Dialectical Behavior Therapy

Ending emotional eating, part 3

Okay, so a few weeks ago, we talked about what emotional eating is and how to begin identifying the differences between emotional vs. physical hunger.

Today, we are going to start thinking about fueling our bodies and really setting the stage for the different things that might make us more vulnerable to emotional eating. Later on, as we continue this series, we’ll also talk more about ways of coping with emotions in a healthy way that starts to diffuse the need for finding comfort through food.

Now that you can identify a bit easier what physical hunger feels like in your body, from Part 2 of this blog series, you likely have a better sense of when you feel hungry throughout the day and maybe even what foods you start to turn to when you’re feeling hungry. One vulnerability to emotional eating can be when we let ourselves get SO hungry that we are making impulsive and rash choices around food. This can also cause us to overeat and become uncomfortable, which only continues that cycle of again allowing ourselves to become too hungry. Have you ever heard that phrase, “I’m so hungry, I could eat a horse!” Not a good place to be when we are trying to make mindful, intentional decisions around food.

One way of decreasing that vulnerability is by staying within that range I proposed, between a 3-7 on the hunger-fullness scale. How do you stay within that scale? Well, for starters, that might look like eating every few hours, so that your blood sugar levels are never dropping off or spiking in drastic ways throughout the day. It can also look like balance, which may mean eating appropriate, recommended portions of your foods (remember, ALL foods fit into this philosophy!) rather than too little or too much. It will look like eating breakfast, lunch, and dinner, as well as a few snacks throughout the day, and getting a balance of different foods from the various food group families. It means not depriving yourself, or “saving up calories” or even counting calories or macros at all. Intuitive eating comes from listening to your body, not calculations or numbers or even the time on the clock.

That may be a difficult thing for many people to accept, knowing how the diet culture influences so many things in our society today. Calories are posted on pretty much every menu you see, and we’re so aware of what is “bad” or “unhealthy” in foods around us. This next step really involves a conscious effort and choice at removing these judgments and removing the influence of some of these other food qualifiers.

When you go to Starbucks or to a restaurant for lunch or dinner, can you honestly say that you order what you WANT on the menu, and that the calorie postings next to the food options you choose don’t influence what you pick? It can take a while to get to that place, and it takes a lot of hard work to retrain your mind to see ALL foods as important and necessary.

When it comes to intuitive eating, we are teaching our bodies and our minds that food isn’t what holds power. Food by itself is not special - WE make it that way. Food is food. We ourselves place important and emphasis on it, and THAT is what creates these ideas of food being good or bad. I sometimes say to my clients that I wouldn’t recommend someone only lives on cake, the same way I wouldn’t recommend that someone only lives on carrots. Everything in our lives must include moderation, flexibility, and a healthy dose of forgiveness. Anytime shame starts to enter the picture, especially when it comes to food, we find ourselves in a dangerous place where polarization can start to take place. It’s in that place of judgment and shame where emotional decisions and black-and-white thinking around food (and our bodies!) can really evolve. Over time, learning to identify those tendencies with a good eating disorder therapist and dietitian, AND learning how to re-train your brain to have a positive and healthy relationship with your body and with food, you can start to see that shift from judgment and shame to acceptance and compassion.

How have you been doing this holiday season? I’d love to hear what your challenges and successes have been. Please leave us a note below in the comments, and don’t hesitate to reach out to make an appointment, if you’d like to discuss any of these topics further.

What is therapy and do I need it?

I still think therapy gets a bad rap sometimes. I DO think we are moving, collectively as a culture and society, toward more acceptance of mental health issues (most of the time). I can sometimes see how the stigma that has surrounded even the terms “mental health” or “therapy” is starting to lift, and how we are beginning to speak more in mainstream culture about accepting help from licensed professionals.

However, I still think we have a long way to go.

I often tell first-time patients - the ones who have never sat in a therapist’s office and who are completely green to these process - that there is “no man behind the curtain” a la The Wizard of Oz. There are no “tricks” up my sleeves, and I am not here to dupe you. But, for some reason, we sometimes have some suspicions about what therapy is all about, and I’m here to hopefully clear some of those up.

First, we’ll start with a list of what therapy isn’t:

  • It isn’t magic. There IS research-proven evidence that just coming to a therapist’s office and sitting in the room for that hour is generally anxiety-relieving and helpful. Most people leave their therapy sessions feeling a bit better, so there is truth there. However, there’s no magic wand (as much as I wish there was). You won’t be “cured” by coming to one, two, or even six sessions. Your symptoms and issues will not magically disappear.

  • It isn’t a time that therapists sit and judge you for whatever brings you in. We are human beings, too. We recognize that judgments are natural and a part of what we are taught to do from the time we are young. However, we receive years of training on how to cultivate a variety of ways of approaching individuals and conceptualize what brings you in holistically. In short, we won’t ever laugh at you, judge you, think less of you, or ridicule you for what you share. (And if that EVER happens in a therapy room, please get a new therapist - ASAP!)

