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“Do you REALLY think it’s possible to prevent someone from getting an eating disorder?”

That question, posed to me in 1997 by a mom of a teenage girl, stopped me in my tracks.  We were attending a kick-off cocktail event for the Eating Disorders Information Network (EDIN), the non-profit I founded to help people with eating disorders find therapeutic services.

At that time, I thought eating disorders were too complex for anyone to make a serious dent on the front end and thought the most I could do was steer people who were already suffering to a therapist’s office.

But I couldn’t shake her question. 

In my gut I sensed that reaching moms was the key.  But only two or three moms of high school-aged girls would show up for my “Preventing Eating Disorders” presentations.

Fast-forward 13 years.  EDIN’s focus shifted from treatment to prevention and as a result, we began having tremendous success reaching parents, teachers, coaches, and friends.  The key was dipping down, reaching out to moms of babies, toddlers, kids and ‘tweens: moms who feel that what they say and what they do actually still matters to their girls.   

I wrote The M.O.D. Squad Workbook (for Moms Of Daughters), basing it on the seven principles that form the basis of nearly all my work with my Eating Disordered clients. 

My intent is this: That mothers will become highly conscious of their own words and actions, while helping their girls develop emotional coping skills that can buffer them from the unhealthy messages swirling around them.

Parents should be aware that certain children who are sensitive, anxious, and perfectionistic are more vulnerable to developing eating problems.  M.O.D. Squad principles are particularly relevant for raising this type of kid.  

I will discuss the principles over the next seven columns. Here’s the first one:

YOUR DAUGHTER NEEDS YOU TO BE A ROLE MODEL, NOT HER BUDDY

“Fight Aging!” “Reclaim Your Youth!” “Ban the Gray,” “Turn Back Time!” 

We’re bombarded with the message that we can—and should fight the aging process.  We pride ourselves on being young, hip moms. But at what point does our focus on looking youthful and beautiful become a problem, or even an obsession? 

And how might this obsession impact our daughters? 

We all want our daughters to have a positive self-image and tend to be generous about telling them how beautiful they are.  But what happens when we then turn around and disparage our own wrinkles, hips and bellies? Out loud?  In front of our daughters?

This negative self-talk sends the message: “This is how females in our family really feel about themselves.”  This can sow seeds of self-doubt in your child because it’s tough for a girl to feel more confident or pretty than her mom.     

Daughters also complain to me about other types of “boundary violations” done by their mothers.  They feel their moms:

·      Share too many intimate frustrations about spouses, money worries, and/or conflicts with the extended family. 

·      Expect them to look and act perfect or achieve academically, athletically or artistically to fulfill her own unfulfilled dreams. 

·      Compete with them, trying to diet into their smaller, designer jeans, want to hang out with their friends and share secrets.

 

Meanwhile, these daughters confide in me:


·      “I don’t WANT to know about my parent’s problems.”

·      “It’s embarrassing to wear a larger size than my mom!” 

·      “I can’t stand her borrowing my clothes!”

·      “I don’t want a sexy mom!  Eeeww!”

·      “She gets more upset about my friend-drama than I do!”  

 

Good boundaries help a child develop a sense of self—separate from you. Unfortunately many of us grew up in families with poor boundaries, making it hard for us to have healthy instincts when it comes to these issues.  

Let’s say you felt emotionally abandoned by your mom and vow to be close to your daughter.  You may unwittingly end up treating her like a friend (and unconsciously hoping she will fill the hole in your soul left by your mom).  Because she’s a great listener, you share your personal business with her.  The problem is that she’s not emotionally mature enough to handle these adult issues. But you’re her mom, so she’s kind of stuck.  She senses in her gut that something isn’t right, but she lacks the vocabulary to describe her discomfort.  She figures SHE must be the problem, right? 

Over time, she may struggle to define herself separate from your desires for her.  If your kid is bright and sensitive (and we know she is!) she may feel ambivalent about growing up because she senses your discomfort when she pulls away. Or if she feels too controlled by you, she may need to rebel in a big and painful way (e.g. by doing the opposite of what you want), making the transition to womanhood fraught with conflict. 

How does all this relate to eating disorders? 

One possible manifestation might be for her to restrict her food, especially if you are a dieter.  This may be her attempt to please you (if you value self-control around food) or to stop herself from growing up (since that does not please you).  

If she loses control and binges, she may purge the calories away out of her fear of your fear of fat.    

Or she may turn to food to calm her anxieties (especially if you are a “comfort eater”).  Her weight and poor body image become the focus, rather than the underlying issues that are fueling the problem.    

Your daughter needs you to be a role model, not a buddy.  She needs to see you as someone who is comfortable in her womanly body and feels valuable enough to take care of that body.  She needs to know that you get your needs met from your adult relationships (e.g. your friends, your husband, your therapist!) and that you do not expect her to take care of you.     

So, Raise Your Right Hand and Recite the First M.O.D. Squad Principle:

I will put my daughter’s need for a role model above my desire to be her friend.  I will remain aware of the powerful influence that my words—about my daughter, my own body, and others—have in shaping my daughter’s beliefs and attitudes about beauty, fat, appearance, weight, and being an adult woman.  I am committed to eliminating diet-talk and negative body-talk.

####

Disclaimer #1: These principles apply to Dads and sons as well.

Disclaimer #2: An eating disorder is not a choice.  It is a mental disorder caused by a complex combination of genetic, personality, familial, social and cultural influences.   

####


To start a M.O.D. Squad group in your area, visit www.MyEdin.org.

 


Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.



More Dina Zeckhausen articles, click here.


  ©ShareWIK Media Group, LLC.

I’ve had a rough day. I DESERVE this ice cream!”  “I can’t stop until all the food is gone.”  “I am a Stress Eater.”

 

How often do you eat for reasons that have little to do with actual physical hunger?  Have you ever gone on a diet because your life felt out of control?

 

It goes without saying that people with eating problems—from the under-weight teen to the overweight grandmother—are not good at reading their body’s signals.  At some point in their lives they lost touch with, or stopped trusting, the wisdom of their bodies.

 

Even many people without eating disorders struggle with this concept.  We view our bodies as The Problem, in need of sculpting, injecting, liposucking, starving and perfecting.  We seek diet gurus, appetite suppressants and surgeons to help us conquer our appetites. 

 

We don’t think it wise to listen to our guts.  The misconception is, “If I listen to my gut I will weigh 400 pounds!”  Well, listening to your gut means stopping when your gut is satisfied and not eating for emotional reasons.

 

Oh.  

 

An overweight Brigham Young professor, Steven Hawks, lost 50 pounds by eating intuitively.  His big secret?  He only ate when he was hungry, he ate what he truly craved (even if it was ice cream for dinner) and stopped when he was physiologically satisfied.  CNN’s Soledad O’Brian interviewed him, asking incredulously, “You mean you just eat when you’re hungry and stop when you’re full?  Wow.  That sounds REALLY hard!” 

 

So how can we implement the professor’s simple principles?  There are three steps:

 

1. Differentiating between physical and emotional hungers

The other day my 13-year-old stated, “I’m hungry!” Then he paused and added, “Actually, I’m not really hungry.  I’m bored!”   I was thrilled that he was able to make this subtle distinction. Boredom and stress are the most common reasons for mindless eating.  (I contend we could eliminate the obesity epidemic today if people stopped using food to cure boredom and stress.)  

 

So if your child asks for food but you suspect she’s not actually hungry, you might say something like, “Let’s think about this. Go down inside your body.  Is your TUMMY hungry or are you feeling something else?”  If she can’t answer right away, offer suggestions: “Are you bored?  Is there anything else you are feeling?”

 

2. OK, so you got to a non-hunger feeling.  Now what?

A lot of times just by naming the feeling, you can figure out what you (or your child) actually needs.  Sad?  You may need a good cry.  Angry? You may need to speak up.  Nervous?  See if you need to push through the fear or run the other way! 

Before you try to talk your kid out of a bad feeling (a natural instinct to make bad feelings go away) take a moment to empathize first: “Oh, that feels yucky” or “I can understand why you might feel that way.”  Sometimes that’s all that is needed to feel okay!  The better you are at responding to feelings directly, the less likely these feelings will be stuffed, avoided or numbed with food or dieting.  

 

3.  Dealing with Hunger/Fullness. 

Hunger is much easier to discern than Satisfied.  Some of us keep our tanks topped off all day long so we never actually feel hungry!  It’s OK to feel hunger before you eat; ever notice how much more delicious food tastes when you are hungry?  

Unfortunately many of us view “Satisfied” as a yellow light and don’t slam on the brakes until “Stuffed.”  We inhale our food so there isn’t time for Stomach to let Brain know that the food has arrived.   The smells, tastes, visual impact, social atmosphere, conversation, the TV, are all distractions.  Your brain’s happy-centers are all screaming, “Yee-Hah! Keep that pleasure a-comin’!”  Meanwhile, your belly is whispering in the tornado: “I’m good. You can stop now.”

Huh?  Did you hear something?

So become a Belly Whisperer.   Once you trust the system which has kept humans trim for millions of years, then you’ll have more faith in your kids’ tummies.  It may mean feeding them their big meal when they get off the bus or letting them have a snack before bed.  I realize this is a controversial approach.  Many of us have strong traditions about feeding our families: three meals a day; eat what the grown-ups eat; no snacking; something green at every meal; clean your plate before dessert; kitchen is closed after dinner.  I do not mean to imply that these rules lead to eating disorders.  But I am also a fan of flexibility: it’s okay to compromise if the old system doesn’t work for your child’s body.

  

So, Raise Your Right Hand and Repeat after Me:

 

M.O.D. Squad (moms of daughters) Principle #2:

 

I will encourage my child to honor the wisdom of her body by helping her differentiate the needs of her stomach from the needs of her heart. I will help her respect her body’s hunger and fullness signals and I will teach her through my words and deeds healthy, effective ways to cope with difficult feelings.

####

Disclaimer #1: These principles apply to Dads and sons as well.

Disclaimer #2: An eating disorder is not a choice.  It is a mental disorder caused by a complex combination of genetic, personality, familial, social and cultural influences.    #

To start a M.O.D. Squad group, visit www.MyEdin.org.



Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.



More Dina Zeckhausen articles, click here.


©ShareWIK Media Group, LLC  

Eating problems among children are epidemic, with obesity rates in some states as high as 33%.  Some schools are sending Body Mass Index (BMI) “report cards” home to parents in an attempt to address this problem.  While many parents are, in fact, aware of their children’s weight status, education about nutrition and exercise are not always sufficient to address these complex issues.

The fact is that many children (like adults) use food to comfort difficult feelings.  Parents may put their kids on diets (or a child may start her own) but these efforts are rarely effective and may actually backfire.  Depending upon a child’s personality, putting a kid on a diet may produce obesity in the rebellious child (“I’ll just binge when Mom’s not looking”) or anorexia in the compliant child (“I’ll make Mommy proud and eat PERFECT from now on!”)
   
Interestingly, children with anorexia and over-eaters share two common traits:
1.    they misread or are disconnected from their hunger-fullness signals
2.   they are not very good at labeling feelings.  The technical term for this is “Alexythymia”—Latin for “lacking words for feelings.”
 
The bottom line is this: if you want to help prevent your kid from developing an eating problem, obsessing about carbs, fat grams and calories, you may be barking up the wrong tree.   The best approach may be to help your child tune into her body, learn to interpret its signals accurately, trust the wisdom in these signals and then to respond to them appropriately.

Radical concept, I know.  It may even seem like a Herculean task if you’re a chronic dieter and baffled by your body’s subtle language.  Do you use food for comfort, for reward, or to numb your stress?  Have you embarked on a diet because your career, marriage or life felt out of control?  Helping your child understand and trust her body can be tough if you have an ambivalent relationship with your own.

So Step One is for you to start listening to the subtle language of your own body.   How often do you use food – or the restriction of food--to meet non-food related needs?  Keep track for a day and let me know what you discover~
 


Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 


More Dina Zeckhausen articles, click here.


 

©ShareWIK Media Group, LLC 2010
 
 

Alex, a high school senior with flowing golden hair, described her “perfect” parents with more than a hint of disdain. 

“I’m not exaggerating; when they were dating they were known as Barbie and Ken,” she told me. 

Her Mom was a dietician; tall, thin and obsessed with healthy nutrition.  Her father was a local newscaster with chiseled All-American features.  Alex had an older and younger sister, both of whom had inherited their mother’s lanky physique.  By the roll of the genetic dice, Alex ended up short and round.  Beautiful in her own right, she felt like the odd girl out in this family of tall beauties.    

What Alex had inherited was her father’s penchant for swimming.  Her muscular shoulders were the result of thousands of hours of swimming laps in the pool.  And her dad had big plans for his talented daughter; definitely a college scholarship, but perhaps even a spot on the Olympic team.  A college swimmer himself, he had quit the team his sophomore year, disappointing his father and himself.   At the time, he decided he wanted a normal college experience and the hours underwater were taking a toll on his social life. 

But he had always lived under the shadow of “the swimmer I could have been.”  His failure to reach his potential haunted him.  When he discovered his second daughter’s natural gifts in the water, it re-ignited the burning ember in his soul.  From the time she was small, Alex’s dad pushed her to fulfill what he saw as her potential (and his unfulfilled dream).  

He drove her. Hard.

Over the years her father had invested thousands of dollars for swim coaches and consultants and never let her forget it.  But his plans clashed with her desires.  As college approached Alex, too, was burning out.   While her passion for swimming waned, her dad upped the pressure, yelling at her in the car after mediocre performances.  He refused to hear how unhappy she was. 

Eventually, with seemingly no other way to cope with overwhelming anger and helplessness, Alex started binge eating and throwing up her food.  Her bulimia was her body’s way of saying “STOP”!! 

Alex’s parents brought her to see me when they discovered her eating disorder. In therapy she found a safe place to find her voice.  She started to open up to her father with more courage.  Facing his daughter on her terms, he realized that his unmet needs had blinded him to the damage he was doing to the child he loved.  He relented.  

Alex quit swim team. As a swimmer, she’d had a voracious appetite from burning so many calories; she was accustomed to eating large quantities of food.  She started listening to her body’s signals and liked the new body that emerged.  Her weight and appetite naturally re-calibrated themselves.  

