F.E.A.S.T. Conference 2014: Remember to Take Care of Yourself, Too!!

March 28 2019

A few years ago, I flew to Dallas to attend the 2014 F.E.A.S.T. Conference, Connecting the Dots: Expanding the Knowledge Base and Extending the Circle of Care to Fight Eating Disorders.

Three of the speakers - two presented together - focused on a critical aspect of the Circle of Care; namely, the caregiver(s).  This topic is often overlooked because so many of us are focused on the Knowledge Base rather than on the Circle of Care.  However, without a strong Circle of Care -- whether it's composed of mom, dad, partner, aunt, uncle, brother, sister, grandparents or friends to name a few -- the well goes dry.

Those of us who make up that circle must take care of ourselves.  So, how can we do that?

I attended the session titled "From Hopeless and Fearful to Empowered Caregiver!" by Becky Henry, CPCC, who is the Founder of the Hope Network, LLC and a member of the F.E.A.S.T. Board of Directors.  The second session, presented by  Karl and Ellen Kregor,  the grandparents of a young woman who attended the conference, was titled "Extending the Circle of Care: how can extended family support a loved-one with an eating disorder".  [I wish I could have attended both and I look forward to watching the video of the Kregor's session.]

I've written previously about the enormous responsibility taken on by parents and other family members and friends who step up in one way or another to ally with a person who is fighting an eating disorder.  I've written about my own recovery, both in terms of learning how to advocate for my loved one in a healthy way - i.e. taking care of myself; as well as my own recovery from bulimia more than 35 years ago.  If you've been reading my and others' blogs, you probably have seen terms and phrases like in the trenches; post-traumatic stress disorder;  it's a marathon, not a sprint; help! 

Emily Long, LPC, developed a list, a link to which is no longer available, about Extreme Self Care (which is also the title of a useful book of the same title by Cheryl Richardson - The Art of Extreme Self Care).   I've reprinted Emily Long's list of 100 items below.  Many of these suggestions are on my own list and I've added a couple more.  One of the first things Becky Howard asked us to do at the start of her presentation was to make a list of what we do for self-care.  Did you know that smiling releases endorphins?  that laughter does the same thing?  Even if you don't feel like smiling, smile.  I always feel a shift; I'm pretty sure you will, too.

As family members, our goal is to identify things we can do -- if only for a moment or a few minutes, or an hour, or an afternoon -- to take a break.  To re-nourish our spirits and our bodies.  To reconnect with our own support system.  Frankly, I truly believe it's impossible to carry on without these kinds of activities.  Some of the suggestions are beyond the means of some readers; others just aren't possible given time contraints.  But, all offer a way to disconnect, recharge and take a long drink from that Well, the gathering place for women over the ages.

Post the list where you can see it!   On the refrigerator, on your mirror, by the front door.

Thanks to a meeting I attend just about every Saturday, I've learned the acronym H.A.L.T.  It's a reminder that if I am hungry, angry, lonely or tired, I need to halt what I'm doing and take a break.  Here are some ideas:

