Defining Self-Acceptance... Or At Least My Definition

I have felt a strange sort of pressure to write something profound on my blog to ring in the New Year. And I don't like that kind of pressure! It doesn't support my creativity, it stifles it. In fact, I started to lose hope that I'd find something truly meaningful to write about. And then I had this awesome learning moment with a client that sowed the seed for this little post.

My client, whom we'll call Sally, was telling me how she's been reading up on all sorts of positive body image blogs. You know, blogs that encourage you to love yourself and accept yourself as you are right now. And that was just all too far from reality for her to be able to swallow. She told me "I can't love my body. I can't stand living in it. I don't feel good physically in my body. Why would I accept something that makes me so miserable?" 

And I understood what Sally was saying. Often, people confuse self-acceptance with stagnation. Staying miserable, learning to put up with something you hate. Many people wrongly assume that they'll never change if they accept themselves (not to mention love themselves!) as they are right now. But it turns out that isn't true.

ACCEPTING SOMETHING DOESN'T MEAN YOU HAVE TO LIKE IT. The reality is that self-acceptance FACILITATES CHANGE. Acceptance can be defined as "the act of assenting or believing." Once we come to truly accept where we are at in life, what works for us, and what doesn't, we are then able to make decisions based on that reality. Here are a couple of diagrams to show what I mean.

Cycle of Non-Acceptance

Cycle of Acceptance

I share this message with you as a new year is about to begin because it's a time that you might be thinking about setting goals and contemplating how you'd like to improve upon this past year. So  you just might want to consider adding self-love and self-acceptance to the top of your list. Ironically, it just might help you accomplish everything else you had in mind.

I'm going to leave you with a quote from a fabulous book that I stumbled upon while researching this blog post. The quote relates to accepting your body as it is right now.

How can you begin to learn the lesson of acceptance? By recognizing that what is, just is, and that the key to unlocking the prison of self-judgment lies in your own mind. You can either continue to fight against your body's reality by complaining bitterly and immersing yourself in self-deprecation, or you can make the very subtle but powerful  mental shift into acceptance. Either way, the reality remains the same. Acceptance or rejection of your body only carries weight in your mind; your perception has no bearing on how your body actually looks, so why not choose the ease of acceptance rather than the pain of rejection? The choice is yours. "

Found in "If Life is a Game, These are the Rules" by Cherie Carter-Scott PhD

Have you had an experience with self-acceptance? Please share it!

Mindfulness: The Art & Science of Changing Your Brain

What do you think about when you hear the word "mindfulness?" To be honest, I used to think "nope, not for me!". Breath in, breath out, follow my breath. Ugh! I honestly couldn't see the point and every time I tried it seemed like a miserable failure. 

And then I attended a workshop by the brilliant Dan Siegel, MD and also began reading one of his many books on mindfulness entitled "The Mindful Therapist." My mind has been forever changed now that I'm beginning to understand why mindfulness is so critical to our health. 

I'm going to give you a 3 part synopsis of how Dr. Siegel's work on mindfulness has changed my life:

1. Mindfulness can be defined as: awareness of the present experience with acceptance, no judgement

2. Our brain naturally goes a thousand miles a minute. That's what it is designed to do. When we practice bringing it to the present moment physiological and structural changes occur in our brains! Yes, the act of bringing our mind to the moment changes the very structure of our brain.

3. As this happens, there are PROFOUND consequences. I will name a few: we become more open, less rigid in our thinking, more creative and resilient, less anxious, able to act rather than to react.

Practicing mindfulness is tough stuff. But it's with the act of practicing, the act of drawing your mind to the quite present moment WITHOUT JUDGMENT that the magic happens.

Below is a story of one person's journey with a 30 min meditation. Enjoy.

Recently I went to a 30-minute guided mindfulness meditation session. The teacher spoke for about 5 minutes at the beginning of the session, suggesting ways we could approach quieting our minds for that half hour. She suggested relinquishing following the breath, which is a typical approach to mindfulness meditation.

