Family-Based Therapy: Three Steps to Anorexia Recovery, Part 2

As we continue our exploration of the application of Family-Based Therapy for recovery from anorexia nervosa, it might be helpful if we first do a quick review.

In Part 1 of this series we discussed why parental involvement in a child or adolescent’s recovery process is so vital to recovery success. Children need their parents. Parents want and need to be involved. Beyond these simple relational facts, research results have proven that a parent’s active involvement in a child’s recovery process is often a major determinant of a successful outcome.

There are three main stages for implementing a Maudsley or Family-Based Therapy (FBT) approach. The first stage is weight restoration. This phase is nearly guaranteed to strike fear into the hearts of even the most stalwart parents. The basis of this fear and trepidation, accordingly to treating professionals and parents active in the FBT approach, is a simple misunderstanding. Maudsley Parents, another parent support and advocacy organization, explains that the confusion comes in when a parent sees food as different from medicine. FBT treating professionals are able to clear up much of the confusion and fear when they explain to the parents that food is medicine, and as such it is both medically-prescribed and absolutely necessary for the reversal of the anorexic adolescent’s malnourishment.

During the weight restoration phase, the treating team, which often and ideally includes a medical doctor, therapist, dietician, and psychiatrist, coaches the parents on the proper administration and dosages of “food as medicine.” With coaching and support, parents learn how to empathize with the pain, fear, and anger their adolescent may express, while continuing to insist that the child take in proper dosages of the necessary medicine. Family mealtimes and parental supervision of caloric and nutrient intake is a vital part of the success of this phase. Simultaneously, siblings are taught how to support the patient, and the treating team works to help the patient reintegrate with siblings and with the family unit. Parents who persist and learn the skills necessary to successfully navigate the weight restoration phase find that it is tremendously healing and nurturing for both the patient and for the family unit as a whole.

The next phase is one parents will look forward to during the entirety of phase one, because in phase two parents begin turning control of eating back over to the adolescent. The family unit’s ability to transition to this phase is dependent upon the patient’s continued weight gain, acquiescence to continual increases in food intake, and a positive change in the demeanor and dynamic of the family unit. Often at this phase, everyone from the patient to the parents to the siblings is feeling relief that the eating disorder symptoms are being effectively and consistently addressed, and this relief changes the family interactions for the better, reducing resistance and strengthening resolve. Parents can then begin to give the patient more control over food choice and eating. There is a trust bond that is mutually demonstrated and earned again with each meal as parents see that the adolescent is both willing and medically able to make their own sound and healthy food choices. The patient is also able to eat away from the parents to such an extent as they are able to demonstrate the same healthy choices with friends, peers, and other family members that they do in the home. While this phase can feel stop-and-start especially at first, the entire family is encouraged by the patient’s progress through dependence to interdependence to eventual independence in making healthy nutritional choices and practicing effective body care.

During phase three, the focus moves beyond the food to a re-establishment of a healthy adolescent identity. This is the most exciting phase when parents, siblings, and the patient begin to see the real fruits of persistence with the FBT approach. Here, the adolescent is able to maintain 95% of their ideal weight consistently. Signs of desire or intent to self-starve have abated. The patient has newfound ability to navigate mealtimes with relative ease whether in the home or while out with friends or family. Privileges around food come back into alignment with other privileges that signal a growth from child to adolescent into the teen and young adult years. Often there is a much increased closeness within the family unit and signs of the fear, anger, and resistance that characterized much of phase one and into phase two have vanished (also easing residual parent concerns that phase one and two supervision may somehow irreparably harm the parent-child relationship – research results show that for most families the exact opposite is the case). With weight restoration and stabilization and mealtime autonomy also comes a willingness and ability on the part of the patient to look at some of the underlying triggers and issues that may have contributed to the anorexia. In phase three, the patient can begin or resume work with a therapist and other treating professionals to further discuss healthy life coping skills, identity development, and pursuit of life dreams and goals.

Emergence from phase three shows a young, bright, promising future where the anorexia used to be. The entire family continues to exercise vigilance even amidst beaming smiles and a huge, long sigh of RELIEF.

At Southlake Counseling, we have more than twenty years’ experience with successfully treating eating disorders, disordered eating, body image, self esteem, recovery, health, and wellness concerns in children, adolescents, young and mature adults. Our caring, compassionate, professional and highly trained staff partner with you and your family to smoothly navigate all three phases of the Family-Based Therapy (FBT) process. Discover how rewarding and satisfying it can be to become an active participant in your child or adolescent’s health and wellness by contacting us at www.southlakecounseling.com

Be Well,

Kimberly


Family-Based Therapy: Three Steps to Anorexia Recovery, Part I

When I read the words “three steps to…” I usually think, “Oh, here we go. Someone is about to tell me that something very difficult is really very easy.”

Rest assured, that is not going to happen here. I am a licensed treating professional with more than two decades of experience treating eating disorders, but I am first and foremost a parent too, and I know that all individual or family-based positive change takes persistence, patience, effort, and time.

