anorexia Archives • Food Freedom Therapy™

5 Myths about Intuitive Eating

If you’re not familiar with intuitive eating at all, you can read the basics about it here. In this post, I want to address some of the misconceptions I often hear about intuitive eating.

Myth #1: Intuitive Eating is a Diet

Intuitive eating is not a diet, although, unfortunately some people approach it that way. Intuitive eating is about having unconditional permission to eat all foods, which requires rejecting diet mentality and making peace with food. The goal of intuitive eating cannot be to lose weight because that will inevitably conflict with listening to and honoring your body.

Myth #2: Intuitive Eating Means Eating Whatever You Want, Whenever You Want

This is an oversimplification of intuitive eating, which does teach having unconditional permission to eat all foods and honoring your cravings, as we’ve already discussed. However, intuitive eating teaches ten principles that work together, so it doesn’t work well for a single principle to be applied without the others.

For example, principle #8 is “Respect your body.” To do that, you have to be attune to how your body feels and what it is communicating to you. If you eat nothing but ice cream, your body will not function optimally and will tell you so through stomach discomfort, blood sugar fluctuations, or a number of physical symptoms. (Interestingly, research shows the ability to perceive these sensations—called interoceptive awareness—is higher in intuitive eaters.) So the question when considering what and when to eat is not just what will taste good, but also, what will feel good to my body now as well as later?

Additionally, I’d like to point out that because intuitive eating rejects restriction and food policing, cravings for “junk” food typically decrease in frequency and intensity. Studies have shown that intuitive eating typically ends up with people eating a wider variety of foods. Yes, at first, you might find yourself eating a lot of the foods you previously restricted and that’s normal. As the Intuitive Eating book says,

“When you first begin the healing process, you may find that you’re eating more of the foods that you had previously restricted. This restriction has led to deprivation, and you may end up eating more of these foods for a while. Once the deprivation has healed, these foods will take a balanced place in your eating life.”

Myth #3: Intuitive Eating Just Means Eat When You’re Hungry and Stop When You’re Full

While two of the principles of intuitive eating are honoring hunger and fullness cues, that can be more challenging than it sounds. Which is why the other eight intuitive eating principles are just as important! Recognizing and responding to hunger and fullness is complicated if you’re still steeped in diet mentality, aren’t truly satisfied by your food choices, or are habitually using food to cope with feelings.

Myth #4: There’s No Care About Nutrition with Intuitive Eating

“Honor your health: is #10 of the principles, so definitely, nutrition is a factor in intuitive eating, and is often referred to as “gentle nutrition.” Being attuned to your body while making food choices will naturally lead to some care in nutrition, because while no foods are “bad,” some are obviously more nutrient-dense than others. Our bodies do not feel good eating less nutrient-rich foods all the time, so being attune to our bodies means we will notice that and want more nutritious foods as well. I’ve seen people swear they hated vegetables and they’d never want anything but cookies and cake if they let themselves eat intuitively who actually end up craving sugar less and wanting salads sometimes!

Myth #5: You Will Gain Weight with Intuitive Eating

I think this fear comes from the belief that letting go of food rules means eating high fat and/or high sugar foods all the time. We’ve already talked about how once feelings of deprivation are healed and principles of gentle nutrition are learned, intuitive eaters actually eat a variety of foods. Several studies have associated intuitive eating with having a lower BMI, though please, please don’t take that to mean you’ll lose weight eating intuitively. (Remember, this is NOT a diet and trying to lose weight will always undermine true intuitive eating!)

The truth is everyone will have a unique experience in regards to weight as they transition to intuitive eating. Some will gain weight while others will lose weight, and some will stay exactly the same. It depends on what weight your body wants to be at as well as how responsive you were to your body’s food and movement needs before versus how responsive to those needs you become as an intuitive eater.

Final Thoughts

Intuitive eating really is simple in theory, but it can be hard to put into practice. It’s a completely different relationship with food and your body than most of us have had since we were very young. While it does take time to unlearn diet culture and become an intuitive eater, it’s totally doable! If you’d like to talk with me about learning intuitive eating or have questions about it, please contact me or schedule an appointment.

Much love,

Sources

Tribole, E., & Resch, E. (2012). Intuitive eating: A revolutionary program that works (3rd ed.). New York: St. Martins Griffin.

Herbert BM, Blechert J, Hautzinger M, Matthias E, Herbert C. Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite. 2013;70:22-30.

