Tag Archives: eating disorder recovery

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

In the last blog, I introduced you to Lindsay Stenovec, Registered Dietician, and her Meet-Lindsay experience healing disordered eating and becoming a dietician. Lindsay is now a Mom who works with women recovering from disordered eating. Here is some of the fabulous insight she shared with me during her interview:

What are some of the things you work with that are specific to moms recovering from eating disorders?

Something that has become more and more apparent to me is that there’s a lot of shame when a mom who’s in recovery has an increase in disordered eating. They could be in recovery for 2 years, 10 years, 15 years, but if they start to realize during their perinatal journey, they’re struggling, it brings up shame. They forget to take into account that this is actually one of the riskiest times for recovery. And a small or large amount of eating disorder behaviors or thoughts that can come back into the mind are not uncommon.

When I get  initial calls for support, a lot of the self-talk I hear from recovering moms is “I feel  so stupid,” or “This shouldn’t be happening,” or “I can’t believe this is happening again. I thought this was far behind me.”

I’m always really quick to say:

“This is actually something that a lot of women in recovery experience. It’s one of the riskiest times for recovery. And it doesn’t say anything about your recovery or how much work you put into it. And look here you are on the phone with me! You have totally recognized what’s going on. You’re getting support. That’s you taking care of yourself. This is exactly what you need to be doing: reaching for and getting support!”

Right off the bat it’s important to make sure that they know they didn’t do something wrong; that there is nothing wrong with them. A lot of the times disordered eating thoughts and behaviors come up as a result of the hormonal changes that women experience. And pregnancy/postpartum, are big life changes. It isn’t surprising that disordered eating “coping skills” come up.

Shame: 

pregnantI also see that there’s a lot of worry around body changes during pregnancy and postpartum. This is a big time of change, not just physically, but also emotionally. What I have noticed is, for women in recovery, it may take a little while to open up about that. I’ve notice a trend with not wanting to say out loud or fully express the distress around body changes, because they don’t want it to be there. They don’t want to be feeling this way about their bodies. They feel shame about feeling bad about the change in their body. And so keep that really close to their vest. But over time it starts to organically come out. For moms in recovery, just know that this could be a risky time, and seeking support can help.

(Side note: shame is such a big obstacle for recovering women. I tell my clients shame stands for the false message of SHAME= Should Have Already Mastered Everything. Let’s challenge that message, again and again. You get to be human and in-process, just like the rest of the world. And you deserve compassion, just like you offer your little one.)

How can pregnant and postpartum women sort through all the food recommendations that are in magazines, doctor’s offices, and diet-culture and  find what works (and doesn’t) for them?
We do have some changing nutritional needs during the perinatal period. However, oftentimes they are presented in a way that reinforces diet culture. And so there’s some work to be done regarding how we consider nutrition. How do we incorporate that into our own bodies’ wisdom? For example, if I’m working with someone who is early in pregnancy, the first trimester is often survival mode for many women who have pregnancy nausea. The cues from your body are so strong, they are very chaotic, and they are not to be messed with. So if I were to say, as a dietician

“Hey you know you should really more broccoli during your first trimester because vitamin C is very important and broccoli has lots of vitamin C,”

and then you go home and you can’t even look at broccoli because you’re going to be sick, that nutrition information is not that helpful for you! You have to say to yourself:

“OK, vitamin C might be important, so I could probably take a vitamin supplement to help myself during this time.”

And then, in the meantime, you might be eating saltines and apples. It’s a really interesting time to explore, because the cues from your body are so strong. You have really very little choice other than to go with the flow of what your body is asking for. This level of intuitive eating- of listening to your body’s cues- can be very scary or it can be very empowering. I’ve seen it go both ways.

I believe it’s very helpful to have that dietitian with you to say something like this:

“Oh, you got this piece of nutrition information. Let’s look at whether it’s supportive or not supportive to you and how could we use it in a way that honors what your body is telling you right now.”