Alex started to pour herself into her REAL passion: singing.  She applied and was accepted to a college with a strong music program.  Once she had the freedom to listen to her inner desires and express her true self, her eating disorder abated.  And her father learned a humbling lesson about the limits of his control.  

How many of us as parents need to learn this difficult lesson?  How do we cope when our agenda for our kids clashes with their desires for themselves?  

As parents we wrestle with these issues every day; when should I hold the line?  When should I let my child determine his fate, even if it looks like a mistake?  Is there room for compromise? 

When a child develops an eating disorder, it may be a sign that the balance has tipped.  As a parent, listen for the signs: eating disorders are not always about body image.  Sometimes our children resort to using their bodies to send a strong message when words are falling on deaf ears. 

Raise Your Right Hand and Repeat The M.O.D. Squad Principle #6: BALANCE SAFETY WITH CONTROL

 

While mindful of her need for safety, I will give her age-appropriate opportunities to make decisions and to deal with the consequences of these decisions.  Even when her ideas, tastes and preferences are different than mine I will try to support her decisions so that she feels a reasonable sense of “control” over her own destiny. 

 

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Disclaimer #1: These principles apply to Dads and sons as well.

Disclaimer #2: An eating disorder is not a choice.  It is a mental disorder caused by a complex combination of genetic, personality, familial, social and cultural influences.   

 

####
To start a M.O.D. Squad group, visit www.MyEdin.org.


Dr. Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teens and children with eating disorders and body-image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.
 

More Dina Zeckhausen articles, click here.

 

©ShareWIK Media Group, LLC 2010



 

You’ve heard the crazy statistics:

 

·      Our children are exposed to 40,000 ads a year.  

·      Images of women in magazines are stretched on average 15% to make the model appear leaner and taller. 

·      After just 3 minutes of looking at these images, 70% of females feel worse about themselves.

·      The average runway model used to be a Size 4-6; now she is Size 0. 

These days children and adolescents spend more time in front of a screen than they do with any other activity except school and sleeping, averaging SEVEN HOURS a day of texting, TV, IM, Facebook

So how does all this media saturation impact today’s girls?

The American Psychological Association’s Task Force on the Sexualization of Girls was determined to find out.   

They discovered that the media was harmful to girls in a variety of ways, including causing impairments in cognitive functioning, physical and mental health, sexuality, and beliefs.  In particular, the sexualization of females in the media was linked with eating disorders, low self-esteem, and depression.

In 1998 Harvard psychologist, Anne Becker interviewed middle school girls in Fiji, three years after Western TV shows were introduced to the island.  She discovered TV exposure directly impacted the girls’ attitudes and beliefs.  They not only talked about the positive attributes of characters on TV, but the fact that they became preoccupied and disparaging of their own weight and body shape.  They actually started throwing up their food in an attempt to look like their new TV role models.  None of these attitudes or behaviors was present prior to their exposure to Western TV.   

So, does looking at skinny models or watching Hannah Montana cause eating disorders? 

It’s not that simple. 

All girls are impacted by the images.  But the girls who develop eating disorders are particularly sensitive to their environments.  They are the “canaries in the coalmine.”

So what’s a concerned parent to do (other than locking your child in a padded cell for 18 years)?

Monitor your kids’ media diet.  Change the channel or better yet, turn off the TV.  Ditch the magazines from the coffee table.  Talk to your kids about “the profit motive,” and explain how advertisers purposely try to increase insecurities so we will buy their products.  Along with your daughter, write letters to companies that are particularly bad offenders. 

By speaking up and speaking out, you empower your daughter to do the same.  The best defense is media literacy and awareness. 

Help your daughter channel her anger and healthy resistance outward, towards the purveyors of the messages.  Then she is less likely to turn the anger on herself (and her body) for not measuring up.

Raise Your Right Hand and Repeat The M.O.D. Squad Principle #7: BALANCE ENJOYMENT OF MEDIA WITH A CRITICAL EYE

 

While recognizing the fun aspects of the media, I will teach her to view media critically, being especially aware of messages promoting intolerance, materialism, sexism, weightism, violence against or the objectification of women and the sexualization of children.  I will promote systemic change by speaking out (writing letters, e-mails or taking other actions) when companies demean or objectify women and children.

 

####

Disclaimer #1: These principles apply to Dads and sons as well.

Disclaimer #2: An eating disorder is not a choice.  It is a mental disorder caused by a complex combination of genetic, personality, familial, social and cultural influences.   

 

####
To start a M.O.D. Squad group, visit
www.MyEdin.org

 


Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here.

 

©ShareWIK Media Group, LLC 2010

 

I guess you could say I’m in the change business, although the truth is that most people do not seek therapy in order to change.  They just want to feel better.   Once they realize that in order to feel better they may need to change, their next request is: “OK, help me change, but help me stay exactly the same!”


We humans tend to pick familiar pain over the unknown.  


Since most of my clients struggle with eating disorders, their troubles (at least initially) center around food.   It’s very easy for them to generate a long list of reasons why they no longer want their eating disorder.  But knowing they want to stop and stopping are two different beasts.

 

(In a future column I will address the Other List: the list of ways that the eating disorder benefits, protects and serves them.) 


One of the keys for making the change stick is to find what I call “the hook.”  Everyone needs a compelling reason to get better; something so powerful that they will be able to call upon it in those tough moments when they are making the split second decision whether or not to engage in their eating disorder.


Sometimes the deceptively simple act of making the healthy decision is like steering a ship away from an iceberg. And working with an addictive brain is like re-directing the Titanic; it may require every ounce of available man-power!  It is this hook that will continually help them keep the ship heading in the right direction.


The woman with anorexia must decide whether to deny herself food or face the anxiety inherent in eating. The teen with bulimia must decide whether to purge her body of unwanted calories or live with the consequences of eating too much.  The man who binge eats must decide whether to stuff himself to mental and physical oblivion or to just sit with his feelings.


Typically people try shaming themselves into doing better, being better.  But shame is not a hook with a high success rate; we typically end up feeling so bad after beating ourselves up that we turn to our addiction to feel better. So much for that strategy.   

Sometimes the hook is the fear of death. 


When the Terri Schiavo story was in the news, a client with bulimia was able to stop purging after years of battling the addiction.   Many recall Terri’s story as a “right to die” story; her husband wished to remove her feeding tube after she’d been in a vegetative state for years.  In the eating disorder world, this was a cautionary tale about the danger of bulimia.  Terri’s brain damage resulted from the heart attack she experienced while making herself vomit in her bathroom. For some who had battled with eating disorders, Terri’s death became the hook for their recovery.


But more often than not, a successful hook is something positive.  For some it is the desire for life. I have seen a number of women whose yearning to conceive, carry and nurse a child has been the hook that helped them to gain the feared weight or to stop vomiting.  For some women recovering from eating disorders, pregnancy creates a profound and lasting perspective shift in body image as well as the desire to be healthy for their child.  

 

This brings up the New Age-y myth that you “have to change for yourself, not someone else!”  This rationale may be ineffective for someone whose self-worth is in the toilet.  I believe the impetus to change has to be for Something Bigger than the Self.  In a 12-step group they call it God.  But that Something Bigger might just as easily be their Love for someone else (e.g. my mother with cancer, my husband who loves me, my sweet and innocent child).  It may take some time before they are able to do it for themselves.

 

This concept is not just for people with eating disorders or even for people in therapy.  Most of us are struggling to make positive changes in our lives, changes that will stick.  I dread running, but absolutely love the nice feeling I have in the hours after a run (my short-hook).  I also love the experience of being in a race; that is my long-hook that gets my butt moving. 


The hook may simply be the desire to add one more day to a string of healthy days; to feel proud of oneself.  But the task is nothing short of doing surgery on your own brain with no scalpel. 


When you are making the decision to do the right thing for yourself (whether flossing your teeth, exercising, choosing the healthy option on the menu) what’s your hook?  

Please share what you know~


Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.



 More Dina Zeckhausen articles, click here.

 


©ShareWIK Media Group, LLC 2010

A patient account:  “So here’s the First Wave: I find out my roommate is moving out in a month.  Then I get my paycheck and it is half of what I expected: Wave Number Two.  Then my mom questions my decision to go back to grad school.  Then the Tsunami hits: my boyfriend says he can’t go to the concert this Saturday. 

Now I’m drowning; the water is churning around me. My head is spinning.  I don’t know which problem to address first.  I am paralyzed: can’t think, can’t breathe, can’t decide.  So I binge and purge. 

Then the water recedes and my head is clear.  I can face my problems and sort them out.  I can think and act.”

This bright, attractive 35-year-old has been coping with her life’s problems in this manner for 20 years.   Old habits die hard, especially when they are so effective at ameliorating suffering.  

The misconception in our culture is that eating disorders are about vanity and image.  But these are superficial assumptions and just skim the surface.  The real story is that eating problems are about managing and coping with overwhelming anxiety.  Most of us can’t imagine how stuffing yourself with food and forcing yourself to vomit would help you feel better, but we humans only get addicted when the pleasure and calmness centers in our brains light up.   

Anxiety is part of the human condition; much has been written on the topic.  Often we end up having anxiety ABOUT our anxiety, which only fuels and feeds it.  Buddhist Psychology is about sitting with the feelings rather than fighting them.  The idea is to simply observe the anxiety without judgment, to ride the wave rather than be swallowed by it, trusting that it will dissipate on its own.  This approach can be quite effective. 

Another way to think about anxiety is to see the wave as a sign that there is something important underneath that needs to rise up and be released.   There are healthy and not-so-healthy ways to free the thing (a monster? maybe just a feeling….) that is pushing up for air.   

When I feel anxiety, it’s often a sign that I need to talk to someone about something.  But I was lucky; I grew up in a family that taught me a language for feelings and allowed me to express myself freely.  

  

·       What if I didn’t have labels for my feelings?

·       But what if I felt like I didn’t have a RIGHT to my feelings? 

·       What if I felt like people would discount or dismiss my feelings?

·       Or worse, what if I felt like people would use my feelings against me?


I’d need to get the release some other way. 

For people with eating disorders, binge eating, starving yourself and/or purging all provide that sense of release.  Anxiety is a physical sensation in the body and often demands a physical expression.  People who cut themselves feel that same release of tension when they see the blood; they describe the act of cutting as the need to take something that they cannot put into words and make real and visible.  

Sweating can be a healthier physical release.  There is overwhelming evidence that exercise helps people feel calmer and less depressed.  But people can become addicted to exercise, too, which ultimately hurts the body.  

A good cry is an excellent physical release. Studies show the natural chemicals in real tears help flush out emotional tension, producing calming endorphins.  Unfortunately, many of us grew up hearing ridiculous messages around showing deep emotion:

·       Crying is a sign of weakness

·       Tears are manipulative

·       Only babies or wimps cry

·       “Suck it up!”


When those messages are internalized by a child, this most basic and natural form of release is no longer available to them. 

In my role as therapist, I hand out many Kleenexes.  Inevitably my clients apologize for “dumping” their problems on me or express their fear of looking weak (“I told myself I would NOT cry this session”).  When I assure them that they are in the perfect place to cry, they are palpably relieved.  Rather than feel burdened by their emotions, I feel the release, too.  The anxiety level in the room drops from a 10 to a 3. 

So if you feel that wave coming, instead of allowing yourself to be smashed against the rocks, ride the wave or summon the courage to dive under it. You may discover an important part of yourself-- a feeling or a need-- pushing to the surface. By embracing that aspect of yourself you will find even greater strength to tackle the challenges that await you on the shore.

 


Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.


More Dina Zeckhausen articles, click here.


©ShareWIK Media Group, LLC 2010

“I weigh 102 pounds!”   This statement was accompanied by joyous leaping and fist pumps.  “…and I’m 5’2”!  Finally!”

 

My 13-year old son, a late bloomer like his parents, is thrilled to have surpassed two mile stones which had eluded him up until this moment: the 5-foot mark and the 100-pound mark.  Many of his buddies have met Mr. Puberty and have at least 20 pounds and 4 inches on him; his female friends tower over him. Cooper leaps around the kitchen, thrilled at the changes in his growing body.  “I want to get strong this summer!” he states, sharing his plans to run, swim, bike and even lift some weights.  

 

As an eating disorder therapist, I am struck by the marked contrast between his body-confidence and the body-loathing of my struggling clients.  I wonder how many 13-year-old girls run into their kitchen and excitedly announce that the number on the scale is going up! 

 

I recall a friend whose son’s pubescent friend walked into her kitchen and announced, “I’ve hit puberty, Mrs. Jackson!”  “Oh, really?” she asked, bemused.


“Yep, my voice has changed, I have body odor and I am growing hair in places I cannot even tell you about.”  He was more than matter-of-fact: the dude was proud.

 

Imagine this scenario: Your daughter’s friend walks into your kitchen, smiles and announces, “I’ve hit puberty!  My breasts are growing, I’ve gotten my period, I’m getting rounder hips and I’ve got hair growing in places I cannot even tell you about!”

 

Yes, the image makes me giggle, too.  I’m willing to bet that I could count the number of times this scene has played out in America on one hand (if that).  

 

An adorable video is making the rounds on Facebook: it’s called “Jessica’s Daily Affirmation.”   In it, a 3 or 4-year-old curly-headed blonde stands on her bathroom sink and speaks with great enthusiasm to her reflection in the mirror.  She lists all the things that she likes: “I like my house!” “I like my hair!” “I like my pajamas!”  She finishes with a breathless, “I can do ANYTHING,” as she hops down and runs out the door to face her day. 

 

My mind flashes forward to Jessica at 14, standing in front of her full-length mirror: blonde curly hair, in her pajamas, getting ready for her day.


“I like my hair! I like my hips! I like my family! I like my brain! I like my school! I like my butt!  I like my friends! I like my thighs! I can do ANYTHING!” 

 

Try it tomorrow morning.  Stand in front of a full-length mirror and state out loud the things that you appreciate about your life and about your body, arms outstretched, voice booming so the whole house can hear.  Then run out of your bedroom and see how your day unfolds.      



Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.


More Dina Zeckhausen articles, click here.

