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Karen's Blogs

Blogs are brief, to-the-point, conversational and packed with information, strategies, and tips to turn troubled eaters into “normal” eaters and to help you enjoy a happier, healthier life.Sign up by clicking "Subscribe" below and they’ll arrive in your inbox. 

[No unsolicited guest blogs accepted, thank you]

Bouncing Between Dwelling and Denial

Bouncing Between Dwelling and Denial
When terrible things happen or even when we consider that they might, we tend to swing between two polar extremes: dwelling in distress or denial of it. Either we can’t stop thinking about a potential threat or we convince ourselves that it will never happen. Neither strategy is useful for problem-solving, but both are understandable, as they are our primitive responses to trying to protect ourselves from hurt and hurting. This pendulum swing happens in Post-Traumatic Stress Disorder. Many victims and survivors remain hyper-vigilant and excessively anxious about harm befalling them again and can think of nothing else. Wary of danger, being on the look out for it is their way of trying to ensure that it doesn’t re-occur. Intrusive memories become a warning of all the terrors that could resurface. Alternately, many survivors repress (unconsciously) or suppress (consciously) memories. Such denial makes them feel safe, as if nothing awful ever...
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Try Body Neutrality

Try Body Neutrality
One of areas in which I get the most push back from clients is when I talk about body positivity. The idea of loving a large body which everyone in the world seems to hate is just too much to take in for many higher weight clients. It’s also difficult for people who would like to stop dieting and eat more “normally,” because of their terror of gaining weight and becoming like the people, fat, that is, that they’ve learned to hate.  If you’re in either group, Sonalee Rashatward, social worker and activist, has a message for you about substituting the quest for body love and acceptance with body neutrality. (“What We Can All Learn From the Fat Sex Therapist” by Alexandra Jones , https://www.phillymag.com/be-well-philly/2019/09/18/fat-sex-therapist/ , Philadelphia, 9/18/19, accessed 9/20/19). While fighting fat phobia and weight stigma and many other prejudices, she makes the point that: “. . . those struggling to...
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What Kind of Overeater Are You?

What Kind of Overeater Are You?
I attended a workshop entitled “Nutritional Psychiatry: Your Brain on Food” which had a section on Binge-eating Disorder or BED. (CE International, www.ceinternational.com , Ginger Schirmer, PhD, RD). It included a description of five types of overeaters that I found interesting, although I’m not sure I agree with them being all that different. I’m blogging about them because doing so may help you identify why you overdo with food and develop strategies to avoid doing so. First, consider what Dr. Schirmer had to say about food addiction: that no food is addictive, but that we can form an addiction-like relationship to foods that changes our brain and body chemistry much as it would if we were dependent on drugs or alcohol. I’ve heard others describe this dynamic as having an eating addiction. At any rate, when you read the categories below, remember that Dr. Schirmer isn’t talking about the food being...
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Alexithymia and Eating Disorders

As a social work intern in an outpatient clinic, I had a client who my supervisor diagnosed with alexithymia, a condition I’d never heard of. If I hadn’t gone into the mental health field, I probably never would have run across it. But, it turns out to be highly relevant to therapy and to eating disorders as well.  Here’s what it looked like in my client. My client had been extremely close with her father who died after a long illness. She coped by coming into each session talking about a dead bird she’d seen in the gutter. She was ripped apart by the plight of this poor bird and could talk of little else. To make grieving easier, she used the defense mechanism of displacement to shift her feelings about her father onto the dead bird.  Alexithymia means literally “no words for feelings” and “is prevalent in patients with psychosomatic...
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How Often Are You Triggered by Memories?

memories
Clients spend most of their time telling me about situations which have been or might be very upsetting to them, what I call recall or memory triggers. My job is to teach them how to recognize triggers before, during or after the fact. I’ve blogged often about how to identify slipping into recall, but that’s not enough. You need to know what your triggers are. Remember, you can identify them because they are your emotional reactions that are out of proportion to or in excess of whatever is occurring in reality. Here’s a paragraph from one of my previous blogs. “To stop recall triggers, make a list of troubling memories regarding how you were hurt in childhood: being shamed, abandoned, neglected, compared unfavorably to others, fiercely competed with, ignored, teased, undermined, invalidated, feeling unheard or  invisible, regularly being forced to do things against your will, being manipulated, etc. Recognize that similar...
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Why It’s Hard for People to Give Up Weight Shaming

