Talking to ED – the empty chair technique  

As I mention often, I am in a master’s program at the University of South Florida. Yesterday I had class – Group Theories and Techniques. Part of learning how to lead group therapy sessions is by being a part of a group – being both a group member and sometimes a co-leader with another classmate. We run two equal in length group sessions with our classmates at the latter part of every class. Today I was both co-leader and member.

During the first of two sessions yesterday, I was a member. I participated and some emotions were evoked during the process. Overall, it wasn’t too deep and I felt put together when it was my time to plan to co-lead the 2nd of our two group sessions for the day. As I stood outside with my co-leader and our professor discussing our plan, something said put me in a whirl of emotion. It was so unexpected. I had no choice but to put it aside and put my co-leader game face on.

During this prep-talk, my co-leader mentioned a technique he was interested in utilizing. The technique is part of the Gestalt therapy modality and involves a sort of psychodramatic role play.

The Empty Chair.

The point of the empty chair technique is to allow a group member to process unfinished business or emotions with possibly someone in their life who has caused them grief or trauma. This person may be someone who has passed or someone they have disconnected from due to trauma or disagreement, or even perhaps an aspect of themselves that causes or has caused them a great deal of pain or anguish. The process is intended to allow the person to come to terms or find resolve regarding something in their distant or even recent past. Within this technique’s process, the group member can talk to the person or the part of themselves to let go of some pent up expressions, emotions or statements they haven’t yet been able to divulge to the party “sitting” in the empty chair. The group member can also switch roles as well as seats and reply or provide feedback to themselves that they might have been longing for or wanting from that person or part of themselves.

Well, next week I am going to be performing this empty chair technique as part of a small group assignment in front of my classmates. I am going to be talking toher, to ED. I am excited, terrified, anxious, heated… I have such a range of emotions towards her. No matter how far I have come in my recovery, I still have hatred towards her.  I often say and I truly believe that she plagued me for a reason. She was in my life for a purpose and she  has given my future career and life’s work true purpose in which I am infinitely passionate about it. However, as much as I say I appreciate her for the hand’s on knowledge she has provided me, I still hate her.  I still carry hatred for her for many things.

I can’t wait to tell her how I feel – I can’t wait to tell her that I hate her.

My hope, and the point of the therapy technique, is that by telling her all of the things I have been wanting to tell her that I will have hatred no longer and shewill be permanently removed from my life, my head and my heart.

I am going to clear my mind now and wait for this empty chair experience so I can express true, raw and real hatred towards her in front of my classmates. Of course, I will blog about it next week.

Are genes or “jeans” more of a causal factor in ED and OB development?  

As mentioned in my last blog post, Is Emphasis on Body Image in the Media Harmful to Females only?, I am in graduate school at the University of South Florida in the Rehabilitation and Mental Health Counseling Program and am taking a course that hits pretty close to home this summer. It is called: Obesity and Eating Disorders. 
Weekly assignments include discussion posts to a particular, possibly controversial topic in the world of body image, obesity and eating disorders. This weeks discussion topic:
Genes or Jeans?

A variety of professional disciplines, including medicine, pharmacology, biochemistry, psychology, psychiatry and sociology have investigated both obesity and eating disorders, focusing on that component of the disordered behavior most unique to that discipline’s professional contribution. This promotes a unidimensional model and fragmentary view of what leads to, constitutes, and maintains the disorder. In a mechanical and reductionist paradigm scientist search for identifiable predisposing or causal evidence which contribute to the etiology of specific mental or physical diseases. A medical model of etiology may focus on the biological contributions and/or genetic factors whereas a psychodynamic model will target emotional or psychological variables. Sociology studies the sociocultural factors which are contributing factors. Which factor/factors do you believe contribute most to the etiology of ED and OB. 

Wow, I could go on about this for days… here is my response:

I have to begin with a neutral answer as I believe it is ignorant not to consider both “jeans” and genes and then some in the development of any psychological disorder. Psychological contributing factors to obesity and eating disorders include but are not limited to compulsivity/impulsivity, depression, perfectionism, narcissism, anxiety, etc. Other biological factors that may contribute could include metabolism, body type, etc. Psychosocial and other factors that may contribute to the development include parental eating habits, education on proper nutrition (or lack there of), the fashion industry and, my personal favorite (not) MEDIA.

OK. Now that I stated there are multiple possible causal factors to consider for the development of OB and ED, I will get into my humble opinion…

“JEANS” = Media. Advertisements. Billboards. Magazine covers. The “diet” business. Commercials. Movies. TV Shows. Music Videos. Pornography.
…shall I go on?

What do all of these “jeans” have in common??
-Ans: Digital enhancements.

What does that mean to some people who, perhaps, have more genes that make them more susceptible to internalizing digitally enhanced media? It means OBESITY and it means EATING DISORDERS along with possible body dysmorphia, probable slim-to-no self-esteem, etc.

