White Picket Fence Counseling Center Newsletter Archives

Why You May Have an Eating Disorder

By this point in the year, many people have already tried more than one diet program in order to achieve their New Year’s resolution to lose weight. Others have been trying to keep their daily promise of not using their eating disorder behaviors. They all may be wondering, “Why can’t I do this? Why can’t I eat in a healthier way, no matter how hard I try?”

This is also often one of the first questions our clients ask when they begin therapy. “Why do I have this eating disorder?” They’re convinced that if they know why they do what they do with food, they’ll be able to stop doing those things.

Knowledge is helpful, and we definitely spend a lot of our time in therapy helping you gain knowledge and insights about yourself. Yet knowledge alone doesn’t give you what you need to make the necessary changes, especially without support.

On the website of NEDA, the National Eating Disorders Association, they offer an overview of the four basic causes (contributing factors) of eating disorders. Over the next few weeks, I’ll present each factor and go into more detail about what’s involved.

Their first point is that eating disorders are very complicated, and it’s never just one thing that’s the cause. If it was, there would be just one form of treatment, and as we know, there are many.

The first set of factors that may contribute to eating disorders are psychological factors.

If eating disorders are a method of coping with what’s not working in your life, what are the psychological factors you are coping with? Someone may feel low self-esteem, or a lack of control over what’s happening in their life. They may be experiencing other mood disorders like depression, anxiety, loneliness, grief, abandonment or resentment.

Recovery is not just about eating differently, it’s about looking at your underlying emotions, so that you can begin thinking different and acting differently. 12-step programs, therapy and treatment centers are all places you can go to do this important emotional work.

Workbooks can be a very helpful tool. For example, for low self-esteem we recommend The Self-Esteem Workbook by Glenn R. Schiraldi, 52 Weeks of Esteemable Acts by Francine Ward and Ten Days to Self-Esteem by David D. Burns, M.D. In our experiences, however, workbooks are only helpful if you share your work with someone else.

An eating disorder can be a form of rebellion for someone who feels a lack in control in their life or is feeling angry at someone but is having trouble expressing the anger. It’s as though they’re speaking with the food, saying the things they can’t say with words.

Therapy gives you a place to say those words. Sometimes a more intensive level of therapy is needed, where someone visits our office three times a week. In essence, we become their outpatient program.

For some people, inpatient treatment is the best option. I recently visited the Castlewood Treatment Center for Eating Disorders in St. Louis and learned about some of their treatment methods. For example, they use Internal Family Systems Therapy (IFS) to help their clients integrate different parts of themselves, in order to access their inner compassion, confidence and curiosity.

The IFS process also helps the person see the eating disorder as just one part of their identity, not the sole definition of who they are. This concept was also covered in the book Life Without Ed, by Jenni Schaefer. Your eating disorder may have actually helped you survive and get through traumatic events, but once you go into recovery it’s because the eating disorder is not working for you anymore. It’s definitely not helping your health.

For reducing depression, anxiety and phobias, we may apply a number of different techniques such as thought stopping, cognitive behaviour therapy, mindfulness or thought restructuring. We often recommend that people incorporate movement into their day, in particular things that get them outdoors in natural light.

These psychological factors are only one of four interrelated factors that may contribute to eating disorders. Future blog posts will explore the other sets of factors.

The Powerful Benefits of Physical Activity

At White Picket Fence Counseling Center, we talk a lot about the mind-body connection. Science has shown us that cultivating a positive attitude and peaceful thoughts can actually bring about physical healing.

Can it go the other way? Can increasing your physical activity help to ease your mind and calm your thoughts? Absolutely!

In moving the body, there’s an internal movement that happens at the same time. We feel more whole and well. We come back into our bodies with more physical energy and the stamina to keep up with our daily tasks or add new ones. It just plain feels good (thanks to the release of endorphins – those happy brain chemicals) and helps us be more optimistic.

If strength training is one of the right physical activities for you, you may notice that as you grow stronger physically you also start feeling stronger about your sense of self. It’s a beautiful thing.

