Eating Disorders Today

Does Advertising Affect Eating Disorders?

A recent Hubpages blog raised the question: Does advertising affect eating disorders?

In my opinion, much of current advertising promotes both tiny size fashion in clothes and huge portion size in food. It's an impossible combination many people strive to integrate. 

A person vulnerable to eating disorders will strive to come up with a solution that allows her (or him!) to fit into tiny clothes and eat huge portions of food at the same time.  This person can become terribly ensnared by an eating disorder. 

But something worse exists.  Advertising that pushes people to be small and eat large supports eating disorder thinking and behavior.  The continual onslaught of emaciation, body surgery, and diet publicity actually convinces many people that the lifestyle being portrayed is normal. 

Such media portrayal validates starvation, cutting behaviors and binge and purge cycles.  Plus, this portrayal can delay recovery work.  If a person with an eating disorder is subjected to a barrage of images and messages celebrating the symptoms of her illness, she may believe she is living well and wisely and will not seek treatment. 

This is a cultural phenomenon that is tragic.  It contributes to people taking pride in their illness, proselytizing eating disorders, destroying their health, ruining relationships and, in far too many cases, shortening their lives.

What kind of influence does advertising and media portrayal of fashion, beauty and diet have on you? I welcome your thoughts and feelings.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

How Long Does It Take to Recover from Bulimia or Anorexia? Part III

What does it take to Heal from Bulimia or Anorexia?

Healing from anorexia and bulimia requires development along all seven points I described in my last post.

But what does it take to actually heal? And why does this healing take a long time?

When I went back to college after a 13-year absence from academia, UCLA gave me a yellow piece of paper that listed my required courses.  When I completed everything on the list UCLA would grant me a degree in psychology.

The sheet was 81/2 x 11 inches.  I tacked it on the wall above my desk and set to work.  Every four months I checked off three classes.  It took me three years to work through that one sheet of paper and qualify for my first diploma.

Below is a short list of developmental that can take several or many years to move through.  Still, like my yellow sheet on the wall, the list can inspire a person to keep on keeping on.

Perhaps, most importantly, the list confronts a person with realistic goals when her mind starts making excuses and rationalizing false beliefs.

I’ll write some of the developmental tasks in affirmation form so even reading them is a beginning.

1. I tolerate my feelings.
2. I am realistically aware of what is going on outside and inside my own skin.
3. I know how to establish and honor personal boundaries
4. I know how to make myself safe.
5. I know how to recognize reasonable and honorable people.
6. I know how to enlist the help of reasonable and honorable people in a fair and honest way.
7. I know how to discriminate between healthy and unhealthy activities, environments and companions.
8. I know how to makes honest, self-caring and honorable choices based on healthy observation.
9. I know my own genuine weaknesses and strengths.
10. I take responsible action in the world.
11. I know when to say, “No.”
12. I am able to say, “No,” even if I am uncomfortable about saying so.
13. Regardless of the challenges life presents, I know and trust that I have what it takes to live a good life.

I created thirteen tasks in this list. The number thirteen has significance.  It means breaking an old pattern. It means emerging as something new or a new variation on an old theme.

Actually, as I write this I surprise myself because I began this post by revealing my thirteen-year hiatus from school.  I didn’t make the connection till just now. That’s how the psyche works.

After thirteen years out of school I returned to resume my education on a new path, build a career and create a new life that was and is much better than the life I had
completed.  Thirteen was the break the pattern signal.  And I didn’t know that consciously till just now.

When a person makes positive strides in the direction of achieving these developmental tasks, the eating disorder has less of a function in her life. The person discovers much better ways of taking care of her psychological and survival needs and expands her life into more enriching experiences.  The eating disorder is less or even no longer necessary. 

How long does this take?  It takes as long as it takes to accomplish these tasks. The actual time differs with each person. How each task is accomplished involves the work in psychotherapy that leads to the past, the present and the future.  It leads to new ways of thinking, feeling and responding. It leads to grand discoveries of where a person is truly interested and of how she wants to invest her life energies. 

Recovery doesn’t happen overnight and the work isn’t easy.  However, the good news is that you don’t have to wait for full recovery to reap benefits of healing.  Every step of the healing process allows the person to be more competent in the world, experience the joy of being more capable and especially, able to connect with other good people in a satisfying and healthy way.

By all means, let me know your thoughts about this.  I welcome your sharing.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

How Long Does It Take to Recover from Buliimia or Anorexia? Part II

       Why does recovery from anorexia or bulimia take years? Because vital developmental tasks must be addressed, and development takes time.

Let’s look at what needs to be accomplished in recovery.

       Eating disorders develop to serve a protective psychological function.

       1.      They protect a person from being aware of what they cannot bear to know or feel. 

       2.      They give a person a sense of control when the person has little real control over what's important to them. 

       3.      They give a person a private island of limited sensation and limited awareness. This is a defense that helps when a person is incapable of preventing physical, psychological or emotional boundary invasion.

