My way or the highway.

I am a serious fan of perspectives. I had a high school history teacher who was fond of saying that “truth is increasing complexity”, and in both my personal and professional lives, I have found this to be, well, true.

When a client presents me with a truth, about themselves, about an experience, we work to increase complexity. Are you sure that’s true? Has it always been true? What else might be true? What do others in your life believe to be true? Often, in this way, we are able to triangulate, and to move in the direction of deeper knowing, of more true, but also to open space for subjectivity, and breathe some light or humor or next questions into that space.

It is in the spirit of that kind of inquiry that I offer the following blog post by Holly Glenn Whitaker: http://www.hipsobriety.com/home/2015/2/18/why-aa-didnt-work-for-me-my-story-part-1

This is not a prescription. This is not an indictment of AA. It is also not an endorsement of Holly’s sobriety coaching program. It is, however, a perspective. There’s this Buddhist expression, “If you meet the Buddha on the road, kill him!” It speaks to the dangers of making something or someone your god, which is easy to do when you feel as though you have been saved, but the reification of any one concept or any one guru or organization can be fraught with peril.

I work with a lot of clients who struggle with substance abuse because when the world offers you its misogyny, its transphobia, its racisim and its fat phobia (amongst others) to internalize, numbness and escape often sound like the loveliest of sirens. I have folks who come to my office who have found a sober life working an AA program, and it’s glorious. I also work with clients who have found that the language of powerlessness and surrender was inaccessible to them in the context of a history of sexual trauma or internalized hatred and disempowerment, and who echo Holly’s statement that in fact, making the choice to let go of alcohol because you can’t use it and be well is profoundly powerful, and profoundly empowering.

You can’t get sober by yourself, but you’re also the only one who can get you sober. The rooms of AA are one available community within which to do that work, but they are not the only one: could this be a truth?

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One Size does not (fill in the blank).

So, I highly recommend you go read this http://www.danikabrysha.com/blog/dear-danika-food-addiction-stress-management-and-how-im-finally-finding-peace-and-freedom, knowing that the author is someone I choose to follow on social media and in her blog even though I have specifically chosen not to follow the path she has used to address her eating disorder, and our very definitions of eating disorder and recovery diverge. Here’s why:

1. What if her path is right for you or one of my clients? I have found that I don’t stay on the healthy side of the blurry line between OA and restriction very long, and so it’s not my scene, but recovery is individual.

2. If it’s not your scene either, can you engage with her words as an act of empathic connection with someone whose struggles you share? We’re so quick to judge, and it keeps us separate in our own food and body prisons, rather than forging the community and connections we need to feel seen, heard and not totally nuts.

3. It’s worth it purely for her insight into the absolute brain drain (and effort of futility) that is dieting.

4. Because I’m choosing to put my energy into pumping breast milk these days, rather than blogging much, but I still want you to have good things to read.

You Have to Do It.

During my time out of the office, I’ve been reflecting quite a bit on success. As in, who have I worked with who has really nailed it and made a major improvement in their quality of life and functioning? What has been necessary to drive my own ongoing success in recovery? And how can I boil those answers down to help others better?

What I come back to, time and again, is action. For myself, and others, insight is great because it can provide valuable data regarding why a pattern or behavior started and is entrenched, but it’s basically useless if you don’t act. It’s entirely possible to spend years in therapy making insight after insight and seeing absolutely no change in how it feels to live your particular life. 

For example: Thanks to insight gained in my own treatment, I know exactly why being home alone makes me vulnerable to the siren song of eating disordered urges. However, learning that did nothing for my recovery until I learned to turn the knowledge into action. Now, not only can I predict when those ugly urges will surface, but I work to a. Minimize the likelihood that I’ll be faced with them b. Decrease my sensitivity by actively cultivating positive associations with being home alone and c. Having a long list of things to do to distract and calm myself that I actually use.

This is not groundbreaking information, but it makes a huge difference in outcome, and a surprisingly small number of folks actually approach the work this way. Why? Well, for one, it’s hard, especially at first. Acting on your insights often requires a kind of brute force, blind faith approach at the beginning because the action is often uncomfortable, new and scary, and probably runs counter to a lot of (distorted) beliefs. However, the discomfort wears off fairly quickly once you start to do your insights because evidence builds up that the new actions are working in your favor. 

In other words, you have to take a leap. The classic metaphors here are about letting go of one trapeze to grab the next, or letting go of your leaky life boat to grab a solid buoy – in both cases, there’s a deeply scary moment where you’re holding onto nothing. 

The question I ask, in my office and of myself is, how is that leaky raft working for you? We have the illusion that there’s a choice, to act on our insights and behave in new ways, or to stay in the current patterns. The reality is, you’re drowning. If the new raft is leaky, too, you were going down anyway, which while not exactly cheery, makes my point that, scary or not, you’ve got nothing to lose and everything to gain by taking action based on insight.

