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 circumstances,...
Karen's Blogs
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Karen's Blogs
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 condition”...
“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 the...
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 shockingly...
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 health,...
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 fun....
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 abandonment...
I recently discovered that I’ve blogged about dependence and independence, but not about counter-dependence. I suspect that many of you don’t know what this dynamic entails, although it’s rampant in the eating disorder community. Read on to learn more. A simple definition of dependence is reliance on others, while independence means relying on oneself. Obviously, none of us can be completely one way or the other. As adults, we’re expected to do many things for ourselves, assuming we are able. Your spouse or friend might spoon some ice cream into your mouth for a taste, but it’s unlikely that anyone will take on the job of feeding you when you can feed yourself. Likewise, we can be highly accomplished and autonomous, but we can’t do everything ourselves (perform surgery, pilot an airplane, grow all our own food, fix our own cars). Counter-dependent people will do just about anything to avoid relying...
One dysfunctional pattern you may be stuck in is cycling between blame and shame—being unhappy and wanting to blame someone else (or lots of people) alternating with blaming yourself and feeling deeply ashamed of your deficits, mistakes, etc. Nothing good can come out of ping-ponging between these two effects which both may trigger emotional eating. Here are two examples of this dynamic. You, an adult, have an alcoholic father whom you take care of more often than you’d like to. You often blame him for keeping you stuck living at home making sure he stays alive or gets to work and you feel angry that he’s dependent on you. Or you blame your mom who divorced Dad a long time ago. Alternately, you blame yourself for staying in the situation which makes you feel terrible about yourself. With blame comes deep disappointment and shame that you don’t do anything to help...
While meeting with a new client who’d been abused by her husband for many years, she explained that she’d finally had a breakdown several years before and ended up in therapy in another state. She said she’d sought help because she was crying almost all the time, had little energy left over to take care of her children, and barely wanted to get out of bed in the morning. I told her that instead of having had a breakdown, she’d had a breakthrough and what a grand thing it was that it happened. When we stop trying to hold bad family situations together at all cost, give up making excuses for people who don’t deserve it, start feeling authentic emotions, trust ourselves and let reality sink in, we often have breakthroughs which may feel like breakdowns. Initially, it’s true that what we experience may feel unfamiliar, awful and as if we’re...
Many clients complain that political news overload these days is a major current eating stressor. They feel angry, helpless, despairing and frightened about the future. They don’t know whether to laugh, scream or cry. So they eat. Here’s how to avoid political news overload and retain your sanity: Taking in news: Recognize that though the news is available 24/7/365, we don’t have to partake of it in all forms all those times. I have a friend who listens to podcasts while she runs and when the podcasts are over and she’s returned home, that’s it. She relies on certain sites to keep her informed, is very choosy about what she listens to, and doesn’t tend to listen to an endless array of podcasts on the same subject. It’s not great to focus on the news while you’re eating if it’s likely to trigger overeating because you get anxious or angry hearing...
For several months, I’ve wondered if I was suffering from compassion fatigue, common to many therapists. Then I realized that I didn’t lack compassion with clients who make me feel alive and who bring great joy to my life. As I thought more about what I was experiencing, I realized that I was feeling less and less for abusers in clients’ lives and in the world. I began to feel that it was okay to not feel compassion for people who cause suffering but weren’t themselves suffering. I know we want to aim for understanding and forgiveness, especially those of us with clinical credentials after our names. The therapist’s job is to feel the pain of and with others rather than shrug it off or react to it. But, the fact is that compassion, defined by Dr. Kristen Neff, author of Self-compassion: The Proven Power of Being Kind to Yourself, is...
When I first came across the concept of loving, but not desiring something, I thought it brilliant. It’s from in A Child In Time (page 255), a book by one of my favorite fiction authors, Ian McEwan. Referencing feeling stuck mourning his beloved young daughter several years after her kidnapping, a character in the novel says, “I had to go on loving her, but I had to stop desiring her.” This concept could apply to almost anything. Especially food. The phrase hit home because I’d been out to dinner with a good friend the evening before coming across it and we’d been discussing how to handle her food cravings. She insisted that she loved the chocolate cake in this particular restaurant which, she explained, made it impossible to resist it. As I’d learned to love certain foods without desiring them in order to become a “normal” eater, I wish I’d had...
Although we’ve evolved to eat when our internal food gauge dips to empty, instead, many dysregulated eaters mistakenly turn to food when they’re emotionally depleted. Sometimes our ability to take care of things or people can simply drain us to the point of having nothing left to give. Then, rather than rejuvenate ourselves with sleep, relaxation, joy or rest, we turn to food and can’t get enough of what we didn’t need in the first place. There are a number of ways that we may become emotionally depleted. What they all have in common is putting out more emotional energy than we’re taking in. * Being the go to person. If you’re all things to all people, you’re going to be running on empty far too often. If you say yes to every request—from your kids, partner, friends, parents, siblings, boss, co-workers or neighbors—you’re going to feel exhausted most of the...
