Tag Archives: binge eating

Feminism and Eating Disorders, Part Two: No Means No

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

 

Falling Off the wagon

So I haven’t been blogging here. I do have three blogs coming out soon (stay tuned!) on eating disorder recovery sites. However, in reflecting on my 12-month Butterfly Project for the year, I’m coming back to the intention of: Stay engaged with the process.

In other words, as they say in recovery, don’t quit before the miracle. Or, as Dr. Brene Brown says,

“Stay in the arena!”

I need to remind myself of again and again: in therapy with my clients, in parenting, and in the life-long process of growth.

With my clients, who often struggle with shame if they slip in their eating disorder recovery, we constantly need to re-frame slips as part of the process. Slips are not a detour. As they say in my little one’s school, Mistakes are how we learn.

In our house, when someone drops/spills something by accident or my little one (who has just started writing) makes a “d” instead of a “b,” we say “Hooray! I made a mistake!”

It sounds so easy, but it is not. Simple, but not easy. Re-engage-ing with the process, again and again. I love how Glennon Doyle Melton, mom, recovering bulimic/alcoholic, and author of two memoirs and the blog Momastery has this motto in her household:

“We can do hard things.”

And another relevent peice for recovery and parenting:

“Most of life is boring. What are you going to do/make of that?”

If you have an answer for you, please feel free to leave a comment. I welcome them. And stay tuned as I re-engage with the process!

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.

Marshmallows, Sugar Hoarding, and the Brain

I recently was assisting at my child’s pre-school and two of the children invented a game called “sugar hoarding.” It entailed filling a dump truck with sand (sugar) and bringing it to the “red castle made of all lollipops with no sticks.” (The sticks were deemed useless as they didn’t have sugar).White-Sugar-Cubes

Why are kids (and many adults) obsessed with sugar?

Sugar tastes good and sugar affects the brain.

Dr. Nicole Avena, neuroscientist researcher, author of Why Diets Fail, as well as many other neuroscientists, have discovered sugar causes levels of dopamine to surge in our brains. Dopamine is considered the “reward center” in our brain, and is associated with feelings of pleasure.

Knowing this, as a person who likes sweets, as a Mom of a child who loves sweets, and as a Psychologist who assists clients recover from disordered eating, helps me bring objective awareness to where and why we get “hooked” on sugar. There is nothing morally weak about liking sugar or eating sugar- our brains are wired to enjoy it, crave it, and, according to some, become addicted to it.

Having this awareness does not mean I have joined the “No Sugar” brigade. Nor will I join any other Diet camp that promotes a certain way of eating other than moderation, three meals a day, snacks as needed, and variety. It’s just too crazy-making. For people who like sweets and anxious (Super) Moms, this is unsustainable and a recipe for failure. For people who are already prone to black-and-white thinking in order to manage the complexity of life, going extreme with no sugar often becomes a disaster, an eating disorder, or an unending roller coaster of obsession, perfectionism, and unsustainable attempts to feel okay with one’s self by imposing an external solution on an internal problem.

However, that does not mean I give my child ice-cream for breakfast or marshmallows on demand!

Marshmallows 

There was a classic study in the late 1960s and early 1970s led by Walter Mischel, a professor at Stanford University in which young children were offered one marshmallow right away or two marshmallows if they waited 15 minutes. You can watch a painful and endearing video of children participating in this study here:

In follow-up studies, researchers found that children who were able to wait longer for the rewards tended to have better life outcomes, according to test scores, educational attainment, and other life measures. This ability to wait, although it may seem an easy task, is quite the challenge for children who do not yet have the executive function (the front part of the brain that regulates the ability to see cause and effect) developed.

Executive Function

I just finished reading The Whole Brain Child by Daniel J. Siegel, M.D. and Tina Payne Bryson, PhD in which this executive function and other parts of the brain are likened to the “unfinished upstairs” part. They state “Just imagine the downstairs of a house that is complete and fully furnished, but when you look up at the second floor, you see that it is unfinished and littered with construction tools. You can even see patches of the sky where the roof hasn’t been completed yet. That’s your child’s upstairs brain – a work in progress.”  They write:

Your upstairs brain…is made up of the cerebral cortex and its various parts…Unlike your more basic downstairs brain, the upstairs brain is more evolved and can give you a fuller perspective on your world…This is where more intricate mental processes take place, like thinking, imagining, and planning…it is responsible for producing characteristics we hope to see in our kids: Sound decision-making and planning, Control over emotions and body, Self-understanding, Empathy, and Morality. 1

So how do we help our children (and ourselves) wait before eating the marshmallow (chocolate cake, ice-cream)? How do we develop and cultivate this part of the brain so our impulse for pleasure (sugar, sex, alcohol) can be moderated with our big picture vision of what we value for ourselves, our bodies, our relationships, and our life?

Mr. Mischel (the “Marshmallow man”) says:

…there are two warring parts of the brain: a hot part demanding immediate gratification (the limbic system), and a cool, goal-oriented part (the prefrontal cortex). The secret of self-control, he says, is to train the prefrontal cortex to kick in first.

To do this, use specific if-then plans, like ‘If it’s before noon, I won’t check email’ or ‘If I feel angry, I will count backward from 10.’ Done repeatedly, this buys a few seconds to at least consider your options. The point isn’t to be robotic and never eat chocolate mousse again. It’s to summon self-control when you want it, and be able to carry out long-term plans. We don’t need to be victims of our emotions, we have a prefrontal cortex that allows us to evaluate whether or not we like the emotions that are running us.’

