Читать книгу When Food Is Comfort - Julie M. Simon - Страница 16
ОглавлениеOur bodies contain our histories — every chapter, line, and verse of every event and relationship in our lives. As our lives unfold, our biological health becomes a living, breathing, biographical statement that conveys our strengths, weaknesses, hopes, and fears.
— Caroline Myss, Anatomy of the Spirit
When I asked Jan her reason for seeking therapy, she expressed concern that her weight had been creeping up over the past few years and she couldn’t seem to get a handle on it. A quiet and reserved fifty-four-year-old endocrinologist with a busy practice, Jan was mindlessly grabbing bags of chips, crackers, and cookies at work and drinking “a ton of coffee” to get through her long days. She was overeating at dinner, and on many nights she consumed two to three glasses of wine. She was also struggling with anxiety and low-grade depression, fatigue, migraines, bouts of fibromyalgia, gastric reflux, and an irritable bowel.
As a physician, Jan knew that part of the weight gain and physical symptoms might be related to diminishing hormones, general stress, food allergies, and blood sugar spikes caused by poor food and beverage choices, lack of exercise, and insufficient sleep. But she wondered if her overeating and physical complaints also had something to do with the challenges she was experiencing at home with her youngest daughter and the arguments she and her husband were having over the situation.
Vanessa, age fourteen, was getting poor grades in school, and any attempt Jan made to intervene and help was met with “rage-filled meltdowns.” Jan’s husband, Sam, had a better relationship with Vanessa, but he also was having trouble helping her with her studies or motivating her to do her homework.
Sam, a fifty-five-year-old software engineer who had been out of work a couple of times in the last few years, had more-regular hours than Jan. According to Jan, Sam was supportive of her, but he was concerned that she was working long hours and not taking very good care of herself. He complained about her lack of patience with Vanessa’s emotional struggles. Their older daughter, Tracy, age sixteen, presented no parenting challenges: she was a straight-A student and heavily involved in extracurricular activities. But Jan was concerned that Tracy was also gaining weight.
When I asked Jan if her marriage was satisfying, she said she was so busy working and raising the kids that she didn’t have time to think about her marriage. Even though she and Sam hadn’t been intimate for over a year and their sex life was “never thrilling,” she described Sam as a good husband and father; but she resented his inability to bring home a consistent income.
Jan added that she felt uncomfortable both in her body and with body contact. “I don’t feel good about how my body looks, and I don’t feel very sexual or sensual. Even though I’d like to have a hug here and there, I don’t feel up for anything more than that. I feel bad because I know Sam wants to be intimate. I felt more connected to my body when I was younger and more active. But I haven’t had that connection to myself in decades.”
As Jan shared her concerns with me, she showed little emotion, even as she described her daughter’s outbursts, the challenges of running a busy medical practice, and her resentment of her husband. She recounted her story as if she were reading a news report — her mouth was moving, but her body was stiff and motionless. There was a deeper disconnect that concerned me, and I was feeling the pain she couldn’t allow herself to feel. Clearly, she was stressed out and eating emotionally, but she didn’t seem to be feeling any emotions.
Running Away from Emotions
Most of us find it difficult to tolerate emotions for very long. Sure, we’re okay with pleasant, even arousing, emotions, like joy, contentment, happiness, and excitement. But we’re uncomfortable with deflating emotions such as sadness, hurt, loneliness, and hopelessness, or low-arousal psychological states such as boredom and apathy. Some of us are uncomfortable with anger — ours or anyone else’s. We have limited tolerance for what have been called the master emotions, shame and guilt. When we experience these painful emotions, or witness someone else experiencing them, we want to run away as fast as we can. We’ve been taught to quickly access our rational, upstairs brain and distance ourselves from unpleasant feeling states.
We don’t have much patience for uncomfortable bodily sensations either, as evidenced by all the drugstore shelves filled with pain-relieving pills and ointments. To seek pleasure and avoid pain is instinctual, part of our most primitive neural wiring. Part of the problem is that most of us have never learned the purpose and value of emotions and sensations. We haven’t been taught to pay attention to and embrace the wisdom of our bodies.
