Hope For The Holidays

The holidays can be a very magical and special time for many people around the world but for others the holidays equate stress, anxiety, sadness or anger. This can be for a variety of reasons, familial issues, relationship issues, money issues, health issues the list goes on. For some reason the holiday season is the flashlight that shines on many of these issues for so many. This blog post is written to hopefully shine the light away from all the stress and anxiety and shine the light on the ways you can turn the stress and anxiety into peace, comfort and joy.

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As you are reading this I am sure you are saying how? I know many eating disorder blog posts related to the holidays are focused on the food and food anxiety associated with this time of year. I want to mainly focus on the emotional aspects associated not only surrounding food but surrounding holidays in general. Someone who has or is battling an eating disorder has created a relationship of protection and need surrounding their eating disorder. For many who are still in their disorder the holidays reflect a time where protection and a feeling of safety needs to take place. Protection meaning how do I avoid food this holiday? How do I binge this holiday and have no one notice? How can I purge this holiday without anyone noticing? For someone in recovery the dilemma is how can I prepare for this holiday? How can I stay calm around food this holiday? How can I make sure I don’t under eat or overeat this holiday? I am sure the list of questions and thoughts go on and on. I am here to focus on the fact that these questions and worry can actually feed into the anxiety and stress one may be experiencing. Do not get me wrong to be prepared and mindful and have a plan in place are of utmost importance however ruminating in the thought and worry will only increase thoughts and worry. Implementig action plans and solutions to counteract these thoughts is key.

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For many people that I work with the anticipation of the holiday is often times worse than the holiday itself. Acceptance of where you are at in your recovery or in your disease is a crucial first step for helping you create an action plan.

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Accepting and releasing- This is an important skill because so many people fight and beat themselves up over what they may be going through or facing in life. Accept that you may be struggling, accept that things may not be where you want them be and release any guilt or shame associated with it. Guilt and shame is truly like a prison that keeps you locked up, bound and stuck where you are. If someone who is struggling can come to a place of acceptance, then the light can be shown on the underlying issues that need to be cared for, addressed and movement can begin to happen. This holiday accept and release that this may be a hard time, a stressful time but its ok, you are ok. Release the guilt and shame, release that it may be a hard time for you and accept that for anyone struggling you are doing your best and like any other day the holiday will pass. 

Mindfulness – Become aware of what triggers any emotional upsets or anxiety for you. Whether it be food triggers or emotional triggers. Identify what they might be and for each one create an alternative thought, plan or identify someone you can turn to for support. Many times when someone is triggered the reaction is fueled off of  instinct and impulse. Instinct to push away or ignore feelings, impulse to act out, numb or find a way to cope that may be unhealthy. When someone can become aware of what their triggers are and how it affects their behavior it can be empowering because then an alternative action plan can be created. This holiday if food is your trigger think of a safety person or anchor (object) that you can reference or go to for extra support to help ease your anxiety. Visualize a safe space and take a moment for yourself to be in your safe visual space and breathe.

Presence- Be present with yourself often times someone who is battling or in recovery from an eating disorder has to learn how to reconnect mind body and spirit. An eating disorder serves for many as a way to disconnect from self, people and emotions. The concept of being present can be a difficult one.The concept of being and staying present is important because often times the build up of thoughts of what could or would happen is the catalyst for emotional turmoil and fear. This holiday season challenge yourself to stay present with where you will be, with the people surrounding you, to conversations, to the atmosphere. By becoming present you will allow yourself to become more aware and these are powerful skills to learn.

Prepare- For someone with an eating disorder the stress of being surrounded by food and what to eat and how much can be very tiring. If you are in recovery one of the best things you can do is stick to your meal plan the best you can. For anyone struggling, do your best to plan what you will eat ahead of time so you are not overwhelmed or panicked in the moment. Preparing will allow you to be more present and aware of your surroundings. The anxiety of comments families or loved ones can make or conversations that may be triggering can cause a lot of anxiety as well. Be honest and open beforehand with your family and ask that certain comments not be made or conversations not be had. By setting boundaries you are not only keeping yourself safe you are communicating your needs to the people who love you.

