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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. 

Book Review – The Elephant in the Room

Reviewed by Karen R. Koenig, LCSW, M.Ed. and originally published at New York Journal of Books: https://www.nyjournalofbooks.com/book-review/elephant-room. The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing America “The inspiring story of Tomlinson transforming his relationship with food may break your heart before it eventually lifts it.” The Elephant in the Room should be compulsory reading for people of every size. If you share Tomlinson’s love-hate relationship with food, you just may learn a thing or two that will set you on a path to more normal eating. If you’ve not battled with food or weight, he’ll paint you such a graphic picture that you’ll never look askance at a fat person again. And if you don’t feel compassion for his struggles, check for a missing piece of your heart. When it comes to being fat, Tomlinson tells it like it is: the stigma and...
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Use Regret to Improve Your Life

Ah, regrets. We all have ‘em. No matter how wonderful our lives appear to be or actually are, we can’t help but recall things we did or wish we hadn’t done and wonder about how our lives would have turned out if we’d acted differently. Many dysregulated eaters are beset by regrets which makes it hard for them to enjoy the present or plan well for the future. And, sometimes, the stress of regretting drives them to comfort eating. As wise and witty psychotherapist and author Lori Gottlieb says in Maybe You Should Talk to Someone (p. 166): “. . . regret can go one of two ways: it can either shackle you to the past or serve as an engine for change.” In truth, it’s neither the magnitude of your actions nor the consequences of them that dictate which attitude you’ll have about regret. Nor is it your current...
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That’s So Not Me

As sometimes happens, there’s been a theme cropping in my therapy sessions: “This is not who I am” (said vehemently). This attitude comes from a fixed (versus a growth) mindset ( https://www.karenrkoenig.com/blog/fixed-versus-growth-mindset ) which is the belief that you have an identity and traits you’re stuck with that will never change. This view allows no room for events or insights to impact us that will modify how we think, feel and behave. It’s like never allowing computer updates or uninstalling programs or having a TV that works only on a few channels. We’re all more than our current identity—different at various stages of our lives (childhood, adolescence, young adulthood, middle age, old age). We’re not made to have immutable personas. Naturally, there’s a basic “me” that we recognize as ourselves and a “you” that others recognize as “us,” but it’s the antithesis of growth or healing to say, “That is...
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Self-objectification

Self-objectification is common among people who turn up in my office. It involves internalizing “an observer’s perspective” about ourselves. More specifically, body self-objectification is an unhealthy way of viewing our bodies through the values of others or of society. “Self-objectification is associated with increased risk of poor body image, depression, and eating disorders” and, when studied, “was most consistently and positively associated with neuroticism, perfectionism, and narcissism across multiple studies.” (Carrotte, E., & Anderson, J. R. (2018). “A systematic review of the relationship between trait self-objectification and personality traits.” Personality and Individual Differences, 132, 20-31. DOI:10.1016/j.paid.2018.05.015). Of the three traits listed above, neuroticism and perfectionism are the ones I see in most dysregulated eaters. Neuroticism is seen in a personality tendency toward guilt, shame, anxiety, self-doubt, and self-deprecation. Neurotic clients do a great deal of putting themselves down, feeling insecure about decisions, ruminating about the past, obsessing about the future,...
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Book Review – The Intuitive Eating Workbook for Teens

I wish I’d had The Intuitive Eating Workbook for Teens by Elyse Resch, MS, RDN when I was growing up. My dieting and binge-eating started in adolescence and back then I never gave a thought to these behaviors damaging my mental or physical health. I was ignorant and would have benefitted from knowing about intuitive eating in order to start focusing on appetite cues and valuing my body and stop focusing on weight. The workbook is geared for teens, without talking down to or above them. It covers a wide range of issues beyond what and how to eat. It begins with an explanation of why diets don’t work long-term and the dangerous pattern they set up for young minds and bodies. I love that it links the dynamic of deprivation to rebound eating, of denying ourselves food to rebelling against rules which can generate the desire to overeat. This...
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But I Hate Taking Medicine, Going to the Doctor, Etc.

