Body Image & ACT: Q&A with Author and Psychologist Emily Sandoz, PhD


The collective response to negative body image often includes an attempt to convince people to love their bodies, to embrace every imperfection and to do away with all negative thoughts.  These can be difficult, if not impossible, tasks for most people, particularly amidst the backdrop of a culture that encourages body bashing and a very narrow ideal of “beauty”.  For many individuals, negative thoughts about their bodies are so deeply entrenched that it feels too big of a leap to move from hating their bodies to falling madly in love with them. So if you’re not ready to love your body, what’s left to do?  Emily Sandoz, PhD, along with co-author Troy DuFrene, propose a different path in their new book, Living With Your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy. 

In anticipation of our upcoming Fall Community Event, we conversed remotely with Dr. Sandoz to find out more about her work with body image, Acceptance & Commitment Therapy (ACT), and of course, the soon-to-be-released book.  Read on to learn more about ACT and don’t forget to RSVP for Dr. Sandoz’s free presentation in Baltimore on November 17th, 2013, or download the event invitation (pdf).

 

Q & A with Emily Sandoz, PhD

Q: What was your  motivation for writing Living With Your Body & Other Things You Hate: How to Let Go of Your Struggle with Body Image Using Acceptance & Commitment Therapy (due out Jan. 2013)?

ES: Well, a couple of things. First, I find myself more and more aware of how body conscious we are.  At a very early age, people begin evaluating themselves in terms of their body’s appearance or functioning. For many, this can become a primary means of self-evaluation, becoming more of a focus than other things that person really values or strives for.  Further, I think the general public receives mixed messages about what they are supposed to do with those evaluations.  Are they wrong evaluations? Should they always evaluate themselves positively, always love the body? Should they change their bodies? Is it our responsibility to look good, to be strong and physically capable?  This book suggests that all that struggle to manage our thoughts and feelings about our bodies, or even manage our bodies themselves, can just lead to more and more struggle. We suggest that healthy body image is about body image flexibility – being able to receive our experiences of our bodies, good and bad, and to relate to ourselves and the world meaningfully, regardless of those body experiences.

Q: Many people engage in deep and serious battles with body image on a daily basis.   What are the possible repercussions of going through life hating your body? 

ES:It stands in the way of other things that are more important. You can’t help being critical of the way your body is.  That’s what minds do – they are critical.  They have to be!  But hating is getting entrenched in those self-criticisms.  Letting them drive your behavior, so you end up living your life more about managing your self-criticisms than about your relationships, or your career, or your spirituality – whatever is most important to you.

Q: What are the main tenets of Acceptance & Commitment Therapy?

ES: ACT (said as the word “act”) is based on the idea that healthy living is characterized by psychological flexibility, or the ability to experience ourselves, others, and the world fully and without defense, while taking action toward the things we care about, even when it is painful or scary. Not having this psychological flexibility is actually a driving factor in creating psychological stress and problems such as depression, anxiety and eating disorders.  It’s not our experiences (our thoughts or feelings) that are problematic, it’s all the things we do to try to get rid of them.  Those things interfere with the life worth living.

[Psychological flexibility spans a wide range of human abilities to: recognize and adapt to various situations; shift mindsets or behavior to preserve personal or social functioning; maintain balance among important life domains; and commit to behaviors that are congruent with our values. source: Kashdan & Rottenberg, 2009]

Q: What does the research say about the effectiveness of ACT for body image and eating disorders?

ES: This is a relatively new area, to be sure, but preliminary data coming from a number of different labs are largely supportive of the application of ACT to body image and eating disorders.  My own work in this area has recently moved to basic research, focusing on the nature of body image inflexibility, how it develops, and how flexibility can be trained. My hope is that this work can complement the treatment research by promoting continued development based on better understandings of body image flexibility and inflexibility.

Q: Many people are familiar with Cognitive Behavior Therapy (CBT) and Dialectic Behavior Therapy (DBT) but may be less knowledgeable about ACT.  What are the main differences between ACT and other evidence-based treatments for eating disorders and body image such as CBT and DBT? 

ES: Well ACT is a cognitive behavior therapy, but it differs from many CBT’s in that it challenges the idea that thinking must change for observable behavior to change.  In this area, ACT posits that healthy body image and eating does not depend on challenging critical thoughts about the body. It depends on learning to engage in meaningful, values-based action regardless of what thoughts are coming up.

Q: “Acceptance” can be a difficult concept for people to really understand and put into practice.  Why is this?  And what’s the most effective way to define or describe acceptance as it relates to body image?

ES: It’s tough because we sometimes think acceptance means liking or tolerating tough experiences.  Applied to body image, acceptance simply means making room for all thoughts and feelings about the body, whether we like them or not.

Q: What are the potential barriers to “letting go” of one’s struggle with body image? To that same point, what are the possible benefits?

ES: We are trained from a very early age that things that hurt are wrong, that we are responsible for managing our feelings.  In the case of body image, we are also taught that managing our bodies is our responsibility.  We are taught that it’s right to struggle, that we should feel good and look good, and we should be willing to struggle to get there. Because of this, considering letting go of that struggle is hard to even imagine. We find ourselves wondering what would happen to our experiences of our bodies if we stopped struggling. Would our bad feelings about the body completely overwhelm us if we weren’t managing them?  And what about our bodies themselves? If we weren’t struggling – Would we suddenly become grotesque? Would our bodies become completely disabled?  Of course, letting go of the struggle does mean that we expose ourselves to all kinds of hurt that we don’t like having.  Only letting go of that struggle frees us up to do other things that are more important – to allocate all those resources to the things we really care about, even when it hurts. And we know it’s going to hurt because we feel most vulnerable when we’re going after the things we want. So in ACT, we practice doing that, in the presence of the worst kinds of body hurt.  It’s not just hurt anymore, though, it’s hurt with a purpose.

Q: You talk in your new book about the idea that acceptance “isn’t something you do once”.  Can you elaborate on that notion?

ES: Well, it’s not like we pass through some portal where suddenly we are all-accepting and the work is done. It takes practice.  We think we’re doing great, then we suddenly notice all these new ways of inflexibility showing up, these new scary or painful thoughts coming up.  It’s just human nature.  Working on body flexibility is a lifetime commitment to making the things that matter to you more important than managing your experience of your body.

Q: Where does the element of “Commitment” come into play when working on body image struggles?

ES: Building a lifelong pattern of flexibility takes commitment. From an ACT perspective, commitment means noticing when we are being inflexible, when we are working to move away from ourselves and our own experiences, and simply turning back.

Q: What are some of the other areas in life in which the principles of ACT might be beneficial?

ES: Any area of life that is, for you, characterized by attempts to manage your experiences instead of managing the meaning in your life is an area of life that might benefit from the ACT principles.  And the ACT community provides a wealth of resources for people looking to do this kind of work. The Association for Contextual Behavioral Science website has a whole section for folks who are looking for support applying these principles in their lives, and New Harbinger publishes a number of self-help books for a range of difficulties people experience.

Q: On November 17, 2013 you will be in Baltimore speaking about How to Let Go of Your Struggle with Body Image.  What do you hope people will take away from this event and who could benefit from attending?

My main hope is that people may leave curious. Curious about how they struggle with their body image and what costs that has in their lives. Curious about how their lives might look different if they let go of the struggle with body image and embraced their experiences of their body, painful or pleasurable.  Curious about how they might use the time and energy if they weren’t spending it on the body image struggle.

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Emily K. Sandoz, PhD, is assistant professor of psychology at University of Louisiana at Lafayette, LA. She is a therapist who specializes in treating clients using acceptance and commitment therapy. Sandoz is coauthor of Acceptance and Commitment Therapy for Eating Disorders and The Mindfulness and Acceptance Workbook for Bulimia. She received her doctorate from the University of Mississippi, and she lives and works in Lafayette, LA.

