Riner Counseling

Mary-Catherine McClain, PhD, Ed.S., M.S.

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Eating Disorder Recovery: Being the Exception to the Rule

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Eating disorders and substance abuse addictions are full of paradoxes. For example, individuals feel protected if his/body is too thin or too big—thus making them “unattractive” and “safe” from being vulnerable and hurt by others. On the other hand, eating disorders increase vulnerability by making the body physically unhealthy, weak, and isolated from loved ones. Similarly, an individual may feel power by restricting intake and “controlling” body size and appearance. However, this obsessive focus on body, food intake, and overall size leads to compulsive behaviors that actually take control over the individual. The scale may lead to feelings of happiness and confidence one day and create feelings of despair, sadness, and anger the following day.

 

One common message I hear in private practice is the desire to be “unique” Similarly, having difficulty going into treatment because he/she is not “sick enough” compared to person X and Y. Clients often communicate that it is okay for a friend to have a muffin yet not acceptable for him/her to consume a muffin because it would lead to weight gain. Alternatively, needing to exercise for longer durations due to having a slower metabolism compared to peers. In other words, there seems to be a conviction that they are “special” and that “rules” don’t apply to them. This type of thinking is very dangerous and represents a negative trap for remaining stuck in distorted and unhealthy patterns of behaviors.

 

While the human body is resilient, it will not accept such illusions or exceptions to the rule. The body will respond to danger (e.g., eyelids blinking faster to avoid dirt) unless it is too numb or too weak to be present—which often happens when the body is undernourished or under the influence of substances. The body also does not lie. For example, someone may say they are not “sick enough” and blood results may appear normal, yet the body density scan will reveal a diagnosis of osteoporosis.

 

A significant part of treatment and recovery is re-connecting with the body and learning how to listen and honor it. This is extremely difficulty because it requires courage, hope, faith, trust, and strength to let go of illusions and seek reality. The longer someone has struggled with addiction the more challenging it may be to release negative ways of thinking and behaving. Binge eating and restriction do not lead to sustaining changes in lowering anxiety and depression. To achieve freedom and more emotional control, a person needs to address and process the underlying roots and concerns that are leading to negative urges and related behaviors. Staying present and being connected is incompatible with numbness or a loss of consciousness. Ultimately, the process of being in the moment and approaching underlying feelings provides freedom and a fresh start towards becoming friends with your body. The body is no longer considered an enemy but rather a trusted companion.

 

Another principle in treatment is looking beyond the individual level; instead of trying to be “unique” or “normal,” examine what health truly means to you and not how society, a friend, a sibling, or family member defines health. Be alert to tricks and illusions—specifically recognizing that the sense of being an further proves the rule. Allow yourself to “do what everyone else can do” as you take your body where it needs to go. As you choose to enter recovery, consider letting go of defenses and rules, and ask yourself the following:

 

  • How are you denying your body requests today?
  • What are you doing to grant requests made by your body?
  • How are you continuing to punish your body?
  • What are you doing to reward your body?
  • What are ways to re-connect with your body?
  • What is one way you can show your body trust, kindness, and friendship today?”

 

Remember, even as you learn a rule based in reality you are still subject to it. Recovery and treatment require consistent reflection, vulnerability, honesty, and self-awareness. Search for traps, lies, and mind games, and most importantly, invest in a relationship with yourself and

Filed Under: Addiction, Behavior Modification, Body Image, Eating Disorder, Self-care, Self-Esteem, Self-Injury Tagged With: , , ,

Learning to Love Ourselves

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Presently, the majority of Americans grow up watching and hearing that their appearance is inferior and not good enough when compared to the “ideal” body. This leads to fear of judgment, insecurity, and body disgust—possibly resulting in avoiding romantic relationships and friendships. Other individuals may be afraid to apply for jobs due to fear of being negatively evaluated regarding their shape and/or size.

