One tiny seed is placed in the dark of Mother Earth, it is watered by rain from Heaven, blessed by man and often grows as tall as six feet, just like man. When they become mature and in harvest season, so rich from God’s blessings, like man, they often become stooped with age. The main stalk is strong which is the life center and often has seven branches or twigs symbolizing the seven days of the week. Also, it has 12 green leaves representing the 12 months of the year. The branches often have three nice sunflowers symbolizing the Blessed Trinity. Each flower has 52 golden yellow petals, which represents the 52 weeks of the year. In the center of the yellow frame of petals are 365 rich seeds representing our calendar year. These seeds are protected from weather by husks, and contain a sweet meat and oil for the nourishment of our bodies. Even the birds of the air feed on them. Each morning, the sunflower faces the rising sun to the East, as to say, ‘Good Morning to the Great Spirit.

We call this beautiful stately flower of God, the Emblem of Spiritualism.

The flowers are often planted in a cluster, or a long row, and act as a fence or barrier from storms, as well as shade from the hot summer sun. We’re all blessed with a very wealthy Father who meets our every need. If we would remember that self-preservation is nature’s first law, we would thank God for our Health, Wealth, Prosperity, and Spirituality in the knowledge of the life of the Sunflower. Truly, our God is Wonderful!

~ Author Unknown

WHO SHOULD ATTEND

Summit for Clinical Excellence is the premier provider of Addiction, Mental & Behavioral Health Continuing Education for therapists and counselors. This 3 Day Conference will offer an in-depth view of eating disorders and their treatment, featuring industry-leading presenters.

This training will be valuable for those working in the areas of: Mental Health, Behavioral Health, Addictions, Marriage & Family Therapy, Psychology, Nursing and Trauma, with up to 19 CE’s available*: APA,  ASWB,  CAADAC,  CBRN, CBBS,  NAADAC,  NBCC, &  CDR. * Approval Pending

If you have not joined us before, you will discover how the Summits are a whole different experience in conferencing!

PRESENTERS

Pamela Peeke, MD, MPH, FACP,
Margo Maine, PHD, FAED,
Jon Robison, PHD,
Ann Kearney-Cooke, PHD,
Mark Schwartz, ScD,
Carolyn Costin, MED, MFT,
Judith Banker, MA, LLP, FAED,
Patricia Pitts, PHD,
Judith Brisman, PHD,
Kim Dennis, MD,
Buck Runyan, MS, LMFT, LPC, CEDS,
Melissa Rocchi, MAAT,LCPC,ATR,
Jancey Wickstrom, LCSW, DBT, Lee Roach, RD, &
Sheila Thomas, LMFT, CSAT

TOPICS COVERED
Advanced Clinical Training in latest Research, Trends and Treatments.
Expert Panel and Eating Disorder Case Studies
Neuroscience & E.D.
Midlife & Treating Eating Disorders
Freedom from Binge Eating
Body Discomfort
Treating Teens with E.D. & Co-occurring Disorders
From Buddha to Brain Scans
Attachment & Intimacy

No one would go flying without a full tank. And yet in life, we expect ourselves to soar on fumes.

When I was learning to fly, the first lesson was on “pre-flighting,” the process of checking out everything on the airplane to make sure it was airworthy. One of the most important steps was taking out the dipstick, a wooden stick (think paint stirrer) with a scale on it—something like the one pictured here. I would have to climb up on the strut of the Cessna 152, unscrew the gas tank on each wing, and put the dipstick in to see how far the gas came up on the scale.

My flight instructor, Clio, was strict about my sticking to my “personal minimum,” the least amount of fuel I would need to go flying for an hour. If the dipstick measured just a smidge below that minimum, I was dying to cheat. Who wanted to haul out the heavy gas hose, climb up on a ladder with it and inevitable spill gas all over my lovely outfit?

Cheating was out of the question. If I even started to compromise on fuel, Clio would point out that it was a matter of life and death.

I know that for many people with eating disorders, fuel is also a matter of life or death. And actually, it is for all of us.

We need fuel to soar in all dimensions of our lives: physical, emotional and spiritual. And fuel comes in many forms. Food is only one kind.

You might think of how energized you feel right now on all levels. On the dipstick scale from 1-10, what would your fuel level measure today—physically? Emotionally? Spiritually?

Now, is that number a good level for your “flights” in the world? What would be your “personal minimum,” the level below which you should never fly?

The next question is a serious one: Are you willing to be dedicated to sticking to your personal minimum? A client at one of my retreats called this idea “revolutionary.” “That would mean changing my life!” she said.

Now, here’s one more thing to consider: your premium fuel. If I put jet fuel into my little Cessna, we’d crash on takeoff. Each vehicle needs a certain kind of power-up. What’s your premium fuel?

You might think about what the premium fuel is for your body. What really makes you feel the best, the most energetic, the healthiest?

Now, what is the best fuel for your mind? And your spirit?

You might make a list for each dimension. Maybe what fuels your mind is good conversation, or maybe you’re an introvert and get your energy from solitude. Maybe your soul loves nature, or maybe you’re fueled by meaningful books or great music or by family and friends.

What counts is knowing. If you know your fuel is dangerously low and you know what the premium fuel is that you need, then you—and only you—are the pilot who can make things right. And you and all the people who “fly” with you will feel safer and happier because you took charge.

Pamela Hale Trachta (Guest Blogger),
Author of Flying Lessons: How to Be the Pilot of Your Own Life

When I was learning to fly a small airplane, you’d think I would have been thrilled. After all, I was pretty fortunate to have this opportunity. But I had trouble holding on to the beauty and thrill; instead I got hijacked by fear.

One day after practicing emergency landings  (by picking a flat spot in the desert and then doing everything short of actually putting the plane down in the cacti) I was headed back to the airport with my flight instructor. I was sweaty but happy, since now all I had to do was one regular landing and then I’d go buy my celebratory latte.