These are just a few of the many mental, emotional and physical benefits of incorporating healthy movement into your life. Which ones have you noticed? Which ones would you add?

Mindfulness and Meditation Resources for Your Journey

This month we’ve been talking about mindfulness and meditation, including a video about the benefits of meditation and how to open your mind to meditation. Here are a few recommended resources if you would like to learn more about these topics:

Books

• The Relaxation Response by Herbert Benson
• Women, Food and God by Geneen Roth
• Natural Prozac by Joel Robertson
• Managing Stress by Brian Luke Seaward

Online resources

• Guided imagery recordings and other mindfulness and meditation resources from Health's Journeys by Belleruth Naparstek -
• Expert-recommended books about mindfulness and meditation at Shambhala Publications – including books by Thich Nhat Hanh
• Books and articles by Dr. Susan Albers
• Mindfulness mediation resources by Jon Kabot-Zinn

Recovery resources

For those in 12-step recovery, ask your sponsor or other recovering compulsive overeaters or food addicts about their experiences with Step 11. learning from others who have walked in your shoes can be a powerful and healing experience..

Related articles

A Few Mindful Moments Can Bring Powerful Healing

Open Your Mind to Meditation

What are the Benefits of Mindfulness and Meditation? (Video)

Open Your Mind to Meditation

I don't have a perfect meditation practice and you'll rarely find me sitting cross-legged or chanting. Yet I do have a regular spiritual practice that incorporates mindfulness and meditation. For example, I center myself each morning, and sometimes again in between clients or in between work and going home. Sometimes I take a moment for myself before making a phone call, to release whatever I might be thinking about and focus my attention on the present moment.

Meditation doesn't have to look like what you think it will. Open your mind to your own style and examine different resources and classes. At the White Picket Fence Counseling Center, we often hold free introductory classes where you can try things out before you commit.

A lot of people come to our Center to reconnect with themselves, and are surprised to realize that we incorporate so many physical modalities. As we discussed in a previous post, these physical activities can actually improve your brain chemistry, helping you to manage the stress of recovering from an eating disorder.  

You can practice mindfulness by sitting still, but you can also practice it when you're moving around, when you're having a conversation with someone. Imagine mindfully listening to another person! When is the last time you listened that way, concentrating on hearing their words and nuances, witnessing their body language, all without any inner dialogue going on about what you think or what you're going to say next?

There are different levels of mindfulness – you may need to work your up to the more traditional forms of meditation. Some stepping stones might include:

• Guided imagery
• Journaling
• Drawing
• Singing or playing music
• Stretching
• Making a collage
• Doing crafts
• Taking a walk
• Sitting quietly on a bench and watching people
• Experiencing something in beautiful in nature
• Taking a quiet moment
• Looking at art

For more suggestions, please see these previous articles:

Stillness Suggestions

How I Incorporate Spirituality into my Life

Some guided meditations instruct you to connect, mentally, with different parts of your body, for example to imagine your muscles clenching and then relaxing. For those with an eating disorder, it may feel too threatening or uncomfortable to connect with certain body parts. My advice? Start with your feet.

Most people find it safest to connect with the feet – though it's not always easy. At a recent training for MY Therapy (a combination of mindfulness and yoga therapy), when the instructor asked us to connect with our feet, we all laughed when we realized we had all looked down instead of just imagining our feet.

So open your mind to the idea of mindfulness, and find a gentle way to introduce this powerful practice into your life. You'll be amazed at the gifts you may find inside your mind.

What are the Benefits of Mindfulness and Meditation? (Video)

Meditation can help you get in touch with your feelings and gain awareness of things that are going on that may be causing you stress and leading you to restrict or overeat. Therapy and meditation can both be catalysts that clear away stuff so people can resolve things themselves and self-activate.

As you'll see in this video, meditation may reveal things you don't like or aren't ready to deal with. That's why it can be helpful to have the support of a therapist, therapy group, 12-step group, sponsor or trusted friend who can help you process your experiences and feelings.

Watch the Benefits of Meditation, by Andy Puddicombe, co-founder of Headspace: 

 

Meditation can help you uncover what's going on, and talking that out in therapy or other safe settings can help you get centered and clear to make healing changes. And maybe even reach enlightenment along the way.

