Eating Disorder Therapist in Rockville, Maryland. Serving Montgomery County, Maryland. Specializing in the treatment of anorexia, binge eating, orthorexia, bulimia, compulsive exercise.
She has just finished dinner when the urges begin. It feels like the food in the pantry is calling to her. All she can think about is the package of Oreos, the peanut butter and bread, and the chips. She wants nothing more than to get lost in the cycle of eating. To numb out and to feel that initial pleasure, as she washes down a package of Oreos with gallon of milk. But part of her, doesn’t want to do this again. She wants nothing more than to be able to stop this terrible cycle. Yet, she doesn’t know how to cope with these intense urges. As an eating disorder therapist in private practice in Rockville, Maryland, I specialize in helping people to recover from eating disorders. The following are a few of my tips for what to do when you feel urges to binge eat. Steps to Take 1. Take a deep breath. 2. Remove yourself from the kitchen (if you are in the car drive home, i.e. remove yourself from the triggering environment if you can) and go somewhere where you can sit down. 3. Remind yourself that just because you have an urge, does not mean that you need to act on it. With practice, you can learn how to sit with and ride out the urges that you experience. Urges typically will naturally go down on their own, the more that we can sit with them. 4. Remind yourself of how you usually feel after a binge episode. Bingeing gives a temporary high or feeling of “comfort” or “calm” with long-term distress and unhappiness. Typically people feel physically and mentally terrible after a binge episode. 5. Be kind to yourself. Recognize that you are using bingeing either as a response to physical or emotional deprivation (i.e. you aren’t eating enough throughout the day, or you are eating things yet feeling guilty about them), and/or to cope with uncomfortable or unpleasant emotions. 6. Ask yourself, “Am I feeling physically hungry?” 7. If the answer is no, ask yourself, “What am I looking to feel (or to not feel) through turning to food?” One good option would be to write about this in a journal or notebook. 8. Identify two healthier coping strategies that you can try to get a similar feeling (i.e. if it’s a sense of comfort, call a friend or play with a pet). 9. Tell yourself that you will at least try these two healthier coping strategies before acting on the urge to binge. 10. If afterwards, you are still feeling the urge to binge-try reaching out to someone for support. 11. Remind yourself that you are not saying that you must give up bingeing forever. You can always go back to bingeing-however try to take it one day (even one meal) at a time. What if you tried something different this time? 12. Reach out for professional support. No one should have to struggle with an eating disorder or disordered eating alone. Getting help when you are struggling is a sign of true strength, not weakness. Eating disorders are treatable illnesses and full recovery is possible! The Bottom Line If you do end up bingeing after taking these steps, it’s so important to be compassionate with yourself. You are not alone in struggling with this and you are not simply “lacking willpower.” You are struggling with something, that no one would choose. It’s also so important that you don’t do anything to try to “compensate” for the binge, as this will only keep the binge/restrict cycle going. If you could ride out the urge even for a little bit, this shows that you were practicing an important skill and with time (and additional support) you can learn how to ride out the urge completely. If you could ride out the urge to binge completely, take a moment to recognize and acknowledge this. Ultimately, you deserve a meaningful and joyful life. No matter what you may be telling yourself, finding freedom from bingeing is possible. Yes, for you too. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com
1 Comment
This goes out to the person who is secretly struggling. The one who on the outside appears to have everything together, yet underneath it all, feels trapped. The one who “eats normally” in public, yet binges on a jar of peanut butter, a loaf of bread, and bags of tortilla chips, at night. Who goes to sleep with a painfully aching stomach and feelings of guilt, shame, and self-loathing. Or perhaps you have intense anxiety around the thought of eating at a restaurant, and paint on a false smile, while underneath you are frantically tallying calorie counts in your head. You wish you could just "eat normally," yet it feels like your list of "food rules" is getting increasingly more strict. Maybe you struggle with exercising despite illness and injury. You wish you could let yourself rest, but the anxiety around doing so feels totally unmanageable. Or perhaps you struggle with bingeing and purging. You feel exhausted and unable to stop, yet each time you tell yourself that it will be the last one. Afterwards, you feel disgusting and ashamed. Maybe you question whether you are actually struggling with an eating disorder. That voice in your head may tell you, “But you don’t look sick,” or “You only do this behavior x number of times. It’s not that bad,” or “Eating disorders are illnesses that only impact teens.” These are all statements that your eating disorder may tell you, in an effort to try to keep you from seeking help. While often people struggling with eating disorders are unable to see how “ill” they actually are, it’s also important to note that even if you struggle with disordered eating (rather than an eating disorder)-you still deserve to seek help and support. It’s important to note that eating disorders can impact people of all races, ages, genders, weights, and body sizes. Think of your eating disorder as an abusive partner that will tell you anything to try to keep you trapped in its grip. Maybe you tell yourself that you can handle this on your own, or that you simply need to have “more willpower.” Eating disorders are not a choice and they aren’t about “lacking willpower” or being “shallow.” Rather, they are serious mental illnesses. No one would choose to binge until they feel physically ill, to purge and feel disgusted with themselves, to have constant thoughts about food and body, to have bradycardia and other health complications, to lose friends and to isolate themselves, or to be unable to eat at a restaurant without feelings of anxiety and dread. You Deserve to Seek Help No matter what your mind is telling you, you deserve to seek help from trained professionals. Eating disorders are treatable illnesses and recovery is possible. No one should have to struggle with an eating disorder alone. Seeking help when you are struggling is a sign of true strength, not weakness. Living with an eating disorder can feel miserable. It may give you a temporary “high” or feeling of “comfort,” however in the long run, it only leads to increased anxiety and unhappiness. Maybe part of you is scared or unsure if you even want to let go of your eating disorder. This is entirely normal. However, you’ve been doing things the same way and continuing to have the same result. What if you tried something different? If you find that you hate your life in recovery, you can always go back to your eating disorder. However, once recovered, I don’t think that you will want to. You deserve a life that is free from constant thoughts about food and your body. Take the first step to reach out for help. It will be worth it. