Eating Disorders Today

Eating Disorders and Body Communication

       Much material I read and hear about eating disorders concerns how a person feels and thinks about her body.  But not much has come to my attention that relates to how the body thinks and feels.

      How the body thinks and feels may be a concept that requires a stretch for some or even many people until we open ourselves to understanding the language of the body.

       The body has no words.  Still, our bodies tell us when they need sleep or food or a change in external temperature.  Our bodies tell us when they need a more firm or cushioned bed or chair.  They certainly tell us when something is hurtful to them, like too much heat or cold or abrasion or puncture.

       Most of us have had a near miss when our eyelids blinked faster than thought to avoid a spec from flying into our eyes.

       Our bodies communicate potentially life saving information like when the hair on the back of the neck rises.  This is a primitive body warning of danger on a survival level.

       An aspect of eating disorder recovery involves giving respect to the body itself and learning not only its language but also how to heed what the body says.

       What if the anorexic woman listened to her endocrine system that cried out for nourishment as hormonal function shut down?

       What if the bulimic woman listened to her esophagus plead for a rest from the continuous flow of digestive acids?

       What if the compulsive eater or binge eater listened to a stomach that cried out for mercy and relief from the continuous need to stretch to the point of pain?

       What if, instead of war, we learned to make peace with our bodies?

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

Imagery and Intuition regarding Eating Disorders

       The Marion Woodman three day Dreams workshop was warm, challenging and wonderful. I’ve been wondering what to share with you.  Dream work is so personal, but then, so is eating disorder recovery.

       The most powerful image I had, toward the end of the second day, my intuition tells me is relevant to all eating disorders.

       Marion is in her eighties.  Her body is disintegrating.  She uses and needs a cane.  She conserves her energy as best she can.  She survived and recovered from a serious bout with cancer.

       But, when she speaks, her spirit is fiery. Her eyes glow.  Her voice is strong.  She beams warmth and assertive direction that makes us forget her physical frailty as we become inspired by her wisdom and passion.

       The image came through to me of a candle, but not a candle with a wick that burns on top. This white luminous candle contains a wick in the center that burns all the way from top to bottom within the wax.

       The fire within sends out heat that melts the wax from within.  So, for Marion, the image was of her inner fire melting her body away.

       I stayed with this image since Marion inspired it but was not it.  The image went much farther.

       The length of interior burning wick, if too hot, melts the wax encasing.  The candle is gone leaving only a line of fire.  Well, that could mean that the spirit burns brightly but is without a body.  This is an anorexic dream.

       Another version is this:  The length of interior burning wick is hot and melts the wax encasing. But, more wax is added on a continual basis.  This makes the wax thick and forever thickening so the heat of the fire doesn’t penetrate through the wax and into living space.  The candle keepsg getting bigger and the light is continually less visible.  This is the experience of the binge eater or compulsive overeater.

      What about bulimia?  In terms of my image, bulimia is tormented in a different way. In this image the wholeness of the fire and the wax is aware.  The fire burns and the wax melts beginning to reveal the blazing wick.  But the feelings that go with that fire are too intense to bear. Then the wax builds up thickly to bury the flame.  The dullness of that burial is too lonely and terrifying, so the wax is allowed to melt away until the terror of exposure forces the build up again. This is the in and out, here and gone grueling and endless repetition that is unaddressed bulimia.

       These are powerful and helpful images for me. They hold intellectual, emotional and physical understandings in a way that only intuitive imagery can pull together and allow to develop simultaneously.

       Where do you go with these images? 

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

Expect Some Dreamy Posts!

       “Dreams” is the title of the seminar I’ll be taking this week end in Santa Barbara with Marion Woodman (a talk) and Steve Aizenstat.

       Integrating a person’s inner life with her outer life in harmony and health has long been crucial, in my experience, for achieving eating disorder recovery.  Regardless of the specific diagnosis:  bulimia, anorexia, binge eating, compulsive overeating – and all the possible associated behaviors, like cutting, shoplifting, over exercising, over scheduling, under achieving, abusive and exploiting relationships greatly benefit from developing a healthy integration between mind, feelings and body.

       Marion Woodman is one of the early writers in the field of eating disorders.  She is a gifted Jungian analyst with a way of understanding and bringing healing opportunities to men and women and, from my perception of her, particularly to women with eating disorders. I listened to her audio tape, "Dreams" many times and often recommend it to patients. Marion Woodman understands women and the language of dreams!