       4.      They create an obsessive sense of entitlement to make up for the lack of boundary awareness or the lack of knowledge or skill in honoring personal boundaries or limits.

       5.      They protect a person through numbness and obsessive thinking from knowing what they feel such as anger, fear, disappointment, regret, guilt and shame. A person may even need to block feelings of love, passion and joy if knowledge of those feelings would disrupt the status quo of her environment.

       6.      Eating disorders allow limited but intense feelings to surge within the person and explode out as a form of relief from tension.  These episodes are often highly dramatic and can be both manipulative and destructive in relationships.

       7.      In many situations eating disorders protect a person from knowing she is competent, intelligent, capable and creative when such knowledge might be disruptive to her present life and the imagined (and sometimes real) consequences are intolerable.

       Healing from anorexia and bulimia requires deep, rich and healthy development along many layers of the personality.  When this is achieved the person can cope with the difficult ordinary and sometimes extraordinary challenges life presents without the protection of the eating disorder. Healing also frees a woman to be capable of giving and receiving honest emotions in worthwhile relationships.

       As a matter of fact, healing frees a woman to actually be a woman.

       I’d be glad to elaborate on any of these points.  Please feel free to ask questions and share your opinions and experiences in the comments.

       In the service of easy blog reading I’m trying to keep posts as short as I can while still giving you as much recovery information as possible.

      In my next post I’ll talk a little about some of the work required to heal from bulimia and anorexia.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

How Long Does it Take to Recover from Bulimia or Anorexia? Part I

       This is a reasonable question I'm often asked.  Not only can I not provide a specific time, but also I can't guarantee that someone will indeed recover.  And I certainly can't give the answer so many people want, which is days or a weekend or at most, a quick stay in a residential program.
 
       The question is complex with a different answer for every individual. 

       If you are still reading after this undesirable news, please let me talk a little about eating disorders and recovery.

       People develop eating disorders for a reason. Eating disorders help a person cope with living when the person has not developed other ways to successfully take care of herself. 

       Healing has to do with developing a competent, mature and aware sense of self and awareness in the world.  It has to do with restarting stalled emotional development so that the person can take care of herself realistically in the face of simple and complex life challenges.

       How long does it take to accomplish the required developmental tasks?  A substantial period of time from several years to many years, depending on the challenges of each individual.

       But please don’t despair at the thought of the time involved.  Recovery is a process. As you move through time and stages of recovery, you reap benefits as you go.  Your life improves as you gain more health.

       During the healing work, yes, you will need courage to face your pain.  But you will also experience joy as you discover the authentic worthwhile you.

       I’ll write more about the recovery process in my next post.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Professional Boundaries with Eating Disorder Patients: considering right brain studies and work of Dr. Allan Schore

  (elaborating on my comment in Eating Disorders for Professionals Blog)

       Today, happily, we have evidence based scientific research to back up the use of our humanity in our clinical work with patients.

       Appropriate boundaries between patient and psychotherapist are essential in any psychotherapy and particularly in the field of eating disorders.

       However, the topic is often discussed in terms of content:  e.g. a patient asks my age, if I'm married or divorced, if I have children, my religion, if I've ever had an eating disorder.

        I believe that when a patient wants to know about my private life or wants to include me in her private life (weddings, funerals, births, graduations, award events, etc.) that the patient wants and needs a particular psychological emotional experience from sharing the experience with me.

        In other words, its not the information or event that is the issue. The sharing of our humanity is the point. The patient wants to know that she will be understood and appreciated. She wants to know I have a history that will inform me in terms of being present and empathic with her.

       She wants to know that I can appreciate her pain and personal dilemmas. She also wants to know that I have survived my challenges and her stories will not shock me or cause me to judge her. Perhaps most of all, she hopes that I have healed from what she suffers and that if I have healed then she can heal too.

       The valuable experience between us is not content, but right brain to right brain communication.  We use words because we have to. We communicate far more than words, We need more than words to heal and be healed.

       Allan Schore, in his fantastic research on affect regulation, impacts many areas of social science and biology by showing that right brain communication is received by the right brain and actually changes brain structure to allow developmental progress. Developmental progress is exactly what is needed for eating disorder recovery.

       The discoveries revealed by the increased sensitivity of neuroimaging validates what many sensitive clinicians have known for a long time. Honesty, caring, empathy, sharing spontaneous imagery, acknowledging physical responses to clinical material makes for effective connection, growth and increase possibilities for healing.

       The key question I ask before I reveal personal information to a patient is this:  Will my answering this question burden the patient or will my answering support her healing?  Often, when I'm asked a personal question I will respond by saying, "I will answer your question.  But before I do, can you tell me why you want to know or what meaning this information has for you?"