Love and compassion- Be loving and compassionate to yourself, the holidays can be hard, but getting through the holidays when struggling with an eating disorder can be very challenging. Remember to be kind to yourself with your words, actions and thoughts. Reach out for support and allow yourself to be your own support system as well. Love and use your voice to be open with any struggles you may face and set boundaries with family or friends to help them understand your needs and wants. By loving yourself you are allowing others to love and help you as well.

Have hope, if the flashlight can be focused not on the stress, worry and anxiety but onto the hope that is within, chances are the light will showcase things that for someone struggling with an eating disorder can begin to look at, focus on and be grateful. Lets shine the light on hope this holiday season and most of all shine the light of hope within ourselves.

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The Invisible Line: Finding your voice and setting your boundaries

For so many people the ability to stand up for their inner needs and wants can be very difficult. Often times many people I encounter hold many of their emotions and thoughts within themselves. I know especially for the eating disorder population so much of what feeds into their negative view of themselves is driven by an inability to feel they should be seen, heard or have a voice. I work very hard with my clients to not only empower them, but to help them find their inner strength to define their emotions, define their thoughts, define their needs, assert themselves and set boundaries in their worlds. This concept of standing up for ones self is a very hard concept for many people but for the eating diorder community it is especially tough. An eating disorder is a selfish disorder, its a mean disorder, its a bullying disorder. It makes a person feel unworthy, unlovable, and most of all unimportant. This post is for anyone who ever felt unseen, unheard, unloved, for the tears cried at night, for the silent taunting screams that haunt so many. To anyone who ever felt neglected, unappreciated, judged.

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So many peoples lives are spent and driven by the constant worry about what others think, worried about how others see and view them and I ask why? I encounter this pattern with so many of the eating disorder clients I work with, they have such a need and a desire to give all of themselves to loved ones, to worry about how others see them, never feeling good enough, never feeling like they matter. Often times this preoccupation with what others think and how they see us instill a silence within a person. This silence is a dangerous cage, when someone takes their emotions, thoughts and locks them away it’s only a matter of time before all those pent up emotions and thoughts want to break free. I have noticed that for a lot of people who suffer from an eating disorder they have either been surrounded with too rigid of boundaries which leads to suppressed emotions or not enough of a boundary which leads to a sense of not knowing ones own identity. The inability to handle or process emotions from lack of boundaries for someone struggling with an eating disorder can be acted out in many ways.

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Someone struggling with anorexia restricts their food because I often hear it is the one thing that they can control but it is also a way to numb emotions and thoughts. As someone starves themselves and the physical implications start to take affect, the internal implications are unwinding as well. Their is an inability to process or define their emotions and if emotions come up the anorexia serves as a numbing agent. When you are physically depleted, your brain is depleted as well. There is a disconnection between mind and body and often times someone suffereing from anorexia is so malnoursihed or week it serves as a way to disconnect from the world and emotions. This is why in treatment centers when someone is being renourished its an overhwmelming experience. They start to feel again and so many of the negative emotions and thoughts will begin to resurface.

Someone struggling with bulimia its a physical action based behavior. Someone who binges and purges or just purges whatever they ate is coping with emotions and thoughts through a physical act. The pain they feel is often times acted out through purging. It’s a physical release of what has been kept inside of them.  Its a physical representation of trying to purge ones emotions. I hear many comments from so many who suffer from bulimia that its a coping tool for them to release their pain, sometimes its a violent act against themselves, its an aggresive expression of the pain unfolding within them. Within the brain itself the brain associates the cycle of bulimia as a coping pattern so in treatment it is almost like detoxing someone off a drug. The withdrawls from the act of purging leave someone who suffers from bulimia feeling helpless and overwhelmed, when their feelings come up the coping tool they have used for so long is no longer their to serve its purpose and that can be very difficult for someone recovering from bulimia.

