Monday, July 27, 2015

Meditation Monday: Embracing Impermanence

By Nancy Hall, MA, NCC, LPC

In an effort to take the “manic” out of “Monday,” this weekly post explores techniques, issues, latest research, and other thoughts on meditation. Nancy facilitates a weekly meditation group at The Awakening Center. For more information, contact her at 773.929.6262, extension 17 or

Sometimes we feel stuck—convinced our suffering will never end. The fact is, our experience is always changing. And even our worst suffering will not—cannot—stay the same. But there are times when we cling to experiences or feelings—we fight impermanence, not wanting to let go. This also leads to suffering as we simply cannot hold onto things that are always changing.
            Change or impermanence does not necessarily mean things are progressing on a straight line. The reality of change is that it tends to be circular, or there is an ebbing and flowing. Sometimes we believe we are stuck in an unwanted emotion or behavior pattern, but if we examine closely, we’ll see there are slight differences—in the behavior, our emotions, our judgments.
            Accepting impermanence allows us to treasure the present moment. Clinging to an experience we simply don’t want to end or despairing that we may emotionally suffer forever takes us out of our bodies and into the trance of thinking. We churn and ruminate. But the world continues to change and evolve whether we notice it or not.
            I created the following imagery to explore the notion of impermanence a bit further.
  • Take a moment and imagine that you are in an orchard of trees—and it is spring time. All the trees are in bloom.    
  • Move in to one particular tree—notice its blooms
  • Notice any emotions or feelings that arise as you look at this flower
  • What does it feel like to enjoy this flower even though you know it will drop and die soon?
  • Now imagine time has passed and the flower has withered and fallen to the ground
  • What emotions arise in you?
  • Does your sense of loss come from worry that you’ll never see another flower as beautiful as this one was? Do you know this to be true?
  • While feeling the loss, invite yourself to connect to gratitude for having the experience of observing the flower. Connect to the hope that spring flowers will come again.

       Accepting impermanence can be the route to hope. We can accept our pain and acknowledge that it won’t last forever—hope can stabilize us as we cope with the reality of our pain. But judgment and self-criticism stifles hope. So it’s important to have a mindfulness practice so that you can catch yourself going down that rabbit hole.
            Whether you accept it or not, change is a part of the human existence. Embracing impermanence can help you be fully present in your life.

Nancy Hall, MA, NCC, LPC is a staff therapist and the intake coordinator at The Awakening Center. In addition to seeing clients for individual therapy, she leads the weekly meditation group and co-leads the Somatic-Experience-Informed Trauma Healing Group. Check and subscribe out her blog “All Shapes and Sizes,” which appears on Chicago Tribune’s media partner