       People suffering from eating disorders have rarely experienced a quality relationship where their boundaries were respected. In general, they know little about respecting boundaries.  Responding with respect and care to their questions helps begin the process of learning and appreciating what personal boundaries are - mine and theirs.

       This kind of communcation also shows a woman with bulimia or anorexia that she can meet limits and caring from a person at the same time. Such an experience is often new and always in the service of health and personal development.

       People recovering from eating disorders need the presence of honest, caring and respectful human beings in their lives.  I believe, with the backing of neuroscience, that we psychotherapists can’t keep true to our profession unless we are true to our humanness.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Death, Tragedy and the Wounded Soul

        A young anorexic woman died in Ireland because her psychiatrist mother drowned her daughter in the bath. It's a tragic story of Gothic proportions going back who knows how many generations. The mother couldn't bear the daughter's anorexia.  The daughter refused treatment.  The mother had an eating disorder.  The grandmother committed suicide.  The story in "This is London" stops there, but the human story has got to go back who knows how far.

       I'm haunted, as many people must be, by the horror, the extremity, the tragedy, the ignorance, the blindness, the waste and the ongoing and spreading suffering of this event.

       Eating disorders go deep into our souls.  Personally I think that they go deep into the souls of the individual with the disorder and also deep into the soul of our society.  Something powerful in our current human condition is bringing up a terrible despair that eating disorders are making public.

       If we can a bring thorough recovery to people with eating disorders, and embrace effective ways of preventing anorexia, bulimia, binge eating disorder and all the rest, we will also be finding a deep cure for the problems in our society that spawn eating disorders.

       I hope this sad and profound tragedy will spur people to look more deeply into both the psychological and cultural forces contributing to sustaining eating disorders in our midst.

       Wounds of the soul are showing.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Perspectives on Eating Disorder Recovery and Relapse

       A thirty-three year old man wrote to me saying he had been a binge eater most of his life and now was fully recovered because food has been a non issue for two years.

       Of course, I am glad he is happy with the strides he has made in his life.  But his post got me to thinking.

       I have been working since 1980 with people who have and who have had eating disorders.  I don't know what people mean by "fully recovered." 

       While it is possible that people can have two years or more of being in a state where food is a "non-issue" that doesn't necessarily mean they are "fully recovered."  By the same token, someone who has not binged or purged for some time and then begins again may actually be signaling growth rather than relapse (although, of course relapse is possible too.)

       As I see it, people develop eating disorders as a way of coping with what they cannot bear.  The people committed to getting well work in psychotherapy, 12 step programs, spiritual programs, nurture their creativity and gain education and skills necessary for them to function as they choose in this world.  As part of this life long process they feel their emotions, recognize and bond with trustworthy people, and develop a sense of self worth.  As they develop they learn and discover how to address their inner and outer life situations without the eating disorder.

       However, as they age, develop, mature, take on new challenges, are confronted with life's strong pleasant and unpleasant surprises, aspects of the eating disorder may return.  If it's not a relapse, (meaning collapse and surrender) it can be a signal that a new strength needs to be developed or that the person is overstretching his capabilities and needs to pace himself. 

       The eating disorder, a tried and true mechanism developed to a person survive, returns to some people not as an enemy but as a guide to teach the person about how they are feeling or not feeling.  The teaching occurs in a language the person understands perhaps better than any other.  TThis is the language of the eating disorder, which for many has been a life long companion.

       In my opinion the "recovered" person, is consciously aware of his or her liaison with the eating disorder.  It's as if the eating disorder were some kind of sleeping general or police force who, when the person takes on more than they can bear, rises up to alert, protect and defend the person using the old eating disorder methods.  This gets the person's attention dramatically.  The "recovered" person recognizes the return of the eating disorder urges or actual behavior as a signal to pay attention to something that is out of conscious awareness. 

       Past recovery work allows the person to reevaluate what's going on in his/her life knowing now that something is being denied. He or she can then do more inner work so they can be fully present for their experience without needing the numbing protection of the eating disorder.

       There can be gaps of five, ten even twenty years of no acting out and then the old faithful protector emerges to wake up a person who is involved in more than she/he can bear and doesn't know it.  The eating disorder lets them know it.  It can last for only a few days and be of tremendous value.

       I would not like people who have occasional psychological informative incidents of their eating disorder symptoms thinking they have lost their recovery.  Nor would I like people who have no symptoms for two years to think that their disorder is over.

       No one knows what challenges life will present in the future.  I doubt that any of us are fully equipped to deal with what the future will reveal.  We all need to keep learning and growing
to survive and thrive in this life.  And we all have signals that let us know we need to learn and grow beyond our current limitations.

       A return of eating disorder urges is one kind of signal that more growth and learning is required.The more recovery work the person has done the more capable he or she is of continuing the recovery work when those inevitable life challenges emerge. Those urges can help open a blind eye or a dulled psyche to a new challenging reality and help a person continue to live a full life.

       What are your perspectives on recovery and relapse?

       Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Boyfriend Wants to Help His Girlfriend Who Suffers from Anorexia

        A young man wrote asking how to help the woman he loves.  She is anorexic. They've been together for a little over a year. He says one good thing about the situation is that she is aware of her condition and has begun to talk with him about it.

        He is combing the Internet and bookstores reading hundreds of stories and medical write-ups about eating disorders and anorexia in particular. He says he feels that the more information he has the better he can behave toward his girl.

        I'm trying here to give you the message and the tone of his letter without giving you his exact words.  Those words belong to him.  But the message within his words applies to many young men (and not so young men) who are in a relationship with an anorexic woman.

        He says he and his girlfriend have begun to have wonderful conversations about her condition.  He feels these conversations are a good sign because she is not getting upset as they talk.  He wants to do the right thing, be supportive and help her get well. 

        He tells her that the two of them can get through this problem and that he will remain committed to her no matter what.  He says that he never has loved anyone as much as he loves her.

        He repeats throughout his letter in many ways that he feels good about her turning to him for help.  He wants to make sure he is doing everything possible for the woman he loves to help her get well. I am the only person he has spoken to about his girlfriend.  Her condition is private and he wants to honor that privacy as he helps her get well.

        My heart is touched by his plea for help. I only hope I can help you see what I see in his bittersweet request.

       At the end of this post is my answer to him.  I stand by what I said. What I didn't say is this:

       Anorexia is a profound illness that affects the mind and spirit as well as the body. A person who is anorexic denies herself in many ways.  She is often unreachable by any form of nourishment. 

       A person who is in the throes of anorexia is like a starving person standing before a feast, pleading for food.  Generous people offer her food,but the starving person pushes it away, throws it away, spills it, can't hold the plate, can't hold the fork, can't deal with the temperature or consistency, can't swallow properly, and on and on.

       The people at the feast, who do not understand her illness, will meet each problem as it comes with a solution.  They will hold the plate, change the temperature, provide more comfortable utensils, find
ways to help her throat function with massage or medicine or hospitalization, and on and on.

       Each attempted solution will have flaws that keep that starving person from taking any nourishment. She may cry, complain, suffer and plead for help.  But she cannot accept it.  Eventually she will be visibly angry and actively spurn attempts to help her or criticize the people trying to help her for being invasive, critical, bossy, controlling, selfish, and on and on.

       This is only part of the picture. I'll talk about more in future posts.  But this part of the picture is what concerns me regarding the young man's request for help.

       He sounds to me as if he feels that all his love, energy and intellectual prowess, if rallied properly, will save his beloved.

       He doesn't know that he can be drained while his efforts somehow continually fail to reach her in a healing, nourishing way.

       I hope you understand that I am describing the symptoms of an illness. This is not about the authentic woman living under the burden of the anorexia.  That authentic woman is barricaded within herself by the illness. The ardent boyfriend is confronted with more symptoms than he knows.

       I fear for both of them.

       Still, there is a way out.  Healing can happen if both people recognize that some of their feelings and behaviors are a direct consequence of the anorexia and must not be given power.

       Specific suggestions to the young man:

Dear Young Man,

1.      Encourage your girlfriend to work regularly with a mental health professional who has expertise in treating eating disorders.

2.      Go to Overeaters Anonymous meetings occasionally, and listen to people talk about their experience in suffering and recovering from eating disorders.

3.      Let your girlfriend know you are doing this and let her know you would go with her to an OA meeting or two to get her started if she were willing to go.

4.      Go to Al-anon meetings yourself and learn the basics about being in relationship with someone who has a disorder similar to addiction.

5.      Let your girlfriend know you are doing this because her being at risk from this illness causes you great concern, and you want to know how to help yourself deal with your own suffering as well as help her.

6.      Make sure you take care of yourself.  You might consider getting supportive counseling for yourself.  Getting too involved in her recovery can cause problems for you and your relationship.

       You need all the support, knowledge, patience, self respect and self-confidence you can rally and develop to see this relationship through. It takes skill and attention to boundaries and self care to learn how to be in relationship with the person you love and not be in relationship with the disorder.         

       Good luck!  You sound like you really care about her. She's fortunate to have you by her side.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Eating Disorders and the Challenge in Asking for Help: An Artist's Perspective

Eating Disorders Today Welcomes Guest Blogger, Janna Stern, Gifted Artist and Great Friend

       I'm an artist, an M.D., a wife, mother and grandmother with a passionate interest and concern for people who suffer from eating disorders. I feel honored to be asked to contribute some of my work as a guest on Joanna's blog as I find her dedication to the cause and her work to be on target.

       My painting: "In God's Ear." can be viewed at http://serendip.brynmawr.edu/exhibitions/stern/.

       My thoughts about how the image relates to eating disorders:

       People look for a savior. Both the afflicted and those who love them or are trying to help them cry out for help.

