Thursday, December 31, 2015

Throwback Thursday: Finding Your Tribe

Originally published on 12/10/2014

By Erin Diedling, M.Ed, LCPC


Recently, I was invited to a retreat. I didn't know anyone attending, including the hosts who invited me. I knew very few of the details, and after I booked my travel arrangements the dates were changed. It was getting weird. At that point, I thought about not going. But my gut said “GO.” I checked in again and considered the outcome of going versus not going. It still said “GO GO GO!” Now I know why. Something about this group of strangers gathering to focus upon spirit and to heal together pulled at me.
            This group of healers were from around the globe, and each brought a special unique healing gift. All the gifts were different. We exchanged modalities and taught each other. At the meditation center, we sat under the majestic redwood trees and exchanged stories until late at night. It’s still unfolding. The relationships, transformation, and the experiences that were shared. The sense of belonging and connectedness. It was profound. My spirit got giddy to be around this group. We stay in touch and feed each other with strength and connection. It’s like push pins on a globe that light up when we video chat.
            Then I came home and was so excited to share the transformation with my colleagues and clients. I realized I had a work tribe. I get to work with a crew of unbelievably talented practitioners. We get excited to see each other in the halls and trade stories and support each other’s work. It’s kinda magical.
            I’m blessed. I have a tribe. I have many tribes.
            So often in our work at The Awakening Center with complex trauma, eating disorders, high anxiety, and so forth, clients are isolated. The biggest difficulties many of my clients face are loneliness and isolation. People can experience that in a crowd or at home alone. I know that seeking company is risky for some. It can be uncomfortable. And I’ll admit, I can be an extrovert when I want to (or when I need to be). Introverts can have a tough time taking advice from an extrovert because their fear is overlooked. I want to acknowledge your fear. It’s risky. You can get hurt. There’s a deep longing to connect without the means or the understanding of how.
            So I will ask, where are the invites? Is there an interest you have that pulls at you. Is there and alumni organization, cultural club, business group, and on and on?
            I urge clients and friends to seek out their tribes when they’re feeling lost. Author and spiritual leader Rob Bell said, “If you’re feeling your world is too small or if you’re feeling stuck, then make your world bigger.”
            Is there a tribe that is inviting you? Is there a tribe that calls you? If you have to convince or campaign for it, it’s probably not your tribe.
            Or, consider the tribes that are inviting you. Are they appealing to you? Do they freak you out and make you want to run? Probably not your tribe. Sometimes it’s like the Hans Christian Andersen tale of the Ugly Duckling. He can’t see its own beauty. He thinks he’s a duck who looks different from other ducks. It takes a couple of mated beautiful swans to initiate the naïve swan into the tribe. “Look at you at your grace and talent, where have you been, we’ve missed you, come swim with us.”
            Sometimes our biological families are our tribes. Other times we create a family out of friends, coworkers, places of common interest, the art studio, volunteer organizations, places of worship, or institutions of learning.
            Please respond, and let people reading this blog know where you find and have found your tribe. Where do you get a sense of belonging? And how do you invite others to join in? Thanks for reading this. I’m grateful for your participation.


Erin is Director of Trauma Healing and Sr. Staff Therapist at The Awakening Center. She completed an advanced 3 year training with Somatic Experience Trauma Institute (SETI). She does body-centered psychotherapy, teaches meditation, and leads the Somatic Experience–informed trauma group at The Awakening Center. She periodically teaches her signature Design Your Life Workshop. She specializes in treating complex trauma, eating/anxiety disorders as well performers and artists. Erin dances, paints, and writes in Chicago. 

Monday, December 28, 2015

Meditation Monday: A Story Left


 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 nancyhalltac@gmail.com

In the Tuesday night meditation group, I like ending the practice with a poem. I feel like this gives the right brain a little bit extra to chew on even when the meditation is over. In the most recent group, I shared the poem “Deciphering the Alphabet” by Francine Sterle. Descriptions of animal tracks, weather, and terrain remind us that our lives are always changing. This is the good news and the bad news. Whatever is happening now—joy, suffering, pain, happiness—only exists in the present and will eventually become something different. Perhaps the joy will become deeper. Or hopefully the pain will subside. But the sweet may turn bitter.

This is the double-edged sword that can both encourage and undermine hope. We do have a say in this process though. We are not simply passively waiting to see what shape our experience will take. Our suffering can either deepen or be relieved because of our choices.

