Posts Tagged ‘shame’

Happy Fat Tuesday!

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Oh, what’s Fat Tuesday, you ask?  It’s traditionally the Tuesday right before the beginning of the Christian Lenten season, Ash Wednesday, built as a last indulgence before the fasting and self-denial of Lent kicks in.  Back in the day, it was a time when you ate lots of food before the last part of the winter fast (likely because food stores were getting low around this time).  It’s Mardi Gras.  It’s Shrove Tuesday.  It’s Paczki Day, if you live around some good Polish stock.  It’s the tops.

I was raised Lutheran, and although I am no longer religious, the traditions I grew up with still stick.  We always started the day with paczki (pączek the singular), which if you’ve never had one…probably go eat one, you’ll understand.  It’s like a delightful, fat, stuffed doughnut, usually filled with fruit fillings, custard, or creams.

This morning I picked up two dozen paczki for my office and classes, and for the first time, didn’t have an urge to eat one, just because they were in the car.

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Can you blame me?!

 

Lots of times, especially on holidays, it’s an expectation to eat or drink specific foods, merely because of the day or because they are part of the celebration (think turkey on Thanksgiving, egg nog at Christmas, green beer on St. Patrick’s Day), whether or not the food is something you enjoy, or feel you want.

Fundamental principles behind Inuitive Eating (my bible, how’s that for blasphemy) are to eat foods that are appealing, mostly eat foods with nutritional value, and to pay attention to internal cues of hunger and satiety.  Basic for those without disordered eating patterns, but like learning to live in an alien world for ED folks working toward recovery.

The greatest thing about intuitive eating, though, is their recognition that it is normal to not always pay attention to these cues.  Our environment, culture, and social world all interact with our patterns of eating, and these cues might differ from what our body’s trying to tell us.  Think about accepting a slice of pumpkin pie after Thanksgiving dinner, even though you’re stuffed, because your mom made it, and it’s expected to eat pie after dinner.

To eat intentionally means being aware of both sets of cues, both internal and external, then making a mindful decision about what you will put in your body.  It means not eating something just because it’s a certain day, but checking in with your body, and with your mind, determining your priorities and what’s important, then making your choice.

I don’t even like paczki very much, but eat one every year, because it’s tradition.  I’m sure you have times in your life when you’re pressured (or even just feel awkward saying no).

Also traditional is to “give up” something for Lent.  In Christian tradition, this mirrors Jesus’s trials in the desert for 40 days, ending on Easter Sunday.  Often, the first thing we think to give up is food we like.  Just like eating for non-mindful reasons, depriving ourselves of food/drink we enjoy can lead to disordered thinking/eating patterns later down the road.*

Simple denial (restriction, in ED terms) can make food loom large in our minds – it’s one of the reasons dieting is notoriously unsuccessful.  When we say we can’t eat something, it can lead to increased desire to eat that food, simply because it is forbidden.  It creates a huge cloud of feelings around it, and even shame if when we eventually do eat it…which, for those astute readers, is basically an eating disorder.  Food does not have moral value, and the food we choose does not reflect on our personhood or our moral value as people.

Enjoy your Fat Tuesday, if you celebrate it.  I hope you choose to enjoy it in mindful ways that honor your personhood and value.  Eat with intention.

And if you want a paczek, eat one intentionally!

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*Please refer to “The Underpants Rule” – you can do anything you want with your own body, including prioritizing weight loss, or health, or not!  This is not a list of what everyone should and should not do, just information and thoughts.

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So therapy for eating disorders, and really therapy in general, is all about being gentle and kind to yourself. Often, our mental health hinges on ingrained sense of worthlessness, habits of kicking ourselves when we’re down, and long held patterns of shame.

good?