Saturday, July 25, 2015

Understanding Borderline Personality Disorder

By Nancy Hall, MA, NCC, LPC
This article was first published in Nancy’s blog, "All Shapes and Sizes," on January 23, 2015. Nancy is facilitating a workshop on BPD at The Awakening Center Sunday July 26. For more info, email at
For many, getting the diagnosis of Borderline Personality Disorder (BPD) comes as a relief. Finally, something to explain the mood swings, constant fear of abandonment, and relationship challenges. For others, it becomes an obstacle to treatment. Understandably, working with someone with BPD can be quite challenging, and often therapists allow only a few in their caseload. But new treatment approaches and an improved understanding of the disorder are giving sufferers and family members hope.
            According to National Education Alliance: Borderline Personality Disorder, 14 million adults are struggling with BPD. Traits or symptoms include:
·                  Intense fear of abandonment
·                  A pattern of unstable and intense relationships
·                  Unstable self-image
·                  Self-destructive impulsivity
·                  Recurrent suicidal behavior or non-suicidal self-injury
·                  Chronic feelings of emptiness
            Emotions are often intense, and anger can seem explosive and reactive at times. Those with BPD tend to function in the extremes, especially in relationships. He or she might struggle to see gradations in people; a friend or partner will be idolized one day and hated the next. At the core is an intense fear of rejection and abandonment.
            Diagnosis is difficult, especially since BPD tends to co-occur with other conditions, such as substance abuse, eating disorders, or anxiety disorders. And often the individual is consumed with shame, self-hatred, and hopelessness, so seeking help does not feel like a viable option. Additionally, the chaos and drama is often so engrained that it feels like his or her identity. The BPD sufferer cannot imagine who he or she is without those traits or behaviors.
            It has been difficult to pinpoint the cause of BPD. It does seem to run in families, but it’s unclear if that means it has a genetic component or if it is related to attachment issues. Trauma also seems to be a key factor, as 70% of those diagnosed with BPD report a history of physical or sexual abuse. Ultimately, the biological-based temperament + invalidating environment + trauma can all come together to trigger BPD.
            Treatment options are available and are showing quite a bit of success. If you or a loved one is looking for help with BPD, look for someone with training in:
·                  Dialectical behavior therapy (DBT): This form of therapy combines cognitive-based practices with a person-centered approach. Clients are led through a skills-based curriculum where they learn (1) mindfulness, (2) emotional regulation, (3) distress tolerance, and (4) walking the middle path.
·                  Mentalization-based therapy (MPD): The therapists helps clients tell the difference between their feelings or thoughts and other people’s. Folks with BPD tend to see their feelings as “the truth,” and MPD helps them find alternatives to this.
·                  Transference-based psychotherapy: This psychodynamic therapy explores the relationship between the client and the therapist to help work through the emotional instability.
          Families and individuals can find relief from and help for this stressful and emotionally draining disorder. But we all have to work to remove the shame and stigma around BPD. For more information, visit NEA: BPD.
Nancy Hall, MA, NCC, LPC is a staff therapist and the intake coordinator at The Awakening Center. In addition to seeing clients for individual therapy, she leads the weekly meditation group and DBT group. Check and subscribe out her blog,All Shapes and Sizes,” which appears on Chicago Tribune’s media partner

Monday, July 20, 2015

Meditation Monday: How We Make Our Suffering Worse

By Nancy Hall, MA, NCC, LPC
In an effort to take the “manic” out of “Monday,” this weekly post explores techniques, issues, latest research, and other thoughts on meditation. Nancy facilitates a weekly meditation group at The Awakening Center. For more information, contact her at 773.929.6262, extension 17 or

While on a family road trip, I developed a nasty cough. My husband started the trip with a bad cold and he worried that he had passed it along to me.
            “Are you getting my cold?” he asked.
            “Nope. it’s allergies.” I insisted
            The next day:
            “Are you sure you’re not getting sick.”
            “Positive. Allergies.”
            As you’ve probably guessed, I was getting sick. In fact, when we got home, I was diagnosed with bronchitis. But when the coughing started, I did not want to admit that I was sick. I convinced myself that somehow I could will the sickness away. That almost never works.
            I’m not sure if anything would have turned out differently if I had acknowledged that I was getting sick. Would I have rested more or consumed more fluids? Maybe. Did I make myself sicker by not doing these things? Hard to say. But I certainly did myself no good by denying the reality of the situation.
            We create this sort of secondary suffering with emotional pain as well. Someone hurts our feelings; we deny, resist, or minimize our sadness or anger; the pain only intensifies.
            Everyone experiences pain—physical or mental pain. If you stub your toe, you experience physical pain; if someone says something unkind, you experience mental pain. These are examples of primary suffering. We can get caught up in pushing away or avoiding the pain. Maybe we blame ourselves or others. This makes the pain worse, which is secondary suffering.
            What would happen if we accepted the primary pain when it occurs? What if we didn’t get stuck in avoidance or obsession but instead mindfully accepted the pain that is present for what it is?
            When we engage our tools of distraction to control or avoid pain, we increase our suffering because a habit or unhelpful coping mechanism becomes entrenched. We might then have a third level of suffering to contend with—judgments, shame, or anger about how we’re coping. Turning away from pain offers temporary relief—but the return of the pain in some form or fashion is inevitable.
            But what value is there in leaning into pain and suffering? Why should we subject ourselves to that? Because no matter how long we distract, avoid, or detach, the pain and suffering that is part of human existence will remain.
            Confronting and tolerating pain builds hope.
            To do this, you have to let go of the controls. Take your hands off the steering wheel and let the pain be.
            I could not get adequate treatment for my bronchitis until I stopped resisting and trying to control it. It was only then that I could get relief in the form of medicine, rest, and—most importantly—lots and lots of sympathy. And popsicles. 