Someone struggling with binge eating it’s a way to disconnect from emotions and self. Its an uncontrolable force that takes over its a disociation where a person is not present in the moment until after the binge where guilt and shame then take over. The guilt and shame ruminate and taunt the person which leads to a lower sense of control, worth or value. These negative emotions then fuel the cycle of numbing out and mindlessly eating all over again to further serve a numbing purpose. In treatment for someone who uses food during emotional times this can be a very hard adjustment.

I bring up these three behaviors and components because they all have things in common, they serve a purpose to help someone distract, disconnect and dissociate from emotions that prove to much to bare or handle. I truly believe if someone can develop a way to assert their needs and boundaries and become and advocate for themselves because they believe they are worth standing up for,  it would help them define, process and learn how to handle hardships, needs and emotions. Boundary setting is a crucial skill for people to learn. We must empower our clients to envision and create an invisible line.

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Here is an example list of some unhealthy boundaries:

• Sacrifice their personal values, plans or goals to please others

• Allow others to define who they are and make decisions for them

• Expect others to fulfill all their needs

• Feel guilty when they say no

• Hesitate to share their opinions or assert themselves if they are being treated unfairly

• Frequently feel used, threatened, victimized or mistreated by others

• Afraid of confrontation or conflict

• Take responsibility for other people’s feelings

• Tell others how to think, feel or act

I really work hard to empower my clients to feel comfortable with their voice and their instincts.

Here are some good ways to start defining your needs and emotions:

1. Create a personal bill of rights to slowly feel comfortable identifying  needs and asserting them.

2. Become aware and identify your emotions, thoughts and feelings within your body. This process is about slowly reconnecting with yourself.

3. Set limits for yourself based on your needs and emotions

4. Acceptance- Come to a place of acceptance. Assert your need that you are of value and your thoughts and opinions matter.

For many people when someone starts to assert themselves it can at first be a shock to not only the people in their lives but to themselves. My message to everyone out there who may be struggling with so many emotions that they have pushed down or kept hidden, is to slowly trust in your inner voice, to slowly fight for yourself. There is a purpose to your pain and maybe one purpose is to give you a power you have had all along.

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Breaking Binge

I love to address and discuss topics that inspire me, motivate me or allow me to think of things in a new light. When I decided to start an eating disorder recovery & support group I was baffled that majority of the emails I received were from men and women looking for help with binge eating. I personally have noticed and this is my opinion that binge eating is less frequently talked about or discussed. I believe that clinically and socially anorexia and bulimia are more focused on because of the more obvious physical presentation of the eating disorder however binge eating while physically not as apparent is equally as tragic, harmful and devestating. Statistics state that binge eating is the most common of all eating disorders. According to the National Institute of Mental Health (NIMH), binge eating disorder statistics are as follows: 1.2% of adults experience BED in any 12 month period. This means that 1.6% of women and 2.0% of men will experience BED in any one year. Binge eating is an uncontrollable urge or impulse to intake an overconsumption of food. I am writing this post and dedicating it to those who suffer from binge eating. I have heard many clients desperate to find a way to control their urges to binge. They feel helpless, lost, trapped in the vicious cycle of their binge eating and many feel hopeless. This blog post is not only to educate the clinicians but to give hope to those who feel they will never regain their control. Recovery from any eating disorder is possible.

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I wish I could provide the ultimate answer on how to stop binging or how to overcome an eating disorder, while I may not have an answer my mission has been to educate people on the different resources, techniques and ways clinicians and someone struggling can help think about and fight eating disorders.  I believe every person I work with or see functions and responds differently. What works for one person will not work for another. This is why I am constantly stressing for the clinicians to look at the bigger picture and think outside of what has been or is being conventionally done. Not to take away or say it doesn’t help but I believe we can go further, research more and find new answers or approaches to help those who may be suffering.

