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.

Breaking Anxiety's Grip

Breaking Anxiety's GripAmy Grabowski, MA, LCPC

"My heart beats so fast that it feels like it will explode out of my chest..." "A feeling of doom washes over me. Everything looks bleak and scary...." "My thoughts start to race... What if? What if? What if?"

When I was 19, I started to feel anxious and have panic attacks. Looking for help, I described how I was feeling to a doctor. He blankly diagnosed panic attacks, handed me a prescription for a tranquilizer and walked out. I felt alone, like some kind of shameful freak.

What I really needed from him, I didn't get: an explanation, and some reassurance that I was going to be OK.

When clients come to me with anxiety, I help them heal themselves in four ways. First, I give them reassurance that they are definitely NOT alone with these feelings. Anxiety is the #1 reason Americans seek counseling. Secondly, I help them understand anxiety, how it develops, and how to feel more "in control" of it.

Third, I teach them ways to help them stop the anxiety spiral. Then fourth, they learn how to comfort the "part" of themselves that becomes anxious. Anxiety is excessive worry that is difficult to control. It causes: restlessness, being keyed up, feeling on edge, fatigue, difficulty concentrating, irritability, muscle tension, difficulty falling or staying asleep, or restless unsatisfying sleep. (If you think about it, most people in our high pressure society feel anxious.)

Panic attacks are periods of intense fear or discomfort, with physical symptoms that develop abruptly and reach a peak within 10 minutes. These symptoms include: pounding heart, sweating, trembling, shortness of breath, feeling of choking, nausea, abdominal distress, dizziness, faintness, feelings of unreality or being detached from oneself, fear of losing control, fear of going crazy, fear of dying, numbness, tingling, chills or hot flushes.

When you understand anxiety, it becomes less frightening and then can be dealt with in a calmer more logical manner. Anxiety is an instinctual survival mechanism - developed millions of years ago. When Ms Cavewoman saw a sabertooth tiger, her brain registered a "threat", and activated her "fight or flight response". Her body gives her a squirt of adrenaline to make her heart beat faster, lungs breathe more rapidly, thoughts come more quickly, and her muscles to tense up - so that she could fight or flee. This is all well and fine if I am about to be hit by a Northbound Lincoln Avenue bus. That automatic squirt of adrenaline burns off as I run for my life.

But, most "threats" in today's society are abstract. Our brain cannot tell the difference between a real threat and an "imagined" threat. So when we think "Oh no! What if I gain weight?" or "Oh my God! My boss won't like me if I speak up!" we get the same automatic squirt of adrenaline - even though you would never start a fistfight or flee in terror.

Worse yet, we notice our bodies' symptoms and think "Oh no! I'm shaking! What if someone notices?" Our mind sees this as another threat, and before you know it, squirt! - another dose of adrenaline. This speeds up our bodies and minds even faster. When this is noticed, "Oh my God! What's wrong with me?" - (you guessed it) squirt, more adrenaline. And so on, and so on. To stop this out of control cycle, we need to recognize anxiety in our bodies. I often ask clients, "Where in your body do you feel anxiety? What does it feel like?" If your first anxiety symptom is a "lurch" in your stomach, then the next time it occurs you may recognize it and process it in a way that avoids the out-of-control-spiral.

Deep breathing exercises, visualizations, and other techniques can halt the anxiety spiral. For example, visualize the most calming color imaginable, and then the color of your anxiety. Take a deep breath in through your nose, and imagine that you "breathe in" your calm color. When you breathe out through your mouth, "exhale" anxiety. As you breathe in your calm color, imagine yourself in a calm setting, such as a beach, a cabin or anywhere that feels safe. As you exhale your anxiety, imagine that it floats away from you like smoke or confetti in the wind.

Since anxiety tends to make us zoom into the future, especially with "What if" thoughts, introducing a "mantra", a calming phrase that is repeated over and over, can be very reassuring. A mantra such as "Right now, this moment, I am not in danger" can bring us back to the present.

Sometimes just identifying that we are feeling anxiety and are having body symptoms, (but without the catastrophizing), can be calming. For example, "OK, I'm having body symptoms. So what? Nothing's going to happen" After doing all this for a while, you will feel in control of the anxiety by breaking the upward spiral of symptoms that had you in anxiety's grip. But it is not enough to just control the physical symptoms of anxiety. To finally stop the anxiety from reoccurring, you must address the underlying issues that started the anxiety originally, - usually with the help of a licensed counselor.

For each person, these underlying issues are unique. Yours may be based on family dynamics from years ago, or a trauma that never fully healed. Whatever the cause, the process of resolving these issues is the same. Feel a bit of the anxiety. Then visualize this feeling as a "part" of you who needs something from you. Often this part will be a younger version of you that is stuck in the past, and can't move forward because it did not get what it needed then.

If you imagine sitting next to this part, you may feel empathy and compassion for the part. Ask the part what it needs from you, what words it wants to hear more than anything else. Often the parts wants validation, acceptance, and reassurance -- phrases like: "Its OK to feel this way." "You are still good enough even though you're scared." "It's going to be all right." and "You are not alone." Write these phrases down on a card and pull out your card whenever you need to calm down.

When the part is calmed down, then you, your adult self, can take care of what caused you to become anxious in the first place. It sounds easy, but it does require work and persistence on your part. Using the guidance of a licensed counselor, you can finally resolve these underlying issues. Breaking the grip of anxiety will spiral you upwards -- to happiness, health and success!

The Importance of Inquiry

I have recently finished Geneen Roth’s book Women, Food and God: An Unexpected Path to Almost Everything and it has definitely gotten my wheels turning. I particularly enjoyed her discussion of what it feels like to truly inquire about what you’re feeling- and the process of relating to your feelings, instead of from them.

Roth writes:

“Inquiry is body based; it is not a mental process. You sense what it feels like to be inside your skin, your arms, your legs. You notice the sensation and you notice the location of the sensation. Sensation, location, sensation, location. If, for instance, you are feeling sad, you ask yourself where that feeling is located in your body. You notice a gray heap of ashes in your chest, and up pops the belief that ‘love exists for other people but not for me.’ You become curious about that belief. How old were you when you first learned that? And what were your feelings at the time that never got noticed or felt or understood?

It’s good to ask some questions that allow you to focus on the sensations themselves. You can ask yourself if the feeling has a shape, a temperature, a color. You can ask yourself how it affects you to feel this. And since no feeling is static, you keep noticing the changes that occur in your body as you ask yourself these questions” (Roth, 104-105).

With the stress of everyday life: work, school, family, it is so easy to become detached from the body. We become ‘talking heads’ only thinking instead of really feeling. The exercise of reconnecting with the body and seeing what a particular part of it feels like in a stressful, sad, exciting, or joyful situation can be very eye opening. This allows for an exploration of the body that doesn’t involve food or weight, or self-criticism, simply curiosity. Curiosity that can lead to real self discovery. It also allows for small increments of success. For some, the task of focusing inward on body sensation for five minutes a day may be enough at the beginning, for others it may mean an hour long meditation on each area of the body and the feelings that may be harbored there.

I really love the steps involved the process Roth describes above. Starting with curiosity eliminates judgment; the act of exploration eliminates the ‘talking head’; and the experience of the feeling in the body allows for a refreshing openness and understanding to wash over your heart.

Women, Food and God is a wonderful book full of wisdom and I would definitely recommend it. But, if you don’t have the book, try inquiring about your body and your soul and see what it feels like to reconnect with yourself and the world around you.

Peacefully,

Claire Jolly

Claire Jolly was a summer intern at The Awakening Center. She is a student at Centre College in Ohio.