Real Recovery from Bulimia & Binge Eating

How to find a teacher/coach

I got an email asking about coaching: how much it costs and how to find a good one. I wrote back:

The only coach I have worked with is, unfortunately, very expensive. The 9 month package I bought from him costs usually $18,000 or $19,000 (or it did 3 years ago, anyway). He gave it to me for $14,000 because he had an on-going business coaching relationship and friendship with my boyfriend at that time. I bought it because 1) I basically got an ultimatum from my boyfriend then, 2) I was desperate to change - I felt like I was at "rock bottom" with the bad choices I continued to make, and 3) I had the money - I was 34 at the time and decided it was a good investment after a lifetime of fear, rage, and confusion.

If I were to do it again, I would have paid for a much shorter commitment, though, since I felt I learned pretty much all I needed (or wanted??) within about 4 or 5 months, max. It was quite intensive, and I was ready to give it a go on my own within 4-5 months.

You can find a couple other coaches listed on my blog in the left hand column, but to be honest I haven't heard of any great success stories from anyone working with them yet. Keep in mind, too, that "coaches" aren't generally covered by insurance.

You might want to look into this approach I wrote about in the blog: New non-traditional recovery help. You're going to have to do research. Look perhaps for therapists who have been trained in Cognitive Behavioral Therapy since, from what I know, it's pretty close to what I did with my coach. Therapists are generally covered by insurance, too, so this is probably the most economical way to go. The key, however, is finding someone to TEACH YOU, GIVE YOU TONS OF EXERCISES and FEEDBACK, and HOLD YOU ACCOUNTABLE for doing the work and pushing yourself beyond your comfort zone and self-defeating automatic reactions to things. A therapist who just listens to you isn't even worth your time, let alone your $$. You have a lot of missing skills and/or bad knowledge that keeps you making self-defeating choices, probably without your even being aware of it.

Learning to live the life you really want requires something like a school education: instruction, repetition and practice, correction and feedback, and testing (testing in this analogy is how your life changes as you grow). You need a very active teacher.

As I’ve said before: Recovery is an active process in partnership with the world and what it throws at you. Just talking about it, thinking about it, even writing about it won’t get you there.

Keep seeking and asking questions, keep learning. You'll get there.

Tons of free ED articles at Gürze.com

The full list is here.

Be sure to check out these specialty topics:

            For Families

            Eating Disorders in Youth

Eating Disorders in Males

Recovery Tips

Treatment

New non-traditional recovery help

My friend, e, has been researching non-traditional recovery treatment for awhile now, and she’s found a new one she wants to share with all of you.

She writes:

“Still on the fence here for my next step, but as I continue researching, I wanted to let you know of a kick-ass therapy, Dialectical Behavioral Therapy, developed here in Rain City (Seattle) that is very similar in many ways to what Matt (your coach) seems to do, and it's used for very severe disorders (including EDs, BPD) with extremely high success rates. It's systematized and takes a year commitment. Like Matt, it involves digging out the triggers, tons of homework, highly encouraged coaching calls between weekly therapist sessions so you don't let your brain re-groove into old habits between sessions, and it also includes (unlike Matt) obligatory once a week group skills classes--teaches core living skills that you practice together as a group. The goal of the therapy is "creating a life worth living" and they move you in that direction in a very systematic, brain-re-development-savvy way. At the high end, it costs $1,000/month. The low end here in Seattle is about half of that. I can get insurance coverage, too. People can go to Behavioral Tech to find practitioners--this is the main "official" training group that grew out of the UW professor's program.”

It looks interesting! Thanks, e, for sharing all your wonderful research! Please keep us posted!

Update on my (hopefully LAST) anti-anxiety meds weaning

Gu asked me how I was doing since I so suddenly quit my last 10 mg/day of my anti-anxiety meds last Saturday, 6/2/07, as I mentioned in this post. I’m glad he asked. I feel like I’ve taken you all on a roller coaster about this for 2+ years, so I figured you were all sick of hearing about it!

But, I really wanted to share my experience with you, because it’s a great learning experience that I hope you all can get something out of, too.

I’ve tried to quit in the past, but the timing always seemed to be off: something stressful popped up or I just didn’t like how I was feeling. Below are some of the posts documenting my 2+ year journey from 40 mg/day to none and showing how I have gone back & forth and back & forth on my opinions and plans.

Vaca and update on my "exercise plan" (April 02, 2007)

Update on anti-anxiety weaning (February 26, 2007)

Today is my year & a half anniversary with Todd! (February 13, 2007)

Post from one year ago (February 08, 2007)

Bloating in recovery (February 07, 2006)

Why I'm quitting my anti-depressant (April 03, 2005)

End of my anti-depressant! (March 27, 2005)

But, on 6/2/07, I knew I HAD to quit, no matter what. I realized the side effects were standing in the way of the life I wanted for myself, so it had to go.

Since Saturday, I’ve been feeling great. I’ve happy and motivated and energetic. Of course, there is another variable contributing to this: I shared with Todd my last secret stemming from low self-esteem, self-doubt, insecurity, and fear. This was a huge burden that weighed on me 24/7. Once I opened up to him, I have felt light and free and even a bit fearless and unstoppable.

The big difference between what I’m experiencing THIS time (vs. all the times I’ve tried to quit before) is that I have been completely focused on the benefits of quitting – not the uncertainties or the potential negatives. My excitement about the benefits of quitting was very strong – it outweighed by far my fear of the potential negatives. I stopped being controlled by my fear of the unknown. I started being controlled by my excitement for change. I knew I would have to find a way to deal with any negatives; there was no longer any way around it.

This gives support to the ideas that:

1)       your attitude about a change often determines your resulting experiences, and

2)       actively visualizing yourself enjoying future positive results is incredibly powerful in creating those positive results.

In the past, I didn’t see enough potential benefits from quitting. This time, I could ONLY see one particular, very enticing benefit. Potential negative results paled in comparison.

A few days after I quit, I think I had some small physical adjustments: I felt dizzy, a bit nauseous, and had little hot flashes for a couple of days. Nothing too worrisome, though. I’ve noticed another interesting but not-unpleasant effect that continues today . . . I get emotional and a bit teary-eyed by small shows of kindness or connectedness that I witness: Someone saying something nice to a stranger, someone stopping to pet a stranger’s dog and chat awhile, someone going out of their way to help someone.

Each time I witness these things, my heart does a little flip-flop. Feeling loving and hopeful for the world feels just. so. damn. good! It’s an incredible physical response as well as psychological.

I am so incredibly grateful to be witness to all these little acts of kindness and connection. I’m sure they’ve been there all along, but for some reason, either I didn’t notice them, or I felt too disconnected to comprehend them.

For most of my life, I saw people in general as bad, threatening, dangerous, only self-serving. And, the interactions I witnessed (or focused on?) seemed to always support those beliefs.

Now, I see acts of kindness all over the place. And, each time, I get an emotional and physical (believe it or not) rush that I never got before.

I don’t know if this is all because I quit my medicine (these pills are known for being a bit numbing) or because of the burden lifted in my relationship with Todd (and myself), or a combination of both. But, God, I feel great.

And, I have evidence that even stressful things are going to be fine without the pills. Last Thursday was the busiest day I ever remember having in my 4+ years at this job, and I did fine. Not only did I get everything done, but, more importantly, I kept a good attitude with everyone and even took extra time to help some people out. OK, I was a bit brash with the woman who asked me for this extra time. But, I helped her out, and I apologized later.

Oh geez, I’m getting all teary-eyed again. I gotta go get a tissue.

Vaca and update on my "exercise plan"

So, we're finally heading out to Hawaii tomorrow. Thank goodness! I really want a break from my job!