When we were parallel to the runway and I was thinking about my approach, Clio leaned over and just turned off the power. Silence, except for the pounding of my heart.

I froze. No information coming in. All my training was for nothing now; I was paralyzed.

“Your emergency procedures, Pam? Where are you going to land?

“Ummm, I’ll land in that arroyo just ahead.” I was making up a ridiculous answer, since I really had no idea.

“Pam, how ‘bout the runway?”

I could have died. It was right over my left shoulder, if I only could have seen that far. Clio had just given me one more simulated emergency—an easy one. And I had flunked.

Fear can hijack our normal thinking process, which contracts along with our vision, hearing and our bodies. I couldn’t see my safe landing place even when it was right next to me.

This story is the reason why my  Flying Lesson for Life #1 is: Know Where You’re Going to Land.

Clio pointed out to me that the antidote for fear and stress is training. Rehearsing what you’ll do if “the engine fails” is the key to safety.

So how does that apply to problems with food? You might think of it in several ways:

1.      If you’ve used food as a “safe landing place,” something that gives you comfort and security, you know that it doesn’t turn out that way. What feels like it’s going to be safe turns on us and becomes a place of danger instead. So we need to practice “landing” somewhere else—in a place that truly is safe.

2.      A safe landing space in aviation would be a place that is flat, unobstructed and long enough to come to a stop. What place would be like that for you? Are there people in your life who offer you an open, spacious place to “land,” without putting obstacles in the way?

3.     The trouble with family and friends as a safe landing space is that they have their own troubles, failings and emergencies. So it’s great if you can develop a safe landing place that is internal and eternal. If you believe in a higher power, you’re fortunate. Or, maybe it’s nature. Or music. But make it something holy, something that no one can take from you.

4.      Whatever you choose, practice going there. Make it a spiritual practice to give yourself a spacious, solid, unobstructed safe place that you visit even when you’re feeling great. That way, you’ll remember how to get there in more turbulent times. Particularly if fear has you by the throat, that practice will kick in and save the day.

Here’s a suggestion for a Safe Landing Place practice: Sit still and breathe. Breathe deeply and feel how your body responds. Focus on your heart, and imagine that your heart is breathing you. Your heart is your center, the place where you remember that you are all right exactly as you are. See if you can allow that place in your heart to open into a space where you can “land.” A place where you feel solid ground underneath you. A place where all is well.

If you can work on mastering this one Flying Lesson for Life, all the others will come. This is the foundation. It is one we all need in today’s world, so you are not alone. Sink into it. Enjoy it. No one can ever take your safe landing place from you. It is yours forever.

Pamela Hale Trachta (Guest Blogger), Author of Flying Lessons: How to Be the Pilot of Your Own Life

When I was six, I believed I could fly on my own power. I thought it was just a matter of practice.

So, I gave myself my first flying lessons from the ladder of my swing set. I would climb up, turn around and face the yard, gather the image of flying into my body, spread my arms out…and jump!

The fact that I usually made green body prints in the grass didn’t discourage me. And neither did the fact that my family situation wasn’t exactly perfect. Some mysterious force within me believed I could rise above it all and fly, like a goddess in a myth.

Do you remember childhood fantasies of flight? I have clients who report questionable forays from branches of tall trees and other high places. Even though they struck terror into their parents, they remember the certainty that they had that power within them.

Or do you have night dreams of flying? I ask this question to audiences and about half of them raise a hand. If you’re in that half, what do you think your dreams mean? How does it feel to fly on your own power?

Now for your waking dreams and fantasies. What would it mean for you to fly in your life? If you had the power to just take off and rise above your current “landscape,” how would that feel? What’s the predominant energy: Power? Freedom? Joy?

Take a moment to imagine flying and feel the energy in your body. This is important work.

We know that athletes visualize their perfect performances. But these days, good coaches have them do more than picture the outcome in their minds. They encourage them to feel the experience in their bodies. And when they can do that, the body and brain have almost the same experience as if they were executing the perfect high dive or topping their record in breaststroke.

We all have powers within us that we aren’t using. The good news is that we’re learning how to tap into them.

My own offering to you is my metaphor of flight. I’ll be exploring in a series of blogs how you can remember how to soar in your life, without really having to leave the ground. This is material from my book, Flying Lessons: How to Be the Pilot of Your Own Life.

My experience learning how to fly a small plane in my late ‘50’s brought up every fear I knew I had, plus a galaxy of fears I didn’t realize were lurking under the surface of my otherwise fortunate life.

Thanks to my strong female flight instructor, Clio, I earned my private license. But the real point is what happened afterwards. About a year after that victory, I was diagnosed with breast cancer. My flying lessons came in very handy. I found that the lessons I learned in the air were lessons for my life. Here are the 7 of them that I use every day to navigate in turbulent conditions:

1.      Know Where You’re Going to Land

2.      Bring Enough Fuel for the Journey

3.      Take the Pilot’s Seat

4.      Remember Why You Long to Fly

5.      Communicate with the Controllers

6.      Broaden Your Scan

7.      Give Way to the Winds

I’ll bet you get the metaphor just from reading the titles of the lessons. In future blogs I’m going to explore each lesson with you in more detail. Because I believe this metaphor can help you get out of a stuck place, where gravity is holding you down.

You have the power to fly. It’s just a matter of practice!

 ~Pamela Hale, Guest Blogwriter

The goal of becoming an attuned eater is to develop a healthy relationship with food. That’s different than deciding to eat only healthy foods! There is so much angst these days over what’s “good” to eat and what’s “bad” to eat, that food often causes more anxiety than enjoyment.

Remember that as you decide what to eat, the goal is to “make a match” that will satisfy your hunger. You may also take other factors into consideration as you decide what will truly nourish you. Perhaps you’re a vegetarian or keep kosher, and these philosophical views affect your choices about how to feed yourself. Perhaps you have some sort of physical illness or condition where eating – or not eating – certain foods supports your health and well-being. If so, deciding to make these adjustments to your food choices as you honor your hunger and fullness is an act of self-care in the service of promoting wellness, rather than an act of deprivation in the service of pursuing weight loss.