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, compulsive exercise, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com Today, I was in session with a brilliant client (this is shared with permission) and we got into a conversation about how negative body image relates to ‘the red car syndrome.’ What is ‘The Red Car Syndrome?’ Have you ever had the experience where you are shopping for a specific type of car (let’s say a red Honda) and suddenly you start to notice that car everywhere? This is the known as ‘The Red Car Syndrome.’ However, it doesn’t just relate to cars. The reality is that often the things that we focus on expand. For instance, let’s say that you have the core belief “I am such a failure.” You likely will start to see “evidence” of your belief everywhere. The reason behind this phenomenon is that we have a reticular activating system within the neocortex of our brain. This system helps us to filter important information and impacts what we focus on. It heightens our awareness of certain things. ‘The Red Car Syndrome’ and Negative Body Image So how does this syndrome relate to negative body image? Often for people struggling with negative body image there is a desire to try to change their body, as they believe this will improve their body image. For instance, someone might decide that they need to “lose weight” or to “gain muscle.” When you focus on trying to change your body to reduce or eliminate perceived “flaws,” the negative feelings that you have about your body often expand. When we try to change our bodies, the message that we are sending is that our bodies are flawed. When we view our body as flawed, we will start to see more “flaws.” While focusing on trying to change your body may give you a “temporary high,” in the long-term it leads to increased anxiety and discontent. Ultimately, the more that you focus on what you dislike about your body-the worse you will feel about your body. How to use ‘The Red Car Syndrome’ to Cultivate Positive Body Image I define positive body image as not spending so much time thinking about your body, because you are busy living your amazing life. To use ‘Red Car Syndrome’ to cultivate a more positive body image here are a few quick tips: 1. Start to surround yourself on social media with body-positive accounts and images of body-diversity (i.e. people of all shapes and sizes). 2. Listen to podcasts that promote body-positivity, such as Life Unrestricted with Meret Boxler, Body Kindness with Rebecca Scritchfield, Food Psych, The BodyLove Project Podcast with Jessi Haggerty, and Fearless Rebelle Radio with Summer Innanen. 3. Make a list of the things that you are thankful for that your body does for you (i.e. body function). 4. Make a list of the qualities that you appreciate about yourself, which have nothing to do with your appearance. 5. Think about hobbies or interests that have nothing to do with your body, appearance, or food, and begin to pour your energy into those things. The Bottom Line Struggling with constant thoughts about food and your body can feel exhausting. However, with access to support and treatment-you can find freedom. If you are struggling, it’s so important to be compassionate with yourself. It’s not your fault if you are suffering, however you can make the choice to seek help and to start to do some of these exercises. After all, your life is worth so much more than spending your time hating your body and trying to change it. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com Do you want to come to dinner with us tonight? Her friend asks.
The spiral begins. Her anxiety is mounting. She finds herself lost in endless Google searching of the menu, trying to calculate the nutrition information, searching for pictures of the different options. Her mind is racing, trying to figure out what she can order. It all feels completely overwhelming. It’s no wonder that she’s started declining invitations for meals out, when she is so filled with anxiety and dread. She feels increasingly isolated and alone. Walking by others laughing and eating outside at restaurants, she finds herself looking at them wondering how they can appear so calm and relaxed around food. She struggles with constant thoughts about food, weight, and her body. She finds herself bone-chillingly cold at times. She feels completely trapped. She is not simply making the choice to restrict food, decline invitations to go out to eat, or to exercise despite illness or fatigue. She is struggling with a serious mental illness. As an eating disorder therapist in private practice, I am grateful to be able to help people to recover from eating disorders. The following are three tips for your recovery from anorexia. 1. Start to separate out “the eating disorder self” from the “healthy self.” When I work with clients, often we will start to differentiate between their “eating disorder self” and their “healthy self.” An Example: Eating Disorder Self: “You can’t eat that. It will make you gain weight and it’s so bad for you.” Healthy Self: “No food is good or bad and I deserve to nourish myself with food that I enjoy. What’s truly unhealthy is feeling anxiety and guilt around food.” The first step is starting to recognize the unhelpful thoughts that you’re eating disorder self may be telling you. Then you can practice telling yourself more helpful coping statements, and taking actions that align with your “healthy self” values-no matter what your mind is telling you. 2. Practice acting “as if.” This tip is essentially the “fake it until you make it” approach. Even if your “eating disorder self” is telling you a ton of unhelpful things, it’s crucial to practice taking pro-recovery actions anyways. Often the actions come before the thoughts start to change. Our thoughts alone do not have power to harm us. Therefore, no matter what your eating disorder is telling you to do, it’s important to practice taking actions that help to support your recovery-rather than fuel you’re eating disorder. 