1. Naps
2. Massage
3. Have an Adventure Day
4. Read (easy, fun reads though, not self-help or professional books!)
5. Snuggle with the cat (or dog or baby or kids)
6. Hugs
7. Long walks and/or hikes
8. Bubble baths
9. Movies (again, easy watches – not horrific documentaries or violent battles or super sad ones that remind you of your own losses)
10. Order dinner in (or have someone else make it)
11. Say no
12. Buy yourself flowers
13. Sip a mug of hot, soothing tea
14. Play in the snow
15. Dig your toes into the sand (dig your toes in the grass.  Remember the movie Pretty Woman?)
16. Feel the sun (or rain) on your face
17. Hold hands
18. Meditate
19. Get a facial
20. Listen to your favorite music
21. Make a delights list
22. Do something on your delights list
23. Repeat above (over and over)
24. Acupuncture
25. Snuggle with your partner
26. Have sex
27. Journal
28. Turn off the computer, cell phone and TV for 24 hours
29. Go on a retreat
30. Sit and people watch
31. Garden or even weed!
32. Do something creative (draw, knit, crossstitch, paint, cook, write, color, make a collage, etc.)
33. Daydream
34. Dance with a child
35. Have a Harry Potter movie marathon (it’s a personal favorite!)
36. Take a mental health day from work
37. Keep your daily to-do list to 3 items or less
38. Swing on the swings
39. Have energy work done
40. Have a laugh fest with your best friend
41. Eat simply
42. Break up with your TV
43. Allow yourself to cry and experience your emotions
44. Join a support group
45. Get a pedicure (or manicure)
46. Tell yourself “I love you”
47. Browse your favorite bookstore (or music store)
48. Have a game night with friends
49. Write thank you notes to those who have touched your life and inspired you
50. Spend the day exploring your town – go places you don’t normally go
51. Practice random acts of kindness & senseless acts of beauty
52. Write a love letter to someone you love ( doesn’t have to be a partner)
53. Write a love letter to yourself
54. Have a “Freedom from Self-Improvement Day”
55. Listen to Holosync
56. Color (try going outside the lines – its fun!)
57. Keep a gratitude journal
58. Talk a walk with your camera – take pictures of all you see that delights you
59. Find and notice something beautiful every day
60. Do something badly.  Keep doing it.
61. Admire beautiful artwork
62. Do absolutely nothing
63. Do one brave thing everyday
64. Play
65. Treat yourself to something
66. Wear something that makes you feel beautiful or handsome and confident
67. Have an “All Day PJs Day”
68. Say I love you everyday
69. Jump in piles of leaves
70. Quit the job you hate that drains you
71. Say YES to what you truly love
72. Give yourself permission
73. Let go of belongings you no longer love or use (even family heirlooms)  Also applies to relationships
74. Hire someone to clean your house
75. Hire someone to mow your lawn
76. Let go of your story - aren't you tired of it?
77. Laugh
78. Be generous
79. Lay in the grass and watch the clouds
80. Take a long walk with your dog
81. Ride horse
82. Give up New Year’s Resolutions.  Pick a word instead
83. Stop drinking caffeine
84. Dance around your house
85. Forgive others
86. Forgive yourself
87. Make a list of the things you want to do in your lifetime
88. Do one of those things
89. And then do another
90. Eat healthy, whole foods
91. Eat something unhealthy AND enjoy it without self-criticism or guilt
92. Watch cartoons
93. Read the comics
94. Smile for no reason
95. Call the friends you’ve been meaning to call
96. Go complaint free
97. Schedule a day of no schedule
98. Go boat riding
99. Buy yourself a cheery balloon
100. What do you do for extreme self-care?
101. Seek therapy/psychiatric care
102. go outside in a rainstorm and splash through puddles
103. Walk through your local nursery.  I did and took a photo of the petunias at the top of this page (and then bought the basket and brought it home).
104. Eat a piece of dark chocolate
105. Give Up [this is not what you think so read my definition just below]

#105 - Give Up - is an important one for me.  Somewhere along the line through these many years I realized that to Give Up does not mean to quit; rather, it means to give it up to God so that S/He can relieve me of my worries and cares for awhile.  Another similar expression is "Turn it Over."  In the middle of the night when I wake up, I now envision God wrapping my loved one in a white soft blanket and holding her so I can get some sleep.  This image has helped me countless times to get the necessary sleep to carry on.

#101 - my own experience re seeking therapy/psychiatric help

To close, my mother who was part of my family member's (and my) Circle of Care loved to needlepoint.  She created this for me so I would remember that I do not have to "do it" alone:

281 miles in one day to make a difference

On Wednesday, April 17, 2013, at the same time that others were speaking out about eating disorders across the United States and while the Eating Disorders Coalition was coordinating visits on Capitol Hill, I got up early and drove 281 miles round trip from my home in Tucson to the State Capital in Phoenix and back to share my story as a parent; as a family member.  I was grateful for the opportunity because as another parent put it to me after the briefing, only parents who've been through this "get it."  It's impossible to truly convey the story of this journey in just a few minutes.

