Tag Archive | Negative Voice

Top Ten Strategies to Use at Meal and Snack Times

 

Until you are fairly far along in the recovery process, you may need varying degrees of strategies to help with your eating. Ultimately, you will be able to achieve a more peaceful relationship with food and your body, but until then, here are ten strategies to use. Also remember that you are very vulnerable to the “voice” of your eating disorder in the moments before, during, and after you eat, so mentally “arm” yourself for the possibility of hearing negative, critical, and catastrophizing statements during these times. Take your power back!

 

 

1.  Write down and use positive healthy statements for eating times, such as “I am going to do what is best for my recovery at this meal, no matter what negative thoughts I have.” “I need this food to help my body stay strong.” “By eating this meal, I am helping to gain clarity.” “There is no such thing as a perfect meal, but I will do the best I can to eat well.” “I need food for my organs to function at 100%.” “Even if I eat more than I set out to eat, I will not beat myself up because I am doing the best I can.” “Nothing bad can possibly happen to me by eating this meal right now. Only good things can result from giving my body nourishment.” “I will not base what my nutritional needs are on the negative feelings I have about my body. I will eat what I know to be the best meal for my overall health, and my psychological well-being.

2.  Try not to go longer than 4 waking hours without food. The body is designed to be fed at regular intervals and going too long without food may create heightened food obsessions, cravings, and extremes in hunger. By sticking to a fairly regular schedule of eating, you will be better able to think clearly and tune into your body’s needs better.

3.  Make sure you are in a calm emotional place when you sit down to eat. Eating while upset, angry, anxious, or in any negative emotional state can alter your hunger and fullness cues, and increase eating disordered thoughts, urges, and behaviors.

4.  If you need meal time support from a family member, friend, or other loved one, ask for it before you sit down to eat. Once you sit down with food in front of you, you are already too vulnerable. Sometimes a supportive person can distract you from the negative eating disordered voice and can help make the meal/snack a more enjoyable experience overall.

5.  There’s a saying that goes “if you fail to plan, you plan to fail”. Try to think about what your day is going to look like in terms of schedule, activities, places you will be, and people you will be with. Think about, and plan for how you will meet your nutritional needs. You don’t have to obsessively plan everything you will eat, but be prepared for the day. Clients often say to me “I didn’t have time to eat this food or that food.” “I didn’t have time to prepare my food.” “I didn’t have xxx food in the house, so I just grabbed something at the last minute.” “I didn’t know what I wanted so I didn’t eat.” “I didn’t have anything I liked to I just ate random stuff.” “I ran short on time so I just grabbed something and ate it in my car.” These are excuses, justifications that are not putting recovery as the top priority. Decisions like these will ultimately set your recovery back. Recovery must come first, and having a plan to eat well, and often, must be priority #1.  (I am very busy during the week, and I never ever go to work or anywhere without either bringing plenty of food with me or knowing where I can buy a very satisfying meal/snack. Planning to be well fed reduces my anxiety and assures me that I will be able to meet my needs as well as I possibly can.

6.  Try your best not to multitask while eating. Even if you need distractions while eating, try to be as present as possible. The more mindful you are, the more you can be attuned to what your food needs are. Try not to eat while driving, watching TV, on the computer, or working?

7.  Make sure the meal/snack “counts” psychologically. Too often, people with eating disorders make food choices based on rigid rules, not based on what they like. If you are on a meal plan, or if you are working on intuitive eating, choose foods that appeal to you. Choose foods that you are in the mood for, not foods that you think you “should” have. Eating the same exact foods every day, eating by strict rules, eliminating certain food groups or nutrients, eating less than you know is best for you, are all forms of restriction and will potentially backfire sooner or later.

8.  Make sure you are working on incorporating a wide variety of foods and all the macronutrients (protein, carbohydrate, and fat). The human body has a need for all the nutrients, to work optimally. It is best to have at least three or four food groups at meal time, and at least two food groups at snack time. By having a variety of food groups, and having foods that appeal to you psychologically (strategy #7), your body will be well fueled and you will feel satisfied. By accomplishing both physical and psychological satiety, you will also get food off your mind a bit easier, obsessions may diminish, and your mind will be freed up to focus on your passions and other pleasures. Remember though, that your eating disordered “voice” will try to beat you up for eating foods that give you pleasure. Tell that negative voice that by eating foods you like, you are getting stronger and closer to recover

9.  Eat sitting down at a table or counter, with as pleasing of surroundings as possible. Use appealing tableware, tablecloth or placemat, and utensils. It is optimal to have all the conditions possible to have a pleasant, mindful meal. You could even make your own special placemat, bowl, or plate. Try not to eat standing up. Food eaten while multitasking or standing up doesn’t “count” psychologically, sets you up for feeling dissatisfied, and increases urges to crave more food.

10.  If one meal or snack doesn’t go well, or if you have used an eating disordered behavior at any time during the day, don’t write the entire day off as a “failure”. At the very next time you need to eat, in order to maintain your structure, you have the opportunity to turn things around. Try to never, ever, end the day with an eating disordered behavior or disordered meal. Make sure you end your day doing something positive with your food. There is no stronger statement you can make regarding recovery than going to bed having done the best you could at the end of the day.

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What Does Recovery Look Like?

The second in the series of three questions I am asked the most is:

“What does recovery look like?”

Answer: Wow! I have changed my answer to this question over the years. In my opinion, recovery is a highly personal “picture”. Recovery to one person will look differently than to another. I’d love your answers, in addition to my own!

In my opinion, recovery doesn’t mean being a perfect eater. Recovery doesn’t mean having a preconceived body size. Recovery doesn’t mean eating to be a certain weight or size.

