Tuesday, November 19, 2013

Recovering The Sense of Self

Recovering The Sense of Self
Amy Grabowski, MA, LCPC

Editor's Note: Amy is in the process of writing a book about recovering from eating disorders. Occasionally we have printed excerpts from it. This is the beginning of a chapter about finding the sense of Self. You may want to read some previous excerpts on our website.

"Over the weekend, I went to an office party with my new boyfriend. It was the first time that he was introducing me to his friends and boss. He seemed really nervous and kept going into other rooms, just leaving me sitting there all alone. The critic in my head kept screaming at me, 'You're so fat that he can't stand to be seen with you! You are such a loser that he's embarrassed to be with you.' I could hear it but something different happened this time. Deep inside I felt something, not a voice but just a sense of knowing that the critic was wrong. I felt OK. I knew that he was just nervous and it wasn't because of me."Ann

Describing the Self is like trying to describe a beautiful color. It is difficult to put into words. But like recognizing the beautiful color once you've seen it, when you recover your sense of Self, it will feel familiar. Amanda described it well, "It's like trying to remember a song you've heard only once. But if you hear it again you remember it. And if you hear it again and again, over time you can sing it to yourself whenever you want."

The familiarity is because you were born with a sense of Self, and you were very expressive of your Self from age two or three on. Now, your Self is there hidden away below the surface; it may be covered in layers of defenses and "old trash", but it's there. Remember the analogy from chapter 2 about the President of the US being hidden away if the country were in attack? For whatever reason, in your personal history, it was not safe for you to be in your Self and your Self was hidden away for safekeeping. For some of you it was a constant gradual daily wearing away of your Self. For others it may have felt more like an explosion! 

Some of you remember feeling good about yourself until puberty, and others say they felt bad before they even entered preschool. It doesn't really matter how or when it happened, the effect was the same.

Speaking of puberty, there have been a number of studies and books written about the dramatic change and loss of self-esteem when girls reach early adolescence. As Mary Pipher writes in her book, Reviving Ophelia: "Just as planes and ships disappear mysteriously into the Bermuda Triangle, so do the selves of girls go down in droves. The crash and burn in a social and developmental Bermuda Triangle." Many of my clients have talked about Junior High School as being the most painful time of their life, like Rachel,"In third or fourth grade, I felt really confident, I liked myself a lot. I was comfortable in my body. I remember having eating contests. Who could eat the most? And standing up on the table and winning the eating contest. And it wasn't a binge! Oh no! I would eat and just forgot about it. I lost her in Junior High School. I wonder where is that person? Where did she go?"

I know what you are thinking, "Yeah, right. Everyone else who reads this book has a Self hidden away, but not me. I'm defective, I'm hopeless." That is just a Bully talking. As you will learn in the next chapter, the Bully is just trying to protect you from being disappointed. For years the parts have organized around a system based on the lack of Self and they are suspicious of any change to this system. They will try to protect the system because they don't trust that the Self will really stay and be there for them. Like the members of an orchestra whose conductor has been absent for a long time, it would take time for them to be assured that she will not leave again. Some of the parts may actually feel relieved that the Self is coming back, but other parts may feel threatened. They may actively try to sabotage this work we are trying to accomplish. (This is another reason to be working with a therapist.)

One of the problems that people encounter when trying to find their sense of Self is that the Self is physically subtle and verbally very quiet - and the parts are physically intense and verbally LOUD! The Self is easily out-shouted by the chattering and clamoring of the parts. As we all know, the squeaky wheel gets the grease - we give our attention to the parts who are the loudest. Often times also, because one or more of the parts are LOUD and very outspoken, they are the ones who you may identify with as being your "self". Because this false-self does not have the qualities of the Self, the mistaken thought of allowing this part to take over and be in charge, may be horrifying.

Sometimes people confuse what I mean by the sense of Self. They think of it as being "in control" or an optimistic cheerleader quality of confidence. While feeling in control and being confident are qualities of your Self, the Self is deeper than that. It is a deep-seated feeling of inner strength and wisdom within. When you are in your Self, you know that no matter what happens you can handle it, you have all the resources you need within you. And from this strength and knowledge, you calmly feel in control and confident.