The legislative briefing was sponsored by Senator Katie Hobbs of District 24 in Phoenix and coordinated by a group of dedicated people who are part of the Arizona chapter of the  NEDA STAR program.  A huge thank you to Senator Hobbs and to the organizing committee.

Four of us spoke (two of us are therapists, at least two are in recovery, and I'm the parent):  Sam Lample, Dena Cabrera, Jennifer Keyes, and Jennifer Aviles.

NEDA sent out an announcement about the briefing.  Senator Hobbs sent around an interoffice memo to all the Arizona legislators.  This event was an important first step.  A seed was planted.  This event, simply by being advertised although unfortunately not well-attended by the very legislators we hoped to attract (even offering lunch during a brief half hour session), brought eating disorders to the desks of their staff if not to the desks of our representatives themselves.  One of my representatives, Senator Steve Farley, stopped by her office, Senator Hobbs told me, to learn more about today's briefing.

I personally hope that perhaps next year there will be more interest that eventually, as has happened in, for example, Virginia, legislation will be passed for at least school screenings.  I learned that the Phoenix NEDA walk may have attracted as many as 200 people.  The one in Tucson attracted at least 30 to 40 [estimate].  Each step literally brings awareness to a situation that needs attention; to a cluster of brain disorders -- eating disorders -- that are not rare; in fact, the numbers are hidden in many cases because so many people -- girls and boys, men and women -- keep it a secret.

In addition, Senator Hobbs  picked up the (to me) priceless AED Eating Disorders Publication:  Critical Points for Early Recognition and Medical Risk Management in the Care of Individuals with Eating Disorders.  I had brought several copies of this publication to the briefing.  Several were taken.

F.E.A.S.T. and the AED have produced several publications, actually.  You can download and print  information by clicking here.

My intention is to write a letter to all the legislators from Southern Arizona and include a copy of both these publications.  [I find it helps me to write intentions publicly!  I didn't make much progress on this intent because I became ill and my family member's illness took a downturn.]

We all spoke to several points including the need for  managed care from the moment of diagnosis, the need for early diagnosis, the need for screening in schools and colleges/universities, the need for those who manage insurance companies' coverage to understand that treatment as long as necessary is the key to recovery, and to the myths of eating disorders.  The text of my presentation addresses additional issues.

I gave the text of my prepared talk to Senator Hobbs.  My talk was admittedly longer than the five minutes given to me (I timed it at 12 minutes, actually) but then how does one cram 25 years of trying to find help for my loved one and what I've learned so I can educate not only those who can make a difference (legislators) but also parents and family members (who so very much need support, too).  We ran out of time; I was unable to finish but I think I got some significant points across to those present.  I will work on a shortened version and provide a link here, later. 

The big point I want to repeat here is that without the comprehensive managed care of my loved one's Mental Health Team here in Tucson, I do not think she would be alive today to continue to take advantage of treatment that may possibly help her to extricate herself from her eating disorder.  A hospital here in Tucson stepped up with changes in protocol to help my family member address her eating disorder.  If this team and this hospital could do this, so can others.

But, here in Arizona, we need resources -- financial and human.  We need legislation to make a difference!  We need health insurance that provides comprehensive treatment for eating disorders -- brain dysfunction -- on parity with other diseases like cancer, like multiple sclerosis, like autism....

This morning, I learned of a talk by Emma Woolf  that was on the BBC.  She is in recovery from anorexia.  Her talk on her journey plus the latest research on the brain -- again, eating disorders are biologically-based brain disorders -- is so comprehensive, I'm providing a link here.  [I hope those who come across my blog will spend the 15 minutes she takes to talk about her experience and the knowledge she has gained.]

We all have so much work to do.  Following the session, a young woman whose sister recently passed away from anorexia spoke to me at length about her and her family's journey to try to help her sister.  I include this to remind readers that families are part of all of this, too.  We need support and a listening ear, too.  For how else can we keep going?

A huge thank you to all the people who are working on obtaining effective treatment for eating disorders.  A huge thank you to those who are devoting their lives to research on this biologically-based brain disorder.

Together, we can all make a difference.