Why It’s Hard for People to Give Up Weight Shaming
Although I usually enjoy comedian Bill Maher’s humor on his show Real Time, I was appalled and disgusted at his misinformed fat shaming monologue in September. Just like “obesity,” fat shaming is a complicated subject and there’s no simple answer for it. But there are five reasons that it occurs.  Lack of civility People fat shame because we live in a highly uncivil culture where everyone thinks they have the right to say whatever they want to everyone else. Due to the advent of social media, very little is kept private anymore. There was a time (younger folks will need to trust me on this) that people, for the most part, kept their religious and political opinions to themselves. Of course, humans always have gossiped, but that was the point—it was done privately, one-to-one or in a small group, not blabbing our judgments to hundreds or millions of people. We say...
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Co-dependence and Dysregulated Eating

Co-dependence and Dysregulated Eating
Can it be that in all my blogs, I’ve never written specifically about co-dependence? I think that is the case, which is odd considering that it’s a prevailing trait among my clients—dysregulated eaters and otherwise.  According to “6 Signs of a Codependent Relationship: Research explains why the ties that bind are practically unbreakable” by Linda Esposito, LCSW (Psychology Today, https://www.psychologytoday.com/us/blog/anxiety-zen/201609/6-signs-codependent-relationship , 9/19/16, retrieved 9/6/19), co-dependency is “when two people with dysfunctional personality traits become worse together.” Suffice it to say that co-dependence involves poor boundary setting and maintenance, enabling unhealthy behavior, not taking responsibility for oneself, over-focusing on others’ needs to the exclusion of your own, and a general life imbalance around caretaking of self and other. You can read more about it online or in two classics books, Co-dependent No More by Beattie or Facing Co-dependence by Mellody.  For now, I want to talk about how co-dependence and eating disorders...
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Book Review – My Body’s Superpower

Book Review – My Body’s Superpower
How I wish I’d had a copy of Maryann Jacobsen’s book, My Body’s Superpower: The Girl’s Guide to Growing Up Healthy During Puberty, in my pre-adolescent and adolescent years. Although many decades have gone by since then, I still vividly remember how difficult it was to manage my feelings, my changing body and the world I lived in. If you have a female child who’s approaching or going through the changes of puberty, you’ll want to purchase a copy of this book to help guide her through it. The premise of My Body’s Superpower is that we all have secret powers that become superpowers once we discover, practice, and start using them regularly. The book begins with Jacobsen, a dietician, mother and author who writes about effective parenting, explaining what puberty is and describing its five stages. She describes early and late puberty and even has a short section for boys...
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My Interview from Eating Enlightenment

food
“30 Years and 7 Books of Eating Disorder Recovery Wisdom,” is an interview of me by Jared Levenson. Below is a bit about my crazy eating days. To hear more of my story and recovery, listen to this podcast at https://eatingenlightenment.com/2019/12/01/eating-disorder-recovery-interview/ .  I talk some in my books and more in my sessions with clients about how I went from being a chronic dieter and world-class overeater to a “normal” eater. They are often amazed when I tell them that I’ve been recovered for half a lifetime which, at 72, sometimes seems like it was just yesterday and sometimes seems like my warped relationship with food happened to another me and not the one I am today. I was a deprivational eater who weighed myself several times a day. I counted calories to know what and how much to eat. You could have slapped on me any other label that applied...
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What’s the Difference Between Constructive and Destructive Emotional Discomfort?

What’s the Difference Between Constructive and Destructive Emotional Discomfort?
Emotional discomfort is a complicated subject. Is it a feeling to take seriously, to ignore or to overcome? Does it serve or hinder us from growth? How can we learn to distinguish constructive from destructive emotional discomfort? After two sessions in a row discussing emotional discomfort with clients, I began thinking more about it. In the first session, a client said that she overate because “I didn’t want to feel uncomfortable stopping.” This led to discussion of why and whether she could have managed her uncomfortable feelings in order to avoid experiencing a different kind of discomfort, that is, over-fullness. In my next session, a client expressed pride that when she’s with certain kinds of people—mostly narcissists like her father—she’s now able to see them for what they are (from her emotional reaction to them) and either distance herself from them or manage being in their company. For certain, emotions are...
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Self-attunement