3. Set small goals to challenge yourself. It’s so important to challenge yourself and to “step out of your comfort zone” when it comes to recovery from anorexia. Ideally, with the support of a treatment team-it is crucial to start to set small goals to start to challenge any food or exercise rules and rituals. This can help to build your confidence in your ability to recover, and help to break these unhelpful rules and patterns. For example, you might make a list of any “fear foods” and work to gradually challenge yourself to have them (multiple times)-with the support of your therapist, dietitian, or loved one. The Bottom Line Often for people struggling with anorexia, there’s this belief that they are “not sick enough” to seek treatment or to work towards recovery. It’s important to note that typically there is no point where your “eating disorder self” deems you as “sick enough.” If you are struggling, you deserve to seek treatment and support. No one should have to battle an eating disorder alone. Additionally, People struggling with anorexia can come in a variety of shapes and sizes and it’s important to point out that you do not have to appear emaciated (or even thin) to be intensely struggling. Eating disorders are mental illnesses and you can’t tell who is struggling based upon their physical appearance. Ultimately, living with anorexia is a pretty miserable experience. While there may be short-term feelings of a false “sense of control,” or a high, in the long-term, it typically leads to misery, depression, and isolation from others. While anorexia is a terrible mental illness that is not a choice, you can make the decision to seek help and start on the path to recovery. There is a beautiful life waiting for you on the other side of this eating disorder. Freedom and full recovery from anorexia is possible. Yes, for you too. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, compulsive exercise, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD. Connect with Jennifer through her website: www.jenniferrollin.com Netflix’s new movie “To The Bone” opens with a warning that reads, “The film was created by and with individuals who have struggled with eating disorders, and it includes realistic depictions that may be challenging for some viewers.” While it’s partly true that some of the more realistic elements of the film could be incredibly triggering for those who are struggling with eating disorders (as well as for individuals who have the underlying genetics to develop an eating disorder), there’s also so much about this film that actually just perpetuates dangerous myths about eating disorders and recovery. The movie, which was written and directed by Marti Noxon and stars Lily Collins and Keanu Reeves, depicts a young woman’s battle with anorexia. It has been met with a lot of controversy, especially within the eating disorder recovery and treatment community. I think the creation of this film was well-intentioned. The director and lead actress both shared that they have personally struggled with eating disorders in the past and that their aim was to raise awareness and to diminish shame and secrecy. Raising awareness of eating disorders and decreasing shame and stigma surrounding seeking help is crucial. One of the positive aspects about the film is that it is opening a larger conversation about eating disorders and seeking treatment. However, as an eating disorder therapist in private practice, I have some major concerns about the way anorexia is being depicted in this movie and the impact that this can have on individuals. Concerns About The Movie As an eating disorder specialist, I know that often people with eating disorders struggle with the thought of “not being sick enough to need treatment.” This is a common eating disorder thought, and the problem with the depiction of eating disorders in this film is that it perpetuates the myth that people with anorexia always appear visibly emaciated. The film also goes out of its way to highlight Ellen’s frail appearance, with close-up shots of her spine and a scene where she takes her clothes off to reveal an emaciated frame. Therefore, I’m afraid people might view this film and think because they don’t appear “as thin” as Ellen they do not deserve to seek treatment. It also worries me that this movie is educating the general public along these same lines as well. For instance, so many people with eating disorders have experienced friends, family and treatment professionals saying incredibly damaging things such as, “You don’t look like you have anorexia.” It’s important to note that eating disorders (including anorexia) can impact people of all different shapes and sizes. You can be considered “normal weight” or “overweight” (I dislike these terms but use them to make my point) and intensely struggle with an eating disorder. You cannot tell who is struggling with an eating disorder by looking at them. Eating disorders are one of the few mental illnesses where we judge someone’s level of suffering based on their physical appearance. No matter what your body looks like, you deserve to seek treatment and support. The movie does depict a woman in a larger body; however, she of course struggles with binge eating disorder. Again, this is perpetuating the myth that you can tell what kind of eating disorder someone struggles with based on their body size, which is blatantly false. Does The Movie Glamorize Anorexia? I have a lot of compassion for the director and producer of the film, as it’s very difficult to make a movie about anorexia without glamorizing the illness. However, the issue here is that the lead character, Ellen, is super likable, glamorous, and “cool” as she is struggling with this deadly disease. Anorexia is not Lily Collins with a perfectly done smokey eye, staring sullenly out of the window, cracking funny/sarcastic one-liners, and enjoying fun escapades with friends and family. Anorexia is often feeling too depressed to want to leave your house. It’s isolating yourself from friends and family because you are afraid to be around food. It’s constant thoughts about food 24/7 and intense anxiety. For some, it’s hair falling out, low heart rate and osteopenia (however, even if you have no medical complications, you still deserve to seek treatment). It is