What if you viewed behaviors such as restricting, bingeing, purging, cutting, and/or using, as resilient attempts to try to regulate emotions, for some to cope with past trauma-as well as a way that you might be trying to communicate deeper messages.
 
Of course, these behaviors may seem helpful in the short-term, but in the long term they do not actually solve the underlying problems, make you dependent on them, and often make you feel increasingly anxious and unhappy.
 
However, when you shame yourself for struggling you typically only make things worse.
 
What if instead, you practiced applying compassion and a mindful curiosity to the behaviors that you are struggling with?
 
You are not ‘crazy,’ or broken, or screwed up, rather you are in pain and trying desperately to cope.
 
ASPIRE
 
I created the acronym ASPIRE as one skill that you can use when you have urges to engage in restricting, bingeing, purging, self-harming, and/or using.
 
It’s important to practice using this skill when you are not feeling triggered, so that it is easier to access in those moments. Just like learning how to ride a bike or play an instrument, it will take practice in order for this skill to start to feel more natural and eventually even automatic.
 
Also, it’s important to note that even if you engage in a behavior after-the ‘win’ can simply be creating space (i.e. pausing) and using this skill beforehand.
 
Telling yourself that you are going to do this skill in place of the behavior will likely be a set-up. So, start by telling yourself that you will practice using this skill before using the behavior.
 
1.  Alternate ways to communicate  

• Write a journal entry or poem about how you are feeling.
• Draw to express your emotions.
• Create a collage (smash book or alter book).
• Draw on your body, where you would like to self-harm.
• Write a song.
• Talk to a friend, therapist, treatment team member, or support person.

​​ 
2.  Self-soothe  

• Listen to meditation, music, or ASMR.
• Drink tea or another warm beverage.
• Light a candle, or put scented lotion on.
• Wrap yourself in a fuzzy (or a weighted) blanket.
• Watch a nature video, or one of a beach scene.
• Play with a pet.
• Sit outside in a relaxing place.

 
3. Practice self-compassion.  

• Instead of beating yourself up for having urges, think about what you’d tell a friend who was struggling.
• I know it might feel very unnatural at first, but practice speaking kindly to yourself.
• Remind yourself that you are not alone and that others struggle with this too and that you are doing the best you can in this moment.

 
4. Invite curiosity.  

• Rather than judgment, practice some mindful curiosity.
• Was there an internal or external trigger?
• What are you looking to feel or to not feel through using this behavior?
• What might you be attempting to communicate?

 
5. Respond effectively.  

• Think of a more values-aligning and compassionate way that you can respond to these thoughts/feelings/urges.
• Could you respond by doing what they call in DBT an ‘opposite action’ i.e. if you are feeling an urge to restrict-having a nourishing meal, or if you are feeling the urge to self-harm putting lotion or drawing where you’d like to cut?
• Think about what you are looking to feel or not feel through using this behavior and other more adaptive ways that you can get your needs met. For ex: are you self-harming to try to ‘feel something’ because you feel numb? Other ideas to get that same feeling might be holding ice, eating something spicy, etc.

 
6. Enlist support.  

• Reach out to people who can support you (either by distracting you, listening to how you are feeling, or helping you to come up with ideas for more values-aligning behavioral responses).
• I.e. can you text/message/email/or call a friend, family member, therapist, treatment team member, reach out to a crisis chat line etc.

 
Prompt:
 
1. Make a list of the behaviors that you are currently struggling with and next to each one write the functions or ‘what it does for you.’
2. Get curious about what the messages behind these behaviors might be-what do you think that you may be trying to communicate (to yourself and/or to others). Reflect on the details of your behaviors to see if you can find any meaning there (ie location that you are self-harming, foods you eating during a binge and ask yourself is physical or emotional restriction of those foods happening etc).
4. Next to each function, list at least one other more values-congruent way that you might be able to get that need met (if it’s not a self destructive desire).
5. Share this assignment with a therapist (if you are looking for support virtually or in Maryland fill out the contact form to schedule a free 20 min consult with a member of my team). 

You can get your life back and you don't have to continue to feel so trapped.

​Ultimately, you can find more life-affirming ways to get your needs met, gradually putting your eating disorder (or addiction, self harm, etc) out of a job. 

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​I was telling my recovery story on a podcast the other day when I remembered a metaphor I’d thought of to describe my eating disorder many years ago.

I remembered how this vision came to me of a bulldog that was inside me.