I’m flabbergasted when clients adamantly refuse to take medicine, seek medical attention, or get recommended health treatment. This kind of irrationality is what gets people into trouble in the first place. Fortunately, clients come to me to learn how to take better care of themselves, so I am in a position to help them make better decisions. If you’re someone who refuses to go to a doctor, the hospital or take medication, I’d like you to stop and think about whether this is in your long-term best interest. Many clients say, “I hate going to the doctor,” “But I don’t want to go to the hospital,” or “I don’t like dependent on medication.” As if there are actually people out there who enjoy going to the doctor, are happy about going to the hospital, or like the idea of being dependent on medication. Doesn’t your attitude sound a tad silly...
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Making New Meanings of Full and Satisfied with Food

At dinner celebrating a friend’s birthday, I was full and satisfied by dessert time, while she’d eaten a small dinner just to save room for dessert. She ordered key lime pie which came with a slab of dark chocolate melted on top of it and the waiter brought over a dish of chocolate chip ice cream as well because I’d mentioned that it was her big day. I managed to down a few spoonsful of ice cream, which she insisted I share, then watched her polish off the pie. When she was done, she asked if I wished to take home the remaining ice cream and slab of chocolate and I joyfully took it off her hands. I don’t care for dessert after a meal when I’m usually full. From my diet-binge days, I hate feeling uncomfortably full or too hungry. My habit is to eat seven or eight mini-meals...
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Sorting Out Beliefs Learned from Parents

I’m sometimes amazed at what clients tell me, as if what they’re saying is a provable fact. It’s obvious to me that their thinking isn’t rational and that they have no idea they’re spouting—or, worse, believing—falsehoods. Sometimes these untruths are about eating and sometimes they’re not. Either way, they’ll need to change these beliefs to become “normal” eaters and emotionally healthy people. When we’re children, we believe nearly everything our parents tell us—but that doesn’t mean that all they say is true or that the beliefs we learn from them serve us well in adulthood. Just as you’re probably not still adorning your living quarters with dolls, toy soldiers, miniature tanks, stuffed animals or posters of teen idols, it’s not great mental health to be walking around with outdated, erroneous beliefs in your head. We believe what we learn growing up for several reasons. First, we don’t have the brain...
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What You Need to Know About Suicide

One of the most difficult jobs of a mental health clinician is dealing with someone who is suicidal. Being a layperson with family members, co-workers or friends who want to kill themselves is even scarier. At least we have training in what to do and not do. Here are some things to consider when dealing with people who say they’re suicidal or who you think might be. (“Suicide rates on the rise: know the signs, ask the right questions to help them stem the tide” by Alison Lauria, Social Work Advocates, 10-11/18, pp. 13-20). You may believe that suicide is a rare occurrence, but the fact is that, “Nearly 45,000 Americans age 10 and older died by suicide in 2016, making it one of the leading causes of death in America. And the suicide rate is rising…more than half—54%—of those died by suicide did not have a known mental health...
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Time to Take Down Your Façade

“Sometimes the façade becomes the building,” laments one of the characters in the entertaining and deeply moving novel, Rise and Shine, by Anna Quindlen, a favorite author. How sadly true. I see how that has happened to many of my clients, with and without dysregulated eating, and know that they must tear down that façade to become a whole and healthy person. It’s no mystery how we got to be the way we are. We are built psychologically to survive. That is how the human brain is wired: to adapt to an environment in order to make the best of it. Unfortunately, when this happens, we may think we’re growing toward the light, but end up growing toward the darkness when how we act, believe and feel, which is adaptive in childhood, become maladaptive in adulthood. I have many clients who are Adult Children of Alcoholics (ACOAs) and they have...
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Sleep, Circadian Rhythms, Eating and Weight

