink that soda. Then, the very next day, Ed says, “Eat that entire gallon of ice cream, and drink three cans of soda. Eat as much as you can until you feel sick.” Ed’s rules are designed to harm us.

 

After you are able to recognize Ed’s rules in your life, you must try to disagree with and disobey them. Even if it seems impossible for you to actually disagree with one of Ed’s rules, you must still try to disobey him. If you are able to break his rules no matter what, you are taking a huge step toward separating from Ed. Disobeying Ed means you are moving in the right direction. Don’t expect it to be easy.

 

In the beginning of my recovery twenty years ago, I would say this to my ED voice every week when getting ready to attend my recovery support group:

You can come if you want. You are welcome to ride the bus with me to get there, you are welcome to attend the meeting. You don’t get to decide if I go. We are going. I show up, now, regardless.

And then I would go to my support group. Every week. For the record, Ed kept trying to convince me otherwise:

“You haven’t had any eating disorder behaviors in a week (a month, 6 months,…), you don’t need to go!”

Or

“You just had a hard day at work. You already did your job today. You need to rest. Just skip it this one time.”

Or

“You’re fat.” (Ed’s answer to every question and reason for not participating in any and all aspects of life.)

My Ed voice doesn’t do this anymore because it knows it has been banished. It’s not driving the bus, car, or whatever vehicle you want to use as a metaphor for the-part-of-the-Self-that-is-driving-decision-making. However, fear is still here. Fear says

“You don’t need to do your spiritual practice today – just sleep in.”

Or

“You don’t need to write. It is too tedious, it doesn’t pay, your favorite publisher is closing down, no-one reads anymore, anyway… “

FullSizeRender-4.jpg

“The agony and ecstasy of writing” soulcollage(r) card

But the thing is, writing makes me happy. Not euphoric-happy; but content-happy. Clear-happy. Free of resentments and the cumulative-gunk-of-living-cleared-out happy. My first year of recovery I worked in a recovery book store. Sometimes, when I had to open the store early, I would not have time to write before coming in. The owner of the store (who was also my friend and inspiration for getting into recovery) would know the days I had written and the days I hadn’t. He would say “STEER CLEAR OF HER” and bring me coffee on the days I hadn’t. 🙂

Writing is like recovery, meditation, or any creative practice that you show up for on a regular and consistent basis. It gradually, subtly, integrates the shit (compost, anger, resentments, fears) into new sprouts. And these sprouts grow into plants (or not – some of them die and that is appropriate). And the plant that survives becomes the tree of who you arvelveteen rabbit.jpge and who you are becoming. It brings the gift of hard-won persistent and regular work. It makes you more authentically you in a subtle but essential way. It wears down your anxieties, softens your fear. It uses your sadness and grief as a way into the interior of your (and other’s) Hearts. When you show up to the page, day after day, month after month, year after year, you become real. Velveteen Rabbit real. And by the time you become Real, you don’t care anymore what the Ed-voice or the fear-voice have to say. They can’t stop you any more. You have found the Real-ness. That is the Big Magic.That is recovery.

 

 

Believarexic

Saying goodbye to santa and hello to yoda

Confession: I love reading books about rehab. Memoirs, fictional accounts, self-help journeys, I’ve read them all. Even though I worked in chemical dependency and eating disorder programs for over a decade, and continue to work with recovering women in my private practice, I’m not being a martyr. I actually enjoy reading these books. Partly, I screen them to decide whether to recommend them to clients (any book that teaches new disordered eating techniques, mentions clothing sizes or weights, or finding a new way to get high is automatically off the list). I also treasure working with and reading about the early days of recovery, as they are often such a rich, albeit challebelievarexicnging, time of growth.

I just finished reading Believarexic, a novel by J.J. Johnston. It is the story of Jennifer (J.J.)’s adolescent journey into a hospital treatment center for eating disorders. Besides the frightening but quaint 80’s references (cassette mix tapes, awful fashion trends, a psychiatrist smoking?!) ), this was a lovely book that I would highly recommend. Here was the hook:

“In her heart, J.J. knew that she would be a happy, healthy adult one day. But how? Instead of a clear road to that future, J.J. was lost in a twisting maze. She needed a guide, a mentor, someone who knew her inside and out. So one morning before weigh-in, J.J. closed her eyes and promised: When I’m grown up, and thriving, I will come back to this me- here, now. Healthy me will help bulimarexic me find the way.”

