Category Archives: eating disorder recovery

Helping Moms Eat Intuitively and Accept Their Bodies During Pregnancy and Postpartum

In the last blog, I introduced you to Lindsay Stenovec, Registered Dietician, and her Meet-Lindsay 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.

Shame: 

pregnantI 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

 

Moms, Food, and Diets

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 Stenovak, Dietician, Mom, Recovery advocate, and host of The Nurtured Mama podcast

Lindsay+Stenovec

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! No_DietingUnder 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!

Advanced Maternal Age and Recovery: Sharing Grace



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.ama

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:

Emotional Clearing

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.

Practical Steps

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.

On Fertility:

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.

Miracles happen

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.

Grace

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

miracle-babybelieved 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

 

 

Recovery and Advanced Maternal Age: A Story of Hope

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

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image from Everydayfamily.com

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.

What happened?

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.

Internal Readiness

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

References:

*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.

 

Butterflies, Recovery, and The Stages of Change

Do you ever wonder if change is possible for you? If you’re just going to have to be stuck in despair, your eating disorder, depression, alcoholism, or feeling not-good-enough forever?

I have this posted on my office door:

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Butterflies have long been a metaphor for recovery for me. Butterflies (the eggs they start as, the caterpillars they become, the cocoons they build, and the butterflies they emerge into) embody the miracle of transformation that happens in recovery.

In recovery, one model for  change, called the Stages of Change,* divides the gap between thinking-about-change and implementing it into 5 Stages. This model was developed from addiction recovery, but can be used for eating disorder or postpartum depression recovery, or another vision you thought was not possible for your life. As an example (because it clearly embodies tangible hope, which can be hard to do in eating disorder or postpartum depression recovery), I’ll take you through my butterfly garden stages of change. As you are reading, you can fill in whatever vision of yours that you think is not-yet-possible.

  • Stage 1: Precontemplation or The Hopeless-Caterpillar Stage (Not thinking about changing, Do not want to change, or Feel change is hopeless/not possible. This is the stage in which disordered eating, drinking, or depression feels “normal” and/or there is a feeling of resigned this-is-the-way-it-is-and-will-always-be.)

FullSizeRender copy

So with my butterfly garden vision, there were years of thinking about this. (“Oh! I should do this! Oooh what a great way to practice ecological conservation in my own backyard! I love butterflies! I used to study butterflies! What a great idea! Butterflies are deeply symbolic of the transformation that happens in recovery and motherhood!!”etc, etc.)

Clearly, as evidenced by the exclamation points, they were excited, visionary thoughts. They were so excited that they tired me out even thinking them. I went back to changing diapers, trying to survive early motherhood, engaging with my professional work, and maintaining my own recovery self-care.

  • Stage 2: Contemplation or The Asking-Friends-About-Their-Cocoon-Experience Stage (Considering there is a problem, Still ambivalent about changing but willing to become educated about alcoholism/eating disorders)

When I was in the contemplation stage, I would pay attention when my little one and I visited butterfly exhibits in museums or the 12185061_10153638687100120_4790037831536255808_oinsect house at the zoo. I would talk to the butterfly curators. I would get inspired by people planting gardens. I read one blog about a guy who re-introduced an endangered butterfly species just by creating a native garden for their caterpillars. I read educational signs at the museum and zoo and thought “Oh! They’re endangered! I could plant a butterfly garden to help! I could do that thing I’ve been thinking about!” Then I went back to my life and didn’t take any action about it.

  • Stage 3: Determination or The I’m-Not-Always-Going-To-Stay-A-Caterpillar-Because-I-Know-There’s-Something-More Stage (Deciding to stop the behavior such as drinking or disordered eating, deciding to seek postpartum depression support. Beginning to make a plan.)

So in this stage, I was thinking “Well, even though I’m not much of a gardener, I could do this. I could get a book. I could go to the local garden store and talk to the people there. I could start a list of native plants that attract and feed larva, caterpillars and butterflies…” I was deciding that I was going to take action. I was envisioning how I was going to take action. I was less tired about the ideas, more determined, and getting ready to take action. I saved money to buy plants for my future butterfly garden.

