Читать книгу Healing Your Hungry Heart - Joanna Poppink - Страница 17

“Every patient carries her or his own doctor inside.”

—Albert Schweitzer

This chapter goes more deeply into how you live and what needs your attention. What follows are possible early warning signs of an eating disorder or behaviors that, when repeated, can indicate an ongoing eating disorder. Be gentle with yourself as you examine the things you consider normal and routine, but which may indicate a serious problem.

You benefit from reviewing the way you live. How you behave with and around food, how you eat and do not eat, and the habits and idiosyncrasies you've developed around eating relate to the full scope of your life. For example, if you binge on food, you may also binge on people, or clothes, or drama. If you purge, you may feel clean and powerful when you throw away objects, leave gatherings, or end relationships. If you starve yourself, you may also restrict emotional nourishment and deprive yourself of money, education, and the opportunity for healthy relationships. If you feel proud when you refuse food, you may feel proud when you refuse assistance or opportunities to better your life.

Once you have an accurate picture of your eating disorder, you have a window into the patterns of your emotions and psychology. You also—and this is important—can use your eating disorder behaviors as a metaphor to understand how you behave in other situations. This is the beginning of making your eating disorder a valuable life teacher.

Your first and ongoing challenge is to not judge yourself. Merciless self-condemnation is a symptom of an eating disorder. You may have people in place who do that for you—that's another sign. If you can't resist criticizing yourself, give yourself a time limit to do so, and then do your breathing exercises. A brief mindful breathing practice after a bout of self criticism can help you realign yourself with self-kindness.

Defining unusual eating behaviors is a challenge, because what's considered normal keeps changing in our culture. Unfortunately, this difficulty makes it easier for early warning signs of an eating disorder to be missed, denied, or rationalized. Today, eating disorders not otherwise specified (EDNOS) cover more of the population than identified eating disorders. Disordered eating, emotional eating, binge eating, or occasional purging may qualify as EDNOS. For recovery purposes, look at any form of eating that seems disordered and that troubles you, causes you problems, or is essential for you to cope with unbearable feelings.

In the not-so-distant past, taking time to sit at a dining table and eat three meals a day at a slow and gentle pace was normal. Now, grabbing a smoothie for breakfast while you dash for the car, rushing through a twenty-minute lunch “hour,” or ordering Chinese food and then eating it from the container with a group of friends are not extraordinary or bizarre activities today. Living on fast food may not be part of a healthy lifestyle, but it doesn't necessarily signal an eating disorder.

Eating a peanut butter sandwich for breakfast and having pancakes or scrambled eggs for dinner is not unusual in a fast-paced urban life, nor does it signal an eating disorder. Eating leftovers for breakfast doesn't indicate an eating disorder, either. Such behavior may mean the food is convenient when you are in a hurry or that you liked it and are eager to have more before it spoils. It could also mean that you are being economical by not wasting food.

Similarly, it's possible to have a seemingly healthy diet and suffer from an eating disorder. For example, in the past decade, the term “slow food” has entered the mainstream American vocabulary. Growing your own food or shopping at farmers’ markets for items you will cook slowly at home can enrich family life, enhance health, and help the environment. Eating slow food, however, doesn't mean you don't have an eating disorder.

Unusual eating behaviors that indicate a problem might include: hiding food so you won't be tempted to eat it, but then becoming frantic when you can't find it in your usual hiding places or can't remember if you ate it already. Frantic, you suck on raw sugar cubes, drink maple syrup from the bottle, or find a bottle of chocolate sauce and drink it straight. None of this soothes as well as your binge food, but you feel a little more calm. You also feel terribly ashamed. And now the kitchen is a mess, and you're anxious because you've got to cover your tracks.

Another indication is when you finish food that is partially eaten, like a container of ice cream. Then you replace the carton with another that is the same size, brand, and flavor, eating from it until the amount of ice cream matches the original before you took any.

