Facing Unseen Physical Problems caused by Eating Disorders
* “Obviously, my body doesn’t believe a word my brain is saying.” Calvin in Calvin and Hobbes Collection
The osteoporosis aspect of eating disorders doesn’t seem to be a concern to people in the throes of their eating disorder.
Osteoporosis doesn’t hurt and doesn’t show. Tooth enamel loss, hair loss, weight gain or loss, skin eruptions all show. The visual is what gets a woman’s attention. Unfortunately she tries to correct the visual without addressing the deep cause of her troubles, her eating disorder.
The unseen damage remains out of awareness for a while: osteoporosis, esophagus tearing, electrolyte imbalance, risk to heart, dizziness from blood sugar imbalance, organ damage, hormonal disruption and the impairment of judgment based on lack of sleep and lack of proper nourishment.
The unpleasant reality is that reality won’t go away. Any acting out of any eating disorder serves to numb a person’s feelings and dim her awareness of what is going on around her.
But turning off awareness does not mean turning off the fact. Living in a state of oblivion doesn’t halt the damage being done.
Oblivion needs to fail as soon as possible.
That failure and the vision of what is actually happening to her body is a terrible shock and brings up terrific anxiety. The challenge is to not use that anxiety as a trigger to binge or purge or starve or exercise to bone breaking lengths.
The challenge is to use that fear and anxiety, that glimpse of reality, to address the eating disorder realistically and start working with a mental health professional who specializes in eating disorder treatment. The challenge is to get even more awareness and get her healing work underway.
* quote from Calvin and Hobbes, p. 7 Scientific Progress Goes “Boink”, by Bill Watterson, Andrews and McMeel Press, 1991.
http://www.amazon.com/Scientific-Progress-Goes-Boink-Collection/dp/0836218787
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
Helpful Quiz, Ability to Conceive, Osteoporosis
Breaking the Mirror posted answers http://www.breakingthemirror.com/ Quiz Answers!January 11, 2008 to a to a ten point eating disorder quiz posted on a teen fashion site.
Posting this quiz is a wonderful idea. It helps provide clear information that can combat prevalent and false ideas about eating disorders.
I would add that while birth control is always a good practice when someone is sexually active and not prepared to conceive a child, it is also true that severe anorexia can seriously
limit a woman’s ability to conceive.
Another point missing from the quiz relates to bone strength. Many young women with eating disorders develop osteoporosis. It doesn’t hurt, and it doesn’t show. Some anorexic women who are
only 17 years old have lace bones comperable to a very old and fragile woman.
That said, stating health risks will not scare a person into recovery. But they might scare a person into treatment!
I hope so. I’ve recovered from bulimia and have been a psychotherapist dedicated to eating disorder recovery for many years. It seems that girls and women need to notice that the eating
disorder eventually causes more pain than they can bear before they are willing to risk giving it up.
This requires a desperate kind of courage because they genuinely face the unknown in the therapy work. It can be almost impossible to imagine a life without the eating disorder. Yet, a
glimmer of the freedom that might be possible if they were genuinely free of the behavior, the thoughts, the anxiety, the planning and strategizing, the need for the cover up lies
can keep a person on the recovery road.
I’m glad to know that in the sea of high drama, repetition and hype on the internet relating to eating disorders, some realistic information is being offered that can be truly
helpful to people looking for solid recovery.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
What a Healthy Relationship with Food Looks Like - a lesson from children
Two little girls, sisters, 5 and 7 years old, were spending the afternoon with me in my home. We are great friends.
We had been painting in my studio and running in the grass counting Buddhas (I have a lot of Buddhas in my garden).
Suddenly the five year old announced, "I’m hungry!"
The more demure seven year old gave her sister a look that said, not so loud and impolite, please while she looked at me and nodded, "Me, too."
I said, "Well, let’s go look in the refrigerator and see what I’ve got."
They both grinned and ran into the house. The content of other people’s refrigerators is fascinating to children.
We found a kind of apple they had never tasted, a fuji. Five said "no.". Seven said, "Try it. It might be good."
I peeled the apple. This was a task so totally expected and assumed that no verbal request was given. Five wordlessly handed me the apple with a most effective facial expression and automatic gesture that clearly informed me of my job.
They decided the apple was good. We also found some cottage cheese and carrots. So we peeled the carrots. I sliced the apple. We dished out the cottage cheese and sat in the dining room for lunch.
