Does Advertising Affect Eating Disorders?
A recent Hubpages blog raised the question: Does advertising affect eating disorders?
In my opinion, much of current advertising promotes both tiny size fashion in clothes and huge portion size in food. It’s an impossible combination many people strive to integrate.
Cashing in on Symptoms of Illness
A person vulnerable to eating disorders will strive to come up with a solution that allows her (or him!) to fit into tiny clothes and eat huge portions of food at the same time. This person can become terribly ensnared by an eating disorder.
But something worse exists. Advertising that pushes people to be small and eat large supports eating disorder thinking and behavior. The continual onslaught of emaciation, body surgery, and diet publicity actually convinces many people that the lifestyle being portrayed is normal.
Such media portrayal validates starvation, cutting behaviors and binge and purge cycles. Plus, this portrayal can delay recovery work. If a person with an eating disorder is subjected to a barrage of images and messages celebrating the symptoms of her illness, she may believe she is living well and wisely and will not seek treatment.
This is a cultural phenomenon that is tragic. It contributes to people taking pride in their illness, proselytizing eating disorders, destroying their health, ruining relationships and, in far too many cases, shortening their lives.
I often ask myself, what would be the economic repercussions in this country if all eating disorders vanished? If everyone with an eating disorder suddenly became healthy what would happen to dollars?
For example, diet books, diet programs, unhealthy life styles, size zero clothes, various magazines, commercials, diet foods, junk foods, binge foods, fast foods and all their supportive staff and structure (models, photographers, accountants, designers, advertisers) would be out of business. I think the stock market would plunge and the economy would reel.
Mighty forces are in place that cater to eating disorders. You need strength, courage, support and deep personal commitment to rise through these forces to honor your recovery work.
What kind of influence does advertising and media portrayal of fashion, beauty and diet have on you? I welcome your thoughts and feelings.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
How Long Does It Take to Recover from Bulimia or Anorexia? Part III
What does it take to Heal from Bulimia or Anorexia?
Healing from anorexia and bulimia requires development along all seven points I described in my last post.
But what does it take to actually heal? And why does this healing take a long time?
When I went back to college after a 13-year absence from academia, UCLA gave me a yellow piece of paper that listed my required courses. When I completed everything on the list UCLA would grant me a degree in psychology.
The sheet was 81/2 x 11 inches. I tacked it on the wall above my desk and set to work. Every four months I checked off three classes. It took me three years to work through that one sheet of paper and qualify for my first diploma.
Below is a short list of developmental tasks that can take several or many years to move through. Still, like my yellow sheet on the wall, the list can inspire a person to keep on keeping on.
Perhaps, most importantly, the list confronts a person with realistic goals when her mind starts making excuses and rationalizing false beliefs.
Necessary Developmental Tasks Stated in Affirmation Form
Here are some of the developmental tasks written affirmation form so even reading them is a beginning.
1. I tolerate my feelings.
2. I am realistically aware of what is going on outside and inside my own skin.
3. I know how to establish and honor personal boundaries
4. I know how to make myself safe.
5. I know how to recognize reasonable and honorable people.
6. I know how to enlist the help of reasonable and honorable people in a fair and honest way.
7. I know how to discriminate between healthy and unhealthy activities, environments and companions.
8. I know how to makes honest, self-caring and honorable choices based on healthy observation.
9. I know my own genuine weaknesses and strengths.
10. I take responsible action in the world.
11. I know when to say, “No.”
12. I am able to say, “No,” even if I am uncomfortable about saying so.
13. Regardless of the challenges life presents, I know and trust that I have what it takes to live a good life.
Thirteen Breaks the Pattern
I created thirteen tasks in this list. The number thirteen has significance. It means breaking an old pattern. It means emerging as something new or a new variation on an old theme.
Actually, as I write this I surprise myself because I began this post by revealing my thirteen-year hiatus from school. I didn’t make the connection till just now. That’s how the psyche works.
After thirteen years out of school I returned to resume my education on a new path, build a career and create a new life that was and is much better than the life I had completed. Thirteen was the break the pattern signal. And I didn’t know that consciously till just now.
Developmental Benefits
When a person makes positive strides in the direction of achieving these developmental tasks, the eating disorder has less of a function in her life. The person discovers much better ways of taking care of her psychological and survival needs and expands her life into more enriching experiences. The eating disorder is less or even no longer necessary.
