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Narrative Approaches Help Conquer Disordered Eating

The approaches found most effective to recover from eating disorders and “disordered eating” behaviours include (but are not limited to) cognitive-behavioural, narrative, family systems and developmental theories. These knowledge bases help those struggling with body image issues and eating disorders to work alongside mental health therapists, dietitians and doctors to improve health outcomes. Today’s blog post provides a sample of the approach in one homework assignment completed by a teen girl. She was asked to first write from her perspective and then, second, re-write the story from the perspective of a five year old.

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1-      “Stinkin Thinkin”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the hallway of her locker, she stared down it and looked behind her. ALONE, she thought. She turned the combination key until it was open, and began organizing her locker and getting the books that she needed.

People started filling into the halls, some would say hi but they would still leave. They don’t really want to be with me anyways, she thought. The halls were now crowded and she just wandered until the bell rang, When it did, she walked into class and sat down. She acted happy and engaged in conversation; meanwhile she was feeling like complete crap.

At lunch time she debated on eating. DON’T EAT, you’ll lose weight, she thought. But she was hungry, so she ate anyways. Don’t eat when you get home, she thought. But she did, and became into a binging session, which lead to purging. PurgepurgepurgepurgepurgepurgepurgePURGE. The voice inside her head was loud enough to make her listen. She didn’t eat for the rest of the night.

After her shower, she regretted glancing in the mirror because now she was sad and angry. She grabbed the fat on her stomach and began to cry. I hate my body, she thought. She looked away, put some pj’s on and cried herself to sleep. I can’t wait until the day that I can love myself, she thought.

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You can see here a small sample of how pervasive the thoughts can become underlying disordered eating patterns. Of course, the feelings of disgust, loneliness, anger, confusion, worry, anxiety, sadness and isolation will drive and increase the negative behaviours of over exercise, laxative use, food restriction, binging and purging. With these thoughts, feelings and behaviours the person’s story about themselves, their bodies and their options  for recovery, worsens.

When taking a narrative approach, combined with cognitive-behavioural strategies to change, people suffering are asked to consider the perspective from a five year old’s vantage point. In order to contemplate change and re-writing of the negative story, clients are to ask themselves; What would a five year old me say about eating, body, exercise, food etc.? The following is the second part of the teen girl’s homework; narrative “re-writing” of disordered eating from the five year old’s view;

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2-      “Five year old”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the school, she looked around her and thought, people will be here soon, I’m just early. She played and waited for people to arrive.

People started arriving, some would say hi but they kept walking past her. They’re just busy, she thought. The halls were now crowded and she just wandered until the bell rang. When it did, she walked to class and sat down. She acted happy and engaged herself in conversation, meanwhile she was feeling pretty badly.

At lunch, she debated on eating, if you’re hungry eat, she thought. So she did. You can always have a snack when you get home too, she thought. She felt guilty for eating and was contemplating purging. Ew don’t do that, that’s gross, she thought, so she didn’t.

After her shower, she looked in the mirror and felt confused about her body. Every body is different and unique, she thought. She looked away, found some pj’s and went to sleep.

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Thanks to this courageous teen author for sharing her narrative homework above in her efforts toward a healthier and happier future.

For experienced, professional guidance in this area, book your appointment today.


Photo credit: ardelfin from morguefile.com

Many families will come to counselling as a sign of support to help a loved one through a difficult time (e.g. addiction, cooperative parenting, disordered eating, anxiety, depression, OCD, etc.). Sometimes families will provide financial support for a treatment program while others may attend sessions to improve overall teamwork. Still, other family members will change habits in the household to reduce the chance of addictive behaviours reoccurring.

How much family support is too much or not enough? This question is difficult to answer. As parents, we want to help our children (even if they are adults) to the best of our ability. However, sometimes this means we may be doing too much for them. Doing too much can often prevent individual growth and development. Parents may also want to take responsibility for the child/adult’s behaviour.