  • Stage 4: Action or The Building-Your-Cocoon-Of-TransFormation Stage (Beginning to take actions such as announcing to loved ones they are going to change, seeking support of a therapist or treatment program, beginning to attend eating disorder or postpartum depression recovery support groups or 12 step program)

    IMG_2637

    Little one helping me. “Mama, this is actually MORE FUN than screen time!”

So at this point, I told my family I would like a butterfly garden book for Christmas. I started actually writing (instead of thinking about) a list of plants. I bought a guide to local butterflies. I made a place on a shelf for my butterfly-garden materials. I posed on a neighborhood list serve about local butterfly plants. I made a special pile of materials that was designated butterfly-garden research. I looked into local gardening stores.

  • Stage 5: Maintenance  or The I-Now-Know-It-Is-Possible Stage  (An alcohol, disordered-eating, or depression-free life is becoming “normal,” and the threat of old patterns becomes less intense/frequent. Relapse prevention skills and support systems are established.)

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This is the stage that my garden is in now. Though this may sound like an end-point, (Ta Da! We’re Done! Now everyone lives Happily-Ever-After, The End), it’s actually a beginning.  Now I have to water the plants. My husband (who is more of a seasoned gardener) helped to replant some of the plants in wire baskets under the soil so they would be protected from gophers, and in full sun (important for butterflies).

People in this stage of recovery CAN have the luxury of resting somewhat, having done some tough work digging in the soil (therapy, treatment, etc) of planting their garden of transformation. However, the work of continued action is crucial in maintenance. If I don’t water my plants, they might not survive. If you don’t go to your recovery support meetings, or practice the self-care skills you cultivated in your recovery from PPD or an ED, you are at risk of relapse. One of the best ways to prevent relapse/stay in the butterfly stage is to connect with a caterpillar. That is why I work in recovery. So I can remember the darkness of the cocoon AND stay in the sunlight of the spirit.

Here’s to your garden, your butterfly-ness, your recovery. Whatever stage it (You) are in.

*Researchers, Carlo C. DiClemente and J. O. Prochaska, introduced a five-stage model of change to help professionals understand their clients with addiction problems and motivate them to change. Here is one summary article that I referenced in this blog: “Stages of Change” by Mark S, Gold, MD

A Recovery Story

A Recovery Story

We are reading The Velveteen Rabbit (by Margery Williams, originally published in 1922) in my women’s eating disorder recovery group this week. I find this book to be even more relevant for adults – especially women who struggle with people pleasing, body image distress, or “looking good” on the outside while feeling shame on the inside. If you haven’t read the book, go read it. Read it to your little one; read it to yourself.

In the Jungian dream tradition of Every-aspect-of-the-story-is-an-aspect-of-yourself, I offer the following:

The Boy

The little boy is your “inner child” and/or your core, essential self. It is the part of you that is not afraid of vulnerability and loves with a fierceness that is clear and unclouded with doubt or fear. This part of the self wants to connect, is playful, and has all of her feelings. This is the part of you that has the capacity to be dependent, interconnected, and fierce in attaching. This is the part of you that is not afraid of love. This part says, “Stop it! He isn’t a toy. He’s real.” This part is fiercely protective of vulnerability and life. This part knows very clearly who and who is not safe, according to a nonverbal heart-sense.

The Expensive Mechanical Toys

This part of the self is very well polished. Most airbrushed magazine images represent this part of the self. Many Politicians present this part of the self. It is an inflated, idealized version of the self often not in touch with its shadow aspects or vulnerabilities. Any addictive or expensive behaviors that feed feelings of “not enough” come from this part of the self trying to maintain its polish. The desire for the “perfect” body (house, relationship, career, Super-mom-ness image) – without having to feel any feelings of inadequacy – comes from here. This part of the self “boasts about [itself] and snub the rabbit for being made of cloth” in order to not experience shame.

The Nurse Maid

The Nurse Maid is an aspect of your critical self, or Superego. This aspect of the self is big on “tidying up,” thinks feelings are “a bother,” is very concerned with being “grown up.” This part thinks the boy (your inner child/essential self) makes “a lot of fuss over a toy” (your feelings and interdependency needs).

The Doctor

Yet another version of Super-Ego-dom, the Doctor is the adult authority who has lost touch with his own body and heart-sense. It is the doctor with no bedside manner who says the rabbit is “a mass of germs. Burn it right away. You can always get a new one.” The doctor may have vital pragmatic information to share, so it is important to take into account. However, it has lost her vital connection with vulnerability, and therefore needs to be only consulted in conjunction with and not at the expense of other parts of the self.

