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.

Falling Apart: Erin Diedling

Falling Apart

By: Erin Diedling

Falling Apart, Coming Unglued, Becoming Unraveled…It’s Good Stuff. No. really.

The idea of it sends most people running, saying uncle or plugging their ears. But it is also an act of being. An act of bravery. I speak from the front lines.

I have the great privilege to work with the brave clients who seek help in dealing with a binge-purge cycle, ADHD, OCD or the myriad other smart ways their nervous systems attempt to right the proverbial ship. I find that these clients use these tactics because they are simply looking for a way to defend against what may feel like a greater emotional pain. It’s actually quite intelligent of the body and psyche to defend against what feels scary and overwhelming. They may fear that if they don’t defend against the overwhelm, they may fall apart. But don’t underestimate the power of coming unglued…the genius of falling apart.

This is usually the difference between a client who goes away to treatment and a client who tolerates the suffering so as not to go away to treatment. That’s what treatment centers are FOR – for clients to fall apart and to have multiple safety nets in place as they do fall to pieces. It is the grateful kind of falling to pieces.

Most of the work I do in a private practice setting, while working with trauma, eating disorders and blocked artists/creatives has to do with controlled little-falling-aparts. Clients keep it together during the week and then come the weekly appointment, in a safe incubator they fall apart a tiny bit in session, do some psychoeducation, and get back on the road of day-to-day life armed with new tools and skills.

In our offices, at The Awakening Center, in a quiet, non-shaming and safe way, we hold a space for clients to gently sink into and feel those emotions. We invite them to sense inside and find a voice, an image, a color, a sense, an expression for that small quiet or scared part to speak up, to be scared, and to get the comfort – to FEEL the comfort and finally get what she needed, even if it is 20 or 30 years after the scary, annoying or triggering incident.

Sometimes it is in the falling apart that the true self can come forth. In allowing ourselves space, time and permission to fall apart, we allow things to ultimately fall INTO place.

I recently had an experience going into what I affectionately call, “the dark night of the soul”. And I don’t say that lightly. It was some of the most difficult, albeit intentional, raw space I’ve ever handled. It is my job to keep others safe. To keep it together. To be a healing force for the mental health of my clients and to forge greater awareness of trauma treatment in the world.

And yet, at the core of me, I knew I needed to fall apart. So I did. I gave myself time, space, permission and the required ethical time away from client work to go through whatever it was that would get me where I knew I needed to go. I craved greater self love. I craved putting my emotions as a priority. I wanted to KNOW what interested me. But I grew up in an environment which put all that on the back burner. There was always a fire to put out, there was always chaos or oppression to dodge.

I see this in my clients. When kids grow up in that kind of home and I ask them as adults what they prefer, what they like, what they desire, I’m often met with silence and a faraway stare. This is a new question to a client who grew up in chaos and/or trauma. If we’re lucky, we’ll actually have time to explore those preferences in therapy. They may have habits, ways to regulate the nervous system, ways to stay safe via ADHD, OCD, restricting or binging and purging, etc, etc. Habits to stay safe are one thing. But when you ask them what they WANT, what is fun, what is worth it, what is desirable, what makes them tick????? Well, that is a whole other ballgame.

Counselors often attract the kind of client they are or the kind of client who has been through what the counselor has been through. Hopefully, a good and ethical counselor will continuously do the internal work so that she can be a wise and experienced resource to her clients. That experience can only add to the compassion within the therapeutic alliance.

My compassion has increased as I see clients who are looking at the potential for unraveling. I let them know that it doesn’t have to happen all at once. That they have their answers inside. That finding the answer may involve some falling apart. It may also involve some joy.

For me, in the process of falling apart, I trusted in the universe and I trusted that the child inside could and would get the support she needed. I joyfully sank into the trust of the universe. And interestingly, the universe delivered. Gratefully, colleagues, healers, friends, even strangers showed up for me in such unusual places. I got everything I needed and more. And my heart is broken open, inviting, but protected and radiating trust. This is all new.

So, you say you’re afraid of falling apart? It’s pure genius. Go for it!