What were you taught in childhood about emotions and bodily sensations? Did anyone actually take the time to help you identify and name these important signals from within? When you expressed your emotions, were you heard and were your feelings validated? Did anyone try to talk you out of them? Did it feel safe to express all your emotions, or were you criticized or shamed for having particular emotions, such as anger, disappointment, or grief? Were sensations such as butterflies in your stomach, or headaches, addressed or minimized? Did your caregivers allow time for processing feeling states, or did they rush to solve your problems? I always knew my emotions were about to be dismissed and I was about to receive a lecture when my mother began a sentence with “Look, Julie. . .” How did your caregivers handle their own emotions and bodily sensations?
If it isn’t safe to express our emotions within the family, we resort to acting them out. Thumb sucking, bed-wetting, temper tantrums, moodiness, defiant behaviors, hurting ourselves, and substance use or abuse are behaviors we turn to instinctively to cope with emotional pain. We also unconsciously adopt defense mechanisms to push unpleasant experiences and memories out of awareness. Perhaps when painful memories surface, you distract yourself from the pain you feel by minimizing it through rationalization or intellectualization: “My parents did the best they could. Everyone has had challenges. It’s the past, and I’m over it.” Maybe you have a long-standing pattern of disconnecting from yourself and going numb: this is known as dissociation. You may notice that you have trouble remembering painful childhood events: this is known as repression.
Emotions and bodily sensations are like street signs, precious signals from within that point us in the direction of our needs. They do not go away when we disconnect from them. They do damage behind the scenes, until they finally get our attention, one way or another.
Hidden Hurts
I asked Jan what she remembered from her early childhood experiences, as I was sure that her emotional disconnect had begun a long time ago. She didn’t remember much before age five, when her mother was hospitalized for a nervous breakdown, seemingly related to postpartum depression. Her father, a hot-tempered, distant man, told her that her grandmother would be coming to stay with them and that Jan needed to be a “good girl” and take care of her younger siblings. Her father, a litigator, worked long hours and retreated to his study every evening after dinner. While Jan never saw him drunk, he did have a few drinks every night. She was afraid of him: he rarely hit the kids, but he had a tendency to be verbally abusive, especially with their mother. One of the reasons she married Sam was because he was “the exact opposite of my father — he was even-keeled, kind, and patient, and he loved children.”
Jan recounted an incident when she accidentally burned the collar of her father’s shirt when learning to iron. “I feared for my life — the veins in his neck bulged out, and he grabbed me by the arm so hard I thought it would break off. He cursed at me and sent me to my room without supper. My mother did nothing, as she was quite passive and was also afraid of his anger.” As Jan recounted the story, I inquired as to whether her daughter’s “rage fests” felt similar to her father’s bouts of anger. She said that she had never made this connection because of their age difference, but agreed that they were similar and that her response was the same to both — to run for cover. Clearly this wasn’t helping Jan or her daughter.
The year her mother was hospitalized was a difficult and lonely year for Jan. She remembered being afraid that her mother would die. But it was no use sharing her concerns with her father or grandmother. “My father couldn’t be bothered with us kids, and my grandmother was a cold and stern woman. If I complained about anything, she would remind me how hard she had had it in her childhood, as one of nine children.”
Her mother’s recuperation lasted over a year. Jan remembered wanting to be closer to her mother but finding it difficult because her mother suffered from anxiety and depression, and was overwhelmed with raising three kids and coping with a volatile husband. She often went to bed early, leaving Jan to tend to the little ones. As Jan described this period of her life, her head and shoulders drooped, and her body slumped in the chair. I was sure that I could see some sadness in her eyes, but when I inquired, she said she felt nothing. She knew it was a sad experience and that she should feel sad, but she felt numb.
Escaping from the Pain
When I asked Jan if she remembered feeling sad or lonely in her childhood, she replied that she learned early in life to block out unpleasant emotions and retreat into food and things she was good at. From elementary school on, she excelled at schoolwork, and, like her father, she was a voracious reader. She was also athletic and took part in team sports like soccer and volleyball. Studies, reading, sports, and caregiving duties at home kept her away from “all those terrible memories and feelings.” I had a hunch that her older daughter might be following in her footsteps.