It’s ironic that clients often don’t want to discuss their sleep habits but focus obsessively on their eating habits. In truth, sleep may be a substantial determinant of what and how much we eat, and disruption of our circadian rhythms may have a significant effect on what we weigh. Here’s what science has to say on these subjects. According to “Sleep Longer, Eat Less, Maintain a Healthier Weight” by Mugdha Thakur, MD (Duke Medicine Newsletter, 5/2008, p. 7), “Sleep is a modifiable risk factor in the link between obesity and cardiometabolic diseases…” and “Reduced sleep affects the regulation of appetite hormones such as ghrelin, which increase appetite, and leptin, which decreases appetite.” It is also thought to increase cortisol (a stress hormone) release, which increases eating behavior. Consider the paradigm above: By sleeping less, you’re putting yourself at risk of generating increased stress and appetite. This combination is the perfect...
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Neurotic versus Personality Disordered

I remember being fascinated in my social work psychopathology class as my professor described two types of clients we’d be treating. One type would seek us out and the other likely would need to be dragged, kicking and screaming, into our offices. Although I’m not sure after 30-plus years in practice that I’d draw such a sharp distinction between the two types, I do think back to my professor’s description when I meet clients for the first time or listen to them talk about the folks who populate their lives. The first type has what we call a neurotic disorder. To paraphrase my professor, they think that all their problems are their fault. No matter what has happened to them, they brought it on. They made the wrong choice, didn’t see something coming, and berate themselves for staying too long in bad situations. They are mercilessly hard on themselves and...
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The Best Parenting Style for Children

I don’t generally treat children, but I am asked a good many questions from clients about how to feed kids. I’m glad they ask because it means they understand that how they feed their children may cause or deter their progeny from developing eater disorders. Here are excerpts from a great article on nourishing children. In “Of the four parental 'feeding styles,' only one is good for kids' health, experts say,” nutritionist Lisa Drayer provides descriptions of feeding styles and why they are or aren’t useful for teaching kids how to be “normal” and nutritious eaters. ( https://www.cnn.com/2018/10/04/health/parenting-food-drayer/index.html , accessed 10/5/18) The Authoritative style is characterized by controlling what children eat—insisting that they eat certain foods and amounts of them. This style pulls children away from their natural appetites and, instead, teaches them to eat to please others (aka parents). Another control method is restricting what or how much kids...
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Fear Is an Excellent Motivator for Positive Change

I had a client decades ago when I worked in a Boston methadone clinic who used to tuck his stash of heroin under the trolley tracks in a hidey hole, so he’d know where it was but wouldn’t get caught by the police with it on him. He did get caught with and arrested and was then terrified about what would happen to him. When he was released from jail, we talked about how his fear response was working backwards—he felt fear after the fact when he should have felt it beforehand. The point of fear, from an evolutionary standpoint, is to keep us from doing or repeating behaviors that will harm us. We wouldn’t survive without this instinct. But some people push away useful fear and, therefore, continue to endanger themselves. For instance, I have a client with COPD who had difficulty talking about how cigarettes were destroying his...
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What Jane Fonda Has to Teach You About Mental Health

Whether or not you’re a fan of Jane Fonda as an actress or an activist, she has a lot to teach us about recovering from bulimia and body image disorder, discovering and expressing one’s authentic self, and achieving self-esteem. At 81, she’s far from past her prime and actually may just be reaching it. Or, so I thought, after watching Jane Fonda in Five Acts ( https://www.hbo.com/documentaries/jane-fonda-in-five-acts ). Growing up in a highly dysfunctional family, she was a sad child. Her father, the actor Henry Fonda, was far from fatherly and she wanted nothing more than to please him. Her mother suffered from depression and died by suicide when Jane was 12. Jane says that her perfectionism began at a very early age, based on the belief that if she did everything right and flawlessly, she would please and get the love she needed from her parents and others. Toward...
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How Do You View Feeling Broken?