Post Traumatic Stress Disorder

[Warning:  this may be triggering to those on the path to recovery from an eating disorder.]

The National Institutes of Health website includes a document on Post Traumatic Stress Disorder.

As the article notes, PTSD is a type of anxiety disorder.  It can occur at any age.  It can follow a natural disaster.  It can follow traumatic events.  The causes listed include:

• Assault
• Domestic abuse
• Prison stay
• Rape
• Terrorism
• War

I believe that PTSD can occur to those who are witness to the destructive effects on a family member of serious diseases like cancer and an eating disorder.  One study documented that some family members are still feeling the effects of the trauma of cancer in a young family member 10 years after the event.

Wait, you say.  But eating disorders?

Yes.  Eating disorders are biologically based brain disorders that affect the behavior of people who develop them and affect family members who more often than not become distraught by the changes in personality and physical health that occur in their loved ones.

Yes.  It is believed that eating disorders are the deadliest of all brain disorders .  "Anorexia nervosa (AN), in particular, has the highest mortality rate of any psychiatric disorder.  Risk of premature death is 6-12 times higher in women with AN as compared to the general population, adjusting for age."   Work is continuing to reduce that number and, in fact, the number may have been reduced somewhat by the knowledge that has been gained in the past couple of years including the increasing visibility of family based training (FBT) and what is referred to as the Maudsley Method, first developed at Maudsley Hospital in England.

But, still.

So, to those who leap to the conclusion that a family member exhibiting behaviors that seem like PTSD
Quote from the linked article:
PTSD can cause many symptoms. These symptoms can be grouped into three categories:
1. Re-experiencing symptoms:

• Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
• Bad dreams
• Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.
2. Avoidance symptoms:

• Staying away from places, events, or objects that are reminders of the experience
• Feeling emotionally numb
• Feeling strong guilt, depression, or worry
• Losing interest in activities that were enjoyable in the past
• Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
3. Hyperarousal symptoms:

• Being easily startled
• Feeling tense or “on edge”
• Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

---

 or who appears to have  become or is enmeshed with the loved one with an ED, stop for a moment and think about the trauma that a parent especially often goes through when their child or adolescent or even adult child or spouse [only some behaviors are listed here of the many that occur]

• stops eating
• loses weight dramatically
• exercises compulsively, sometimes late at night or in their room behind a closed door
• becomes violent and abusive day after day after day when presented with food and asked to eat
• gets up after everyone has gone to bed and eats everything edible in the refrigerator or pantry and then either vomits the food into the toilet, into plastic bags they store in their bedroom, or into the garbage bin, or in the shower (while the water is running and running and running)
• turns to cutting, drugs and/or alcohol in an attempt to subdue their anxiety when presented with food that to them increases their anxiety when they eat or that helps them get through the cycle of binging and purging
• tries to separate family members such as the mom and dad so they can continue their ED behaviors because one of the parents may not believe the situation is as serious as a medical emergency, which eating disorders are
• drinks water to the point of hyponatremia or purges food and therefore electrolytes resulting in a visit to the ER only to receive an IV that corrects electrolytes and then sent out the door within 24 hours because they are determined to be "stable" even if they are visibly emaciated
• uses laxatives even though either there's nothing in the intestinal tract to process or because they believe the laxative will interfere with digestion and absorption (doesn't work, actually) and again terribly interfere with their electrolyte balance
• is ejected from a residential facility because their behavior is disruptive to other patients and the facility does not have the staff or the treatment area to help them through the rage phase 
• emerges from a long residential treatment only to return to those behaviors
• or even dies no matter what treatment has been available and/or provided

How helpless and angry a parent can feel  when they are blamed for an eating disorder even though in multiple children households no one else exhibits or exhibited eating disorders at the same age or even if they do; when their family is labeled dysfunctional because when they finally seek help they are all torn apart by watching what has been happening; when they cannot scrape together the funds to pay for treatment that may or may not -- after many attempts -- work; when their insurance policy listed as comprehensive only provides 10 days or a month of treatment when research is showing a person needs a full year at least of complete and steady nourishment in order to even get on the path to recovery; when there is no one for them to talk to/with because a support group is not available or they themselves cannot afford supportive therapy to cope with the horror of what is occurring in front of them.

