Sleep: An Essential Yet Overlooked Component of Recovery?

If you’re not getting enough high-quality sleep then you are missing out on a huge component of recovery.

Our culture has a funny attitude towards sleep. We love it (because it feels good!) but we also act like it’s a weakness. People boast about how they only need 4 hours of sleep to function as if that’s a noble thing. You don’t hear anyone bragging about how they make sure to get a solid 9 hours of sleep every night. It’s seen as “indulgent” or “lazy.”  

Is it lazy to have lower levels of inflammation in your body?
Is it lazy to be more productive at work?
Is it lazy to retain information when you’re studying?
Is it lazy to lower your risk of cancer and Alzheimer's disease?
Is it lazy to let your body repair itself and increase your muscle strength?
Is it lazy to be more creative?

I don’t think so. Sleep does all of these things.  

The irony is that people who don’t sleep often make it sound like they’re using their “extra” waking hours doing “productive” things like working or exercising. What they aren’t acknowledging is that they’re shooting themselves in the foot because the things they are trying to accomplish are infinitely harder without proper sleep.

What does any of this have to do with eating disorder recovery?  

Everything.

The initial phase of recovery involves stabilizing the eating disorder behaviors and restoring physical health. Even if you can’t see or feel it, your body has internal repairs to do from being inadequately nourished. This is true whether you have anorexia, bulimia, binge eating disorder or anything in between.  

The recipe for these repairs is nutrition + sleep. The repairs require the substrate of food and lots of sleep. In fact, when you're sleeping is when the actual action happens. There is a shift in your hormones when you are in deep sleep that promotes growth and repair.  

Our best shot at deep sleep happens between 10 pm and 2 am. That’s when humans naturally fall into the deepest sleep based on our circadian rhythm and the earth’s light and darkness patterns.  

Tips for getting great sleep

  • Have a bedtime routine - Create a routine that lets your brain and body know that you are winding down and getting ready to sleep.  
  • Go to bed at a consistent time each night - Your body needs to have a predictable bed time to make falling asleep easy. Go to bed and wake up at the same time every day, even weekends.  Sleeping in will throw off your bedtime schedule the next night.
  • Have a fluid curfew - Cut yourself off liquids about 2 hours before bed time to give your bladder plenty of time to empty before bed. We don’t want you waking up because you have to pee.
  • While you’re at it, have a caffeine curfew too - Everyone’s body processes caffeine at different rates. Regardless, caffeine stays in our system for hours and even if you don’t feel the buzz, it can still be impacting your sleep. A good rule of thumb is to cut yourself off no later than 2 pm.  I personally have been shooting for noon as my cutoff time.
  • Avoid screens in the bedroom - The glow from your TV, cell phone, tablet or computer makes your brain think that it’s light outside. And light = awake. It interferes with your body’s natural production of melatonin, a hormone that is higher at night and helps us sleep. And don’t think that taking a melatonin supplement will counteract it because it doesn’t. Your body gets desensitized to the melatonin supplements after a while anyway. Try reading a fiction book before bed - something that gets you out of your own head and doesn’t have you thinking too hard.
  • Keep your room dark and cool - We sleep best when there is no light (not even a night light), and when our environment is cool. In fact, studies have shown that the optimal sleep temperature for humans is 62-68 degrees F. That’s pretty chilly to a lot of people - and if you are struggling with body temperature regulation due to the eating disorder, you may need it a little warmer than this.  

There are tons more things you can do to help yourself sleep better, but these tips are a great place to start. If you are having trouble falling asleep or staying asleep through the night, talk to your treatment providers and they can help you figure out what’s going on. It’s common for people with eating disorders to also struggle with anxiety or insomnia, and there are lots of things that can be done to help with that. 

Give yourself the gift of great sleep. You’ll be shocked at how much better you feel. 

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

Mirror Mirror on the Wall Mirror, Am I Hypocrite After All?

Angie viets - mirror mirror on the wall - eating disorder recovery

One of the biggest reasons I love my job is the amazing people I work with and the opportunity to build relationships with them. Their trust in me as their dietitian is that I not only talk the talk, but I also walk the walk. Many times in my career, statements that I have made to my clients have come back to gnaw in my ear like a pesky gnat. Humble pie can be a hard slice to swallow, but if I am going to be authentic to these incredible yet vulnerable people I MUST do the same as I tell them.

I have always prided myself on how resilient and tough I thought I was. However, if I speak honestly, these two traits are not what they used to be. As a collegiate athlete, I had the energy of a three-year-old on a Halloween candy high and a pain threshold so high that I was up hours after having an emergency c-section because I was determined to be with my baby as much as possible even if my legs were like wet noodles. Now I find myself scheduling power naps so I can function at the end of the day and the slightest possibility of a cold has me trading in my Chardonnay for Emergen-c cocktails because, well, who has time to be sick?

The biggest test of all is now my role as a mother. As independent as we believe these little humans to be, they are also absorbing everything we do so they can model it. As a mother of a young daughter, it breaks my heart to see and hear the societal messages she will grow up with.

Things to keep in mind as you go about your day, unaware that impressionable little ears may be listening:

  • When we get ready in the morning, are we mirroring a woman that is confident in herself – not based on how her outfit looks, but rather by how she is preparing to tackle that day?
  • When you step on the scale, are you giving the impression that the little “hunk” of metal is a grade of who you are?
  • When you are on your “diet,” are you giving the impression that you are not enough and you need to change?
  • When we tell our kids to go outside and run around to get their energy out, what do you think they associate with when you say, “I have to go run to burn off this ice cream?”
  • Do we walk proudly as we are responsible for bringing these amazing people into the world, or do we crawl into a shell so we may not see the amazing blessings that have come our way?

I often wonder if God has possibly put a time line on those youthful traits that I once admired so that I may slow down and enjoy the day with more diligence. Perhaps making myself more aware of pain so that I actually pay attention to what is hurting me? If I could mirror anything to my daughter, my friends, my clients and the world it would be that we need no explanations for who we. Just take me as I am and allow for grace, as I am guaranteed to make some mistakes!

Angie Viets - Rebecca McConville

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

Why We All Need to Read Carolyn Costin's Review of To the Bone

Watch this week's recovery video in which I share my thoughts on To the Bone.

Below you can read Carolyn Costin's official review of To the Bone:

"I was hesitant to see the new Netflix eating disorder movie, To The Bone. As someone recovered from anorexia and an eating disorder therapist, author, educator and spokesperson I generally do NOT like eating disorder movies, documentaries, TV specials, “reality shows” or even autobiographical books about eating disorders and tell my patients to steer clear of them. However, when asked by Project Heal to attend the screening and moderate a panel discussion afterward, I agreed.

The film stirred up controversy even before its release and because of its significance as the first major film on eating disorders with the potential to be seen in 100 million homes, I wanted to ascertain the situation for myself. Did To The Bone have something of value or was it going to end up on the “do not watch” list with so many others.

To The Bone is based on a true story about a young woman with anorexia nervosa, and brings viewers into the eating disorder world, including interactions her family, her doctor, and a variety of other patients in a treatment center. The patients are portrayed realistically, without showing gratuitous scenes of behaviors such as wretching into a toilet while at the same time not glamorizing the illness by avoiding anything that could be potentially controversial or disturbing.

This is a film based on what happened in the life of one individual, not a movie about understanding, preventing or treating eating disorders. It’s not meant to educate the public on the causes of the illness, or how best to treat it. It is writer/director Marti Noxon’s autobiographical story (with some artistic license thrown in). Marti felt her story was important to tell in order to raise awareness about a misunderstood subject.

To The Bone will, for sure, raise more questions than provide answers, and that is exactly what Marti had in mind. Her hope is to promote a conversation about an illness that is still not well understood by the public and does not get appropriate coverage or concern.

The film’s main character, Ellen, has anorexia nervosa, from which more people die than any other mental illness, yet no one has taken it seriously enough until now to put resources into a major film. Marti felt compelled to make a film and make a difference and faced many obstacles along the way. For example, several people whom she tried to get interested in the project told her they did not think the eating disorder topic was a big enough issue. She knew, and many of us know, better.

Are there things I dislike about the movie? Yes. Do I think there were unrealistic parts? Yes. Would I have done things differently? Yes. As an eating disorder treatment provider, educator and activist, I wish there ha been more explanations given about the disorder and that the movie had shown more about how treatment helps people recover. I would have included much more and much different therapeutic dialogue and I would not have depicted the eating scenes at the treatment center in the same way.

Much of the controversy surrounding the film comes from the fact that Lily Collins, who played the part of Ellen, also suffered from anorexia as a teen and yet she lost weight to authentically play the role.

I too was concerned and unsettled upon hearing the leading actress had suffered from anorexia in the past yet lost weight to play the part. As a therapist I certainly would not recommend any of my clients do this. But after meeting and talking to the real person, Lily, her mom and Marti, I learned about the care and thinking that went into her decision including the medical and nutritional monitoring that took place. But even that is not the most important thing here. What is far more important is that Lily is fine. Not only did she not relapse, she found the entire experience “insightful” and “therapeutic” learning many things she did not know or understand when she was 16 and suffering from her eating disorder.

To those who express their anger and boycott the film, I wonder what would they suggest as an alternative? As far as I know, no one has yet offered a better solution for Ellen’s character. Should Marti have found an actress currently suffering from anorexia to play the part? Should some other actress have lost weight for the part? Should she have hired a normal weight actress to play the part of someone with severe anorexia nervosa? All of these alternatives would have brought their own problems, concerns and controversies. To avoid all potential problems or criticism, no movie could be made at all.