We really have to learn what intuitive eating calls gentle nutrition. We have to learn how we can incorporate that gentle nutrition into our lives. We have to think about the different stages someone’s at, and to realize that healthy eating doesn’t mean rigidity. Healthy eating doesn’t mean restriction or not allowing yourself to enjoy food. There is no such thing as a right way to intuitively eat. There’s only listening to your body and going by what it needs. Your body does have wisdom, and it is going to be giving you different information every day. The only way you’re going to know what it needs is to is to pay attention to it and just do the best that you can.

In conclusion? Pregnancy (and postpartum) are great times to practice:

*letting go of perfectionism and shame,

*eating intuitively and listening to your body’s needs,

*being present what what-is (rather than what your fantasy wants it to be) and

*receiving support and practice being good enough.

To connect with Lindsay’s Nurtured Mama podcast, Facebook group, and resources, click HERE

 

Moms, Food, and Diets

In continuing with the fabulous interviews for the forthcoming book Good Enough Mama: Taking Care of Yourself and Your Recovery During Pregnancy and Postpartum, today I want to introduce you to Lindsay Stenovak, Dietician, Mom, Recovery advocate, and host of The Nurtured Mama podcast

Lindsay+Stenovec

What made you want to become a dietician that specializes in eating disorder recovery?

My own journey definitely led me to this area of specialty. Having suffered from disordered eating and body image distress informed it. In college, as a nutrition major, thought I was doing the “right thing,” eating “healthily” when really it was diet mentality. I thought I was being a good nutrition major. I was following the rules that were given to me. I genuinely thought there was something inherently wrong with myself in my body for not being able to adhere to these recommendations that just weren’t realistic or appropriate for my body. And that would send me into these cycles of struggling with disordered eating. So, long story short, I hit this point in late in my senior year of college where I said:

“Enough is enough. I just I have to let myself eat enough food!”

I started to experiment with this, and realized I could relax around food! And I found it was actually not so scary. And shortly after that I was introduced to intuitive eating as well as the world of eating disorder treatment.

(Intuitive eating can be defined as a nutrition philosophy based on the premise that becoming more attuned to the body’s natural hunger signals is a more effective way to attain a healthy weight, rather than keeping track of the amounts of energy and fats in foods. For ten principles of intuitive eating from authors Evelyn Tribole & Elyse Resch, go to: Ten Principles )

Intuitive eating – and using this approach to eating disorder recovery – fit in very nicely with my own personal experience. I realized there was this whole world of people practicing intuitive eating and “Health At Every Size” (HAES)  who were saying not only “It’s OK to eat,” but also “It’s ok to eat enough and enjoy it! You have permission to do this!” I realized, Oh these are my people and this is my jam! There was no going back.

What is diet-mentality and how did you break out of it?

Diet mentality says that a variety of body shapes and sizes are not OK and that you can’t trust yourself around portions. In my nutrition program at school, they were teaching us that you’re going to have to really work hard to help people not eat too much. It was fear-based: one wrong moved you are going to be out of control.

I remember having a discussion in my nutrition program about portion sizes and all of a sudden I realized “Oh my gosh, the ‘serving size’ on the box is just the unit of measure! No_DietingUnder no circumstances is this like the right amount for everyone to eat, every time they sit down to eat that food.” All of a sudden I had so much validation for myself in struggling with trying to stick with a cereal box recommendation, feeling so hungry, and thinking there was something wrong with me. I could eat more than one bowl of cereal because, even though it said one bowl was a “serving size,” one bowl didn’t fill me up!

I remember raising my hand in class and saying:

“I just realized that this is the unit of measure not the perfect amount everyone is supposed to eat! This is just a unit of measure that manufacturers picked and put on the boxes. It helps their product look good within diet culture, but it really has nothing to do with what you need in that moment.”

Everyone including the teacher just looked at me strangely, and went back to the lecture. But it was a revelation for me. Back in the day, they used to always say a bowl of cereal was part of a complete breakfast. Not your whole breakfast. And if you want to choose to have a cup of cereal, fine. But make sure to give yourself unconditional permission when you get hungry an hour later.

Stay tuned next for part two of this interview, when Lindsay discusses some of the ways she helps moms with the massive food and body changes during pregnancy and postpartum!

