If there is one thing I’m sure to hear every week from clients, it’s their “need” to get through something. Maybe it’s getting over a break up or a job loss or having their teenager arrested for dealing drugs. Sometimes, it’s their “need” to lose weight or get their act together around food. Whether the challenge is big or small, they tackle it the same ineffective way by believing that if they want something enough, they’ll make it happen. Do you ever fall into this trap? The way discussion usually goes is that a client raises a topic, say, “getting over” a break-up, then says repeatedly in our session, “I’ve got to get past this,” “I can’t keep feeling like this,” or “I have to get on with my life.” What these words tell me is that the only way they know to feel better and move forward is by bullying themselves...

Are you thin skinned? Do you always take things personally and often feel hurt? Would you like to have a more detached attitude about slights and insults and not take them so deeply to heart? Would doing so brighten your life and improve your eating? If you’re easily wounded, you’ll likely have a difficult time as a dysregulated eater not using food for comfort. You’ll see rejection and hurt constantly aimed at you. Life is full of slings and arrows, and how you think about and deal with them is key to maintaining high self-regard and feeling okay in a world that is not tailored to avoid hurting us. It takes learning and practicing changing beliefs in order to become thick-skinned. Thick-skinned people have specific qualities and ways of thinking which help them ward off the blows of life. They…aren’t seeking love or approval from everyone they meet. They recognize that some people...

The time to think about how to stay sane over the holidays is neither while they’re happening nor after they’re over. If you want to stay sane—not just think about it without genuine intent—you’ll start thinking about how you want this season to be now. If you live alone, that may an easier job than if you have a family. Either way, the goal is to create the structure and balance you want and feel so strongly that you follow through.Alone time:When are you going to have time with yourself or with people you love? If you live alone, that doesn’t mean you can take self time for granted, especially if you have a million friends or family members insisting that you join them for a holiday event. Time by yourself is especially crucial if you’re an introvert, which I bet many of you are. Carve time into every day where...

Most dysregulated eaters agree that their self-talk is abysmal, that they’d never speak to someone else the way they speak to themselves nor let others put them down the way they put themselves down. Just to be sure you know the kind of self-talk that is hurtful and, therefore, unacceptable, I thought I’d share what you don’t want to say. When clients make mistakes, they often accuse themselves of being stupid or dumb. They may say it playfully or even with a smile, but it’s still a put down. And they’re neither stupid nor dumb, but simply weren’t paying attention or didn’t do as well as they’d hoped. Why, then, would they call themselves stupid or dumb? Perhaps because they were told that these descriptors fit them as a child or this is what their parents said to themselves when they made mistakes. When things don’t work out, clients often say, “This is...

Occasionally, we all act like our parents. How can we not, as they are the ones whose genes we carry and who first taught us how to be in the world. A number of my clients are aghast that they will become too like their parents which colors how they choose to think and act—often to their detriment. Here are some examples of this dynamic:One client is very timid and works overly hard to be agreeable—the kind of woman I write about in Nice Girls Finish Fat. Her father spent most of her childhood raging at her and her sister after their mother died and he had to raise them himself. Afraid of his anger, people kept away and the family became quite isolated. My client vowed early on to put a damper on her temper and go along to get along. Now, middle-aged, she’s had two abusive husbands and is in...

I’ve just spent the better part of an hour unsuccessfully digging through reading material trying to identify where I read (within the last week!) that “biography is not identity.” I had to wait to carve out time to blog about this subject and, in the interim, forgot where I found these four words which leapt off the page and tattooed themselves onto my brain. How often do I hear clients make a determination about who they are based on what happened to them as children? Every day. If they were poor and had to go to neighbors’ homes begging for food to feed their younger siblings, they still carry deprivation and shame with them. If their father left them and their mother when they were toddlers, they still think of themselves as fatherless, abandoned children. If their mother trashed them with her words when she got drunk, they can’t shake the belief...

It’s somewhat ironic that humans often worry a great deal about how people will view and judge them, but may behave unconsciously in ways that elicit judgment. It’s vital that we are all in touch with how we present ourselves—from our appearance to our words and tone to how we behave. We may not wish to be judged, but we will be, because that’s simple the way of humanity. Robert Parkinson talks about the impressions we make in “Being perceived as you want to be” (Sarasota Herald-Tribune, 6/24/17, D3). He maintains that, “People will assume many things about you. Help them make the correct ones.” I love this directive because it says that we get to play a big part in how others perceive us. On a related note, I recall a social work school instructor suggesting that we get clinical clues about how clients value themselves from their appearance. He said...