To move toward recovery, one needs to start putting old behaviors behind, including negative self-talk, self-harming behavior (which, coincidentally, includes binge eating and exercising as a form of punishment ) and basing worth as a person on achievements and how hard one is working to change what is “bad.”
I’ve also been pretty heavily looking at the Intuitive Eating program, which focuses on the idea of trusting your body to know what it wants to eat and how much it needs to eat. One of the examples that’s stuck with me is that instead of saying things like “I really ate like a pig today” or “man, I need to do better tomorrow,” you’d focus on thoughts like “I had many opportunities to honor my hunger today” or “my body really needed rest today.”
Part of recovery is this reframing. But I realized this morning I keep thinking of this kind of thinking and attitude is a sign of weakness.
Now, pushing ourselves is a time tested value of our culture; for many with ED, pushing ourselves looks like a constant barrage of “never good enough.” These thoughts are fueled by fear – fear that if, for whatever reason, we calmed down our self-flagellation, we would be down the path of no return, eating until we burst and never exercising again. This kind of thinking is ridiculously hard to change. Imagine being miserable with yourself all the time, but scared to change because you could worsen exponentially.
So how do we move forward? How to rebuild trust in a body we hate? How to rekindle love for the body we’re in? How to truly believe we can truly stop punishing ourselves, that what we are really is enough? Unfortunately, like everything else, the best teacher is experience, and experience only comes after we take that leap of faith.

not just feeling sorry for yourself

In mental health there is and has been a hot debate about the efficacy of medication to treat mental illness concerns.  Most research and evidence shows the quality of the relationship between therapist and client is the most robust factor predicting change and improvement (studies here).  Medication is rarely enough to cause real and positive change in someone struggling with mental illness; although a portion of the population, about 6% is diagnosed with severe and persistent mental illness (SPMI), the vast majority of those who are prescribed medication to treat mental illness are generally high functioning.  While one in four adults will suffer from mental illness in a given year (which is a huge number – 25%??  Whoa!), we still have an enormous complex about being open and honest in our quest for recovery.

Our cultural ideal is rugged independence – we score higher on that dimension than any other country on earth.  We look up to those who have made it on their own and pulled themselves up by their bootstraps.  This ideal doesn’t hold up well for most of us in the human race; we need social connections to survive , we benefit from collective action (unions, suffrage, state government road maintenance) and most of us need help learning what we do before we can support ourselves – even those who don’t do college were most likely apprentices, learning from someone who knew what they were doing.  Why wouldn’t mental health be the same?

Few mental illnesses require lifelong medication and maintenance; these are the SPMI, including Sczhizophrenia, Bipolar I Disorder and Major Depressive Disorder, recurrent.  These disorders disrupt normal functioning and cause significant distress for those suffering from these illnesses as well as those around them.  Major Depression isn’t just feeling sad and eating some ice cream after work; it’s not being able to move, not caring enough to shower, not having the energy to follow through on suicidal thoughts.

why do we make people ashamed for making an effort?

Beyond these, the most serious disorders, are significant mental illnesses of a potentially shorter duration.  One can be in a depressive episode (lasting about 2 weeks) and need medication to break out of that period, but may not require lifelong medication maintenance.  Obsessive disorders require extensive behavioral and cognitive therapy to replace harmful behavioral/thought patterns with more adaptive versions.  Certain medications can help with correcting these patterns and in rebuilding receptors to prevent a return to maladaptive behavior.

Mental illness is just that – an illness.  With the small exception of religious exemptions, we don’t chastise people for taking medication to cure their strep throat or to manage acid reflux.  It’s time to stop shaming ourselves and others for trying to recover.

One of the mainstay concepts in any sort of treatment, but particularly in the treatment of sex offenders, is to assist clients in differentiating bad action from bad self.  It seems on the surface to be a distinction that is easily made – just because someone does a bad thing does not necessarily make them a bad person.  However, there are so many layers and perceptions imposed by our family of origin, society and culture, it ends up being one of the most labor intensive parts of treatment.

Understanding that good people can do “bad” things is often intuitive.  Psychologically we usually operate from what is called the “self-serving bias,”  the tendency to cut ourselves a break.  We are able to access our internal thoughts and motivations, so its easier to justify doing something ourselves versus someone else.  When we feel threatened (like, say, someone’s screaming at us that we’re a piece of shit that deserves to be killed) we are WAY more likely to engage in this behavior.