Almost without exception, when someone doesn't have a sense of Self, they describe an inner emptiness that is very frightening. There is a deep profound sense that something is missing! The emptiness is where your Self is supposed to be. For example if I want to plant a rose bush I have to dig a hole. The hole is where the rose bush will be, the potential for the rose bush. But until the rose bush is planted, it's just a hole. The hole, the emptiness inside us, is the potential where you will experience the Self again. It was there, but now it's concealed and we're going to bring it out of hiding and put it back. One of the best side effects of recovering your sense of Self, is that the inner emptiness disappears! It gets filled, just as the hole disappeared as soon as you put the rose bush into it.

Our goal is to live our life in a state that Dr. Schwartz calls Self Leadership. It would be almost impossible to live our life in our Self perfectly all of the time. When life throws us a zinger, and it will, not because we are weak or defective - but because we are humans living in a human world - a part may react and need help. The Self will compassionately notice, and take the time to attend to her needs. This may mean pulling resources from other parts or from other people who can be trusted. The parts and Self can then return to its healthy new system.

Once you know what it feels like to be in your Self, you will be able to consciously "breathe into" that feeling again and again. It will not come naturally at first. Like learning a new language, at first it will feel foreign, but the more you use it the more comfortable and familiar it will feel. With practice you can become completely fluent. I encourage my clients to practice every day, perhaps starting with a morning ritual that includes intentionally getting in touch with their sense of Self.

Monday, November 11, 2013

Catching the "Uh Oh's"

Catching the "Uh Oh's" 

Amy Grabowski, MA, LCPC

When "Lisa" came into my office I could tell she was very upset. "I don't know what happened. All of a sudden I started eating and I couldn't stop! I just can't control my eating. There must be something wrong with me. My body just can't handle food like normal people do. I need to watch everything I eat. I'm so scared to lose control like that."

Lisa's torment may sound familiar to you. I know that when I was in my eating disorder, I too described binges very similarly. I remember telling my therapist that it was like a wave that just came over me, out of the blue. I was sure that my body was somehow to blame.

Lisa's reaction is typical too. Since she can't figure out what brought on the binge to begin with, she can only try to fix what she is aware of: the food. But becoming more controlling with food and more restrictive in her eating doesn't work; it only makes the problem worse.

So if trying to control the food isn't the answer, if restricting her eating only makes it worse, then what is Lisa to do? Sometimes we have to admit that doing more of the same is not the answer, especially when it always results in the same outcome. In the words of Monty Python, "And now for something completely different.!"

Focusing our attention on what foods Lisa binges on is not helpful. Becoming aware of what happened before the binge is much more constructive. When a client comes to me and says she binged, I help her to understand that the binge is just an opportunity to learn about her self and to become aware of what is going on inside. Most women who have eating disorders are not very mindful of what is happening within themselves in the moment. Most of the time, they are ruminating about the past or worrying about the future. But the present moment is a blank, they are unaware of what they are experiencing in the moment.

To become aware of what led up to a binge I often will help a client "dissect" the binge. I ask them to talk about the 24 to 36 hours before the binge began. We try to recreate what happened in detail: who she interacted with, what she ate, what she was thinking, what she was feeling. I often ask clients, "When did you know you were going to binge? What was the first sign that you were headed for trouble?" Not surprisingly, the majority of the time, clients had an inkling of a sign in advance of the binge. I used to call these signs the "Uh Ohs".

Does this sound familiar? A tiny voice in the back of my head would be saying "uh oh something's wrong" hours before the binge even began. If I didn't pay attention, I would miss it. The voice would then just get louder, "Uh Oh! Something is definitely not OK." If I continued to ignore it or not pay attention it would turn into "UH OH! Do something quick!" But if my unawareness continued, it would soon be, " UH OH! Oh forget it! Too late! Let's eat!"
If my clients become more aware, more mindful they are more able to catch the "uh ohs" as soon as possible, when they are still very quiet voices. When the uh ohs are small, they can be handled more easily than if they are loud and extreme. When I described this to Lisa, she came up with a wonderful analogy that helped her to "see" what she needed to do. (And you know how I love analogies.)