Self-attunement
I can’t recall where I learned about it, but somewhere I read a while back about successful people being attuned to themselves. There was a study or bunch of studies which came to this conclusion (having no citation, you’ll have to trust me on this one). Right away I thought about my clients—which ones were more or less connected to themselves and how they related to their progress in eating disorders recovery. Clinicians learn and generally talk a good deal about attunement in terms of how connected/in sync parents are to their children. When a parent on a long car ride finds her child crying, he might respond with understanding that children get fidgety strapped into car seats and need distraction. When a child comes home from school saying she’s fine but looks anxious and anger, an attuned parents asks if things really are okay.  Parental attunement to children requires time,...
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Recovery Works—Just Not as Fast as You Want

Recovery Works—Just Not as Fast as You Want
Many pieces of recovery need to come together to reach your goals. If you’re focused on looking in the mirror or down at the scale, you’ll miss them. You want quick change, like now! I get it. But for success, instead of measuring progress in pounds or inches, you’ll need to shift your focus to how you’re making small attitudinal and behavioral adjustments in other aspects of life that will eventually move you toward recovery. Recently a client was lamenting the “bleepin’ lag time between learning how to have a better relationship with food and her body” and actually doing better around food and improving her health. It’s true, the lag time can be frustrating and seem daunting. That’s because there’s generally a good deal for dysregulated eaters to learn in order to manage life in a healthier manner. For the umpteenth time: It’s not just about the food. Clients start...
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Let’s Hear It for Uncertainty and Confusion

uncertainty and confusion
What is it that scares some people so about being confused or uncertain? Why does not knowing throw too many folks into a tailspin or make them want to crawl into bed and pull the covers up over their heads? What if you were to value not knowing what you want or what to do and not stress about it but hang in their and learn from it? William Blake, the English poet, painter and printmaker, is quoted as saying that “Without contraries, there is no progression.” Author David Robson of The Intelligence Trap: Why Smart People Make Dumb Mistakes tells us that, “The latest neuroscience…shows that we learn best when we are confused.” Blake is saying that we need to engage with contraries (feelings, ideas, etc.) in order to emerge from them to make progress. Robson explains how we learn best when things are a bit tough, through “desirable difficulties”...
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The Importance and Value of Treats

treats
Many dysregulated eaters crave and overeat “treats.” But, guess what: If you’re eating them all the time, they are no longer treats. That’s because a treat is something pleasurable, out of the ordinary, and not in your daily routine. It’s meant to be an occasional pleasure to the palate or boost to the spirit, but many dysregulated eaters ruin their purpose by seeking and consuming them excessively. From my own bingeing history and 30-plus years of working with troubled eaters, my take is that they often don’t enjoy life very much and seek food to increase its pleasure. That’s just plain sad. You cannot have a healthy relationship with food if you’re overly reliant on it and it’s your singular go-to for pleasure and a bounce in your step.  I’ve had clients who use vacations the same way. They’re anywhere from unhappy to miserable in their lives and seek travel to...
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Self-deception

baking cookies
Self-deception is a funny thing in that most of us would swear we don’t engage in this behavior, which is a way of showing that we do. One theory about self-deception is that it’s an anomaly or glitch in the 200,000-year-old brains of Homo Sapiens. However, evolutionary psychiatrist Randolph M. Nesse (author of Good Reasons for Bad Feelings), maintains that lying to ourselves has a function in the survival of our species, that is, to move us along in our primary task of procreation. As you know—if you’re honest with yourselves—the eating arena is rife with little lies. In Johare Window terms (Google it), this construct involves “what you don’t know you don’t know,” information that’s out of consciousness, aka your blind spot. Most of the time we’re unaware it exists because acknowledging it would hinder our need to feel okay. In the case of dysregulated eaters, that lack of consciousness...
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Purging After Eating

Purging After Eating
Been there done that: purging after eating, that is. I had bulimia for about 18 months in my late twenties. Back then my binge-eating was in full force and I thought that purging (a more genteel word for “vomiting”) was such a clever idea to combat overeating. This was long before the word bulimia came on the scene. No one I knew purged and I don’t recall reading anything about its health dangers. I suppose there was less shame attached to it because there was no big fuss made about it. But somehow I knew it was wrong or, at least, something I didn’t want to be doing. I finally confessed to a friend who knew about my ongoing struggles with food that I was also vomiting (let’s call it what it is), and she very caringly insisted that I find myself a therapist post haste. I think I told her...
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How to Thrive During the Holidays