I put on some Mozart because we had been discussing the theory that listening to Mozart made children smarter.
The girls ate with gusto and no talking. Then they started talking a little as they ate more slowly. Then they talked even more and ate less. At one point the seven year old described how she felt listening to the music and wondered if she were getting smarter.
She then got up and danced. The five year old joined her. The remaining food on the table was forgotten as the girls leped and jumped to Mozart’s music.
My experience? My imagery saw each child with a transparent fuel tank on her chest. When the fuel tank was empty they immediately felt hunger and knew it. The thought of food was exciting. Looking at the food, making decisions about it, preparing it was thrilling. Eating it was glorious.
As the gauge on the fuel tank registered an increase, their eating slowed. By the time the tank was full they had lost complete interest in the food. Not only that, but the burning fuel released energy to their minds and bodies and that energy turned into joyous dance.
I smiled at my cavorting little friends, thinking, This is what the absence of an eating disorder looks like. This is what a healthy relationship with food looks like.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
Eating Disorder In-patient and Residential Treatment
A worried mother called me this morning, concerned that she had not yet received my eating disorder in-patient/residential treatment program list. http://www.poppink.com/list.html
I was on vacation in Maui with my family and couldn’t send the list until today.
The mother, in the Midwest, is deeply concerned about her 25 year old daughter on the east coast who is a compulsive overeater and obese. They are both looking for an in-patient program that will get her started in recovery. Well, actually, I think they hope that checking into the best program they can find will result in cure.
I’m always concerned when someone says that “some kind of support might be needed after” a residential treatment experience. To me this phrase reflects a naive hope that a person can go away ill, come back cured and the burden of the illness will be lifted off everyone involved.
This fantasy simply must be dispelled so that unnecessary disappointment and feelings of failure don’t delay or even destroy positive moves toward recovery that are being made. Residential treatment can help people get on the recovery path. After residential treatment people with eating disorders still have to walk that path, or climb or crawl or, as 12-step says, “trudge” their way to recovery.
When you know you are working toward progress, even when you are backsliding a bit, you can keep your energy directed on the healing task in front of you. You might feel frustrated at times. Who doesn’t? But you can handle feelings of frustration. We’ve all had lots of practice with that.
When you know that in-patient is a first, not a last step you can be less hard on yourself. You can ease into the program and do the best you can. You don’t have to feel a sense of failure at all. By putting yourself in a healing environment you are making yourself a winner. When that healing environment becomes your own inner self, your recovery becomes more solid. The transition between in-patient treatment and solid inner recovery is usually long term psychotherapy.
How long is long? It’s long enough to make that internal healing environment in you as solid as can be. It’s long enough for you to have solid practice and experience in living a healthy life in a new way without needing bulimia or anorexia or a binge or a cutting or starving episode to get through. It’s long enough to guide you, support you, ease you, escort you to a healthy life.
Please remember, the search for something “perfect”, the desire to find the “perfect” program, the urge to reach the “perfect” size or be the “perfect” person in any way at all is a symptom of an eating disorder. We humans are not designed to be “perfect”. Our design is that of a human being with all our flaws and contradictions. There’s something wonderful about being like a kaleidoscope, an endless colorful variety of perspectives, intact and whole.
I hope with all my heart that the woman who called this morning and her 25 year old daughter who is locked into her own mind and body by her eating disorder, can find the help and the direction they both need to get relief from their suffering and find their eating disorder recovery path.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
Eating Disorder In-Patient Experience
A wonderful, honest, detailed and accurate description of what it’s like to go through an eating disorder in-patient experience is posted on: http://ballyhoo.typepad.com/mollyblog/eating_disorders/index.html
Molly Freedenberg shared her eating disorder recovery viewpoint and by so doing, gave a gift to the eating disorder recovery community.
Her post dispels myths and fantasies about early recovery. I’m especially glad that her vivid examples make clear that in-patient or residential treatment is the beginning, not the end of recovery.
I’ve heard from too many people who believe that “going in-patient” is both a last resort and also a complete treatment experience after which a person with an eating disorder will be “cured.”
Even in the news where celebrities with eating disorders are discussed, I see the idea expressed that the eating disorder in-patient programs “failed.”
