Last week we talked about Poodle Science and the importance of accepting our bodies at every shape and size. One of the techniques that I mentioned that I use for eating disorder treatment with my clients is intuitive eating.
Diet Culture Perspective
Usually by the time I begin working with eating disorder clients, they have gained an unhealthy perspective on food. This perspective usually comes from family, friends, media, and diet culture. My clients view certain foods as good and other ones as bad. According to their perspective, the only way to be “healthy” is to follow a strict diet. This means religiously counting calories, limiting certain food groups, or staying far away from “bad” foods as defined by whatever diet they are on. Throw in excessive exercising, vomiting, and other dangerous habits, and we have a perfect storm for an eating disorder.
What is Intuitive Eating?
One of the ways I help clients going through eating disorder treatment is by helping them reexamine their relationship with food through an intuitive eating lens. Intuitive eating is based on the belief that we are already born with the signals we need to adequately nourish our bodies – all we need to do is learn how to listen.
There are a number of principles or main ideas behind intuitive eating, and I am going to highlight just a few:
Some Intuitive Eating Principles
Honor your hunger: Being hungry is your body’s natural way of telling you that it needs fuel to keep you going.
Make peace with food: There aren’t good food and bad foods. Rather, there are foods that are more nourishing to your body and there are foods that are more nourishing to your soul. We need BOTH!
Respect your fullness: Being full is your body’s natural way of telling you that it’s fueled up and ready to go!
Respect your body: You may not love your body, but learning to respect it can go a long way in your recovery.
Process your emotions in healthier ways: Most people with an eating disorder have used food or restriction to self soothe or to numb out. It’s important to learn other ways to process your feelings.
You’re Already a Natural Intuitive Eater
Intuitive eating, in today’s diet culture, seems like a revolutionary approach to eating, but it’s not! From the time we are born, we naturally know how to eat. Babies will cry when they are hungry and stop eating when they are full. A toddler will push away their plate full of birthday cake when they no longer want it. Children and infants know just how much and how often they should eat. The problem is that over time, diet culture teaches us not to trust our hunger and fullness cues.
But the good news is that we can become intuitive eaters again. On a personal note, I struggled with an eating disorder for nearly two decades. There were times when I felt so hopeless, as if my only option was to be on a diet my whole life. But I was SO wrong. Through eating disorder treatment, I have learned how to become an intuitive eater. I no longer struggled with dieting or obsessing over the number on the scale. Desserts or “forbidden foods” hold no power over me anymore. As a result of my recovery, I am happier, healthier, and more free than I’ve ever felt before. Remember this: It’s never too late to heal your eating disorder and become an intuitive eater.
Scheduling and More Information
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I often say to the families I work with, “It’s takes a village to raise a kid.” I do not yet have biological children, so I will never profess to know what it is like to be a parent. However, I do have nearly two decades of experience working with children (first babysitting, then summer camps, then substitute teaching, then crisis intervention, and now, my independent practice).
All of my experiences with children thus far have led me to believe that it truly does take a community to raise a child. It takes teachers, parents, grandparents, aunts, uncles, school counselors and other adults to raise a healthy, well-adjusted kid. If you work with kids in any way, you have likely had an affect on their upbringing. As kids get older, they tend to spend more time in school and in extracurricular activities and less time with their parents, which is why I say “our” children are always watching. While they may not be your biological children, if you are spending a significant amount of time around kids, then you can rest assured that they are watching you, too.
Why does this matter? Well, let’s look at a few examples below:
-A few weeks ago I had a teenager and her mom in my office. It was brought up that during dinner a few nights back, the rest of the family ate pasta while mom ate a salad with grilled chicken. Mom mentioned that the pasta looked amazing but she wouldn’t allow herself to have any because she is on a mission to lose weight. While this may not seem overtly harmful, adults talking about their diets and weight-loss often leads to children feeling highly dissatisfied with their own bodies. -Many years ago when I worked for a crisis intervention unit, I performed an assessment on a young boy who said to me “My dad tells me that he loves me, but sometimes I hear him talking to my mom about how they would have more money if they didn’t have kids.” While dad surely did not mean for his child to hear this, the child now, unfortunately, can never un-hear it. -On a more personal level, when I was in kindergarten, I did not follow directions on one of my assignments. My teacher looked at me and yelled “Are you stupid?!” To this day, looking back on that memory still floods my body with shame from head to toe. -As another personal anecdote, I had a soccer coach in high school who always tried to have genuine conversations with me and made efforts to get to know me on a deeper level. She acted this way with all of the kids on the team. The respect that she had for all of us was palpable and we all felt seen and heard by her.
