Tag Archives: anorexia

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

 

A Letter To My Belly

 

Dear Belly,

Every morning my little one pulls up my shirt, kisses you, and says, “I came from there!” You are fleshy now, stretched. I feel warmth and softness when I touch you. Mother. You hang over my jeans a bit. My sagging muffin top. I try not to mentally airbrush you out of pictures- the little traces of shame that still linger, the empire cut shirts, even though I haven’t been pregnant for five years.

Twenty years ago disgust for you filled my world. And crushed my spirit. All the self-loathing, anger, fear and shame were stuffed into you. I’m sorry. So many apology letters written to you in those first years of eating disorder recovery. But I did grow to accept you! And fed you. And then you created an amazing child! (Ok it was my womb, but you are the flesh that stretched to accommodate). You grew and stretched beyond what I thought was possible

Belly, I’m sorry that there are so many images in the world that don’t look like you. I know those images make you feel unloved, disgusting, flabby. I’m sorry those images make you feel wrong.

Those images tell you all kinds of crazy sh*t:

“Be smaller! Be flatter! Do this to be loved! Be big and full of yourself until age seven and then be flat and hungry. But don’t feel hungry! Just look thin! Don’t get angry! Hide your intuition. Don’t listen to it. Be attractive by not being yourself! Don’t get stretched. If you get stretched, get sucked and stitched back in.”

I just want you to know, Belly, they’re wrong, those messages. Contrary to what the images tell you, there is nothing wrong with you. Let me say it again as you have received those other brutal messages so many times.

Belly, there is nothing wrong with you.

“You’re Too Sensitive” and Other Lies Your Eating Disorder Tells You

This month’s theme is Honoring Sensitivity, and I’m going to jump right in with what I hear on a weekly basis in my therapy practice working with recovering women:

  1. “You’re too sensitive.”

My adult clients often say, when entering eating disorder recovery, “I’m too sensitive,” as if it were a curse, or something that needs to be gotten rid of in the recovery process. Often they received this “too sensitive” message as children. Maybe when they

IMG_1071

Butterflies do not tell themselves to “Stop being so sensitive and get over it.”

cried, felt things deeply, were highly intuitive, or were sensitive to stimuli such as noise, textures, or smells,
they were told: “Get over it,” Don’t be a crybaby,” “If you feel scared or ashamed don’t show it” or (covertly)”Don’t talk about feelings. They are weak and we don’t have room for them here.” Your Eating Disorder (ED voice) is the one that judges (and then tries to hide, numb or cut off from) your sensitivities because they were not embraced and/or too painful to experience as a child.

I tell these adults that, even though it may be the opposite to what they want to hear,

Recovery is an invitation to embrace what wisdom your sensitivity has to offer.

Being sensitive means that your are strongly in touch with the part of you that knows, intuitively, what is right for you and what isn’t. It is the part of you that gets, on a gut level and often immediately, (even if it’s not what you want to know) whether someone is a good or bad fit for you in dating. It is the part of you that feels a palpable rise in anxiety before you engage in disordered eating behaviors, because it knows that you are about to act violently toward your sensitivity, trying to numb it rather than listen to it. It is the part of you that senses when a friend is feeling sad or mad, even when they try to mask it. It is the part of you that easily connects with nature or animals or young children being themselves. It is the part of you that knows when someone needs help or is not being treated fairly and feels a protective and empathic response toward them. People who struggle with disordered eating often are highly attuned to other’s feelings. However, they can be insensitive toward their own feelings, judging them as “bad” or “wrong.”

2. If I’m having a feeling, it is bad and I should make it go away.

Closely related to being sensitive is having feelings. The voice of the Eating Disorder (ED) does not like to have feelings. It really doesn’t matter which feeling – sadness, anger, shame, joy, happiness ED doesn’t like it. However, as Brene Brown, author of The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are, states:

“We cannot selectively numb emotions, when we numb the painful emotions, we also numb the positive emotions.”

Feelings-Wheel-ColorWe have to go toward the feelings we’ve left behind in childhood in order to reclaim those parts of ourselves nd become full human beings again. We have to go toward, not away, from the feelings that scare us. I often give clients a feeling wheel to look at and identify which areas they are comfortable and which areas they are not. Some people like to hang out in “purple,” some in “red,” some in “yellow.” You may be very comfortable with sadness, but terrified of anger – or vice versa. Instead of judging this, recovery involves getting curious about it and learning to inhabit all the different colors. Because if you don’t feel, you can’t heal.