Recovery and Advanced Maternal Age: A Story of Hope

I’m in the process of interviewing professionals and recovering women for my book, Good Enough Mama: Taking Care of Yourself and Your Recovery During Pregnancy and Postpartum. And I’m being blown away by the amazing women I am meeting. So I’ve decided to share some of the experience, strength, and hope they are offering in their stories.

But first, a bit on Advanced Maternal Age (and how it relates to eating disorders):

There are many reasons why women are delaying having a baby until later in life, including: effective contraception, gender equality, women reaching higher educational

ama

image from Everydayfamily.com

levels, cultural value shifts, divorce or partnering later in life, lack of childcare support, an absence of supportive family policies in the workplace, economic hardship, job instability or work in male dominated fields that are not supportive of or understanding of motherhood.*

Along with reaching higher educational levels, many recovering women want to do personal growth work and solidify their eating disorder recovery prior to becoming a parent. However, delaying childbirth until after age 35 can further inhibit fertility for women that may already have fertility problems leftover from their eating disorder history.

Twenty million women and 10 million men have an eating disorder at some point in their lives, according to the National Eating Disorders Association. Fertility problems, though they can be overcome, are among the potential long-term consequences of such conditions, with some studies suggesting that eating disorders account for about 18 percent of patients seen in infertility clinics, says Dr. Leslie A. Appiah, associate professor in the University of Kentucky College of Medicine’s Department of Obstetrics and Gynecology. **

OK, enough with the stats. I’d like to get to the stories of hope because the purpose of this blog (and the upcoming book) is sharing hope: hope that recovery is possible, hope that motherhood is possible, hope in the knowledge that you are not alone.

So without further ado, let me introduce you to Sheira Kahn, MFT. Sheira is a marriage and family therapist in private practice with two decades of experience in treating eating disorders and three decades of her own recovery. For those of you struggling with hope that you can still be a mom later in life: She had a baby at age 50.

Here is her recovery story:

When I was a teenager and I was bulimic. The house where lived was filled with turmoil that I literally couldn’t stomach. Thankfully, when I moved out, I stopped purging. However, hatred of my self and my body persisted. I still hated my body and I hated every bite of food that I ate. The mental part of the disorder persisted. I was in pain and I knew that I didn’t want live that way. So I joined a meditation school where they taught us about how to work with the critic. And since my critic was always criticizing me about my body, I did what they said to reduce your critic. Every time my inner critic was loud and mean, I practiced. And my relationship with my body changed, because there was less hatred being channeled from a critic toward myself. Then, a book on hunger and fullness signals taught me how to listen to my stomach, not my critic, when making food decisions.

What inspired and motivated you to get into recovery?

I was in so much pain. I wanted the pain to be reduced. I think with some people, the coping mechanism (of the disordered eating) works to keep them numb to the pain, so  they keep doing the coping mechanism. But for me I was in pain. It wasn’t a hard decision for me. I felt so bad. I thought recovery was going to make me feel better, so I threw I threw myself into it.

Did you always know that you wanted to be a mom or did that desire come later?

I always did growing up and then, in my 20s, I thought I didn’t. And then it came back. And then it came back very, very strongly. I assumed that would happen for me, as it seemed to happen so easily for other people. I had no idea that it that I would have to go through a lot actually to become a mom.

What happened?

For me it was a combination of factors. I wanted to be partnered.  I married someone that I had fallen in love with when I was 21. He wanted to have kids, and I didn’t. Then I changed my mind, but then he had changed his mind! That relationship wasn’t working out for several reasons. Then I got married again. I was in my I was 40’s when we started trying, so I was on the late side as far as far as fertility. It might have happened if I had felt safer in the relationship. However, I didn’t feel safe in the relationship to bring in a child. I believe this influenced my already shaky fertility. However, I knew I really wanted to have a baby, and I was ready to do whatever I needed to do. I was ready to have a baby or have a family, even without a partner who is willing to do it. I just knew that I had to go for it.

By that time there were some things in place that showed me I could be successful being a mom. I felt healed enough in myself. I had a sense of inner strength and I had support. I was making good livelihood on my own at that point, so I knew I’d be able to provide for a baby.

What happened in the decade between 40 and 50?

Three things during that decade: internal readiness, emotional clearing, and practical steps.