I have touched upon some of this in my essay here on this site.  I am grateful for the support I have found among friends, at an Al-Anon weekly meeting I attend without fail unless I am out of town, by working with a therapist who "gets it" and who has worked with me so I have the tools to keep going, from the people on supportive websites such as Something Fishy and Around the Dinner Table/F.E.A.S.T., and by working with a team of professionals to address the effects of this horrid, horrid disease on my family member.

PTSD is very real among us parents.  It can disable us when the illness goes on for months or even years (and to some parents even a few weeks can feel like a very long time).  If you are reading this and are a professional who is working with a child or adolescent or adult and often seeing his or her parent or significant other in the waiting room, please remember to ask her or him how they are doing and if they need help.  Recommend that they carve out some time for themselves to do something they enjoy even if it's only a nap or a brief walk with the dog or a date with their significant other.  Recommend that if they can afford to, to see a professional themselves.  If you have time, develop a list of  resources for that parent or significant other.

It can be for some a very long road and sometimes the light just doesn't seem to appear.

Guest Post by Marjie Ruth - Recovery is a Process

"It is good to have an end to journey towards; but it is the journey that matters in the end."

 ~ Ursula K. LeGuin

Dear Family & Friends of the Eating Disordered;

The topic of recovery is one that is almost always on many of our minds in one capacity or another. So, what is recovery? Recovery is what we all want for our loved ones. We want them to get past their addictive behavior, to regain their health and happiness, and to rejoin life as a fully functioning and productive person. For some of us recovery is thought of as simply getting things back to the way they were before we ever even knew about the disorder or suspected it might be a possibility. Webster's tells us that recovery is to "regain a normal position or condition [as of health]". Yes, to get back to normal--that is a most succinct way of putting it.

"Get back to normal". Those 4 words sum up the burden that has been in our hearts and is the bottom line when the maelstrom that is in our minds comes to rest. Some of us, after lying awake in the dark hours of the night and crying quietly into our pillows, know that it is the prayer we whisper through clenched teeth: "Please, please make things normal again!".  But everyone who has studied even a little psychology knows that the word "normal" is a nebulous term at best. Normal is often defined in the eyes of the beholder. What's normal for one family might seem quite ludicrous to another. And the key thing for us to remember is that the eating disorder was developing and occurring even when we thought everything was just fine, normal. Are we just asking to go back to a state of blissful ignorance or do we really want recovery?

Another stumbling block when we talk about recovery is that we are often thinking in terms of a cure. We've cured polio. We're searching for the cure for cancer and the common cold. Is there a cure for an eating disorder, for any addiction? Because many practitioners use the disease model when talking about and treating ED's, we tend to think that a cure is the ultimate goal. But the disease model for mental illnesses and that for physical ailments have some inherent differences. There is no invading virus or bacteria to be isolated and eradicated with an ED. Even the cause of an ED is difficult to cull down to any one thing as it appears to be the result of a whole slew of mitigating factors: genetic predisposition, environmental & experiential factors, hereditary issues, triggering events, hormonal levels, etc. etc. A cure would be great for that would mean the possibility of a vaccine...but neither seem within the realm of possibility at this point.

So, again, what is recovery? If not necessarily a return to the state before we were aware of the disorder and if not a cure, what is left? Recovery is a process. It is a process with the first step being admitting to the disorder and one's powerlessness against it. That might seem like overstating the obvious to those who blanch at the holocaustic appearance of the anorexic or are sickened by the the sight of the binging bulimic and the sound of the purging aftermath. But for the person mired in the disease, it is the first and often most difficult step in a long, long struggle. Denial is the self-preserving force of every addiction. An addiction begins slowly (without the victims' having any intention of becoming addicted) and innocuously hidden in a facade of "this feels good & I can control it". It's only dabbling in a potentially self destructive behavior at that level. By the time the tentacles of the addiction have penetrated and ensnared the mind of its victim, it is so much in control of their physical and mental being that its very nature does not allow for recognition of itself as the invading enemy. Instead, it is seen as the very essence of necessary normal, as needed for life as air to breath. For most addicts the addiction feels to them like that which is keeping them going, while everyone around them watches in horror as the addiction gradually destroys its primary victim.

