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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. 

[No unsolicited guest blogs accepted, thank you]

How Has Your Eating Disorder Helped You Cope?

  I have a client who binges and purges whenever she’s stressed. If this describes you, consider this: What if it’s the best way you know of to cope with the vicissitudes of life? What if you’re trying to save yourself from worse pain by these actions? I don’t know if you know the story of Aron Ralston who cut off the lower half of his arm to free himself from being pinned by a boulder in the Utah desert. I remember hearing his story and thinking that he believed amputation to be his last resort or he wouldn’t have done such a painful thing. Most people, I assume, probably agreed. Ralston’s heroics drifted into my consciousness when I was talking to my client about her stress-induced binges and purges. I asked what words came to mind when she thought about them and she blurted out, “Disgusting, repulsive, shameful, foolish, disheartening,...
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Chronic Pain and Food Seeking

Whether you have pain that’s short-term, say a severe headache or a broken bone, or chronic and long-term, as can happen with fibromyalgia or neuropathy, you may be using food as a crutch to get you through the day. Being in pain can steer you toward the refrigerator in several ways, but you can learn not to let it do so—and improve your health at the same time. You may turn to unhealthy food: · For comfort from pain because you hurt badly and wish to feel better. Who could blame you for that? However, food is not meant for comfort, except occasionally. Especially if you’re suffering is ongoing, you may be telling yourself it’s okay to eat lots of sweets and treats because you feel so miserable. Or because life’s not fair. But, it’s not okay to mistreat your body when it’s already feeling awful. It’s far better to find...
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What to Do to Feel Contentment and More

I spend a good deal of therapy time talking with clients about how to self-soothe and talk themselves down from the ledge when they feel heightened anxiety. Ours is not at heart a culture that teaches or helps us do that in spite of all we hear about meditation, yoga, and cognitive-behavioral therapy. We’re not exactly a deep feeling culture. We’re externally rather than internally focused. But Norwegians seem to have found a way to do what we need to take classes to learn. The word they use to describe what they call their national pastime is “koselig.” (“Why are Norwegians so happy? In a word: ‘koselig’” by David Allan, CNN online, 5/1/19, accessed 5/1/19). Allan says, “You could roughly translate koselig (pronounced "koosh-lee"), as ‘coziness,’ but that leaves out crucial components of it, like enjoying the company of others and a connection with nature.” Neither of these pastimes should be...
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What to Do When Life Takes an Unexpected Turn

I can’t believe I’ve lived this long and never heard of the essay, “Welcome to Holland” written by Emily Kingsley in 1987 (Texas Parent to Parent, Austin, TX, accessed 4/30/19.) When you read it, you’ll see why it needs no introduction other to say the author is talking about having a child with a disability. Here it is: “When you’re going to have a baby, it’s like you’re planning a vacation to Italy. You’re all excited. You get a whole bunch of guidebooks, you learn a few phrases so you can get around, and then it comes time to pack your bags and head for the airport. Only when you land, the stewardess says, ‘WELCOME TO HOLLAND.” You look at one another in disbelief and shock, saying, “HOLLAND? WHAT ARE YOU TALKING ABOUT? I SIGNED UP FOR ITALY.” But they explain that there’s been a change of plan, that you’ve landed...
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What Crisis Can Mean in Your Life

Many people come to therapy because they’re “in crisis.” Usually, they see the crisis as something terrible, perhaps the worst thing that ever happened to them. I get it, but my job is to try to help them see this “crisis” as something more, maybe even positive. It’s not a new idea to view “bad” things that happen to us as possibly being good in the long run. Philosophers, spiritual leaders and experts in human behavior have written about this subject for ages. Yet, when something unpleasant or unsettling happens to us, we generally go right to thinking about how awful it is and how terrible it will be for our lives. To be clear, I’m not talking about fatal health or medical problems, the loss of a loved one, fire or flood demolishing your home, or severe traumas like being raped. Here are some examples of what I mean. Your...
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What Do You Want Most in Life?

I spend my days listening to what clients want. Sadly, I rarely hear them sharing wanting to be mentally healthy above all else. That is what I want for myself and for all of you. Setting a goal to achieve as much mental health as you can means that you may need to sacrifice other, lesser goals. This doesn’t mean they’re not worthwhile pursuits. It means that their exclusive pursuit may be what’s holding you back from growing mentally healthier. In and of themselves, there’s nothing wrong with desiring them. But they’re not the whole shebang is what we want to strive for. Here are some goals that dysregulated eaters and clients say they want: To be heard and seen . To be sure, this is an admirable, very human goal. Who wishes to go through life feeling that you don’t matter and aren’t worth a whit? However, it’s important to...
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Becoming Who You Want to Be