a voice in your head that’s constantly yelling at you. It is feeling completely trapped. It’s not being able to find pleasure in things. It’s becoming a shell of your former self. While the movie attempts to show some of these complications, it’s easy to see how for those with the underlying genetics, temperamental, and psychological factors, this could easily become “aspirational.” Eating disorders are not glamorous, they are miserable and can be deadly. If you are struggling, you deserve to seek treatment and support. The Movie’s Depiction Of Treatment And Recovery I think the makers of the movie tried to highlight that anorexia is not simply about “wanting to be thin” and that it can have a devastating impact on family members, which was great. However, the movie missed the opportunity to dive deep and provide any real insight into the underlying causes of the illness (not once did they mention genetics) as well as how to effectively treat eating disorders. Further, the treatment approach shown in the movie is not at all realistic of eating disorder treatment. For instance, the woman with binge eating disorder randomly eats jars of peanut butter at every meal. Patients are allowed to choose their own food, and there appears to be little staff monitoring. Additionally, little is shown of the actual therapy component or of Ellen’s recovery journey. This aspect would actually have been helpful to highlight, as this depiction only serves to promote misconceptions about treatment and recovery. While hardly any of the actual treatment and recovery process is highlighted, specific eating disorder behaviors and “tricks” that people use in treatment are highlighted in abundance. Specific calorie counts are referenced, as are “lowest weights,” and a variety of detailed eating disorder behaviors that I will not reference here due to my desire to not unnecessary trigger anyone. We know that this kind of content can be highly triggering to people with the underlying genetics for an eating disorder and for this aspect alone, i’m highly concerned about the impact that it will have. Further, the doctor at one point advises Ellen’s family to “let her hit bottom” (terrible advice, and how are we determining “bottom” here, exactly?!) and tells Ellen that he doesn’t want to treat her if she isn’t interested in getting well. If many people with eating disorders waited until they “wanted to get better” to seek treatment, they would never seek treatment. Part of the illness is often an inability to see how “ill” that you actually are. Also, the movie doesn’t provide any resources for people who watch it and wish to seek help. It would have been easy for them to have a message at the end referencing The National Eating Disorder Association helpline; however, they chose not to do so. I was expecting to be riveted by the film, especially given that working with people with eating disorders is my passion. However, I didn’t actually even find it that interesting. It plays out a lot of tired old stereotypes about people with eating disorders, and while the main character is likable, I felt that the storyline overall fell flat. Ultimately, while I’m thankful that it’s prompted a larger discussion about eating disorders and raised awareness, I don’t think that it added anything new or helpful to the conversation. The Bottom Line If you or someone you know thinks that they might be struggling with an eating disorder, it’s so important to reach out for help from a professional. Seeking help when you are struggling is a sign of true strength, not weakness. No one should have to struggle with an eating disorder alone. With access to treatment and support, individuals with anorexia can recover and go on to lead meaningful and purpose-driven lives. Full recovery is possible! Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com She told herself that it wouldn’t happen again. Then, after dinner she found herself reaching into the pantry for the jar of peanut butter. The TV plays in the background, as she compulsively begins to eat a package of Oreos and peanut butter straight from the jar. She feels completely out of control and powerless to stop. Thirty minutes go by, and she finds herself surrounded by empty boxes, cartons, and wrappers, from all the food that she just consumed. Her stomach aches painfully and her head is throbbing. Filled with a sense of guilt, shame, and self-loathing, she finally drifts off to sleep. It’s important to note that she is not simply “lacking willpower” or “making a choice” to eat until she feels sick. Rather, she is struggling with binge eating disorder. Binge eating disorder is the most common eating disorder in the U.S., however it is often highly misunderstood, stigmatized, and not frequently discussed. Additionally, many people who are struggling do not seek treatment due to shame, guilt, and denial of the seriousness of the illness. As an eating disorder therapist in private practice in Rockville, Maryland, I am grateful to be able to help teens and adults to recover from binge eating disorder. The following are my tips for how to cope the day after an episode of binge eating. 1. Practice self-compassion. Many of the people that I work with express feelings of shame and guilt after binge eating. It’s important to note that you are so not alone in feeling this way or in struggling with binge eating disorder. Binge eating disorder is a mental illness and you are not simply “lacking willpower” or a “undisciplined person.” No one would choose to eat until they feel physically sick. You are not choosing to struggle with an eating disorder, and you can make the choice to start working towards recovery. Also, you did the best you could with the coping skills that you had in that moment, and you can also learn from this experience. It’s so important to practice self-compassion, as well as to explore your bingeing behavior from a place of curiosity and non-judgment. “Beating yourself up” for bingeing will likely only serve to perpetuate the behavior and cause you to feel even worse. Think about how you would talk to someone that you love who was suffering from an eating disorder. It’s unlikely that you would harshly criticize and berate them. It’s crucial to practice saying kind things to yourself. You deserve to extend the same kindness to yourself that you would give to someone you love. 2. Nourish yourself, rather than restricting. The tendency or urge the day after binge eating is often to skip meals or to try to follow some kind of restrictive diet (yes, “clean eating” or cleansing falls under this category). Here’s the thing, I