A lot of the time in Eating Disorder’s we hear the phrase it is not about food. It seems strange that a preoccupation with all things food weight and shape is not primarily about the food. So, what are eating disorders about? In short, they are a culmination of predisposing factors, mixed with stress and at some point, the sufferer has tried to diet. These three things added together make it more likely that someone will develop an eating disorder. A part of Eating disorder behaviour is the sufferers attempt to gain self-control through food.
Most eating disorders are maladaptive which means they do not help the person adjust to the environment or situation. The more people try to control their binges or purging episodes the more difficult it becomes to get rid of these strategies.
Monday 25th March marks the start of Eating Disorders Awareness Week. There will be information a plenty circling the internet regarding eating disorders. For me as an Eating Disorders Specialist therapist every week should be eating disorders awareness week as awareness is important but not as much so as the messages of hope that recovery stories carry.
How do ED's Develop?
There are several predisposing factors to eating disorders appearing these are not in themselves causes of the mental health problem but some of these things will be present prior to the eating disorder manifesting and are classed as predisposing factors.
A member of the family, has a history of eating disorders, depression, alcohol or drug addiction
Stress or traumatic events, social media, food famine or food feast
Anxiety, low self-esteem, an obsessive personality, a perfectionist, sensitive
Sexual, emotional, physical psychological
Overly concerned with being slim, particularly if you also feel pressure from society or your job – for example, ballet dancers, jockeys, models or athletes
Criticised for eating habits, body shape or weight.
For quite some time ED behaviour has been a global response to stress. Most ED behaviours will become more prevalent at stressful times in a person’s life. That coupled with an emotional deficit of being able to cope with difficult emotions is normally how the eating disorder creeps into someone’s life.
Why it is not all about the food
Eating Disorders are not all about the food, for the sufferer food dominates their waking hours whether they are denying themselves the correct calorie amounts or overeating in bingeing episodes. The ED behaviours are simply the symptoms of the illness, the pervasive low self esteem and battle for self-control.
Whilst only a Dr or Psychiatrist can diagnose an eating disorder, if you have a nagging doubt that something is up with your or someone you know behaviour then these signs could suggest that you may want to start looking for some help.
Dramatic fluctuations in weight
Preference to make own meals or not eat what others are having
Excessive food restrictions
Expressing extreme body dissatisfaction
Secretive Eating – evidence of wrappers
Feelings of guilt after eating
Frequently weighing themselves
Trips to the bathroom soon after eating
Hoarding food in preparation of bingeing
Skipping meals and fasting
Making lists of good or bad foods
Sudden interest in healthy eating and refusal of foods previously enjoyed
Body checking behaviours
Continual denial of hunger
How to get Help
Finding an Eating Disorder Specialist Therapist or centre can be tricky. There are however great services in the community that are separate to the NHS. Beat is a a charity that has a directory of therapists that treat Eating Disorders. As does the National Centre for Eating Disorders. Recovery from Eating Disorders is possible and often I see people who have nearly lost hope of getting their lives back to normal. 'You don't have to see the whole staircase, just to take the first step (Martin Luther King) and a step towards Eating Disorder recovery is worth it.
National Centre for Eating Disorders UK
Eating Disorder Specialist Area
On the 17th of February it is random acts of kindness Day. When I was younger one of my favourite books was pay it forward by Catherine Ryan Hyde. A young boy is tasked by his teacher with coming up with an idea that can change the world. The boy comes up with paying it forward which means that you provide a favour to three different strangers. They don’t pay you back in any way they then pay their favour forward to three other strangers and so on. What I really like about the concept is that it is about random acts of kindness which I am sure is where this day springs from.
There are many quotes floating around on the internet among my favourite is ‘kindness is free sprinkle that stuff everywhere’ which is so true. We are often listening ears to friends and family. We often help each other out in times of need but we are often not as kind to ourselves as we are to other people.
The inner critical voice.
Often in session I have adults and young people who present with almost crippling anxiety because of their inner critical voice. The inner critic can quickly become a self-fulfilling prophecy because your thoughts heavily influence how you feel. It doesn’t take long for your thoughts to become self-destructive and chip away a your self-esteem ‘thoughts like I am not as good as other people” or I will never be successful” are damaging. You no longer have to be a victim to your own harsh thoughts and can take steps to develop a more productive dialogue with yourself. Below are 6 steps that will teach you to be kinder to yourself and help quieten that inner critic.
1) Recognition; it’s really important to develop an accurate awareness of what you are thinking. Just because you are thinking something doesn’t make it true. It is possible that your thoughts are exaggerated and biased.
2) Evidence; Once you are able to recognise that your thoughts are exaggeratedly negative it is time to apply ‘how likely’ is this to be true? And what evidence do I have which supports or negates what I am thinking? For example if you are thinking “I never do things properly” or “I always quit new things” think how true is this what things have you done properly and what evidence do you have to support your more balanced statements.
