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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. 

Beware of Flights into Health

What is a “flight into health” and why is it the opposite of what it sounds like and a dynamic to avoid? It is: “In dynamic psychotherapy, the early but often only temporary disappearance of the symptoms that ostensibly brought the patient into therapy; a defense against the anxiety engendered by the prospect of further psychoanalytic exploration of the patient's conflicts. (Flight into Health - Medical Definition from MediLexicon, https://www.medilexicon.com/dictionary/34029 , accessed 11/24/18) I see “flights into health” often in my practice. All psychotherapists do. So that you can recognize them in yourself and people you know, here are some examples. A client prone to depression who has no meaningful work and hasn’t found the right man comes back from a vacation abroad and is jazzed and hopeful about her future because of her experience. After a while, her depression returns. She’s been in therapy for years and this vacation →...
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The Benefits of Rupture and Repair in Therapy

You might think that the word “rupture” couldn’t possibly be included in the lexicon of therapeutic terms. “Repair,” sure, because that’s the business of therapy. But, rupture? In fact, “rupture and repair” is an often-used clinical phrase, which applies to a breach in the therapeutic relationship followed by its restoration and positive continuation. A rupture may be caused by an overt disagreement between therapist and client, a client holding onto negative feelings about something a therapist said or did or didn’t say or didn’t do, or any disturbance in their cordial equilibrium. This dynamic is not something that client and therapist need to avoid. In fact, it’s something they should both welcome as proof of the strength of their connection and bond. Moreover, the repair part of the process is not only about fixing what’s gone awry with therapist and client. It’s a way of illustrating through new, healthy experiences that...
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How to Snap Out of Traumatic Memories

I often blog about Rapid Resolution Therapy to treat trauma memories, and encourage readers wishing to resolve old issues quickly, or simply improve their lives, to learn more about it at http://www.rapidresolutiontherapy.com . In the meantime, try this practice next time you’re upset or don’t want to feel so emotional. Some background: We often feel distress when we confuse actual events going on in the present with emotion-laden memories of events that are stored in our amygdala. Its job is to automatically warn us of incoming threats by being alert to situations and events which are similar to ones we’ve experienced as fearful and disturbing. Casting an ultra-wide net and using general criteria, it triggers a warning every time an event in the present comes close to being like a scary one from the past. The problem is that when the amygdala gets triggered, memories from previous painful situations flood through...
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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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What Makes Us (Truly) Happy?

As a therapist, I spend a lot of time talking about happiness. I’ve written blogs about it, posted numerous articles on it, and have a smattering of books on the subject sitting on my bookshelves for clients to borrow to learn more about the subject. Though information abounds about happiness, many of my dysregulated eating (and otherwise troubled) clients have problems finding and holding on to it. “Is happiness genetic?” by Jen Christensen ( www.cnn.com , 7/30/13, accessed 11/13/18) helps us understand why. There are two types of happiness: hedonic and eudaimonic. The hedonic type comes pleasurable experiences or instant gratification—that jolt or a bolt of happy which washes over you. This is the buzz we get from eating high-sugar/high-fat foods, shopping, or receiving a text from a beloved. The other type of happiness, eudaimonic, derives from a sense of well-being that arises from working towards and achieving goals which give...
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What Does Self-management Involve?

You have one primary job in the world: to manage yourself. If you take care of others, then you have a secondary job as well. If you cannot manage yourself even when you finally become an adult, don’t despair. You can learn. I have many clients who’ve made tremendous strides in self-care in a year or two of therapy. Sound like a long time? Not as long as spending the rest of your life lacking the knowledge for self-management. Self-management, according to Jenni Stahlmann and Jody Hagaman who write a syndicated parenting column, involves people learning “how to understand their emotions, contemplate their choices and then make proactive decisions rather than reactive or impulsive ones.” (“Helping kids develop self-management skills, Sarasota Herald Tribune , 11/12/18, B2) Wouldn’t being able to do that go a long way toward helping you eat better? According to Travis Bradberry and Jean Greaves, authors of “Emotional...
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There’s a Big Difference Between Privacy and Secrecy

Several clients over the decades have insisted that they can’t share certain things about themselves because they’re “very private” people. While I understand their view, I see them as trying to protect themselves from the feeling of vulnerability that may arise from opening up. There’s a difference, you know, between privacy and secrecy. We all need privacy—to be free of observation or disturbance—both emotional and physical, in some aspects of our lives. That’s why there are enclosed spaces for trying on clothes in dressing rooms and stalls with doors and locks in bathrooms. That’s why we wince in horror at the thought of people reading our diaries or, worse, our minds. To feel emotionally secure, there must be a real or imagined space for us to retreat in which we’re free from prying eyes and ears and can just be our authentic ourselves. Privacy is a healthy, protective practice when engaged...
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How to Sense Enoughness

A question that crops up frequently in therapy—because it’s so prevalent in life—is when something is enough. Clients usually reference the term around food, but we could apply it to any aspect of life. Although sufficiency and satisfaction are key to balanced living, many dysregulated eaters (many of us, period) have no idea how to determine what’s enough. They have what I jokingly call an “enough disorder.” To learn more about it, read chapter eight in my book, Starting Monday. Enough is a felt sense–a physical or emotional sensation that draws attention to itself, a mind/body reaction to internal or external stimuli. An example of the former is how while noodling over what birthday gift to buy someone, say, your brother Joe, you say to yourself, “Well, that’s enough thinking about that.” This thought comes from a feeling of not wanting to continue putting attention on what to buy Joe. You...
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Book Review – The Elephant in the Room

Reviewed by Karen R. Koenig, LCSW, M.Ed. and originally published at New York Journal of Books: https://www.nyjournalofbooks.com/book-review/elephant-room. The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing America “The inspiring story of Tomlinson transforming his relationship with food may break your heart before it eventually lifts it.” The Elephant in the Room should be compulsory reading for people of every size. If you share Tomlinson’s love-hate relationship with food, you just may learn a thing or two that will set you on a path to more normal eating. If you’ve not battled with food or weight, he’ll paint you such a graphic picture that you’ll never look askance at a fat person again. And if you don’t feel compassion for his struggles, check for a missing piece of your heart. When it comes to being fat, Tomlinson tells it like it is: the stigma and shame,...
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Use Regret to Improve Your Life

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,...
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