I first read Brene Brown's book "The Gifts of Imperfection" nearly two years ago after watching her landmark TED talk. Both the talk and the book affected me in ways that no other work had before. Her research and message has changed me as a person and as a clinician. I actually wrote a bit about this in another blog post over a year ago. In the past couple of years Brene Brown has become a pretty big deal- first with TED and now OPRAH. It just doesn't get much bigger than Oprah. (I have my own mixed feelings on Oprah but that is perhaps for another blog post at another time.) But I love love love this exchange between Oprah and Brene. It's only a few minutes long so check it out.
So I have two primary motivators for gushing about Brene Brown.
1. On October 20, Brene is starting this super cool 6 week ecourse. It looks like a blend of her book plus art therapy. It's only $70 plus the cost of materials. You can read more about it here.
"In this 6-week art journal eCourse students will roll up their sleeves for hands-on, interactive art explorations that will help you move from who you think you're supposed to be...and embrace who you ARE."
2. I wanted to introduce you guys to Brene's work if you weren't aware of it already. She's written a couple of books but her book "The Gifts of Imperfection" is a fantastic place to start. In it, she introduces 10 guideposts that emerged from her research on shame and vulnerability. Turns out that the people who live "wholeheartedly" cultivate these gifts.
#3 Resilient Spirit
#4 Gratitude and Joy
#5 Intuition and Trusting Faith
#7 Play and Rest
#8 Calm and Stillness
#9 Meaningful Work
#10 Laughter, Song, and Dance
Perhaps this book resonated for me so much because these are the essential ingredients I see in my work that help to facilitate health and healing. Over the past several years I have come to scorn the "self-improvement" and always striving for perfection type of messaging. I have come to embrace the Buddhist principles of self-acceptance and self-compassion. I have learned that all we need "to be" is right inside of us. And that what we need most is to connect to what is already there. And Brene's research and writing beautifully illustrates how it is possible.
To finish up this blog post, I'd like to share a quote from "The Gifts of Imperfection" from her chapter on authenticity.
"If you're like me, practicing authenticity can feel like a daunting choice- there's risk involved in putting your true self out in to the world...I think we should be born with a warning label similar to the ones that come on cigarette packages: Caution: If you trade your authenticity for safety, you may experience the following: anxiety, depression, eating disorders, addiction, rage, blame, resentment and inexplicable grief. Sacrificing who we are for the sake of what other people think just isn't worth it. Yes, there can be authenticity growing pains for the people around us, but in the end, being true to ourselves is the best gift we can give the people we love."
Thanks Brene, I think so too.
This past weekend, we had a major storm out here in New England. In fact, I’ve never seen so much snow at once! As I was watching Facebook, my inbox, and news reports I was intrigued with everyone’s efforts to prepare for the upcoming deluge. In fact, I found it incredibly interesting. Many people headed to the grocery store and stock piled their cupboards, fridges, and freezers (along with grabbing cash and filling up their gas tanks).
I think this behavior has such relevance to the world of nutrition. When we fear impending famine, we stock pile “just in case.” How many of you repeat this pattern with your diets? If you have ever participated in a “diet” than you have repeated it even if you don’t know it! Creating a famine by cutting out certain foods or food groups actually triggers a natural and healthy survival mechanism to feast. This survival mechanism causes us to think obsessively and crave those forbidden items. And as many of you know from experience, when we are both psychologically and physically restricted we don’t just crave moderate amounts of those items, we yearn for COPIOUS amounts of them. And before you know it, a terrible pattern has emerged… Famine (even with the best of intentions) has set you up for feasting.
This past weekend I was giving a workshop on Intuitive Eating/Intuitive Living with my colleague and friend Amber Barke. During the workshop we were discussing the very challenging topic of self-acceptance and I shared this blog post, which I wrote just over a year ago. I thought I'd re-post it, as the message seems relevant, particularly around this time of year. Enjoy.
My client, whom we'll call Sally, was telling me how she's been reading up on all sorts of positive body image blogs. You know, blogs that encourage you to love yourself and accept yourself as you are right now. And that was just all too far from reality for her to be able to swallow. She told me "I can't love my body. I can't stand living in it. I don't feel good physically in my body. Why would I accept something that makes me so miserable?"