You see, digital enhancements mean that the images were “photoshopped” and changed and “perfected”… that means they aren’t even real. So, in the world of “jeans”, if you are someone who internalizes these images and makes a firm self-worth-dependent decision that, unless you look like what you see (fake images), you aren’t good enough. What do you think happens when people strive to become what they see in the world of “jeans”? They fail. They fail because its impossible. You know what failing to achieve what one sees in the world of “jeans” does to someone who has decided they MUST look like the fake and the impossible? It creates a vicious, ugly cycle called OBESITY and EATING DISORDERS.

I’ll give you just one detrimental example of what the world of “jeans” and media did for me in my former eating disordered perspective:

Picture a popular gossip magazine cover. Picture the “best and worst beach bodies” edition cover. You see sand and beach chairs, designer bikinis and wedge sandals, 6-pack abs and perfectly flowing hair…. and then you see a zoomed in shot of cellulite. You know what I have? Cellulite. And, lots of it.

But, wait…What is cellulite anyway?!?

You know what my biggest trigger to developing and maintaining bulimia? …feeling worth LESS and scared to DEATH of my body because of magazine covers just like this one…

Is emphasis on body image in the media harmful to females only?  

I have mentioned to my fans at Eating to Live, Not the Alternative on Facebook that I am currently enrolled in an exceptionally interesting and personally meaningful course this summer. If you don’t know, I am in graduate school at the University of South Florida in the Rehabilitation and Mental Health Counseling Program. I am taking a course that hits pretty close to home. It is called: Obesity and Eating Disorders.

Well, weekly assignments include discussion posts to a particular, possibly controversial topic in the world of body image, obesity and eating disorders. This weeks discussion topic: 

Is emphasis on body image in the media harmful to females only?

There is a significant body of knowledge out there that addresses the impact of the media on body image on adolescent girls. Social comparison significantly influences girl’s attitude about themselves. However in the last few decades males are exposed to imagers of their idealized body type and these images have an impact on the male psych as well. Adolescent boys as well as girls are pressured to engage in potentially unhealthy behaviors to achieve these idealized body sizes and shapes. Is this just another “catastrophizing “ of a situation that affects just a very small minority or is it an alarming trend in our culture that has ongoing and exacerbating psychological implications for boys. Discuss.

Hmm… Here is my two cents worth of a response:

I have done tons of research on the effects of media on body image. It is absolutely true that there is a significantly larger amount of research dedicated to the effects of media on female body image rather than male. However, the amount of research studies does not take away from the data that IS available. That data shows that the emphasis on body image has an impact on both genders. 

Although data shows that a larger percentage of females develop eating disorders, males are not immune to the effects of images in media. Media is a multi-billion dollar business for a reason. It works. And, its not going anywhere. Photoshop and digital enhancements will only become more digitally enhanced. Fashion will only continue to evolve and create trends “to die for”…or, to diet for… or, to bulk muscle up for… or, to slim down for… or, in the case of ED’s, to starve or purge for. What happens when a male or female “fails” at achieving the body type or image they see in digitally enhanced mass media? They either become obsessed with it or, they lose hope. Hence, the cycle of eating disorders and obesity for BOTH males and females.
So, “is this just another “catastrophizing “ of a situation that affects just a very small minority or is it an alarming trend in our culture?”
First of all, disordered eaters and obese Americans are NOT a small minority. MILLIONS of people suffer from ED’s.
From the National Eating Disorder Association:
“Did you know…

Nearly 10 million females and 1 million males in the U.S. are battling an eating disorder such as anorexia or bulimia, while millions more suffer from binge eating disorder?”

How can you consciously label 1 million males seriously suffering from an eating disorder as a “small minority”? And, allow me to point out that these statistics are based on the DIAGNOSED eating disordered population. Trust me, there is surely a sadly large amount of people who suffer from ED’s that never get diagnosed. I know this to be true because I was one of them and I know more that fall into that same undiagnosed category.
–Secondly, how could the internalization of mostly-impossible-to-achieve and wildly unrealistic digitally enhanced FAKE images in media which have empirically been shown time and time again to be a huge causal factor in eating disorder development not be considered something with an alarming trend? Did you know eating disorders are the #1 psychiatric KILLER? Is that NOT alarming?

I am alarmed…

Eating Disorder Awareness Week: Everybody knows somebody…  

Did you know? Everyone of you coming across this blog knows somebody…

Are you wondering what kinda somebody I’m talking about?

Someone like me. Someone like a couple Facebook friends of mine and a couple old Kappa Delta sorority sisters of mine. Someone like Victoria Beckham or Paula Abdul, Kate Beckinsale or Diana the Princess of Wales, Calista Flockhart, Elton John or Janet Jackson, Oprah Winfrey, Portia de Rossi, Mary-Kate Olsen or Tara Reid.

All of these somebody’s have one thing in common: having suffered from a potentially deadly EATING DISORDER.

Everybody knows somebody.

Did you know?

