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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. 

Sorting Out Beliefs Learned from Parents

I’m sometimes amazed at what clients tell me, as if what they’re saying is a provable fact. It’s obvious to me that their thinking isn’t rational and that they have no idea they’re spouting—or, worse, believing—falsehoods. Sometimes these untruths are about eating and sometimes they’re not. Either way, they’ll need to change these beliefs to become “normal” eaters and emotionally healthy people. When we’re children, we believe nearly everything our parents tell us—but that doesn’t mean that all they say is true or that the beliefs we learn from them serve us well in adulthood. Just as you’re probably not still adorning your living quarters with dolls, toy soldiers, miniature tanks, stuffed animals or posters of teen idols, it’s not great mental health to be walking around with outdated, erroneous beliefs in your head. We believe what we learn growing up for several reasons. First, we don’t have the brain capacity...
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What You Need to Know About Suicide

One of the most difficult jobs of a mental health clinician is dealing with someone who is suicidal. Being a layperson with family members, co-workers or friends who want to kill themselves is even scarier. At least we have training in what to do and not do. Here are some things to consider when dealing with people who say they’re suicidal or who you think might be. (“Suicide rates on the rise: know the signs, ask the right questions to help them stem the tide” by Alison Lauria, Social Work Advocates, 10-11/18, pp. 13-20). You may believe that suicide is a rare occurrence, but the fact is that, “Nearly 45,000 Americans age 10 and older died by suicide in 2016, making it one of the leading causes of death in America. And the suicide rate is rising…more than half—54%—of those died by suicide did not have a known mental health condition”...
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Time to Take Down Your Façade

“Sometimes the façade becomes the building,” laments one of the characters in the entertaining and deeply moving novel, Rise and Shine, by Anna Quindlen, a favorite author. How sadly true. I see how that has happened to many of my clients, with and without dysregulated eating, and know that they must tear down that façade to become a whole and healthy person. It’s no mystery how we got to be the way we are. We are built psychologically to survive. That is how the human brain is wired: to adapt to an environment in order to make the best of it. Unfortunately, when this happens, we may think we’re growing toward the light, but end up growing toward the darkness when how we act, believe and feel, which is adaptive in childhood, become maladaptive in adulthood. I have many clients who are Adult Children of Alcoholics (ACOAs) and they have the...
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Sleep, Circadian Rhythms, Eating and Weight

It’s ironic that clients often don’t want to discuss their sleep habits but focus obsessively on their eating habits. In truth, sleep may be a substantial determinant of what and how much we eat, and disruption of our circadian rhythms may have a significant effect on what we weigh. Here’s what science has to say on these subjects. According to “Sleep Longer, Eat Less, Maintain a Healthier Weight” by Mugdha Thakur, MD (Duke Medicine Newsletter, 5/2008, p. 7), “Sleep is a modifiable risk factor in the link between obesity and cardiometabolic diseases…” and “Reduced sleep affects the regulation of appetite hormones such as ghrelin, which increase appetite, and leptin, which decreases appetite.” It is also thought to increase cortisol (a stress hormone) release, which increases eating behavior. Consider the paradigm above: By sleeping less, you’re putting yourself at risk of generating increased stress and appetite. This combination is the perfect storm...
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Neurotic versus Personality Disordered

I remember being fascinated in my social work psychopathology class as my professor described two types of clients we’d be treating. One type would seek us out and the other likely would need to be dragged, kicking and screaming, into our offices. Although I’m not sure after 30-plus years in practice that I’d draw such a sharp distinction between the two types, I do think back to my professor’s description when I meet clients for the first time or listen to them talk about the folks who populate their lives. The first type has what we call a neurotic disorder. To paraphrase my professor, they think that all their problems are their fault. No matter what has happened to them, they brought it on. They made the wrong choice, didn’t see something coming, and berate themselves for staying too long in bad situations. They are mercilessly hard on themselves and shockingly...
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The Best Parenting Style for Children