Gast, J., Madanat H., & Nielson A. (2012). Are Men More Intuitive When It Comes to Eating and Physical Activity? Am J Mens Health, vol. 6 no. 2 164-17.

Madden C.E., Leong, S.L., Gray A., and Horwath C.C. ( 2012). Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutrition. Mar 23:1-8. [Epub ahead of print].

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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#ScrewYourBeautyStandards

We are not born disliking our bodies. We are innocent in our self-acceptance until we learn there is a “right” way to look. After that, we evaluate ourselves against whatever ideal we are taught because it is our nature to compare. If we are fortunate, we will grow up in a family that values inner qualities over appearance. Sometimes that can protect us from internalizing the broader culture’s narrow beauty ideal. But it’s difficult to stay immune to all the messages from everywhere else… the teasing from kids at school… the magazine covers with Photoshopped images… the TV commercials pushing their weight-loss products…

And some are not fortunate enough to grow up in families where beauty is recognized in a diversity of shapes, sizes and colors. For too many, the pain starts at home and family opens the first wounds, which are only deepened by peers and the media.

Seemingly from all corners, the message is clear: We aren’t good enough. Not T-H-I-N enough.

Because thin = good and we so reason, therefore, fat must = bad, right? Some will even directly say that it is.

I used to buy into all of it, like so many do. I hated my body long before I developed an eating disorder, and it laid the foundation for me to go down that path. I was so desperate to lose weight, to be accepted, to feel okay for once. I was so mad at myself for not being thin like my friends and the pretty girls I saw in the media.

Thankfully, now I’m recovered—from both my eating disorder and my body hatred. But I’m still angry. I’m angry that we live in a culture that works so dang hard to make us feel bad about ourselves. You can’t go a day without seeing advertisements for products related to weight loss, makeup, hair dye, eye creams, tummy-control pants, and on and on and on. If you don’t feel pretty, thin, or young enough, then they promise to change that if you’re willing to spend enough time and money.

And I mean lots of money. Beauty is a $532 billion industry and is expected to just keep growing. The problem is that every commercial you see isn’t simply trying to sell you something; first, it tries to convince you that you need what they’re selling. It plays on, sometimes even creates, insecurities. The subtle goal is for you to feel bad about yourself so that you’ll then want to buy something that will (supposedly) make you feel more confident.

While common sense likely tells us that we’re influenced by the media, it never hurts to have some research to back that up—which of course, it does. Indeed, research shows that media influence can lead children and adolescents to internalize ideals imposed by society, which also increases the probability that they will suffer from issues like body dysmorphia and eating disorders. Studies suggest this can start as young as six years old, if not even earlier. We’re talking Kindergarteners, maybe younger!

That makes me angry for every little girl that is harmed by these messages poured into her about her value and what she is supposed to be. I hope that like I have, you’ll learn to turn that anger and disgust that you direct at yourself for not being what you “should” be, and you’ll start getting angry at the diet and beauty cultures instead. Not because makeup is evil or dyeing your hair is inherently bad, but because being sold the idea that you can’t feel good about yourself without those things is wrong. Being told we have to be a certain BMI to be attractive and worthwhile is beyond shallow—it’s destructive and sick, and I will never stop fighting for a better world for my son and daughter.

If you’d like to talk about how to get break free from these destructive cultural messages and finally accept yourself as you are, please contact me about a teletherapy appointment or follow me on Instagram or Facebook.

Much love,

Sources

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.572.7007&rep=rep1&type=pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540021/

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The Effects of Dieting on Your Body and Mind

In my last post, I talked about the diet-binge cycle that results from trying to restrict certain foods or overall calories. I didn’t go into detail about the physical and psychological effects of dieting, so that’s what we’ll discuss today. And there are a lot of negative effects of dieting, despite the widely-accepted belief that dieting is good for your health.

Brain and Hormone Changes

Many dieters restrict carbohydrates, which is a primary source for glucose, but our brains needs glucose to function properly. “If carbs are strictly reduced, the brain will be cut off from its main energy source, which can drastically alter brain functioning,” says Cheryl Mussatto, RD (registered dietitian). “One such change can occur with serotonin, a chemical produced by the brain. Serotonin regulates our sleep cycle, mood and appetite, all of which will be noticeably altered along with experiencing brain fog.”