Internal Readiness

There was an internal readiness that I didn’t achieve until I was 48 years old. I came from a family where there was emotional trauma. There was extreme disconnection: fighting, antagonism, conflict, and fear between my parents. That set me up to have very few skills for building long term relationships. It gave me a layer of fear. When there are emotional injuries like this, it’s like a layer in your body. It felt like a layer of beliefs that went along with this fear. I thought that I would never be able to have a family. Or that it could happen for other people, but not me. I saw it happening for other people, and I believed it couldn’t exist for me. There was all this evidence that had confirmed the belief I held: Sheira doesn’t get to have family. I had been divorced once and then was getting divorced a second time. I had miscarried…

(Don’t worry! Remember this is about hope. The story doesn’t end here! Stay tuned next week for part two where we get to the Hope part of Experience, Strength, and Hope)

Sheira Kahn, MFT, is a marriage and family therapist in the bay area who gave birth to a beautiful baby girl at age 50. To read more about her professionally, you can visit her website here

References:

*Mills M, Rindfuss, RR, McDonald P, Te Velde E,“Why do people postpone parenthood? Reasons and social policy incentives,” ESHRE Reproduction and Society Task Force: Hum Reprod Update, 17(6):848-60, Nov/Dec 2011.

** Medaris Miller, Anna “The Lasting Toll of An Eating Disorder: Fertility Issues,” US News and World Report, March 31, 2016.

 

Midlife Mid-Drift

I had one of those moments today. As I was pulling on my jeans, I could feel they were too tight. My midriff was mid-drifting. And that first automatic thought – “I’ve gained weight!”- was quickly followed by a shitload of culturally conditioned fat-shaming judgements. The good news is that then I took a deep breath. And remembered this voice comes in when I am suffering in some way that needs tending. That I have over twenty years of eating disorder recovery behind my back (and in my stomach). That this fearful voice doesn’t pop up very much any more and I have another way of being with myself now. Compassionate-Curious-Recovery-voice kicked back in.

Might these jeans be tight because they just came out of the drier?

If you did gain weight, so what?

Here’s how the rest of that conversation went down:

Anxious-part-of-self: What do you mean so what? SO WHAT? My body is supposed to stay the same. This is my recovery body and it’s not supposed to change.

Compassionate-Curious-Recovery-Self: Interesting. Where did you hear that? Actually, your body has changed many times over the past two decades. Most people’s bodies do. Who told you your body is supposed to stay the same? I think I remember your very first recovery mentor telling you twenty years ago (when I was a young adult and she was middle-aged) two things:

1) The size of your body is not your business.

2) The only constant is change.

When I work with women on body image suffering, often there is a correlation with the uncertainty that come with the life-passage transformations such as young adulthood, marriage, pregnancy, postpartum, middle age, and elderhood- and body image. Life transitions can be challenging, and the culture we live in doesn’t have a container for women traveling through these rites of passage. We do have a body-shaming culture that tells us there is something wrong (with our bodies) and it is our responsibility to fix/change them (our bodies). In the absence of community, and of rituals that assist us in crossing these thresholds, a fearful body-shaming voice can come in to keep us “safe.” Safe from what? Safe from the scary changes of the unknown by assuring us that If you can keep your body from changing, then this (life-change) will not be distressing. Safe from having to go through it alone. Safe from facing all the mixed messages in a culture that feels ambivalent at best, and actively disdainful at worst, about supporting women through the rites of passage into adulthood, motherhood, middle age, and becoming a crone. But in practicing hating our bodies, we miss out on appreciating how wise they are in leading and guiding us through these life transformations.

Midlife Mid-Drift (and other women’s body/life changes)

In perimenopause, the ovaries produce less estrogen, which can cause the body to store extra fat (because fat cells can produce estrogen, which offers the body a safety net). Interesting. Thus the thickening around the middle. Pretty smart, body!

In adolescence, a hormone called GnRH (gonadotropin-releasing hormone) is released, and then forms two new hormones that signal the body to gain weight and become fertile. Smart body!

