2001 Newsletters
January–April 2001
Feeling Like a "Disappointment"
Amy Grabowski, MA, LCPC
("Bonnie" is a composite of many of my clients who have had similar experiences with similar reactions.)
"Bonnie" came to my office feeling depressed. Over the weekend, she had attended a wedding (or a baby shower, or an engagement party) of a close friend. Even though she had a good time, she noticed a nagging doubt come over her. She started thinking, "I'll never get what my friend has." As the evening wore on she felt more and more alone.
As we explored these feelings I wondered aloud what her friend had that she wanted. "I'll never be loved like she is," came the reply. I could have pointed out the distorted thinking patterns or her inability to predict the future, but instead I asked why she thought so. "I'm not lovable. There's something wrong with me."
At that moment I knew what she was feeling because back in my own eating disordered days I too felt the same way. And even though I knew the answer I asked the next question anyway, "When was the first time you felt this way?"
"I've felt it all my life."
"As a child, what did you feel?"
"Like I was a big disappointment to my parents."
Many clients use words very similar to these. The events that trigger these feelings may be different, but the feelings almost always boil down to the same thing: "I'm a big disappointment to my parents. I'm not who they wanted as a child. There must be something wrong with me."
I have to preface the next part by stating that I firmly believe that all children are born perfect and whole, likable and lovable, just as they are! And if nurtured in an accepting and validating environment, they would be "perfect" just being themselves. (Being a parent myself, I know that there are NO perfect parents, NO perfect environments. Even the most empathic, nurturing parent sometimes has bad days or says hurtful things now and then. And the messages I am talking about in this article are not the result of the few times that a parent rolls their eyes and sighs with exasperation, but rather the accumulated effect of repeated occurrences of negative responses to the child.)
As I mentioned in the last newsletter many people with eating disorders got overt/or covert messages that said, "In order to be lovable, you should be different, you shouldn't be you." Now in the 14 years that I have been working with people with eating disorders I have consistently found them to be wonderful, likable, talented, incredible people, just as they are! So how did they develop the feeling that deep down inside they are "a disappointment"? I'd like to give an example from my own family.
I have a son and a daughter who I love very much, but more importantly I really like them. I think they are both great kids and I enjoy being with them very much. My daughter, Alison and I are very much alike in both appearance and temperament. So while raising her, I often have been in situations where it feels like I am watching old movies of my own childhood. When Alison was only 6 years old, she and her cousin James were hiking around in the woods by my parents house. I was relaxing and talking to the rest of the family, when all of a sudden we heard both kids screaming! They had disturbed a bees nest and Alison was stung repeatedly on her back. (If you've ever been stung by a bee you know how painful and frightening that can be! Now imagine that you are only 6.....) I ran as fast as I could, scooped her up in my arms and carried her, up the hill, to my parents house. She continued to scream and cry as we inspected the stings. My father volunteered to drive into town to buy some children's Tylenol and Benedryl for her. Sitting in a rocking chair together, I rocked her for a long time, applying ice to her back, while she continued to cry. I kept telling her, "It's going to be OK. Mommy's here." Eventually, my father arrived and we gave her the medicines and she was able to fall asleep.
Why am I telling you this story? It's because of my mother's reaction to the event. After we left she told my sister, "Alison always makes such a big deal about everything. She's such a drama queen." My first reaction was anger. "How dare she criticize my daughter! She's just a little girl!" I wanted to say I didn't care if my mother liked my daughter or not, that I liked her and thought she was a very likable little girl. But it really bothered me that my mother often didn't like my daughter. She's too "flamboyant", too outspoken for my mother, who prefers children who play quietly in the corner, who are "no bother". Then an incredible sense of sadness came over me. I started remembering all the times when I was a little girl and also was told in overt and covert ways that I was "too much", or "too over-the-top". I didn't feel liked or likable. I felt like a disappointment, like there was something wrong with me. And each time this happened I would try to not be me and a little bit more of my "self" was sacrificed.
I included this example to show that the problem doesn't lie in the personality of the child. But rather in the needs, preferences, or expectations of the parent. Maybe the "disappoint-ments" from your past are less tangible. If your parents wanted you to be an "easy child" then every time you were "fussy" you would feel their disappointment. If you were supposed to be a perfect showcase child, then every time you were messy or made a mistake (when you were "human"), they would be disappointed. If your body was supposed to be skinnier than it was genetically meant to be, they would be disappointed. If you were supposed to make mommy "happy",... yep, you guessed it, disappointment. And each time you may have vowed to be a different person, to not be your "self".
One of the developmental tasks a young child is supposed to learn is that love is constant. I believe that love should be like the oxygen in the room. Its just there, you don't have to think about it. But many people with eating disorders came from homes where love was turned on and off like a light switch: If you displease me, I'll love you less. If you make me angry, I won't love you. (Imagine if parents turned off the oxygen when they were displeased! We would report them for child abuse!)
Part of recovery is reclaiming our "lovability"! We were lovable even when we were "fussy". We were lovable even when we would rather run around the back yard than sit and look pretty. We were lovable even when mommy was unhappy - (that's a whole article unto itself!!!)
In order to recover our "selves", we need to reclaim our right to be who we were meant to be. We have to reclaim our inherent talents and personalities and see them as being "good enough" just as they are! In the next issue I will talk more about this in my article: "Right Brain/Left Brain and the Flip Side of the Same Coin".
_____________________________________
The Meaning of Food During the Early Years
Susan Bachman, MSW
Rarely do we think of all that has gone into forming our relationship with food and eating. When there are no problems with eating, we take it for granted. It is a biological function and everyone needs to do it. And when there are problems, there is shame and frustration, but still oftentimes no further exploration of all that goes into this complex and meaningful part of our lives.
In fact it begins in the womb, when our nourishment comes to us directly from mother. Our fetus-bodies process and utilize the nutrients, but we don't yet use all of our body parts which later become so integral a part of the experience of eating.
After birth, some parents choose to nurse, which extends the physiological connection between mother and child around the act of feeding. But whether an infant is breast or bottle fed, to say that the purpose of feeding is primarily for nutrients is to miss a crucial aspect of the importance of eating. From the first day of our lives and maybe earlier, eating is an event that establishes the framework for future experiences and relationships.
It brings to mind a number of famous studies done in the 1940's and 50's researching children who were raised in institutions. These children were given food and shelter and they were tended to physically, but they were not stimulated or held. In other words, they were fed but not nourished. Those who survived had devastating developmental and psychological problems.
. It wasn't enough just to feed them, for nourishment is so much more than calories. For baby, nursing or sucking on a bottle is also an occasion for stimulating and pleasing the senses. Baby has the opportunity to take in the touch of another's skin, a smile, and the sound of a loving voice. These first sensory pleasures lay the groundwork for what will become a more refined use of senses, eventually helping the growing child to interpret her world.
The young infant needs her caregivers to satisfy as many of her needs as possible because she has no way of regulating her urges. This means feeding upon demand. As her mental and physical development get under way, little by little, throughout the years, her parents can turn over the responsibility for these functions to her. This gradual process is the development of self-regulation, which involves a wide variety of functions, including the regulation of food intake.
Of course there was a time in our history when this was not the popular viewpoint. In the 1920's and 30's there was a child-rearing trend toward putting the newborn on a feeding schedule and denying her food no matter how much she cried. "Giving in" supposedly produced a coddled child. According to Selma Fraiberg in The Magic Years, "A good mother of the period closed her ears to the noise, set her teeth, and waited until the kitchen clock registered hunger" (p. 72).
This is an example of how a child might be denied a crucial opportunity to develop an internal sense of what it feels like to be hungry. Furthermore, the experience of having food withheld is likely to create feelings of helplessness and distress which are then associated with eating and perhaps with the relationship to the caregiver. When a child's basic needs go unmet so early in life, it is possible to see how she might later have mixed feelings about meeting her own needs.
Though the groundwork is laid in infancy, the developmental importance of food and eating continues throughout the life cycle. In toddlerhood there is the event of learning to feed oneself. Usually quite a messy affair, which involves the child feeling the different textures of various foods, with her hands and her mouth, sensing the difference between hot and cold, tasting food, smelling food, spitting it out and of course the wonderful feeling of omnipotence the toddler experiences when throwing food. This is all an important part of child development.
The ways in which emotions and food go together become more apparent in the older toddler. In my practice as a psychotherapist with families, I very often get parents who are worried about their child's eating habits. The child might insist on eating only certain foods, or need foods prepared in a certain way or by a certain person; he might restrict his food or overeat. Sometimes these preferences are indications of a child's psychological issue and sometimes they're not.
But either way, there is usually an emotional component to the situation. For a parent, feeling that one is unable to adequately feed one's child evokes feelings of failure and frustration. And sometimes eating becomes the battleground for addressing important issues between parent and child.
It used to be that our first experience of having a regular meal out of the home came during our first year of grade school. The school lunchroom continues to be a place that is loaded with energy, excitement and fear, and yet seldom do we think of the important peer interactions that take place around food at the school lunch table. If lunches are brought from home there is competition and trading of treats. The contents of the brown bag or lunchbox reveal information about a classmate's home life. And though every school might have similar lunchroom noise, it is not too hard to imagine that underneath it all, there are more than a few students with private thoughts and worries about separation from home around mealtime.
