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:

Marjie Ruth: Are you adapting or changing.......

Another gem from Marjie Ruth.  As usual, at her request for those who might want to re-post this, please include her contact information found at the end of her essay.  Please consider leaving in as well the information about the support group she sponsors in case someone in the Tampa, FL area needs support and reads this.

I raised this topic last week in my meeting. No matter how many Al-Anon meetings I attend, how diligently I work my program, or how many times I repeat/review the Serenity Prayer and other valuable teachings, I still come back to this.......

"Our ability to adapt is amazing. Our ability to change isn't quite as spectacular."

 ~ from The Spellman's Strike Again by Lisa Lutz

Dear Family & Friends of the Eating Disordered (ffed);

Our support group will be meeting this Wednesday evening (9/11) at the Hyde Park Counseling Center in Tampa at 7:00pm, as usual. The ABA 12-step group is also continuing to meet at the same time, same place. Yes, it's an historic date that brings back memories just saying the date. 9/11 - where were you when you heard the news of the terrible tragedy taking place? We'll share that with each other at our meeting. And here's a thought: anyone under the age of about 17 has no memory of that day, so for them it will be yet another event to learn about in history class. Perspective changes everything. 

But let's move on to this week's opening quote which is from a very lighthearted, fun book. Actually, this is the 4th book in what has developed into something of a series, and I'd recommend reading the other three first, beginning with The Spellman Files. These books fall into the genre of "Something I Can Read That Absolutely Won't Depress Me & Actually May Make Me Chuckle"...and every few moments spent reading such, ends up being a micro-mini vacation for me. Ahhhh, sweet mindless escape. Are you surprised? You don't actually think I sit around reading books all about eating disorders do you? Heck, no. That would be a short path to depression and insanity. Dealing with a loved one's disorder is punishment enough. 

Now that's not to say that I haven't ever done such reading. I've indulged in my share of psychology text book searching complete with yellow highlighter at the ready. There's a bookshelf above my desk that holds a fair size assortment of books relating to eating disorders, some better than others and at least one that was a huge mistake. I've even spent time in a university library digging into medical books and journals with determination and a zeal to find some answers or at least some meaningful clues. My passion at that point was born out of a raging desire to find a way to get my loved one better, as in "back to normal healthy in mind and body" again. We seemed unable to find any professionals that could help, so I was determined to find the way myself. And there was nothing really wrong with my stumbling efforts to become educated, except that I harbored the delusion that I could make my loved one recover. I have never given up my desire to have my loved one be healthier and happier--that is a mother's plight. What has changed is that I've gradually come to the understanding, that I can't do it for her. 

With this realization comes release: release of my energy being funneled into trying to take control of her disorder; release of the unrealistic desire that there is some magic formula that will make it all better, ie The right treatment program or The right pill; release of the notion that the more I focused on fixing things, then surely my efforts would be rewarded. But don't think that I released such patterns of thinking and behaving easily. Ha...far from it! Please refer to the opening quote which very concisely sums up my journey with ED. Our ability to adapt is amazing. Enabling is a form of adapting to disordered behavior. Our enabling just makes our loved ones more able to indulge their addictions. We adapt our life patterns of thinking and acting to accommodate their addiction. Even upon recognizing this--as the second part of the quote points out, Our ability to change isn't quite as spectacular--changing our behavior is anything but easy. I still find myself slipping back into old thought patterns and needing to regain my footing and even re-examine choices in light of possible enabling that has crept back in. It seems that the only constant in life is change, and yet I'm consistently balking at & even feeling incapable of changing my behavior or thought patterns.

For anyone, change is not easy, either to accept or to achieve. For someone with an addiction, no matter what it is, change is terrifying and seemingly impossible. "They" need to change their addictive ways. And "we" need to change our enabling ones. Both tasks require a great deal of time, determination, and practice. 12 step meetings are there for all of us. Plenty of books provide helpful encouragement and advice. But for each of us, taking good care of ourselves is a critically important point. We need to treat our bodies and our minds in a healthy manner, and one ingredient in doing that is taking the time to rest and recreate. 

Which brings us back to the books by Ms Lutz. When was the last time you treated yourself to some quiet, non-working, non-stressing time? If you had trouble answering that inquiry, then it's been too long! I encourage you to find yourself a good book and a comfortable chair in a quiet spot and work on some recreational therapy for yourself. Put the cell phone on mute, let the computer hibernate, and turn off the guilt. Start small if you need to, but try it for even 5-10 minutes as a first step towards making a change in your own life. Tell you what, if you'll promise to give it a try, so will I. Let me know how it goes!

Marjie Ruth

sruth1@tampabay.rr.com

marjieruth1@gmail.com

727-244-9011 (c)

Guest Post by Marjie Ruth - Choice

"We choose to be healthy; we choose joy; we choose happiness. These are all choices we make when we have the power to choose. But in order to feel that power, we have to learn what it means to love ourselves."     
~Angela Passidomo Trafford

For those of you who have been to a support group meeting or have been reading these emails for a while, you know that certain "C" words are very important in our struggle to deal with an eating disorder in the life of a daughter or son, a wife, or a friend. The list started out with 3 words describing our relationship with the addictive behavior of a loved one.