This is where family therapy helps, drawing upon family systems research and practice. It helps families clarify when to take responsibility or ownership and when not to, how to set clear boundaries and opportunities for change. Families can also establish new roles and expectations along with accountability measures for noncompliance and strategies for encouraging and increasing the behaviours desired.

Insufficient family support can be very debilitating for a person with mental health concerns and, thus, for the family as a whole. Strained and inconsistent communication is very common when there have been hurt feelings and years of promises broken.  As the support of loved ones grows thin, the person with mental health concerns can become even more distant and make even more harmful decisions. Balancing relationships within the family and keeping supportive connections while in treatment is a very important topic to discuss with a professional counsellor.

There are many ways in which a family can support one another through the difficult times. Start with this LISTEN acronym:

L: Learn to hear each other out more, increasing understanding and Love for one another.

I:  Inspire one another by having Integrity with your word and authenticity in your actions.

S: Solution-oriented state of mind helps focus on positive steps forward, finding solutions.

T: Treat others with respect, Teach caringly, Talk calmly and with Teamwork language.

E: Establish family goals together, Empower action and Encourage achievement.

N: Never give up on each other.

What a Puzzle

One of the most difficult puzzles to put together is how to best help a loved one suffering from an eating disorder. As their family, we want to support them, love them, and even help “cure” them. We watch them struggle and we too will struggle right along with them. We observe their weakness, their apparent helplessness, thus we often feel weak and helpless too.

“Snap out of it!” “You’re perfect the way you are!” “Why don’t you just stop?”

There are so many phrases that we might say to them to try to reach them, however it just doesn’t seem to be registering. One way to understand why is to sincerely believe that the “eating disorder” can take great power over an individual, their willpower and even their cognitive capacity. Just because it appears as though the person is giving in, this is not actually a realistic nor helpful perception for onlookers to adopt. They’re just not thinking clearly…

Anorexia’s spoken rules are those of self-denial. Anorexia promises to reward you for denying yourself anything and everything you need and desire. Anorexia tells you that denying all your needs and desires will make you strong, happy and free of pain. If you are tired, anorexia forbids you to sleep. If you are hungry, anorexia forbids you to eat. If you are cold, anorexia forbids you to turn up the heater or put on a sweater. Anorexia forbids you from enjoying your sexuality. The most important of Anorexia’s rules is that you must follow all the rules perfectly at all times” (Maisel, Epston, & Borden, 2004).

This description speaks to the dominance that the “voice” of an eating disorder can have over a person. Agreed, a supportive and loving family can help an individual in treatment, however, professional help is essential. With a structured treatment plan, training and clarity of roles, the dominance of an eating disorder may be tackled and overcome effectively. It takes much courage and intentional effort from all team members: family, friends, the individual with disordered eating and selected health care professionals to successfully implement the treatment plan.

For professional and confidential support to help you fight your battle with disordered eating, call us today.

January 1st fosters a desire for renewal, to seek ways to develop a better physique and a new mind set. For some reason, we feel the need to put the previous year behind us and start anew. We have the opportunity to create a year filled with possibilities and the potential to achieve great things.

The top two New Year’s resolutions that people make are financially and fitness-driven. We want to be better at managing our finances. We want to achieve that new promotion. We want to seek out connections to secure our dream jobs.

Our focus on fitness stems from the fitness and fabulous looking icons that show off their amazing bodies and tell us that we can achieve this look as well. They look better than we do; they appear to have better lives and are happier because they look amazing. We want to look and feel as great as they do and we want quick results. We look past their years of dedication and healthy lifestyle they worked on to gain such results.

Gym facilities, yoga studios, and bootcamp programs thrive this time of year. The big buzz on looking better is discussed in our offices, amongst our peers, and all over social media.

For people suffering with eating disorders, the buzz of fitness and body images can be overwhelming and difficult to cope with.