While it’s true that some programs are better than others and some programs are more suited to an individual’s needs than another, it’s vital to remember - or learn for the first time - that in-patient treatment programs are the beginning and not the end of treatment.
To request a list (free) of eating disorder in-patient programs, please go to www.poppink.com and click on “in-patient programs” in the sidebar. Be advised: the list is international, comes as an attachment and is 94 pages long. I’ve been building it for many years.
Thank you again, Molly, for your generous and insightful post. I hope many people who need to begin their eating disorder recovery will find your post and get an accurate and thorough snapshot of what in-patient eating disorder recovery programs can offer.
Joanna Poppink, MFT, psychotherapist, eating disorder recovery specialist, Los Angeles, CA
anorexia, bulimia, compulsive overeating, binge eating recovery; www.poppink.com
Emergency Hospitalization, Eating Disorder, Coming Home
Yes, you can help your eating disorder recovery by ordering your environment.
Jeremy asks in his blog http://jeremygillitzer.blogspot.com/ if bringing his home into order will help him stabilize after his emergency six week hospitalization for eating disorder recovery. To me, it sounds as if his emergency escort to the hospital was a rescue mission, and that he is lucky he got his life saved.
Now it’s time for him to take over and rescue his own life. That’s true for everyone with an eating disorder. The big questions are what to do? how to start? when to start?
When to start? Answer: ASAP, with now being best.
How to start? Not as easy but the answer is usually right before our eyes. As old school 12-step says, "Do what is in front of you to do." Then follow it. If it’s a paper clip on the floor, pick it up and then see what’s next. If it’s a phone call to make or hair to wash and comb, or a diaper to change, or a bed to make, or dishes to wash, or an appointment to keep, do it. Then you’ll see what comes next.
If you can see what’s in front of you to do and take healthy and practical action regardless of how you feel you are on a good road. But maybe you can’t see it. Maybe you’re so flooded with so many tasks and feelings that you are immobilized. What then? That’s when people ask, "What should I do?"
Jeremy asks, should I clear out and organize my home? I say, Yes!.
Living with an eating disorder in control of your actions leads to chaos in your life and environment. Creating a healthy structure that will hold your life securely even when you feel insecure is the insurance you need to keep your life and your relationships intact.
What’s above reflects what’s below and vice versa. Inner chaos creates outer chaos in your home, your file system, you closets, your kitchen cupboards, your closets, your work, your relationships. Everywhere you look you see the chaos theme reinforced. That view goes in your psyche, and you feel hopeless and overwhelmed.
You know where those feelings lead: binge, purge and more.
So, by putting some order in your outer life you can give your psyche the signal of order and personal empowerment than can influence your state of mind.
Yes, Jeremy. Clear the clutter out of your house. It will help you clear out what’s unnecessary in your mind. Get rid of what doesn’t work for you, especially if it’s broken. That will help you get rid of your reliance on old ways of thinking that don’t work for you. Put some beauty in your home. That will help you smile and be more comfortable in your own skin.
House organization is certainly not a substitute for ongoing and deep psychotherapy that is necessary for recovery. But, following the principles of Feng Shui in the home can help you bring more balance and health to your life and help your stabilize on your path to eating disorder recovery.
Joanna Poppink, MFT, psychotherapist, eating disorder recovery specialist, Los Angeles, CA
bulimia, anorexia, binge eating, compulsive overeating recovery work. www.poppink.com
Coping with Feelings after New Years
A Nourishing Treat for Getting Through This Week Well
As you move through this first week of the New Year, I recommend that you read or re-read Joseph Campbell’s Hero with a Thousand Faces.
This is the classic that can guide your through your journey to eating disorder recovery. Even if you
don’t see the relevance, your unconscious will gladly take in the healthy nourishment Campbell has to offer.
I met Joe many years ago at an imagery conference at UCLA. We met in a big hall outside the workshops. Many of the speakers and workshops were good, but at that moment I was fleeing a bad presentation. Joe was also in flight from something he couldn’t bear as well.
We sat on a step at the bottom of the staircase and talked for well over an hour. The energy, honesty, humanity and richness of the man came through so well I can feel him today. He also had a twinkle in his eye for attractive young women which I enjoyed. After all, he was a most popular professor at Sarah Lawrence for many years.
Many books came later. His influence on the creation of Star Wars came later yet.