She said bingeing was like going over a waterfall in a small boat. If she was far back upstream on the river and she paid attention to quiet signs (the sound of the waterfall, the mist of the waterfall in the distance, the acceleration of the current of the stream) she would become aware that "uh oh", there was a waterfall ahead. She would be able to paddle to shore to not go over the waterfall. If she was not paying attention or ignored the quiet signs, she would be closer to the waterfall and it may be hard for her to get to shore by herself. When she became aware that "Uh Oh!" there's a waterfall ahead, she would have to ask for help from someone who could help her bring her boat to the shore. But if she still did not pay attention or continued to ignore the signs (which by the way are becoming ever louder and more apparent - UH OH!) she would be so close to the falls that it would be inevitable that she would go over - " UH OH , too late! Let's Eat!!!"

By dissecting a binge we learn what our "uh oh's" are for us: what emotions, relationships, feelings, body sensations, thoughts and events are likely to cause us distress and if not taken care of can trigger a binge. Let's go back and look at what Lisa was dealing with on the day before her binge.

At first Lisa focused on the food aspect of the binge. "I had such a craving for sweets and on my way home I kept fighting off the urge to pull into every convenience store. Finally I broke down and bought a huge bag of cookies and since I knew I was going to get rid of it, I bought some cake and ice cream too." I asked her to think of any associations to the sweets, what they meant to her at that particular day.

"Well, it could be that at a meeting at work today someone brought in a tray of sweets. I wouldn't let myself have one even though I really wanted one." I commented, "I think we just found an "uh oh". But I'm sure there's more to this."

Lisa reflected, "I was really hungry when I binged, because I hadn't eaten much that day. I usually only have coffee for breakfast and a salad for lunch." (Did you just hear another "uh oh"?)

"Tell me about how you were feeling during the day?" I asked. Lisa related, "For some reason, I was a bit on edge ("uh oh") and I'm not sure why. Nothing really happened at work." She had been at a meeting led by her supervisor with seven of her coworkers. She just happened to be the only female at the meeting. At one point in the meeting her supervisor asked Lisa to make some copies even though she was not sitting by the door. "As I maneuvered my way around everyone else's chair to get to the door, I was annoyed that he asked me, a female, to make the copies. The guys who were closer to the door know how to make copies. Why didn't he ask one of them? But I know I shouldn't let it bother me, it's such a little thing." ("UH OH!")

"But it did bother you," I prompted. Lisa's face lit up as she realized, "Yeah! I was mad and felt belittled by him! I tried to make myself feel superior by turning down the sweets in the meeting. But I kept yelling at myself for letting it bother me at all (UH OH!) !"

"Is this the first time something like this has happened at work?" I asked.
"Oh no. He does things like this all the time at work. I tried to talk to him about it, but he dismissed my concerns," she replied. Her face became downcast as she realized, "I think I'm going to have to find a new job and I'm scared."

"Lisa, I think we found the biggest UH OH of them all."

As you can see by this example, if Lisa just focused on the cookies she would be missing what really was wrong. She learned how to pick up subtle signals that she was experiencing an emotion that she needed to deal with. Eventually with practice she became more mindful of her internal reactions to what was going on around her. She started making connections between these reactions and feelings and her cravings for binges. Working hard over time, she was able to learn how to handle these events without resorting to food.

Tuesday, November 5, 2013

Mentors, Kids and Advocates

Mentors, Kids and Advocates
Amy Grabowski, MA, LCPC

A Note From Amy: As I’ve mentioned in the newsletter before I’m writing a book about recovery from eating disorders. The following is another excerpt. You can read previous excerpts on our website.

….We all have a Self, a capable conductor, within us. The Self is the part I refer to as “Wisdom”. When we are in our Self, we feel centered and grounded. It is because of this centered and grounded state that we can feel calm and peaceful. An important aspect of the Self is compassion, a loving, empathic nurturance towards ourselves, the parts and others. The Self also feels courage and confidence, and possesses the clarity needed to handle whatever life gives us. Using its qualities of curiosity and creativity, the Self helps the parts resolve any problems that may arise. We are able to be current, to stay in the present when we are in our Self. And through the Self we connect to who we are, to our parts, to other people and to our place in the bigger picture of life. When we are in our Self, we have the capacity for objectivity – the ability to step back and observe our parts, other people, or ourselves, without criticism or judgment.

