Recovery From Anorexia is Worth the Fight

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By: Hope Virgo

Sharing my story of anorexia hasn’t always been easy. I never know what someone’s reaction will be when I tell them that I spent a year living in hospital with anorexia. Battling to stay alive whilst my heart went in to a critical state.

But now I am out the other way. Now I can say I am an eating disorder survivor I don’t feel embarrassed about it but I want to take this time to tell you why I battled to stay well and have managed to stay well since!

  1. You think anorexia is your best friend. You think she has your best interests at heart but she doesn’t! She really is a nasty piece of work who doesn’t support you and doesn’t care about you!
  2. Realizing that what you see in the mirror isn’t always accurate! For me I looked in to the mirror every day and saw a body I hated back. I still have days when I struggle with my body image but I now know the reality of my feelings and I know how my mind plays tricks on me so I don’t see what others see.
  3. Knowing your triggers: for me exercise was a huge issue & yes it has helped me stay well but it can also be risky! When I begin to struggle again I am tempted to push myself that bit harder whether on a run or on the gym. But now I know that! When I hit that point I can challenge it and ask for support.
  4. Realizing that anorexia is dangerous: I remember when I was at CAMHs they would tell me I was going to die but I never ever believed them. I thought they were lying to me when they told me my heart was failing. But they weren’t… I was so close to dying from anorexia and it is scary how many people do. I know you won’t believe clinicians when they tell you this but please try and listen to me.
  5. Know your motivations for getting well and fighting: I used to have mine written down so I wouldn’t ever forget them. But remind yourself or the things anorexia will stop you doing – travelling, having a family, missing out on night outs with your friends.
  6. Realize talking does not make you weak: Throughout my recovery I had to learn to express my feelings through talking and I got good at it. However, it is still something that at times I struggle with. If I am having a bad day I feel like I am a failure or that I have let down these rounds me but the reality is I haven’t. It is not a failure to admit you are struggling but I guarantee talking about things makes it so much better.

I don’t want to lecture you on anorexia but I want to assure you that recovery is so much better. It is hard work yes and at times you don’t see the point of carrying on, but I guarantee your life is so much better when she is not your friend!


IMG_0056About the Author: Hope Virgo suffered with anorexia for 4 years before being admitted to hospital in 2007. She lived in the hospital for a year and since being discharged, has fought to stay well. Hope now lives and works in London, runs marathons and has a keen interest in exercise and maintaining good mental health. Her latest book Stand Tall Little Girl is available to order on Amazon.com

The Power of Resistance: Saying No to the Diet Culture

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By: Crystal Karges, MS, RDN, IBCLC

Carefully disguised in the name of health, diet culture has saturated our society, taking many different forms, including “eating clean,” veganism, elimination diets, cleansing diets and more.  When done in the name of wellness and disease prevention, many abnormal eating habits can be justified, the potential dangers overlooked when the objective is to be healthier.

With the damaging effects of dieting trends lurking about, especially for those recovering from an eating disorder, when do things take it one step too far when it comes to health and nutrition?

The Reality of Diet Culture

While diet culture has evolved over the years, often taking different forms, the reality is that our society continues to obsess about dieting, reaching an unattainable body type/weight, and all that this entails.

In the face of an “obesity epidemic,” dieting has in fact become commonplace, a false form of security and control as a means of counteracting our fear of fat and everything associated with this.  It comes as no surprise that some of the top dieting questions asked in Google include, “How to Lose Weight Fast,” followed by “Best Way to Lose Weight.”

In a recent survey about body image and dieting, 91 percent of women responded that they were unhappy with their bodies and resorted to dieting, with approximately 66 percent of Americans currently on a diet [1].  There is something startling and abrupt to be recognized about a dieting industry that rakes in billions of dollars each year.  People are looking for answers in the wrong places, often complicating their health and risking their overall quality in life by engaging in our prominent dieting culture.

Going Against the Flow

Is there anything that is justified about being on a diet? Is health, nutrition, or wellness achieved with anything that condones restrictions in any form?

The reality is that dieting, no matter its form, is counter to what our bodies are intuitively capable of doing.  For individuals who are susceptible to having an eating disorder, dieting can be the trigger that influences the development of these fatal illnesses.

No matter the look or claim of any type of diet, the bottom line is always the same: Diets DON’T WORK!  The things that are often lost with dieting include self-esteem, confidence, energy, health, quality of life, and an overall peaceful relationship with food and body.

So what can you do in the face of our dieting culture? Resist.

Resist the urge to jump on the bandwagon of a new “health regime” you see trending on Instagram or the diets that claim to give you energy and optimize your longevity.

Anything that recommends restricting any food groups, demonizing certain foods, or deters you from trusting your body completely should be scrutinized and likely avoided completely.

do-not-give-up-2015253_640Your body contains all the innate wisdom needed to guide you safely through the diet-infested culture we live in, avoiding the heartache and misery that is attached to dieting in any form.  It’s simply a matter of resisting what our culture has deemed as desirable and fighting for normalcy; going against the flow of what everyone else seems to be doing, and making peace with our bodies through gentle nutrition, intuitive eating and exercise.

This may ostracize you from mainstream acceptability, but in the end, you will never regret the choice you made to stand for freedom from dieting.

 

References:
[1]: Mintel Consumer Reports, “Diet Trends – September 2016”, http://reports.mintel.com/display/748044/ Accessed 19 April 2017

Crystal Karges_HeadshotAbout the Author: Crystal is a Masters-level Registered Dietitian Nutritionist (RDN) with a specialty focus in eating disorders, maternal/child health and wellness, and intuitive eating. As a Certified Intuitive Eating Counselor, Crystal has dedicated her career to helping others establish a healthy relationship with food and body through her nutrition private practice and work with Eating Disorder Hope.  Combining clinical experience with a love of social media and writing, Crystal serves as a Contributing Writer and Social Media Events Manager for Eating Disorder Hope, where her passion to help others find recovery and healing is integrated into each part of her work.