The list of impressionable moments that can change or solidify the way a child feels about themselves is limitless. What I’m trying to say is this: Kids are always taking in information, even when we think they aren’t. They are listening, they are observing, and most importantly, they are picking up on the feelings of the ones around them. If we’re not careful as adults, we can send dangerous messages to children that reinforce diet culture, low self-esteem, perfectionism, feelings of abandonment and being unloved, etc. All of this can ultimately lead to depression, anxiety, and other mental health disorders.
This is not a call-out to parents only, nor is it an attempt to parent-shame. We’re all doing the best we can and need to treat ourselves and others with compassion. Rather, this is a shout-out to all of the adults in this world, as most of us will find ourselves around children at some point in our lives. The next time you find yourself in the presence of a child/children, please make every effort to leave them feeling like they matter and that they are accepted; for this is how we start building self-esteem in children, which will have positive ripple effects on generations to come.
I have not been feeling well for months. -low energy, aches and pains everywhere, chills, and chronic fatigue. I’m so exhausted that I can barely make it from my bed to the couch downstairs without feeling drained. At first I thought maybe it was depression, but as the months went on, I started to get this feeling that there is something deeper going on with me aside from depression. I have a history of thyroid issues in my family, and I’ve been told by a few doctors that I should keep an eye on my thyroid levels, as they have historically been on the lower end of the spectrum.
Thus, after months of feeling like total crap, I picked up the phone and made an appointment with an endocrinologist, hopeful that this doctor will give me the answers I am looking for. I scheduled my appointment for the end of December – and what did I do immediately after I hang up the phone?
I agonized over the appointment. Every day that it got closer to me having to go to the doctor, I felt my anxiety increasing. I loathe going to the doctor. In fact, I’m petrified. And here is a little glimpse as to why doctors appointments, for myself and many others, are often traumatic:
My recent appointment with the endocrinologist went as follows:
I arrived, checked myself in for my appointment, got my temperature taken, and was called back by one of the techs.
“Step on the scale please,” she says. I respond “Oh, no, I am in recovery from an eating disorder and I cant – ” She cuts of me off. “Ma’am, we really do need your weight if you’re going to be a patient here.” I feel myself starting to shut down. “Ok dont be a big baby, just get on the scale” I think to myself. As I step on the scale, I say to her “Okay but it’s triggering to weigh myself so can you please not tell me what my weight -” She cuts me off again to say my weight out loud in front of multiple other people in the office so that someone else can write it down.
And then the shame starts. I start sweating. “Oh my god oh my god that bitch yelled my weight out to the whole office everyone is going to know my weight oh god I cant breathe.” I walk into the room to wait for the doctor. Soon enough the doctor barges in the door and says hello without making eye contact. She sits down at her computer and asks me deeply personal questions without looking back at me one single time.
“You wrote down that you have PTSD?”
My heart sinks right into my gut. I stammer on my words as I try to give a 15 second elevator speech about my trauma to a woman who isn’t even looking at me. As I finish speaking I start to cry into my mask. “Why couldn’t I just tell her I wasn’t comfortable discussing it?” I think to myself. But I cant help it. I’m with an “authority figure”. I’m playing out my trauma – giving my all to a person who promises to help me but doesn’t actually care about me.
She types on the computer in complete silence for what feels like 15 minutes. She gets up, touches my hands, my ankles, my neck, my chest, and says “There doesn’t seem to be anything wrong.”
I finally start to get angry. “That can’t be right. I’m telling you, I don’t feel well. I know when something is wrong with my body. I am in recovery from my eating disorder and eat better now than I ever have in my life and somehow have put on an excessive amount of weight in the last few months that has me extremely concerned about my health.”