 

 

©ShareWIK Media Group, LLC 2010


I’ve noticed a sad and strange paradox in my clients struggling with eating disorders.  While sufferers are typically bright, compassionate and caring people, when they are in the midst of an eating disorder, they can appear selfish, deceitful and even lacking in integrity to those around them.   

To paraphrase author Anne Lamott (who has written about her battles with food): “I felt like the piece of sh*t around which the world revolved.”

I believe this fundamental paradox (selfish yet lacking Self) helps explains the difficulties that those in the eating disorder community have with increasing compassion and understanding surrounding these illnesses.  In the wake of an eating disorder, loved ones may be as emotionally and physically devastated as victims.  

Just imagine this scenario: your best friend gets cancer, but the cancer actually causes her to believe that the life-saving treatment, chemotherapy, is toxic.  The cancer itself has made her phobic of the cure.  Now imagine your friend has to get chemo three times a day and you must convince her on a daily basis that she can no longer trust her own brain. 

Some tense battles would ensue. You can envision how such an illness could tear at the fabric of your relationship as you watched the person you love slowly commit suicide by denying herself treatment.  

For people with anorexia and bulimia, the “chemo” is food.  Supporters become angry at the illness that has stolen their loved one (who still walks and talks but is not really there).  And there is no place to direct their anger except towards the person who is already suffering.  Typically people-pleasers, the person with the eating disorder does not want to upset anyone else, so she becomes an expert in faking, hiding, placating.  This is but one of the ways that eating disorders destroy relationships.

Kate is a 30-year-old client who has had an on-going battle with bulimia for over half of her life.   Bright, beautiful, outgoing and funny, she used to binge and purge a dozen times a day.  She has worked hard in therapy and is down to a once-a-week binge-purge episode.   Married to a patient and supportive guy, they have an adorable 2-year-old boy whom she “loves more than life itself.”  She refrained from purging during her pregnancy, but relapsed immediately after his birth.

While her husband is aware of her on-going struggles, despite my urging she will not reach out to him for help before an “episode” (even though at this point he could likely talk her out of it). On the contrary, she diligently works her bulimia around him, squeezing it into her moments alone and then “not lying, but just not telling” her husband about them.  He tells her how gorgeous she is (of course she thinks “he has to say that”) and he just wants her to love herself and her body as much as he does.

And yet when he leaves the house for a trip to Home Depot, she sneaks in a binge and then heads to the bathroom to throw up.  According to her, they have a “Don’t Ask, Don’t Tell” policy about her eating disorder: “What he doesn’t know can’t hurt him,” she rationalizes.   This is a woman with strong morals who will teach her son the importance of honesty and trust.  


She only lies in the service of her eating disorder.  

I believe that she will only let go of her eating disorder when she realizes how important she is; how much she matters to those she loves.  I am hoping she can remember in those alone moments, to put her marriage and her love for her child above the ”secret love affair” she is having with “ED” (Eating Disorder). 

I reach for analogies about secret addictions and affairs. Her husband has been trying to quit smoking for years.  “How do you feel about your husband smoking?”  “I hate it!  I think it’s a gross habit!”  “But what if he only smokes when you aren’t around and hides the evidence so you never find out?  Is that okay?”  She smiles, ”OK, I see where you are going with this.  But I don’t want him to die from lung cancer!”  “Well, I’m sure he doesn’t want his wife and the mother of his baby to die from a heart attack or esophageal cancer from years of purging, either.”  

You see, Kate, when you walk into that kitchen to binge and the bathroom to throw up, you bring your child and your husband and me and all the people who love you in there with you. Not only are you NOT alone in that bathroom, it is very crowded in there. Every one of us hurts when you binge and purge.  When you injure this person that we all love, when you are not fully present in your life, you not only deny yourself of life’s joy, but you deny the entire Universe of the gift of wonderful YOU.

Yes, Kate, you matter that much.  

Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.


More Dina Zeckhausen articles, click here.  

©ShareWIK Media Group, LLC 2010



Angela, a strikingly beautiful but shy 30-year-old woman, was finally facing her addictions.  A few months earlier she had felt suicidal: but now, with a new job and a new outlook, she was ready to get down to the serious business of taking care of herself. 


She mentioned a book she was enjoying called “Nice Girls Don’t Get the Corner Office.”  The book was opening her eyes to the self-sabotaging patterns that she developed years ago, particularly when it came to expressing herself at work.  


Her prior corporate environment was a traditional old-boy network, and she had often felt at odds with her mostly male co-workers. She felt it necessary, for the advancement of her career, to silence her rage at their chauvinistic attitudes.  But her anger leaked out and caused her to be perceived as moody and difficult.  At the end of long days of biting her tongue, she binged on huge quantities of food and then threw it all up.  

 

Her silence was literally killing her.    


Starting a new job with a clean slate, she was determined to be “the nice girl,” but somehow this didn’t feel right either.   While the culture felt much better here, the role of placating kiss-ass was not helping her eating disorder.  “If my boss screws up, I either won’t tell him, or I’ll be super sweet about it and point it out as a question, like: ‘Do you think that it might be better to do it this way?  I don’t know, it’s just a crazy thought…’”  


This new self-help book was suggesting that speaking up clearly, without either blowing up or doing a soft-sell, might actually be good for her career (“…and your body,” I added). But the thought of being assertive, of “finding her voice,” terrified her.  She had vacillated between two extremes throughout her life; helpless, silent victim or angry shrew.  She had lost trust in herself and did not know how to read the signals coming from her own body. 


Not surprisingly, the topic of her addictions came up.  It became clear that the multiple cigarette breaks, the bottomless coffee pot, and the daily binge eating and purging served an important function.  I asked her what would happen if I could magically make her addictions disappear. She gave it some deep thought: “Without cigarettes, coffee and bulimia, I’d be a raving Bitch!”


Our task in therapy will be to help her understand and de-construct her anger.  We’ll discover when her anger is actually a positive energy moving her towards self-expression or productive action. We’ll help her discern when something in the present is triggering un-expressed anger from her childhood (which should be expressed in MY office, not hers).  And we will help her decide when and how to just let some things go.  By recognizing the Wisdom inside of her Anger, she will be able to use the gift to great advantage.  I suspect that a more gentle attitude towards herself and the world will dissipate much of the fuel that feeds her addictions.

        

What price does your body~ and the Universe~ pay when you silence yourself? 


 

Dina Zeckhausen is a nationally-known psychologist who specializes in treating adults, teenagers and children with eating disorders and body image issues.  She is a regular ShareWIK.com columnist and the author of the children's book, "Full Mouse, Empty Mouse: A Tale of Food and Feelings."  You can visit her on the web at dinazeckhausen.com and MyEdin.org.

More Dina Zeckhausen articles, click here.  

©ShareWIK Media Group, LLC 2010

Recently, a dear friend (and mom of three sons) shared the fact that her boys complain to her about how “weird” the girls are about eating when they're out together as a group or at school.   While some girls diet in order to get skinny and attract boys, there are those who starve themselves because they have NO interest in the opposite sex.  By returning to a pre-pubescent body, they are attempting to stave off the anxiety that comes with turning into a sexual being.  


More often than not I hear guys say they like to date girls “with meat on their bones.”  They hate the thought of asking a girl on a date only to have her order salad with dressing on the side.  And while there are some who are as body-obsessed as the media indicate, I believe the majority of guys would rather be with someone who is self-confident (and curvy) than insecure (and thin).

 

As far as the guys go, I’ve seen it all:

·      Narcissistic men who actually encouraged their dangerously thin   wives to maintain their unhealthy lifestyle in order to achieve some media-generated body ideal. 

·      Loving men who stood by their partners through the most excruciating phases of recovery and served as key support people in the recovery process. 

·      High-quality guys who walked away from a loved one because the eating disorder had destroyed the relationship.


But for young men seeking a healthy partner (and young women who want to attract one) this tale might provide a clue:


My cousin is tall, blonde and buff from years of surfing the California waves; he is the total Malibu Package.  He looks like a Ken doll and could have had the pick of any Barbie on the beach.  But he’d known plenty of women who were obsessed with their appearance or guilt-ridden around food, and he was uninterested in signing up for a life-time of this.  He was seeking a life partner who would share his love of fun, healthy adventure. So when it was time for him to search for his future bride, he devised an ingenious screening device: The Hamburger Test. 

 

He asked every first date out for a burger.  And he watched.


Did they ask the waitress to hold the bun?  Skip the cheese? Keep the sauce on the side? Or, God forbid, hold the meat? 


The Hamburger Test was his own personal Rorschach, providing valuable information about how his date felt about experiencing pleasure, taking risks, showing up in her life without guilt, claiming her space, owning her appetites.


On his first date with Heidi, a beautiful (and healthy!) pre-school teacher, she ordered the burger—AND the fries.   Ten years and two children later, they have shared many adventures and many hamburgers.   They also eat organic food, do yoga together and are raising their children with a lust for life, encouraging them to embrace all their appetites; for fun, music, art, dance-- and food.


These days it can be a challenge to find women (and men) who live this balanced a life.  When a person’s relationship with food is out of balance, it may be an indicator that other aspects of their life need some work.  The best preparation for a healthy relationship with a partner is a healthy relationship with yourself.  Listen to, respect and honor your appetites. Proudly take up space here on the planet.  Doing so will make you attracted to (and attractive to) just the right partner.

 

Dina Zeckhausen is a nationally known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

© ShareWiK Media Group, LLC 2009

There is a part of me that is very practical.  Despite my high regard for the right side of the brain, my attraction to musicians and artists and my passionate belief in drawing outside the lines, I’m actually a “straight arrow” at heart. 

 

I believe in doing what is ‘right’ (though not necessarily what is expected), and like any self-respecting youngest child, I’m passionate about what is ‘fair.’

 

So, even as a teenager, I got the take-home message that health and safety trumped everything else.  I can’t say that kept me from making really stupid choices – it was the 70s after all – but I do recall making a good choice, at least once in high school that may have saved someone’s life.

 

To do this, I broke the cardinal rule of teenagers:  I told on a friend.   What’s worse, she was in the grade above me!

 

Four of us ate lunch together every day at school.  There were salads without dressing, low-fat milk, contrasted with a representative sampling of the “mystery meat” offerings for the day, fried okra, dessert (of course).   It was a free cafeteria, so we could grab whatever we wanted to nibble– a teenage girl’s dream: taste it all with no obligation to eat.

 

After lunch, like clockwork, one of my friends (let’s call her Lara) would take her leave to go to the gym to call her boyfriend.   We thought nothing of it. 

 

Until one day, the rest of us were hanging around, marveling at all the food we had consumed – there was nothing left on the table!  And then it hit us:  there were no pay phones in the gym.  (Cell phones were not a basic accessory in those days  -- you actually had to put a dime into a payphone to place a telephone call.)  

 

It clicked.

 

We figured out what was happening.  Lara was gorging at lunch, and then going to the gym to throw up.  Bulimia.  It had to be – did you see how much food she just ate!?

 

We discussed it with genuine concern.  What to do?  Tell the school? Confront her?  Choose a teacher we could trust?  What if we were wrong?  She would be SO pissed off. 

 

Kids’ books and movies are replete with heroes taking matters into their own hands, putting themselves at risk of life and limb rather than calling upon a trusted adult. Harry Potter and Percy Jackson can’t help themselves, and that‘s what makes them such fabulous stories.  But the truth is that those plot lines sorta irk me.  Isn’t there a point when we should be teaching our kids (and adults, to be honest) to recognize when to ask for help?  Now THAT’s a valuable life skill (note to self: write a blog about asking for help)!

 

Fortunately, I was never as brave as Hermione Granger, and the messages of health and safety had been drilled into me from an early age.  In a fit of momentary brilliance, we recognized that Lara’s problem was outside of our realm – that she needed more help than we could offer.  While we were as stupidly fearless as the average teenager (may I remind you that the term “designated driver” had not been invented?), we had the good sense to know when to draw the line.

 

In the end, we decided to tell my mom, who was friends with Lara’s mom.  My mom took care of it and we never talked about it with Lara.

 

I tell my kids that they can trust me with any information and I will hold their confidence and that of their friends…unless it’s a matter of serious health or safety (yes, that’s a subjective call, I know), and then confidentiality goes out the window.

 

I don’t remember my mother being so direct with me about that – but I suspect I got the message somewhere along the line. 

 

Here’s the take home message is this story and what I’m noticing:

 

1.   Someone else’s life is important enough to risk their anger, or even their friendship. 
2.   Pay attention to ‘normal’ issues  -- whether teenagers or adults  -- and watch for signs that something has changed.  If you recognize something going on that might be a health risk, don’t assume everyone else does, too.
3.   When health and safety is concerned, other people’s business just might be your business.  There is a fine line between not getting involved, and avoiding the responsibility to help a friend.  Pay attention to your urges to get involved – trust that your heart will guide you well.
4.   Ask for help when you really aren’t sure how best to handle an important situation.
5.   Sometimes we have to break some rules in the interest of other, more important matters  (we broke the unwritten code of teenage silence).
6.   Make sure the children in your life, whether or not they ‘belong’ to you, have a trusted adult that they can go to without fear of recrimination.  Let kids and teens you love know they can trust you.  Teens who have adults they can trust make better choices than teens who don’t.

 

The girls from the lunch-table and I are still friends—in fact, we saw each other this week.  We have lost touch with Lara, but I hear about her from time to time. 

 

Many years ago, my mother ran into Lara.  Lara thanked her, and asked that she send a message to me, thanking her for saving her life.  Through our intervention, she had gotten the help she needed.  Now, I believe she has a daughter of her own.   I definitely hope her daughter has a good bunch of lunch buddies in high school.

 

 

Elaine Taylor-Klaus is the founder of Touchstone Coaching and a regular ShareWIK.com columnist.

 

More Elaine Taylor-Klaus articles, click here.

 

©ShareWIK Media Group, LLC 2010

 

When people first arrive for therapy for compulsive eating, the binge is experienced as being completely outside of the realm of their control. It feels as if someone else possesses their body for large chunks of time (during which they engage in their eating disorder) followed by the eventual reunion of the “Self with the Body.”  By that time, the food is gone, the body hurts and a deep shame floods in, providing fuel for the next binge.  

 

The first part of getting a handle on the trance known as a Binge is figuring out, to quote the Talking Heads: “How did I get here?” 

