In honor of September’s National Recovery Month and its theme, “Recovery is For Everyone: Every Person, Every Family, Every Community,” I wanted to take a moment and highlight just how amazing and truly inspiring it is to witness persons and their families recovering from eating disorders. I remember working in a hospital for eating disorders and being astounded that these individuals would fly across the country, battling snow and ice and travel delays, many times in desperate states physically and mentally, to engage in what I believed was one of the most difficult things a human can do: recover in the environment that they struggle with the most, food and the body.
Unlike a person with an addiction to alcohol or drugs, we can’t just remove the problem substance. Persons with eating disorders have to learn how to develop a healthy relationship with food and their body. And that trigger is with them all day long, every day. Think about it. From the lens of addiction recovery, what we need to do for eating disorder recovery would be like taking the alcohol use disordered person, walking them into a bar, setting them down with a drink, and saying it’s time to develop a healthy relationship with alcohol.
To me, it was always astounding to see how many persons were willing to walk into the gauntlet of treatment, which includes three meals and three snacks, monitored bathroom breaks, minimal exercise, therapy all day long, and a milieu full of other persons with eating disorders. What courage they have! The strength one has to muster to do this gives me goosebumps! Not to mention what we know about temperament and the natural harm avoidance that is present in many with eating disorders. I think their courage speaks to something in their hearts, a belief deep down that they deserve a different life, even if that part is really small at first or isn’t used to having a voice or a seat at the table.
I am deeply grateful to all those I have helped navigate their massive undertakings of eating disorder recovery. I am also deeply grateful to all the families who assisted their loved ones in doing this work, oftentimes while navigating their own recovery journeys too. And finally, I am deeply grateful to be part of a community here in Denver, and virtually across the world, in which we hold hope and compassion for those recovering, at whatever pace they need to go -- because, you see, these heroes are really some of the strongest people you will ever meet. Hand to heart to my heroes in eating disorder recovery. Happy National Recovery Month to all!
Check out my website or reach out to me via my contact page. I offer free, 30-minute consultations to new clients.
Our last days of summer are here in the Colorado mountains! The aspen trees at higher elevations are beginning to tinge yellow, and the mornings have that whiff of the ending of growth. Even though it has been years since I went to school, I still get excited for the atmosphere of learning that September brings. Memories of cool days and busy coffee shops with intellectual conversations come to mind.
I think about my younger self, in the first years of college, searching for the meaning of life, wanting to make a difference in the world, and longing for love and acceptance. I wanted my parents to be proud and supportive, even though I was pursuing a degree in English that I might not use in the future. There is definitely a piece of that younger self with me in late summer -- the one with big dreams, the one that keeps me in check and reminds me to find moments of joy when I get too focused on solving all the problems in my world.
One Piece of Advice for Your Younger Self
On one recent summer evening filled with conversation about kids and memories, a friend asked me, “Given the opportunity, what one piece of advice would you give your younger self?” Boy, lots to think about there! And what a great question to reflect on knowing what I know now.
Today, I ask that question to you. What’s your answer? Given the crystal ball you now have into your past, what have you learned that could guide you? Would you have believed it at the time? I don’t ask you in order to trigger regret but rather to reinforce that what you’ve realized now is so important to you.
One thing I would definitely say to myself is to spend more time in nature and to make sure that I use that space to reboot my energy levels. Watch my latest video for a little glimpse of a lovely place where I spent time recharging in southern Colorado.
As a way to deepen the exploration of what’s important to you, there’s a therapy exercise I like to use with Life Compass Cards, developed by Joanne Steinwachs. You sort 108 word cards that represent values that may or may not resonate with you, using guidance from the exercise instructions and some coaching from the facilitator on how to narrow it down to your top 7 values. I find the exercise useful and also difficult at times. It requires you to let go of those things you may find important but not necessarily the most important to you. It’s a lovely endeavour to do with your therapist or a trusted friend.
So whether you are on your own recovery journey or supporting someone on their’s, I encourage you to enjoy the end of this summer and the beginning of the introspective opportunity that fall gives us. Make a plan to spend more time with who and what is important to you, perhaps inspired by that question from my dear friend. And, if your younger self has some advice for you, listen carefully to what that voice says!
Check out my website or reach out to me via my contact page. I offer free, 30-minute consultations to new clients.
