ChickSpeak

Continued from last week, our third installment of our Q&A with Eating Disorder Experts, Aimee Liu, accomplished author, and Judith Banker, President-Elect of the Academy for Eating Disorders.

Because we hear from you, our ChickSpeak community, often about topics ranging from a basic lack of self-confidence to full-blown anorexia and bulimia, we decided to enlist the help and support of an expert. Aimee Liu is the author of GAINING: The Truth About Life After Eating Disorders, just published by Warner Books. GAINING is, in part, a sequel to Liu’s very first book, SOLITAIRE (1979), which was also America’s first anorexia memoir.

In her latest book, Aimee Liu revisits the questions of what really causes eating disorders and what it takes to fully recover. Aimee interviewed leading researchers and more than 40 other women and men with histories of eating disorders, then found the common threads of behaviors and traits that linked each story together. The end result is moving, strengthening and- beyond anything profoundly encouraging for anyone suffering and for loved ones trying to best be of support.After reading GAINING and being deeply impressed with Aimee’s honest and thoughtful examination of her own journey of recovery and her findings from in-depth research, we knew we had to share her book and break-through strategies with all of the women we care about, especially YOU.

What came of our Q&A with Aimee was extraordinary, not only because she graciously answered questions from our ChickSpeak members, but because she also brought in the ideas and incites of Judith Banker, President Elect of the Academy of Eating Disorders. ChickSpeak will run the full interview as a special four part series over the next month. A big thanks to both Aimee Liu and Judith Banker for your time, support and enthusiasm in this!

These were challenging questions!  Some of them pressed for insight that goes beyond my expertise.  Rather than attempting to answer them “perfectly” on my own, I decided to admit my limitations and call for professional advice. (In other words, I used this occasion to practice what I preach in Gaining: when you need help, don’t be ashamed to seek it!)  I turned to Judith Banker, president-elect of the Academy for Eating Disorders, who generously gave these questions her full attention. (For information about the AED, go to http://www.aedweb.org/.) Because Judith’s responses are so full of important information, I don’t want to paraphrase her, but am including her answers uncut (marked by JB) alongside my own (marked AL).  Bear in mind that Judith is the professional - she founded and directs the Center for Eating Disorders in Ann Arbor, Michigan (http://www.center4ed.org/ ).  My own answers will reflect only what I have learned as a survivor and student of eating disorders, and from the feedback I’ve received from readers of Gaining. –Aimee

1. I have a history of eating disorders, and even when I’m healthy, am still- to a degree- afraid and anxious about food. I think I can handle my health, but am concerned that I might pass eating issues along to my children one day. What things can I do or keep in mind regarding a future family? Also, you write that eating disorders have a genetic componant. Does that mean that my future children are destined for an uphill battle?

AL: Recognizing this possibility and caring enough to stop the cycle before it affects your children is the first key to prevention, so good for you for asking this question!  For yourself and for your children’s sake, I urge you to shift your focus consciously from fear to love.  Ask not what you’re afraid to eat but what you love to eat - and what you love to do and try and explore in life generally.  Focus on sharing these passions with your children, and take the stress off your fear of passing on your fears.  Be mindful of all the pleasures that accompany mealtimes, food, shopping, and cooking, and consciously make MORE of those pleasures.  Have fun with food yourself, and over time, your pleasure will overtake your anxieties around food, and you will naturally teach your children that healthy eating is a joy and a privilege as well as a vital necessity. 

As for your children’s innate vulnerability, remember that genes are not destiny and that every child is different.  If you notice that your child from an early age is finicky, needs rules and order, worries about making mistakes or not being “good enough,” then you’ll know this child has a heightened risk for eating disorders and needs your help to learn how to relax, have fun, make solid friends, and feel safe even when taking risks.  But you also need to let your child make mistakes as she grows up and establishes her own identity apart from you.  One of the best ways you can protect her is by encouraging her to think for herself, make her own well considered choices, and learn from her inevitable failures.  Show compassionate support without passing judgment, and she’ll learn to treat her body and herself with similar compassion.