And why wouldn’t it be? You have worked so hard in the previous year to lessen the importance of body image and now it’s on blast everywhere you turn. You have learned to shift your thinking from a place of unrealistic body shapes to a place of appropriate concepts of health and wellbeing (sorry if this offends any of those wanting to look like Béyonce or are pursuing the JLO butt workouts daily).  A person suffering with an eating disorder has started to transform his or her mind to understand that looks do not equate to a happy life.

It is important that during this time when our society is consumed with looking good, to stay focused on YOU and what you are personally working on. Seeking additional or increased support does not equate to failure. Getting health coaching to improve eating behaviours, emotional balance and body image attitudes is a sign of strength. Call us today to keep your focus moving forward!

Business & Women Fight Back

This video ad is one company’s effort to help people acknowledge the destructive qualities of negative thinking. While it is noble, it still falls short of a positive psychological perspective by suggesting “fat talk” are the women’s own thoughts. We grow up hearing things like, “This is your attitude”, “Change your thoughts”, and “You have a bad attitude” rather than more inclusive conversations about what Carl Jung referred to as the “collective unconscious”.

We all have what I love calling “stinkin’ thinkin'”. No one is immune however, if you are or if you know someone who is without negative thinking, I would sure love an interview; find out how to be totally positive… (mild sarcasm noted).

“Fat Talk”, “Ugly Talk”, “Unworthy Talk” and “Stupid Talk” are collections of thoughts that, in narrative terms, are simply groups of thought or schemata that have been loaded onto our minds. Born with little data or thought on our minds, we are cognitively loaded with zillions and gazillions of data or thoughts. Family, friends, acquaintances, media, nature, in fact, all experiences are saved on our minds; many to be used at some later point as reference material to assist us with the myriad of tasks in life.

Narrative theory suggests the very thoughts we select to focus on make up a story about ourselves, others and our world. As this story shifts, possibly becoming more negative in nature, our emotional state and related behaviour also become more negative and burdensome. This is quite an empowering view however, as it indicates we are capable of selecting different thoughts or “re-writing” our stories. The women in the video discovered just how negative their story about body image had become by seeing thoughts right before their own eyes. This is one helpful tool to change thought patterns toward a healthier narrative.

Seeking assistance is a strength. It takes courage to recruit a professional counsellor to help uncover and understand the thoughts underlying negativity in our lives. At Jeff Packer MSW & Associates, we provide a safe, confidential and empowering space where you can improve your awareness of the factors contributing to problematic areas and develop the tools to rewrite your life more positively.

To fight off negative talk and improve your story, call us today !

 

Food Issues May Increase Over Holidays

Presents are great, laughter with family and friends is nice, but some of us believe that the real enjoyment of the holidays is the abundance of food. Special meals and traditional dishes are prepared this time of year. Some of us are very mindful of healthy eating now, so that we may fully indulge in the sometimes not-so-healthy meals we will have over the holidays.

As our aunts, mothers, and grandmothers gather in the kitchen, (men in some families too) and create what can only be described as magical aromas, it is sometimes difficult to keep in mind that members of our family require dietary support. Not only can some of us have severe food allergies (e.g. gluten, nuts, dairy), but some of us also require a lot more TLC (tender, loving care) during the holidays. Disordered eating issues can also be worse during the holidays and family get togethers.

“As she reached puberty, her thin frame began to fill out, raising concerns about the effects of her weight gain on her performance as a gymnast. She began to restrict her intake of food, but found that after several days of semi-starvation she would lose control and go on an eating binge. This pattern of dieting and binging lasted for several months, during which her fear of becoming fat seemed to increase. At age 13, she hit on the ‘solution’ of self-induced vomiting. She quickly fell into a pattern of episodes of alternating binging and vomiting three or four times per week,” (Davidson, Neale, Blankstein, & Flett, 2002).