But give yourself a gift and a boost into healing by reading his first book, the book he wrote when he was a young man starting his own journey. Enjoy.
I encourage to discover how you already are the heroine of your life.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
Binge Eater Discovery
A post just came in to my eating disorder recovery discussion board on www.poppink.com. The poster was shocked in her discovery that she is a binge eater. She is now looking for help.
I hope you can appreciate my gladness at her discovery. I’m not happy that someone has any form of an eating disorder. But when a person discovers that she does have an eating disorder that discovery is good news.
Now she has an opportunity to stop criticizing herself about her weakness, bad character, and all the other horrible and relentless judgments she makes about herself. Once she knows she has an illness, a disorder with a name, she can begin to look for guidance in her recovery work.
She can stop the endless pain of trying to do what doesn’t work and begin her path to health and freedom from those debilitating binges.
Joanna Poppink, MFT, psychotherapist, Los Angeles, CA eating disorder recovery specialist, bulimia, anorexia, binge eating recovery; www.poppink.com
Hung Over or Exhausted or Frightened?
The week after New Years can be tough. Fantasies around New Years may be more powerful than Christmas wishes. New Years is often a time of hope for the end of eating disorder symptoms.
You hope for the beginning of a new and true love. You hope that at last, you can be your real self, be recognized as the quality person you are and welcome peace and opportunity in your life.
When all those wishes don’t come true as the New Year opens the disappointment can be intense. That disappointment can bring on a state of depression where you have low energy and just want to cry
alone with your best friend - bulimia.
Please, hold out. You might be hung over from too much of everything over the holiday. You might be exhausted from activity and tension. You might be frightened because of the sudden transition from holiday to quiet regular life.
Maybe you are experiencing all three.
Give yourself a chance to adapt to the shifts your mind, heart, body and emotions need to make after the holidays.
A big tip that always needs reminding, that all of us tend to forget:
Don’t get too hungry.
Don’t get too thirsty.
Don’t get too tired.
Hunger, dehydration and fatigue will play havoc with your emotions, your ability to think and your ability to perceive realistically.
Give yourself a few days of eating three healthy meals a day, drinking 6 - 8 glasses of water a day and
getting eight hours of sleep at night.
You will be happily surprised at how much better life looks.
This is not a cure for bulimia. But it is a way to catch hold of some health so you can take the steps
necessary for solid recovery. And wouldn’t that be a nice way to start the New Year?
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
Bulimia Emergency Tips for New Years
When your gut trembles and aches with fear, when your upper arms seem to vibrate on their own, when the back of your throat aches, when what you see begins to have an unreal quality you are experiencing raw vulnerability that is a prelude to a binge/purge episode.
If you suffer from bulimia the end of a holiday season can leave you in this fragile emotional condition. You may attempt to use rage to wipe out these feelings. You may try to control the people around you to
prove your power when deep down you feel powerless. You may want to hide under the covers or throw a full on tantrum.
Please remember these are symptoms of your illness. You can get through this.
After the holidays a quiet comes to town, which is difficult for a person with bulimia to bear. Generally people use the after holiday time to rest, clean up, see how much money they’ve spent and get ready
to go back to school or work.
A person with bulimia can’t move smoothly from high-energy conditions to a calm and even state.
Other people relax after an intense time. They rest and regroup. The bulimic person crashes and feels frightened and unstable.
This instability can set off one binge/purge episode or a series of binges and purges that can last for days or weeks.
If you are near this state, please remember to be kind and giving to yourself. Try these simple tasks:
1. Take a shower and wash your hair
2. Make your bed
3. Eat breakfast and immediately go for a walk
4. Go to an OA meeting
5. Call your therapist. If you don’t have one, start looking for one.
6. Go to an animal rescue shelter and volunteer to walk a dog
7. Go to the library and write thank you notes to anyone you can think of
8. Look at something you usually think is beautiful – even if nothing seems beautiful now.
9. Postpone your binge or purge. Start thinking about what else can nourish you.
10. Journal, journal, journal.
Find ways to put yourself in environments that nurture healing, creativity and learning. Someday you will create that for yourself. For now, stretch yourself in that direction because every moment of your life can be the beginning of a New Year for you.
Joanna Poppink, MFT, psychotherapist eating disorder specialist, Los Angeles, CA bulimia, anorexia, compulsive overeating recovery, www.poppink.com
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