We’ve established before that when one is feeling shame, the natural reaction is defensive, because shame threatens our very sense of self-worth, of having the right to exist.  Separating our actions from who we are is essential to change, because you can change an action.  It’s not as easy to change who we are.

I was thinking about this a lot since yesterday, when it was explained to me why body hatred was so stupid.  Like, fundamentally stupid.  Leaving aside all the stuff about WE ARE WOMEN AND BEAUTIFUL, hating the container we’re in is…stupid.

When I was younger I’d make the argument against racism that it’s stupid to hate what’s on the outside, because it makes no rational sense.  And it came to me that hating our bodies is almost exactly the same.  Our bodies are results of behaviors and genetics and actions we take and food we put in and sun we get and clothes we wear and the climate we live in.  Too often, most obviously in weight loss settings, we are told to hate our bodies, that we are disgusting and weak and shameful.  Which leads to shame.  Which means NO ONE who is being told they are awful is in any place to start changing behavior.

The conversation around bodies and weight is about who people are, rather than the things they do.  Changing behaviors may not change body composition, and that’s okay.  Because we need to focus on the behavior, not the container.  We need to focus on the behavior, rather than the person inside.  Because the people who struggle with weight are people.  Bad actions do not equal bad self.

First and foremost let me apologize for the lateness of this update; I’ve been increasing my involvement in therapy and working toward recovery from my own eating disorder, and I am still not sure if the simple act of writing about food and body image is a trigger for me.  But we shall soldier on (and I will update 1x/week, by Thursday of that week, from now on).

Is this the only way “fitness” looks?

We shall soldier on not least because our society remains incredibly delusional.  We continue connecting health and thinness no matter how many studies, medical doctors and anecdotal stories are released decrying the link between body fat and health.  Faithful readers of research (and more modestly, this blog) know how tenuous this connection is; one can more easily judge the health of a person by observing diet and exercise habits than by simple appearance.

Once again, I was in CVS and stumbled upon Health magazine.  A name which I immediately connected with a desire for more varied workouts, as I am bored constantly and need to switch up routines.  However, as I looked at the cover all I saw was Jessica Alba talking about staying slim.  Articles about how I could be slim for life, the habits of thin people, how I could “torch fat” with CrossFit workouts and how I could work out like a supermodel (and, it is implied, eventually look like a supermodel) assaulted me.  I felt almost to the point of tears – is it too much to ask to find a workout plan without the goal of losing fat?  To be able to exercise without wanting to do so to be thinner?

It is this flawed connection that limits our ability to exercise for the joy of movement.  It limits our ability to appreciate our bodies because they are strong or functional or capable or flexible.  When our only concern is appearance, these things cease to be important.  Because really, who cares if she’s strong when she’s so fat?  The fat is all that can be seen.

The 2000 novel Jemima J by Jane Green has a great line in it that has been burned into my memory.  It’s a story about an “obese” woman who loses over 100lbs and all of a sudden her life comes together (eventually her weight settles at 145 pounds when she is “completely happy with the way she looks”).  I used to read this book every other week when I was in high school, and the message I got out of it was that my life would finally come together once I lost weight.  She was “obsessed” with exercise but ended up getting exactly what she wanted (the love of a man, obviously) after months of drinking only water for breakfast, eating a plan salad for lunch, and plain chicken for dinner.  This is what it takes to have a good life.

I remember being so ashamed that I couldn’t do what she did; oh, don’t get the wrong idea, I tried.  Having hot water with lemon in the morning is unsatisfying but I figured I’d try it – it worked for her!  I, after all, was only 40 pounds away from 145, where I could be completely happy with how I looked.

I was unhealthy.  In many ways, I probably still am.  But we as a society cannot release this shame and work toward health until we let go of the idea that being thin is all that counts.