You can’t make a film about a troubling topic without troubling people. There is no way to deal with a sensitive, disturbing, and difficult subject, such as eating disorders, without upsetting or “triggering” a sub set of individuals most closely associated with the issue, whether professionals, patients or their families. If no one was disturbed by this film, there would indeed be something terribly wrong. Eating disorders are disturbing, confounding illnesses. Would I advise patients to go, no, they don't need to see it, they already know what the movie is trying to reveal.

The other controversy has so far sprung from those who have seen the trailer and complain that showing a white skinny girl is not fully representative of the spectrum of eating disorders and the scenes might be triggering for those who are vulnerable or already suffer from the illness.

They are right. However, the trailer is not representative of the movie. The movie portrays 7 patients with varying diagnoses, body shapes, gender and color. Particularly arresting is Alex Sharp’s portrayal of the male patient, Luke.

Will the trailer and the film trigger some people, yes, but I found this film less potentially triggering than most. The trailer shows perhaps one of the most triggering scenes of the film. But you can’t make a film about eating disorders without upsetting or triggering some people. During my own eating disorder just watching someone in a movie eat, get on a scale, go on a diet, or work out at a gym was triggering. Any program, of any kind, about eating disorders will trigger some and that will be the case withTo The Bone, but not such that is loses all value which will be as diverse as the people who go to see it.

With my 40 year history in the eating disorder field, I am passionate about anything that can be done to help understand, prevent and treat these illnesses and even though To The Bone has weaknesses and is not the movie I would make, it is still an important step in bringing eating disorders front and center. I can put aside my own biases both as someone who recovered and as a current expert in the field and see this movie for what it is, one woman’s story that is authentic, sad, realistic, disturbing, scary, and true. And as for hopeful, let me just say that the real Ellen, Marti Noxon, is recovered and here to say it is possible and that speaks volumes." - Carolyn Costin, July 14, 2017

Carolyn Costin - Angie Viets

Carolyn Costin, MA, MEd., MFT, CEDS, FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker. In her twenties, Carolyn recovered from anorexia and became a teacher and a psychotherapist. After successfully treating her first eating disorder client in 1979, she recognized her calling. In 1996, she created Monte Nido, the first licensed, residential eating disorder treatment facility in a home setting. Having left Monte Nido in 2016, Carolyn maintains her private practice and remains very active in the eating disorder field lecturing, training, teaching, writing and supervising. In 2017, Carolyn founded The Carolyn Costin Institute, which offers Eating Disorder Mentor and Coach Training, online and in-person Continuing Education for clinicians, and other specialized trainings.

Should You Watch 'To The Bone'? A Yoga Therapist Shares Her Hopes and Concerns About The Movie

Photo Credit: Netflix

Photo Credit: Netflix

When pictures and trailer clips of a disturbingly thin Lily Collins began to show up in my news feed the other week, I resolved to avoid the movie To The Bone and all discussions about it. I wasn't going to watch the trailer, read about the movie, comment about it on social media, or write a blog post about To The Bone, the first motion picture about eating disorders due out in the US on July 14 on Netflix. I was determined to sit this one out and wait for the buzz to pass.  

Collins plays a severely anorexic teenager named Ellen, and when I say "severely anorexic," I am not exaggerating. She's a haunting figure, barely there. She is painfully ill and her body is painful to take in. Even now, writing about her, I feel a pit in my stomach--a raw visceral reaction that comes from a sincere concern for the actress, the memory of and deep care for the women with whom I have been in treatment, and from an honest and personal knowing about the life she portrays in the film. Also unsettling for me is the fact that Lilly has a history of anorexia and bulimia. And now, here she is, as sick as can be again, reliving anorexia. For all these reasons, I was set on not getting caught up in To The Bone. I just couldn't see how this movie and the hype around it would support me in my life.

Low and behold, the very next day after explaining all of this to a friend, I received an email from The Renfrew Center of Philadelphia, asking me to appear as an alumna on a local news station with Samantha DeCaro, PsyD, Assistant Clinical Director at Renfrew to discuss my reaction to the 3-minute trailer for the film. Of course, I was excited (exhilarated really) and quite touched Renfrew invited me to do this. How could I not be? And I am grateful they did, because it turns out I do have some important things to say about the trailer, and I am actually a better woman, mother, yoga therapist, and member of the eating disorder recovery community for speaking out. 

In the less than 48 hours I had to prepare for my 3-minute interview on Fox29, I watched the trailer several times, read articles about the film and its director and lead actress, had a heart to heart with my husband, and put out an inquiry on social media, asking people to tell me about their thoughts, opinions, and concerns about the trailer for To The Bone.

After hearing back from so many people, I felt secure in my initial reaction to avoid the film. Many people had similar responses to Collins' physical appearance. More than that, they were deeply disturbed that the actress has a history of anorexia and bulimia and reported she lost weight in a "healthy" way for the film. Like the others who wrote to me, I am very worried about the message this sends to the recovery community as well as teens and others who are vulnerable to messages about weight loss and the connection between one's self-worth and jeans size. After more than 20 years of healing from anorexia, I can say with confidence, that it is highly not possible to lose weight in a "healthy" way. And there is clearly nothing healthy about Collins' body, and I am worried about the state of her mind after embodying this role in such a dramatic way. 

Based on the trailer, anorexia is clearly front and center. I am concerned that anorexia has become the face of eating disorders in the media. The "thin ideal" has glamorized the disease, making it a one-dimensional disease about weight and food. I am hopeful (fingers and toes crossed) that To The Bone will give voice and attention to other types of eating disorders and that other bodies, genders, races, and a spread of ages will be represented. To exclude these bodies and voices would be a severe shortcoming on the part of the film and an enormous disservice to the eating disorder community, including the families and supports of those who struggle.

I am also hopeful that the movie will portray the complexity of eating disorders as well as capture the resiliency that is possible with proper treatment and dedication to one's healing. The joke in the trailer about "calorie Aspergers" is offensive, and not one appreciated by several of the people I corresponded with on social media. In the context of the movie, it may work. But as a one off, it makes me wonder if the complexity of anorexia will be brought to light. 

Another concern is that the movie's ending will suggest that Ellen gets to go home cured. This just isn't the case in real life, and to give families and supports such false hope could be devastating for all parties involved. Let's hope that recovery isn't itself glamorized as a mountain that is conquered after a few weeks or months away at treatment.

Although I value Collins' lived experience and dedication to her career and mission to, I am concerned that To The Bone will fall short in its efforts to accurately educate. I worry it will trigger many and even set off a desire to be "sicker" in others. Still, I am hopeful that this film will initiate important conversations about eating disorders and their prevention and treatment. I am hopeful that the recovery community will come together with honest feedback about whether or not a motion picture in the first place is helpful. As my husband shared with me, a documentary is much more humane and real; let the individuals who are living it share in real time about their experiences.

There are many more concerns and hopes I have about To The Bone, but I want to turn this blog post over to you now. I'd like to hear your thoughts and opinions about the trailer. Please share in the comments below or email me. It's only from learning from one another that we can grow stronger in our voice and more confident in our right to use it!

Sadly, the video clip of my interview is currently unavailable. Should it become available, this post will be updated!

Jennifer Kreatsoulas - Angie Viets - To The Bone Movie

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications.  Connect with Jennifer.

How Yoga Can Help You Return to Your Senses in Eating Disorder Recovery

Photo Credit: Marion Michele

Photo Credit: Marion Michele

I was 18, pulled from my sophomore year of college, and on my way to inpatient treatment for the first time. I sat in the backseat of the car, curled up in my mother’s arms, cold, weak, and desperately afraid.

I have one distinct memory from that ride to Philadelphia: driving past the old Nabisco factory, which, until it closed in 2015, had filled the entire neighborhood for decades with the smell of sugar cookies. As a child, that smell and the cookies the factory produced were mouthwatering. A source of pure joy. An innocent pleasure. That day the sweetness in the air was a cruel joke. I couldn't bear it. I rocked in panic, my throat closed, I moaned, cried, and buried my face as deep into my mother’s side as I possibly could.

That was the first time my sense of smell had been so intensely stimulated in a while, and it petrified me. Starvation had numbed me and compromised my senses. The fear of smells and tastes were paralyzing. My vision was blurry, and I could only hear my eating disorder voice. All other sounds were muffled in the background.

It’s only through looking back on that memory 20 years later, that I understand how anorexia literally desensitized me. As we all know, our eating disorders serve a precise function: to protect. Along the descent into eating disorder hell, protection turns into destruction, leaving us isolated in the torment.

We hollow out physically, emotionally, mentally, and spiritually. Sensation is unwelcome. Feeling is not the point.
Jennifer Kreatsoulas - Yoga Helps Return to Your Body

In my experience, the healing process from an eating disorder is a tumultuous effort of learning how to “sense” again—how to sense hunger cues, emotions, our bodies, our intuition, and how we feel in relationships. It’s also a return to our literal senses, sensations, and sensory experiences. In many ways, this aspect of healing—returning to our senses—is what resuscitates our souls by bringing color, textures, and richness back into our lives.

How do we go from numb to sensory human beings?

I find it to be an ongoing process that requires support, patience, and resilience. In my healing, yoga has helped me return to my senses in profound ways. For me, yoga is a safe place to learn how to feel and name sensations that happen in my body. In half pigeon pose I sense an intense stretch in my hip, in forward folds I feel discomfort in my hamstrings, and in triangle pose I notice the sensation of expansion. The more I have become comfortable identifying, naming, and sitting with physical sensations that arise in my body, the easier and more natural it becomes to name and feel emotions, even the painful ones.

