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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Borderline Personality Disorder

Here’s something you may not know about. There is a strong correlation (an association, not a cause and effect) between the clinical diagnosis of Borderline Personality Disorder (BPD) and eating disorders. For me, diagnosing is a helpful tool in understanding clusters of symptoms and guiding treatment. On the other hand, I understand how a diagnosis can feel like an unwanted label and a stigma if misused. Criteria outlined in the fourth edition of the DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, aka the DSM-IV-TR, for BPD are as follows: 1) frantic efforts to avoid real or imagined abandonment; 2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation; 3) identity disturbance: markedly and persistently unstable self-image or sense of self; 4) impulsivity in at least two areas that are potentially self-damaging (eg, spending, sex, substance abuse, reckless driving, binge eating); 5) recurrent suicidal...
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Feel, Then Think

Lucky us! We’re born with the ability to feel and think, and we need to use both wisely to manage life’s problems and resolve our eating issues. Some people get stuck in emotions and rarely call upon good judgment. Others think ‘til their brain hurts, but hardly ever experience authentic emotion. Are you one of these types? Maybe you intellectualize—live in your head—to avoid experiencing painful emotions. You research, make lists, and weigh pros and cons. You chunk down problems and come up with well-oiled solutions. Yet you rarely know what you’re feeling. If you focus on emotions at all, it’s to brush them aside. When you experience them, you generally describe them with vague words like upset or stressed. Due to a childhood in which your emotions weren’t heard or validated adequately, you’ve closeted them away and that’s where they’ve stayed. Instead you rely on thinking exclusively to guide your...
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Stop Replaying Bad Memories

One of my goals as a therapist is to help clients unearth childhood memories so they can better understand themselves in the present. With other clients, especially those who’ve experienced trauma, my goal is to help them let go of powerful, hurtful memories. My focus depends on where they are in the emotional healing process Events which we perceive as bad make an indelible mark in our memory bank. Our brains are built to recall them with special clarity and intensity to avoid similar harm in the future. Speed down the hill on your bike, then fall and break your arm often enough, and one hopes experience will teach you to slow down. In this way, recalling events which have hurt us is a beneficial process that leads to prevention. However, continuing to replay a distressing incident or period in your life over and over long after you’ve squeezed out every...
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Pain and Pleasure

A client made an interesting comment which strikes at the heart of receiving pleasure, with food or otherwise. We were discussing why she doesn’t go all out to pursue joy and passion, and she said, “Well, you know, the price of pleasure is pain.” Ouch! As soon as I heard her response, I knew this was a core belief that both inhibited her ability to eat “normally” and prevented her from creating a happier life for herself. Do you believe that the price of pleasure is pain? Or that there is any price to pay for pleasure? You may not be aware that this is your assumption, so take a minute to examine it. Do you throw yourself into enjoyment or do you get anxious during or after you feel it? According to your belief system, how okay is it to feel joy and have fun? Are pleasure and pain connected...
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Self-regulation

I’ve been writing about self-regulation for decades, mostly in the realm of eating—I find the term disregulated more accurate than disordered, and regulated more accurate than intuitive—but also in terms of monitoring emotions and behavior. Recently, I’m pleased to see the terms self-regulation and dysregulation cropping up in more and more articles. The better you understand how to regulate yourself, the better your life will be. To self-regulate is to adjust behavior consciously, specifically to not allow it, outside of your awareness, to bounce you from one extreme to another. Whether you’re opening or closing your heart, your mouth, or your wallet, the idea is to make decisions only in your best interest. If you want to do/say/eat/spend/work/play, etc. too much or too little, that’s okay, as long as you make the decision consciously. If you want to spend time at either extreme—in what I’ll call an open or closed position—fine,...
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Emotional Dysregulation and Reregulation

It’s probably not uncommon for someone to say or do something that sends you, a dysregulated eater, into an emotional tailspin—which then propels you, immediately or even hours later, to the refrigerator. If you have some self-awareness, you may make the connection between a person’s actions or words and your distress. If you have little or no self-awareness, you might feel a vague upset, but not necessarily relate it to someone triggering your distress. However, this is exactly what happens. I recently read an article which explains how you get set off. The author, Janina Fisher, Ph.D, explains how, because we are social animals, people who are disregulated can all too easily disregulate others. Disregulation occurs when someone’s emotions, and not their good judgment, are running the show. They don’t realize or can’t control how upset, distressed, enraged, fearful, or anxious they are and their presentation shows it. They yell, sulk,...
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Anger Instead of Anxiety

Many people get anxious around folks who don’t treat them well—a spouse, partner, friend, parent, child, neighbor, boss, or colleague. They’re anxious before seeing the person, while they’re with them, and after the fact. Well, there’s a better way than agita to respond to mistreatment! Some good, old-fashioned anger might just do the trick. Does this sound familiar? You feel anxious when…your date is rude to you, your partner walks in the front door and immediately comes down on you for a mistake you made earlier in the day, your best friend breaks a movie date last minute and calls you oversensitive for getting upset, your father insists you fly out to see him when he knows you’re in the middle of finals, your brother shows up drunk at your birthday party, your colleague misses work repeatedly and you end up picking up her slack, your adult child refuses to move...
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Emptiness