On November 17th, Dr. Sandoz will be the featured guest speaker at The Center for Eating Disorders at Sheppard Pratt‘s fall event, How to Let Go of Your Struggle with Body Image.  Click on the link to find out more about the FREE event and to reserve your seats.

The Center for Eating Disorders at Sheppard Pratt offers outpatient therapists trained in Acceptance & Commitment Therapy. If you’re interested in this type of therapy and would like to find out more about starting treatment for an eating disorder and/or body image, please call us at (410) 938-5252.

 

Connecting with EMME on Body Image, Beauty and Balance…

 

The Center for Eating Disorders at Sheppard Pratt is gearing up for a week of free community events in recognition of National Eating Disorder Awareness Week 2013.  To help us kick things off, supermodel and positive body image advocate, Emme will provide a special keynote presentation in Baltimore entitled “Connecting BODY+MIND+SPIRIT” on February 24th, 2013. In advance of this free event, we asked Emme to share her unique insights into the current cultural ideals regarding beauty and to comment on some of the key elements that have helped her establish a positive, balanced relationship with her body, mind and spirit throughout her career.

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 Q & A with Emme Aronson:

Q: Through your development of EmmeNation and your role as an Ambassador for the National Eating Disorder Association, you have become a powerful advocate for positive body image. What does the term body image mean to you and how did it come to be such a significant part of your overall message of self-acceptance?

Emme: Body image is the framework for the house where our soul resides. If the foundation is weak, the house crumbles and the soul cannot fully exhibit its magnificence. How we live day-to-day depends on whether or not we have a connective or disassociated connection with our soul and our body.

Often we live from the neck up in a constant, not fully self-accepting state so to speak. By not breaking this chain of self loathing, body bashing, and guilt, dis-ease within one’s self grows and negativity cycles infinitum. At the same time a select few get richer at the cost of millions being diseased or disconnected each day, even each hour if engaging in large doses of media/TV.

It has always been my opinion that only by taking responsibility for one’s health and well-being of the mind, body and spirit, all parts moving in unison together as a befriended system, will we ever be set free from the onslaught of purely capitalistic influences. Our vitality of health, not to mention our culture and the imminent sustainability of our environment,depends on this effort.

Q: What would you say are some of the biggest pressures facing women and girls today that impact the way they experience their bodies and their inner selves?

Emme: I feel it’s the “capitalism-at-all-costs” mentality which, sadly, gets carried on the backs of women starting at an early age. This constant reminder of inadequacy plants insecurity where there once was none, or the seeds may get passed down generationally from mothers to daughters. With the hypersexualized advertising culture in full swing today, these dormant seeds are watered and the negative impact on body image, self-esteem, goal setting, visualization, and accomplishments rolls on, eroding the cornerstone of our society – women and children.

Q: What has your modeling career taught you about your relationship with your body?

Emme: Coming from a news media background, I immediately saw the lack of body diversity in the reporting of beauty. The story was loud and clear that natural body diversity was not to be discussed in mainstream media, and if it was, you were not to highlight it or shoot beautiful, size diverse models side-by-side. This was due to pressures caused by astounding amounts of money being dumped into diet related advertising (based on products with a 98% failure rate). The diet industry today probably makes well over a hundred billion dollars a year. (Psychology Today stated 50 billion in 1997, up from 30 billion in 1987). Understandably, a conflict of interest precedes that kind of money, especially when in uninformed hands. So its my job, and the job of other NEDA ambassadors, to reach out to the media as best we can to share best practices in reporting on body and eating related issues via the protocol presented to networks, women’s magazines and online outlets. An informed media gives them the opportunity to do good and make a choice, which is the best case scenario.

Q: The fashion and beauty industries often receive a lot of criticism for the role they play in pressuring women (and men) to look better, thinner, different, “perfect”, etc. How have you managed to balance your interests in fashion and beauty with your message of self-acceptance and inner beauty.

Emme: Having regularly been involved in the beauty, fashion, TV and clothing industries during different parts of my 20+ year career, I work on maintaining a balance between all the influences. I’m sure I have ruffled a few feathers when I’ve refused to say a line for a commercial, submitted a suggested rewritten line for a show, or refused commercial opportunities worth a lot of money because they didn’t align with my brand. I know a few people thought I was too righteous or full of myself but at the end of the day, I realized I didn’t need to defend myself but instead, had to go by the feeling I had in my gut. Your gut is a wonderful guide, if it’s tight and constricted, wait on whatever is in front of you. If you feel ease and grace, move forward. You may not understand what’s holding you back but listen to that innate guide that’s been with us since the beginning of time. That sensation doesn’t lie. It sometimes takes a lifetime to be still and feel it but, more times than not, it’s right.

Q: At various points in your life you’ve been faced with significant challenges, including a cancer diagnosis, which have surely tested you emotionally and physically. How have you managed to maintain a gratitude-driven existence and a positive relationship with your body throughout these ups and downs?

Emme: If I didn’t have the hearty body that I have, my cancer and treatments during chemo would have wrecked me. I feel today that cancer was one of my best teachers on so many levels.

However, where I gained the most appreciation for my curvaceous body was when I was pregnant. I absolutely loved being able to carry a child and know I was holding this new life in me. Regardless of the fact that my body gained 70 pounds and I was very large, I felt, without a doubt, that this was what my body was meant to do and I embraced myself at every stage. I even did a photo shoot (with all my bits covered but pretty much nude) and it’s one of my favorite shots.

Q: What is your favorite or most useful piece of advice for individuals who still struggle to find peace with their bodies on a daily basis?

Emme: Develop your list of gratitude and concentrate on that list until the anxiety of not being perfect subsides. This stops me before negative self speak rears it’s angry head. (Granted this sometimes takes years to work, but never giving up breeds success). After repeating this often enough like a trained dog, you come to realize you are much more than the empty shell we call our body. Instead of value being based on shape or size, a person’s true value has a chance to rise and nourish the individual and those around them, shining light on personal character traits like: helpfulness, friendliness, playfulness, bravery, courageousness and so on. Once again, take away the soul and you’ve got nothing, just bones, tendons, muscle and fat.

Q: In addition to your work in the U.S., you’ve been active globally with efforts to help women develop positive relationships with their bodies. Can you tell us more about some of these international efforts?

Emme: I’ve been so blessed to have been given the chance to travel a great deal domestically as well as internationally for my work. As a model I got to represent curvy women on three continents, and today I speak out in national and international press on issues relating to self-acceptance, the tricky issues around body image and how important achieving a healthy balance is to sustainability. Recently I was nominated as a Green Apple Ambassador by the Center for Green Schools, a program of the United States Green Building Council (USGBC) (@mygreenschools).  I’m being asked to co-create a K-12 curriculum with the CGS showing the correlation between the following: positive body image + environment = sustainability. Not only in the confines of the ED community are these issues being worked on but in the corporate world, educational systems, and in architectural environments. What is now being discussed in many professional circles is this: If you don’t feel good about yourself, you will not reach for better, think better, act better, eat better, do better, and ultimately may not care about anything beyond your immediate grasp, thus disconnecting you from the world in which you live. Not a great scenario overall.

So there’s clearly a lot of work to be done in the here and now with children, parents, grandparents, schools and the professional community to take responsibility for what we say, think and do to ourselves, to others and to the environment. And guess what? It boils down to such a simple notion:everything rolls from the source!

Q: Do you think we, as a culture, are making progress moving towards “body peace” instead of body bashing as our norm? What have you noticed?

Emme: We’re certainly speaking more about our bodies in print and online, and women are more reflected ethnically, in more various shapes/sizes and in a wider age range, thankfully. All are very important for our culture to see what exists beyond sterile, digitalized images and corporate projections of beauty. However, the more we seem to make progress and move forward toward diverse representations, the corporate push for a more restrained image pops back in again. So education is key and awareness is paramount. An educated and positively engaged mind, body and spirit can help filter what we see, hear and absorb. Indeed, buyer-be-aware of what we “buy into”. Our dollars can be spent in much better ways and can send a bigger message if we really put our heads together for real change in corporate America. I’ve learned, slow change is lasting change.