       They feel likes dolls at the mercy of some autocratic or whimsical owner. There is no clear path.

       Nearly everyone acknowledges a superior being and tries to reach out to a deity for solace and direction. The doll looks so weary and helpless, as if it has been cast aside several times in searching for a savior that never came.

       Most people with eating disorders only trust themselves and feel safe with their own system of maintaining control and order. When everything in the world is out of control, they ultimately are in control of what they do and where they seek comfort.

Janna Stern, M.D. artist
email: janna@jannastern.com
URL: http://www.jannastern.com

Recent Flurry of Blog Posts Regarding Family Dinner Research

Love is left out of the eating disorder prevention equation yet again.

       Eating disorder prevention does not mean following a check list of correct
behaviors at the dinner table.  It means behaving reasonably  and practically with
a powerful undertone of love, respect, a glad willingness to listen, honesty
confidence to passionately disagree and deep certainty that right or
wrong everyone in the family loves and will stand by everyone else.

       When that is brought to daily life in a family, including family
dinners, eating disorders don't have a chance to develop.

       Researchers have a tough time factoring love in their studies. I can
appreciate the difficulty.  I also am dismayed by research results
that do not consider the presence or absence of genuine love and
respect.

  Researchers say..."what happens at that table has an impact on teens
as well. Juggling schedules to make time for eating together,
creating healthy, nutritious dishes, and having positive interactions
at the table are all components of healthy family meals."
http://www.thatsfit.com/2008/01/14/family-meals-help-girls-avoid-eating-disorders/

       Yes, these are components. Please include love and respect, spacious
time, generous listening, appreciations of differences, honesty and room for laughter
and shared passions.

       Now we're talking about family meals that help prevent eating disorders.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Facing Unseen Physical Problems caused by Eating Disorders

* "Obviously, my body doesn't believe a word my brain is saying."  Calvin in Calvin and Hobbes Collection

       The osteoporosis aspect of eating disorders doesn't seem to be a concern to people in the throes of their eating disorder. 

       Osteoporosis doesn't hurt and doesn't show.  Tooth enamel loss, hair loss, weight gain or loss, skin eruptions all show. The visual is what gets a woman's attention. Unfortunately she tries to correct the  visual without addressing the deep cause of her troubles, her eating disorder.

       The unseen damage remains out of awareness for a while: osteoporosis, esophagus tearing, electrolyte imbalance, risk to heart, dizziness from blood sugar imbalance, organ damage, hormonal disruption and the impairment of judgment based on lack of sleep and lack of proper nourishment.

       The unpleasant reality is that reality won't go away.  Any acting out of any eating disorder serves to numb a person's  feelings and dim her awareness of what is going on around her.

       But turning off awareness does not mean turning off the fact.  Living in a state of oblivion doesn't halt the damage being done. 

        Oblivion needs to fail as soon as possible. 

       That failure and the vision of what is actually happening to her body is a terrible shock and brings up terrific anxiety.  The challenge is to not use that anxiety as a trigger to binge or purge or starve or exercise to bone breaking lengths.

       The challenge is to use that fear and anxiety, that glimpse of reality, to address the eating disorder realistically and start working with a mental health professional who specializes in eating disorder treatment. The challenge is to get even more awareness and get her healing work underway. 

* quote from Calvin and Hobbes, p. 7 Scientific Progress Goes "Boink", by Bill Watterson, Andrews and McMeel Press, 1991.

http://www.amazon.com/Scientific-Progress-Goes-Boink-Collection/dp/0836218787

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Helpful Quiz, Ability to Conceive, Osteoporosis

      

       Breaking the Mirror posted answers  http://www.breakingthemirror.com/  Quiz Answers!January 11, 2008 to a to a ten point eating disorder quiz posted on a teen fashion site. 

       Posting this quiz is a wonderful idea. It helps provide clear information that can combat prevalent and false ideas about eating disorders.

       I would add that while birth control is always a good practice when someone is sexually active and not prepared to conceive a child, it is also true that severe anorexia can seriously
limit a woman’s ability to conceive.

      Another point missing from the quiz relates to bone strength. Many young women with eating disorders develop osteoporosis. It doesn’t hurt, and it doesn’t show. Some anorexic women who are
only 17 years old have lace bones comperable to a very old and fragile woman.

       That said, stating health risks will not scare a person into recovery. But they might scare a person into treatment!

       I hope so. I’ve recovered from bulimia and have been a psychotherapist dedicated to eating disorder recovery for many years. It seems that girls and women need to notice that the eating
disorder eventually causes more pain than they can bear before they are willing to risk giving it up.

       This requires a desperate kind of courage because they genuinely face the unknown in the therapy work. It can be almost impossible to imagine a life without the eating disorder. Yet, a
glimmer of the freedom that might be possible if they were genuinely free of the behavior, the thoughts, the anxiety, the planning and strategizing, the need for the cover up lies
can keep a person on the recovery road.