 

So we de-construct the binge, breaking it down into a chronology of micro-decisions that steered the train towards, then ran it off the cliff.  We uncover patterns: the external triggers (the time of day, the place, the sights and smells), the internal triggers (loneliness, anxiety, grief) and the lies of the eating disorder (“get that bag of candy for your niece,” “you have to buy the Oreos: they’re on sale!”) and the exact moment the person took the first compulsive bite.  

 

For people without eating problems (all three of you) you know intuitively the moment when it’s time to stop eating.  It’s subtle, yet clear.  Perhaps you’ll enjoy a bite or two more—purely for the pleasure factor—but you know that eating much past that point will lead to physical discomfort.  So, you willingly and easily stop there.  No internal battles, just a calm feeling of “All is Right!  I can have more later if I want it!”

 

But for people about to “blow” a diet, emotional eaters and people with bulimia, this magical stopping place on the hunger-fullness continuum is not a yellow light or a red light.  It’s a bright GREEN light! 

Once the Switch Flips, there is no turning back.  One bite past the imaginary “I-should-have-stopped place” leads to the “I’ve-blown-it-so-I-might-as-well-REALLY-blow-it” place.

 

For the person struggling with bulimia, knowing they’ll be getting rid of the food dis-inhibits the binge since the belief (lie) is that the purge will negate any apparent weight consequences (never mind the too-many-to-mention dangerous INTERNAL consequences of vomiting).  The logic goes: If I’m going to throw up, I better make it worth my while.

 

For the emotional eater who doesn’t plan to throw up, the logic goes: “I’m already fat.  Tonight doesn’t matter.  Losing weight is like climbing Everest.  I will be good tomorrow.” The promise of future deprivation also serves to dis-inhibit the binge.

 

So the lid is off and it’s a free-for-all.  What sweet relief to finally enjoy all the “forbidden foods” which were not allowed up until this point! Hunger and satiety are now completely irrelevant; what matters is taking advantage of this ultimate freedom until the last minute before the food police crackdown, and haul the protestors off to prison.  

 

So the work in therapy is about challenging:

·      Perfectionism. (“I am perfect or I suck”)

·      Black & white thinking. (“I have been BAD and later I will be GOOD”)

·      Rigid food rules. (“I can only eat certain foods, unless I am on a binge”)

·      The inability to delay gratification. (“Eat it all now because I can’t have any later”)

·      The shame that fuels it all. (“At my core, I am Bad”).

 

Jenna was a bright and accomplished college sophomore.  She had high standards for herself and a raging case of bulimia which was typically fueled by a drunken binge the night before.  During one session, she walked in beaming, announcing proudly that she had had “A Turn-Around Day.”  After months of feeling at the mercy of her eating disorder, I could tell this was BIG: “Do tell!” 

 

“Well, I’d had a terrible morning food wise, and it typically would have morphed into a full day of bingeing and purging.  But around noon, I suddenly got this crazy idea. I grabbed a blanket, a book and a drink, put on my sneakers and headed to Piedmont Park.  I read for a while under a tree and then walked leisurely around the park, trying to enjoy the day and the fun people-watching.  I tried to calm my anxiety about the morning binges and decided that I would listen to my body for the rest of the day.  I wasn’t hungry for a while, but when I finally tuned in to my body I found that I really wanted something light and healthy, so I got a salad and some fruit.  It didn’t feel diet-y or like punishment, it was REALLY what my body craved.  That night, instead of going out partying with my roommates, I ate a small dinner, took a shower and went to bed early.  I had a Turn-Around Day, Dina!”  

 

That was the moment that Jenna started to turn around her eating disorder.  The breakthrough came, not by kicking herself, but by being kind and gentle with herself, listening to and respecting her body and forgiving herself for having a tough morning.   

 

Why not see where giving-yourself-a-break leads you?

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

© ShareWiK Media Group, LLC 2010  

 

 

 

 

As a psychologist who works with emotional eaters, I witness the struggles and pain they experience on a daily basis: beyond the debilitating self-loathing are the judgments and insensitivities of those around them.  Traditionally the media have fueled the fire, promoting anorexic body ideals and airing shows like The Biggest Loser where contestants are shamed for “only” losing 5 pounds a week.  Plus-size actors are typically cast in roles where they are bullies or bullied, angry or humiliated.


When I heard there was a new show on the ABC Family called Huge about a group of teens at Fat Camp, I worried the program would be just another exploitive depiction, a chance to promote more stereotypes.


I was wrong.


Monday nights at 9:00 have become the favorite hour of the week for me and my 13-year old son, Cooper.  He is obsessed with this show.  It’s not that he has a weight problem or an issue with food.  He has, however, grown up in a family where we openly discuss prejudice, from racial and religious intolerance to homophobia and weightism.  He’s had friends of all religions, colors and sizes, and our gay friends are the most compassionate, creative and loving couples he knows.  Given that, I think this show feels more like real life than any other popular teen TV fare.   


What I love about Huge is the fact that the weight loss issue is a relatively minor sidebar.  Instead, we learn to care about the complex inner struggles and social interactions of these characters.  They are all deliciously complicated; the gal who annoys us one moment will display vulnerability and emotional depth the next.  And the show manages to wrestle with thorny issues without being preachy. 


In one episode the teens steal some alcohol and get drunk in the woods (“Oh, No!” thinks this protective mom.  “They’re glorifying stealing AND drinking!”)  Not so fast: the pretty girl ends up puking and the rest of the drunken teens coldly humiliate sweet Alistair.  So even though they “get away” with drinking, some significantly bad stuff goes down.   


Tonight’s episode was “Parent’s Weekend.”  Through the kids’ relationships with their parents, we come to understand the angst that leads these campers to the cookies.  Throughout the show, the characters wrestle with their demons, struggling with ways to cope with the gut-wrenching pain triggered by their families—without turning to food.   


After the show, as my son, Cooper laid in bed, I asked him to tell me what he thought of tonight’s episode.


“Now I know why everyone eats! Will eats because her parents blow her off and make her feel unimportant.  Ian eats because his parents fight all the time.  Amber eats because her mother is competing with her for attention.  Becca eats because she is an orphan.  Dr. Rand eats because her father abandoned her mother.  Alistair eats because his father doesn’t want him to be gay…” 


There is no way to watch this show without having one’s consciousness raised about the emotional underpinnings of weight issues.  Huge effectively shows how weight problems are less about calories than feelings.  


As I turned out the light, Cooper said, in hyperbole typical of a 13-year-old, “If they don’t continue this show for another season, I will die!”  By renewing Huge, the decision-makers at ABC Family can do more than save the life of my kid; they can continue to sensitively shed light on the fact that the Calories-In, Calories-Out approach to weight loss has failed. It’s time for a new paradigm. 


The impact of this show could be Huge.        


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.


More Dina Zeckhausen articles, click here


© ShareWiK Media Group, LLC 2010  

I recently put together a therapy group for adult women struggling with bulimia. Most of these women have impressive corporate jobs and the majority of them are truly miserable in these careers.  I have witnessed this phenomenon for many years and while there are exceptions to what I am about to say, there is clearly a pattern worth noting.

Women with eating disorders (WwED) tend to get "eaten alive" in the corporate culture. I believe this is for a number of reasons (again, forgive me for over-generalizing!).

·   WwED tend to have a strong (some might say rigid) sense of right and wrong.  Lots of not-so-savory stuff goes down behind the scenes in Corporate World.  The politics, the focus on the bottom line at the expense of morality, the hierarchy of the system just feel wrong at a gut level to these women.

·   WwED tend to be highly sensitive to unspoken emotional realities.  This sixth sense, the ability to read between the lines, can be very difficult to manage in an environment where emotions/feelings are denied, expressed indirectly or viewed as a weakness.
     WwED yearn for a meaningful life.  Many of these women work for companies whose mission does not “turn them on” (e.g. a law firm, managing rich peoples’ money, the insurance industry).  Even if they really believe in the mission of the company (e.g. if they sell a product that has value) the passion for work will be thwarted if they see the company engaging in activities that sabotage the mission.
·    
     WwED tend to care more about real connections with people than money and possessions.  Since the premise of Corporate World is that money is a primary motivator, for these women there is an emptiness to the entire pursuit.
·      
     WwED tend to have highly developed empathy-system and get their greatest joy from being helpful and improving the planet.  They want to be part of the Solution, not part of the Problem.
·      
Many WwED have artistic or creative talents that are either buried or under-utilized. The loss of this aspect of the self can lead to depression and an underlying sense of meaninglessness.  Often this loss is unconscious, but it provides fuel for their eating disorder as a sense of angst or disconnection from the self.


As a wise client told me, "Integration" is a more accurate description of healing from an eating disorder than "Recovery."  Getting better requires integrating all the aspects of the self: Head, Heart, Body and Soul.


As these women are working in therapy, they start to re-evaluate all of their choices, from relationships to their careers.  They may start out seeking fulfillment in other places, such as volunteering for the Humane Society on the weekends, but they notice a sinking depression (and worsening of eating disorder symptoms) every Sunday night in anticipation of another soul-crushing week.  


The strong need for security/stability/predictability and control can over-ride the need for deeper fulfillment. Often they have been pressured by their parents to pick the “safe” career path.  They believe that their misery is their fault, a sign that they are whiny, spoiled or ungrateful (“You have a job, afterall!”).

 
The first step is for them to understand that their misery is not their fault; it is that their lives are out of alignment with their deeper selves. Then they need permission to dream about their ideal profession and to speak these secret yearnings out loud to a receptive audience.  This process is highly liberating.


For some, there comes this magical moment, a turning point when the soul screams, "ENOUGH! I cannot take this for one more minute!"  That’s when the WwED jumps ship. 


Typically she lands in a much better place, free from the shackles of what-other-people-think, societal expectations, and all the “shoulds.”  Not surprisingly, many end up as therapists, artists, teachers, writers, and nurses.  Some start non-profits or do mission work.  They may lose their golden handcuffs, but for the first time they feel truly free.  Not surprisingly, eating disorder symptoms tend to abate when one is fulfilling her life's true purpose.  (Remember, we were talking about eating disorders?)  Eating disorder numbs the pain; but when the life we are living feels congruent with our inner selves, the need to “go numb” goes away.  The split between Private Self and Public Persona is healed.  


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

© 2010 ShareWiK Media Group, LLC   

“It’s been a real roller-coaster,” Ellen said as she settled onto the couch for our therapy session.  A working mom of two kids, she had come to therapy initially to deal with her struggles with weight and food.   A bright and successful woman, underneath her professional accomplishments was a profound insecurity about her skills as a mom.  She expressed her deepest fear: “I am terrified that I am going to turn into my mother.”


It was bad enough that her mother had been drunk for much of her childhood, but 

even when she was sober, her mother was negative and complaining.  Her complaints centered around her misery at work, money woes, and various aches and pains; but she saved her choicest rants for her sweet but passive husband (whom Ellen adored).  Growing up, Ellen felt it her daughterly duty to work hard at cheering up her depressed mom, an ultimately futile task.  There was no room in the family for Ellen’s emotional needs; Mom’s took up all the space.  In order to cope with her own overwhelming feelings (and her guilt over “betraying” her father by listening to her mother’s complaints), Ellen used food for comfort and emotional anesthesia. 


Since entering therapy, Ellen was working hard to uncover the feelings that caused her to eat when she was not physically hungry.  In this session, Ellen talked about how a recent phone call from her mother stripped away her defenses.  Her mother had, once again, started complaining about Ellen’s Dad, but this time she crossed a line: she went into detail about her father’s inadequacies in the bedroom.   Ellen felt physically sick as she listened and tried to support her mother, but when she hung up the phone she felt like she was having a panic attack.   

 

Ellen wanted to eat and eat and eat until the pain in her heart and soul and belly went away.   But instead she allowed herself to feel it.  Tears welled up and she found herself crying throughout the day.  A few days later she found herself in her shower, raging out loud at her mother.  The anger from years of being held hostage to her mother’s narcissism and martyrdom boiled to the surface. 

 

“It was weird, Dina, I was actually shouting at my mother, alone in my house, like a crazy person.  I couldn’t stop myself,” Ellen said.  “But am I just whining?  I can’t stand it when people blame all their problems on their parents.  I’m an adult.  What good does it do me to go ranting around the house?  The past is the past!” 

 

Releasing this depth of emotion is neither whining nor ranting.  What Ellen was experiencing was more akin to grieving; mourning for the child that experienced such intense, chronic emotional pain.  By finally re-connecting to that pain and NOT numbing it with food, she had gained access to an important part of herself.   

 

Along with anger comes the ability to say, “No.”  Along with sadness comes empathy for the Self, and a new found desire and capacity for self-care.

 

Often people who struggle with eating disorders had parents who were either disconnected from their emotional world or mis-attuned to their needs.  When these ancient feelings emerge, the Adult-You can finally start to take care of the Kid-You.

 

So what did this all mean for Ellen?

 

She is ready to finally set limits with her mom.  When her mother starts complaining about her father, she will say, “Mom, I know you are terribly unhappy, but you need to talk about your feelings with a friend or a therapist.  I cannot listen to you criticize Dad any more.  He will always be my father and I love him.  It hurts me when you put him down.” 

 

Her mother will likely act wounded and resentful, and may even call her “selfish” for only thinking of herself.  But I re-assured her that being called “Selfish” by a Narcissist is a sign that she is getting healthier! Re-training her mother will be an on-going process and Ellen will likely need to remind her mom of the new rules many more times.  Eventually her mother will get it: that if she wants to dance with her daughter, she’ll need to learn some new steps.  

 

And by continuing to listen to and honor her feelings, Ellen’s eating disorder will no longer be necessary.  Rather than forcing herself to stop eating by dieting, the changes in her attitudes toward food will be organic, emanating from her inside out.

 

Ellen shed some tears as she thanked, and then grieved for her old friend, Food.  She realized that Food had actually helped her to survive her childhood without going insane or killing herself, but she would no longer be needing it in the same way. 

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

© 2010 ShareWiK Media Group, LLC   

 

 

 

 


“I miss my anorexic days.”    


Haley is a beautiful 22-year-old, who is now on the heavier side of normal.  After a long bout of severe starvation, she entered a season in which her worst fears materialized: she started eating and couldn’t stop.  