Instead she referred to a passage she had recently stumbled upon in the Bhagavad Gita that suggested that the labor, or effort, was the goal of this meditation practice; that we should not expect results or a mindfulness “product.” She went on to give us other ideas to use as a focus: the deep red of fall leaves that correlates with the chakra of groundedness, or the fiery red that corresponds to passion for life and self-confidence. We could also focus on an image from nature, or the words “softer, softer, softer.”

Then she was quiet. The room was quiet. My mind was not quiet: “ ‘Effort,’ I like that idea, just keep putting in the work at all my endeavors, yes, effort, interesting.” Then I observed that I was “thinking.” “Thinking,” I told myself.

I tried to see the two colors of red and feel grounded and self-confident. My mind wandered to an image of a leaf I had seen earlier that day; it had startled me by being so loud just by turning onto another leaf after a puff of wind.

The room stayed quiet. My neck felt tired. I felt tired. I wondered if anyone would mind if I quietly lay down. I decided they would.

I remembered an image I like that I recently cut out from a magazine—a young woman, smiling, her arm draped around her painted self-portrait (with the help of Photoshop). My words for that image have been “Here I am; I am good.” I want to be her: solid; self-confident; with an inner self that she herself has created that goes with her throughout her day, unchanging, no matter the circumstances. I stayed with this image for a few minutes.

I continued to move from image to image, occasionally saying the words “softer, softer, softer.” These words were soothing.

Then the session was over. I walked home and Ms. Anxiety swept into me like a Nor’easter. At home I stared out my window at the crescent moon’s light.

No results? Perhaps what the meditation leader meant by the words “effort” and “labor” was “engagement”—that engaging with any activity, including mindfulness meditation, is accepting, not resisting the activity. I stared at the moon and thought, “I will continue this labor as best I can.”

Ha! I’ve just spent 2 hours playing Freecell on my computer. The images from last week’s meditation session have grown pale. Today was an anxious day and “engagement” seemed impossible. I know the labor takes practice (as in, it must take place). I am resisting.

But: Begin again. Loud leaf. Quiet night. Re-engage to groundedness and self-confidence. “Here I am; I am good.” Softer, softer, softer.

#endED Twitter Chat with Michelle May

If I said it once, I'll say it again: I am STOKED about tomorrow night's twitter chat. We have the pleasure of chatting with Michelle May, author of "Eat What You Love, Love What You Eat: Break the Eat, Repent, Repeat Cycle" and creator of "Amy I Hungry?". Michelle is a motivational speaker and guru of mindful eating. So we'll be discussing principles of mindful eating as well as how that relates to eating disorder recovery. HOWEVER, you don't have to have an eating disorder to benefit from this fantastic chat.

If you're new to Twitter, here's a primer on how to participate. It's simple, go to www.tweetchat.com and enter the keyword "endED" and it will appear as if you're in a chat room. Watch the tweets stream live and join in on the conversation.

Here are the questions we'll be chatting about tomorrow evening, 8:30 EST.

1a. How do you define mindful eating?
1b. Some people think that dieting is “mindful.” What do you think?
2a. People sometimes resist mindful eating; how do you introduce this concept?
2b. What is a simple way to help someone become more mindful about their eating?
3 How does mindful eating help with yoyo dieting and disordered eating?
4 Can mindful eating help when there are specific medical issues like diabetes?
5 How do you get people to buy into the concept of mindful eating?

Sunny Sea Gold and "Food: The Good Girl's Drug"

In March I attended the BEDA conference and had the pleasure of hearing from and meeting Sunny Sea Gold. Sunny currently works for Redbook, has written a book for girls struggling with binge eating “Food: The Good Girl’s Drug”, maintains her blog, has recovered from her BED herself, and is a rock star “recovery warrior.”

Her book is truly inspiring and I highly recommend to clients struggling with binge eating disorder and emotional eating. Her honesty, warmth, life experience, and practical advice shine through the pages. She fills a vital niche for women (especially young women) struggling with food and their body. Please check it out.

Sunny was gracious enough to do an interview with me. She is a busy lady and I’m no New York Times reporter. But she is passionate about sharing her story and providing the kind of hope all women struggling with an eating disorder truly need. I hope my words convey the genuine care and intelligence that Sunny exuded over the phone. Enjoy, comment if you are so inclined, and share the love.