So what I am about to share with you is not easy at all – but it is very possible, and it is highly effective. In this two-part blog series on implementing Family-Based Therapy (also called the Maudsley Method) for recovery from anorexia nervosa, we will examine the reasons behind the newfound acceptance and popularity of a family-based approach to treatment, as well as the three steps every family will follow to implement family-based therapy in the home.

The role of the parent in eating disorders recovery has long been a controversial one. In the past, treating professionals have commonly regarded parents as, if not the main culprits, at the very least a large part of the problem. Parents have been cordoned off from the treating area, banned from the therapy room, locked out of the kitchen.

Today that thought process is changing. Efforts from concerned parents such as Laura Collins, the author of “Eating With Your Anorexic” and founder of the F.E.A.S.T. parent support and advocacy group, and treating professionals like Dr. James Lock, co-author of the “Treatment Method for Anorexia Nervosa: A Family-Based Approach,” have reassured parents that they do have a place in the treatment process – and a vital role that only a parent can fill.

Additionally, there is a growing body of scientifically-sound research that highlights the efficacy of involving the parent in the adolescent’s recovery. The message is clear – parents can learn, parents can help, parents are needed.

For parents of an anorexic child or adolescent, this is very, very good news!

For single parents who are concerned that the process won’t work without a parental team, there is even more good news. Recent research has shown that the FBT approach can work equally well with a single parent head of household. The main determinant of success is not dual parenting but rather parent education, commitment, and involvement in the process.

Stay tuned next week for Part 2 when we examine the three phases of FBT, what a parent can expect during each phase, and a big picture look at a typical outcome for families who adopt the FBT approach.

At Southlake Counseling, we have more than twenty years’ experience with successfully treating eating disorders, disordered eating, body image, self esteem, recovery, health, and wellness concerns in children, adolescents, young and mature adults. Our caring, compassionate, professional and highly trained staff partners with you and your family to smoothly navigate all three phases of the Family-Based Therapy (FBT) process. Discover how rewarding and satisfying it can be to become an active participant in your child or adolescent’s health and wellness by contacting us at www.southlakecounseling.com

Be Well,

Kimberly

Your Say Yes to Life Monday Motivator: The path to body peace is paved with good intentions

In this final post of our three part series on examining body peace, it is time to acknowledge that our intentions have always been good.

Your intentions have always been good.

Not a one of us, when we were small, dreamed of growing up to hate our bodies. I know I didn’t!

While in other blogs I may write from a more objective, clinical space to help you better understand medical complexities in layman’s terms, in this series I am speaking to you directly from the heart.

I want you to know that I, too, had great intentions even while my eating disorder was getting worse and worse, and even when I feared I wouldn’t survive it. At no time in my journey to where I am today was I trying to develop a life threatening disease. I wasn’t trying to kill off my body. I wasn’t trying to worry those around me. I wasn’t trying to fail at life or destroy my potential to live it.

I developed my eating disorder for two reasons. One, I had a biological predisposition to do so. And two, I experienced a variety of environmental triggers that in turn triggered my own inner survival mechanism to  control what was within my power – my own body.

The path to body peace often makes several detours along the way, but there is never a lack of good intentions. In fact, after more than two decades of serving and supporting individuals to move from the dangers of an eating disorder and low body esteem back to the holistic health and wellness they desire and deserve, I can state with the utmost confidence that I have not yet met a person struggling with body dissatisfaction and eating disorders who didn’t have good intentions.

We mean well. We truly do. We are trying to make sense of a complex world full of complex choices and complex people. We are incredibly strong, and even while enduring experiences that might level others, we survivors have found a way to survive.

Now, it may be that the way we survived such experiences in the past no longer works for us now, but that does not take away from the fact that we survived them – somehow.

Again, we had the best of intentions.

So now, to seek and achieve body peace, it is time to re-examine our intentions in light of the new information we have that what we did yesterday or last year or ten years ago to survive is no longer the only or best option we have. It is no longer the path we wish to choose to get to where we want to go.

We are ready to try something new.

Knowing this, we can now make a new intention to choose a different path than an eating disorder or body dissatisfaction to manage life’s stressors.

Wow!

For instance, we can choose to seek help, and in so doing we can choose to work on the intentions beneath our intention to survive, which may include our intention to thrive, to love, to succeed, to connect, to experience, to accept ourselves and others as we are, to serve and give and also receive and appreciate all that life has to offer.

Again, these intentions have never changed – and they never will.

All that has changed is the path we now choose to get there.

At Southlake Counseling, we have more than two decades of experience with guiding and supporting individuals just like you to achieve and exceed your recovery, health, and wellness goals. We offer the full range of professional support services, from dietary and nutritional coaching to group support to wellness consulting to individual therapeutic sessions. Visit us to learn more about how you can put your wealth of good intentions to work for you in a positive, nurturing, self-respecting way as you say “no” to body hate and YES to life! www.southlakecounseling.com.