-Eating Disorders are the deadliest of all psychiatric illnesses.
-Approximately 8 million people report suffering from an eating disorder; this includes about 1 million boys and men and 7 million girls and women.
-81% of 10 year olds are afraid of being or becoming “fat”
-Half of girls 11-13 years old consider themselves “overweight”
-22% of college women admit to “always” being on a “diet”
-Only 1 in 10 people suffering from an Eating Disorder will ever receive treatment
-3 in 100 women in America suffer from bulimia; 1 in 100 suffer from Anorexia.

Everybody knows somebody who has fallen into the statistical categories above.

Eating disorders do not discriminate by weight, color or gender. Everybody knows somebody who is suffering or who is vulnerable to suffering.

“Everybody Knows Somebody” -NEDA, 2012, Eating Disorder Awareness Week

[I realized this blog was never posted — it is from February 2012 during Eating Disorder Awareness week. Rather than not posting it, I am posting it now, just  tad bit late 🙂 ]

How bad do you really want it…?  

I’ve had many a sufferers come to me and say: “I want recovery.”
Well, the first question that comes to present mind is: “how bad do you really want it?”
When the sufferers know I have recovered, they say they want to be in recovery just like I am.

Well….. I realize this may seem harsh but:

Is it really because you can’t?? Is it really that you won’t?? Are you really ready for life outside of ED and poor body image??

If you are REALLY ready, how bad do you really want it?!?

I think to ask this question because I know what it takes to recover. I know what it takes, and I know that that question is key.
It’s so key because you have got to really, seriously want it. You have to want it bad. In fact, you have to want recovery more than anything. You have to want recovery more than you want to eat, more than you want to restrict, more than you want to binge and more than you want to purge.
You have got to want recovery so bad that you no longer listen to ED. In fact, you don’t just stop listening to ED, you shun ED, you curse ED, you get angry at ED. You don’t just turn your back on ED, you kick ED the hell out. You have to want it so bad that you are no longer willing to allow ED and its voice to control you.
You have to want recovery more than you want to be “perfect”, “skinnier”, “prettier” – whatever those mean… You have to go minutes, days, hours without allowing ED and it’s irrational thoughts to control you. You have to want it so bad that you start taking control of your own life and your own recovery. You have to want recovery so bad that you take a stand; you take a strong, firm powerful stand. You have to want it so bad that you make that choice and you NEVER look back; you NEVER give in to ED; you NEVER allow that voice to be louder than your own EVER again. Never, ever again will ED control you. You have to want it that bad.
If you really want recovery, you don’t care about anything else as much as you care about recovering. When you get to the point that all you want to do is recover from ED, then you might start a real road to recovery. When you want recovery as much as you want to breath, then you might be successful.
Do you want recovery?
Do you REALLY want recovery?
Well… How bad do you REALLY want it?

That whole “good enough” thing…  

That whole not feeling “good enough” thing… the concept really gets to me sometimes. Sometimes I feel it is self-induced, sometimes I feel like its encouraged by outsiders. Either way, I suppose, its my choice and its my responsibility to choose the way I feel about myself.

Society and those within it always have something to say. Isn’t that the truth? Sometimes its people you know, people you’d like to know, people you’d like to not know… always someone. There is always someone or some billboard or some advertisement that wants to get in our sensitive heads. They point out that there is just always something missing…

But, what is it? What’s missing?

Let’s talk about what “good enough” means. Or, does it even have a meaning? Could you look it up in the dictionary and find one? Let’s see:

Good: of favorable character or tendency; attractive; pleasant; competent; useful

Enough: as much or as many as needed; adequate; sufficient for the purpose

Perfect: flawless and faultless; unblemished

I had to throw in the the definition of perfect. Perfect… you have got to be lying to yourself if you say you or anyone you know is perfect. Flawless? Faultless? Totally unblemished? Not a soul besides Jesus Christ can claim those silly words. So, why the heck are we striving for the impossible? And more importantly, why are we so damn surprised and feel defeated when we can’t achieve what is impossible to achieve? Doesn’t make sense, right?

So, “good enough”… if I had to combine the above definitions of good and enough to define “good enough”, it might go like this:

Good Enough: sufficient favorable character and tendency; as useful and competent as needed for a purpose

Well, shoot! I have sufficient favorable character… at least I think I do, most of the time 🙂
I am useful and competent for a purpose, or multiple purposes…
I have favorable tendencies! I also have unfavorable ones, but hey, I ain’t perfect!

Am I perfect? Heck no I’m not. Newsflash for all: neither are you. You aren’t perfect or flawless or faultless or unblemished. And, you never ever will be. RELAX, you never ever have to be!!

Am I good enough? Heck YES I am! I have good character and I havemostly favorable tendencies! I feel I have a purpose and I do things along the lines of that purpose. I try and I smile while I’m at it! And, THAT is “good enough”! It’s good enough for ME! Therefore, it should be good enough for YOU and for the society in which I am a part of.