Sunny, sharing the story of your eating disorder and recovery is a pretty bold thing to do. What inspired you to share your story?

At 15 I realized that something was wrong with the way I was eating and treating my body. And when I realized what that something was (at the time we called it compulsive or emotional eating) I knew without a doubt that I wanted to tell other people about it.

In the early years of my struggle, the help available was good but the books were aimed at grown-ups. Geneen Roth’s work helped but it didn’t always resonate, because she was speaking to an older audience. During my recovery I had periods of utter hopelessness but somewhere deep inside I knew it would be better. I knew that when it did getter, I would share my story with the girls who haven’t heard about recovery in a way that is relatable.

In my early 30’s I started doing some research and I couldn’t believe this type of a book hadn’t been written yet. This fact encouraged me all the more. As I developed my book proposal I created the HealthyGirl.org website to get the word out. I was surprised at how quickly readers started engaging. While there are a lot of great websites and resources out there, there seems to be something very powerful about hearing from someone who is recovered and is talking about it.

Recovery is a hot topic. How have you defined it for yourself?

Full recovery was an intimidating idea for me early on. In my early years, I thought full recovery was never binging again. But when I got further along in my recovery and was binging so rarely and the binges were so small I considered myself recovered from BED. I no longer had an active eating disorder. I was no longer using food to cope. Now, I can’t even recall the last time I binged. In fact, I totally agree with the post you wrote about recovery. I can’t believe how normal I am with food and weight. Even my Mom (who has never had an eating disorder) can’t believe I can have chocolate hanging around the house without eating it.

Your recovery was a 15 year journey. What were the 3 most important factors in your recovery?

I worked very hard in my recovery and there were a lot of things that were important along the way, and I talk about them all in the book. But the top three contributors to my recovery were:

1. Therapy

2. Self-Help Books

3. Support Groups: I attended a binge eating disorder support group for three years

Most people with BED also struggle with their weight. Do you think it’s possible to focus on weight and eating disorder recovery at the same time?

I really feel that focusing on recovering from the eating disorder first is extremely important. Dieting can actually “pull the trigger” and derail the recovery process. However, after I recovered from BED, I did make changes to my diet to facilitate weight loss. It happened but really slow. I did have to repair my relationship with food first.

It’s often said that a better body image takes longer than eating disorder recovery. What do you think?

I have a neutral body image. I can appreciate things about myself that are attractive but it’s just not that important to me anymore. During recovery something switched. A lot of the messaging I got as a child was that the way I looked (ideally thin) was the most important thing. Through therapy, I was able to replace those messages with messages I truly believe and value. The self-esteem work I did in therapy was pivotal. Another turning point for me was when I stopped dieting. I realized that if I became neutral about my weight I could be neutral about my body. It didn’t mean I loved the way I looked all the time but I didn’t obsess about it either. Another really important part of improving my body image was buying things that fit. It was important to feel good in my clothes no matter my size. And as I recovered my body got smaller and that was fine too.

What are the myths about improving body image?

One myth is that if you stop obsessing about your weight you’ll be stuck in a body you dislike. As you recover, your expectations will loosen and your body changes. As you continue to nourish your body, it will start to trust you and get to a more natural weight for you.

Binge eating is more prevalent than anorexia or bulimia but it doesn’t seem to be talked about as much. Why do think that is? What can we do about that?

I used to feel angry that it was being ignored—I believed that BED was less talked about because it’s simply not glamorous. Binge eating can be seen as weak, sloppy, and out of control, the antithesis of the values of our culture. While there is truth to that, BED is also truly a newer concept than other eating disorders like anorexia and bulimia. It wasn’t even mentioned in the DSM until 1994. And I know it will take a while for the medical community to catch up. Another factor is that overeating and binging is so prevalent that people just don’t realize it’s a problem. Groups like BEDA are incredibly important as it gives legitimacy to the disorder. Also, sharing stories is incredibly important. That’s one of the reasons why I share my story.

If you had one piece of advice to offer to women struggling with binge eating, what would it be?