There’s a process that goes on in recovery that’s more subtle than overt and which is full of greater complexity than most dysregulated eaters can imagine. I know, as I was one of them. One barrier to this reality is a major trait of troubled eaters: all or nothing thinking. More often than not, clients come to me with the stated or unstated wish or belief that if they just try hard enough, they’ll become “normal” eaters. Nothing could be further from the truth. Another aspect of misperception is that it’s very hard to imagine being any different than we are. We can fantasize about it, but we can’t deep down have the experience of what we’re not yet. Which leads me to point out the gradual transformation that happens in healing and recovery. Initially, people try out different skills and inevitably have difficulty with them. They forget to practice them;...
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Be Brave

I sometimes wonder if I talk enough about bravery when it’s one of the most significant qualities a person can have. I know that with clients, we discuss their anxiety and worry, fears and frustrations. But the other side of the coin is just as important: to recognize the acts of bravery that we engage in and even those we consider engaging in which someday may come to fruition. Why bravery? Because so many dysregulated eaters don’t realize they need to be brave to overcome their eating disorders. Here are 20 large and small acts of bravery relating to food and your body to aspire to or pat yourself on the back for if you’ve already engaged in them: Stop dieting. Leave an abusive relationship. Quit weighing yourself. Seek therapy. Throw out food when you’ve eaten enough. End relationships in which you’re mistreated on a regular basis. Eat high-calorie/high-fat food in...
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Why We Do What We Do

We act in certain ways because we’re driven by what we call human nature. Over the centuries, there have been varying views of what that entails. “The bad news on human nature, in 10 findings from psychology” by neuroscientist Christian Jarrett (Aeon, 12/5/18, adaptation of an article published by The British Psychological Society’s Research Digest, accessed 12/7/18) may help you understand more about why we and others say and do things that are not always in our best interest. Here are some evidence-based conclusions about our baser desires and reactions. · We believe that people deserve their fate and blame the less fortunate for what happens to them. In part, this may be why many dysregulated eaters are hard on themselves and confuse taking responsibility for their actions with self-blame. · We are not particularly rational, open-minded creatures. Remember this when you’re arguing with someone and the facts that you present...
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What Constitutes an Adult?

This blog came about thanks to (another) lively and enlightening discussion I had with a client about what qualities make us feel like adults. Even when we’re chronological adults, we may not know how to act maturely or may have only a hazy idea of how adults ought to conduct themselves. After all, our concept of adulthood is rooted in a template of how our parents and other important grownups acted when we were children. Many dysregulated eaters may not have bothered to update this view, even long after they have become adults themselves. The discussion with my client on adulthood grew out of the conversation we’ve had on more than one occasion about her feelings when we touch on whether or not she acts childishly. This time, rather than focus on what behaviors or reactions might be childish or childlike, I headed in another direction: How did she feel about...
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Is It a Chore or a Challenge?

Twice in one day, I had clients complain about exercise and eating healthily being chores. They had nothing but negative things to say about how they felt about engaging in these activities. Obviously, the intense feelings they had about these activities are only made worse by filing them in the category of “chore” in their brains. Would it, I wondered with them, make a difference to categorize them as “challenge”? According to the English Oxford Living Dictionaries, a chore is either a “routine task, especially a household one,” or “a tedious but necessary task.” (accessed 1/21/19, https://en.oxforddictionaries.com/definition/chore ). Even here we have leeway. Thinking of exercise as a routine will get the job done. It’s something you do frequently and regularly, so much so that you have no need to even think about it. The second meaning is more like how my clients view chores: as one big “Ugh!” They give...
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What Is Secondary Gain and How It Can Hurt You

I’m often struck by the fact that psychological concepts that I recognize like the back of my hand are unknown to many clients. I don’t know why I’m surprised, considering that the education of a therapist is based on possessing a thorough knowledge of psychology. One of these concepts that people don’t readily see and often need a therapist to point out to them is called secondary gain. To put it simply, a primary gain is one we’re conscious of and a secondary gain is one that is generally unconscious. The term is often applied in relation to poor health. The primary gain from going to the doctor would include getting proper diagnosis and treatment. The primary gain from telling people about your sickness might include informing friends about why you’ve been isolating or even finding out if they’ve gone through what you’re experiencing. With primary gain, we have an intentional,...
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Time to Raise the Bar on Deservedness

I feel sad for my clients who settle for so little in relationships and in other aspects of life. You may do the same thing if you compare what you have now to what you had growing up and think this is the best you can do—with friends, romance or work. In childhood, you may have been neglected or physically or sexually abused. Now you put up with emotional abuse or indifference thinking, “At least I’m not being hurt physically.” You may have suffered emotional abuse at the hands of your parents and now accept romantic or friend relationships with people who are sometimes nice to you but mistreat you at other times. You stay because this is the best you’ve been treated to date and are grateful that at least someone isn’t awful to you all the time. You stay because life has improved. But you’re still not getting the...
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Fake News—In Your Head