Recovery means consistently not using food behaviors to cope and communicate your needs and desires, because you have developed more effective healthy ways to cope and express yourself.

Recovery means never dieting.  That’s right! You can never diet again. This is such a challenging area for many people. So very often, clients say to me “Normal people diet. Normal people manipulate their bodies. Normal people overexercise. Normal people use diet pills. How come they can do these things and I can’t?”

“Normal” people don’t have a mental illness where any or all of these behaviors are symptoms of the illness, and when engaging in these behaviors are expressing symptoms of the illness and thus making it worse.

It is not “normal” to do any of those things. Just because something is common, doesn’t mean it is “normal” and it definitely doesn’t make it good or right or healthy or something to aspire to. In my opinion, recovery means not restricting, bingeing and purging, using other substances (diet pills etc), compulsive exercise behaviors, or any type of harmful behavior (even “mildly”).

Once you have an eating disorder, you are VULNERABLE to all things that “normal” people engage in related to food/exercise. That isn’t your fault. It is simply a side effect of having an eating disorder.

Even when you are in a healthy place in your recovery, certain behaviors will still put you at risk. Dieting, for example, is the number one behavior that triggers eating disordered thoughts and can be a catalyst sending you right back into your illness. So you can never diet again…ever. Recovery means redefining “normal”.

How does exercise fit into recovery? Again, remember that you are vulnerable. Exercise (even if it has never been a part of your illness) can be tricky. Everyone knows that movement is good for people. When you have a history of an eating disorder, you have to be attentive to the purpose behind the desire to exercise. If you are healthy and you exercise, you have to be cautious that the purpose doesn’t switch from being healthy to “feeding” your illness. Be honest with yourself and set healthy goals for your exercise. Make sure it doesn’t take on a level of importance where it becomes a “job” or a “behavior”.

Recovery means having a peaceful relationship with food. Food is an essential part of life, but when you are in recovery, food doesn’t occupy all your thoughts. In recovery, you think about food in a neutral or positive way. You don’t have strict black and white rules regarding food, unless medically necessary.

Recovery doesn’t mean having a perfectly happy existence. But, your worst day well will still be better than your best day sick because you won’t be sick and your life will be REAL. Life has ups and downs. Life is difficult at times and joyous at times. Your eating disorder just makes life more difficult on every level, in every way. So, without it, your life ultimately will be less difficult. You will also feel all your feelings – the positive ones and the negative ones. Your feelings are essential, and feeling themwon’t kill you!

Think of all the things you cannot do because of your illness. You will have the opportunity to do any of these things, if you choose, when you are in recovery.  It is freedom.

Recovery means practicing different forms of regular, consistent self-care. Everyone has different ideas of how they can practice this. For some, self care involves having hobbies like reading, blogging, knitting, or doing crossword puzzles. Others like to have creative outlets like singing, painting, playing a musical instrument, or other art forms. Some like listening to inspirational music every day. Whatever you consider self-care, you need to do it regularly.

Recovery is whatever you want it to be. It’s your life. Define it. You only get one life, make it the best one it can be! It’s worth going for!!!

 

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The New Year: BEWARE of the Diet Propaganda

The New Year is once again upon us and the dieting industry will soon begin its massive onslaught of propaganda to convince consumers that they cannot begin the year without a firm resolve to change their body weight, shape, size etc.

Before we talk about how to fight back, here are a few insights into the way the marketing industry works.  Advertising is based on getting consumers to believe that they will NEVER be happy unless they buy this product, do this activity, eat this food, vacation at this place, and the list goes on.  When sellers look to market their product they seek to find a way to prove that “this” is where true happiness can be found.  Their message is that if you don’t buy, do, eat etc. this or that you will never be able to achieve real happiness. And of course you didn’t achieve this real happiness yet.  You haven’t tried this particular remedy.  So, the bottom line is, if you want to be happy do as the advertisement says.

Herein lie the dangers in New Year’s advertising.  New Year resolutions are often comprised of dieting and exercise promises.  The dieting industry goes all out in trying to convince their unhappy consumers that the ONLY way to start the year on the right foot is to buy new gym clothes, sign up to a gym, buy the diet pills and drinks, and begin a new and “all-improved” diet.  THIS year you are going to achieve REAL happiness by changing your body.

However, this is all a myth!  It is a lie perpetuated by the dieting industry, already a multi-billion dollar industry, in order for them to get richer on the backs of their trusting, vulnerable consumers.  This year, DON’T BE FOOLED!  The dieting propaganda is just that – PROPAGANDA!

Webster’s dictionary defines propaganda as “information, ideas, or rumors deliberately spread…”  It is information that is biased and made to fit their agenda; to get you to do as they say.  In order to make you feel like they have your best interests in mind they will promise you the ultimate happiness if you just buy, do, eat their product.

Here is the truth!  You CANNOT achieve any sort of happiness through trying to change your external body.  Extreme dieting, exercising solely for weight loss, or any disordered behaviors (diet pills, laxatives, etc) can never help you attain real happiness.  Happiness, true happiness, comes from within.  It is a synthesis of your inner self, your inner values, and your external actions and behaviors.  It comes while bringing meaning and compassion into your life.  It is an inevitability that stems from nurturing your mind, body, and soul with healthy behaviors, actions, and thoughts.  Attaining the ultimate happiness is NEVER dependent on the way your external body looks.  In fact, by focusing only on your external body you lose the ability to achieve happiness.  Your vision of the world becomes narrow and you become constricted to a disordered space where it is virtually impossible to find happiness.