Things didn't work out quite like I had planned (of course!). Since I didn't get any exercise for Dec or Jan, my plan was to be pretty diligent at working out through Feb and March so I would be "ready" for this trip. I kept up my exercise plan until mid-March when other things began happening that took priority. I had an important speech to deal with one week, and the next two weeks? I hadn't told you, but I got pretty bad poison oak again. My top lip swelled up to 3 times its regular size after smooching my poison-oak-covered dog. Ugh. The rest of my body was in pretty bad shape, too! I couldn't bear the pain of working out on top of that. So, I stopped working out.

I got better, but then I just plain didn't want to do it. So, I didn't. It was a frustration to Todd I think because since he gets so much pleasure and stress-relief out of working out that he keeps hoping I'll get the same reaction. I just don't. At least not from the traditional type of "working out" that we do with weights and calisthenics. So, I just plain refused.

So, I'm going to Hawaii with a slightly bigger and flabbier body than I had planned. This would have been a disaster for me a few years ago. But, now I'm choosing to just shrug it off. I'm going to enjoy myself no matter what my body might look like (or should I say, "what I worry it looks like.")

It's funny which physical things I worry about these days. I haven't worried about exercise in 3 - 4 weeks. And, I'm letting my gray hair grow out. We had a BBQ on Saturday (first of the season; yay!), and I had a great time. It was all really nice and happy people and great food and great weather. One friend took me aside and told me that I really needed to start coloring my hair again. The gray is really aging me and taking away from my “pretty face.” But, for some reason, I just don't want to deal with it anymore. So, the gray stays. But, Todd helped me Nair my butt yesterday. Seriously.

Oh well. I’m just going along, feeling my way through my day to day decisions as best I can.

Last week I tried to reduce my anti-anxiety meds a bit more. But, then I stopped cuz I was getting more impatient and testy than I would prefer. I realized that I am a bit stressed about spending a week with Todd’s whole family (8 adults and 5 kids in one house). I know there is no rational reason to be stressed, but I honored it and decided to go back up to my regular dose of 10 mg/day. I’ll try it again after the vacation. It really is amazing how much better I feel on the meds! There is no pressing reason to stop taking it . . . I guess I just want to prove to myself that I can live perfectly well without it – even if I’m not as “perfect” as I can be with the meds.

I’ll continue to keep you posted. I hope you all are doing great. I’ll be on vaca until 4/10. I’ll check back in then. Love to you all!

Cognitive Behavioral Therapy is the way to recovery!

I found a great article on Cognitive Behavioral Therapy (CBT) you all should read. I have known about CBT, but I admit I never researched it much. It looks like my coach was practicing CBT with me without specifically calling it that. And, it’s what I’ve been working to teach you. That’s great news! If you can find a therapist or counselor specializing in it (with a proven track record – you’ll have to do some research), you’ll be getting essentially what I got with my coach, but it will be covered by insurance!

So, if any of you want to begin working with someone (therapist or counselor or whatever), get started researching professionals who have been trained in and have a track record in successfully teaching CBT. Be careful, though. The article goes on to warn that there is a quality issue among practitioners. You have to be very careful about researching how much a practitioner knows about it and how successful s/he has been in using it with clients.

Below are the best parts of the article. It sounds like all the stuff I talk about, doesn’t it?

Kerrin Gerson survived a traumatic and turbulent childhood growing up in the Deep South in the 1980s. Her mother died of breast cancer when Kerrin was 15; her relationship with her father disintegrated when he remarried soon after. She left home and spent her last two years of high school living out of her car or crashing with friends. "One moment I had a loving mother, and the next moment I had nothing. Absolutely nothing," she says.

She married at 26, divorced two years later, in 1996, and fell into even deeper depression. Antidepressants did little to ease her symptoms; Paxil made her anxiety worse. She had suicidal thoughts. "I was convinced I was worthless, unlovable and a fraud," says Gerson, now 39.

Today Gerson is off medication, out of therapy and happier than she has ever been. She owes her rebound to a startling revolution in psychological counseling that has taken four decades to unfold--and which now is spreading to the farthest reaches of American medicine. She fixed herself with cognitive behavioral therapy.

Gerson turned to CBT in 1997 after spotting an ad for a patient trial in a Nashville newspaper. She was surprised when her therapist, Vanderbilt University psychologist Steven Hollon, didn't bother to dwell on her troubled childhood. Instead, he focused on fixing the present. He made her write a log of daily activities and gave her homework assignments, such as a night out with friends. He zeroed in on her negative thoughts about herself and slowly convinced her that they were distortions.

"It turned out to be the greatest gift," says Gerson, a first-grade teacher who has just opened a yoga studio with a friend. CBT, she says, "saved my life and gave me an entirely new worldview."

And that is the essence of CBT: Depression, anxiety and other ills aren't the cause of a cascade of debilitating thoughts and self-loathing--they are, instead, a result of the same. Eliminate bad thoughts and you can short-circuit bad feelings. CBT drops the endless search for past hurts, teaches patients how to prevent negative thoughts from creeping into their minds and coaches them on how to cope. "We are starting to believe that what you think has a powerful influence on symptoms," says Harvard psychiatrist Arthur Barsky, who has tested CBT. "You first get the anxiety-producing ideas, and then you get the emotions." Boston University psychologist Michael Otto adds: "Now there is an alternative to being on the couch."

Moreover, CBT intentionally is finite in duration. It aims to push patients out of the shrink's office after only 10 to 25 visits, in sharp contrast to traditional psychotherapy that can run on for many years. (Some CBT patients need more.) That makes CBT particularly popular among employee health plans and insurers intent on reducing the costs of psychotherapy. "Woody Allen therapy is forever," says Hollon, Kerrin Gerson's shrink. "This is about taking action."

In dozens of small patient trials staged over three decades, cognitive behavioral therapy has been shown to be surprisingly effective in quelling an ever expanding array of mental maladies: depression, anxiety, panic attacks, obsessive-compulsive disorder, post-traumatic stress syndrome, bulimia, hypochondria--even insomnia. Now almost 150 clinical trials are under way to learn whether CBT also can help patients with Tourette's syndrome, gambling addiction, obesity, irritable bowel syndrome and more; one trial studies the therapy in children who have been sexually abused.

Even in New York City, modern-day mecca of psychoanalysis, CBT "is spreading everywhere," says New York psychologist Robert Leahy, author of The Worry Cure. His CBT practice in midtown Manhattan had little competition when he set up shop 24 years ago; now 150 or more rivals claim varying degrees of expertise in the method.

One Leahy patient, a bond trader, had been mildly depressed for years, ignoring the problem until he heard about CBT last year. The trader, 48, had grown up poor, working since age 11 and putting himself through college. Though he had millions in the bank, he constantly worried he would go broke. So Dr. Leahy had him review his finances at therapy sessions to convince himself he was in good shape; therapist exhorted patient to stop comparing himself to $100 million hedge-fund managers. "It's had a dramatic impact," the trader says. "Dr. Leahy got me to understand that it wasn't just about the money; it was about lifestyle and family. I am as happy as I have ever been."

Thomas Duffy, 59, says CBT helped him conquer his fear of bridges and tunnels. A medical salesman in New Jersey, he must drive to hospitals in four states, but in the late 1990s a car trip over a big bridge would spark a panic attack that felt like a crushing heart attack. He would leave home at dawn to allow time to drive around major spans such as the Verrazano-Narrows. He tried Xanax, an antianxiety pill, but it made him sleepy. Then Duffy heard a radio commercial about CBT while driving, and he signed up in 2000. In 12 weeks a therapist taught him breathing relaxation exercises, helped him confront his fears and slowly weaned him off drugs. Now he drives wherever he wants. "I would say I am cured."

[CBT’s founder,] Ellis today is 93, sickly and nearly deaf, but he still bristles with attitude. "Freud wasn't working, it was incompetent, so I looked around for something better," he says. He found inspiration in the words of the ancient philosopher Epictetus: "Men are disturbed not by things but by the principles and notions which they form concerning things." In 1955 he introduced a method called rational emotive behavior therapy that focused on eliminating irrational, self-defeating thoughts and replacing them with healthy ones.