Ultimately, the question for you to consider is what feels good and what feels bad as you decide how to listen to your physical hunger. A cheeseburger can feel like a great match on a day that you crave protein, and it can feel like a terrible match on a day that your body needs something lighter in your stomach. Likewise, an apple can feel like a great match when your body craves something sweet and crunchy, or it can feel like a terrible match when you need something more substantial in your body.

By keeping all types of foods available, and tuning into your body’s needs, you’ll find that you can naturally incorporate healthy foods into your life. As diet survivors let go of judgments about what they should eat, we’ve never met anyone who only wants cakes, cookies, ice cream and chips. But we’ve also never met anyone who only wants salads, broccoli and oranges. (In fact, sometimes people find that eating “healthy foods” makes them feel like they’re on a diet – but we’ll save that for another time!) The difference is that rather than deciding to eat these foods because of external rules and restrictions, as an attuned eater you’ll experience the pleasure that comes from nourishing yourself from the inside out!

Food records are very effective tools for teaching someone how to identify physical hunger cues and emotions around eating. At their best, sometime food records can help the individual distinguish between the two! For many, this activity provides a sense of safety, clarity, & awareness. Unfortunately, others may experience resistance due to various reasons (i.e. difficulty with completing the records with consistency, eating disorder driven fears, or unease with facing the facts through honest observations). For many, though, they are very helpful, so it is worth a try!

If you feel resistant, try setting a goal that includes a small time frame, perhaps starting with a few days. You can also look at it as an experiment rather than a forever commitment. Food records can be very insightful, providing evidence of where small, desirable changes can be implemented.

There are many different forms for keeping a food journal, so I encourage you to find one that works the best for you. There are a few book recommendations at the end of the article as well as a sample food record template for download.

Typically, food records include:

•  Time, location, and type of food eaten (with approximate amounts)
• Rating level of hunger / fullness rating before and after the meal (1-10 scale). The hunger scale will help you connect with your body. Most rating scales range from 1-10. One is extremely hungry.  A  three is hungry for a meal and the ideal level for beginning a meal. A four is bit hungry, maybe for a snack or with a plan to eat soon. A seven is comfortably full and the ideal target for comfortable satiety. A ten is      extremely and painfully full, usually only attained after an episode of emotional or binge eating.
• Rating level of urges to engage in behaviors and whether or not you engage in behaviors: restricting, binging, purging, low body image, etc.
• Any feelings, emotions that come up. When keeping my own food journal, I have noticed that an increase in anxiety completely unrelated to food can make me more vulnerable to urges.
• A description of any outstanding events, circumstances, or challenges. For example, thanks to keeping a food record, an urge to binge and purge may be able to be traced back to forgetting to pack a snack before leaving the house earlier in the day.

In summary, the main goal of maintaining a food record is to raise awareness and help identify thought and behavior patterns that lead to mindfulness around food and eating. It may be difficult to put a number to your hunger and fullness at first, and that’s okay. Develop a log that fits and works for you the best. The most important thing is not to get too hungry or too full.

A dietitian, Ralph Carson, gives an excellent metaphor: “When talking about hunger and fullness I like to use the analogy of filling our car with gas. The important thing is don’t let your car run out of gas and don’t overfill the tank once its already full.”

[DOWNLOAD A SAMPLE FOOD LOG TEMPLATE FOR FREE!]

Recommended Reading:

Meal by Meal: 365 Daily Meditations for Finding Balance Through Mindful Eating by Donald Altman

Intuitive Eating by Evelyn Tribole and Elyse Resch

– Faith (Guest Blogwriter)

LOVE YOUR BODY FAIR: Mirasol at University of Arizona, Feb 26^, 2013

Enjoy a peek from our booth at the Love Your Body Fair at University of Arizona here in Tucson, AZ, one of our National Eating Disorder Awareness Week outreach events. We were so impressed with the experiential opportunities to practice body and self-appreciation thanks to the brilliant creativity and enthusiasm of the student groups who tabled.

This year, the Campus Health Service actually hosted Love Your Body Week, a rather ambitious and encouraging expansion from previous one day events. It is always exciting to see attention being devoted to topics such as body image, which is a highly sensitive and yet a very relatable concern, especially in college. Most women have some level of concern with their appetites, eating, and bodies and we know more and more men are sharing these pressures, too. Body image screening tents were set up throughout campus to help individuals identify potential concerns that may need addressing.

Media literacy was provided by showing the documentary, Miss Representation. “The film explores how the media’s misrepresentations of women have led to the underrepresentation of women in positions of power and influence.”

Later in the week, Dr. Jean Kilbourne, who has studied body image for nearly 50 years, presented her lecture, The Naked Truth: Advertising’s Image of Women. Dr. Kilbourne also provided a low cost training for professionals.

Congratulations to Campus Health Service for presenting such an impressive array of events!  If you are a student of UA, you may be interested in learning more about their wonderful Love Your Body Program, a small group, peer training program designed to promote body acceptance that runs each semester.

BINGE EATING DISORDER ASSOCIATION CONFERENCE: March 8-10, 2013 (Bethesda, MD)

With more than 8 million men and women suffering with Binge Eating Disorder (BED) and the upcoming DSM 5 ( Diagnostic and Statistical Manual of Mental Disorders ) recognizing BED as an official diagnosis, we were very excited to attend the BEDA Conference this year. The conference was very well rounded, offering tracks for mental health providers, dietetic and nutrition providers, and individuals and family touched by BED.