If you can fathom all of that, you can begin to understand why the recovery process is so very tough to initiate. We often talk about the need to "hit bottom" before real recovery can begin. This is an outsider's way of describing what appears as an addict's downward spiral until, in looking back, we can see the point where they finally began to fight against the disorder, that point where they "bottomed out". This is not something that can be orchestrated by others and is unique to each individual just as each of our mental/emotional constructs is unique. For some, the realization that what they are loosing due to the addiction is greater than what they are getting from it will come sooner--while for others, it may take months or years with increasingly damaging forays into the depths of the disorder. And, most sadly, there are those who will loose their life to the disorder without ever seeing the ED clearly for the killing monster it is. This is true of all addictions.

But, if that process towards recovery can get started, there is the hope (and it has happened for many) that it will progress through a series of levels, each one bringing the person closer to a healthy and functioning place in their recovery process. The 12 step model lays out the series of prescribed phases to further this process. The AB Anon handbook points out very clearly that the first two steps (#1-admitting to being powerless against the addiction and #2- coming to believe that a Power greater than self can restore sanity) are both the most critical --being those upon which all further recovery is predicated--and the most difficult.

Once this process has begun, we--the families and friends of the addicts--must address how we are to deal with the otherdreaded "R" word: relapse.  For those of you who have been through it already, you know how once you learn of the relapse your stomach immediately knots in its very pit, and you feel that sinking-into-a-black-hole feeling of panic all over again. And familiarity certainly does breed contempt in this case. We are nearly traumatized to be revisiting that most horrific of emotional places that we never ever wanted to be in the first time around and had spent countless hours and probably dollars working to get away from forever. I can say nothing to take away the frustration and fear that any one of us would naturally experience. But I can offer some assurance by pointing out that relapse often occurs (according to the AB Anon handbook) because either of the first two steps of the 12 step process had not been fully internalized and dealt with. Think of the analogy of learning to ride a bicycle. Help is required for the first time ride, usually in the form of a parent's firm hand on the rear of the seat while running along with the tentative peddler. The sense of balance is something that must be learned from experience as it really does feel impossible and dangerous to the untrained rider. Training wheels (liken those to residential treatment or intensive therapy) can give a feeling of what riding a two-wheeler is like. But take off those little wheels (leaving the residential setting, dealing with situations outside of the therapist's office), and it is something else indeed. And we've all seen the child who continues to peddle & do just fine when, unbeknownst to them, we have let go of the seat. But then, when they look back and realize they are on their own, their fear overtakes them and they wobble and fall. So, too, an individual can seem to have been doing marvelously in therapy, and we are filled with expectations (recognize the word & recall the danger?) of better things to come. But life assails them, confidence flags, and the urge to resort to the addictive coping mechanisms is screaming in their minds. Relapse can be horrifying and ugly for everyone involved, but it is vitally important that we, the friends and family, do not communicate despair to the person in the battle against the ED. Just as you dusted off the young rider while offering words of praise for what they had undertaken so far and encouragement to give it another go round, so too we must be there expressing love and calm understanding to encourage our loved ones that we understand what a difficult battle they face and that we realize that set backs will be part of the process.

And that leads us to the importance of our own recovery. While we can not do recovery for anyone else, we can not effectively be supportive if we have not worked on our own recovery. And how do we do this? By continuing to increase our understanding of the recovery process including the realities and the possibilities, and accepting that it is all out of our control. Our recovery means coming to recognize and deal with our own emotional baggage about the ED: our anger, fears, frustrations, hopes, worries, and going through the grieving process in order to reach acceptance. It means continuing to work at learning how to cope with while not contributing to the addictive behavior. It may mean working on issues of our own like a tendency towards perfectionism or a need to be in control of others, for example. Recovery for us means learning how to listen, how and when to let go, how to establish healthy boundaries, and nurturing our lives and relationships apart from the ED. While we might have started out thinking that recovery is all about making someone else well, hopefully now we are coming to realize that it is more about understanding the process they will have to work through while applying the same process to our own lives.