About halfway in the poem is this stanza that I was particularly struck by: 
Everything that moves leaves a story. No story
            can exist by itself.
 Upon the first reading, I misread the first sentence as “Everything that moves has a story.” But notice Sterle uses the word leaves.

This critical stanza places the impermanence of nature within a context—we are not alone. Everything that moves—which is, well, everything—leaves traces or remnants. Our actions affect others—thus the importance of the word leaves.

Our experience of meditation parallels this poem. It differs each time we close our eyes and begin deeply breathing; and the practice may change from moment to moment. But with it, we also create and then leave a story.

As you move through our life, what story do you wish to leave?

Enjoy your practice.



Tuesday, December 15, 2015

What is Recovery? Part 1


by Amy Grabowski, MA, LCPC

I am often asked by my clients, “Is an eating disorder a lifelong illness? Will I ever be better? Will I ever stop thinking about food, eating and weight?”

When I first started my recovery from eating disorders more than 30 years ago, I read everything I could get on the subject. Often, I came across the opinion that eating disorders were lifelong illnesses that could only be controlled and not cured. I went to a 12-step support group that preached that I was ill and would have this illness for the rest of my life; my only hope was lifelong abstinence. This made me feel hopeless and I would think, “Well why bother even trying to recover if I am going to have this for the rest of my life?”

(I have to admit that I didn’t meet another person who had recovered from an eating disorder for several years after I started my struggle to recover. The whole time there was a nagging feeling that I was trying to buck the odds.)

There are two halves to recovery: one half represents making peace with food, eating, weight and the body; the other half represents finding your Self and making peace with your Parts. Having completely recovered from my eating disorder, I can now say that it is possible to recover fully if (and this is a big “IF”) the underlying issues that caused the eating disorder to begin with are addressed and resolved through therapy.

Now there’s the hurdle! Some people get to the point where their food is under “control” and decide that they are recovered, even though they have to “control” it each and every day. They may or may not be aware of some vague feeling of not being at ease with themselves: inner emptiness; lack of sense of identity (“Who am I?”); a feeling of being directionless and lost in life; unresolved anger, anxiety, depression; or a deep unrelenting loneliness and despair that they cover up with their new “control” over food. If one considers this to be “recovered” then yes, eating disorders are lifelong illnesses.

If you fix only one half of your recovery--the eating, food, and weight half--then you will always be tense, on edge, rigid, strained, and uncomfortable. Eating will always be a struggle. To feel what I mean, put your hands together so that your fingertips are touching and your fingers are curved, like you are holding a large softball. (See Figure 1-1.) Pay attention to how this feels. How long could you hold your hands like this? Most people find it comfortable, fairly easy to do. Both hands can relax because they support each other.
Figure 1-1

Now, keeping your left hand in the same curved position, take the right hand away (Figure 1-2). Now what do you notice? Without the support of the right hand, your left hand must tense to keep its position. The fingers may start to shake. Are you feeling pressure in your hand or wrist? Tingling? It would be uncomfortable to hold your hand like this for too long.

Figure 1-2
Bring your hands back together again (Figure 1-3). Notice what happens. The left hand instantly relaxes. It becomes easy again because the two hands balance and support each other.

Figure 1-3
The same is true with the two halves of recovery. If you only fix the eating, food, and weight half, you will be tense and uncomfortable. When your Self and your Parts are at peace then eating, food, and weight can be easy and in balance as well. You need both halves of recovery to relax and feel complete.

“But what about relapsing? Don’t I have to be constantly on the lookout for relapsing? Aren’t I at risk for a relapse if something ‘bad’ happens to me?” Well, that’s a good question and one that again does not have a definite answer. Sometimes I compare having an eating disorder to having a broken leg. If I broke my leg I would have a cast put on it until it healed. At that point the cast would be taken off; the bone would be healed. However if the weather was bad, the bone may ache, but I certainly would not put another cast on it. I would probably just be gentle with it, and take care of it.

Because I have discovered my Self and my Parts are at peace, I consider myself totally recovered from my eating disorder. I do not have to think about my food or eating to maintain my weight. If I find myself thinking about these things, I consider it a red flag and I stop and think to myself, “What needs taking care of that I am not taking care of?”

These food thoughts are a friendly reminder that I am not tending to myself. But because I have learned healthy new ways to cope with life’s ups and downs, I care for myself on a regular basis and so food thoughts are rare. Just like my analogy of the broken leg, there are times when the “weather is bad,” and I have to be gentle with myself. I keep a lookout for what I need and find ways to take care of my needs. But I don’t put the “cast” back on and say I have an eating disorder!