And I understood what Sally was saying. Often, people confuse self-acceptance with stagnation. Staying miserable, learning to put up with something you hate. Many people wrongly assume that they'll never change if they accept themselves (not to mention love themselves!) as they are right now. But it turns out that isn't true.
ACCEPTING SOMETHING DOESN'T MEAN YOU HAVE TO LIKE IT. The reality is that self-acceptance FACILITATES CHANGE. Acceptance can be defined as "the act of assenting or believing." Once we come to truly accept where we are at in life, what works for us, and what doesn't, we are then able to make decisions based on that reality. Here are a couple of diagrams to show what I mean.
Cycle of Non-Acceptance
Cycle of Acceptance
I share this message with you as a new year is about to begin because it's a time that you might be thinking about setting goals and contemplating how you'd like to improve upon this past year. So you just might want to consider adding self-love and self-acceptance to the top of your list. Ironically, it just might help you accomplish everything else you had in mind.
I'm going to leave you with a quote from a fabulous book that I stumbled upon while researching this blog post. The quote relates to accepting your body as it is right now.
How can you begin to learn the lesson of acceptance? By recognizing that what is, just is, and that the key to unlocking the prison of self-judgment lies in your own mind. You can either continue to fight against your body's reality by complaining bitterly and immersing yourself in self-deprecation, or you can make the very subtle but powerful mental shift into acceptance. Either way, the reality remains the same. Acceptance or rejection of your body only carries weight in your mind; your perception has no bearing on how your body actually looks, so why not choose the ease of acceptance rather than the pain of rejection? The choice is yours. "
Found in "If Life is a Game, These are the Rules" by Cherie Carter-Scott PhD
Have you had an experience with self-acceptance? Please share it!
Have you ever read a book that has truly transformed you? A book that has transformed your world view, your priorities, and your purpose? There have been a few of those books in my life time. Professionally, the first time this happened was when I read the book “Intuitive Eating.” That book profoundly influenced the course of my career and totally altered my perspective. The next book was “Rethinking Thin” by Gina Kolata. And the next book was the seminal feminist writings of Naomi Wolfe in “The Beauty Myth.”
Most recently I have added two more books to the “books that will change your life forever” shelf. I know that sounds dramatic and perhaps cliché. The first of these two is “Two Whole Cakes” by Lesley Kinzel. It’s actually a book that I feel every human being should read because it addresses the very relevant issues of weight bias and weight stigma. An issue that is so pervasive that it is hardly noticed. I’m actually working on writing a book review but am having trouble since I can’t seem to do it justice.
And the second of these two books is “The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are” by Brene’ Brown. Ya, catchy title, huh?! The GIFTS of imperfection…say what?!? I’m not going to write a book review here. But I am going to share with you a tasty morsel.
In 2008 Brene’ and her husband Steve asked themselves “When things are going really well in our family, what does it look like?” Their answers included things like sleep, exercise, nutritious food, going to church, control over finances, time for vacation and time to hang out, meaningful work that isn’t all consuming. These became their “ingredients for joy and meaning.” (This excerpt can be found on page 102 of her book.)
So rather than share with you a list of ingredients for a recipe like I normally do, I’d like YOU to come up with a list of ingredients that are your recipe for JOY AND MEANING. What are the things in your life that bring you joy and meaning? What will you have to sacrifice in order to get more joy and meaning in your life? Less money? Fewer accomplishments professionally?
I’d love to know what ingredients bring your life joy and meaning. If you feel comfortable, please share!
P.S. If you want more Brene' Brown...check her out on TED. I highly, highly, highly recommend it.
Thank you to all the participants for our Twitter Chat last night! We helped to ring in a body positive summer by participating with Dr Deah-Expressive Arts Therapist and Health at Every Size Expert .
Missed the chat? We saved a recap here for you!
Q1. What does the term expressive therapy mean? What are some examples?
@dr_deah It’s a form of treatment using a multi-modal approach to facilitate healing, insight, behavioral changes.