Nancy Hall, MA, NCC, LPC is a staff therapist and the intake coordinator at The Awakening Center. In addition to seeing clients for individual therapy, she leads the weekly meditation group and DBT group. Check and subscribe out her blog “All Shapes and Sizes,” which appears on Chicago Tribune’s media partner

Monday, July 13, 2015

Meditation Monday: Connecting to and Accepting Suffering

By Nancy Hall, MA, NCC, LPC 
In an effort to take the “manic” out of “Monday,” this weekly post explores techniques, issues, latest research, and other thoughts on meditation. Nancy facilitates a weekly meditation group at The Awakening Center. For more information, contact her at 773.929.6262, extension 17 or

OK—I can hear the reaction. “I thought meditation is supposed to make me feel better! I’m trying to make this pain go away and now you’re saying I have to feel it?!” Yep. I am.
      The first noble truth of Buddhism is suffering exists. Ageing, illness, natural disasters are all part of this world that cause deep pain. But our suffering becomes greater when we resist accepting the pain—when we fail to acknowledge it or we engage one of our tools of distraction to numb or escape from it.
     Dialectical Behavior Therapy (DBTS) offers four responses1 to any problem that arises:
  1.  Solve the problem by changing or leaving the situation
  2. Change the emotional reaction to the situation
  3.  Radically accept the situation and your reaction just as it is
  4. Stay miserable—or make things worse

   The same responses can be applied to suffering. But before we can respond, we need to acknowledge that we have pain. We have to sit with our wounds—being fully present with them. We have to really examine how the wounds have affected our lives and how our neglect of them has created more suffering for ourselves or others.
      Meditation practice can help us be a witness to our own suffering. Given the emotions that might arise during this process, I recommend practicing with a group or therapist. But if you want to start on your own, select a challenging truth in your life that is creating moderate suffering.
  • Bring to mind a situation or challenge that is causing you pain
  • Breathe deeply and connect to where your body is holding on to that suffering
  • What does it feel like? What is the experience for you?
  • Observe and describe without judgment. Just the facts—“I notice my breathing becomes shallow” or “I feel a knot in my stomach.”
  • Notice any urges to engage in distracting behaviors. Again, with compassion. If your mind wanders away from the suffering, that is not a sign of weakness. Reconnect to your breath and return to the image with gentleness and kindness
  • As you observe the wound, offer yourself kind words, as if you were a friend sitting next to yourself: “I see you’re really hurt,” “I’m so sorry this is so hard,” “There is a lot of pain there.”
  • Offer yourself compassion through touch. Place your hand on your heart, gently rub your arm—whatever feels right. These small gestures trigger the release of oxytocin in the brain, which creates comfort.
  • Continue breathing and notice the waves of emotions. Notice how they rise and fall.

      If connecting to any level of pain or suffering becomes overwhelming, it’s OK to back away. Trust yourself. You don’t have to dive head first into the deepest depths of despair. It’s perfectly fine to touch the pain and then back away. This builds mastery and tolerance.
      Some resist connecting to pain because they feel underserving. “Others have it much worse,” or “There are people starving in the world. Who cares about my petty problems?” There is not a finite amount of suffering that is doled out according to your life circumstances. Acknowledging the pain of your own experience does not minimize or take away the suffering of a Syrian refugee. On the contrary. Connecting to our own suffering allows us to feel deeper empathy for others.
      I know this isn’t an easy task, so take it slow. Suffering is inextricably linked to being human. Acknowledging your suffering and then responding to it with kindness creates the space for joy and love to enter. So take some breaths and listen to your heart.
 Nancy Hall, MA, NCC, LPC is a staff therapist and the intake coordinator at The Awakening Center. In addition to seeing clients for individual therapy, she leads the weekly meditation group and DBT group. Check and subscribe out her blog “All Shapes and Sizes,” which appears on Chicago Tribune’s media partner

