When Food is the Enemy

I see women in my practice every week who suffer from eating disorders (ED).   I never used to see men with  ED but that has changed. Still, the incidence is much less frequent than with women and, when it does present, it is often much less severe in nature. I used to see it more in gay men but now I see it far more in heterosexual men.  I also encounter it  more often as a condition on the disordered eating spectrum with most men regardless of sexual orientation,  rather than a full blown ED. 

In medical school I recall how many of the women I knew who would food restrict. I only knew of one male who would food restrict.   I actually got very thin myself, but quickly realized I needed food to stay awake most nights on call.

What’s on the menu?

It feels like we don’t know how to eat anymore. There is Keto this, low carb that, low fat vs clean eating. In the end we are at war with our bodies and food has become the enemy. When and why did food become a moral issue? I hear my patients say they were “so bad” because they had an extra piece of pie at a holiday dinner. It’s hard to imagine a world where we would accept the bodies we have rather than the bodies we wish we had. What will this imagined body bring us? Will it provide the elusive happiness we have been searching for?

Exercise is Healthy, right?

One of the latest eating disorders that has fallen on the more acceptable realm is ” Exercise Induced Bulemia.” Make no mistake it is still a compensatory way to maintain a lower body weight, but somehow it became socially acceptable to run, cycle or attend workouts at gyms that burn many calories. I frequently see women trying to keep up with their male partners. Sometimes it is the only way to spend significant time with them especially if they too have body image issues. Granted we are a more sedentary culture, but this is beyond going for the evening walk to move those stiff muscles at the end of the day.

Novel concept: eat when hungry

I am unsure of how to win this war on our bodies and the war on food. If my patient hates her body, I will ask her what about it she hates. She will usually say her double chin or her belly that hangs too low. What ever the “perceived defect” is, it likely originates from a place of self hatred. I listen and reflect back the negative and harsh feeling she feels at liberty to use against herself. Sometimes patients leave quickly if I won’t join them in this ritual of self hatred. Hopefully they stay and we can keep going deeper to understand this vicious attack on the self.

Stayin’Alive

We all remember the Bee Gees’ song from the 1970’s movie Saturday Night Fever. Who knew the phrase would have so much meaning almost 40 years later? I certainly didn’t. Fever was now something to be feared. As I have aged another year and have more gray hair to prove it, I find my body feeling older each day. 57 wasn’t that hard of a pill to swallow. However, the stress of the pandemic certainly added more than one year for most people emotionally. We learned new ways to shop, to mask and to love. Hugs were no longer allowed unless someone was in your “bubble.”

To vax or not to vax, that is the question

Then came the question of vaccine or no vaccine. I became a doctor long before I became a psychotherapist. I am not afraid of needles at all, but this was a new vaccine unlike any other. BUT COVID-19 was also a virus unlike any other before it. I was lucky in that being on the medical staff of a local hospital gave me the opportunity for vaccination back in February .There is no doubt in my mind getting vaccinated was the right decision for me. I will always support my patients decisions on what they feel is right for them. Sometimes that can be hard because I have to leave my own bias’s and opinions out of the therapy room. I can’t say I haven’t made that mistake in the past. I am far more conscious of how important it is to let my patient decide what is right for her.

I hope you Dance

I hope you all have remained healthy and safe. I  am personally feeling very hopeful  now that the numbers have dropped again.  If you have a fever may it be caused by dancing to some good old music!

My New Blue Door

Yesterday I finally painted my office front door a vibrant blue. It had been the black I painted it a few years ago because I thought that went better with the yellow siding. I think my contractor had suggested it and I went along with it thinking he knew better than me about what I wanted. I have never liked the black but it was “ok.” I discussed colors with my teenage son who has a very good eye for this and we decided on Benjamin Moore’s Pacific Palisades Blue. I didn’t realize it at the time we picked but I needed a change that this door would come to symbolize. Without getting into details I knew that something needed to shift inside of me. That I needed to start seeing myself differently in order to move on from something. In essence I had been stuck in one facet of my life. Yes, even us immortal therapists struggle with being stuck sometimes. I needed a new door to open and I had to have the courage to walk through it. So I did. It was quite liberating and freeing. It feels great!

Stuck feels like a four letter word

Frequently I deal with my patients who are stuck. Sometimes, but rarely it unsticks quickly. Other times it can go on for a very long time. I find it mostly in the stories they have told themselves. It usually involves their self worth. That my patient  believes she deserves far less than than she does. That she must settle for crumbs. I can’t tell her she deserves more and expect she will instantly  believe it. She must do the inner work and determine this for herself. I do of course tell her that she deserves everything she wants. It will require going deep inside to figure out why she doesn’t believe this in the first place. It can be a long and painful process, but the only way through it is through it.

It takes as long as it takes!