Coping with disordered eating can be quite difficult over the holiday season.  Those suffering may feel like family members will be paying particular attention to them because they are the ones with “the problem.”  Uneasiness with meal times and menu planning is quite often present, making certain topics and particular foods become “off the table”. It may just be helpful to reduce tension by developing a “peace treaty” for the holidays, withdrawing stress raising topics and foods from the holiday menu because they are known triggers to unhealthy eating behaviours.

Over the Christmas holidays, we wish your family all the best as you cope with thoughts and situations that can easily hinder a fun-filled and relaxing holiday experience.

Should you want assistance with family relationship improvements and to recover from disordered eating patterns,  schedule your appointment for 2014 today!

Help For Eating Disorders Saves Lives – Durham Region

In a “sweeping” analysis of 77 studies, involving more than 15,000 subjects, University of Wisconsin researchers post-doctoral student Shelley Grabe and psychology professor Janet Hyde found that “exposure to media depicting ultra thin actresses and models significantly increased women’s concerns about their bodies, including how dissatisfied they felt and their likelihood of engaging in unhealthy eating behaviours such as excessive dieting.” (www.news.wisc.edu/15215)

My earliest memories about my appearance were of my mom and me (although I think I had insecurities about my appearance prior to these recollections). She would say that I would look prettier if I didn’t have my father’s nose. Absurd, I know now; however, that was a comment that stuck by me for the rest of my childhood and well into being a young adult.

So here’s how stinkin’ thinkin’ worked. It took that one silly comment from my mom and planted it into my head (like a seed being planted into the ground). Then, it would look at all my experiences to come and water the seed so that that one comment would grow and other related thoughts would sprout. Thoughts such as, “I’m ugly” “I’m not good enough” “I’m fat” “I don’t want to eat” “If only I was skinny like her.

Much of my experiences revolved around the media. Going to school and developing friendships, most of our conversations included the latest fashion trends, the hottest celebrity gossips or the fittest athletes. Body images were ingrained in me and consumed much of my eating, clothing, and activity choices.

I eventually became so tired of thinking about my body appearance. My body’s health and well-being now overshadow the superficial ideations exposed by the media. I’ve been blessed with education on disordered eating, self-esteem building, healthy body-image thought processes and family conflict and dynamics.  This has allowed me to discover that with healthy mind management, my external environment can have little to no control over who I am, what I look lik, and how I feel about myself. I learned that the cultural ideal of beauty is unrealistic and prejudice.

The authors of the study cited above emphatically conclude;

“We’ve demonstrated that it doesn’t matter what the exposure is, whether it’s general TV watching in the evening, or magazines or ads showing on a computer. If the image is appearance-focused and sends a clear message about a woman’s body as an object, then it’s going to affect women.” (Postdoctoral researcher Shelly Grabe)

For some of us, more help and assistance is required. And that’s perfectly OK! Some of us suffer from feeling powerless against our thoughts, images from the media, and difficult relationships in our lives. There are few safe outlets in our community that provide us with the strength to cope and heal. Disordered eating behaviours can develop unknowingly and unconsciously, often masquerading as our best and only way of coping within an unsafe and chaotic environment.

Disordered eating involves a wide range of abnormal eating behaviours, such as chronic restrained eating, compulsive eating and habitual eating. Eating patterns are chaotic and the physiological aspects of eating (like feeling hungry or full) are ignored (www.nedic.com).

Some people, even the ones who love us the most, have a difficult time understanding disordered eating or what is required to provide support during recovery. This is normal, however, the lack of understanding may create increased conflict and stress for the entire family. The process of overcoming disordered eating patterns takes a lot of work and a supportive and informed environment is essential for success.

Jeff Packer MSW & Associates, a registered, professional counselling service in Oshawa, Ontario, works with the individual engaging in abnormal eating and their family members. Treatment is catered to their individual needs and goals. It is important to include family doctors and registered dietitians in the recovery process. We also strongly encourage family members and loved ones to participate in family sessions.  This can help families improve and strengthen their relationships as well as learn to create loving and supportive environments for those in recovery.  To start your road to recovery, call us today.