So much of recovery is about trusting that thread that you are sending into the future for yourself. The courage it takes to send that thread out ahead of you into your future life often gives you the grit and vulnerability required to delve back into the past to heal the hurt parts of yourself.

We go there with Jennifer in this book: back to her experience in her family of origin, her anxiety with her mom, separating her mom’s anxiety from her own, her anger toward her dad, her dad’s anger, her hidden alcoholism and the generational links, her desire for perfection and to be “good” (or if not good, at least thin)…

Some of the recovery highlights J.J. learns on her journey include:

Not Dancing on the head of a pin

It is impossible to dance on the head of a pin: expecting yourself or anyone else to sets you up for disappointment and suffering. J.J.’s therapist advises her in her treatment to not idealize or devalue anyone, including herself in her recovery process. No-one is All Good or All-Bad; No-one can maintain perfection all the time or make horrible mistakes all the time.

Melonie Klein, an early Freudian, first coined the term “good breast/bad breast” in her object relations theory conceptualizing how infants “split” their caregivers into good or bad, but aren’t able to integrate them into a cohesive, imperfect being.* Although this may sound infantilizing, it is actually something we all do and takes a mature person to integrate this on a deep level into their Being. On her treatment journey, J.J. must allow staff members and herself to not be all-good or all-bad in order to break this pattern from her family of origin. Here is a conversation she has with her therapist:

I wonder if you have a habit of idealizing people.

What do you mean? I don’t idealize my dad. Obviously.

No? When we idealize people, we place them on the head of a pin. If they are perfect- kind and loving, like your mother- there they will stay. But if they are less than perfect, they will topple off. One mistake and down they go…If we idealize people, we also create a wide space between ideal and not ideal. I really want you to think about this, because I believe you do this to yourself, too.

What? I definitey do not think I am perfect!

When we are perfectionists, we idealize ourselves. You are making yourself stand on the head of a pin. It is a grueling balancing act. You do not allow yourself to make any false moves, any mistakes. You have no freedom. You must earn top grades…excel in extracurricular activities…be liked by every single person…look a certain way…maintain a dangerously low weight, or you fall off the head of a pin.

Recovery is an often painful process of allowing yourself and others to imperfectly make mistakes as well as be impeccable with their words and actions.

(Side note on where I do hold an absolute position as someone who recovered myself before working in the field professionally: if you are working professionally in the field of recovery, you need to be recovered from behaviors and have your own support outside of work. Professional supervisors and colleagues must ethically check and support each other in maintaining this necessity. This is NOT EVER, EVER the patients’ responsibility and mirrors dysfunctional family dynamics in treatment settings when it occurs.)

Coming to Peace with Santa No-Longer-Being-Real

IMG_1724One of the most poignant scenes is when Jennifer has Christmas while she is still in treatment. She goes on a pass outside of the hospital to see her parents, who come to visit her in a hotel nearby. It is a disjointed family making the best of the pain they are living through. It is the beginning of Jennifer no longer being a child and unaware of her family system’s imperfection. There are all kinds of uncomfortable feelings, communications, and dysfunctions. It reminds me of when kids discover there is no Santa. Painful.

Recovery is kind of like that: it is about letting go of magical thinking and taking responsibility of your own happiness. There is sadness in letting go of the illusions. Being aware of how everything is not perfect in your family is painful. Discovering that Santa will not come and deliver presents magically (because he is able to read your mind), and travel down the chimney (even if you don’t have one), is painful.

Jennifer’s clothes are becoming too tight as she gains weight. It is too painful for her to go clothes shopping for new ones yet, and she can’t have diet soda anymore. I remember the pain of this weight gain 20 years ago in my own recovery process. I now work with women every week bringing their ED (Eating Disorder) clothes into my therapy office to ritualize the sadness of letting them go. They cut them up, write goodbye letters, turn their ED clothes into art or journal projects in order to support their larger life in recovery.

