Body Image Eating Disorders Mental Health Recovery Therapy

Starving at 8

image © sarit photography

I know an 8-year-old who’s been known to choose an outfit specifically because it makes her “look thin.” This same 8-year-old often doesn’t finish meals because she thinks she’s fat. She’s the same 8-year-old that has begun to develop food rituals, often leaving the table with a reorganized plate full of uneaten food. Simply put, she already has an irrational fear of getting fat.
It’s hard being a girl. It’s hard to find a way to look at your unique self without comparing it with images of Barbie or Bratz. It’s hard to accept that  the beauty standard set by Cinderella or Sleeping Beauty isn’t actually real. But children, whose minds are filled with wonderful imagination and fantasy, aren’t going to cognitively recognize images that are potentially harmful. Instead, many will attempt to achieve the pink, thin, fluffiness of a Disney princess, or the skinny sass of a Bratz doll. Often times, even when parents are encouraging a healthy body image, the education on the school yard has a dramatically different lesson plan than the one from home. I’ve overheard conversations on the school yard that have made me pause – -it’s clear that body-image issues are in abundance and the pressure to look thin and svelte is invasive and intense.

So what can parents do? Start with eliminating the shame game. This might mean letting your daughter dump that maple syrup on her pancakes or having a cupcake at a birthday party. It’s a treat, not a vehicle for punishment!  Encourage healthy eating, but can you do it with compassion rather than the mallet of criticism?  Eliminate “fat talk”: your kids don’t need to hear it and frankly, it’s not good for you either. Stop trying to control what those around you eat. It’s not your job!  I’ve seen dads controlling the food intake of their wives and daughters to the point of devastating eating disorders (my dad was one!); and I’ve seen moms spewing “fat talk” or signing up for any and every diet fad while their daughters learn to eat in secret or restrict because they’re terrified of the incendiary reaction of their parental food monitors. These behaviors certainly don’t encourage self-love. If anything, they sow the seeds of self-destruction.

If you’re worried that your son or daughter might be developing an eating disorder (note: boys are not immune to this!), look out for some of these signs.

(Please note, certain behaviors are warning signs, but in combination and over time, they can become quite serious):

Behaviors specific to anorexia:

  • Major weight loss (weighs 85% of normal weight for height or less)
  • Skips meals, always has an excuse for not eating (ill, just ate with a friend, stressed-out, not hungry).
  • Refuses to eat in front of others
  • Selects only low fat items with low nutrient levels, such as lettuce, tomatoes, and sprouts.
  • Reads food labels religiously; worried about calories and fat grams in foods.
  • Eats very small portions of foods
  • Becomes revolted by former favorite foods, such as desserts, red meats, potatoes
  • May help with meal shopping and preparation, but doesn’t eat with family
  • Eats in ritualistic ways, such as cutting food into small pieces or pushing food around plate
  • Lies about how much food was eaten
  • Has fears about weight gain and obesity, obsesses about clothing size. Complains about being fat, when in truth it is not so
  • Inspects image in mirror frequently, weighs self frequently
  • Exercises excessively and compulsively
  • May wear baggy clothing or many layers of clothing to hide weight loss and to stay warm
  • May become moody and irritable or have trouble concentrating. Denies that anything is wrong
  • May harm self with cutting or burning
  • Evidence of discarded packaging for diet pills, laxatives, or diuretics (water pills)
  • Stops menstruating
  • Has dry skin and hair, may have a growth of fine hair over body
  • May faint or feel dizzy frequently

Behaviors specific to bulimia

  • Preoccupation or anxiety about weight and shape
  • Disappearance of large quantities of food
  • Excuses self to go to the bathroom immediately after meals
  • Evidence of discarded packaging for laxatives, diuretics, enemas
  • May exercise compulsively
  • May skip meals at times
  • Teeth may develop cavities or enamel erosion
  • Broken blood vessels in the eyes from self-induced vomiting
  • Swollen salivary glands (swelling under the chin)
  • Calluses across the joints of the fingers from self-induced vomiting
  • May be evidence of alcohol or drug abuse, including steroid use
  • Possible self-harm behaviors, including cutting and burning

If you notice even one of these, it’s time to address it. Talk to your daughter or son, talk to your doctor. If necessary, elicit the help of a treatment facility. In other words: Get help. Showing our kids that we care and are willing to stop our own negative behaviors in order to help them is invaluable. It’s a family problem, not an individual one.