       I plan to walk among the trees on the Pacifica campus, participated in the dream workshops throughout the days, speak and share with wonderful people, write down my own dreams, muse about the dreams of my patients and those collective dreams that speak for our culture.

       The nourishment from the people, place and theme I know will benefit my in mind, heart and soul.  From this will come new and surprising integrative thoughts and feelings that are bound to appear somehow in my blog posts as well as the rest of my personal and professional life.

       If you care to join me in this experience, take note of your dreams this weekend.  Write them down.  We can share them next week on this blog and see where our dreams lead us.

       Here’s a bit about the wonderful Marion Woodman (excerpt from the Marion Woodman Foundation website www.mwoodman.org

Marion Woodman, LLD, DHL, PhD, is a Jungian Analyst, teacher and author of The Owl Was a Baker's Daughter; Addiction to Perfection; The Pregnant Virgin; The Ravaged Bridegroom; Leaving My Father's House; Conscious Femininity; Dancing in the Flames (with Elinor Dickson); Coming Home to Myself (with Jill Mellick); The Forsaken Garden: Four Conversations on the Deep Meaning of Environmental Illness, Marion Woodman, Ross Woodman, Sir Laurens van der Post, and Thomas Berry, edited by Nancy Ryley; The Maiden King (with Robert Bly); and Bone-Dying Into Life. A visionary in her own right, Marion Woodman has worked with the analytical psychology of C.G. Jung in an original and creative way. She is the Chair of the Marion Woodman Foundation.

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

Awakening to Eating Disorder Recovery

       How does a person with an eating disorder take genuine action that will realistically create a solid recovery path?  How does she maintain her sense of purpose so she keeps to that path despite painful challenges?

       These are two of many vital questions I’m attempting to address in this blog. They are in the back of my mind always when I think about eating disorder recovery.

       I remember my first psychotherapy session with the psychotherapist who led me through the first years of my own recovery from bulimia.  She was the third person I ever told I was bulimic and the first who was not in a 12-step program. I was terrified. When I saw that she was still warm and interested in me and not overwhelmed by my revelation I thought I was free to breathe again.

       But then she said, “We’ll begin an interesting journey.”  I burst into tears.  She was surprised.  She wanted to know why I was crying.  Perhaps you who are reading eating disorder recovery blogs and websites will understand.

       My psychotherapist said we would begin a journey.  I told her, it had taken me years of hard work and despair to reach the point where I could sit before her.  And she called this the beginning.

       I cried because my beginning was such a long time ago.  I cried because I had come so far only to learn that this now was just the beginning.

       Of course, I didn’t have much recovery to work with then so I didn’t appreciate the concept of “new beginning.”  Now I realize that in recovery and in most or all areas of life, we always have an opportunity to see and live any and every moment as a new beginning. 

       But I was bulimic then.  I thought in terms of black and white, all or none, and I thought in a linear fashion.  I had no idea that my way of thinking was narrow and confining.

       Sometimes, on a dark night with heavy black clouds and pouring rain the world seems mysterious, powerful and almost invisible.  What you do see is distorted by slanting water, shadows and imagination.

       Then suddenly, from out of an unknown somewhere a bolt of lightning strikes out across the blackness.  The startling glare dispels shadows and brings the world up clear and vivid. The moment passes. The dark returns.  But your memory of the light remains. You got a glimpse of the presence beneath the cloak of darkness.

       Eating disorders are like that black stormy night, full of passion, fear and misguided distorted visions.  The stroke of lightning is the life force in us that gives us a glimpse of who and where we really are. We may not like what we see. 

       But if we can hold that awareness a little longer each time our inner lightning strikes, our awareness will grow. We can use it to build our way out of the darkness and into an opportunity of finding our healthy and distortion free life.

       What equips a person to get on and stay on her recovery path?  It has to do with keeping alive those many tiny glimpses of light and health that shoot through the eating disorder way of life. When you gather enough of those glimpses you have a compelling vision of a better life. 

       Lightning is raw energy.  A glimpse of the truth of your life comes from your inner life force.  That’s a kind of raw energy too.  The awareness leads you to your Recovery path.  The energy helps keep you on that path.

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

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

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

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