I could easily extend this discussion into adolescence and adulthood, but there is already a heightened cultural awareness of the meaning that food and eating have during these years. The bottom line is that food is stirring. It is laden with much meaning, both developmentally and emotionally throughout the life cycle. And while we need food in order to survive, it is not like putting fuel into an automobile. Viewing it as such denies us the opportunity of understanding our relationship with food in all of its complexity, and in the end prevents us from being truly nourished.
Susan Bachman, LCSW has a special expertise in working with parents of young children.
_____________________________________
Nutrition Q&A: Why Nutrition Counseling?
Elisa D'Urso-Fischer, RD, LD
Q: Why do I need to see a dietitian if I am seeing a therapist? Why do I need to see a therapist if I am seeing a dietitian?
A: There is increasing evidence that the team approach is most effective in treating eating disorders. The roles of the dietitian and therapist sometimes seem to overlap and cause confusion for both clients and therapists. In addition, there are many kinds of dietitians and therapists. If one explores the roles of these professionals, it becomes easy to see why both are necessary and essential to promote the fastest and most permanent progress.
Sondra Kronberg, M.S., R.D., president of the Eating Disorder Council of Long Island, N.Y., and Board member of the American Anorexia/Bulimia Association, recently wrote an article for their newsletter titled "Nutrition and Eating Disorders: A Shared Journey". She describes the recovery team as a partner-ship. "Patients are the experts of themselves, their behaviors and thoughts. The nutritionist is the expert of physiology, nutrition information, eating thoughts and behaviors. The therapist is an expert on the emotions and underlying dynamics that support the eating disorder.. Responsibility and answers lie within the patient, the team is a guide."
Traditionally dietitians receive the scientific training necessary to assess someone's physiological status and determine their nutritional needs. The dietitian can then calculate the amount of nutrients the person needs, develop a food plan that meets these needs, and provide some suggestions for getting started. The client was then supposed to implement these recommendations with occasional check-ins with the dietitian for further guidance and refinement of the dietary plan. Unfortunately, this was a frustrating process for everyone. It didn't work. It didn't work because it wasn't internally driven, and it didn't deal with the emotional aspects of eating or the underlying issues of an eating disorder.
Some dietitians seek extra training in treating eating disorders. These specially trained dietitians, often referred to as "nutrition counselors" or "nutrition therapists," can help clients learn how variations in their carbohydrate, protein, fat, and calorie intake can affect their physical and emotional sate of being. They can help clients identify, distinguish, and satisfy physical and emotional hunger. Armed with the scientific knowledge of how food works in the body, they can help to identify false and distorted beliefs about food and the body. They can help to uncover and identify how someone may be using food to cope with many areas of their life. However, this is where the expertise of a psychotherapist becomes essential. What may have been "uncovered" in nutrition counseling needs to be explored and worked on in psychotherapy. The therapist delves into the real issues that are causing the eating disorder. Eating Disorders are not about food. For the most part, discussions about food should be with the dietitian, leaving more time for the therapist to work on the emotional and psychosocial issues.
Working with people around their food and eating is very complex and multidimensional. The treatment of an eating disorder is a process that requires a team of specialists. With good communication between the dietitian and therapist, remarkable growth and change can take place.
___________________________________
Art Therapy: Powerful Healing
E.J. Wilton
So many people want to know, "What is art therapy?" Art therapy is a powerful way to experience healing and recovery. There is a misconception that people need to be "good" at art to participate in art therapy. Truthfully, we are all creative with the potential to change undesired aspects of our lives regardless of our artistic ability. Sometimes, words, can slip by us where as self-created images are forever. Having a series of art pieces can provide important documentation of significant feelings and issues. New insights can develop when reviewing art productions months or years later.
Art therapy allows expression of our inner chaos and pain in a safe and reassuring environment. When individuals commit themselves to working with an art therapist some of the benefits include increased self-understanding, emotional growth and healing. Art therapy helps us to give our lives the meaning we want in a visual way.
________________________________
Introducing: Sandra Sheinin MD, Kate Schechter, Andrea Harris Alpert
We are pleased to announce the addition of a psychiatrist, and two new therapists to The Awakening Center. Sandra Sheinin, MD, received her medical degree and her psychiatry residency training at Northwestern University Medical School. Her special areas of interest: include: eating disorders, post-partum depression, pregnancy loss, infertility and breast cancer; and is available to see clients for medication management and psychotherapy. "I cultivated my interest in women's mental health by volunteering at Planned Parenthood and working at Y-ME Breast Cancer Information. Throughout my medical training, I have conducted clinical research that explored the interconnections between psychiatric and obstetric/gynecologic health. I've treated many women with depression and anxiety who also struggled with body image and self-esteem. I believe these issues are best addressed by offering a multitude of interventions, including various forms of therapy and medications. I strive to create a supportive environment where my client feels safe to openly explore feelings and experiences. By helping to facilitate understanding and awareness, the client can ultimately feel empowered to make healthier choices and live a more fulfilling life."
Both Kate Schechter, LCSW and Andrea Harris Alpert, LCSW bring a wealth of experience working with people of all ages and backgrounds in individual, couples and family therapy. With a background in clinical social work and comparative religion, Kate is especially interested in the dimension of the future in the therapeutic process and in the role of hope and imagination in growth. She aims to help people identify constricted and self-defective patterns and to define and develop new ways of meeting life's challenges creatively.
Andrea recognizes the courage that it takes for people to begin the therapeutic process. She works hard to provide a climate where her clients feel safe and understood so they can begin the process of exploration. By tailoring her approach to meet the specific pace and goals of each client, Andrea helps to facilitate self-awareness growth and healing.
________________________________
- Feeling Like A Disappointment - Amy Grabowski, MA, LCPC
- The Meaning of Food During the Early Years - Susan Bachman, MSW
- Nutrition Q&A: Why Nutrition Counseling? - Elisa D'Urso-Fischer, RD, LD
- Art Therapy: Powerful Healing - E.J. Wilton
- Introducing Sandra Sheinin, MD; Kate Schechter, and Andrea Harris Alpert
Feeling Like a "Disappointment"
Amy Grabowski, MA, LCPC
("Bonnie" is a composite of many of my clients who have had similar experiences with similar reactions.)
"Bonnie" came to my office feeling depressed. Over the weekend, she had attended a wedding (or a baby shower, or an engagement party) of a close friend. Even though she had a good time, she noticed a nagging doubt come over her. She started thinking, "I'll never get what my friend has." As the evening wore on she felt more and more alone.
As we explored these feelings I wondered aloud what her friend had that she wanted. "I'll never be loved like she is," came the reply. I could have pointed out the distorted thinking patterns or her inability to predict the future, but instead I asked why she thought so. "I'm not lovable. There's something wrong with me."
At that moment I knew what she was feeling because back in my own eating disordered days I too felt the same way. And even though I knew the answer I asked the next question anyway, "When was the first time you felt this way?"
"I've felt it all my life."
"As a child, what did you feel?"
"Like I was a big disappointment to my parents."
Many clients use words very similar to these. The events that trigger these feelings may be different, but the feelings almost always boil down to the same thing: "I'm a big disappointment to my parents. I'm not who they wanted as a child. There must be something wrong with me."
I have to preface the next part by stating that I firmly believe that all children are born perfect and whole, likable and lovable, just as they are! And if nurtured in an accepting and validating environment, they would be "perfect" just being themselves. (Being a parent myself, I know that there are NO perfect parents, NO perfect environments. Even the most empathic, nurturing parent sometimes has bad days or says hurtful things now and then. And the messages I am talking about in this article are not the result of the few times that a parent rolls their eyes and sighs with exasperation, but rather the accumulated effect of repeated occurrences of negative responses to the child.)
As I mentioned in the last newsletter many people with eating disorders got overt/or covert messages that said, "In order to be lovable, you should be different, you shouldn't be you." Now in the 14 years that I have been working with people with eating disorders I have consistently found them to be wonderful, likable, talented, incredible people, just as they are! So how did they develop the feeling that deep down inside they are "a disappointment"? I'd like to give an example from my own family.
I have a son and a daughter who I love very much, but more importantly I really like them. I think they are both great kids and I enjoy being with them very much. My daughter, Alison and I are very much alike in both appearance and temperament. So while raising her, I often have been in situations where it feels like I am watching old movies of my own childhood. When Alison was only 6 years old, she and her cousin James were hiking around in the woods by my parents house. I was relaxing and talking to the rest of the family, when all of a sudden we heard both kids screaming! They had disturbed a bees nest and Alison was stung repeatedly on her back. (If you've ever been stung by a bee you know how painful and frightening that can be! Now imagine that you are only 6.....) I ran as fast as I could, scooped her up in my arms and carried her, up the hill, to my parents house. She continued to scream and cry as we inspected the stings. My father volunteered to drive into town to buy some children's Tylenol and Benedryl for her. Sitting in a rocking chair together, I rocked her for a long time, applying ice to her back, while she continued to cry. I kept telling her, "It's going to be OK. Mommy's here." Eventually, my father arrived and we gave her the medicines and she was able to fall asleep.