#1 - You did not Cause the addiction.
#2 - You cannot Control the addictive person, their behavior, or their addiction.
#3 - You cannot Cure their addiction.

This was our starting point and a lot of emotional information to handle. Through experience and learning from one another, we have added 2 more words.

#4 - You can learn how to Cope with the person and their addiction.
#5 - And you can learn how not to Contribute to the behavior.

(If you would like more to read about any of these very important points, hang on as future emails will deal with each point more in depth.)

And now for a sixth word to add to the list.

#6 - You can grow in your understanding of the role of Choice in the life of the addicted as well as in your own life.

This word, Choice, is like a recurring melody in my own life as it seems to come up in so many contexts again and again. Back in my college days as a philosophy major, I was quite taken with the existentialists who--surprise, surprise--emphasize the power & role of personal choice in our lives. Camus, Sartre, and others express frustration with how unable or unwilling most people are to embrace this notion. Choice is viewed as personal empowerment.

But what Angela Trafford (see opening quote above) is emphasizing, is that before we can even begin to appreciate our own power to choose, we must first come to know, understand, and accept ourselves for who we are. Basic psychology emphasizes the importance of a healthy self esteem if an individual is to grow and prosper emotionally. Without a healthy degree of self appreciation, it is nearly impossible for us to love ourselves. And this is a core concern of the therapy that deals with eating disorders. The disorder is a symptom of a severely wounded psyche, one that is suffering to such a point that the pain of it makes the world seem almost too difficult to handle and so much so as to leave its victim feeling powerless. Hence, there is a sense of relief (however misplaced) that comes from the illusion of power restored through the dietary abuses of the disorder. "I can  experience the  pleasure of  unbridled binging while eliminating the fear of weight gain," thinks the bulimic. "I can resist the calories and have gestapo-like control over what goes in my body and ultimately I can change my body and even make it disappear if I choose," thinks the anorexic. What begins as a choice to try on power for size, ends up as an addiction with the controller becoming the controlled. What seemed a way out of a painful prison, becomes a trap of unparalleled proportion. It is as if they experience thinking that they've found a way out of mere detention, only to find themselves in a concentration camp--a metaphor with all too many parallels to the anorexic in particular.

The hope is that with the therapist as guide, the disordered person will be able to slowly and painfully begin to take down the walls of the camp through the process of recognizing and healing past hurts, rebuilding an ailing self esteem, and developing a voice that is one of strength and self integrity. This voice of recovery will have the courage and self compassion to make choices that are healthier and more likely to lead to happiness. The pain did not occur all in an instant. The damage was done probably less like that of a hurricane (a single traumatic event) and more like the relentless toll of tides and waves on a small wooden dock (the persistent and cumulative effect of life's daily harsh and sometimes toxic social environment on fragile and sensitive psyches). The damage we see--the visible weight loss, the evidence of binging and purging, the social withdrawal--is the outward manifestation of pain that has been present inside for a lot longer.

Getting help is the important first step in recovery. (Technically, being willing to get help is the first step with finding help being the first hurdle.) Patience and perseverance are the next. And along with this comes the necessity of choice. Each sufferer of an addiction must ultimately make a choice for life, a choice to recover. And along with that singularly pivotal choice comes a barrage of individual choices that must be made constantly, each step of the way in order to support and facilitate that choice to fight for recovery. Every single day, involves a multitude of complex and difficult choices. A million times over one must choose to eat and to eat wisely and healthfully. While it sounds so simple to us, it is a monumental task, especially in the beginning, as with each bite of every meal there is a struggle against the full force of the disorder which has quite literally taken over the brain. A thousand times over the addict must choose to be honest with self, therapist, and family. Endlessly they must choose to resist giving in to the thoughts in their head that distort self image so radically. Every minute that they are awake a fight must ensue to keep strong against thoughts that tear at their fragile self worth, only to find that even when sleeping too often dreams are nightmares that torment and rob them of needed rest while requiring still more recovery upon wakening. And always they must keep on choosing a painful recovery...keep on choosing life.

The good news is that for every time the choice is made for recovery--honestly and without compromise--it strengthens and heals the inner self. The world around will not be changed by it, but the person's ability to deal with the world, with life, and even their own reactions to the world will be changed. The eventual result, if they can continue choosing recovery, will be a person who is no longer beaten down by the tide, but instead can find pleasure in surfing the waves.

Marjie Ruth
727-244-9011 (cell)
sruth1@tampabay.rr.com
MarjieRuth1@gmail.com

As always, feel free to pass this email on to anyone who might be the least bit interested. Just be sure to include my name at the end so that they will know who takes responsibility for all that's written here and whom to contact if they should feel the need. Thank you.

So..... what about anorexia then?

Updated March 31 2019

After reading and writing a lot about reward seeking behavior, I want to return to the topic of anorexia but want to review my experience as a starting point.