“Because I was a good student, I was allowed to stay in my room for hours on end, and I could block out all the family drama.” Jan told me she rarely invited friends over because she never knew what to expect with her father’s moods. “During elementary school, my brother and sister started fighting regularly, and I would retreat to my room with my books and a stash of my favorite treats. I know this sounds crazy, but sneaking and hiding bags of cookies, pretzels, chips, and candy was really exciting. I always looked forward to coming home to my books and my stash. I think that’s why the ever-changing array of junk food at the office is so appealing to me.”
Jan was aware that the environment she grew up in might be playing a role in her current inability to cope with and manage relationships. She recounted a recent experience of being humiliated by a colleague in a professional meeting. Unable to process the flood of emotions, she described the experience as “feeling like I was falling apart.” When she left the meeting, she grabbed a box of four ice-cream bars from the freezer at work and ate them all on the drive home. A couple of glasses of wine at home finished off any residue of emotion.
Jan also revealed that she found it difficult to stay in the exam room when she had to share disturbing lab reports with her patients. While no physician enjoys delivering bad news, Jan found her patients’ emotional pain and occasional outbursts unbearable. She usually called in her nurse, a sweet older woman, to do the comforting and soothing. I didn’t need to be Sherlock Holmes — or a seasoned psychotherapist, for that matter — to see the parallel with her difficulties in handling her adolescent daughter’s outbursts.
Leaning to the Left
In traumatic, undernourished, emotionally empty childhoods, one side of the brain may be understimulated, while the other becomes more dominant. The right side of the upstairs brain is more directly connected to the downstairs brain: information flows up from the body to the brain stem, the limbic areas, and the right cortex. The right side, which develops earlier, offers us a more direct connection to our whole body and the electrical, chemical, and hormonal discharges that we call emotions. The left side of the upstairs brain is more removed from these sources of input.
Jan was raised in an academic family that emphasized education and work. She had learned to “lean to the left” — to stay logical, literal, and linear and to avoid right-hemisphere-generated emotion and body awareness. The right side of her brain’s neural circuits had, perhaps, been underutilized for decades. Jan strenuously avoided any situation — discussions with her daughter, intimacy with her husband, or interactions with upset patients and staff — that might trigger uncomfortable emotions and bodily sensations.
Jan’s adaptations to a traumatic childhood, including her determination to have a better life than her parents’, were resourceful and had helped her move through life and achieve professional success. But her unconscious “leaning to the left” was keeping her from connecting with herself and others. Imprisoned in a rigid and unemotional world, she was surviving but no longer thriving.
Listening to the Body
Infants and small children depend on their caregivers to help them regulate emotional and physical arousal. Our earliest social relationships are formative in the development of the stress-response apparatus, our body’s system for regulating arousal. The body’s stress apparatus involves the lower brain centers where emotions are perceived and processed, the immune system, the endocrine (hormonal) glands, and the nerves and nervous system. All these systems are joined together into a mind-body continuum through several pathways.
Children in the care of responsive, nurturing adults develop healthy stress-response mechanisms. Infant observation studies suggest that we are born with a high degree of “relational knowing.” We are keenly attuned to our caregivers’ subtle emotional shifts, such as the muscle changes in a mother’s face that convey softness or tension, fear or joy. We react to the tone and speed of their voices. We notice that their eyes are wide open or nearly shut. All these subtle or not-so-subtle shifts are linked together for us by a single regulatory system called the autonomic nervous system (ANS).
The ANS has two branches. The sympathetic nervous system (SNS) acts as our body’s accelerator and is responsible for arousal, and the parasympathetic nervous system (PNS) serves as the brake. The SNS includes our fight-or-flight response — it is responsible for the shot of adrenaline that speeds up our heart rate and prepares us for action when we almost rear-end the car in front of us. The PNS calms down arousal by slowing the heart rate, returning our breathing to normal, and relaxing our muscles when the danger has passed.
When we are exposed to chronic stress and negative emotional arousal in infancy and early childhood, we experience this high-intensity activation as contraction of our internal organs, muscles, and joints and tension in other parts of our body, like our eyes, our ears, and the base of the skull. When we have developed these patterns in childhood, it is highly likely that they will persist throughout life. High emotional arousal, or, as in Jan’s case, repression of emotion and arousal, can lead to physical changes that contribute to nervous system dysregulation and conditions such as fibromyalgia and irritable bowel syndrome.