"If you were abused, you accept it, too damn bad," he says. "You want to get rid of the idea, 'It harms me for life.'" Over the ensuing decades Ellis formed his own teaching institute and clinic, traveled the world and trained thousands of students.

Early on Beck [another CBT practitioner] noticed that his depressed patients always put the worst possible spin on everyday events, thinking things that had no real basis in reality: "Nobody loves me" or "It's hopeless." He theorized that distorted thoughts were the real cause of their bad bout of the blues. Replace the bad thoughts with better, more realistic ones and happier emotions would follow.

He started coaching patients face-to-face on how to critically evaluate their own fretting, teaching them to interpret everyday setbacks more realistically. The patients got better in just 10 to 12 weekly sessions. In 1975 he founded the Center for Cognitive Therapy at U. Penn, treated thousands of patients, trained 30 disciples who formed their own research programs to study CBT and indoctrinated another 50 or so who went into private practice; they established their own training programs. In 1994 he founded the nonprofit Beck Institute for Cognitive Therapy & Research to help teach the method more widely. It is run by his 52-year-old daughter, Judith Beck.

CBT trials continued to turn in impressive results. In 1999 JAMA published a study saying CBT works for insomnia. In 2004 CBT was shown to alleviate hypochondria in six sessions; to help depressed adolescents and kids with obsessive compulsive disorder; to quell insomnia better than the drug Ambien over the long term. In 2005 CBT starred in studies of severe depression and in preventing suicide attempts.

Update on anti-anxiety weaning

It'll be 2 weeks tomorrow since I cut down from 20 mg Citalopram (generic Celexa) to 10 mg, and I'm doing great. For some reason, I've actually been better than before I cut down. I've got more energy, and I've been calmer and happier. Maybe because I'm so excited to be done with this part of my life? Who knows.

I can't cut down to 5 mg cuz I'm already cutting 20 mg pills in half. So, it's going to have be 10 mg to 0 mg in a few weeks or so. I asked my doctor to prescribe me 10 mg pills (that I could cut in half when I was ready) to help me wean, but she wouldn't unless I went in to see her (for a $15 co-pay and time off work). I said I wasn't interested. My doctor is just a medical doctor; she has no training as far as I know in medications or issues like this. Plus, I've weaned myself off meds several times before, so I'm hardly worried I'm going to freak out or something. What could she do for me except give me the damn Rx?! Once again, I suspect it's just for liability sakes. And, I'm not wasting my time or money to cover her ass.

Sorry to be so jaded about that . . .

Anyway, things are going well. I even did a good chunk of my taxes yesterday. They've gotten much more complicated because of my investments this year, but I still really want to do them myself. Todd thinks I should hire a professional. But, I really want to be able to do them myself, even if it takes a long time. Only once did I have a professional do them, and that was because I got a free coupon from H&R block when I first went to college. He has offered to look them over for me, though, and compare them to his professionally done ones. Hopefully, we'll catch any mistakes doing that.

I've also got a couple really tough emails from you guys that I need to get to. Boy, sometimes your emails really get me in the gut. But, I'll get to them, I promise.

I hope you’re all doing very well. Love, me.

P.S. I am in no way encouraging any of you to stop or to not even start taking medication like Celexa or whatever you find works for you. I have been so incredibly grateful to it for helping make my life a little easier. After a tough life, I think we all deserve to have things a little easier! So, take good care of yourself and explore taking meds or switching meds if you find they help you, too. I've been recovered for about 2 years now, and I am only now ready to begin taking on the challenges of life without the help. And, remember, if your medicine makes you tired or apathetic, it's not the right one for you. Try a different one.

Today is my year & a half anniversary with Todd!

OK, maybe we're just looking for something to celebrate, but I'm ok with that! We're celebrating today just like it was any other anniversary. We're going out tonight to a really nice restaurant, Grace. Tomorrow, we're celebrating Valentine's Day, too. We'll be cooking at home for that one, though. It's so hard to go out to dinner on Valentine's Day cuz EVERYONE is going out and cuz all the good restaurants serve only an expensive "fixed price" menu.

It's kinda funny (?) that our anniversary is also the day I begin weaning myself off my anti-anxiety meds, Citalopram/Celexa, that I've relied on and trusted for about 5 years now. The new lower dose pills came in the mail yesterday. This time, I really know I'm ready. How do I know? Cuz I've accepted that I won't be perfect, I will be challenged, and I know now that Todd won't leave me and people won't be horrified and abandon me because I'm not perfectly calm and patient and wonderful all the time. As, Laurel Mellin always says, “You don’t have to be perfect to be wonderful!”

Hell, I haven't been "perfect" while ON the pills! I've still gotten down. I still took time off from my blog in December and January while I was pouty about my sister. I still occasionally interpret my commute as a race and competition that seems to communicate with others my value as a human being (crazy, huh?!). I still had a little girly freak-out on Super Bowl Sunday cuz I wasn't happy with my outfit and my hair and had both Todd & my other roommate, Michelle, running around trying to calm me down and find me a suitable outfit! It’s OK. We all laughed later, and the world didn’t end cuz we were late to the party. I’m only human.

Because it makes me feel good about myself and just generally happy, I will continue to work on getting better at my patience, calmness, compassionate interpretation of everyone around me, allowance of others (and myself) to be themselves, my gratitude, my optimism, my appreciation of all the beauty in the world. My goal for myself is total enlightenment – think Gandhi or Mother Teresa. Yes, that’s a stretch for a mere mortal with a (very) late start, but I really like having them as role models. And, I enjoy having a goal and something really good and positive to reach for.

I’ll keep you all posted. Happy early Valentine’s Day everyone. Give yourself a kiss, a big bear hug, and some extra love tomorrow, ok?

Post from one year ago

I thought this was interesting. This post is from one year ago yesterday. At the time, I had just decided to stay on my anti-anxiety meds, Citalopram, although at a half dose of what I was on before working with my coach. This was momentous because a year before that, back in March of 2005, I wrote a big long post on Why I'm quitting my anti-depressant.

I have ordered a prescription for half of what I've been on since then. When that comes in, I'm going to begin weaning myself completely off of it. Yes, I know I go back & forth on the med situation. And, perhaps this little experiment won't work out like I want it to. But, just like I keep telling all of you: you have to take risks and prove things to yourself. And, you have to continue to investigate your decisions to see if they’re based on crap beliefs or if they’re based on what is truly in your heart but are perhaps frightening to you.

I've been on a simplifying kick for the last 6 months or so. That was when I decided I would stop coloring my gray hair cuz I didn't like the thought of being a slave to it for the rest of my life. Soon after that, I thought, "well, are you planning to take your anti-anxiety meds for the rest of your life?" And, I began thinking about my own 2+2=5 beliefs about it and my fears about being off of it. I realized I continue to take it because of my old fears that people will reject me when they realize who I REALLY am. I'm afraid that people won't tolerate me if I get overly worried or anxious about things (even though I've been working REALLY hard to keep a creative, optimistic attitude rather than my old pessimistic, frightened one). I'm afraid that *I* won't like myself without the meds.

I'm afraid that if I lose my temper, if I have a panic attack, if I get all wound up with tension like I used to, that people will leave me. That's the bottom line I've found for why I continue to take it.

So, I'm going to face my fears and push through them – just like I tell you all to do all the time. Sure, maybe I won't be as calm and patient as I am on the meds. But, I'm getting better and better at that every day - I'll continue to work on it even without the meds. Sure, maybe I'll lose my temper and regret it later. Sure, maybe I won't be perfect. But, you know what? So, what? If there is one thing I've learned, it's that I'm ok just as I am. I accept me with all my quirks and imperfections. I accept me with the challenges I have in life. And, I love and respect myself for continuing to learn and challenge myself and grow.