Here are some of the most memorable highlights:

1. Insurance protocols and reimbursement tips. Though these sorts of discussions aren’t necessarily “fun”, we learned some excellent information from Lisa Kantor, attorney at law, who specializes in getting coverage for eating disorders treatment approved when admission or claims are denied. Make sure you document every single conversation you have with your insurance company. Make sure you have a copy of the actual terms of your insurance benefit contract, too. Finally, if you feel you are stuck with getting coverage approved, inquire about whether any co-occurring conditions (i.e. depression) would merit the coverage you need.

2. Eating Disorder as a metaphor for communication. It is not a new concept to consider that those suffering with eating disorders are using food and weight to creatively communicate inner dilemmas, but it is a great reminder that opens the door for compassion. Perhaps this quote will frame it directly, “Every time a person goes on a diet, they are telling themselves that they’re not good enough.”  If you feel like you are in a plateau with talk therapy, try drawing upon your creativity as a recovery tool! By approaching expressive arts activities as opportunities for dialogue rather than something that needs interpretation, you could learn a lot about what you truly wish to communicate with the world around you! Use your voice, not your body, to speak!

3. Neuroscience research points to mindfulness techniques. There is a lot of very exciting data coming out of the neuroscience field that offers hope. It appears that some body image distortion can be linked to defective neural processing and multisensory deficits, where the brain locks into a mode of misinterpretation. Mindfulness techniques can be used to increase interoceptive awareness or feeling states in the body. The wonderful thing about this is that anyone can learn mindfulness and it is a portable tool that can be tapped into almost anywhere you go! It requires a consistent discipline to re-pattern the brain, but with 20 min. a day dedicated to this practice, amazing outcomes are possible in the course of just a few short months, eradicating years and years (or even decades) of powerlessness and hopelessness.

4. Our new favorite phrase: weight neutral. It is especially imperative for treatment providers to be aware of their attitudes around weight. Personal biases and weight stigma are harmful enough in their own right. However, imagine opening up your deepest wounds and entrusting your life story only to be faced with someone else’s unresolved issues around weight stigma! We want to strive for weight-neutral care, where the size and shape of a client’s body do not make a difference in regards to the attention, compassion, and quality of care they will receive! In many ways, Binge Eating Disorder has been overlooked, partially due a lack of research and it’s exclusion in the DSM. With its inclusion in the upcoming DSM V, there will be many people coming out of the shadows to seek help. Let us meet this new demand with our whole hearts, so that anyone suffering with an eating disorder feels safe to seek the support they need to be well.

Dear Jeannie,

Recently, my weekly articles have been focusing on personal energy and instant energizers. Today’s article, however, is steering away from that and taking a different course: A Facebook friend recently quoted Dr. Christiane Northrup, and her thought-provoking words have stimulated a lot of discussion. She said, “Obesity is a solution to chronic stress,” and many folks have argued that obesity is an indication of stress, not a solution. I decided to investigate the statement!

With my background as a counselor, I am well aware that the extra layers of fat are often used as insulation, sexual protection, physical protection and even social protection so others might expect less from you.

I also believe that the basic problem is not the overeating. What is causing it? It’s that saying, “It’s not what you’re eating, it’s what’s eating you.” Many folks overeat/binge in an attempt to manage their pain and stress. In fact, I’ve often said that, “Food was the glue that kept me together.”

The resulting obesity, therefore, is also not the problem, but rather an indication that something challenging has happened or is happening to the individual.

Since my curiosity was piqued, I looked into the origin of the Dr. Northrup quote and discovered an interesting discussion in Hungry for Change. I found it so intriguing that I am sharing some of it with you here:

In 1992, Vincent Felitti, M.D., head of the Department of Preventive Medicine at Kaiser Permanente in San Diego, noticed a number of his patients dropping out of the Kaiser’s obesity program. The patients, Felitti noticed, didn’t quit because they couldn’t lose weight. What was going on? Why were his patients dropping out? To answer these questions, Felitti conducted a research project. Through his study—popularly known as the Adverse Childhood Experiences (ACE) study—Felitti discovered that a high proportion of the dropouts had histories of childhood abuse or neglect. These childhood experiences, he concluded, continued to affect his patients’ health and well-being, even if the experiences had occurred more than 50 years earlier.

“What he concluded,” says Christiane Northrup, M.D., “is that obesity is not the problem. It’s a solution. It’s a solution to chronic stress. It’s a solution in many people to sexual abuse, to dysfunctional family situations, and other personal traumas.”

The chapter continues on, discussing emotional eating, and offers:

Once we understand that sudden weight gain is often the result of the body’s protection mechanism, we can start to deactivate this mechanism by addressing specific stresses in our lives….

When you’re under stress, your body produces stress hormones called cortisol and epinephrine. I used to joke that I’d gain weight just looking at a sweet dessert, and it wasn’t so far-fetched after all. Dr. Northrup explained, “When your stress cortisol hormone levels are high enough, they’ve documented that looking at a doughnut actually changes your metabolism.”

“Stress also increases fluid retention,” Dr. Northrup continues. “I call these liquid pounds. If you’re under stress and you sleep for only three to four hours a night, you will gain two pounds just from that. You want to take care of those liquid pounds before they turn into real pounds, which they inevitably will.”

Dr. Northrup believes that the best ways to decrease stress hormones are 1) Getting a good night’s sleep – this will break down excess cortisol and epinephrine better than anything else. 2) Exercise — a walk three or four times a week is all it takes. 3) Laughter — decreases these hormones.

She concluded by saying that anything that is sustainably pleasurable will decrease stress hormones.

Information taken from: Colquhoun, J., ten Bosch, L., & Hyman, M., Hungry for Change (New York: HarperCollins, 2012), 67-70.

Some immediate implications:

For those of us of normal weight: Now that we understand that obesity is often a solution to chronic stress, isn’t it time to be more compassionate with obese folks?

For those of us carrying excess weight: Isn’t it time to be more compassionate to ourselves? And isn’t it time to heal the traumas from the past?

