Category Archives: PTSD

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

 

Bleeding Nation: What I Heard in Therapy This Week

What I heard in the therapy office (paraphrased to protect confidentiality) and in life the first three days after Donald Trump was announced to be the President elect:

(Statements in red are symptoms of Post Traumatic Stress Disorder, PTSD)*

“I can’t come to therapy today because I feel sick. I don’t think I can go to work today- how will I get any work done?”

(You may keep very busy or avoid seeking help because it keeps you from having to think or talk about the event.)

“I lay wide awake in bed next to my sleeping child thinking ‘how will I keep her safe? How am I going to keep her safe?’”

“I couldn’t get to sleep and then I kept waking up in the middle of the night feeling like I was in a nightmare.”

“I was very short with my children this week. I knew it was because of the anger/sadness/grief that I hadn’t processed, but it kept coming up suddenly in a huge wave, like a tsunami.”

(You may be jittery, or always alert and on the lookout for danger. You might suddenly become angry or irritable. You may have a hard time sleeping.)

“I watched as more and more states kept bleeding. I kept seeing the image of this over and over in my mind.”

“Every time I see his face or hear a news report with his name, I leave my body.”

“I tried to go for a walk to ground my self, but there was a man right next to me on the sidewalk and I was afraid to walk in front of him. I was afraid of being grabbed or attacked from behind.”

(You may have nightmares. You may feel like you are going through the event again. This is called a flashback. You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports or hearing someone’s name are examples of triggers. Memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place.) 

“I really thought we were going to shatter a glass ceiling, but apparently the only vaginas allowed in the white house are the ones being f*cked.”

“I feel so angry, but I find myself apologizing all the time. I’m afraid of how angry I am.”

“I thought slavery was over, but apparently it is not. I thought this was a land of diversity, but apparently this is the land of white-ness.”

“When we recited the pledge of allegiance at my son’s school, I started sobbing: One Nation? With Liberty and Justice for All?”

“As I ride the bus, I look around and I wonder: can any of these people be trusted? Are their hearts breaking, too? Are they afraid of being deported?”

“My daughter came home from school asking if her Spanish speaking teacher was going to have to leave the country.”

(The way you think about yourself and others change because of the trauma. This symptom has many aspects, including the following:

  • You may not have positive or loving feelings toward other people and may stay away from relationships.
  • You may think the world is completely dangerous, and no one can be trusted.)

*From the PTSD VA website:

http://www.ptsd.va.gov/public/PTSD-overview/basics/symptoms_of_ptsd.asp

There is a lot of healing to be done. Many people in this country are starting to dive into finding common ground or looking for ways to “decrease the splitting.” Because I work primarily with women, many of them sexual assault survivors (one in three women in this country has been sexually assaulted or raped), their voices, bodies, and experiences need to be heard, believed and validated as they are right now. That is part of the healing. Anger is valid. Rage and terror are valid. Fear is valid. Shame is valid. Sadness and pain are valid. In my experience of recovery, bypassing the feelings doesn’t do anyone any good. If you don’t feel, you can’t heal. I will get back into inspiration and action soon, but right now, if you are still struggling and wrestling with emotions, I am with you.

In the meantime, here are some grounding practices that can help when you are experiencing anxiety/fear/PTSD:

  1. Mindfulness

Mindfulness practices such as deep, diaphragmatic breathing, counting your breaths, can help bring your nervous system out of “fight or flight” and back into your parasympathetic nervous system. It is from this place that you can “rest and digest.”

  1. Somatic awareness practices

Soma refers to the body. Practices such as pushing weight into your feet on the floor (if you are sitting) or progressively tensing and relaxing muscles in your body (ex: tense your facial muscles, then relax, tense your shoulders, then relax, tense your hands, then relax, and so on through your whole body) can help bring you back into your body if you dissociate. Walking can also help your psyche and your emotions “move” out of feeling stuck and into processing and beginning to heal.

  1. Talk to a Safe Person

If you are struggling with PTSD, professional counselor/therapist/Psychologist can help you. If you are feeling trauma (but may or may not have PTSD), a friend, colleague, family member or support group can help you feel less alone.

Many people have been struggling with overwhelming feelings this week. You are not alone.

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