What happens when we believe fake news and what happens when we take as truth the random irrational thoughts floating through our minds day in and day out is pretty much the same thing. When we stop even trying to distinguish fact from fiction—within or without— and go with how we “feel,” we surrender rationality and suffer grave consequences. When our eating behaviors are the product of mental flotsam—denial, fantasy, pretzel logic, and irrational fears—we can forget about growing healthier or wiser. The fake news being generated by our brains (aka eating disordered thinking) will keep us chained to the merry-go-round of emotional and mindless eating forever. The only way off this very unmerry go-round is to take charge of our minds and start separating fact from fiction, fake news from real news. Here are the top 10 hits being broadcast 24/7 on the fake news channel of dysregulated eaters: I...
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What Is Instead of What If

One of my clients said that she’s practicing staying focused on “what is” rather than on “what if,” and I thought that was a great phrase and way to live. Living according to this creed, she’s making changes in her current life rather than agonizing about the future. What if you stopped obsessing about “what if” and made “what is” your primary focus? There is, of course, nothing wrong with considering what might happen in the future in order to try to make better decisions in the present. In fact, this is the best way to problem solve. But, there’s a big difference between intentionally thinking about consequences and putting your life on hold or not experiencing it to the fullest. Here are some examples of how these major differences play out: Some people have little direction in life and only the broadest of goals such as wanting to be happy....
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The Best Decisions Are Based on Rationality

Reading a book about how strongly human nature inclines toward irrationality and the importance of fighting to be rational made me think about illogical beliefs that clients bring into therapy. Although their lives are problem-laden or they can’t reach their eating and other goals, they are often upset when I challenge these irrational beliefs. Because my job is neither to placate nor make them feel good in the moment, but to get and keep them mentally healthy, I challenge them anyway. If you want the health, happiness, and success that other people achieve, you can’t hold these beliefs:   That will never happen to me. It’s understandable how this thought takes root. How reassuring to believe that bad things happen to other people and not to us. Or that bad things may befall us, but they only protect us from worse things happening. If we believe that unfortunate things happen only...
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Turning Insight into Action

Nearly all who come to therapy voluntarily are seeking enlightenment. They yearn for eureka moments, mental lightbulbs flashing, ah-ha insights that will rock their world. All well and good, as most behavioral changes begin with shifts in thinking. But insights are only the start of a process, not the end, which is purposeful, positive action. This shift from insight to action comes up frequently in therapy. One phone client shouted in exasperation, “I am so tired of asking why. I don’t care why I eat when I really don’t want food. I want to not do it.” Another lamented, “I understand my childhood, I so get why I’m like I am. Now how can I be different.” Another tearfully asked, “What am I doing wrong? Why aren’t I happy?” To use an automobile metaphor, insight is like shifting into first gear. It gets you out of your parking space or driveway....
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Why Facts Don’t Always Change Our Thinking

Those of us who aspire to be rational creatures generally believe ourselves to be whether we are or not. When asked, we insist that we base our decisions on facts and expect that others should do so as well. But, as explained in “The partisan brain” (The Economist, 12/8/18, p. 33, accessed 12/10/18), the evidence shows that facts aren’t the big persuaders that we wish them to be. This subject is highly relevant to dysregulated eaters who find it hard to believe that diets don’t work long-term or that certain foods will likely harm their health down the road. As many of you know, these truths don’t always change your thinking or behavior. Ever wonder why? Jeremy Frimer of the University of Winnipeg suggests that “people are willing to dismiss or deny facts and opinions that run counter to their beliefs.” According to the authors of The Enigma of Reason, Hugo...
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Didn’t Cause It, Can’t Fix It

If I had to generalize, I’d say that I spend a large chunk of the therapy hour trying to persuade clients that they can’t change the feelings or behaviors of other adults. Talk about continuing education. My best shot at helping clients accept this tough-to-swallow concept is to tell them, “If you didn’t cause it, you can’t fix it and if you didn’t start it, you can’t stop it.” They seem to get this idea on a theoretical level but find it hard to put into practice in specific instances. Here are some ways this theory might be applied. I treat a great many clients who have abusive (leaning toward sociopathic) partners. To a person, these abusers had awful, dysfunctional childhoods full of neglect and/or abuse. My guess is that these abusers’ parents had pretty crummy beginnings themselves. So, my clients meet someone at age 19 or 27 when their personalities...
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How (Not) to Give Advice

About a million times a week (okay, that’s a slight exaggeration), I hear clients tell themselves that they need to do something. They also share with me what they direct other people about to do—stop smoking, go back to college, see a doctor, quit playing the lottery, etc. They order people around the same way they order themselves around and it doesn’t work for others any better than it works for them. So, it was with great delight that I read a recent column by Dr. Ellen Glovsky, “Giving Advice in Motivational Interviewing” in a recent newsletter. Here’s her advice on giving unsolicited advice: “The truth is that most people will become more resistant when confronted and in this way the clinician’s behavior can cause resistance. I know it feels urgent in a situation in which the client is highly likely to harm themselves. It is very important to not push for...
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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