The second premise is that each of the parts has a positive role in the system. In an orchestra, the tuba’s role is to add depth by contributing low bass notes to the music. Another role of the tuba is to emphasize the beat. While other instruments may also have similar roles, only the tuba can do it in its own unique way. Our parts also have a positive intention behind all that they do. When the parts are cooperative and working together, it’s easy to imagine what the intention is. If we asked the tuba what it is trying to do for the orchestra, the musician would answer, “My bass notes add depth and rhythm to the music. I’m trying to help the orchestra as a whole sound as wonderful as possible so that the audience thinks highly of us.” It’s when the parts are not cooperative and are not working together, or when the conductor isn’t present that the positive role and intention may be harder to find.

Just as musicians are organized into identifiable sections of the orchestra, our parts can be organized into groups as well. It is entirely possible for you to experience one, two, or several parts in each group with slightly different roles. For example, in the Mentor group you may have one who manages your finances, while another monitors your career path.

One of the difficulties of describing each group of parts is making it easy enough to understand without oversimplifying the parts’ complexities. When you read about the different groups of parts, please trust your own inner wisdom. If I say Mentors often feel adult in age, but one of your Mentors feels young to you, so be it – have faith in your own experience. You don’t have to force your parts to fit my description. The descriptions that I give are rough guidelines, not rigid rules.

I’ll start with the parts I call the Mentors. These parts often feel adult in age and are often experienced as cognitions, or thoughts. Their positive role is to manage our day-to-day life while motivating us to learn, grow and to be the best we can be. They possess the ability to organize, plan and problem solve. These parts are very productive and promote “doing”. In the long run, the Mentors want us to find fulfillment and meaning in our life.
But, all work and no play make Jill a dull girl, right? While the Mentors keep us moving forward in life, the Kids make life enjoyable along the way. You know by their very name, Kid parts usually feel young. More often than not, these parts are experienced as emotions and sensations in the body. When in balance and in harmony with the other parts, they feel fun and playful. Your sense of humor comes from the Kid parts. They possess an awe and wonder of life. A deep sense of self-worth, contentment and a love of life can come from the Kid parts.

The last group of parts is the Advocates. The Advocates remind me of adolescents; they bring an enjoyable kind of “spunk” and energy into the mix. These parts can speak to us through our thoughts as well as through our body. The Advocates push us to take care of ourselves, to stand up for ourselves, and to protect ourselves. They remind us to have balance in our lives and encourage our parts to be in balance as well. Remember “all work and no play”? The Advocates also remind us that “all play and no work” doesn’t feel well either. The many roles of the Advocates can be as varied as reminding us to rest when tired or to speak up when someone takes advantage of us.

There is an openness to the relationship between the different parts. The parts communicate freely with each other and with the Self. The parts want the Self to listen to them, it’s important that they feel heard. They want the Self to appreciate what they do for the system as a whole. And the parts want the Self and the other parts to take care of them when they need it.

When the system works it’s wonderful! But when the system doesn’t work, when there is no sense of Self and the parts leap in to fill the void, it’s painful, chaotic and frantic!

Notice I said, “no sense of Self” instead of “no Self”. It’s not that the Self is entirely absent; it’s just hidden away. In another of Dr. Schwartz’s analogies, the Self is like the President of the United States. If the United States were under attack, the President would be whisked away to a safe place for his or her own protection. After the crisis, he or she would return to his or her leadership role and everything would return to normal. So your Self is there somewhere, hidden away for it’s own protection.

Returning to the orchestra analogy, if the conductor of the Chicago Symphony didn’t show up for a performance one day, the musicians probably would perform as professionally as usual. The audience most likely wouldn’t be able to hear any difference. When the conductor returned, the musicians would be concerned and would want an explanation. The relationship between the conductor and musicians would be back to normal quickly.