 

Repeated over and over, the internalized message is restriction, ignoring body hunger/fullness cues, over-exercising, and obsessive thoughts. Social media further enhances these messages as pictures and posts are filled with vegetables, workout videos, and latest diet ideas. Similar, “clean” eating moralizes and degrades food as either acceptable or non-acceptable, and implies dirt or filth if not categorized as “clean.” “Cheat” days also signal or imply a crime has been committed and therefore sets negative associations with food.

 

The goal is eating balanced and nutritious foods with the intention of maintaining a healthy heart and body. Likewise, trusting intuitively body signals. In order to increase self-love, combat internal body anxiety, and reduce external messages, consider these 4 tools:

 

  • Start to build self-trust: rather than fighting your body, listen to it. Focus on your cravings rather than labeling food as good or bad. Instead of using a clock, eat when you are hungry and remember it is a process.

 

  • Practice loving yourself exactly the way you are today. Do not put it off. Your worth is not defined by a number or a size. Remember the amazing things your body allows you to do daily.

 

  • Identity triggers for body anxiety; is it a word, person, situation, picture, or action. For example, have a doctor blind weigh you if you don’t want to know your weight or if it could be triggering.

 

  • Choose your feed and models rather than changing your food; remove followers who contribute to feelings of body shaming. Choose body advocates and individuals who support body positivity.

Filed Under: Body Image, Self-care Tagged With: ,

Supporting Someone Struggling with an Eating Disorder and Poor Body Image

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One of the most frequent questions asked by family members, friends, and other partners is, “How can I help and do more to support my loved one?” The general consensus is that individuals want to support and love the individual struggling, yet do not know what to say or do without negatively impacting the recovery process. Consider these 10 ways to promote more positive helping and healing:

 

  1. Become Educated. Learn as much as you can about the specific eating disorder. One of the best books you can purchase and read is, Life without ED. You can also read articles and blog posts on the National Eating Disorders Association (NEDA) website. Similarly, ask your loved one how you can help rather than demanding change or invalidating his/her feelings.

 

  1. Recognize that eating disorders are not just phases, fads, or intentional behaviors. Rather, they are serious mental health diseases that have an extremely high mortality rate. Consider treatment like cancer; you would do everything and anything in your power to obtain the best treatment possible. Likewise, eating disorders require professional treatment at its finest.

 

  1. Be realistic. No easy or quick solutions exist for someone recovering from an eating disorder. No magic cure is available, and thus treatment requires significant time and energy. It is also helpful to remember that change without motivation and your support is rare. Practice patience and listening, and over time, this will produce positive results.

 

  1. Present concerns in a straightforward manner. When bringing up your concerns, be gentle, respectful, and caring. Do no have these conversations in public. Plan a specific time when you both have the opportunity to talk without being rushed. It can also be helpful to have information available about the consequences of eating disorders as well as potential treatment options in the area. This information can raise their consciousness and own level of concern—ultimately empowering them to make a healthy decision for their health.

 

  1. Engage in non-food related conversations. The focus should not always be on food. As your loved one engages in treatment, let the provider do the real work with them. Your role is to remember that this person is not just their eating disorder. Focus on fun things, maintaining a consistent and routine schedule, encourage new activities, and explore events that have nothing to do with weight, food, or exercise. For example, gardening, journaling, going to a local festival, or painting.

 

  1. Do not be their therapist. While it can be important to listen to your loved ones, don’t play the role of dietician or counselor. It is important for individuals with eating disorders to establish his/her own boundaries, just like it is important for you to maintain your personal boundaries. It is not your job or role to be food police. Rather, your role is to encourage, support, listen, and validate how difficult recovery can be from an eating disorder.

 

  1. Role Model. Use appropriate language, engage in positive body talk, do not talk about dieting, refrain from making comments about appearance, do not comment about the size/fit of clothes on someone, and reduce purchasing magazines and supporting other social media sites that promote eating disorder behavior.