The practice of naming physical sensations can be applied to other activities as well. My advice is to find an activity that you enjoy and take stock every so often of what you feel and where you feel it. Name the sensation. Become familiar with it. Observe it. This skill will become useful for naming emotions and experiencing them versus turning to symptoms to banish them.

I recognize that naming sensations in our bodies can aggravate or cause turmoil around body image. Even so, healing requires we name those feelings too. Part of regaining our senses is also knowing and defining our limits. Trust your instincts around when and how often to practice identifying sensations.

Like all aspects of healing, returning to our senses is also a process.

Yoga has also helped me develop my sense of sight. Before I used to stare down food like I would an enemy. Or I'd avert my eyes, turn away from what was fearful. In yoga, we often talk about keeping the eyes soft to embody a sense of ease and calm. I’ve noticed that when my eyes are soft (meaning I am not scrunching up my forehead to fiercely concentrate), my thoughts are kinder. I judge, berate, and demand less. I am more open to the sensory experience of the pose and less concerned about controlling the outcome.

Applying soft eyes in difficult life moments has often made the difference between making a positive choice versus an unhealthy one. Soft eyes have also helped me to stand in front of the mirror and see myself from all angles with compassion.

On a final note, as I recall the Nabisco factory and the difficulty it caused me that day, I can’t help but smile when I imagine how happy the smell would make my two little girls, how much it would light them up, and how they would beg me to stop for cookies. Children have the most beautiful relationship with their senses; automatic, curious, simple, and joyful. Little ones represent the model of what’s possible for all things good. They remind me how much more fun sensational is than numb.

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications.  Connect with Jennifer.

Just Eat the Damn Cupcake

Photo Credit: Joseph Gonzalez

Photo Credit: Joseph Gonzalez

It seems we have entered an era where eating a cupcake is either as provocative as Christian Grey or as rebellious to culture norms as Lady Gaga. When did food become so powerful that it now is assigned a moral value: bad vs good, healthy vs unhealthy, clean vs unclean?

Some have described this constraint as willpower, however, willpower is defined as control exerted to do something or restrain impulses. Impulses are a sudden strong and unreflective urge or desire to act; willpower can be disrupted by emotions and depleted over time. Does this sound like energy that should be devoted to making decisions such as whether to eat a cupcake?

I bet you're thinking, I can't get the damn cupcake out of my head now. The brain has taken over and the brain always wins! So, let’s go back to the whole Christian Grey fascination. This has been labeled the "Ironic process therapy" or, as I call it in my practice, "the bad boy effect," which is the psychological process where deliberate attempts to suppress certain thoughts make them more likely to surface. So whether you're trying to avoid thinking about a cupcake because you think it is "unhealthy" or staying away from Mr. Grey since your girlfriends tell you he is nothing but trouble, you now have ignited your brain to hyper focus on both.

This process is worsened by stress and can eventually lead one to have more immoral out-of-character thoughts. Insert a clip of Miranda on Sex & the City here – the episode where she tries to avoid eating cake she has in her apartment by pitching it into the trash, only to later be at her wit's end diving back into the trash inhaling cake in a binged manner.

Although avoiding relationships with characters such as Mr. Grey are likely in your best interests, why can't there be a healthy relationship with delights such as cupcakes? This has led me to ditch diet mentality that strives off imbalance and join the Intuitive Eating movement. Intuitive Eating believes in the power of neutralizing all foods' meaning – not assigning moral value to one food over another. Yes, this means cupcakes and quinoa should be considered equal. This does not mean they necessarily have the same nutritional value, but like many struggling with perfectionism, culture has now decided that diets are the new thing to perfect.

For those of you not familiar with Intuitive Eating, following are the key principles:

  • Reject the Diet Mentality
  • Honor your Hunger
  • Make Peace with Food
  • Challenge the Food Police
  • Respect your Fullness
  • Discover the Satisfaction Factor
  • Honor Your Feelings without Using Food
  • Respect your Body

These principles incorporate choosing foods – not only by taste – but also by prioritizing how it nourishes your body. I love a great cupcake (personal favorite is Gigi cookie dough), yet if I had it daily it would not provide the same satisfaction and likely not appease my hunger.

So, the next time you really want a cupcake, put the children to bed, take a deep breath, put Fifty Shades on the screen and ENJOY!

Angie Viets - Rebecca McConville

Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.

The Phantom Pain of Trauma

Photo Credit: Joshua Fuller

Photo Credit: Joshua Fuller

Let’s talk about trauma.

Not all trauma looks like a war veteran who hits the ground when a car backfires. (Although that is very real and very frightening).

Some trauma looks more like scar tissue. Or like a vine that has wrapped around a tree trunk. It grows with you, shapes you, distorts the way you branch out into the world.

Over time it becomes a part of you. You barely even feel it anymore. There are only subtle traces of it — maybe a nagging ache in an otherwise happy moment, or a dark thought that surfaces from seemingly nowhere.

Not feeling is not the same as healing.

It simply means you’ve accommodated it, made just enough room in you for the two of you to coexist. (Often, trauma pays its rent in drugs, alcohol, or food.) But the result is that you move through life without ever knowing why you act the way you do. Why you never managed to grow out of that propensity to self-sabotage or self-destruct.

Trauma, left untreated, changes who you are and how you look at the world. (After all, trauma by definition is a type of damage to the mind that occurs in response to an event that exceeds one’s ability to cope.) Your primary goal — conscious or not — becomes shielding yourself from experiencing that perceived threat ever again. Even if it means withdrawing from the people around you. Or turning to booze, drugs, food, sex, and whatever else can dampen your overtaxed emotions (or the opposite — can dissolve the fog and let you feel something).

The pain of trauma doesn’t always come from the content of a memory or flashback. Sometimes the pain you’re trying to “escape” (as the doctors say) is the accumulation of bad choices you continuously make to regulate yourself. The pain of loneliness after intimacy became too risky. The pain of self-doubt when your thoughts and feelings seem alien. The pain of chronic stress and anxiety that churns your gut because, if the trauma occurred early enough, you didn’t develop the coping strategies that other people use to manage life’s normal oscillations.

Trauma isn’t always nightmares and intrusive memories. Some trauma is more insidious. It’s not the direct pain of an open wound, but the phantom pain of growth that never occurred. And until you deal with it, your movement will be forever restricted.

I’m learning to move freely through the world.

Joanna Kay is a New York City writer and social media professional in recovery from a 14-year battle with anorexia. She is the author of The Middle Ground, a blog that chronicles the period between completing treatment and reaching full recovery. Having encountered many hurdles accessing treatment, she also writes frequently about insurance coverage and other urgent issues facing eating disorder patients. Joanna is a mental health advocate with the National Eating Disorders Association and writes and speaks widely about the recovery process. Visit her blog.

Flip the Script: 3 Ways To Boost Your Self-Image This Summer

Photo Credit: Pexels

Photo Credit: Pexels

As summertime approaches, many people begin to get more critical of their bodies in anticipation of wearing bathing suits and being more exposed while out in the sun.

This can be a time of massive anxiety for some who may feel unhappy with their bodies or for those who may be struggling with or are in recovery from eating disorders and or body image issues. Visions of walking into a pool party or onto the beach and stripping down to a bathing suit can be a source of panic for people who are already self-conscious of their appearance on a daily basis.

It is important to approach this time of year by staying focused on having a healthy and positive mindset. With that, a key step to maintaining a good outlook is knowing how to eliminate thoughts and behaviors that could lead you down a negative path. Here are three ways to flip the script and have an emotionally healthier, self-esteem building this Summer.  

1. Overcome Negative Thoughts About Self-Image

Overcoming negative self-image thoughts about yourself or others around you during the summertime can be challenging. This is when eating disorder voices scream the loudest, and this is also when we need to extend the most compassion and gratitude to ourselves.

It is somewhat natural to experience negative thoughts about self or body image in the summer as we are often comparing ourselves to other people. It may sound silly, but honoring the thoughts as they arise and acknowledging why you may be having them is a great way to flip the script.

When you catch yourself in this mental state, express gratitude to yourself for how far you have come, the hard work you have put in to living a healthy lifestyle and give yourself some grace for the pain you may be experiencing underneath those thoughts.

For example, you may be feeling down because of something you ate that makes you feel guilty. Say to yourself, “This is a great opportunity to learn from my thoughts. Why does it make me feel bad? Is this realistic? Or is just my eating disorder that is trying to raise its voice?" Staying in awareness of your self-talk can help you overcome negative thinking.

2. Focus On Building Healthy Relationships

Getting rid of toxic relationships is a fundamental component of sustaining good mental health. Relationships take a lot of energy and if we are focused on the ones that drain us or are toxic to our health, it opens the doors to negative thinking and self-destructive behaviors. If you are inside a toxic relationship with a loved one, it may be wise to distance yourself from them for a while.  

Instead of fighting old relationships that are not working or supporting you, concentrate on building new, healthy relationships or even working on developing current relationships you have that could be a more positive influence on you. Reach out to people who leave you feeling uplifted and motivated. Fostering these types of relationships can be a powerful way to stay optimistic.

Being mindful of who you allow into your life and mental space is imperative. Romantic relationships, in particular, can be full of ups and downs, so it is important that you stay vigilant with creating healthy boundaries and honoring the most important relationship you truly have, which is the one with yourself.

3. Keep A Positive Attitude

If you are experiencing negative thoughts and emotions, the best thing to do is to let them out and give them room to breathe. The more we try to push them away or bottle them up, the more likely we are to move down a negative path. Allowing ourselves to feel can help us work to shift our thoughts to more positive ones.

Another great thing to do to keep an optimistic and positive attitude is to play and do things you love like going for a walk, doing yoga or dancing to your favorite music. When we make time to be playful, laugh and have fun, we naturally move away from any self-destructive thinking.