Why am I telling you this story? It's because of my mother's reaction to the event. After we left she told my sister, "Alison always makes such a big deal about everything. She's such a drama queen." My first reaction was anger. "How dare she criticize my daughter! She's just a little girl!" I wanted to say I didn't care if my mother liked my daughter or not, that I liked her and thought she was a very likable little girl. But it really bothered me that my mother often didn't like my daughter. She's too "flamboyant", too outspoken for my mother, who prefers children who play quietly in the corner, who are "no bother". Then an incredible sense of sadness came over me. I started remembering all the times when I was a little girl and also was told in overt and covert ways that I was "too much", or "too over-the-top". I didn't feel liked or likable. I felt like a disappointment, like there was something wrong with me. And each time this happened I would try to not be me and a little bit more of my "self" was sacrificed.
I included this example to show that the problem doesn't lie in the personality of the child. But rather in the needs, preferences, or expectations of the parent. Maybe the "disappoint-ments" from your past are less tangible. If your parents wanted you to be an "easy child" then every time you were "fussy" you would feel their disappointment. If you were supposed to be a perfect showcase child, then every time you were messy or made a mistake (when you were "human"), they would be disappointed. If your body was supposed to be skinnier than it was genetically meant to be, they would be disappointed. If you were supposed to make mommy "happy",... yep, you guessed it, disappointment. And each time you may have vowed to be a different person, to not be your "self".
One of the developmental tasks a young child is supposed to learn is that love is constant. I believe that love should be like the oxygen in the room. Its just there, you don't have to think about it. But many people with eating disorders came from homes where love was turned on and off like a light switch: If you displease me, I'll love you less. If you make me angry, I won't love you. (Imagine if parents turned off the oxygen when they were displeased! We would report them for child abuse!)
Part of recovery is reclaiming our "lovability"! We were lovable even when we were "fussy". We were lovable even when we would rather run around the back yard than sit and look pretty. We were lovable even when mommy was unhappy - (that's a whole article unto itself!!!)
In order to recover our "selves", we need to reclaim our right to be who we were meant to be. We have to reclaim our inherent talents and personalities and see them as being "good enough" just as they are! In the next issue I will talk more about this in my article: "Right Brain/Left Brain and the Flip Side of the Same Coin".
_____________________________________
The Meaning of Food During the Early Years
Susan Bachman, MSW
Rarely do we think of all that has gone into forming our relationship with food and eating. When there are no problems with eating, we take it for granted. It is a biological function and everyone needs to do it. And when there are problems, there is shame and frustration, but still oftentimes no further exploration of all that goes into this complex and meaningful part of our lives.
In fact it begins in the womb, when our nourishment comes to us directly from mother. Our fetus-bodies process and utilize the nutrients, but we don't yet use all of our body parts which later become so integral a part of the experience of eating.
After birth, some parents choose to nurse, which extends the physiological connection between mother and child around the act of feeding. But whether an infant is breast or bottle fed, to say that the purpose of feeding is primarily for nutrients is to miss a crucial aspect of the importance of eating. From the first day of our lives and maybe earlier, eating is an event that establishes the framework for future experiences and relationships.
It brings to mind a number of famous studies done in the 1940's and 50's researching children who were raised in institutions. These children were given food and shelter and they were tended to physically, but they were not stimulated or held. In other words, they were fed but not nourished. Those who survived had devastating developmental and psychological problems.
. It wasn't enough just to feed them, for nourishment is so much more than calories. For baby, nursing or sucking on a bottle is also an occasion for stimulating and pleasing the senses. Baby has the opportunity to take in the touch of another's skin, a smile, and the sound of a loving voice. These first sensory pleasures lay the groundwork for what will become a more refined use of senses, eventually helping the growing child to interpret her world.
The young infant needs her caregivers to satisfy as many of her needs as possible because she has no way of regulating her urges. This means feeding upon demand. As her mental and physical development get under way, little by little, throughout the years, her parents can turn over the responsibility for these functions to her. This gradual process is the development of self-regulation, which involves a wide variety of functions, including the regulation of food intake.
Of course there was a time in our history when this was not the popular viewpoint. In the 1920's and 30's there was a child-rearing trend toward putting the newborn on a feeding schedule and denying her food no matter how much she cried. "Giving in" supposedly produced a coddled child. According to Selma Fraiberg in The Magic Years, "A good mother of the period closed her ears to the noise, set her teeth, and waited until the kitchen clock registered hunger" (p. 72).
This is an example of how a child might be denied a crucial opportunity to develop an internal sense of what it feels like to be hungry. Furthermore, the experience of having food withheld is likely to create feelings of helplessness and distress which are then associated with eating and perhaps with the relationship to the caregiver. When a child's basic needs go unmet so early in life, it is possible to see how she might later have mixed feelings about meeting her own needs.
Though the groundwork is laid in infancy, the developmental importance of food and eating continues throughout the life cycle. In toddlerhood there is the event of learning to feed oneself. Usually quite a messy affair, which involves the child feeling the different textures of various foods, with her hands and her mouth, sensing the difference between hot and cold, tasting food, smelling food, spitting it out and of course the wonderful feeling of omnipotence the toddler experiences when throwing food. This is all an important part of child development.
The ways in which emotions and food go together become more apparent in the older toddler. In my practice as a psychotherapist with families, I very often get parents who are worried about their child's eating habits. The child might insist on eating only certain foods, or need foods prepared in a certain way or by a certain person; he might restrict his food or overeat. Sometimes these preferences are indications of a child's psychological issue and sometimes they're not.
But either way, there is usually an emotional component to the situation. For a parent, feeling that one is unable to adequately feed one's child evokes feelings of failure and frustration. And sometimes eating becomes the battleground for addressing important issues between parent and child.
It used to be that our first experience of having a regular meal out of the home came during our first year of grade school. The school lunchroom continues to be a place that is loaded with energy, excitement and fear, and yet seldom do we think of the important peer interactions that take place around food at the school lunch table. If lunches are brought from home there is competition and trading of treats. The contents of the brown bag or lunchbox reveal information about a classmate's home life. And though every school might have similar lunchroom noise, it is not too hard to imagine that underneath it all, there are more than a few students with private thoughts and worries about separation from home around mealtime.
I could easily extend this discussion into adolescence and adulthood, but there is already a heightened cultural awareness of the meaning that food and eating have during these years. The bottom line is that food is stirring. It is laden with much meaning, both developmentally and emotionally throughout the life cycle. And while we need food in order to survive, it is not like putting fuel into an automobile. Viewing it as such denies us the opportunity of understanding our relationship with food in all of its complexity, and in the end prevents us from being truly nourished.
Susan Bachman, LCSW has a special expertise in working with parents of young children.
_____________________________________
Nutrition Q&A: Why Nutrition Counseling?
Elisa D'Urso-Fischer, RD, LD
Q: Why do I need to see a dietitian if I am seeing a therapist? Why do I need to see a therapist if I am seeing a dietitian?
A: There is increasing evidence that the team approach is most effective in treating eating disorders. The roles of the dietitian and therapist sometimes seem to overlap and cause confusion for both clients and therapists. In addition, there are many kinds of dietitians and therapists. If one explores the roles of these professionals, it becomes easy to see why both are necessary and essential to promote the fastest and most permanent progress.
Sondra Kronberg, M.S., R.D., president of the Eating Disorder Council of Long Island, N.Y., and Board member of the American Anorexia/Bulimia Association, recently wrote an article for their newsletter titled "Nutrition and Eating Disorders: A Shared Journey". She describes the recovery team as a partner-ship. "Patients are the experts of themselves, their behaviors and thoughts. The nutritionist is the expert of physiology, nutrition information, eating thoughts and behaviors. The therapist is an expert on the emotions and underlying dynamics that support the eating disorder.. Responsibility and answers lie within the patient, the team is a guide."
Traditionally dietitians receive the scientific training necessary to assess someone's physiological status and determine their nutritional needs. The dietitian can then calculate the amount of nutrients the person needs, develop a food plan that meets these needs, and provide some suggestions for getting started. The client was then supposed to implement these recommendations with occasional check-ins with the dietitian for further guidance and refinement of the dietary plan. Unfortunately, this was a frustrating process for everyone. It didn't work. It didn't work because it wasn't internally driven, and it didn't deal with the emotional aspects of eating or the underlying issues of an eating disorder.
Some dietitians seek extra training in treating eating disorders. These specially trained dietitians, often referred to as "nutrition counselors" or "nutrition therapists," can help clients learn how variations in their carbohydrate, protein, fat, and calorie intake can affect their physical and emotional sate of being. They can help clients identify, distinguish, and satisfy physical and emotional hunger. Armed with the scientific knowledge of how food works in the body, they can help to identify false and distorted beliefs about food and the body. They can help to uncover and identify how someone may be using food to cope with many areas of their life. However, this is where the expertise of a psychotherapist becomes essential. What may have been "uncovered" in nutrition counseling needs to be explored and worked on in psychotherapy. The therapist delves into the real issues that are causing the eating disorder. Eating Disorders are not about food. For the most part, discussions about food should be with the dietitian, leaving more time for the therapist to work on the emotional and psychosocial issues.