If society tells me I am not “good enough” because I don’t look a certain way or do a certain thing, I might want to ask myself a question… Who the heck decides what a certain way or certain thing is?! The dictionary doesn’t define “good enough”, why should society? Yo society, what the heck do you mean?! Can ya be more specific?!

Better yet, To SELF: Who am I allowing to set an undefinable definition of what is “good enough”?! WHY am I allowing it and WHEN am I going to get a common sense clue that “good enough” is all within my control, my character, my tendencies, my purpose…

Good Enough is ALL about ME. Good Enough is ALL about YOU. 

Good Enough is not a societally defined concept. Heck, its not a Webster’s defined concept either!

So, if something is always missing per society or per ourselves, what the heck is it? I know!! A definition…

Do yourself a favor… create your own definition and LIVE by it. Adjust it as needed. Do what YOU want with it. After all, if you create it, you own it! You can do whatever you want with it.

Take control of what is YOURS to define. If “good enough” comes with your own personalized definition, only YOU can be the JUDGE. Now that sounds like having some power and control over your life, doesn’t it? I like the sound of that. Don’t you??? Well, GO CREATE IT!

Meditating via the “5-minute rule” to avoid her…  

I chose to take a different approach to a discussion post I was asked to complete on Meditation and Relaxation strategies in therapy. I took a personal approach. Below is my experience with “meditation” before I even knew I was meditating. Meditating helped save me from her on multiple occasions. 5 minutes was sometimes all it took. Sometimes…

I have used meditation in my past without even realizing I was doing “meditation”. I suffered from an eating disorder for many years. I used to utilize a “5 minute rule”; this is what I have named the treatment tool in more present time. When I felt the compulsive urge to binge and/or purge, I would sometimes get myself together enough to say “OK. Just give yourself 5 minutes. Just breath for 5 minutes…” Multiple times, deep breathing while trying to calm the thought saved me from my eating disordered thoughts. 

Now-a-days, I realize that my “5 minute rule” was a meditation technique. It allowed me to become more aware of the greater world around me and less aware of my compulsion driven mind. The process of meditation stated in the book is almost exactly what I would do:
1. Sit quietly and alone, usually seated on my bedroom floor and between my bed and the wall.
2. Comfortable clothes… usually is the wardrobe of a disordered eater. Yep.
3. My body would be relaxed… actually it was most likely limp. My eyes would be closed.
4. “Breathe through the nostrils and down into the abdomen. Make sure your breathing is regular, slow, and rhythmical.” (p.457). Yep. All of that. Deep breathing; deep breaths that I would hear inhaling through my nose and exhaling fully out of my mouth. My exhale would usually be blown out, slowly, as if I was blowing through a straw. This would calm me and would provide me with a breath to hear to drown out my thoughts.
5. “Dwell on a single…word, phrase, or your breath.” (p.457). I usually would repeat a mantra of sorts. It may have been different in wording from time to time, but it always came with the same underlying idea — “You don’t have to do it”. “It’s okay…it’ll be okay.”  “It’s okay…tomorrow is a new day.” Those mantras or just the sound of my breath was my source of concentration.
6. Be passive to distractions. Yep. The only distraction I needed to avoid in this meditation practice was my disordered eating thoughts. In fact, I dubbed the disordered eating thought source myself in the 3rd person. She needed to be ignored. Her thoughts were my distractions. Thats where the previous, number 5, step became so necessary in order to achieve a successful “5-minutes”
7. Practice Regularly… Yep. Unfortunately, I had to do this quite regularly at some points in my struggle. FORTUNATELY though, it worked sometimes! And sometimes avoiding a binge/purge was a HUGE victory.
See, the point and my rule, if you haven’t gotten it yet, was to give myself 5 minutes before I acted in bulimic behaviors. If I could succeed, it was hopeful that I may avoid her that time. If I couldn’t, well… I won’t go into that here.
Mindfulness Meditation:
I have used mindfulness many times during my journey towards recovery. It is amazing what mindful eating can do for an over or binge eater. Being aware and in the here-and-now when you eat provides an entirely different experience then just eating. Noticing every bite, the textures, temperatures, feel, smells, the way it looks and is presenting, the sweetness or savory tastes… 
Rather than judging yourself for the food you are eating, just being in the moment and enjoying it provides an eating experience that is much more filling. The experience is filling in the sense that you will likely eat slower this way and allow your brain to register the food you are consuming in the speed in which it does so. This can help an overeater feel full in stomach and in brain to avoid eating too much before its too late. The experience of mindful eating is also filling in the sense that you will be enjoying it more fully with every sense.
A mindful eating exercise is something that could prove so useful in therapy. It is relatively easy. It doesn’t involve any specific tool; just some food of choice and maybe a piece of paper to capture the experience is all the client would need.
Meditation – an extremely valuable and FREE tool to use in therapy. In my opinion, addicts, regardless of their drug of choice, should almost always be treated therapeutically using some level of meditation utilization. Addiction recovery is all about making choices. You can use, or you can not use. If an addict can give themselves just a 5-minute chance to avoid using and reflect on those 5 minutes of sobriety, they could quite possible avoid the urge and walk away sober, too. 