Be Well,

Kimberly


Your Say Yes to Life Monday Motivator: Without war, we wouldn’t know peace

I know what you are thinking – where there is a will to avoid war, there is always a way.

I couldn’t agree more.

However, after more than two decades working in the clinical field as a trained health professional, it is clear to me that sometimes we are at war before we realize what war is.

At that point, it is time to call a spade a spade and take the steps necessary to return ourselves to the peaceful state we prefer.

For instance, I see many individuals who are suffering from an eating disorder. Anorexia, bulimia, eating disorders not otherwise specified, and binge eating disorder are increasingly common in today’s “War on Obesity” thin-obsessed culture.

Here is the problem we are facing – the world we live in glamorizes declaring war on our own body for the purposes of making peace with other dreams we hold dear – like the dream to be accepted, to be loved, to be successful. Somehow, without our probably even realizing it (I know I didn’t realize it when I was in the early stages of recognizing my own battle with an eating disorder 30 years ago!) we have adopted an internal belief system that states that where we desire peace, we must also accept war.

There is another way.

But for those of us who are suffering with an eating disorder, it is both useless and unproductive to spend time beating ourselves up for what we could have or should have done differently.  An eating disorder is a lethal psychiatric disease for which there are effective treatments, and just like any other disease it deserves our highest respect and the full complement of professional care.

So for those of us who are suffering from an eating disorder, or from other forms of body-war such as low body-based self esteem, poor body image, disordered eating habits, and reluctance to engage in life’s opportunities due to how we believe that we look, we must simply acknowledge that for reasons we may not even fully understand, we have declared war on our body, and we now instead desire war’s opposite – body peace.

Body peace IS possible. I know that it is possible because I too at one time declared war on my body, and I was able to turn my own ship around and instead declare first a truce, and then a state of peace, with my own body.

It is no one’s fault when an eating disorder develops. No one single factor causes an eating disorder to unfold. Eating disorders are a complex dance of biology, psychology, and sociology, and just like for any other disease, when all the causal elements are present in one place, an eating disorder is likely to arise.

What is then important is to turn our attention from focusing on the problem – the war we were waging on our body that we now must wage against our eating disorder – to the opportunity. The opportunity is the chance to get better, and in the process to fully understand our own weaknesses, strengths, motivations, dreams, beliefs, judgments, expectations, needs, and desires at a deeper level than we ever dreamed possible.

In short, we get the opportunity to examine what it feels like to be at war, and to use that example to try on a different state for size – a state of peace. We can literally use the feeling of war to remind us of what we do not want more of, and instead turn our attention to anything that feels unlike war – and use that as a guide to explore moving closer to a state of peace.

In that way, the war can even be a gift. It is a clear sign from within telling us that something is wrong and needs our attention. It is a flag of warning trying to get our attention, and we should thank it for its devotion to warning us now, before it is too late.

If you are suffering with disordered eating, low self esteem, low body esteem, poor body image, or unwillingness to engage in all that life has to offer due to how you perceive yourself in the mirror, you both need and deserve help and support.  I am living proof that there is a different way to live life – before I became a health professional, I experienced what it felt like to stand in those shoes, and that is how I know it is possible to break free.

I started Southlake Counseling, the first comprehensive eating disorders care facility in the Davidson area, for precisely this reason. At Southlake Counseling, our staff is more than just skilled, trained, and experienced. We are compassionate. We can empathize. We have been there and we know how it feels. We can help you say “no” to the precariousness of living life side-by-side with an eating disorder and instead say YES to life!

Don’t let another day go by where you live at war with the skin you are in. Remember, without war, we wouldn’t know peace. To learn more, visit us at www.southlakecounseling.com

Be Well,

Kimberly


Your Say Yes to Life Monday Motivator: Making Peace with Your Body

When I was struggling through the recovery process to overcome my eating disorder, the word “peace” was never found in the same sentence with the words “my body.”

Yet today, I am able to see and support my body in all ways with a feeling of peace and also with gratitude for all that my body does to support me.

You may be reading this – or may even be tempted to skip reading this – for precisely the same reasons I would have been tempted to skip it when I was in the midst of the recovery process.

“Make peace with my body?” you may be thinking, “Impossible.”

But it is not impossible. You have my word on that.

Now, is it easy? No.

Does it happen overnight? Nope.

Does everybody achieve it? Not by a long shot.

But we all have the potential to make peace with our body, to love our body as it is, for all that it is. In fact, making peace with our body is good practice for making peace with ourselves!

But it is up to us. We get to choose how we will go through this life – how we will feel about all things “us” – starting with the physical expression of our uniqueness that we call “my body.”

In this first of a three-part blog series, we will examine some basic concepts that can be helpful no matter what your current state of health or fitness may be. In following posts we will devote more time to examining special instances where making peace with your body is even more critical – for instance, if you suffer from a health condition like an eating disorder.

