Think, Before Acknowledging

By Michel Harris, RD, LDN, CDE

 One of my clients, who recently achieved her goal weight, arrived to our session looking defeated. She explained that her attempt to donate blood turned humiliating when the receptionist commented on her thin appearance and then announced to the entire room how much she weighed. A second client, who is close to her goal weight, endures hurtful comments from her co-workers on a daily basis. They cannot seem to stop reminding her of how lucky she is to “eat anything she wants and stay so thin.”

The way in which these people behaved towards my clients reminds me of a scene from the movie “Splash.” Darryl Hannah is in a department store purchasing underwear, and the saleslady, while trying to sell her something fancier, commented on her appearance, then said “My daughter-in-law, on the other hand is lucky, she’s anorexic.” For both of my clients, the remarks of others sting because having an eating disorder makes them feel anything but lucky. Just like the saleslady in “Splash,” these comments seem to equate underweight and thinness as a status everyone desires. While they wouldn't be expected to know the circumstances that my clients have faced, they have acted disrespectfully by assuming they enjoy being recognized for their appearance.

You may think that underweight and thin have the same meaning, but to clarify, underweight refers to someone who is not at his or her desired weight for health. A thin person is at a healthy weight but is often viewed as underweight by those who are dissatisfied by their own appearance.

As a dietitian, I have heard just as many stories involving humiliation of underweight and thin clients, as I have of those who are overweight or obese. However, since the media promotes underweight and thinness as the appearance everyone strives for, it is assumed that weight-related comments are welcomed by this population.

When you are about to ask your friend why she is eating yogurt or exercising because she is so thin, stop and remind yourself that she may be struggling with accepting her own body or maybe she is very confident with living a healthy lifestyle. Remember, you don’t know her life story or how she came to her current appearance.

I will close with a line from one of my favorite songs by the artist Monica: “Just one of them days a girl goes through.” While this song is about a relationship in which the girl apologizes to her boyfriend for wanting to be alone sometimes, I used to play this song in my college days when I was having a poor body image day. All of us, despite our body size, have days in which we are uncomfortable with our body. Let’s support each other and acknowledge our non-physical attributes.

Michel Harris is the staff nutritionist at The Awakening Center. She counsels clients individually and in group. Check back on the Calendar page for updates on new groups in 2015. Michel is accepting new clients, so call 773-929-6262 for more information.

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.

Keeping the "Shoulds" in Check

“Life moves pretty fast. If you don't stop and look around once in a while, you could miss it” – Ferris Bueller

I watched this movie recently and it reminded me of several simple pearls of wisdom. We all have a tendency to become too concerned with the “shoulds” in our lives. I should apply for the job. I should connect with old friends. I should get more sleep. I should drink more water. I should be more... I shouldn’t have... the list goes on. We receive a constant feed of friendly suggestions from magazines, the news, and even friends and family. While these suggestions can be helpful, they can sometimes become overwhelming, making us feel we can’t do anything right. If we could just do or fix...whatever...things would become clear or better. The problem with “shoulds” is they get in the way of what we’re doing now and can keep us from living in the present. The important thing to remember is that we are in control of our lives and decisions. Allowing the “shoulds” to interfere with our goals doesn’t encourage us forward and can keep us from really living and deciding what we think is important.

When the “shoulds” start to creep in, take a minute and do a self-check. Is this “should” a manifestation of an outside influence? Is it scary or intimidating? How does your body react when you focus on it? Doing a self-check allows us to focus on one issue at a time, keeping the thoughts from snowballing, and can get us in touch with our true feelings. Is the “should” really important or is it just getting in the way of what we’re doing now?

As Ferris so wisely noted, if we don’t slow down and think about what’s really important, in the present moment, all of those “shoulds” will continue to creep in and cloud what’s really important.

Claire Jolly is an intern at The Awakening Center. She is a student at Centre College and leads the Eating Disorder Drop-In Support Group on Tuesday evenings.

"Pause"

"Pause"

Jolene Hwee, a Practicum Student from Northwestern University, has written the next blog article called “Pause”. Her article reminds me that we live in such a busy world that we don’t often take the time to “Pause” and take care of ourselves for all the little things we need to do, but also all the little things that we know we should do. But it is in those little “Pauses” that can change our lives. October is Breast Cancer awareness month. I encourage all of you, both women and men, to “Pause” and check your breasts. While 80% of all breast lumps are benign, it is with early detection that Breast Cancer is most beatable.

My niece Morgen Paul is doing the AvonWalk for Breast Cancer in Washington DC in memory of my sister Terri who died in 2003 after a courageous 10 year battle. If you would like to help find a cure for Breast Cancer, please consider donating to a member of her team: “Terri’s TaTa’s”. Click on this link: AvonWalk for Breast Cancer: Terri's TaTa's

Namasté,
Amy Grabowski

“Pause”

This summer I became a mother.

My life changed in every way possible. I was thrust from a world of books and clinical training to one filled with diaper changes, burp cloths and 3am feeds. Overnight, I became severely sleep deprived, physically exhausted and mentally overwhelmed. I was suddenly responsible for a tiny human being who was dependent on me for her every need, and although this responsibility was often a joy, it also filled me with wordless anxiety.

Maybe you have also experienced a change in your life- the loss of a friend, a new job, moving cities, marriage, graduation, a change that fills you with a kind of suffocating, racing anxiety that you can’t get away from. Maybe you experience sleepless nights, hectic days, and a constant wondering “How can I stop feeling so anxious? When will I ever stop worrying?”

I have found that it is precisely during these intense, anxiety-filled days that being mindful is necessary, but oh so difficult.

Mindfulness is “awareness without judgment of what is, via direct and immediate experience” (Cindy Sanderson, PhD). You are being mindful when you listen to a song and experience every note, when you make some tea and take time to smell its aroma, when you dance without self-consciousness and when you notice the colors of the sky during sunset.

Mindfulness is meeting every moment of life in the present, with complete awareness, and suspending our judgments, whether positive or negative. Unfortunately, the world we live in does not encourage mindfulness; we are expected to be multi-taskers, to do two or three or four things all at the same time. Most of us have two or more pressing responsibilities, work, school, family, friends, that constantly demand our attention. We admonish ourselves for not doing what we ‘should’ and doing what we ‘should not’. We often spend our time planning the future or ruminating about the past, rarely appreciating the present. We move through life with breakneck speed, asking, “What’s next?” instead of savoring what is now.

When anxiety overtakes us, the ‘shoulds’ and ‘should-nots’ may seem even louder. They can easily drown out our sense of self, rock our sense of equilibrium and steal whatever sense of peace we may feel. It becomes easier is do things on auto-pilot, to stomp through life, to hastily tick things off our lists, and hope that somehow, someday, that anxiety will go away.

But will it?

This is what I want to suggest; instead of hitting the fast-forward button, why don’t we try to hit pause.

Pause, and breathe. Pause, and feel. Pause, and savor.

Maybe, just maybe, if we slow down and take the time to live in this present moment, life and all its demands will be that much more manageable.

For me, being mindful is learning to be with my daughter without thinking about my work; and to be at work without worrying about my daughter.

What does being mindful mean to you?

Jolene Hwee