3. Needs are bad/weak/not okay unless you are taking care of someone else’s.

It’s so interesting how sensitive people can be fabulous caretakers but – how shall I say this – absolutely and completely suck at identifying, asking for support, and receiving care for their own needs. It’s called codependency in recovery lingo. The underlying unconscious assumption is: If I take care of you, you won’t be uncomfortable. And then I’ll be okay, because I’ll just match all of my needs to yours! But people have different needs.
And people who develop eating disorders usually haven’t been allowed to idchameleonentify their own needs separate from others. There are many good reasons for this, often stemming from family of origin dynamics. Being a chameleon pretending you don’t have any of your own needs certainly has some benefits: you can blend in to many environments and “fit in,” You are not going to be singled out as “the scapegoat,” you can get along with many different kinds of people and work environments without being offensive.

However, at some point, a person recovering from an eating disorder will need to start risking the vulnerability of identifying their own needs. And this can be uncomfortable because, as a wise friend of mine says, “When you stop people pleasing, people aren’t pleased.” However, you WILL most likely, as you identify and start risking having some of your needs seen and met, feel less anxious, more at peace, and less concerned with the necessity of pleasing others.

4. If I just get the RIGHT food plan then I won’t have these uncomfortable feelings or needs anymore.

This ED belief can actually hang on for a long time. Because, even in recovery, it morphs and becomes clever, saying things like “I’m just trying to help you be healthy. You felt so much better when you were eating (fill in your own ED’s version of no sugar/whole grain/not wholegrain/gluten/fat-free/high-or-low protein obsession here).”

You are most likely to need a food plan in the beginning of your recovery. That is appropriate. If you have been skipping breakfast and lunch and bingeing on ice-cream for dinner, you are going to need to add the first two meals back into your day as well as get some vegetables, protein and carbs in there. If you have been avoiding “fear foods” such as cookies, bread, or salad dressing with fat, then you will need to practice having salad dressing (on the salad not the side), dessert, or scary snacks, in order to know you can tolerate the anxiety and be okay. Your food plan may be more structured or less structured during different parts of your recovery. It will change, just as you will. But finding the exact “right” food plan in order to not have uncomfortable feelings is a lie. Your food plan should support you having feelings rather than restricting or numbing them.

If you are sensitive, you are going to feel. Therefore you are going to feel the food you eat. If you have an allergy, are celiac, or have another medically related issue regarding food choices, then you need to tend to this. Otherwise, we need to look at the feelings not the foods. Because the feelings are what your ED is trying to avoid by obsessing on whatever food plan you are convinced will make you “right” or “better.”

Here is one of my favorite quotes from Cheri Huber, a zen writer and teacher:

“There is nothing wrong with you.”

Really. There is nothing wrong with you. There is nothing to fix around you being you. Be YOU and consider there is nothing wrong with that. That is the work of a lifetime and not fixed with any food plan.

5. And the number one lie I hear from ED in my office every week is: Once I’m recovered, I will be “thin” (which means…)

And then we work on filling in the dots for the associations with what “thin” symbolizes. Some of them include:

  • I will feel confidant/comfortable in my skin.
  • I can dance, wear a bathing suit, do the-thing-I-won’t-let-myself-do-at-this-size.
  • I will be worthy of a romantic relationship.
  • I will be worthy.
  • I can go back to work (postpartum) or
  • I can get or go after the job that I really want.
  • People will love me.
  • People I love won’t leave.
  • People I love won’t die.
  • I won’t have to feel grief, sadness, anger or shame.
  • I won’t be sensitive anymore.

The list can go on, but the important piece here is calling ED out on the lie: if you are human, you are not always going to feel confidant, you are going to be imperfect, regardless of the size of your body. You are going to experience loss. You are going to die. What are you going to do before that? Because that is what ED is doing its darndest to prevent you from experiencing and engaging in: your LIFE.

Stop believing the lies and keep taking tiny (or huge, this can change day-to-day, moment to moment) steps toward fear: your recovery is there, as is your life. Because FEAR can mean many things:

F*ck Everything And Run (in the land of ED);

Face Everything And Recover; or

False Evidence Appearing Real.