Also, as Jillian Greaves, RD explains, “If you’re overly restricting carbohydrates, this is a form of stress on the body that can disrupt normal endocrine function.” The endocrine system, responsible for your hormones, is related to many other systems in the body. “This disruption may contribute to cravings, an irregular or stopped menstrual cycle, hypoglycemia, mood swings, anxiety, chronic fatigue, suppressed immune function and thyroid disturbances.” Some studies show that low-calorie diets raise the stress hormone, cortisol, which can have some serious negative health effects over time.

Additionally, our brain is made up of 80% fat and also needs dietary fats to function properly. If you don’t eat enough fat, you may miss out on some of the brain-boosting benefits of dietary fats including better memory, lower risk of dementia and Alzheimer’s, and better focus and concentration. Medical studies indicate that people on diets have slower reaction times and less ability to concentrate than people not on a diet.

Dieting causes your metabolism to slow down to conserve energy and send it right back into building up fat stores. Also, a 2011 study shows that changes to appetite mediators—so-called “hunger hormones”—promote weight regain after diet-induced weight loss. These compensatory mechanisms driving weight regain last for at least one year and could be long-term or even permanent.

Sleep Problems

Some research connects restrictive dieting with poor sleep quality. In one study, even a short period of dieting (just four weeks) resulted in a significant decrease in the amount of time women spent asleep and a greater difficulty falling asleep. Sleep is an important part of health and a lack of sleep can result in inflammation, an increased risk for diseases, and other concerning side effects.

Nutrient Deficiencies

Many important vitamins like vitamins A, D, E and K, are fat-soluble, and your body needs fat to properly absorb those vitamins. Without enough fats, the vitamins you eat can pass through your system unabsorbed and can result in nutrient deficiencies. Also, restricting entire food groups can cut out main sources of important nutrients.

Weight Cycling (aka Yo-Yo Dieting)

Weight cycling describes the pattern of repeatedly losing and regaining weight, often with increased overall weight in the long-term. “Long-term diet research (two years or longer) suggests that most people regain all the weight lost during a diet, whether they stick to the diet or not,” Julie Dillon, RD says. “In fact, many regain more weight than was lost in the first place.” One 2016 study found that repeatedly going through these starvation cycles prompts your body to store more fat, which is likely a survival response against starvation. Also, dieting slows down your metabolism, as previously discussed. “If you follow people over the long term, dieters are more likely than equivalent non-dieters to end up gaining weight over the next 2 to 15 years after the diet,” says Sandra Aamodt, PhD, author of Why Diets Make Us Fat.

Weight cycling is linked with increased insulin resistance, a condition which can develop into type 2 diabetes (T2D). In other words, maybe yo-yo dieting is a more likely cause of T2D than weight itself! Weight cycling also causes other health complications such as higher blood sugar, blood pressure, cholesterol, risk of heart disease, and inflammation. In many cases, acute inflammation is a necessary and helpful human function that can promote healing in response to infection or injury. However, sometimes inflammation is chronic, which can make you feel drained or foggy and harms health, Dillon explains. “Short-term research suggests many diets lower inflammation, but research looking six months out or more shows that inflammatory markers increase.”

Overeating & Bingeing

Weight is actually regulated by our bodies, and each of our bodies prefers to be within a certain weight range, called a set point. “Your brain will defend this amount just like it defends your body temperature,” explains says Stephan Guyenet, PhD, author of The Hungry Brain. As you lose weight, the amount of leptin in your bloodstream drops and sends a signal to your brain to help you fight to bring that fat back (remember those hunger hormones I mentioned earlier?). This is at the heart of why diets don’t work, says Aamodt (author of Why Diets Make Us Fat). “Whenever your weight changes too much, your brain will intervene to push it back to what it thinks is the correct weight for you.” This push-back from your brain is what Guyenet and others call a classic starvation response: your brain responds by upping hunger and cravings.

“In lab experiments, when scientists want to induce rodents to binge eat, the most reliable method for doing it is to reduce food intake until they’re at a lower weight and then expose them to super tasty food, like Cocoa Puffs or Oreos,” Aamodt explains. She adds that in human research, some studies that look at the brain show that this type of junk food activates reward centers even more fiercely in those who have lost weight. And, she says, animal research may suggest that repeated dieting makes the brain more vulnerable to binging behavior even after the diet is done.