@jekjess It's using various approaches - especially creative ones - to achieve therapeutic goals in ways that talk sometimes can't
@dr_deah Modalities used include art, drama, music, movement, imagery, storytelling,writing.
@MarciRD Is based on the assumption that people can heal through use of imagination and the various forms of creative expression.
Q2.1 What are some of the benefits to incorporating expressive therapy into eating disorder treatment?
@jekjess Client can express what they can't put words to/are too ashamed to say, client can discover talents
@MarciRD My clients are the most creative people I've ever met. ED stifles creativity, so important to bring that creative self out!
@dr_deah: Many of our associations & patterns w/food & nurturing occur @ a preverbal level
@MarshaHudnallWe find that expressive therapy helps people access feelings they often can't otherwise
- 2.2 Why are the Ex. Arts Therapies helpful for this population?
@jekjess Client can express what they cant put words to/are too ashamed to say, client can discover talents
@dr_deah body image issues are visually stimulated because messages are delivered via the media. Using art, theater & dance we “fight fire w/ fire” by using the medium that delivers the message
@MarciRD Creativity can be a means to externalize and separate from the eating disorder.
@rosiemolinary I love that the creative arts allow for a partnership between body, mind, + soul, a partnership that may have been alienated w/ED -
@bigpictureRD significant to use creative process & energy for positive reasons, motivation
@ScritchfieldRD: one good belly laugh is as effective as 10 minutes of meditation (which is also good) may be better than meds
3. Often people feel vulnerable creating art, music, dance or other means of self-expression. What might help break through the intimidation?
@dr_deah It’s about material generated not how it looks, which of course is the point of body image therapy in the first place
@rosiemolinary empower them to realize that they are doing it for themselves, not to worry about perfect but process and revelation
@dr_deah: A competent E.A. Therapist sets up sessions w/the premise that there’s no right or wrong in how one expresses
@dr_deah Improv activities are spontaneous not enough time to get self conscious
- 4. In what ways can a RD use Ex. Arts Therapy Activities to achieve their treatment goals?
@MarciRD I like them to draw out what hunger/fullness means to them.
@ScritchfieldRD: I have done vision boards in session. We cut out words from magazines - put together a me board
@MarciRD I encourage my clients to use color and pictures for expressing emotions for before, during, after a meal
@rosiemolinary Fill basket w/random things (rock, rubber duck, etc) +have client pick something out of basket + tell story w/ relevant connection
@jekjess I think I would have LOVED to do an art "food journal" regarding feelings after eating etc, visualize
@dr_deah I have also worked with clients to identify what the real "monster is" in their lives that they are attributing to the food
@MarciRD A4 I have a client who recently asked me to record a mindful meditation track on her phone to listen to while I'm away.
@ MyDietitian I use mountain image, help them to identify the "peak" of having a positive eating experience, what that means for them/their body
@dr_deah I use future fortune telling symbolism sometimes too, eg a crystal ball as an image to play with
@MarciRD A4 This book has been really inspiring, easily adapted to nutrition work: http://t.co/6K9x0z4W #endED -
@dr_deah For more art therapy ideas I post at http://t.co/RD4CO2Ka
5. What is HAES?
@dr_deah: HAES is a health based paradigm that starts with accepting and respecting the diversity of body shapes and sizes
dr_deah It also promotes individually appropriate & enjoyable life enhancing physical activity As opposed to exercise that is focused on a goal of weight loss
@MarciRD: HAES is positive approach to taking care of ourselves. Does away w/ comparison & shame & truly supports well-being
@ElizabethEats: I feel like i say this everyday but: you can tell NOTHING about a person from how they look. why we NEED #HAES
@dr_deah: Many people start dieting because their natural body size and shape is not what society deems as beautiful.