She says “Well, I’ll send you for more bloodwork but in the meantime, you should exercise, 20 minutes a day. Sound good?”
NO THIS DOES NOT SOUND GOOD, DOC. If exercise was the f&%$*@! answer, I wouldn’t be here talking to you, now would I? The problem is that I do exercise, perhaps not as much as I would like because I’m so exhausted I can barely function but I do my damn best. I’m not here because I needed you to tell me to exercise. I’m not here to talk about how to lose weight – I’m here because everything in my body is screaming “SOMETHING IS WRONG.”
But I dont say any of that to her. Instead, I nod through my tears “Yes, I’ll exercise.” and I am sent to the front desk to check out. The woman hands me a piece of paper with the summary of my appointment, in which it says that the doctor discussed BMI with me and I agreed that I was going to exercise every day for 20 minutes.
And I sobbed. The discharge summary said nothing other than that I am overweight and need to exercise. I threw it in the garbage because IT IS garbage. Why why why can we be so obsessed with someone’s weight but be completely oblivious about the trauma that is often behind the number on the scale? Why are we still even talking about BMI? There is a plethora of research negating its validity as a tool for determining health.
How differently could that appointment have gone if she had asked me what is going on in my life aside from exercising? If she had looked me in the eye when she walked in the door and made me feel seen and heard? Would I have been so horribly triggered if they had respected my right not to step on the scale? I guess I’ll never know, but I do know one thing:
This sort of stuff happens in doctors appointments over and over and over again. Folks who are struggling with eating disorders are often masking trauma. When you get to the root of the trauma, you mitigate the eating disordered symptoms. The person then learns how to listen to their bodies and eat intuitively, and their weight becomes whatever it is meant to be.
WEIGHT WILL TAKE CARE OF ITSELF. It is not necessary for doctors to be discussing BMI when 90% of the time, we don’t show up to the doctors to discuss BMI. Weight isn’t, despite what so many people think in this fat-phobic society, the root of all evil. Unprocessed emotions, underlying autoimmune diseases, irregular metabolic functioning, and suppressed trauma, are just a few of the many, many things that are more important than BMI.
I wasn’t given the time of day by this doctor, as has been the case with dozens of other doctors. Instead of leaving with answers for what is going on with me when I know something is wrong, I left full of shame and rage that no one will listen to me when I am doing everything short of screaming at the top of my lungs “SOMETHING FEELS OFF WITH MY BODY PLEASE HELP.”
I’ve been in recovery from my eating disorder for awhile now. I’m more in tune with my body than ever before, but because my BMI labels me as being overweight, everyone jumps to the conclusion that it must be my diet and exercise that are off.
We need to do better. We need to get rid of the BMI are start assessing people’s ACE scores (see https://alyssascolari.com/understanding-adverse-childhood-experiences/ for more info on ACE scores) because this is ultimately what’s going to kill people, not their BMI. You can put someone on the biggest, best diet in the whole world and they will still continue to have health issues until you get to the core of their wounds.
“Trauma-informed” is not just some training that we need to get in order to check off another box on our “to-do” list. It’s a crucial part of the work that all healthcare professionals do. When we start to shift our focus towards a truly trauma-informed practice, I can guarantee that we’ll start saving more lives than the BMI chart ever has.
As somebody who is rarely ever short on words, I find myself struggling to speak lately. I am quiet these days, possibly because I’m not too sure how to put words to the things that I have experienced over the last couple of months that have culminated in me being re-traumatized on multiple levels.
I will never tire of the way in which I feel so alive when I sit with my patients. It feels so natural for me to enter their worlds and help them to make connections, process pain, and heal what hurts. But sometimes I don’t do so well when the roles are reversed. When I become the patient, looking back at my therapist, I am speechless. Perhaps this is because words simply do not feel like enough to describe what has recently transpired in my life.
I suppose I am doing as well as any one person could be doing after being re-traumatized. There have been moments, especially this past week, when I have wanted to crawl right back into the cold, icy arms of my eating disorder -anything to take the edge off and make me feel like I have some sort of control. I’ve had to fight like hell to maintain my connections with safe, supportive people instead of isolating. And once or twice this week, I even had to take the risk of reaching out to my treatment team to help get myself grounded.