I don’t generally treat children, but I am asked a good many questions from clients about how to feed kids. I’m glad they ask because it means they understand that how they feed their children may cause or deter their progeny from developing eater disorders. Here are excerpts from a great article on nourishing children. In “Of the four parental 'feeding styles,' only one is good for kids' health, experts say,” nutritionist Lisa Drayer provides descriptions of feeding styles and why they are or aren’t useful for teaching kids how to be “normal” and nutritious eaters. ( https://www.cnn.com/2018/10/04/health/parenting-food-drayer/index.html , accessed 10/5/18) The Authoritative style is characterized by controlling what children eat—insisting that they eat certain foods and amounts of them. This style pulls children away from their natural appetites and, instead, teaches them to eat to please others (aka parents). Another control method is restricting what or how much kids eat...
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Fear Is an Excellent Motivator for Positive Change

I had a client decades ago when I worked in a Boston methadone clinic who used to tuck his stash of heroin under the trolley tracks in a hidey hole, so he’d know where it was but wouldn’t get caught by the police with it on him. He did get caught with and arrested and was then terrified about what would happen to him. When he was released from jail, we talked about how his fear response was working backwards—he felt fear after the fact when he should have felt it beforehand. The point of fear, from an evolutionary standpoint, is to keep us from doing or repeating behaviors that will harm us. We wouldn’t survive without this instinct. But some people push away useful fear and, therefore, continue to endanger themselves. For instance, I have a client with COPD who had difficulty talking about how cigarettes were destroying his health,...
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What Jane Fonda Has to Teach You About Mental Health

Whether or not you’re a fan of Jane Fonda as an actress or an activist, she has a lot to teach us about recovering from bulimia and body image disorder, discovering and expressing one’s authentic self, and achieving self-esteem. At 81, she’s far from past her prime and actually may just be reaching it. Or, so I thought, after watching Jane Fonda in Five Acts ( https://www.hbo.com/documentaries/jane-fonda-in-five-acts ). Growing up in a highly dysfunctional family, she was a sad child. Her father, the actor Henry Fonda, was far from fatherly and she wanted nothing more than to please him. Her mother suffered from depression and died by suicide when Jane was 12. Jane says that her perfectionism began at a very early age, based on the belief that if she did everything right and flawlessly, she would please and get the love she needed from her parents and others. Toward this...
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How Do You View Feeling Broken?

How do you view your “broken” spots? Are they embarrassing areas of your life that you can’t bear to think or talk about? Do they make you feel less than and as if you’ll never see yourself or be seen as normal? When you think of your mistakes and failures, do you cringe and hope that no one ever finds out about them? I seriously hope not, but if you do, this photo and the explanation that goes with it may shift your view and make you feel a whole lot better about yourself. This beautiful bowl is unique because of its fractures. I love that idea. For example, part of my uniqueness (and, oddly, my professional success) comes from having had eating disorders galore—chronic dieting, overeating/emotional/compulsive eating, and bulimia. At the time, I felt horrible about my behaviors and incredibly defective and broken. Now I look back and proudly think...
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Give Saying No to Yourself a Different Meaning

Most emotional, mindless, compulsive overeaters consider saying no to themselves a huge drag, just about the worst thing that could happen to them. That’s because “no” has a negative connotation for them from childhood. Healthy adults see “no” as positive: it balances out all the many yesses they say to themselves and puts up the proverbial guardrails on the crib so that the baby doesn’t fall out and hurt itself. It’s a self-loving, gentle reminder to think ahead to the consequences of their actions, an expression of how much they value (in Jungian terms) both expansion and containment, the voice inside that cares enough to, as my father-in-law used to joke, “Save me from myself!” What exactly does no mean to you that it’s become such an unwelcome, outlaw of a word that you can’t bear to say it around food? Here are some possibilities: No means cut out the fun....
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