How long does this take? It takes as long as it takes to accomplish these tasks. The actual time differs with each person. How each task is accomplished involves the work in psychotherapy that leads to the past, the present and the future. It leads to new ways of thinking, feeling and responding. It leads to grand discoveries of where a person is truly interested and of how she wants to invest her life energies.
Recovery doesn’t happen overnight and the work isn’t easy. However, the good news is that you don’t have to wait for full recovery to reap benefits of healing. Every step of the healing process allows the person to be more competent in the world, experience the joy of being more capable and especially, able to connect with other good people in a satisfying and healthy way.
By all means, let me know your thoughts about this. I welcome your sharing.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
How Long Does It Take to Recover from Buliimia or Anorexia? Part II
Why does recovery from anorexia or bulimia take years? Because vital developmental tasks must be addressed, and development takes time.
Let’s look at what needs to be accomplished in recovery.
Psychological Function of Eating Disorders
Eating disorders develop to serve a protective psychological function.
1. They protect a person from being aware of what they cannot bear to know or feel.
2. They give a person a sense of control when the person has little real control over what’s important to them.
3. They give a person a private island of limited sensation and limited awareness. This is a defense that helps when a person is incapable of preventing physical, psychological or emotional boundary invasion.
4. They create an obsessive sense of entitlement to make up for the lack of boundary awareness or the lack of knowledge or skill in honoring personal boundaries or limits.
5. They protect a person through numbness and obsessive thinking from knowing what they feel such as anger, fear, disappointment, regret, guilt and shame. A person may even need to block feelings of love, passion and joy if knowledge of those feelings would disrupt the status quo of her environment.
6. Eating disorders allow limited but intense feelings to surge within the person and explode out as a form of relief from tension. These episodes are often highly dramatic and can be both manipulative and destructive in relationships.
7. In many situations eating disorders protect a person from knowing she is competent, intelligent, capable and creative when such knowledge might be disruptive to her present life and the imagined (and sometimes real) consequences are intolerable.
Necessary Psychological Development
Healing from anorexia and bulimia requires deep, rich and healthy development along many layers of the personality. When this is achieved the person can cope with the difficult ordinary and sometimes extraordinary challenges life presents without the protection of the eating disorder. Healing also frees a woman to be capable of giving and receiving honest emotions in worthwhile relationships.
As a matter of fact, healing frees a woman to actually be a woman.
I’d be glad to elaborate on any of these points. Please feel free to ask questions and share your opinions and experiences in the comments.
In the service of easy blog reading I’m trying to keep posts as short as I can while still giving you as much recovery information as possible.
In my next post I’ll talk a little about some of the work required to heal from bulimia and anorexia.
How Long Does it Take to Recover from Bulimia or Anorexia? Part I
Realistic Answer
How long will recovery take? This is a reasonable question I’m often asked.
Not only can I not provide a specific time, but also I can’t guarantee that someone will indeed recover. And I certainly can’t give the answer so many people want, which is days or a weekend or at most, a quick stay in a residential program.
The question is complex with a different answer for every individual.
If you are still reading after this undesirable news, please let me talk a little about eating disorders and recovery.
Purpose of an Eating Disorder
People develop eating disorders for a reason. Eating disorders help a person cope with living when the person has not developed other ways to successfully take care of herself.
Healing Tasks
Healing has to do with developing a competent, mature and aware sense of self and awareness in the world. It has to do with restarting stalled emotional development so that the person can take care of herself realistically in the face of simple and complex life challenges.
How long does it take to accomplish the required developmental tasks? A substantial period of time from several years to many years, depending on the challenges of each individual.
Recovery is a Process
But please don’t despair at the thought of the time involved. Recovery is a process. As you move through time and stages of recovery, you reap benefits as you go. Your life improves as you gain more health.
During the healing work, yes, you will need courage to face your pain. But you will also experience joy as you discover the authentic worthwhile you.
I’ll write more about the recovery process in my next post.
Professional Boundaries with Eating Disorder Patients: considering right brain studies and work of Dr. Allan Schore
(elaborating on my comment in Eating Disorders for Professionals Blog)
Humanity Appreciation
Today, happily, we have evidence based scientific research to back up the use of our humanity in our clinical work with patients.
Appropriate boundaries between patient and psychotherapist are essential in any psychotherapy and particularly in the field of eating disorders.
However, the topic is often discussed in terms of content: e.g. a patient asks my age, if I’m married or divorced, if I have children, my religion, if I’ve ever had an eating disorder.