The good news is recovery is freeing, too. You are not responsible for anyone else happiness. You don’t have to take care of anyone but you. You get to have your own anger and joy. And you get to make your own decisions. Jennifer discovers she is not responsible for defending  her mom, that her dad is not “all bad,” and that her brother would rather be skiing that be with them for Christmas. And she gets to choose to never go back to treatment again and to do whatever it takes to stay in recovery.

Do or Do Not. There is no try.yoda

At one point early in her hospital treatment, Jennifer discovers that her psychiatrist is not just a clinician. She is also a human being who is able to quote relevant material relevant to the recovery journey. When providing compassionate awareness to her struggle, her psychiatrist notices that she is very hard on herself and that she is in the early stages of learning how to be assertive with her needs. When Jennifer has cried and screamed at what she (rightfully, we discover later) feels the nurse accuses her of being untrue, her doctor provides perspective and throws in a lovely quote. (I thought this to be timely as this week clearly Star Wars continues to inspire the next generation…)

Jennifer needs to know her fate. She searches Dr. Prakesh’s face for answers. “[The Nurse] said I’m going to have consequences?”

“I do not believe you have done anything that requires consequences.”

“I had a tantrum.”

“You certainly did. Dr. Prakesh raises her eyebrows. That is something I would like you to work on. Communicating your needs, assuring yourself in a reasonable manner?”

Jennifer nods.

“Good,” Dr. Prakesh says. “Now scoot off to breakfast. And do not let this ruin your whole day.”

“I’ll try.” Jennifer says.

“Do, or do not,” Dr Prakesh says, “There is no try.”

Even if Jennifer hadn’t been inclined to like Dr. Prakesh before, she would now. Her psychiatrist just quoted Yoda.

This holiday may you celebrate your recovery. May you remember the hard times and the work you have done, may you honor the ways you are no longer suffering, may you help someone who still is. Though Santa is not real, it’s possible to find a whole new magical life, based in the reality of you learning to be YOU, one day at a time. It IS possible. So many of us have made the journey and calling you to continue. As J. J. states in the addendum:

” GET. HELP. I’m not kidding. If you have even just a glimmer of a spark of a thought that you might have an eating disorder, then your eating is disordered enough to need help. The End. Full Stop. No arguments.

“There is SUCH A BETTER LIFE FOR YOU. Recovery is not easy, but it’s worth it. I promise.” 

I could not agree more. Amen.

 

References:

* Melonie Klein Click here for info on Melanie Klein theory

Get your Butt out of the way

Many years ago, when I was in the early phase of recovery from an eating disorder, I challenged myself to buy a pair of pants embracing my butt. They were not my usual baggy style, were well-fitted, and had glitter on the butt! It was an “opposite action” to wear clothing that my internal body image critic would have never allowed. And, as all opposite action creates, it helped me develop a sense of esteem in myself by practicing an “esteem -able act.”

Many women do not like their butts, literally. Occasionally I find a woman who loves and/or accepts her butt. Jennifer Lopez is the poster child for embracing her butt as an asset.

According to Harvard medical School research, the fat found in large buttocks and hips may even protect against type 2 diabetes.

Fat found commonly around the lower areas, known as subcutaneous fat, or fat that collects under the skin, helps to improve the sensitivity of the hormone insulin. Insulin is responsible for regulating blood sugar and therefore a big bottom might offer some protection against diabetes. The research shows that…people with pear-shaped bodies, with fat deposits in the buttocks and hips, are less prone to these disorders.

Cell Metabolism, Dec. 2008, Diabetes in Control: news and Information for medical professionals, January 20, 2009, Diabetesincontrol.com

Wearing different kinds of pants (glitter or not) no longer challenges me and esteem able ac218604_10150263001270120_1161725_ots have become different in my work as a Mom and Psychologist. Now getting my “butt” out of the way has become “But I don’t have TIME to work on my book!” or “But my child won’t eat vegetables, no matter HOW I prepare them!”

Whatever your butt or but issues, see if there is a way to find an opposite action, even if it is a baby opposite action step to get your but out of the way, remembering that often what’s in the way IS the way .

PS Babies love their butts. Try to remember a (or create for the very first) time when you could love yours.

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