Many clients were victimized in their dysfunctional families when they were children or adolescents. They had no choice. Even if they wanted to run away, they lacked the means or ability. Children and other powerless people are true victims. Though the Oxford Language Dictionary defines victim as someone “harmed, injured, tricked or duped,” are you really a victim as an adult when you can avoid something happening?  Perhaps that’s where the confusion comes in. Some people put themselves in situations where they’ll more than likely get “harmed, injured, tricked or duped” and choose to do so repeatedly. There’s a difference between a car veering off the road and hitting you and standing squarely in front of the car so it can’t miss you. In the former case, you’re not choosing to put yourself in harm’s way by standing at the bus stop with everyone else, while in the second you’re going...

Some people assume they can’t change habits because they’re lazy, unmotivated, undisciplined or lack will power. This assumption is dead wrong, and if you want to change behavioral patterns, you must give up these inaccurate beliefs and be open to learning about what works to rid yourself of old habits and develop new ones. Ready? “How to Conquer Your Primitive Brain” by Adam Piore (Newsweek, 2/17/23, pp 22-31) debunks myths about destructive habit formation and advocates scientifically proven strategies for constructive habit replacement. Some of the article’s major points: “Research suggests that habits, which operate below conscious awareness, usually cannot be tamed simply by resolving to resist them . . . we need to reverse engineer the chain of behavior that precedes them, and then either remove the cures that set us off altogether, or take the time to build new habits that will replace them.”“Habits are an essential tool of...

We’re told to live in the moment, but if you don’t use some of them planning for the future, what will happen to you down the road? I don’t mean for you to worry which is not planning. I’m talking about realistically thinking about how your life will be 10, 20 or 40 years if you continue on your same path and don’t move healthfully forward. Specifically, what will middle or old age be like if you don’t change habits or face fears? My client Grant , 41, was perfectly comfortable living at home with his elderly father. Grant worked part-time, had no health benefits and prided himself in spending his time as he wished. When his father, who had Medicare and social security, had a heart attack and needed more care than he could afford, Grant had no savings to help out. Although he had a college degree in political...

Attempting to Zoom with three college friends, I twice tried and failed to get into the session. I assumed I’d done something wrong ‘til I received a text from one friend who was having the same difficulty and another from the Zoom “inviter” who couldn’t get the link to work. We each thought we were the ones who’d messed up. Then the ”inviter” re-sent the link and three of us got in, but the fourth kept texting, “I can’t get in. Help! What am I doing wrong?” She eventually used the re-sent link and there we all finally were laughing at how pathetic we are at technology. These are my kind of people: their first thought is they must be at fault. Why, you might ask, would I be such a fan of people who automatically think they’re wrong? Because back in social work school, one of my professors explained how...

Every time someone says, “Oh, they’re so nice, they’d give you the shirt off their back,” I think if this is our standard for niceness, no wonder so many people are dysfunctional. My reaction is always the same: It’s not a great thing for someone to go shirtless. Better for them to keep theirs on and help others get their own shirts. Being selfless, noble or altruistic are admirable, appropriate qualities—but only in some situations. When someone stops to drag a driver out of a burning car, that’s an amazing act of self-sacrifice. When a well-fed person encounters a hungry person on the street and gives them half their sandwich, that’s kindness and compassion in action. When you take the money your parents give you for your birthday to upgrade your cell phone and instead give it to your friend who lost theirs in a fire, that’s living with an open...

A pattern that shows up a lot in dysregulated eaters is clients trying to prove something. Their goal is to show someone (or themselves) that they are or aren’t a certain way and they go at it with such a vengeance that it overrides their common sense and ability to make healthy decisions for themselves. For example, my client Dawn who’s recovered from drug and alcohol abuse has recently taken a part-time, entry-level job, her first since quitting drugs. She enjoys it but working the night shift has turned her life upside down—she’s eating poorly, is exhausted all the time, and can’t attend her usual AA or NA meetings for support. When I asked why she stays in the job or hasn’t requested a more suitable schedule, she said she’d thought about asking for another shift, but didn’t want people to think she’s a quitter. She expressed fear that her parents...

Devouring a column by advice giver par excellence, Carolyn Hax, I had a good chuckle at her response (which I paraphrase) to a letter writer: When life is irritating and people are jerks, just “deal with it” and don’t make a big to-do. I confess there’ve been times when I’ve felt like saying exactly that to clients but never had the nerve because it’s sounds so un-therapist like, so unprofessional. Aren’t we supposed to be infinitely understanding, patient, compassionate, and kind no matter what?  After reading Hax’s Washington Post column (that comes out in my local paper), I began thinking about whether there’s a place for her manner of brashness in the therapy session, which is meant to be a space for honesty and straight talk. I decided there is and that my job, above all else, is to help clients become emotionally healthy and that sometimes frankness and bluntness is...