       I'm glad to know that in the sea of high drama, repetition and hype on the internet relating to eating disorders, some realistic information is being offered that can be truly
helpful to people looking for solid recovery.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

What a Healthy Relationship with Food Looks Like - a lesson from children

            Two little girls, sisters, 5 and 7 years old, were spending the afternoon with me in my home.  We are great friends.

            We had been painting in my studio and running in the grass counting Buddhas (I have a lot of Buddhas in my garden).

            Suddenly the five year old announced, "I'm hungry!"
      
            The more demure seven year old gave her sister a look that said, not so loud and impolite, please while she looked at me and nodded, "Me, too."

      I said, "Well, let's go look in the refrigerator and see what I've got."

      They both grinned and ran into the house.  The content of other people's refrigerators is fascinating to children.

     We found a kind of apple they had never tasted, a fuji.  Five said "no.".  Seven said, "Try it.  It might be good."

     I peeled the apple.  This was a task so totally expected and assumed that no verbal request was given.  Five wordlessly handed me the apple with a most effective facial expression and automatic gesture that clearly informed me of my job.

     They decided the apple was good.  We also found some cottage cheese and carrots. So we peeled the carrots. I sliced the apple. We dished out the cottage cheese and sat in the dining room for lunch.

      I put on some Mozart because we had been discussing the theory that listening to Mozart made children smarter.

      The girls ate with gusto and no talking.  Then they started talking a little as they ate more slowly.  Then they talked even more and ate less.  At one point the seven year old described how she felt listening to the music and wondered if she were getting smarter. 

      She then got up and danced.  The five year old joined her.  The remaining food on the table was forgotten as the girls leped and jumped to Mozart's music.

      My experience?  My imagery saw each child with a transparent fuel tank on her chest. When the fuel tank was empty they immediately felt hunger and knew it.  The thought of food was exciting. Looking at the food, making decisions about it, preparing it was thrilling.  Eating it was glorious. 

      As the gauge on the fuel tank registered an increase, their eating slowed.  By the time the tank was full they had lost complete interest in the food.  Not only that, but the burning fuel released energy to their minds and bodies and that energy turned into joyous dance.

      I smiled at my cavorting little friends, thinking, This is what the absence of an eating disorder looks like.  This is what a healthy relationship with food looks like.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Eating Disorder In-patient and Residential Treatment

     A worried mother called me this morning, concerned that she had not yet received my eating disorder in-patient/residential treatment program list. http://www.poppink.com/list.html

     I was on vacation in Maui with my family and couldn't send the list until today.

     The mother, in the Midwest, is deeply concerned about her 25 year old daughter on the east coast who is a compulsive overeater and obese. They are both looking for an in-patient program that will get her started in recovery.  Well, actually, I think they hope that checking into the best program they can find will result in cure. 

     I'm always concerned when someone says that "some kind of support might be needed after" a residential treatment experience.  To me this phrase reflects a naive hope that a person can go away ill, come back cured and the burden of the illness will be lifted off everyone involved.

     This fantasy simply must be dispelled so that unnecessary disappointment and feelings of failure don't delay or even destroy positive moves toward recovery that are being made.  Residential treatment can help people get on the recovery path.  After residential treatment people with eating disorders still have to walk that path, or climb or crawl or, as 12-step says, "trudge" their way to recovery.

     When you know you are working toward progress, even when you are backsliding a bit, you can keep your energy directed on the healing task in front of you.  You might feel frustrated at times.  Who doesn't?  But you can handle feelings of frustration. We've all had lots of practice with that.

     When you know that in-patient is a first, not a last step you can be less hard on yourself.  You can ease into the program and do the best you can.  You don't have to feel a sense of failure at all.  By putting yourself in a healing environment you are making yourself a winner.  When that healing environment becomes your own inner self, your recovery becomes more solid. The transition between in-patient treatment and solid inner recovery is usually long term psychotherapy. 

     How long is long?  It's long enough to make that internal healing environment in you as solid as can be. It's long enough for you to have solid practice and experience in living a healthy life in a new way without needing bulimia or anorexia or a binge or a cutting or starving episode to get through. It's long enough to guide you, support you, ease you, escort you to a healthy life. 

           Please remember, the search for something "perfect", the desire to find the "perfect" program, the urge to reach the "perfect" size or be the "perfect" person in any way at all is a symptom of an eating disorder.  We humans are not designed to be "perfect".  Our design is that of a human being with all our flaws and contradictions. There's something wonderful about being like a kaleidoscope, an endless colorful variety of perspectives, intact and whole.