However, the bulldog was not my eating disorder.

The bulldog was my inner critic, my perfectionism, my ‘too hard on myself’, what I often called my inner taskmaster. And the eating disorder was the toy I could throw to the bulldog to give it something concrete to focus on rather than attacking me. (Of course, I don’t have anything against bulldogs! But for some reason this was the image that came to me then).

Before my eating disorder I felt like this inner critic, this inner unforgiving taskmaster, would attack me for every little thing I did. It was so exhausting, and so disheartening, trying to live in such a way as to never give him reason to attack me - always vigilant against mistakes, always having to give everything 110%.

The eating disorder, in all of its pain, exhaustion and isolation, at least was something concrete that could reliably distract the dog. I knew the rules, I knew what to do, and yes the rules might keep escalating but they were predictable and the dog would be distracted from attacking who I was as a person, as long as I got my eating disorder totally right.

It was extremely exhausting though, and there was no room for error.

One slip-up with the eating disorder and the dog would be on me.

But at least I knew what to do to get him off my back again, be the most disciplined, have the most willpower, be smaller, exercise more.

But it came to me one day.

I was spending so much mental, physical and emotional time and energy dedicated to distracting the dog, but it wasn’t getting me anywhere in the long run. I had to sustain it indefinitely, the dog was never going to get softer on his own, I would never be free from having to distract him or from bearing the brunt of his attacks on me.

And I gradually started to realize that the only way I could ever be really free from how bad my inner critic could make me feel, how cruel my inner taskmaster was to me, was to begin putting energy not in distracting it with how ‘disciplined’ and ‘rule-abiding’ I was, but in confronting it and softening it.

My new approach did not stop my eating behaviors right then and there. Recovery took time and it was definitely not a linear journey. 

But I began devoting more and more time and energy to things that I believed would help me to soften that inner critic, so that it would no longer be so painful to try to give up the eating disorder.

Before I took this approach, whenever I would try to recover, yes I would have some relief from my eating disorder behaviors that were making me miserable, but having to face my inner bulldog’s wrath towards me as a person often felt even worse. It made the eating disorder seem easier than the shame and hate I felt for myself without it, and so I returned to it over and over.

But turning my attention to softening the inner critic bulldog itself - now I finally began to see a light at the end of the tunnel of these constant behaviors…. Challenging my eating disorder began to feel less painful and scary, because the dog wasn’t as ferocious as he used to be.

I began meditating, and this helped me to connect with a deeper, wiser, more loving part of myself, that had always been there but had just been buried under all of my fear and self doubt.

I began reading self-help books that spoke to me, mainly in the areas of self-compassion, inner critic work, spirituality, and other topics I wanted to develop in as a whole person.

And slowly, I started building a foundation on which to connect with a deeper part of myself, and on which to value myself more unconditionally so that even when my inner critic would attack me, I had a loving part of me that could comfort me and gently but strongly talk back to it.

I gradually began to develop a sense of myself that was greater and more solid than my achievements or eating disorder.

And with time and effort of putting my attention on these things, the bulldog got softer and softer, and the eating disorder behaviors and rules felt more and more unnecessary.

Of course, challenging them and the recovery process was still difficult, but I began to strengthen a self-compassionate, wise, loving side of me who could meet my fear and pain in place of my inner bulldog.… and this made such a difference.
 

The Eating Disorder Center is a premier outpatient eating disorder therapy center founded by Jennifer Rollin. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, bulimia, OSFED, and body image issues. We also offer therapy for obsessive compulsive disorder. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney, Silver Spring, Germantown, and Washington D.C. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com ​​
​

​Struggling with intrusive thoughts, obsessions, and time-consuming rituals is exhausting.

Many people who struggle with OCD feel ashamed about their thoughts and behaviors. However, if you are struggling, you are definitely not alone. 

As an OCD specialist, my passion is helping people to find freedom from OCD and to reclaim their lives.

The following are 5 tips for your recovery from OCD.

1. Begin to label fringe thoughts. 

In the Mindfulness Workbook for OCD, Hershfield and Corboy use the term “fringe thoughts” to describe thoughts that are not regularly in one’s consciousness, but that pop up from time to time.

These thoughts may be desirable or undesirable.

To someone without OCD, these thoughts pass by without distress, however, for someone with OCD, these thoughts have a “sticky” quality and can be alarming, leading to fears that the thought will lead to an action.