Road to Recovery: Liza Kulimanova

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By TJ Spencer

Project HEAL provides grant funding for people with eating disorders who cannot afford treatment. For many, this treatment has gone beyond saving their lives – it helps them save others’ lives as well.

Such is the case for Liza Kulimanova, a 2014 Project HEAl grant recipient who currently runs a website, educational YouTube channel and a blog dedicated to helping others overcome their struggles with bulimia.

For Liza, her 13-year struggle with bulimia began in her home country of Russia. She remembers being happy until around age 11, when she began dedicating more and more of her time to her studies and striving for perfection. After trying different weight loss centers and Chinese acupuncture to help cope with her struggles, she was prescribed Fluoxetine to help with depression – but it just wasn’t working.

Her days before treatment were filled with a routine of “dwelling on negative thoughts, zoning out, restricting, binging, purging…being extremely busy and ‘productive,’” Liza explains.

This routine was further perpetuated with she immigrated to the United States in 2010.

“I had no support in the USA and I was extremely isolated,” she says.

She then began searching online for scholarships for eating disorder treatment and discovered Project HEAL. With the grant, she was able to attend treatment at The New Beginning in Scottsdale, AZ.

“Treatment was hard and painful, but at the same time giving me relief and making me feel so much better. I am so grateful for treatment and I see bulimia as a gift now. It really allowed me to become a healthier and better person and grow tremendously from the inside,” she explains.

Today, Liza’s routine is filled with smiling, being more present and aware, checking in on herself, creating time for herself and being open to people, along with blogging and bodybuilding.

“I am very determined and disciplined, and willing to grow consistently,” she says.

This determination and discipline has allowed her to become an ambassador for bulimia treatment through her website, blog and YouTube channel.

“Believe that recovery is possible, because it is. Love yourself enough to get better — just take the first step and see where this journey will lead you. Let your life to unfold and let go of the control,” she advises.


headshotAbout the Author: Second-year journalism and French double major at Seattle University, TJ Spencer is originally from a small town in California, but Seattle stole her heart. In her free time, she enjoys writing, reading and showing off her embarrassing dance moves at cardio dance class. You can find her around Seattle photographing anything and everything, or in her bedroom practicing her French by talking to her roommate’s rabbit.

My Secret New Love of Spontaneity

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By: Heather Birchall

This may not be true of most anorexics, or even a portion, but honestly I can pinpoint the day I became anorexic, and the day I decided ‘enough is enough, now give me a piece of that lemon meringue pie’.

I’d battled the disease for four years but suddenly, like a cat with a ball of yarn, it unravelled itself overnight. I became determined to put on weight until my period started again, and I could look at myself in the mirror without seeing shadows. It took maybe a few months, and when it happened, I went out shopping.

In the 90’s every student in the UK worth their salt shopped at Top Shop. It’s really hard to find clothes that fit when you’re anorexic. I wore kids clothes generally, or tied an unflattering belt around my waist to hold up skirts and jeans. But now everything was snug, and I gave myself a new look – a short skirt with tights, thick black ones in winter, sheer in summer and patterned or multi-coloured for occasions.

This became my outfit of choice at work, hiking up the Lake District hills and through two pregnancies. Even when I moved to California, where active wear is all the rage, I couldn’t shake the look. But, despite all the confidence I’d gained, there was one thing that just kept nagging at me, and it annoyed and frustrated me. I just could not be spontaneous. I’m not talking about booking a last minute flight to Hawaii spontaneous, but rather “do you fancy checking out that new place for lunch now spontaneous.”

Even when I was recovered, and considered my eating disorder to be a thing of the past, at the beginning of each day I decided what I was going to eat, and there wasn’t room for extra helpings.

restaurant-1284365_1280So, when colleagues asked me out I declined and, as soon as a gaggle of them left, I would take out a forlorn looking sandwich stashed away at the bottom of my bag.

After a while they didn’t ask anymore. Sometimes I would go with them and just buy myself a cup of tea. This honestly seemed feeble to my companion – a bit like pouring a glass of wine in the evening. You need a friend to eat with you, not make a cup of tea last for 40 minutes while they munch on sandwiches and cake.

I’m 40 now, anorexia over 20 years behind me, and it’s only recently that I have been able to take up that lunch offer without any qualms at all. It’s such a relief that I don’t have to plan, and deprive myself of something at the start of the day to make up for that birthday cake that someone wants to share after school pick-up, or that trip to Pinkberry on a whim.

I sometimes wonder though if my future might have been different if I’d accepted those lunch invitations in my twenties and thirties. Would I have progressed in my work faster by discussing things with colleagues at Starbucks? Would I have found out titbits of gossip that made the afternoon pass quicker if only I’d gone on that outing to Pret A Manger?

Maybe I’d have made some closer friends during that time in my life if I’d just had the nerve to go out to a restaurant rather then unwrap the sandwich I prepared each morning. Thankfully there will be enough spontaneous lunches ahead to outweigh the many I turned down. I can happily now raise a glass to spontaneity.


pumpkins 10.00.25About the Author: Heather Birchall started volunteering with ProjectHEAL in early 2016, and has primarily been responsible for interviewing new volunteers and chapter leaders. Before moving to California and developing a passion for the non-profit sector, Heather was an expert in Victorian painting and photography, and spent eleven years working in curatorial roles at the V&A Museum, Tate Britain, and Whitworth Art Gallery, University of Manchester.

FAQ Friday: Are Weight Transformation Images Liberating or Triggering?