If you or a loved one are struggling with negative thought patterns or body image issues, contact us today to learn more about how we can help you navigate these tough waters.  

Angie Viets - Foundations Recovery Network

Foundations Recovery Network’s mission is to be the leader in evidence-based, integrated treatment for co-occurring mental health and substance use disorders through clinical services, education and research. Our vision is to be the best at delivering effective, lasting treatment and providing superb experiences across our continuum of care in all places.

Our treatment programs also have the flexibility and focus to address whatever stage of recovery our patient is in even if the stage of mental health recovery does not match with the stage of addiction recovery. The use of motivational services based on the patient’s stage of readiness will promote engagement, retention and solid long-term recovery outcomes. This sets our program apart from other treatment options.

Started by Foundations Recovery Network (FRN), Heroes in Recovery is a grassroots movement that seeks to remove the social stigma associated with getting addiction treatment and being in recovery. The Heroes movement is about building a recovery community that bands together to share powerful stories of personal transformation in order to inspire others to get help.

6 Simple Tips to Manage Eating Disorder Recovery on Vacation

Photo Credit: Slava Bowman

Photo Credit: Slava Bowman

You're away from home. You may not have a kitchen. You might be traveling to a place with foreign foods. Your schedule might be thrown off by long travel times, different activities, and time zone changes. While vacations are exciting for most people, for those of us in recovery from eating disorders, they can be more than a little stressful.

It can be tempting to say, "It's okay, I'll just figure it out as I go," but why take the risk? Having a plan may feel a little square, but it's better to have a plan so you can relax if things are going well than to struggle and have no plan for getting back on track. Whether you're heading abroad or traveling closer to home, here are some tips to manage vacation time in eating disorder recovery.

Tip #1 - Communication

Funnily enough, one of the most important factors in eating disorder recovery is also one of the most important factors in travel - communication. Talk to your travel buddy about your needs and concerns. If you need to stop and eat at regular intervals, talk about that. If you're planning on doing something outside of your comfort zone (trying a new food, wearing a bathing suit in public), talk about how they can support you.

Be very clear about what you need, and about what you DON'T need. Sometimes it can add stress to have someone asking about your food choices, and monitoring your bathroom usage. If your buddy is checking up on you more than they need to, you can communicate that, too.  "Thanks for checking in, but I've worked out a plan for this part of things. I'll let you know if I need any support outside of what we discussed."

Talking openly about this stuff will set your mind at ease and, most likely, theirs, too. Navigating eating disorders can be tricky - for you, and for those supporting you. Having a clear plan, and knowing how everyone fits into it, can really help make everyone more comfortable.

Tip #2 - Research

Something else you and your travel buddy can do together before you go is research. Figure out where you're staying, and what the food prep options are there. Will you have a kitchen? A mini-fridge? Is breakfast included? Knowing whether you can prepare some of your own meals or if you'll be dining out almost exclusively can help you plan.

You can also look into what restaurants are available near you. Check out the menus, choose a few options that look good to you at each, and write down some places you'd like to try. You don't have to schedule which ones to dine at when, but it's helpful to have choices narrowed down so you don't get overwhelmed. Think of it as "planned spontaneity".

Tip #3 - Do A Test Run

If you're traveling somewhere that has different food options than you're used to, do a test run before you leave. Let's say, for example, you're traveling to Japan. You'd like to try sushi there, but it's not something that you usually eat. Do a test run, in a safe way, before you go. Go to a local sushi restaurant and try a few different varieties. If there isn't a Japanese restaurant in your town, try making a fish and rice-based meal at home.

Get used to the flavors, and investigate how that type of meal works for you. Did you order enough, or would you need a side or another roll to make a satisfactory meal? Did you feel energized after, or were you a little sleepy? This can help you determine where sushi fits into your day when traveling.

Tip #4 - Pack Some Favorites

Even the best-laid plans sometimes go awry. Your flight might be delayed. You may sleep through your alarm and have to rush to the next activity. You may just need the comfort of a familiar food. So pack some.

While I would wholeheartedly encourage you to try new things as often as you can, I recognize that it's not always possible. Having some travel-safe snacks on hand can really help you out in those moments. Take along some protein bars, trail mix, crackers, etc. that you can eat on-the-go, or when things get stressful. Then, plan to get back on the horse. Cook something, order in, or go to a restaurant. Just try not to rely on packed snacks the whole rest of your trip.

Tip #5 - Keep Things (ahem) Moving

Travel can wreak havoc on the digestive system. It's not anything permanent, but constipation and its associated bloating can be triggering for those in recovery. Make sure you're drinking an adequate amount of water, eating some fibrous foods like veggies or beans – don't neglect your fats – and take a walk around the block when you can. You can also talk to your team before you go about the best strategy for you, if constipation hits.

At the end of the day, try not to stress about it. (Easier said than done, I know) Make sure you've packed some stretchy-waisted pants, and try to stay mindful whenever possible. You're hanging with some cool people, seeing some really awesome stuff. Try not to let the only memories you make be of digestive stress.

Tip #6 - Roll With The Punches

No matter how well you plan, there will always be something you didn't see coming. Whether it's a lost pair of sunglasses or a snack you hadn't anticipated, try your best to stay flexible. Breathe, use your buddy for support, and dive in.

Life is all about the unexpected, as is travel, as is recovery. Your challenge will be to keep moving forward, and trying to find the enjoyment wherever you can. Who knows? Maybe that wrong street you turn down will lead you to an amazing view you wouldn't have seen otherwise. Keep your eyes and heart open, and bon voyage!

Angie Viets contributors - Kelly Boaz

Kelly Boaz, CNP is a Toronto-based Holistic Nutritionist (CNP), specializing in eating disorder recovery and food freedom. After winning her 17-year battle with anorexia, Kelly Boaz turned her life’s focus to helping others do the same. She is also a writer and speaker (TEDx, TDSB), raising eating disorder awareness, and helping people heal their relationship with food and their bodies. You can find out more about Kelly, or get in touch via her website.

What to Do When Your Eating Disorder Throws a Tantrum?

Photo Credit: Julian Santa Ana

Photo Credit: Julian Santa Ana

Does the eating disorder ever kick and scream inside your head, demanding that you obey and making you feel like crap if you don’t?  

It’s like living with a toddler in your head.

This rings even truer for me now that I have an actual toddler who is throwing tantrums.  During a recent tantrum, I was sitting there thinking about what to do and it went something like this:

-What is he upset about?
-Can something be done to help?
-Should I give him what he wants, or should I set a boundary and say no?
-This is really hard.  
-I notice that my body is really activated right now - my heart is beating faster, my stomach hurts, and I just want to spring into action.
-I am feeling angry, frustrated, helpless and sad.  
-This is totally like when the ED throws a tantrum!

The short vs. long-term dilemma

When the eating disorder throws a tantrum, you basically have 2 options: 

a) You could give in to the eating disorder's demands and quiet the voice now.  

b) You could say no to the eating disorder and suffer the wrath of those loud thoughts, and probably feel crummy about yourself for a while.  

The problem with choice “a” is that by giving in you have reinforced the behavior. It’s like buying the tantruming kid the toy he’s pleading for. The message conveyed is that throwing a tantrum gets him what he wants. Same thing with the eating disorder. By giving in you have reinforced that neural pathway, which becomes more and more automatic over time.  

The challenge with choice “b” is that it’s going to be difficult right now. And that’s really hard.  Just like when my son tantrums, it’s painful as a mother to watch your child cry and feel upset.  But I know that in the long-run he’s better off with the boundaries. It teaches him to work through the discomfort, rather than expecting to always get his way.  

An important point

What you are doing when you choose to tell the eating disorder no – in the face of a tantrum – is very important.  

You are showing yourself that you CAN work through the discomfort.  

You are also showing yourself that you CAN stay the course in recovery, even (especially) when the eating disorder doesn’t want you to.  

Ultimately this is what it takes to recover. Those boundaries are there to keep you safe. The eating disorder behaviors are self-destructive and at times dangerous. So even though the boundary doesn’t feel good in the moment, it is ultimately protective.  

How to take care of yourself while the eating disorder tantrums

It is important to give yourself lovingkindness while the eating disorder is throwing its tantrum.  

Start by noticing that the tantrum is happening and that you are actively making the choice to disobey the eating disorder.  

Give yourself compassion for how hard it is. You might tell yourself, This is really hard right now.  It sucks that I am going through this. I trust that it will eventually pass. In the meantime, I am going to be kind to myself, and firm against the eating disorder.

Be intentional about your next move. Make an empowered decision about what you are going to do in the face of the tantrum. For example, if the eating disorder is telling you to skip lunch, you could make a plan to eat lunch with a friend for accountability.  

Ride the wave. The tantrum will be like a wave that comes and goes. It might crest multiple times before it completely passes. You can’t prevent the waves from happening, but you can learn how to ride them. It may help to distract yourself with something kind or productive.  However, don’t forget to check back in with yourself later to make sure that the eating disorder isn’t being sneaky and working in other ways.  

You will find that with practice, your tantrum-resisting muscle will grow stronger. You will become more and more aware of when the tantrum is happening, and you’ll feel confident in your ability to respond in a way that is both firm and compassionate.  

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

5 Reasons Why Yoga is So Good For Your Mind and Body

Photo Credit: Body Love, Soul Purpose

1. As a discipline for the body and mind, yoga helps you cultivate vibrant health. Yoga is a superb form of balanced exercise and offers a potent source of calm in our stress-filled lives.

2. Yoga is a powerful mind/body system that has helped countless people achieve inner peace and fulfillment. Yoga helps you reconnect with yourself from the inside out by working with your body and breath, your mind and emotions. 