If you want to stop emotional eating, please check out my book, Stop Eating Your Heart Out: The 21-Day Program to Free Yourself from Emotional Eating. I wrote it because I suffered from binge eating disorder and, over 30 years ago, began to explore tools and techniques to help me recover. I share my recovery methods so that other emotional eaters can also end the misery and self-recrimination around their eating.

Stop Eating Your Heart Out will help individuals who currently have or once had major stress in their lives and turned to food.

Blessings,

Meryl Beck
Author: Stop Eating Your Heart Out

To start, brainstorm a list of behaviors/thoughts that are standing in the way of a positive recovery.

For example, some of my issues were:

• weighing my food to exact grams and calorie counting
• only weighing myself in the morning, including refusal to be weighed at the doctor
• assuming people were looking at me thinking I’m ugly or judging what was in my grocery cart and knowing I had an eating disorder
• never eating out or anything anyone else made because I didn’t know what was in it
• ALOT of black and white stinking thinking

For the sake of this article, I’ll “track” just the behavior of weighing my food and calorie counting through the process of change.

1. Raise awareness and track the behavior: The first step is to become almost hyper-aware of the behavior. For one week, keep a chart of how often, when, where, how, and why you feel a certain way of acting upon that behavior. When I made my daily chart of how much I had to take time to weigh my food, calculate everything, every recipe, I became aware of how much time it was taking out of my life. It also narrowed my food choices, kept me isolated from my friends when they would go out, and food preparation took that much longer. Emotionally, I became aware that weighing and calculating my food helped me feel secure that I was eating the proper portion, eating healthy and giving my body just what it needed, no more, no less. Awareness of my healthy intentions behind the behavior taught me I did not need to engage in negative eating disorder behaviors to be secure.

Troubleshooting: If you don’t know where to start, make a list of behaviors, thoughts, perceptions that are in the way of making positive changes and then choose one to begin changing.

2. Make a plan and take small steps: The second step of changing the behavior is making a plan and taking small steps toward success. The action plan can become your new sense of security, too. Any habitual behavior is extremely difficult to stop! There is no doubt meeting your goals requires willingness, intention, and conscious effort. Break challenging goals down into smaller actions that you agree are reasonably possible. Continuing with my example of weighing and calculating my food, I definitely took baby steps. I began with putting away my food scale, but I was still allowed to use measuring cups for my food portions. Once I stopped being furious with my treatment team over that (just kidding!), I moved toward building a meal plan of exchanges and stopped using the measuring cups. I began eyeballing my portions since I knew what they looked like on all my plates and in all of my glasses. As I worked with this step, I also slowly stopped calorie counting and began to just rely on exchanges, which made eating much more flexible! Although I still didn’t go out for full meals with friends, I did become comfortable enough to do snacks out, which led to less isolation and more socialization without letting food alienate me from life.

Troubleshooting:

- Break larger goals down into smaller steps
- Set guidelines aimed at decreasing situations that trigger negative feelings/behaviors
- Come up with distractions to do instead of the behavior
- Continue keeping a log of actions/feelings to track the behavior

3. Notice the difference: The final step is taking notice of the changes you have made and acknowledging how things are different now. Although I felt worse and my anxiety was through the roof when I started giving up my food scale, giving it up gave me so much freedom, helped me eat more intuitively, and has definitely had a major positive effect on my recovery. The entire process did take a lot of support, but by continuing to work through it, the anxiety and urges did end up decreasing, making maintaining the changes much easier.

Troubleshooting:

- Give yourself credit, because even small changes can create a big changes in time!
- If you are feeling defeated, learn from the exceptions. Analyze how you feel when you are able to stop a behavior, even for just a short time? What does it feel like if you are able to stop the behavior completely? What differences are there in your anxiety levels?

Closing Words

No, change is not an easy process. However, when you stay persistent and ask for support, your goals become possible. Recovery requires a lot of conscious effort, honesty, vulnerability, determination, and persistence. Sometimes, you just have to buckle down and use that opposite to emotion skill where you just have to do what your ED doesn’t want you to do. Be patient and gentle with yourself through this process. Work through the anxiety and let yet another door of re-entry to LIFE open. You are worth it and you deserve it!

 ~Faith, Guest Blogwriter

Reference:
Costin, C., & Grabb, G. (2012). 8 Keys to recovery from an eating disorder: Effective strategies from therapeutic practice and personal experience. New York: W.W. Norton & Company, Inc.

Honestly, I still get a little frustrated. I’m now living in a more rural area and there were no events even occurring. In fact, finding anyone in clinical practice with eating disorders experience in my area is near impossible. The part that makes my inner jealousy scream out is, “Why do thousands of people show up dressed in pink and don pink ribbons of hope and healing to run a race raising money for breast cancer (they even get an entire month of national awareness) while National Eating Disorders Week softly goes by with little fanfare, no grocery clerk asking if you would like to donate $1 for research, no parades, very few walks or runs, etc…” I whole-heartedly support what the breast cancer community is able to accomplish; I only wish the eating disorder community could break through and keep a similar pace. After all, “EVERYBODY KNOWS SOMEBODY.” 

Bottom line, I don’t need a special week to raise awareness and I am not going to wait around until next year for something to happen! Although I’m one person, I try to take action and make effective choices by the way I live my life, and share it with others as well. Also, everything takes time. I’m sure all the breast cancer walks didn’t begin with thousands of balloons either.  However, patience is not my virtue

This is why I try to do little things ranging from the daily choices I make to bolder actions such as sharing my discoveries and educating professionals and the public alike. For example, I love participating in “Operation Beautiful,” where you leave positive notes in random places. If I see a commercial or ad that is using women as a object to sell their product, I will refuse to shop/buy from that company. I do leather-craft and 20% of anything we make is sent towards eating disorder scholarship and funding. These may seem like small contributions, but if everyone started to take action daily, or even weekly, things will become more progressive. In my book, every week is National Eating Disorders Awareness Week!