1. Linehan, Marsha. DBT Skills Training Manual, 2nd Edition. New York: Guilford Press, 2015.

Saturday, July 11, 2015

Contemplating Deprivation and Abundance

By Amy Grabowski, MA, LCPC
In a recent Women’s Eating Disorder Therapy Group, we discussed Good foods and Bad foods. This dichotomy refers to foods that you have permission to eat and foods that are forbidden. When a client says, “I just started eating cookies and I couldn’t stop” I always ask, “When was the last time you let yourself eat cookies?” I predict her answer will be, “I never let myself have cookies.” The more you deprive yourself of a food (or a whole group of foods), the more this food glitters and calls your name. When you finally break down and allow yourself to have it, you’ll go overboard. A Part, whom I call The Child on Your Tongue, says, “You’re going to let me have cookies!? I don’t know when you’ll let me have cookies again, so I’m going to eat them all!”
      This makes sense from your Anxious Part’s point of view. Imagine you are in a refugee camp, and here comes the rice truck. You don’t know if or when the rice truck will come again, so how much rice do you eat? Most of us would eat until it came out our ears. But if you knew the rice truck will return every two hours, you could then eat just enough, knowing that in another two hours you can have more, and in another two hours you can have more, and in another two hours you can have more. You can trust that food will always be there for you.
     A long time ago, the members of the group decided to do an experiment. It took a while, but we finally found a food that no one had ever binged on: tuna. So we said, “Whatever you do this week, do not eat tuna. But on top of that, remind yourself constantly that you can’t eat tuna.”
     The next week, some members said, “That was no problem for me. I don’t really like tuna. I didn’t eat tuna at all—I didn’t want it. I was fine.”
     Another woman craved tuna all week, knew exactly how she wanted it cooked, and where she was going to get it. After the group was over, she had plans to eat tuna. (Did you notice any craving for tuna just by reading this experiment?)
     Another person forgot about the experiment. She went to a restaurant, ordered tuna, and in the middle of the meal realized she wasn’t supposed to have it. She felt so guilty that she thought about not going back to group. She considered lying, “I was fine.” She felt so much guilt and shame she confessed, as if she had smoked crack!
     One person binged and purged tuna several times that week!
So think about it, why did that happened? When we focus intently on something, when we forbid ourselves from having something, the more alluring that food becomes. When a Part of us or an outside authority puts rules on us, “You shouldn’t be eating that!” our Rebel Part is inclined to do the opposite, “You think you can stop me! Well, I’m going to eat it all! You think you can take it away from me! Ha ha! Just try!” Or The Child on Your Tongue grabs it and eats it greedily—just in case you won’t let her have it again.
     The Food Police Part and the Rebel get locked into this circular argument, “I’m going to grab the food out of your hands because you will eat it all.” “I gotta eat it all because you grab it away.” “I have to grab it because you will eat it all.” “I gotta eat it all because you grab it away.” And so on and on and on…
Total recovery from an eating disorder means that you do the work (recover your sense of Self and get your Parts back in harmony so they feel heard, appreciated, and taken care of) to resolve the underlying issues so that eventually food, eating, and weight become non-issues. I tell my clients that we have to take the magic out of Food! and turn it back into, well, food. Total recovery is being able to eat whatever I want without feeling guilt, remorse, despair, panic, or self-hatred. After I eat I forget about it; it becomes a non-issue. I can get on with the rest of my life. Total recovery means listening to my body for what it wants and needs—such as delicious brussel sprouts and kale salad with pumpkin seeds and dried cranberries—while also allowing my body to have fun foods, such a pizza, cookies, or ice cream.
At this point, I usually get quizzical looks, “You mean you can eat ice cream or pizza and not feel bad afterwards? That’s fine for you, but I can’t stop eating! I can’t have those foods. I must be addicted to them.” Part of my recovery process involved learning how to eat like a “normal” eater. Normal eaters eat foods like ice cream and pizza. Normal eaters eat three meals and a snack or two a day. Normal eaters eat when they are hungry and stop when they are full. Normal eaters do not panic at the sight of pizza!
I have a story that will illustrate this concept. When I was in college, I had a friend who would bring a slice of leftover pizza for lunch every Tuesday. At the time, this truly amazed me. For one, the words leftover and pizza never went together in my vocabulary! Second, she brought it EVERY Tuesday! I was dying to find out how she could do this without blowing up like a hot air balloon.
I finally got up the courage to ask her about it—how could she have pizza every Tuesday and feel OK about it? She told me that she and her roommate had a Monday night ritual in which they would have pizza and watch a certain special TV show. They always had leftovers, and so each would take a piece for lunch the next day. At this point I was totally in shock. Pizza on Monday AND enough left over for two on Tuesday! What was her secret? How did she do this? How could she “control” herself having pizza so often?! I don’t know how I asked since I was desperately trying to not let on that I had any food issues. She said simply, “If you knew you were going to have pizza every Monday night for the rest of your life, it would be no big deal to you too!”
That’s it?! I thought there was some wizardry at work here—like calorie-free pizza or eating it with cabbage to take the fat grams away. Nope. She simply had taken the magic out of the pizza and turned it back into, well, food. Wow! I saw a line of pizzas stretching off into infinity! She taught me about the opposite of deprivation—she was talking about Abundance.  
This story illustrates that when we give ourselves True Permission to have a food, we do not have to control it like we did before. Total recovery involves learning how to give ourselves True Permission: “Yes I can have that and I can have it again too.” This is opposed to Sort-of Permission: “Well, OK. I’ll have it this one time, but never again!” (You know the consequence of Sort-of Permission: “Since I can never have it again, I better eat it all and then some!”) The positive outcome of True Permission is that we do not feel deprived and can trust that there will always be enough and that we will always be able to get our share. When we have True Permission to eat anything, we can listen to our body and enjoy nourishing foods without feeling like the fun treats are being withheld.
When we embrace the abundance that is waiting for us, we no longer have to eat as if our favorite treats will be snatched away.
Amy is the Founder and Director of The Awakening Center and for almost 30 years has been helping others get to full recovery from eating disorders. If you would like to inquire about the Women’s Eating Disorder Therapy Group, please contact her at (773) 929-6262 x11.