You may pour hot sauce or hot spices on your food, not because you like the spices, but so the food will burn your mouth and throat and stomach. You hope that the pain involved with every bite will slow down your ability to binge or stop you completely. If any of these examples sound familiar to you, you have an eating disorder.

Eating disorder indications take many forms. You cut food into many tiny pieces. You feel busy, thoroughly occupied, and safe for the moment while you are cutting because you are close to food but not eating. When you are eating with others you spit food into your napkin and hide it under your plate. You are angry or anxious if someone comments on what you are eating.

Appetite control drugs won't stop this kind of behavior, because you are not reacting to food on the basis of physical hunger. When you see what may be your own episodes articulated, you are more likely to sense the anguish and almost blind fear and desperation behind the behavior. Awareness of proper nutrition and portion size for a healthy body is irrelevant to your needs on these occasions. Strict dieting only pulls back these urges like a sling shot. As your fears and tensions build, you snap back into an even more voracious binge episode with or without purging.

If you are anorexic, you may starve for long periods of time and then break through with a binge that would amaze even a bulimic woman. The purging afterwards can bring up blood as well as food. You might pass out.

Internally, you may feel like you're warding off an incoming dark, rolling thundercloud that could destroy you unless you reach for your eating disorder behavior. Recovery is about developing ways to cope with such feelings without resorting to self-destructive behavior.

I often tell a new client that I'm not going to take her eating disorder away from her. I can't.

I often tell a new client that I'm not going to take her eating disorder away. I can't. I don't know how, and even if I did know how, I wouldn't. It's serving a purpose. To strip your eating disorder away would leave you exposed and vulnerable to your unbearable fears with no protection. It would be like taking off your armor in the middle of a battle. Yes, the armor is heavy. You are hot and sticky in there. You can't move quickly. You could drown in a stream. You can't touch another person or feel another's touch. But the armor does protect you from arrows and spears that are coming at you from all directions. You take off armor when you can take care of yourself. Then the benefits of your defense outweigh the discomforts and risks. You seek recovery work when you realize the eating disorder you rely on to soothe you is causing more suffering than you can accept. Or you seek recovery when your eating disorder fails and you can no longer use it for emotional relief.

As you recognize symptoms and situations that relate to your eating disorder and understand that they are not fundamental to your nature, you develop more distance and more curiosity about them. This helps you be more gentle and patient with yourself. When your self-criticism diminishes, you are free to take new recovery steps.

You may discover you have unusual attitudes about food. Some foods may seem to have the power to call out with emotional messages, memories, promises, threats, joys, or dangers. Perhaps pasta, pancakes, Asian noodles, popcorn, or ice cream seem to promise you a safe haven. You can eat these foods and be comforted. Perhaps chocolate kisses or chocolate-covered cherries or thick grilled cheese sandwiches, or bananas with peanut butter, or whole jars of olives, or bread heavily laden with melted butter were family favorites and indulgences when you were a child. Perhaps your family had lovely private times together while eating these foods. Thus, they call to you when you are craving safety or intimacy—or maybe they frighten you for the same reason. The glitch in your system that creates the eating disorder is that you go for the symbol rather than the real thing. If you don't know a realistic way to bring safety and ease into your life, you may eat or starve to reach your personal safe haven.

You may have a loved one in your life who also has difficulties with food. He or she may encourage you to eat more than is healthy and satisfying for you or less than is adequate to sustain a healthy weight.

Nora, fifty-five, has suffered from compulsive overeating since she was a teenager. When she was a teen, her mother criticized her for being fat during the day but secretly gave her deep-fried peanut butter sandwiches and chocolate shakes at night when everyone had gone to bed. Nora liked the experience of kindness and intimacy with her mother during those times. Now, without realizing it, she tries to reclaim that sense of being loved through food.

The glitch in your system that creates the eating disorder is that you go for the symbol rather than the real thing.