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by Dr. Colleen Reichmann, Licensed Clinical Psychologist 

 

“Are the weight transformation images a good thing or are they negative for the recovery community?”

 

woman-smartphone-girl-technology-2-650x437This is an important topic, because of the recent swift growth of the online pro-recovery and body positive community. The notorious “Transformation Tuesday” pictures that have historically reeked of diet culture (i.e. images of individuals pre and post-weight loss) have been commandeered by our beautiful community.

If you search #transformationtuesday on social media today, you will still find a slew of weight-loss before and after pictures. However, dotted among these pictures will be the occasional weight-gain picture– typically an individual pre and post-weight restoration during recovery from an eating disorder.

Recently another hashtag started trending – one that is more specific to the recovery community- #gainingweightiscool. A search of this hashtag will almost exclusively yield these before and after weight restoration pictures of individuals in recovery from eating disorders.

Additionally, some of the most loved body positive and recovery accounts routinely post these transformation pictures. These accounts are widely followed, and hence have the potential to deeply impact the community as a whole.

So while I am typically against black and white responses, I do tend to believe there are more negatives to these transformational images than positives. Let me explain:

 

The Negatives

These images focus on just that – images.
They put a face to eating disorders. This encourages us to do what we are all subconsciously primed to do anyway – focus on someone’s appearance as a gauge to estimate how sick they are or once were. The vast majority of individuals suffering from eating disorders are not underweight-indeed many individuals with anorexia may not ever appear drastically underweight. Hence the dangerous myth that eating disorders are all about weight loss is not something that we want to perpetuate via social media.

Additionally, more simply, they encourage us to focus on the outside. We are all SO used to focusing on the outside anyway, and recovery from an eating disorder usually involves a fight to recognize that worth stems from the inside. So putting focus on visual depictions of the illness seems like a step backwards.

They ramp up competitive eating disorder voices.
This is a no-brainer. These pictures are triggering for many individuals struggling with or in recovery from an eating disorder. Though the message may be that #gainingweightiscool, the stark visual image of sickness leaves the door open for the eating disorder voices, saying things like, “I’m not sick enough,” or “I never got sick enough,” to creep, ever so sneakily, back in.

An important note is that some well-known body positive activists will post disclaimers on their transformation pictures to address this very point. For example, some will post pictures featuring the pre-weight restoration and post-weight restoration with a notation at the bottom to the tune of: *YOU DO NOT HAVE TO LOOK LIKE I DID FOR YOUR STRUGGLE TO BE VALID. EATING DISORDERS COME IN ALL SHAPES AND SIZES*

Disclaimers like these might, however, have the drawback of speaking to rational thought, and the “I’m not sick enough” thinking is anything but rational. Rather, it’s ED thinking. For some, this notation may not be enough to break through the thoughts that come along with the triggering images once they begin. The “I’m not sick enough” thoughts can still be pervasive even after one has been well-educated about the fact those suffering come in all shapes and sizes.

They perpetuate societal misunderstanding.
Society (and sometimes doctors, insurance companies, etc.) already seems to have a tough enough time grasping the fact that eating disorders have no face. ED’s affect people of all different genders, sexual orientations, ethnicities, ages, and YES- body types. They Do. Not. Discriminate. And yet, the vast, vast majority of articles and educational pieces for the mass media are written about one type of eating disordered individual – the young Caucasian female with Anorexia Nervosa. Articles for the commercialized media are more often than not accompanied by images of emaciation.

Why? Because this sells. Anorexia is easily sensationalized in the media because of our current societal obsession with the thin ideal.

Those of us involved in recovery awareness and activism cannot necessarily help what a women’s magazine chooses to focus on. But we can help what our social media community chooses to promote. By posting these transformation pictures, we are adding to the societal idea (as well as the eating disordered thought) that anorexia is Everybody’s Favorite Eating Disorder, and that people who are not underweight are not sick. In doing so, we are also perpetuating the tendency to overlook those suffering from other forms of this illness like Binge Eating Disorder, Bulimia Nervosa, Other-Specified Feeding and Eating Disorder (OSFED), and Avoidant and Restrictive Food Intake Disorder (ARFID).


The Positives

They fight stigma.
It cannot be denied that these transformation pictures buck the trend-among a slew of weight-loss idealization pictures, it can be so refreshing to see someone celebrating weight gain! It is a great reminder that weight loss is not always the goal, and that “healthy” can mean different things for different people.

They allow people to own their stories.
The pictures can be liberating to post. Our society sends an overwhelming message that mental illness is something to hide or be ashamed of. These pictures are an attention-grabbing, incredibly courageous way of saying, “Hey! I went through something. I’m STILL going through it. And you know what? I’m not ashamed. I’m a brave warrior and I’m fighting every day.”

Also, sometimes when one goes through something as trying and difficult as an eating disorder, there is a pull to show people just how much suffering occurred. A pull to shout, “Hey! I went through hell and back, see?” After staying silent and numb for so long, (as people tend to when suffering from their eating disorder), sometimes there is that irresistible pull to break free, tell one’s story, and in turn, set it free. There is absolutely nothing wrong with this.

And furthermore, not everyone considers their social media account to be part of a social justice movement. Some people simply want to document their journey, and posting their pictures is 100% their right in doing so (although sometimes the pictures depicting severe emaciation do get reported and removed by Instagram).

They start a conversation.
If the pictures are public (and even if they aren’t) they start a conversation. They start a conversation among strangers, family and friends. They force people to confront their own biases about weight gain and health. The pictures are a visual declaration that weight gain can be positive, beautiful, and life-saving. They are a pictorial screw-you to the diet culture script- the idea that weight loss is ALWAYS the goal and that skinnier is ALWAYS healthier no matter what. These pictures have the potential to open people’s eyes and minds to the idea that all bodies are good bodies, and that health can fit every size.