Holidays
I’ve written dozens of holiday blogs and articles over the decades and here’s another. You can check out previous ones in my blog archives on my website. My goal here is to provide simple guidelines for you to follow over the holidays which will help you take excellent care of yourself and make you proud of yourself.  Focus on what’s enough. Whether we’re talking about food, alcohol intake, cleaning, decorating, gift giving or partying, get in touch with what feels like the right amount for you. Ditch all-or-nothing thinking and stay connected to self-regulation. Don’t diet. Holidays are a perfect time to practice “normal” eating. Sure there are more treats around, but that just gives you more opportunity to have small amounts of foods you really love. Have a tapas mentality—a little of this and a little of that is enough. Emotional regulation. Keep tabs on your emotions. If you know...
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Embracing the Right Kind of Anger

Anger
Driving home from doing an errand, I heard an interview (shout out to NPR) about women and anger which got me thinking about how many dysregulated eaters and people with high weights—not just women—use anger in the opposite way from how it is useful. Wouldn’t it be great, I thought, if they could channel anger more effectively.  Here’s what I see and hear. In general, these clients (and others as well) are angry at things which don’t merit anger or won’t be changed by it, while they feel accepting of or helpless about things which they have a shot at changing if they direct their rage at it. For example, dysregulated eaters could be angry at the culture and the media which are overtly or covertly pressuring them to diet and hate themselves unless they lose weight Instead, they’re furious at themselves for not being or becoming slimmer.  They could be...
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Distinguishing Thoughts from Feelings

Thinking
Many clients and the children, partners or parents they bring along to sessions have no idea that there’s a distinction between what they feel and what they think. Confusing the two leads to their being reactive and to poor decision-making and problem-solving. Differentiating the two is key to improving your relationship with food and your body. Here are examples to help you distinguish thoughts from feelings.  I ask a client how he feels about his job taking him away from his wife so much of the time and he responds, “I don’t really have a choice about it right now.” A client tells me that when her mother gets drunk, she’s nasty to her and I wonder how that makes her feel. She says, “Mom doesn’t mean anything by it. She’s drunk.” A client reports that his son came out to him as gay and I ask how he feels about...
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Dangers of Ultra-processed Food

Grocery Shopping
If you’re a frequent reader, you know that I rarely blog about nutrition. That’s because my focus is on the how and why, not the what, of eating based on the belief that (almost) all foods can be part of the healthy, “normal” eating.  I try my best to avoid the concept of “good” and “bad” food. Broccoli does not sport a halo above its leafy stalks and no devil’s pitchfork rises out of a scoop of ice cream. One need not be a perfectly nutritional eater; occasional treats of high-sugar/high-fat foods are fine and welcome. Ultra-processed foods, however, are in a category all their own because of the manifold, negative effects they have on our bodies. In “Are Ultra-Processed Foods Making Us Fat: A new study shakes things up” (Nutrition Action Healthletter, July/August 2019, pp 3-6), Kevin Hall, PhD minces no words about the dangers of the likes of “sodas,...
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This website is owned and operated by Karen R. Koenig, M.Ed., LCSW. It contains material intended for informational and educational purposes only, and reasonable effort is made to keep its contents updated. Any material contained herein is not to be construed as the practice of clinical social work or of psychotherapy, although adherence to applicable Florida States, Rules, and Code of Ethics is observed. Material on this website is not intended as a substitute for medical or psychological advice, diagnosis, or treatment for mental health issues or eating disorder problems, which should be done only through individualized therapeutic consultation. Karen R. Koenig, LCSW disclaims any and all liability arising directly or indirectly from the use of any information contained on this website. This website contains links to other sites. The inclusion of such links does not necessarily constitute endorsement by Karen R. Koenig, LCSW who disclaims any and all liability arising directly or indirectly from the use of any information contained in this website. Further, Karen R. Koenig, LCSW, does not and cannot guarantee the accuracy or current usefulness of the material contained in the linked sites. Users of any website must be aware of the limitation to confidentiality and privacy, and website usage does not carry any guarantee or privacy of any information contained therein.  Privacy Policy