Emptiness is both a physical sensation and an emotion and is somewhat difficult to describe because of its nature—it’s easier to describe something than its absence. However, understanding underlying issues about and resolving discomfort with both types of emptiness will go a long way toward helping you recover from eating problems. Let’s tackle physical emptiness first, the sensation in your belly when you’re hungry—the gnawing, gurgling, and mild contractions telling you it’s time to fuel up. How you feel about this emptiness and how you respond to these sensations makes all the difference. If you perceive stomach emptiness as welcoming and as an invitation to feed your body pleasurably, you’re all set. For you, emptiness is a natural state which can be responded to with food and eating is a self-enhancing act. On the other hand, if you view physical emptiness as dangerous or scary, how will you move on to...
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Self-centering

So many disregulated eaters, especially you nice girls and guys, fear being self-centered—you know, selfish, egotistical, or self-absorbed. Instead, you turn yourself inside out to be self-effacing and other-oriented, as if focusing on you is a sin. In reaction to early care-takers who were too self-centered, you now fail to center on yourself nearly enough. Once again, all-or-nothing thinking rears its ugly head, as if people are totally self- or other-oriented. The healthy among us are both!   Here’s a question for you: If you are not centering on your life, who is? That is, if you are not the center of your own universe, who is? Who could be other than you? How can someone else be the center of your life? They can only be the center of their lives! Not to be redundant, but by a process of elimination, you must be the center of your own life....
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Compassion, Acceptance and Mercy

This blog topic comes from a discussion with a client who was often highly critical about her body and overeating and who feared that if she showed herself “compassion” for making mistakes with food and “accepted” her weight, she wouldn’t try to change. Perhaps you too fall back on a sharp tongue lashing or a swift kick in the butt for motivation, rather than non-judgmentally exploring your behavior and figuring out how to do better next time. This client decided, instead, to show herself mercy, a term filled with benevolence, self-love, kindness and forgiveness. Here’s what the American Heritage Dictionary has to say about acceptance and compassion. To accept is, “To receive gladly; take willingly; To receive as adequate or satisfactory.” Compassion is, “The deep feeling of sharing the suffering of another in the inclination to give aid or support, or to show mercy.” Do these sound like synonyms to you?...
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Release

If you binge-eat, it may be due to your emotional rigidity. You believe there’s an absolute right or wrong way to do things, hold yourself to ridiculously high standards, and strive relentlessly for perfection. You find it difficult to recognize or exist in a gray area or see a middle ground in most aspects of life. You lack the flexibility and fluidity that enables you to bend with the wind and roll with the tide. What you often seek in binge-eating is release of inner tension, pure and simple. Binge-eaters vividly describe the release they seek in food—the damn breaks, the horses charge out of the barn, the tsunami washes over them and carries them out to sea. We might say that the more rigid your inner world, the more energy you seek to release. You yearn for the total abandon mindless eating provides because you find it hard to experience...
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Rapid Resolution Therapy

I took a workshop in Rapid Resolution Therapy (RRT) which is designed to put the past behind you, especially if you’re a trauma survivor. I’m blogging about RRT to alert you to its existence, not to promote it. After a one-day seminar, I claim to be neither an expert nor to know enough about it to say that it is reliable, effective clinical treatment. However, disclaimer aside, it’s worthwhile to understand the principles behind it. Psychology distinguishes between kinds of trauma: “big T” such as war, rape, sexual or physical abuse, serious physical assault, kidnapping or living through a disaster, and “little t,” including chronic emotional abuse or neglect. RRT claims to resolve trauma suffering, describing itself as “a state of the art and cutting edge approach that heals the invisible wounds of trauma. Holistic, gentle, and compassionate, it painlessly eliminates the negative influences from traumatic events even when there are...
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More on Food and Mood

I know that some of you are having quite a time wrenching yourselves away from dieting. You may desperately want to lose weight quickly, feel hopeless that “normal” eating will ever get you there, be scared to trust yourselves, or not want to put in yet more effort to harness your natural appetite in order to manage your weight. Although I’m anti diet, this blog is for those of you who are struggling to give it up, even as you inch toward employing the principles of eating more “normally.” If you insist on following some kind of food plan, for mood at least, consider choosing one that’s low-fat rather than low-carb. That’s the skinny according to an article entitled “Memory and Mood May Depend on Muscle Strength and Diet Choices” in the February 2010 issue of the Duke Medicine Healthletter. The article states: the “Commonwealth of Scientific and Industrial Research Organization...
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Food on the Brain