But first, I want to share some of my favorite basic self-assessment tools that can help you get started on the path to lasting body peace and acceptance.

In my own experience as both an eating disorder survivor and as a professional working in the field, I have found that it is critical to assess where you are as a measure of what is not working and a tool for defining what you want.

So if, in this moment, you and your body live either completely or somewhat at odds with each other, then take a moment to examine where you fall in relation to the statement, “I accept and love my body unconditionally.” What comes to mind first when you read that statement? Jot it down.

Now you know where you are. You just put a dot on your own map – “you are here.”

Next, you have to figure out where you want to go – not where you think it is reasonable to go, or where you think it is possible to go, but where you would like to go. What are your goals when it comes to body peace? Do you long for total body confidence? Total body acceptance? Total body love?

Take a moment and jot down any goals that come to mind. Now you know where you want to go. You have put another dot on your own map – “your destination is here.”

Next, it is time to take a look at what seems to be standing between you and your goal. In other words – if you do not at this present time totally accept and love your body peacefully and unconditionally, then what could help you to do that safely?

It is also of critical important to be realistic here. Otherwise it is easy to set yourself up for failure by reaching for a goal that is literally impossible to achieve, whether due to genetic body type and features, health needs and requirements, or some combination thereof.

When you are done applying these basic assessment tools, you will have a roadmap of sorts that lays out on paper where you are now, where you want to go, and some of our own ideas about how to get there.

The next step is to identify safe, healthy, and affirming tools to help you get there. While it is possible to do this work on your own, it is always advisable to take help and support from knowledgeable professionals as well as family and friends while you are on the journey. Making the transition from body-hate to body-peace can be physically, mentally, and emotionally challenging, and having a knowledgeable, skilled and compassionate support team in place assures the highest chance of success.

At Southlake Counseling, we have more than two decades of expertise in helping people just like you to meet their recovery, health, and wellness goals, including transitioning from a place of total body non-acceptance and hatred to a space where the body is loved and accepted as a valued friend and protector. If you are having difficulty setting and meeting your body-peace and acceptance goals, contact us. We have been there. We know how it feels. We can help. www.southlakecounseling.com

Be Well,

Kimberly




My Steps to Recovery – Saying No to ED and Yes to Life!

I have been asked numerous times over the last twenty years about HOW to recover from an eating disorder and IF it is REALLY possible.  I am here to tell you that Recovery is not only possible, but can become a reality for you, too.

In honor of Mental Health Month I wrote this post to answer that question and to give you some words of encouragement – I recovered from an eating disorder after suffering for over 8 years and now use that experience to help others recover.  My way was only my way and no indication of what will work for you, but my experience may give you some ideas for recovery, as it does contain things I often find useful in working with my clients.  Recovery is a very personal experience, so take what you can use and leave the rest.

What did it take to stop?  Honesty, openness, and willingness. And a lot of hard work and persistence.

Has it been worth it? Absolutely. Today I am free of being controlled by unconscious urges with food and compulsive exercise.  I know how to respond so I don’t have to engage in the behavior. I am more self-aware, healthy, and centered. I also realize that food is just food and weight is just a number on the scale.  Neither can bring me true happiness. And I have finally accepted people don’t like me or dislike me because of my body, but because of who I am as a person.

Is it perfect? No, because perfect doesn’t exist, and I live in a world where focus on body, diet, and perfection is idealized. I need to maintain a certain acceptance, willingness and awareness. But this is such a small price to pay for having freedom.

How did I do it? I am actually working on writing the story of my recovery, but to give you the shortened version, this is what I did and the steps I took.

1)     I accepted that I had an eating disorder and I needed help.  I also came to realize it was not my fault, and I had no need to feel ashamed. An eating disorder is a real medical condition. I didn’t ask to have one, I just developed it due to a combination of many factors; genetics, triggering events, family issues, and peer pressure.

2)     I retired my “Cinderella Complex” and came to accept and realize that no one was coming to save me.  I would have to develop responsibility for saving myself.  Looking outside myself was not the answer, I had to look within and discover my true self.

3)     I came to understand that although it was not my fault, it was my responsibility to do whatever it took to learn to control the urges I had and the actions I took. Thus, I needed to make a decision on how I was going to approach the problem and then begin to do it.

4)     I decided that I would do whatever it took to reach recovery and regain my life. I reached a point where I realized that living with an eating disorder was really no way to live. I could learn to eat in a healthy way, manage my urges, and learn to tolerate my feelings without necessarily acting on them. As Goethe once said, “The moment one definitely commits oneself, then providence moves too. All sorts of things occur to help one that would never have otherwise occurred. A whole stream of events issue from the decision, raising in one’s favor all manner of unforeseen incidents and meetings and material assistance which no man could have dreamed would have come his way. Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it. Begin it now.”