I believe that when a patient wants to know about my private life or wants to include me in her private life (weddings, funerals, births, graduations, award events, etc.) that the patient wants and needs a particular psychological emotional experience she believes will come from sharing such an experience with me.
Sharing Specific Personal Information
In other words, its not the information or event that is the issue. The sharing of our humanity is the point. The patient wants to know that she will be understood and appreciated. She wants to know I have a history that will inform me in terms of being present and empathic with her.
She wants to know that I can appreciate her pain and personal dilemmas. She also wants to know that I have survived my challenges and her stories will not shock me or cause me to judge her. Perhaps most of all, she hopes that I have healed from what she suffers and that if I have healed then she can heal too.
Person to Person - Right Brain to Right Brain
The valuable experience between us is not content, but right brain to right brain communication. We use words because we have to. We communicate far more than words, We need more than words to heal and be healed.
Allan Schore, in his fantastic research on affect regulation, impacts many areas of social science and biology by showing that right brain communication is received by the right brain and actually changes brain structure to allow developmental progress. Developmental progress is exactly what is needed for eating disorder recovery.
The discoveries revealed by the increased sensitivity of neuroimaging validates what many sensitive clinicians have known for a long time. Honesty, caring, empathy, sharing spontaneous imagery, acknowledging physical responses to clinical material makes for effective connection, growth and increase possibilities for healing.
Answering Personal Questions
The key question I ask myself before I reveal personal information to a patient is this: Will my answering this question burden the patient or will my answering support her healing? Often, when I’m asked a personal question I will respond by saying, “I will answer your question. But before I do, can you tell me why you want to know or what meaning this information has for you?”
People suffering from eating disorders have rarely experienced a quality relationship where their boundaries were respected. In general, they know little about respecting boundaries. Responding with respect and care to their questions helps begin the process of learning and appreciating what personal boundaries are - mine and theirs.
This kind of communcation also shows a woman with bulimia or anorexia that she can meet limits and caring from a person at the same time. Such an experience is often new and always in the service of health and personal development.
People recovering from eating disorders need the presence of honest, caring and respectful human beings in their lives. I believe, with the backing of neuroscience, that we psychotherapists can’t keep true to our profession unless we are true to our humanness.
Death, Tragedy and the Wounded Soul
Reflections on Tragic Death In Ireland
A young anorexic woman died in Ireland because her psychiatrist mother drowned her daughter in the bath. It’s a tragic story of Gothic proportions going back who knows how many generations. The mother couldn’t bear the daughter’s anorexia. The daughter refused treatment. The mother had an eating disorder. The grandmother committed suicide. The story in “This is London” stops there, but the human story has got to go back who knows how far.
I’m haunted, as many people must be, by the horror, the extremity, the tragedy, the ignorance, the blindness, the waste and the ongoing and spreading suffering of this event.
Eating Disorders Go Deep
Eating disorders go deep into our souls. Personally I think that they go deep into the souls of the individual with the disorder and also deep into the soul of our society. Something powerful in our current human condition is bringing up a terrible despair that eating disorders are making public.
If we can a bring thorough recovery to people with eating disorders, and embrace effective ways of preventing anorexia, bulimia, binge eating disorder and all the rest, I bellieve we will also be finding a deep cure for the problems in our society that spawn eating disorders.
I hope this sad and profound tragedy will spur people to look more deeply into both the psychological and cultural forces contributing to sustaining eating disorders in our midst.
Perspectives on Eating Disorder Recovery and Relapse
Meaning of “Fully Recovered”
A thirty-three year old man wrote to me saying he had been a binge eater most of his life and now was fully recovered because food has been a non issue for two years.
Of course, I am glad he is happy with the strides he has made in his life. But his post got me to thinking.
I have been working since 1980 with people who have and who have had eating disorders. I don’t know what people mean by “fully recovered.”
While it is possible that people can have two years or more of being in a state where food is a “non-issue” that doesn’t necessarily mean they are “fully recovered.” By the same token, someone who has not binged or purged for some time and then begins again may actually be signaling growth rather than relapse (although, of course relapse is possible too.)
Effective Ongoing Recovery Work
As I see it, people develop eating disorders as a way of coping with what they cannot bear. The people committed to getting well work in psychotherapy, 12 step programs, spiritual programs, nurture their creativity and gain education and skills necessary for them to function as they choose in this world. As part of this life long process they feel their emotions, recognize and bond with trustworthy people, and develop a sense of self worth. As they develop they learn and discover how to address their inner and outer life situations without the eating disorder.