A Few Mindful Moments Can Bring Powerful Healing

Whether you're someone who's not ready or interested to pursue a spiritual life, or someone who's looking for the way to strengthen a connection, mindfulness is an approach that is accessible to everyone.

At White Picket Fence Counseling Center, we hear a lot of people say things like, "I'm so bright in other areas of my life – why can't I get this?" or, "I've been so successful in my career, but I just can't get control of my eating or food issues."

The simple truth is that eating disorders don't make sense. We need to make sense of them. And the only way to do that is to tune in to what's going on inside. Not just in our minds (we're so used to living "from the neck up") but in our whole bodies.

Last month on the blog we talked about the mind-body disconnect of eating disorders, and how yoga is one very effective way to reconnect. A big part of yoga is an invitation to be still and look inwards, listening to your body (on and off the mat) and listening to your mind.

In yoga we call it meditation, but if that doesn't feel right for you, call it mindfulness. Being mindful of who you are, where you are, what you feel, what you know and what you want.

Some people have used the analogy of plugging yourself in, the way you would your cell phone. Whether you're re-charging, or even charging up for the first time, getting quiet and practicing mindfulness can help you achieve the feeling of being centered, or grounded.

When you're lost in the compulsion, obsession, discomfort and unease of an eating disorder, you can feel pretty out of control and out of reach. That's why virtually every recovery and treatment method recommends some form of mindfulness as a way of reconnecting the body and mind.

If you're still not convinced that mindfulness is worth the time or effort, consider this:

Imagine that you're driving along the road and all of a sudden someone pulls out in front of you and you're forced to slam on your brakes to avoid an accident. What's going on in your body at that point? Your muscles are probably clenched, as is your stomach (where digestion has actually stopped, so that the rest of your body's systems will be ready for whatever stressor you're facing). Your heart is probably racing from the urge of adrenalin.

In psychological terms that's called the fight or flight response, and it's a really good illustration of the mind-body connection. The good news is that just as anxious thoughts can cause stressful reactions in the body, so can relaxing thoughts cause healing reactions in the body.

And just as good news, relaxing bodywork can soothe the mind from anxious thinking to more positive and hopeful, actually altering your brain chemistry in the process. So we can see how mindfulness helps to heal both physical and emotional pain. Here is an article from Psychology Today about a research study that demonstrates how meditation positively alters the brain: http://www.psychologytoday.com/blog/choke/201110/meditation-small-dose-big-effect.

Over the next few weeks on the White Picket Fence Counseling Center blog, we'll explore the benefits of mindfulness, as well some methods and tools that you can start using right away – even just a few minutes per day could make a big difference to your mind, body and yes, your soul.

Yoga Resources for Recovery from Eating Disorders

If you would like a very gentle start to your yoga practice, I recommend the book yoganap: Restorative Poses for Deep Relaxation by Kristen Rentz. It contains restorative yoga poses, designed for complete relaxation. The author is a professional during the week and a yoga instructor on the weekend. Her instructions are easy to understand and the exercises are totally doable. There are even some poses you can do from your desk at work!

For further reading, you can explore the Yoga Journal website at http://www.yogajournal.com/.

How the Principles of Yoga Can Help Heal Food Issues

Though I've been practicing yoga for years, it was in my recent yoga teacher training program when I started to realize the broad implications of the benefits of yoga. Just as the book Living Your Yoga implies, there are many places in our everyday life where yoga can apply.

Here are some of the yoga principles that have come up most often as I have counseled people with eating disorders and food addiction to "live their yoga."