“Have you ever been tempted to revert back to old behaviors?” Well to be perfectly honest yes. Since my recovery I have had fleeting thoughts, but I have not acted on them nor have I wanted to. Even when something terrible happened to me, it was not a struggle to maintain my recovery. Why? Because the underlying issues that caused my eating disorder have been resolved. Inside I no longer feel like the same person I was when I had the eating disorder.

In therapy, if you take a good hard look at what those underlying issues are all about and learn to endure the scariness, discomfort, and anguish of resolving these feelings, then you do not have to use food to cover up these issues. Food becomes, well, food, a non-issue. Food becomes something you eat to fuel your body, nothing more and nothing less. You can enjoy food and eating without being wracked with guilt and self-hatred afterwards. You can eat when you are hungry, eat what you are hungry for, and stop when you are no longer hungry. If one considers this to be recovered then no, eating disorders are not lifelong illnesses.

I will leave it up to you as to whether you consider this a lifelong illness or not. Because ultimately it is up to you as to how far you are willing to take your own recovery. Are you going to stop when your eating is under “control,” or are you going to find the courage to continue until you find your Self and all of the underlying issues are resolved? That will then give you the answer.

If you have comments or questions about this article I would love to hear from you--please make a comment below.

Next week, I’ll write more about the two halves of recovery.
Peacefully,
Amy

*My thanks to Danielle Meyer, MA in Art Therapy, who posed for these pictures.

Amy Grabowski, MA, LCPC is the Founder and Director of The Awakening Center, which celebrated its 20th anniversary last year. She can be reached at (773) 929-6262 x11 or awakeningcenter@aol.com




Wednesday, November 25, 2015

Understanding Diabulimia


By Michel Harris, MS, RD, LDN, CDE
Imagine a mother watching her five-year-old daughter (we'll call her Lisa) wasting away, despite eating larger than usual amounts of food, and experiencing frequent urination. Unfortunately, those were symptoms of undiagnosed Type I diabetes. While this was not desirable, after receiving education, Lisa was able to return to a healthy state because of daily, multiple insulin injections, a well-balanced meal plan, and participation in sports activities.

Ten years later, Mom noticed that once again, Lisa was consuming larger than usual amounts of food, but she assumed it was just a growth spurt. However, when Mom was changing the sheets on Lisa's bed one morning, she found several vials of unused insulin under the mattress. At this point in time, Lisa had been fully responsible for administering her daily insulin injections and monitoring blood glucose levels. When Mom approached Lisa, she got very defensive but then broke down in tears and admitted that she was only taking one-fourth her usual amount of insulin, and sometimes skipping it altogether.

People with diabetes experience burnout in performing daily self-care to manage their condition. But after much discussion, Lisa admitted that she was not taking her insulin to help control her weight. As a teenager, not only was Lisa having to deal with a chronic condition that required a significant amount of attention each day, but she was also faced with the discomfort of normal weight increases during puberty and the pressure to be thin.

You may have heard of bulimia, a condition in which one eats large quantities of food, then purges the calories via self-induced vomiting, laxative use, excessive exercise, and/or diuretics. Lisa is suffering from a form of bulimia called Diabulimia, and her chosen method of purging is controlling her insulin doses. Without going into too much detail, insulin is a hormone produced by the pancreas that is vital in shuttling glucose (sugar) from the blood into body cells after nutrients are digested and absorbed into the bloodstream. Those with Type I diabetes must inject insulin at meals, snacks, and on occasions when their blood glucose levels may be too high. Failure to do so results in weight loss because the cells cannot use glucose for energy and other vital body functions; that excess of glucose is eliminated in the urine and also builds up to potentially life-threatening levels in the blood.

Diabulimia is a serious condition that requires a treatment team including a psychotherapist, psychiatrist, registered dietitian, medical doctor, and endocrinologist. Symptoms to be aware of are

  • Frequent urination
  • Weight loss despite eating large quantities of food
  • Abnormally high blood glucose levels
  • Excessive thirst
  • Weakness
  • Fatigue
  • Inability to concentrate
  • Hiding insulin/purposely not taking insulin

In severe cases, the person may develop diabetic ketoacidosis, a potentially fatal condition in which blood glucose levels become dangerously high. People with Type I diabetes are already at risk for several long-term complications that include neuropathy (numbness and tingling of the extremities), cardiovascular disease, retinopathy, kidney disease, and gastroparesis. Since Diabulimia elevates blood glucose levels, this further increases the risk of developing these complications if treatment is not immediately sought.