Your body prefers to use carbs for a number of basic brain functions, so eating too few of them can cause your brain to fight back. “Cutting out carbs through any low-carb diet (including paleo and keto) can set a person up for binge eating in part because when we don’t eat enough carbohydrates, our body releases a brain chemical called neuropeptide Y,” says Julie Dillon, RD. “This chemical’s job is to tell our body to eat carbs — and eat them now.” When a person’s brain is flooded with this chemical, it can result in an animal-like instinct to go crazy on carbs — attack a plate of brownies or eat an entire pizza, for example. “It can feel like every cell in your body is demanding carbs, which can lead you to feel that you lack willpower,” Dillon explains. “But it has nothing to do with discipline. Rather, this neurochemical is trying to save your body from experiencing fainting, dizziness or worse!”

Body Image & Self-Esteem Issues

You might think that going on a diet would make you feel better about your body, but research shows quite the opposite. A study of college students showed that for men and women, dieting (even diets described as “normal” in severity) resulted in an increased concern with weight and a lower self-esteem. Another larger study showed that both men and women who reported dieting behaviors were less likely to have a positive body image. And of course, I think we are all familiar with the feelings of shame, failure, and poor self-image that happens whenever we “fail” at a diet.

Preoccupation with Food & Eating Disorders

The Minnesota Starvation Experiment, conducted in the 1940s, revealed groundbreaking information about how calorie deprivation affects the human brain. “It demonstrated that a lower calorie intake provokes the mind to overly think about food,” explains Dillon. Even years after the study had ended and participants again began eating a higher number of calories, participants who had been limited to diets of 1,500 calories per day found they felt fixated on food. Some participants even changed their careers, eventually becoming chefs. “Dieting provokes the brain to dream about food and consume thoughts. We believe this is a necessary evolutionary response to not eating enough,” Dillon says. And as we previously discussed, the response to deprivation is often bingeing, which can lead to eating disorders like binge eating disorder (BED) and bulimia nervosa.

But problems can arise even if the body is getting enough calories. Some dieters aren’t focused on consuming fewer calories as much as they are concerned about avoiding certain foods, sometimes entire food groups. Though these types of dieters might start out with good intentions of eating healthy, too often the diet rules progress into rigid thinking about food and disordered eating… sometimes even an eating disorder that has been termed “orthorexia” (orthorexia is characterized by an obsession with “healthy” eating).

Mood Changes

“Research suggests going on any restricted diet places a person at a higher risk for experiencing depression,” Dillon says. Numerous studies also link chronic dieting with increased stress and anxiety. Neither is surprising since, as we learned earlier, dieting affects serotonin functioning. Of the approximately 40 million brain cells we have, most are influenced either directly or indirectly by serotonin. This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and even some social behavior.

Other Problems

Some people who diet, especially those on keto, might experience bad breath and even vaginal odor (a side effect referred to as “keto crotch”)
Dizziness, light-headedness, and lethargy/decreased energy
Decreased sex drive
Not eating enough carbs, a primary source of fiber, can lead to constipation, bloating and other digestive issues
Social isolation due to not being able to participate in social activities involving food
Decreased hunger and fullness cues

If Not Dieting, Then What?

Like me, Aamodt (author of Why Diets Make Us Fat) and other anti-diet professionals advocates for a style of eating called intuitive eating. It’s a non-dieting approach that allows you to listen to your body and nourish it with what it wants (sometimes kale, sometimes a brownie) in the amounts it wants (more or less depending on your hunger). It might sound too good to be true, and while it’s not, there is a catch. Intuitive eating is not just another diet disguised as “wellness”; the goal is not weight loss and that can be a barrier for some who are intent on losing weight.

As I said in my last post, I totally understand that giving up on intentional weight loss is difficult for so many reasons. It can be done though! If you’re interested in learning how to ditch dieting and making peace with your body and food, check out my resources page or please contact me.

Much love,

Sources:

https://www.nbcnews.com/better/health/what-happens-your-brain-when-you-go-diet-ncna802626

https://uhs.berkeley.edu/sites/default/files/bewell_nodieting.pdf

https://time.com/3092086/weight-loss-depression/

https://www.thedailymeal.com/healthy-eating/hidden-side-effects-popular-diets/slide-35

https://www.webmd.com/depression/features/serotonin#1

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Why Can’t I Stop Bingeing?!