How many of your problems are due to not being true to yourself? Not being authentic and knowing exactly who you are, recognizing your preferences and distastes. Many of my clients with eating dysregulation tell me they’ve been people-pleasers for so long that they’ve become disconnected from their own needs and desires. And you? I was reminded of authenticity by two dinners with friends. First was the night my husband and I dined out with a couple who are wine connoisseurs who spent a good deal of time discussing what wine to order. I, on the other hand, ordered a low-priced Chardonnay because I always joke that I’m a Ripple girl at heart—someone who lacks a sensitive palate for the taste of high quality alcohol. Since that’s the case, I don’t bother to fuss about wine and can live with my ignorance. Then the next week we dined out with neighbors,...
Anxious people tend to lump all their anxieties together—running out of gas on a road trip, their spouse leaving them for someone younger, failing an exam, dying in a plane crash, or losing their wallet. The truth is that all of these things are possible, but each has a different probability. By looking at the likelihood of events that frighten us, we can reduce anxiety, live more comfortably in the world, and reduce emotional eating. Remember, just because it’s possible for something to happen, does not mean that it will. Stop and think if you confuse or equate possibility with absolute certainty. Do you automatically fear and believe that whatever is causing your worry is a definite? By that, I mean do you take all of your fears seriously and give them equal weight? If so, you will be anxious a great deal of the time. While it is true that...
Our minds are like our homes. Create a hostile, unsafe, chaotic environment in your living space and few folks will want to visit or, if they do, they’ll soon be unhappy, uncomfortable and wanting to leave. Provide a comfortable, hospitable, inviting, safe, environment and they’re likely to want to relax there and return frequently. What kind of “home” is your mind: warm and friendly, cold and intimidating, an utter mess? Because we spend a huge amount of time in our minds, it pays to create a mental and emotional landscape that’s hospitable to and supportive of growth and well-being. That can’t happen if we’re highly critical of ourselves or others, frequently confuse memory with reality, regularly make invalid meanings of events, or wall off parts of ourselves from our consciousness while stuffing our minds with grievances and misery. If this is what you do, no wonder it’s difficult for you to spend time...
Yes, you read the title of this blog correctly: Pre-Traumatic Stress Disorder. It’s a condition I made up which in no way takes away from the serious and enduring effects of Post-Traumatic Stress Disorder (aka PTSD) which many of dysregulated eaters suffer from. I’m not in any way making fun of PTSD or minimizing it, I assure you. The bona fide PTSD may happen when an external event dysregulates and overwhelms our nervous systems. The fictitious condition, which many of my clients also have, comes from catastrophizing external events and spending too much time thinking about future possible disasters. It’s a way of viewing the world as a glass that’s always half-filled, and not with water, but with poison. It’s a mindset that says, “Something terrible will happen to me and I’m positive that I won’t be able to cope with it. It will ruin my life and any chance of...
After a recent spate of high-profile suicides, I thought it important to talk about the subject openly because some of you reading this blog may be thinking about it. Or have thought about it. Or have attempted it. Or maybe you know someone who’s taken his or her life. Whenever necessary, I speak directly with clients about the possibility of their being suicidal, but it’s never an easy subject to bring up. However, it’s a lot more comfortable than what I would be feeling if a client attempted it. I’ve had clients who’ve been passively or actively suicidal, and those who’ve had to be hospitalized or hospitalized themselves when things got too iffy for them or for scary someone else. I’ve known people, mostly acquaintances, who’ve killed themselves—a co-worker decades ago, a man I very briefly dated who lived in Canada, and two very wonderful elderly people who led full lives and...
Josh Humi, author of “Life Guide”, asserts that there are two kinds of happiness: experiential and reflective (“A Living Humanist Document,” The Humanist.com, 9/28/17, accessed 9/29/17, https://thehumanist.com/). He explains the former as “the enjoyment of a present-moment experience (for example, eating a tasty meal or sharing a laugh with friends),” and the latter…”as one’s belief that he or she has lived a valuable life, to the extent that one reasonably believes he or she could have lived a valuable life (for example, via personally meaningful accomplishments).” He describes reflective happiness as having a “long-lasting ‘background’ impact on one’s happiness,” that is, that “all else being equal, pursuing the latter will likely have a greater positive impact on one’s happiness over the long run.” I would add that reflective happiness adds depth and breadth to who we are, while experiential happiness is limited to what we did. I’m blogging about happiness after having...
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