Friday, June 19, 2015

Yoga: A Journey to Self

 By Annie Felice
 Tadasana: Tree Pose by Sejz Inn
If youve ever taken a yoga class, think back to your experience of Savasana, sometimes referred to as corpse pose or final resting pose. You lie on your back, close your eyes, and relax your arms and legs. Resting like this for anywhere between two and ten minutes, I have experienced the deepest moments of peace, bliss, and wholeness. I used to think that I was simply exhausted after a challenging yoga practice, but now I know why I feel so great in Savasana – I am in Self energy, meaning I have connected to the place inside me that is grounded, calm, steady, core essence.
            How can yoga help you access your Self energy? Yoga is both the practice of acknowledging the parts of you that are present, as well as the practice of separating from these parts and helping them return to balance.  The most frequently out-of-balance part that I encounter in my clients is a Critical Part. Nearly every single one of my clients has an Inner Critic, a part of their personality that is rigid and very demanding of perfection. Yoga challenges our perfectionistic, judgmental parts who tend to see things as black-or-white and have strict standards that must be met for us to be "good enough." In yoga, there's no such thing as perfecting a pose, and it “counts” as doing yoga whether you stay in childs pose the entire time or balance on one finger tip.
            Practicing yoga also challenges our Distracting or Numbing Parts. We all have parts who try to prevent us from thinking about or feeling uncomfortable thoughts or emotions. Something unpleasant bubbles into our consciousness, and BOOM, a part of us tells us to drink, eat, shop, sleep, zone out on our cell get the idea. Yoga encourages us to literally and physically stay with the uncomfortable, by holding poses that are challenging. Our inclination is to hold our breath, clench, resist, and tighten when something is uncomfortable, but that only makes the uncomfortable more uncomfortable. Yoga teaches us how to find comfort in the discomfort—through breath, acceptance, and trust that the discomfort is temporary.
         With our parts in balance, we are able to connect with Self energy. That place of peace, wholeness, and connectedness is always present; it's just a matter of remembering that place is within you and creating the space to access it. Whether it's yoga, meditation, petting your dog or cat, walking in nature, listening to music...I encourage you to find something that helps you connect with your Self energy. 

Annie Felice, MA, LPC is a staff psychotherapist at The Awakening Center. She specializes in the treatment of eating disorders and body image issues, anxiety, depression, grief, and relationship issues. She has specialized training in Internal Family Systems which is informally known as "parts work."