• Letting go – instead of using food behaviors to bury uncomfortable feelings, let them go
• Getting centered – instead of feeling pressured and anxious, pause and come back to the present moment where you can make more self-compassionate choices
• Connecting to other people and to a higher power – food has been barrier between you and other people
• Tolerating discomfort – learning to sit with uncomfortable feelings will give you the power to move through them without using food or food behaviors
• Taking time to relax and regenerate – instead of feeling intimidated by silence and stillness as they compete with your busy mind, let it all go and give your body and mind the break they need
• Being grounded – feel a sense of support and connection to the earth below
• Soothing yourself – instead of reaching for food or other harmful behaviors, learn to self-soothe in healthy ways
• Surrounding yoursef with beauty – empower your sense of self-worth by choosing to indulge in healthy forms of joy and pleasure
• Witnessing without reacting – let go of judgment and practice accepting things as they come

If you're interested in learning how to apply these principles in your own life in recovery, watch for more details about our yoga classes. For those who want to go deeper, we will offer small yoga therapy groups and private yoga therapy.

Yoga practice is a safe place where you can feel both relaxed and energized. Through yoga you can learn to use these principles and apply them to your whole life, gaining clarity and a sense of rejuvenation, and freedom from the stressors of an eating disorder.

The Mind-Body Disconnect of Eating Disorders

For people with eating disorders, there's a clear disconnect between body and mind – it's like living from the neck up. Because that reconnection is so vital to recovery, many treatment methods are designed to realign the mind, body and spirit.

Getting back that connection helps people find acceptance, awareness and appreciation for their bodies, which naturally leads to wanting to take better care of themselves.

Drawing on my recent experience with yoga teacher training, and in partnership with some of my colleagues who are already registered yoga teachers and yoga therapists, we now have yoga and yoga therapy at the White Picket Fence Foundation.

Yoga is much more than just postures. In fact, some of my therapy clients have been benefiting from my yoga experience for years, as I've incorporated relaxation techniques like breathing exercises, guided imagery and meditation.

The benefits of yoga are well researched, and it is a natural fit to help with food issues. For example, many people have a problem with overeating or restricting during stressful times.Yoga works directly upon the nervous system to evoke relaxation and diminish stress. It activates the parasympathetic nervous system that promotes rest and regeneration and reduces the fight or flight response that brings anxious, stressful feelings.

In the next article, we'll explore some of the principles of yoga and how they can be applied to recovery from eating disorders.

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

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

 

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.

How I Incorporate Spirituality into my Life

In last week's article we discussed how spirituality is a vital part of the recovery puzzle, just as important as your emotional and physical healing.

Here's how I incorporate spiritual practices into my daily life:

Yoga – I've been doing yoga on and off since I was in high school. My mother was even a yoga teacher for awhile, and shortly after she had surgery she needed me to assist by teaching a class. That's what really propelled my interest. There are many types of yoga, including some that are very active. I do a style of yoga that's very gentle and restorative. I feel more spiritually connected when I allow myself to be still and get centered.

Guided imagery – I use guided imagery to quiet my mind. Listening to the audio recordings help me connect to the present moment. At HealthJourneys.com, you can pick up a free guided meditation sample. If you like it, they have many other resources for you.

Taking walks in nature – If you keep your eyes out, you might spot me walking all around Winter Park with my dog, usually with a ponytail on top of my head! The sights, sounds and smells of nature instantly remind me that I am part of a big, beautiful world.

Healthy exercise – Aside from yoga and walking, I regularly experiment with other forms of healthy exercise. This grounds me in my body and helps me to appreciate my health and mobility. 

Healthy meals – When I make the effort to prepare pleasing, nourishing and delicious foods, I feel as if I'm giving myself a type of spiritual nourishment.

Gratitude lists – I use this technique to remind myself every day of everything I have to be grateful for. It's also something I used in my general psychology course at Valencia College. As they arrived in class, the students had to stop at the whiteboard and write down one thing they were grateful for. Most of them said it was a really positive experience, though some found it a bit embarrassing. On the last day of class, one fellow wrote, "I'm grateful I don't have to write my gratitudes in the front of the classroom anymore, but I will keep on writing them for me!""

Philanthropy – When I do something for someone who can't, it makes me feel connected and part of the world. This isn't always about giving money; it can mean volunteering at the food bank or offering workshops or groups at a reduced rate so everyone can access therapy if they need it.

Having fun – Making time to laugh and get together with people I care about definitely enhances my spirituality. It lightens my load and clears away any negative clutter that's blocking my connection.

 

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.