Monday, March 28, 2011

Breaking up is hard to do

The following dramatization is based on the therapeutic technique of voice dialogue, with acknowledgment to Jenni Schaefer & Thom Rutledge and Daphne du Maurier (there's a juxtaposition of authors you don't see every day!) for their inspiration.

          Jessica takes a deep breath, filled with resolve.  She blurts, "I'm breaking up with you."
          Twenty sighs, raising a skeptical brow.  "Again?"
          Jessica tightens.  "You need to go, and the sooner the better."
          Twenty laughs.  "You want to get rid of me?  After all I do for you, you want me to just disappear?"
          "What you do is make me miserable.  I'll be so much happier without you."
          Twenty stops laughing and grows serious.  "You honestly think life's going to be better when I'm not around?  Think you'll get a boyfriend, do fun things, make more friends, wear nicer clothes, maybe even get a new job?"
          Jessica thinks about how much more confident she'll feel without the extra twenty pounds that weigh down her body and her life.  She gives an emphatic nod.
          Twenty leans in, voice lowering.  "What happens when I'm gone and none of those good things happen?   What if you're still miserable and you don't have me around to blame everything on?   You won't be able to say, "He'd like me if I was just skinny."   You'll have to face the possibility that it's not your looks people don't like, it's you."
          "There's nothing wrong with me."  Jessica asserts, but her voice falters.  "You're the problem."
          "You just don't get it, Jessica.  I'm your best friend.  I keep you safe and protected."
          Twenty moves closer, holding her gaze.  "If you think you're too fat to go out with a guy, you won't go out with anyone.  And if you won't go out, your heart won't ever get broken.  I keep you from taking risks and getting hurt."
           Jessica feels her resolve slipping away.   She shakes her head.
          Twenty says,  "I'll never leave you, Jessica." 
          "No,"  Jessica turns away from the mirror.  She hurries to the kitchen, opens the freezer door and stares inside.  Her eyes land on a carton of ice cream. 
          She hears Twenty's voice, speaking softly, comfortingly.  "Go on, have some.  You'll feel better.  It's easy, isn't it?  Why don't you? Why don't you?  Go on. Go on."
          Jessica stares into the freezer.   She hesitates.

You could easily replace "Twenty" with "Ed" (as Jenni does in her book) or with bulimia, anorexia, binge eating, and so forth.   The point is that whatever you are struggling with is usually there for a purpose, to protect you in some way.  An eating disorder is a friend as well as an enemy.

In Daphne Du Maurier's book "Rebecca" (and in the movie) Mrs. Danvers urges the main character not toward an open fridge, but an open window, telling her it'll all be easier if she just takes a (literal) leap.

What do you think Jessica will do next?  How can she talk back to Twenty?  How can she comfort and support herself?

How can you do the same?



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Sunday, March 20, 2011

Feel the magic!

I have a magic wand in my office.  If only it worked the way Harry Potter's does in books and movies!  If it had actual powers, I'd wave it over people and magically heal their relationships to themselves. I'd instantly create self-acceptance to replace self-criticism and help people process feelings instead of turning on themselves, using food/weight as a weapon.  

Alas, the magic wand doesn't work that way.  But here's the good news:  people have the power to change, to identify patterns and destructive attitudes and to react and act differently.  We have our own magic within us.  We can heal ourselves with a combination of insight, hope, tenacity, reflection, courage, and more.

Eating disorder behavior and thoughts often serve to distract from deeper fears and conflicts.  When you can work through these concerns, you may no longer need the eating disorder to cope with the uncomfortable/unbearable feelings that arise from them. Imagine if in a wave of a magic wand, all thoughts of food, weight, calories, fat grams, or anything connected to disordered eating are completely blocked.  If these concerns no longer occupied your mind, what would you think about? 

Fear of abandonment: concern that others will leave you and that you’ll be alone. Is this a familiar concern?  If so, what comes to mind?

Fear of rejection: concern that other people will judge you and won’t like you.  When is the first time you remember feeling this way?

Fear of punishment:  Fear that you’ll get in trouble or be punished in some way.  Do you feel this way a lot? 

Guilt:  Feelings of guilt or fear that you’re going to feel guilty in the future.  Often this guilt leads to anxiety, which is felt as one of the above fears.  For example, “If I do something wrong, then others are going to react by either abandoning, rejecting or punishing me."

Addressing the underlying fear and working through it, what it is and where it came from (easier said than done!!) can help you be less worried about these issues.  And when you're not as worried, you may not turn to or from food to cope.

Comments and questions are welcome.  Please share on Facebook and/or Twitter so more people can benefit from the information on this blog.

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Sunday, March 13, 2011

Got guilt?

My friend Amanda and I met for a yoga class recently.    "Great class," I said afterwards, as we walked to our cars.

"It was," she agreed.  "But I feel so guilty for leaving Jon with the kids.  Here I'm at yoga having fun and he's giving the twins a bath.  I feel so selfish."

Guilt involves a painful feeling of self-reproach or criticism based on the belief that you’ve done something wrong.  There are different types of guilt:

Self-guilt: the guilt you feel as a result of actually being or existing in the world, for having any needs.  The sense is that by needing anything – food, nurturing, comfort, security, love  – you are exposing a deficiency in yourself, that it is fundamentally wrong to have needs. This often involves a sense that your needs/wants will be burdensome to others.  You go out of your way to put the needs of others before your own.