In pregnancy, weight gain is distributed in all kinds of useful ways, including: increased

jadebeall mothers belly

Photo by Jade Beall, A Beautiful Body Project, http://www.jadebeall.com

blood, breast tissue, fat stores for future breast feeding, amniotic fluid, the placenta, oh, and the actual baby! Wise body. 

Just like postpartum, when the stomach carries shapes and marks that show it grew to hold a child. Successful body!

My body is  changing again.  It’s what happens for women throughout the life cycle. By the way, when I was researching reasons why a woman’s body changes in adolescence, the perinatal period, and midlife, guess what popped up on Google? You got it: 10 Ways to Diet That Away. (“That” being the inevitable changes in your body.)

A Recovery Reminder

If you are in recovery from an eating disorder, or any form of body image hatred (aka if you live in this culture), DO NOT visit Dr. Google for your answers to questions about life transitions. Dr. Google will always tell you that losing weight is the answer to complex life problems. Stop dieting, start rioting, and find your people. Find your support team of friends, professional help, and spiritual sustenance to help midwife you through your life transitions. Listen to the wise, fiercely compassionate and sometimes as* kicking part-of-you-that-knows and act on that voice. Now is not the time to let the weight on your stomach go. Now is the time to let the weight of holding up unrealistic expectations of who-you-are-supposed-to-be vs. who-you-actually-are go. Or, as Brené Brown so eloquently states about midlife:

I think midlife is when the universe gently places her hands upon your shoulders (or your midriff), pulls you close, and whispers in your ear:

I’m not screwing around. It’s time. All of this pretending and performing – these coping mechanisms that you’ve developed to protect yourself from feeling inadequate and getting hurt – has to go.

Time is growing short. There are unexplored adventures ahead of you. You can’t live the rest of your life worried about what other people think. You were born worthy of love and belonging. Courage and daring are coursing through you. You were made to live and love with your whole heart. It’s time to show up and be seen.
That about sums it up: Show up and be seen, midlife midriff mid-drift-ing over your jeans and all.

Butterflies, Recovery, and The Stages of Change

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

I have this posted on my office door:

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

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

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

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

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

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

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

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

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

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

    IMG_2637

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

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

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

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

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

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

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

Get your (skinny clothing) skeletons OUT of the closet

“It is true that there are skeletons hiding in our closet, but there is treasure

hiding there, too.” -Teal Swan

OK moms and recovering women, as we all know, bathing suit season is fast approaching. In my work as a therapist for moms and women recovering from eating disorders, sessions are starting to revolve around:

  1. How to hide body parts while wearing summer clothing
  2. How to avoid wearing a bathing suit
  3. Comparing and Despairing

I encourage moms, and anyone with body image issues (so basically everyone) to let that shit go. Of course I mean emotionally (I’m a therapist 🙂 ) But I also mean literally: Bring in the old bathing-suit/pair-of-short-shorts/sleeveless-little-red-dress and we will have a goodbye ritual.

Marie Kondo, in her famous (and clearly written BC: Before Child), The Life Changing Magic of Tidying Up (2014) writes:

The best way to choose what to keep and what to throw away is to take each item in hand and ask Does this spark joy? If it does, keep it. If not, dispose of it.

Although easy-sounding, this can be tricky. When I ask my clients to bring in their clothes from their pre-pregnancy or pre eating disorder recovery days and ask,

“Does this [shirt/dress/pair-of-jeans] give you joy?” they almost always say unequivocally,

“YES.”

And then I ask “Is it REALLY the [shirt/dress/pair-of-jeans]?”

To which they say “YES.”

Then we sit there and look at each other in a staring contest. However, since therapy is expensive, this usually only lasts a few minutes at most. Then they might say something like:

“Well, maybe it’s the memory if wearing this pair of jeans and feeling confidant.”

Or

“I wore this dress on my first date with my husband.”

Or

“When I was [this size], I didn’t ever feel anxious.”

Or

“I was happy when I wore this.”

Then I ask them where the happiness came from.

“The shirt/dress/pair of jeans” they say.

“No,” I say. “From you. The happiness came from inside of you.”

Them: “No, it was the dress.”

Me (Their Best-Self): “Go buy another.”

Them: “I’m not the right size.”