Learning how to handle stress goes a long way toward curbing dysregulated eating. Of course, all stress isn’t created equal, but our responses are generally ingrained and we react unconsciously. In order to manage stressful situations, think about how you react interpersonally, that is, whether you move toward or away from people when stressed. There are two extremes you want to watch out for: Do you close up and push family, friends and co-workers away or do you grab onto and cling to them for dear life?  Many people cave inward when life starts to spin out of control. My client Shara says of her romantic relationship: “When we’re stressed, neither of us wants to talk. It’s like we need to crawl into our own shell to keep it together. We can go on like that for days or even weeks.” My client Grant does exactly the opposite: “I ask everyone...

How do you know you’re breathing? When I ask clients this question, they think it’s a silly thing to ask and usually say, “Well, duh, I just know.” What I want them to recognize is that there are some things we don’t question. Instead, we “just know” they’re true.  Two such truths to acknowledge intertwine: that we’re lovable and have choices. Do you “just know” you’re lovable or is this a question that you’re unsure how to answer? Healthy people know they are (that is, they’re worthy of love and have lovable qualities) in the same way they know they’re breathing. Their worth and value is either a given from an early age or a question that’s been asked and answered at some point in life, so they never have to consider it again. It’s also true that there are choices and consequences in life. We make a decision and either...

The documentary, Stutz, will touch hearts and go a long way toward healing the mind of anyone with eating problems, weight concerns or low self-esteem. Actor Jonah Hill wrote and directed this film about his long-time therapist, renowned psychiatrist and author, Dr. Phil Stutz (not to be confused with TV’s “Dr. Phil”).  From the notes I scribbled on scrap paper watching the Netflix film: “I keep thinking of how Stutz’s teachings could help heal my clients, blog readers and Facebook followers. I was awed at how open, honest, and vulnerable Hill was, telling the world who he was below his public persona. I ached hearing Stutz’s sad life story and felt buoyed at the amazing man he became in spite of childhood suffering and developing Parkinson’s.”  Hill made this film to honor Stutz who helped him heal from over-eating, poor body image, and low self-esteem and to share with others “the powerful...

One of the most talked about topics in therapy is boundary setting. If you grew up in a family with appropriate boundaries in which people knew where they ended emotionally and others began, you probably have no problem with them. You do what family members modeled, it feels natural saying yes and no as appropriate, and you choose to be around people with healthy boundaries. If your parents and relatives exhibited poor boundaries—prying into each others’ business, taking advantage of each other, always saying yes and never saying no or vice versa, and being bossy—you likely have problems with them too. Not to worry: this is a learnable skill that requires paying attention, having courage, knowing what to say when, and practicing until they trip off your tongue easily. When someone violates your boundaries, you might instinctively:  Explain what someone is doing wrong or point out they’re not listening to you.Repeat...

The trend toward forgiveness has been around for decades. But what about people who have a compulsion to instantly forgive people no matter how heinous their crimes against them or others. Here are a few examples. Bobby came to see me for overeating problems, and the fact that he was a trauma survivor soon surfaced. After describing his horrendous childhood—Dad was murdered when he was six, Mom was an abusive alcoholic, and he was the oldest of five children whom he was charged with taking care of. Neglected physically and emotionally, he was the one who got stuck asking neighbors for help and money and the one who cared for his mother when she was dying of liver cancer. When I asked how he felt about caring for his mother who barely cared for him, he said he felt bad for her because she’d had a hard life. I understood his...

I confess, I’m a creature of habit: I have dance classes on Tuesday night, watch TV or read from 8:30 on in the evening, exercise 10-11 most mornings, and my best friend and I exchange phone calls every Sunday at 9 a.m. Although I have my share of flaws, I’m nothing if not consistent, raised as I fortunately was by creatures-of-habit parents. So, what do you do if you weren’t raised with a model of consistency and want to learn how to do things more regularly and stop flip-flopping between performing and avoiding certain activities? This is an especially crucial skill for dysregulated eaters who swing from under- to overeating and being a couch potato to becoming gym rats. In How to Be Consistent, Brad Stulberg explains the five principles to follow to develop habits of consistency. I’m sure you’ve heard some of them before, but maybe this time you’re ready...