I hope you choose to walk right into and through that false evidence that appears real according to ED.  It is worth it. Love is on the other side of this false evidence. You are worth it. You always were.

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

Trapped faces and family Roles

Are you a salsa dancer? Free form? Do you watch from the side and “don’t do dancing”? All family systems have a dance and all family members play a role. There is nothing wrong with this, unless you find yourself square dancing when you prefer salsa or if you are being called to lead a partner dance with your parent and you are 5-years-old.

My preschooler recently was at the “small manipulatives” table at preschool and made this:

Trapped Faces and Family Roles

He called it “Trapped faces.” Though I am 95% sure this was not his intent or interpretation, it did remind me of what can happen in family systems when individual members carry certain emotions, roles, or characteristics for the family. When everyone is not allowed to have all aspects of their human experience, certain aspects of being human can become trapped in individuals. Some of these may include being: the responsible-one, the one-who-is-depressed, the angry-raging-one, the one-who-takes-care-of-everyone–else, the-one-who-is-creative, or the one-who-achieves or-looks-good-for-the-family.

Below is a list of family roles that children often adopt (based on the work of clinicians Virginia Satir, Claudia Black and Sharon Wegscheider) summarized beautifully by Laura Doughty, LMHC:[i]

The Hero

The hero is the responsible, accomplished one. She gets good grades in school, is goal oriented and self-disciplined. Externally, she appears successful and together; internally, however, she bears the burden of making the family look good. She holds the belief that if she is perfect enough, the family problems will go away or be solved.

The People Pleaser

The people pleaser tries to ease and prevent any trouble in the family. She is caring, compassionate and sensitive. She also denies her own needs, and, as a result is anxious and hypervigilant.

The Scapegoat

The scapegoat is the family member who is blamed for the trouble in the family. She acts out her anger at any family dysfunction and rebels by drawing negative attention to herself. While she is more in touch with her feelings than the other roles and is often creative, in school she gets poor grades and is often in trouble.

The Mascot

The Mascot is the class clown with the uncanny ability to relieve stress and pain for others. But there’s something missing that he won’t find until he looks beneath the humor façade and faces his own pain.

The Lost Child

The Lost Child is quiet, withdrawn, lonely and depressed. She doesn’t draw attention to herself because she doesn’t want to be a burden. But what she wants most is to be seen and loved, and to be healthy, she must allow herself to be visible.

Many family systems “roles” also include the Alcoholic/Addict and the Caretaker/Codependent. The Codependent often tries to prevent the alcoholic from experiencing consequences of their behavior and cares for others at the expense of themselves.

New Roles

In my clinical practice, I often see aspects of all of these family roles and “trapped faces” in adults. Many recovering anorexics identify with the hero child or the people pleaser, many bulimics or alcoholics can see the mascot or the scapegoat in themselves. Adult children of alcoholics may see the lost child in themselves. In the process of recovering from an eating disorder, depression, anxiety, codependence, or alcoholism, there needs to be room to include allowing ALL aspects of yourself. That doesn’t mean you have to act it out all of these roles. If you’ve never expressed anger, it doesn’t mean you need to start raging. However, it does mean that you allow yourself to own parts of yourself that may not have been able to develop in the “trapped-ness” of your family system.

If you were the scapegoat as a child, you can now see, embrace and practice as an adult that you have hero responsible, leadership qualities as well. You have skills that are valuable and you are not the problem. If you played the role of the hero as a child, you can consider getting a B+ or even failing a class as an adult, just to practice imperfection and seeing the world doesn’t fall apart if you don’t get an A. It means you allow yourself to have aspects of being angry, sad, happy, carefree, irresponsible, responsible, pleasing, rebellious, and creative.

The Past and the Present

My clients often ask me: “But what if my mother/father/family member boss/husband doesn’t change? How can I?” The answer is that YOU can embrace all of your human experience, whether or not your mother/father/other family member does or does not. That can be challenging and difficult, especially if they want to trap you into staying in the role that is most comfortable for them to be playing within the family system. As a child, you didn’t have much of a choice. Your survival depended on fitting into your family system to have your needs get met. As an adult you have other choices. That is where recovery is simple but not easy. Emotionally, it feels like you don’t have choices and you need to continue being the Hero/Scapegoat/People Pleaser/Mascot/Lost Child. Time does not exist in the emotional world, so your inner child will feel as if it needs to keep playing that role.