3) Pause the repeat. It is really easy when we have a bad day or feel we have done something wrong to keep torturing ourselves with a replay of the scenario. This makes it easy for the critical thoughts to spiral out of control. Simply accepting what happened in the moment and then distracting yourself with an activity should help you to halt the repeat.
4) Get Compassionate: You would never talk to a friend or family member the way you talk to your friend. It is unlikely that if your friend is retelling a story that you will respond with ‘you’re so stupid’, ‘no-one likes you’ and you can’t do anything right so why berate yourself with such negativity. Instead respond to any mistakes you’ve made with compassion and as kindly as you would treat a friend. Try responding with ‘you made a mistake it’s OK to make mistakes’ or ‘it’s not the end of the world it just feels like it’. By gaining some compassion for yourself and distancing who you are from something you have done is really important.
5) Find and Replace; Overly critical thoughts can be replace with more accurate statements. More rational and realistic statements will add balance to your thinking. For example ‘I never do anything right’ becomes ‘sometimes I do things really well and sometimes I don’t.’ The key difference here is that it is a more realistic and balanced statement as opposed to being polarised black and white thinking.
6) Get to the root; It is easy to catastrophize when we are trapped in a negativity spiral. Sometimes it can be helpful to examine the worst case scenario and think ‘how likely am I to recover from this’ By reminding yourself that you have the ability to survive tough times and problems will boost your confidence and allow you to start problem solving.
The inner critical voice can be really difficult to control. It takes practice and patience but if you do manage to start challenging it you may start to feel less anxious, more empowered and confident. Surely that has got to be worth a try? – Good luck.
Valentine's Day and Loneliness
February the 14th is approaching and for many, being single or bereaved on Valentine ’s Day, makes it a difficult day to get through. Over the last few years it seems that Valentine ’s Day has exploded, year on year it seems to be bigger than ever. From cards, to shop displays, to social media blasts, memes and supermarket deals. For those people who are singletons who don’t want to be or people who are bereaved it can be a potent reminder of what they feel is missing from their lives. Although I am all for spreading more love in the world I guess it’s about recognising that it’s not all love and happiness for everyone. There are plenty of people who find Valentine ’s Day and the preceding weeks leading up to it difficult and it is possibly more people than you may think.
In a world where we are more ‘connected’ than ever and it is easy to catch up with that long lost cousin over social media we are becoming ever lonelier and socially isolated so why is this? Social isolation is linked to higher blood pressure, lower cognitive abilities and increased chances of premature death (The Conversation 2018). It is thought that loneliness is the new bad kid on the block and its negative impact on health are thought to rival that of smoking and obesity.
9 Million people in the UK or to put it another way 1/5th of the UK’s population say that they are always or often lonely according to a survey completed by the British Red Cross and the Co-op in 2016. Feeling lonely can be difficult especially if it coincides with other co-morbidity such as obesity, depression or anxiety. There are steps that can be taken to help make you feel less lonely.
Charles Bukowski once said – “if you have the ability to love, love yourself first” and I think this is true. Love does need to come from within and it feels as though with Valentine ’s Day looming it is the perfect time to remind you how counselling can help you feel less lonely.
1) Counselling gets you out of the house and away from work. By going to see a therapist you are tackling the problem head on by admitting that something in your life is not OK. It gives you somewhere to go that is a neutral and safe space where you can talk about anything that is on your mind, including your loneliness.
2) Your Counsellor will most likely focus on your feelings. By expressing what is going on for you and letting it out you are no longer holding on to the same level of emotional distress. The saying goes; a problem shared is a problem halved and although there are no guarantees that your therapist can cut through your problems like a hot knife through butter they will listen to you with empathy and understanding and help you make sense of your emotions.
3) Your Counsellor is dependable they will be there week in week out at a time and date of your choosing. This helps to make you feel more grounded and in control, plus your week will have structure, centred around human connectivity. You’ll know when the next time that you will be talking to someone will be to directly tackle the issue of your loneliness.
4) Entering into counselling has a likely side effect that your confidence and self-esteem will grow which may lead you to wanting to try new things which seemed daunting in the past. Trying new things is a great way to make new friends and meet new people who if you connect with should stop you from feeling so lonely.
5) The therapeutic, professional relationship between yourself and your Counsellor is genuine and real, not only will your Therapist be supporting, empathetic and helpful it also proves that you are able to make and maintain a genuine relationship with someone else. This connectivity from another person is priceless, as humans we are social animals and need to connect with others to survive and thrive. Which is why feeling lonely can be so detrimental to our health.
Therapy is a great place to start feeling better about yourself and your life so that you can move forward feeling more empowered to make new and lasting connections with other people and to make significant changes.
Loneliness is not to be taken lightly given its mental and physical health impact. If you are feeling lonely perhaps it is time to reach out to a professional counsellor who can help you start feeling less isolated and more in control.
If you’d like to reach out to me feel free.
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