Sylvia, twenty-three, said she had no control or influence over her finances and lived with her aunt, who locked the refrigerators and cupboards and carefully monitored Sylvia's eating allowance—small portions of inexpensive food—while the aunt ate normally. Sylvia, very thin, suffered from a kind of anorexia. She was caught in a system that perpetuated the eating disorder. Away from that environment, when a friend offered her food, she was afraid to eat, afraid of being punished for disobeying the rules she believed she must live by.

One afternoon, while I was grocery shopping, I saw a young woman I knew shopping with her mother. Martha was EDNOS with strong anorexic symptoms. She didn't see me, and her mother didn't know me. The pair was hovering over a fruit display. I saw Martha caress apples, bananas, and mangos and look questioningly at her mother. Her mother frowned and shook her head. Martha, carrying an empty shopping basket, like a beggar woman hoping for crumbs, walked alongside her mother as she filled her cart with food that was destined for a locked refrigerator.

Martha, though intelligent and creative, didn't have a sturdy enough psyche to create a life of her own where she could earn her own money to buy and eat her own food. She was well educated, but she had been sexually molested regularly and was physically abused as a young child. Her mother, perhaps unaware of her jealousy and rage, treated her like an unwanted captive. Her distant father considered her a sexual toy. The young woman's heart, spirit, and ability to be her true self were locked away in a psychological prison long ago. She didn't have access to a way out yet.

Martha haunts me. I wonder how many women are like her. What doorway or window, or glimmer of light, could reach through her interior prison so she could begin to move toward recovery as I hope you are doing? Maybe she is reading this book.

Cooking masses of food for family and friends or as a caterer, yet not eating anything yourself, is another warning sign. Carolyn, forty-seven and a working professional, watched friends eat food she longed to eat herself. She used all the control she could muster to deny herself the nourishment she craved and her body needed. She felt proud of her success in not eating.

Carolyn needed to maintain a sense of superiority over other people. She believed she could live without what she considered to be mundane needs for physical nourishment. She felt others were stuck in heavy body prisons while she was moving beyond the need of her slight frame. She was striving to be perfect, a pure spirit with no need for the gross consumption of food. She used the words, “It will make me fat” frequently, but her real fear was that food would make her solid and present and part of the human community. If that happened, she wouldn't be able to find safety through her pursuit of being light, untouchable, and perfect. This issue of striving for self-defined perfection will come up again in future chapters.

Cleo, forty-two, looked at foods with a sauce as dangerous because they might taste good. She feared that if she took one mouthful of a food that tasted good to her, she would have no control, eat too much, and get fat before she left the table. Cleo behaved as if her imagined fear was a real threat. She believed if she reached for something she desired, she would lose all control. Cleo not only denied herself food but also intimate relationships, career opportunities, and even simple items to decorate her home. Her walls were bare.

I remember speaking to an emaciated woman lying in a UCLA hospital bed, dying of starvation. She was asking for help and said she wanted to live, but she wouldn't let the doctors give her a feeding tube because, she said, “They all want to make me fat.” The tragedy is that the extreme of this distorted thinking ends in death.

Fear permeates many examples of eating disorders; fear needs to be addressed more than the food itself.

Another unusual attitude about food results in weight gain rather than thinness. Food can seem dangerous if you are hungry. You then become more afraid of feeling hungry than of the food. If you graze continually throughout the day, especially on high fat/high sugar snacks, you can assure yourself of never being hungry. Then you have a sense of being in control even though you are frustrated and miserable as your weight continually climbs.

Fear permeates these examples, and fear needs to be addressed more than the food itself.

Further complicating matters, a starved body also means a starved brain. A starved brain creates a mind that cannot think clearly and is subject to wild distortions. It's important to remember that a heavy person can have a starved brain as well as a thin person.

If you have an eating disorder, you ignore the genuine needs of your body. Yet, your body is real, and the human body needs adequate nourishment to function. Adequate nourishment becomes part of recovery, yet it has to be approached with caution since you will experience any change in your eating habits as tampering with what keeps you safe in this world.