You know what else I’ve learned? People aren’t going to abandon me for my imperfections. That’s a crap belief and fear that, apparently, is still haunting me. I’m going to fight that now. And, I’m going to PROVE to myself that it’s crap. I’m going to prove to myself that people will stick around me because they care about me and all the wonderful things I have to offer them – even if I’m far from perfect.

Yeah, I’m still scared. I’m scared I’m going to have to work a lot harder at keeping my calm, staying patient, staying compassionate so I don’t get upset with people. But, I can do that. You guys are all working so hard that you’ve inspired me to take up this challenge. I’ll keep you posted.

On Inpatient Treatment . . .

Mina just asked a question in my very first post, Day 1 of my Recovery, just about 2 years ago. She asks:

Has anyone ever been to an inpatient facility? Any thoughts or opinions on it?

I've never been to an inpatient facility, personally. But, from the stories I've heard, I'm not a big fan of them. They're super expensive, sound like hellish torture, and I don't believe they work, at least for the great majority of people. I have many readers who have tried them (perhaps some of you can speak up and offer your opinions), only to relapse a few months later. Plus, after they've used all their family's money and gotten everyone's hopes up, they end up feeling tremendous guilt and shame that they have "failed" to recover. They end up even more hopeless, depressed, and intensely bulimic. I think that because of liability and other stupid legal issues, the “treatment industry” has its hands tied a bit. They really HAVE to treat the symptoms (so you don’t die on their watch) without teaching you what you really need to know to treat the underlying cause. I also believe since many patients are minors, they have to be very careful to not piss off the parents (who are also footing the entire bill). They can’t tell patients that their parents are teaching them a load of crap, or that they’re not teaching the right lessons, or that their homes are the source of much of their pain and confusion. My coach advised me NOT to get formal training in counseling or therapy cuz then I would be BOUND by their currently “approved” treatment for eating disorders even though I don’t agree with them. I would be more open to being sued.

I have had to pick up more than a couple of readers who have come back to me after having said "goodbye, I'm off to treatment to kick this thing forever." Below is an email exchange I had just last week. My online friend wrote:

"I'm sorry to bother you but I am struggling more than ever. I really don't want to carry on living in this mess. I have just come out of inpatient treatment for my binge eating/bulimia, which I was in for a month. I was introduced to the 12 Step program while I was in there. I relapsed once while I was there and as soon as I left. I have been binging constantly for the last 4 days and am isolating in my house. My eating has become more out of control than ever and I'm scared . . . . I don't really get the twelve step process, I keep analyzing it and finding fault in it. The thought that I have to fight this disease every day for the rest of my life is so overwhelming and depressing, and the meetings just remind me of this endless struggle. I don't want a life that feels like a losing battle.”

In my response, I told her:

Your experience just gives me that much more reason to say that current approaches to recovery just don't work for the large majority of people! And, I've never believed that the 12 step approach was even a respectable approach for eating disorder recovery. With that said, please don't beat up on yourself because they didn't help you. If they did, you would be in a very small minority. Inpatient treatment and the 12 Step model just don't work for eating disorders!

Consider it a great, brave experiment that you got up and tried it. You're seeking out and trying all available resources and that is to be commended. Don't stop reaching out and trying things out. That is the only way to recovery, because clearly, you don't currently have the skills or knowledge you need. So, for your grand experiment, congratulate yourself. And, congratulate yourself for being TOO SMART to blindly put all your faith in the 12 Step program that, like I argue here, is not appropriate for everyone. You got those 2 approaches (IP AND 12 Step) out of the way. It's time to move on to the next approach.

Please don't call yourself a greedy pig - you know in your heart that is not the case. Food is how you've learned to cope with your lack of skills to make decisions and just LIVE without an excess of paralyzing fear, insecurity, and uncertainty. Food has given you the little bit of calm you need to make decisions and just get out of bed some days. You have done what you needed to to survive.

Now, you know that doesn't work for you in the long term. So, you have to deal with the root of the problem - your lack of life skills and your false beliefs that the world is a scary place that necessitates you worry constantly about every little thing, that if you make a wrong decision the rest of your life will be an utter mess with no hope of correcting, that if you let down your guard you'll end up a failure with nothing to live for, that if you say or do the wrong thing everyone in your life will realize you're an awful person and will abandon you (OK, so maybe those were MY own fears that food calmed for me, but I'm sure yours aren't too different).

I'm happy to hear you know it's only YOU that can fix your life. But, now, will you accept that you don't currently have the skills or knowledge to be able to do that?? Can you admit that your current beliefs about yourself and the world around you are what got you into this mess in the first place? So, of COURSE, you're going to run back to your coping mechanism - that's the only relief you have? You need a teacher that you can trust to teach you, push you, correct you, test you - until new healthy beliefs and decision-making are your habit. Keep seeking out that teacher in books, online, in classes or lectures, in happy, contented people you'll meet along the way. I’m working very hard to figure out how best to teach you guys to recover on your own. And, when you are no longer tied in knots with worry and doubt, you'll no longer need to cope, and you'll no longer feel drawn toward food. Your addiction will just fade away.

I also want to add, Mina, I have never had any comments from anyone who went to "IP" and recovered completely afterwards. I can't believe, as a recovered person myself, that if someone fully recovered after a stint in IP, they would never come back to give a little support and hope and encouragement to the rest of their community online.

Anyone else out there have anything they would like to add? Please feel free to present any opposing opinion. I would love to find even ONE person who recovered from ED using IP and/or the 12 steps. I would love to feel even a tiny bit of hope for people who decide to go IP. I would love to believe that the recovery industry is finally getting the hang of treating EDs. Please share your opinions with Mina and everyone else who is wondering the same thing.

Anyone want to participate in research for a graduate thesis?

Hi all. I got a letter from a woman who is doing her graduate thesis at National-Louis University on group therapy and bulimia. She has offered to pay $12 to anyone willing to complete a confidential short questionnaire about the topic. If you are 18 years of age or older and have been in (preferably still in) group therapy for your bulimia, she would really like to hear from you. I have copied her questionnaire here for you to consider. If you would like to participate, please send your answers to Melissa at edresearch@earthlink.net.

I tried group therapy in college for a little while, so I tried answering the questions myself. But, I admit I don’t remember much since it was 16 years ago.

Age bulimia began: 20

1) Can you describe your state of mind when your bulimia began and how you felt after your first bulimic episode?   I was under extreme pressure and anxiety dealing with college and the sudden realization that I’m not as smart, as capable, as strong, as interesting as I had thought I was. I felt surprise after my first purged – I hadn’t done it on purpose. But, afterward, I felt excited about my little secret, and I felt exhilarated that I, so quickly and easily, eliminated all my guilt and worry about the huge dinner I had eaten.

Please describe if your bulimia began as a means to control weight. It began as a means to deal with my out of control binging at our ridiculously large and fattening dinners. It soon became a way to calm my anxiety and panic.

2) How long did it take for you to realize that these actions were damaging to your health and for your family and friends to notice that you had a problem with bulimia?  I realized it could be damaging the first night I woke up with really bad heartburn. I felt awful and couldn’t get back to sleep. It was then that I realized how dangerous my stomach acid is and how it could be damaging my teeth. The next day I bought my first (of thousands) bottle of antacids and began to use them after purging to deal with the acid in my mouth.

Did you seek help or did someone suggest it? No one knew about it for a long time, so I sought help on my own. The problem was that I was seeking treatment for the bulimia – not the underlying inability to cope that made binging/purging so addictive. Of course, it was bound to fail.