Working with people around their food and eating is very complex and multidimensional. The treatment of an eating disorder is a process that requires a team of specialists. With good communication between the dietitian and therapist, remarkable growth and change can take place.
___________________________________
Art Therapy: Powerful Healing
E.J. Wilton
So many people want to know, "What is art therapy?" Art therapy is a powerful way to experience healing and recovery. There is a misconception that people need to be "good" at art to participate in art therapy. Truthfully, we are all creative with the potential to change undesired aspects of our lives regardless of our artistic ability. Sometimes, words, can slip by us where as self-created images are forever. Having a series of art pieces can provide important documentation of significant feelings and issues. New insights can develop when reviewing art productions months or years later.
Art therapy allows expression of our inner chaos and pain in a safe and reassuring environment. When individuals commit themselves to working with an art therapist some of the benefits include increased self-understanding, emotional growth and healing. Art therapy helps us to give our lives the meaning we want in a visual way.
________________________________
Introducing: Sandra Sheinin MD, Kate Schechter, Andrea Harris Alpert
We are pleased to announce the addition of a psychiatrist, and two new therapists to The Awakening Center. Sandra Sheinin, MD, received her medical degree and her psychiatry residency training at Northwestern University Medical School. Her special areas of interest: include: eating disorders, post-partum depression, pregnancy loss, infertility and breast cancer; and is available to see clients for medication management and psychotherapy. "I cultivated my interest in women's mental health by volunteering at Planned Parenthood and working at Y-ME Breast Cancer Information. Throughout my medical training, I have conducted clinical research that explored the interconnections between psychiatric and obstetric/gynecologic health. I've treated many women with depression and anxiety who also struggled with body image and self-esteem. I believe these issues are best addressed by offering a multitude of interventions, including various forms of therapy and medications. I strive to create a supportive environment where my client feels safe to openly explore feelings and experiences. By helping to facilitate understanding and awareness, the client can ultimately feel empowered to make healthier choices and live a more fulfilling life."
Both Kate Schechter, LCSW and Andrea Harris Alpert, LCSW bring a wealth of experience working with people of all ages and backgrounds in individual, couples and family therapy. With a background in clinical social work and comparative religion, Kate is especially interested in the dimension of the future in the therapeutic process and in the role of hope and imagination in growth. She aims to help people identify constricted and self-defective patterns and to define and develop new ways of meeting life's challenges creatively.
Andrea recognizes the courage that it takes for people to begin the therapeutic process. She works hard to provide a climate where her clients feel safe and understood so they can begin the process of exploration. By tailoring her approach to meet the specific pace and goals of each client, Andrea helps to facilitate self-awareness growth and healing.
________________________________
May–August 2001
Right Brain/Left Brain and The Flip Side of the Same Coin
Amy Grabowski, MA, LCPC
"Discover the person you were meant to be". You may have seen this tagline on our stationary or newsletters. In the last newsletter I ended my article by saying "In order to recover our "selves", we need to reclaim our right to be who we were meant to be." What do I mean "meant to be"?
Many of my clients, if not all, come to me saying they don't like who they are. They don't believe themselves to be likeable and have spent many years trying to be someone else; trying to not be themselves. Bonnie* remembers being told by her mother, "Why can't you be more like your sister, Bev? She's so quiet, (smart, good, neat, fill in the blank)." Bonnie on the other hand was physically active, talkative, funny and outspoken. As a child she started to believe that being active, talkative, funny and (especially) outspoken were "bad" and that there was something wrong with her. As she describes it she felt, "defective, not good enough". In order to get her mother's approval she had to stop being herself. She had to quiet the voice of her "Self" inside her. She did this by starving herself, by starving her "Self".
I want to tell you about two books I have read. This may seem like I am going off on one of my tangents, but I promise that it is relevant and I will come back to Bonnie's story later. My two children have Attention Deficit Disorder (ADD). They can both be very distractible, inattentive and in their own worlds. Helping them finish their homework can be excruciatingly difficult. Sometimes I would feel like I was going to lose my mind! Then I read Right-Brained Children in a Left-Brained World. As I read this book, I not only recognized my children, but myself and most of my clients as well.
You see, according to the author, the world is mostly left-brained: logical, analytical, orderly, sequential. Left-brained individuals "like making and following rules. They have a greater tendency to accept and appreciate what they hear and read rather than questioning and thinking independently. They like the familiar and the predictable; they often feel uncomfortable with new ideas, challenges, and surprises. They shine in jobs that involve a lot of routine and are at their worst when a crisis erupts that calls for creative problem solving." (Interpret that as: black and white thinking patterns, difficulty with transitions and change, rigidity: always solve problems in same way, never try anything different. These are hallmark characteristics of families of people with eating disorders!)
Right-brained individuals on the other hand are visual, holistic, whole-to-part learners; they excel at multi-tasking. They are intuitive, empathic and sensitive, both physically and emotionally. "They see a minimal need for rules, are impulsive, question authority, and embrace new challenges and ideas. They are highly competitive and perfectionistic."1 (Does that sound like Bonnie? Does that sound like you?)
As I said earlier, this describes most of my clients. Because they are intuitive, empathic and sensitive to other's feelings and moods, as children they learned how to "read" other people. But because they were children, they were not able to distinguish an opinion from a fact. Many of them came from left-brained families who did not like things or people that were "different". Define different? To a left-brained individual, different is anything that is unfamiliar or qualities that they cannot personally understand. Remember, left-brained individuals are uncomfortable with new ideas and challenges. Intuition, sensitivity, impulsivity, etc. are qualities that were often devalued, overtly or covertly. "Don't be so sensitive!" Does that sound familiar? After hearing these things over and over, many of these negative opinions are internalized into a definition of who they "think they should be".
(Because empathy and sensitivity are right brain qualities, left-brainers are unable to be sensitive to the impact of their words on the right-brainer. The frustration is that there is no appropriate "come back" to a left-brainer. "You're too insensitive" doesn't have the same "sting" to it. It is in my own humble "right-brained" opinion that the world needs more sensitive people. It would be hard to start a war if you were sensitive to the fact that each soldier has a family who loves him/her. It would be hard to hate another person if you could empathize with them. So when someone says to me, "You're too sensitive." I say, "Thank you.")
Now I don't mean I want you to blame your parents for your problems. This isn't about blame, this is about accepting responsibility for what is yours, and letting go of what is not. Not all parents are insensitive to their children, or deliberately put them down. Over the years I really have come to believe that most of my client's come from homes where their parents are doing the best they can. As my own mother said "Babies don't come with instruction manuals." But, there is quite a range of what constitutes "the best" these parents are capable of: from truly loving and well meaning, to inwardly empty and hurting, to intentionally sick and sadistic. As one client once aptly put it, "If they ain't got it, they can't give it." But I think it's helpful to realize where some of this devaluing came from even if the source didn't mean to make you feel devalued. If we can understand it, sometimes it's easier to change something.
So now that you are thinking, "Oh, I'm right-brained that's why I felt different", I'll tell you about another book that was very helpful, Teenagers With ADD, a Parent's Guide. Authors Jeffrey Freed and Laurie Parsons help parents of ADD children to see attributes of ADD in a positive light. For example, my children are highly distractible. Our family joke is that they can be distracted by air! If I view distractibility as negative, I might yell at them and make them feel bad about themselves. But if I look at it as a sign of their immense curiosity about how things work and the relationship of things in the world around them, I treat it positive. When they are distracted I remind them of their curious natures and help them to keep their curiosity in check until it is more appropriate to do so. They actually come away from this feeling better about themselves ("I'm curious!") but also in their ability to turn on and off certain behaviors ("I can focus now and not lose my momentum.").
There is a flip side to every coin. Every quality or characteristic you have, even ones that others in your family didn't like, even one's that you don't like, can be seen as positive. Let's look at Bonnie again. It was easy for her to view being active as a good thing: being athletic is already a plus in our society. She started viewing her sense of humor as an advantage. The ability to put others at ease, to break through tension by saying something funny can be a real asset. Humor is also a way to view life less seriously.
Bonnie had trouble finding anything positive in being outspoken. (It is often the outspoken member of the family that clashes the most with the critical parent, because she may speak about those things that the family ignores, hoping it will go away. "Don't rock the boat!" is a common family motto.) When we started to discuss people throughout history who were outspoken, for example Rosa Parks, she began to see that outspoken people have a strong sense of justice and can make changes in the world by saying "I don't like this. I think this is wrong." I asked her to think of what would happen if there were no outspoken people in the world. When she could link her outspoken nature with her power to make changes then she could appreciate this quality too.
Getting back to what I said in the beginning of this article, the person you were meant to be was born whole, lovable and likeable, perfect just as she was. When we can shed others' opinions about these qualities, then we can decide for ourselves that we are "good enough".
I'll talk more about this in my next article: "Rescuing the Child"
*"Bonnie" is a composite of several clients; all names have been changed to protect the privacy of all involved.