Burn out… it’s like asking me to binge and purge.  

The following entry is going to be a (very) long one. Today I came home from work frustratingly talking to myself in my car on the ride home. I work with mentally ill and I assure you, I am not psychotic. I am just frustrated and seriously burnt out. Do you know what serious frustration and burn out does to a former bulimic? This burn out inspires me to seek comfort. As a former bulimic, this comfort seeking behavior by history has lead directly to binge-purge behaviors. How dare my job make me want to binge and/or purge. I am fed up with being fed up. I am sick of working in a job that makes me even think about seeking food for comfort. This is my burn out story…

Wanna talk about burn out? Let’s talk about clinical case management.
More specifically, let’s talk about clinical case management for a homeless division in the metropolitan area of Tampa Bay, Florida. The first thing we’ll touch on is the pay scale; they call it a salary but, it hardly qualifies. In fact, the salary I was presented with on my hiring date is almost low enough to reach 50% AMI. AMI? You might be wondering what that stands for. Well, as an employee of a Hillsborough County mental health care agency who utilizes the Shelter Plus Care assisted housing program funded by HUD, I wondered that very thing myself for some time. HUD? Shelter Plus Care? What? I used to wonder about those, too. I’ll throw one more abbreviation at ya: FMR. FMR? You guessed it, I wondered about that one, too.
Let’s get back to the topic at hand – burn out – as I attempt to explain those previously mentioned abbreviations and acronyms.
Right now, at this very moment, I feel incredibly burnt out. As a clinical case manager, working for a government and privately funded mental health care agency, I am fried. The program I work under comes with the following abbreviated description:
The ________ program serves individuals and families who are homeless and have been diagnosed with a mental illness as well as possible substance use disorders. The ________ program provides case management, life skills training and employment services utilizing the Shelter Plus Care program to provide stable housing for the consumer(s) with an ultimate goal of consumer self-sufficiency.
Let’s break that down so you understand the population in which I “serve”. Mentally ill, possible substance abusers; variable and quite possibly erratic individuals and families. Homeless; low-to-no income. If they do have income, it probably isn’t via earned paycheck. Nope; these consumer’s are not what you may think of as a consumer. They are not shopping or spending, they are quite literally consuming.
These consumer’s more than likely have no income. The income that usually comes with a low-income, homeless individual or family is likely in the form of a child support check (or multiple child support checks), cash assistance or TANF (yep! there’s another abbreviation to wonder about), social security disability checks and non-cash assistance SNAP, formerly known as food stamps (I figured out right away that “SNAP” and “food stamps” were synonymous, but not because I was trained to know so…).
Coincidentally (uh, sorta), when dealing with a homeless population, you also find a trend of lower education levels and/or more detailed criminal records. So, in allfactuality, some of my clients are educationally ignorant and/or criminals. Now, if you knew me, you would know that I am not a jerk. I realize calling the people I “serve” ignorant and criminal sounds harsh. Its not meant to be, however. Its just the truth. Through my experience, I can handle this truth. Hopefully, so can you.
On the note of some of these consumer’s being uneducated and/or felons, let’s just brush lightly the topic of employment services. How productive or easy does it sound to attempt to find employment for such a population? And, I didn’t even remind you that they are also mentally ill by diagnosis. On top of that, some of them are current or prior substance abusers, remember? Thank God we have a separate person that attempts to handle that tall order. The next fact of the matter is that the employment specialist (ES) hardly ever actually finds anyone of the consumers employment. Let me assure you if you need to be assured; this fact does not exist because the ES doesn’t try their damnedest to do so. Talk about burn out… the ES definitely, and rapidly, become’s a likely candidate for burn out.
As a clinical case manager (CCM) with the above described variable and likely labile population, it too is a position that one is likely to get burnt out in.
Shelter Plus Care (S+C), lets talk about that. HUD (US Department of Housing and Urban Development – thank you, google), has a government funded supported housing program called S+C. This housing program is to be utilized by those that have become homeless, chronically or initially by Florida definition (don’t ask…), and are mentally disabled. S+C supported housing assistance varies and is based on AMI, FMR, percentage of verifiable household income and average utility allowances. What?
I owe it to myself and to the field of mental health counseling through support and multi-faceted services in which I believe in to grind a different gear for at least a minute. I have to admit, I have had some pretty pricelessly rewarding and heartwarming days in my position. There was one time that a consumer on my case load credited me for their continued life. It all started when this particular Major Depressive, Post Traumatic Stress Disordered, non-medication compliant, previously homeless consumer called me (screaming) with homicidal ideations. I reacted without reacting. I knew my consumer. I knew her uproar was not directed at me or the psychiatric doctor’s office receptionist she cursed out and threatened homicide to. This manic uproar was indirectly directed directly toward her former sexual abuser. Knowing this and being able to be compassionate to the facts of this particular consumer’s case allowed me to be patient despite her obscenities. I was able to de-escalate the consumer and assist her in finding what it was she was in seek of: help. After having done so, she credited her still-beating, non-murderous nor incarcerated heart to me. Priceless.
As I sit here tonight, eating peanut M&M’s and drinking red wine for dinner, I imagine if my ringing phone would have presented such an angry and erratic greeting towards me from this consumer or any other on my case load today. Today, I worked in burn-out mode, frustrated and swearing against a job that a little over 4 months ago saved a life. Today, I don’t think I could have accomplished what I accomplished on that day with that client (or any other) in that state. I do not know if I would have had it in me to remain patient and compassionate today. I do not know if I could have saved the same life if I had to save it in the same fashion today.