3)   Can you describe what type of psychological support and interventions have been used in your treatment (such as group therapy, individual therapy, or hospitalization)?  ? I tried group therapy for a while and then got individual counseling at my university. But, I simply didn’t understand how to use either to get better. I thought if I just answered all their questions and talked about it, I would just miraculously get cured. The group therapy was a mish-mash of many different problems. I was the only one with an eating disorder.

How long and how frequently do you meet with your therapist/groupI know they were weekly sessions, but I can’t remember how long I continued. I know for sure I didn’t continue after college because I didn’t want to pay for it.

4) Does your therapist(s) encourage or discourage group members contacting each other outside of the group sessions? I don’t remember there being anything said about it. I remember one very awkward thing: when I began the group therapy, I was shocked and horrified to see a woman I knew pretty well socially. She was best friends with a woman I had lived next to in my freshman year dorm. Neither of us wanted to admit our problems to each other (talking with strangers is SOO much easier!). But, eventually, I admitted I was bulimic. She admitted she had been raped. We never, ever spoke of it outside of group. 

If this type of contact is discouraged, did you ever contact and interact with a group member(s) outside of the group session anyway?  Please explain why and how it affected your treatment. Since I knew this woman socially, it made it very awkward since neither of us wanted ANYONE outside of group to know our secrets. So, I only interacted socially with her in complete avoidance of our issues.

5) How did personal interaction between yourself and your therapist(s), even if you were part of a treatment group, affect you and your treatment experience? I never felt any kind of connection with my therapists over the years. In graduate school (age 27-29), I tried again seeing a therapist and the doctor who gave me my meds (forget what he was, exactly). So, I was actually seeing 2 “counselors” at the same time (because it was included in my health insurance). I remember “feeling better” for being able to talk with them about everything. But, I never slowed down in my binge/purge behavior.

6) When considering your personal relationship with your therapist(s) and any relationships you might have had with other group members (within the group or outside of the group meetings), which was more beneficial to you and your treatment?  Why? I guess that, since I never went to a group meeting with other bulimics, my answers here aren’t as useful. I did, however, hold small group meetings once I recovered. I felt very bonded with “my girls.” But, I guess you would have to hear from them about their experiences.

7) How would you describe your path to recovery from bulimic behavior and thoughts?  I hired a coach to actively TEACH me how to live! He taught me which of my thoughts and beliefs were irrational. He helped me replace them with rational, reasonable ones. He held me accountable for the practice (homework) that would prove to me that my new beliefs were right and would make my new beliefs become habit. He corrected me; he challenged me; he TAUGHT me.

Have you sometimes relapsed? Expecting someone NOT to turn to their coping mechanism occasionally after recovery is exactly like expecting a student to never get a test answer incorrect after they learn the teacher’s lesson. Of COURSE we’re going to make mistakes! Life is a series of trial and error and success. Making mistakes and learning from them is WAY better than never trying at all. Over time, we’ll learn that making mistakes won’t kill us and will only help us achieve what’s important to us. We’ll learn how to make better decisions for ourselves (hence avoiding regret and guilt and resentment). We’ll replace our old irrational beliefs that always lead to self-defeat with courage, patience, compassion, and excitement for ourselves and our lives. We’ll

8) When reflecting on your treatment experience with bulimia, do you have any suggestions about what could be done, or done differently, that would help you and your recovery? I wish treatment professionals would stop focusing on the behavior of the addiction and start either teaching us or challenging us to learn on our own how our irrational beliefs about ourselves and our worlds are what overwhelm us and make the calming effects of binging/purging seem so alluring. We not only need to learn to cope with the world, but we need to challenge our beliefs that world and our lives needs to be coped with. Life really isn’t that hard – we just make it seem that way in our own messed up heads.

If you would like to make any additional comments, please feel free to do so here.

I don’t think group therapy is a great approach to recovery. It just allows a bunch of people with irrational beliefs (like 2+2=5) to reinforce and encourage each other to continue thinking 2+2=5. It’s kind of like letting a bunch of students get together and teach each other how to do advanced calculus when none of them can even add! No one learns anything but more irrational ideas. They aren’t corrected; they aren’t instructed; they just fumble around in the dark. There is nothing inherently WRONG with us except that we were taught that 2+2=5. Life doesn’t make sense – it’s scary, it’s overwhelming, it seems messed up. We need to remedial education on life, rational and reasonable expectations of life, ourselves and other people, and how to not be so damned scared and powerless all the time! We need TEACHERS.

Why purging is addictive . . .

We all speculate on this. I always say simply that purging is very calming. It clears and quiets the head of all chaos; it calms the panic; it relaxes my mind and body. But, I certainly couldn't explain why.

Jeremy actually did some research on the subject, and he found that there is a very real bio-chemical reason why purging makes us feel so good. I'm really happy to finally have a valid medical reason now. Of course, like J says, the treatment industry doesn't get this at all. So sad.

Also, thanks again everyone for your supportive comments and emails. I'm back on my feet now. I just needed a little break from all things sad and challenging - like the purpose of this blog. I had a nice birthday weekend for me and for my sister. One additional sadness was that Todd's grandmother passed away Nov 30, so on Sunday (my actual birthday), he had to fly to Texas for almost a week for her funeral and to help settle her affairs and her estate. Thank goodness for my dogs! They are the best of company when I'm feeling down. They always love me, and they HAVE to continue to get their walks everyday, no matter how I feel. So, they got me out in the world hiking and walking and got my adrenaline flowing, and that is always good for my mood and energy levels.

My littlest one is sitting right behind me now, sharing my chair while I type this. She's got her head on her early Christmas present, a soccer ball rope toy, and she's looking up at me. To me, dogs truly are little miracles, gifts from the Universe, to show us unconditional love and to make our lives joyful inspite of ourselves. Love to you all.

Bloating in recovery

My new friend Marla wrote with a story very similar to mine (except that I was definitely a daily binger/purger):

“I have been struggling with bulimia for over 15 years and despite therapy and medication - I simply can't seem to "let go". I'm not a daily binger/purger but when I do engage in the destructive behaviour my depression worsens, as does my body image and overall sense of self. Now that I'm re-focused and back on track I feel so bloated and "fat".  I'm eating three meals as well as a few snacks (keeping it down) but I feel/look pregnant!  Is this a common symptom of recovery? Please advise.......thanks.”

So many people seem to have the same problem of bloating when they first begin recovery! I have to tell you, I don’t think I really had this problem. Of course, my belly has always been a bit rounder than most women’s, so perhaps I just didn’t notice it. But, since so many people complain about it, I would feel safe in assuming that it’s just a side effect from recovery. Of course, another side effect of recovery is that your face and neck will look smaller cuz they're not swollen 24/7 anymore!

One thought: could it be from suddenly digesting lots more veggies and fruits? I’ve heard that anyone can get bloating from suddenly beginning to eat more fiber. I’ll look into that and get back to you. It would make sense that when we begin to try to eat normally, we’re going to feel more comfortable with foods like these. What is your diet like now??

I would recommend to anyone in recovery that they put all their old, favorite skinny jeans away for at least 3 months. And, I mean really AWAY – give them to a friend to hold if you have to. The LAST thing you need to be focused on is your pant waistband! Get out all your “fat” pants and/or invest in some “recovery wear” of cute sweats, yoga pants, or track pants. Come on – you know that when your pants aren’t tight, you feel better. Help yourself succeed! Nurture yourself a little!

Marla, I, too, found no relief with various medications and several attempts at therapy. Just talking, even when I completely understood WHY I was like I was, did nothing to help me change all my old patterns, my habits that would lead inexorably down the spiral of anxiety to a binge and purge. I had to learn how to CHANGE my habits. I first had to learn how my interpretations of the world around me were always the most pessimistic, the most self-defeating and hopeless that my creative, yet paranoid and frightened, mind could dream up. It’s one thing to accept that, yeah, maybe I’m just paranoid. It’s another thing to push yourself to PROVE to yourself that your negative interpretations are completely wrong and just lead you for no real reason at all to feel panicky or depressed or self-hateful (for example). And, then you’re open to new interpretations: that you can handle whatever comes along; that life is too exciting for you to waste anymore time obsessing about your body; that you are truly blessed and so very lucky; that you are so great and lovable and have so much love and goodness in you to share; that you’re needed.