To paraphrase the opening quote:

When we understand the recovery is not something to be achieved, but rather a way to live, than the process will become our journey.

Marjie Ruth
sruth1@tampabay.rr.com &/or MarjieRuth1@gmail.com

(727)244-9011 (c)P.S. Wow, congratulations on making it this far!! I know this was a long email...thanks for bearing with. Pls feel free to share this with anyone who might be interested. Do include my email address so they know who to blame for all of this verbosity. If you've received this and would rather be off the list, write back and just say "remove". I'll understand. Questions or comments? Send those my way also.

Guest Post on Defusing Spiraling Thought Patterns

 Marjie Ruth's latest post appeared shortly after I wrote my thoughts on expectations, possibilities and fantasies.  As I mentioned the other day, one of my tasks is to change the way I think.  Marjie has provided an excellent essay here on how to approach thoughts that for me can morph into frightening fantasies.  Perfect timing for me and hopefully for other readers, too.  I'm grateful to be on her mailing list!

Dear Friends & Families of the Eating Disordered,

I know that your life is probably very busy, but I hope you will remember that our group is still meeting and that in times of rush, pressure, and stress it is more important than ever to dedicate some time to taking care of yourself. And hopefully, you find the information from and time spent at the group meeting to be of support and encouragement. Our meeting this week will be on Weds (5/18) in Tampa at Hyde Park Counseling Center from 7 to about 8:30pm or so. Would love to have you there. Feel free to bring along anyone who might be interested. Please drop me a quick line if you think you will be attending.
The subject line for this email has to do with a section I read from a book called "Don't Sweat the Small Stuff...and its all small stuff", subtitle: Simple Ways to Keep the Little Things From Taking Over Your Life,  by Richard Carlson, PhD.  If you haven't read it, it's a great little handbook for reviewing and reshaping our thought patterns. It is broken down into 100 short topics with each taking only a few minutes to read. It's a good book to use for brief daily meditation. For example here is part of one such entry. I have taken the liberty of altering the original somewhat to be more on topic for our purposes. With acknowledgment to Dr Carlson and apologies for my liberties, my "alterations" are in italics:

Be Aware of the Snowball Effect of your Thinking

    A powerful technique for becoming more peaceful is to be aware of how quickly your negative and insecure thinking can spiral out of control. Have you ever noticed how uptight you feel when you're caught up in your thinking? And, to top it off, the more absorbed you get in the details of whatever is upsetting you, the worse you feel. One thought leads to another, and yet another, until at some point, you become incredibly agitated.
    For example, you might wake up in the middle of the night and find yourself thinking about something to do with your loved one's eating disorder. Maybe it was an OK day, but now one thought--a concern about a skipped meal, an angry conversation, perhaps an uncomfortable silence or unexplained avoidance--is just something that triggers an alarm response in you. And as you lay there in the dark you soon start to have that "Here we go again" feeling of slipping into a black hole of despair with no apparent way to get help. Your thoughts soon take you from a slammed door to a free-fall feeling of near panic. The night is dark and long, but a solution or cure seems to be slipping farther and farther away. Your mind starts racing from scenario to worse scenario. You find yourself bouncing between "what could we have done differently" to  "why does she (or he) have to put us through this" to "while I thought things were getting better, it seems it might only be worse than ever". You formulate and then discard one strategy after another. You try on different approaches to the problem, only to find fault with each one and feeling more and more like you are caught up in a totally impossible situation with no way out. For many people, there's no limit to how long this type of "thought attack" can go on. In fact, I've been told by clients that many of their days and nights are spent in this type of mental turmoil. Needless to say, it's impossible to feel peaceful with your head full of concerns and annoyances.
    The solution is to notice what's happening in your head before your thoughts have a chance to build any momentum. The sooner you catch yourself in the act of building your negative snowball, the easier it is to stop. In our example here, you might notice your snowball thinking right when you start focusing on the eating disorder and the things that make you fearful. Then, instead of obsessing about the why's, the what if's, and the how's of this horrible disease, you say to yourself, "Whew, there I go again," and consciously nip it in the bud. You stop your train of thought before it has a chance to get going. You can then focus, not on how overwhelmed you are, but on how grateful you are and this is where you need to fill in the blank. Perhaps your gratitude can be for that fact that however slow progress may seem, at least your loved one is involved in therapy. Or maybe you can be thankful that your loved one is feeling safe enough to express their anger. Or maybe just for something as simple as the fact that you both survived another day and tomorrow always brings new hope. Perhaps you can find some thankfulness in knowing that there is a support group that you can go to and talk over some of the things that trouble you, see that you are not the only one, and see that others have survived it. If you think of something that you feel you need to do in the morning, write it down and let it go until the morning.  You might even consider keeping a pen and paper by the bed for such moments.
    You may indeed be a very stressed person, but remember that filling your head with thoughts of how overwhelmed you are only exacerbates the problem by making you feel even more stressed than you already do. Try this simple little exercise the next time you begin to obsess. You'll be amazed at how effective it can be. You can cultivate the ability to defuse your own spiraling thought patterns. Discover the peace that comes through gratitude.