Q: Who could benefit from attending your presentation in Baltimore on February 24th? What message or skill do you most hope people will take away with them after hearing your talk?

Emme: I hope to connect with those who want to feel less alone and those seeking answers. No need to suffer in silence or bump along life’s journey by yourself. There’s no right or wrong when seeking out one’s truth. So my only message is this: Come with an open heart, you never know what may inspire, inform or ignite you. There’s only one you, and you are perfect just as you are!

 

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Many thanks to Emme for taking the time to respond to our questions and for sharing her strength and insight with our readers.  If you’d like more information about Emme’s presentation on February 24th, you can visit www.eatingdisorder.org/events or download the event flyer.  The event is free to attend but pre-registration is required to reserve seats.

Interested in more on this topic with Emme?  Join us for a special Twitter Chat with her on Thursday, February 21, 2013 from 1:00-2:00 EST.  Follow @CEDatSheppPratt and @EmmeNation for details and reminders.   

All photos of Emme courtesy of EmmeNation.com

Hope Through Science: CARRIE ARNOLD Talks About Decoding Eating Disorder Recovery

  

On November 4th, 2012 The Center for Eating Disorders at Sheppard Pratt will welcome Carrie Arnold to Baltimore for a special community event entitled, Hope Through Science: Decoding Eating Disorders.  Carrie Arnold is a trained scientist, science writer and also the creator of the popular eating disorder recovery blog, EdBites.  After her own decade-plus long battle with an eating disorder, Carrie recently released a new book designed to share the science of eating disorders in a user-friendly way that not only educates readers but empowers recovery.  In the book,  she discusses how delving into the biology behind anorexia helped her to overcome her own illness. 

In advance of her presentation, we asked Carrie to share a little bit about the new book,  the recovery journey, and why science is for everyone.  Read on to see Carrie’s responses, and don’t forget to click on the image at the bottom of the post for details on how to RSVP for her upcoming presentation. 

Q:  As a scientist, science writer and someone who has dealt with an eating disorder yourself, you have a unique perspective about some of the most critical aspects of the disorders and the science behind them.  What would you say is the one piece of scientific knowledge about eating disorders that everyone should know?

CA: I think the most important thing for someone to know about eating disorder science is that EDs are real, treatable illnesses. They are not choices–sufferers aren’t choosing to starve, binge eat, purge, and over-exercise. Rather, they are symptoms of a potentially deadly illness that requires rapid, intensive, and evidence-based treatment to bring about full recovery.

Q:  Can you list some of the potential benefits to learning about and understanding the biology of eating disorders? 

CA: For me, learning about science was a way to start moving forward rather than continually looking at my past to try and figure out what might have caused my disorder. Insight didn’t bring recovery. Learning my triggers was important, but trying to get to the “root cause” of my eating disorder wasn’t helpful because there really wasn’t a root cause. Rather, it was a perfect storm of events that tripped my predisposition to anorexia. Malnutrition and ED behaviors were perpetuating the disorder, and the first step in recovery was weight and nutritional rehabilitation.

Q:  What role did this knowledge play in your recovery process?

CA: Focusing on nutritional restoration as the first step of recovery was probably the most important. As much as I hated it (and believe me, I hated having to gain weight and stop ED behaviors!), I could think much clearer when I was at a healthy weight for me, and eating regularly. Studies have shown that reaching and maintaining a biologically appropriate weight is one of the best predictors of recovery, and having a treatment team and family that insisted upon this was probably the most important thing in my recovery.

Q:  Your new book focuses primarily on the science of anorexia but research gains have been made for all eating disorders in recent years.  Can individuals with bulimia, binge eating disorder and eating disorder NOS also benefit from uncovering the science behind their eating disorders? 

CA: Absolutely. I primarily discussed anorexia in my book because that was the disorder with which I had the most personal experience, and because the amount of research out there is so massive that I couldn’t tackle everything in just one book. Understanding what eating disorders are and what causes them (often, individuals have a biologically-based predisposition to EDs that are frequently triggered by an energy imbalance in the form of dieting, an attempt to “eat healthy,” growth spurts during puberty, increased training for sport, etc) can free the sufferer from blaming themselves and their families for past events and instead focus on moving forward.

Q:  Will your talk be applicable to individuals struggling with all types of eating disorders or just those with anorexia?

CA: This talk is definitely for people with any type of eating disorder. Even much of what we know about anorexia can be applied to other disorders–the importance of regular eating, addressing co-occurring conditions, understanding triggers, and relapse prevention. These things are universal.

Q:  While the focus of your book is on the biology and genetics of eating disorders, you make it a point to communicate that environment is still important and does influence behavior.  Why is this an critical reminder for readers?

CA: Many people hear the word “biology” or “genetics” and believe that if an eating disorder is related to either of those two things, then recovery is impossible. Their eating disorder was fate and there is nothing they can do. Which is the furthest thing from the truth! We can’t change our genes, but we can change our environment. Genes don’t act in a vacuum; environment is also important. Psychotherapy, for example, can physically change the brain and help you learn better coping strategies. I have to make sure to eat 3 meals and 2-3 snacks each day to maintain my recovery, as well as taking steps to prevent undue stress and sleep deprivation, all of which can trigger ED thoughts.

Q:  It can be helpful for individuals who are struggling with eating disorders to hear from other people in recovery, to know that it is possible, and that it’s worth it to keep moving forward.  What advice would you give to others who may still be struggling or are trying to find the motivation to pursue recovery?

CA: It was really hard for me to believe in recovery after years of illness, ineffective treatment, and failed attempts at recovery. Ultimately, I couldn’t sustain motivation on my own, especially in the face of overwhelming anxiety and depression. I needed other people in my life to believe in my own recovery until I was strong enough and well enough to believe it myself. It’s one of the most ironic features of my recovery- I didn’t have motivation to get better and sustain recovery behaviors until I was well on my way to wellness. It’s why support from friends, family, and treatment providers is so important.

Q:  What would you say has been the most meaningful or most worthwhile part of your own recovery?

CA: Not being so scared of everything. I can relax at times. I can laugh. I can be myself.

Q:  Who could benefit from coming to your talk, “Hope Through Science” in Baltimore on November 4th?  What would you say to people who might initially be turned off or intimidated by the word “science”?

CA: Eating disorders are so misunderstood that I think anyone touched by an eating disorder (sufferers, friends, family, and clinicians) could benefit from learning more about the subject. Our culture likes to portray science as something that’s just for geeks and eggheads. In reality, lots of people are interested in science, even if they don’t always know it. This won’t be like high school science class – I promise!

Q:  As someone who understands the suffering of an eating disorder and the hard work of recovery, what do you hope attendees will take away with them on November 4th after hearing your presentation?

CA: That recovery is hard work, takes a long time, and requires lots of support, but it’s possible with the right treatment.

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Many thanks to Carrie Arnold for taking the time to share her insight and knowledge for this blog.  Click on the image below for details about her upcoming presentation in Baltimore.  The event is FREE to attend but space is limited so be sure to RSVP.  If you have questions, please don’t hesitate to call us at (410) 938-5252.

Nurturing a Positive Pregnancy…Lessons Learned from Eating Disorder Recovery

Several months ago, The Center for Eating Disorders had the pleasure of hosting former World Champion rower, Whitney Post, as a keynote speaker during National Eating Disorders Awareness Week.  In her talk, Invisible Victory, she spoke about her identity as an elite athlete and how she ultimately used it to her advantage in recovering from her eating disorder (ED).  During her visit to Baltimore, Whitney also shared that she was expecting a baby this June, and that  her work in ED recovery had provided a unique perspective and helpful skills for navigating the ups, downs and body image challenges of pregnancy.  In honor of Mother’s Day,  we asked Whitney if she would help us re-introduce our Nurture blog series for moms and mothers-to-be, and she graciously agreed.  The result is this insightful and delightfully down-to-earth Q&A  post about her ongoing journey through pregnancy and recovery. 