Binge eating has always been looked at as an emotional way of coping which it is. So clinicians tend to ask questions and dig deeper into the emotions, triggers and thoughts associated with or what happened before, during and after a binge. These are all great questions and things to examine and explore. Yes binge eating resonates with a great deal of the emotional turmoil going on inside, like I said in my previous post “Untangling The eating disorder web” binge eaters tend to take in to much never feeling fully gratified or satisfied. I am challenged however to look at Binge eating in multiple lights. I discovered this amazing book titled “Brain over Binge” written by Kathyrn Hansen. Reading this book my mind was blown away at her way of describing the binge cycle. While yes for many of our clients and for those who suffer from binge eating it is very emotionally driven however once in therapy and those emotions, issues and triggers are unveiled and identified what about the binge urge itself and the brain chemical component of the cycle? How do we tackle the brains urges and break the habit that has been conditioned and formed for so long. I can honestly say as a clinician like most of us do, we want to find the emotional answers, identify the triggers use distraction techniques coping skills, but what if those do not work for some of our clients? This book gives insight onto another way clinicians and someone who may be suffering can view themselves and their binge urges.  

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The author viewed her urges to binge as a survival instinct coming from a place of restriction or constant thoughts of not overeating. Scientifically if we look at someone who is starving themselves or restricting their food the brain and body kick into overdrive, needing food and nourishment to survive. This can lead to an insatiability and a need to eat more than one normally should to satisfy their body. This is where the guilt and shame come in and for some purging takes place .This cycle is triggered by the brain and body going into survival mode. She calls it the cycle of the divided brain. She splits up the behaviors assigning them as your conscious choices to restrict and diet, they are you and under your control. She describes the binge part the part with no control as “it” meaning the brains survival instinct. This revelation or way of viewing it was very powerful and in many ways made sense.  The cycle diagramed below many clients have expressed to me gave them hope that they could regain control over their urges. They felt their binge eating was not a part of them or their identity which I feel for many can be freeing. They said it explained to them what their binge eating truly was and that they were not helpless to give in to it. 

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As clinician we tell our clients when urges to restrict, binge or purge come up to use coping skills or to distract until the urges go away and for many clients this is very powerful and works and has helped many to recover. I am speaking to those out there where distraction only heightens the urges or delays them until eventually they are given in to. The author has stated to sit with your urges allow them to come over you like a wave and allow the thought to come but DO NOT act on them. She likens it to a storm the waves will come and crash down on you but eventually the storm will settle. She breaks down her steps that helped her which I have listed below from her blog.

1.    View urges to binge as neurological junk. (This means quit believing the urges signaled a real need – physical or emotional – and stopped assigning the urges any value or significance whatsoever.  View them as automatic brain messages generated in the  lower brain that deserved no attention. 
2. Separated the highest human brain from the urges to binge.(This means realizing the urges are not you, but instead are generated in brain regions inferior to your true self. Your true self resides in your prefrontal cortex – Your highest human brain – and it gives you the ability to say “no” to binge eating.  You have to know your urges are powerless to make you binge, and your true self has ultimate control over your voluntary actions.)   
3.  Stop reacting to your urges. (This means stop letting your urges to binge affect you emotionally and spiral you down to guilt and shame.  Allow them to come and go without getting wrapped up in them. This will make the urges tolerable and eventually easier to resist.) 
4. Stop acting on your urges. ( You don’t have to substitute any other behavior or emotionally satisfying activity for binge eating. I only had to refrain from binge eating.)
5. Get excited. (This is a bonus. By rejoicing in the success you do have even if its one urge or one day  you speed along the brain changes that can change habits and behavior.)     

The tools I listed above may only help some people and for others it may not but the beauty in educating people and increasing awareness is getting all different methods and inspiration out there. Every human being is different which is why what may work for one will not work for another. As clinicians we need to to understand and know the different ways to view eating disorders. If we look at them based on characteristics and treat them in one specific way we are doing a disservice to so many people who do not fall into “designated general categories”  We as clinicians by doing more research by exploring new avenues give our clients  to benefit from it. My message today is there is hope, there are alternatives, we just have to be open to explore all outlets and all forms of thinking because for those who suffer educating them and trying to understand who they are will help uncover the ways we can guide them on their path to recovery.