3. Yoga allows you to release body-stored memories, fears, and traumas that trap you in the past. Yoga helps you to achieve emotional balance, live in the present moment, and begin to feel joy (again). 

4. The wisdom of yoga helps you to navigate the ups and downs of everyday living. Yoga helps you to lovingly explore your self-doubt and struggles, welcoming time and again, the life that you have, imperfections and all. 

5. Yoga can lead you to accept your body, uncover your particular gifts, discover your own true self, and cultivate a more satisfying life in the world. 

If you’re interested in learning more about how yoga can play a part in your recovery, and/or would like to participate in a Women’s Fall Retreat that will incorporate all of the recovery-focused benefits of yoga above, click here for more information

Rachel Daggett - Angie Viets

Rachel Daggett, MS, MFTI is a Wellness and Recovery Coach and a Registered Therapist Intern. She has a private practice in Manhattan Beach, CA, and strives to be an active force of empowerment and love in the community. Through struggling with her own eating disorder and journey of healing, and now being recovered, she has become an advocate for eating disorder recovery and mental health. Rachel has a Masters degree in Psychology, and believes in the importance of caring for the mind, body, heart, and soul as a whole. Rachel is a yogi, a dog-mom, a beach-girl at heart, and has recently started studying the natural healing power of essential oils. Visit her website

Is There a Perfect Way to Eat?

Photo Credit: Rachael Gorjestani

Photo Credit: Rachael Gorjestani

In my practice as a Registered Dietitian, I talk a lot about food. Clients ask about which foods to eat, how much to eat, when to eat… Many are extremely confused with the information they have gotten from friends, family, colleagues, healthcare providers and the media. It can certainly be challenging to make food choices when we are always bombarded with conflicting information.

It can be both reassuring and unsettling to know this truth:

There is no single way of eating that will work for everyone.

Often, this is not what people want to hear. Instead, they want the magic formula that will give them health and happiness. Unfortunately, I can’t provide this (and nobody can, no matter how good their marketing is!).

Instead, I can offer support, compassion, and guidance. Although everyone’s needs are different, here are some general themes I address with many clients.

1. Eating on a regular basis

For most people, having regular meals and not going too long without food is beneficial. While needs vary greatly, more than 4-5 hours without eating is detrimental in many cases. Not everyone will require snacks, but they can certainly be helpful. Explore what works best for you based on your schedule, your preferences, and your body’s needs.

2. Being curious about your body’s signals

Our body gives us many clues regarding our needs. If you are in the early stages of healing from an eating disorder or chronic dieting, you may find that your hunger and fullness cues are unreliable or simply non-existent. This is quite normal. At first, you may need more structure around meals. However, you can still try tuning in to see what your body is telling you. Maybe you are tired and need more rest, or maybe you are thirsty and need hydration. Be curious about what your body is telling you. It’s smarter than you think!

3. Eating a variety of foods

One of our best ways to ensure we are getting enough nutrients is to diversify the foods we eat. It sounds overly simple, but getting foods from a variety of sources can be helpful and ultimately, much more satisfying. For many healing from eating disorders, food choices can become very limited. When you feel ready, and if you are able, connect with a therapist or dietitian who can guide you in experimenting with fear foods in a safe way.

The bottom line

There is no such thing as the perfect way to eat. What works for one person may be completely inappropriate for someone else. Explore your needs and wants, and try noticing what works for you. What brings you the most energy, the most happiness? This is most likely what is best for YOU.

Remember: You are doing the best you can. You’ve got this!

Josée Sovinsky is a passionate Registered Dietitian working in a community setting in Toronto, Ontario. After facing her own struggles with disordered eating during her degree, she developed a strong interest in helping those affected by eating disorders and mental illness. She decided to learn more about intuitive and mindful eating, body acceptance and Health at Every Size®, which now strongly guide her work. She dreams of a world free from mental health stigma, body shaming, and disordered eating. When she is not helping others make peace with food, she enjoys baking, photography and doing yoga in her living room. Visit Josée's website and connect with her on social media.

Are You Managing an Eating Disorder or Healing from One?

Photo Credit: Catherine McMahon

Photo Credit: Catherine McMahon

“I’m not going to help you manage an eating disorder,” my dietician flat out said to me shortly after I discharged from intensive outpatient treatment. “I’ll continue to work with you, but I won’t help you be a functioning anorexic.”

Whoa! Harsh, right? Brutally harsh, I’d say.

Her words hit me hard in the gut. I felt nauseas and defensive. I was at once insulted and found out by her remarks. After months of inpatient, day, and IOP treatment, and a commitment to long-term outpatient work with my team, I was insulted that my integrity and dedication to recovery wasn’t obvious. Had I not just left my family for a month, taken leave from my job, eaten meals I was terrified of, gained weight, persevered through calorie increases and exercise restriction, and turned myself inside out every day to heal my mind and body? Honestly, what else did she or anyone else want from me?

Still, way, way deep down, I knew my dietician was right. Yes, I had done and accomplished quite a bit during all that treatment; no one was taking that away from me. However, I admit, at the time, living as a “functioning anorexic” was quite appealing. The perfect solution.

If I could pull off being a “little sick and a little well,” if I could do just enough to keep my team and my family off my back, then surely, I’d be “doing” recovery. I’d just be doing it on my terms—or, I should say, the eating disorder’s terms. I’d prevent weight gain, still have room for a little hunger, and feel in charge of my life.

Living this way did not get me very far, and it wasn’t long before I was weary of performing, pretending, and being untruthful to myself and those I love. Merely functioning wasn’t as “safe” as I’d thought it would be. In fact, it was the exact opposite, as the threat of returning to treatment consistently came back in play every few weeks.

I may have dabbled with how “recovered” I was willing to be, but there was positively no way I would settle for being a chronically ill mother and wife. That’s where I drew the line.

And so, I kicked myself into gear by taking a more genuine and sincere approach to healing from rather than merely managing the eating disorder. I did this by adopting the attitude that recovery is a lifestyle, not a side job or something “extra” we must do.

Between therapy appointments and going to groups and keeping food logs, recovery can feel like a time-consuming side job. Over time, this attitude toward recovery can cause us to become resentful. The more resentful we become, the less motivated we are to keep up our efforts.  

When respected as a lifestyle, recovery serves as the foundation from which we must attend to everything in our lives to keep us well and moving forward. To make recovery a lifestyle, I strive to let every choice I make be informed by this question: Is “x” going to support me in my healing or is it going to work against me?

Reflecting on this question guides me to honesty with myself about the people, places, and things in my life that merely help me manage an eating disorder versus those that support me in healthful ways. I choose to avoid the landmines and replace them with things that empower me and build me up. It’s not always easy, but this system of self-accountability has made a profound difference in my approach to recovery and deepened my commitment to myself.

Take a pause and ask yourself: Am I managing or healing the eating disorder? Are there thoughts, rituals, and behaviors in place that covertly are in cahoots with the eating disorder?

There’s no shame in your answer. What’s most important is taking this time to get brutally honest with yourself. I encourage you to tap into your resilience and slowly but steadily begin to loosen the grip on things that do not serve you in healthful ways and replace them with thoughts, rituals, and behaviors that do.

As you shift away from the “functioning” and “managing” mentality and embrace an intention of healing, life will ultimately become more filled with you and the goodness you have to offer this world—your gifts, talents, and passions. And I promise you, it is so worth it!  

Jennifer Kreatsoulas, PhD, RYT 500 is the founder of Chime Yoga Therapy and specializes in eating disorders and body image. In addition to her private yoga therapy practice, Jennifer leads yoga therapy groups at the Monte Nido Eating Disorder Center of Philadelphia, is cofounder of the Body Kindness Project, and a partner with both the Yoga and Body Image Coalition and the Transformation Yoga Project. She is the creator of the home video series Yoga to Strengthen Body Image and Support Eating Disorder Recovery. Her writing on the topics of yoga, body image, motherhood, and eating disorder recovery can be found on her blog as well as several influential online publications.  Connect with Jennifer.

More Than Weight Has Been Gained

Image Source: Pexels

Image Source: Pexels

The Road to Residential

Two years ago today, at 5 a.m. on a frozen Tuesday morning, my fiancé and I rented a car and drove 100 miles from New York City to Philadelphia, where I would be entering residential treatment for anorexia. I’d been in a day treatment program for a little more than seven weeks by that point, but it had become clear that I needed more help. My weight, already dangerously low, hadn’t budged, so my treatment team determined that my best chance at recovery would be in a 24/7 care facility.

I had no idea how long I would be gone. I didn’t tell anyone what was happening. With the exception of my fiancé, my mother, and my therapist, everyone assumed I was safe and sound in New York City going to work and planning my wedding. Not even my bridal party — who by January were finalizing dresses and accessories — knew that their texts to me were, in fact, being answered by my fiancé, because I was not allowed to keep my cell phone at the treatment center.

I worried that I wouldn’t be discharged in time for my bridal shower and I’d have to find a way to explain my absence. I worried what would happen when I arrived at my first dress fitting with vastly different measurements than the ones that had been ordered for me months earlier, while my weight was plummeting.

Nothing was certain other than the fact that we were on the road and there was no turning back. From the passenger seat, I watched the city skyline recede in the side mirror and tried not to think too much about the radical action I was undertaking.

More Than Weight Has Been Gained

When I wrote about this day last year, I was only just starting to realize how much I had lost to my eating disorder in the eleven years before I walked into treatment. I felt sad thinking about the frightened, confused, empty young woman I was.