You control your moods and experience by eating the foods you have learned “work” for you. For example, you can eat several handfuls of nuts or some fruit and cheese before you go out to dinner with other people. By eating this heavy food, you protect yourself against feeling hunger in public. You protect yourself from feeling out of control, vulnerable, or natural with your companions. You can choose what you will eat and feel comfortable.

This may or may not be a problem. Only you know if this is troublesome for you. If you need to binge and purge before a social dinner, you have a problem.

If you know you will be eating with people who delay the meal beyond your comfort zone, it makes sense to eat beforehand so you aren't too famished. But if you are unwilling to allow others to see you when you feel something authentic, including hunger, then you are eating in advance for protection.

Emotional eating presents a dilemma if you eat to relieve tension even though your stomach is quite full. You might eat on a full stomach and cause yourself pain so you can't participate in activities. Or maybe you eat on a full stomach and throw up. Hours on a treadmill might take care of those calories, but running while your stomach is overloaded can create digestive problems.

Eating until you are so full you pass out is an indication of a possible eating disorder. If you do this to relieve stress, you make yourself non-functional. You have to cancel appointments, miss opportunities, and are unavailable to friends and family. Trying to get through emotional strain by chewing packs of sugar-free gum is an attempt to get binge eating relief without eating. The excessive chewing can cause gas, painful gastric distress, and embarrassing diarrhea. If and when these complications occur, they only add to your sense of shame and worthlessness.

The ultimate goal of a woman in the grip of severe anorexia is to disappear, to lose her body completely, to not only be as light as air, but to actually be air. This dangerous goal gets mixed up with spirituality. The anorexic woman wants to be “pure spirit,” gossamer in the wind. If she could reach this impossible ultimate fantasy, she would be invisible to the human eye and sensed only as a vibrating energy that others could feel but not see. If this is you, please know that in your attempt to reach such a goal, you can starve yourself into emaciation, organ destruction, and loss of brain function. If you continue striving for this “ultimate” goal, you will die.

A different anorexia scenario involves separating your sense of self from your body. If you achieve this psychological split, you create an experience where you send your body into the world while your real self remains unknown. You become a puppeteer moving the strings of your body, manipulating it to be the shape required and to function as needed. This, I believe, is part of the dynamic for anorexic women who need or want to be thin for public display.

Yet another addition to these scenarios is believing you feel anxious and bad about yourself because your body is fat, ugly, and disgusting, irrespective of your actual appearance. You use the words “fat” and “ugly” interchangeably. You believe you would feel better, even wonderful, if you were beautiful. Again, you try to use your physicality to tend to your emotional needs, usually at the price of a healthy body.

I've worked with celebrities whose beauty is acclaimed by thousands, even millions, yet who still say they feel fat and ugly. Such a woman knows that her appearance wields power in her world. She may use her beauty as a negotiating tool or as a way of influencing or manipulating. She may consider people influenced by her appearance to be fools because they don't see the frightened, helpless, ugly, fat, and unlovable person she believes herself to be. She's in a complex and painful state. She's won because her true self is invisible. She's lost because she's alone with her ever-present, self-punishing inner voice.

A woman who suffers from binge eating or bulimia can also believe she has the power to make herself invisible.

A woman who suffers from binge eating or bulimia can also believe she has the power to make herself invisible. The need to isolate is part of all eating disorders to some degree.

When Kimberly, twenty-nine and suffering from bulimia, needed her binge foods, she put on her “invisible clothes,” usually innocuous sweatpants and sweatshirt and a blank look on her face, and got herself to a grocery store or take-out restaurant. She didn't look anyone in the eye. She avoided personal connection and felt that she was a shadow figure who couldn't be seen. If she saw someone she knew, she made it clear with body language that she didn't see or recognize them. If the person didn't respond to her, it reinforced her belief that she was invisible.

When Kimberly got home she rushed through putting away the perishables, leaving out the boxes and bags of salty, crunchy, and sweet. She gathered up her binge foods and felt relief that she could give up the strain of being invisible and get on with eating, secure in her sense of being alone in her private and unseen world.