Burn out. I am feverishly burnt out in my position. I have thought I might be getting there for a couple months now. Today I reached the broiling point. Today I reached the step before last in a S+C housing application process for a consumer, household of 4; himself and his long-time girlfriend, their son and their daughter (ages 5 and 8). This is the second time I have reached this step before last with this family. Today is the second time I have had to tell this same family that I’m sorry, but you will remain homeless today. I’m sorry but that light at the end of the tunnel I keep promising is there keeps getting burnt out (right along with your case manager). AMI, FMR, HUD and S+C. What do all of these things mean? Today, Area Median Income, Fair Market Rate, US Department of Housing and Urban Development and Shelter Plus Care meant that this family that has been sleeping in a local park since last week are going to have to remain there. The tunnel just extended and the light I have been encouraging them exists has, again, been burnt out and is still, once again, out of their reach.
Had I been trained on these things, these resources and abbreviations, I would have been able to catch the discrepancy in their S+C landlord portion of paperwork myself. In other words, I would have been able to do someone else’s job along with my own for the same whopping $14-and-change per hour “salary” I make now. And, its not that I WANT to do someone else’s job because, I don’t; I don’t want to, I don’t have time to and I (obviously) don’t have the training to do so. This someone else didn’t catch, and neither did I, that the consumer’s (second) prospective unit was unaffordable according to HUD’s FMR calculation worksheet which is based on 50% AMI. The overall calculated expenditure was over the maximum allotted amount of $958.00 for a 2 bedroom unit.
Wow. Look at that! I made an accurate sentence with the same previously questioned and quizzical abbreviations. Ya know how I did that? Experience. I repeat, experience, not to be mistaken for training. You know where that experience has gotten me? In this hot seat called burn out. That’s where I’m sitting after today’s horribly informative puzzle called experience. I have been putting the pieces of this puzzle together through frustration and aggravation, mistakes and confusion (mine and other’s) since June of last year. I have been putting a puzzle together in the world of clinical case management for a homeless services division at the largest mental health care agency in Tampa since I got hired through burning and tormenting experience.
Experience. I repeat, experience, not to be mistaken for training. I have been putting a puzzle together through scorching experience, my own inquisitions, google searches and the most frustrating of mistakes; mistakes of which really couldn’t possibly be my own. A mistake is when you learn something and you still don’t do it right. You see, you can’t achieve if you aren’t exposed to the material in which you are expected to achieve. Productive achievement, known as intelligence in a classroom, can only be measured in terms of what the employee, or student, has been taught or trained to do and know. You see, today I felt frustrated not because I had to be the middle man and the bearer of bad news due to someone overlooking necessary calculation discrepancies. No. Although that lead to it, I felt frustrated and ultimately burnt the heck out because I had to stop and wonder for a moment, did I do that? Was I supposed to have caught that? Is that part of my job? Should I have been the one to catch the discrepancy in order to more immediately find alternate housing options for this park-residing family of 4? Did I do that?
No. Well, not really. Experience. Once again, today I learned through experience and NOT from training. I get it now. I get it. Landlord deemed rental obligation plus average yearly utility usage in Hillsborough County according to HUD which is divided by the 12 month certification period together has to be under $958.00 per month for a family that is at absolute $0.00 income in seek of 2 bedroom housing assistance. Pheewww! I get it. I facilitated the filling out of the HAP contract and RTA (don’t even ask…) by the landlord. I faxed the paperwork to the appropriate housing program representative. I quite capably could have seen that the rental obligation of $849.00 per month plus a requirement that the tenants pay, not only electricity, but water, trash and sewer as well means that unit is out of the FMR price range of $958.00 for a 2 bedroom unit. Once again, pheewww!
I get it now. And now, through this wretched experience, I will NEVER NOT make it my job to notice such a red flag again. Not because I was trained, not because it is my job but, because of this scorching experience I will NEVER be able to NOT hold myself accountable in doing so again. Not because I hope for a raise or recognition, no; I will hold myself accountable for the notification of such a bright, and now obvious to me, red flag because it is ME that had to tell this family that they, in fact, cannot move into the home they have been sleeping in a park across the street from for a week. No raise in the world could make that task worth it or any easier, ever.
If I can help it, I will do anyone and everyone’s job I have to in order to never have to do that again (for the second time to the same family for two different overlooked yet obvious reasons). And, here it goes, the cycle of emotional burn out to physical burn out  back to emotional burn out and so on commences. I realize I hate my job today not because of what I do or the population I work with. I hate my job because I am not adequately trained to do it. I hate my job because I cannot do everyone else’s. I hate my job because I am burnt out, not to mention underpaid. Or, did I already mention that?
By the way, well, two by the ways… One: This person, this supported housing program manager who overlooked this discrepancy until today, on the family’s move-in day, is a person I actually genuinely care for and like. This person is nothing short of a great person. This person didn’t do his job. This is true. However, I am not naive. I am realistic. This person has probably been burnt out, overworked and underpaid for a lot longer than I have. It is not unrealistic that he could miss these things from time to time. Should he have missed it? No. But, he’s only human.
Second and the more important by the way: I absolutely insisted and worked on and found a loop hole or whatever it should be called for this family… I decided my job as their clinical case manager was to be the one to stand up for them when enough has become way more than enough! I decided my job as their clinical case manager was to demand alternate options after such mistakes were made and such obvious facts were overlooked. I demanded emergency housing for this family. They will not be sleeping in a park tonight, no way. I insisted and called and pleaded… they now have 3 nights worth of emergency hotel vouchers. Why/How can they be granted motel vouchers for emergency housing for 2 adults that have two minor children living with them in a park and they weren’t able to be granted such assistance before??? This is a question I literally cannot handle questioning or I won’t wake up to go to work tomorrow. Politics. There is always someone who says, yes. We will help you. Or, no. We cannot. Rhyme or reason? Not always…