That was the beauty of working with a coach. He gave me great daily & weekly exercises focused on taking small risks around my bigger fears and insecurities and to help me realize all the many ways I’m very capable and creative and a very GOOD, loving person inside. And, he held me accountable for everything. Plus, he would point out to me every little negative or self-doubting or self-defeating thing I would say or write. It’s amazing how insidious it is! When we began working together, I couldn’t talk for two minutes without him pointing out how I was putting myself down, doubting my abilities, or assuming people were judging me or out to hurt me. I’ve put an example of one of the daily exercises I did for him here for you to download. I can’t recommend highly enough that you do this for yourself.

Also read these relevant posts: "What to expect in recovery" and Lasting damage after bulimia.

I should update everyone on one thing: way back in March 2005, I decided I was going to wean myself off my anti-anxiety medication, Celexa. I got down to a quarter of my old dose and began to struggle again – not with the bulimia, but with the anxiety and inability to stay calm. This made it difficult to keep focused and working on my book. I tried very hard to regain the ground I felt I lost by cutting down the medication. But, after a period of a couple of weeks, I gave it up and decided to stick at one half my old dose. I had too many things I suddenly wanted to accomplish, and the medication makes it so much easier for me to get them done. I am happy with my decision, and I feel good about it, even though my coach still thinks I should keep trying to get off it completely. So, I can still recommend that if taking medication helps you by calming you or giving you more energy or whatever, TAKE IT. And, don’t feel even the tiniest bit bad about it.

A novel treatment?!

Ok – when I read articles like this, I get a little frustrated. The article talks about this “novel, wonderful” approach to treating “anorexia/bulimia” by having the afflicted separate his or her self from the illness by envisioning the illness as an external attacker, a soldier from the “culture war.”

From the article, "Waging war against a deadly disorder:"

“In this sense anorexia is embedded "social suffering", whereby people discipline, punish and even torture themselves to meet ideal measures of health, fitness and beauty.”

I get frustrated because I think it’s pretty well known that EDs are NOT, at their root, about food or even our bodies. EVERYONE is coping with the same society and media, the same cultural ideals, the same idealized lifestyle of wealth, power, and physical attractiveness. It’s only we who haven’t learned to effectively cope with those pressures who succumb to an illness in response. I, for a good example, only quit my addiction after I went back and actively, committedly learned those critical coping skills and unlearned my incorrect, unhealthy, irrational habits of interpreting my world and my role in it.

I didn’t have to emerge from my illness angry or resentful at society or the media. I didn’t have to change society or anyone in it. I certainly don’t have to fight against society everyday. It seems like this doctor is priding himself on teaching sufferers how to fight their illness – but that’s all we do while suffering – everyday, every hour, sometimes every damn minute! We fight, we struggle, we argue against it. But, pretty much every day, we go to bed defeated, losers. I decided to hire a coach to help me quit my addiction and other symptoms of anxiety, rage, and depression solely because I was just so tired of fighting myself all the time. I couldn’t fight anymore.

And, I consider myself cured not because I fight a better fight against my illness everyday. No, I consider myself cured because I no longer have any reason to fight at all. I’m just stronger now. I’m no longer bothered by media or society. I KNOW and have gained confidence and trust in my unique role in my society, and I respect and honor it. I am no longer a victim of society’s ideals – as in all matters, I’ve learned how to be an objective observer of its attempted manipulations, and I have no need to play. I don’t hate or stay angry because of this attempted manipulation. Rather, I objectively understand it and accept it for what it is– it’s just to SELL products and services by making us feel we’re lacking if we don’t BUY. Additionally, I’ve learned to feel compassion for those who do get caught up in it – those who have to keep acquiring the next big thing to bring them temporary, though pretty reliable, feelings of contentment and significance in this big world. Perhaps it is these people who need David Epston to teach them how to fight.

In many ways, perhaps we bulimics (and anorexics?) are intuitively smarter than the consumer-society at large. We end up a mess of confliction because we know in our hearts that mass consumerism isn’t the answer everyone else sees it as. For if we did blindly buy this pair of expensive jeans or that hot new car or check out that hot new restaurant, we would probably feel more satisfaction, more contentment than we do. As it is, all we do is fight ourselves: we subconsciously disagree with what society tells us to value, but we have no external validation for what we feel in our hearts to be truly valuable. And, so we end up a confused, chaotic mess, turned hateful against ourselves for so obviously not fitting in and seeing no external evidence that we're ok just as we are.

We don’t need to learn how fight harder. We need to learn how to stop fighting by learning to see our world through the perspective that no fighting is needed. We only need to tap our own creativity, our optimism, our dedication to taking good care of and respecting ourselves and our precious uniqueness. We need to learn to believe in ourselves and our unique values and that we always have alternatives and options and that we’re utterly capable of handling anything that comes up – by learning, by thinking creatively, by trusting our hearts, by accepting and having faith that the only things we truly NEED in this world are either already inside of us or available in abundance.

I should add this disclaimer that I have never been clinically anorexic. Yes, I’ve starved myself for periods of time, but that was for poverty, not for lack of wanting to eat. I do believe anorexia and bulimia are completely different beasts. And, perhaps the only fault of this article is in grouping us together and treating bulimics as perhaps the less interesting of the two. I always get immediately skeptical when articles on treatment use the grouping “anorexia/bulimia.” It seems uneducated, or at least an unreasonably simplistic shorthand, since one can very easily exist without any signs of the other. After a 14 year, daily battle, I argue that I'm a very experienced and knowledgable bulimic. But, I honestly don't have a clue as to why an anorexic would want to starve themselves!

Maybe this doctor is right on in his work with anorexics, but what he’s saying does not at all feel appropriate for bulimics. I do think, regardless, that either the reporter or the man himself, make David Epston (is he even a doctor? The article doesn’t say) seem overly sure of himself, even smug in his opinion that he has found the “cure” or at least the best treatment to date for “anorexia/bulimia.” I know there is much more to Mr. Epston and his approach than this one short article can reveal, and I don't intend to attack him as a person when I obviously have so little information about him. Truly, I am profoundly thankful for his dedication to the problem of EDs. But, I disagree completely with the way he and his beliefs are presented in the article.

What do you think?

Why I'm quitting my anti-depressant

I’ve been getting emails asking me why I decided to get off my anti-depressant and why now, so soon after my recovery. People remind me that usually these medications are necessary to correct chemical imbalances in the brain, and they’re worried that I’m setting myself up for a relapse.

It is true that this is very soon after my recovery. And, it is true that I probably did have a chemical imbalance in my brain for most of my life. I’ve struggled with panic attacks and a baseline state of anxiety for as long as I can remember. And, if the medicine makes me a better person, happier with myself, and makes people enjoy being around me more, it just seems self-defeating to want to stop taking it right now . . . or ever, for that matter.

But, you see, I believe so profoundly in the new skills I learned from my coach that I truly believe that I now know how to handle any situation or emotion that comes my way! On a more scientific basis that perhaps you can’t fully have faith in yet, I also believe that with all of my consistent, relentless practice in denying the negative pessimistic thoughts and replacing them with loving, optimistic thoughts, I have successfully “reprogrammed” my brain and neurology. My brain now reacts more quickly with optimism than pessimism. It no longer reacts automatically by releasing the chemicals linked to a fight-or-flight response, which generates the panic and upset. It seems, in fact, to be more patient – waiting for me to better understand the situation before it reacts with any inundation of chemicals. And, with my intellect now in control, rather than an old programmed automatic response, I am completely able to consciously make a decision on how to react! And, so, I believe that my panic attacks are a thing of the past!