So don’t be fooled.  Don’t believe the ads when they tell you that they have the answers for you.  THEY DON’T!  YOU DO! The answers are inside your heart and soul.  Look within and stay strong.  Nurture yourself.  That is the ONLY way to find true happiness.

 

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Your Teen May Be Headed For Trouble

Your teenage girl appears to have it all together.  She is bright, pretty, has good friendships, and is athletic.  She develops an eating disorder…what happened?  When a teenager feels out of balance, when the things she feels she CAN control are out of balance with the things she feels she CAN’T control, she feels uncomfortable.  For instance, she can’t control that school pressures are enormous and she studied as hard as she could for an exam and got a 92 instead of a 98.  She can’t control that her parents argue.  She can’t control that her boyfriend isn’t ready for a serious relationship and wants to break up with her.  If she is a perfectionist, these out of control situations may even make her feel like a failure.  She is vulnerable.  She decides to go on a “simple diet” to lose 5 pounds to feel better about herself (because she has been taught by the media that thinness = happiness).  On this diet, she realizes that her weight and the amount and types of food she puts into her body, are things she can control when other things in her life she can’t always control.  The more out of control her life feels, the more important it becomes to control her weight and her eating.  If she is vulnerable enough, the dieting could lead to an eating disorder.

The media, in all forms, sends messages to teenagers that in order to be happy, you must be thin and beautiful.  A teenager is bombarded by these messages in magazines portraying waif thin computer altered models.   Television is sending us messages that if dieting doesn’t work, you can even have an extreme makeover to fix your appearance flaws.  Life-threatening surgeries are portrayed as a brilliant quick-fix.

Teenagers also are living in a diet-obsessed environment.  65% of our country is overweight yet, if you’re not on the latest diet – South Beach, Atkins – something is wrong with you.  Everywhere you turn, in magazines, on TV, every news program, online advertisements,  you are bombarded with messages about how to lose weight.

Imagine being a vulnerable teenager, perhaps of normal or slightly above normal weight, struggling with all types of issues, and then having to sit at a lunch table trying to eat a sandwich where no one would eat a “carb” if their life depended on it.  Everyone is talking about how “fattening” bread is.  The peer pressure to diet is extraordinary.

So, you have this vulnerable teenager, feeling out of control, unable to communicate her feelings, experiencing academic and societal pressures, and peer pressure to be thin, and you have the perfect storm… a scenario that can create disordered eating and eating disorders – anorexia, bulimia, binge-eating disorder.

What behavioral signs should a parent look for?

Behaviors vary according to the type and severity of the disorder.

  • If your teen talks more about her weight in a negative way
  • If she asks often “do I look fat?”
  • If she starts cutting out things in her diet such as foods that were once her favorite foods, such as desserts, and says she doesn’t like them anymore
  • If she exhibits rituals around her foods like cutting it up into small pieces, measuring foods, or pushing things around on the plate
  • If her clothes appear looser
  • If she avoids social situations where food is involved or makes excuses not to eat
  • If she has become a vegetarian but will not eat fats and oils or higher fat vegetarian foods
  • If she grocery shops or prepares food for the family but refuses to eat it
  • If she goes to the bathroom often after eating (to purge)
  • If she begins to exercise compulsively, doing excessive amounts of cardiovascular exercise, sit-ups, jumping jacks, leg lifts, push-ups
  • If she is using diet pills or laxatives on a regular basis
  • If, in secret, she binges on high calorie foods
  • If you see empty food packages in her room or in the garbage
  • If she avoids food at holidays

 

What strategies can a parent employ to help your teen avoid dieting/disordered eating?

  • Don’t diet – healthy weight can be achieved through normal eating and changes in lifestyle.  Be a healthy eating role model.  The “do as I say, not as I do” philosophy doesn’t work with food
  • Don’t discuss weight at home, yours or your teenager’s (especially dad)
  • Never criticize your own body
  • Get rid of your scale
  • Don’t criticize your teenager at mealtime; don’t engage in power struggles over food
  • Be a critic of the media
  • Encourage size diversity
  • Encourage your teen to appreciate her qualities other than her weight to help boost her self-esteem
  • Encourage your teen to express all of her positive and negative feelings with you
  • Have structured meals as often as you can to create a normal eating environment – if a teenager who wants to diet has an unstructured or chaotic eating environment at home, it makes it easier for her to diet and get away with it

REMEMBER, YOUR TEENAGER’S DISORDERED EATING IS NOT ABOUT FOOD.  IT IS ABOUT UNDERLYING ISSUES OF SELF-WORTH, COMMUNICATION AND GETTING NEEDS MET.

If you see any of the above “red flags” or have any concerns about your teen, call a professional who is trained in the detection and treatment of eating disorders.

 

 

 

 

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Donna’s Top Ten Things to Tell Yourself in Those Moments When Your ED is Trying to Drag you Down!

When you are feeling beaten down by your eating disorder or questioning recovery, what do you say to yourself??? Here’s my top ten things to say to yourself when you feel like you need to reinforce staying in recovery.