Marjie Ruth
727-244-9011(c)sruth1@tampabay.rr.com

Reflections on Expectations, Possibilities, and Fantasies

A year ago this month, I experienced something I'd never felt before -- overwhelming despair --  and knew I needed to do something about it.  About five months later, I wrote a post about my experience and what I chose to do.

I was faced with a similar situation this past Thursday evening.  My coping "tools" this time around include my husband who has taken the time to understand eating and brain disorders better and therefore has become an effective listener; my therapist and our continuing work on how I think and what I do about those thoughts; and the wonderful support group I'm so grateful to be a member of.

I raised the topic of expectations this morning and the thoughts that topic elicited from the group were nothing short of amazing.  We all walked away with such a variety of perspectives on the term without my needing to go into any personal detail at all.

One of the sayings I've come to respect is expectations breed resentments.  Before you, the reader, object and say that expectations are a good thing:  witness what we have learned to survive in this world is based on many expectations and also what happens in school systems when children are expected to succeed rather than to fail.   I agree with you.

But there are other kinds of expectations that lead me, at least, in the direction of oh no's (negative fantasy) automatically rather than oh boy's (positive fantasy).  I'm programmed, having been a witness to harmful behaviors for more than twenty years to expect the worst or at least to expect not so great an outcome  even though my own outcome was positive!!!!  (More on this soon when I finish reviewing Aimee Liu's new book titled Restoring Our Bodies, Reclaiming Our Lives).  So, when I learned about something my loved one had done, I was stunned because I had seen what this choice had done in the past and my mind leaped into the future with visions of dire consequences.

However, this year I also realized that I'd changed.  My mind, as I said, still leaped into a future fantasy.  However, I have come to understand at a much deeper level that I am not prescient.  And I know from my own experience and life that choices I've made in the past are no longer viable or healthy options for me so why should I assume that anyone else's choices will result in calamity rather than a learning experience with a positive outcome?

But, being a parent brings with it a deep connection with one's child(ren).  So this time, rather than sink into despair, I hovered between hanging on/seeing what will unfold and working my way into a different state of mind.  Both states are a development I did not think a year ago I would be able someday to reach.  And yet, here I am.

I'm sad, to tell the truth.  I feel afraid of that pain and potential grieving that I may face.  Actually, I'm living it today because I am grieving for the person who once upon a time didn't make such a harmful choice.  I am scared (but not to death) that the choice will grab hold again.  I also comprehend that there isn't anything I can do about it other than turn it over, detach with love, and pray that there's enough wisdom in my loved one now to avoid harm once the issue leading to the decision is addressed.  [N.B. I frequent Al-Anon meetings because six years ago I was unaware of a support group for eating disorders and I believed (still do) that the behaviors that become entrenched are similar to addictions.]

So, I'm going to continue to hang on to the concept of "possibilities" and work through the pain and fear that I'm feeling today.  Quien sabe?