Now, in this second year, I’m conscious of how much I’ve gained throughout this recovery process. I’ve gained physical health, emotional wellbeing, and mental strength. I’ve gained friends and community, as well as meaning and purpose. Perhaps most important of all, I’ve gained a more intimate and honest relationship with my husband, which I wouldn’t have been capable of having if I were still preoccupied with my disordered inner life.

For all of this, I feel immensely grateful to the team of people that has helped me along the way. These treatment providers — therapists, nutritionists, psychiatrists, counselors, mentors, and more — are truly heroic. I am alive because of the care I’ve received from them.

In this spirit, I want to share an interview with you, because I think it demonstrates what I’m saying here. I recently had the opportunity to speak with Dr. David Susman, a clinical psychologist who runs a website dedicated to mental health, wellness, and recovery from mental illness and addiction. Dr. Susman regularly posts “Stories of Hope” on his site, and he was kind enough to include me in his latest installment.

Click here to read the Q&A, “Living in the ‘Middle Ground’ of Recovery.”

(Thank you again, David!!)

The Only Way to Heal

Along with the gratitude, I can’t help but re-experience some of what I was thinking and feeling about on this day last year. The thing is, I don’t feel these emotions as sharply as I did then. I’ve spent a solid amount of time in therapy feeling and processing and then feeling again, because that is the only way to heal.

Leaning into these feelings seems to be working. Each day, I feel a little less angry that anorexia is part of my life story. A little less afraid of a future without weight loss as my go-to coping mechanism. A little more convinced that this eating disorder will be a chapter of my life and not my entire story. I’ve begun to make peace with this whole ordeal.

Thank you for joining me on this journey.

Joanna Kay is a New York City writer and social media professional in recovery from a 14-year battle with anorexia. She is the author of The Middle Ground, a blog that chronicles the period between completing treatment and reaching full recovery. Having encountered many hurdles accessing treatment, she also writes frequently about insurance coverage and other urgent issues facing eating disorder patients. Joanna is a mental health advocate with the National Eating Disorders Association and writes and speaks widely about the recovery process. Visit her blog.

What Guilt Has to Do With Embracing Your Authentic Self

Source: Pexels/Thnh Phng

Source: Pexels/Thnh Phng

Has your self-help turned into self-criticism? Read this article featuring the first part of my interview with Danielle LaPorte, author of White Hot Truth.

Are You Free?

“How has your day planner changed and morphed with this revelation?” I ask, hoping she’ll send me a screenshot of her week ahead to verify the transformation.

Instead, she delivers something much sweeter, “There’s an inner-peace now, a calmness, and a feeling of spaciousness. There’s room to be myself. Room for the answers to show up. Room to change my mind. I’m no longer attached to others beliefs. Time has expanded.”

With all that talk of inner-peace—still an ever-elusive concept to me—I wanted to ensure I was getting the real deal. Knowing Danielle was raised Catholic, much like myself, and a working mother, I needed to test out her humanness; make sure she wasn’t this fully enlightened spiritual anomaly, but a legit woman like me who swirls around a shit storm of emotions on the regular. Clearly, it’s not cool to ask someone, “Are you for real? Can I trust that what you’re dishing out is reliable and authentic?” Instead, you gracefully enter a side door and ask about guilt. Why guilt? Because as women, the willingness to openly talk about what doubles us over with guilt is a litmus test for authenticity I’ve found reliable time and again.

“I noticed you mentioned the “G” word earlier, what’s your relationship like with guilt?”

There’s a pause. I notice this pattern in our brief time together. It’s not my sense she desires to give a perfect answer to prop herself up, but more a need to be precise and honest. It takes courage to pause long enough to check in with yourself to offer clarity. 

“It’s always there, but I’ve got it in check. Guilt is part of having a conscience. Guilt is part of being a loving, caring person. When you expand you’re going to bump up against other people. Someone’s feelings are going to get hurt. You’re going to erect some boundaries. It won't be easy. As you choose what’s most loving for yourself you create disharmony which may create some guilt. I feel less and less guilty about the hurt feelings that occur from making healthy choices for myself.”

I snuggled in a little more to her realness. Her truth is also mine. Guilt lives right here inside of us all AND, it doesn’t have to be a current that takes us under.

“Saying no for me is pretty clear. I don’t want to go backward. Saying yes when I mean no leads to exhaustion. There is a very basic equation when determining where to spend my time: Social media or my kid? An extra hour of sleep or a book review? Getting sick or pleasing someone else? Saying no becomes much easier when health is your priority.”

Loving her more with each #truthbomb I secretly wished we were sitting on her deck, instead of me sitting on the floor of my office, criss-cross applesauce. “Danielle, when do you feel most disconnected?”

“When I’m not being feminine. When I shift from being this juicy fluid girl, to being too harsh, abrupt, or abrasive I feel instant regret. I replay the incident over and over in my head sometimes for the next couple of days. Eventually, I let it go and endeavor not to do it again; until the next time.”

We both crack up laughing because this is white hot truth. Screwing up and then making peace with yourself is exactly what it means to be on a spiritual journey. We mess up, get out of alignment, and then, with courage we forgive ourselves, let it go, move on, and then circle around it again, because guess what, we are human and this is our work. The goal, the evolution, perhaps the revolution, is not to spin out for two days forever, maybe you cut it down to two hours, but we get back into alignment with more ease.

“I was recently talking to my shrink about this very situation and how gross it felt. She shared with me that you are becoming more yourself and you step out of that space it’s even more noticeable. You can hardly bear the lie.”

I feel her truth in my bones. My heart whispers, “Mmm. Hmm. Just like me…”

“May I Shine So that Other’s May Shine As Well.”

I asked Danielle to open our conversation with an intention. “May this conversation bear the truth of light that helps other people see their capacity to grow. May everything that comes of this be all about love and clarity. And so it is.”

You can soak up more of Danielle on her website where you’ll also find her book.

Hungry for more?

*Part 1 in this blog series can be found here.

Angie Viets, LCP is an author and clinical psychotherapist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible! Read more.

Danielle LaPorte’s White Hot Truth Soothes Self-Help Fatigue

Source: Unsplash/Annie Spratt

Source: Unsplash/Annie Spratt

Has your self-help turned into self-criticism?

The self-help struggle is real. Collectively we search for the truth, our path, and purpose from the outside in. We seek answers from psychologists, psychics, and priests without slowing and softening to the wisest guru of all: Ourselves. During my sultry conversation with Danielle LaPorte about her newly released book, White Hot Truth, she shed some light, because, as she says “it’s all about the light,” on how she became her own guru.

Danielle vividly explained the moment when she realized she was at a “jarring juncture: the conflict between sincere spiritual aspiration and the compulsion to improve.” As she opened her day planner and saw upcoming appointments with a shaman, psychotherapist, and astrologist, along with scheduled massages and yoga classes, she had a revelatory moment where she realized “all of this self-helping was becoming a bit of a burden and impinging on my ability to create with a capital C. Spirituality was becoming just another thing on my f*ing to-do list.”

Through breathy prose she broke down how she questioned her spiritual quest and transformed her to-do list, thus creating freedom and fluidity. With her lyrical lathering in full force (by the way, I highly recommend the audio version of the book; you can thank me later) I noticed my shoulders settling into their natural position, less like accessories for my ears, more gliding down my back like wings. My breath eased its way into a gentle rhythm as I physically released the anxiety of my own daunting self-help regimen.

What is this feeling overcoming me as this diva I’ve admired for years (and secretly channeled in moments of insecurity) – thanks to her rockstar books like The Desire Map and The Firestarter Sessions – reveals her process and progress (because, as she says in her Canadian accent, “everything is progress”) to me? Ah, yes, it’s relief! Relief that there’s another way. Relief that we can still be self-evolving, spiritual seekers, without stressing ourselves out on the regular. Without drowning ourselves in green juice cleanses and repeatedly clearing our chakras. We can liberate ourselves from the perpetual spiritual striving through discernment and self-love. Finally!

“It’s Not How We Seek Spiritual Growth; It’s Why We Seek It.”

Many of us, myself included, are drawn to the vast sea of self-help. Investing copious amounts of cash to feel free. We sign up for the lightworker retreat, past life regression, and some oh-so-necessary karmic healing. Yet, ultimately—I’m speaking from my own decades worth of psychotherapy, angel card readings, and psychic sessions—it wasn’t ever quite what my soul needed to truly heal. Why? Because everything I thought I could find ‘out there’ was already inside me. I’d become dependent, tethered actually, to the feedback from others that only I could best offer myself. What once was a young woman chained to an eating disorder like a dog on a leash, was now someone addicted to guidance from experts. Looking to strangers to tell me about…me. Someone who could only get quiet and still in a yoga studio. I was missing the point.

It’s painful to be lost, for sure. However, suffering is waiting for someone else to bring you home when you knew the way all along. You don’t need to wait until next Wednesday at 2 p.m., or head to an ashram to get clarity about your path, because, as Danielle says, “the best self-help is self-compassion.” Guess what, it’s free!

Self-Help or Self-Hate?

When Danielle described, in her alluringly poetic way, that underneath all of our self-helping is a whole hell of a lot of self-hatred I heard myself silently screaming, “Hell ya, sister! Preach!” I mentally scanned the thousands of self-help books I’ve purchased in an attempt to transcend whatever self-imposed trap I was caught in. Books with promising titles like, 10 Steps to Radical Self-Acceptance, left me feeling frantic as they gathered dust on my nightstand. Why do I continue to buy into the notion that a book, sermon, or healer holds the key to unlock the door to my evolution? Probably because it seemed easier.

