White Picket Fence Counseling Center Newsletter Archives

When the Body is Programmed for Disordered Eating

For people with an eating disorder, “diets” don’t work. This is true whether dealing with compulsive overeating, anorexia, bulimia or other unhealthy behaviors and disordered eating such as emotional eating or food obsession. Changing what you’re doing with food is not about applying willpower or self-discipline. Sometimes there are complex biological issues underlying someone’s food behaviors.

At NEDA’s website, the National Eating Disorders Association, they outline four factors that may contribute to eating disorders. The first two are psychological and interpersonal, and today we will discuss biological factors.

There is fascinating research being done in this area. We already know that there are brain chemicals that affect hunger and digestion, and that these may be unbalanced in people who have eating disorders.

While of course we leave these research pursuits to our colleagues in the medical and scientific fields, as therapists we follow it closely, especially when working in a team approach with these other professionals.

At our center we always rule out the physiological issues first. Often our clients will need to go to their primary care physician or psychiatrist to find the right balance of medications/supplements that will restore them to balance or homeostatis.

For example, a client with depression could have a thyroid issue, low blood sugar or a vitamin deficiency. We would want that treated before we addressed the depression in therapy, or at the same time.

And then there is the nature versus nurture debate. When eating disorders run in families, as they often do, is that because everyone in the family is genetically predisposed to have an eating disorder, or because family members have learned unhealthy behaviors from each other?

It’s important to point out that just because an eating disorder is genetic or physiological, it doesn’t mean it can’t be changed, but it sometimes requires a more intensive therapeutic process, or inpatient therapy.

Have you been feeling stressed lately?

Stress. It’s everywhere. Like a bad penny, it keeps turning up, affecting your mood, your personality, your effectiveness, and often causing anxiety or irritability on the job, at school, or at home. It’s not a pleasant feeling when you want to enjoy life, but can’t. Wouldn’t it be nice to live your life stress free? Now you can. Through education and identification, we can help you better cope with stress and rescue you from this daily demon.

As a professional, I needed to find a way to reduce stress in my own life and studied and researched stress and methods of coping with it. That’s when I discovered SIT – Stress Inoculation Training. It is a prescribed program of Cognitive Behavioral Therapy that can help individuals cope with stressful situations. This methodology helps us to better understand the nature and cause of stress in our lives and teaches effective coping mechanisms to release and cope with stress effectively.

SIT is a treatment that is flexible and can be tailored to fit your needs. The goal of SIT is to enhance your artillery of coping skills and increase your confidence in applying these skills by employing three phases of intervention:

1st Phase: Conceptual Education
2nd Phase: Skills Acquisition and Consolidation
3rd Phase: Application and Follow-through

How does SIT work?

1. Conceptual Education

The first phase of SIT focuses on enhancing awareness and understanding of what is causing your stress, how it is impacting your life, and how well you are or are not able to deal with it or cope effectively.

2. Skills Acquisition and Consolidation

The second phase of SIT helps you learn about and acquire the coping tools and the necessary skills you need to add to your current skill arsenal. In this phase, you will also learn about and rehearse the coping skills you need to combat stress so that your responses become more natural in the face of immediate stressors.

3. Application and Follow-through

The final phase of SIT provides opportunities for you to practice your newly acquired coping skills in increasingly stressful situations. We all know that practice makes perfect. It can turn a learned response into a natural habit. Through guided practice, you will become more confident and better able to handle stress naturally and effectively.

I’ve tried this on my own and with groups of individuals like you. It works! SIT is a widely successful intervention in helping us cope with stress in a healthy manner. If you are interested in learning more about SIT and want to live a happier, healthier, stress-free life, please join us in our upcoming workshop on Monday, May 7, 2012. You are welcome to call me today to set up your appointment and make this the first day in the best of your life.

Best regards to you,
Erika Bent, B.A., Graduate Student Intern
UCF Clinical Psychology Masters Program

What Does it Mean to Surrender?