Some helpful links:

Voice in Recovery
Peggy Orenstein
Also, check out “Brave Girl Eating: A Family’s Struggle With Anorexia” By Harriet Brown

Addiction Alcohol Alcoholism Holidays Mental Health Recovery

New Beginnings

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It’s Passover, and you know what that means? It’s that time of year where it’s customary to drink four glasses of wine through dinner as part of the Passover story! It means giant family gatherings, with the myriad of wacky personalities. It also may mean some anxiety for the newcomer (or even someone with time, you never know!) For some, it’s this Passover week, for others, it might be the upcoming Easter Sunday. Either way, self-care is key. Ask for help if you need it, and have an exit plan–better to have one and not need it than to need it and not have it!

This particular holiday reminds me of my early introduction to alcohol. My family didn’t drink that often; holidays were the exception. Still, I have distinct memories of sitting at the family Passover table, with my thimble full of Manischewitz wine, thinking I was the coolest kid in the world. I remember the warmth in my belly, and the slight fuzz in my head (I would get sneaky and steal sips from other folk’s glasses). I remember thinking I was a part of the adult world, and a real part of my family. It was a childhood delusion, of course, but the memory stuck.

Wine has deep roots in some religions, for example, in Christianity it represents the blood of Christ, and in Judaism, the fruit of the vine. It’s an accepted, expected, ritualistic piece of the religious meal. But as we get sober and learn to participate in the rituals of our varying cultures, we must learn to make adjustments. No one wants to see you drunkenly opening the door for Elijah! We drink grape juice instead of wine, and we learn to adapt the rituals and meals to our sober, clean lives.

Passover is about freedom from slavery and tyranny; and like Easter, it’s reflective of Spring and new beginnings. What apropos likeness to our recovery! Here, we are offered an opportunity to begin to view our sobriety as freedom from the tyranny of drugs and alcohol. Our recovery is our new beginning and our new life. Remember what Chuck C. said: “You cannot think your way into a new way of acting, but you can act your way into a new way of thinking.” Have a safe, sober, and joyous holiday week.

Anxiety Depression Mental Health Recovery Self-Harm

Cutting: Beyond YouTube

Cutting is back in the spotlight after a study by TheJournal of the American Academy of Pediatrics brought attention to the high numbers of YouTube videos showing teens and young adults exhibiting self-harming behaviors. By simply typing “self-harm” and “self-injury” into YouTube’s search engine, Dr. Steven P. Lewis, et al, discovered numerousvideos showing various levels of self-harming behavior.After extensive review and documentation, these were the findings:

“The top 100 videos analyzed were viewed over 2 million times, and most (80%) were accessible to a general audience. Viewers rated the videos positively (M = 4.61; SD: 0.61 out of 5.0) and selected videos as a favorite over 12 000 times. The videos’ tones were largely factual or educational (53%) or melancholic (51%). Explicit imagery of self-injury was common. Specifically, 90% of noncharacter videos had nonsuicidal self-injury photographs, whereas 28% of character videos had in-action nonsuicidal self-injury. For both, cutting was the most common method. Many videos (58%) do not warn about this content.”

Researchers worry that these videos might lead to a normative view of cutting and self-harming. As one who self-harmed for years (even into my sobriety), my concern isn’t whether or not this will be viewed as normal, but rather, is anyone taking action and listening to this loud cry for help?
It’s not fun to self-harm. It isn’t a source of pride. It’s not something you share with those around you. It’s not something you do to feel “a part of” or to be “cool.” For me, it was something I did to actually feel because I was so numbed out. In the flash of the adrenaline rush, I felt alive and present when I self-harmed. I felt like it was the only way to feel “real” in my otherwise surreal life. I also felt immediate and devastating shame. It was scary. It was embarrassing. Having to explain abhorent injuries to the curious when the perpetrator is you is nightmarish.
Getting help took an act of bravery on my part. I had to tell someone. I had to talk about it…openly. I had to face my shame and fear so I could transform it into something positive. I had to do some deep, spiritual work in order to learn how to turn self-harm into self-care. I continue to do this work, so I can  revel in self-care and be of service to others. I had to build a fellowship of support that would be there if I slipped back. I empathize for the kids on YouTube. I hope someone reaches out the hand of recovery and lets them know they don’t have to hurt like that anymore.