I swear to the God of whom I did this work in’s name that by the end of these 3 days, every resource and every priority had better be placed on this family. This family better be in a home, preferably the one they’ve been staring at in the park across the street, by motel check-out time on March 8th. I refuse to make another, a third, phone call to this family. I refuse to make a third call like the second call I had to make to them today (not to mention the call I had to make to the [pissed] landlord who has been sacrificing rent checks from elsewhere to hold and make ready this particular unit for this particular family). If I do have to make a third call, that phone call is gonna go like this: I quit my job in which I hate because I am burnt out. I quit my job and therefore you are no longer my “consumer”. Now you are a human and I , I am a fellow human. In God’s name, I will quit my job and invite this family into my God given living room before I tell them their light has burnt out again. Do you “hear” my frustration in these words? You know where such frustration comes from? Burn out.

I am frustrated to a point that translates into hatred for my job. I am so drained that it translates into pure and overall exhaustion. I am so exhausted that I can’t do this job and have enough energy at the end of the work day to exercise my body at the gym or exercise my mind in my textbooks. I lack the energy to maintain conversation with my long-distance fiance or work on my graduate school class requirements. At the end of the day, all I can do lately is focus on putting out a fire that is my CCM burn out.
Burn out. I am an over-worked, under-paid and under-trained, emotionally and mentally drained clinical case manager. I am totally burnt out.

Food in disordered eating: a need/fear, love/hate relationship  

I’ve thought thoroughly about the last few years of my life. It doesn’t stop at a few years though. When I think about my life, you know what I picture? A blur…

Up until recently, I have lived in this blur. One, long, 26 year strong, blur. But, I am 27 now. Thank God for this 27th year…

In this 26 year blur, one thing is clear and clearly present.


Food. That is what stands out. That is what is reliably evident. Food is one thing that has dominant and recognizable presence in this blurred recollection. Throughout my life, I’ve ate about “it”…whatever “it” has been. I have obsessively thought about eating. I have compulsively eaten. I have purged what I’ve eaten. I have exercised off calorie-for-calorie-and-then-some of the food I have compulsively eaten. I’ve eaten only to eat some more. I have purged only to remain relentlessly in thought about eating even more.

Food. I have been in love with food my entire life. I have eaten in happiness and in celebration; I have eaten in mourning and in sadness. Whether alone or in company, when I have eaten I was never just eating. I was never just eating to live. In good times and bad, I have lived and I have lived to eat. I have turned to food and I have eaten about “it”.

Food. I have been terrified of food for as long as I can remember. The thought of going to an event in which food would be present was always so scary. Holidays in which food is the center of attention have mocked me and succumbed me into my binging tendencies. Thanksgiving; I was never thankful for this holiday or any like it. I have spent hours thinking about and preparing for such holidays’ meals. I have fasted before and after them. I have been that girl that goes to 2 hour spin classes and excessively exercised on and around these holi-days. I have rationalized and blamed overeating, binging and purging on said holidays. Not just holidays… Dinner parties, weddings, you name it… any event where food is displayed, served and present has pushed me into whorls of anxious fear and has terrified me.