“I shouldn’t be so hungry/tired.”   
“I’ll go to whatever movie/restaurant/vacation you prefer.  It makes no difference to me where we go.”
“Sure, I’ll babysit for you tomorrow night.  It’s not a problem to cancel my plans.”

Depletion guilt:  the guilt you feel when you think that by meeting your needs, you are doing so at the expense of someone else.  This involves a sense that if you do something for yourself or meet your own needs, you are taking something away from others, depleting them in some way.   In my friend Amanda's case, by going to yoga she perceived that she was burdening her husband with childcare duties (otherwise known as fatherhood, ahem).  Some other examples:

“If I leave my husband, he’ll be miserable.  I can’t do that to him.”
“I’m turning down that great job in Chicago.  My mom was so upset when my sister moved to New York, I’ll stay in L.A. no matter what.”
“I want to be an artist but my parents will be so disappointed if I didn’t go to law school.  They’ve been counting on me to join the family law firm since I was born.”

QUESTIONS:

What is it like to ask for what you need or want? 


How do you react to compliments, gifts or attention?


Do you often feel as if you’re taking too much (of anything)?


Are you more comfortable being a “therapist” to your friends than talking about yourself?


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Friday, March 4, 2011

Change ahead...

"Things do not change; we change."  -Henry David Thoreau

"It's been three months and I'm still bingeing," said a client (call her Danielle*) recently.  "Why haven't I gotten better?"

Danielle has been turning to food since childhood, about two decades.  She's been in treatment for three months.   She's in therapy twice a week, which equals about 24 total hours invested in recovery so far.  Two decades cannot be undone by what is in effect one cumulative day of therapy (are you listening, insurance companies?). 

If you don't feel as if you're recovering from disordered eating quickly enough, remember that it took time to develop this way of turning to or from food to deal with internal conflicts.  It will take more than a few months to create a different relationship to yourself.   As you tear down one structure, you are building another;  it takes time to deconstruct one model of being in the world and to construct another.

It's also important to consider other ways of valuing progress.  Although Danielle is still bingeing, she has made significant changes in other ways.  When she first came to my office, Danielle was emotionally shut off and very intellectual in her approach to the world.  Three months later she is able to recognize her feelings, see patterns in the way she relates to people, and notices that she turns to food when she feels uncomfortable.  

When you think about change and recovery, think about what you're adding to your life (insight, interest in yourself), not just about the pounds you want to lose or gain.  Those are the building blocks on which recovery is built!   

*Danielle is not a real person but an amalgamation of many 

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Wednesday, March 2, 2011

Being vs. Doing

We’re human beings, not human doings!

Our society values productivity and accomplishment. If you grow up in a family (and a culture) that is primarily or solely interested in what you are doing/accomplishing/achieving, you learn to value yourself by being productive; it becomes the basis of self-esteem. 

When others express interest only in your accomplishments, you learn to value yourself only for what you have achieved.  When others dismiss or devalue your feelings, you learn to do the same.  Feelings become frightening and a source of anxiety. Disordered eating is a way of coping with those feelings.  So is staying busy and focused on achievements.

Doing can serve as a distraction from your emotions.  It can take the form of:
Working all the time
Going online all the time
Going to the gym
Running errands
Having the TV on for "company"
Going out with friends all the time to avoid being alone
Thinking about what you need to do next/making lists
Thinking about calories, fat grams, the number on the scale

Being puts you in touch with your emotions.   It looks like this:
Being alone
Staying aware of  thoughts and feelings
Being able to comfort and support yourself

How do you keep busy?

How did you learn to use “doing” to escape “feeling”?

What happens if you are alone with yourself?

What are you afraid you might think?

What are you afraid you might feel?



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Tuesday, March 1, 2011

There's color in-between black and white!

Congratulations to Natalie Portman on her Oscar.  I found the film thought-provoking in terms of its parallels to disordered eating.  

(Semi-spoiler alert - don't read if you haven't seen the movie):   In addition to the character's perfectionism, which many people can relate to, I was struck by her struggle between different parts of herself and how difficult it was to integrate them.  She could not hold both the sweet, dependent (white swan) part along with the feisty, independent, sexual (black swan) part of herself. It was a battle of which self would kill off the other, rather than a bringing together of disparate aspects of "self".  I view the end as a symbolic soul murder; she did not actually die, but killed off the part of herself she could no longer tolerate, a girlish part that she had outgrown and wanted to get rid of, just as she got rid of her stuffed animals.

So often people struggling with disordered eating are unconsciously trying to lose the perceived bad parts of themselves by losing weight.  They may by symbolically trying to get rid of uncomfortable feelings by purging food.  This is only one aspect of eating disorders, but it's an aspect I thought the film captured well.  

Self-acceptance suggests that we accept all parts of ourselves - the aspects we like, as well as those we don't like.  We all have a black swan part of ourselves, as well as a white swan part (and hopefully a rainbow of parts between the black and white).   

Accept yourself today and every day!

And a small comment about the Academy Awards.  Many viewers love watching the stars parade down the red carpet.  They see slender, gorgeous people dressed  in beautiful - or sometimes tasteless! - gowns and tuxedos.  Most of these stars spend weeks or months on diets, being botoxed, highlighted, and spanxed by an army of trainers, stylists, doctors, hairdressers, and estheticians.  Keep in mind that's not what real people (and stars are real people) actually look like!    





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