 Q & A with Whitney Post

Q: Have you noticed any similarities or parallels between the pregnancy experience and the recovery process?

WP: I remember early on in pregnancy lying in bed and trying to take stock of all the changes that were going on in my work, my body, my energy, and my identity.  It felt overwhelming to say the least, but what occurred to me was that I was so glad I had all the training of recovery to help me navigate this new journey.  I already knew how to surrender large areas of my life for the sake of something new and different.  I think both recovery and pregnancy are about building new life.  In each the process is long, full of uncertainty and discomfort, and full of hope.  There is a great demand for outside support and people who have been through the process before, and the ability to surrender to what the process is asking of you vs. having things exactly the way you want them.

Q: Can you describe how the process of recovering from an ED has helped you prepare for the experience of pregnancy, particularly as it relates to your body image?

WP: I wanted to be one of those women who remained toned and just grew a big round belly out front.  I am not.  I wanted to be one of those women who stayed true to her satisfying workout regimes.  I am not.  And I wanted to be one of those women who seemed to get more stylish as her belly grew, with cool accessories and funky outfits.  I am not. 

But what I am is one of those women who is putting the health of the child growing inside me first, and doing my best with all the rest.  I just do it while wearing clogs, and in between very moderate (“lame” would be another term) workouts.  As the weight started to come on, I could feel two sides of my brain at work.  One said, “this is a miracle and weight gain is part of the process.  This is healthy and natural.”  Meanwhile, another, old part of my brain shouted, “Hello!!!! You are gaining weight!!  Remember how unhappy you were last time this happened?  Do something about it now!!!”  Every time another round of clothes has to be retired because it becomes snug, a part of me feels an old tug to feel bad about myself.  But recovery taught me the skills of being able to recognize these two different voices and gave me the ability to make a choice, vs. listening to whichever voice is scarier.  I am pleased to say that, “this is normal and natural” now wins easily over “go on a diet!”

At my OB office when they check you in for each visit they hand you a cup to pee in and ask you to weigh yourself.  They leave the room and come back in about ten minutes.  For several months I would worry about having to weigh myself, as part of my recovery has involved not knowing how much I weigh.  I could have asked them to weigh me and just looked away, that would have been totally valid, but I just chose to do the drill and let them decide if I was gaining too much or too little.  As long as I’m not trying to control my weight, but rather trust that to the doctors, and manage healthy meals and appropriate workouts, I feel I am on track.

Q: How can pregnancy positively or negatively impact recovery? 

WP: I have found that I have had to work pretty hard at taking care of my recovery because my needs changed suddenly.  I had to find a new way to eat when everything made me nauseated.  I had to find a new way to work the tools of the program when I was too tired to go to 12-step meetings I normally went to.  I had to find women who were in recovery who had been pregnant to learn from them.  So suddenly, the little world of my recovery resources needed to be updated and shifted, and that has been a big investment on my part.  So I think if you let the things that sustain you in recovery slide because you have less energy or those resources don’t fit as well, you can be on a slippery slope, because you may also find yourself (as I often have) more emotionally vulnerable than normal.  But if you look at it as a time to invest in a new phase of recovery and build a community around you, it can strengthen you.

Q: Can you share some concrete steps women can take during pregnancy to help them nurture a positive relationship with their changing bodies?

  • Recognize you may have conflicting feelings and impulses but make sure your actions reflect your goals and values.  (for example – I want to diet because I don’t like gaining weight but my goal is to have a healthy baby and pregnancy, and so I will accept that gaining weight is part of the process and is temporary).
  • Talk to other women who have been through it and speak honestly about your experience.  You can be a wonderful mother and still not enjoy every aspect of pregnancy – they are not mutually exclusive.
  • Ensure from the outset that you have an OB who is supportive of prioritizing health vs. weight.  Then, trust your doctors when it comes to monitoring weight, exercise, etc., and get someone (nutritionist or physician) to work with you on the food and eating part, if you struggle with it, so you aren’t alone.
  • Focus on the positive parts – go to birthing classes, pay attention to the baby kicks, pick out baby clothes, prepare the house, etc.
  • Go with your body’s intuition about when it needs a rest, a snack or a cry.  You may not be able to keep up with your old self, or your old standards, and that’s okay.  It’s important to accept that your body now has a whole new task to prioritize; supporting the physical growth and development of your baby requires a lot of energy.

Q: As an eating disorder treatment professional, a recovery advocate and now a pregnant woman yourself, what are your thoughts on the mainstream media’s representation of pregnant and post-pregnancy bodies? 

WP: Mainstream media has never been helpful when it comes to figuring out how my body should look, and a pregnant body is no different.  The women chosen to be pregnancy models or on the covers of magazines are a very select group of pregnant women who all look much the same, and are all captured in about their fifth or sixth month of pregnancy when the belly is often cute and round.  If you go to a prenatal yoga class and look at all the bodies (as I often did – I was barely able to focus on the poses) you will see all the different shapes and sizes of bellies regardless of the phase of pregnancy.  Some of them seem pretty wacky looking as we are just not accustomed to seeing really pregnant women!  I find it much healthier to see these real live pregnant women than to look at the models.

As for “after the baby” the media is obsessed with how fast a woman can “get her body back.”  I’m happy Heidi Klum made it her goal to be a sexy Victoria secret model within weeks of giving birth, but I don’t think that is helpful for most women.  I am really looking forward to being able to run and do a sit up and move my body with greater ease and speed after the baby is born.  But the reality is I will be sleep deprived and in a very demanding phase of feeding, soothing, and getting to know a new baby, and at that time, I don’t need to be preoccupied with how quickly I can lose weight.  Focusing on eating well and getting in some sleep and exercise will be my goal for good self-care.

Q: Is there one piece of advice that has been particularly helpful for you in terms of staying focused on wellness and body positivity during pregnancy?

WP: Trust your body and stay connected ~ not that different from recovery, right? : )  Pregnancy can make you tired and moody, and both of those things can make socializing less appealing. I have found that I need to push myself to stay connected to old pals and to reach out to start to create a new community of moms-to-be. 

Q: Are there any lessons you’ve learned through ED recovery that you think may also be helpful for individuals as they venture into the day-to-day life of motherhood with a new baby?

WP:In recovery I spent a lot of time learning how to figure out what I needed, and how to stand up for that need while being kind and respectful of others.  But I still need to fight a part of me that is stuck in the habit of  “people pleasing.”  In pregnancy part of my job is to avoid putting myself in bad situations (being around people who have contagious colds or flus, overdoing myself with social/work demands), even though I might have been fine with these situations when not pregnant. This means I have to say “no” to things more often.  I learned early on that if I went against an instinct about my limits of comfort, I was really uncomfortable. I imagine some of the same will be true with an infant.  So my lesson that I am learning over again is that I need to respect my instincts and boundaries, and while I may inconvenience people in the process, we will all survive.

Whitney Post is the President and Co-Founder of Eating for Life Alliance and spends much of her time educating college students, professionals, athletes and coaches about eating disorder prevention and treatment. The Center for Eating Disorders is incredibly grateful to Whitney for sharing her insights, experiences,  and advice about pregnancy and recovery for this post We wish her well as she ventures into motherhood!  If you’d like to share your own ideas on this topic, please leave your thoughts in the comments section below or join the discussion on our Facebook Page

If you enjoyed this blog, you may want to read these previous entries from CED’s Nurture Blog Series:

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*Significant health risks (for mom and baby) are associated with eating disorders during pregnancy.  It is recommended that the eating disorder be significantly resolved before a pregnancy is attempted.  If pregnancy does occur prior to recovery, it is imperative that you receive appropriate medical and psychological support. If you are struggling with an eating disorder during pregnancy, or are working hard to maintain your recovery during pregnancy, we would like to remind you how important it is to be honest with your OB and other medical providers during this time.  It’s critical that your providers are aware of your medical history and any current and past ED symptoms so that they can provide the best possible health care for you and your baby.  