Mental Health Recovery Spirituality

Acts of Kindness

I came across a beautiful article written by Ed and Deb Shapiro, authors of “Be the Change” in which they call for a “Revolution in Kindness.” Their article expressed the need for compassion and kindness and asks us to change our actions. It really made me think about recovery and how we so often come into the rooms bereft of problem-solving skills, angry, and hurting, and lashing out.

Most of us come in as the antithesis of kind. The change we experience in recovery is profound as we learn to transform our programmed responses to people, places, and things. Truly, these new actions do require a sort of metamorphosis. As we begin the recovery process, we are choosing to cease fighting. We admit we’re wrong, we admit powerlessness, and slowly, we begin to learn how to function gently and with clarity.

It’s tough to admit we’re wrong, especially when we are attached to the context of the situation itself, and even more so when we’ve invested so much energy in our anger and its corresponding story. But wouldn’t it be liberating NOT to fight–to admit that you are (gasp) wrong?! Sounds crazy, I’m sure, but think about it: so much of our conflict is created because our egos command us to prove we’re right (even when we’re not!). We often fight to the point of ending friendships, both personal and professional, but in the end, our fight means nothing at all.

The 12 steps ask us to give up our ego and self-centered behaviors. By demanding honesty in our inventories and actions, we are propelled to adopt a more altruistic approach to the world. We make amends for our actions, righting the wrongs we’ve caused, and we learn to stop the harming behaviors that got us here. This also means approaching our difficulties with kindness instead of closed fists. When we change our actions, we ultimately have a chance to end the incessant violence permeating our lives: the bullying, school shootings, hateful speech, drug and alcohol abuse.  Ed and Deb Shapiro said, “Kindness is completely revolutionary: it will change each one of us, it will change others, and it will definitely change the world.” What a wonderful reminder, then, to take responsibility for our actions and point less fingers at those around us. The world can be a sticky place, so why not begin to unstick it with small acts of kindness and compassion? Try it: One kind act, one day at a time.

Mental Health

Abuse and the Brain

                          (Image via Wikipedia)

    What is rudeness? We name it, become frustrated by it, react to it, sometimes even weave the behavior into our own lives. But why? Well, from a biological perspective, we are products of the environment we live in. As we move beyond the dyads of intimate conversation and expand into larger social groups, the societal mores can get watered down. If those stereotypical, expected polite behaviors cease (manners), stress increases and rudeness emerges. Dr. Douglas Fields, author of “The Other Brain” talks about environments where “strict respect and formal polite discourse” are more pronounced, saying that “these polite and formalized behaviors reduce stress in a stressful situation that arises from being an individual in complex society.”
    I am further intrigued by Fields’ information about children and the effects of stress in relation to their brain development. Dr. Douglas Fields says, “Stress is a neurotoxin, especially during the development of a child’s brain.”  It’s so important that we look at this, particularly from the lens of recovery. We are shown over and over again how psychological trauma in childhood leads to an increase in depression, anger, hostility, drug abuse, suicidal ideation, and loneliness. Studies also show us that abuse, be it physical, emotional, or sexual, negatively “undermine the normal wiring of brain circuits,” impacting the brain’s ability to connect the right and left sides through a “massive bundle of connections called the corpus callosum.” An impairment of that connection is directly associated with craving, drug abuse and dependence,as well as a decrease in one’s ability to make moral judgments.
    Researchers have also found that parental verbal abuse is more damaging to brain development than even physical abuse. Peers have an impact on our teens as well. In fact, according to a team of brain imaging scientists lead by Martin Teicher, MD, Ph.D, “The most sensitive period for verbal abuse from peers in impairing brain development was exposure during the middle school years. This is the period of life when these connections are developing in the human brain, and wiring of the human brain is greatly influenced by environmental experience.” 
    This information provides us with a wonderful opportunity to make a difference with our actions. So, what do we do? I’d start with being more aware of our actions, particularly regarding our speech. Before saying something, ask yourself  “Is what I am about to say helpful or harmful?” Taking a deep breath before speaking would also be useful. The process of maturing and brain development is rough for the kids as well as the adults. As parents, we simply need to remember to pause.