The farther you draw back the rock in the slingshot, the further that rock will fly.  It’s basic physics.  


Remember pulling all-nighters back in college?  The following night you’d “binge” on sleep, tacking on some extra hours to your average sleep allotment.  You’d know and expect that your body would compensate after a period of sleep-deprivation.  There’d be no beating yourself up for a sleep-binge.  On the contrary, you’d fantasize all day about the delicious moment when you could shut your eyes, and you’d relish that extra sleep with No Guilt.


Sleep and Food are our most basic human needs. 

Then why, when a person binges after food-deprivation, does she inevitably feel guilty and ashamed?  Anyone who’s ridden the diet rollercoaster can relate to this.  We’ve been fed the lie that we should be able to deny our most basic need, ignore our hunger pangs, and exert complete control when we’re surrounded by the sustenance our body craves.  And this we should be able to continue to do so simply with the power of our Free Will. 


I. Must. Not. Give. In. To. Food.   


The high of anorexia is the feeling of having conquered our weak and pathetic human need and desires.  Observers secretly laud and glamorize this apparent Willpower. (If I had a nickel for every time someone at a cocktail party, upon learning I work with eating disorders, said, “God, I’d just like to have anorexia for two weeks…”)


For some with anorexia, that first binge (which may just be one bite of a forbidden food) sets them on a course of voracious eating and sometimes to weight gain.  For others, the fear of gaining weight is so powerful they rid themselves of calories through vomiting or dozens of laxatives or running for hours or starving again. Each attempt to stave off weight gain only guarantees the next binge.


Binge is to Starve as Night is to Day. 


The longer this cycle continues, the harder it is to find the middle place.  But the good thing about the binge is that THIS is often the catalyst for therapy. 


So Haley speaks longingly of her anorexia-days, when she felt like she was on top of her appetites.  Over time it’s easy to forget why we left a bad relationship; months and years dull the sharpness of the pain, and sweet memories bubble up.  I challenge her definition of Happy and ask her to describe life in Anorexialand.  “Tell me about the hangover…”


 “Well, my hair was falling out.  I was tired and hungry all the time.  I was numb.  I was constantly cold.  I thought about food 24/7.  My family was freaked out.  I avoided my friends.  I didn’t laugh for months.  I avoided social situations.” 

“What do you miss about it?”


“Well, I felt like I was really accomplishing something by not giving in to food.  Plus, I could fit into really tiny clothes.”

“That sounds like a helluva price to pay for a pair of skinny jeans.” 


“I know, I know, but I was Happy.”


Here is where I try to help Haley understand the difference between Happy and High.  In the case of anorexia, the high is not the delightful buzz of a glass of wine; it’s the slam-you-in-the-ass addictive and potentially deadly high of heroin. It feels WAY too good, so good that the sufferer (although she doesn’t know she is suffering) will destroy her organs, ignore the emotional needs of her children, disconnect from her man and lose her friends to maintain this powerful Illusion of Ultimate Control.   Concerned comments from loved ones only fuel the fire, feeding the feeling of “success.” 


Perceptions become distorted, values shift. 


This is not “Happiness.” Happiness has no hangover, no ill effects. Happiness draws people to you, it involves connection to self and others, pleasure, smiles.  Happiness is a calmness in your center.  

   

I tell Haley that the binge is a gift.  The binge cracked her illusion of control.  The crack brings misery, but without misery there is no seeking help, no desire for change.  Where there is misery, there is hope.


But returning to the high of anorexia is not the answer. 

Over time, together, we will find the middle place.  

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2010 ShareWIK Media Group, LLC

 

 

   

Last week I attended a luncheon on Childhood Obesity.  On the panel were distinguished professionals in the field: the head of nutrition for the Centers for Disease Control, pediatricians from the local children’s hospital and exercise experts. The audience of 300 Atlanta glitterati included local media people, state legislators, and big donors from around the city.  

   

Given my passion for this topic, I eagerly awaited the distinguished panelists’ remarks.  In her opening prayer, Dr. Kathleen Hall shared the importance of mindfulness and the connection between stress and weight.  


“OK,” my therapist-self thought.  “They get it!” 


Each of the speakers brought their perspective to the issue, like the blind men describing the elephant (“It’s like a rope!” “It’s like a wall,” ‘It’s like a snake”).   We heard about BMIs ("Body mass index" is a measure of body fat based on height and weight that applies to adult men and women) and negative health consequences of obesity. We were told about programs being implemented to “decrease energy intake” and “increase energy expenditure” in our state.  I waited and listened for someone to address the missing piece.  


Why was no one talking about the heart of the elephant?  Is it because we are like the blind men, and we cannot see it, touch it or measure it? 


When it was time for the Questions and Answers, I got that sick feeling in my stomach that I used to get as a kid in class when I was itching to speak up. 


I was gripped by fear.  All of these important people!  What if I freeze up? Blank out? Sound stupid?  


Encouraged by friends, I got in line at the audience microphones.  I was ready to grab the mike.   


“Well, we are all out of time!” the moderator announced. “Thank you everyone for coming!”  


Sigh.


So here are four points I wish I had had the chutzpah to make that day:  

 

·      (1)  The Key Role of Emotions:  If obesity was simply a matter of socio-economics, nutrition education, more sidewalks and access to fruits and veggies, then no one in a room full of successful, educated people would be overweight.  Even those of us who know about healthy eating and exercise may find it hard to do “the right” thing.   And why is it so difficult?  Call it what you will: serotonin deficit, anxiety, stress eating, inadequate emotional coping skills, buried trauma, low self-esteem.  But unless we teach our kids healthy emotional coping skills, then they will turn to food to manage their sadness, stress, anger and boredom, just like their parents!  Mental health is at the heart of physical health. 


·      (2)  Health vs. Weight.  This may just seem like semantic hair-splitting, but The Fat is Bad message can be highly destructive.  Kids are already getting this message on the playground, in the media and in their homes.  This is the core belief that leads to anorexia, bulimia and secret binge-eating.  We need a national paradigm shift to a  “Health at Any Size” mind-set.  For the sake of our kids, we must be mindful of the message.   


·      (3)  Weightism is a Human Rights Issue. Kids learn about anti-semitism, slavery and sexism in school, but “weight-ism” should also be included in diversity lessons.  The argument against this is: “but you can control your weight!”  So, therefore it’s okay to discriminate, harass and bully you?  Cyber-bullies often attack victims’ weight, knowing that this cuts to the core.  Weight-ism should be part of anti-bullying campaigns, and kids should be taught Compassion and Empathy for each other, especially regarding this issue.


·      (4)  Body Image vs. Self-Image.  While we are connected to our bodies, we are more than our bodies.  In a world that focuses on the outsides, obesity prevention efforts should address what makes someone beautiful as a person, because someone who LOVES themselves is more likely to take care of themselves.  Any efforts which may cause kids to feel ashamed about their weight may only make them heavier, since they are likely using food to soothe and comfort themselves.  


If all this seems too hard, EDIN’s programs have addressed all of these issues for the past seven years. But we are a small organization; we don’t receive government funding or have a national PR campaign.  We need a radical shift in consciousness before we can truly have an impact and we need your help. 

 

Thank you.


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2010 ShareWIK Media Group, LLC

A core belief of depression is not only that “Life sucks,” but “It Will Always Be This Way.”  This hopelessness can lead to suicide.


That’s why I’m so grateful to the folks who are reaching out to gay youth with the “It Gets Better” message. Started by Fort Worth City Councilman Joel Burns, who spoke openly about his struggles growing up gay, the message to “hang in there” past the pain is simple but profound.  The “It Gets Better” message is at the core of psychological resilience.


I recall my mom giving me that message when I was a kid by repeatedly counseling me, “Tomorrow this will be behind you and you will be looking back on it!”  I have used this belief to calm myself through anxieties throughout my lifetime.  

Many of my therapy clients were not so lucky.  


Their parents did not give them life survival skills because they were too caught up in their own pain.  My clients-as-kids dared not imagine a brighter future; life was about minute-to-minute survival.  Fantasizing about a happier time was a luxury they could not afford.  Keeping expectations low protected them from being blind-sided by more disappointment.  Why set yourself up, when the other shoe always drops?  


This adaptive survival strategy becomes a problem when they’ve grown up, escaped their dysfunctional families and built loving homes.  They cannot allow themselves to see and appreciate how far they’ve come, to experience joy in the present, nor to dream.  Expecting to suffer, they make sure that they do, even if it is of their own making.  Plagued by chronic anxiety, they still anticipate the worst.  They may call themselves “cautious” or “realistic,” but this life-stance can morph into chronic negativity and even paranoia. 


I use a powerful imagery exercise with these clients. Here’s how it goes:


Close your eyes and connect to a recent moment when you actually DID feel good, even if it was fleeting.  Now turn up the volume on that moment and really EXPERIENCE it.  Then, while holding onto that feeling, imagine yourself walking back into the past, down a long hallway with many doors.  Pick a door and walk through.  You’ll see a vision of a child in the distance, sitting in front of your childhood home.  As you get closer, you notice that the child is a younger version of you.  Sit down beside that child and let them know, “I’m from your future, and It Gets Better.”  This child has been waiting for your arrival, waiting to hear from you.  The child has been wanting to share the pain they’ve been experiencing, so you just listen as the child shares their pain and sadness and anger.  After a while, pick her up and carry her with you away from the house, through the door and back into the Here and Now.   


Often a person who has experienced a painful childhood is reluctant to go back and greet this child-part of herself.  She may say, “That’s ancient history. It doesn’t affect me now. Why go back and feel all that pain again?”  


Far from “not being affected” by our histories, in fact, that CHILD may be running the show (like the little man behind the curtain in The Wizard of Oz).  The kid-part can lead us into poor relationships and bad career choices. She may push love away, or fuel deep sadness, uncontrolled rages, gripping addictions or paralyzing anxieties. 


Sometimes the reluctance to travel back in time is really because deep down she believes she was essentially a bad kid and deserved the poor treatment she received.  Or she fears that if she connects to that kid, she’ll feel burdened and drained by her incessant needs and demands. 


In fact, by re-connecting to and embracing your child-part, and letting yourself know that this time you will be heard and cared for properly, you may start to feel more whole… and more hopeful.  When the kid-you hears “It Gets Better,” the adult-you may be able to actually relax and experience some childlike joy again. 


Re-connection and hope will get you through…

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2010 ShareWIK Media Group, LLC  

 

 

        

 

 

 

 

 

 

 

These days researchers and writers like to boil all maladies down to the biochemical level.  The medicalization of all things sure makes life simple: if it’s just faulty brain chemistry, then there’s eventually going to be a pill for it.  


But there is no pill to erase the feelings that grip Katherine’s gut when she walks into her childhood home for Thanksgiving.  The Marlboro stench of the old curtains, the worn areas on the carpet, the heaviness on her mother’s hips and in her voice, the back bedroom filled with unopened boxes from QVC shopping binges, her father’s palpable misery about his job, the bathroom where she first learned to throw up… 


These are all powerful triggers for Katherine’s addictions.

 

After a year of therapy, she’s made great strides. When she first arrived, she had a successful corporate career and a decade-long battle with bulimia.  Over the months as her bulimia improved, other addictions seemed to grow stronger: on-line shopping, cigarettes, endless pots of coffee.  


Each addiction is her attempt to manage a deep and abiding angst.  She discovered that dread and deep sadness were, in fact, her normal way of moving through her world.


So we began to connect the dots.  


Her father always hated his job but felt trapped due to her mother’s shopping addiction; buried in unnecessary junk, she kept the family in perpetual financial peril.  Her dad made it a point to let everyone in the family know on a daily basis that he was suffering at work FOR THEM. 


Trapped in their own misery, they saw hope in their bright and athletic daughter: they decided to turn her into a soccer star. They had big Olympic-sized dreams for her. They forced her to play for an abusive coach who screamed, shamed and taunted his players, especially regarding their weight.  He singled out Katherine and was especially hard on her, forcing her to run extra laps and humiliating her in front of her teammates. Her parents spent all extra money on her soccer career, but this was THEIR dream for her, not hers.  Since she was clearly miserable, they called her “ungrateful” and a “spoiled brat”… and she believed them.


“What is wrong with me?” she thought.  “I am such a bad kid.”


Her primary experience in her childhood home was a gaping hole between what she needed and what she got.  And she did what most kids do: she took it personally.  “It must be me.”


It was during that time~ miserable in her body, abused by her coach, pushed by her parents~ that she started throwing up her food.  Trapped in a body and a family and a life that did not fit, she discovered ways to go numb.  It was purge or go crazy.  


As we explore the meanings and functions of her addictions today, she is learning that she’ll need to do for herself what her parents could not:  discover and meet her true needs. This is no easy feat since she is “waking up” in a corporate career which is so far from her inner self.  Going to work feels like standing on that soccer field, a character in her parents’ script: she continues to feel the need to go numb.


Like her mother, she shops compulsively on-line and keeps herself financially off-balance. Like her father she suffers in a job she hates because she feels trapped by the part of her that won’t stop shopping. Cigarettes and caffeine provide the artificial energy to push her through her day.  

  

To Katherine, Sick, Miserable, Addicted and (most of all) Stuck is Normal.


After a year of weekly sessions, she recently admitted her true heart’s desire, warning me first not to laugh or tell her she’s crazy. “Dina, I really want to be a therapist. People always ask me for advice with their problems and I think I have a really good perspective.”  I wasn’t surprised by her admission; she is sensitive and compassionate, a natural care-giver.  

 

So we started to explore the possibility of a radical life-shift.  What if she stopped shopping compulsively and saved her extra money for graduate studies in something that was actually fulfilling to her? 


“How could I ever be around my family?” she asked. 

 

When she goes home now, her guard is up.  She will not make eye contact for fear of being sucked into their abyss.  But by Day Two she is back in her old bathroom, throwing up.  The legacy of her family is addiction: to change and be happy will feel like a betrayal, an abandonment of all she knows.  I remind her that healthy families encourage their children to build happy lives: dysfunctional families need their kids sick and stuck so they will never really leave. 


Katherine’s next task will be to explore her fears about steering her life in a direction of her own making.  There will certainly be a “cost” in terms of further separation from her family.     