The Sixth Sense
Fortunately, the majority of physiological processes necessary to ensure our survival, from electrolyte balance to regulation of our heartbeat, happen outside our awareness. Our incredible machines are constantly making behind-the-scenes calculations and adjustments to keep us healthy and in balance. If external adjustments are required, our body and brain send us signals, generally in the form of sensations. When our body needs fuel and proper nutrition, it signals us with hunger pangs and cravings for particular foods. Thirst is a signal that fluid levels are low. When we need sleep, we become drowsy. Our sensations vary in intensity. If we feel a mild ache in a knee, we may continue the tennis game; if we feel a sharper pain, we call it quits.
If all parts of your brain are communicating properly, it is easy to read your body’s signals and respond appropriately. Not only do you quickly perceive and make sense of your body’s various sensations, but you can also pick up more subtle cues using your intuition, or what some call the sixth sense.
Suppose you’re walking in an empty parking lot or on a dark street and have a sense that someone is behind you and perhaps following you. Or you step into an elevator and get a gut feeling that it isn’t safe to ride with the unsavory character already in there. Your heart beats faster as your nervous system sends out an alarm. You feel tension in your body as your brain stem, limbic area, and cortex work in concert with your body to assess the threat. You instinctively grab your keys, walk faster, scan the area for help, or pretend you forgot something and back out of the elevator. When the threat has passed, without your thinking about it, your body releases the tension, and you feel calmer.
If you have experienced chronically high levels of emotional arousal in your early years, the various regions of the brain may not be communicating properly, and the region responsible for fire alarms and vigilance may be running the show more often then you’d prefer. Not only do you risk misreading situations and perceiving danger in too many situations, but you also most likely fail to pick up subtle yet important cues about the world around you.
The Effects of Stressful Early Childhood Experiences
Early parental deprivation (even in mild forms) can lead to a decrease in the production of the brain chemicals necessary for experiencing a sense of well-being and joy. These chemical deficiencies can manifest themselves in behaviors such as fearfulness, hyperactivity, and withdrawal and can set a child up for an increased sensitivity to stressors for life.
Deprivation and stressful early childhood experiences can also lead to a chronic excess of stress hormones such as adrenaline and cortisol. Stress hormones are a critical part of our response to biological or physiological threats, but high levels of these hormones in the womb, in infancy, and in early childhood can damage the brain. Cortisol, in particular, can damage certain brain systems, like the midbrain dopamine system, and shrink others, like the hippocampus, a structure important for the processing of emotions and the verbal and narrative memories that help us make sense of our world.
When our world is chaotic and unpredictable, our stress apparatus gets wired for easy triggering, and we are more likely to be reactive, overactive, anxious, agitated, panicky, and depressed. Too much stress early in life can reduce a child’s ability to handle stress throughout life, which in turn can increase the risk of the child’s turning to external sources, such as food, for short-term relief, soothing, and comfort.
The Destructiveness of Chronic Stress
In the past quarter century, Western researchers have confirmed what ancient wisdom traditions have always asserted: our bodies do not exist in isolation from our minds. We can’t separate biology from psychology: everything is interconnected. Psychological stressors contribute to biological breakdown and vice versa. Stress affects virtually every tissue in the body.
Both external and internal stressors were contributing to Jan’s physical complaints of fatigue, migraines, fibromyalgia, gastric reflux, and an irritable bowel. Long, exhausting days at work, lack of sleep and exercise, and the consumption of alcohol and unhealthy convenience foods were putting strain on her body and causing her adrenal glands to secrete high levels of stress hormones. She was often anxious or depressed, and because her nervous system had been highly sensitized by early stressful experiences, she suffered from a heightened perception of pain.
Some of us handle stress better than others. Our ability to handle stress without turning to substances is determined not only by our innate constitution but also by the social support we experience early in life. Hans Selye, a respected physician and researcher and the author of The Stress of Life, points out that people can become addicted to their own stress hormones. Some people who are habituated to high levels of external and internal stress from early childhood need a certain level of stress to feel alive. For these folks, a life that is calm and stress-free leaves them feeling boredom and emptiness. I was concerned that this might be the case with Jan.