How many times have you called yourself a failure after eating something you felt you shouldn’t have? After all, dieting is just a matter of willpower, right? So after every “failure” when we’ve eaten the wrong food or eaten too much food, we beat ourselves up for blowing it (again!) and are left feeling convinced we are weak… maybe even addicted to food. That would at least explain why we feel so powerless to stop the bingeing and overeating, even when we so desperately want to stop. “I am not going to do that again,” you probably promise yourself, and double-down on your commitment to follow the rules this time.

The truth is, your bingeing is not because you don’t have enough willpower. And it’s not because you’re addicted to food. It’s because dieting is a flawed methodology, with inherent side effects that cause its own failure. Notice I said that dieting is the failure—not you. Research shows that 80 to 95% of people who diet don’t lose weight long-term. That means it’s rare for people to sustain weight loss on diets, and those who do are statistical outliers. Still, dieting for intentional weight loss is prescribed all the time for all kinds of reasons! If dieting was a medication, it would never get FDA approval with such terrible success rates. Especially when you consider the mental and physical consequences of dieting, which I won’t go into detail today (check out this post for that). For now, I just want to look at the diet-binge cycle on a pretty basic level so you can see the domino effect that is set into motion the minute you start a diet.

Dieting: Restricting certain food or limiting amounts of food.
Dieting “High”: Initial feelings of control, accomplishment, and relief of anxiety related to weight and eating.
Deprivation/Obsession: Preoccupation with food, hunger, feelings of deprivation, and cravings.
Anxiety: Fear of losing control, anxiety around food.
Binge/Overeating: Bingeing on restricted or “bad” foods, “breaking the rules”.
Shame and Guilt: Feeling like a failure, beating yourself up.
Anxiety: Worry about gaining weight due to bingeing.
Dieting again to relieve anxiety… and starting the cycle all over again!

As you can see from this cycle, bingeing is an expected response to deprivation for most people (even some people with anorexia nervosa experience “binges”). There are biological reasons for this, in addition to the emotional ones, which we will discuss in the next post. So if you want to stop bingeing, you have to stop dieting and restricting. I know this isn’t the answer most people want, because it’s hard to accept that dieting doesn’t work. For one, we’ve been brainwashed to think it does and to blame ourselves for not being able to lose weight long-term. And also, because giving up dieting feels like giving up on the dream of losing weight and finally keeping it off.

Giving up on intentional weight loss is incredibly difficult given the weight stigma and biases that surround us, but it is possible. You can start rejecting diet culture by learning about Health At Every Size (HAES®), which provides a rarely-heard scientific perspective on issues related to weight. It would also be helpful to work with a good eating disorder therapist or dietitian who can guide you through the process of learning intuitive eating and healing your relationship with food and your body. If you’d like to talk with me about that, please contact me!

Check out the follow up post to this one, The Effects of Dieting on Your Body and Mind.

Much love,

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No Pain, No Gain (Not)

How do I hate this tank top? Let me count the ways… Listen friends, if you puke or faint during exercise, your body is telling you to stop! Intuitive eating and intuitive moment go hand-in-hand and have the same underlying philosophy—Listen to your body! Our culture has done us a huge disservice to by making us believe exercise has to be painful or unpleasant to be beneficial. Even just the word “exercise” fills most people with a sense of guilt or dread (or both). How many times have we started exercising only to quit because we hated it?

Just like how intuitive eating requires dieting rules go out the window, joyful movement (as intuitive eating author Evelyn Tribole calls it), calls for tossing the exercise rulebook out the window too. You don’t have to burn X calories, exercise for X minutes, or do X workouts a week. You don’t have to throw up or be able to barely move the next day. Many people are turned off from moving their bodies because they think if they don’t do it hard or long enough, it doesn’t count. It does! Even light exercise can have a lot of physical and emotional benefits, so give yourself the freedom to explore what kind of movement feels good to you. Maybe it’s stretching or some simple yoga poses on your lunch break? Or maybe riding a bike with a friend? One of the ways I love to move my body is to push my daughter in the stroller outside while I listen to an audiobook.

Movement can be challenging physically but it should be something enjoyable! It shouldn’t injure you or make you miserable and it certainly should NOT be a punishment for something you ate. Let’s be kinder to ourselves when it comes to exercise and maybe we’ll discover it really can feel joyful!