​This brings us naturally to the next tip: becoming mindfully aware of when you are engaging in thought-action fusion, a cognitive error. 

2. Thought-action fusion.

If you think something, will it automatically turn into an behavior?

It can be very powerful to remind yourself that just because you think something, it doesn’t mean that you will automatically begin to do something.

Another way to consider this is: is this thought actually dangerous? And, if it’s not dangerous, do I actually need to suppress it and engage in compulsions to make that thought okay? 

3. Seek support, not reassurance.

Many people with OCD engage in reassurance seeking.

For example, they might ask a family member: I would never _________, right?

Often, family members feel tempted to say, “of course not.”

The trouble with reassurance seeking is that you typically need more and more of it to feel better.

As a result, reassurance seeking actually makes the initial fear more powerful.

Consider finding a way to seek support instead. For example, you could say “My OCD is really trying to make me think I did something frightening,” or “The OCD voice is so strong today.” This will give your loved one a chance to give support by saying something like “I know this is really hard for you. Remember that these thoughts are coming from OCD and not you.” 

4. Educate yourself on OCD.

The more you understand the disease, the better.

That scary thought that you thought no one else had might be more common that you think.

Normalizing what you are experiencing will naturally decrease your anxiety and help you stop engaging in exhausting rituals as you are more and more easily able to attribute thoughts to OCD.

It can even be helpful to name your OCD and begin to identify it’s voice versus your own.

5. Reach out.

Talk to a friend or family member and consider meeting with a therapist.

No one should have to struggle with OCD alone.

You can find freedom from intrusive thoughts, obsessions, and rituals. 
 

​The Eating Disorder Center is a premier outpatient eating disorder therapy center in Rockville, Maryland. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. We also offer therapy for obsessive compulsive disorder. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney,  Silver Spring, Germantown, and Washington D.C. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com ​

 
“It seems like I’m actually experiencing my feelings, now that I’m no longer bingeing and purging my emotions,” my client in recovery from bulimia shared.
​
Eating disorders are believed to be caused by a combination of factors including, genetic, temperamental, and environmental influences.
 
However, one thing that almost all of my clients with eating disorders have in common is difficulty in expressing, processing, and coping with their emotions.
 
 
Emotional Avoidance and Eating Disorders
 
Emotional avoidance, is described as actions that are intended to prevent an emotional response from occurring, such as fear, anger or sadness.
 
People struggling with eating disorders often turn to their eating disorder behaviors in an unconscious effort to try to help themselves to “feel better” and to cope with difficult emotions or life circumstances.
 
For instance, for many people struggling with anorexia, their response when it comes to coping with feelings of anxiety, sadness, or loneliness, is to restrict their food. This may give them a false sense of “control” and specialness. For individuals with bulimia, bingeing and purging provides them a momentary feeling of comfort, “control,” or relief. For people struggling with binge eating, eating often feels like “an escape,” comforting, calming, or a way to numb out.
 
The reality is that eating disorder behaviors often provide short-term relief or satisfaction, and long-term feelings of increased depression, loneliness, and misery.
 
Let Yourself Feel
 
Eating disorder treatment involves a variety of tools and strategies for helping clients to reclaim their lives. However, one important element is helping them to learn how to identify, process, and cope with their emotions in ways that align with their life values.

Many of my clients struggle with being able to sit with themselves and their emotions. Often eating disorder behaviors are used as a way to try to regulate or distract from intense emotions. 
 
I often say to clients that trying to suppress our emotions, is kind of like trying to hold a beach ball under water. It takes a lot of effort and eventually the beach ball will fly up above the water with force.
 
As a culture, we are often not taught to express our emotions. However, emotions serve important functions in our lives, as they are signals of things that we need to pay attention to.

There is a quote that I love from Norah Wynne, which says "Feelings will not kill you. No one has ever died from experiencing an emotion, but people have died trying to stuff them down."

It’s important to share with clients that their eating disorder behaviors are often coping strategies that they are using to try to regulate their emotions. These behaviors may have helped them to get through some difficult and traumatic times, however they are also no longer serving them.
 
With treatment and support, people with eating disorders can learn how to heal their relationships with themselves, food, and their bodies.
 
They can also learn how to express and process their emotions, without the constant strain of trying to suppress or run from their feelings. Part of living a meaningful life is being able to experience all of one’s emotions, both pleasant and unpleasant.