  1. None of my problems will get better if I act on my eating disorder urges right now. Nothing ever gets better if I stay sick.
  2. Using this behavior right now is just masking the real problem. What am I trying to “accomplish” by using it? What is this urge trying to tell me?
  3. I cannot use a behavior just once and expect that I won’t want to use it again. Eating disordered behaviors are addictive. The more I use them, the more I want to use them.
  4. I need to stay stronger than my illness. I need to fight hard every single meal, every single day.
  5. I need to remember that recovery isn’t supposed to be comfortable. If I am not comfortable right now, I must be doing something right!
  6. Recovery doesn’t have to be perfect right now. I just need to do the best I possibly can in this moment.
  7. It is never too late to start over. No matter how long I have struggled, I can start my life over right now.
  8. My body doesn’t define me. I cannot hurt it through my eating disorder behaviors or other forms of self-harm. My recovery has to involve taking good care of myself – mind, body and soul.
  9. I need to eat food to nourish my body. I need to eat well each and every day for my body to be strong and healthy.
  10. I am NOT my eating disorder. My eating disorder is NOT my identity. It is an illness, not a choice but I am free and able to make the choices I need to make each and every day to get better, find my true identity and live free of this illness.
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WE

We are told we are too fat or too thin.
We are told we need to be perfect little angels.
We are told we are so smart, how could we possibly have this illness.
We are told we need to be perfect.
We are told we need to raise the bar.
We are told we need to keep up appearances.
We are told that everything’s going to be ok when it really is not ok.
We are made to feel we are damaged if we are imperfect.
We are told we are ruining the family.
 

News flash!!!!
 

We are not perfect.
We are not damaged.
We are not going to try to be voiceless angels.
Sometimes things are just not ok.
We are sick.
We need help. 

We are not victims.
We suffer.
We have strength.
We have courage.
We have hope.
We will prevail.
We will live.

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Are You a Casualty of Dieting? Tips for “Normal” Eating

No matter how many years or decades you have overeaten or how many diets have failed you, you still can learn how to become a “normal” eater—eating when you are hungry, choosing satisfying foods, remaining aware while eating and enjoying food, and stopping when you are full or satisfied.

 

Note: You did not fail on these diets. These diets failed you.

 

To succeed at weight management, you will need to:

  • Focus like a laser on eating “normally”
  • Stay persistent like a dog digging for a bone
  • Not expect overnight success
  • Switch your attention from the scale to your appetite
  • Learn effective life skills to manage stress and internal distress

 

Disregulated eaters can learn how to eat “normally.” Here are some tips to speed you on your way.

 

Using self-talk

Learn “normal” eating skills: Look in the mirror daily and tell yourself you can learn the skills of “normal” eating.

 

Think of foods as nutritional and non-nutritional: Instead of thinking of foods as “good” or “bad,” consider them as nutritional or non-nutritional, or nutritional or “fun”. “Good” and “bad” are moral terms that are best avoided in the food arena.

 

Give yourself praise: Do not put yourself down for the mistakes you make with food. Instead, lavishly praise yourself for your successes, even the tiniest ones.

 

Try a different approach: If experience tells you that diets do not keep your weight off, do not try to convince yourself that you should diet. Instead, give yourself points for trying a different approach.

 

Become your own cheerleader: Never say anything to yourself that you would not say to a young child you love, including calling yourself stupid, hopeless, bad, a failure, or worthless. Become your own cheerleader by generating positive thoughts about yourself and your progress.

 

Avoid all-or-nothing thinking: Do not use words like “never” and “always.” Remind yourself that most of life is not black and white, but gray. Think incrementally.

 

Do not dwell on untrue comments: Detoxify negative things people say about or to you that are untrue, rather than repeating them to yourself. Remember that what people say belongs to them, not to you, even if your name is attached to their words.

 

Connect to your emotions: Ask yourself often how you are feeling, so you can connect more easily to your emotions, but explore only with curiosity, not condemnation.

Stop judging yourself harshly: Develop self-compassion. Treat yourself lovingly. Practice speaking to yourself with extreme esteem.

 

Keep a positive attitude: Do not keep telling yourself that learning to become a “normal” eater is hard, because saying so only programs you to find the work more difficult. Instead, substitute words like challenging or doable.

 

Recognizing hunger

Rate your hunger: Check in with yourself often to see how hungry you are by using descriptions such as “not hungry,” “moderate,” “very,” and “famished” or a 1-10 scale.

 

Evaluate if you are hungry: Every time you think about food, ask yourself if you really are hungry enough to eat or if you actually need something else.

 

Consider having smaller meals: Experiment with eating smaller meals more frequently.

 

Think about hunger as a signal: It means that you need fuel, not that you have to go out and seek the most fantastic eating experience of your life.

 

Know what hunger means: Practice believing that hunger is for fuel and pleasure, not for meeting emotional needs.

 

Choosing satisfying foods

Choose for yourself: Do not get hung up on what other people are eating. Instead, ask yourself what you would like to eat.

 

Forget about good and bad: Remind yourself that foods fall on a nutritional continuum (high value/low value), not on a moral continuum (good/bad).

 

Make a satisfying choice: Never eat without first stopping to consider what you want. Spend time making your decision by tuning into your appetite.

 

Stay clear of guilt or shame: Refrain from allowing guilt or shame to contaminate your eating decisions. Avoid secret eating.

 

Choose foods that you like: Do not eat foods that you do not find satisfying or enjoyable. Eating them will make you think that you are on a diet.

 

Eating with awareness and enjoyment

Look before you eat: Before you eat, look at your food, its portion size, and presentation. Breathe deeply. Look again before taking a mouthful.

 

Chew every mouthful thoroughly: Chewing a lot helps to thoroughly release the flavor of foods.

 

Let food sit on your tongue: This allows your taste buds to absorb the flavor and transmit messages about your appetite to your brain.

 

Talk or eat: When you are talking, stop eating. When you are eating, stop talking.

 

Stay connected: Pay attention to your body’s appetite signals while you are eating.

 

Forget about guilt and shame: Push away guilt and shame while you are eating. Focus only on sensory pleasure.

 

Pause while you are eating: Think about how you are feeling about your food in terms of quality and quantity.