"The day came when the risk to remain tight in a bud was more painful than the risk it took to blossom." – Anais Nin

Twelve step programs have many recovery tools that can be beneficial to those who are struggling with food addiction, emotional eating, anorexia, compulsive eating or bulimia. One of these valuable concepts is surrender. This admission of powerlessness is at the core of Step One, and is really the heart and foundation of 12 step recovery.

In order to make a positive change in your life, you need to have a heartfelt commitment. Everyone who comes to our office shares that they want to make changes, but they're not always at the point of true surrender. They may not have given their whole selves over to the process of change. They're not willing to experience the discomfort, stress and uncertainty – the risk of blossoming.

Twelve step programs have a saying that it's the "the gift of desperation" that often leads people into successful recovery. This happens after years of trying over and over again to change something, control something or give something up. They may succeed for a short time, yet as soon as a tricky situation comes up they go right back to their familiar behaviors.

At that point, the truly desperate will realize that they must surrender. Their way is not working.

Merriam-Webster says that by surrendering, we "cease resistance to an enemy or opponent and submit to their authority."

Note that this authority is not your counselor, sponsor or any other person. Some think of it as the compulsion or behavior; other see it as the food. Surrendering to this "enemy" means having a healthy respect for the seriousness of the problem and acknowledging that we're powerless over controlling it by ourselves.

Overeating and restricting food not only make people emotionally isolated and miserable, but can lead to many serious health issues and even death. Change is scary, but the consequences of not changing are even scarier.

Twelve step programs have many tools, resources and supports that can help you get to a place of surrender. Our counselors at the White Picket Fence Counseling Center can help, or we are also happy to make referrals to someone in your area.

Have patience and respect for your own time line. Some people surrender quickly, and others hold on for years. Commit to the process and stick with it – because you never know when it's going to happen for you. Another much-loved saying in the rooms of recovery is:

"Don't quit 5 minutes before the miracle happens."

• How willing are you today to surrender your harmful eating behaviors and commit to change?
• Are you willing to let go of control?
• Are you willing to embrace something new?
• Are you willing to let go and trust the unknown?
• Are you willing to seek support from someone who's been where you are (e.g., in a 12-step program or support group)?
• Are you willing to seek support from a professional who is highly trained and experienced in helping other people with similar issues as you are facing?

Click here for a list of 12 step recovery programs and links to their websites.

A List of 12 Step Groups and Websites

• AA - Alcoholics Anonymous
• ABA – Anorexics and Bulimics Anonymous
• ACA - Adult Children of Alcoholics
• Al-Anon/Alateen, for friends and family members of alcoholics
• CLA - Clutterers Anonymous
• CoDA - Co-Dependents Anonymous, for people working to end patterns of dysfunctional relationships and develop functional and healthy relationships
• DA - Debtors Anonymous
• EA - Emotions Anonymous, for recovery from mental and emotional illness
• FA - Food Addicts in Recovery Anonymous
• FAA - Food Addicts Anonymous      GA - Gamblers Anonymous
• NA - Narcotics Anonymous
• OA - Overeaters Anonymous
• SAA - Sex Addicts Anonymous
• SLAA - Sex and Love Addicts Anonymous
• WA - Workaholics Anonymous

 

Make Amends to Make Your Guilt Disappear

12-step programs such as Overeaters Anonymous and Eating Disorders Anonymous contain many useful tools that any of us can use. When it comes to healing guilt, one of the best methods is found in steps 8 and 9.

Step 8 reads, "Made a list of all persons we had harmed and became willing to make amends to them all." Step 9 continues with, "Made direct amends to such people wherever possible, except when to do so would injure them or others."

The 12-step process recognizes that guilt over our unresolved issues with people, places and institutions are what cause us to reach for unhealthy behaviors such as food addiction, emotional eating, bulimia, over-exercising and restricting.

When they feel guilty, a lot of people are quick to apologize. Unfortunately, they're just as quick to repeat whatever it is they just apologized for. There's no relief for either person, because there wasn't any action or change behind the apology.

The 12-step process of making amends goes beyond an apology, to actually changing the words or actions that harmed the other person. If we have acted out of integrity with the kind of person we wish to be, we can do something to repair the damage in a real way.