Invisible Victory: An Athlete’s Story of Hope & Triumph in Eating Disorder Recovery ~ Q & A with Whitney Post

In observance of National Eating Disorders Awareness Week 2012, The Center for Eating Disorders at Sheppard Pratt in Baltimore is excited to offer a special community event to raise awareness about the serious nature of eating disorders, the importance of treatment and support, and to help shed some light on the surprising place where eating disorders often hide – on sports teams and among athletes.  On February 26th, former World Champion rower, Whitney Post, will be speaking about her own identity as an elite athlete and how she ultimately used it to her advantage while recovering from an eating disorder.  Today, Whitney is the President and Co-Founder of Eating for Life Alliance and spends much of her time educating college students, professionals, athletes and coaches about eating disorder prevention and treatment.   

In advance of her talk, we asked Whitney to comment on this important topic and provide our readers with a glimpse into her February 26th presentation entitled, Invisible Victory: An Athlete’s Story of Hope & Triumph in Eating Disorder Recovery. 

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Q & A with Whitney Ladd Post:

Why do you think it is important to address the intersection between sports and disordered eating? What are the benefits to creating awareness and spreading education about this particular topic?

WP: For starters, we live in a culture that is incredibly rewarding of the goal-oriented, driven, take-responsibility, and perfectionistic qualities of athletes.  In addition, the media sensationalizes athletic bodies, not just athletic performances. In athletes, the body can become an obsessive focus as well as a tool for athletic success. Many of the traits that make people successful and driven athletes, can also be easily misdirected towards disordered eating and an overly-critical body image. In one study of college female athletes, 88 % felt they were overweight or needed to lose weight. Another challenge is that some athletic cultures perpetuate the myth that weight loss improves performance, and athletes may be reluctant to acknowledge a problem or seek treatment. In short, it can be very easy for athletes to hide a serious and dangerous eating disorder because they often appear, from the outside, to be excelling at their sport and may look incredibly fit and healthy.

My goal is for everyone, athletes in particular,  to understand the physical and emotional consequences of eating disorders and disordered eating in the short and long term.  Weight loss in athletics can often be presented as the magical elixir, but if it compromises health it will ultimately compromise performance.  I want athletes to know that it is a highly treatable disorder with early and proper interventions, and I want to address their reluctance to seek treatment. In my experience an eating disorder never gets better if left untreated, only worse.

Research tells us that eating disorders are biologically-based illnesses but that a variety of other factors can also play a role in how and when the illness is expressed in different individuals.  Did being an athlete affect your struggle with the eating disorder?  What role did it play in your recovery?

WP: When people ask me if lightweight rowing gave me an eating disorder, I say absolutely not. I loved being on the water, I loved the sense of team, and I loved working hard to win. Yet, I also had an attraction to the grueling process of making weight for the sport, as part of my willingness to put my body through extremes for the sake of weight loss.  Lightweight rowing offered me a mechanism to play out my unhealthy relationship with food and my body.  My years as a lightweight further entrenched my eating disordered mentality.

Yet, there are many features of athletics that can be applied to recovery if the right goals are set.  The sense of team, commitment, step-by-step training toward a goal, and positive self-coaching as well as support and guidance from others can be applied to the treatment of an eating disorder.  Part of my message is that some of the same liabilities of competition and training can be redirected toward recovery.

Your blog about eating disorder recovery is called “Invisible Victory” – why do you refer to this victory as invisible?

WP: Great question.  For me, all my goals in my sports career involved getting noticed, recognized, and praised.  There was always a teammate or a coach or spectator to witness when my hard work resulted in success.  The situation was very different with my eating disorder recovery.  I had to be my own cheer leader, because so many of my victories were not even perceptible to anyone else.  Monitoring and changing my thoughts, behaviors, and reactions were crucial to creating a new relationship with food and my body.  I had to learn to both accept the invisible nature of my new quest, and celebrate the victories big and small with or without witnesses.

When you were struggling with an eating disorder, did you ever reach a point where you didn’t think recovery was possible?  If so, what helped you push past it and what message would you give to other individuals who may be feeling that way now?

WP: Recovery felt very much the way many of my lofty athletic goals felt.  At times I faced feeling totally devastated, discouraged, and depressed, but I never stopped working in the direction of my goal.  So of course there were many times when I wasn’t sure I would ever find my way out of my little prison in which I was both warden and prisoner, but I never stopped trying.

How has your definition of health changed throughout your life as you were struggling with an eating disorder and now, as an advocate for recovery?

WP: The biggest tangible change over the years has been that my self-worth and self-image are no longer tied to exercise. Exercise is still very important to me, but now I workout mainly for the health, mood, and social benefits (I love working out with a friend).   I believe the best way to advocate for health and recovery is to live it.  I continue to place a high priority on physical, spiritual and emotional health.  Without that, nothing else works very well.

It’s clear from your bio at Eating for Life Alliance (ELA) that you’ve accomplished a great number and variety of personal and professional goals.  What would you say you are most proud of today and why?

WP: I am so happy to be freed up from the narrow vision of the world that defines eating disorders.  Instead of all the daily struggles faced when I defined myself by my body, I am now free to channel my energies to so many things.  For me, recovery from my eating disorder was a gateway to an easier and more fulfilling life.  I have a wonderful marriage and a new family, great friendships, and the opportunity to work professionally on something I am passionate about.  Before recovery these things seemed to always belong to other people, not me.

What do you hope is the take-home message for those who attend your presentation on February 26th?  Who could benefit from attending?

WP: My message is one that can benefit anyone who has been affected by an eating disorder themselves or has had a loved one with an eating disorder.  It is also important information for any parent, professional, educator, coach or friend who will likely be in a position to help someone someday if they know what to look for and how to respond.

One practical message I plan to get across to athletes and those who work with them is this: although athletes have a unique set of factors that make them more susceptible to eating disorders, they also have impressive assets that can be enlisted in helping them recover.  Eating disorders are common in athletes, and I don’t want anyone to be isolated and without the help she or he needs.

I want to offer education and encouragement to everyone who attends and wants to know more about eating disorders as they pertain to exercise and athletics, as well as to anyone out there who is looking for more hope.

Download the event flyer (pdf)

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Many thanks to Whitney Post for taking the time to provide these responses and for having the courage to share her story so that so many others may know they are not alone. 

If you would like to hear more about Whitney’s story of recovery, please join us on Sunday, February 26th at 2:00 pm for our NEDAWeek kick-off event, Invisible Victory: An Athlete’s Story of Hope & Triumph in Eating Disorder Recovery.  All are welcome to attend this FREE event.  We strongly encourage athletes, coaches, athletic trainers and athletic directors from surrounding schools and colleges to attend,  as well as any individual who has been personally affected by an eating disorder, their parents, friends, educators, and health professionals.  Please download an event flyer for details.  Attendance is free but seats are limited so pre-registration is encouraged by emailing: RSVP@sheppardpratt.org

This is just one of several special events to be offered over the course of NEDAWeek.  Find out more on our Events Page

You can also request a mailing of event flyers or posters for your organization by emailing  kclemmer@sheppardpratt.org.  

 

“Navigating Our Culture’s Body Anxiety & Finding Body Confidence” ~ Q & A with SUSIE ORBACH

Susie OrbachSusie Orbach is a psychoanalyst, activist and author of many books including the classic, Fat is a Feminist Issue and her latest publication, Bodies. In addition to co-founding The Women’s Therapy Centre  in London and The Women’s Therapy Centre Institute in New York, Orbach serves as consultant and co-originator of the Dove Campaign for Real Beauty.  She is also convenor of www.any-body.org through which she recently organized a series of international summits aimed at promoting body diversity and changing the way our culture turns individuals against their own bodies.