I recently watched an interview with Brené Brown during which she shared many incredible thoughts. The one that stuck most with me was that “joy is the most vulnerable emotion” and that, for many persons, the experience of joy triggers a “dress rehearsal for tragedy.” This idea means that, for some people, what brings them joy also elicits thoughts about loss or not having joy. Part of this connotation may have to do with how we learn early in life to organize our mental world in opposites (e.g. hot and cold, light and dark, or on and off). For those in recovery, it is the very experience of joy that may help lead them into the reason to recover in the first place. Joy, like love, lets us know how to move toward who and what is important to us. Joy is an emotion we want to share and use to connect with others. So if joy triggers a “dress rehearsal for tragedy,” how do we help persons with eating disorders experience it and not cause more pain in the process?
Understanding Harm Avoidance and Self-Directedness
One thing that has helped me understand persons with eating disorders over the years is the temperament trait of Harm Avoidance and the character trait of Self-Directedness, as assessed by the Temperament and Character Inventory developed by C. R. Cloninger and applied to the study of eating disorders. Persons with eating disorders, both recovering and recovered, tend to have elevated scores in Harm Avoidance and lower scores in Self-Directedness.
Harm Avoidance is a trait of wanting to be prepared for the future, making sure the details are all sorted out, and not wanting to break the rules or get in trouble. There is a tendency towards worrying and anxiety. The higher you are in Harm Avoidance, the more prone you are to be fantastic at planning and details and the more likely you are to worry about the future and want to follow the “rules.” Persons with higher Harm Avoidance may also tend to excel in professions where they need to pay attention and remember that instructions and details will mitigate risk. You want a good dose of Harm Avoidance in your surgeon, your CPA, your engineer, and your architect, for example!
Self-Directedness is a changeable character trait that describes the ability to direct one’s behavior towards who and what is important to them as well as their own values and goals. Persons with eating disorders tend to score lower on Self-Directedness. When making decisions about what to do or what choice to make, they will make those decisions to avoid harm, relieve problems and pain, and not break the rules rather than do what feels like the best decision for them. Persons with low Self-Directedness may people-please or be compliant because they don’t want conflict or for people to be mad at them. There is nothing wrong with this strategy in and of itself; we all need to make decisions to avoid problems and pain. However, things become problematic when you are too focused in that direction and are not making decisions based on what you need and what you value. When you seek to increase Self-Directedness, you can override the temperament trait of Harm Avoidance and choose, with intention, to move in a direction that feels right for you and what you believe in.
The good news is that you can change Self-Directedness and also manage your temperament trait of Harm Avoidance. Steven Hayes, founder of Acceptance and Commitment Therapy, has studied the processes by which people get well and states that doing what you love and sharing that with others is the secret to moving out of psychological problems. Watch his TEDx talk for a more in-depth look at psychological flexibility.
Five Ways to Practice Joy
Back to the experience of joy. It is not surprising to me that joy elicits a “dress rehearsal for tragedy,” especially for Harm Avoidant persons with lower Self-Directedness. Joy may feel risky, undeserved, and/or not appropriate because not all the problems have been solved yet. It may be a reminder that good things are transient and will not last, that it’s best to get ahead of the game and plan for the inevitable. Yet it is the experience of joy and sharing it with others that will help lead the way out of psychological difficulties. There is the double problem with eating disorders in that this way out requires one to feel emotions with the body -- the very thing that is so hard to be present in -- to even access the experience of joy.
If you are struggling to experience joy yourself, I feel for you. No doubt it will be hard and may not feel okay or natural at first. I promise that I have seen persons in that same space transform when they begin to allow those small moments. If you are supporting someone with an eating disorder, giving permission and helping to create moments of joy can be perhaps some of the most important supports you give.
Here are five ways you can practice or help someone else practice the experience of joy:
This blog is dedicated to all the wonderful attendees at the support group for persons 50+ with eating disorders facilitated by therapist Lauren Jouzapatais and me through The Eating Disorder Foundation. You all are a very important part of my experience of joy each Tuesday. I am so grateful for you all.
For more information, check out my website or reach out to me via my contact page. I offer free, 30-minute consultations to new clients.
1 Cloninger, C. R., Przybeck, T. R., Svrakic, D. M., & Wetzel, R. D. (1994). The temperament and character inventory (TCI): A guide to its development and use. St. Louis: Washington University Center for Psychobiology of Personality.
2 KLUMP, K., STROBER, M., BULIK, C., THORNTON, L., JOHNSON, C., DEVLIN, B., . . . KAYE, W. (2004). Personality characteristics of women before and after recovery from an eating disorder. Psychological Medicine, 34(8), 1407-1418. doi:10.1017/S0033291704002442
3 Fassino, S., Abbate‐Daga, G., Amianto, F., Leombruni, P., Boggio, S. and Rovera, G.G. (2002), Temperament and character profile of eating disorders: A controlled study with the Temperament and Character Inventory. Int. J. Eat. Disord., 32: 412-425. https://doi.org/10.1002/eat.10099