For more information about Binge Eating watch my discussion on the show  Behind The Mask: Eating Disorders Unveiled.

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It’s not about the FOOD

Having worked with eating disorders for over five years I have had many conversations with many different clients. Each story is unique, the way their eating disorder started, the triggers they feel, how they used their eating disorder to cope, the reasons are all very different. One main point I always try to educate people about is no person who suffers or who has suffered from an eating disorder is the same. The behaviors, patterns may be similar but the underlying issues, reasons etc are all very different. One other point I try to educate people on and bring awareness to is that EATING DISORDERS ARE NOT ABOUT THE FOOD!  One common thing clients have come to me and said was, they were triggered or angered by a family member or friend telling them ” To just eat a burger” “Why can’t you just eat ” These types of  question comes from no fault of the person asking it but it does stem from a lack of understanding and education about the depths of an eating disorder. This is why my mission has always been to increase awareness and education because the more people can understand the many layers to the emotional aspects and causes of an eating disorder the better the support system of those who have an eating disorder can understand and cope themselves. My main message to people is that an eating disorder or any addiction for that matter does not discriminate, it does not care about your race, age, financial situation or gender. It can affect anyone anywhere the more we as a nation can understand eating disorders the more we can help those who are fighting them.

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The common assumption is that eating disorders are about an obsession or fear of food. That the main focus for someone with an eating disorder is a fear of getting fat and body image. While these are slightly true and what seems to be the most focused on, the reality is that an eating disorder like any other addiction or drug of choice is another avenue of emotional coping. It is another way to numb out, to feel a sense or release and to escape or avoid unwanted emotions. Anorexia, Bulimia & Binge Eating are also like a drug they give a person a sense of a high or release. The truth is that an eating disorder is often the cause of some sort of trauma, emotional event, life situation, or a number of many other factors.

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I also like to educate people to not blame the parents or family environment. Like anything else a child may have had very loving healthy parents but an outside source could have caused some emotional damage. A person with low self-worth or without a strong sense of identity may be more vulnerable. . This a why eating disorders  can occur at younger ages because at a younger age the identity is just forming and often times the opinion of peers is so important that it can shape how a young adult or child views themselves. I also often hear that people assume eating disorders are a way for someone to gain attention or  “attention seeking”. This infuriates me and further motivates me on my mission to educate. Someone does not choose to develop an eating disorder it is an all consuming disorder that if someone had a choice to just stop they would. It is like any addiction or disease once it reaches a certain point interventions must done to recover. This is why understanding the emotional background of the eating disorder is crucial to developing an appropriate response and treatment approach. Education at an early age is important. Bullying and the medias portrayal of beauty as well as our nations preoccupation with dieting etc are all contributing factors. 

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My message to everyone is do not judge anyone and assume their road is easy. Do not diminish the struggles and challenges someone may be facing. Instead be curious ask questions, educate yourselves there are too many stereotypes about eating disorders that we must break, we must make people aware of the reality. That there is much more to someone who is suffering from an eating disorder than a fear of getting fat and a fear of food. Look beyond what you see. 

Emotional Reactivity? Our Emotions are linked to our body.. What?

One thing I have noticed working with eating disorders is how much the emotional reactivity of someone affects their thoughts, actions and their body sensations.  The eating disorder behavior whether it be through restricting, purging, over exercising, or binging is usually an emotional reaction to a triggering event. I often hear stories such as a mother or father making a comment that is triggering, friends isolating or alienating someone, bullying, a romantic relationship gone awry, the eating disorder behavior is a way for someone to act out their chaotic emotions. I often ask a client of this reaction ” You did this to get back or punish the person who did you wrong or caused you pain but in the end who is it hurting” It often is reflected back to them, it hurts them and feeds into the cycle of self loathing and affirms the belief that they deserve to be punished. In attempting to punish someone else, the cycle ends up punishing them. One of the emotions that I hear come up is anger, anger is one of the most triggering emotions for someone who suffers from an eating disorder. Anger however is a secondary emotion, there is always a bigger emotion almost like the elephant in the room lingering behind anger. Often times we don’t know to to contain or process anger, that is why many people have coping outlets to deal with anger, shame, frustration etc. It can be alcohol, drugs, or eating disorder behaviors. Many times we respond in anger to the words or actions of someone in our life but not only are we responding to what they did or said but how we interpret the meaning of what was done or said. Your body takes on that energy and then inside you feel anger. Our body takes on our feelings and our emotions are what follows. 