Much love,

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When Your Doctor Doesn’t Get It

I’m currently 5 months pregnant and have had some frustrating experiences with the midwives I see, even though I told them from the first appointment that I have a history of an eating disorder. But they are hyper-focused on food and have suggested fad diets. The last midwife I saw asked me to walk her through a typical day of my diet, starting with breakfast. I told her I was not comfortable with that (I’m very protective of the recovery I worked so hard to achieve!) and I don’t want to find myself triggered by focusing too much on diet. She said she wanted to be sensitive to that, but then proceeded to be anything but and asked me questions like, “Do you eat fast food?” with a judgmental tone.

Unfortunately, it’s common for people with eating disorders to have run-ins like this with the medical community. I’ve heard some doosey stories from clients, let me tell you, including the patronizing but typical, “Just eat,” or “Just stop it” responses when they finally have the courage to disclose their disorder.

So it’s completely understandable that for many people with an eating disorder, going to the doctor is a very anxiety-provoking experience. Sometimes, it can even be downright triggering. Here are some tips to help it be a more positive experience, as well as what to do when your doctor just doesn’t get it.

Tell your doctor about your eating disorder or history of an eating disorder. I know, I know… I just talked about how awful doctors’ responses can be. And it is, admittedly, just a really uncomfortable conversation to have. But they don’t have an opportunity to respond well if they aren’t told, and they will hopefully show some sensitivity (there really are some who do!). Also, some meds are not recommended for people with certain eating disorders because of possible adverse reactions like seizures so your doctor needs to know your entire medical history when prescribing things for you.
Opt to do a blind weight or don’t be weighed at all. You can close your eyes or stand backwards on the scale while they weigh you so you don’t see your weight. Or you can just not be weighed at all. You might get some pushback, but it is your right to refuse.
Communicate with your doctor about what triggers you. Whether it’s avoiding being weighed or declining to talk about a fad diet that’s being suggested, you can draw boundaries by saying you don’t feel comfortable discussing those things. IMPORTANT: I’m not suggesting automatically shutting your doctor down about these topics, because ideally, they should be a part of the team helping you be healthy. And you need to be sure your motivation for avoiding these topics is pro-recovery and not to hide or maintain your eating behaviors. But some doctors just aren’t sensitive or informed enough about eating disorders to be helpful. So if you’re realizing your doctor falls into that category, be your own advocate and remember that you, not the doctor, are in charge of your care.
Find a new doctor if necessary. If advocating for yourself and offering your doctor some education about eating disorders isn’t working (or you don’t want to even put that effort in), don’t be afraid to part ways with your doctor. We as patients are consumers, which means if we’re not comfortable with the service and treatment we’re receiving, we have every right to take our business elsewhere and shouldn’t feel guilty about that at all.

A big part of eating disorder recovery is learning to find your voice, so these tips are not easy to do. But they are an opportunity to practice using your voice, taking charge of your life, and realizing you are capable. You can do it.

Much love,

Cherie Miller, MS, LPC opened Dare 2 Hope Counseling to help clients all over the country get free from their food, weight, and self-confidence struggles. Her specialty is eating disorders, including anorexia, bulimia, binge-eating, orthorexia and other unhealthy eating patterns. Contact her here.

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A Potential Flaw in Positive Thinking Psychology

Photo Credit: ileanaandrei.ro

There’s a lot of talk these days about positive thinking and how important it is to change your thinking to improve your health and happiness. And while I won’t argue that our mindset affects our feelings and behavior (because I believe it absolutely does), I am concerned that we can put too much emphasis on thinking. That’s a big statement for a Cognitive Behavioral Therapy (CBT) therapist to make! But here’s the balance that I would like to bring to the discussion: Though highly influential, thoughts are not an all-powerful force in our lives.

There are potential drawbacks to believing that everything we think affects our behavior. So even while we acknowledge the significance of our thoughts and strive to have healthier, more constructive thinking patterns, let’s also recognize some limitations of our thoughts. For example, thoughts…

do not always reflect what we really believe, feel or want.
do not always mean we will act on whatever that thought is.
do not always reflect reality.

Let’s take a closer look at why each of these points is relevant.