JB: Recent genetic research indicates that anorexia nervosa is moderately heritable and that the tendency to be anxious and depressed, an inherited personality trait, is a significant factor associated with the development of anorexia. What does this mean for you and your future children? Learning ways to manage worries, anxiety, and depressed mood will help to protect you against relapse and will also help you teach your future children how to  effectively work with their emotions.

Remember that recovery is an ongoing process. Our culture continues to bombard us with messages that generate fear and anxiety about food and weight. We each must practice pro-active measures to protect ourselves from internalizing these messages. The ways to do this are myriad. Yoga and meditation, relaxation techniques, incorporating play and outside activities in to our daily lives, and building strong community and social supports are valuable ways to counteract general anxiety and depression.

Continue to gently challenge your ongoing food fears and anxieties. Don’t let yourself become complacent. Try new foods regularly. Experiment. You will see that many of your fears are simply superstitions that are leftover from your eating disorder.

Learning to work with your own anxious or depressive personality traits and your own food fears will help you parent your future children in ways that will protect them from developing eating disorders.

2. It was a struggle not to pull back into the safety of my obsession with food and weight, where no one could see how I felt. It was frightening and humiliating to give up my established identity as a fragile waif when I had no idea what identity would take its place. But I sensed I needed to experiment. “I think these girls are quite delayed,” Harvard psychiatrist David Herzog agreed when I asked him about the emotional immaturity that so often is part of anorexia. “They’ve never been given the opportunity to experiment.”

How does one create a sense of urgency about creating a new identity and a need to experiment?  How do you face the fear and begin to let go of the life that is really keeping you from living?  And is there a way to hasten the onset of emotional maturity?

AL:  Patience and compassion are key.  Hope, rather than urgency, is what drives recovery, and hope is all around us if we just pay attention, but it may come at first in mere glimmers - a friend’s caring smile, the love of a pet, the thrill of music sung by a chorus, or the beauty of sunshine on water.  Emotional maturity is the result of countless daily encounters and appreciations such as these.  The best way to hasten this process is to pay attention and cultivate mindfulness so that you notice what gives you hope, what engages you, what makes you feel as if you care and, through caring, that you matter. 

I believe that a sense of purpose is essential to the formation of a healthy identity.  By this I mean the sense of purpose that is gained by creating, giving, or working for the benefit of other living things.  Eating disorders isolate and starve us of this sense of purpose, so it’s unrealistic to think that someone struggling with anorexia will, overnight, recover and save the world.  But we don’t have to save the whole world to feel that we have purpose!  Nor do we have to “recover” overnight.  Showing kindness and compassion to one person, or dog, or plant is the first step in creating a larger, more mature identity. With each new demonstration of compassion to others, our ability to treat ourselves with kindness also grows and so does our sense of healthy purpose in the world. 

JB: What an excellent question! It opens up a very complex aspect of recovery.

When you are recovering from an eating disorder the maturation process will occur at its own natural pace. Learning to trust that pace, not hurrying or pressuring yourself to grow up quickly, is part of becoming who you really are. However it is critical to have the guidance of a trusted therapist to help facilitate the process as it is easy to get stuck or discouraged. People often are afraid they will never catch up to their peers, however, many aspects of your self continue to grow despite the stunting influence of the eating disorder. Recovery is not about catching up to your peers—it is about opening up to and integrating the undeveloped aspects of your self with the parts of your self that are higher functioning and mature.

The eating disorder thought system can confuse you along the way by triggering self-criticism, shame, guilt, or other negative emotions, when you touch on your genuine identity. The support and guidance of your therapist can help you avoid getting derailed by these reactions and experiences. 

Each time you sit with your feelings, each time you allow yourself to recognize and identify your own thoughts, reactions, needs, expectations, and desires you are growing and strengthening your true identity. With enough support, this opening up to your self can become self-perpetuating—that is, each time you connect to your authentic self it sets you up to do it again. Learning to recognize when you are experiencing your real self, learning to trust your real self, and learning to let go of the ways you have learned to disconnect from your real self is a complicated, dynamic journey. If you have the safeguards of emotional support and expert guidance the pace of your growth will take care of itself.