How do you view your “broken” spots? Are they embarrassing areas of your life that you can’t bear to think or talk about? Do they make you feel less than and as if you’ll never see yourself or be seen as normal? When you think of your mistakes and failures, do you cringe and hope that no one ever finds out about them? I seriously hope not, but if you do, this photo and the explanation that goes with it may shift your view and make you feel a whole lot better about yourself. This beautiful bowl is unique because of its fractures. I love that idea. For example, part of my uniqueness (and, oddly, my professional success) comes from having had eating disorders galore—chronic dieting, overeating/emotional/compulsive eating, and bulimia. At the time, I felt horrible about my behaviors and incredibly defective and broken. Now I look back and proudly...
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Give Saying No to Yourself a Different Meaning

Most emotional, mindless, compulsive overeaters consider saying no to themselves a huge drag, just about the worst thing that could happen to them. That’s because “no” has a negative connotation for them from childhood. Healthy adults see “no” as positive: it balances out all the many yesses they say to themselves and puts up the proverbial guardrails on the crib so that the baby doesn’t fall out and hurt itself. It’s a self-loving, gentle reminder to think ahead to the consequences of their actions, an expression of how much they value (in Jungian terms) both expansion and containment, the voice inside that cares enough to, as my father-in-law used to joke, “Save me from myself!” What exactly does no mean to you that it’s become such an unwelcome, outlaw of a word that you can’t bear to say it around food? Here are some possibilities: No means cut out the...
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Does It Really Matter When We Eat?

Whether or not we take good care of our bodies, most of us have a schedule we eat on. Taking topnotch care, we may ensure that we eat early in the day to replenish our bodies nutrient-wise after a long night’s sleep and keep ourselves fortified during the day to sustain our energy. If we don’t take such great care, we may grab food on the go, refrain from eating during the day, and do our heaviest eating at night. Does it matter when we eat? Scientists think so. Here are some highlights from “When we eat or don’t eat, may be critical to our health” by Anahad O’Connor (7/24/18, accessed 9/15/18, https://www.nytimes.com/.../when-we-eat-or-dont-eat-may-be-critical-for-health.html ). “Studies show that chronically disrupting [our circadian rhythm]—by eating late meals or nibbling on midnight snacks, for example—could be a recipe for weight gain and metabolic trouble.” Satchin Panda, a professor at the Salk Institute and...
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Find Many Things to Look Forward to Every Day

I often hear from clients that they seek food for pleasure when they have nothing to look forward to. I wonder how they have so narrowly constructed their lives to have so little joy, fun, and satisfaction. Most of them can’t wait for vacations, looking forward to them for months ahead of time, but such time away or off is over in a flash. What about the days they’re not on vacation? Why not put a bit more punch into them to prevent unwanted eating? I was thinking about this issue when a close friend told me on the phone that she was resuming horse-back riding after a three-year hiatus. She was excited talking about having done it once recently and feeling that she couldn’t wait to do it again. I could feel her anticipation through the phone lines. Our conversation got me thinking of an elderly woman I knew...
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How to Stop Being Permanently Aggrieved

If you’re ever going to end your eating problems and create a satisfying life for yourself, you’ll need to give up being permanently aggrieved. Perhaps you don’t realize that this is your view life (and how others may view you) and would be wildly distressed if you were to acknowledge that you see the world as constantly stacked against you, the helpless victim who’s been cheated by life. You may feel so distressed at the idea of having this worldview that you tell yourself you don’t. Understandable, but refusing to recognize your perpetual put upon-ness is only a barrier to living the wonderful life you yearn for and deserve. So, what do I mean by being permanently aggrieved? Read on. First is looking to blame others for why you’re not happy, successful, loved, etc. Because it’s so painful to think that you could have brought unhappiness, failure, and rejection or...
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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