Right-Brained Children in a Left-Brained World; Jeffrey Freed and Laurie Parsons, 1997, Simon & Schuster
Teenagers with ADD, a Parent's Guide; Chris Zeigler Dendy, 1995, Woodbine House
Amy Grabowski, MA, LCPC: "I am writing a book on recovering from an eating disorder and would find it very helpful in my writing process to have input from you. I invite you to a series of free lectures/dialogs/discussions based on the chapters of the book."
_______________________________________
Top Ten Lies Your Scale May Be Telling You
Kathleen Check, Student Intern
Lie #10: You are weak willed if your body does not resemble a fashion model's body.
Lie #9: If you could just exercise for two hours instead of one, you wouldn't feel fat anymore.
Lie #8: You would have more friends if you lost 5 pounds.
Lie #7: You would have more friends, socialize more, and have a boyfriend/husband/significant-other if you lost 10 pounds.
Lie #6: You can see the frozen yogurt sundae you ate last night, on your hips!
Lie #5: You must have the perfect body to love yourself.
Lie #4: You have gained 5 pounds since yesterday.
Lie #3: If you purchase the size 6 dress (when you fit into a size 10), you will be motivated to diet and lose 10 pounds.
Lie #2: You can never be too thin.
Lie #1: You're fat and you will never be good enough.
Different people hear different things from their mirror. What is your mirror telling you? More importantly, what are you telling yourself about what you see?
________________________________________
Repealing Food Laws
Marianne Evans-Ramsay, RD, LD
The food police are the voices that scrutinize every eating action. It is the sum of the food rules that you adopted through dieting, read about in a magazine or book, or the ones you heard from family and friends. Dieting rules place trust in an external authority rather than an inner wisdom. Time and again clients describe their rule-bound eating: no eating after 6 p.m., minimal lunch before a dinner date, no breakfast because then I'll eat more the rest of the day, no sweets in the house, no butter or sauces on anything, etc. Think about the rules that dictated your eating today. Were they anything like these real food laws?
In Joliet Illinois, it is against the law to put cake in a cookie jar.
Banana peels can't be tossed on the streets of Waco, Texas.
Memphis, Tennessee, law prohibits the sale of bologna on Sunday.
In California, it is illegal to peel an orange in a hotel room.
Iowa State law makes it illegal to have a rotten egg in your possession.
In Gary, Indiana, it is against the law to ride a bus or attend a theater within four hours after eating garlic.
In Greene, New York, it is illegal to eat peanuts and walk backward on the sidewalk while a concert is playing.
Pennsville, New Jersey, has a law prohibiting anyone from selling baskets of fresh cucumbers within the town limits.
(Eat Your Words, Charlotte Foltz Jones, 1999)
Your food rules are probably much different than these laws, but perhaps it is time to begin to see your own food rules in the same light: odd, funny, and bizarre. These food laws were passed at one time, and some may have been repealed by now. To repeal your own food "laws" you can decide to imagine a new way to experience food, creating your own relationship with food.
Eating by rules results is an unnatural relationship with food and narrows the way you live. In The Tao of Eating, Linda R. Harper, Ph.D. encourages one to consider what Taoism teaches: emptying our minds of the artificial rules and knowledge that diets propose for weight loss. This is part of the process of undieting.
As this process begins, one can start making independent food choices. On a daily or hourly basis you begin to think about what you really want to eat and then eat it. You are not figuring out what you will eat tomorrow or next week. This requires a mindful attention to what your needs are in the here and now. Have pizza for breakfast, waffles for dinner, snack all day long if that is what your body needs. Eating what you really want also includes not eating what you really don't want. If you are not hungry in the evening then skip dinner, if you planned to have dessert but are too full, pass it up. You could also eat a few bites and leave the rest. You can leave food on your plate. You can choose to skip any meal or planned snack if that feels natural at the time.
This process takes a lot of practice, especially when one is not used to responding to the bodies' internal messages. This will take patience and persistence. On this path, there are no diet "deadlines" to strive for.
____________________________
Art Therapy
Jenn Thill, Intern
"I have gained more insight through my participation in the Art Therapy Group than I have in verbal therapy", a current Art Therapy Group member reported recently.
The Art Therapy process can be a unique way to address personal issues. This process allows us to connect with our own non-verbal, visual language. It is important to realize that each of us DOES have the ability to connect with our creative selves. Art Therapy is NOT about being a great artist, it is about using the art process and product as a tool. Visual images, as well as verbal statements, compete and circle around in our heads…the art therapy process begins to make some of these images concrete. It is this tangible process and these tangible products that allow us to piece together our internal patterns and make sense of our external selves and how we view the world.
Jennifer Thill is a recent Art Therapy Graduate from Illinois State University. She is currently leading the art therapy group on Saturday mornings.
_________________________
Feedback from a Reader
"I was reading an old issue of the Awakening Center's newsletter (May -August 2000), in which your article "What Do You Value?" asked for insights on this question.
I once read a book that asked the reader to list his/her true values and life goals and this is what I came up with:
1) Being a kind, fun, caring person who enriches the lives of others with my presence.
2) Continued education - intelligence.
3) Being at peace with myself and the world.
4) Having a long, healthy life.
5) Being a good friend, sister and daughter.
6) Creating, in my lifetime, something unique and lasting that can be enjoyed by others.
When I sat back and reviewed what I'd written, I realized that not a single one had anything to do with my physical appearance and I cried at the frustration of spending at least 95% of my day and my brain power thinking about something so insignificant."
_______________________________________
- Right Brain/Left Brain and The Flip Side of the Same Coin - Amy Grabowski, MA, LCPC
- Top Ten Lies Your Scale May Be Telling You - Kathleen Check, Student Intern
- Repealing Food Laws - Marianne Evans-Ramsay, RD, LD
- Art Therapy - Jenn Thill, Intern
- Feedback from a Reader
Right Brain/Left Brain and The Flip Side of the Same Coin
Amy Grabowski, MA, LCPC
"Discover the person you were meant to be". You may have seen this tagline on our stationary or newsletters. In the last newsletter I ended my article by saying "In order to recover our "selves", we need to reclaim our right to be who we were meant to be." What do I mean "meant to be"?
Many of my clients, if not all, come to me saying they don't like who they are. They don't believe themselves to be likeable and have spent many years trying to be someone else; trying to not be themselves. Bonnie* remembers being told by her mother, "Why can't you be more like your sister, Bev? She's so quiet, (smart, good, neat, fill in the blank)." Bonnie on the other hand was physically active, talkative, funny and outspoken. As a child she started to believe that being active, talkative, funny and (especially) outspoken were "bad" and that there was something wrong with her. As she describes it she felt, "defective, not good enough". In order to get her mother's approval she had to stop being herself. She had to quiet the voice of her "Self" inside her. She did this by starving herself, by starving her "Self".
I want to tell you about two books I have read. This may seem like I am going off on one of my tangents, but I promise that it is relevant and I will come back to Bonnie's story later. My two children have Attention Deficit Disorder (ADD). They can both be very distractible, inattentive and in their own worlds. Helping them finish their homework can be excruciatingly difficult. Sometimes I would feel like I was going to lose my mind! Then I read Right-Brained Children in a Left-Brained World. As I read this book, I not only recognized my children, but myself and most of my clients as well.
You see, according to the author, the world is mostly left-brained: logical, analytical, orderly, sequential. Left-brained individuals "like making and following rules. They have a greater tendency to accept and appreciate what they hear and read rather than questioning and thinking independently. They like the familiar and the predictable; they often feel uncomfortable with new ideas, challenges, and surprises. They shine in jobs that involve a lot of routine and are at their worst when a crisis erupts that calls for creative problem solving." (Interpret that as: black and white thinking patterns, difficulty with transitions and change, rigidity: always solve problems in same way, never try anything different. These are hallmark characteristics of families of people with eating disorders!)
Right-brained individuals on the other hand are visual, holistic, whole-to-part learners; they excel at multi-tasking. They are intuitive, empathic and sensitive, both physically and emotionally. "They see a minimal need for rules, are impulsive, question authority, and embrace new challenges and ideas. They are highly competitive and perfectionistic."1 (Does that sound like Bonnie? Does that sound like you?)
As I said earlier, this describes most of my clients. Because they are intuitive, empathic and sensitive to other's feelings and moods, as children they learned how to "read" other people. But because they were children, they were not able to distinguish an opinion from a fact. Many of them came from left-brained families who did not like things or people that were "different". Define different? To a left-brained individual, different is anything that is unfamiliar or qualities that they cannot personally understand. Remember, left-brained individuals are uncomfortable with new ideas and challenges. Intuition, sensitivity, impulsivity, etc. are qualities that were often devalued, overtly or covertly. "Don't be so sensitive!" Does that sound familiar? After hearing these things over and over, many of these negative opinions are internalized into a definition of who they "think they should be".