While most therapists who specialize in eating disorder treatment are equipped to deal with the behaviors associated with Diabulimia, a registered dietitian with eating disorder experience, and who is also a Certified Diabetes Educator (CDE), should be sought after as part of the treatment team.

Michel Harris is the nutritionist at The Awakening Center and believes in the mindful approach to develop a peaceful relationship with food and exercise in the recovery process of eating disorders.



Monday, November 9, 2015

Meditation Monday: Opening the Heart


 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 nancyhalltac@gmail.com

Meditation often brings relaxation to the body. Jaws and fists unclench; brows become smooth. And something new experiences can happen when the shoulders loosen--the heart opens up.

We often carry our burdens in our shoulders. Without even realizing it, they creep closer and closer to the ears. This tension-related shrugging also pulls the shoulders forward, drawing the area around the heart back. The shoulders bear our burdens and protect the heart.

At the weekly meditation group at The Awakening Center, before embarking on any guided imagery, I take participants through a progressive relaxation of the body. This is so important because if the body is held in a state of “readiness” and hypervigilance, the meditation experience becomes very narrow. We cannot allow our awareness to expand if we’re in a defended posture. Additionally, important information can be gathered by noticing which body parts don’t soften so easily. What is being communicated? What needs extra kind attention?

When we get to the shoulders, I usually instruct participants to allow them to gently drop down and back. Allowing the shoulders to loosen down releases the burden. Slightly back opens the heart area. While this opening of the heart might be challenging and sometimes downright unsafe in the “real” world, I hope that the group is a safe place to experiment with the experience.

Folks who have experienced hurt and trauma heal through building a sense of safety. Within the group, they can practice opening the heart—even just a little bit—without worrying that it will be stomped. They learn to trust their instincts and can begin opening the heart to loved ones—and even to themselves.

Enjoy your practice.



Monday, November 2, 2015

Meditation Monday: Listening


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 nancyhalltac@gmail.com.

The human brain is a wonder. With it, we can do algebra, learn to drive, and figure out how to make cauliflower palatable. But so much of our energy is taken up by the thinking part of the brain. Rumination. Worry. Obsession. Thinking becomes a dream-like state. A trance.

This trance can become a barrier that isolates. Our ability to take in data becomes impeded. Our bodies from the neck down seem separate from our minds.

Meditation can help us awaken from that trance. By breathing and intentionally connecting to the sensations in the body, we begin to gather new information. Your thinking part may tell you that going on that second date is a good idea, but in the meantime, your stomach is in knots.

Psychologist and meditation leader Tara Brach teaches that the first step in opening up the experience is to listen. Listen not only with the ears but with the whole body. Allow yourself to receive the information that is churning through your body from the inside out. 
  • Listen to sensations: Is there twisting, tightening, loosening, fluttering, and so forth?
  • Listen to emotions: Happy, sad, afraid, angry? How are these emotions expressed in the body?
  • Listen to the sounds actually present: What sounds are in the room? Outside the room? Notice the space between sounds. Receive sounds that are actually present instead of listening to the chatter in your head. 

We have so much information available to us if we just listen fully. This is not easy, I know. Thinking and ruminating can be a defense mechanism for some. Trauma or intense emotions can make listening to the body feel unsafe. It’s OK to go at your own pace—start small by checking in with one neutral part of your body. Feel your feet against the floor. Listen to the sounds outside for 60 seconds.

Take these steps with gratitude.

Enjoy your practice.



Monday, September 21, 2015

Meditation Monday: Grappling with Forgiveness



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 nancyhalltac@gmail.com

Psychologist and meditation teacher Tara Brach, PhD, writes extensively about forgiveness, a topic I’ve had a hard time really understanding. It’s not that I don’t believe in it or accept its value, I just resist the notion that forgiveness is easy to experience. But Tara’s writings and guided meditations help provide an entry point.

Tara starts with bringing a mindful attention to the heart area. She asks us to become aware of the state of the heart right now—the felt sense and direct experience of sensations at the heart. What is present in that moment? Openness? Tightness? Numbness? The idea is to become aware of the sensations around the heart without judgment.

We can then begin to explore how the heart is connected to our own sense of being and how we feel connected with others. Do we have a sense of belonging?