 

Know when to stop eating: Stop eating when flavor intensity declines, as it is bound to do. Do not try to polish off all of the food in front of you. Instead, aim for the moment when flavor peaks and you feel an internal “ah” of satisfaction—then stop.

 

Evaluate how full you are: Keep asking yourself while you are eating, “Am I still hungry?” and “Am I satisfied?”

 

Stopping when you are full or satisfied

Know the definitions: Think of “full” as having enough food (fuel) in your stomach and “satisfied” as reaching the high point of pleasure.

 

Quantify fullness and satisfaction: Use words, such as “nearly full,” “too full,” or “just right,” or a 1-10 scale to rate fullness and satisfaction.

 

Tell your body: When you feel full or satisfied, focus on that sensation, and broadcast it to your whole body.

 

Disconnect from food: When you are done eating, put down your utensils, push away your plate, and get up, if possible. At least mentally move on. Do whatever you need to do to disconnect yourself from the food.

 

Decide when enough is enough: Make sure you do not focus on food that is left in front of you. Recognize that you do not have to finish it or clean your plate.

 

Changing your beliefs

 

From: To:

“I need to diet to lose weight.”

“Diets do not work long term.”

“This is too hard.”

“I can learn to do this over time.”

“This will take too long.”

“If I do not change now, I will only end up back in this same place again, so I might as well get going on it.”

“Losing weight is the most important thing.”

“I will lose weight if I honor my appetite and learn to eat ‘normally.’”

“I am bad/worthless/ugly if I am overweight.”

“I accept my body as it is and still will try to improve it.”

 

Stopping emotional eating

Consider your feelings: If you have the urge to eat when you are not hungry, identify the emotion you are feeling.

 

Think of a different response: Remind yourself that feelings need an appropriate response—not food.

 

Know the emotions that trigger unwanted eating: Boredom, loneliness, anxiety, shame, guilt, disappointment, confusion, and helplessness can trigger unwanted eating. Look for more effective ways of dealing with these feelings.

 

Keep a feelings log: This will help you keep track of what is going on inside of yourself all day long.

 

Reduce stress: This will lessen frustration, helplessness, and the overwhelmed feeling you sometimes have that may drive you to eat.

 

Take care of yourself: Make sure you are taking care of yourself (with rest, sleep, hobbies, and fun) at least as well as you take care of others.

 

Learn from your behavior: If you find yourself eating when you are upset, do not take it out on yourself. Treat yourself with compassion and curiosity. Think about your behavior as a learning experience.

 

Find help: If you have a history of trauma or abuse, get help through therapy. A strong correlation exists between such a history and emotional eating and weight gain.

 

Take responsibility for yourself: Do not blame others for your emotional eating. Take accountability for your actions.

 

Build emotional muscle: Tell yourself that you can bear any emotion and practice doing so. You will find that the emotional muscle you build is amazingly strong and enduring.

 

 

References and recommended readings

Koenig KR. Nice Girls Finish Fat: Put Yourself First and Change Your Eating Forever. New York, NY: Fireside/Simon and Schuster; 2009.

 

Koenig KR. The Food and Feelings Workbook: A Full Course Meal on Emotional Health. Carlsbad, CA: Gürze Books; 2007.

 

Koenig KR. The Rules of “Normal” Eating: A Commonsense Approach for Dieters, Overeaters, Undereaters, Emotional Eaters, and Everyone in Between! Carlsbad, CA: Gürze Books; 2005.

 

Koenig KR. What Every Therapist Needs to Know About Treating Eating and Weight Issues. New York, NY: WW Norton and Co; 2008.

 

 

Contributed by Karen R. Koenig, LCSW, MEd

 

 

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I Just Want To Have My Ice Cream!

A patient of mine who struggles with binge-eating and who also has been a casualty of years and years of dieting came in this week and was clearly excited (well, maybe not quite excited) to share with me a “successful food experience” from the past week. She is getting much more adept at distinguishing between her healthy voice and the critical voice of her eating disorder.

She described a day when it was really hot and humid (this isn’t hard to imagine for Jersey in June). There is a “famous” ice cream store in this area called “Hoffman’s”. It has the best ice cream and people come from great distances to enjoy it. She decided she would take her children there to get them ice cream since she was in the area. When they arrived, she had an internal conversation that went like this:

“You don’t want any ice cream.”

“Yes I really do.”

“Do you really want ice cream?”

“No…I guess I don’t.”

“Why would you want ice cream when you constantly complain about your weight?”

“You’re right. I hate my body. I don’t want ice cream.”

“That’s right. You don’t. You will never look the way you want by eating ice cream and other foods like that.”

“But it’s so hot out and I know I won’t be coming back for a while.”

“Everyone here will look at you if you order it because you don’t need it and shouldn’t be here in the first place.”

“You’re right. Everyone will notice me and be making comments about me under their breath. I’ll just get ice cream for the kids.”

“Just buy the kids their ice cream and go home.”

“It looks so good. I’ll just order a ‘small’.”

“You will regret it. I promise you.”

“I might regret it, but I might regret more if I leave without having any.”

“You are a fat pig. Don’t get the ice cream. As soon as you walk out of here, you will beat yourself up.
If you get it, you better not eat dinner.”

“Ok, maybe I’ll get it and skip dinner.”

“You know you can’t do that. That never works. You are too weak. You’ll eat the ice cream, still eat dinner and you’ll end up bingeing and ruining your day. Don’t get the ice cream.”