5)     I took the time to educate myself and learned all I could about eating disorders and what was needed to live without one.  I fully accepted it wasn’t about the food or the weight. I accepted that I couldn’t do it alone and that I needed to practice humility and ask for help.  Being responsible for my recovery didn’t mean I had to do it on my own.  I could be vulnerable, admit my imperfections, and live to tell about it.  I could also allow people to help me.

6)     I did self-monitoring for 6 months, an average of five days a week. I learned SO much about myself, my patterns, and my responses to situations, whether I was tired, lonely, angry, or feeling anything else.

7)     I took medication to moderate my anxiety and depression – it didn’t help me to eat, but it enabled me to lift the depression and anxiety I had experienced since childhood, so I could stay motivated with my practice of all the tools I had learned from others, and developed on my own.

8)     I began to focus on the things in my life that were the most important to me and surrounded myself with positive and encouraging people. I learned to identify my true feelings, and noticed that if I expressed myself in appropriate ways, and set good boundaries, I was less likely to be triggered.  Self-care became a huge part of the process.  I learned how to put myself and my needs first and let go of feeling guilty when I said NO. I practiced  meditations, relaxation techniques and learned to enjoy exercise as a way to move my body rather than punish myself for what I had eaten.

9)     I decided that I was willing to accept that this might take a while, but what did I have to lose?  I could either keep living the way I was, which was in misery, or I could begin to practice all the things I was learning and take some risks.

10) I Learned not to beat myself up when I did slip. I came to realize that we DO slip on the road to recovery, or most of us do. So learning to be a little(or a lot)  more compassionate and accepting with myself was a big part of the process.

11) I Learned to measure my recovery not by the scale, but by how fast I got back on track with my life, how little I berated myself, how much I was able to congratulate myself and enjoy all of my accomplishments.

12) I kept a gratitude journal.  In the deepest darkest days of my depression, anxiety, and ed behaviors I didn’t think there was anything to be grateful for.  I was wrong.  When I began to focus on all that I was and everything that I had, a small light started to shine.  As Helen Keller said “Keep your face to the sunshine and you will not notice the shadows.”

13) Even after my symptoms subsided, I stayed in therapy to discover my true self, who I was without the eating disorder.  How could I be myself if I didn’t know who I was? Look for my upcoming book… How can I be myself when I don’t know who I am TM.

14)            I found a passion and purpose for being- my career and helping others recover and focusing on having my own family. Finding a reason to recover was important.

15) Today I live with the full understanding that yes, my eating disorder could come back at any time. However, this way of life has become an opportunity for self-growth, centeredness, awareness, and acceptance. Today, I have the tools I need and the commitment to use them.  Every day, I Say Yes to Life !

The good news is there really are pathways out of being controlled by ED and other compulsive behaviors. The challenge is that it takes time, commitment, awareness and practice. But then, to be good at anything usually does. I have lived many years free from Ed behavior and am lucky enough to work every day with amazing people who are also on this journey.  If you are on this path, struggling, or just need someone who really understands, give me a call.

To your success and happiness,

Kimberly

Kimberly Krueger, MSW, LCSW is a therapist and the founder and director of Southlake Counseling and The Center for Self Discovery in Davidson, NC. Kimberly may be reached at kkrueger@www.southlakecounseling.com

Southlake Counseling is Lake Norman’s leading behavioral health treatment center, providing a full range of clinical services to children, adolescents, and adults. Southlake services include therapy, psycho-educational and psycho-social assessment, consultations, health education, nutrition, wellness and coaching programs for those suffering emotional, behavioral, health, and educational challenges.


Your “Say Yes to Life” Monday Motivator: the H.O.W. of Recovery (Honesty-Openness-Willingness)

I first came across this powerful principle many years ago in my own recovery from an eating disorder. Long credited to the Twelve Step communities, H.O.W. nevertheless feels like a universal recovery principle, applicable to any individual at any age and in any stage of their pursuit of recovery, health, and whole-person wellness.

In the course of my professional life, I am always delighted to find a new resource that outlines this fundamental recovery principle. On this week’s reading list is an innovative new book called Beating Ana: How to Outsmart Your Eating Disorder and Take Your Life Back. The author, Shannon Cutts, is herself a survivor of an eating disorder, and the book is structured to allow the reader glimpses into not just her own day-to-day hard work of recovery, but also into the recovery journeys of others she has mentored and encouraged along the way.

In Beating Ana, this is accomplished by structuring each chapter around a question from one of her mentees, her answer to that question, and then what she calls a “Recovery Workshop” that invites the reader to learn new recovery skills and tools to progress toward their recovery goals. Each chapter ends with a “Life Celebration Affirmation” which strengthens the reader’s awareness of the hard work they are doing and encourages them to continue doing the hard work of recovery.