#1. Thoughts do not always reflect what we really believe, feel or want. We all have had bizarre, maybe even dark thoughts that pop into our heads at times—that is a normal part of being human. It does not mean you are “crazy” or a bad person. Some people struggle with these types of thoughts more than others, particularly people with issues like anxiety, obsessive-compulsive disorder, or postpartum depression. On the extreme end, I’ve had clients who had intrusive thoughts about things like stabbing their spouses or molesting their child (even though they had no reason or desire to do such things), and they worried it meant there was something evil inside of them. Being bothered by your thoughts is a sign that they don’t reflect your wants or values. In cases like these that go beyond the “normal” occasional bizarre thoughts we all have, there are often biological causes for these thoughts. There is sometimes trauma in that person’s past that can be influencing these thoughts.

#2. Thoughts do not always mean we will act on whatever that thought is. Thoughts do not automatically manifest into behavior. None of my clients who had bizarre, or even violent, intrusive thoughts ever acted on them because that is not who they were.

Now, sometimes our thoughts do line up with our feelings and that makes it more likely we will act on them, but it doesn’t mean we have to. This is key for my clients in eating disorder recovery, who might have obsessive thoughts about not eating or about thinking they are fat (and also feeling fat). Though it can be incredibly difficult, they can choose not to act on those thoughts. In her book, Life without Ed, Jenni Shaefer describes it as “disobeying” the eating disorder. We can have thoughts and feelings about harming ourselves and decide to call a friend instead. A tape can play in our head about how that big presentation at work will be a flop, but then it turns out we nail it.

#3. Thoughts do not always reflect reality. Thoughts, like feelings, are not facts. Research confirms that much of what we worry about doesn’t even happen.¹ And just because we think something doesn’t make it true. We can think we’re ugly and actually be attractive. We can think we’re an idiot and be very intelligent. We can think we are boring and socially awkward while in reality, people find us engaging and pleasant to be around. The stories we tell ourselves are just that: stories. And sometimes stories are only partially true or sometimes they are completely false.

It is really, really good news that while we work on changing detrimental thoughts, we are not completely at their mercy until they change or go away. We can still choose to ignore or to act opposite of our thoughts when they aren’t healthy. Remember friends, we are not just thoughts… we also have a will and a conscience and many other elements that make up who we are and drive what we do.

Much love,

¹References: “85 Percent of What We Worry About Never Happens” By Don Joseph Goewey (www.huffingtonpost.com/don-joseph-goewey-/85-of-what-we-worry-about_b_8028368.html)

When Recovery Is One More Way to Beat Yourself Up

Most people with eating disorders struggle with perfectionism… and that certainly includes how they approach the recovery process. Is that you? Do you hold perfectionist standards for what recovery should look like and how long it should last? These standards are based less on the reality of recovery and more on the unhealthy expectations of yourself that contributed to the eating disorder in the first place. There is no room for error, little compassion for oneself, and the notion that recovery should be relatively quick once the decision is made to get better.

But dear one, that approach to recovery will leave you feeling like a failure because unrealistic expectations are always a set-up for failure. Recovery is worth it, yes, but no doubt about it, it is also messy and hard. And it always takes longer than we want it to. Going into the process accepting these things can help you avoid feeling discouraged or giving up entirely. So let’s create some new rules for recovery that are more compassionate, realistic, and ultimately, helpful. Here were my 5 rules for recovery when I was in it. I’ve seen clients come up with some amazing others. Make your own list and read them whenever you’re feeling frustrated with yourself about recovery.

My 5 Rules of Eating Disorder Recovery

1) I will not rush recovery. I will give myself whatever time I need to heal properly and wholly. And I will not be angry with myself for how long it takes.

2) I will not expect healing to be a straight path. There are going to be bad days and setbacks and temptations to give up. But I will keep going and will not let recovery be just one more area in my life where I demand perfection from myself.

3) I will not make excuses; I will take responsibility for my thoughts, feelings, and behaviors.

4) I will say my affirmations out loud every day, even if I don’t believe them. Even if it feels stupid or weird.

5) I will not listen to the inner terrorist, and I will challenge her lies with Truth.

I’d love to hear some of the ones you’d put on your list!

Much love,

How to Love a Porcupine

At an eating disorder support group I led recently, a mom said the one “gift” her daughter could give her was to try and recover from her anorexia. She was struggling with understanding how her daughter could see the damage her eating disorder was doing to their family and still refuse to even try recovery. Without saying these exact words, I believe her feelings were akin to, “If you loved me, you would stop.”