“I’m so sick of the same old stupid conversation. I’m sick of arguing with you. I’m sick of feeling bad about myself. I’m sick of listening to you. I’m sick of feeling this way. I want the stupid ice cream. I’m entitled to make this choice. I just want to have a nice day with my kids. The ice cream is not going to make or break my day. I can eat ice cream whenever I want. I will never diet again. I’m taking charge of this eating disorder. I will not be bullied into avoiding foods I like and then bingeing because I feel like a criminal. I’m working hard at recovery and I’m not going to let one dish of ice cream on a hot sunny summer day turn into a battle ground where I lose AGAIN!”

This conversation with herself lasted about 2 minutes. It was a loooong two minutes. She went up to the counter, ordered her kids their ice cream, ordered herself a dish of “Rocky Road”, paid for it and walked out. She sat outside with her kids, and enjoyed her ice cream. She ate most of it but at some point she was a little full so she got a lid for it and took the rest of it home. She had never done that before. In the past, she would always finish it, even if she was full, because she would feel so guilty about eating it in the first place and would swear that she would never buy it again. On this day, she made a deal with herself that from this day forward if there is a day that she wants ice cream, she will drive to Hoffman’s and get herself ice cream.

On that day, she successfully took the power away from the food and away from her eating disorder. She had mixed feelings after the whole incident was over. She felt victorious, but also a little guilty, sad, and exhausted too. You see, although her ice cream adventure was ultimately a success, the struggle is still there. Conversations like this will happen in her mind again and again and again. Each time they happen, she will have to fight with all her energy. Her eating disordered voice is very loud, critical and unwavering. She has to fight equally as hard for herself, against it. In time, her skills will get better. Her own voice will get stronger. It will not happen over night. Her eating has been an issue for her since she was 5 years old. She is 45.

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Life’s Lessons Never End

When do the lessons ever get learned???  That’s the first question I keep asking myself? Is there such a thing as getting comfortable with your feelings? That’s the second question. Why do I continue to feel the same stuff over and over and why can’t I just move past these issues? That’s the third question. For goodness sake, I’ve had enough practice at all this!!! I want to just feel the good stuff!  Wow! That sounds really unrealistic and misses the point of the lessons I MUST learn!

So, seeing as it is Sunday, of course I am learning a ton of lessons today. You see, I’m no different than all of you. I have ups and downs. I feel all sorts of painful emotions that I want to make go away. But I am determined to fight through it all because I don’t want to ever go back to my eating disorder to “save” me from it all. I always say that my worst day well is still better than my best day sick. Some days it is harder to hang onto that notion but it is still my mantra.

So…here goes with my story of the week. Recently, I got a call from an old friend who I lost touch with many many years ago. She learned of my whereabouts through a mutual professional colleague and she decided it would be nice to catch up. I was so surprised to hear from her after 25 years but was very excited to see her and catch up on our lives. We met for coffee this week and when I first saw her, she looked exactly as I had remembered her, as though time had stood still. She had a smile that lit up the room. She was lovely! We got our drinks and sat in a quiet corner to chat.

She asked me lots of questions about my life…was I married? Did I have children? Where did I live? How did I like my work? Etc. I was happy and excited to tell her all the details. She told me all about her life as well. This is where I started wilting like a weed. She was extremely humble, but revealed that she was extraordinarily happy in her marriage of 20 years. Her husband was “the best friend I could ever have”.  She said she has 4 beautiful children – 2 boys and 2 girls. (She showed me a photo. They were “picture perfect”.)  She’s the president of a very big company. She has her “main house” in a different state and her “summer/weekend house” at the Jersey shore. Meantime, I know exactly where her summer/weekend house is and it is twice as big, and ten times nicer than my only house. She started giving me details about how nice it is to get away with her family to the summer/weekend house where they swim and play tennis on their private tennis court. I felt myself really making an effort to be happy for her. After all, she worked very hard for her success and deserves to be happy. She asked me if I was happy and I said “yes, but I wish I had a little more free time”. I asked her if she was happy and she said “oh yes, I have a very good life!” Then, she asked me “what do you do in your spare time? Do you have any hobbies? You must have some down time.” You would have thought she asked me a question about quantum physics. I just stared at her and thought to myself “I have no idea”. I said to her “I am so busy, I really don’t have a lot of down time to do much of anything else besides work-related things.” “Really?” she said. “I started running marathons a few years ago and I play tennis and golf. You should try them. They are a lot of fun and really good for your mind.” “Good for you!” I said. “I’m so happy for you.”

After two hours, we both had to leave and promised to catch up once or twice a year. She invited me to come to her weekend/summer house some time, to which I replied “I’d love to!” We hugged goodbye and went our separate ways. She got into her BMW. I got into my GMC.

What are my lessons???

First of all, my life is my life. My life is not her life. Sure, her life sounded perfect but there is truly no such thing as a perfect life. And, even if her life is perfect, it is hers. If I continue to focus on her life, I lose the focus on my own. If I continue to focus on hers, in no way will that misguided attention improve mine. It will only serve to make me feel inadequate. You see, for all the good in my life, there is still the little nagging part in the recesses of my mind that is always anxious to make me feel inadequate, like that young girl who never felt good enough.

Never ever compare yourself to others. If someone else appears to have everything you want, they probably don’t. My friend surely appeared to have everything she ever dreamed of, but I’m sure, in our two-hour meeting, she didn’t feel compelled or comfortable telling me the negative stuff she has gone through.

I’m not even intent on comparing  her job with mine because I love my job. I can’t imagine doing anything else. It is extremely rewarding and gives me immense pleasure. I too, have a good marriage and wonderful children. And my home is just fine for me. I don’t need a second home either. The comparison came in when it dawned on me that she had such extreme confidence and lightheartedness. She was completely comfortable in her skin and in her life. It just felt to me like she never struggles. She has never suffered from a mental illness. She has never felt inadequate. She likes herself and she doesn’t have to work for it. That was the rough part. I have worked for years at feeling all those things she felt naturally.