15418558271_0f50aacf1b_o

There are both positives and negatives to these transformation pictures, but my final thought would be to proceed with caution. You never know who could be triggered by the image.

Your journey is yours to own, so of course it is within your right to post your photos and empower yourself and your recovery. I would simply suggest that you be deeply thoughtful about what your reason is for posting the pictures before doing so. Consider not putting too much emphasis on them, and instead focusing on your inner strength, your mind, your newfound ability to deal with tough emotions, and your fresh starts in relationships.

Eating disorder recovery involves so, so much more than the outside.

And, as a final note to the well-known body positive accounts: please use the images sparingly. You are all doing such amazing, impactful work. Your message is SO important, and you have the potential to influence so many. So while your journey may have involved weight gain, there are an infinite amount of other variables involved that make you YOU. Be sure to shine a STRONG light on those as well.

 


 

About the Author:

As seen on a Sussex Directories Inc site

 

Dr. Colleen Reichmann is a licensed clinical psychologist, practicing in Virginia Beach. She works in a group practice, and is a staff psychologist at the College of William and Mary. She is an eating disorders and women’s issues specialist She is an advocate for feminism, body positivity, health at every size, and FULL recovery. Connect with her on Instagram, Facebook, or send her an email.

 

 

 

 

 

 

 

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.

 

 

 

 

The Unmeasurables of an Eating Disorder

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by Jennifer L. Gaudiani, MD, CEDS, Founder & Medical Director of the Gaudiani Clinic


Illness cannot always be measured, and neither can wellness. This is one of the great medical challenges facing those with eating disorders, where often the act of measuring becomes the obsessive focus of life: how many calories/miles/pounds/steps?

Unfortunately, the Western medical system—of which I am a proud member, even while realizing its limitations—further puts the focus on measurables. In our strained system, patients can get triaged into “ok” vs. “sick” based on numbers that may have little to do with their overall suffering. No one would question that certain measurable values carry clear and present danger: an abnormal potassium level, sodium level, bicarbonate level, measure of kidney or liver function, or a very low body weight.

However, the vast majority of patients with eating disorders live within the torment of the ED voice, carrying out its demands to varying degrees in eating disorder behaviors, and never have a medical measurable that validates their illness.

No number that clearly tells their medical practitioner, “This person needs more support, a higher level of care, a greater degree of attention, a family meeting, more compassion.”

It’s a tragedy. Because the ED voice is already saying, “You’re not sick. You’re fine. You’re not worthy of treatment. You have to get to ‘x’ to be really ill/accomplish our goals.” The fact that those with eating disorders are some of the smartest, hardest working, most driven people imaginable means that often they are in fact achieving and performing at high levels that to most would be incompatible with a life-threatening illness. Then medical invalidation further supports the ED voice, and people continue to suffer and be pulled further and further away from their values.

What are some of these unmeasurables I’m talking about?

Normal electrolytes

Sodium, potassium, and bicarbonate are almost always normal in pure restriction, no matter how intense. While often abnormal due to purging, electrolytes can all be completely normal, even when someone is purging a lot. Why? I have no idea. My theory is that the body has learned over time to accommodate purging behaviors and keep itself stable. (The body is an extraordinary, remarkable entity…thanks body for hanging in there despite bad treatment.)

Stable weight despite intense ED behaviors, or a “normal-appearing” body weight despite recent weight loss

In an overly weight-focused society (don’t even get me started), weight can be one of the factors that clinicians/programs/insurance focus on to an extent that really highlights the severity of weight bias in our culture. I can’t tell you how many patients have experienced dangerously unconcerned medical care because their body looks “normal” or is of a higher weight, even if they’ve lost a catastrophic amount of weight recently due to medical or eating disorder cause. The patients whose bodies don’t “look” malnourished are often ignored by the medical system. This is a grave mistake, and it misses not only medical complications that need evaluation and treatment, but also the whole human who is clearly suffering and ill and needs more help.  

Irritable bowel syndrome/pain syndromes/dysautonomia

Many patients with eating disorders are also prone to somatic manifestations of emotional suffering. That means emotions are made physical in the body. On more highly stressful days, someone could experience more intense than usual symptoms of nausea, bloating, diarrhea or constipation, back pain, lightheadedness, passing out, gastroparesis (slowed stomach emptying), and more. Issues like Positional Orthostatic Tachycardia Syndrome (POTS) are prevalent in those with eating disorders, and worsen as nutrition and self-care worsen. Guess what? None of these things show up on a lab panel or a CAT scan. The response of the medical system is usually to say, “You’re fine.” The eating disorder has a field day with that one, even as the soul wilts a little more. Or perhaps worse, “It’s all in your head.” That compounds the ever-present guilt, as the person thinks that somehow if they just wanted to be less sick, they’d have less pain. Baloney! These are all complicated medical problems with workups and solutions that are beyond the scope of this blog. However, the right thing to do is deeply validate the suffering and focus on whole-person wellness to try and reduce symptoms.

 

In sum, many aspects of illness are unmeasurable. This is particularly true with eating disorders. If you have an eating disorder, at any body shape or size, you’re not ok.

Don’t compare yourself with your sickest day ever. Compare yourself with the you who embodies your values daily, who treats you kindly and compassionately, the one who uses food as fuel and enjoyment, without torment. The distance between eating disordered you and that you can’t be measured by any medical test…but it’s real.

Keep working toward recovery. It’s worth it.