In the chapter called “The H.O.W. of Recovery”, Ms. Cutts explains how easy it is to be bullied by the fast-moving train of an eating disorder as it progresses. She writes, “We convince ourselves that we are but spectators at our own funeral, powerless to do more than watch as events unfold to their logical conclusion….We do not yet see the truth. We do not yet perceive that, even as our inexplicable, indescribable self-torture escalates, and even when the eating disorder rolls out the big guns, we are still here.”

We accomplish this awareness and regain our inspiration, courage, and strength to keep fighting, she explains, through practicing the H.O.W. of Recovery – often better known as Honesty-Openness-Willingness. Beating Ana explains each of these principles as follows:

  1. Honesty: objectively looking at your life and seeing what is broken and who can fix it
  2. Openness: being open to believing that the way life has been doesn’t dictate the future
  3. Willingness: the “I will do whatever it takes” attitude that sustained recovery requires

Ms. Cutts then encourages readers to journal about each of these three core elements to any successful recovery process – in her words, “[to ask] yourself whether or not you feel that you have each quality and have it in sufficient measure to commit to healing and to your own life.”

It has been my experience as well that when we have the honesty to admit what is no longer working in our lives, the openness to believe that we have the power to change what isn’t working, and the willingness to do whatever it takes, that literally anything is possible. No dream is too unrealistic, no amount of work is too much, and no sacrifice is too great to achieve release and lasting freedom from the prison of an illness that claims body, mind, heart, and spirit without a backward glance.

I encourage all of you to examine H.O.W. you are approaching your own recovery, health, and wellness goals this week and thus far in 2010. If you find that you are struggling to connect with your awareness of your own Honesty-Openness-Willingness, we encourage you to tackle this challenge by being honest, open, and willing to ask for help. At Southlake Counseling, we have more than two decades of expertise and compassion invested in helping individuals just like you to achieve their dreams and realize their full potential. We are excited about sharing your journey as you reach for and even exceed your own potential! Contact us today at www.southlakecounseling.com – we look forward to hearing from you!

Be Well,

Kimberly

Your “Say Yes to Life” Monday Motivator: Food is My Friend…or is it?

One of the areas of life that seems the most problematic in today’s society is the issue of food’s role and purpose in our lives. Is food fuel for the body? Is it an emotional warm blanket when we’re feeling down? Is it an expression of celebration that reinforces and even creates relationships? Is it a treat at the end of a long day?

To most of us, food is all of the above – and more. In past Monday Motivators, we have discussed how our attitudes towards and choices around food can and often do fluctuate frequently – sometimes even in the course of a single day – and how confusing and conflicting such fluctuations can be.

In the scientific principle known as Occum’s Razor, the “simplest explanation tends to be the right one.”  In the case of food, this principle would deduce that food is fuel for the body, plain and simple, no more and no less.

But try telling that to the part of us that wants chocolate cake when we’ve just experienced a breakup. Just try to explain that to the part of us that thinks the best way to motivate us to make healthier choices is to yell “good choice as usual, Lardo” when we are enjoying a bag of chips. Or how about when our date suggests sharing a decadent dessert as the perfect end to a romantic evening…how likely are we to explain to him or her, “Well, truffles aren’t an item my body really needs for nutrients so I’ll have to decline, but thanks anyway.”

Not at all likely, right?

In Internal Family Systems (IFS), we might instead begin to assign names to these seemingly disagreeing parts of ourselves, and then to decode what their real message, purpose, and role is in our lives.

For instance, the Inner Controller is always going to tell us what we think we need, rather than want, to hear – declining that truffle, using self-disrespecting language, doing whatever it takes to keep us on the dietary straight and narrow.

The Inner Indulger, on the other hand, will eschew discipline for pleasure every time. The Indulger loves romantic truffles, sees nothing wrong with a delicious bag of chips, and wouldn’t think twice about offering its suffering self some chocolate cake in recompense for a bad day.

The small gap or vast expanse that exists between the Indulger and the Controller is what students of IFS learn to call the “Pleasure Polarity.”  Managing the pleasure polarity, and more than that, hearing, affirming, and guiding the Indulger and Controller to learn to (gasp) get along is what a student of IFS will become adept at.

IFS students understand that each voice comes to us with a desire not to harm, not to degrade, but to support and protect us. As we walk the guided path of IFS, we will understand what our parts already understand – that we have needs that food can provide for, and that each part thinks it knows best how to care for us and meet those needs. We will perceive with tremendous clarity and newfound hope how each voice, in its own weird and wonderful way, has our best interests at heart – and is often willing to fight to the death on our behalf against another voice with an opposing opinion.

So how do we help these parts of ourselves stop squabbling and get along as they each seek the same goal – our wellbeing?

We have to first understand that each voice has a point. In between the Indulger and the Controller we find not just the Pleasure Polarity, but the Support Polarity and the Power Polarity. In the Support Polarity, we must balance the Indulger’s neediness and the Controller’s need for denial. In the Power Polarity, we must recognize our tendency to people-please against our desire to rigidly control ourselves and others.