That is where you can bring your newly growing conscious adult self in and practice differently. You may need to risk shaking up the family system in practicing a new dance. If your family system is used to a precise salsa or ballet dance and you start practicing a chaotic free form dance, it may not be welcomed. Nobody in your family knows the steps to that dance. Do not be surprised if you encounter resistance.

The Gift of Resistance

I recently heard a Zen teaching about a master and a bird. The master was holding the bird on his finger and the bird was learning how to fly. If the master dropped his finger down quickly, the bird would fall, and need to be caught. If the master held his finger still, the bird could practice jumping off his finger and flapping its wings in order to develop strength. This allowed the bird to fly.

Externalizing Parts of Yourself to get free of them

One way to release feeling trapped/stuck in playing only one role regardless of whether members of your family system change is to externalize them through art, writing, or drama and see what wisdom they have to share. These parts of yourself are often “protecting” vulnerabilities that were too scary to be seen as a child but can now offer wisdom as an adult. They also hold strengths that can offer you help in your life currently. The “Lost Child” part of myself is the one that makes art and studied to become an expressive arts therapist. Here are some examples of my own and some of my clients’ soulcollage® card collaged images (shared with permission). Soulcollage® is a process of making a whole deck of collaged cards, each card representing one aspect of your multifaceted Self.IMG_1564

Addiction

I am your addiction. No matter what it is: food, pills, worry, it will never be enough. Feed me and I will want more.
Listen to me; believe me and I will take over. Listen to me, but know that there is fear underneath that needs tending, and I will get smaller and not run your life.

Body image stomach in knots.

I am one who has pain internally and believes all others can see it. The wisdom I have to offer you is that this pain is not something you can avoid or run away from. There will always be pressure. If you aIMG_1423ccept that I am here, I can offer you ways to own your power and listen to your gut.

Postpartum Depression

I look like I have it, all but there is part of me lying on the couch hiding all the time. I want to go to sleep. I can’t be perfect. Not even going to try.

The wisdom I have to offer is that you can no longer overachieve. This is the ultimate experience of practicing imperfection and asking for help. Let someone see me and you may find you are not alone.

Creating Recovery Families

Last but not least, many recovering people find they need to create a “recovery family” to help them practice new roles. This can be a collection of recovering friends, your therapist/treatment team, a 12-step sponsor or other people who embrace and welcome all the parts of you and themselves. These are people who want to help you practice new roles, want to help you learn how to practice imperfection if you are recovering from perfectionism or playing the hero or practice taking leadership steps if you are more familiar with being a scapegoat or lost child.

Where in your personal relationships, work life, home life currently are you playing the same role over and over? Where can you embrace the strengths that some of your more familiar roles offer? Where can you risk bringing in another part of you?

[i] “The Effect of Family Roles on Life’s Choices” Laura Doughty, LMHC, Thriving, A Journal of Well being, Spring 2010.

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.

The Binky fairy

IMG_0519Once upon a time, I thought parenthood was a fairly straightforward and linear process. I thought if the child was slow at something like completing potty training or letting go of their pacifier, it was basically because the parent wasn’t doing what they were supposed to be doing, usually according to the timeline some expert had written in a book.

Eighteen years ago I also thought recovery from an eating disorder would be a straightforward journey. If I could just get a handle on the food-thing, and the body-thing, that would be the end of it. Poof! Everything all better! (More on that later.)

Then I had a child that was unbelievably attached to his pacifier. If there were a pacifier anywhere within a two-block radius, he would find it. No matter if it was waaaaaaay under a couch or say, a monster truck, he would find it and it would be in his mouth before anyone had time to say, “Wait (let me at least rinse it off…)!” Other children choose the breast, the bottle, potty training, sleeping through the night, talking… to take their own sweet time in learning or letting go of. And, as every parent discovers, the way to make this holding on stronger is to fight for control. (Have you ever tried to force a toddler to poop in the potty? As Dr Phil would say “How’s that working for you?”)

So all this to say, my child chose to hang onto the pacifier. Or, as he named it “nukey” (nooh-key). As a parent and Psychologist, I went through all kinds of fretting over whether I was teaching stuffing/”pacifying” his feelings, ruining his teeth, delaying his speech, ruining future capacity to empathize due to blunted affect (I’m not kidding- there is research on this), etc… I made space for him to cry or have angry feelings in transition times. I consulted Pediatricians, Developmental Psychologists, and Dentists. (They all had different opinions). I was ready to be the one to initiate letting-go-of-nukey process many times. My husband said, “Nobody goes to college with their pacifier.” I believed this around nobody going to college in diapers. However, I really wasn’t sure it was gong to happen with nukey. I thought, you know our child MIGHT actually bring his to college.