(Because empathy and sensitivity are right brain qualities, left-brainers are unable to be sensitive to the impact of their words on the right-brainer. The frustration is that there is no appropriate "come back" to a left-brainer. "You're too insensitive" doesn't have the same "sting" to it. It is in my own humble "right-brained" opinion that the world needs more sensitive people. It would be hard to start a war if you were sensitive to the fact that each soldier has a family who loves him/her. It would be hard to hate another person if you could empathize with them. So when someone says to me, "You're too sensitive." I say, "Thank you.")
Now I don't mean I want you to blame your parents for your problems. This isn't about blame, this is about accepting responsibility for what is yours, and letting go of what is not. Not all parents are insensitive to their children, or deliberately put them down. Over the years I really have come to believe that most of my client's come from homes where their parents are doing the best they can. As my own mother said "Babies don't come with instruction manuals." But, there is quite a range of what constitutes "the best" these parents are capable of: from truly loving and well meaning, to inwardly empty and hurting, to intentionally sick and sadistic. As one client once aptly put it, "If they ain't got it, they can't give it." But I think it's helpful to realize where some of this devaluing came from even if the source didn't mean to make you feel devalued. If we can understand it, sometimes it's easier to change something.
So now that you are thinking, "Oh, I'm right-brained that's why I felt different", I'll tell you about another book that was very helpful, Teenagers With ADD, a Parent's Guide. Authors Jeffrey Freed and Laurie Parsons help parents of ADD children to see attributes of ADD in a positive light. For example, my children are highly distractible. Our family joke is that they can be distracted by air! If I view distractibility as negative, I might yell at them and make them feel bad about themselves. But if I look at it as a sign of their immense curiosity about how things work and the relationship of things in the world around them, I treat it positive. When they are distracted I remind them of their curious natures and help them to keep their curiosity in check until it is more appropriate to do so. They actually come away from this feeling better about themselves ("I'm curious!") but also in their ability to turn on and off certain behaviors ("I can focus now and not lose my momentum.").
There is a flip side to every coin. Every quality or characteristic you have, even ones that others in your family didn't like, even one's that you don't like, can be seen as positive. Let's look at Bonnie again. It was easy for her to view being active as a good thing: being athletic is already a plus in our society. She started viewing her sense of humor as an advantage. The ability to put others at ease, to break through tension by saying something funny can be a real asset. Humor is also a way to view life less seriously.
Bonnie had trouble finding anything positive in being outspoken. (It is often the outspoken member of the family that clashes the most with the critical parent, because she may speak about those things that the family ignores, hoping it will go away. "Don't rock the boat!" is a common family motto.) When we started to discuss people throughout history who were outspoken, for example Rosa Parks, she began to see that outspoken people have a strong sense of justice and can make changes in the world by saying "I don't like this. I think this is wrong." I asked her to think of what would happen if there were no outspoken people in the world. When she could link her outspoken nature with her power to make changes then she could appreciate this quality too.
Getting back to what I said in the beginning of this article, the person you were meant to be was born whole, lovable and likeable, perfect just as she was. When we can shed others' opinions about these qualities, then we can decide for ourselves that we are "good enough".
I'll talk more about this in my next article: "Rescuing the Child"
*"Bonnie" is a composite of several clients; all names have been changed to protect the privacy of all involved.
Right-Brained Children in a Left-Brained World; Jeffrey Freed and Laurie Parsons, 1997, Simon & Schuster
Teenagers with ADD, a Parent's Guide; Chris Zeigler Dendy, 1995, Woodbine House
Amy Grabowski, MA, LCPC: "I am writing a book on recovering from an eating disorder and would find it very helpful in my writing process to have input from you. I invite you to a series of free lectures/dialogs/discussions based on the chapters of the book."
_______________________________________
Top Ten Lies Your Scale May Be Telling You
Kathleen Check, Student Intern
Lie #10: You are weak willed if your body does not resemble a fashion model's body.
Lie #9: If you could just exercise for two hours instead of one, you wouldn't feel fat anymore.
Lie #8: You would have more friends if you lost 5 pounds.
Lie #7: You would have more friends, socialize more, and have a boyfriend/husband/significant-other if you lost 10 pounds.
Lie #6: You can see the frozen yogurt sundae you ate last night, on your hips!
Lie #5: You must have the perfect body to love yourself.
Lie #4: You have gained 5 pounds since yesterday.
Lie #3: If you purchase the size 6 dress (when you fit into a size 10), you will be motivated to diet and lose 10 pounds.
Lie #2: You can never be too thin.
Lie #1: You're fat and you will never be good enough.
Different people hear different things from their mirror. What is your mirror telling you? More importantly, what are you telling yourself about what you see?
________________________________________
Repealing Food Laws
Marianne Evans-Ramsay, RD, LD
The food police are the voices that scrutinize every eating action. It is the sum of the food rules that you adopted through dieting, read about in a magazine or book, or the ones you heard from family and friends. Dieting rules place trust in an external authority rather than an inner wisdom. Time and again clients describe their rule-bound eating: no eating after 6 p.m., minimal lunch before a dinner date, no breakfast because then I'll eat more the rest of the day, no sweets in the house, no butter or sauces on anything, etc. Think about the rules that dictated your eating today. Were they anything like these real food laws?
In Joliet Illinois, it is against the law to put cake in a cookie jar.
Banana peels can't be tossed on the streets of Waco, Texas.
Memphis, Tennessee, law prohibits the sale of bologna on Sunday.
In California, it is illegal to peel an orange in a hotel room.
Iowa State law makes it illegal to have a rotten egg in your possession.
In Gary, Indiana, it is against the law to ride a bus or attend a theater within four hours after eating garlic.
In Greene, New York, it is illegal to eat peanuts and walk backward on the sidewalk while a concert is playing.
Pennsville, New Jersey, has a law prohibiting anyone from selling baskets of fresh cucumbers within the town limits.
(Eat Your Words, Charlotte Foltz Jones, 1999)
Your food rules are probably much different than these laws, but perhaps it is time to begin to see your own food rules in the same light: odd, funny, and bizarre. These food laws were passed at one time, and some may have been repealed by now. To repeal your own food "laws" you can decide to imagine a new way to experience food, creating your own relationship with food.
Eating by rules results is an unnatural relationship with food and narrows the way you live. In The Tao of Eating, Linda R. Harper, Ph.D. encourages one to consider what Taoism teaches: emptying our minds of the artificial rules and knowledge that diets propose for weight loss. This is part of the process of undieting.
As this process begins, one can start making independent food choices. On a daily or hourly basis you begin to think about what you really want to eat and then eat it. You are not figuring out what you will eat tomorrow or next week. This requires a mindful attention to what your needs are in the here and now. Have pizza for breakfast, waffles for dinner, snack all day long if that is what your body needs. Eating what you really want also includes not eating what you really don't want. If you are not hungry in the evening then skip dinner, if you planned to have dessert but are too full, pass it up. You could also eat a few bites and leave the rest. You can leave food on your plate. You can choose to skip any meal or planned snack if that feels natural at the time.
This process takes a lot of practice, especially when one is not used to responding to the bodies' internal messages. This will take patience and persistence. On this path, there are no diet "deadlines" to strive for.
____________________________
Art Therapy
Jenn Thill, Intern
"I have gained more insight through my participation in the Art Therapy Group than I have in verbal therapy", a current Art Therapy Group member reported recently.
The Art Therapy process can be a unique way to address personal issues. This process allows us to connect with our own non-verbal, visual language. It is important to realize that each of us DOES have the ability to connect with our creative selves. Art Therapy is NOT about being a great artist, it is about using the art process and product as a tool. Visual images, as well as verbal statements, compete and circle around in our heads…the art therapy process begins to make some of these images concrete. It is this tangible process and these tangible products that allow us to piece together our internal patterns and make sense of our external selves and how we view the world.
Jennifer Thill is a recent Art Therapy Graduate from Illinois State University. She is currently leading the art therapy group on Saturday mornings.
_________________________
Feedback from a Reader
"I was reading an old issue of the Awakening Center's newsletter (May -August 2000), in which your article "What Do You Value?" asked for insights on this question.
I once read a book that asked the reader to list his/her true values and life goals and this is what I came up with:
1) Being a kind, fun, caring person who enriches the lives of others with my presence.
2) Continued education - intelligence.
3) Being at peace with myself and the world.
4) Having a long, healthy life.
5) Being a good friend, sister and daughter.
6) Creating, in my lifetime, something unique and lasting that can be enjoyed by others.
When I sat back and reviewed what I'd written, I realized that not a single one had anything to do with my physical appearance and I cried at the frustration of spending at least 95% of my day and my brain power thinking about something so insignificant."
_______________________________________
September –December 2001
Rescuing The Child
Amy Grabowski, MA, LCPC
In the last issue of our newsletter, I promised to write more about shedding others' opinions about qualities of our personalities. I said, "then we can decide for ourselves that we are 'good enough'." I realize this statement implies that you simply just 'decide' one day that you are good enough and Bingo! you feel 'good enough'! Oh, if only it were that simple. Recovery from an eating disorder comes in layers. You may work on the surface of an issue the first time you uncover it. Later you may find that the same issue comes to you needing work on a deeper level. When the same issue comes back a third (fourth, fifth or sixth) time, you are probably ready to resolve the issue at your core!