Addiction is always more complex than biochemistry. It’s tougher than just changing behavior. Beneath addiction is anxiety; below the anxiety are core beliefs about the self that may need to be revealed and challenged.  This is why the journey towards true healing requires many more than 12-Steps.   

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2010 ShareWIK Media Group, LLC  

Cara has been seeing me in therapy for several years for help with her food and weight issues.  A bright, attractive woman married to a great guy, she has a significant amount of weight to lose.  Over the years, she has lost weight through dieting only to gain back more than she originally lost. The extra weight holds her back sexually with her husband, decreases her physical activity and has contributed to arthritic pain. She fears that cancer, heart problems or diabetes could be in her future.  

  

Through the course of our work, she has made tremendous progress in multiple areas. She’s set up her life to pursue her many creative gifts, including building a career that combines her business savvy with her passions.  She and her husband have improved their communication.  She has widened her network of support and developed deeper and more authentic friendships. 


However, her weight has barely budged.  Frustrated with herself and this therapy process, she wonders if the change will ever take place. She has trouble trusting that, in fact, she has been putting the pieces in place for her to finally succeed. 


There is a term in Science called “homeostasis,” defined as: the property of a system that regulates its internal environment and tends to maintain a stable, constant condition.  Family therapists use this term to describe the family system.  Members of a family often feel pressure to remain the same so as not to throw the system off balance. Rigid families discourage change, while flexible families are more likely to evolve in positive directions together.


In a healthy family, the dramatic weight loss of one member may cause everyone to get healthier; the system is flexible enough to “bend” and it can re-organize itself at a higher (healthier) level. But in a rigid family system, one member losing weight may put too much pressure on the family. Sometimes the family cannot bend that far, and it breaks.  


For Cara, the fear of this break is at the root of her weight problem.  Losing the weight for good will take a profound and deep mental shift. In order to consistently make the daily changes, she will have to re-write her family story--a story which was composed generations ago.  Then she will need courage to hold onto her new story while remaining engaged with her closest family members. 


Cara grew up in a working class family in a small town.  Her parents divorced when she was a kid and it was her job to care for her younger sister, do well in school and be the emotional caretaker for her parents.  As a child she comforted herself with food (like everyone in her family).  No one spoke of, nor thought about, the concept of emotional needs.  Life was about daily survival.


Cara grew up fast.  Bright, exceedingly capable and responsible, she pretended that she was fine so as not to trouble her family. Over the years, her weight climbed as she buried her feelings in food.  She went to college, got a job and left her small town for the big city.  


Cara was saddled with two conflicting family messages: while it was her role to bring esteem to her family (they loved to “brag on” her successes) it was also conveyed that she should never act “too good” for her family. The no-win message was: “Succeed!... but don’t make us feel bad about ourselves.  Make us proud, but don’t get too big for your britches.” 


As an adult, Cara can now see from the outside how her family has made and continues to make poor life decisions, how they are often the cause of their own misery. There is a sense of fatalism and passivity in her family. In all the things they say and do, this message is conveyed: We are unlucky.  Bad things happen to us.  Let’s pray things get better some day, but we might as well EAT since our fate is out of our control.


As a successful, married woman hundreds of miles away, Cara has proven to herself that she is the writer of her own script. But when it comes to her weight, Cara has bought the family myth: There is nothing I can do about it.  We’ll just see what happens.  Maybe someday it will change. 


But the core fear is that eating healthy, exercising and feeling good in her body will mean that she has out-grown her last connection to that which is familiar.  When she goes home, their idea of fun is eating lots of fattening and delicious food.  They bond through Food and the misery of being overweight.  If Cara makes a healthy food-choice in their presence, they chide her for being a “party-pooper.”  In her family the unhappy, over-weight women view women in healthy bodies as alien, superior creatures: it is an “Us vs. Them” mentality.


While being an “Us” may kill Cara, being a “Them” feels like abandoning (and being abandoned by) the family she loves.


Cara will need to accept that it is possible to BOTH take care of her body AND love and connect to her family members.  She will have to develop stronger psychological boundaries, so that their suffering does not become her burden to fix.  When they tease her for being healthy, she can learn to not take it personally.  Cara can find a new way be part of her family, with physical energy and healthy self-worth. 

   

There may be more tears shed in my office as she grieves the loss of the old, familiar way of being close to her family, but she can learn how to forge new healthier bonds without sacrificing her own well-being. 

   

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2010 ShareWIK Media Group, LLC    

As an eating disorder specialist, I work with bullying victims all day, every day. The irony is that no one may be actually bullying them; they are not getting mean texts on their phone.  No one is spreading cruel gossip, beating them up or even threatening them. 


All of this bullying goes on inside his or her own head.  They carry around their Inner Bully 24/7.  This may actually be the WORST form of bullying because the victim rarely, if ever, gets a break from the constant stream of abuse. 


Courtney, a beautiful mother married to a great guy, has suffered from her eating disorder for over half of her life. Her husband, Bob, wants nothing more than for his wife to love herself and take care of her body. But the Bully-in-her-Brain says:


You are fat, hideous and gross. Don’t let Bob near you; if he touches your flab, he’ll be disgusted. Don’t ask him for help when you’re having a tough time; he’s sick of your whiney demands; you’ve burdened him enough.  Tell him everything’s fine; what he doesn’t know won’t hurt him. Besides, if he knew what a horrible person you really are, he would divorce you like a hot potato. 


Then the most insidious part. Courtney’s Inner Bully tops it off with:


I know the Real you. I’m the only one who will tell you the Truth.  All those people saying you are worthy, lovable and beautiful are lying, jealous, ignorant or want something from you. You cannot trust them. If they knew the Truth they would leave: but I will NEVER leave you.


This faulty but entrenched belief system reminds me of the character of the wife in the movie “Inception.”  She spends so much time inside of her own dreams that she loses touch with Reality. 


When people in the “outside world” (e.g. people who don’t understand eating disorders) picture people with eating disorders, they imagine the 58-pound woman on Oprah or the 800-pound man on Jerry Springer.  They do not picture the attractive, well-put together, fit-looking, successful, career-woman or home-maker. 

 

But looking OK doesn’t mean you’re OK.  Eating disorders are only partly about weight.  The other part is about eating behavior, about the Bully-in-the-Brain. 


I wrote a play called “What’s Eating Katie?” in which the bully of the eating disorder is played by a separate character. This character starts off seductive and sexy, with lies and promises of Beauty, Popularity and Love.  Over time he chips away at his victim, teenager Katie. He becomes an abusive, controlling and domineering creep while Katie becomes more isolated and unsure of herself.  


People with eating disorders who’ve seen the show ask me, “How did you know what it sounds like inside of my head?” 


Empathy is the antidote to bullying. We are hard-wired to respond with empathy when we see sadness or hurt on someone’s face.  This is why the explosion in the use of technology has increased bullying incidents.  Texting, e-mailing or internet posting removes the face-to-face contact, causing the loss of human connection.  Sometimes it’s enough to remind kids, “If you wouldn’t say it, don’t send it.  Be the same person online that you are in real life.”

     

But reforming a hard-core bully may necessitate a deeper intervention: pushing them to feel their own hurts. In treatment for offenders, bullies who lack empathy are asked, “Do you remember how it felt when your father yelled at you?”  When they can re-connect to their OWN feelings, then their hearts crack open and they’re more likely to be able to empathize with others. 

 

This is similar to the process used to help people recovering from eating disorders. When bad things happened to them, they were not encouraged to “feel their feelings” about it.  To survive, they went numb (by starving or over-eating) and tried to control  the pain by internalizing the bully.  “I can beat myself up better than anyone else can.”  

 

Rather than using their eating disorder to numb the pain, actually experiencing their feelings in a safe place can help the person develop empathy for the part of them that was victimized. “Remember how it felt when those kids were mean to you at school?” “What did you experience when your Dad beat up your Mom?” There is something about this process that is transformative. 


True recovery means the Kind part of you becomes stronger and louder than the Inner Bully.  Healing comes when you start seeking evidence to support the notion that you are loveable and worthy, instead of seeking (or distorting) evidence that you are worthless and evil. Over time, the voice of the Bully in the Brain will become softer, more distant and, best of all, impotent.


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here

 

©2011 ShareWIK Media Group, LLC  

 

 

 

"I am overwhelmed with anxiety right now. My heart is racing; I’m pretty panicky, actually…” Jeannie, a beautiful and brilliant college student, had been in therapy with me for the past year. “When did you start feeling this way?” “About three days ago I did something really stupid.  I’m not sure what possessed me; I knew it was probably a bad idea…”

So I know what you’re thinking: she got really drunk or high. She had sex with some random bad boy. She did one of any number of regrettable activities that give college students the haunts. 

But you’d be wrong. 

In fact, she did something recommended by trusted medical professionals.  She engaged in an activity that serves as a daily morning ritual for millions of Americans.

She stepped on a scale.

In her anorexic days, Jeannie’s secret fear was that if she ate just one extra bite, she’d never stop.  Sure enough, that’s what happened. Like many who battle with anorexia, her extreme weight loss was followed by a rapid re-bound up the scale to a weight past where her body felt happy. 

Binge eating and rapid weight gain often result from extreme dieting.  On average when a person loses five pounds on a diet, they gain back six. The sad part is that they continue to believe the myth that their out-of-control eating is a sure sign that they cannot trust their bodies, so they continue trying to fix the problem by exerting more control over their appetites. They cannot believe that binge eating is the natural result of food restriction, and that more stringent efforts to restrict their food consumption will only lead to more immense and intense binges.  “Like night follows the day,” I tell them.  

This paradox reminds me of those Chinese Finger Traps, the little bamboo tubes where you plug the ends with your index fingers.  The initial reaction of the victim is to pull the fingers outward, but this only tightens the trap… The solution to escaping the trap is to push the ends inward toward the middle, which enlarges the openings and frees the fingers.

In other words, you have to stop doing the thing that seems logical – letting go of your old notions of escape – while moving towards the center to be released.

Jeannie continued with her story: “I’d actually been feeling really good about my relationship with my body this past month. I’d been doing yoga and working out a few times a week.  I’d been eating better, not denying myself food, and I’d almost completely stopped the bingeing. I’ve felt more clear-headed, had more energy and been sleeping sounder. My clothes even seemed to be fitting better.”

“I wonder why you didn’t just go with that…” I ask.

“I guess I thought that if I stepped on a scale, then I could have solid proof that I was making progress.  But when I weighed myself, I’d only lost a few pounds.  All that work and just a few pounds!  So now my anxiety is through the roof, and I’ve been binge eating for three days.  I probably gained back every pound I lost in a month.”

Many people find themselves in this predicament; attempting to trust their bodies after extreme weight fluctuations is an excruciating and daunting struggle.  For those going through this process, the scale is not their friend. In fact, I encourage clients to bring in their scales and just hand them over to me (like when police departments offer folks $50 to buy back their guns!).  I fantasize about tossing them off the top of a building (á la David Letterman), shattering them into a million pieces.

Sure, they can always buy another scale or hop on the one at the gym.  So I ask: “What do you imagine would happen if you never weighed yourself again?”  Having never even considered this (How very un-American!) the inquiry is often met with a gasp.  “I’d weigh 400 pounds!” 

“Seriously, has weighing yourself helped you arrive at your body’s healthy weight?”

“Well….”

The fact is, for someone recovering from disordered eating, there is little good that comes from weighing.  If they weigh more than they anticipated, they figure, “What’s the point? I’m still fat so I might as well eat everything in sight.”  If they weigh less, they think, “Woo Hoo! Celebrate!” and they eat everything in sight. Since weight can fluctuate by 2-5 pounds depending upon hydration, bowel movements, and menstrual cycles, the number upon which they are basing their worth, happiness (and “success”) is essentially meaningless.

Focusing on a number – an arbitrary external measurement – misses the point.  Remember that Chinese Finger Trap where the way out is through the center?

Go into your center and ask yourself: how do you feel inside? Are you experiencing pleasure when you eat? Are you listening to and respecting your hunger and satiety signals? Do you have relationships that fill your heart? Are you honoring your gut by saying “No” when someone pushes, manipulates or guilts you?  Are you speaking your truth?  Are you moving your body in a way that is pleasurable and makes you feel good?  Are you managing your stress? Are you living a life that is fulfilling? 

If you are addressing these essential questions in your life, why would you allow a random number on the scale to trump the value of the things that actually matter?

So if you don’t feel like throwing out, donating or smashing your scale, try this. Paste a sign on it that reads:

“Your worth is not based on a number. Do not weigh your self-esteem! Listen to your body!  Trust your gut! And have a nice day, gorgeous.”  



Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web atdinazeckhausen.com and MyEdin.org.
 
More Dina Zeckhausen articles, click 
here.

©2011 ShareWIK Media Group, LLC


So you’re driving along in your life and the Check Engine light comes on.  You ignore it, maybe even put some tape over it.  You hear a clunking sound; you turn up the radio.  All of a sudden, the engine seizes up.  You can’t move forward.  It’s lonely and foggy out here. You look around and the reality hits you: “I am Depressed.”


The most insidious quality of Depression is that it steals the energy that allows you to do the things that will help you feel better. If you either cannot sleep or can’t get out of the bed, you are drained of the energy to be with people, feed yourself well and exercise.  Your self-worth drops; those things that brought you joy only cause numbness.


It’s time to get thee to a mechanic.


The recipe for recovery typically involves two parts (although not always!): Part 1: Medication, and Part 2: Psychotherapy. 


Some folks try to omit one ingredient.  One way to think of it is that sometimes Part 1 gives you the strength to do the things that you learn about in Part 2. 


As someone in charge of Part 2, I view Depression as a gift (if used properly!).  The gift is that it can be the impetus to reach out for help.  Seeking therapy is both a gift to yourself (how awesome to be able to talk about yourself for an hour) and a courageous act (you may make discoveries that push you out of your comfort zone.)  Sometimes the places where you get stuck are unconscious remnants from your childhood: exploring your patterns with an outside observer may help you move your life in a new direction.  

 

I have noticed a number of themes amongst my clients battling Depression.


Lack of connection.