Until.

One day my boy woke up and, in the middle of playing, said, “I’m ready to say bye to nukey.”

I said ‘What?!”

He repeated himself.

I asked him if he knew that would mean: all the nukies would go away and he wouldn’t ever have them again. We talked about the binky fairy bringing his nukies to new babies.

He said he understood. He then proceeded to say how he needed a box. We decorated it. We put all of his nukies in the IMG_1450box. We wrote a letter. And then we left the box for the binky fairy and went to bed without any nuksies.

I was ready for meltdowns. I was ready for the fall out. I was ready to pull out the one I had hidden in reserve. But there was no need; he was ready to let it go.  He was ready to let it go, and so he did (which, for the record, is what the Developmental Psychologist said). Life soon rushed in with new challenges and opportunities.

So what the heck does all this have to do with eating disorder recovery?

Early in my recovery from an eating disorder seventeen years ago I thought I needed my eating disorder and other obstacles (depression, darkness, isolation, loneliness) to be “deep” and “creative.” I was literally and emotionally trapped in the myth of the starving (and restricting and bingeing and purging) artist. And yet very few paintings emerged when I was in the midst of my eating disorder. Nonetheless, I continued to hang on. I held on even as I was trying to let go. I held on for as long as I needed to hold on. And then, when I was ready, (with my own support team ready with metaphorical binky fairy boxes) I let go. I didn’t need it anymore. I had other tools. Not surprisingly, that year was my most prolific period of painting. This healing expression led me directly into pursuing a Master’s degree with a focus in art-as-healing and beginning to assist others in their recovery process. Later I was called to earn a doctorate in Clinical Psychology. Though my plan  (with the eating disorder) was to be a suffering artist, that was not the plan life called me to live my way into. When I lived my way into letting go of “this food-and body thing,” being a suffering artist was no longer the goal. Assisting others in letting go of the suffering was. My eating disorder actually led me directly INTO the freedom of recovery and living a depthful and creative life of meaning. But not in the way I had originally planned.

What’s in the way IS the way

I often work with my clients on what purpose their eating disorder is serving. Until that need is met, they’re usually not ready to let go. If the eating disorder is helping manage anxiety, other tools need to be added and practiced. If it is postponing grief, or helping comfort loneliness, grief and loneliness need to be allowed in. If it is helping in a scary or difficult transition (adolescence, motherhood, loss of relationship, marriage or divorce), other ways to walk into and through the unknown of becoming this new person need to be welcomed. I once had a client use the metaphor of her eating disorder being a “blankie,” a comfort blanket that had grown thorns and barbs. It started out as comforting and then turned into something that repeatedly harmed her, even as she turned to it for comfort. Facing the loneliness she had been avoiding was no longer as painful as holding onto the “comfort” of the eating disorder.

As you begin to look at what goals, intentions, visions you have for 2015, I would encourage you to invite creating WITH your obstacles on the way to letting them go. What obstacles would you like to “go away”? Invite support for letting go of the obstacles and consider “What’s in the way IS the way.” Miracles await. As Carl Jung has been quoted as saying “God enters through the wound.”

Or as Glenda the Good Witch (the adult version of the binky fairy?) said to Dorothy in the Wizard of oz when she asked “Why didn’t you tell me all I had to do was click my heels three times and say there’s no place like home?”

glinda the good witch

Glenda responded “Because you wouldn’t have believed me.”

(As always, the purpose of this blog is to be inspirational toward recovery, and not serve as psychological treatment.)