Symptom Return Can Signal Need to Grow
However, as they age, develop, mature, take on new challenges, are confronted with life’s strong pleasant and unpleasant surprises, aspects of the eating disorder may return. If it’s not a relapse, (meaning collapse and surrender) it can be a signal that a new strength needs to be developed or that the person is overstretching his capabilities and needs to pace himself.
The eating disorder, a tried and true mechanism developed to a person survive, returns to some people not as an enemy but as a guide to teach the person about how they are feeling or not feeling. The teaching occurs in a language the person understands perhaps better than any other. This is the language of the eating disorder, which for many has been a life long companion.
“Recovered Person”
In my opinion the “recovered” person, is consciously aware of his or her liaison with the eating disorder. It’s as if the eating disorder were some kind of sleeping general or police force who, when the person takes on more than they can bear, rises up to alert, protect and defend the person using the old eating disorder methods. This gets the person’s attention dramatically. The “recovered” person recognizes the return of the eating disorder urges or actual behavior as a signal to pay attention to something that is out of conscious awareness.
Past recovery work allows the person to reevaluate what’s going on in his/her life knowing now that something is being denied. He or she can then do more inner work so they can be fully present for their experience without needing the numbing protection of the eating disorder.
When Symptoms Return
There can be gaps of five, ten even twenty years of no acting out and then the old faithful protector emerges to wake up a person who is involved in more than she/he can bear and doesn’t know it. The eating disorder lets them know it. It can last for only a few days and be of tremendous value.
I would not like people who have occasional psychological informative incidents of their eating disorder symptoms to believe that they have lost their recovery. Nor would I like people who have no symptoms for two years to believe that their disorder is over.
Need for Continued Growth and Learning
No one knows what challenges life will present in the future. I doubt that any of us are fully equipped right now to deal with what the future will reveal. We all need to keep learning and growing to survive and thrive in this life. And we all have signals that let us know we need to learn and grow beyond our current limitations.
A return of eating disorder urges is one kind of signal that more growth and learning is required.The more recovery work the person has done the more capable he or she is of continuing the recovery work when those inevitable life challenges emerge. Those urges can help open a blind eye or a dulled psyche to a new challenging reality and help a person continue to live a full life.
Boyfriend Wants to Help His Girlfriend Who Suffers from Anorexia
Young Man Seeks Help for His Anorexic Girlfriend
A young man wrote asking how to help the woman he loves. She is anorexic. They’ve been together for a little over a year. He says one good thing about the situation is that she is aware of her condition and has begun to talk with him about it.
He is combing the Internet and bookstores reading hundreds of stories and medical write-ups about eating disorders and anorexia in particular. He says he feels that the more information he has the better he can behave toward his girl.
I’m trying here to give you the message and the tone of his letter without giving you his exact words. Those words belong to him. But the message within his words applies to many young men (and not so young men) who are in a relationship with an anorexic woman.
The Personal Side
He says he and his girlfriend have begun to have wonderful conversations about her condition. He feels these conversations are a good sign because she is not getting upset as they talk. He wants to do the right thing, be supportive and help her get well.
He tells her that the two of them can get through this problem and that he will remain committed to her no matter what. He says that he never has loved anyone as much as he loves her.
He repeats throughout his letter in many ways that he feels good about her turning to him for help. He wants to make sure he is doing everything possible for the woman he loves to help her get well. I am the only person he has spoken to about his girlfriend. Her condition is private and he wants to honor that privacy as he helps her get well.
My heart is touched by his plea for help. I only hope I can help you see what I see in his bittersweet request.
At the end of this post is my answer to him. I stand by what I said. What I didn’t say is this:
Resistance to Help
Anorexia is a profound illness that affects the mind and spirit as well as the body. A person who is anorexic denies herself in many ways. She is often unreachable by any form of nourishment, emotional as well as nutritional.
A person who is in the throes of anorexia is like a starving person standing before a feast, pleading for food. Generous people offer her food, but the starving person pushes it away, throws it away, spills it, can’t hold the plate, can’t hold the fork, can’t deal with the temperature or consistency, can’t swallow properly, and on and on.
The people at the feast, who do not understand her illness, will meet each problem as it comes with a solution. They will hold the plate, change the temperature, provide more comfortable utensils, find ways to help her throat function with massage or medicine or hospitalization, and on and on.