The Fever (Dis-ease)

The fever is any kind of dis-ease that comes with a message for you. Your Eating Disorder is a fever. Postpartum Depression is a fever. Anxiety, adrenal fatigue, irritable bowel syndrome, and immune disorders can be seen as fevers. Grief is a fever. “Fevers” or Dis-eases, come with messages for creating more ease. They ask that you listen to the bodily and emotional aspects of the self to which you have not been tending. Dis-ease often calls for rest and less achievement-oriented productivity. The fever forces – (or offers the opportunity for) – aspects of the self that are overly-concerned-with-being-productive to pause, so that more contemplative, creative, and wise aspects can emerge.

The Other (Real) Rabbits

Often these parts of the self feel separate from you, because they appear to be others. You may feel ambivalent or jealous toward them, because it appears they have what you want and you don’t have it. However they are actually showing you what is possible for you (to recover, have what you want, be authentic). Although they may appear to be showing off, these authentic beings are actually just being themselves when they dance, whirl and jump. They are showing you it is possible and lighting the way for you to live your way into it.

The Fairy

Some might call this aspect of the Self your Higher Power. Like Quan Yin, the Bodhisattva of Compassion, it is born from the tears of suffering. This part of you is always with you, especially when you are feeling most alone or when you “hit bottom.” It is the hope that is born from despair. This part lights the way for you when you have lost your way. to the light. When you surrender to, when you re-member to, this part of your Self, magical and transformative things happen.

The Skin Horse

Last, but not least, is the Skin Horse, the Wise part of the Self. It is kind, discerning, and has an inner glow. It often has a wrinkled face, saggy arms, and love handles, as it is difficult to become this wise in your early years. It is the part of your Self with whom you feel safe, and perhaps a tiny bit afraid.  This part is compassinate and also doesnt take any BS. You are not going to be able to convince this part that a new wardrobe, the Paleo diet, or the latest juice “cleanse” will make you feel better/authentic. This part of the Self knows the Real deal and the Real deal is about becoming Real.

“Real isn’t how you are made,’ said the Skin Horse. ‘It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real.’

‘Does it hurt?’ asked the Rabbit.

‘Sometimes,’ said the Skin Horse, for he was always truthful. ‘When you are Real you don’t mind being hurt.’

‘Does it happen all at once, like being wound up,’ he asked, ‘or bFullSizeRender-19 copy.jpgit by bit?’

‘It doesn’t happen all at once,’ said the Skin Horse. ‘You become. It takes a long time. That’s why it doesn’t happen often to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.”

-Margery Williams, The Velveteen Rabbit

Here’s to your Real-ness, Dear One.

Many Blessings.

We Have Met The Enemy and S/he is Us

Moana’s Archetypal Message Offers Hope and Healing… Lava Monster and All

I was very excited to see the movie Moana. But it took a long time. Life got in the way…my little one and I went to the theater twice and it was sold out…and then, finally, we saw it. I entered expecting it to be good, but by the end I was sobbing. Like many archetypal stories, this one reaches right onto your heart. And with this one, the hero is a girl. A girl who has nothing but a canoe, a friend in the ocean, and a grandmother who believed in her.

 

Everybody has a canoe, whatever your “canoe” is: the vehicle that carries you on your journey to awakening. For some it is writing, or art. For some it is meditation, 12 step, or yoga. And everyone has someone who believed or believes in him or her. (More on that later). And every one of us, no matter how far gone, disconnected, unworthy, or unforgivable we think we are, knows the truth about themselves deep down. Not the Demigod complex of trying-to-rule-the-world-because-he-feels-unworthy-so-he-is-constantly-trying-to-make-up-for-it-by-acting-bigger-than-he-is. Not that part. (Although Heaven knows there is a lot of that energy going around, and that part definitely needs both compassion and fierce confrontation). But I’m not talking about that part here. I’m talking about the deeply-humble, but most powerful intuition-heart-knowing.

In Moana, the Goddess Te Fiti is the one who held the “greatest power ever known,” who creates Life. And she shared it with the world! And yet, without her heart she began to crumble, and a terrible darkness was born.

What is thArt-HighRez-3918-3157178725-Ois power of creation?