As an author and international body image activist, Orbach lectures extensively worldwide.  On October 2nd, 2011 we are excited to welcome her to The Center for Eating Disorders at Sheppard Pratt in Baltimore where she will be presenting a free talk for the community entitled, Navigating Our Culture’s Body Anxiety and Finding Body Confidence. You can get the details and reserve your seats for the event here.

In advance of her presentation, we asked Dr. Orbach a few questions about her upcoming talk and her responses are below.
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Q & A with Susie Orbach:

Q: The title of your upcoming talk at CED is “Navigating our Culture’s Body Anxiety and Finding Body Confidence”.  In your own words, how would you define body anxiety?  How do you define body confidence?

Susie: Body anxiety: Waking up and worrying whether it is going to be a good day or a bad day in relation to food; scrutinizing your body –dreading it will have the faults you see there, hoping it won’t; feeling pierced throughout the day with negative body thoughts; making plans to change the way you eat, exercise because you must ‘punish yourself’ and so on

Body confidence: waking up and feeling your physicality; reflecting on what you are doing that morning and what you might want to wear. Eating just what you want and relishing it when you are hungry. Moving your body because it feels good. Enjoying going about your life trusting your body will be there in a good way with you.

Q: In your opinion, where does the responsibility lie for this culture of extreme body dissatisfaction we have come to accept as the norm?  With whom does the responsibility lie to change it?

Susie: Big questions I hope to answer in my talk…The important thing is that whether in advertising, the media, food industry, the beauty industry, there are things we can to do change the situation. We need bold strategies from the individual, to the corporate to the political governmental

Q: What would you say is the biggest cultural myth that affects body image and/or weight struggles?

Susie: That the diet industry is on our side. It isn’t. It is part of the problem not the solution

Q: You have played an integral role in the creation of an international movement called Endangered Species.  What is the mission of this project?  In what ways has the project begun to accomplish its goals and what is on the horizon?  How can individuals contribute to the movement?

Susie: Come and join us one and all…set up a group in Baltimore, propose a project or join one of our existing projects. You are really welcome and needed.

Endangered aims to transform the culture that makes us afraid of our bodies and their appetites. We launched this year on the 100th Anniversary of International Women’s Day. In London we are working with Parliament, with Girl Guides, with the Y, with many different Body Activist Groups – some in Fashion, some in education,  to take on those industries which grow fat on making girls and women, and increasingly men, feel wary of their bodies and their desires.

*Check out some great highlights from the Endangered Species Summits compiled by  Elena Rossini who is also the director of the upcoming documentary, The Illusionists.

Q: Many people, especially individuals with eating disorders, often struggle with intensely comparing themselves and their bodies to other people.  What do you think are the origins for this process and what roles do you see body competition and comparison playing in our society today?

Susie: Body competition is destructive and ubiquitous and not made easier by the cosmetic surgery industry, photo shopping and celebrity culture. Our visual culture is so full of images of people that don’t actually exist and it is very damaging.

Q: In your experience treating individuals with eating disorders and body image disturbances, what one piece of advice would you offer to individuals working towards recovery and body acceptance?

Q: Susie: Look back at pictures of yourself from a few years ago when you thought you looked awful (if you kept them), the odds are, you’ll find you were quite ok, lovely even. Then reflect upon the sad fact that you didn’t trust you looked ok then but you did so perhaps you have to risk feeling a tiny bit ok now…….

But in truth I wouldn’t give one piece of advice! It would depend on the individual….

Q: What keeps you hopeful that we will be able to push back against society’s damaging messages with regard to body satisfaction?  Do you think we will see real change in the way future generations relate to their bodies?

Susie: I am deeply pessimistic. But I also think: what choice do we have but to challenge the hurt and the vicious attacks on bodies. What gives me hope are the number of body activists out there – young, old, across cultures and class who are insisting on something more humane in relation to our bodies.

Q: After attending your community talk in Baltimore on October 2nd, what primary message do you hope individuals will take from your presentation and put into practice?

Susie: Gosh, that’s tough. We are all individuals and will take and give different things to the day and so what hits home will vary, but I hope it is the determination to make peace with our bodies.

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We hope so too.

Do you have your own questions for Susie Orbach? Join us in Baltimore on October 2nd for the chance to ask.  A reception and book signing will follow the presentation.  Attendance is free but seats are limited – don’t forget to RSVP.  Get details HERE.

Are you a treatment professional?  You may also be interested in the continuing education event taking place earlier the same day:

October 2, 2011 (8:00-11:00am) The Body in Therapy: An In Depth Look at Countertransference and the False Body with Susie Orbach, approved for 2.0 CME/CEU credits.  Download the program Flyer (pdf)


Is ‘MyPlate’ Missing the Mark?

In conjunction with Michelle Obama’s Let’s Move campaign, The US Department of Agriculture (USDA) released the federal government’s newest national food and nutrition icon on June 2nd.   The new icon, referred to as MyPlate, is actually the 7th in a succession of food guides promoted by the USDA over the past 95 years.  The most recent predecessor to MyPlate was MyPyramid, introduced in 2005, which most people are relatively familiar with.  The new MyPlate is arguably easier to interpret than the pyramid, particularly because MyPlate recommendations are communicated through a simplified visual that consumers use every day – a dinner plate.

Michelle Obama had this to say about the usability of the new icon, “When mom or dad comes home from a long day of work, we’re already asked to be a chef, a referee, a cleaning crew. So it’s tough to be a nutritionist, too. But we do have time to take a look at our kids’ plates. As long as they’re half full of fruits and vegetables, and paired with lean proteins, whole grains and low-fat dairy, we’re golden. That’s how easy it is.”   Easy as it may seem, we still have some reservations about the new icon, particularly the dietary suggestions and some of the interactive tools that accompany it.

  • Blanket Assumptions. MyPlate’s overall recommendation is: “Enjoy your food, but eat less”.  This statement operates under the basic assumption that all Americans overeat which is simply not true.  What if the consumer already eats appropriate portions, or perhaps doesn’t eat enough to fuel their body?  “Eat less” sounds a lot like a universal prescription for restriction and leaves little room for honoring internal cues for hunger/fullness.
  • Is this just another diet? The reigning factor in MyPlate seems to be focused on control; control your diet and portions within the confines of the plate, and avoid too many of what MyPlate defines as “empty calories” (more on this term later).  Healthy, normalized eating involves trusting your own body’s hunger, fullness, and taste cues to help give you everything you need. The My Plate icon could be a helpful reminder of the importance of a balanced diet.  However, working overtime to make every meal fit precisely into MyPlate could be more harmful than helpful in establishing a peaceful relationship with food.  Furthermore, many of the associated online tools on the USDA website, including “analyze my diet”, food tracking and calorie counters seem to foster an unnecessary focus on precise counting/measuring of foods.
  • Essentially Missing. Fats and oils are not visually represented anywhere on MyPlate despite the fact that fats and oils are necessary for energy, transportation and absorption of vitamins, satiety, taste and texture, heart health, and cholesterol.  They are an essential nutrient, and a major component of all brain and nerve cells. The MyPlate website does state that “oils are not a food group, but are essential.”  If the goal is healthy and balanced eating, such an essential part of the human diet needs to be represented on this easy-to-read graphic as it was with the last two government food models. Showing healthy ways to incorporate dietary fat and oils into meals could help educate consumers on appropriate amounts of dietary fats and oils as opposed to just instilling a fear of them by ignoring them altogether in the icon.
  • Labeling Foods. Labeling foods as good/bad or healthy/unhealthy is a way of thinking that isn’t making Americans any healthier and can actually promote disordered eating.  Yet the USDA website where MyPlate lives continues to assign the  “empty calories” label to a long list of  foods.  A calorie is a measure of energy, equal to the amount of heat that is contained in food and released upon breakdown in the body.  All food provides energy to our body – glucose to fuel our cells, protein to build, repair, and maintain body tissues, and fat for healthy cell membranes and brain development. Remember that by incorporating different choices from all food groups, you will naturally be achieving an appropriate balance of calories – thus leaving room for the treats and extras that are physiologically and psychologically satisfying.  Removing labels on food, such as “empty calories”, and working to make all foods neutral lends itself to a healthier relationship with food, and helps with food habituation – when you’ve had a food item a multitude of times and can decide freely whether you’ll truly enjoy and taste the food when you have it.
  • Logic. The plate pictures protein, grains, fruits and vegetables with a side of dairy as an ideal meal. How would an average consumer translate this message? Perhaps strawberries just don’t make sense with your Chinese food meal.   Does this picture create the notion that every food group must be consumed at every meal? (i.e. veggies with your cereal?)  That feels like a lot of pressure.  And what about lasagna or casseroles when almost all of the food groups may be combined into one dish – where does that fit into the MyPlate icon?  Looking at an overall weekly balance of nutrients and food choices would be more appropriate than feeling as if the eating must be perfect on every plate at every meal.
  • Does it promote overeating? Does the plate send the message that someone should push past their satiety point just to incorporate that fruit or dairy serving? Not honoring the fullness cue could trigger feelings of shame and guilt (not to mention physical discomfort), which can lead to emotional eating or compensatory restricting.