Sometimes it can take years to get unstuck and walk through the a new door. It can be terrifying.  We can imagine all kinds of bad things happening.  So rather than risk it we stay stuck.  Getting unstuck can be a lengthy process. The insurance companies would have us believing it’s a matter of weeks , maybe a few months to unstick. I don’t agree. I also know   it doesn’t matter how long it takes. In my supervision with a Jungian analyst I used to wonder how long it would take my patient to become unstuck? This particular supervisor always said “it takes as long as it takes”! He was so right. I must be patient with my patient and stick with her through her difficulties imagining a different life for herself. One where she has what she wants instead of struggling to have it. One that lets her walk through the new door and into the life she deserves. My job is to simply walk along side her while she is finding that door.

What new door do you imagine opening for yourself? What in your self proclaimed story needs to change?

Happy Thanksgiving!

Dreamweaver

If you grew up in the 1970’s like I did. You would know that Dreamweaver was a song released by Gary Wright June 1, 1975. It has been used in movies and played numerous times on the radio. I never appreciated the song until I was much older. Since doing more work in my own therapy over the years I have come to learn that dreams tell us so much about our non-waking lives, aka “the unconscious.”

Does the shadow really know?

Dreams tell us something about our lives that we don’t know. Like whether or not to change careers or move to a new home. Or how we might still be hurting ourselves through the negative relationship we have with ourselves.  For example dreaming about being abandoned might be trying to explain how we abandon ourselves. Our shadow can also show up in our dreams. In jungian psychology the shadow is thought to be an unconscious part of one’s psyche that we don’t readily identify in ourselves. For example the “not me.” If I am like myself, a zoftig blonde women in her fifties and I dream of a red headed thin woman in her 20’s it would be a shadowy part of myself. In my waking life that is definitely “not me” but in my non-waking life she is alive and well.

Get on Board the dreamweaver train 

Dreams interpretation requires skill and patience. Writing dreams upon wakening is the best way to ensure the accuracy of our recall of the dream. I tend to use a voice recorder for my dreams. I then print it out and write any associations in the margins. The two questions I pose are “why this dream now” and “what is this dream trying to tell me about my life today?” Another fun way is to draw or paint a dream. Seeing what images arise on the paper can be really helpful with the interpretation of the dream. In the next few months I will be starting a dream group. It will meet twice a month and will be limited to 8 to 10 members. It is not a psychotherapy group. It is a group where members will help the dreamer interpret the dream through non-judgmental feedback.  Check out my FB page for updates!

Thin Privilege

In recent times we are learning how certain groups are afforded more rights or privilege than others. As someone who grew up fat most of my life except for about ten years in medical school and residency, I know what it is like to be treated differently from thin people. I was also not a fat child or teen, but I ALWAYS felt like I could be thinner. I don’t think I know any women in or out of my practice that at sometime was not unhappy with her body. I see more women than men in my practice who are dieting or using extreme forms of exercise to maintain thinness. However, lately I see more men trying for that twenty something body well into midlife. Today’s discussion is not about trying to convince you that diets fail in 98% of people.  It is about how badly fat people are treated. It is also about the privilege I see afforded to thin people.

Seatbelt extenders are shameful

On airplanes seats are designed for thin people. At one time a major airline was requiring fat people to purchase two seats. I thought this was odd because up until age two a child can sit in a seat with the parent for free. Yet if you have an extra 20 pounds of fat you will need to purchase the extra room. What’s even more humiliating is having to ask for the seatbelt extender. You might fit in the seat but to safely sit there you will have to ask the flight attendant for the seatbelt extender. Why would anyone design a seat like that? Cars are not designed for seatbelt extenders. If you are a woman shopping for clothing in the plus size category, you will also  know that ten dollars gets added on for those sizes. As someone who sews, I highly doubt an additional ten dollars worth of fabric was used to make the garment and sewing a seam is sewing a seam.

Dieting makes us feel bad

Some of the most accomplished women in my practice “feel like failures” if their bodies have gained back the weight they worked so hard to lose. It is usually a repetitive cycle, they lose, they gain, they lose and gain time and time again. They only see that failure rather than their accomplishments as good friends, mother’s, doctors, lawyers, nurses etc. My job is not to stand in their way if they truly wish to diet to try to be thin. I am there to understand it with them. Why do they hate their bodies so much? What started the war with their bodies? Was it a mother who was always dieting? Was it something they learned?  Did a doctor tell them to lose weight?

It’s time stop hating Fat people

I am learning more about white privilege these days. I will admit I was unaware of how lucky I was to be afforded things others were not. I am now far more conscious of what I need to do to stop it in myself and my community. I know the time is also here to stop thin privilege as well. I am tired of seeing fat people ridiculed, passed over for jobs, labeled as lazy or unfit. It’s time to stop hating fat people.

Fat women hate Fat women too

I know I have had patients leave my practice because of my being overweight. Oddly the women who seemed upset with me were not the thin ones. It was the women who had body’s similar to mine. They wanted to see me as bad because I wouldn’t join them in hating their bodies. Thankfully through my own therapy I found a therapist who helped me stop the war with my own body. Each day I am grateful this body lets me dance, ride a bike, garden or walk. We must stop giving so much privilege to any group. For today I will think about ways I  might still conform to thin privilege, to be “the good fat person.” I would ask you to think about it too.