One of the great privileges of doing this work is being able to see the light return into someone's eyes, for them to be exploring their true passions and interests, for their brain space to be no longer ruled with thoughts about food and their body. Full recovery and living according to your true values, is completely possible. 

An assignment to put this into practice:

• What emotions (if any) are you trying to push down, avoid, or distract from?
• What behaviors are you using to try not to experience this emotion?
• How is doing so serving you, and how is it not serving you?
• What would be on healthy way that you could process the emotions that you are experiencing, i.e. writing, an alterbook, talking to a friend, drawing, talking to a therapist?

The Eating Disorder Center is a premier outpatient eating disorder therapy center in Rockville, Maryland. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. We also offer therapy for obsessive compulsive disorder. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney,  Silver Spring, Germantown, and Washington D.C. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com 

I was excited to get the chance to interview my amazing associate, Kate Dansie, MSW, LCSW-C.

​From the moment that I interviewed Kate, I knew immediately that I wanted to hire her to work on my team! 

Kate is compassionate and warm, highly knowledgable, and is incredibly skilled in helping individuals with eating disorders and/or obsessive compulsive disorder to find freedom.  

Jennifer: Tell me a little bit about yourself and what fueled your interest in helping people recover from eating disorders and OCD?
 
Kate: From a very young age I was interested in medicine. I seriously considered a career as a nurse or doctor, but my senior year of high school I took a psychology class, and I was hooked! I went on to study psychology in college, and found my counseling classes particularly fascinating. As I entered college, my own struggle with perfectionism, obsessive worry, and an eating disorder worsened, and I sought help from my college counseling center. It was this experience that was my biggest inspiration. 
 
Jennifer: Do you subscribe to a health at every size approach?
 
Kate: I absolutely do. I was initially introduced to Health at Every Size by another eating disorder therapist. Learning about HAES was life changing for me as I know it has been for countless others.
 
Jennifer: How would you describe your approach to OCD treatment?
 
Kate: When treating OCD, I use a combination of Mindfulness, Cognitive-Behavioral Therapy, Acceptance and Commitment Therapy, and Exposure & Response Prevention. I think it is essential to provide psychoeducation about the illness, particularly at the beginning of treatment. For example, it is important to note that those with OCD are often very conscientious, and I like to clarify that our goals in treatment are not to make them less so, but rather to free them from intrusive thoughts and exhausting rituals. I also like to have people pick a name for the OCD so they can begin to distinguish between their own voice and the voice of the OCD. This is typically a fun thing to do and makes for a wonderful beginning of treatment.
 
Jennifer: What would you say are some of the biggest challenges and most rewarding aspects of your job?
 
Kate: It can be hard at times to see how many people struggle with eating disorders and OCD; however, as soon as they come in I am also already full of hope for them. I feel truly honored to walk alongside my patients as they recover. By far the most rewarding aspect of my job is when a patient comes in and shares a victory with me, no matter how big or small. My heart just swells in those moments.
 
Jennifer: What is one piece of advice that you would give someone who is struggling in their recovery?
 
Kate: I’d tell them to remember that they are not alone. There are many others out there struggling, and they do not need to feel ashamed of what they’re going through.  I’d also remind them that recovery is not a linear process. It can be easy to feel like the obstacles that you experience along the way are blocking the path to recovery, but they are the path to recovery.
 
Jennifer: What would you say are some common misconceptions when it comes to eating disorders?
 
Kate: There are so many. One of the biggest myths is that eating disorder only impact young, white females from a high socioeconomic status. This is not true at all. Eating disorders, just like any mental illness, do not discriminate and can impact individuals of any race, socioeconomic status, sex, and age. Another common myth is that eating disorders are about “vanity.” They are not. Eating disorders are diseases.
 
Jennifer: How would you describe your approach as an eating disorder therapist?
 
Kate: I tailor my treatment approach to each individual because everyone is unique. However, I enjoy drawing on Acceptance and Commitment Therapy, Family Systems Theory, Cognitive-Behavioral Therapy, and Dialectical-Behavior Therapy. Similar to the way I treat OCD, we begin to distinguish between the voice of the eating disorder and the healthy self. We identify rules set by the eating disorder self. Then, we design small experiments to begin breaking them and test the hypothesis that their eating disorder might be telling lies.

We live in a society where “You look great, have you lost weight?” is unfortunately seen as a normal greeting. 

Recently, I went to a party where comments about people’s bodies and weight seemed to be the initial topics of conversation. I overheard numerous conversations congratulating others for their weight loss or thinness.

