In an earlier post I mentioned two books that reflect my journey to recovery from anorexia/bulimia. There are others that incorporates this story, as well. I think these five books would be useful reading for an adult beginning their recovery from an eating disorder. The four books are: Crave by Cynthia M. Bulik, Ph.D.; Sensing the Self by Sheila M. Reindl; <Gaining> by Aimee Liu, Restoring Our Bodies, Reclaiming Our Lives edited by Aimee Liu, and most recently Brain Over Binge by Kathryn Hansen. It was while I was reading Aimee Liu’s book a couple of years ago that I began to put it all together. Having now read her second book, I feel strongly it should be added to this list.
Crave is a thorough, heavily researched, and written for the layperson toolbook that provides readers (whether fighting binge eating disorder or knowing someone who is) with relevant information including real-life accounts; up-to-date science on genetics, personality and behavior; and techniques based on the psychology of personality and behavior to get people on the road to recovery from Binge Eating Disorder (BED). Binge Eating Disorder (BED), a disorder involving excessive or compulsive consumption, is characterized, according to Bulik, by two points: “…other people would view it [the amount eaten] as an unusually large amount of food and ….[the person] is totally out of control while eating it.” Since bulimia is characterized by binging and then purging, I ordered the book.
Moving from this point while providing information on all eating disorders including a fascinating chapter titled “Be Comfortable in your Own Genes” in which she includes family and twin studies as well as current genetic information, Dr. Bulik draws on studies and case histories to substantiate the notion that behavior is a combination of genetics, personality and environment. More importantly, she illustrates the importance of these factors in the development of binge eating disorder by discussing each one. Much of what she presents, including nutrition, the dynamics of families (a touchy subject that she handles very well), and the personality as well as mental state of the individual can be found in other current comprehensive writings about eating disorders.
However, what I found to be most helpful and fresh was her intense focus on the concept of “know yourself.” I think this focus has been lacking in other similar books and I would recommend this book specifically for anyone with any kind of an eating disorder for this reason.
A substantial and easy to understand part of this book is devoted to providing models – “profiles” -- to help the reader identify his or her behavior patterns and personality characteristics to effect what Bulik calls a ”….permanent solution…, [meaning] real long-term behavior changes that you embrace and that become your toolbox for success for the rest of your life.” Bulik provides details to describe ten types including, for example, the Moody Blues Binger, the Angry Binger, and the Low Self-Esteem Binger. She spends considerable time on the concept of triggers, which she defines as … any cue, either in the environment or inside your head or your body, that leads you to unhealthy behavior…” in relation to these profiles. She highlights the concept of “emotional velcro” in her discussion of what might make one person more susceptible to an eating disorder than another. She then provides strategies to effect what she calls a “protective response” by again emphasizing that the reader needs to look carefully and long (journaling or charting is suggested as a tool) at his/her own behavior, triggers, and red flag feelings. Bulik’s goal, using a lot of nutritional information also provided in the book, is to help the reader understand oneself, break her/his pattern of behavior, develop healthy eating habits and forge a new path.
Sheila M. Reindl’s book, Sensing the Self, is written specifically for women in recovery from bulimia and is based on research as well as interviews with thirteen women, not a big data set admittedly. However by drawing on many, many studies and by speaking with these women at length, Reindl was able to ferret out similarities that rang true for me and which I think would be useful for others to think about.
As a caveat, I did not fully support all her interpretations of family interactions and felt there was a great deal of blaming towards family members. I do know that some families really do have dynamics that are harmful for the healthy growth of a child. Reindl referred to such behavior as emotional neglect and abuse, terms that are relevant in some cases, but certainly not in all. One cannot know until one is in the thick of it or sometimes until years later. I did appreciate one important sentence, “ .... Invalidation of one person by another can occur without either party being aware of it at the time.”
What is important, I think, is learning how to communicate effectively using active listening so that a child/young adult’s needs, fears, interests and yearnings are acknowledged and valued.
Some parents, through modeling by their own parents, never learn how to parent or even listen effectively. Being present, attending activities, taking meals together, etc. may lead them to believe that they are doing the right thing. It’s the how rather than the what that makes the difference. I have learned to accept that unless someone is truly malevolent or seriously ill, one tries the best they can to do the right thing.
The words in the book’s title – Sensing and Self – are basic to her belief that one must be totally in touch with all one’s senses in order to recover. One must be able to learn or relearn to experience and interpret life in a productive way. Since so many with eating disorders flee from their own emotions and sense of experience – shut down, working on how to recover can be very hard and take a long time. Reindl cites Marsha Linehan’s important body of work including Dialectical Behavioral Therapy, often referred to as DBT, a method that “….integrates aspects of cognitive-behavioral therapy, dialectical thinking, and Zen mindfulness practice, comprises many of the ingredients that the women [in Reindl’s book] found helpful as they learned to sense and tolerate self-experience.” (p. 13) Reconnecting can be painful.
Ultimately, Reindl proceeds to study the importance of six essential elements to recovery, which are:
- A specific and intentional act directed toward getting help
- Others' timely, attuned response to the act directed toward getting help
- An abiding context conducive to sensing self-experience
- A belief that one will recover
- Investment in the process of recovering.
My recovery incorporated these elements and my progress relied on my investment in the process. I need to re-emphasize here that I was seriously entrenched in my bulimia and I was in my early thirties when I had had enough. My point is that through seriously hard work one can recover.
Amee Liu in <Gaining> brought my thirty-eight years of recovery into focus and outlined for me how I've “made it.” I recognized so much! In fact, the first section of her book is titled, “Know Thyself: Tempermental Truths.” Liu writes in her note “….my psychological recovery took decades.” (p. ix). As the book jacket indicates, “Through cutting-edge research and the stories of more than forty interview subjects, readers will discover that the tendency to develop anorexia or bulimia has little to do with culture, class, gender or weight. Genetics, however, play a key role. So does temperament. So do anxiety, depression, and shame. Clearly, curing eating disorders involves more than good nutrition.”
I do believe culture has a part in this. I say a resounding "Yes" to the rest.
Like Carrie Arnold and others, Aimee Liu incorporates extensive research on the work of research scientists, psychiatrists, psychologists and other therapists in her discussion of the life experiences of the people she interviewed. Her Acknowledgments are as important as the content of the book itself, her Introduction as illuminating as the stories of others. We are fortunate that these women contributed in writing to our knowledge of eating disorders and continue to travel and speak about the process of recovery, as well.
I've just edited this post to include Aimee Liu's second book - Restoring Our Bodies, Reclaiming Our Lives, which I've written about in another post and include here.
Finally, and new to the scene, is Kathryn Hansen's Brain Over Binge. Like the other writers mentioned, Kathryn Hansen also incorporates the findings of researchers as well as discusses her own journey. She believes that therapy was not part of the equation that led to her recovery. Instead, she focuses on the concept of how a habit is formed. I've written a thorough review of her book here. In addition to the importance of nutrition, those with an eating disorder need to dismantle months if not years of habitual harmful behavior. To do this, they must form healthy habits to replace the harmful ones. Hansen discusses how she did this.
Again, I highly recommend these five books.