Me (Their Best-Self):

“You are the right size. You are the right size. Right now. Your stomach is the right size. Your thighs are the right size. Your arms are the right size. Your JEANS may be the wrong size, your DRESS or your BATHING SUIT or THE CLOTHING INDUSTRY may be the wrong size, but not you.”

“But what about the happiness I felt when I wore these jeans (dress/bathing-suit)?”

More staring, but with compassion and softening. And then we cut up the clothes. Sometimes we make them into journal covers. Or toddler clothes (because that is who size zero is made for).

Then we get to the tears and the grief. Because motherhood, and eating disorder recovery, is not only a whole new body. It is a whole new life. Do you really want the life you had when you were wearing that dress/bathing suit/jeans? You may have had more freedom (moms), or you may have had a thinner body, but were you really happy? Were you not just as- if not more- obsessed about food or worried about somebody finding out or seeing “the real you” (because under the dress you were feeling anxious, insecure, and lonely)? So your tummy was smaller. Did you wake up in the morning filled with joy about everything in your life, your relationships, your career, and your connection with meaningful purpose because your stomach was free of stretch marks or your arms were thin? I doubt it.

Happiness, in my opinion, is more about being in acceptance with what-is rather than what-you-would-like-to-be. If you have a little red dress that you used to wear in your pre-mommy or pre-recovery days that doesn’t fit (and never will because spanxs-are-for-women-who-willingly-subject-themselves-to-torture-and-isn’t motherhood-already-hard-enough), let that shit go. Is it really making you happy hanging there in your closet? Or is it looking at you every day saying:

“You used to wear me. Now you are a hippo-that-wears-sweat-pants.”

That doesn’t sound like it’s sparking joy. That sounds like a shaming, mean voice that should not be allowed in your house and definitely not in your closet.

Saying goodbye to the illusion of happiness being tied to an unattainable body shape/size can often bring up grief…which then can lead to freedom, which feels like, yes, you guessed it, happiness. Maybe not full-on joyful euphoria, more like self-accepting contentment. But isn’t that good-enough? Isn’t that what you wanted all along?

Oh, and more space in your closet for new clothes.

how to dress for your shape

Orchids, Dandelions, and Recovery

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

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

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

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

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

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

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

Orchids and Dandelions [i][ii]

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

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

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

“Because other people do.”

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

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

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

a dandelion will say:

“Sure!”

If you suggest:

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

an orchid will say:

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

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

To which I would reply:

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

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

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

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

FullSizeRender-13 copy

NOTES:

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

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

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

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

 

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

 

What Anxiety Says… and a Compassionate Response

Anxiety comes up frequently for people in recovery and moms. When I imagine anxiety, it looks like this:

fullsizerender-13-copy

It is rigid, red and rapidly moving.  Usually, we want anxiety to go away. We want to just get rid of it. But when we ask what anxiety has to say, and respond with curiosity or tenderness to the scared-self, a new relationship can emerge. Below are some examples of what the anxiety part of the self might say.

Here’s What Anxiety Says:

  • I’ve made a bullet-point list for you. You should do everything on the list and then I will go away.
  • (After list is complete): “OK, that was the first one. I now have several more.”
  • Other people have it all figured out, so you should pretend like you do. One way to do this is to look good. I will help you with that. Try to look perfect.
  • You are the only one that struggles with this anxiety. It makes you isolated, and you don’t belong because of it. Therefore, you should hide it.
  • Be very busy. If you’re not busy, doing things, I can help keep your mind be very busy. I can even make your thoughts race.
  • I will always be your friend, but especially from 1:00-4:00am. At that time, I will remind you of the ways you are incompetent, the world is falling apart, and you can’t do anything about it. If you go on social media during this time, I will find lots of evidence for you.
  • Other moms are doing it better. You are not qualified to be a good parent. You should read parenting books to illuminate all the ways you are f*cking up.
  • Your body is the wrong size/shape. You can (and should) fix that. If you do, I may go away (but I will probably stick around because you will need me to manage you, since you can’t be trusted).
  • Not eating, bingeing, purging, drinking, or smoking pot are good ways to get me to go away. (Oh, and you will need to maintain that. And you should hide that you do that, because it is shameful).
  • The world is not safe. I have found lots of evidence of this for you.