When you become a student of IFS, you begin to walk the path of balance and moderation with wisdom, confidence, and self-compassion. You “get” yourself – in all your various parts – in a new and deeper way. You can make better choices when you understand that all of these parts or facets of you are all you – all valid, all worthy of a voice, all worthy of respect, appreciation, and satisfaction. As this understanding becomes established within, you become better able to evaluate the choices before you and make a fair assessment of each part’s needs, the airtime you will allow each to have, and your need to make sure that one is not over-indulged while one is ostracized.

Or, to once again apply the principle of Occum’s Razor, we could simply say that you will begin to realize that when a part of you hurts, you hurt. And when a part of you heals, you heal.

If you are struggling to balance the competing needs, demands, and desires you feel inside of you when it comes to making healthy food choices, Internal Family Systems can help. At Southlake Counseling, we have more than two decades of experience guiding individuals to meet and exceed their food-related recovery, health, and wellness goals. Whether you are just seeking a tune-up in the New Year or part of your bigger picture for 2010 includes a complete overhaul in your nutritional lifestyle, we look forward to partnering with you to help you say “no” to inner conflict at the table and YES to your own healthy, happy, and whole life! Visit us at www.southlakecounseling.com today!

Be Well,

Kimberly

Your “Say Yes to Life” Monday Motivator: The Helping Hand Mindfulness Extends

Well, here it is – the first week of a brand new year!

Exciting, isn’t it!

Or maybe a little nerve-wracking….stressful….already packed full of resolutions, expectations, old memories of what not to do from the barely-departed previous year (aka baggage), and more than a bit of fear.

Enter “mindfulness”. Mindfulness is a powerful tool that can facilitate the kind of positive life change that resolutions seldom do. Best known as one of the four core tenets of Dialectical Behavioral Therapy (DBT), mindfulness is commonly defined as “awareness without judgment of what is, via direct and immediate experience”1.

How can mindfulness help you in 2010?

While resolutions and expectations are born of past experiences, and thus are colored more by painful remembrances of how we did not measure up to our own standards or others’ in the past, mindfulness keeps us anchored here in the present, which is the only place where any true change is possible.

The first step to using mindfulness as a tool for positive change is to be able to distinguish it from what we normally do. So let’s take a common New Year’s resolution as an example – a resolution to adopt healthier eating habits.

Without mindfulness, here is what you might expect to happen on January 2nd, when, full of good intentions and steadfast resolution, you approach the refrigerator. You open the door and stare in at the new healthy selections you just purchased, sitting there on the shelf next to last night’s party leftovers. Your hand shoots resolutely towards the healthy side of the shelf. Your mind says, “You know you won’t be able to keep this up. You might do okay for a few days, but sooner or later you are going to break your resolution. You might as well just go ahead and eat those party leftovers anyway. They are going to spoil otherwise, and it is wasteful to let perfectly good food spoil just because you are trying to eat healthier. You can eat the healthy stuff you bought tomorrow.”

Does any of this self-sabotaging dialogue sound familiar?

With mindfulness, you do not waver between the past and the future, trying to predict the probability of an outcome that is only possible here, now, in the present moment – an outcome that you are in charge of and are perfectly well-equipped to determine.

So now let us take the same example, but apply the tool of mindfulness to achieve a different outcome. There you are, standing in front of the open refrigerator door. Your eyes fall on last night’s leftovers, and then on the new healthy items you have just purchased.  Your hand reaches toward the healthy side of the shelf, already anticipating the crunch of the sautéed bell peppers with chicken and seasoning that you are going to make for dinner. Your stomach grumbles. You begin gathering all the ingredients to make your meal. Happily, you unwrap your new sauté pan that you got for Christmas, add a little olive oil, and start chopping vegetables. Thirty minutes later, you sit down for a lovely, healthy meal that is both delicious and satisfying. You clean up, and head into the living room to catch your favorite television show.

What just happened here? With mindfulness, you sabotaged your saboteur by simply staying present. You didn’t allow your mind to wander back to the past, which is forever out of your control, or to the future, which is not yet within your control. You stayed true to the reason you visited the refrigerator in the first place – to fuel your body with delicious, healthy nutrients per your New Year’s intention NOW, in THIS moment, to offer yourself the gift of healthy eating habits. You chose tasty ingredients, enjoyed putting them together into a meal, ate them with gusto while you were hungry, stopped when you were full, cleaned up, and moved on to the next activity you had planned.

Mindfulness hands back on a silver platter your power to make new, self-affirming choices in the present moment. Mindfulness is your best friend in a season too often filled with recriminations, regrets, fears, self-doubts, and atoning resolutions. The past is in the past, right where it belongs. And the future depends on the choices that you make right now, today.

So take mindfulness by the hand, and walk confidently and positively forward together in the present moment to greet the New Year.