 


 

About the Author:

ckgaudianiclinic-094-copy-300x300Dr. Jennifer LGaudiani is the Founder and Medical Director of the Gaudiani Clinic, a unique outpatient medical clinic for adolescents and adults with eating disorders. She is one of very few internal medicine physicians in the country who hold the Certified Eating Disorder Specialist credential from the International Association of Eating Disorder Professionals. Check out the Gaudiani clinic on Facebook and Twitter.

 

 

 

 

 

 

 

I Am A Library, and You Are Too

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By Erica B

For a highly intelligent woman, I have made some awful decisions. I treated myself with a complete lack of respect and love that almost led to my demise. I had anorexia for seven years, from ages twelve to nineteen.

I spent the formative years of my life not in the closet regarding my sexuality, but in the closet regarding my entire self. I writhed with insecurity as a child, and by age twelve, I decided to change that. I took each of my flaws and obliterated them until I was just a carcass. Then, I took that carcass and forced it into my idea of my best self. I worked until I embodied my personal opinion of perfection. I was well-mannered and respectful. I was a straight A+ student. I was a rock in the tumultuous lives of my friends. I was a nationally-ranked athlete. I was striking to the eye.

The only thing I wasn’t, however, was a person. I was all but dead. I locked my body and my soul in a dungeon together and fed neither, so they ate away at each other until nothing of either remained. And no one noticed because, why would they? How could someone performing so well also be killing herself from the inside out?

You see me, my accolades and my easy-going personality and sarcastic sense of humor, and assume that you know me. You assume that I am the perfect person I present to the world, just like you assume of everyone else. And that makes you feel insecure.

You know what I’m referring to—think about that person you stalk on Facebook and think, “God, why is his life so perfect and I can’t even get a text back?” You look at everyone as though they are their Facebook profiles.

Wake up!

I wish anorexia upon no one, but I vacillate between resenting it with every fiber of my being and regarding it as a blessing. Recovery brought me insights that most 19-year old women don’t have, and I’ll shout these realizations from the rooftops if I think it’ll make a difference in even one person’s life. So, listen up:

15361704293_aae669c7e4_zAs humans, we are not one page of a book, nor are we one lone book—we are libraries. Our bodies are shelves upon shelves of the books that make us, us; the fiction and the nonfiction, the memoirs and the encyclopedias and textbooks and diaries. Some have dusty covers and that new-book smell, and others have well-worn covers and dog-eared pages. However, we all make the mistake of thinking of others as just one single page, whereas we are the only library in the world. So we hide our libraries deep inside and only show others that one piece that we’re proud of, the one epic page with the perfectly polished sentences and appropriate metaphors. We keep the worn and the poorly written and the dark and the embarrassing ones for ourselves, bringing them out only at night to read by candlelight stealthily, as though we commit some mortal sin by even recognizing their existence.

This is absurd. Everyone is multi-faceted. We ostracize ourselves when we think that we are the only library in a world of single pages. We think, “I am the only one facing this challenge, and so I must hide that, because there is something wrong with me.” Gather a room of one hundred random people, and ask them if they’ve ever thought, “There is something wrong with me, and I feel alone.” Nearly everyone will raise their hands. You will be shocked. Everyone will be shocked. If everyone feels alone, is anyone really alone?

You are not alone.

I know I am not alone. After nineteen years of reading just from my perfect novel with the pristine cover, I have read aloud my dustiest and darkest and saddest volumes to others, and they have read me theirs. I don’t advocate for transparency; I don’t open my library to the public now and invite random strangers to read every volume. Far from that. But, I no longer deny the existence of my library. It is no longer guarded by rabid dogs and several padlocks. I reveal the whole library to select people, carefully and slowly; I reveal certain sections and volumes more freely than others.

As I reveal more and more, and others reciprocate, I find myself in stronger relationships than ever before. I never believed that it was possible for me to connect with others, but I was wrong. Authenticity is not an attribute of a relationship—it glues together relationships. We believe that flaws repel us from others, but they really draw us together. Everyone has their imperfections and insecurities and if you think you don’t, do us all a favor and call a therapist because you’re the most messed-up of us all.

You take the first step to healing when you recognize that struggle is an inevitable part of life. So if you have learned anything from my ranting, let it be this: struggling does not mean there’s something wrong with you. Struggling means that there’s something right with you—you’re a person. So, embrace it. Welcome to this planet, where everyone struggles every day, because that’s what makes us people.

 


Frequently Asked Questions Friday-Pregnancy and Eating Disorders

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Frequently Asked Questions Friday

FAQ

Pregnant-Woman

This week’s question is:

How do I maintain recovery from my eating disorder during pregnancy?

So this is an interesting question, because I think that the answer very much depends on the individual. I have had friends in recovery who have said that being pregnant saved them, that those nine months were the most carefree nine months ever, because the pressure to maintain an idealized body was gone. Others that I have worked with have told me that pregnancy was the time that their eating disorder was the loudest. Others still have confided that pregnancy sparked a relapse.

What is important to note is, if you have a history of an eating disorder, it’s likely tricky to predict how you will react to all of the physical, psychological, and emotional changes that pregnancy brings. This is why I think this question is good for EVERYONE to consider-not just for those who are currently in recovery and pregnant, but for anyone who ever might become pregnant one day.

Because pregnancy is so personal and individualized, I felt that this question deserved a more well-rounded answer than my sole clinical opinion-so I called in the troops! Two brave, smart, warriors who have experienced pregnancy during recovery agreed to share their feelings, tips, and tricks about this very topic with you all!

 

Veronica:  When we found out we were having a baby we were so excited, but in the back of my mind I was afraid of how I would do with gaining all of the weight that comes along with the blessing. I was afraid that it would trigger old habits and behaviors with the new changes that were about to begin. Throughout the 9 months as my belly grew, I just kept reminding myself of the little miracle that was growing inside of me and how he was depending on me to take care of myself in order to thrive. I was actually a little surprised with how much I loved being pregnant. I loved that I was eating not only for me, but for my baby. For once in my life I didn’t worry about the weight I was gaining, but instead embraced it. Embraced the life that my body was able to nourish. How amazing is that…my body was able to nourish and grow another human being! So wonderful!