Surrender

sur·ren·der verb \sə-ˈren-dər\

  • : to agree to stop fighting, hiding, resisting, etc., because you know that you will not win or succeed
  • : to give the control or use of (something) to someone else
  • : to allow something (such as a habit or desire) to influence or control you

         I used to hate the word surrender. It sounded like giving up, waving the white flag, losing myself and my voice. And yet when I look at these 3 definitions in the context of eating disorder/addiction recovery, I get curious. Hmmmm, well the first one certainly applies to the willingness required to begin recovery: you have to be willing to stop repeating the same battle, again and again and again. As they say in 12-step Program, “Insanity is doing the same thing over and over, expecting different results.” The second definition is tougher, especially for people recovering from eating disorders…give up CONTROL to SOMEONE ELSE? But isn’t the problem feeling OUT of control, not feeling empowered, and/or early childhood wounds around someone else not helping regulate our food and feelings from a place of INTERNAL locus of control? This is where the third definition of surrender is, I think, actually an accurate description of an eating disorder or addiction: To allow a habit or desire to control you. Because when you get right town to it, when you are deep in it, IN the food (or whatever your “drug” or behavior of choose is) you know you are not in control and the “habit” has started to control YOU.

    Surrender and the Body

         One of my early eating disorder recovery mentors, someone who was much further along in their recovery when I was in my first year of exploring what-the-heck-surrender-had-to-do-with-recovery, said:

         “The size of your body is not your business.”

    “WHAT? I said. What do you mean?

         She repeated herself. “The size of your body is not your business.”

    I told her “if that’s recovery, I can’t do it.”

    She said “there isn’t anything you need to do here. Surrender is an internal process, not an external event.”

         On some deep level, I knew she was right. I knew it in the core of my being. My mind still fought it, but my heart; my gut knew it to be true. I’d love to say “And then everything changed and I became a licensed Psychologist helping everyone else recover the next day. The End.” But that’s not how growth and recovery work. I then continued to solidify my recovery for the next few years, went back to school to earn my master’s degree, began working professionally in recovery, then earned my doctorate degree, continued working professionally in recovery, etc etc… I tell my clients it is not a linear process, it is not a fast process, it is not an external process, and it is not an event. It is a slow transformation of willingness wrestling with willfulness and softening into surrender, again and again.

    How pregnancy is a good (literal) metaphor for surrender

         Pregnancy is a good metaphor for what it is like to find willingness and surrender in the body. When a woman is pregnant, there are all kinds of things she needs to be aware of and make choices about due to her growing a tiny being inside her body. Soft cheese, wine, even salami can cause miscarriage or a lifetime of harm if not avoided or eaten properly. Many medications are questionable in their safety, and, if a woman is diabetic, she has to be even more cautious about what, how and when she eats during pregnancy. These choices, along with the long list of bodily and emotional experiences that come with carrying a child for 9 months (breast tenderness, constipation, gas, nausea, bloating, fatigue, aches, mood swings, urinary incontinence) require a pregnant woman to surrender her own control and familiar experience of her body and feelings in the service of something else (her child). She actively chooses loving limits in her food choices (the right balance between bingeing and restricting) and she lets go of needing to control the size and shape of her body in the service of surrendering to something greater. This is similar in recovery from an eating disorder.

    I often have clients recovering from eating disorders ask me:

    “But what does that mean in terms of how many cookies I eat?”

         I tell them they need to find their own right answers that are the exact right balance of not restricting while not over indulging/bingeing. Unfortunately or fortunately, there is no list of “off-limits” foods like there is during pregnancy. However, finding the right loving limits in surrender in eating disorder recovery is similar to motherhood in that it is like working with a toddler. Power struggling will get you nowhere. You may win a few battles, but the war will continue to wage. Surrender is a flow and it is a willingness to continue to connect emotionally with yourself in the parts of you that weren’t met as a child. Eating cookies for lunch or never eating cookies aren’t what surrender is about. Asking questions such as “what do I really nRuby-Slipperseed right now?”  and “what is in the best service of my recovery?” are.

     It’s not always an easy journey. It can be like Dorothy traveling the road to Oz. There are many lions, tigers, and bears along the way. And Oz isn’t really the destination. And you are always already home. But you still need to go on the journey to discover that. Then you will actually believe and trust in your body whatever the size or shape that there’s no place like home.

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

How Neuroscience is Helping Us Understand Eating Disorders and Recovery

Image

 

Have you ever eaten “comfort foods” to calm yourself down? What about having a little ice-cream when feeling sad or depressed? Or does the thought of eating chocolate cake after a meal totally stress you out with anxious thoughts about your body? According to the latest research into neuroscience, there is a reason for it…

To read the full article, click here:

http://www.psychedinsanfrancisco.com/how-neuroscience-is-helping-us-understand-eating-disorders-and-recovery/

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