@MarciRD: Q5 Stands for Health At Every Size- check out their website http://t.co/hYkFWpnR #endED
@HAEScoach: What is #HAES? #endED” nutrition + activity + self + fun + curiousity + discovery = healthy mind AND body lifelong #endED -
5.2 What are common misperceptions about a HAES approach?
@MarciRD People think it gives the green light to binge eat and not exercise. They forget the key word- HEALTH at every size
@bigpictureRD So many misconceptions! That it's not health focused, & gives permission to be out of control
@dr_deah We know Weight cycling often results in weight gain and increased eating disordered behaviors
@ScritchfieldRD misconception about #HAES people are lazy, don't want to take care of themselves, that they "could" be thinner, thinness=health
6. Why is it important to emphasize HAES as a society and as a therapist?
@MarciRD We need to work on changing the paradigm of health = thinness. We have the power to affect our personal circles too!
@MyDietitian A6 to prevent doing any harm. Help combat negative self-talk. create a reality of feeling good at any size
6.1 How can we stay HAES focused this summer?
@dr_deah Try 2 avoid engaging in comparing bodies and using negative body talk
@dr_deah Pay attention to your cues of hunger appetite and satiety Move your body for pleasure and health not weight loss
@MarciRD Encourage clients, friends, family to embrace life/fun NOW...not in 10 lbs...
@ dr_deah I have great resources and links on my website http://t.co/blb4ciag
@MarciRD There are so many fun ways to be active in the summer- volleyball, kayaking, frisbee, walks, hikes. Have fun and get outside!
@dr_deah So Try starting from a place of love& self-acceptance it makes it easier 2 take better care of ourselves#ended
Thank you for everyone that joined us! You can see more tweets if you search #endED
You can learn more about Dr. Deah by visiting her website or her Facebook page. Mark your calenders for our next chat; July 25th where we will be talking with @ednmaryland !
What do you think about when you hear the word "mindfulness?" To be honest, I used to think "nope, not for me!". Breath in, breath out, follow my breath. Ugh! I honestly couldn't see the point and every time I tried it seemed like a miserable failure.
And then I attended a workshop by the brilliant Dan Siegel, MD and also began reading one of his many books on mindfulness entitled "The Mindful Therapist." My mind has been forever changed now that I'm beginning to understand why mindfulness is so critical to our health.
I'm going to give you a 3 part synopsis of how Dr. Siegel's work on mindfulness has changed my life:
1. Mindfulness can be defined as: awareness of the present experience with acceptance, no judgement
2. Our brain naturally goes a thousand miles a minute. That's what it is designed to do. When we practice bringing it to the present moment physiological and structural changes occur in our brains! Yes, the act of bringing our mind to the moment changes the very structure of our brain.
3. As this happens, there are PROFOUND consequences. I will name a few: we become more open, less rigid in our thinking, more creative and resilient, less anxious, able to act rather than to react.
Practicing mindfulness is tough stuff. But it's with the act of practicing, the act of drawing your mind to the quite present moment WITHOUT JUDGMENT that the magic happens.
Below is a story of one person's journey with a 30 min meditation. Enjoy.
Recently I went to a 30-minute guided mindfulness meditation session. The teacher spoke for about 5 minutes at the beginning of the session, suggesting ways we could approach quieting our minds for that half hour. She suggested relinquishing following the breath, which is a typical approach to mindfulness meditation.
Instead she referred to a passage she had recently stumbled upon in the Bhagavad Gita that suggested that the labor, or effort, was the goal of this meditation practice; that we should not expect results or a mindfulness “product.” She went on to give us other ideas to use as a focus: the deep red of fall leaves that correlates with the chakra of groundedness, or the fiery red that corresponds to passion for life and self-confidence. We could also focus on an image from nature, or the words “softer, softer, softer.”
Then she was quiet. The room was quiet. My mind was not quiet: “ ‘Effort,’ I like that idea, just keep putting in the work at all my endeavors, yes, effort, interesting.” Then I observed that I was “thinking.” “Thinking,” I told myself.
I tried to see the two colors of red and feel grounded and self-confident. My mind wandered to an image of a leaf I had seen earlier that day; it had startled me by being so loud just by turning onto another leaf after a puff of wind.
The room stayed quiet. My neck felt tired. I felt tired. I wondered if anyone would mind if I quietly lay down. I decided they would.
I remembered an image I like that I recently cut out from a magazine—a young woman, smiling, her arm draped around her painted self-portrait (with the help of Photoshop). My words for that image have been “Here I am; I am good.” I want to be her: solid; self-confident; with an inner self that she herself has created that goes with her throughout her day, unchanging, no matter the circumstances. I stayed with this image for a few minutes.