I think the hardest part for me was after my son Lane was born. My body had changed, but now I had a tiny human to take care of other than myself. I was nursing so I was starving all the time (even in the middle of the night). So although my body had changed, and I weighed more than I did pre-pregnancy, I knew I needed to eat in order to produce enough milk to feed him. Things were different. It was far more important for me to eat to fuel my body and his than for me to fit back in my clothes. I also knew that once he was older he was going to watch me. I knew that from this day forward I was not just taking care of me; I was taking care of him and setting a good example. That meant having a good relationship with food and exercise.

I am now 24 weeks pregnant with our second son (!) I continue to remind myself not to worry about the changes in my body. It continues to be a daily challenge, but I am using the same coping tools and support systems as I did during my first pregnancy to work through it. I went to the doctor today for my standard check-up and was dreading getting on the scale. I wasn’t going to look-but then I reminded myself that I am more than a number. My weight and body shape does not make or break the woman I have become. Our bodies are amazing, God designed them to grow another human being, and that is a true gift.

Jen: It was surprising to me how quickly my eating disorder voice came back as soon as I found out I was pregnant; I had been in recovery for a solid eight years by the time we got the news. Some of the voice’s content was the same, especially surrounding numbers and perfection. I was quickly obsessed with being a “perfect pregnant woman.” I wanted to gain the perfect amount of weight, no more no less. I wanted to eat only the most “perfect” foods. I was gripped by the thoughts of being a perfect mother and took on so much of the responsibility. Often my thoughts went something like this, “If I do X, then Y would happen to my baby, and I am a terrible mother.”

My first piece of advice and truly the most important is to rally your troops. Tell your support system about the thoughts you are having or that you are concerned you will start having the thoughts. Make a plan before you are “in it.” Second, become informed and educated about your pregnancy. Doctors are good sources, google is not. It is easy to get swept up into new mother forums because it can give us instant gratification (instant gratification is totally not something people with eating disorders like or anything…sigh), but it can almost always give us something else to worry about. Lastly, actively practice awareness, mindfulness, and gratitude. My favorite moments in pregnancy took place in my bathtub. I would be fully immersed in my connection with my daughter. I would be gratefully thinking about the incredible things my body was doing in its efforts to grow a baby. I would accept my anxious thoughts if that came to me but kindly bring my mind back to my baby. Towards the end, this would usually result in sweet reminder from my girl giving me a kick or a roll, as if to say, “I love you.” I was unbelievably grateful that I could be so terrible to my body for so much of my life and it was still willing to give me my most precious gift. You are a goddess, Mama, let your body do what it was made to do.

 

As you can see, Jen and Veronica struggled and triumphed in unique and separate ways with their recovery journeys during pregnancy. Veronica talked about the body negativity that plagued her throughout both of her pregnancies- specifically when it came to gaining the necessary weight. This aspect of pregnancy can actually be upsetting to both recovered and non-eating disordered individuals alike; especially if low body image and self-esteem were a struggle prior to pregnancy (which research tells us is the case for the majority of women).

As Veronica mentioned, it is important to use continuous self-talk when these thoughts pop up. Remind yourself of the miracle that your body is making (despite, as Jen stated, how much you may have put your body through in the past!) Remind yourself of how much this miracle needs the energy from the food that you are providing him/her. Perhaps you may even take on a mantra at this time-something simple like, “Nourish to (help my baby) flourish!”

And of course, if weight gain feels overwhelming to you during your pregnancy, ensure that you have professional support, as well as moral support systems in place to lean into and discuss these concerns.

Contrastingly, Jen struggled with the idea of being the “perfect mom,” and having the “perfect pregnancy.” She referenced how this was most definitely her ED voice, albeit cleverly disguised as thoughts of wanting to be the best for her child. That is the thing about eating disorders. They are wily. And they might not present themselves in a completely overt manner. This is why it is so important, specifically during pregnancy, but also during every other phase of life, to be very mindful and aware of how ED speaks to you. When do these thoughts get loud? How have they tricked you in the past? The more aware you are, the more pitfalls you can pinpoint and avoid-like a true warrior. For example, if you, like Jen, are drawn to instant gratification, but also suffer from anxiety, be sure to avoid things like the mom forums that she mentioned. If you tend to be a perfectionist, and you know that this has triggered your ED in the past, identify one or two point people that you can talk to about this during your pregnancy. People that know this tendency in you, and that you can trust to be honest and empathic. (“Listen I’m feeling a lot of pressure to use only cloth diapers and make all my food for my baby by hand when she is born…Is that doable or is my perfectionism getting on top of me again?”).

Summarily- I don’t know that I can put it better than Jen- “Rally your troops.” Make sure you have a solid professional and personal support system in place for this journey. And, as Veronica mentioned, use your coping tools! Whether that means mantras, daily reminders, journaling, self-talk, mindfulness, gratitude-doesn’t matter which one it is, as long as it clicks in and works for YOU. Because along the way during those nine months, there are a plethora of other triggering situations not addressed here that can arise-feeling sick, feeling very full, comments from others- “You have GOT to be having twins!” “You are getting so big!”-But as long as your have your professional support systems, personal support systems, and coping toolbox, you will likely be able to handle these as they come. Sure, they may not be the most enjoyable situations to endure (seriously, why do we feel it is our right to tell pregnant women how big we perceive their bellies to be-or TOUCH them at that?!) but with the awareness and tools, you will be able to b r e a t h e and utilize healthy coping mechanisms instead of resorting to eating disordered behaviors during these times. Shine on recovery mamas.