My physiology, too, is completely different and more able to absorb stresses that come along. The constant tension I carried in my back and shoulders for as long as I can remember is completely gone. Yes, it pops up sometimes at work when I’ve got a deadline (and, I’m working on reducing the frequency of that as well), but I’m not carrying it around with me all the time.

And, really, the ultimate reason I’m quitting now is I’m very excited to prove to myself and to you that this approach is nothing short of miraculous. If I can recover from 14 years of bulimia and successfully quit my anti-depressant after only a few months, you would be more likely to believe in what I have to share and work hard at incorporating it into your own life, right? Right.

Tomorrow is the end of week 1 at reducing my dose. So far, I feel wonderful. Time will tell, and I’ll keep you all posted!

**Update: I tried a couple of times to fully quit, and I did, but then I went back on to help me through a rough patch of a few months. But, I basically quit for good (unless I want a little helper again someday  J) in June of 2006. Read the full saga here.

End of my anti-depressant!

Today I began weaning myself from my anti-depressant, Celexa (Citalopram)! I had planned to begin on April 1, to give myself enough time after recovery to be completely confident with my new skills, but I got impatient. So, I began today.

I’ve been taking 40 mg/day of this medicine since April 2002 – that’s a full three years! I began taking it not for depression, but almost entirely because of my issues with rage. It was completely out of control and could flare up at just about anything. In the middle of a rage, I would put myself in very dangerous situations and didn’t care one little bit. After I calmed down, of course, I would be horrified at my complete lack of concern for my or anyone else’s safety. Since I was often in my car when these rages would flare, there were many times I just got lucky that no one got hurt or even killed.

Celexa also completely controlled my panic. I still had plenty of anxiety, but thankfully I haven’t had a single panic attack in the years I’ve been taking the medication.

I’m weaning myself very slowly. I’ve planned it out over a period of 6 weeks. I’ll reduce my daily dose by 10 mg/week every 2 weeks. I’ll keep you posted on how I’m feeling, but I really feel completely confident that I no longer need the medication. I’ve learned how to handle anger, depression, and anxiety on my own with the choices that I make. Yay me!

**Update: I tried a couple of times to fully quit, and I did, but then I went back on to help me through a rough patch of a few months. But, I basically quit for good (unless I want a little helper again someday  J) in June of 2006. Read the full saga here.

Is therapy needed at all??

By now you probably know that I’m not a big fan of therapy for recovery from eating disorders. But, after my weekend with my coach, I have even more to say on the topic.

I questioned him a lot about the value of therapy because I know bulimics are told constantly that they need to go to therapy to get well. Yet, therapy never worked for me. So, I wanted to check in with someone with lots of experience in helping people improve their lives.

He first reiterated his number one, most basic belief about our well-being: we become what we think about. He said that all the time we spend in therapy rehashing all the crap we’ve been through is time we spend thinking negative thoughts, which lead to negative emotions, which usually lead to negative beliefs and behaviors.

He said that even if we have all the knowledge and understanding possible about WHY we are the way we are, we will merely accomplish “managing our dysfunctional lives at a higher level.”  And, that’s exactly what happened to me after all my therapy when I lived in peace and acceptance of my bulimia for about 7 years or so! He truly believes that we don’t have to know anything at all about the source of all the pain we carry around . . .

We just need a burning desire to become better, healthier, happier people, free from the pain of our pasts. Then, we can begin the work of connecting with our intuitions/our hearts to learn what is most profoundly, deeply important to us to live fulfilling lives. And, then we can begin the work of changing ourselves into that vision of who we truly, desperately want to become. When we’re focusing on the beautiful lives we want, we are much more likely to get there than if we’re focusing on our horrible painful pasts that were and still are completely out of our control.

Let me know what you think about this.

Please don't use a 12 step program!

I've always been skeptical of the 12 step or 100% abstinence way of healing. But, I know I realize that it could actually be more harmful to many eating disordered people. It may work for some, but I really believe it takes a hell of a lot more time, more pain, and more effort.

·          First of all, 12 step and abstinence approaches focus only on the eating disorder, which is only a symptom of what's going on inside us. I think for most people, it's a prescription for failure. You can't get rid of your main coping mechanism without some serious growth and development of your inner self - your heart - your intuition. You'll have a very hard time, and/or simply blow up!

·          Secondly, it says you must give up all your power to God and admit that you're powerless over the addiction. Well, of course, you're powerless right now! You aren't yet connected with your inner self, which is the ultimate in power! Your inner self wants to live a great life, and believe it or not, it already KNOWS what it needs to get you there. It just needs acceptance, love, and a little coaxing to speak to you. You absolutely CAN connect with your inner self and power, and you CAN trust and rely on yourself to make a better life for yourself. There are people like my coach who are brilliant at helping us do this. You are VERY powerful!

·          These approaches deny your ability to BELIEVE that you can conquer you eating disorder 100% for life. That is absolutely NOT true! And, this negativity is very damaging to your heart and your sense of hope. You need, instead, to be inspired and energized by your vision of the life you want to live. You've had enough negativity in your life and your heart; this is the time to set yourself free of negativity, doubt and fear. The eating disorder is a easy to conquer compared with ridding yourself of this negativity that festers inside you. You need to surround yourself with hope and inspiration and positivity; because BELIEVING in yourself is the one most critical element to recovery and going on to do amazing, fulfilling things with your life.

·          These approaches treat you as a failure if you have a relapse. That is exactly NOT the way to treat you! You need constant hope and positivity and encouragement, not blame and guilt and shame. This one makes me so mad! I hate the fact that if you slip 6 months into your program that you have to start over from day one. NO! Working on yourself to become healthier and happier and live a great life is a wonderful thing! It's a self-loving, self-nurturing, and exciting process that everyone should go through. You should feel proud of yourself every day that you're committed to this journey. Guilt and shame should be banned from your acceptable list of emotions from the first day you commit to getting well!

·          Lastly (for now!), neither 12 step nor abstinence programs teach you how to design and go after a better life. They want only to "cure" you of your illness (of course, as I mentioned above, they don't really believe you can be cured). They don't give you a vision of what your inner self needs to do to live a fulfilling life. You need a coach and some real positivity and belief to do that.

Basically, I hope you stay away from these programs. I want you to feel empowered that this is the time - you are ready - to completely change the way you live your life. I want you to be so excited about living each day pursuing your dreams, not dreading each day because it's always a fight to stay abstinent. I want you to go on to do amazing things with your life - and that means you must connect with your inner self to learn and understand what will truly make you happy. I want you to develop complete trust in your intuition to know what's right for you, always, and that means you KNOW you are completely well and you can trust yourself to always take care of you and do the right thing for you.

Talking vs. Changing

If you’ve read all my posts, you probably know that I’m not a huge fan of therapy or therapists.  You also know that I recently began professional coaching.  Someone today asked me what exactly “coach” does, and how that differs from what a “therapist” does.

Let me first say that I certainly don’t want to discourage you from seeking therapy; it may work very well for you – particularly if you haven’t yet figured out some of the reasons why you use bulimia to cope.  And, I should mention that since I haven’t had many financial resources available, perhaps I’ve only had access to the less than great therapists.  But, I know for sure that they (I worked with 3 or 4 during my 20’s) didn’t help improve my bulimia one little bit.  I should also add that my sister went to therapy loyally for about 8 years or so before she committed suicide.  So, you see there is basis for my opinion.

Very simply, I see the difference between therapy and coaching is this:  Therapy is about exploring and TALKING about who we are, why we are, and how we feel about everything. Therapy makes us feel better about ourselves.  Coaching, on the other hand, is about MAKING OURSELVES BETTER.  Coaching helps us to destroy our negative, unhealthy beliefs and thoughts and replace them with positive, healthy ones.  And, having positive, healthy beliefs and thoughts inevitably lead to positive, healthy actions and on to positive, healthy lives that fulfill us and make us happy and excited to live and experience each day to its full potential.  That sounds much better doesn’t it?