I continued to move from image to image, occasionally saying the words “softer, softer, softer.” These words were soothing.
Then the session was over. I walked home and Ms. Anxiety swept into me like a Nor’easter. At home I stared out my window at the crescent moon’s light.
No results? Perhaps what the meditation leader meant by the words “effort” and “labor” was “engagement”—that engaging with any activity, including mindfulness meditation, is accepting, not resisting the activity. I stared at the moon and thought, “I will continue this labor as best I can.”
Ha! I’ve just spent 2 hours playing Freecell on my computer. The images from last week’s meditation session have grown pale. Today was an anxious day and “engagement” seemed impossible. I know the labor takes practice (as in, it must take place). I am resisting.
But: Begin again. Loud leaf. Quiet night. Re-engage to groundedness and self-confidence. “Here I am; I am good.” Softer, softer, softer.
If I said it once, I'll say it again: I am STOKED about tomorrow night's twitter chat. We have the pleasure of chatting with Michelle May, author of "Eat What You Love, Love What You Eat: Break the Eat, Repent, Repeat Cycle" and creator of "Amy I Hungry?". Michelle is a motivational speaker and guru of mindful eating. So we'll be discussing principles of mindful eating as well as how that relates to eating disorder recovery. HOWEVER, you don't have to have an eating disorder to benefit from this fantastic chat.
If you're new to Twitter, here's a primer on how to participate. It's simple, go to www.tweetchat.com and enter the keyword "endED" and it will appear as if you're in a chat room. Watch the tweets stream live and join in on the conversation.
Here are the questions we'll be chatting about tomorrow evening, 8:30 EST.
1a. How do you define mindful eating?
1b. Some people think that dieting is “mindful.” What do you think?
2a. People sometimes resist mindful eating; how do you introduce this concept?
2b. What is a simple way to help someone become more mindful about their eating?
3 How does mindful eating help with yoyo dieting and disordered eating?
4 Can mindful eating help when there are specific medical issues like diabetes?
5 How do you get people to buy into the concept of mindful eating?
In March I attended the BEDA conference and had the pleasure of hearing from and meeting Sunny Sea Gold. Sunny currently works for Redbook, has written a book for girls struggling with binge eating “Food: The Good Girl’s Drug”, maintains her blog, has recovered from her BED herself, and is a rock star “recovery warrior.”
Her book is truly inspiring and I highly recommend to clients struggling with binge eating disorder and emotional eating. Her honesty, warmth, life experience, and practical advice shine through the pages. She fills a vital niche for women (especially young women) struggling with food and their body. Please check it out.
Sunny was gracious enough to do an interview with me. She is a busy lady and I’m no New York Times reporter. But she is passionate about sharing her story and providing the kind of hope all women struggling with an eating disorder truly need. I hope my words convey the genuine care and intelligence that Sunny exuded over the phone. Enjoy, comment if you are so inclined, and share the love.
Sunny, sharing the story of your eating disorder and recovery is a pretty bold thing to do. What inspired you to share your story?
At 15 I realized that something was wrong with the way I was eating and treating my body. And when I realized what that something was (at the time we called it compulsive or emotional eating) I knew without a doubt that I wanted to tell other people about it.
In the early years of my struggle, the help available was good but the books were aimed at grown-ups. Geneen Roth’s work helped but it didn’t always resonate, because she was speaking to an older audience. During my recovery I had periods of utter hopelessness but somewhere deep inside I knew it would be better. I knew that when it did getter, I would share my story with the girls who haven’t heard about recovery in a way that is relatable.
In my early 30’s I started doing some research and I couldn’t believe this type of a book hadn’t been written yet. This fact encouraged me all the more. As I developed my book proposal I created the HealthyGirl.org website to get the word out. I was surprised at how quickly readers started engaging. While there are a lot of great websites and resources out there, there seems to be something very powerful about hearing from someone who is recovered and is talking about it.
Recovery is a hot topic. How have you defined it for yourself?