 

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Jen Misunas Buckwash is a happy, healthy new mom to a 5 and a half month super girl. She is a practicing professional counselor in PA and will complete her doctoral degree in Psychology in May. She has been in recovery since 2008.

 

 

 

 

 

 

 

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Veronica Carr Yerger is stay at home Mom and online fitness entrepreneur from Dillsburg, Pennsylvania where she lives with her husband Mark, little boy Lane and another boy on the way in March 2017. She shares her 20+ years of experience in coaching, mentoring, and fitness with her clients on a daily basis emphasizing a strong balance of positive body image, family, life, and faith. veronicayerger@gmail.com, FB@verionicahealth, IG @veronicahealth

 

 

 

 

 

 

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Colleen Reichmann is a licensed clinical psychologist, specializing in the treatment of individuals with eating disorders, body image issues, self-esteem issues, and women’s issues. She lives in Virginia Beach with her husband, goldendoodle and (brand new!) sheepadoodle.

Let’s connect!

Email questions to: blog@theprojectheal.org

Instragam @drcolleenreichmann

Facebook Page: Dr. Colleen Reichmann

 

 

 

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.

FAQ Fridays- Are the Friends I Make in Treatment Good for Me?

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Frequently Asked Questions Friday

FAQ

This weeks question is:

Are my friendships with the people I met in treatment good for me?

 

This is a tough one. I personally do not believe that there is one right answer to this question. I think that it depends on 1. The nature of your friendships, 2. Where you are in your own recovery, 3. Where the other individuals are in their recoveries, and 4. Your personality and friendship dynamics. Did you expect me, the psychologist, to say, “No. These friendships are not good for you. End of story”? Well I cannot, in good faith, say that. And perhaps I diverge from many of my colleagues in my belief on this matter, but I do not consider this to be a black and white issue. I think that there are several themes that apply to friendships formed in treatment, so I will attempt to give this complicated question the multifaceted answer that it deserves:

 

It’s no secret that eating disorders are competitive illnesses. In fact, for a great deal of sufferers, treatment can be made more tricky because the eating disorder becomes triggered to be the “best” when surrounded by others who are also ill. This is why a number of treatment centers have policies ruling against socialization after discharge. However, having an eating disorder can also be incredibly isolating. It can be a welcome change to have a friend who just gets it.

 

But when you both have an eating disorder, and you are both trying to recover, things can easily get dicey. Eating disorders are tricky illnesses. You can want recovery in your heart of hearts, and still feel a twinge of jealousy when you see someone else acting on behaviors. You can be working towards weight restoration with all of your might and still find yourself perusing how to cut calories. It’s difficult enough to manage your own symptoms and tease out if the eating disorder is in control at the moment. Now throw another person in exactly the same boat into the mix. You both want recovery. You both understand the torturous nature of this confusing illness. And you are both dealing with working through the ED thoughts and stopping the behaviors. On one hand, it’s beautiful to feel that type of camaraderie. (In a world where most seem to be shouting “Just eat!” what a breathe of fresh air to sit across from someone shaking just as much when they pick up the sandwich.) On the other hand, you are now vulnerable to a particularly strong type of trigger- the relapse of a friend.

 

Anybody who has been through this can tell you- it’s incredibly difficult to watch a friend go through a relapse. It’s easy for the eating disorder to sneak in during this time and set off those competitive feelings. It’s equally as easy to take it personally. (i.e. How could she do this when we are in this together? Doesn’t she know what this does to me?) Additionally, there is the danger of feeling the responsibility to save her. You might feel the pull to begin to pour all of your time and energy into helping her. The danger here? You begin to neglect your own recovery, and, again, the door is left ajar for the eating disorder to flare up.

 

So what is the solution? Should you, as those aforementioned treatment centers suggest, cut off all relationships with fellow patients after being discharged? Or should you throw caution to the wind and venture on towards the sister/brotherhood of recovery warriors? The truth is, only you can answer what is the right solution for you. I know some people who have felt that they need to keep themselves at arm’s length from fellow patients. These individuals have shared that they sought an identity outside of the eating disorder, and noted that they wanted to surround themselves with the healthiest people possible. One friend told me that she felt it necessary to immerse herself in “normal eater world,” so that she could attempt to emulate her friends who have had historically healthy relationships with food and weight. Another individual told me that she was tired of conversations surrounding triggers and fear foods, and indicated that she felt the need to cut off these relationships if she truly wanted to recover for good. I have also heard the opposite-people who feel that their relationships with their fellow warriors were vital to recovery. Some will hold that the bonds that are created when people go through treatment together are unlike any other. There is sense to this- there will never be another time when you are more raw and vulnerable, so these relationships do have the potential to be very deep. In fact, our fearless Project HEAL leaders have shared that they met in treatment, and that their relationship was indeed important to their recovery processes.

 

So, as I initially stated, similar to most everything about recovery, the answer to the question of whether or not relationships between two people in recovery are healthy is not black and white. I believe the answer is- there is no absolute answer. Just like any friendship- some may flourish and some may become toxic. Certainly, many may find a sense of acceptance and peace in these relationships. Others may feel that it is best to keep a clear boundary between friends and fellow patients. No matter how you feel, it is important to be honest with yourself and others about what is helpful to you during the recovery process. No two journeys to recovery are identical, which means you must pay close attention to what is helpful to you. Listen to your inner voice when it comes to friendships with fellow recovery warriors. It may be that you need to return to you original circle of friends after treatment, and keep fellow patients at arms length to protect your own recovery. Or perhaps these friendships will be better suited for you later on in recovery-when you are feeling strong and have a deep sense of what triggers you and what helps you to cope. At that point, you may just find that these friendships can truly be like no other-just ask our Project Heal co-founders! Whatever the case, you and your recovery must come first, so pay close attention to your inner wisdom. It’s there, I promise.