Women have long-held the power of creation in their bodies. It’s not an accident that women with disordered eating hate or try to starve away parts of themselves that reflect this power of fertility: their hips, their stomachs (wombs), their butts. The power of fertility is profound but, in the current culture, relationship with this power is ambivalent at best. This fertile power is not just literal, it is symbolic. Archetypally, the feminine includes the Great Mother, the Earth Mother that holds the power of creation. Long ago the Venus De Willendorf embodied fertility. Hindu goddesses such as Aditi and Aitimmavaru are the mothers of the deities and laid the egg that hatched the gods Brahma, Siva, and Vishnu. In the Wiccan tradition, the Mother Goddess is sometimes identified as the Triple Goddess, composed of Maiden, Mother, and Crone. Another name for the mother goddess is Gaia, Earth Mother.

The feminine goddess archetype also holds the power of destruction, as seen in the Hindu goddesses Durga and Kali dancing on her dead consort, Siva. In Moana, this destructive force is embodied in Te Ka, the lava monster. A similar goddess in Hawaii is Pele, the goddess of the volcanoes. She is also the creator of the Hawaiian islands. This points to how interrelated these forces of creation and destruction can be.

Creation or Destruction?

Any woman with disordered eating knows, in her body, when this force of feeding life turns into a force of destroying or hurting. When eating an enjoyable bowl of ice-cream turns into frantically stuffing the entire carton in, shoveling it down so quickly so it can be violently thIMG_1539 copyrown back up, that is the destroyer. That is where feeding your own life-body turns against the self. There are many reasons for this: trauma and abuse, a family or larger culture that tells women “nice girls don’t get angry,” ambivalence and fear of becoming a women in a culture that does not celebrate the power of the feminine, and many more. We do not have rituals to celebrate becoming a woman in American culture, and so it is a time when many girls start to implode. Mary Pipher, author of Reviving Ophelia: Saving the Selves of Adolescent Girls writes: “Adolescent girls discover that it is impossible to be both feminine and adult.” And so menstruation, having a woman’s body, and speaking from the place of your inner truth become submerged, hidden, hated, and cut off.

Back To Moana

So Moana, from her childhood has this connection with herself and the world. She connects with the ocean; it “calls her.” She connects with the turtles; she connects her Grandmother’s sense of knowing something bigger than what her family and culture are telling her to be the truth. And, like many women struggling with disordered eating, wanting to be good girls, and finding their voice, she wrestles with it. She sings:

“See the light where the sky meets the sea/ It calls me/ No one knows how far it goes”*

And later

“The voice inside is a different song/ What’s wrong with me?” *

This questioning part, this part that doesn’t match up with cultural expectations needs mirroring and validation. Without it, self-destruction (disordered eating, depression, anxiety, etc) runs rampant. We all have, if we look far and deep enough, this person or Being that mirrors our inner truth in our life. It may be a teacher who “got” your art. Or it may have been an aunt who had travelled her own healing journey and was in recovery from alcoholism. If you are lucky, it was a parent. For many of us, we find this mirroring understanding in a therapist. For Moana, this was her Grandmother. Her Grandmother is the self-described “village crazy,” who doesn’t have to answer to Moana’s father (the Village Chief).

“I’m his mother – I don’t have to tell him anything!” *

This Grandmother is what Clarissa Pinkola Estes would call a “Wild Woman,” one who has power in her body. In the Hopi tradition there is a butterfly dancer. As Clarissa Pinkola Estes, PhD writes in Women Who Run With The Wolves, (Ballentine Books: New York, 1992)

The butterfly dancer must be old because she represents the soul that is old. She is wide of thigh and broad of rump because she carries much. Her gray hair certifies…IMG_1860 copy[that] the Butterfly Woman can touch everyone…This is her power. Hers is the body of La Mariposa, the butterfly.

It is not about what her body looks like – it is about listening to her feeling within:

The wilder woman will not be easily swayed…For her the questions are not how to form, but how to feel. The breast in all its shapes has the function of feeling and feeding…Does it feel? It is a good breast.

The hips, they are wide for a reason…they are portals, the handholds for love, a place for children to hide behind…

There is no “supposed to be” in bodies. The question is not size of shape or years of age, or even having two of everything, for some do not. But the wild issue is, does this body feel, does it have right connection to pleasure, to heart to soul, to the wild?…Can it in its own way move, dance, jiggle, sway? Nothing else matters.