always encourage my clients (even if they are not physically hungry) to have a solid breakfast (plus lunch, dinner, and snacks) the day after a binge episode. It may seem paradoxical, but it’s also important they are start to honor their specific food cravings and begin to incorporate them into their regular meals. Restriction of food serves to perpetuate binge eating disorder and can be one of the triggers for bingeing (with emotional factors being another big one). If you restrict the day after a binge episode, you are actually fueling the eating disorder. I explain to clients that bingeing is often a natural and adaptive bodily response to real or perceived deprivation. Our bodies evolved to ensure our survival as a species and it makes sense that physical and/or emotional restriction can trigger subsequent binging episodes. If there were times of famine or food scarcity, we were primed to eat as much as possible when we encountered food again. Therefore, physical or emotional restriction of food can be a major trigger when it comes to binge eating. Physical restriction is the idea of depriving yourself of certain foods (i.e. not allowing myself to eat the brownie), whereas emotional restriction is eating a food while experiencing a sense of guilt or shame (i.e. I eat the brownie, but feel guilty about it). Thus, it’s important to work to challenge and eliminate any restriction, as part of your recovery from binge eating disorder. Also, it’s crucial to note that compulsive exercise or trying to “compensate” in some other way following a binge, is also only going to serve to perpetuate the binge/restrict cycle. 3. Do NOT step on the scale and instead do some self-care. If you still own a scale, I’d recommend throwing it out (although taking a hammer to it could also be therapeutic). I find that for my clients knowing their weight is unhelpful. If their weight must be monitored, then I ask that they do “blind weights” with their doctor or registered dietitian. Knowing the number that you are on the scale tells me nothing about your attractiveness, intellect, health, mental health, worthiness, or anything else of importance. When we focus on this external measure, we lose touch with our bodies and engaging in food and movement choices that actually feel pleasurable to us. Instead of stepping on a scale, I’d encourage you to practice some self-care. If you feel that your bingeing was triggered by emotional factors, I’d ask you to think about what feeling you were looking to experience (or to not feel) when you turned to food. For instance, let’s say that you were looking to feel “comfort” or “companionship.” You might then start to explore some healthier ways that you can start to get these needs met. For example, you might consider getting together with a friend or family member, playing with a pet, or drinking a cup of warm tea while cuddled up with a blanket. In therapy we also work on learning how to sit with and tolerate binge urges and uncomfortable emotions, primarily through using dialectical behavioral therapy skills. If you are not familiar with dialectical behavioral therapy (DBT) i’d highly recommend looking into this approach. The Bottom Line Living with binge eating disorder feels miserable. You are not making the choice to struggle with an eating disorder, however you can choose to reach out for help. Seeking help when you are struggling is a sign of strength, not weakness. With access to treatment and support, you can fully recover from your eating disorder, and find freedom with food, body-acceptance, and reconnect with your life values. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. She provides eating disorder recovery coaching via phone to people worldwide. Connect with Jennifer through her website: www.jenniferrollin.com As a therapist in private practice in Rockville, Maryland, specializing in helping teens and adults struggling with eating disorders and body image issues, I help my clients to start to separate out their “eating disorder self,” from their “healthy self.” For instance, we might start to notice things that the “eating disorder self” is telling them and then practice responding from “the healthy self.” An Example Eating disorder self: You can’t eat that pizza, it’s so bad for you. You don't deserve to eat it. Healthy self: I always deserve to nourish myself with food that I enjoy. Food isn’t good or bad. All foods can fit in a healthy diet. I help clients to recognize what the “eating disorder self” is telling them, and then take actions that are more in alignment with their “healthy self.” This becomes easier with time and practice and over-time the “healthy self” voice and habits can become more automatic. One of the goals of therapy is to strengthen “the healthy self” to take over the job of the “eating disorder self.” Eating Disorder Sunglasses The other day I was in a session with a client, when she came up with a brilliant analogy (which she gave me permission to share), called “eating disorder sunglasses.” When people are struggling more intensely with eating disorder thoughts, their perception of reality (and of their past struggle) may be very skewed by the eating disorder. It’s as if they are viewing things through a pair of “eating disorder sunglasses.” Through therapy we can slowly work to take the sunglasses off, so that they can start to view things in a healthier way. Sometimes people in recovery may look back on when they were deep in their eating disorder through a pair of “rose colored eating disorder sunglasses.” For instance, “the eating disorder self” may try to convince them that “it wasn’t that bad” or even that things “were a lot better” when they were intensely struggling with their eating disorder. However, the reality is that generally people who are struggling with eating disorders feel miserable. While eating disorder behaviors, may give people a feeling of temporarily relief, comfort, or a false “sense of control,” in the long-run they only serve to bury the underlying issues and make then feel even worse. Like an abusive partner, the "eating disorder self" paints this rosy picture to try to regain it's control over you. However, you don't have to listen and agree with what it says. Some Exercises If you are struggling with taking off your “eating disorder sunglasses,” here are a few brief exercises that you can do. 1. Make a list of what your life could look like 5 years from now if you stay trapped in your eating disorder vs. if you fully recover. 2. Write a pro/con chart of acting on eating disorder behaviors (this is a dialectical behavioral therapy skill).
