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.
[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
[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
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!
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:
- “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
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.”
We 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 identify 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.
…and recovery is always possible
My first year with the baby was dreamy, so when I started to decline, I didn’t think it was Postpartum depression (PPD). The docs had said PPD could occur anytime in the first year. They didn’t say what it was when depression occurred after that. Since my self-esteem was plummeting, which is one of the hallmarks of PPD, I concluded that my downward spiral was my own fault, due to poor management of my time and energy. It got ugly as the chemistry in my brain lost more and more balance.
What it felt like is that the sun that energizes the earth and had brightened my day was no longer available. I couldn’t feel its warmth. People often use the sun metaphor when talking about depression. When the depression lifts, they say, it is like the sun comes out again. This is very much what it was like for me. When the sun was absent, it was so frustrating because I knew what was missing – a connection to the universe – but I could not get it back. Movement, light, forward momentum – they were gone.
Usually, when you walk, you go forward.
In the dark season, your footsteps dissolve in the mighty, silent ink.
Lost, you have no choice but to sink into what you cannot see.
You reach out but your hands slide down the slick walks of despair,
This relentless, downward pitch can only be a vein of hell.
the baby sleeps through the night, you get a day off, you lie down and rest.
beats your heart. Your mind says nothing.
You feel heat again in your spine. You see orange at the corners of your eyes.
This quiet place at the bottom where the flame always burns,
must be a chamber of heaven
that it took the darkness for you to see.
I wish that I had known sooner that what I was experiencing was a delayed onset of PPD. I would have sleep-trained the baby earlier, and arranged for more visits like the one I just had at my mom’s. A late-onset PPD diagnosis also might have prevented a lot of anger directed at myself for being such a failure at managing my life. So I say, if you have a child under two and you meet the criteria for PPD, it probably is PPD and deserves to be treated as such. At the risk of stating a cliche, you deserve the support you need to feel better.
Sheira Kahn is a recovered bulimic and Marriage and Family Therapist who practices in the East Bay and Marin County. She teaches self-esteem workshops and classes on reducing emotional eating and is co-author of The Erasing ED Treatment Manual, available on Amazon.
At the age of 50, she gave birth to Alexandria in April of 2014. Her blog can be found on www.sheirakahn.com.
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 challenging, 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
One 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.
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?”
“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.
* Melonie Klein Click here for info on Melanie Klein theory
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 acts 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.
Once 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.
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 box. 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?”
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.)
Grapefruit, Atkins, Paleo, Pooh: When is it a diet, when is it a disorder, and what is it really about?
Many 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
The Don’t Diet Live it workbook, Wachter and Marcus, 1999
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:
Your Dieting Daughter (Chapter 7 “The Thin Commandments”) By Carolyn Costin
National Eating Disorders Association (NEDA) website