Full recovery was an intimidating idea for me early on. In my early years, I thought full recovery was never binging again. But when I got further along in my recovery and was binging so rarely and the binges were so small I considered myself recovered from BED. I no longer had an active eating disorder. I was no longer using food to cope. Now, I can’t even recall the last time I binged. In fact, I totally agree with the post you wrote about recovery. I can’t believe how normal I am with food and weight. Even my Mom (who has never had an eating disorder) can’t believe I can have chocolate hanging around the house without eating it.
Your recovery was a 15 year journey. What were the 3 most important factors in your recovery?
I worked very hard in my recovery and there were a lot of things that were important along the way, and I talk about them all in the book. But the top three contributors to my recovery were:
2. Self-Help Books
3. Support Groups: I attended a binge eating disorder support group for three years
Most people with BED also struggle with their weight. Do you think it’s possible to focus on weight and eating disorder recovery at the same time?
I really feel that focusing on recovering from the eating disorder first is extremely important. Dieting can actually “pull the trigger” and derail the recovery process. However, after I recovered from BED, I did make changes to my diet to facilitate weight loss. It happened but really slow. I did have to repair my relationship with food first.
It’s often said that a better body image takes longer than eating disorder recovery. What do you think?
I have a neutral body image. I can appreciate things about myself that are attractive but it’s just not that important to me anymore. During recovery something switched. A lot of the messaging I got as a child was that the way I looked (ideally thin) was the most important thing. Through therapy, I was able to replace those messages with messages I truly believe and value. The self-esteem work I did in therapy was pivotal. Another turning point for me was when I stopped dieting. I realized that if I became neutral about my weight I could be neutral about my body. It didn’t mean I loved the way I looked all the time but I didn’t obsess about it either. Another really important part of improving my body image was buying things that fit. It was important to feel good in my clothes no matter my size. And as I recovered my body got smaller and that was fine too.
What are the myths about improving body image?
One myth is that if you stop obsessing about your weight you’ll be stuck in a body you dislike. As you recover, your expectations will loosen and your body changes. As you continue to nourish your body, it will start to trust you and get to a more natural weight for you.
Binge eating is more prevalent than anorexia or bulimia but it doesn’t seem to be talked about as much. Why do think that is? What can we do about that?
I used to feel angry that it was being ignored—I believed that BED was less talked about because it’s simply not glamorous. Binge eating can be seen as weak, sloppy, and out of control, the antithesis of the values of our culture. While there is truth to that, BED is also truly a newer concept than other eating disorders like anorexia and bulimia. It wasn’t even mentioned in the DSM until 1994. And I know it will take a while for the medical community to catch up. Another factor is that overeating and binging is so prevalent that people just don’t realize it’s a problem. Groups like BEDA are incredibly important as it gives legitimacy to the disorder. Also, sharing stories is incredibly important. That’s one of the reasons why I share my story.
If you had one piece of advice to offer to women struggling with binge eating, what would it be?
Don’t let anything stop you from getting help. It doesn’t matter what steps you take, just that you take them. I used to get wrapped up in making the right choice, the right food plan, the right therapist, etc. it doesn’t really matter as long as you are taking the steps. If something has stopped working for you, try something different. Talk to more people, ask what they did, try what they did. I can attest to the fact that if you keep moving forward one step at a time you can get better. It’s slow at times, and that sucks but it can get better. It took me 15 years! But here I am.
I was recently asked by Nina V, owner of the website www.helpforeatingdisorder.com, to write an article on Intuitive Eating and eating disorder recovery. I recently completed my training to become a certified Intuitive Eating Coach and was thrilled to share my thoughts. Enjoy.
Intuitive Eating is a phrase that is famous among many people hoping to recover from an eating disorder. It’s actually a concept developed by two dietitians, Evelyn Tribole MS, RD and Elyse Resch MS, RD. My goal with this blog post is to accomplish four things:
1. Explain the difference between Intuitive Eating and eating that is guided by an eating disorder (ED)
2. Discuss whether or not it’s possible to recover from an eating disorder by becoming an Intuitive Eater
3. Discuss the challenges of incorporating Intuitive Eating into eating disorder recovery
4. Share some tools to address those challenges.
An eating disorder is, by nature, the antithesis of Intuitive Eating (IE). This page from the IE website summarizes the basic premise of what IE is all about. But when I talk with my clients about the differences between IE and disordered eating, here’s what they tell me.