Food. I have been totally obsessed with food for as long as I can remember. As a child, I would sneak extra food; I would sneak and eat food in the middle of the night. I would eat others left overs (hence a  [horrible] childhood nickname of mine: garbage disposal). I would eat just to eat because I couldn’t stop thinking about wanting to eat something(s).

Food. I have rationalized and premeditated eating from the time I realized I could do such a thing. I have convinced myself why its okay for me to be eating; I have decided what I could/would do to get rid of what I was about to eat before I ever even ate it. I have eaten compulsively and uncontrollably. I have premeditated how I would get rid of [purge] what I was about to eat in order to eat some more after I purged what I ate in the first place.

Food. It has completely consumed, controlled and down right owned me. Relentless has been the thought of eating and not eating. Relentless has been the thought of binging to purge and purging to binge again. It has dominated my mind and controlled my behaviors. It has made my plans and canceled my commitments. Because of food, I have called in sick to work and have sold out my friends. Binging and purging does not like company.

Food. I have always been similar to the rest of the animal world in the sense that we all need food to live. Until recently, however, I was always quite different from the rest of the world in that I lived to need food. I lived to need, fear, love and hate food.

Eating to Live, Not the Alternative.

This transition, from LIVING TO EAT into EATING TO LIVE, is so incredibly and realistically possible. This blog entry has been about reflection for me. For those of you reading this who may be or may have suffered from disordered eating patterns, tendencies and compulsions, I hope and pray that this blog entry can serve as a reminder or first time revelation that YOU ARE NOT ALONE.

Feeling alone is a huge element of disordered eating and an even bigger barrier to recovery. But, you aren’t… You aren’t alone now, you never were and you never will be. I have been there. I hear you. I feel you. I understand.

All the while, during my entire tenure as a disordered eater, I lived a normal life in total facade. I always come back to poetry, the same poem every time, when I disclose my life in facade: Suffering In Silence. Specifically, I think of this stanza:

In a whirlwind of sorrow and war
Reality’s blurred by her facade
Secrets, silence, truth; all these remain

You are not alone… You will never be alone. You do not have to Suffer in Silence.

Please do not remain silent. Please do not suffer in sorrow and in war without hope of recovery.


Not only is recovery possible, recovery is sitting right in front of you. Just like food is all around you, so is recovery. Food is wonderful and delicious and necessary. Food is not scary; it doesn’t have to be. Do not be scared. Do not be scared that you can’t be “perfect” enough to be in recovery. Do not be scared.

You do not have to try to exist in perfection. Perfection exists and has always existed in you. You were created perfectly. You cannot become perfect. Do not be scared.

You cannot need and fear nor love and hate food and truly live at the same time.

Let go…

You can live freely, easily. You can eat to live, not the alternative.

An Eating to Live, Not the Alternative life in recovery is possible.

My Secret revealed. Thanks, Dentist…  

I thought I safely held my secret. I thought I had it down, deep down, out of sight and out of reach. I thought my facade was impenetrable…

And then I went to the dentist.

It was my initial visit with a new dentist. The dentist was located on Flagler Drive in downtown Palm Beach. The office felt serene as it had a serene view of the intracoastal. I felt comfortable there. The staff was attentive and kind. I knew I had some issues going on with my teeth; I already had a couple crowns post a couple of root canals. For a short period of time, the Atlantic ocean became my center of attention.

And then my name was called.

I sat in the half reclined chair, hesitant to lie back. I was in the company of a good looking middle aged dentist and his female nurse who seemed to be in her mid-30’s. They put that typical dental bib around my neck and I lied back.

Doc said, “Let me just take a look, ok?”
Me: “Um… okay.”

A few glances later, Doc sat up and put down his mirror instrument. He asked his nurse to step out for just a minute.

Doc said, “Question… do you throw up a lot?”

(insert the gasp of all gasps)

…caught. He caught me. My dentist caught me and he totally called me out.

……tears. Tears came without my permission. I didn’t answer him. I didn’t have to.

………caught. He caught me. My dentist caught me and he totally called me out.

My secret, the one I thought I had safely hidden, revealed. And all I did was say “ahhh…”

I spent quite a bit of time at this dentist’s office. I also spent quite a bit of money at this dentist’s office.
After 3 root canals, 2 crowns and 1 temporary crown, I maxed out my credit card and my pride. So, I quit.

Well, I haven’t been to the dentist since that dentist. It’s been about 2 years since I stared out into the intracoastal at that office. That temporary crown is still there, well, sort of… it’s pretty worn. So still is my pride. But, I have decided to bite the crowned bullet.

I have a dentist appointment next week. I can only imagine what he will think of the view of my teeth. I wonder if he, too, will call me out on my purging history. As weird as this is, I want him to. I want him to call me out and to ask me if I throw up often.  I want to say “NOT ANYMORE.”

….to be continued post new dentist appt.