Much of the advice we get these days about becoming and staying healthy involves eating nutritiously and being active. However, one piece of advice doesn’t get as much play as it should, which is to stay socially connected for better health. As an eating disorders therapist, for decades I’ve encouraged clients to seek and maintain healthy attachments to increase emotional well-being—including reducing emotional eating. Research concludes that deep attachments bolster physical well-being as well. In “The socially connected live in a virtuous circle” (Sarasota Herald-Tribune 6/20/17, E25-26), Jane Brody tells us that “Social interaction is a critically important contributor to good health and longevity.” She cites a Harvard Women’s Health Watch report: “‘Dozens of studies have shown that people who have satisfying relationships with family, friends and their community are happier, have fewer health problems, and live longer.’” Moreover, she gives us this surprising result from California researchers: “‘…those with close social ties...

A common occurrence is having a client come into my office and start telling me about a problem. That’s what clients are supposed to do with me, right—cough up their problems? Well, sure, that’s true, but I’m talking about describing their problems to the exclusion of focusing on what they might do to reduce or eliminate them. For example… A client might sit down and begin complaining about her husband being over-involved in his work and rarely spending time alone with her. She’ll describe in detail the instances during the week that he’s come home late while l listen, maybe making a comment or asking a question. When I ask if she’s followed up on corrective ideas we talked about previously, she’ll shrug and say how hard it is to change him and return to complaining. Another client might come in with a list of times he’s binged during the week and give...

I’m always looking for evidence-based ways to help clients improve their mental health. There’s so much pseudo-science out there, that I was delighted when a friend told me about the website of Greater Good in Action: https://ggia.berkeley.edu/. All of their practices are based on scientific studies and trials. Of course, that doesn’t mean that all of their suggestions will work for you. It only means that they work for many people. The Greater Good in Action at UC Berkley encourages these practices:Awe: Observing nature and the beauty of the worldCompassion: Loving-kindness, eliciting altruism, feeling connected/supportedConnection: Effective apology, forgiveness, shared identity, friendship, gratitudeEmpathy: Increasing closeness, letting go of anger, active listening, positivityForgiveness: Forgiveness, letting go of anger, effective apologyGratitude: journaling, letter-writing, positivity, nature, relationshipsHappiness: strengths’ focus, random acts of kindness, best possible self, gratitudeKindness: shared identity, feeling connected, compassion, make giving feel goodMindfulness: body scan meditation, mindful breathing, self-compassion breakOptimism: three good things,...

I love the kind of days when the same themes keep re-appearing from one client to the other. Sometimes the theme is realizing that the most important approval comes from ourselves. Or that detachment is far superior than wanting to change someone. Or the theme that echoed through practically every session one particular Monday in late May. Most of my clients learn about self-compassion from me and we have long discussions about it how they never learned it from their parents who didn’t possess it or why they never received much of it growing up. They understand that self-compassion—meeting suffering with kindness—is missing in them and generally do quite well in healing their eating and other problems by generated greater care and concern toward themselves. They find it quite amazing how a little self-compassion can go such a long way toward helping them have a better attitude and a better life. On this...

Many people hurt themselves with food. As a recovered world-class binge-eater, I have vivid memories of how I used to eat until my stomach ached. Until my heart was full of sorrow and disappointment in myself. Now, decades of healing later, having learned so much about the pain and healing of eating disorders from my clients, I realize that there are several reasons that we inflict pain on ourselves. We are used to hurting, and life feels weird without the pain—to live happily, enjoying ourselves, accepting our bodies and our faults is not possible because we are supposed to strive to be—and be—perfect. If we don’t have a perfect body, it’s not worth trying to have a barely acceptable one. If we don’t have the perfect life, including a job we love and a partner to love us, what’s the point of pretending to be satisfied with less. We hurt ourselves because we...

I’m often amazed at what I hear people say about therapy when they have never engaged in it. I recognize that they learn about it by watching TV and movies and take as truth what people have shared about their experiences seeing a psychotherapist. I understand why they might think as they do, but that doesn’t mean that their view is accurate. Here are three myths I’ve heard in my three decades as a clinician:Myth #1: I must be really messed up if I need therapy.The idea that reaching out for mental health help means there’s something gravely wrong with you misses the point of therapy entirely. It isn’t about how serious your problems are, but about how to get help to resolve them. Does it matter if your tire is flat with a nail stuck in it or whether it came off the rim? Not really. You still need to...