My second lesson is that no one should ever lose themselves to anything so much that they lose the passion for doing good things for themselves. I see this all the time in my practice. People become so focused on their eating disorders that they forget who they really are, they forget what their real strengths are and what other qualities they possess. They also don’t take the time to develop other skills, passions, relationships and talents. This was a wake up call for me. When I thought about the question “what do you do in your spare time?” all I could think of was the many things I used to do that I no longer do. I thought, “Why don’t I do those things anymore?” I have become so busy with work that I stopped having hobbies or self-care activities. That is the very thing I always encourage my clients to do and I stopped doing it! Yikes! I failed at my own advice!

My third lesson is that we are always learning lessons… until the day we die. Even though I think I’ve learned some of these lessons already, I am still learning them. I guess we are in for a lifetime of “the school of life”. In addition to accepting that these lessons are lifelong, I cannot ever expect to feel only the positive feelings. I tell my clients this all the time as well. We all need to feel a complete array of feelings and we have to be able to be comfortable being uncomfortable. That is an absolute necessity for life and for recovery.

So, I have made four goals that I encourage you all to make with me, if you aren’t already doing them:

  1. I will make time to do more of things I used to enjoy so much. I will try to get more balance in my life. I will not lose sight of the many aspects of who I am.
  2. I will feel all my feelings, no matter how bad or good they are. They are a part of me and they all deserve to be expressed.
  3. I will not compare myself or my life with others. I will focus only on mine. It’s the only one I have. (this lesson must be continually be popping up for a reason)
  4. I will accept that life’s lessons are lifelong. Some are easier to grasp. Others take longer to learn. I am never done.

 

Coping with life’s ups and downs is your responsibility. Your eating disorder can mask life, but will never ever be able to help you live your life to its fullest.

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The Wolves Within Us


An old Cherokee is teaching his grandson about life. “A fight is going on inside me,” he said to the boy.

“It is a terrible fight and it is between two wolves. One is evil – he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.”

He continued, “The other is good – he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith.

The same fight is going on inside you – and inside every other person, too.”

The grandson thought about it for a minute and then asked his grandfather, “Which wolf will win?”

The old Cherokee simply replied, “The one you feed.”

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Guilty as Charged!

Take a look at Merriam-Webster’s definitions of guilt and guilty. Notice  several of the words and/or phrases in the definitions – breach of conduct, violating law, penalty, offense, inadequacy, self-reproach, grave, crime. 

Think of how you feel when you have engaged in a healthy eating behavior like following your meal plan well. Think about when you have “enjoyed” something to eat. Think about when you have had a successful day. Or, think of how you feel when you “slip” and use an eating disordered behavior. Is your eating disorder right there, waiting to tear you down for having a good day or doing something good for your recovery? Is the healthy part of your brain making you feel badly for making a mistake… for not being perfect?

Isn’t it incredible how almost anything you do with your food can elicit this powerful, negative, undermining feeling of guilt? Your eating disordered mind tries to make you feel “guilty” if you do the healthy thing so that you won’t do it again or makes you doubt if you can keep it up. That’s the game that your eating disorder plays. It’s a “no win” game that’s designed to make you lose, no matter what move you make. It’s like playing chess against an expert who knows all your moves in advance.

But, the perfectionistic, authoritative, inflexible part of your mind might also make you feel guilty when you make a mistake, as though you have to do everything perfectly in order to recover and if you make a mistake, you need to feel guilty or be “punished” in some way.

So, are you going to let this “brain-altering parasite” aka your eating disorder, steal away your recovery? Will you allow it to make you feel guilty for trying to save yourself? When you do self-caring behaviors, are you going to let your eating disordered thoughts hijack you and make you feel so bad and guilty that you immediately fall back into disordered behaviors?

No, no, no!!! When you do something good for yourself, you should have a victory party! You have NOT committed a crime for which you should feel guilt! You have performed a recovery step for which you should be PROUD!

Second, should you feel guilty for not having a flawless recovery? Are you going to let your perfectionistic mind (or the pressures from others) make you feel like you either have to get everything picture perfect or you’ve failed?

No, no, no!!!  Recovery cannot be perfect. That is an unattainable goal. Recovery is imperfect and has ups and downs. The key is that you are always trying to move forward, not backward. But in moving forward, you may take two steps forward and one step backward.

There is no room for guilt in recovery, not for doing the “right” thing, and not for making mistakes along the way. As long as you are trying to get better and learning from your mistakes, you should feel proud of yourself for fighting an illness that is challenging, confusing, fearful and one where there is no “magic pill” to make it go away.

Fight for your recovery, feel proud of your accomplishments, and by all means, don’t let guilt derail you off your path.

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Self-Compassion

“With self-compassion, if you care about yourself, you do what’s healthy for you rather than what’s harmful to you.”  

This is the last line from a quote in a New York Times article that discusses a new area of psychological research called “self-compassion” and a new book on the topic by Kristin Neff, Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind.

The first thing I tell a client that comes into my office with an eating disorder is “This illness is not your fault.” The second thing I tell my clients is that “You need to be kind to yourself in order to heal from this illness.”

People who suffer from eating disorders – anorexia, bulimia and binge-eating disorder, are extraordinarily sensitive, kind-hearted individuals. They are the types of people who make others feel good about themselves with their compliments, love, unending ability to listen and empathize.  Unfortunately, these sufferers reserve their adoring ways for others, and when it comes to themselves, they are self-critical, self-loathing, unforgiving, and merciless. They overinflate their flaws and minimize their attributes. They beat themselves up for the most insignificant “mistakes” and struggle to see their strengths and successes – in the food arena as well as in other areas.