Anyone who has been in a relationship with someone with an eating disorder or substance addiction can probably relate to that. In your head, you might know it has nothing to do with you, but it feels like it does. And often, when you push people to get better before they are ready, they will act in pretty unloving ways to defend themselves. It can be be like trying to hug a porcupine…the more you try to help, the more you get hurt. This frustrating cycle usually leads to feelings of resentment and maybe even pretty strong anger—on both sides. So how do you get out of the cycle without giving up on the other person? Here are some tips on how to love a porcupine (i.e. someone not ready to recover).

#1. Realize how difficult it is to even choose recovery, much less walk through it. Another girl in the group who has an eating disorder told that mom that her own mother had expressed similar things to her in the past before she started into recovery. “I love my mom so much. I felt like I would do anything for her… but she was literally asking me to do the one thing I couldn’t do at the time.” This brave young woman went on to explain that the fear was overwhelming, even to the point of overwhelming her love for others. “I was absolutely terrified at the thought of treatment and gaining weight.”

#2. Be a learner. Unless you have an eating disorder, you can never fully understand what it is like to have one, but you can educate yourself to become more sensitive and knowledgeable. There are a lot of books on the subject (see recommended reading at the end), online resources like NEDA and ANAD, and possibly some support groups local to you. If your loved one is willing to share about their experience, that is of course, an ideal place to learn. Eating disorders by nature tend to be surrounded by secrecy and shame, but there are things you can to make it more or less likely he or she will open up. Which leads to #3…

#3. Work on being a safe person. As you learn more about eating disorders, you’ll be more attune to things that could be detrimental for your loved one. Even with the best of intentions, people often say or suggest things that are triggering or insulting. Oversimplifying their struggles by telling them to just eat or to just stop throwing up, assuring them they look great, or suggesting diet plans are examples of common but counter-productive attempts to help.

In general, taking a non-judgmental approach that doesn’t shame, scold, or criticize the other person is more likely to foster open communication. Assure him or her that you want to understand better than you do now and that you’re ready to listen… and then really listen. At times, it will be appropriate to encourage them to get help, but if you jump to that too quickly, the other person is more often than not going to feel misunderstood. Check out this article from NEDA for more detailed tips on talking to a loved one about his or her eating disorder.

#4. Draw appropriate boundaries. This is a tricky one that could probably be its own blog post. Basically, you have to figure out where the line is between supporting someone and not trying to control them. Trying to control others doesn’t usually work and can even make them more resistant to change (thanks to that rebellious nature in all of us). For example, unless they’ve asked you to provide some accountability, comments about what they are or are not eating will likely backfire. Pushing someone to recover before they’re ready usually means recovery won’t be successful, even if they appear to be going through the motions. The person’s own motivation is key.

There are some exceptions to these principles. One is in cases where the eating disorder is so severe that medical care is necessary and then yes, intervention could mean life or death. If you’re not sure whether you’re in such a situation, talk to a medical doctor or therapist who is familiar with eating disorders.

The other exception is if you are the parent of a child or teenager. Naturally, your boundaries with that person are already different because they are under your care and you are responsible for their physical and emotional well-being. In that case, I believe forcing a child into treatment might make sense. But keep in mind the same caveat about personal motivation applies… recovery won’t happen until that person, regardless of age, decides for themselves to really try.

Following all these steps won’t guarantee you don’t get “poked” while trying to help. Believe it or not, people with eating disorders feel like they have a lot of reasons to stay sick and the thought of recovery can be, as that young woman said, absolutely terrifying. The fear and shame that accompany eating disorders make recovery hard to consider. Take care of yourself and resist the temptation to take on “fixing” them. Offer patience, support, and honesty, and by all means, seek out help and support for yourself! It’s not easy to love a porcupine.

Much love,

Sometimes Wrong is Good

Photo credit: http://eduvir.com.br

If there’s one thing that all my eating disorder clients have had in common, it’s this: at some point or another, they believe they can’t really recover.

This is the best I can be.
I’ll never get better.
I’ll always be stuck like this.
Recovery isn’t possible for me.

But you know what? Every person I know (including myself) who has recovered from an eating disorder said and believed those same things.

It turns out, we were wrong.

Maybe you’re working on recovery and the hard days leave you feeling like you’ll never get there. Or maybe recovery feels so impossible and elusive that you’re not even trying. Either way, what if you’re wrong? Maybe, just maybe, it’s not only possible but you will actually get there eventually. Being wrong isn’t usually a good feeling, but it would be pretty awesome to be wrong about this, wouldn’t it?

Dare to hope.

Much love,