So, the next time you sit down to a meal, take a look at your plate. Not in an effort to follow the MyPlate guidelines exactly, but more so to be mindful.  Are you choosing a variety of foods from each food group throughout the day or week? Do the food choices make sense and complement each other?  Are you able to stop when you feel full?  Choosing foods that nurture the body and the mind are all steps on your road to health, and a healthy relationship with food.

Do you have questions about MyPlate or other nutritional guidelines?  Ask our Registered Dietitians and we’ll post the questions and answers on our blog!  Submit questions by emailing kclemmer@sheppardpratt.org anytime before August 10th.  Add “ask the dietitian” in the subject line.


Submitted by Courtney Perkins, RD with contributions by CED’s team of Registered Dietitians

Life Beyond Your Eating Disorder: Q&A with Johanna S. Kandel ~ Part 2

Today we feature a continuation of  a two-part interview with Johanna Kandel, author of Life Beyond Your Eating Disorder and upcoming keynote speaker for The Center for Eating Disorders at Sheppard Pratt’s NEDAWeek kick-off event. Check out Part 1 to read Johanna’s thoughts on the role of control, humor and fear in the process of recovery.  In part 2, below, Johanna discusses her top 3 recovery tools and what she hopes people will learn from attending her presentation in Baltimore on February 20th, 2011.  You can find out more about this free event here.

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Q&A with Johanna S. Kandel ~ Part 2

Q: In your book you talk about not knowing who you were during the height of your illness and that you felt like you had become your eating disorder.  How did you re-discover yourself and did you encounter any surprises along the way?

JK: One of the biggest fears I had when approaching recovery was not knowing who I was or what I liked.  I truly believed that recovery meant knowing everything about me at that moment.  My therapist assured me that no one was expecting me to know all the answers to the all important questions right away.  No one was expecting me to write an epic-autobiography about all of my likes and dislikes the moment I began the recovery process.  Life, like recovery, is a journey and you may find that what you like today may not be what like you two weeks or two months from now. The biggest surprise that I encountered was that I actually started having a good time exploring all the things I gave myself permission to try.  Nothing is written in stone, so give yourself permission to explore and try something new.  You never know, you might just like it!

Q: What would you say were the top 3 most important things in your recovery toolbox?

JK: Filling my tool box with as many tools as I could was integral to my recovery.  Some of my most favorite that I used on my journey were:

~ Ignorant Stamp to help me to ‘stamp out the ignorance’ and not let people’s comments fuel my negative voice.

~ The Dresser with Seven Drawers which allows me to take a look at the ultimate best outcome (top drawer), the ultimate worst (bottom drawer) and then come up with a middle ‘okay’ drawer/outcome.

~ The Box of Crayons – Just as in a box of crayons there are so many colors other than just black and white.  As someone who lived in only the black or white (all or nothing), learning to embrace all the colors in the crayon box of life was so important.

Q: What do you hope people take away from your presentation in Baltimore on February 20th?  Who could benefit from attending?

JK: My biggest wish is that people take away the message that there truly is life beyond eating disorders.  People can and do recover.  There is help, there is hope, and there is healing.  I battled for so many years alone and afraid.  I didn’t believe that I would/could get better.  I didn’t think it was an option.  Turns out, it absolutely was and can be for anyone that is struggling too.  If you or someone you know is battling and/or recovering, I hope you will be able to join me on Sunday, February 20 at the Center for Eating Disorders at Sheppard Pratt.  I am so incredibly honored to be part of their Eating Disorders Awareness Week events and really look forward to seeing you there!

In good health,

Johanna

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We would like to extend our sincere gratitude to Johanna Kandel for taking the time to provide such hopeful and insightful responses for this blog.  We are very much looking forward to her Life Beyond Your Eating Disorder presentation in Baltimore on February 20th, and we hope you can join us.  Download the event flyer (pdf) and remember to pre-register as space is limited, and seats are filling up quickly!

More Upcoming NEDAWeek Events at The Center for Eating Disorders:

  • Love Your Tree‘ Community Art Exhibit and Reception on February 22, 2011 at 6:30pm
  • Free Eating Disorder Screenings ~ February 21-25, 2011

Visit our Events page or call (410) 427-3886 for more info on any of the upcoming events.

Life Beyond Your Eating Disorder: Q&A with Johanna S. Kandel

Each year in February, The Center for Eating Disorders at Sheppard Pratt kicks-off National Eating Disorder Awareness Week  with a special event designed to shed light on the serious nature of eating disorders.  This year, we are excited to host Johanna Kandel who will present a free talk for the community entitled “Life Beyond Your Eating Disorder” on Sunday February 20th, 2011.  Johanna is an author and the Executive Director of The Alliance for Eating Disorders Awareness. She will not only be helping to spread awareness and education about eating disorders but she will share her own inspiring story of recovery and hope.   In advance of her arrival in Baltimore, we asked Johanna to provide us with a glimpse into her experience with the recovery process. Read her responses below and visit our Events page to RSVP for her talk in Baltimore on February 20th.

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Q & A with JOHANNA S. KANDEL ~ Part 1

Q: In the preface to your book you quote a philosopher who said “A journey of a thousand miles begins with a single step.”  Why is this an important message for individuals who are struggling and what was your first step towards recovery?

JK: Recovery from an eating disorder is definitely a journey that happens one step at a time.  It doesn’t happen overnight and it is not perfect.  When I became so sick and tired of being sick and tired, and when the pain of living with my eating disorder exceeded my fear of recovering, I knew that it was time to do whatever it took to start the process of recovery.  The first step I took was reaching out to my parents and asking them for what I needed most of all: help.  However, the idea of changing everything right away was way too scary. I had to remember to take it one moment at a time.  And if I tripped along the way, I had to pick myself up, dust myself up, and keep on stepping.

Q: Was there a time during your illness that you knew something was wrong but you convinced yourself that you had everything under control?  If so, how did you eventually break free from that thought process?

JK: Ah, control…the famous word!  I have to say that when it came to control, my eating disorder pulled a ‘bait and switch’ on me.  At first it lured me in with its promises of feeling like I had ultimate control, but very quickly I realized that the eating disorder was the one in control (while garnering a path of self-destruction).  For so many years, my negative voice was the only thing I heard.  My healthy voice was only a distant whisper and seemed liked a complete stranger.  Learning how to first press the “pause” button and then the ‘stop’ button {when the negative thoughts were taking over my thought process} is what allowed me to ultimately break free.