The flashbacks have become more frequent and I am finding that the way in which I talk to myself or about myself has become increasingly negative. I’m having to focus nearly all of my efforts into the self-care department. It would be so much easier for me to constantly work so that I don’t allow time or space to process all that has happened, but I’m trying to be intentional about slowing down. My boundaries in both my professional and personal lives have gotten tighter (i.e., avoiding contact with potentially triggering people, setting limits on how many hours I am working a day, etc.). While this process has required an exhausting amount of introspection, I have become much more aware of the things that I can and cannot hold space for right now.
So what does this all mean? Does it mean I’m too sick to do my job? Does it mean I am unraveling and cannot function? Does my pain make me any less competent in my profession?
No. Not at all. If anything, being fully in touch with my emotions and having awareness of my limits right now makes me more competent in my profession than I’ve ever been. I am completely aware of how much I am hurting right now, and I am fully aware that I have more on my plate than I bargained for.
Therapists are humans too, and as a human, being in recovery from PTSD does not mean that I will never have bad days again. It does not mean that I am immune to being traumatized in the future, nor does it mean that I am immune to a relapse in my eating disorder. Relapse is not only possible, but is also probably given my circumstances right now. Healing is not linear. None of us will ever wake up one day and be 1000% cured. The simple act of being alive means we will most likely experience pain multiple times throughout our lives.
But the exciting news is that with every breath I take, I have become more aware and more empowered to take my healing into my own hands instead of self-destructing, which is what I would have done in the past. As distraught as I have been, I have turned away from self-destruction and instead, I have made every effort to take better care of myself than ever before. This is what healing looks like. Healing doesn’t mean that we never hurt again! Healing means that, when the pain creeps back in, we feel more equipped to cope and to persevere. I am healing because although I will never be okay with what has happened to me, I am choosing to love myself through it in every way that I can.
I truly don’t know what the days will bring given my current circumstances, but I do know that with every decision to love myself instead of hate myself, I heal a tiny bit more. I have the tools, the love, and the support I need right now. And when all else fails and I simply cannot turn down the intensity of the pain, the anger, or the worry, I turn back to one of my favorite fictional characters who, I believe, said it best:
“No good sittin’ worryin’ abou’ it. What’s comin’ will come, and we’ll meet it when it does.” – Rubeus Hagrid, Harry Potter and the Goblet of Fire
Today, the day after Thanksgiving, is my favorite day of the year! Yet, it’s also one of the hardest days of the year for those of us who struggle with being elbow deep in diet culture and eating disorders.
The day after Thanksgiving leaves so many of us feeling guilt and shame over our bodies as a result of what we consumed yesterday. Eating disorders and diet culture, at their core, are really all about having control; and in a world that feels more out of control than ever before, I am sure that the urge to over-exercise and restrict food intake as a way to make up for the the calories consumed yesterday is extremely strong.
So I’m here to ask you one thing, and that is to have mercy on yourself.
When you find yourself opening your eyes in the morning and immediately thinking about what you ate yesterday, have mercy on yourself.
When you tell yourself that you need to work out as a form of damage control for the food you consumed, please have mercy on yourself.
If you feel as though the only way you deserve to get through the day today is by eating lettuce that you later end up purging, please have mercy on yourself.
If you find yourself staring in the mirror and pinching and poking the softness on your body, wondering if your stomach is more doughy today than it was yesterday, have mercy on yourself.
When you find yourself starting to feel hungry, but do not feel as though you deserve to eat because you enjoyed yourself yesterday, have mercy on yourself.
And finally, if you find that you cannot stop chastising, telling yourself that you were out of control yesterday, and calling yourself names that are shame and guilt inducing, I beg of you, please have mercy on yourself.
You do not have to spend the day obsessing over how to reverse what you ate yesterday because you did absolutely nothing wrong. One huge meal will not, I repeat, will not have any effect on your weight. You deserve to nourish your body today, whether that means having three full meals with snacks, or snacking throughout the entire day.