Don’t let anything stop you from getting help. It doesn’t matter what steps you take, just that you take them. I used to get wrapped up in making the right choice, the right food plan, the right therapist, etc. it doesn’t really matter as long as you are taking the steps. If something has stopped working for you, try something different. Talk to more people, ask what they did, try what they did. I can attest to the fact that if you keep moving forward one step at a time you can get better. It’s slow at times, and that sucks but it can get better. It took me 15 years! But here I am.

Intuitive Eating and Eating Disorder Recovery

I was recently asked by Nina V, owner of the website www.helpforeatingdisorder.com, to write an article on Intuitive Eating and eating disorder recovery. I recently completed my training to become a certified Intuitive Eating Coach and was thrilled to share my thoughts. Enjoy.

Intuitive Eating is a phrase that is famous among many people hoping to recover from an eating disorder. It’s actually a concept developed by two dietitians, Evelyn Tribole MS, RD and Elyse Resch MS, RD. My goal with this blog post is to accomplish four things:
1. Explain the difference between Intuitive Eating and eating that is guided by an eating disorder (ED)
2. Discuss whether or not it’s possible to recover from an eating disorder by becoming an Intuitive Eater
3. Discuss the challenges of incorporating Intuitive Eating into eating disorder recovery
4. Share some tools to address those challenges.

An eating disorder is, by nature, the antithesis of Intuitive Eating (IE). This page from the IE website summarizes the basic premise of what IE is all about. But when I talk with my clients about the differences between IE and disordered eating, here’s what they tell me.

Disordered Eating is:
• Rigid
• Dictated by rules
• Ignores physical cues for eating
• Very judgmental and associated with feelings of guilt and shame
• Cues to eat or not eat are based on external factors or from the head, not the body

Intuitive Eating is:
• Flexible
• Dictated by whether or not you are hungry or full
• Allows you to enjoy a wide-variety of foods, without guilt or shame
• Cues to eat are largely based on your physical need and cravings for certain types of food

Is it possible to recovery from an ED by using IE?
This is a really great question. And this article, written by Evelyn Tribole, gives a fantastic explanation of how IE can be used in the treatment of an ED. It’s written for clinicians, but I use it as a handout with my clients and highly recommend you read it. Within the article is a table that explains how IE applies to EDs. I explain to my clients that when you are in the throes of an eating disorder, it’s too noisy to hear your health IE voice. So we use a structured eating plan (sometimes called a meal plan) as a bridge to walk you away from your ED and towards becoming an IE. However, the structured eating plan is only a tool to get you from an unhealthy eating disordered place, to a place that you can start listening, trusting, and responding to your body. It’s extremely important to note that the very nature of an eating disorder disrupts your biology. And following a structured eating plan is like using “Control-Alt-Delete” on your body, giving it time to heal and reset it’s natural rhythm of hunger and fullness.

I personally feel that it is extremely difficult to do this on your own if you are in the midst of an ED. In fact, I always recommend that anyone with an ED work very closely with a dietitian that specializes in the treatment of EDs. They can prescribe an appropriate structured eating plan, help you learn to reframe disordered thoughts about your body and food, and guide you to a place of trust between you and your body. It is very very hard to do this on your own.

What are the challenges of incorporating IE into ED recovery?
• In the beginning, your hunger/fullness cueing isn’t reliable or accurate so you cannot use that to guide your eating. While that is the goal of IE, it is not appropriate in the beginning stages of recovery.
• It’s easy to confuse your healthy IE voice with your ED voice, especially early on.
• Years of disordered eating create distrust with your body, and trust is the core of IE.

What are some tools?
• If possible, work with an experienced RD who specializes in treating eating disorders
• Read the article I shared earlier and keep the table of how IE applies to ED in mind
• Buy the book “Intuitive Eating” as well as the fabulous IE cds (which are different from the book). Hold this up as your gold standard ad goal for recovery!
• Don’t go it alone. Support is crucial for recovery and you deserve it.

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#endED Twitter Chat Re-Cap with Harriet Brown

Last week Harriet Brown was our guest expert for our monthly #endED Twitter Chat. She taught us a lot about family based treatment for anorexia and the important roles that families play in supporting their loved one through recovery from an eating disorder. (If you want to learn more about her story, this is a link to the New York Times article that started it all.)