Janet, forty-five, achieved her invisibility by using what she considered sleight of hand. In public she ate small and seemingly inconsequential tidbits she was certain no one would notice. While other people filled their plates or nibbled on appetizers, Janet was stealing. She took candy decorations from food trays when she believed no one was looking and quickly popped them in her mouth. She also filled her pockets and her purse with sweets to eat on the way home.

A very large woman knows about yet another kind of invisibility. She can be still and disappear into the background. I remember attending a crowded Overeaters Anonymous meeting of about 200 people. Men and women of all ages and sizes sat in rows of chairs. Those who couldn't find a seat sat on the floor or stood along the walls.

I sat in a chair near a thick pole for at least twenty minutes before I realized a woman was standing in front of that pole. She seemed to gradually appear. She must have weighed close to 350 pounds. She wore a loose-fitting garment in shades of brown and stood immobile and expressionless.

After I noticed her, I looked around the room again. I saw four more women, large, immobile, expressionless, in bland neutral colors, whom I hadn't seen before. I wondered how many women I had never noticed; how much I played into the invisibility mechanism by accepting their unspoken communication: “Don't see me.”

Recovery involves becoming visible, ending isolation, and coming out from behind a barrier that protects you from exposure, criticism, reality, friends, opportunities, love, and hope—a barrier that blocks you from life itself.

Another warning sign of an eating disorder is striving for perfection. I'm not referring to the perfection a scientist seeks in conducting valid and reliable research. I mean the kind of perfection where you need to have the perfect body and are miserable and self-critical if you fall short; where you need to create the perfect environment or be the perfect person at your job, at school, or in your family and feel an inner disaster if you fall short. If you can't focus on a relationship, a conversation, or an activity because your mind is busy figuring out ways to make something in your life perfect, you are experiencing warning signs of an eating disorder.

Recovery involves becoming visible, ending isolation, and coming out from behind a barrier that blocks you from life itself.

Why? What is it about perfection? Why is a bulimic woman merciless in her self-criticism? Why is an anorexic woman so driven to be perfect she is willing to face death? Why do women who binge or eat compulsively feel so removed from acceptability and standards of perfection that they numb themselves to emotional pain and function tangentially in the world as they attempt to be unseen?

Perfection is the ultimate safety. When anything is perfect, it is beyond criticism, beyond judgment. But perfection, for us mortals, is impossible to achieve. In Greek mythology, whenever a mortal attempted to achieve the status of a god or even one quality of a god, the mortal was cursed and went mad or died. The lesson: Humans aren't designed to be perfect. Perfection is for the gods.

Recovery begins as you venture toward being kind and honest with your genuine, mortal self. You may be ready to be in a room with other people who are working toward recovery, or you may need to be more private as you begin your healing efforts. Respect your feelings. You can begin to move on your healing path through the suggestions in this book—doing affirmations, breathing exercises, and writing in a Recovery Journal. See more specific exercises and activities related to this chapter in Appendix B.

My goal is to help you build a solid recovery, layer by layer. Beginning this journey requires courage. You are changing direction. You are opening your mind and heart to what you don't know yet. Courage and trust are a vital part of recovery work because you don't yet have a backlog of successes on which to build your confidence. You're going on faith, hope, and courage now. Honor and nurture those qualities. Go gently into the unknown, building as you go.

I've described many forms an eating disorder can take, but not all. Yet enough is here to help you see how much of your life and your behaviors are determined by eating or not eating. Please congratulate yourself for staying with this reconnaissance and getting a more thorough sense of where you are and what needs to be addressed to get well. This is a tender time.

Daily Exercises

1 Follow your breath for five minutes at least three times a day.

2 Read or recite your three affirmations twenty times each at least three times a day. See Appendix A, “Affirmations.”

3 Write about one or more of the warning signs discussed in this chapter or a personal experience where you recognized eating disorder signals.