Her “Wild Woman” Grandmother mirrors and nurtures listening-to-her-inner voice inside her body for Moana. She sings:

“You may hear a voice inside/ And if the voice starts to whisper/ To follow the farthest star/ Moana, that voice inside is/ Who you are” *

And this is the truth that guides Moana on the hero’s journey that every recovering woman must travel: Who are you?

Who You Really Are

This is the work that I engage with my clients every week: Who are you? How can you listen to your values? What does your inner Wise self have to say? How can I help you separate enough from the critical voices telling you “Stay small” or “Art is not for grown ups” or “You should do something more practical” rather than follow your dream of becoming a Nutritionist/Healer/Artist/Yoga Teacher/Environmental Educator/Women’s Advocate. This process involves separating enough from the cultural dictates and negative messages enough to hear the quiet voice inside. It is the moment when Moana, abandoned by Maui on the boat and despairing, is visited by her Grandmother’s spirit. And her Grandmother asks the question: Moana, Who are you? This is the point at which she discovers “the call isn’t out there at all – it’s inside me.”

You might be thinking “But how is this going to help in my recovery and in the world we are living right now?” Well, there certainly are a lot of “lava monsters” whose hearts have been stolen in the world right now. Where do we start? Where do I start? Where can you start? We start with ourselves. I start with myself. You start with yourself.

OLYMPUS DIGITAL CAMERAThe cartoonist Walt Kelly stated, “We have met the enemy and he is us.” Moana, in looking for the place to return the heart of Te Fiti suddenly realizes it is in her worst fear. The heart of Te Fit is inside the lava monster. But she is not afraid. Because she knows that fear, that addiction/eating disorder/lava monster/war/global warming/misogyny (as just a few examples J) are not outside her: They are inside her. And the call to awaken was always inside her as well. The call to find her true self. There is nothing to fear.

One of my favorite quotes from A Course In Miracles, A Self-Study in Spiritual Thought says:

The course does not aim at teaching the meaning of love, for that is beyond what can be taught. It does aim, however, at removing the blocks to the awareness of love’s presence, which is your natural inheritance. The opposite of love is fear, but what is all-encompassing can have no opposite.

In Moana, the, still voice of never-ending, powerful, and all-encompassing love emerges as she sings to the Lava Monster Te Ka:

“I have crossed the horizon to find you, I know your name / They have stolen the heart from inside you, but this is not who you are / You know who you are, who you truly are.” *

*Lyrics from Soundtrack to Moana (2016)

All original art work copyright Linda Shanti Mccabe

 

Orchids, Dandelions, and Recovery

Some addiction counselors recommend getting a pet after going through treatment (for alcoholism, eating disorders, depression) before you start dating. The thought being that first you learn how to tend to an animal that has a body and feelings, isn’t ashamed of them, doesn’t abandon them, and lets you know when you do (abandon them). It’s a metaphor for self-care, responsibility, and tending: tending to recovery, tending to relationship, tending to health.

Plants are harder. They don’t bark at you, jump on you, or snuggle up to you. They don’t beg for food or scratch on the door.  They just sit there, in their pot, very quietly, thriving. Or not thriving. For someone with a black thumb, it’s hard to tell.

This orchid plant has been in my office for two years. It has never bloomed until this past week.FullSizeRender-13

At one point it had sticky gunk covering its leaves and I thought it might die. Orchids are particularly challenging. With orchids, there are long periods of just sitting there, mostly looking ok, but not blooming. For two years, I watered it. Just a little, because I have heard they don’t like being flooded. Sometimes I put it on the sunlit windowsill, but not for very long, as I have heard that they don’t like too much light, either. As one gardening site states:

“Insufficient light results in poor flowering. However, too much light can lead to leaf scorch.” *

Well, I don’t know what leaf scorch is, but I certainly don’t want that for my orchid! And I certainly don’t want my clients coming into an office with a leaf-scorched plant! That would not represent hopefulness or health in the recovery process!

Orchids are what some might call “high maintenance” plants. They require very specific conditions or they will not flourish. “High maintenance” is not always a description that is welcomed. I prefer sensitive. Like orchids, many recovering people have orchid-like temperaments: sensitive and requiring certain conditions to flourish. Without these conditions, they may “go dormant” (depression) or become sick (eating disordered, addicted) in order to survive.