Below are some of the gems from our chat that I wanted to pass along to you. In no particular order...

• 1. We need more research to assess the experiences and needs of families struggling with an eating disorder. You can help by completing this 15 minute survey online.

#endED Twitter Chat with Harriet Brown

Our next #endED Twitter chat is Wed, April 20th with Harriet Brown. We'll discuss myths and facts about anorexia nervosa, family-based treatment, and ways in which families can positively affect eating disorder recovery. Check out the Facebook Event Page for more details, including how to participate in a twitter chat if you've never done so before. Below are the questions Harriet will be discussing. I hope you can make it!

About Harriet Brown
Harriet is a tremendously successful writer, whose work has appeared in The New York Times, O, Health, Glamour, Vogue, and more. She specializes in writing about issues that affect the lives of women and children.

In her book "Brave Girl Eating: A Family's Struggle with Anorexia" she "recounts her family’s efforts to help their oldest daughter recover from anorexia nervosa." It is one of the best books I have read on the topics of eating disorders, families, and family-based treatment. An absolute must-read for anyone affected by an eating disorder.

Questions we'll discuss during our Twitter Chat
Q1 What do you think are the biggest myths about anorexia nervosa (AN)?

Q2.1 What exactly is family-based treatment (FBT)?
Q2.2 How is it different from other types of eating disorder treatment?

Q3.1 What are the biggest myths about FBT?
Q3.1 What are the obstacles for families to use FBT?

Q4 What should I do if I think my child has an ED? (this would be a great place to share resources/stats)

Q5 How can we help our children have a balanced/healthy relationship with food and their bodies?

Q 6 What has been the most rewarding part of sharing your knowledge and experience with families struggling?

About #endED
The goal of #endED is to bring anyone and everyone together who care about ending eating disorders. My hope is to end the silence and myths about eating disorders, create a place for honest and informed discussion, while offering hope and encouragement.

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Connecting to Ourselves: Hungers

This past week I had the privilege of attending a conference with the phenomenal speaker Anita Johnston, Ph.D. and author of Eating in the Light of the Moon. Dr. Johnston talked a lot about deciphering our true hunger by using imagery and metaphors.
 
One thing in particular that really stood out to me was when she talked about our two different kinds of hunger.
1) Our physical hunger for food. Our bodies need food to fuel us through the day, and they will tell us through hunger when they are low on fuel (aka energy).
2) Our hunger for our other needs and desires. These can be spiritual, emotional, or relational needs.
When we learn what our hunger cues are, we can decipher whether or not we are physically hungry.

If we are not physically hungry, yet we want to eat—this is the perfect opportunity to get to know ourselves better.

I love this way of looking at eating. Whether we are restricting foods or emotional eating, both are the result of our bodies wanting to tell us something. There is no guilt in this. We just get to be a detective and try to find out more about ourselves.

We can ask ourselves: What feeling or emotion do I not want to feel? Why do I not want to feel it?

Our answer might be “I don’t know”. But overtime, our detective work might show us a pattern of wanting to eat when we are not hungry (or not wanting to eat when we are hungry) when __________________. We are all different and each one of us would fill in the blank differently. People might try to suppress anger after they get off the phone with a certain person, pain when they have an injury, loneliness when they are home alone, or fear when they are in a new situation that they are unsure about. The list could go on and on.

The bottom line: feelings and emotions are uncontrollable and are part of our everyday lives. We cannot control them anymore than we can control an earthquake or a tornado; we can only control our responses to our feelings. Yet, many times we unconsciously suppress them and do not allow ourselves to truly feel them.

Simply taking time to check in with your hunger, both physical or emotional, is a way to get to know yourself better and find out what your needs really are. Food does not meet all of our needs—it only satisfies physical hunger. So, next time you are craving a food but are not hungry, try exploring what feelings, emotional needs, or relational desires you might be suppressing. There is no judgment in eating or not eating whatever you are craving. There is only a great opportunity to explore what other “hungers” you have.