Each attempted solution will have flaws that keep that starving person from taking any nourishment. She may cry, complain, suffer and plead for help. But she cannot accept help. Eventually she will be visibly angry and actively spurn attempts to help her or criticize the people trying to help her for being invasive, critical, bossy, controlling, selfish, and on and on.
This is only part of the picture of a person deep in the illness that is anorexia. I’ll talk about more in future posts. But this part of the picture is what concerns me regarding the young man’s request for help.
Risks in Trying to Save Someone from Her Anorexic Symptoms
He sounds to me as if he feels that all his love, energy and intellectual prowess, if rallied properly, will save his beloved.
He doesn’t know that he can be drained while his efforts somehow continually fail to reach her in a healing, nourishing way.
I hope you understand that I am describing the symptoms of an illness. This is not about the authentic woman living under the burden of the anorexia. That authentic woman is barricaded within herself by the illness. The ardent boyfriend is confronted with more symptoms than he knows.
I fear for both of them.
Possible Path to Healing
Still, there is a way out. Healing can happen if both people recognize that some of their feelings and behaviors are a direct consequence of the anorexia and must not be given power.
Specific Suggestions to The Young Man:
Dear Young Man,
1. Encourage your girlfriend to work regularly with a mental health professional who has expertise in treating eating disorders.
2. Go to Overeaters Anonymous meetings occasionally, and listen to people talk about their experience in suffering and recovering from eating disorders.
3. Let your girlfriend know you are doing this, and let her know you would go with her to an OA meeting or two to get her started if she were willing to go.
4. Go to Al-anon meetings yourself and learn the basics about being in relationship with someone who has a disorder similar to addiction.
5. Let your girlfriend know you are doing this because her being at risk from this illness causes you great concern. Let her know you want to know how to help yourself deal with your own suffering as well as help her.
6. Make sure you take care of yourself. You might consider getting supportive counseling for yourself. Getting too involved in her recovery can cause problems for you and your relationship.
You need all the support, knowledge, patience, self respect and self-confidence you can rally and develop to see this relationship through. It takes skill and attention to boundaries and self care to learn how to be in relationship with the person you love and not be in relationship with the disorder.
Good luck! You sound like you really care about her. She’s fortunate to have you by her side.
Eating Disorders and the Challenge in Asking for Help: An Artist’s Perspective
Stop Eating Disorders Welcomes Guest Blogger, Janna Stern, Gifted Artist and Great Friend
I’m an artist, an M.D., a wife, mother and grandmother with a passionate interest and concern for people who suffer from eating disorders. I feel honored to be asked to contribute some of my work as a guest on Joanna’s blog as I find her dedication to the cause and her work to be on target.
My painting: “In God’s Ear.” can be viewed at http://serendip.brynmawr.edu/exhibitions/stern/.
My thoughts about how the image relates to eating disorders:
People look for a savior. Both the afflicted and those who love them or are trying to help them cry out for help.
They feel likes dolls at the mercy of some autocratic or whimsical owner. There is no clear path.
Nearly everyone acknowledges a superior being and tries to reach out to a deity for solace and direction. The doll looks so weary and helpless, as if it has been cast aside several times in searching for a savior that never came.
Most people with eating disorders only trust themselves and feel safe with their own system of maintaining control and order. When everything in the world is out of control, they ultimately are in control of what they do and where they seek comfort.
Janna Stern, M.D. artist
email: janna@jannastern.com
URL: http://www.jannastern.com
Recent Flurry of Blog Posts Regarding Family Dinner Research
Love is left out of the eating disorder prevention equation yet again.
Eating disorder prevention does not mean following a check list of correct behaviors at the dinner table. It means behaving reasonably and practically with a powerful undertone of love, respect, a glad willingness to listen, honesty confidence to passionately disagree and deep certainty that right or wrong everyone in the family loves and will stand by everyone else.
When that is brought to daily life in a family, including family dinners, eating disorders don’t have a chance to develop.
Researchers have a tough time factoring love in their studies. I can appreciate the difficulty. I also am dismayed by research results that do not consider the presence or absence of genuine love and respect.
Researchers say…”what happens at that table has an impact on teens as well. Juggling schedules to make time for eating together, creating healthy, nutritious dishes, and having positive interactions at the table are all components of healthy family meals.”
Yes, these are components. Please include love and respect, spacious time, generous listening, appreciations of differences, honesty and room for laughter and shared passions.
Now we’re talking about family meals that help prevent eating disorders.
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