You can bring to mind a few key people from your life and sense the degree of connectedness or separation that you are aware of. Tara posits that the gateway to unconditional love is to begin to investigate where we’ve created separation in our lives. What allows us to include or exclude others from our hearts?

A path to allowing the heart to open is through forgiveness. A forgiving heart can let go of the armor that sustains separation.

Forgiveness is not saying “what you did was OK.” You might decide to never see someone yet not exclude him or her from your heart. Forgiving is the movement of your own heart from past to present.

After becoming present with the state of the heart, you can then reflect on where you feel unforgiven by others. Whether intentional or unintentional, we have all acted or spoken in ways that left others feeling unseen. In reflecting on these situations, we can give the wound our attention. We can allow the other person’s hurt to register. And then we can ask for forgiveness.

“I see the pain I’ve caused you now and I ask that you forgive me.”

Tune in to whether you will allow yourself to feel forgiven. Is it possible to receive forgiveness? Where are you having a hard time forgiving or accepting yourself for something? See if you can sense underneath whatever feels unforgivable to see what was driving you. Fear? Confusion? Hurt?
See behind the action with perspective. See vulnerability or suffering that might have led you to cause suffering. When you sense that, begin to offer yourself forgiveness in the same way.

“I see and feel the pain I’ve caused myself and I forgive myself.”

Many find that when they stop punishing and blaming themselves, they begin to see the causes and conditions that cause suffering.

Widen the circles of forgiveness to include someone you feel has hurt you. Every one of us has felt betrayed, violated, rejected. Sense where this is true for you and where your heart is feeling armored.

Forgiveness can be a lifelong process, and yet in any moment that we enter with sincere intention, the armor begins to crumble. Depending on the violation or your feelings about it, you might want to work with your therapist so that you feel safe and grounded. But you can allow yourself to see the person and the offense; you can see your wound and lean into that pain with kindness and tenderness.

Sense the compassion that is holding your own heart and then widen your perspective so you can look with clear eyes at the person who hurt you. See if you can look past the mask to see the hurt or fear that might be driving him or her. Your deepest wisdom knows that when we’re not suffering, we don’t cause suffering. Sense the possibility of extending forgiveness.

“I see and feel the pain you’ve caused me and I forgive you now.”

If you’re not quite ready, you might say something like “it’s my intention to forgive you.”


Tara Brach helps explore forgiveness without minimizing or suppressing the wound. We actually have to open our hearts to the pain to create space for forgiveness. And I find comfort in that paradox.

Monday, August 31, 2015

Meditation Monday: Replacing Illusions with Values



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 nancyhalltac@gmail.com

When we examine our coping behaviors, how many are truly reliable? Or even actually helpful for that matter? We often take refuge in behaviors or habits that we believe give us control or comfort. But when we can step back and connect to our own clarity, we realize that we’re believing in an illusion.

Instead of giving true comfort or control, many behaviors leave behind shame and regret; self-compassion becomes difficult. The need for comfort and soothing remains present and we turn to our old habits. Then more shame, and the cycle continues

But the short-term rewards of unhealthy coping behaviors seem so great; the desire to numb, distract, disconnect, soothe. The needs at the core of these urges are never quite satisfied. Instead, cravings remain, triggering behaviors, triggering more cravings, and so on.

The urges and cravings take up space in thoughts and feelings. As you begin to connect to your deep wise self, what can you place at the center of your life? What gives you true comfort, soothing, peace?

Take a moment and connect to a behavior or belief that has caused you suffering yet it still takes up a prominent position within you. Perhaps it’s not at the center, but it might be a behavior or belief that seems hard to live without

How have you relied on this behavior? Whether it’s an addiction or compulsion, have you clung to it? What are the consequences?

Check in with your body to notice if any tension or stress has crept back in. Re-engage with your breathing—let it anchor you.

Now, take a moment to ask yourself, what matters to you? What inspires you?

Where are you able to experience stillness…compassion…curiosity…peace?

As you experience the calmness of this moment, ask yourself, what can you truly put your trust in? God as you understand? Nature? Goodness of people? Yourself? A combination?

Whatever that looks like to you, allow yourself to connect to that trust. Where can you turn when you suffer? Where do you go to find your values?

Again, there is no right answer. And the image might not be clear—just let the possibility exist. If you are not sure where you can turn to find values or trust, see what it feels like to turn somewhere…even if you don’t have a clear idea of where that is.

