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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. 

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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 meant to...
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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, energy and...
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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 to make...
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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” (WW....
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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 liven their...
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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 usually...
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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 because...
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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 you’ll be with...
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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 mad at...
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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 that. He tells...
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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, salty snacks,...
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Fight for Your Life

Fight for your life
I was talking with a client about how easily the good in life had come to him as a long-time underachiever able to get by and find success with little effort, and how this attitude was now a major impediment to becoming a “normal eater”—and to his ability to literally fight for his life. The theme of not trying hard enough in one way or another echoes throughout the histories of most of my clients and is the theme of many sessions. Not long after this conversation, a friend described hearing some neighbors complain about how people in this country who are poor, uneducated or disenfranchised are that way because they don’t try hard enough. Missing was the understanding of the part that biology and culture play in success, the recognition that we emerge from an unequal playing field, and the compassion for how hard most people do try to improve their...
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Can You Really Boost Your Metabolism?

Exercise
Clients who struggle to keep their weight down often ask me how they can burn more calories and boost their metabolism. They’re not asking about exercise. They’re looking for a quick fix—pharmaceutical drugs and illegal methamphetamines to help them lose weight or keep it off. Back in my dieting days, I recall taking some over-the-counter pills myself for that purpose, but all they did was to keep me awake when I wanted to sleep.Devotee of science that I am, it amazes me that people get away with making false or unproven claims that their process or product will boost metabolism. And, let me tell you, these top selling books do better than mine do which are about learning how to eat in tune with appetite. I understand why, but it still makes me angry because desperate people are getting duped into something that doesn’t work.Says Michael Jensen, director of the Obesity...
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Balancing Emotions

Balancing Emotions
Emotions and personality traits run on a continuum and, to many clients’ surprise, are value neutral. Is it better to be angry or ignore being hurt? Is it healthier to play it safe or take a risk? In both cases the answer is that it depends on the situation. Hence, the view of emotions and traits as value-neutral and relative to what’s going on. My guess is that as a dysregulated eater your emotional reactions cluster at one end of the continuum or the other rather than being situation dependent.Consider the personality traits you possess and the emotions you generally feel and notice how you feel about their opposites. Here are some dyads to get you started. Detached…entangled, impulsive…cautious, fearless…anxious, controlling…passive, prompt…tardy, messy…neat, social…introverted, other-oriented…self-oriented, spendthrift…wasteful, rebellious…by-the-book, pessimistic…optimistic, private…open book, patient…impatient. I could go on, but you get the point. For sure, we’re born with certain temperaments due to genetics, in-utero experiences,...
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It’s Time to Stop Our Body Critiques

dance class
I have eyes, ears, a nose and a mouth that all are in decent working order. I proclaimed this aloud one night after waffling about whether I looked okay to attend an evening dance class of people I’ve known for years. My proclamation was my way of saying I’m done worrying about how I look. I really want to be free of this ridiculous pre-occupation.As I tell clients, sometimes we just need to get fed up with our own silliness. Especially as women, we need to stop our obsession with self-grooming. Because I don’t think in all-or-nothing ways, I’m not suggesting that we give up caring about our appearance. It’s fine to care but, as with eating, we need to be able to say when enough is enough. We acquire this mistaken idea that we need to look a certain way from our personal family experience growing up and from the culture...
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Were You Raised with the Best Tools for Success?

Success
Most of my clients with dysregulated eating weren’t raised with a set of effective life skills that support eating disorder recovery. Worse, when they falter on the way to achieving their goals, they behave in exactly the wrong ways to help them assess why, correct course, and move forward. If you weren’t taught how to pursue goals, yet want to become a “normal” eater, you’ll need to change how you think about success. Here are some examples from my practice over the decades of the ways that parents fail to model and teach children how to successfully reach their goals. Parents:sporadically stop addictive behaviors such as drinking or taking drugs for a while, then relapse, but refuse to get help, insisting they just need to exert more will powerlet themselves be emotionally abused by a spouse for whom they make excuses hate to see you struggle, so they do your homework and school...
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Stress Eating Due to Caring for Elderly Parents

dario-valenzuela-PAGBeJrLiDA-unsplash
One of the major stressors my clients encounter is caring for aging parents needing help due to paring down belongings and moving, sickness or surgery, or simply managing tasks they can no longer do as they grow older. Even if providing help doesn’t drive clients to eat emotionally, it’s certainly a drain on their emotional resources. In the best of relationships between parent and child, this endeavor can be time-consuming and energy-sapping. In the worst, it can feel like a downright burden. If you were well-loved and well treated by your parents, you probably have similarly positive feelings toward them. You want them to feel safe, secure, and happy and don’t much mind doing whatever you can to make that happen. Although grocery shopping, taking them to medical appointments, taking over bill-paying or calling or visiting them more frequently may take time out of your busy schedule, you don’t begrudge doing this...
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My Article on Weight Stigma

taylor-smith-C44h1ZmlFF0-unsplash
Weight stigma may be more dangerous for higher weight people than carrying around a great deal of weight. Culturally generated, fat blaming and shaming have reached the heights of hysteria in this country. Whether you carry a higher weight or rigidly restrict food or purge in terror of weight gain, it’s crucial that you understand the health and mental health damage that internalized weight stigma poses. Here’s a recent article I wrote for therapists on treating internalized weight stigma. (“Three Steps to Challenge Internalized Weight Stigma” by Karen R. Koenig, LCSW, M.Ed., https://www.socialworktoday.com/archive/exc_0719.shtml, accessed 7/12/19)As an eating disorders therapist, I treat many high weight clients. Some are 40 pounds heavier than they would like to be, while others weigh over 300 pounds. In either case—in fact, in most cases—clients who weigh more than the norm have internalized culturally-induced weight stigma which is damaging to both their physical and mental health. Our job...
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When Old Memories Co-opt the Present

When Old Memories Co-opt the Present
A client and I spent a session getting to the roots of an upsetting reaction she couldn’t shake after a dinner out. Her intense feelings are typical of what happens to us when events that are over and done with rear their ugly heads in the present. We’re unsettled in two ways: first, by whatever happened to cause our distress and, second, by the immensity of our distress over a situation that we know intellectually is no big deal. Here’s what happened. My client had dinner with friends at a restaurant she loved but hadn’t visited in a while. She enjoyed her selection—mahi-mahi corn tacos with jasmine rice and vegetables—and ate mostly the fish because she craved protein, thinking she’d take the rest home and eat more of it during the night or save it for another time. Satisfied and pleasantly full, she asked the waitress for a doggie bag.At home, opening...
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Loving Rather Than Needing

Love and need
When we say we love someone, we may believe that we need them in order to be happy which is not necessarily true. We can go on to be fine when we lose someone we love because loving and needing are not the same animal. In my view, love develops into mutual caring and allows two people to value each other for being their authentic selves, while need pressures people to be a certain way and not change. Love flows outward toward others, while need pulls others toward us (whether they want to move toward us or not). Love is other-oriented and generous while a need is restrictive and deprivation. When we confuse need and love, we’re usually seeking someone to complete us in a way we may or may not be conscious of. Let’s say . . .We’re painfully shy and socially awkward and find someone who’s gregarious and appears at...
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