This is rarely an easy process, and that's why it requires spiritual guidance and strength. Sometimes it's not clear how to make up for what we did, and we need some extra clues or insights. Other times we may see what we have to do, but we feel afraid or reluctant to do it. We need extra strength and courage – especially if there may be consequences for admitting what we did wrong.

Whatever the situation that is causing your guilt, it's important to be thorough in the process of making amends. Otherwise you can put a cycle in motion where you keep hurting the other person or you keep hurting yourself. As part of your amends, you can create a new plan of living when it comes to that person or situation. How would you like the relationship to look and feel? How would you like to behave in the situation? What kind of person do you want to be?

In some cases, even after you've identified a person or institution that you owe an amends to, you can't do it right away. Maybe you don't have the financial means to fully repay a debt. Maybe the person you harmed has died or moved away. The important thing is to get yourself to a place of being willing to make the amends, and then find a way to do it.

A 12-step sponsor or a therapist can be very helpful during this process. This person can also make sure that you haven't slipped to the other side of the equation where you're taking on responsibility for something you haven't done, out of a sense of people pleasing or co-dependency.

Reflect on all the people or institutions you have hurt or harmed, and get yourself to a place where you're willing to do whatever it takes to repair the damage that was your part. Sometimes the action takes place right away; sometimes the action is deferred or done through someone else.

Before making amends, be sure that you have forgiven the other person for any harm they may have done to you. The amends process cannot work if you are still full of rage, resentment or defensiveness.

No matter how much love you may have in your heart when you approach the other person, you can't expect them to accept your amends or be ready to forgive you. They may not be able to do that right now and you have to accept that. You're making these amends to relieve your own poisonous, toxic guilt. You can hold your head high, no matter how the other person responds.

The biggest amends you may have to make is to yourself, for putting yourself through all of this guilt. If you can change your perspective and behaviors so they're more loving and kind – to yourself and others – that will change our relationships, alleviating our guilt and replacing it with relief and gratitude.

There are three key benefits of making amends are. First, an apology for hurting someone in the past can be a great way to build a bridge to a better future relationship with others or with oneself.

Next, it's ideal for removing the weight of guilt, shame and remorse. Finally, step 9 leads right into step 10, which is a daily reflection on how we behaved. We can use step 10 and the journaling process to clean stuff up every day so it never builds up beyond 24 hours. It's a beautiful way of living.

 

Guilt is a Four-Letter Word

Be honest. How many of your actions and decisions today were driven by guilt? Were you trying to relieve guilt that you already felt, or trying to avoid feeling guilty later?

Using guilt as a motivator starts a chain reaction that can very self-destructive. This is true for everyone, but for someone in recovery from an eating disorder, food addiction, compulsive eating, anorexia or bulimia, this pattern can compound the emotional difficulties you're already dealing with.

When you base your decisions on feelings, including guilt, you tune out rational thought, as well as the self-nurturing intuitive thought that is available by making a spiritual connection.

Let's say you agree to babysit your friend’s kids, even though you already had plans that you now have to cancel. You felt obligated and worried about how your friend might respond if you said no. You didn't think you could deal with your feelings of guilt.

By saying yes to your friend, you may have avoided the guilt, but you've put yourself at risk for feeling resentful because you gave up doing something you were looking forward to. And the discomfort of that resentment can drive you right back towards using food, weight obsession, purging or over-exercising as a coping mechanism.

What's even worse is how guilt and resentment can strain your relationships with the people whose love and support is so vital to your recovery.

If you want to stop being a slave to your guilt, you can start by getting more awareness of how it's showing up in your life. Your journal is a great tool for tracking and reviewing these notes. You can also share your writing with a therapist or trusted friend to get feedback and insights.

If you want to stop guilt in its tracks, try to do less "mind reading" or projecting your own thoughts onto others. For example, maybe you think you friend will think you don't care about her or her kids if you say so no her request.

Again, turn to your journal. Write out all the things you imagine the other person is thinking or feeling. Seeing them in black and white may help you to realize that you can't be sure whether they're true. Getting some objective feedback can help here as well.