At the heart of these core issues are self-definitions that our "parts" cling to like a leaky lifeboat. We can talk about these definitions, we can analyze them and look for the distortions in them, we can substitute other words or phrases, we can treat ourselves like a friend,… but if we don't actually change why the part clings to this definition, it will continue to be a problem for us.
It is imperative that certain conditions exist in the recovery process before you can change the way the parts relate to one another. If you have not read my article "From Critic to Ally" (http://awakeningcenter.net/volume-4-2.htm#ally) I urge you to do so and work on that before going on to this issue. If you go inward and work with the "child parts" without having a cooperative relationship with the critics first, the critic can attack the child and make the problem worse.
In the last issue of the newsletter I wrote about how other people's opinions of us become part of our self-definition. Let's go back to "Bonnie"*. During her recovery, she did a lot of work to unburden herself from her family's problems, but she still struggled with some unhelpful self-definitions - especially one that insisted she was a liar! Situations would happen in her adult life, such as trying to get out of a request that she did not want to fulfill or sparing a friend's feelings about a new hairstyle, and "Boing!", Bonnie was flooded with feelings of being trapped, shame and self-hatred, "I am bad! I am a liar!" We had already worked with her critic and so we knew this was not from that part. Deep down inside, a young part of her was stuck in the past, clinging to an old burden.
We began to investigate this burden and tearfully Bonnie admitted as a child she "always" lied, that she "never" told the truth. (If you analyze these two statements, they are all-or-nothing statements, overgeneralizations, mental filters and many other cognitive distortions covered in the book Feeling Good by David Burns ©1980.) As a child she felt compelled to lie to "build herself up" in other's eyes, mostly because she didn't feel good enough to be liked just for herself. She also lied because she had a creative mind and vivid imagination - something as an adult she could learn to love about herself, but as a child she was shamed for. But a big reason she lied was to get out of no-win situations at home. But lying to get out of these no-win-situations, created another no-win situation because she hated herself even more whenever she did it. Do-si-do, around we go: lie, self-hate, lie, self-hate.....
She had a memory that stuck with her. She had been caught in a lie (probably because the lies of a 6 year old are pretty transparent) and her mother "Renee" tried to force her to admit that she had lied. She knew, even at the age of 6 that if she admitted she had lied she would be punished severely. So she stuck to her story. This enraged her mother and she was adamant that Bonnie had to admit she had lied. Bonnie remembers sitting there on a stool, crying in the middle of the kitchen with her mother screaming at her for hours! Whenever Bonnie felt like "a liar" in the present, she had flashbacks of sitting on the stool in the kitchen - with all the emotions of that day flooding back: trapped, scared, shame, self-hatred.
A big part of recovery is being able to see that you are likeable, even though you received many messages that someone may not have liked you. (Often times people like Renee had trouble separating a person's worth from their actions and behaviors - one can be a good enough person even if they occasionally lie.) Bonnie and I found a "part" inside her who felt sorry for the little girl - who saw her as an innocent victim who was forced to protect herself in a hostile situation. This part said, "I want to help her, to take care of her, to rescue her - but how? My mom is always standing over the girl, screaming. I'm afraid of her." We needed to get past her fear and rescue that child.
First we did some math, at this point in her recovery Bonnie was older than Renee in the original scenario! She realized how young Renee actually was when Bonnie was a child - her mother started having children when she was barely more than a child herself by today's standards! How unprepared Renee was for such an awesome responsibility! In Bonnie's mind the mother figure looming over the little girl started to shrink. Bonnie's fear lessened to the point that she felt able to enter the situation as an adult.
This adult part of Bonnie was angry at how Renee was handling the situation. Reminding herself that she was older than Renee and a lot more educated too, Bonnie spoke to Renee in a firm and authoritarian voice, "Stop this, look what you are doing to her! You are the adult! Get a hold of yourself! Leave her alone! You don't do that to little kids! She's just a little girl. I'm not going to let you do this to her anymore!" And because Bonnie was older than Renee, Renee stopped and listened to her. Renee was shocked that someone was standing up to her! She was scared of Bonnie! As Bonnie repeated over and over, "You don't do that to little kids! She's just a little girl!", Renee began to "deflate". She wasn't this big scary monster, she was just a pitiful, uneducated, young, overwhelmed mom who had meager resources to handle the complexities of raising children - especially one with such an active, creative, imaginative spirit.
Bonnie now could move from her angry part to the loving nurturing part who could take care of the little girl. Bonnie told the little girl that she was going to take her away to someplace where she could be loved and protected. The little girl felt relieved! Bonnie imagined holding the little girl in her lap, stroking her hair and telling her that she loved her. As Bonnie explains, "I found to my surprise how easy it was to love that little girl! She had wonderful qualities that were easily loveable. Ironically the same qualities that my mother got so angry at! I kept telling her that she was loveable and likeable, just for who she was - that she wasn't a liar. She wasn't "bad". That she was a good girl. I needed to teach her in a warm and loving way when it was appropriate to exaggerate or embellish, and when it was appropriate to tell the truth." This helped Bonnie open up to the honesty within her - to decide to value that and to live according to her values.
*Bonnie is a composite of several clients; names have been changed to protect their privacy. This work was done over a series of sessions, not all at once.
Amy Grabowski, MA, LCPC: "I am writing a book on recovering from eating disorders. I invite you to be a part of this process through a series of free lectures/dialogs/discussions based on the chapters of the book."
________________________________________
Body-Dysmorphic Disorder
Sandra Sheinin, MD
Although many people are familiar with the conditions of anorexia and bulimia, there is less familiarity with the condition body dysmorphic disorder. Body dysmorphic disorder, as with anorexia and bulimia, involves significant concern with body image and appearance. Unlike anorexia and bulimia, eating disturbances are not diagnostic criteria, although eating disturbances may coexist with this condition as part of a different diagnosis. Body dysmorphic disorder is receiving more attention as it is being increasingly recognized as a serious and potentially debilitating condition.
Those with body dysmorphic disorder have a distorted body image due to extreme preoccupation with a slight or imaged defect of a body part despite a virtually normal appearance. Common targeted areas of preoccupation include the skin (acne, scars, wrinkles, blemishes), hair (too little, too much), facial features (nose, lips, overall symmetry), breasts and genitals. This preoccupation contributes to impairment socially and professionally. The inability to curtail the preoccupation can result in poor self-esteem, restricted interests, isolation, anxiety, depression, an eating disorder and multiple plastic surgeries in an attempt to fix the perceived defect. Often there are unrealistic expectations of how a surgery can ameliorate the perceived defect and all of the attendant preoccupation and distress.
Characteristics of body dysmorphic disorder can include constant mirror checking, excessive time spent on physical appearance, continuous reassurance seeking from others about appearance and camouflaging the area of concern in elaborate ways in hopes of minimizing its perceived significance. Often all negative and difficult feelings and events are attributed to this imagined defect. As with other conditions, there is a continuum on which people can fall in terms of number and intensity of symptoms, degree of symptom interference and level of awareness.
Usually symptoms are present by late adolescence or early adulthood, although the symptoms may not actually come to clinical attention until later. It is thought to occur equally among men and women. Hypothesized etiologies are both environmental and biochemical. Given the prevalence of societal images that project a narrow and unobtainable standard of beauty, it is no wonder that people struggle with feeling comfortable with who they are and how they appear. Some understand the self-punitive self-conceptualization as a displacement of anger that might be difficult to express toward the original source. Others believe that an alteration in serotonin is associated with the condition, either shaping the tendency towards symptom development or secondary to symptom production.
Some consider body dysmorphic disorder to be a variant of obsessive-compulsive disorder which is characterized by intrusive, upsetting thoughts that are difficult to control (obsessions) and/or rituals that are conducted in an attempt to master or alleviate the anxiety (compulsions). Body dysmorphic disorder can be understood as analogous to obsessive compulsive disorder if the preoccupations about one's negative self image are thought of as obsessions and mirror checking, reassurance seeking and camouflaging behaviors are thought of as compulsions. Conceptualizing the similarities between the two is important in that it can help guide treatment recommendations.
Medications that alter serotonergic activity in conjunction with therapy have been shown to be of benefit with both obsessive-compulsive disorder and body dysmorphic disorder. The class of medications called the selective serotonin reuptake inhibitors (i.e., Prozac, Zoloft, Paxil, Celexa) has helped to attenuate the frequency and intensity of the preoccupations and behaviors. This class of medication is also beneficial in treating depression and anxiety, two other conditions that commonly coexist with body dysmorphic disorder. Therapeutic approaches include insight-oriented treatment where symptoms are examined in terms of their meaning and historical significance and cognitive behavioral treatment where symptoms are reconceptualized as outgrowths of dysfunctional thinking patterns and actions.
- Rescuing the Child - Amy Grabowski, MA, LCPC
- Body-Dysmorphic Disorder - Sandra Sheinin, MD
Rescuing The Child
Amy Grabowski, MA, LCPC
In the last issue of our newsletter, I promised to write more about shedding others' opinions about qualities of our personalities. I said, "then we can decide for ourselves that we are 'good enough'." I realize this statement implies that you simply just 'decide' one day that you are good enough and Bingo! you feel 'good enough'! Oh, if only it were that simple. Recovery from an eating disorder comes in layers. You may work on the surface of an issue the first time you uncover it. Later you may find that the same issue comes to you needing work on a deeper level. When the same issue comes back a third (fourth, fifth or sixth) time, you are probably ready to resolve the issue at your core!