3. Create a list of your true values vs. the values of “the eating disorder self.”
Seek Help If you are struggling with an eating disorder or a difficult relationship to food, it’s so important that you seek help from professionals. Seeking help is a sign of true strength, not weakness. The teens and adults that I work with who are in recovery from eating disorders are some of the strongest, most intelligent, and compassionate people that I know. People with eating disorders have so many strengths, which they can use to help them along in their recovery process. No one chooses to have an eating disorder; however, you can make the choice to start your recovery journey. With access to treatment and support, full recovery from eating disorders is possible! Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping adolescents and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com Your recovery from an eating disorder has been going strong. Perhaps you’ve been making strides in facing “fear foods,” are opening up in therapy, and learning how to use new coping strategies. Then, for some reason or another, you find out your current weight, which often causes “the eating disorder self” to start freaking out. Suddenly, you may find yourself faced with loud “eating disorder thoughts” and a desire to go back to your disordered behaviors. For some people with eating disorders, recovery can bring about body changes. Not everyone’s eating disorder causes weight loss. However, for those whose eating disorder kept them below their natural weight range, recovery will help your body to get back to its set-point weight. What is Set-Point Weight? Our set-point weight is a range (typically consisting of 10-20 pounds) that our body will biologically fight to maintain. The same way that we cannot choose our eye color, or height, we cannot decide our bodies natural set-point weight range. Body diversity is real and thus our set-point weight range can vary from person to person. When we try to suppress our body below our set-point weight, our appetite and metabolism will adjust to try to maintain our set-point. If we are below our set-point, our bodies may try to conserve energy by stopping our period, turning off our temperature regulation, or slowing our metabolism. Our thoughts will start to turn more towards food, as our body wants to ensure that we are taking in enough nutrition. The idea of set-point can feel scary to people in recovery. However, it can also be comforting to know that when we provide our bodies with adequate fuel and engage in gentle movement, our bodies will take care of regulating our weight. What if I Understand Set-Point and Am Still Struggling to Accept my Natural Weight? As an eating disorder therapist in private practice in Rockville, Maryland, the following are a few of my tips for accepting body changes in recovery. 1. Practice self-compassion. The first element of self-compassion is mindfulness. It’s important to acknowledge and notice that you are suffering. You might also pay attention to any emotions that are coming up for you and where you feel them in your body. The second element of self-compassion is the idea of “common humanity.” Many people in recovery struggle initially with accepting body changes and their natural body size. It’s important to note that you are so not alone in how you are feeling. Additionally, you are not “vain” or “shallow” for focusing on your weight and body. Rather, you are struggling with a serious mental illness. However, full recovery is possible. The third element is being kind to yourself and treating yourself the way you would a loved one who was struggling. Beating yourself up for having unhelpful thoughts about your body will only serve to make you feel even worse. Instead, try acknowledging how brave and strong you are for working on your recovery and for sitting with these unpleasant feelings. You deserve to treat yourself with the same kindness that you would give to someone you love. 2. Ask yourself what you are really hoping to feel or gain through attempting to change your body. It’s important to ask yourself, “what do I feel that having my “ideal body” or “being thinner” would bring me? No one desires to have a certain body type simply for the sake of acquiring that body type. Rather, often we desire to look a certain way because of what we believe it will bring us. For instance, diet-culture (and eating disorders) try to convince us that “thinness” will give us a sense of self-worth, love, health, and acceptance. While it is true that weight discrimination exists and that people in larger bodies are often unfairly judged in our society, the reality is that we cannot control our world, other’s opinions of us, or our ability to be loved through our weight. Every day people of all shapes and sizes find love, achieve success, and feel joy and happiness. Once you ask yourself, what you are really hoping to gain ( i.e. confidence, a loving relationship, etc)- you can then look at some ways that you can actually work towards those things, without trying to change your body. 3. Make a list of all the other things that have changed in your life through recovery. Your eating disorder may try to convince you that you were so much happier when you were in a smaller body. However, this is just another way that it is attempting to control you. While for many recovery can bring weight changes, it’s also important to look at what other changes have occurred in your life as a result of your recovery. Living with an active eating disorder is a miserable place to be. If you’ve gained weight in your eating disorder recovery, what else have you gained? Maybe you’ve gained the ability to laugh with your friends, to enjoy dinners out with family, to pursue your passions, and to feel engaged in your life in a meaningful way. These things, are a billion times more important than any number on a scale or pants size (no matter what your eating disorder is telling you). Ultimately, what do you want to be remembered for? No one writes in someone’s obituary, “she was so thin,” or “I’ll remember her for her 6 pack.” Eating disorders often will isolate you from loved ones and take your mental energy away from focusing on what truly matters. Work to shift focus to the things in your life that are actually meaningful and in alignment with your true values. 