I began coaching because my boyfriend had tried out this guy and became a huge fan.  He started going for career coaching and ended up working on some less than healthy personal beliefs and behaviors he wasn’t even consciously aware he had.  My boyfriend didn’t even know at the time exactly how messed up I was.  He only knew that I had had some issues with anger and panic in my past, and that I now “treat” them (ie. cover them up) with medication.  In our discussions about our future, we discussed how I would go off the medication while I was pregnant and breast-feeding.  But, he knew from his experiences with the coach that if I didn’t actually FIX the issues leading me to rage and panic, I would go right back to my old behaviors without the medication.  That’s not going to work with children around.  But, really, only because it was so important to him, and he’s so important to me, that I finally relented and coughed up a HUGE chunk of my savings account (my security) to pay for it.

Well, to get right to the point, I’m already a big fan of this approach and believe it is the best route to recovery for all us bulimics and borderlines!  Essentially, in only my first weekend with him (2 full days, from 8 am to about 8 pm), we identified and critically damaged all the bad crap that I had learned as a child or made up along the way.  Then, he laid a strong foundation in my mind and heart for all the good, empowering stuff that I should have learned.  Then, he sends me away for a month with daily and weekly exercises to nurture all the good stuff until it becomes all I know and believe.

In my next weekend, we’ll build a written plan for my future. We all desperately need goals and dreams (beyond our next binge) that make us happy and excited as we work toward them each day.  These goals are not simply “I want to make lots of cash!”  For example, I already know 3 goals that are very important to me: 1) get rid of my bulimia (and assorted other issues) for ever, 2) put my crappy 14 years with bulimia (etc.) to good use by helping others to heal as well, and 3) to have a strong, loving marriage and 2 happy children with all the self-esteem, self-confidence, and courage they should have and that took me until age 34 to acquire.

Here is my guy’s web site. This page in particular details the specific program I’m in. 

http://extraordinaryliving.com/services/lifeofmydreams.html

Explore the links in the left navigation area.  Doesn’t it sound like just what we need? 

Before you get too excited about coaching, keep in mind that it does cost a lot, and insurance really won’t cover it.  Insurance will cover only the minimum it can get away with while still being able to claim that it cares about mental health.  If you have the financial resources, you should do this right now.  If you don’t have the money, then keep checking this blog, because I plan to share as much about this approach as I possibly can.

No Miracle Cure

Most bulimics, I believe, are not only bulimic.  It’s just one symptom of something more profound.  I, for example, have been diagnosed at some time or another as having anxiety disorder, severe depression, bulimia, and frightening issues with rage.  Overwhelming, isn’t it?  How the hell am I supposed to tackle so many deficiencies?  Just the thought of it all makes me even more depressed – so much so, I need to go binge and purge!  Certainly, that’s how I used to handle it.

My first attempt to get “fixed” was therapy.  I tried it in college where my school-subsidized health insurance would pay for it.  To some extent, talking about everything in my past was certainly therapeutic.  It helped me to understand myself a bit and gave me a captive, sympathetic audience to which I could complain and whine about my horrible childhood.

As you may have guessed, my first round of therapy failed miserably.  I just got worse after college when I was living alone in a new town, was unaccountable to anyone, and knew very few people who would interrupt my evening plans by calling to chat or go hang out.  One thing I found with therapists is that by the time I was done talking about my disadvantaged childhood, I felt completely justified in being so messed up.  For me, their sympathy and understanding tended to enable me in seeking comfort in whatever way I could; you know what that means.  And, all they could offer me was talk, not strategies or realistic, achievable ways for me to change my behavior. 

But everyone believed so much in therapy at that time: Oprah, Sallie Jesse, even Jerry Springer.  So, I tried it again in graduate school when I was 28 and 29.  My therapists of course were focused on the bulimia- it’s just such an awful addiction, right?!  But, all my fighting and struggling to free myself seemed utterly feeble compared with the power of bulimia.  And, I even realized over time that bulimia made me feel so much BETTER, while fighting it only made me feel weak and disappointed in myself.  I learned that lying to the shrinks made everyone feel better –them, since they felt like they were helping me to conquer such an ugly unfortunate illness, and me, since I honestly enjoyed having the bulimia so much more than my agonizing and futile attempts to get rid of it.

Only once they felt my addition was under control did they turn their attention to my next big obstacle: depression.  By this time, there was a new, seemingly miraculous invention called Prozac. So, I tried it and ended up staying on it for a few years.  While I was in school, even I didn’t really notice the worst of the side-effects since I could nap anytime I wanted to – and, I just happened to enjoy napping a LOT.  When I began my first job out of college, it didn’t take long to realize that Prozac was doing more harm than good.  I couldn’t make it through the day without putting my head down to take a nap on my desk.  I remember having to drive to meet clients and being barely able to keep my eyes open, let alone keep alert.  I never made it through a meeting, no matter how important, without having to fight to stay awake.  The last draw was when I was in a one-on-one meeting with my supervisor discussing my performance, and I STILL couldn’t keep my eyes open.  I quit the pill immediately.

And, looking back, it didn’t even really work.  I was still bulimic; I was still depressed; I still got panic attacks.  The thing I liked was that I was just the slightest bit more numb.  It did seem to take a bit of the edge off.

As miserable as I found Prozac to be, I found a different pill, Celexa (or the generic spelled Citalopram or Citalpram), to be wildly successful in cutting the panic and to be very helpful with the depression.  I would actually recommend that you talk to your doctor about it if you have trouble with either of these.  No, it didn’t help me quit bulimia, but it did give me extra energy that I used to get other tasks done.  It gave me the motivation and strength to get out of a dead-end relationship and pick up and move to California (which I had really wanted to do for awhile).  And, that, if nothing else, did help me feel happier and more in control of my life.  Bulimia saps you of energy and drive, and Celexa/Citalopram did give some of that back to me. 

After almost 3 years, I’m still on Celexa: 40 mg per day.  But, to be honest, I don’t think it’s been working very well for a while.  That actually gives me hope that it’ll be easier than one would think to quit it.  I plan to get off it completely this year; my goal is to be prescription-free by my one year anniversary of committing to quit: 12/9/05. I’m going to do it slowly, however, and I’m only going to start once I’ve been bulimia-free for some period – like 3 to 6 months.  Some would say I should give it 6, but I’m feeling pretty eager to get done with this period in my life altogether, so I’m thinking 3.  I’ll keep you posted on that when it’s time.

What I really want this chapter to convey to you is this: 1) there is no miracle cure, neither therapy nor medication, and 2) bulimia is only one of probably a set of issues you have to deal with.  If you (or your therapist) focus only on bulimia, it’s purely self-defeating.  Bulimia is generally a coping mechanism, and if you try to take away the coping mechanism without addressing what you’re having trouble coping WITH, you’re either going to fail or you’ll find another, maybe more harmful, way to cope.  I would argue to keep the lesser of the evils and focus first on finding the reason you’re having so much trouble finding peace in your life and your mind.  If you read my entry “On Guilt and Forgiveness” you know that my biggest issue keeping trapped in bulimia was my guilt for the way I treated my mother and my sister as a child.  There are plenty of other reasons why I turned to bulimia in the first place, but 14 years later, this was the main thing keeping me there. 

I have to go for now, but in my next “chapter,” I’m going to discuss WHY I think bulimia is always is accompanied by a host of other illnesses. And, I’m going to introduce you, maybe for the first time, to a disorder that actually identifies all my separate disorders as symptoms.  And, I’ll discuss why it was actually a miracle to me to find that I had this big doozy of a disorder.  Until then, take care of yourself as well as you can.