I truly believe that people often do not intend to hurt others by exclaiming, “You look so thin, that’s awesome,” or “Did you lose weight? How great,” or even, “You got bigger.” In light of that, the following are three reasons why you should never comment on someone’s weight.

1. You cannot tell anything about a person’s health, happiness or life circumstances based on their weight.

We live in a society where often weight loss is perceived as “good” and weight gain is seen as “bad.” This fundamental assumption is inherently flawed. Weight loss and gain tells you nothing about a person’s health, happiness, habits, or life circumstances. The person that you are praising for their weight loss could be suffering from a life-threatening eating disorder, cancer, depression, grief, the diet-binge cycle, intense self-hatred, or numerous other issues. The person that you are judging for their weight gain may be happy, healthy, in recovery from an eating disorder, finally letting go of the diet mentality, etc.

Being thin is not “good” and being fat is not “bad.” There shouldn’t be this sense of morality surrounding weight. Additionally, our bodies are meant to change throughout our lives. This is part of being a human being and nothing to be ashamed of. All bodies are good bodies, but more importantly people’s worth is not based upon their weight or shape.

2. Weight-related comments can be highly triggering for people.

There are so many examples of how weight-related comments can trigger people. For instance, we know that for those in recovery from an eating disorder, weight-related comments can be incredibly triggering and can serve to fuel their disorder or cause a relapse. It’s also important to note that you cannot tell who has an eating disorder based on their physical appearance. People with eating disorders come in all shapes and sizes.

Let’s say that someone has simply lost weight on a diet and you applaud them on their “weight loss.” Since we know that diets have around a 95% “failure” rate when it comes to maintaining weight loss in the long-term, this “praise” will only serve to make them feel worse when they inevitably gain the weight back. This can serve to perpetuate the diet-binge cycle, which has been shown to have highly detrimental effects in regards to people’s health and happiness.

3. It shifts focus away from things that are actually important.

I am sometimes struck by how I can be among a group of ambitious successful women who have amazing careers and are raising children, yet the conversation is primarily focused around dieting and weight-related concerns. These are women who have achieved incredible things and yet they are choosing to focus on something so trivial and meaningless. I do not blame them, as this is largely a cultural and societal issue.

Body image issues and diet-culture impact people of all genders. However, I do think that particularly as women it’s important to note that a focus on these issues often keeps us from “playing big” in other areas of our lives. Diet-culture and a fixation on thinness actually rose in prominence around the time that women began to gain more political rights in our society.
​
Additionally, It’s sad to me that people will approach someone that they haven’t seen in a long time and the first comment that they think to make is about the individual’s weight. What if instead you asked them about their passions, their relationships, and how they are doing in general? There are so many more important and interesting things to focus on than a person’s weight or eating habits.

What to Say if Someone Comments on Your Weight

The following are some simple suggestions for what you can say if someone comments on your weight.

“You look great! Did you lose weight?”

- I choose not to focus on my weight. There are so many more interesting things about me.
- No clue. I don’t weigh myself. So how has your family been?
- I feel great and that’s all that matters.
- Nope. I just look and feel great.
- That question honestly makes me pretty uncomfortable, as I try not to focus on my weight as a barometer of my worth.

“Have you gained weight since I last saw you?”

- I’m happy and healthy, thanks for noticing.
- Is weight something that you focus on?
- No clue. I don’t tie my self-worth to a number on a scale.
- I’m trying not to focus on my weight, so I’d rather you not comment on it.
- Yep! (with a smile).
- I don’t think that’s an appropriate question. My body is nobody else’s business.

Ultimately, your worth and your value do not come from your appearance, the number on a scale, or your body. Your value lies in the kindness that you extend to others, the spark in your eyes when you laugh, the way that you pursue your passions, and your relationships. You are enough, just as you are.
 
The Eating Disorder Center is a premier outpatient eating disorder therapy center in Rockville, Maryland. We specialize in helping teens and adults struggling with anorexia, binge eating disorder, and bulimia, and body image issues. We also offer therapy for obsessive compulsive disorder. We provide eating disorder therapy in Rockville, MD, easily accessible to individuals in Potomac, North Potomac, Bethesda, Olney,  Silver Spring, Germantown, and Washington D.C. We provide eating disorder recovery coaching via Zoom to people worldwide. Connect with us through our website at www.theeatingdisordercenter.com ​​​