An older single man found himself eating boxes of cookies every night to soothe his Depression. His alcoholic mother had not filled his emotional tank when he was a kid; as an adult he had trouble comforting himself when he was alone. A former alcoholic himself with 20 years of sobriety, he was encouraged through therapy to re-started attending AA meetings each morning.  He made breakfast dates and dinner dates. He plugged his friends’ numbers into his cell phone and scrolled through his address book when he felt lonely (instead of hitting the cookies). Over time his Depression lifted as he internalized the awareness that he was loved and an important part of the web of human existence.


Lack of meaning.

A middle aged woman had spent 20 years raising her kids. When they left home, she cared for her sick mother. When her mother decided to move in with my clients’ brother, my client became severely depressed. In therapy she realized that her life had lost its purpose: to care for others. She realized that volunteering at the local children’s hospital could meet that need.  It helped her realize that she mattered, and lit up her heart when the hospitalized children smiled at her. 

    

A stalled grief process.

A single woman who had struggled to find a healthy romantic relationship lost her father to cancer. He had been her sole source of unconditional love, as her mother was critical and judgmental.  Left without her father’s love, her grief morphed into Depression.  She felt paralyzed month after month; she withdrew from her friends and comforted herself with her dogs, TV and food.  As she spoke in therapy about her father, she realized that the way to honor his legacy of unconditional love was to give that love away.  Rather than waiting for a man to love her, she started exploring the possibility of adopting a child. This re-energized her and gave her father’s loss meaning.    

    

Anger turned inwards.

One woman became suicidally depressed after 40 years of tolerating her emotionally abusive husband.  She feared speaking up because he could get “so mean.” In our sessions, she realized that painful experiences in her childhood had taught her to please others and caused her to believe that she was helpless to change bad situations (hence, her decision to end her life rather than speak up!).  She learned in therapy that she had a right to express her dissatisfaction in her marriage.  Her husband attended some sessions, and her new assertiveness changed the dynamics in their marriage. He learned to listen and not interrupt; she learned to tolerate his insensitivity and discovered she had a thicker skin than she realized. As she found her voice, her Depression abated and their marriage improved.  

          

Not measuring up.

A teenage boy wanted to die.  He’d just seen the roster for the school’s football team and he had not made the cut.  His family lived for football, and his parents had spent the past year talking about his try-outs for the upcoming season.  When he didn’t make the team, he was devastated at having disappointed his parents. But when his parents responded with support instead of disdain, he felt relieved. When the coaches encouraged him to switch to a new sport, the cloud of Depression lifted.  His life wasn’t over, it was just turning in an unexpected direction.  

      

Unexpressed creativity.

A 40-something wife had put her creative energy on hold for over 12 years; her husband’s job kept him away from home and caused her to act as a single mother. For years, she had neither the time nor energy to devote to her significant artistic talents. When she came to see me, she was binge eating and purging to medicate her Depression. When she demanded changes in her marriage, her husband was willing to make changes to his work situation.  This freed up time for her to pursue her creative pursuits.  Her brain chemistry changed when she was engaged in her art; she realized that she ignored this aspect of her psyche at her own peril!     

 

The well is dry.

A depressed nurse came for help.  While she loved caring for her patients, she was on-call 24/7. She gave and gave, but had no chance to fill her own cup: friends, yoga, exercise, sewing had all fallen by the wayside. She took a medical leave. She realized that she had difficulty setting boundaries in a number of areas in her life, especially with her mother. As she started to say “No,” she freed up energy for herself.  As she decided to shift her nursing career to one that accommodated a saner schedule, she felt more like herself again.  


So if your Check Engine light is on, ask yourself:


Ø Am I feeling disconnected?

Ø Is my life lacking meaning or purpose?

Ø Are there tears I need to shed over a loss?

Ø Is there anger I need to express? 

Ø Am I not measuring up to some fantasy ideal?

Ø Is my creativity stifled?

Ø Has my well run dry?


And if you need help finding the answers to these questions, your mechanic has an open bay.    


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here


©2011 ShareWIK Media Group, LLC 

Karen, an attractive, fit and fashionable 48-year-old mother, has come to get help for her 17-year-old daughter Ashley’s weight problem.  


“I’m really worried about her health. She’s put on 30 pounds since middle school.  She’s a bright and beautiful girl, but her weight is making her miserable,” she told me.  “She’s never had a boyfriend and she’s avoiding her friends.  Every time she gets in the car, she’s buying junk food. I’ve tried dieting with her, signing her up for gym memberships and personal trainers. I’ve offered to buy her a new wardrobe if she lost weight.  Nothing motivates her! I’m afraid whatever I do is only making things worse.”


The next week, I hear Ashley’s story. She’s overcome with tears as she describes her struggles with food and her mom.  Perceptive, sensitive and academically accomplished, she’s very hard on herself. “I can’t understand why I can’t get my act together in this one area!”


She feels hurt by her mother’s pressure to lose weight. To Ashley, whether it’s shopping together, having a meal, or going for a walk, it feels like every encounter is an opportunity for her to feel judged by her mom. 


Ashley’s mother’s concern about her weight is an octopus whose tentacles wind through every interaction, choking the fun out of their relationship. Her mother’s unspoken message is: “I’m disappointed and embarrassed by you. Something’s wrong with you, but I’m at a loss.”


This painful pattern between Karen and Ashley is the age-old dance of millions of mothers and daughters. 


To the Moms: Let Go.

Your daughter’s problem is not that she isn’t motivated enough. She doesn’t need to be “incentivized” with clothes, trips or cash if she drops weight. Believe me, she wants it as much as you do.


What’s happened is that your daughter’s struggle with food  -- an area that should be a negotiation among her head, her belly and her heart -- has become a relationship issue between the two of you. Over the years, your concern and disappointment in her weight has taken up residency in your daughter’s psyche. Your feelings are so salient that she can’t discern the subtle signals in her own body. 


You may be a successful, take-charge woman, used to influencing outcomes. But as difficult as it may be to accept, this one’s out of your hands. 


Perhaps you’ve struggled with your own weight issues. Your fear for your daughter has intensified your involvement in her problem. You’d do anything to prevent her from suffering the way you have. 


Or perhaps you’ve never had food issues and your daughter’s drama is a mystery to you.  Maybe you can eat and exercise without all the fuss, and you view her struggle as a character flaw. 


Whatever your story about food, you can’t solve her problem.  It’s time for you to let go. 


When I say “let go,” I mean not offering to diet with her, not cutting out weight loss articles for her, not asking after her walk how many miles she went. It means not sighing when she reaches for seconds or stiffening when she orders fries. It means not showing off your skinny jeans or bragging about how great you feel after your workout. It means never uttering, “Are you sure you really need that?”


Letting go means trusting that she’ll figure out her weight issues on her own time table.  It means accepting that this might take years, not weeks or even months. 


At the same time, it doesn’t mean denying support if she ASKS for it. If she can’t afford a dietician, therapist or personal trainer and you can, this could be a meaningful gift, if it’s freely given.  No checking in about “how it’s going,” with the implication “I better see results on the scale.” If that’s your mind-set, don’t bother. It will only become another place for her rebellious instincts to sabotage the process.


Here’s the New Paradigm: your role is to develop a more loving and connected relationship with her, whatever her size. This means consciously, deliberately never implying that her value goes up as the number on the scale goes down. She gets that message every day in the culture. Your role is to be a buffer –to detach her worth from her weight.    


To the Daughters: Grab the Reigns and Take Five Steps


Step 1: Get your Mom out of your food. Your relationship with your body is yours and yours alone. That means doing the right thing for your body, not rebelling against your “controlling mom” by eating junk and lying around. Grab the reigns. Instead of rebelling against her, rebel against the diet mentality...which leads to Step 2.


Step 2: No more counting points, fat grams, pants sizes, calories and pounds. Letting go of the numbers might seem scary, but be honest: all that counting only raises your anxiety, which makes you want to eat! Steps 1 and 2 should lower your anxiety. Good.  Breathe. 


Step 3: Become a Belly Whisperer by learning to discern the signals in your gut. It’s recognizing when you’re eating past the point of satiety, and when you’re eating because you’re procrastinating, rebelling, rewarding yourself, or taking a break. At this Step you’ll still do all these things, but you’ll watch yourself do it and imagine better alternatives.  Even if you still choose to eat, the key is that you’re turning your compulsion into a choice.  Even if nothing changes behaviorally, you’re making progress. These deeper changes must take place in order for lasting behavioral (and weight) changes to occur. 


Step 4: Make a different choice.  Instead of eating when you feel like procrastinating, try painting your toenails or reading a magazine instead.  You’ll notice you feel better.  The new choice will reinforce itself, making it easier to do it again. 

     

 Step 5:  Choose healthier foods because you feel better when you eat better. This feels very different from eating healthy because you’re “on a diet” or because your mom is watching. By the time you get to this step, the change in your eating is organic and based on self-love rather than a capitulation to your mom’s wishes.  Organic changes stick.  But getting to Step 5 takes time, so be patient!    


A final word to you both:


Getting the Food Fights out of your relationship is an important developmental milestone in the lifecycle of the mother-daughter relationship.  From the day a little girl is born, the mother-child bond is embodied through food and feeding. The path to a healthy separation around food issues can be bumpy and painful, but the rewards to you as individuals and for your relationship are well worth the struggle!

 

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here.

 

©2011 ShareWIK Media Group, LLC

 

Flight attendants have it right – and the advice is just as useful for those on a plane as well as off. “Remember to place the oxygen mask over your nose and mouth before assisting your child.” In other words, fail to take care of yourself and you won’t have what it takes for your kid. 

 

This is especially true for mothers with eating disorders. Anorexia is the most blatant form of self-neglect. Its theme is the refusal to meet the body’s most basic needs (for food) but it often entails the denial of other important needs (i.e. love, pleasure, intimate connection).  


While the stereotype is that eating disorders are a current day affliction caused by media images, they’ve been around for centuries.  Generations of women have suffered, but they were undiagnosed and untreated. Some wound up in mental hospitals or experienced chronic illness and early death from malnutrition or suicide. Those who were higher functioning got married and had kids. 


When an eating disorder goes untreated for decades it becomes an entrenched and defining quality of one’s self-concept. 


I’m the thin one. 


I’m the one who resists the treats at the restaurant.

 

I’m the one who cooks for others but never succumbs to temptation.  


The “pride” in being able to achieve these victories over the body’s needs is a substitute for self-worth.  Like saccharine, its momentary sweetness has no real substance behind it.

  

Unfortunately, the older generation of moms had little awareness of how living on nicotine, caffeine, saccharine and adrenaline would affect their offspring.  Their adult children often struggle with a deep and abiding sense of emptiness. 

   

Olivia sits in my office, the daughter of one of these moms. “I’m grumpy,” she starts off one summer morning. “Actually, I’m hung over, as in ‘Food Hangover.’ Had dinner with Mom last night.”  


A successful, attractive professional in her late 40’s, Olivia secretly binge eats whenever she spends time in the presence of her mother.  That night before, Mom had come through town and taken Olivia out for dinner, ordering a side salad with no dressing and black coffee (“…always the damn black coffee!” Olivia fumes). Her mom excused herself several times to step outside for a cigarette. She looked with judgment and disdain as Olivia ordered dinner off the menu. By the time dessert arrived, Olivia was planning her post-dinner binge back at the house.  


Olivia felt like her mother wore her anorexia like a badge of honor. During her childhood Olivia’s mother never ate dinner with the family.  When they went on vacation, her mother would avoid eating all day, admonishing the kids, “You’re not hungry!” when they started asking for lunch around 2:00 p.m.  Sometimes Olivia would discover her mom quietly eating a box of crackers late at night in the dark kitchen; she’d hide the box like it was heroin.   


Because she was chronically hungry, Olivia’s mother was often irritable and short-tempered, blaming Olivia for being “overly dramatic” or “too needy,” a trait most loathed by someone with anorexia. Because her mother’s cup was empty, she perceived her daughter’s normal needs (for love, food, attention) as burdensome. Because Olivia was a bright, sensitive child, she could come to no other conclusion than that she was faulty, unlovable, too much, a disappointment. Despite her many friends, her professional success, and her delightful and effervescent personality, for 47 years Olivia has held firmly to this core belief.  

  

Thankfully, today there is less shame and greater awareness about treating eating disorders.  Moms who are suffering are seeking help.  


Kerri, a mother of three, had become so depressed from her food rituals that she was not able to parent her kids, spending hours every day in her darkened room.  She avoided family meals, then binged and purged when they were otherwise occupied. She sought therapy when she became frightened by her suicidal plans. She’d written the good-bye letter to her kids and staked out the bridge she was planning to drive off. But her eldest daughter was on the verge of puberty and starting to worry about her body image.  This was Kerri’s wake-up call. She did not want to abandon her daughter at such a crucial stage. She remembered feeling emotionally neglected by her mom at 13 and believed that this contributed to her bulimia.


She called me for help, petrified to reveal her secret to her husband, but ready to break bulimia’s 30-year grip.   


Kerri has worked hard in therapy these past two years. She is now fully engaged as a mother because she is trying to meet her needs by getting sleep, eating meals, exercising, taking medication for depression (and having hot dates with her husband!). She has meaningful discussions with her daughters about their changing bodies, saying the things that she wished her mother had told her at that age. Her kids now see her as a source of love and support rather than a source of pain.   

 

Meanwhile on a summer morning, I try to help Olivia stop taking her mother’s inability to love her personally. Even as the Adult Olivia knows her mother has an untreated illness, the Kid Olivia still believes the faulty messages that her mother conveyed. So Olivia will need to fill the emptiness with real acts of love. She can nourish her body with rest and exercise and delicious meals (with no guilt). She can fill her heart with the love of her close friends. She can feed her soul by making a difference in the world. 


Food is as essential as oxygen for our survival, but you never hear people feeling guilty for breathing too much, or making ridiculous statements such as: “Wow, you look great! Are you cutting back on oxygen lately?” 


Maybe when a woman decides to become a mother, her doctor should say something like: “You are about to embark on an important journey. Please be sure to feed and nurture yourself before you attempt to nourish a child.”

 

Dina Zeckhausen is a nationally known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.

 

More Dina Zeckhausen articles, click here.