4. Practice radical acceptance. It’s ok if you aren’t at a place where you are in love with the appearance of your body. Ultimately, our bodies are meant to change as we age. Therefore, putting your self worth into your appearance is a recipe for discontent. It can be helpful to work to practice a dialectical behavioral therapy skill called “radical acceptance.” Acceptance does not mean that you must love your body, rather it means that you work to accept it. Fighting against your natural weight is not serving you. Accepting your natural size will enable you to strengthen your recovery and take better care of yourself. Additionally, it’s important to note that in recovery you may have periods of intense body-image distress. However, these periods are only temporary. Thus, it’s critical to practice “leaning into the discomfort” of the emotions and continuing to take recovery actions-no matter what you mind is telling you. No feeling lasts forever and if we can sit with them, they will naturally rise and peak on their own-much like ocean waves. The Bottom Line I encourage my clients to get rid of their scale and if they must be weighed to be doing “blind weights.” Scales, clothing sizes, and the BMI chart, ultimately tell us nothing about our value as people-or anything else of significance. If you are struggling with urges to use eating disorder behaviors, it’s so important to reach out to a professional, friend, or family member for support. Learning how to turn to people rather than your eating disorder, can be a crucial aspect of strengthening your recovery. Despite what your eating disorder may be telling you, I know this to be true. You are not more valuable if you take up less space. Further, your worth is not found in your body size or shape. Your true value is found in the sparkle in your eyes when you laugh, the way that you pursue your passions, how you help others, and in your relationships. You are enough, and you are worthy of love and belonging, just as you are. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping adolescents and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. Jennifer provides eating disorder therapy in Rockville, MD, accessible to individuals in Potomac, Bethesda, Olney, Germantown, and Washington D.C. Connect with Jennifer through her website: www.jenniferrollin.com She is running. Sweat is dripping down her face. Her eyes lingering on the numbers lit up on the treadmill. Pain is shooting through her leg. She thinks that she might have strained or pulled something last week. Yet, the thought of missing a day at the gym fills her with anxiety and fear. She can’t remember the last time that she took a day off. Her friends praise her for her dedication and “fitness.” They say that they wish they could be as disciplined. But it is not discipline that causes her to run for miles every morning. There is a voice in her head, which demands that she keep running. She is not choosing to feel and behave this way. She is a prisoner to her own mind. The media and society frequently pronounces the health benefits of regular exercise. However, for individuals who are struggling with compulsive exercise, this can become physically and mentally unhealthy. As a therapist in private practice in Rockville, Maryland, specializing in helping people struggling with eating disorders and compulsive exercise, the following are three of my tips for breaking free from compulsive exercise, and getting your life back. 1. Cultivate an awareness of your thoughts and behaviors surrounding exercise. The first step is to identify aspects of your relationship to exercise that are problematic. For instance, notice the thoughts and stories that you are telling yourself surrounding exercise. For example, do you tell yourself that “a workout does not count unless I sweat?” Or maybe, you exercise to compensate for eating. These are examples of some unhealthy ways to view movement. Additionally, it’s important to look at whether you are struggling with any of these other warning signs that your relationship to exercise could be unhealthy:
You can take this compulsive exercise self-assessment to further evaluate your relationship to exercise. Additionally, it can be helpful to come up with some "healthy self" coping statements that you can put in your phone. An example might be, "I deserve to eat and nourish my body, no matter how much I have exercised today" or "The amount that I exercise, does not define my worth as a person." 2. Work to challenge any exercise “rules.” You can also make a list of any exercise “rules” that you feel that you must follow. For example, “I always exercise for ___ amount of time,” or “I only take one rest day per week,” or “I must sweat when I exercise.” Then, gradually work to challenge these rules, in small and manageable steps. For instance, you might start by taking one rest day a week or trying a gentle yoga class instead of running. Or you might begin by shaving off 10 minutes of your daily exercise routine. It’s important to note that when you are breaking “exercise rules” you may feel intense discomfort or distress. However, it’s important to remind yourself that this distress is only temporary. The more that you can challenge any exercise rules, the easier this will become over time. Ultimately, the eventual goal is to learn how to find forms of movement, which you can actually enjoy-as well as to be able to find variety, flexibility, and balance. 3. Come up with a list of other coping strategies. A question that I might ask a client struggling with compulsive exercise, is “When you think about exercising, what emotion are you looking to feel?” Then, we can look at some other coping strategies that the individual can use to try to get that feeling. For instance, if someone wants to feel “calm” we could explore other ways that they could feel a sense of calm such as meditation, coloring, journaling, getting a massage, or taking to a friend. Sometimes using movement to relieve anxiety makes sense, however the problem occurs when this is someone’s primary way to cope with their emotions. Thus, it’s important for people to have a variety of both processing and distraction coping strategies that they can use. I might also ask someone what else is bothering them that they are trying to distract themselves or “numb out from” through exercise. Then, we can actually address this issue-rather than putting a temporary “band aid” on a gaping wound. The Bottom Line In a society where everyone is loudly proclaiming the health benefits of exercise, breaking free from exercise compulsion can be tough. However, it’s important to note that rest and gentler forms of movement sometimes are the healthiest choice. Especially, for those who are in recovery from an eating disorder or exercise compulsion, sometimes the healthiest thing for them to do is take a period of time off from exercise or to engage in gentler forms of movement. You are not lazy for taking time off from exercise, you are actually taking good care of yourself. Additionally, rest is a crucial component of any exercise routine (for both mental and physical health reasons), as exercise ultimately is a stressor for your body. If you are struggling with an eating disorder and/or exercise compulsion, it’s so important to reach out for help from a trained professional who specializes in this area. Often people who are struggling find that their worlds become very small and their relationships suffer. When you look back on your life at age 80 do you really think that you will be fondly reminiscing about the years spent on the treadmill, or obsessing about your body shape and weight? No. You deserve to have a meaningful and joyful life. One that you cannot have if you stay trapped in an exercise compulsion. However, with access to treatment and support full recovery from eating disorders and compulsive exercise is possible! Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping adolescents and adults struggling with anorexia, binge eating disorder, and bulimia, body image issues, and compulsive exercise. Jennifer offers eating disorder therapy in Rockville, Maryland, and eating disorder recovery coaching via phone/Skype. Eating Disorder Therapy easily accessible to people in Potomac, Bethesda, Germantown, Olney, Silver Spring, Maryland, and Washington D.C. As parents, it can be difficult to tell what is really behind your teen’s recent desire to lose weight, newfound interest in “healthy” eating, or preoccupation with food. As a therapist in private practice in Rockville, Maryland, specializing in helping teens and adults with eating disorders and body image issues, I have spoken with many parents about “warning signs” that their children were struggling, which they initially missed. There is no guidebook for how to tell if your child is secretly struggling with anorexia, bulimia, or binge eating disorder. Eating disorders often thrive on secrecy and silence. Many children may be unaware themselves that they are starting to slip into a life-threatening mental illness. The following are some common warning signs that may signify that your teenager is struggling with an eating disorder. 1. Eating rituals or strange eating behaviors. One sign to look out for is if your teen has started to adopt eating rituals or strange eating behaviors. Eating rituals include behaviors such as, cutting food into tiny pieces, arranging food in certain patterns, or constantly measuring food. Other eating rituals could include using the same utensils or only eating foods in a specific order. These rituals could be warning signs of anorexia nervosa and could also be an early sign of binge eating disorder. It is important to note that the presence of rituals alone doesn’t necessary indicate an eating disorder, but is something to consider in the context of the person’s other behaviors and attitudes towards food and weight. 2. Excessive or unusual use of condiments and beverages. Another sign of a potential eating disorder is if your teenager is using condiments/and or beverages in a way that is excessive or strange. For instance, if you notice that your teen is using an excessive amount of mustard, salt, or other spices on their food that would be one red flag that they might be struggling with disordered eating or an eating disorder. Additionally, a warning sign that your teen may be struggling with an eating disorder or disordered eating is if they begin abusing beverages, such as diet sodas or coffee in an attempt to feel full. 3. Preoccupation with weight, body size and food. Other warning signs to look out for is if your teen suddenly appears preoccupied with thoughts of their weight, body size, and food. For instance, if your child has an intense fear of weight gain this is one sign that they could be suffering from an eating disorder. Further, if your teen decides that they are dramatically changing their eating habits-it is important to take note and to observe their motivation and the rigidity of their habits. For instance, your teen might suddenly proclaim that they are “not eating carbs,” or have become a vegetarian (with no history of an interest in this from an ethnical standpoint). Other red flags could be if they appear to stick to only a few “safe foods,” become fixed on fat content of foods, hoard food, cook elaborate meals for others but do not eat them, or go to the bathroom frequently right after eating. Additionally, if you start to notice that large quantities of food are going missing this would be another important sign to look out for. 4. Isolating themselves from people or becoming less interested in things they previously enjoyed. Another indicator of a teen who may be struggling with an eating disorder is if they become socially withdrawn and start to isolate themselves. It is a warning sign that there may be a deeper problem if your teen no longer desires to socialize and instead is consumed with researching recipes, going to the gym, and/or talking about food, calories, "clean eating," or dieting. When someone is struggling with an eating disorder often their eating disorder becomes their primary relationship and begins to take the place of the real relationships in their life. The Bottom Line If you notice any of these warning signs, and suspect that your teen may be struggling with an eating disorder, it is critical that you reach out to an eating disorder treatment professional. They can assess your child to see whether they are struggling and if so, provide treatment. Eating disorders have the highest mortality rate of any mental illness and individuals who are struggling need access to evidence-based treatment and support. It is also important to note that you cannot determine whether an individual is struggling with an eating disorder based upon their weight. Eating disorders do not discriminate and those who are struggling may come in all shapes and sizes. Additionally, early intervention is important to regards to helping people to recover from eating disorders. Therefore, the earlier that you can have them evaluated-the better. It is also critical that you approach them with compassion and support-rather than judgment. They are not making the choice to feel and behave this way, but with treatment and support they can recover and go on to lead meaningful and productive lives. Lastly, it’s important that you can be compassionate with yourself. It's not your fault that you may initially have missed the warning signs. Further, parents and families do not cause eating disorders; however, they can be incredible allies and sources of support to their children in recovery. Jennifer Rollin, MSW, LCSW-C: is an eating disorder therapist in private practice in Rockville, Maryland. Jennifer specializes in helping adolescents and adults struggling with anorexia, binge eating disorder, and bulimia, body image issues, anxiety, and depression. Jennifer offers eating disorder therapy in Rockville, Maryland, and eating disorder recovery coaching via phone/Skype. Eating Disorder Therapy easily accessible to people in Potomac, Bethesda, Germantown, Olney, Silver Spring, Maryland, and Washington D.C. |
About MeI'm an eating disorder therapist in private practice in Rockville, MD. Archives
September 2019
|