Note: Connecting to Ourselves is a monthly column written by Janet Zimmerman. We are CONSTANTLY surrounded with distractions and negative messages that take us away from what is really best for us (think about all of the icky dieting messages to get you geared up for bikini season, ugh!). Janet will be writing about a wide variety of topics to help you connect with the best ways to take care of YOU!  Janet is a dietetic student, positive body image advocate, and intuitive eating promoter. You can find Janet on twitter @JanetZimmerman where she loves tweeting yummy recipes, positive quotes, and mindful tweets.
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#endED Twitter Chat with Evelyn Tribole Re-Cap

In 2004 I was living in Southern California and completing my dietetic internship. I was one of the very few assigned to spend a couple of months working at a residential treatment facility for eating disorders. Not only did I learn that I was passionate about treating eating disorders, but I discovered the book “Intuitive Eating” for the first time. At this treatment facility, eating intuitively was used as the ultimate goal for balanced/healthy eating. I was sold and intuitive eating has informed both my work and my own relationship with food and my body ever since.

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When Evelyn accepted the invitation to serve as our guest expert for the #endED twitter chat, I was thrilled! I know that Evelyn and Elyse’s book and cd have served as beacons of light and hope for thousands of people, including those in recovery from an eating disorder.

Intuitive Eating (IE) is based on 10 principles. You can read them here. It is also rooted in three core concepts:
1. Unconditional permission to eat
2. Learn to cope with emotions without food
3. Rely on internal hunger & satiety cues

While we discussed quite a bit last night, here are a few token gems that I’ll keep with me (IE = Intuitive Eating and ED = Eating Disorder):

• Public health needs to emphasize healthy behaviors--not a weight, not a size...
• Decisions based on fear do not usually result in positive outcomes. It just reinforces more fear. 
• Reject the diet mentality. We are trained by our culture to believe that dieting is not only acceptable, but expected.
• Health includes, emotional health--flexibility, not perfection.
• When you really listen and have full permission, your body craves all sorts of food. It craves balance.
• Kids who diet are 13 times more likely to binge eat... 
• Important to recognize there is no single time-table for recovery. 
• Parenting--just eating dinner w/no electronics, gadgets, or tv--promotes attunement and family health
• If we could promote more HAES & health campaigns we would be healthier & happier vs fear, body hating
• Fat talk interferes w/ authentic truth. Negative feelings often dumped onto body--ie. Easier to be angrier at body than a friend.
• People need positive eating experiences to help w/fear. But dieting escalates fear, because the desire to eat intensifies...
• IE = honoring health, curiosity, & internal wisdom. ED = rigid, judgmental, external or from head. 
• I think it's important that people learn that dieting predicts MORE weight gain. Several studies show this--in kids, teens & adults.

Measurement of Health: Our Neck?

Anyone who knows me well, knows that I think measuring things like weight and BMI isn't all that useful.  I just don't feel that the information tells us a whole lot about our health. I believe that it gives us a sliver of information, not the whole picture.  I believe that focusing on behavior is much more important.  Working towards healthier eating habits and moving our bodies more is far more productive for our health than being concerned about the number on the scale (which for someone who works with eating disorders knows that weight tells very little about health).

Check out the book "Big Fat Lies" if you are interested.  The author describes (in detail) the flawed data that our current BMI and weight charts as based on.  I highly recommend it.

Just today, a client forwarded me an article I couldn't help blogging about because it's just so darn ridiculous.    Apparently a new study shows that your neck measurement may actually be a better way to determine your body fattness.  What!?  As if we need another number to be concerned about.  

The study authors had the following to say:

"We've been using BMI to advise parents and patients for making healthy choices," he said. "Unfortunately, often we tell someone their BMI is 27 or 30, most of the time it doesn't mean much. To tell you that your neck is wide, these are some of the risks associated to it -- that we feel people would be able to relate to it better than BMI."

I couldn't help but laugh. Let me be so bold as to offer you some advice- stop obsessing about numbers.  Stay focused on what you can do today and every day to be healthy: get plenty of sleep, stay hydrated, eat lots of produce, make an effort to move your body, you get the idea.
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