Mental Health Recovery

New Year Intentions

(Image by Christopher Chan via Flickr)

Round two of Holiday Madness is complete, and hopefully, we are on the other side in one piece. Now on the last stretch of the holiday road, we can now let go and get ready to celebrate the coming of the New Year.  For starters, many are ending this decade sober and stronger than they once were, optimistic in their desire for positive personal change in the year to come.  Some may be teetering on the edge of relapse, or may have already ventured down that path.  Hopefully, they make it back to the willing arms of recovery–remember, it just takes the willingness and desire to ask for help!

That said, all of us, sober or otherwise, look upon the burgeoning new year as a summons to better ourselves. We habitually make promises and set intentions to behave differently than we did the year before; we typically do pretty well in keeping those promises in the first month or so, and then, well, complacency begins to set in. The new membership to the gym starts to gather dust or we fall short in our attempts to deepen our spiritual practice, listening less to the call of our hearts and more to the chatter in our heads; at some point, we may even forget why we made these promises and intentions in the first place.

After countless years of failed “resolutions,” and a persistent sense of disappointment,  I decided to begin a new tradition, which is to no longer make promises I can’t keep, but rather, set intentions that allow me to get back up again if I should fall short. Intentions like being more committed to my life, my family, my sobriety, my spirituality. Or intentions to be kinder to myself and spend less time berating myself for things that are banal and insignificant, i.e., not making it to yoga one day or getting frustrated while I’m driving. In the grand scheme of things, one failed yoga class or a frustrated honk of the horn won’t eradicate the initial intentions that were set. Rather, those moments of forgetting allow me to ignite a practice of forgiveness, which allows me to forgive some of those shortcomings as I work so diligently to transform them.  Frankly, the real intention is our effort to change. “Progress not perfection,” right?

As long as we go forth one step, one breath, one day at a time, eventually, all the effort will pay off, leaving us with less dust, and more fervent joy.

Mental Health

A Yoga State of Mind

What is it about eating disorders that make us hate who we are and what we look like while inviting failure in our attempts at change?  Good question and one I’m not sure I’ll ever really know the answer to.

Image by myyogaonline via Flickr

    After a lifetime of intermittent starvation, exercise bulimia, and a passion for laxatives and anything that would purge that pesky bran muffin, etc., from my system, I decided to take the inward route and follow in the footsteps of the many eating disordered women I know: delve deeper into a yoga practice. For once, I wasn’t trying to lose my imaginary weight, but rather, I wanted to heal. I decided to approach this ancient practice with a beginner’s mind, rather than the one that has been dallying in yogic practice for over a decade. I chose not to pay attention to the pretzels and skinny bits in my classes, instead, focusing my gaze on my mat. What’s happened has not only been wonderful, but healing on a deep, cellular level. Does that mean I don’t get triggered? Nope, surely not, but it does mean I view my body in a healthier way: as powerful and strong, grounded in earth and sky, and present. With each breath and asana, I move toward a healing space, recognizing my limits, discovering my strengths and meeting them both with kind awareness.
    Body dysmorphia is a life-long disease. It loves to play games and trick you into thinking it’s correct in its delusions of grandeur. However, as we heal and grow in our sobriety and in our efforts to be kinder toward ourselves, our disordered perceptions of mind and body can begin to change. The beauty of a yoga practice is that it teaches us to recognize our limits, embrace our strength, all the while using the fluidity of our breath as an anchor to the present moment. It’s rather like a moving meditation, really. On the mat, I find myself forgetting how I “think” I look as I stay present and get out of the thinking mind. It makes staying present OFF the mat infinitely easier, and allows me to be kinder to myself about myself. What a wonderful gift!