Disordered Eating is:
• Dictated by rules
• Ignores physical cues for eating
• Very judgmental and associated with feelings of guilt and shame
• Cues to eat or not eat are based on external factors or from the head, not the body
Intuitive Eating is:
• Dictated by whether or not you are hungry or full
• Allows you to enjoy a wide-variety of foods, without guilt or shame
• Cues to eat are largely based on your physical need and cravings for certain types of food
Is it possible to recovery from an ED by using IE?
This is a really great question. And this article, written by Evelyn Tribole, gives a fantastic explanation of how IE can be used in the treatment of an ED. It’s written for clinicians, but I use it as a handout with my clients and highly recommend you read it. Within the article is a table that explains how IE applies to EDs. I explain to my clients that when you are in the throes of an eating disorder, it’s too noisy to hear your health IE voice. So we use a structured eating plan (sometimes called a meal plan) as a bridge to walk you away from your ED and towards becoming an IE. However, the structured eating plan is only a tool to get you from an unhealthy eating disordered place, to a place that you can start listening, trusting, and responding to your body. It’s extremely important to note that the very nature of an eating disorder disrupts your biology. And following a structured eating plan is like using “Control-Alt-Delete” on your body, giving it time to heal and reset it’s natural rhythm of hunger and fullness.
I personally feel that it is extremely difficult to do this on your own if you are in the midst of an ED. In fact, I always recommend that anyone with an ED work very closely with a dietitian that specializes in the treatment of EDs. They can prescribe an appropriate structured eating plan, help you learn to reframe disordered thoughts about your body and food, and guide you to a place of trust between you and your body. It is very very hard to do this on your own.
What are the challenges of incorporating IE into ED recovery?
• In the beginning, your hunger/fullness cueing isn’t reliable or accurate so you cannot use that to guide your eating. While that is the goal of IE, it is not appropriate in the beginning stages of recovery.
• It’s easy to confuse your healthy IE voice with your ED voice, especially early on.
• Years of disordered eating create distrust with your body, and trust is the core of IE.
What are some tools?
• If possible, work with an experienced RD who specializes in treating eating disorders
• Read the article I shared earlier and keep the table of how IE applies to ED in mind
• Buy the book “Intuitive Eating” as well as the fabulous IE cds (which are different from the book). Hold this up as your gold standard ad goal for recovery!
• Don’t go it alone. Support is crucial for recovery and you deserve it.
Last week Harriet Brown was our guest expert for our monthly #endED Twitter Chat. She taught us a lot about family based treatment for anorexia and the important roles that families play in supporting their loved one through recovery from an eating disorder. (If you want to learn more about her story, this is a link to the New York Times article that started it all.)
Below are some of the gems from our chat that I wanted to pass along to you. In no particular order...
- 1. We need more research to assess the experiences and needs of families struggling with an eating disorder. You can help by completing this 15 minute survey online.
3. Feeling confused about family based treatment for eating disorders? This awesome interview debunks myths and sets the facts straight. One of the biggest myths is that you have to be a special type of family to make family based treatment work. But according to this research article, most families can make it work.
4. Another obstacle to making family based treatment work is getting the pediatricians on board. This is a useful guide for community physicians.
5. Want to know what you can do to help your child develop a healthy relationship with food and their body? Banish fat talk, stop commenting on weight and size (it is over-valued in our culture), do not label foods as good or bad and do not use it as reward or punishment, have fun and be curious about food, and appreciate imperfection- it's a part of life!
6. Curious in learning more about family based treatment? Maudsley Parents is your go-to resource.
I hope this summary is useful. Feel free to pass it on and stay tuned for details on our next #endED Twitter Chat.
The goal of #endED is to bring anyone and everyone together who care about ending eating disorders. My hope is to end the silence and myths about eating disorders, create a place for honest and informed discussion, while offering hope and encouragement.