     I hope with all my heart that the woman who called this morning and her 25 year old daughter who is locked into her own mind and body by her eating disorder, can find the help and the direction they both need to get relief from their suffering and find their eating disorder recovery path.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA                       bulimia, anorexia, compulsive overeating recovery, www.poppink.com

    

Eating Disorder In-Patient Experience

     A wonderful, honest, detailed and accurate description of what it's like to go through an eating disorder in-patient experience is posted on: http://ballyhoo.typepad.com/mollyblog/eating_disorders/index.html

     Molly Freedenberg shared her eating disorder recovery viewpoint and by so doing, gave a gift to the eating disorder recovery community.

     Her post dispels myths and fantasies about early recovery. I'm especially glad that her vivid examples make clear that in-patient or residential treatment is the beginning, not the end of recovery.

     I've heard from too many people who believe that "going in-patient" is both a last resort and also a complete treatment experience after which a person with an eating disorder will be "cured."    

     Even in the news where celebrities with eating disorders are discussed, I see the idea expressed that the eating disorder in-patient programs "failed." 

     While it's true that some programs are better than others and some programs are more suited to an individual's needs than another, it's vital to remember - or learn for the first time - that in-patient treatment programs are the beginning and not the end of treatment.

     To request a list (free) of eating disorder in-patient programs, please go to www.poppink.com and click on "in-patient programs" in the sidebar. Be advised:  the list is international, comes as an attachment and is 94 pages long.  I've been building it for many years.

     Thank you again, Molly, for your generous and insightful post.  I hope many people who need to begin their eating disorder recovery will find your post and get an accurate and thorough snapshot of what in-patient eating disorder recovery programs can offer.

Joanna Poppink, MFT, psychotherapist, eating disorder recovery specialist, Los Angeles, CA

anorexia, bulimia, compulsive overeating, binge eating recovery; www.poppink.com

Emergency Hospitalization, Eating Disorder, Coming Home

       Yes, you can help your eating disorder recovery by ordering your environment. 

       Jeremy asks in his blog http://jeremygillitzer.blogspot.com/ if bringing his home into order will help him stabilize after his emergency six week hospitalization for eating disorder recovery.  To me, it sounds as if his emergency escort to the hospital was a rescue mission, and that he is lucky he got his life saved.

       Now it's time for him to take over and rescue his own life.  That's true for everyone with an eating disorder. The big questions are what to do? how to start? when to start?

       When to start? Answer: ASAP, with now being best.

       How to start?  Not as easy but the answer is usually right before our eyes.  As old school 12-step says, "Do what is in front of you to do."  Then follow it.  If it's a paper clip on the floor, pick it up and then see what's next.  If it's a phone call to make or hair to wash and comb, or a diaper to change, or a bed to make, or dishes to wash, or an appointment to keep, do it.  Then you'll see what comes next.

       If you can see what's in front of you to do and take healthy and practical action regardless of how you feel you are on a good road.  But maybe you can't see it.  Maybe you're so flooded with so many tasks and feelings that you are immobilized.  What then? That's when people ask, "What should I do?"

       Jeremy asks, should I clear out and organize my home?  I say, Yes!.

       Living with an eating disorder in control of your actions leads to chaos in your life and environment. Creating a healthy structure that will hold your life securely even when you feel insecure is the insurance you need to keep your life and your relationships intact.

       What's above reflects what's below and vice versa. Inner chaos creates outer chaos in your home, your file system, you closets, your kitchen cupboards, your closets, your work, your relationships. Everywhere you look you see the chaos theme reinforced.  That view goes in your psyche, and you feel hopeless and overwhelmed.

     You know where those feelings lead: binge, purge and more.

       So, by putting some order in your outer life you can give your psyche the signal of order and personal empowerment than can influence your state of mind.

       Yes, Jeremy. Clear the clutter out of your house.  It will help you clear out what's unnecessary in your mind. Get rid of what doesn't work for you, especially if it's broken.  That will help you get rid of your reliance on old ways of thinking that don't work for you. Put some beauty in your home.  That will help you smile and be more comfortable in your own skin.

       House organization is certainly not a substitute for ongoing and deep psychotherapy that is necessary for recovery. But, following the principles of Feng Shui in the home can help you bring more balance and health to your life and help your stabilize on your path to eating disorder recovery.

Joanna Poppink, MFT, psychotherapist, eating disorder recovery specialist, Los Angeles, CA   

bulimia, anorexia, binge eating, compulsive overeating recovery work. www.poppink.com

 

Coping with Feelings after New Years

A Nourishing Treat for Getting Through This Week Well

       As you move through this first week of the New
Year, I recommend that you read or re-read Joseph Campbell's
Hero with a Thousand Faces.

       This is the classic that can guide your through
your journey to eating disorder recovery.  Even if you
don't see the relevance, your unconscious will gladly take
in the healthy nourishment Campbell has to offer.

       I met Joe many years ago at an imagery conference
at UCLA.  We met in a big hall outside the workshops.
Many of the speakers and workshops were good, but at that
moment I was fleeing a bad one.  Joe was also in flight
from something he couldn't bear as well.