I once started something called the “blogging pants,” which were being sent around the US and Canada. It was mimicked off the Sisterhood of the Traveling Pants. No one knew what size they were, and when you received them, the person added a positive quote and sent them forward. Sadly, they have gone missing, so keep your eye out as they were going to make their way to NEDA in honor of their “Know Your Genes” campaign. Regardless, the pants traveled and met many wonderful people along their journey. My point in sharing all of this is that we can all do something and if we don’t I ask, “Who will?”

NEDA’s website has a ton of ideas for getting involved with eating disorders awareness! You can take a training to give talks and become a recovery speaker, be a media watchdog, organize events, etc. Even if you don’t have a group to develop things with, there are many things you can do, and you might even be surprised at what comes of it. Eating disorders should no longer be stuffed under the rug; we need to scream out loud and clear because we know these disorders thrive off of silence.

From NEDA:

• Activity & Event Planning Timeline: Looking for ideas that fit your audience type and time frame? Check out this list to find a fun option.
• Host a Screening Event: NEDA now offers an easy-to-use online screening tool, in partnership with Screening for Mental Health Inc., perfect for holding an eaing disorder screening event in schools, universities, hospitals, community centers, or anywhere internet access is available! Use the Planning Guide for Eating Disorder Screening Events to get started!
• Just One Thing: Everyone can do something that fits their time, resources, and interests…just pick one from the Just One Thing list!
• Mix & Match: 10 easy, fun ways to make a difference
• Operation Beautiful: Join the campaign to end fat-talk…one post-it note at a time.
• Event Planning Guide: Want to host an event but not sure where to start? This guide walks you through the main components and is great for group planning.
• Flyers, Bookmarks & Handouts: Ready to print resources, includes signs and flyers to post around schools with information on eating disorder awareness.
• Host a volunteer NEDAwareness Week Speaker at your school or university. Each year volunteers across the country offer to speak to your class or community group about eating disorders. Find a NEDAwareness Week Speaker today!
• Legislative Advocacy: Check out the Take Action Now section to see how you can help build eating disorder awareness support in congress.
• Be a Media Watchdog: Consumer voices matter! Click on Take Action Now  for practical tips and tools for becoming a media activist.
• NEDAwareness Week Supporter Certificate:  A certificate of appreciation and recognition for the volunteers who help make your event a success.
• Request a Free NEDA CD-Rom Toolkit: Have access to your very own disc, consisting of NEDA’s Parent, Educator, and Coach & Athletic Trainer Toolkits.  Simply fill out this online request form.

The important thing to remember is that even if you just get the information now, it doesn’t expire. Keep reaching out and raising awareness. If you didn’t have time to organize something last week, get some materials together and a well thought out plan and maybe next month will be your time to put on an event to give voice to the silent epidemic year-round! You do not have to save your ideas until next year!

Plus, I encourage you to think about daily choices and how small little acts can also lead to more awareness, even if its through a note, a few words, or one small action. Granted it takes courage and a bit of boldness, but it also offers a great opportunity to continue building that self-confidence, which is a strike against the eating disorder.

Thank you for letting me have my soapbox and wanting to change everything with the snap of my fingers. Remember that each day is a new day, and you don’t need a special week to bring awareness or education to others. Small steps and actions is what compiles into the thousands of balloons being released at a NEDA fundraiser and walks across the nation. Maybe we’ll even get our own month!

~Faith (Guest Blogger)

The experiential learning aspect of recreational therapy has always appealed to me. Even at my most stubborn and resistant moments as an adolescent inpatient, the recreational therapist was almost always able to help me engage in treatment. Recreational therapy gave me at least one thing to look forward to on the schedule every day, whether a therapeutic outing, open studio time, a movement group, or other creative activity.

What I love about making Life Saver Cards is that it forces you to carve out little bit of time to focus on some key areas of managing distress: support network, recovery motivations, positive reminders, alternative coping options, inspirational quotes & affirmations. Have you ever heard someone say, “I’m losing my mind,” when they were stressed? This activity will give you a tangible index of recovery reminders that you can tuck away in your purse, backpack, or briefcase to draw from when needed.

Supplies:

Blank note cards, pens and markers, stickers, hole puncher, & piece of yarn or hemp. I made my own notecards out of cardstock, but you can find a variety of options in the office supply section of a store.

Topic # 1: My support network

Front:  The front of the first card will become the “cover” of your deck of life saver cards. If you are feeling creative, have fun with decorating it with a doodle or some fun stickers.

Back:   On the back of the first card, write down at least 5 people who make up your support system. Think about your friends, family, sponsor, and treatment team.  Make sure to only include those helpful to you when you need support and include their contact information, whether a phone number or email address. If you have a smart phone, it might be a good idea to program their contact info while you are at it.

Topic # 2: My Motivations

While there is no doubt the eating disorder has served some sort of purpose for you, there has also a breaking point that lead you to seek out recovery. Brainstorm all of the reasons why you choose to heal. Use this card as a reminder during times when you forget why you are fighting so hard for your recovery.

Front:   Positive reasons – What does/will recovery give me?  How does/will it improve my life?

1. I want to be able to start a family and have healthy relationships
2. I want freedom from the thin trap so I can reclaim my true beauty
3. I will have the energy to achieve my fullest potential serving others

Back:    Negative reasons – What does my eating disorder take away from my life?  In what ways is it harmful to me?

1. Giving into the eating disorder will take away the confidence I have worked so hard to build.
2. Lying about my behaviors will lead to the loss of trust from my friends and family.
3. There are more important things to spend my time on than worrying about food.

Topic # 3: Positively positive

Front: Write a prompt on the front of the card that inspires positive focus. You will make several cards, one for each prompt you choose. When the negative thinking reel runs wild, it can be hard to pause and consider what is good without a nudge in that direction. Here are some prompts to get you started. Choose the ones that you believe will be most helpful to you when you need encouragement and feel free to come up with a few of your own.