 

  1. Avoid Power Struggles: Eating disorders are stubborn, and can become more difficult to heal from when love is conditional. Do not associate gaining weight or loosing weight with love. It is OK to admit when you are frustrated, feeling helpless, and powerless. Do not make threats or take away things just because you do not approve of a choice or behavior. Recovery has to come from within, and remember that change is reduced when control is taken away.

 

  1. Maintain Hope. Recovery is possible, and it is important that you maintain your faith and hope in the process. Recovery will have backwards and forwards steps, and if you can remember that, you can be more understanding when there is a setback or halt in the recovery process. Likewise, know that you are not alone and that support groups exist.

 

  1. Take care of You. It is equally important that you maintain good self-care during times of stress and worry. Consider also talking to a professional, writing in a journal, or having a support team. You will have many thoughts and feelings during the process, because your life is also being significantly impacted.

 

Filed Under: Addiction, Body Image, Eating Disorder Tagged With: , , ,

No Body is Perfect

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Does your physical appearance dictate your self-worth, confidence, or happiness level? In today’s society, it is all too common for magazines to use Photoshop and airbrushed images, which ultimately leads to unrealistic expectations and unattainable standards. Likewise, how often do you hear people arguing or bickering about the size of their bodies, asking if this makes ‘me’ look too fat, or stating that they should skip dessert? Other individuals may make body comparisons, decline social invitations due to self-doubts, or try on 20 different outfits before feeling somewhat satisfied. Each of these represents indicators that you may have a poor body image—which easily leads to eating disorders and other emotional problems. To improve your self-worth, consider these 5 body image booster tips: 

  1. Consider the functions and purposes of your body. Create a gratitude list of what your body allows you to do on a daily basis, such as playing an instrument, walking to get the newspaper, dancing at concerts, lifting groceries, walking up stairs, or typing an email to a friend. Your body gives you life, breath, and mobility. It also allows you to communicate through crying, laughing, and smiling. Consider your body your personal automobile, asking yourself if you want to fuel it up with positive self-talk or run on empty with negative self-talk. This will also help build self-acceptance.
  1. Change your language and environment. Negative body image talk only fuels negative feelings and emotions about our bodies and ourselves. Invite people into your life who provide support and who see beyond physical characteristics and attributes. When you hear other women and men bashing their bodies, challenge their statements or indicate your discomfort with that topic. Change the focus because negative body talk is contagious. Rather than meeting a friend for lunch or shopping, consider a different context such as a bookstore or park.
  1. Use your voice. Tell others when it negatively affects you when others’ talk about weight and physical appearance. This doesn’t have to be communicated in a blaming way, but rather in a gentle and compassionate way that builds and encourages all parties involved. Other ways for self-expression are to journal or to write sticky notes describing what makes you unique outside of weight and physical attributes. No two people are alike, so consider your other achievements and positive qualities. Ask friends and family what they admire and respect about you. Repeat to yourself that a number on a scale or the size of a body part is not indicative of your self-worth.
  1. Listen to your body and your needs. It is easy for humans to fall into the comparison trap. The problem is that we all have different needs. Are you choosing a lighter meal or salad because your friend is, or because that is really what is best for you? Someone who exercises or is more active on a day-to-day basis will need more fuel than someone who is less active. The problem is, we don’t always see the full picture and that is when comparisons can become self-defeating. Likewise, healthy eating does not equal dieting. Before going with the pack, take a step back and listen to your body and its needs.
  1. End unhealthy relationships. If friends or significant others make negative comments and fuel an unhealthy dialogue with yourself, consider taking a break or limiting toxic interactions. Life is too precious to spend it with people who make you feel bad about yourself, who don’t appreciate your positive qualities, and who are only focused on the external appearances. This also serves as an act of self-care and personal empowerment—you have the power and control to decide whom you hang out with and for how long. Choose wisely and choose people who love you unconditionally.