As you can see, it is not a kind voice, this anxiety. It is relentlessly hypervigilant to the ways that you are inadequate. Strangely enough, this part of the self is often trying to protect you: from vulnerability, from the unknown. In my training as an Imaginal Psychologist, one way we worked with different parts of the self – and integrating them back into wholeness – was to bring fiercely compassionately objective voice into the dialogue. Compassionate awareness can take several different forms: it can be humourous, fierce, gentle. It can be rational and empirical. In my experience, this compassionate part is much more flowing and less rigid than anxiety. It feels like a deep breath down into the cooling water under the anxiety. It might look like this:

compassionflow-13-copy-3

Here are some examples of what this voice of might say to anxiety. What the Voice of Compassionate Objectivity Might Say:

  • Isn’t it interesting to notice the associations between anxiety and accomplishing or not accomplishing things?  So interesting to notice…
  • I bet you could choose to do some, all, or none of the items on the list, and your value as a human would remain fully intact and whole. How about you try and I will be the witness observing?
  • Is “figured out” an equation? If “it” is figured out, does that mean fear or suffering disappears?
  • Who are those “perfect,” and “busy” people? If they exist, might they be struggling with the same fear of inadequacy you are?
  • If there are 7.5 billion people (roughly) on the planet, do you really think you are the only one who struggles with these thoughts and feelings? Might it not be the very thing that connects your heart, mind, and body with humanity?
  • I wonder what would happen to your thought-speed if I help you breathe. Does it change if you breathe all the way into your abdomen? It doesn’t need to change. But if you are in discomfort from the racing, bringing attention to your breath can help your body shift into parasympathetic (rest) mode. Would you like to try?
  • I will do everything I can to help you get a good night’s sleep, honey. I’m going to help you with loving limits: no social media at night. Not helpful.
  • We can take stock of your strengths and weaknesses during the day and/or with someone who can add compassion and objectivity to the assessment. When you’re feeling weak, that’s not the time to assess your weaknesses.
  • If you can’t sleep, I won’t abandon you. I’ll stay with you and the anxiety. I’ll be right there with you, surrounding you with care and tenderness.
  • Body size and shape have nothing to do with your worth, honey. I know you keep really wanting it to be about that. But I’m going to keep reminding you the answers you seek are not there.
  • Did you show up to the best of your ability as a Mom today?  Your best can be different on different days. That is ok. Mistakes are how we learn. Oh, and put the parenting books down.
  • You can tolerate anxiety. It won’t kill you. You can ride the wave of this fear without medicating it.

These are just some examples. The goal is not to get rid of anxiety. The goal is to develop a different relationship with it. Perhaps it might look like this?

fullsizerender-13-copy-3

 

Obviously, you will have to see what your own voice of Compassionate Objectivity has to say.

For now, I will leave you with a summary that I and some of the people I work with find helpful:

There is nothing wrong with you.

Nobody has it all figured out.

You are safe right now.

You are not alone.

What I Learned About Recovery From My Little One

Sometimes S’mores are Dinner and You Have to Let the Bad Feelings Out Before the Good Feelings Can Come in

Like many mothers, one of my fears is that my child will eat only sugar and therefore not grow (have deficits in attention, develop an eating disorder, etc.).  When moms have this fear, what do they do? Often, they swoop in and try to control. Here’s what it has looked like in our house:

Me: “Eat your broccoli.”

Little one: “No.”

Me: “Eat your broccoli or no dessert.” (Yes, I am ashamed to admit I have resorted to this in my not-so-enlightened moments as RecoveryMama)

Little one: Takes tiny bite of broccoli floret- like half of a child’s pinky fingernail size- runs around making a horrible face as if being tortured while chewing, swallows, says “Done. Where’s my dessert?”

So, as you can see, my child now loves eating vegetables and we are living happily-ever-after on an organic broccoli farm. The End.

(Just kidding. This is the beginning. The rest is guest blog on on RecoveryWarriors, a fabulous eating disorder recovery resource. Click Here to continue reading)

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