Chronic unpleasant feelings and thoughts, even when pushed out of awareness, are an insidious form of stress, taxing our physiology and resulting in a myriad of physical ailments and “dis-ease” states. When we disconnect from the wisdom of our bodies and tune out our bodily symptoms, we fail to benefit from the messages they convey and the richness and joy life has to offer.
The Body Never Forgets
Jan’s needs for attunement in childhood were not met: she didn’t feel seen, heard, safe, or loved. Instead, her earliest experiences were often harsh, shaming, depressing, and sometimes terrifying. Her attempts to be close to her caregivers were thwarted. She was exposed to chronic stress, and her home life did not allow for the healthy physiological responses of fighting or fleeing. She had to stay, and she coped with it as best she could by blocking out the hostility and neglect and acting as if they didn’t matter. Retreating to her private and safe world of books and food was an instinctive, resourceful, and adaptive way to survive.
But her body has not forgotten what she endured as a child. It has become wired to keep a constant watch for threats she regularly pushes out of her consciousness, prepared to ward off attack, emotional outbursts, rejection, and shame at any moment. Areas of her brain like the prefrontal cortex are in a state of constant hypervigilance. This is why she runs for cover when her daughter has meltdowns and why she leaves the room when her patients are upset. And because she has few skills for processing her own emotions and bodily sensations, her main tranquilizers are food, alcohol, and anxiety medications.
As a grown woman, Jan is living a stifled and deadened emotional existence. It feels normal to her: it’s all she has ever known. While those around her — her daughters, husband, siblings, staff, and patients — are experiencing the routine emotional ups and downs of life, she is stranded in an emotional desert, and her body is keeping the score.
It’s Never Too Late to Start Feeling
Near the end of our session, Jan told me that she had seen other therapists in the past for her weight challenges and bouts of depression, boredom, and emptiness. Previous therapists, she said, had tried to get her to feel and asked her to track and write about her feelings. She had dropped out of therapy a few times because she couldn’t seem to experience her feelings, and she felt like a failure. When she tried group therapy, she witnessed other members “feeling all over the place” but still felt blocked.
I reassured Jan that I wouldn’t try to get her to feel; rather, we would work on enhancing her right-brain awareness of bodily sensations, such as hunger and fullness signals and muscle tension and relaxation. If Jan could become more aware of her bodily sensations and able to stay with and tolerate them, they would offer her important messages about the state of her internal world. We would allow her body to tell us her story and lead us to the pain she had long ago learned to push away and stuff down.
I commended Jan for finding resourceful ways to handle an emotionally painful and difficult childhood. When I praised her for her strength and resiliency, she began to feel something behind her eyes that she said “could be sadness.” She had experienced so little praise in her life that this little tidbit had begun to open the floodgates. It was clear that I could help Jan access her inner world not only by offering her the attunement she so desperately needed and deserved, but also by highlighting her strengths.
The Way to Vitality
I explained to Jan that slowly and gently learning to pay mindful attention to her bodily sensations would help her reside more in her body. Over time, we would carefully draw out the sensory information that had been stored in her body and frozen by trauma. She could learn to connect these sensations to any associated emotions, as well as to current or past physical and psychological events. As we nurtured and strengthened an underdeveloped set of circuits in Jan’s brain, she would be better able to tolerate and regulate her emotions and soothe and calm her nervous system. This would give her more ease and comfort in handling other people’s emotions.
Feeling more connected to herself in this way could also help her feel more comfortable in her body. Jan’s earlier connection to her body through sports was a resource that she could draw on. Exercise that she enjoyed would be a way for her to reconnect to her body and perhaps to tolerate and enjoy the comforts of touch, including more intimacy with her husband.
Learning Mindfulness
If, like Jan, you were exposed to severe attunement failures or early traumatic experiences, an overall sense of threat has been stored in your nervous system and in every cell of your body. But it’s never too late to release this locked-up energy, increase your zest for life, and reduce your attraction to food for comfort.
In part 2, we’ll see how Jan learned to use mindfulness to become more aware of her bodily sensations, stay present to them, and allow them to inform her as they shifted and dissipated. As her tolerance for unpleasant feeling states increased, she began to release and free the energy that had been frozen inside her. As her vitality increased, she felt better equipped to transcend her painful history and transform her life.