Try to check in with your body and listen to what it needs. If we tune out the noise of diet culture, we will discover that our bodies already have the answers to the questions that we have been asking our entire lives. So be extra kind to the body parts that you hate, for those body parts have kept you healthy, safe, and alive far before your brain developed enough to allow diet culture and eating disorders get in the way.
When the guilt and the shame and the urges to restrict, purge, over-exercise, or body check start to creep in, please remember to have mercy on yourself. Not just today, but always.
I am left speechless from the feedback on last week’s blog post! Thank you to those of you who reached out to tell me how deeply you resonated with my words. I value your input and the story that you have to tell because I know how painful and isolating eating disorders can be. I also know the intense emotional pain that lies beneath eating disorders – the pain that most people do not like to speak about, the same pain that we MUST speak about in order to recover. This is such a huge part of what sparked my inspiration for the Light After Trauma podcast.
I view eating disorders as a coping skill for the pain. While I do acknowledge that disordered eating can be learned from family members and societal norms, I have found that more often than not, people use their ED symptoms as a way to cope with painful feelings associated with trauma or abuse. For example, a man may starve himself because he feels like it is the only way he can gain control after feeling so out of control from being sexually assaulted. Or a woman may develop binge eating disorder because the food helps her to stuff down the unwanted feelings that are starting to surface. If she binges until she feels sick, then she will not have any space left over to process her feelings.
With that being said, when I first sit down with a patient who is presenting with ED symptoms, I never ask “So, what’s your trauma history?”
Although I am a trauma therapist, I never directly ask about trauma. If someone is seeing me for help with an eating disorder, then that eating disorder is serving them a purpose – and that purpose is usually to distract or cope with suppressed or repressed trauma. It may take someone months or even years of being in therapy to feel comfortable enough to disclose trauma, especially when it comes to childhood abuse. People will often spend years in their ED, trying to fight off the demons that lurk beneath the obsessive calorie counting and over-exercising. It is not my job to push others to express or acknowledge more of their history than they are ready to. Therapists don’t walk in front of people, pulling them, nor do they walk behind people, pushing them. Instead they walk beside their clients, exploring emotions on the client’s terms, not the therapist’s terms.
But why? Why are people developing life threatening disorders and addictions instead of dealing with their core wounds? Doesn’t it just seem safer to deal with the trauma instead of developing another disorder or addiction?
No. Not necessarily. The feelings of fear, horror, grief, and loss that accompany facing our core wounds can be so intense that our brains cannot process it – either because we are still in the trauma (i.e. an abusive relationship) or because we do not have a sufficient support system (i.e. friends, family, and a good therapist to help you through the process). Unless you’re enveloped in safety, your brain will not allow you to process your trauma because your brain is just trying to keep you alive. We do not choose to be afflicted with disorders and addiction as a way to cope with our pain. The fact of that matter is that sometimes, it is our only option until we can get to a safer place in our lives where we can face the core wounds.
Trauma work is painful. It’s ugly, messy stuff, made even more difficult by those who ignore it, deflect it, and deny it. I have been shut down for speaking out on more occasions than I can count, and I would tell myself over and over again “Some day, the world is going to hear you!” It looks like that day is about to be here soon!
My goal with the Light After Trauma podcast is to help you realize that you can live again after whatever it is that you endured. You can reclaim a life full of love and happiness and support. On my platform, on my blog, in our Facebook community, and on my podcast, there will be no deflection, no ignoring, and no denying anyone’s experiences. While I am undoubtedly nervous about starting up this podcast, I know that it is time to shed more light on what people have gone through and the ways in which they have had to cope in order to survive.
I hope you know how resilient you are.
I hope you know how much happiness can be found on the other side of your seemingly unbearable pain.
I hope you know you are capable of and worthy of an incredible life.
The Light After Trauma podcast launches on August 25th and can be downloaded on Apple Podcasts, Stitcher, Spotify, and wherever else you like to listen. I hope you all continue to interact with me on the podcast in the same way you speak to me through this blog. I know sometimes life can feel so dark, but my hope for all of you is that this podcast can help trauma survivors learn to take back their lives! I am so thrilled to be on this path of recovery with you all.