But, you have to do it.

What would it be like to start now?

Everyone is TOTALLY FREAKING OUT ABOUT HOLIDAY COOKIES.

This morning, I got an email from one of my favorite nutrition writers, John Berardi of Precision Nutrition, which sounded an awful lot like what I’ve been saying to clients for the last few weeks when they come to me TOTALLY FREAKING OUT ABOUT HOLIDAY COOKIES. These are stressed people. Seriously unhappy people. Not exactly holiday cheerful. Because COOKIES. I had people TOTALLY FREAKING OUT ABOUT HOLIDAY COOKIES starting in early November, and I will continue to hear about COOKIES well into January. I’ve shared Dr. Berardi’s words below, but first, my take on this state of affairs.

As evidenced by my egregious use of capital letters, these are high volume, high intensity, high anxiety, high angst concerns. And I’m not trying to be mean about it: people are seriously suffering, and it’s very real. The problem is that we’re talking about cookies. In my mental landscape, a cookie is a palm-sized (or smaller, like those little round ones with the nuts inside and the powdered sugar – I love those) baked good that takes one to three minutes to eat depending on the size. However, for my friends of the freaking out, COOKIES are stomping through their mental landscapes crushing hopes and dreams like Godzilla having a very bad hair day.

The fear is real. It’s real, but it’s also a construction and a self-fulfilling prophecy. If a person starts thinking in November about how hard it’s going to be not to eat a certain food item in two months, and keeps thinking about how “bad” that food item is, and how she can’t control herself around that food item, it gives the damn thing an enormous amount of power. (It also ruins her November.) COOKIES are going to destroy her, she’s sure of it, and ensuring it. And of course, when late December rolls around, she’s going to eat them. How could you not eat something you’ve been debating about for two months? Will she enjoy the cookie? Survey says no. Because the minute it reaches her mouth, she’ll already be berating herself for how weak and bad and lazy and gross she is to have been subjugated by a COOKIE, rather than savoring its tasty flavor, reflecting on the family heritage the recipe represents or something else, you know, nice.

Because holiday cookies are nice. That’s about it. Some are tastier than others, some have memories associated with them, and some are kinda lame and taste like their cardboard box. But they really, really are a pretty minor, albeit pleasant, occurrence if you treat them as such.

Try this mindset on for size: Imagine yourself not thinking about holiday cookies until you’re actually faced with a plate of holiday cookies, perhaps at a party, perhaps on the table in the break room at work. Like, how you don’t think much about getting an oil change until it’s time to get an oil change. Now, assess the plate of cookies. Do you like this kind? Were they prepared by someone special? Are they appealing? Now, assess your level of hunger and your emotional state. Are you fairly full because you just ate a satisfying meal? Are you starting to feel that little nudge in the tummy that suggests it might be snack time soon? Are you bummed out and overwhelmed, or perhaps feeling a little festive? If you’re not too full, and not in an unpleasant emotional state where you’re more likely to be self-medicating than enjoying a treat, and there are cookies on the plate that are truly appealing to you, select the cookie that looks the best and eat it.  Feel free to take a bow.

Then walk away. Because you are not the cookie you just ate. You’re a mature adult human who, on occasion, when the moment is right, chooses to eat foods from the “treat” category because they are fun and nourishing in their own way. You’re not going to get fat. You’re going to get awesome. Because when COOKIES become just cookies, you get the power back, and you get to spend a lot more of your life thinking about other things that are a lot more interesting. Like, what to get your mother-in-law for Christmas. Or world peace. Or really anything.

(And, as a side note, if you are maybe still a little worried about the cookies: you’re much more likely to overeat the things if you treat them as a diet smashing super power, rather than a moderately enjoyable sometimes treat, because that’s how the restrict, binge, rinse, repeat cycle works. I promise, promise, promise you that you will eat fewer cookies if you allow yourself to enjoy them now and again than if you try to avoid all baked goods for two months and then go to your Nana’s house on December 25th.)

Now for the other guy’s take on things:

“My three little ones have been helping my wife and I with the usual chores: decorating the tree, creating cards with construction paper, preparing canned food donations for the local food pantry, and…making delicious cookies. But before you ask for my killer “healthy” cookie recipe, I have a confession: We’re not making not some low-fat, gluten-free, protein-packed, artificially sweetened, possibly-hiding-beets, “healthy” version of a cookie. Nope, we’re making the REAL THING. The kind of cookie that contains butter, sugar, and flour. The kind of cookie where you want a tall glass of milk to help wash it down. The kind of cookie most “nutrition experts” will tell you to avoid completely this year… Just dip some kale leaves into lemon juice with a splash of stevia and it’s exactly the same thing.