For more support, consider scheduling an appointment with a local psychologist or counselor. Talking about these concerns with an objective perspective can also be beneficial. Professionals can help you better identify between an unhealthy and healthy voice, and help you achieve a more realistic self-image.

Filed Under: Body Image, Eating Disorder Tagged With: , , ,

Eating Disorders and Misconceptions

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We live in a society that places significant focus on appearance, and a culture that is strongly obsessed with dieting and thinness. Media is filled with messages that portray an unrealistic thin ideal and imply that beauty is based on external sizes, shape, and weight rather than on internal traits, values, and abilities. Additionally, poor body image enhances vulnerability and often leads to the development of an eating disorder. In the first part of this series, myths and misconceptions around eating disorders will be addressed. Helpful and unhelpful comments will also be discussed.

CHALLENGING COMMON MYTHS

  1. People with a normal weight cannot have an eating disorder. The fact is that appearance alone doesn’t accurately identify or indicate who may be struggling with an eating disorder. Some illnesses are not externally visible to others. It is more about how thoughts regarding body image and weight impact a person’s self-worth and self-evaluation. Similarly, individuals in the “normal” weight range my have more difficulty recovering from an eating disorder because they don’t necessarily feel “sick enough,” or receive the attention and support from others during treatment. Behaviors change first, followed by irrational thinking patterns.
  1. It is only about the food. The fact is that eating disorders are complex, mental disorders and are NOT only about the food. While eating well-balanced meals and gaining weight may be part of treatment, it is not the only key component. It is not about willpower nor is it about trying harder to avoid binge eating. Issues regarding food relate to other unfulfilled emotional needs, such as lack of control, anger expression, and numbing out from difficult feelings and thoughts. Underlying issues relate to depression, self-esteem, anxiety, low assertiveness, stress, physical pain, poor body image, etc.
  1. Only young Caucasian girls are impacted by eating disorders. The fact is that both men and women are diagnosed with eating disorders every year. Likewise, individuals of all age brackets, SES classes, and ethnic backgrounds can struggle with symptoms related to body image and food concerns.
  1. People with eating disorders have the goal of hurting others. The fact is that individuals with eating disorders usually feel shame and guilt for their behaviors, and do not have the intention of acting out or lashing out in revenge. While it can be easy for families and loved ones to blame themselves, eating disorders run deeper than this and it is rare for these behaviors to be deliberately hurtful or spiteful. Eating disorders are also more about coping with stress, even if maladaptive, than a vanity issue.
  1. Normal blood work results indicate being healthy. The fact is that some doctors may not have the specialized training to be aware of key warning signs and traits, or have the knowledge on which tests to use. Similarly, the human body is resilient and adaptive. Therefore, blood tests can essentially be normal even during times of severe malnutrition. Blood tests may be misleading, but bone tests do not lie and do not minimize the potential devastating effects of an eating disorder.
  1. Eating Disorders are Hopeless. The fact is that 60-70% of individuals can make a full recovery if undergoing appropriate treatment. Recovery is a process and happens slowly, likely over several years, but a return to full health without distorted thinking patterns is possible. Do not give up on these individuals.

HELPFUL VS. UNHELPFUL

  • Be realistic regarding change, not expecting it to happen overnight. Be kind when having conversations, and do not get frustrated with lapses. Remain positive and don’t dwell on weight or appearance. Be gentle, resist falling into the guilty trap, and remember that recovery is not a choice you can make, but rather is the responsibility of the person who is struggling.
  • Do not threaten, bribe, or yell at someone who is struggling with an eating disorder, and avoid power struggles. It is important not to ignore the problem, while also not taking control of the situation. Eliminate shame talk and do not challenge someone who believes he/she “is fat.” This is not your role or job. Minimize conversations around weight gain and weight loss, as this could make someone believe a goal is being attained or make someone feel like a failure. Finally, don’t give advice unless it is specifically asked.

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