At Southlake Counseling, we understand how New Year’s resolutions can often collide with last year’s regrets. This is why our staff of trained and experienced clinicians have dedicated over two decades to the study and successful application of Dr. Marsha Linehan’s Dialectical Behavioral Therapy (DBT) treatment methods. If you are struggling with maintaining a positive outlook about making good choices in 2010, we are here to help.  If you would like to learn more about Mindfulness or our DBT program contact us today at www.southlakecounseling.com to learn more.

Be Well,

Kimberly 

1 Marsha Linehan, PhD, Dialectical Behavioral Therapy Founder

Your Say Yes to Life Monday Motivator: “Fat” is Not a Feeling But I FEEL Fat!

We all have “fat days”. Even if you are a man reading this, you probably are not scratching your head wondering what a “fat day” is. You know.

We all know. 

Fat days are like cold-and-flu season, garden weeds, or your dog’s next teeth-cleaning appointment – they are going to come. Inevitably. There is no sense trying to run and hide.

But what can we do? If having “fat days” is more about management than elimination, and we are all going to “feel fat” from time to time, then where is the dividing line between the inevitable and its amount of influence over how we feel about ourselves, our bodies, and our lives?

Once again, it boils down to knowledge…and choice. First, we have to understand and decode where “feeling fat” comes from and what it means to us. Next, we have to decide if this business of “feeling fat” still works for us, or if we would prefer to make a new choice in how we understand and deal with fat feelings, and fat days, in our daily lives. 

So where do we start? We can begin by exploring where feeling fat even comes from, how it started, and why it is so much a part of our culture today that we often accept it without question – and even welcome it in as a helpful, rather than harmful, regular houseguest.

In 1995, the Discovery Channel reported the sad but fascinating results of the introduction of western television programming into the culture of the little island of Fiji. Prior to receiving access to westernized shows like “Melrose Place” and “90210”, only three percent of Fijian females suffered from eating disorders. Three years later, 74 percent of Fijian girls reported feeling “too big” and 62 percent had gone on a diet.

We may not think the environment around us gets under our skin, but we don’t have to look very far to see how much influence it actually has on our day-to-day routines and perceptions of ourselves and others. We feel fat because anti-fat messages are everywhere we are. Billboards, television and movies, advertisements, even our daily dialogues with each other are full of labels like “thin” and “fat”, “good” and “bad”, “healthy” and “unhealthy” – and almost none of it is backed up by actual scientific facts.

In fact, most of the steady diet of fat-bashing that we take in has one purpose and one purpose only – to induce dis-ease so that we will spend our hard-earned cash to fix a problem that is all in our heads!

Okay, so now we know. We have been told to feel fat, and we have – up until now at least – very obligingly obeyed. But now we really do feel fat – so what options do we have to extricate the word “fat” from the very real and valid feelings we are having underneath?

First, we can start to access our power of choice by working hard to understand what “feeling fat” means to us. We have to recognize that “fat” in and of itself is NOT a feeling . More accurately, “feeling fat” it is an edgy little ache that grabs our attention long enough so we will trace it back to its source and deal with the real root issue. So when we feel fat, we can instantly snap to attention and begin our sleuthing process – tracing it back, and back, and back, until we uncover what triggered the fat-feeling so we can deal with that and move on to recapture our sense of health, wellness, and balance.

If you are struggling with or in recovery from an eating disorder, you may already be familiar with the technique of naming your fat feelings. This is a very helpful approach that involves building your emotional vocabulary. There are five major emotions – anger, fear, disgust, sadness, and happiness – and about a million permutations of each. For instance, if we know it is not “fat” that we are really feeling, could it perhaps be “anger”? Or is it instead a permutation of anger – maybe “rage”, “annoyance”, “hostility”, “displeasure”? In this way you can take your power back by naming what you are really feeling, and investigating what your real emotions are trying to tell you so you can work through them and return to peace and equanimity again.

You might also want to try another code-breaking exercise to figure out what “fat” really stands for in your life. In this exercise, you will complete two sentences. First you will write down: “Thin =” and complete the sentence with appropriate descriptions of what “thin” means to you in that moment (examples might include: good , happy, desirable, successful, popular, attractive, etc). Next, you will write down “Fat =” and complete the sentence with your assessment of what fat feels like to you in that moment (examples could include: disgusting, irresponsible, lazy, unattractive, unacceptable, lonely, unsuccessful, etc.). In this way you can backtrack to discover what you are really feeling, and begin to deal with those feelings.

At Southlake Counseling, we understand how painful “feeling fat” can be – we have spent years honing our skills for battling back against our culture’s focus on the socially-acceptable prejudice of weight-ism and helping others to do the same. If you are having trouble completing the exercises above, or if you try your hand at them and find that strong emotions are coming up and you need support to work through them, visit us at www.southlakecounseling.com. Let us help you to start your New Year off on an empowered note by saying “no” to feeling fat in 2010 – and saying YES to feeling what you really feel, owning your right to have and express your true emotions, and doing what you need to do to live the life of your dreams!

Be Well,

Kimberly