Simple, but not easy! Doctors Siegel and Payne Bryson offer a couple of child friendly strategies that are excellent practice for adults as well:

1. Play the tape out and exercise your upstairs brain

Instead of giving in to the immediate answer, exercise the upstairs brain. For example, if your child finds a snugglycute-grizzly-bear-clipart stuffed animal on the floor of the library, instead of saying “No, that’s not yours,” try saying “Hmmm… I wonder where that came from? Do you think someone dropped it and forgot it here? How would you feel if you left your stuffed animal at the library by mistake? Shall we see if there is a lost-and-found and then we can check back in a week if no-one comes back for it?”

Or, if you are struggling with recovering from bingeing on sugary food, instead of acting out of impulsive habit and eating a whole box of cookies, play the tape out (for those of us who still remember cassettes 🙂 )  and say to yourself

“What happens when I eat all those cookies?”

Hmmm… I feel guilty.

“And then what?”

Then I feel sleepy and depressed.

“And then what?”

Then I feel ashamed and don’t want to go out with my friends or show up to work.

“Ahhhhh, ok, so it’s not going to really give you the sweetness that you want right now- it’s actually going to give you a bitter experience of self-loathing. How else can I help you find sweetness and comfort right now?”

2. Move your body

boy-getting-socksAnother way to bring in the upstairs part of your brain is to move your body. This helps your downstairs brain re-find a place of willingness and flexibility when you are feeling rigid and resistant. For example, when your child is saying “I don’t want to put my socks on!” and you want to wrestle them to just get the freakin socks on their feet, you can instead say “Let’s go all the wiggles out of your feet first!” and then jump around for a few minutes. This allows them to calm their “downstairs” brain from flooding the upstairs enough to allow some willingness back in.

In the urge-to-binge scenario, it might be to leave the kitchen and take a walk around the block or dance around your house and move the feelings of anger, fear, or anxiety. Though this may sound silly, moving your body can help your amygdala (the part of the brain that is super activated in fear and anger) calm back down enough for you to access your “upstairs” brain again.

So…in summary,

  • 1. Sugar is not morally bad- there is a reason why we and/or our children want it.
  • 2. We can teach ourselves and our children moderation and pausing on impulsivity in order to become and be the balanced, moral, ethical, empathic people we want to be.
  • 3. It is never too early or too late to cultivate neural pathways in your (and your child’s brain) that can help integrate the upstairs and downstairs of your “house!”

Citations:

1.  Siegel, Daniel J, MD and and Payne Bryson,PhD Tina, The Whole Brain Child, New York: Delacorte Random House, 2011.

2. Drukerman, Pamela, “Learning How to Exert Self-Control,” NYT Sunday Book Review, SEPT. 12, 2014.

Resources:

NPR “Why Sugar Makes us Feel So Good” http://www.npr.org/sections/thesalt/2014/01/15/262741403/why-sugar-makes-us-feel-so-good

Urist, Jacoba, “What the Marshmallow Test Really Teaches About Self-Control,” The Atlantic, Sept 24, 2014.

Stanford Marshmallow experiment, http://en.wikipedia.org/wiki/Stanford_marshmallow_experiment

Motherhood will fulfill all of your unfulfilled desires.

Aka Myth Busting, Part 5

All jobs and relationships have their strengths and weaknesses, their ups and downs, their joys and trails. Why would motherhood not include these? Jack Kornfield, the renoun spiritual teacher, wrote a whole book about the spiritual journey titled “after the ecstasy the laundry.” And motherhood includes A LOT of laundry! After the profound experience of giving birth, comes the day to day experience of diapers, (diapers, and more diapers), dishes, bottles, laundry, and spending a lot of time playing on the carpet or in the playground. There are moments within these experiences of Beautiful Aha’s, humour, joy. Recently, my son said to me literally: “I don’t like money. Money is for grown ups. But why did you wipe that poo off my leg? I was SAVING it!” That was a priceless moment of humour. And yet there are often other experiences, too. Of ambivalence.

Barbara Almond, MD, author of The Monster Within—The Hidden Side of Motherhood, states that maternal ambivalence is “the crime that dare not speak its name.” She writes:

ambivalence

ambivalence

Ambivalence arises where there is a conflict between the needs of the parents and those of their children. For example, a loving mother, who has nursed her infant happily every few hours during the day, cannot really welcome being woken out of a much needed sleep every few hours all night long. Yet many women feel guilty and depressed at their own resentment, exhaustion and unfriendly thoughts. That resentment seems very understandable—after all, she does feed the baby even if she would rather not at that moment–but it isn’t, to the mothers themselves.

         I have met SO MANY mothers, fabulously attentive, empathic, conscientious mothers who admit, years after the fact, how much they struggled with postpartum depression. Why is it so hard to admit? This myth that motherhood “should” be all-encompassingly fulfilling permeates our cultural subconscious. Dr Almond writes:

The need to suppress negative feelings is really more of a burden than parents realize…What kind of a mother resents her children? Every kind—but in different degrees. The problem is not the feeling which is usually temporary, but the fear of speaking about it- and the resulting feelings of self punishment.

Let’s break the silence and allow the full range of feelings, not only for children developing their emotional understanding, but mothers, too. Mothers who have (an appropriate) place to speak what feels to be unspeakable will be freer of depression, of apathy, of anger stuffed inward, more available for their children, and more available for the whole range of motherhood experiences, glowing and not. 

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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