At the heart of these core issues are self-definitions that our "parts" cling to like a leaky lifeboat. We can talk about these definitions, we can analyze them and look for the distortions in them, we can substitute other words or phrases, we can treat ourselves like a friend,… but if we don't actually change why the part clings to this definition, it will continue to be a problem for us.
It is imperative that certain conditions exist in the recovery process before you can change the way the parts relate to one another. If you have not read my article "From Critic to Ally" (http://awakeningcenter.net/volume-4-2.htm#ally) I urge you to do so and work on that before going on to this issue. If you go inward and work with the "child parts" without having a cooperative relationship with the critics first, the critic can attack the child and make the problem worse.
In the last issue of the newsletter I wrote about how other people's opinions of us become part of our self-definition. Let's go back to "Bonnie"*. During her recovery, she did a lot of work to unburden herself from her family's problems, but she still struggled with some unhelpful self-definitions - especially one that insisted she was a liar! Situations would happen in her adult life, such as trying to get out of a request that she did not want to fulfill or sparing a friend's feelings about a new hairstyle, and "Boing!", Bonnie was flooded with feelings of being trapped, shame and self-hatred, "I am bad! I am a liar!" We had already worked with her critic and so we knew this was not from that part. Deep down inside, a young part of her was stuck in the past, clinging to an old burden.
We began to investigate this burden and tearfully Bonnie admitted as a child she "always" lied, that she "never" told the truth. (If you analyze these two statements, they are all-or-nothing statements, overgeneralizations, mental filters and many other cognitive distortions covered in the book Feeling Good by David Burns ©1980.) As a child she felt compelled to lie to "build herself up" in other's eyes, mostly because she didn't feel good enough to be liked just for herself. She also lied because she had a creative mind and vivid imagination - something as an adult she could learn to love about herself, but as a child she was shamed for. But a big reason she lied was to get out of no-win situations at home. But lying to get out of these no-win-situations, created another no-win situation because she hated herself even more whenever she did it. Do-si-do, around we go: lie, self-hate, lie, self-hate.....
She had a memory that stuck with her. She had been caught in a lie (probably because the lies of a 6 year old are pretty transparent) and her mother "Renee" tried to force her to admit that she had lied. She knew, even at the age of 6 that if she admitted she had lied she would be punished severely. So she stuck to her story. This enraged her mother and she was adamant that Bonnie had to admit she had lied. Bonnie remembers sitting there on a stool, crying in the middle of the kitchen with her mother screaming at her for hours! Whenever Bonnie felt like "a liar" in the present, she had flashbacks of sitting on the stool in the kitchen - with all the emotions of that day flooding back: trapped, scared, shame, self-hatred.
A big part of recovery is being able to see that you are likeable, even though you received many messages that someone may not have liked you. (Often times people like Renee had trouble separating a person's worth from their actions and behaviors - one can be a good enough person even if they occasionally lie.) Bonnie and I found a "part" inside her who felt sorry for the little girl - who saw her as an innocent victim who was forced to protect herself in a hostile situation. This part said, "I want to help her, to take care of her, to rescue her - but how? My mom is always standing over the girl, screaming. I'm afraid of her." We needed to get past her fear and rescue that child.
First we did some math, at this point in her recovery Bonnie was older than Renee in the original scenario! She realized how young Renee actually was when Bonnie was a child - her mother started having children when she was barely more than a child herself by today's standards! How unprepared Renee was for such an awesome responsibility! In Bonnie's mind the mother figure looming over the little girl started to shrink. Bonnie's fear lessened to the point that she felt able to enter the situation as an adult.
This adult part of Bonnie was angry at how Renee was handling the situation. Reminding herself that she was older than Renee and a lot more educated too, Bonnie spoke to Renee in a firm and authoritarian voice, "Stop this, look what you are doing to her! You are the adult! Get a hold of yourself! Leave her alone! You don't do that to little kids! She's just a little girl. I'm not going to let you do this to her anymore!" And because Bonnie was older than Renee, Renee stopped and listened to her. Renee was shocked that someone was standing up to her! She was scared of Bonnie! As Bonnie repeated over and over, "You don't do that to little kids! She's just a little girl!", Renee began to "deflate". She wasn't this big scary monster, she was just a pitiful, uneducated, young, overwhelmed mom who had meager resources to handle the complexities of raising children - especially one with such an active, creative, imaginative spirit.
Bonnie now could move from her angry part to the loving nurturing part who could take care of the little girl. Bonnie told the little girl that she was going to take her away to someplace where she could be loved and protected. The little girl felt relieved! Bonnie imagined holding the little girl in her lap, stroking her hair and telling her that she loved her. As Bonnie explains, "I found to my surprise how easy it was to love that little girl! She had wonderful qualities that were easily loveable. Ironically the same qualities that my mother got so angry at! I kept telling her that she was loveable and likeable, just for who she was - that she wasn't a liar. She wasn't "bad". That she was a good girl. I needed to teach her in a warm and loving way when it was appropriate to exaggerate or embellish, and when it was appropriate to tell the truth." This helped Bonnie open up to the honesty within her - to decide to value that and to live according to her values.
*Bonnie is a composite of several clients; names have been changed to protect their privacy. This work was done over a series of sessions, not all at once.
Amy Grabowski, MA, LCPC: "I am writing a book on recovering from eating disorders. I invite you to be a part of this process through a series of free lectures/dialogs/discussions based on the chapters of the book."
________________________________________
Body-Dysmorphic Disorder
Sandra Sheinin, MD
Although many people are familiar with the conditions of anorexia and bulimia, there is less familiarity with the condition body dysmorphic disorder. Body dysmorphic disorder, as with anorexia and bulimia, involves significant concern with body image and appearance. Unlike anorexia and bulimia, eating disturbances are not diagnostic criteria, although eating disturbances may coexist with this condition as part of a different diagnosis. Body dysmorphic disorder is receiving more attention as it is being increasingly recognized as a serious and potentially debilitating condition.
Those with body dysmorphic disorder have a distorted body image due to extreme preoccupation with a slight or imaged defect of a body part despite a virtually normal appearance. Common targeted areas of preoccupation include the skin (acne, scars, wrinkles, blemishes), hair (too little, too much), facial features (nose, lips, overall symmetry), breasts and genitals. This preoccupation contributes to impairment socially and professionally. The inability to curtail the preoccupation can result in poor self-esteem, restricted interests, isolation, anxiety, depression, an eating disorder and multiple plastic surgeries in an attempt to fix the perceived defect. Often there are unrealistic expectations of how a surgery can ameliorate the perceived defect and all of the attendant preoccupation and distress.
Characteristics of body dysmorphic disorder can include constant mirror checking, excessive time spent on physical appearance, continuous reassurance seeking from others about appearance and camouflaging the area of concern in elaborate ways in hopes of minimizing its perceived significance. Often all negative and difficult feelings and events are attributed to this imagined defect. As with other conditions, there is a continuum on which people can fall in terms of number and intensity of symptoms, degree of symptom interference and level of awareness.
Usually symptoms are present by late adolescence or early adulthood, although the symptoms may not actually come to clinical attention until later. It is thought to occur equally among men and women. Hypothesized etiologies are both environmental and biochemical. Given the prevalence of societal images that project a narrow and unobtainable standard of beauty, it is no wonder that people struggle with feeling comfortable with who they are and how they appear. Some understand the self-punitive self-conceptualization as a displacement of anger that might be difficult to express toward the original source. Others believe that an alteration in serotonin is associated with the condition, either shaping the tendency towards symptom development or secondary to symptom production.
Some consider body dysmorphic disorder to be a variant of obsessive-compulsive disorder which is characterized by intrusive, upsetting thoughts that are difficult to control (obsessions) and/or rituals that are conducted in an attempt to master or alleviate the anxiety (compulsions). Body dysmorphic disorder can be understood as analogous to obsessive compulsive disorder if the preoccupations about one's negative self image are thought of as obsessions and mirror checking, reassurance seeking and camouflaging behaviors are thought of as compulsions. Conceptualizing the similarities between the two is important in that it can help guide treatment recommendations.
Medications that alter serotonergic activity in conjunction with therapy have been shown to be of benefit with both obsessive-compulsive disorder and body dysmorphic disorder. The class of medications called the selective serotonin reuptake inhibitors (i.e., Prozac, Zoloft, Paxil, Celexa) has helped to attenuate the frequency and intensity of the preoccupations and behaviors. This class of medication is also beneficial in treating depression and anxiety, two other conditions that commonly coexist with body dysmorphic disorder. Therapeutic approaches include insight-oriented treatment where symptoms are examined in terms of their meaning and historical significance and cognitive behavioral treatment where symptoms are reconceptualized as outgrowths of dysfunctional thinking patterns and actions.