1. I look forward to…
2. One day, I know I will…
3. I appreciate…
4. I deserve…
5. I can always laugh when…
6. Something that can always make me smile is…
7. My greatest strengths are…
8. I love…

Back: On the back of each positively positive card, complete the sentence on the front. For example, if the front of the card said, “I love….” I would write, “Peanut (my dog), my family, my friends, chocolate, ocean breeze, yoga…”

The idea is to be able to take the card when you need to reframe the mind to a lighter place and answer the prompt without looking on the back. However, if you are having a particularly hard time, you will have several reminders on the back to help boost your train of thought.

Topic # 4: Alternative Coping & Behaviors

Include a variety of options when listing alternative coping behaviors. Sometimes we need calm and quiet in solitude where other times we might need distraction and company.

Take a walk         enjoy a candlelight bath              incense or aromatherapy             hold an ice cube                   eat with a buddy            creative journaling          listen to a meditation or visualization         practice yoga                     go to a movie                     coffee shop or bookstore            call a friend

Topic # 5: Inspirational Quotes

Select 3-5 of your favorite quotes that inspire your forward movement in recovery. When selecting the quotes, choose those that truly make your mind’s heart and heart’s mind smile!

“Not all of us do great things. But, we can do small things with great love!”– Mother Theresa.  It’s a gentle reminder that we can all contribute to the greater good with very basic gestures. It gives me a doable sense of compassionate purpose even in those darkest moments. We do not always have to go above and beyond, for there is great beauty in simplicity, too! This is a really helpful quote when feeling a sense of inadequacy.

Other quotes I love include:

“Many of life’s failures are experienced by people who did not realize how close they were to success  when they gave up.” –Thomas Edison.

“When there is no enemy within, the enemies outside cannot hurt you.” –African Proverb

“Don’t ask yourself what the world needs. Ask yourself what makes you come alive and then go do that. Because what the world needs is people who have come alive.” –Howard Thurman

Assemble your deck of cards

Once you have all of your cards together, you can take the hole-puncher and punch a hole in the upper left corner of all of the cards.  Then, loop the string through the stack of cards and tie into a knot. Keep your Life Saver Cards nearby during those rough times. You will have several resources you came up with for overcoming urges right at your fingertips.

~ Heather, Guest Blogwriter

I have traveled and moved a lot in the past couple years. Since I can’t take my two best friends (Modge Podge and scissors) to your house to create you an affirmation board, I did the next best thing. I chose some of the quotes and excerpts that I’ve lovingly toted around state by state. By lovingly, I mean continue to carry even those that have developed water stains, corners the dog chewed, and many tape and push pin holes. You get the idea This first quote is from one of my many “quotable cards,” and one of my favorites, because I always feel like I’m climbing a humongous mountain where there is no plateau. It always seems that just as I get over one thing, another barrier comes my way, which turns up the volume on my internal negative talk radio to LOUD!

Souza’s words are a good reminder that there is more out there. Happiness is a journey, not a destination…I can definitely identify due to some life events that a moment is a moment, so keep them close.

“for a long time it seemed to me that life was about to begin-real life. but there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. at last it dawned on me that these obstacles were my life. this perspective has helped me to see there is no way to happiness. happiness is the way. so treasure every moment you have and remember that time waits for no one.” – Souza

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I discovered Kellie Rae Roberts about two years ago at my local hospital gift shop where they carried some of her artwork which is inspiring & thoughtful. The presentation was right up my ally in the way she wrote and language used, so I immediately fell in love. This is just a short example, but I love the simplicity! Each phrase is a powerful reminder in it’s own. If I had a no fee credit card my house would be full of her crafts!

“Tell your story…believe in healing…honor your intuition…take the journey back to your self…wear more skirts…begin today…embrace vulnerability…do the thing you didn’t think you could…quiet the inner critic…” - Kellie Rae Roberts *Read her story, more quotes, and her art online! 

The excerpt from Nelson Mandela’s speech is a powerful reminder that yes, I am here for a purpose, and yes, it’s okay to be self-confident: a mixed message that society sends us. When my inner critic gets going, I will read this, and it’s always a good jolt reminding me that continuing to listen to the negative self talk is serving no helpful purpose nor is it honoring my Higher Power. This watermarked, chewed quote has traveled with me for seven years!

Our deepest fear is not that we are inadequate, our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that frightens us. We ask ourselves, who am I to be brilliant, gorgeous, talented and fabulous? Actually, who are you not to be? You are a child of God. Your playing small doesn’t serve the world. There is nothing enlightening about shrinking, so that other people won’t feel insecure around you. We were born to manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And when we let our light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others. – Nelson Mandela, 1994 Inaugural Speech

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The mind is strong and surrounding yourself with positive, inspiring, and encouraging messages can have a great effect. Sometimes, I bypass the quotes around the house or will vacantly read them and negatively shout, “Yeah right!” Thankfully, more often than not, I will walk around and mindfully read them, and I have noticed I have gained more ammunition against the negative thoughts.

Plus, never underestimate Modge Podge, scissors, and magazines! It’s quite cathartic to make these sorts of inspirational reminders, and there have been moments where I probably could have collaged anything that stood still!

“Believe in yourself and all that you are. Know that there is something inside you that is greater than any obstacle.”- Christian D. Larson

Just a few books I’d recommend:

The Time Traveler’s Gift by Andy Andrews. Even if you are not spiritual, this book is amazing. It’s a true reminder of hope, having a purpose, embracing each moment. I couldn’t put it down and have actually given it to a few friends.

The Language of Letting Go by Melody Beattie. This is a great daily read for people going through the recovery process.

Power Thought Cards by Louise L. Hay. This is a fun little box of beautifully decorated cards with affirmations on them. Some days I’ll just sit and go through the entire deck reading them.