Orchids and Dandelions [i][ii]

Many of my clients are what might be characterized as “orchids.” (No, not all of them, and everyone has some degree of orchid-ness and dandelion-ness in them). Orchids are a sensitive lot. They need just the right amount of light and water or they don’t bloom. They’re often the ones, as children, that stay on the edge of the playground until the conditions are exactly right for them to jump in and play. I often use this analogy with my clients: If you go to a playground and one person runs right to the slide to go down it, and one person pauses before deciding where they would most feel comfortable playing, who is better? They often either look at me puzzled, or give me an exasperated:

“Well obviously, neither, on the playground. But real life isn’t like that, Dr. Linda. I should be able to go right to the slide (share confidently in class, jump right into a leadership role at a new job, know whether I am going to marry this person on a first date, be Supermom the day after labor and delivery).”

When I ask “Why?,” the answer that comes is:

“Because other people do.”

To which I respond “Hmmm…who are these ‘other people’ and did you do any double-blind research studies before comparing and despairing?”

            Orchids are sensitive to their conditions and often “slow to warm up” in temperament. Dandelions, however, bloom in many different kinds of environments. Dandelions go right to the playground slide. Or the swings. Or hang out with their orchid friend in the quiet zone of the playground. They can grow in soil full of organic compost or they can thrive in dirt under a concrete sidewalk. If you suggest:

“Let’s eat here (Pizza, Bar-on-the Corner, 5-Star Restaurant),”

a dandelion will say:

“Sure!”

If you suggest:

“Let’s eat here (Pizza, Bar-on-the Corner, 5-Star Restaurant),”

an orchid will say:

“Do they have gluten-free or vegetarian options, how loud is it, have the chickens been free-ranging?” (Except usually they won’t say this because they are worried about being too “high maintenance,” so they’ll go to the pizza place and get a stomach/headache from the noise, inability to digest the food, and concern about if the chicken was ranging free.)

            You might be thinking “But those ARE the high maintenance people. That’s Sally in When Harry Met Sally when she takes ten minutes to order a sandwich.”

To which I would reply:

No, those are the people who are going to be deeply affected by the food they ingest, the company they keep, and their external environment. Those are the canaries in the mineshaft. Coal miners they used to take a canary with them into the mine because, when the canary died, they knew the air was toxic and they needed to get out. The sensitivity of the canary was their awareness of their own mortality. Canaries (Orchids) can offer wisdom as to how to honor sensitivity and diversity.  

IF you are an orchid, your work is to stop pathologizing your sensitivity. Get yourself to an environment where you can thrive. Surround yourself with people who embrace your sensitivity. Give yourself the right amount of water and sunlight. Visit nature. Make art, music, or write. If you are an introvert, create quiet introversion recovery time in your schedule. If you have learned how to tend to your own sensitivities, then be of service advocating for other orchids and educate the dandelions. Many (but not all) dandelions are open to helping support orchids. Many (but not all) orchids are open to helping support dandelions. They can thrive together in the right conditions.

If you are an orchid, take very good care of yourself, even when you don’t see immediate results. Remember it took my orchid two years before it trusted me enough to bloom. But, in the famous words of Anais Nin:

“the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.”

FullSizeRender-13 copy

NOTES:

* gardeningknowhow.com/ornamental/flowers/orchids/indoor-orchid-care.htm

[i] I borrowed the metaphor of orchids and dandelions from an esteemed colleague, Vivette Glover, who is a British professor of Perinatal PsychoBiology at Imperial College of London. Dr. Glover cites the article below as one that explores the “Orchid/Dandelion hypothesis.” This hypothesis explores how twins with short 5-HTT (“orchid”) alleles have different environmental susceptibility to depression.

Conely, Dalton, Rauscher, Emily, and Siegal, Mark L., “Beyond orchids and dandelions: Testing the 5HTT ‘risky’ allele for evidence of phenotypic capacitance and frequency dependent selection” Biodemography Soc Biot. 2013; 59(1): 37-56.

[ii] Part of this post originally appeared on Recovery warriors blog https://www.recoverywarriors.com/lessons-recovery-life-little-one/ “Lessons About Recovery and Life I’ve Learned From My Little One,”  November 8, 2016

 

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.

 

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