Addiction ADHD Mental Health

ADHD and Addiction

There’s an interesting correlation between ADHD and substance abuse, with research showing children who have ADHD as being more likely to struggle with addiction issues as adults. According to the Journal of Nervous and Mental Disorders, “some studies show a higher rate of ADHD among substance abusers and that people with ADHD may develop substance abuse problems at an earlier age.”  The three main characteristics of ADHD are: inattention, hyperactivity, and impulsivity, which can lead to high levels of anxiety, restlessness, and stress. Attempting to manage these symptoms can be overwhelming, particularly if one is symptomatic yet untreated.
As researchers and medical professionals dig deeper into addiction issues and ADHD, they are finding proof that lower levels of dopamine is a key factor. Sufferers begin to self-medicate and will often find temporary relief when they smoke marijuana, for example. Why? Well, because THC temporarily triggers the brain to release dopamine and dopamine makes us feel better. The user doesn’t realize the damaging effects THC has to their brain cells and this type of self-medication can set the stage for substance abuse, particularly since the use of drugs and alcohol can provide a sense of calm, even if just for a minute. Also, with an inclination toward impulsivity and risk-taking, ADHD sufferers tend toward perilous behaviors, which can also allude to addiction issues.
It’s important then, as parents, and friends of those suffering from addiction to look at ADHD as a link. Taking a whole-body approach is necessary–one must treat the ADHD component in collusion with the addiction component. Twelve-step meetings or treatment are wonderful tools to combat and cope with one’s addiction and will allow one to better handle the prescription treatment involved with managing ADHD. They have to be undertaken together, however, or one will counteract the other.

Addiction Alcoholism Mental Health

Teen Drinking Amongst Girls on the Rise

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Newsweek just reported new data released from a Partnership for a Drug Free America, suggesting girls are not only drinking more than boys, but they’re drinking for more “serious reasons.”  While boys are reported to drink so they can relax socially, it appears girls are drinking to deal with issues at home and/or at school. Additionally, the media is marketing to young girls, making alcohol even more enticing.  According to Newsweek:

“For years, boys were the focus of underage-drinking  interventions, but for the past decade, researchers have seen a close in the gender gap, and the media have jumped on the news. Researchers speculate that more products devoted to making  drinking easier and tastier—the sugar-laden beverages known as alco-pops—are a factor. ‘There’s a whole new raft of products that have come out in the last 10 to 12 years that were oriented to young females,’ says David Jerigan, executive director of the Center on Alcohol Marketing and Youth. ‘Alcohol now gets sold to girls as a functional food: it gets sold with calorie information, a drink of fitness, a drink with health benefits.’”

According to Leslie Walsh, MD, Director of Adolescent Medicine at Seattle Children’s Hospital, girls tend to be “more attuned to their feelings,” and more inclined to internalize issues rather than reach out.  Research on the adolescent brain also shows girls developing an earlier sensitivity to emotional stress than their male counterparts. Makes sense, then, that they would reach for something like alcohol, which purportedly subdues stressors and makes that stress easier to manage. It’s hard for adolescents today: The economy has tanked, many are watching their parents struggle from lost or reduced income, leaving them wondering what their future may hold. At the same time, they’re bombarded with images selling everything from thinness to beauty to the latest technology, while also learning to navigate school, social pressures, and their roles in society. Of course their worlds become stressful and confusing–picking up a drink will only make the stress worse in the long run.
So, what are some of the healthy ways you manage yourstress? We would love to hear from you!

Mental Health

Mindfulness Is Good for Teens, Too

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          With so many distractions coming from various directions, teens are prime candidates for learning lessons in mindfulness. This generation and the one following close behind are prepped to multi-task from birth. As teens are expected to juggle and negotiate everything from school to social media to the latest technology, it’s not surprising they are also seeking a means of “escape” or a way to do more in less time, i.e., drugs and alcohol. So, why not provide them with the tools to manage the business of their lives mindfully? The fact is, doing too much at once has a higher probability of lowering one’s efficiency while also raising one’s stress level–and let’s not forget, it also portends one being less likely to pay attention to what’s important. How present can one actually be if they’re having a conversation with you while typing an email or texting someone else? Or better yet, how much academia is a teenager actually going to digest if texting, social media, and their iPhone take precedence?
          These days, with the buzz about “Eat, Pray, Love,” the accessibility of the Dalai Lama, and the edginess and cool factor of groups like Against the Stream or Insight LA, the path of mindfulness and meditation has become less of a stigmatized lifestyle choice and more of an accepted means of moving through one’s day. It is better to be present and engaged than disconnected and preoccupied with which one of the 14 tasks you should tackle first. It’s hard enough just being a teen–add the pressures of the current trends and haves and have nots, and we have the potential for someone seeking an “out” in one way or another.
         More and more academicians and psychiatrists are stating that mindfulness is a healthier means of meeting the world. Introducing teens in recovery to mindfulness and meditation provides and invaluable tool in their recovery process. Because it puts one in a space of quiet, one soon finds there’s nowhere to go but the present, and though sometimes that can be challenging, there’s really no other place to be.

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