  • Therapy isn’t a band-aid approach. Yes, sometimes we talk about reducing symptoms and improving the present. This is mostly when we are talking about life-threatening and life-interfering behaviors that are putting you and your life at risk. In those instances, we absolutely need to problem-solve and figure out how to relieve the distress that you are experiencing. But, overall, therapy is about long-term change. We work on changing things like behaviors, thoughts, perceptions, and ideologies that might not be serving you anymore. We are tackling some BIG things in therapy. It’s not easy because of this.

  • It isn’t the same thing as talking to your friend. We want you to think of us like you might think of a close friend - someone who is a confidante, trustworthy and personable. However, we are trained and licensed professionals. We have gone through years of supervision and learning to precisely approach you in a way that your friend will likely not be equipped to do. Friends are really important - don’t get me wrong. You NEED friends and social supports. We will help you get there if you’re currently longing for those connections. Just please know that this investment in your health is more than just talking about the issues you’re facing. We don’t just dole out advice and listen (though sometimes this can be helpful and is warranted); we will also work through your stuck points with you and challenge you to move in directions that might be uncomfortable or difficult.

Now, you might be thinking to yourself…”Well, what IS therapy then?” I’m glad you asked:

  • Therapy is learning how to change. It’s learning how to be flexible, how to be self-aware, and how to be accepting.

  • It’s really, REALLY hard work sometimes, and you won’t always leave our offices feeling better. Sometimes, you might actually feel worse. We don’t want you to feel bad, but we also want you to FEEL. That means feeling all of your emotions without checking out.

  • With that, therapy is about learning to feel in a healthy way. We are often taught that our emotions are not okay, that they are too big, or inappropriate. We are here to squash that and help you learn how to feel your emotions without feeling like they are running your life.

  • Therapy is talking. It might also include more creative outlets. I know, personally (and my clients can attest to this), that I use metaphors a lot to illustrate concepts that might be relevant to what you are tackling. So, it is a lot of words, but can also include things like writing, drawing, role-play, examples, and movement. In addition, therapy is about using what you are learning IN your sessions and taking them OUTSIDE of the therapy room. So, you might also be doing “homework” and practicing what you are learning in your real life. This is where you can start to see the changes taking place.

  • Please also know that we want you to put us out of business. The goal is to not need therapy forever. We celebrate each achievement and success you have through this process, and while we enjoy working with you and learning about you, we also have lots of hope for you that you can do this - eventually - on your own, too.

There are probably a ton of things I’m leaving out. Therapy has a real special quality to it that also cannot be summed up in words. If you’re a spiritual or religious person, you might describe it as a soul connection that occurs between two people. I think the best way of truly understanding it and comprehending it is by experiencing it.

I may be biased, but I think everyone would benefit from a little therapy. If you’re interested in learning more or setting up an appointment, don’t hesitate!

Mindfulness, a primer

There is a lot of buzz today about mindfulness. You may hear about it in the media, and if you’re connected with a therapist or PCP, you may even have heard about it from them. A quick google search for the keyword “mindfulness” returned 213,000,000 results, far more than the 108,000,000 for CBT (cognitive behavioral therapy) and many more than the 23,900,000 for the term DBT (dialectical behavior therapy), from which the therapeutic use of mindfulness has grown. Mindfulness, in essence, is the state of being in the present. Not the future. Not the past. The here and now. When you are mindful, you are focusing you attention to the present. A fun way to approach mindfulness is adopting a curious perspective, examining the present as though it is something entirely new and unique. More on this later.

We are finding that you can receive a lot of benefit from practicing mindfulness. Research has linked mindfulness to an increased ability to manage stress, better work-life balance, and benefits to mental and physical health. Recent research has also shown a connection between mindfulness practices in the workplace and improvements in attention and focus, with some benefits proposed for more short and longer-term use or practice. Further, a large analysis of current research literature indicates that mindfulness-based therapy (MBT) can be effective when used to treat anxiety and depression, and really do support the use of MBT in therapy. It is important to note, that in comparison to other treatment methods, MBT still has a way to go. More research is needed to further validate it; this is happening, and the potential outcomes are promising.

I use mindfulness as a part of my practice, and many have reported finding it helpful to deal with their symptoms coming from anxiety and depression. However, it is not an easy practice, and many have also reported that it can be difficult to engage in. It is also not a panacea, and just like most things, won’t “cure” your problems immediately. When used in the course of therapy, mindfulness practices can become a powerful tool in your toolbox. Working together with a therapist, you might find ways that MBT can be helpful. Dr. Ashley will be creating some videos on mindfulness, which you might also find helpful in deciding whether you would benefit from scheduling an appointment with us.