Without question, I’m devoted to spiritual growth, healing suffering (my own and others), and tending to my psyche and soul. There’s nothing inherently wrong with these soul goals, unless, they disempower you, or require you to disown your deeply held inner wisdom. Seek the counsel of others as a conduit to connecting with your truth, not as a means to adopt others' truth about you.

Compulsive Self-Improvement     

Danielle believes, “We are driven by the compulsion to improve. We all look so healthy on the outside, but we’re really actually pretty neurotic on the inside.”

Danielle is clear that she didn’t ditch her spiritual to-do list entirely, she’s found a more useful sequencing of priorities. “Self-referencing is a lifelong journey. I meditate daily, pray, or engage in some sort of contemplation. It’s like brushing my teeth, it has to happen.” Therapy continues to be on her agenda, but it’s evident she’s no longer reliant on it to make a decision.

White Hot Truth is the permission we all need to check in with ourselves deeply, with reverence, and to listen to the wisdom of our bodies and souls. We don’t have to throw the baby out with the bathwater. Keep the yoga class if it serves you. Call the astrologist if you’re in the mood. But let’s stop the perpetual insanity of striving to perfect what was never intended to be perfect. Let’s greet ourselves—our messy, sometimes arrogant, or inconsiderate selves—with compassion, gratitude, and unabashed acceptance. We have everything we need. Already. We are wholly (or holy) enough even when we feel dreadfully inadequate. Beautiful even when we feel broken. The solution is not out there, my love, it’s right here inside. Go talk to the part of yourself that knows. Find her on the trail alongside the river. Find him in the pauses, those quiet moments in between. Sit in your own company and dwell there long enough to remember yourself. That’s the way home. Those are the moments where we hear the truth. Lean on others for support, yes, but don’t let their interpretation or analysis be your sole compass.

Get White Hot Truth!

Hungry for more?

*Part 2 in this blog series will be published on Tuesday, May 23rd, 2017

*I'd love to inspire you to take the next step on your path to recovered and send you my free weekly Recovery Tip videos. Please visit my website to sign up.

Angie Viets, LCP is an author and clinical psychotherapist in private practice. She specializes in the treatment of eating disorders, body image, and overeating. Angie is dedicated to empowering others to nurture their body, mend their relationship with food, and to embody their most authentic self. Her passion for the field was born out of her own hard-won battle with an eating disorder. She believes that full recovery is possible! Read more.

Learning to Trust Your Body Again

Source: Getty Images

Source: Getty Images

Think about the eating-related thoughts that go through your mind on any given day:
“You shouldn’t eat that, it’s too high in sugar.”  
“You can’t be hungry already, it’s not time to eat for another 2 hours.”  
“That has waaaaay too many calories in it.  You don’t deserve to eat it.”  

Notice a common theme among them?  

It’s the overall distrust of your body and your appetite. The eating disorder makes you believe that your own body is working against you and that if you listened to its signals you’d be fat, unhealthy, and completely unworthy of love. Ouch, pretty harsh, huh?

As Geneen Roth, author of multiple books on compulsive overeating, dieting and body image, has said: 

"Your body is the vehicle for your spirit and your soul. It is the piece of the universe you've been given to tend, to care, to cherish. Without it, you couldn't sense or taste or touch or feel."

Why do so many of us distrust our appetites? We’ve been taught to believe that if we ate what we wanted we’d eat ourselves into oblivion. We’ve been taught to fear food and to fear our appetite. The “war on obesity” has become a war on our bodies. Fear of becoming fat has made us afraid of food and afraid of our desire for food.

Sarah’s story (name and details changed for privacy)

Sarah is a client who I first encountered well into her recovery. She was no longer starving herself or abusing her body with purging or excessive exercise. Yet she was still plagued by food and her body. “I never feel full when I try to eat normally. It’s as if I could just keep eating and eating,” she told me. “The only time I feel full is when I’ve binged and am stuffed, and then I feel so ashamed and guilty and disgusting that I want to purge. Those urges still come up sometimes.”  

Sarah was still disconnected from her body. Sure, she was eating at regular intervals throughout the day, but it still had very little to do with her actual appetite cues. It was more of a prescribed regimen for eating. Thus, she ate pretty much the same thing every day because she knew how it would make her feel, and she trusted that it was the “right” amount for her body to maintain its current weight. Any deviation from this made her anxious and uncomfortable, which made holidays and social gatherings hard. It was also hard when she had a food craving for something out of the norm.  

The rupture of trust

How does this distrust of the body happen? Usually, it starts in childhood or adolescence. We are born with a natural trust of our appetite - babies cry when they are hungry, and stop when they’ve had enough milk. Toddlers and small children tend to do the same with food.  

We can learn a lot from children when it comes to eating. They will eat when they are hungry, and will stop when they aren’t. The amount they eat will vary from day to day - some days they eat a ton, and other days hardly at all. That’s because they are tuned into their bodies and trust their body’s signals.  

At some point, however, well-meaning adults interfere. They start trying to control and dictate the child’s eating by saying things like, “Eat your vegetables and then you can have dessert,” or, “You don’t need all that sugar, it’s bad for you.”  

Yes, the adult is trying to help the child eat a balanced diet and to be healthy, but it’s backfiring. Because the underlying, unspoken message is that the child shouldn’t trust what their body has said. The appetite cues should be ignored and suppressed. Wanting something sweet is seen as bad, and the dessert must be “earned” through the holy grail of vegetables.  

Then look at the broader culture we live in, with terms like portion control, detox, gluten-free, dairy-free, fat-free, sugar-free…we’re afraid of food and afraid of our appetites for it.  

Fear-based eating is taking the joy out of food. We need to stop being so afraid of things like sugar, fat and salt. Reality is, they make food taste good. AND foods with sugar, fat and salt do still make a nutritional contribution to our diet. By definition, nutrients are something that the body must have, and sugar is just a carbohydrate, which is a macronutrient along with fat, and salt is an essential micronutrient. That’s how your body sees it when the food is digested and absorbed into your blood stream.  

Rebuilding trust with our body

It’s time to love food again, and to enjoy foods that taste good. Eating is a sensory experience, from the sight to the smell to the texture to the taste of the food. We experience eating with our whole body. And the food is literally the fuel that keeps us alive. Not something to be afraid of - something to be cherished!

The wise Ellyn Satter, a fellow dietitian and eating expert, has said: 

"Go to the table hungry, pay attention while eating, and stop when you are satisfied, knowing that you can come back and eat again when you are hungry later. Eating is meant to be enjoyable."

It takes time to repair and rebuild trust with ourselves. The eating disorder is invested in you distrusting your body and will continue to try and convince you of the ways in which you can’t trust yourself.  

As your True Self gets stronger and you gather more and more attuned eating experiences, you’ll start to see “proof” that your appetite can be trusted. As for Sarah, the client I mentioned earlier, she was able to do this. It took time, patience and persistence. Every eating experience was an opportunity to take a leap of faith that her body knew what it was doing and would guide her appropriately. Sure, sometimes she made mistakes, and sometimes she questioned if she really could trust her body, but over time she was able to see that her appetite was truly calibrated to her body’s needs.  

Some tips for rebuilding trust:

  • Have regular, consistent eating times throughout the day. Your body needs to know and trust that it will get fed again in a few hours. 
  • Keep snacks on hand in case you get hungry sooner than anticipated. Your body also needs to trust that you will feed it during those unexpected times that it gets hungry.
  • Include a wide variety of foods. Keeping food interesting and varied will help your body get all of its nutritional needs met, and it will help you feel satisfied by the variety of flavors and textures of the food.
  • Eat without distractions. Pay attention to your food, like a toddler intently eating and savoring the food off her plate. Paying attention to your food will also foster paying attention to your appetite, and you’ll more readily notice when you are feeling satisfied. 
  • Treat your body with compassion. You will make mistakes with eating. It’s a fact of life. Even normal eaters do it. You’ll sometimes under eat, and sometimes overeat. Notice this sensation without judgment, and give yourself compassion for the discomfort you are experiencing. Let your body guide you on what and when to eat again. 

Process, not perfection

There’s no such thing as perfect eating, so don’t even bother trying. Disappointing for you perfectionists out there, I know! But also potentially freeing? It allows you to experiment with your eating without judgment or fear of failure. Most importantly, it allows you to experience the joy of eating again while trusting that your body will guide you.

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

Leaning Into Yourself: Abandoning Fear & Embracing Yourself

Source: Arno Smit/Unsplash

Source: Arno Smit/Unsplash

We’re all just walking each other home. - Ram Dass

We went around the room, one by one answering the question proposed by our graduate school professor in the Counseling Psychology program I’d recently been accepted into: “Once you complete your master’s and doctoral degrees, what do you intend to do?” Perpetually anxious, I hyperventilated as each member of my cohort detailed their future research plans, careers in academia, and other equally intimidating (and boring, in my opinion) pursuits.

“Angie, what about you?” Dr. Wesley asked sincerely, his head slightly tilted while he awaited the response of yet another ambitious scholar.

“Um, the truth is this is my backup plan.” Oh, God! Holy shit. Did I really just say that? “I mean, I’d like to become a therapist one day, but my real calling is to be a mother.”

Two seconds and twelve hundred heart palpitations later, he moved on awkwardly to the more sophisticated classmate to the right of me who whispered in my ear, “That was awesome!”

Graduate school was a series of humiliating moments, much like this one. Thankfully, despite my profound lack of interest in things like Multivariate Statistics, Research Methods, and Cognitive Neuroscience, I fell in love with courses like Approaches to Psychotherapy and Psychopathology, Group Dynamics, and how we develop and form attachments. In the midst of classes, papers, and presentations, I also made deeply personal and meaningful relationships with my peers, which come to find out is an essential component for healing others.