Monday, June 1, 2015

Moving from Body Hatred to Body Acceptance

“Woman Standing” by Gaston Lachaise
By Amy Grabowski, MA, LCPC
Nothing makes me cringe more than when my clients berate, disparage, or verbally abuse their bodies. I see kind, caring, empathic, compassionate, creative, and intelligent people who are beautiful inside and out—and I HATE that our current society makes them HATE their bodies. .
It is said that 85% of what we look like is determined by genetics. I often ask clients to bring in pictures of themselves from their childhood. During our first sessions together, “Ruth” told me she had a weight problem as a young child, so when she brought in family pictures, I expected to see an obese little girl. To my surprise, Ruth looked absolutely normal weight to me. (This is more common than you think!) When I expressed this to Ruth, she was unable to see it. Looking at the same picture she said, “Can’t you see how fat I was?! I am so much bigger than my friend!” Ruth was almost a head taller than her friend, but I still did not see a fat child. In fact I was concerned for how frail her friend looked.
Then Ruth showed me a picture of her whole family together. In the picture I noticed how close her parents and her older sister were, while Ruth stood apart from them. Ruth and her father were both very tall and broad-shouldered, while her sister and mother were short and small-boned. In fact, her mother looked emaciated! When I commented Ruth replied, “My mother never ate anything. She was always dieting!” No wonder Ruth hated her Body—she learned at a very early age that her Body was (genetically) too big for the image her mother held for her.
Studies show that twins separated at birth look more like each other than the families they grew up with. When we look in a mirror, we may see similarities between our features and our family members’; I have my dad’s nose, my mom’s jawline, and, yes, my grandmother’s hips. But like Ruth, we mistakenly think we should be able to totally control the proportions of our bodies. We accept that people come in many different heights, and we don’t think that those who are shorter or taller than average “are doing it wrong” or “have let themselves go.” Imagine your doctor telling you that you are “overheight” and need to lose two inches!
Of course your doctor may be hounding you to lose weight, which just adds ammunition to your Body Hatred arsenal. But studies have found that people who were overweight, but not obese, were actually 17% less likely to die than those of normal weight. And individuals who were underweight were 73% more likely to die than those of normal weight. 1
So, I like to ask my clients, “If you spend today loving your Body, accepting your Body, or hating your Body, how will your choice effect your day?” No matter what you choose to do, there are no “do-overs.” You don’t get to re-do today if you didn’t enjoy how it felt to to hate your Body.
Did you spend today hating your Body? Maybe it’s a beautiful day, and you’d love to walk on the lakefront path to watch the sailboats on Lake Michigan. But did you keep yourself isolated in your apartment because you’re afraid people will look at you and think you are fat and ugly?
Or maybe you were invited to a friend’s party and you know she throws great parties! Did you keep yourself isolated in your apartment because you’re afraid people will look at you and think you are fat and ugly?
Perhaps you considered relaxing and going shopping at your favorite mall. Did you keep yourself isolated in your apartment because you’re afraid people will look at you and think you are fat and ugly?
So many missed opportunities because we fear what others will think about us! It’s a shame because the life you are missing is yours. And you don’t get to re-do all these opportunities later!
So how do you begin to accept your Body today? I encourage my clients to begin each day with the affirmation: “This is the Body I have today. And I look fine [or okay, good enough, acceptable—whatever word works for you].” Live today as if you believed this statement, because I guarantee you, no one is as negative of your Body as you are.
If you look up fat in a thesaurus you will the word large. If you look up large you’ll get grand. If you look up grand you will get splendid! How would life be if we all thought of our Bodies as splendid!
What constructive words can you find to describe your Body? When I think of my Body as strong and stately, I notice I automatically stand up a bit straighter and feel proud! Play around with words until you find some that feel more accepting, even if your Body doesn’t look like you want it to today.
You may want to surround yourself with beautiful pictures of people of all sizes. Go to an art museum and wander through the galleries. Buy a postcard of the painting or sculpture that makes you feel the best; hang it somewhere you will see often. For myself I love the statue “Woman Standing” by Gaston Lachaise. Her Body looks both graceful and strong—and look at her powerful muscles. To me she looks like a proud woman who is not going let anyone disrespect her or her Body. How splendid is that!
I hope some of this helps you move from Body-Hatred to Body-Acceptance to Body-Appreciation and eventually to Body-Love!
Amy is the Founder and Director of The Awakening Center, which celebrated its 20th anniversary in 2014. She is working on a book about recovering from eating disorders.


Orpana HM, Bethelot JM, Kaplan MS, Feeny DH, McFarland B, Ross NA, “BMI and Mortality: Results from a National Longitudinal Study of Canadian Adults,” Obesity (Silver Spring), Vol 18, Jan 2010, 214-8.