There is nothing wrong with being a generous, giving person who does nice things for others. In fact, giving back can help you progress in your recovery. Giving also has a spiritual effect, and is one of the ways I incorporate spirituality into my life.

As with everything, balance is the key. If you're feeling out of balance, chances are that you're giving out of guilt.

Five Things That Get in the Way of Your Spiritual Connection

This month we've been discussing the spiritual piece of the recovery puzzle. For some, spirituality is an untapped resource. Once you learn about ways of accessing your own spiritual connection and make a conscious effort to do that, a whole new world is opened for you.

Sometimes, though, the path to spiritual awareness can be blocked, and the door to that spiritual world might seem locked to you.

Here is a list of five things that may keep you from making a spiritual connection:

1. Lack of sleep: Feeling tired can impair your judgement, shorten your temper and magnify your challenges so they seem impossible to overcome. In that state it's hard to remember that you have access to an inner source of wisdom, and harder still to listen to that quiet voice. Try getting to bed earlier and/or sleeping later, and practicing other good sleep hygiene habits.
2. Obsession: When your mind is so busy turning over every detail about something in the past (what you should have done or what you wish you hadn't done) or the future (what you should do next, what you're afraid to do or what you hope will/won't happen), there's no room to be open to spiritual suggestions. It's a well-known paradox that sometimes the minute you stop thinking about yourself and your own problems, solutions can magically appear. Try doing something nice for someone else.
3. Focusing on the negative: Another common theory, known as the Law of Attraction, says that whatever you focus on is what you will attract into your life. Try thinking about and showing appreciation for the positive people and things in your life.
4. Strong feelings: In a similar way, strong feelings of resentment, fear, depression, anxiety or grief can all cloud your perception. You may be sure that you know what someone else is thinking or feeling or you may underestimate your own capability. You may lack the confidence to know the difference between your own negative thinking and a message that may be from your spiritual intuition. Try speaking about your feelings to a therapist or trusted friend, or writing in your journal.
5. Using food in an addictive way: When you overeat, undereat, purge or over-exercise, it brings on all four of the previous situations, as well as many other problems. Food can create a false sense of connection, but for food addicts, anorexics, bulimics and compulsive overeaters, food actually drives a wedge between you and other people, and between you and yourself. The deeper into the addiction you sink, the farther away you feel from your spiritual connection. Getting a handle on your addictive behaviors should always be your first concern. We're here to help

If you've been trying different strategies to make a spiritual connection and you're still struggling, check which one of these five situations may be present in your life.

When People Are the Triggers

In the recovery process from an eating disorder, you'll probably start by focusing on the food and your eating patterns. Once you've worked on those things, it will be time to turn you attention to your relationships – your emotional triggers.

You may feel triggered when people start talking about weight, dieting, the newest exercise program or the foods they're eating or not eating. Well-meaning friends and relatives may ask questions about what YOU are eating or not eating, or they may comment on your appearance.

Shopping for groceries or clothing can trigger many different issues around food and weight, and food is on display pretty much everywhere you go at certain times of year like the winter holiday season. Just seeing those huge quantities of food all in one place can be terrifying for someone in recovery from food addition, emotional eating, anorexia or bulimia.

Relationship issues can pop up just as often, where TV commercials, books or other people in your life can remind you of painful situations that are still unresolved. Sometimes you can get caught off guard by a reaction that feels out of proportion, like getting really upset about someone you don't even know.

When someone triggers you, usually it's because somewhere deep down it reminds you of an interaction with your family of origin. This is another reason that we welcome triggers in the therapy process. This is a great opportunity to work through something that you wouldn't have otherwise. 

You don't have to be afraid of triggers. You can learn to understand them and deal with them – not eat over them.

 

Use a Pen to Fight Your Triggers

One of the most helpful tools in 12-step recovery programs is the daily written inventory of what you did well that day, where you could improve, and if there is anything you need to set right with an apology or other action.

This practice can be extremely useful when you're learning how to cope with "triggers" – people, situations or foods that create an emotional response. For people recovering from anorexia, bulimia, food addiction or emotional eating, the first response to being triggered is to use their unhealthy eating behaviors.