During graduate school, I got engaged, married, and had my first baby, in quick succession. While my peers wrote their dissertations, I wrote thank-you cards for wedding and baby showers. As they accepted internships, I accepted—for the first time since childhood—my body and its majestic ability to heal itself and expand to meet the needs of a growing baby. I rooted myself in therapeutic techniques and theories, yet more importantly, I found I was most grounded by my inherent gift to nurture and nourish my baby.

I skipped graduation to attend a trip for my grandparent’s 50th wedding anniversary. Knowing I accomplished the goal meant more than celebrating it publicly, for this accomplishment was much bigger than most people realized. Applying and getting accepted into graduate school was my first giant leap toward recovery.

Despite my insecurity about not being smart enough to get into graduate school, my fear of starting something new and then quitting it when it got overwhelming, all the while hiding out in my illness feeling like a complete fraud as I once had, proved to be an outdated narrative. I flipped the script. I rewrote the story. I discovered I was far more capable than I ever gave myself credit for.

I recovered myself in graduate school. I recovered from an eating disorder, and I recovered to my future passion for helping others heal. There was no hospital or outpatient treatment team (although that would have been ideal). There was the enormity, and often illusory outline, of a dream of living a life beyond the fragmented abyss of an eating disorder. Even when I felt unworthy, I walked towards it. Even when I felt discouraged and defeated, I took another step. I showed up, over and over, for myself. But let me be the first to say, I was a hot mess. I was all over the place and nowhere. I was oozing out and hollow. Uncomfortable and convinced I had to keep going. It wasn’t graceful or glamorous, it was mostly gut-wrenching until it wasn’t anymore. It certainly was not perfect, but somewhere inside I knew I was reclaiming my one true self.

Something shifted later that year, however. The wedding gifts and the framed degree went unnoticed as the incessant demands of mothering ensued. My gratitude for my body’s ability to heal from an eating disorder, to grow a precious little soul, and capacity to deliver that soul into the world became overshadowed with loneliness.

Day after day my husband would leave and go out into the world where there were people, actual people that he talked to, and much to my irritation, would sometimes even have the audacity to go out to eat with them. What?

I was increasingly aware, as I meandered through Target, that this whole motherhood thing was terribly misleading. As I sat in circles with other mom’s during “Books and Babies” at the library, I heard a voice, a loud, demanding voice that said, “Get the hell out of here!”  But where would I go? “Books and Babies” felt like my one shot at connecting with other moms. Other women that maybe, just like me, were feeling like something critical was missing.

I couldn’t figure out why my whole life I had prepared for this thing that I knew without question I was called to do was equal parts misery and magical. My deepest felt sense at the time was that something was wrong with me. Why can’t I just be content with staying at home with my baby? I felt guilty, like some invisible force field of mother’s were frowning down on me, looking at each other with disgust, “Of course, it’s still not enough for her.”

As my son, Beckett, approached eighteen months I sought out and accepted my first position as a therapist at the local mental health center. I shopped daycares like my life depended on it, and in some ways it did. I needed the comfort of knowing my sweet baby would be well cared for while I went to work.

The first several weeks of dropping him off were horrific. His little body clung to me like a rabid animal desperate and afraid. I walked out into the parking lot sobbing, as other mothers hoisted themselves into their SUV’s and reapplied lipstick. I had morbid images of extracting this agony (wherever it lived in my body) and tucking it under their back tires to end the suffering.

When I was at work, I longed to be with Beckett, but when I was at home I couldn’t wait to go back to work where I could put my clinical skills to use. But no matter if I was at work or home, I believed I was failing somehow. I needed help.

My sturdy, reliable eating disorder, my method for managing such complicated feelings, was well into remission. As though handcuffed to the steering wheel I was committed not to turn back to the now rusty behaviors, eager and anxious for me to employ them. I just couldn’t. I knew in my heart, finally, that I simply was unwilling to return to a life dictated and tethered to an eating disorder. There’s got to be another way out.

Pregnancy was the ultimate invitation to heal my body. Motherhood, however, unfolded a rich tapestry woven with opportunities to heal my past and reconnect with my soul.

Fourteen years recovered, three children in my nest, and a million hours clocked in as a therapist later, I’ve reconsidered and reshaped my beliefs about what it means to be called to a profession or a role. Each whisper from our soul is beckoning us to expand, to doubt and underestimate ourselves mercilessly so that we can then more fiercely stand by our own side empowered and emboldened with the knowing that we once again exceeded our limiting beliefs and stepped into the fullest version of ourselves.

So with graduation and Mother’s Day upon us, I’m giving you one hell of an oversimplified recipe for recovery:

  • Walk daily towards one of your soul’s callings.
  • Watch as each step you take towards your passion you shed another thin layer of your old unhealthy ways.
  • Marvel at how messy and majestic you are as you make your way.
  • Lovingly acknowledge each detour and setback as the next lesson to remind you of how strong and steadfast you are despite the distractions and discouragement.
  • Advocate for yourself like you would for a child.
  • Allow your symptoms to guide you home.

Why It's Okay to Dislike Your Dietitian in Recovery

I distinctly remember the day as a hospital dietitian that totally changed my perspective on my profession. I had received a consult for a gentleman who had suffered a heart attack and underwent open heart surgery. With my educational materials in hand, I went to his room and knocked on the door. “Come in,” he said.  

I explained, “My name is Katy and I’m one of the dietitians. I’m here to talk to you about your eating. Your doctor wanted me to go over some information with you before you go home.”  The next thing he said shocked me. “You can tell it to my wife. She does all the cooking.”  

With my poker face I said, “Ok, sure,” and went on to provide the cardiac nutrition education to his wife, hoping that the patient would overhear it and learn something himself. I couldn’t understand why he didn’t care.

In hindsight, I can now empathize with what he was going through. It must have been shocking and terrifying to suffer a heart attack, and very painful to have open heart surgery. The food on the cardiac diet at the hospital probably didn’t taste that great. He needed some time to wrap his mind around what happened, and to take a personal inventory of the changes he needed to make in his life. Then, when he was ready, he would be more appropriate for nutrition education. Hearing me preach to him in the hospital wasn’t going to be helpful.

The thing that was so shocking to me about this encounter was that I had been operating under the assumption that my patients always wanted my help. Especially after something as life-altering as a heart attack. I couldn’t understand why he had no apparent interest in hearing the information, or why he was dumping all of the responsibility for his eating on his wife.  

It was my first real insight into the psychology of working with people as a dietitian. How could it be that they didn’t want to hear what I had to say and do what I told them to do? [gasp]  

Then I started working with clients who have eating disorders and it was like a slap in the face. Talk about people who don’t want to do the things you suggest. If you’ve never stood toe-to-toe with an eating disorder, it’s hard to imagine what it’s like. The best analogy I have is to compare it to a parent telling their child no they cannot stay up late, or no you cannot touch the hot stove, or yes you need to brush your teeth - and the kid spins into a wild rage, lashing out, saying “NO!” or “I hate you!” The parent is doing these things for their child’s own good, but the child doesn’t like it. Eating disorders are much the same way. The person’s true self secretly feels safe and secure (hopefully) that their dietitian is telling them what’s best for their body, but the eating disorder doesn’t like it and will lash out.  

Things I’ve been told by clients with EDs:

  • I don’t like you.
  • F&*$ you!
  • I don’t see the point in coming to these sessions.
  • I’ve always hated dietitians.
  • I honestly don’t want to be here.
  • My parents/therapist/doctor made me come but I don’t really think I need it.
  • I already know everything about nutrition. 
  • There’s nothing you can do that will help me.
  • I don’t trust you.

On the surface, these statements may sound really offensive, and I have to admit that the conflict-avoidant and sensitive part of me always cringes a little bit, but these statements aren’t about me as a person. They are about the threat that I represent to the eating disorder. (And if it is about me not being a good personality fit for the client, that’s fine, I’m happy to get them hooked up with another RD, but this isn’t usually the case with this type of defensiveness and rage.)

The dietitian is the person on the treatment team who is asking you to disobey your eating disorder. The person who is challenging the eating disorder's lies. The person who is helping you see the ways in which the eating disorder is destroying your body. The dietitian is asking you to do the thing you are most afraid of - to eat according to what your body needs, and to cope with your emotions in alternate ways. This may mean gaining weight. It may mean letting go of the fantasy that if you just ate xyz foods and weighed X pounds then your life will somehow be better.  

I get it. It’s uncomfortable, challenging, scary, and often outright infuriating to see a dietitian.  So, it’s ok to kinda hate your dietitian. We understand and we try not to take it personally. At the end of the day, I’m not here to be your BFF. I am here to help you recover. And if I’m never making the eating disorder mad, then I’m probably not doing my job.  

What I can promise you is that I am not fragile, and I will not crumble under the wrath of your eating disorder. My office is a safe place to let out your emotions. And no matter how angry and intimidating your eating disorder gets, I will still be here to fight the fight along side you. You can hate me AND I will still be your cheerleader and advocate for recovery. Maybe someday that hate will turn into gratitude and mutual respect. Many people who recover will say in hindsight that their dietitian was the most challenging member of their treatment team to work with, but was absolutely essential to their recovery.  

So, even if you hate seeing your dietitian, keep an open mind.  She (or he) is there to guide and support you through the difficult process of recovery.  

Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City.  She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.

Interview on the ED Matters Podcast

I got the amazing opportunity to be interviewed on the ED Matters Podcast, hosted by Kathy Cortese! We discussed the unique challenges for recovered therapists treating eating disorder patients. 

Getting excited? You can listen to the interview on Gürze-Salucore's website

For more inspiring interviews subscribe to ED Matters on iTunes, Google Play, or Stitcher.

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