A client told me this anecdote. Her first therapist helped her to see that we can live quite well without controlling everything in our world and she was excited to share this enlightened insight with her mother. But when she told Mom that “anything can happen to anyone anytime,” Mom freaked out and quickly changed the subject. This story reminded me of a former boyfriend to whom I was complaining about my mother when suddenly he slapped his hands over his ears (in a restaurant, no less) and kept repeating “no, no, please stop.” My complaints must have stirred up a helluva storm inside him that he needed to shut out the pain my words were triggering in him. I’ve accepted that life can turn on a dime ever since my father died suddenly in the summer between my junior and senior years in college. Ever since then, I wince when...

I’ve noticed this phenomenon over my 35 years of being a therapist: many clients who are great at giving care are crummy at receiving it. These are people who become uncomfortable when someone wants to do something for them—give them a gift or do them a favor. These are often the same people who rely on alcohol, food or other obsessive habits to deal with life rather than turn to people. Take Astrid who is finally accepting now in her late 50s that there’s a cost to perpetual giving. Doing for all her neighbors, colleagues, and family members exhausts her but it also makes her insist, “It makes me feel good about myself, you know, worthwhile.” Of course, anyone can see that by saying this, she’s also saying that the opposite is true: if she isn’t giving or taking care of someone, she’s of no value. Worse, if she’s taking care...

Many questions and topics come up repeatedly in therapy that you may want answers to, so here they are. Where possible, I’ve directed you to read more about them.  Am I a bad person because I judge and feel critical of others? Rather than thinking others are bad people, use critical thinking skills (based on cognition and rationality) along with your honest emotional reactions to determine someone’s worth and appeal by weighing their pros and cons. You’re supposed to use these skills to know who’s emotionally healthy and who isn’t.  How do I know if I’m normal?  That’s an easy question to answer: there is no normal for everyone for everything. What you’re really asking? Usually, when clients ask this question, they want to know if their thoughts or feelings are healthy/unhealthy or common/unusual. In my book, it’s more important to be healthy than common. Lots of people do awful things...

Most of us spend our lives stressing to make everything work out okay. We want our children to be happy and successful, friends to like us, employers to value us and our work, romantic partners to love us and live forever, and for various and sundry other endeavors to turn out swimmingly. And in so doing, we engage in a fool’s errand. For example, my middle-aged client Josephina is divorcing her husband of many decades to live alone for the first time in her life. Tending toward anxious, she worries about feeling lonely, being able to pay her rent, and managing by herself when she’s used to depending on her husband. She told me, “I just want it all to be okay.” Another client, Alan, studying to be a paralegal, gets frantic when he receives anything less than a B due to his scholarship requirements. He works two jobs and throws...

The words you use to describe your progress are key, so you’ll want to know which ones will move you forward and which will keep you stuck. Here are ways to think and talk about how well you’re doing. I’m guessing they might be quite different than the thoughts and self-talk you’re using now. Small steps. Describe progress as modest changes rather than looking for success in one fell swoop. The discussion of how to phrase progress came up with a client who said that she’s not doing any big things differently but is making small changes which are adding up. She’s going to the gym when she can, pacing her work to be less stressful, encouraging her children to be more active, not keeping juice easily accessible to them, and giving them more responsibility for thinking about consequences and taking care of themselves. Recognize success. I’ve written how the word...

I sometimes know what clients will say before the words are out of their mouths. This happened with my client Antoinette. After doing well in many ways, she succumbed to an urge to binge which led to a “medical” diet, weight loss, and rebound eating. After discussing what she’d learned, she lamented, “But, I’m fat again. It’s the truth.” The phrase, “but it’s the truth” is the one I want to call your attention to as I did to her. I believed her. It was the truth: she had regained a portion of the weight she’d lost and now her clothes were tight again. I couldn’t argue with her, but—here’s the point—since when does something being true mean we need to dwell on and obsess about it? I reminded her it also was no lie that there’s a horrible war going on in Ukraine; poverty, guns and COVID continue to kill...

I recently read a great quote which had no attribution, “I’d rather make mistakes than do nothing, I’d rather mess up than miss out completely.” How true, how true. It seems that people are either on one side of this divide or the other: willing to mess up in order to win or succeed or, at the other extreme, living in fear of erring and surrendering a chance to reach their goals. Sad, huh? Whether we’re talking missteps or major failures, what’s the secret the person quoted above knows that people who fear messing up don’t? It’s really no secret at all, just an entirely different mindset than believing you must do everything right that causes you to live in terror of doing things wrong. The idea is to accept that missteps are an essential part of life that we can’t escape and not be ashamed when you do something that...