If the conductor started to miss performances sporadically and was inconsistent at attending rehearsals, the trust between the musicians and the conductor would break down. Some animosity would begin to develop. In the conductor’s absence, sooner or later one of the musicians would take over, “Okay, I think we should all turn to page 34 and start from measure 178. Let’s play it a little jazzier.” Because the musician is not trained to be a conductor and does not have the qualities needed to be the conductor, eventually another musician is going to say, “Why are you conductor? Why aren’t I conductor? I don’t want to play it jazzy, I think it should be more formal!” Since more than one musician may rebel against the pseudo-conductor, we’ve got chaos and anarchy.

When I describe an orchestra without a conductor, in my mind I picture Junior High School band. Without the teacher, some bully will grab the piccolo and throw it in the tuba. There will be some anxious kid saying, “Oh, we should keep practicing anyway. We’re going to get in trouble!” Another student shouts, “Who cares! I never liked you anyway, get out of here!” Then the drums will play as loud at it can to drown out everyone else.

What happened to the beautiful music that the orchestra is capable of playing? It’s lost! They stopped working together; they each have their own agenda that they feel is more important than any other musician’s agenda. They need the conductor, just as our parts need a capable leader to keep them working together. They need the Self.

Without a sense of Self, we feel hollow and empty, directionless and lost. The connection with our parts and with others is gone. This is the void that Emily described so vividly in chapter 1. I’ll talk about what causes the Self to get hidden away in the next chapter. I want to describe briefly what happens to the parts when the Self is missing. It helps if you think of the parts as existing on a continuum, with being in balance (I may even assert that the part is in it’s “self”) on one end of the continuum and becoming more and more extreme in it’s thoughts, feelings and behaviors as it moves away from the Self, towards the other end of the continuum.

For the sake of simplicity I’m going to start with the Kid parts. Since our parts act just like their “real life” counterparts it helps to imagine how real kids think, feel and react. Let’s imagine that something happens that is upsetting, someone gets mad at you over a misunderstanding. Without the Self’s soothing reassuring presence, the Kids feel frightened. Realizing they are alone, that there is no one to take care of them, they become anxious. They don’t know how to handle the situation because they are young and inexperienced. They begin to doubt themselves and feel worthless, “What’s wrong with me? I’m not good enough.”

When the Kids are more extreme, I call them the Exiles. This is because the more frightened and helpless they become, the more the other parts push them away in an attempt to help you to not feel these uncomfortably intense emotions. The Exiles also hold our memories from our past. The more traumatic the memories, the more the other parts try to lock the Exiles away in order to not face the feelings that arise when the Exiles get close to a memory.

Usually the anxiety felt by the Exiles will activate the Mentors who rush in to try to take care of the situation. Because they do not possess the soothing reassuring wisdom of the Self, their care taking is often not what the Exiles need or want. Mentors, when they become extreme, can become the Bullies. As they become more extreme, their behavior and thoughts become more and more critical and judgmental. “Stop being such a baby! No one else is acting like this. What’s wrong with you? Why don’t you just get over it?” They can become perfectionistic, punitive and loud. Again I will remind you that our parts act and react like their real life counterparts. The Exiles, looking for soothing and reassurance, become more agitated and fearful as the Bullies start yelling at them. The Bullies react to this with more perfectionism, which elicits more anxiety, which elicits more perfectionism… Round and round they go. 

Finally, the Advocates step in. As extreme as the other two parts have gotten, the Advocates become extreme as well. Advocates often take on two extreme roles, one of which is the Rebel. They rebel against the Bullies. “If you can’t be perfect, then why bother! Who cares? It won’t make any difference anyway.” Their other extreme role is the Numb-er (as in Numbing). The Numb-er says, “I can take all the feelings away. I’ll make it all better. You deserve to eat this (or starve, or purge, etc. etc.).”

And you know what happens next. The Bullies jump in and berate you for eating (starving, purging, etc.). The Exiles feel even more anxious and worthless. The Rebels and Numb-ers convince you to eat (starve, purge) even more….

The relationship between the parts become rigid and inflexible. When their words and behavior doesn’t elicit the result they want, the parts get locked into just doing more and more of the same. They become even more extreme. They seem incapable of trying anything different.

Establishing a firm sense of Self and getting the parts back in balance, back in their part-self, is the goal of recovery.