Category Archives: developmental stages

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

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.

 

“Stop cleaning and play with me, Mama”

My son literally said that to me. And just to give some context: I am NOT an immaculate house cleaner by any stretch. I try to stay on top of the dishwasher, the laundry, and getting chunks of food off the floor. That’s it. And that, most of the time, is an impossible, never-ending task. But when my son said that, it was a wake-up call. Pay attention. The days are long but the years are

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short. And children, especially children under five or even six, need to PLAY. And they need to play in an interactive environment of the safety of attachment relationships. Dr Gordon Neufeld, author of Hold onto your Kids: Why Parents Matter (2004) states, “Preschoolers have fundamentally different brain wiring and need to be free of consequences and attachment hunger.”

He cautions that young children need to be free from the work of pursuing attachment relationships so they can do their work, which is to PLAY.

Play helps children build problemsolving networks. At four, five, even six, children are not ready to learn by working because the prefrontal cortex, the part of the brain where a child is capable of mixed feelings, is still under ‘All work and no play’ construction. It only gets wired at between five and seven years of age.

 

     And so I stopped and we did some “special time.” Special time is child-directed play for an allotted time. (See link below for more information on Hand-in-hand parenting and special time). You can set the timer for 7 minutes, 10 minutes, 20 minutes, 45 minutes. It is a tool from hand-in-hand parenting that helps busy parents allocate time for special attention to their children in a realistic way. We played race cars. I was given “Purple pizazz” (naming them has been the latest game). Much better than cleaning the floor.

Resources:

“All work and no play…is not good for the developing brain,” Ottawa Citizen, February, 2012

http://www.ottawacitizen.com/life/work+play/6109961/story.html

 

http://www.handinhandparenting.org/2012/12/04/in-praise-of-special-time/

 

Bellies

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     This is my son’s belly. He is very proud of it. He is also proud of his poo and pee. He lives in a shame free land (so far). I will protect him from shame for as long as I can. He is in Erikson’s “Shame vs Doubt” stage exploring the question “Is it ok to be me?” He happily runs around, showing off his belly, exploring this question. I will fiercely fight for him to hold onto the truth that lives in his belly that it is not only ok but ESSENTIAL that he be himself.

     I remember 15 years ago very early in my eating disorder recovery thinking in the midst of horrible body image distress “My belly is so fat- it looks like it is pregnant!” It wasn’t pregnant- it was full of shame, anger and unexpressed emotions. It was FAT: Feeling Are Thick. It was also nowhere near the size of a pregnant belly, having lived the reality, I now know. If I were to talk to my younger self now, I would say, with great compassion and fierceness, “Honey, you are nowhere near to having a pregnant belly. You want to see a pregnant belly? HERE. Now. What is in there that needs to be birthed and expressed? Get it out because it is not only ok but ESSENTIAL to your recovery and your life that you be yourself.” My older self has learned that. And my belly is now (mostly) free from shame and anger having receivied many apology letters for how I abused it and having been listened to much more frequently over the past decade and a half.

this belly

I’m not going to say it wasn’t difficult with body image postpartum (see “Dear New Mama” and “Does being a Mommy make me look fat?” previous posts). However, I AM proud of my Mama belly. I grew a child in there. Yes, my belly looks different in a bathing suit because I GREW A CHILD in there. Wow. That is pretty miraculous. Thank you belly.

A friend of mine sent me this video postpartum. It is well worth watching the celebration of a woman’s body and belly.

http://www.youtube.com/watch?v=kfOBGQpG9fA&feature=player_embedded#

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