As I age, I’ve been thinking a great deal about wisdom, a useful concept to reflect on in my business of helping people lead their best lives. What I’ve come to believe is that if I can teach clients and readers how to become wiser in order to make better choices for themselves—with food and all of life—I’ll have made an impact. Rather than hear my voice in their heads guiding them, I’d like them to develop their own internal Wise Woman or Man who knows what’s best for them. The word wise has many meanings: good judgment, discernment, prudence, sagacity,  the ability to discriminate, enlightenment and knowledgeable. It is not per se about happiness, success, achievement, love, power or healing. In my mind, it grows out of learning from your experience and that of others in order to make the best choice you can make in any given moment. It’s about...

Ever wonder why it’s hard for you to reach your life goals? Maybe you don’t try hard enough and give up too easily. Maybe you’re low on frustration tolerance and delaying gratification and high on impatience. Or, maybe the goals you set simply aren’t right for you. Should you pursue goals which are easy to achieve which bring little satisfaction or should you set goals which are difficult and may bring greater pride in their accomplishment? All good questions with no easy answers. My reflections on this subject spring from a conversation I had with a client about how well she does in her job, yet how stressful she finds it. In sales, she works with large crowds of people and yet admits to being more of an introvert than a people person. She said she hates all the noise she encounters on her job and all the excess stimulation which, rather...

One of the worst things you can do when you’re in internal distress is to drop your self-care routine—eating regularly, getting enough sleep, exercising, and doing the daily activities that give life structure and embody extreme self-care. Emotional health includes keeping up with self-care no matter what is going on in life. This is exactly what many dysregulated eaters don’t do when they’re thrown a curve ball, endure a major change, or get walloped by something unexpected or unwanted. When your life is thrown out of whack—by illness (yours or someone else’s), job change or extra work, guests staying with you, or unforeseen travel—it can seem as if the world is spinning out of control. You may feel as if the pressure’s on, you’re routine is thrown off balance, and you can’t seem to find time for yourself. Pretty soon you drop all or most of the activities you’ve been doing to...

Try this simple question: Where does change happen—in the past, present or future? Of course, it can only happen in the present. Here’s a more complicated question: If change happens only in the present, why, then, do we spend so much time thinking about the past or the future which we can’t change in the present? Your reflections on and response to this question may be the key to your becoming a “normal” eater. In order to do things differently that will help you develop new, healthier behaviors, you need to be anchored securely to the present moment. You can’t learn how to practice new eating behaviors when you’re ruminating about the past or agitating yourself about the future. I don’t mean to imply that mental time travel happens only in the food arena; these unconscious shifts out of reality and into memory or anticipation may happen any time. Here’s what I mean....

For many people, the hardest two words to say in any language are “I’m sorry.” Ironically, according to Harriet Lerner, psychologist and author of Why Won’t You Apologize?, these words might also be “the most healing words.” (Sarasota Herald-Tribune, “A healthy conscience depends on apologies” by Jane Brody, 2/17/17, E32,  34). Even for those of you who don’t find it hard to apologize when you’re wrong, here are some tips to help you improve at this crucial and beneficial life skill. Before explaining what’s best to say in an apology, let’s look at why saying “I’m sorry” can be difficult. First, maybe you grew up in a family in which you were blamed for everything that went wrong and neither of your parents ever apologized to you or each other. If you didn’t grow up hearing apologies, you might think they’re weird or not know what to say. Moreover, if you were...

Image by Debbie Digioia I hear the same story over and over from clients: I want or wanted to lose weight to find a date or mate. For some, it’s true that being more fit and trim would widen the potential partner pool, but ironically, more often than not, weight is not the problem. Rather, it’s the people they choose as dates or mates that makes relationships not work. The problem is more a statement about their self-esteem than their size. These clients are so preoccupied with looking attractive, looking thin, and looking for love and approval, that they never stop to ask themselves how they manage to unerringly find partners who treat them poorly, show little ability or desire for emotional intimacy, and who, to a person, end up causing them to feel inadequate and rejected. They pay so much attention to being attractive that they don’t think about making choices that...

Guest Blog by Paige O’Mahoney, MD  My favorite quote from the business literature is, “You become what you think about most of the time."* Focus on what you don’t like or don’t want in your life (fat, dieting, food rules, your least favorite body part (more on this later), your worst habit), and that’s exactly what you are likely to get more of. Have you ever noticed how the more you focus on restricting calories or avoiding certain foods, the more you want to consume? You get what you think about. On the other hand, focus on what you want, and you are more likely to get it. Focus on what your muscles need to feel strong and supple and you may find yourself in a yoga or stretching class and actually enjoying it. Focus on eating foods that feel good to you, and a zucchini frittata with goat cheese may be exactly what...