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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You’re Only as Healthy as the Company You Keep

I’m often amazed to hear about clients’ unhealthy friends—substance abusers, unstable people with mental or physical health problems who refuse treatment, dangerous risk-takers, perpetual victims in abusive relationships who won’t acknowledge problems or leave, and narcissists who take advantage of clients financially or emotionally or both.  Clients tell me story after story about these “friends” and come up with all kinds of reasons they keep them in their lives: feeling sorry for them, having been friends for years or since childhood, their possessing many redeeming qualities, or friends having no one to care for them. Clients accuse me of being coldhearted when I suggest that these so-called friends don’t add much to their lives and take away a lot.  I explain why it’s hard to detach from friends or at least reduce contact or closeness with them. Sometimes clients have too much compassion for them. Or they overidentify with them. Or...
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The Dilemma of Parent Care

Years ago, between writing books on eating and building my therapy practice, I tried my hand at writing novels and screenplays. Although none were published or produced, I see the story line of one script play out over and over in my clinical work: that of adult children taking care of parents who abused or neglected them in childhood. Many of these clients don’t even realize the dilemma such a difficult situation presents to them. Here's what I’m talking about. In my screenplay an insecure, introverted 20-something, raised by her widowed father who sexually abused her, ends up taking care of him when he develops Alzheimer’s. She’s never processed the rage she feels at him nor her fierce yearning for an apology for the unspeakable harm he did her. In fact, part of her reason for taking care of him is to get the love and caring he failed to give...
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Stop Saying Others Make You Feel a Certain Way

We grow up hearing things like this, “He made me so angry that I hit him” and “She made me feel bad, so I didn’t go to her party.” For decades I’ve been correcting clients when they make statements like this because they’re, quite frankly, ridiculous. Exactly how can someone get inside your head and make you feel something? If that were possible, I’d get into heads everywhere and make people feel better. Hell, I can’t even “make” my clients feel better and I’m a therapist. Believe me, I wish I had the power. Then why do we so often make this statement and what do we mean by it. First off, how do you think people can make you feel something? How could they plant an emotion inside you? Can anyone really do this? Or now that you’ve stopped to think about it, do you see how mistaken you’ve been? ...
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Make Self-care a Given

Talking with a client we’ll call Essie about maintaining self-care, I chuckled when she said she usually stopped taking care of herself when things were going poorly in life—at work, as a single parent, and caring for her elderly mother. I realized that this is true of many clients: paradoxically, they give up self-care just when they need it most.  I asked if she didn’t walk or feed her dog when things weren’t going well in life, and she looked at me like I was nuts. “Of course not,” she insisted. “If I don’t take care of him, who will?” When I was silent and looked right at her with a “Duh?” expression, she got my point. But, the truth is, she really did think that a person only did self-care when they were up to it and when things were going well. To her, it was normal to stop certain...
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The Benefits of Becoming a People Observer

More often than I’d like, I’m saddened at clients getting themselves into nasty situations because they’ve ignored obvious red flags in people. Understandable, as many are trauma survivors who have difficulty interpreting danger. The way to grow more astute is to develop the habit of tuning up your emotional antennae around everyone. The skills of observing and assessing should not be confused with making judgments, though that is part of the process I’m encouraging. The goal is not to judge people as “bad,” but as not appropriate for you. This means watching people like a hawk, noticing everything they say and do, learning their histories, recognizing their patterns and, most importantly, paying attention to how you feel when you’re around them. I suppose I’ve always been an observer, or why become a therapist, the ultimate observer and processor? I do know that my noticing skills have improved immensely as my clinical...
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Emotional Memories Now versus Then

A client said she wished desperately to learn how to not be reactive. Specifically, she wanted to learn how not to be triggered by her traumatic, abusive childhood. We’d talked a great deal in therapy about trying to stay out of recall and stay in reality, so I valued her desire to pursue being grounded in the present. We can’t erase memories or stop recalling how we felt in them, especially events which threatened our survival, being reactive to previous threats is meant help us outwit current dangers. Memories are guideposts for our journey in the future. We need the ability to recall the threats we faced to recognize future encounters with them.  However, we only need a general idea of what we felt to keep safe; we don’t need to relive the suffering we had at 4 or 7 or 19. A quick identification of the emotions we experienced is...
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What Is Toxic Stress?

You may suffer from toxic stress and not know it. Eating disorders and substance abuse problems, chronic depression or anxiety, difficulty in relationships, and sleep issues all may be symptoms of toxic stress. Because I know the childhoods of all my clients, I’d wager that many of them suffer from it, but don’t know it because they think what they feel is normal though it’s anything but. Here’s an excellent description of toxic stress and its causes from “What Does “I Feel Fat!” Really Mean? by Carolyn Coker Ross, MD, MPH, CEDS (2/224/222, Gürze-Salucore Eating Disorders Resource Catalogue). “Abuse or neglect or any other negative experiences in childhood can lead to what is called toxic stress. Toxic stress causes an overproduction of stress hormones: cortisol, adrenaline, and noradrenaline. This leads to physical changes in the brain. The brain of a traumatized child resets itself to be in fight-or-flight—regardless of whether there...
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How to Find Real Comfort

Dysregulated eaters talk a good deal about seeking “comfort” through eating, but what is comfort and how can we find real reduction or elimination of distress? As I’ve blogged, although turning to food occasionally to manage the blues or the blahs is fine, comfort eating as an emotional management strategy is nothing more than a bad habit.  If you’re readying yourself to learn more effective strategies, consider how you might learn to comfort yourself through both words and actions. In my experience, clients tend to use one strategy or the other, that is, they rely entirely on either taking action or trying to talk themselves down. Using both is a more effective combination.  I’ve been thinking about this subject due some client conversations. One client described how she handled a distressing situation: she got busy, which is a common strategy used by people to dissipate anxiety. She cleaned her apartment until...
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Do Affirmations Really Work

I began as a therapist when affirmations were all the rage, but I never bought into them, used them myself or encouraged clients to do so. Why? Because I thought it was weird that people were trying so hard to convince themselves of their positive attributes. I had a friend back then who said affirmations a lot—not only said but wrote them down and reread them daily. She hadn’t had a great childhood and certainly needed to do something to raise her self-esteem. When you walked into her bathroom, straight ahead of you was a towel cabinet whose front was covered with her affirmations. You could even see them reflected in the mirror above the sink when you washed your hands. I don’t recall exactly what hers said, something like, “You are a worthy person, You are lovable, People love you just the way you are, You are deserving of good...
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How to Make Better Eating Decisions

Becoming a more intuitive eater is neither magic nor mystery. When I think about how I learned to become one, I can break down some of the steps and practices I continue to use (though more instinctively and unconsciously now). Here they are: Tune out everyone but yourself. It doesn’t matter that Uncle Jerry cooked your favorite dessert if you’re full or not in the mood for it. It doesn’t matter if your friends all order fries and you want a baked potato or if they all decide upon salads and you want lasagna. When you’re at a restaurant, stop asking people what they’re planning to order. Why do you even do that: curiosity, for ideas about choices or because you want to eat something similar to them? Pretty much everything you need to know about ordering is on the menu or through asking waitstaff.Tune into yourself. Ask yourself how hungry...
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