By keeping a written record of what triggers you and bringing that to a therapy session or group, you can ask for help to learn how to change your default response and develop healthier coping mechanisms.

A therapist can take you through a role play where you actually rehearse what you will say or do differently the next time that situation comes up. You may also spend time looking deeper into what it is that triggered you in the first place. That awareness can be an important element of the healing process.

Your therapist can help you create a physical symbol of recovery so you can focus on that object until the trigger passes. I've known people to use a picture created in a therapy session, a stone or shell, a word or quote, a medallion or jewelry or even a pen with their name on it. This transitional object can effectively bridge the gap between the work done with the therapist and the triggering stimuli that takes place in everyday life.

The scariest thing about triggers is anticipating them. The first step towards gaining control over them is to capture them on paper and bring them down to size. Right then – triggers begin to lose their power.

Let's Get Triggered

For people with an eating disorder, emotional eating or food addiction, the holidays can be like a minefield of "triggers" – situations or foods that bring heightened anxiety and awaken the compulsion to use unhealthy eating behaviors.

Earlier in my career, I had been trained from the perspective that we shouldn't mention triggers or specific foods in therapy, in case someone would leave their session and binge, purge or restrict themselves right into relapse. Today things are different. It's not that we would ever purposefully provoke someone, but we know that triggers happen out in the world we live in.

Now, if someone is triggered, we know that she or he can come back and discusses that in a future session with the therapist or group. That way we can equip the person with valuable tools for handling similar situations in the future.

By trying to protect my clients from their triggers, I was actually denying them that chance to grow beyond them. Research, as well as my own clinical experience, has taught me that it doesn't help to avoid the triggers in therapy – and it's certainly not therapeutic.

My approach has changed and grown, just as my clients have. It's okay to be triggered in group or in therapy, as long as you process it, like we do here at the White Picket Fence Counseling Center. Whether that happens immediately, or whether you need to think about it and come back, it's important to look at what is happening.

I would even say that today we welcome triggers, and that's because there are certainly going to be triggers out there, especially during the holidays – in the grocery store checkout line, at the gas station and in conversations with friends, family and co-workers. The goal is to not only tolerate these triggers but to embrace them with no thoughts or feelings of hurting yourself.

 

What Are You Not Saying?

Emotions play a role in all eating disorders - they are always about more than food. Eating disorders may also coincide with low self-esteem, psychological disorders, a history of abuse, or even a certain genetic makeup.

When people with anorexia and bulimia restrict food and/or purge, it's a symptom of an inner distress they are trying to calm, get rid of or express.

Expressing our feelings can be challenging. We may feel ashamed by what we think or feel, or we may feel alone because we don't realize other people feel the same way. We may be concerned about how someone else will feel if we say what's in our hearts, or we fear that we'll lose their love and support if they find out what we're really thinking.

Purging and restricting are shields that keep a person hidden in isolation so they don't need to have these difficult conversations. In order to heal from an eating disorder, though, it is vitally important that you speak up about what's bothering you, rather than continue to use behaviors that are hurting you.

Even though you may only be thinking about the body image issues that drive you to restrict or purge, if you dig deeper there are bound to be other issues going on. And these issues will only get more painful the longer you avoid them.

Therapy and support groups provide a safe place where people with eating disorders can express their innermost thoughts and feelings without fear. You can experience what it's like to communicate openly without being judged or criticized.

A therapist can help you sort out your feelings to determine what you may need to say to the important people in your life. That might be asking for a change if someone else's behavior is negatively impacting you, or it might be making an apology for your own behavior. You can even role play and rehearse these discussions so that you feel prepared beforehand.

At the White Picket Fence Counseling Center, we specialize in treating people with eating disorders, food addiction and emotional eating. Please contact us today if we can help you.

Upcoming Groups and Workshops - New Starts and Ideas

Upcoming Groups and Workshops will help you get a jump start in your personal growth process.  Click here to view and download your own printable copy! Tell us what you think of the new workshops - let us also know what interests YOU!