Anyway, when people learn that my family and I sometimes make treats like cookies…or go out for ice cream…or don’t eat 100% protein and vegetables all the time…they get a little confused. “But isn’t Precision Nutrition all about eating good foods and avoiding bad foods?” The answer, I’m proud to say, is no. Precision Nutrition is NOT all about eating “good” foods and avoiding “bad” foods. (I don’t even like those labels.) In a minute, I’ll share what Precision Nutrition is really about. But first I’m going to encourage you to enjoy some sort of cookie, cake, or cocktail this holiday season, too. In addition to songs, and friendship, and holiday cheer…

You see, every time you choose to eat one thing over another, you’re voting for what’s really important to you right now. Of course, you may not realize you’re doing that. But every decision IS a calculation. Of what really matters to you, in that moment. So, with the holidays here for most of us, what DOES matter to you right now?Is it… Feeling good? Connecting with loved ones? Truly nourishing your body? Feeding your soul? Remembering your heritage or family traditions? No judgement here. YOU get to decide your priorities. And  sometimes other things SHOULD win out over “nutrition”.

So I’m not here to tell you what to do, think, or feel. Or to make you feel guilty, ashamed, anxious, or deprived. Instead, I’m here to help you think through the question. To help you choose more consciously, with awareness and intention… Because shortbread and latkes taste great when made with love and shared with friends and family. They just do. And, while some people in fitness have a hard time with this notion, I think that feeling good is part of enjoying life and being healthy…

Here’s my first prescription: Enjoy a real cookie or two this holiday season! Or some other thing you enjoy but think is “off limits”. Just do it consciously, mindfully, and – as we teach in our coaching programs – slowly. Instead of scarfing it down and waiting for the guilt, taste what you enjoy. With intention. Then move on…

But even if you’re not ready to embrace this mindset yet because restricting is your only way to feel in control… Because you can’t believe that enjoying certain foods guilt-free is possible… Because you’re stuck in the middle of a nasty cycle of restrict, collapse, guilt, repeat… My family and I will still share some laughs, shed some tears, and nosh a few cookies this holiday season. We might even raise a glass of egg nog in your honor. Because, around here, we know that connection, love, and enjoyment CAN exist while working toward better health together. And we’re hoping that somewhere along they way you’ll discover the same thing.”

Recovering from anorexia on a health-obsessed campus : The Daily Collegian

A colleague recently shared this piece with me, written by a student at a local college, and it resonated with me and is right in line with a lot of conversations I’m having with clients this fall, who arrive at my office unsure why they are diagnosed with an eating disorder and “have to stop” when many of their peers, especially in the privacy-free dorm setting, are so obviously engaged in the same behaviors, but are not being labeled/diagnosed or sent to treatment.

What I say to these folks, and what I’m saying to you if this rings true, is: if they’re doing what you’re doing, then they’re doing just as much damage to their health and psyches as you are. The eating disordered part of your mind may be crying “Unfair!” and wishing to use this as evidence that your behavior is normal and need not be changed. But the reality is, if you ended up in my office, or in another office being “diagnosed” then your suffering at the hands of your own choices was apparent enough to you or to another person that your functioning could hardly be considered normal. Average and normal are very different things! Your undiagnosed, untreated friend who is restricting, binge eating, purging, over-exercising or abusing laxatives is not the lucky party – you are. You are being offered a chance to heal your relationship with your body and with food such that extreme and damaging behavior no longer feels like the only possible path to ok.

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“I recall my therapist at the time describing the situation like that of a recovering alcoholic taking up a bed in the local bar. The temptation to relapse was evident from day one. After all, I could be certain nobody was monitoring my behaviors – if anything, UMass seemed to be providing the very tools I needed to fuel an all-consuming focus on health.”

via Recovering from anorexia on a health-obsessed campus : The Daily Collegian.

Eating Disorder Recovery Skills Group Forming

Hi, folks – I’m putting together an eating disorder recovery skills group at my office in South Hadley, MA. The group will begin on Sunday October 5th, and will run on Sundays at 1pm until the first week of December. 
 
This group will be insurance-based (students with a referral will not have a copay if they have their college’s insurance); interested clients should contact me directly at kwaggoner@jameslevineassoc.com so that I can arrange for an initial screening, which will be a brief phone call to assess acuity and appropriateness, but basically if you’re at an outpatient level of care you’re probably going to be fine to join. Current clients need not go through a screening – just let me know you’re into it and I’ll sign you up.
 
If your insurance does not have a group benefit, the self-pay rate for the group is $20 per group. Clients may NOT attend on a drop-in basis. Although obviously if someone calls out sick with 24 hours notice I’m not going to yell. The age cut off for joining is 18, with no upper age limit. The group will run as long as I have a 5 person minimum, and I’m going to cap it at 15. Thanks!
 
– Katharine