Here’s a question I received when I asked readers to email me topics to blog about: How to get food off the brain. A trying issue with relevance to both under- and overeaters. As you well know, an obsession with food and weight can lead to highly disregulated eating and ruin the quality of your life. So, how to get food off your mind? Food may be your main agenda because you’re used to thinking about it. You may not realize when your focus shifts to eating, weight, fatness or thinness or you may be all too aware of how these thoughts intrude and fill up the space in your head. Thinking about food and weight are bad habits born of anxiety. When you’re comfortable in your body and with your appetite, you have no need to obsess about them. To eliminate this preoccupation, stay aware of your thoughts and actively...
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Abandonment

When a message board member (http://groups.yahoo.com/group/foodandfeelings) asked me to blog about abandonment, I had to comb through my archives, not believing I hadn’t already written about it. I hadn’t, so here are some of my thoughts on the subject. Boy, if ever there were ever a trigger for emotional eating, abandonment is it. Many of us think of abandonment in the physical sense—loss of someone through death, divorce, or enforced separation. However, most of us don’t experience this kind of physical abandonment in childhood and, instead, grow up with both parents around. The kind of abandonment which is far more common—and far less easy to recognize—is emotional abandonment. Some parents are too self-absorbed to rear children well and pay more attention to their own needs than those of their offspring. Other moms and dads are already enmeshed in a more addictive relationship—with alcohol, drugs, a job, or a hobby. Then there...
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Thoughts Not Truth

How many of you sometimes believe your thoughts are truth? Thoughts, truth—it’s easy to understand how you came to conclude that they are one and the same, but the fact is they most certainly are not. Truth is objective and evidence-based, whereas thoughts are fleeting neurobiochemiocal impulses which travel through the brain and work hard to make us believe they’re the gospel. Differentiating between truth and thoughts can make all the difference in recovering from an eating disorder. Let’s look at what would happen if you were convinced that thoughts and truth were identical. Every time got the idea that you “should” or “shouldn’t” eat something, you’d take for granted that you had to. Because “I must have that leftover piece of birthday cake sitting on the shelf in refrigerator” would lead to a forgone conclusion, your inescapable destiny would be to eat the cake. Because “I have to be a...
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The 48-Hour Rule

As a therapist, I often get asked what I do with difficult emotions, that is, how I handle life’s rough spots. Although I believe that all emotionally healthy people have a range of techniques for dealing with intense feelings, I know we all have certain skills we rely on. Recently I’ve set up a 48-hour rule about a certain kind of emotion visiting me, and have found it very useful. Not long ago, I had a bunch of bummer things happen to me: being hurt by a friend, problems with a few clients, and a rejection regarding a new writing project. In each instance, I felt some combination of crummy—dejected, angry, helpless, frustrated, misunderstood, devalued, or invalidated. So I followed the 90-second rule (see my 8/21/09 blog), allowing my feelings to flow, no matter how uncomfortable they made me, neither rejecting nor inviting the hurt, but letting it come and go...
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Emotional Wounding

If you were severely or chronically emotionally wounded in childhood or later life, you may fear “wounding” others if you say no, turn down advice, refuse to be their only support, or simply desire to focus on yourself rather than on them. Many disregulated eaters abuse food (and themselves) rather than hurt another person’s feelings. Hurting someone’s feelings is not a comfortable thing to do, but when appropriate, it is an essential life skill for quality mental health. Even in healthy relationships, it sometimes happens that remarks will be said or actions taken that hurt. We’ve all been on the giving or receiving end of moments like these because we’re human. In unhealthy relationships, however, your heart may get stomped on regularly. In this case, it’s necessary to gently let someone know that they’re hurting you. If they do not get the gentle reminder, be more direct. If they don’t get...
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Gratification versus Authentic Happiness

Do you know what constitutes authentic happiness? After all, we receive a barrage of confusing messages on the subject throughout our lives. One of the loudest is that gratifying our needs will make us happy—eat this food, buy that car, take a special vacation, learn this, purchase that. Much of what passes for happiness these days is what’s called short-term gratification and has little nutritive value emotionally. In order to achieve true happiness, it pays to understand how it differs from gratifying needs. When we seek gratification, we are looking to please ourselves in the moment. In psychology, the word is most often used to describe the needs of infants and children who, naturally in these stages of development, know no better than to demand that their emotional and physical needs be met instantly (if not sooner!). They lack the ability to consider whether meeting their needs (for a bottle or...
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Book Review: You Are Not Alone

As an author, I’m sometimes asked to write blurbs or reviews of books on eating, which is a wonderful way for me to keep abreast of what’s out there. For example, YOU ARE NOT ALONE (Vol. 2): THE BOOK OF COMPANIONSHIP FOR WOMEN WITH EATING DISORDERS (with a great music CD) by Andrea Roe. Although the book says it’s for women, it’s really for men, too, so don’t be fooled by the title!   The book’s premise is that recovery is possible and its theme is hope. Anita Johnson (author of EATING IN THE LIGHT OF THE MOON) writes in her introduction how hope is the inspiration for recovery. I would add that hope is not a constant thing, but waxes and wanes. One day we make wise, satisfying, nourishing choices around food and feel optimistic and even mildly confident that we are changing, then the next day, we make poor...
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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.