This We Have Now

This we have now
is not imagination

This is not
grief or joy

Not a judging state,
or an elation
or sadness

Those come and go.
This is the presence that doesn’t.
--Rumi

Tuesday, August 4, 2015

What Does It Mean to Be Recovered?


By Michel Harris, MS, RD, LDN, CDE
With most illnesses, a person is recovered once their symptoms have resolved. However, with eating disorders, it's not this simple.

For safety reasons, many of the medical symptoms associated with eating disorders must be resolved prior to discharge from an in-patient program. However, even though discharge criteria has been achieved, there is still a lot of work to do. All types of eating disorders are composed of an accumulation of misguided beliefs and behaviors associated with food. In most cases, one has suffered with his or her disorder for years, so it stands to reason that a few months of intense therapy before transitioning to out-patient treatment is not enough time to change all of these beliefs and behaviors.

There are several opinions and science-based definitions as to what it means to be "recovered" from an eating disorder. The results of research studies can rarely be applied to a whole population, and this concept applies to our definitions of recovery; they do not apply to every single person with an eating disorder.

So the question still remains: what does it mean to be recovered? Overt signs include:

Being able to accomplish daily tasks and be productive without obsessive thoughts about food
Going to a restaurant and ordering what he or she really wants, not the item that is the healthiest or safest. Exercising without the main goal being weight loss

I can go on and on, but you get the picture. Each person's recovered state is individualized, and a major portion of out-patient therapy is spent exploring and identifying what that means. Some behaviors that are considered disordered for one client may not be so for another. A good example is food choices. A few years ago, I worked with a client who questioned whether she was recovered because she still did not eat desserts. Further probing revealed that prior to her disorder, she did not have a sweet tooth, but she did enjoy savory snacks. Since she was able to enjoy the savory snacks (among other factors), we concluded that yes, she was recovered. However, the client who enjoyed cheesecake before the onset of the eating disorder and still experiences anxiety when trying to eat a small slice is still in the process of recovery.

You might feel frustrated because I have not provided conclusive and specific criteria for what the "recovered" mean; but each client has his or her own unique recovered state that must be patiently pursued with the help of the treatment team.

One last thought. The surfacing of an eating disorder thought or behavior that had been dormant for years does not indicate a relapse. Remember, years of disordered eating–related thoughts and behaviors can be reversed but are likely to surface on occasion. The recovered person is able to acknowledge when this happens and apply coping mechanisms to resolve the issue.

The important point here is that although it might emerge differently for everyone, full recovery is possible. So go for it!

Michel Harris is the nutritionist at The Awakening Center and believes in the mindful approach to develop a peaceful relationship with food and exercise in the recovery process of eating disorders.

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 nancyhalltac@gmail.com

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 ChicagoNow.com.



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 nancyhalltac@gmail.com.
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 ChicagoNow.com.


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 nancyhalltac@gmail.com

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 ChicagoNow.com.

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 nancyhalltac@gmail.com

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 ChicagoNow.com.

Notes
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.
Namaste.
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.



Monday, May 4, 2015

Meditation Monday: Listening


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 nancyhalltac@gmail.com


I’m often in awe of our problem-solving abilities. There seems to be no challenge or obstacle that we as people cannot overcome. Human beings can be tireless and able to reach amazing heights.

Doing is very important, but we need to remember to keep it in balance. In meditation, we pause to listen.

Listening is a unique activity in that it requires us to receive instead of do. To really listen to a friend or loved one, we have to stop, focus, and closely tune in. We allow the information to flow in, accepting it as it comes. A barrier to listening is often our attempts to formulate a response while the other person is still talking. Or we might be distracted by an opinion or judgment about what is being said.

We fall into this trap with ourselves as well. Meditation helps us listen to ourselves. We can listen to the surface of the body and to the interior of our experience. We listen to our breath. But we also tune in to our relationship to the information that we’re receiving.

Here’s an example. In my inner reflection and listening, I might notice that I am hungry. But I might resist this information, telling myself that I had a substantial breakfast so I shouldn’t be hungry. I might tell myself that my hunger is a sign of weakness. Or I might just tell myself that it’s time for a snack. Often our resistance or acceptance of our experience informs the emotion that is then experienced.

In the practice of meditation, we listen at different levels. We attend to the specific experience and then notice our thoughts or feelings about that experience. Think of it as the meta-commentary that runs through our minds.

By anchoring ourselves in our breath and learning to allow our experiences to simply exist, we begin to dismantle that resistance.

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 ChicagoNow.com.