 

©2012 ShareWIK Media Group, LLC 


     When people think of eating disorders, they picture the starving 15-year-old girl or the college student throwing up after a cookie binge.  I’d like you to expand your definition.  The 40-year-old woman about to undergo gastric bypass and the successful businessman who is 80 pounds overweight are both wrestling with eating disorders that are no less harmful and debilitating than anorexia and bulimia.      


     Unfortunately, these particular eating disorder sufferers are more likely to encounter a physician than a therapist.  The sad truth is that most physicians are woefully under-trained in nutrition or the psychology of over-eating.  Many doctors write prescriptions for obesity-related ailments but have neither time nor expertise to address underlying causes.  Many feel helpless and frustrated with overweight patients, viewing them as “awkward, unattractive, ugly, and noncompliant” (Obesity, Research Journal, 2003).  Since physicians report having “lower respect” for their overweight patients, it’s not surprising that many of these patients, sensing this disdain, avoid the health care system altogether  (Journal of General Internal Medicine, 2009). 

     

     Recently, I’ve seen an increase in overweight clients entering therapy.  Some are verging on diabetes.  For others, this is their last stop before bariatric surgery.  Still others arrive after surgery, stating, “I know I need to get my head on straight if I’m going to keep the weight off.”    

So many people want quick, simple solutions to this complex problem.  I’d like to share just a few of the themes that come up in our work together so you’ll understand why a diet, a pill or even surgery often won’t do the trick.   

  

***


*Growing up as an overweight child who was teased and bullied for her weight, Jan’s self-worth is in the gutter.  She’ll need to learn to separate her "Worth" from her "Weight," no easy feat in this culture. By developing compassion for herself, taking better care of herself will start to feel right.  (How can you take care of something you hate?)   


*Uncovering and resolving childhood trauma is crucial.  As a child, Danielle used food to both punish and nurture herself after she was sexually abused by her stepfather. She unconsciously kept on extra weight as protection from unwanted sexual advances growing up.  As she works through this trauma in therapy, she’ll learn to establish healthy boundaries so it will feel safe for her to live in a body that attracts attention.  Therapy will also help her become more accepting of her own sexual needs and desires.   


* As a teenager, Tom gained 50 pounds after his mother died from cancer, soothing his feelings of loss and sadness with food.  He’s been unable to shed the weight through dieting.  Allowing himself to grieve will free him of the need to numb through binge eating.  


*Abby alternates between Denial and Panic.  She refuses to look at pictures of herself or gaze into a mirror.  Whenever she really sees her body, she becomes overwhelmed, angry, helpless and despondent.  Abby is learning to see herself accurately as well as manage her anxiety about her weight.  Until she faces and accepts the reality of where she is in this moment, she will continue to use food as soother, comforter and numbing agent. 


*Gary is learning Patience.  Now that he’s got his eyes open, he wants the weight off fast.   He must resist the siren call of “Lose 30 pounds in 30 days” lest he follow that with “Gain 40 pounds in 40 days.”  It will take time to re-wire his brain since it has followed the same neural pathway (i.e. bad feeling=go eat) for decades.  It may take a year to lose those 30 pounds forever, but more important than looking good at the reunion a month from now is being able to dance at his grandson’s wedding 20 years from now.  


*When you look at Sarah, you would not guess that she is a Perfectionist.  But this is the most common attribute shared by every person struggling with an eating disorder.  For binge eaters, the logic goes, “If I can’t follow my diet to the letter, then I might as well eat whatever and however much I want!”  It’s All or Nothing, Black or White, On or Off.  I remind Sarah that the goal is Normal eating, not Perfect eating.  Normal eating is flexible and probably averages out to about 80 percent healthy, 20 percent not-so-much.  This is a formula that a person can live with forever.  


*Ken is intrigued when I suggest he start listening to his body.  He realizes that he has tuned out the signals in his gut for decades. He ignores his satiety signals and barely recalls the last time he experienced hunger.  As we explore his fear of hunger, tears accompany his memories of childhood neglect and loneliness.  Ken is surprised to discover that connecting to this sadness actually helps him feel more alive and whole.  Discovering his ticket out of his eating disorder lies in his gut and not his brain is a new and exciting (and scary) concept.       


*Amanda is learning to recognize the Voice of her eating disorder. It says “I love you and I can make you feel better right now.”  It comes from the primal part of her brain focused on immediate pleasure.  But she can learn to shift into her frontal cortex where she has the capacity to think of the Big Picture.  In a different part of her brain, she can imagine how she’ll feel after she’s overeaten, how she’ll feel in the morning when she wakes up stuffed, how this binge will impact her health over time.  Her challenge is to stay conscious, awake and connected to the big picture when the Voice whispers, “Worry about all that stuff later…”    


*At age 60, Brenda is finally learning to say “No.” Her life-long pattern of taking care of everyone else’s needs only led to resentment, angry blow-ups and debilitating guilt.  Over-eating had been her way to take care of herself.  She’s learning that saying no to others frees up time and energy for activities that are truly fulfilling (and not just filling!).  


***


     Recently a YouTube video from Britain’s Got Talent went viral. It features Jonathon Antoine, an overweight teen who sings like Pavarotti.  Before he sings, you see disdain and disgust on the faces of audience members.  Then he opens his mouth and we discover he is gifted, vulnerable, sweet and courageous.  Our harsh judgment is suddenly transformed into a rush of compassion.  


     Perhaps we can hold onto this little moment of insight when we step away from our computer screens.  We might all feel a little lighter. 


     Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWIK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org. Follow her on Twitter @drzeck.

 

     For more Dina Zeckhausen articles, click here.

 

     ©2012 ShareWIK Media Group, LLC.


     I first learned of anorexia in the early 80’s when I worked as a therapeutic teacher in one of the adolescent units at a local psychiatric hospital near Atlanta, Georgia.  Please forgive the oversimplified discussion that follows. I, clearly, am not medically qualified to discuss this disorder as a professional; but as a teacher and mother, I found the patients with whom I worked fascinating. I was drawn to their emotional complexities and I was in awe of their coping mechanisms. As ineffective as many of these mechanisms were, they were without a doubt creative. 

     Although most anorexics are female, my first encounter was with one of the rare males diagnosed with, at the time, a very puzzling disorder.  “Sam” was 16, thin, of course, and lanky.  He seemed to be very capable intellectually, but he did not stop moving. He stretched, wriggled, exercised, tiptoed and flexed every muscle he could in an unending pattern of movement. He was quiet to the point of being withdrawn. He was emotionally dulled, as he seldom had a reaction, positive or negative, to anything the staff presented to him.  Compliant to a fault, he never actively resisted any direction, but he was a master at avoiding or delaying without creating a lot of drama.  He made little eye contact and had precious little interactions with others. If he could have become invisible, I am certain he would have done so.  Actually, unless you were aware of the continual activity coming from whatever place in the room he occupied, he might have well been invisible.

     Grand Rounds were often devoted to an exchange of observations and potential approaches from the staff intended to get some movement in his case. He came from a relatively unremarkable family who lived in a small Georgia town.  His case was very different from the “celebrity” stories about which we so often hear. I actually think he just outlasted his insurance coverage, which at that time, was extensive.  It was not unusual for our young patients to be with us for eight to 12 months. 

      After his discharge, with relatively minor changes in his behavior, we saw a steady stream of high achieving, socially manipulative, attractive young ladies who fit the stereotype more accurately. Although I am not a psychiatrist, I cannot say that the program at that time made a significant dent in their disorder. They were treated in the same program with the usual population of suicidal, schizophrenic and other cases of thought disorder. We had no need to medically hospitalize any of our patients, so I am sure they were, at least, safe with us.  

     It was clear that the professionals were floating a variety of ideas for the cause of such bizarre behavior.  Was their condition due to an over-controlling father? A poor parenting pattern? Depression? A desire to overachieve? The Twiggy effect? We noted every bite they took at meals or for snacks and set eating goals, a practice now discredited. Programs specifically dedicated to eating disorders had not been created yet.  I believe the work that was done in hospitals across the country during those early years contributed greatly to the research and creation of a more targeted and effective treatment model.

     Although it appeared that much of the irrational thought processes and compulsions that our eating disordered patients exhibited on admission had decreased, I could not detect a significant change in their eating habits, although they did try to adopt less destructive patterns. One young lady, who appeared to be making extraordinary progress, was discovered, just prior to her discharge, to have developed a well-trained reflex that  fooled all of us.  When “drinking” a liquid, she always chose a solid paper cup, into which she carefully and consistently deposited small amounts of whatever she had consumed at her last meal, countering any nutritional benefit the food might have provided.  She gained just enough weight (the accepted measure of success at that time) to get us off of her case, but, clearly, continued to be invested  in the purging cycle of her condition.  We now know much more about the manifestation and treatment of this deadly disorder. 

     I often think about those young patients, whose intelligence and attractive looks were useless in the face of this tragic condition.  I am grateful for my early exposure to the realities and emerging treatment models of anorexia.  I look forward to the day when we unlock even more of the mind’s mysteries and provide the knowledge our professionals need to help the thousands of patients with eating disorders.


Jacque Digieso has been an educator for over 40 years.  She and her husband Joe co-founded The Cottage School in Roswell, GA, to educate adolescents with learning disabilities, attention deficit disorder and other special educational needs. The school currently serves close to 150 middle and high school students.  Jacque and her husband have two sons, one of whom is adopted, and a handful of grandchildren. 

Check out Jaque's blog here, follow her on Twitter @CottageSchoolGA, and learn more about The Cottage School on Facebook here.

©2012 ShareWIK Media Group, LLC. 



This past week, Lisbeth Rhine, the head of the Eating Disorders Information Network, lost her battle with anorexia.  Her death is a devastating blow to those who knew and loved her as well as the eating disorder recovery community as a whole.  It is especially tragic when a person who is a champion for this cause succumbs to the illness.  We feel an overwhelming sense of futility and hopelessness when we lose a warrior on the front lines.   


I met Lisbeth when she joined the EDIN board four years ago.  She was passionate about the issue because she had battled with an eating disorder for decades, dating back to her days dancing with the Atlanta Ballet.  She was an active and involved board member, always raising her hand when we needed a volunteer.  When EDIN needed a new executive director, Lisbeth stepped in as interim director.  She did such an excellent job that the board made her role official.


Lisbeth took on the role of running a nonprofit just as the economy was tanking.  Dozens of charities were closing their doors. Lisbeth made sure EDIN was financially sound, sometimes refusing to pay herself so that EDIN would be in good shape.  She was a dedicated steward of our resources, eliminating expenditures and making us a lean, mean nonprofit machine.  


Over the years Lisbeth’s role expanded.  In the tough economy, she steered EDIN away from annual galas to a popular new fundraiser, the Celebrity Dance Challenge (CDC). She worked tirelessly behind the scenes to organize these highly successful, entertaining (and affordable) events.  


Even as the leader of an organization, Lisbeth was uncomfortable in the limelight.  Two years ago, I was invited to dance in the opening Bollywood number at the CDC.  Just before the big night, a dancer dropped out. I convinced Lisbeth to take her place.  Lisbeth’s dance background was evident as she instantly picked up the moves.  Remembering her out there onstage, I imagine this was a healing experience for her.  After the high-pressured world of ballet, here she was in a rocking, sexy, funky dance.  It was gratifying to watch her take a risk and experience dance in a new way.  


Despite dancing in front of crowds, Lisbeth had a terrible fear of public speaking, an important part of her new role with EDIN.  She recognized that it was important for her to conquer this fear, so after some coaching and encouragement, she started addressing groups of kids, teens and parents.  This past fall, she even spoke at the CDC, openly sharing her own struggle with an eating disorder.  For someone who held her cards close to the vest, this was a big moment.   


To see how much she had grown personally and professionally, people might think that she had conquered the demon, maybe even driven him out of town.  This is why we were all so shocked by her sudden and unexpected death.   


An event like this leaves survivors with a painful mix of feelings.  After the initial shock is a wave of guilt.  “What could I have done?  Did I miss the signs?  Could I have saved her?”


After the guilt comes anger: “How could she abandon us?” 


Then, the loss of hope: “How can we defeat an enemy that destroys our leaders?”  


Then, guilt about feeling angry: “How can I be angry at someone who suffered and died? I am horrible.”  


Please do not feel guilty for feeling angry.  What happened should make you feel angry.  We all feel angry at the senselessness of this loss.  


Losing Lisbeth is wrong.  


Those of us in the trenches often feel like David fighting a cultural Goliath.  We need tireless optimism and hope to keep soldiering on.  Such a loss can steal our resolve or throw us off our trajectory.    


So we must utilize and channel our hurt and anger.  Used properly, anger propels us to act.  This is why it’s helpful to think about the Eating Disorder (ED) as an entity separate from the person suffering from it.   This is the only way to understand how a loving, kind and caring person like Lisbeth can hurt herself.  Lisbeth was tormented by an inner bully so evil that it took her life.  


Be angry about this.  Be angry at ED.  Be angry about all the places that ED appears in our lives, then speak up, confront it, challenge it and change it.


Lisbeth’s death does not make any sense, but her life was important.  The way to honor her life is to continue in her mission.  And that means we must love fiercely.  Be brave in your love, and give your compassion away freely, not just to others but to yourself.  Beating yourself up only feeds the enemy.   


Finally, I want to share a beautiful poem that was sent to me today.  Obviously the universe wanted me to share it with you.   

 

The Summer Day by Mary Oliver

Who made the world?
Who made the swan, and the black bear?
Who made the grasshopper?
This grasshopper, I mean-
the one who has flung herself out of the grass,
the one who is eating sugar out of my hand,
who is moving her jaws back and forth instead of up and down-
who is gazing around with her enormous and complicated eyes.
Now she lifts her pale forearms and thoroughly washes her face.
Now she snaps her wings open, and floats away.
I don't know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,
which is what I have been doing all day.
Tell me, what else should I have done?
Doesn't everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?

Dina Zeckhausen is a nationally known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web here and at MyEdin.org.

 

For more Dina Zeckhausen articles, click here.

 

©2012 ShareWIK Media Group, LLC


©2011 ShareWIK Media Group, LLC. All rights reserved. ShareWIK does not provide medical advice, diagnosis or treatment. For more information, please read our Additional Information, Terms of Use and Privacy Policy.

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