Q: There are several very meaningful yet funny parts in your book – the body armor incident to name just one – did humor play a role in your recovery?

JK: Absolutely!  Surprisingly to me, I found myself laughing quite a bit throughout my journey.  After not laughing at all during my battle with the eating disorder, it was strange at first, but then I began to embrace it.  I learned to how to use laughter as another tool in my recovery toolbox. It was so interesting to see just how many times laughter got me through potentially triggering situations and became an ally.

Q: What were your greatest fears about recovery and moving beyond your eating disorder?

JK: I had so many fears about recovering from my eating disorder.  In fact, it was the fear that stood in the way of my recovery for so long.  It was my security blanket and I didn’t know how to cope or live without it.  I was afraid to live without my eating disorder because I didn’t know who I was without it.  I was afraid of dealing with my emotions, I was scared of feeling, and I was petrified of using my voice. I was also so incredibly scared that recovery (and all the hard work it would entail) would not be worth it.  As I began to walk through my fears and take very small risks, I realized that I could live without my eating disorder and that I was so much more than just that.  I started feeling again and it was (although scary at first) so incredibly wonderful.  I learned that I had a voice that deserved to be heard and I became pretty comfortable using it.  And finally, I can say with 100% conviction that recovery was without a doubt the best thing I ever did.


Part 2 of the interview with Johanna Kandel is now up!  Click HERE to read about her top 3 recovery tools and how she re-discovered herself without the eating disorder.  Can you relate to Johanna’s experience above?  What parts of Johanna’s message have played an important role in your journey to recovery?  Please leave a comment below or join the discussion on our facebook page.

Download the Event Flyer:   Life Beyond Your Eating Disorder ~ JKandel 2.20.11 event (pdf)

Johanna’s book, Life Beyond Your Eating Disorder is available for purchase at Barnes & Noble.com

Support for Parents & Families: Navigating the World of Eating Disorder Treatment & Recovery

Join us on Thursday February 24th, 2011  to hear from a panel of parents who’ve been through the treatment process in various forms with their own children.  Listen to their stories and join the conversation during a special Q/A with the panel members and several treatment specialists from CED. You can read more about the event and meet our panel members below, then download the Event Flyer or visit our website to register for this free event.

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For someone with an eating disorder, the positive role of the family in the recovery process cannot be underestimated.  Parents, spouses, siblings and close support people can make a world of difference for someone who is struggling with an eating disorder, especially as they work towards recovery.  But its not easy.  It takes a lot of patience and presents many challenges for parents and support people who have never before been forced to learn about the complexities of an eating disorder or navigate the world of treatment. Just as the individual with the disorder experiences intense fears, personal hardships, and emotional angst throughout the illness and recovery, so too do those who support them.  It can be torturous to have an eating disorder but in many ways, it can be just as difficult to care deeply for someone who does.

Parents in particular, despite the age of their son or daughter with an eating disorder, can be met with incredible fear, stress and frustration as they try to weed through a completely new landscape of physical and mental health complications, what to say and what not to say to someone in treatment, and how to respond to irritability, refusal to get treatment, or general isolation from the rest of the family.  And while each family has their own unique experience, two things are very common when approaching the recovery process with a loved one:  1) you will have a lot of questions, and 2) you may feel very alone.  That being said, it can be very beneficial to talk with other families who understand what you’re going through and can offer knowledgeable, experienced support.

This year, in honor of National Eating Disorders Awareness Week, The Center for Eating Disorders at Sheppard Pratt will be hosting a Panel Presentation and Q/A event featuring parents who’ve experienced the difficult job of supporting a loved one with an eating disorder.  This free event is designed to create a safe place for families and support people to gather, ask questions and seek feedback from those who’ve been in the trenches themselves.  The panel will also include specialists from the Center for Eating Disorders who will answer questions about the treatment process, types of therapy, health and medical concerns,  nutrition issues, and all things affecting recovery.

All of the parent panel members come to the table with different experiences, different strengths and different outcomes but they all have an important story to tell and a hopeful message to share.   If you have questions about supporting a loved one, or you would just like to listen and know that you are not alone, please join us for this special event in Baltimore on Thursday February 24th at 7:00 pm.

~  MEET The PANEL ~

PARENT & FAMILY Panel Members:

Jane Cawley – Jane and her family helped her daughter, then age fourteen, recover from anorexia nervosa with family-based treatment in 2004. Ever since, she’s worked tirelessly as an advocate for eating disorders, actively helping parents find and better understand information on eating disorders and the treatments available.  She co-chairs Maudsley Parents and serves on the steering committee of NEDA’s Parent, Family, and Friends Network.  She was also recently interviewed for a PsychCentral blog entitled, What Parents Need to Know About Eating Disorders: Q&A with Jane Cawley

Katherine BloomKatherine is the loving mother of Kira Bloom, who lost her struggle with bulimia nervosa on May 21, 2009 at age twenty-five.  Katherine now speaks out to honor her daughter’s memory, the importance of treatment and to share what she has learned in hopes of sparing another family a similar tragedy.

Jean R. – Jean and her family learned to navigate the world of eating disorders when their daughter was diagnosed with anorexia nervosa in 2000.  Through their daughter’s journey they became acquainted with an ANAD support group, and in the spring of 2007, she volunteered to be on the Eating Disorder Network of Maryland board.  Jean has also been involved with Supporting Each Other, a support group for family members and friends of those who have loved ones struggling with disordered eating.  As an educator, Jean sees the importance of education to spread awareness and understanding about this dangerous disease.

TREATMENT SPECIALIST Panel Members:

Steven Crawford, MD – Dr. Steven Crawford is a board certified psychiatrist and Associate Director of The Center for Eating Disorders.  Dr. Crawford has spent over 20 years devoted to the treatment of individuals and families impacted by eating disorders.  He remains committed to providing the best possible treatment for every patient at CED, ensuring a comprehensive continuum of care, state-of-the-art programs and a staff of highly qualified, specialty trained practitioners.  Dr. Crawford also serves on the faculty at the University of Maryland where he trains medical students on prevention, identification, early intervention and evidence-based treatment for eating disorders.

Dina Wientge, LCSW-C – Dina Wientge has been a part of the CED staff for more than 14 years. She received her Masters in social work from the University of Maryland and trained at Johns Hopkins University .  Dina provides family therapy for patients in CED’s inpatient program and oversees all aspects of the Center’s family therapy programming.   She is one of a select group of clinicians from across the country who have been specially trained and certified to provide Family Based Treatment (FBT) for eating disorders.

Debbi Jacobs, LCSW-C – Debbi Jacobs earned her MSW from the University of Maryland, Baltimore, School of Social Work in 1999.  Prior to joining the team at The Center for Eating Disorders, she provided individual, couples and family therapy at the Jewish Family Services in Baltimore with a particular interest in trauma and loss.  Debbi currently provides individual and family therapy at CED’s outpatient department with a concentration in providing support for families engaged in the Maudsley method of re-feeding.

Samantha Lewandowski, MS, RD, LDN – Samantha Lewandowski received her BS in Nutrition from the University of Delaware and her Masters in Health Promotion Management from The American University.  Samantha, a Registered Dietitian, joined the CED staff in 2006, and her main role is working on nutritional goals with patients and their families in the outpatient setting.  As Nutritional Care Coordinator, she also supervises the outpatient nutrition staff, coordinates nutrition programs and provides community workshops and professional trainings on the prevention and treatment of eating disorders.

All family members, support people and health/mental health professionals are welcome to attend.  Download the Event Flyer or visit our Events Page to pre-register and reserve a seat.

If you have questions about this panel or any of our other NEDAWeek events, please call The Center for Eating Disorders’ Outreach Coordinator at (410) 427-3886.