One thing I really love to educate my clients on is how to separate from their emotions which is done by teaching emotional regulation. Those who suffer from an eating disorder often have a hard time even identifying the emotions that are stirred up in them so helping them to not only identify their emotions but how it affects their thoughts and body and then being able to regulate them is a powerful thing. That is why I love to work with clients to help them identify these emotions and learn how to think about them, cope with them so they can feel their feelings but not stay stuck in them. There are many great techniques for dealing with emotions, calm music, journaling one thing I find really helpful is opposite action. Opposite Action is a skill from DBT ( Dialectical Behavioral Therapy) .

This skill educates you on one basic fact, every emotions has a leading action. If we feel fear we have an instinct to hide or run away, if we feel sadness we cry etc.

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The second point of Opposite Action is that our actions affect our emotions. It is described as a cycle so if we change our actions we can in turn change our emotions, just as if we change how we deal with our emotions we can change our actions. The big question to ask yourself is ‘Does the situation actually justify the emotion?’ This question will help you know when to apply opposite action & to reverse the cycle. To achieve opposite action it requires you to be very present and in tune with yourself and emotions and you do the work to change the initial thoughts and reaction patterns. 
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It is important to accept your feelings and not judge them or allow yourself to feel guilt or shame for experiencing emotions. My hope is that you realize that your feelings thoughts and emotions are valid and meaningful. We cannot help how we feel sometimes, sometimes our mind and emotions sneak up on us when we least expect it, but through work and time and self awareness you can control how you handle your emotions. 

New Eating Disorder Recovery & Support Group In Orange County!

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Forgiving our mistakes

I have worked with many different people in the past that come to see me with so many different life issues and hardships and one thing that I notice a lot in working with people is how much peoples mistakes or failures still haunt them. People tend to hold on so tightly to their mistakes and failures that is ends up consuming their thoughts, feelings, and behaviors and most importantly how they view and see themselves. In general we as people tend to be very hard on ourselves and often times that can lead to the mistakes we make becoming our own prison that we can’t seem to break free from.

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If you are someone who still feels trapped by unresolved issues with others or yourself. Trapped by the mistakes you have made or opportunities you didn’t take. Then this post is for you to be able to finally face it and let it all go. To do that there needs to be resolution. As human beings a sense of closure and relief is something we all long for and need to be able to feel a sense of peace or to make understanding, often times however we are not able to receive closure for many different reasons. That is why we have the capability to create our own closure. Einstein said some very true and honest words ” Who never made any mistakes never learned from anything new.” To be able to move on and heal we must forgive others but we must forgive ourselves. I love to use this exercise taken from the Hoffman Process book written by: Tim Laurence.

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This is a good exercise to either do alone or if theres a lot of pain and emotions you feel may come out to do with a trusted friend or partner or even suggest doing this with your therapist. Get into a moment of relaxation and quiet place, start to think about the different things that are or have bothered you, things that you hold onto, things that make you feel any pain, guilt, shame or regret. If the emotions start to stir inside you notice your body and its sensations, notice your mind and your thoughts and allow the emotions to flow in and out of you and pass through you. Be aware to not simply bury the feeling but to actually begin to face them and let them go.

Make a list of the mistakes and regrets you have or have made and after each one write …. And I forgive myself

When you are done take a moment to sit and reflect and then take the paper and ritually rip it up. This is your release of all the pain and mistakes that were holding you back. You have faced them acknowledged them and now you are throwing them away. If you try this exercise let me know how it worked for you, what didn’t or your thoughts.

Have a healing week everyone!