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Colleen Reichmann is a licensed clinical psychologist, specializing in the treatment of individuals with eating disorders, body image issues, self-esteem issues, and women’s issues. She lives in Virginia Beach with her husband, goldendoodle and sheepadoodle.

Let’s connect!

Email questions to: blog@theprojectheal.org

Instragam @drcolleenreichmann

Facebook Page: Dr. Colleen Reichmann

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.

Frequently Asked Questions Friday

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Frequently Asked Questions Friday

FAQ

This weeks question is:

How does treatment differ for males?

 

This is a great question, and one that does not receive enough attention or discourse. Males are and have been left out of the eating disorder discussion for far too long. As a society, and sometimes even as health professionals, we tend to hold the mistaken belief that males do not struggle with body image, or that they cannot develop unhealthy relationships with food. This is simply not true. The percentage of males that report struggling with eating disorders has been on the rise for years, but my argument is that our current understanding of percentages and numbers is likely very inaccurate, due to underreporting. There is still that strong societal belief that eating disorders are “female illnesses,” which leads a lot of male sufferers to feel shameful and stay silent about their pain.

 

One important factor to note is that many males develop their eating disorder along their journey to become “fit” versus simply thin. Our society currently holds a different fitness ideal for males than for females. “Fit” for men may imply more of a high muscle-low fat ratio. Currently, the pressure for males to achieve this body-to be “cut”-is astounding. However, this body type is not natural or attainable for the majority of the male population. The term “muscle dysmorphia” has been coined to describe this preoccupation with less fat and greater muscle definition. Hence males can begin to fall prey to the very same behaviors that females do. This shift can be tricky to identify at first, due to the fact that the original intention was not necessarily weight-focused. However, for many of these male eating disordered sufferers, their focus gets lost and the relentless pursuit of thinness takes over. The sport or activity that was once enjoyed then becomes an obsession.

 

Similarly, males tend to struggle more with legal performance-enhancing supplements — things like whey protein, creatine, and L-carnitine. Studies have shown that the use and abuse of such supplements is on the rise, and up to 22% of males stated that they had replaced meals with said supplements in the quest for a lean frame and large muscles. This behavior is dangerous, eating disordered, and rooted in low self-esteem- however it goes largely unnoticed by the majority of our society. In fact, the use and abuse of supplements seems to be considered somewhat normalized behavior at this point. This is quite problematic because these supplements have been linked to the development of eating disorders, and normalizing their abuse contributes to the trend of ignoring male disordered eating behaviors.

 

It is also important to note that, just as the thin ideal does not contribute to all eating disorders among women, current male fitness trends do not factor into all male eating disorders either. Many males report experiencing the very same influences as females- bullying, a drive for perfection, a quest to disappear, a desire for control, a need for numbness, a history of trauma-when conceptualizing their eating disorders in treatment. Therapy and treatment must include room for males to explore this part of their eating disorder, instead of simply focusing on body dissatisfaction with a focus on fitness trends.

 

At the inpatient or outpatient level, male-only groups tend to be helpful. This is because males have concerns regarding social issues, family dynamics, and body image that are vastly different than those of females. Male-only groups are helpful in that they allow males to specifically discuss and lend support around the stigmatization factor to one another. This is not to say that mixed-gender groups cannot be helpful as well. In the end, everyone is suffering with an illness that falls under the same umbrella, so support and camaraderie in general is a healing experience.

 

Research also suggests that a focus on gender dynamics overall in the treatment for males with eating disorders is important. Individual and societal perceptions of masculinity likely affect one’s experience of disordered eating, and must be explored. Masculinity has been correlated with more negative attitudes toward obtaining mental health help, and may contribute to the reason that males make fewer attempts at seeking help. Hence a therapist may identify this as something to explore further.

 

Other parts of treatment are comparable across genders. For example, treatment outcomes are similar. The basic principle of treatment (i.e. weight restoration, disrupting maladaptive behaviors, challenging thoughts related to weight and shape) also remain the same. For a more detailed analysis of this, I would suggest looking into the article “Males and Eating Disorders: Gender-Based Therapy for Eating Disorder Recovery,” found in Professional Psychology: Research and Practice, by Greenburg and Schoen.

 

I believe that if we continue to raise awareness and educate others about the fact that males can and very much do get eating disorders, the intervention and treatment for males will improve drastically. Currently, there are still far fewer treatment center options for males than there are for females. But as awareness continues to spread, more and more centers are beginning to not only accept males, but also provide specific tailored treatment or “male tracks.” This is encouraging progress. There is also NAMAD- The National Association for Males with Eating Disorders, which provides resources, inspiration, support, and articles for males

(http://namedinc.org/)

 

Conclusively, we still have a long way to go in terms of our awareness and inclusion of males in the eating disorder conversation. But the conversation has begun, and this alone is great progress. Lets keep it going!

 

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Colleen Reichmann is a licensed clinical psychologist, specializing in the treatment of individuals with eating disorders, body image issues, self-esteem issues, and women’s issues. She lives in Virginia Beach with her husband, goldendoodle and (brand new!) sheepadoodle.

Let’s connect!

Email questions to: blog@theprojectheal.org

Instragam @drcolleenreichmann

Facebook Page: Dr. Colleen Reichmann

*The views expressed in this posting are based on this writer’s professional knowledge, training, and experience in accord with current and relevant psychological literature and practice. These views do not indicate that a professional relationship has been established with any recipients. Readers should consult with their primary medical professionals for specific feedback about any and all questions.