Fat Phobia

I am fat. I have been fat since I was in fourth grade. I got very thin in medical school mostly from not eating and dieting. The trouble was I could not keep the weight off. I felt like a failure when I gained back the weight. I weighed a whopping 142 pounds! Over the years and through my own therapy I realized I had to love the body that I had. That I was never going to be thin and that my constant rejection of my body would show up in other ways.

Weight Loss Rarely Lasts

What didn’t help was when my doctors would ask me, “have you ever thought about losing weight?” Are you kidding me?! I don’t know any overweight woman who has not thought about losing weight! Even the thin ones want to be thinner! I don’t know any woman who is truly in love with her body. In my practice so many women reject themselves and their bodies. I am also seeing it more now with men than I had in the past. There seems to be an association with thinness and happiness. Most of the doctors I see for any thing will typically counsel me at the end about weight loss. Thankfully, I have learned to tune it out. I know that weight loss only leads to weight gain and usually we add more back each time. I also know that after five years only 2% can keep the weight off. That is the same statistic as surviving pancreatic cancer. Why would I accept a prescription that has a 98% failure rate? A few years ago I had foot pain from what was diagnosed as a “stress reaction.”. The orthopedist told me I would likely improve if I lost weight. Well, that didn’t happen and HUZZAH my foot got better on it’s own. Guess that blew his theory out of the water.

Attacking our bodies is bad for our health

I am not going to pretend that my own negative feelings never come up now and again. What I must do is take on the battle of rejecting myself. This is what I teach my patients. It’s more about attacking myself rather than the actual struggle. When we reject our bodies it can show up as physical illness. It may show up as Lupus or another autoimmune disorder. Which by definition is the body attacking itself. I will teach my patient not to reject herself. Hopefully she will listen rather than believe I am “not on her side.”

Chickens are the best

This is a picture I would have hesitated to post many years ago because it does not depict a flattering image of myself, BUT this is who I am. I am fat and I love my chickens!  

What the world needs now…

When I was quite young (one to be exact) Burt Bacharach composed a song. It was called, “What the World Needs Now is Love Sweet Love.”  It was released on April 15, 1965. Yes, I was born in ’64 which technically makes me a boomer. The song is just beautiful. This morning I was reminded of how much when the students at Boston’s Berkley School of Music posted a virtual edition of this. It moved me to tears. It also got me thinking about how much we do need love right now.

Frontline is not just doctors and nurses

I woke up today had my daily dose of caffeine and did some thinking about how this all feels. I slept good, still feel healthy and can smell and taste food. Ahhh, another day with out this dreadful virus. I have been staying at home except for a grocery run early last week so I am likely OK. I cruised my emails and came across a post from a neighborhood message board. Someone posted how awful it was that a grocery person at our local chain had tested positive for the Coronavirus. She was angry and had some harsh criticism for the market. I find the lack of care and compassion right now hard to take. The grocery workers have put themselves at great risk every day for us. They are not high wage earners and are under tremendous stress.

Compassion needed STAT!

We all need to be compassionate with ourselves, our neighbors and the essential workers on the front lines which extends beyond doctors and nurses. I will try to post a link to the music, but I am so new to this website it may take me a little bit.For now I leave you with a painting I painted in 2014. I rehung it in my kitchen today to remind me that we need love sweet love to get us through this difficult time.

How are you doing?

We are now about two weeks into the COVID-19 Pandemic. Maybe longer but I’m not paying attention to the actual date it was decided this is a pandemic. I am doing this out of self preservation. I try to listen to news once per day and  not too close to when I go to sleep for the night. I have moved my practice to Telehealth and telephone. Thankfully the insurers have agreed to cover both. In the beginning there were some adjustments but it seems to be running quite smoothly.

Homeschooling is not my forte

Taking care of ourselves will be most important as this unfolds. I ordered new visual journals for myself and my son. I will be curious to see what comes out creatively at a time of great anxiety and uncertainty. My son who is 15 is now homeschooling. He told me he is not worried about getting COVID-19 at all. I guess that’s good. I don’t want him to be afraid at such a young age. I do encourage good eating, sleep and exercise for him. He seems pretty happy and we can both still laugh a lot despite the City of Portland stay at home order. I have seen very funny video clips about mother’s who “are not home schooler types.” I would have to say, it is not my forte either. I am lucky he is in high school and can get into his Google classroom on his own. I am also lucky he can help with our chickens.

Start a virtual community

There are many ways to deal with the stress from this strange new way of living. Meditate daily even if it is for ten minutes. Get creative through art, clay or other mediums if you can. Start planning a garden. Exercise outside. Now that temps are in the fifties it feels glorious! Watch movies or shows on Netflix. Start virtual communities for things like knitting. Have a virtual dance party. Staying socially distant doesn’t mean complete isolation. Take good care of yourselves and stay safe!