Jesus Today (focuses on HOPE) and Jesus Calling by Sarah Young – If you have a Higher Power these devotionals are amazing! I’ve been going through Jesus Today which is more focused on hope, and I can’t believe how each day is just what I need to hear.

The Creative Journal by Lucia Capacchione. Even if you’re not an artist, this book has great exercises that explore the self and help rebuild your identity

-Faith (Guest Blogwriter)

“I am fairly certain that given a cape and a nice tiara, I could save the world!” -Kellie Rae Roberts

This has always been the most challenging time of year for me. The days grow shorter and the sun shines shyly.  Even Peanut, my awesome dog, doesn’t want to get out of bed sometimes.  Honestly, the weather makes me want to curl up in bed and pull the covers over my head, too. All jokes aside, some days are really hard to face. When suffering symptoms of depression, there are occasions where it is good to stop thinking and start doing. During those times, my mantra becomes, “Don’t think, Just do!” It’s not advice that always applies, but when experiencing anhedonia, you have to act against the urge to avoid activities.

Defined as the inability to experience pleasure from experiences once found enjoyable, anhedonia strikes with almost paralyzing venom. Hobbies lose their appeal. Exercise becomes a chore. Social interactions become overwhelming.

Most notable, I lose both drive and desire to do things, even when I rationally know following through would likely be a helpful jumpstart (motivational anhedonia). Sometimes, however, it is as if the pleasure switch actually gets turned off in my brain. What was once somewhat rewarding and enjoyable become tasks or obligations, sometimes accompanied by painful anxiety (consummatory anhedonia).

“Why not pull the covers back over my head?” “I won’t have fun anyways.” “It will take more energy than it is worth…” And the string of negative thinking can so easily take off running in the mind.  When laboring in worry, dread, and a genuine lack of energy, it is so easy to dismiss invitations and cancel plans.

You cannot fight darkness with darkness, though. Isolation and avoidance will only bury you deeper in the hole.

Six strategies to help combat anhedonia:

1. Don’t think. Just do! There is a time to think, a time to be, and a time to do. Sometimes, we just need to act and go through the motions, even when we would rather not. There are many treatments for many illnesses that have uncomfortable phases or components. Even when you do not want to do something and even if you do not enjoy the experience, you will feel better about yourself for keeping commitments, acting opposite of unhelpful thoughts and emotions, and being brave enough to try.
2. Accountability. Find a buddy who will help you follow through and go against the grain of avoidance and help you from getting stuck in a rut. Be selective with whom you choose. Do not choose someone who shares your lack of oomph, as they will be too easy to talk out of DOING.
3. Keep eating well. Stick with balanced eating even if you lost your appetite or do not have the motivation to plan meals, buy groceries, cook dinner, and so forth. You are brave. Ask your accountability buddy to help you when you need support with eating. I really enjoy going out to eat with friends. It gets me out of the house, nourishes me, and provides a social connection.
4. Impermanence. Always and never are strong words that rarely apply. Most of life is ever-changing and temporary. Sometimes we get attached to things, and temperance becomes painful when we lose something of importance to us. However, the flip side of temperance is that when things are tough, you can look forward to relief in due time.
5. Dopamine. For some, anhedonia correlates with a dysfunction in the reward system of the brain, especially with the neurotransmitter dopamine. Natural boosters include small amounts of exercise; eating a diet rich in vitamins, minerals, and whole grains; and spending time with people you care about. In some cases, medications may be medically necessary to balance the brain’s chemistry.
6. Svadhisthana: Second Chakra. Being a yogi, I have had a recent interest studying the chakra energy system. I was really surprised between the descriptions of an imbalanced sacral chakra and the symptoms of anhedonia. The second chakra is the center of desire and pleasure. The individual may lack pleasure, sensuality, sexuality, creativity, and emotion regulation. Helpful yoga asanas for the second chakra might include: bound angle, pigeon, cobra, triangle, king dancer, half moon, seated wide angle, and seated twists.

Written by: Heather, Guest Blogwriter

It’s nothing fancy, and if you take the words literally, you have the skill. Basically, if you are experiencing distressing emotions, you act opposite or do something helpful rather than harmful. This does not mean you suppress emotions, rather, it is used to help regulate and tolerate emotions and experience more positive events and growth.

For example, lately my ‘to do’ list seems to be never ending and I have been extremely overwhelmed.  I’ve been experiencing both fear and depression that many mornings I don’t want to get out of bed. My first urge upon awaking has been to pull up the covers and avoid the day. In that moment, I have to use my skills and self-talk to remind myself that ignoring my responsibilities and not taking care of myself will only have more detrimental effects and cause more stress. So, rather than avoiding the day, I take it moment by moment and get myself up, make a list of small steps to accomplish and face the day acting opposite to my fear and depression even though my body and mind might be screaming “no, no, no, no!”

Another example is sticking to my meal plan when all the monster voices in my body and mind want to engage in old negative patterns and behaviors. All I can sometimes hear is “oh, you can skip that meal or snack,” “you ate too much, go get rid of it,” etc. and I have to act oppositely and remind myself that my meal plan is nourishment to my body and without it I would not be able to do the things I love. Sometimes, I have to combine the skills in my toolbox, layering opposite to emotion with distraction or self-soothing actions.

This skill can be extremely helpful with activating the wise mind, so you can create positive events from deregulated emotions. Again, it is not meant to discount emotions! If you are in an unsafe place and experience fear, get out! Don’t own guilt or shame that is not justified. If you need to say you are sorry because you actually did something against your values, apologize. Just remember that even when our emotions run high and everything in us screams “no!” , take a moment to double check the thoughts, feelings, and emotions surrounding them. Before you react, pause and step back to see if it’s an opportunity to act opposite and even begin to take that small baby step toward creating something more positive in its place.

DBT was created by Masha Linehan. For more information: www.behavioraltech.org

Written by: Faith (Guest Blogwriter)