This article emphasizes that negativity and self-criticism are not motivators for change, whether they come from others or from within. These tactics breed negativity and helplessness, two states of being that reinforce sickness, depression and lack of motivation for positive change. 

Self-compassion is not only the first step in healing, it is an essential step. If you suffer from an eating disorder, remember to treat yourself with the same kindness and respect you would bestow upon your friends, family and other loved ones. You will be pleasantly surprised at the power a little compassion can have in the recovery process.

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Quotes of the Day

Today was an odd day…quite a mixture of positive and negative experiences.

I feel a bit defeated, but I learned a few tremendously important lessons. 

One of the lessons I’d like to share with you is that it is important to focus on the positive and let go of the negative. If you focus on the negative, you can feel immobilized by your thoughts. If you focus on the positive, you have hope and joy!  

Second, perceptions are based on a number of factors. Someone else’s perception does not have to be your reality, nor is your perception someone else’s reality. Try to always communicate effectively what you are thinking and feeling. Be honest. Use your voice!

I needed two quotes for today!!!

Defeat should never be a source of discouragement, but rather a fresh stimulus. ~Bishop Robert South 

The greatest test of courage on earth is to bear defeat without losing heart. ~Robert Green Ingersoll

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Spirituality and Recovery

This is a beautiful post by a beautiful person!!! Thank you PR!!!!

I’m religious, but for years I didn’t consider myself spiritual. I know most people think that religion is synonymous with spirituality but believe me, they absolutely do not go together.  I’m proof of that.  I did everything my religion asked of me but my heart and soul were not into it and many times I considered leaving my faith.  That was especially true when I was in the throes of my eating disorder.  My eating disorder was always telling me that if I would stop participating in religious traditions and rituals I would have more time to invest in using eating disorder behaviors to reach my goal of being the perfect me with the perfect body.  I believed my eating disorder and broke every rule in the book listening to the voice in my head.  I stole food to binge on.  I weighed myself every day, including Saturday, when I knew I was breaking the Sabbath.  I didn’t make blessings on food because food had no meaning to me.  And most of all, I grew angry at God for destroying my life by making me fat and ugly.

Now, I know most of you reading this are waiting for me to say that one day something clicked in my head and suddenly I had this brilliant “ah ha” moment.  Unfortunately, that didn’t happen and as most of us can attest to, it usually doesn’t happen that way.  Instead, I gradually began to tune into a different voice inside my head.  Actually, it was more the voice of my heart and soul but I didn’t know that at that time.  I just heard a different voice in my head that kept reminding me of  the goals and dreams I had.  It helped that I was forced into listening to that voice because I had set my schedule up around healthy activities which were a constant reminder that I was climbing towards a goal.  I truly believe that setting goals for myself is what ultimately unearthed my spiritual self. 

Spirituality, according to some views, is a burning desire within each one of us to give our lives meaning by becoming a “somebody”.  This fire within us is an inborn trait and is the impetus that drives us towards fulfilling our goals and dreams and finding a place for ourselves in this world.  Thus, spirituality is very different than religion, though for many people religion is a manifestation of their spirituality.  For others, spirituality is a connection with their inner selves, their souls, and their belief in the value and meaning of their lives. 

Listening and responding to that voice in my head, reminding me of my goals, became a constant dialogue between me and my soul which slowly allowed me to peel away at the layers, upon layers, surrounding my inner self.  Gradually, I began to sense that inborn desire to become a “somebody” in this world and recognize that my eating disorder was the barrier between me and my spiritual aspirations.  I was then faced with the most difficult decision of my life.  At this fork in the road, would I turn a blind eye to my newfound soul and continue to destroy my inner self by using eating disorder behaviors, or would I begin the arduous climb out of the dark pit of disorder and allow my spiritual self to begin basking in the sunlight waiting for me outside the pit.  The decision was mine to make and yet, how I wished it was not one I needed to face. 

Giving up my eating disorder was the most difficult thing I’ve ever done.  And I still struggle and fight against it every day.  Yet, becoming one with my spiritual self, with that inborn desire to find a place for myself in this world, has made me whole and has given me the greatest gift of healing.  When one is at ease with themselves, in a physical and spiritual sense, then disease, which is the dis ease of dissonance with one’s inner self, can not rule.  Instead, the healing power of the inner self can come forth and help one reach for the stars.

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One of Those Days

Sometimes we just have a bad day. We often look so deeply into things to determine the cause of our pain or to analyze our negative feelings and find a solution to the problem so we can prevent it from happening again, that we forget that it is normal to have bad days. Sometimes we just need to accept that we will periodically have bad days. Period. Then we need to move on and start anew the next day.

I spoke with numerous people today who were just having a bad day. It began at the university where I teach. Two of my students came up to me after class and burst into tears about how they were having a bad day. Then, on my way to the office, I got a couple texts from people who were having a bad day and just wanted to “vent”. At my office, everyone was having a bad day. Then, when I got home, I got a few more texts from people who were having a bad day. Some of the people I spoke to today had major problems they were trying to navigate through. Some were just having a bad day.

We will all have bad days now and then. It is important to try to differentiate between a “bad day” and a serious, complicated issue or issues. As we have heard numerous times before, “don’t sweat the small stuff!”

So, I’ve decided that today was just one of those bad days. It’s time to go to sleep, rest, and start anew tomorrow!

 Sleep well everyone!

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