       We sat on a step at the bottom of the staircase and
talked for well over an hour.  The energy, honesty, humanity
and richness of the man came through so well I can feel him
today.  He also had a twinkle in his eye for attractive
young women which I enjoyed.  After all, he was a most popular
professor at Sarah Lawrence for many years.

       Many books came later.  His influence on the creation
of Star Wars came later yet. 

       But give yourself a gift and a boost into healing by
reading his first book, the book he wrote when he was a young
man starting his own journey.  Enjoy.  Please know that you
can be the heroine of your life.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA
bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Binge Eater Discovery

A post just came in to my eating disorder recovery discussion board on www.poppink.com.  The poster was shocked in her discovery that she is a binge eater.  She is now looking for help.

I hope you can appreciate my gladness at her discovery.  I'm not happy that someone has any form of an eating disorder.  But when a person discovers that she does have an eating disorder that discovery is good news.

Now she has an opportunity to stop criticizing herself about her weakness, bad character, and all the other horrible  and relentless judgments she makes about herself.  Once she knows she has an illness, a disorder with a name, she can begin to look for guidance in her recovery work.

She can stop the endless pain of trying to do what doesn't work and begin her path to health and freedom from those debilitating binges.

Joanna Poppink, MFT, psychotherapist, Los Angeles, CA eating disorder recovery specialist

bulimia, anorexia, binge eating recovery;  www.poppink.com

Hung Over or Exhausted or Frightened?

       The week after New Years can be tough.  Fantasies around
New Years may be more powerful than Christmas wishes.  New Years
is often a time of hope for the end of eating disorder symptoms.
You hope for the beginning of a new and true love. You hope that
at last, you can be your real self, be recognized as the quality
person you are and welcome peace and opportunity in your life.

       When all those wishes don't come true as the New Year opens
the disappointment can be intense.  That disappointment can bring on
a state of depression where you have low energy and just want to cry
alone with your best friend - bulimia.

Please, hold out.  You might be hung over from too much
of everything over the holiday.  You might be exhausted from
activity and tension.  You might be frightened because of the sudden
transition from holiday to quiet regular life.  Maybe you are
experiencing all three.

       Give yourself a chance to adapt to the shift your mind,
heart, body and emotions need to make after the holidays.

       A big tip that always needs reminding, that all of us
tend to forget:

Don't get too hungry.
Don't get too thirsty.
Don't get too tired.

Hunger, dehydration and fatigue will play havoc with
your emotions, your ability to think and your ability to
perceive realistically.

       Give yourself a few days of eating three healthy
meals a day, drinking 6 - 8 glasses of water a day and
getting eight hours of sleep at night. 

       You will be happily surprised at how much better
life looks. 

       This is not a cure for bulimia.  But it is a way
to catch hold of some health so you can take the steps
necessary for solid recovery.  And wouldn't that be a nice
way to start the New Year?

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA
bulimia, anorexia, compulsive overeating recovery, www.poppink.com

Bulimia Emergency Tips for New Years

        When your gut trembles and aches with fear, when your upper arms
seem to vibrate on their own, when the back of your throat aches, when
what you see begins to have an unreal quality you are experiencing raw
vulnerability that is a prelude to a binge/purge episode.

       If you suffer from bulimia the end of a holiday season can leave
you in this fragile emotional condition.  You may attempt to use rage to
wipe out these feelings. You may try to control the people around you to
prove your power when deep down you feel powerless. You may want to hide
under the covers or throw a full on tantrum.  Please remember these are
symptoms of your illness.  You can get through this.

       After the holidays a quiet comes to town, which is difficult for
a person with bulimia to bear.  Generally people use the after holiday
time to rest, clean up, see how much money they’ve spent and get ready
to go back to school or work.

       A person with bulimia can’t move smoothly from high-energy conditions
to a calm and even state.  Other people relax after an intense time.  They
rest and regroup. The bulimic person crashes and feels frightened and unstable.

       This instability can set off one binge/purge episode or a series of
binges and purges that can last for days or weeks. 

       If you are near this state, please remember to be kind and giving to
yourself.  Try these simple tasks:

       1. Take a shower and wash your hair
       2. Make your bed
       3. Eat breakfast and immediately go for a walk
       4. Go to an OA meeting
       5. Call your therapist.  If you don’t have one, start looking for one.
       6. Go to an animal rescue shelter and volunteer to walk a dog
       7. Go to the library and write thank you notes to anyone you can think of
       8. Look at something you usually think is beautiful – even if nothing seems beautiful now.
       9. Postpone your binge or purge. Start thinking about what else can nourish you.
      10. Journal, journal, journal.
   
       Find ways to put yourself in environments that nurtures healing, creativity
and learning. Someday you will create that for yourself.  For now, stretch yourself
in that direction because every moment of your life can be the beginning of a New Year
for you.

Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA
bulimia, anorexia, compulsive overeating recovery, www.poppink.com