My experience with what I believe was anorexia but which was never formally diagnosed because I never sought treatment came along in the late 1950's long before much was known about it. I started with bulimia in ninth grade and then went through a phase (late high school/early college) where I became dreadfully thin.  I did not like how I looked in that phase.

By my senior year in college, I had regained enough weight through eating more than I was purging and I conscientiously would make a point of eating breakfast and lunch while resorting to binging in the evening or on weekends.  I remember trying very hard to quit in my freshman year and that lasted for about two weeks followed by infrequent episodes until the end of that first semester.  Then all hell broke loose in my life and bulimia became entrenched.  I've talked about this in another post. 

From that point on, I maintained a fairly steady weight although too low according to my PCP and went through periods of fluctuation -- heavier binging/purging followed by more controlled episodes, meaning less frequent episodes.   I shared this information with no one.  My BMI was constant until I began long distance running and volunteering and changed my life.  I slowly gained weight and held it for about twenty years and then gained more over the past fifteen years.  With the weight came stamina, fewer bouts with bronchitis until that totally disappeared, and a marvelously strong body.

So although I did lose a lot of weight, I cannot really identify with the concept of anorexia but I've watched my family member wrestle with it and bulimia since she, too, was fifteen. Only anorexia is much more of a factor for her.  In fact, I often wonder what might have happened to me had I not had the habit of bulimia first.  Would I have starved to death?  Was it inevitable?  Why was my path different from my daughter's?  Does it have something to do with the area of the brain involved in reward-seeking behaviors?  

Both of us have a very strong will and both of us have a strong will to live.  The will to live has brought my daughter back from the brink each time.  It has been her choice to get into treatment admittedly with thanks to the existence of Title 36 here and the creation of an incredible team that worked (and still works) on her behalf.  But lately she has given up.

I believe that the AN piece of her brain disorder is significant.  I know that she can make the choice to stop her bulimia and has several times.  But the AN is still there, no matter how well nourished she has become - twice about 10 pounds over a suggested set point.  I don't often write about her so directly but I do so now to illustrate the point that something else is involved in AN.  Going across the line, so to speak, into starvation is not, I believe, a choice.  As I said in an earlier post, something goes haywire.

Nutrition must come first to get the person back across that line and to help them hold that line until the brain rewires itself somewhat.  It is then that therapy has a real role in helping the person develop a solid sense of self as well as total awareness of this underlying syndrome and more importantly how to prevent its recurrence.  Whether or not that syndrome remains lurking there is yet to be determined. 

The answer is somewhere in the brain as well as, of course, in the individual's genome.  As I've said before, we're all like snowflakes.  Not one of us is totally alike.  But something is in there that those who develop anorexia have in common.  

I'm looking forward to further research in this area and hoping that Dr. Walter Kaye and his colleagues will obtain funding to further understanding of this dreadful disease.  Here's a link again to recently published research.

"Cells that Fire Together, Wire Together" - book review of Brain Over Binge

The title of this post, Cells that Fire Together, Wire Together, is the basis (to me) of a remarkable book titled Brain Over Binge: Why I was Bulimic, Why Conventional Therapy Didn't Work, and How I Recovered for Good by Kathryn Hansen.  This expression, found on page 140 of her book, and drawn from page 107 of The Mind and the Brain: Neuroplasticity and the Power of Mental Force by Jeffrey M. Schwartz, M.D. and Sharon Begley (New York: HarperCollins, 2002), sums up what happens when we humans carry out an action enough times that it becomes a habit.

I've attempted to write this review at least three times and because there's so much in her book, I found it difficult to summarize.   So here's my brief synopsis.  I strongly believe buying her book is a good step for those who haven't found an answer to their bulimia.   Her book contains material that I've studied as well as heard from researchers in the field of neuropsychology here at the University of Arizona.  The material dovetails so very well with my own experience, too.  

[update comment July 2, 2015 - I noticed that people are selecting this link.  I've placed a link to this post in my "Of Note" section.]

A good habit obviously is a good thing.  But those with the tendency towards (genetics?) strong reward-seeking behavior that is not tempered by the temporal lobes can run into trouble.  So, what is the solution?  And, can stopping binging and purging be a choice?  I happen to think so but I reached that conclusion long after (in terms of the length of time I battled bulimia) Kathryn did and I reached it because I was sick and tired of being sick and tired. 

Kathryn reached this decision because she encountered a program - Rational Recovery - that worked to steer her into a different perspective and she then spent a lot of time learning about her brain and how it's currently understood to work.  I also know people who've managed to use Alcoholics Anonymous with the same results.  I believe that there is an underlying biological reason for all of these disorders. 

Interestingly enough, I've also learned recently that people during the 1800's used sugar/sweets to get high.  Stop and think about that for a moment.  

The beauty of our brain, as Ms. Hansen eloquently and with considerable research puts it, is that the neurons and other material in our brains can continue to develop new pathways throughout our lives.  The neuroplasticity of the brain -- something I learned about in my class here at the University of Arizona last spring -- is our saving grace in so many ways.  We can learn new habits, we can learn to use a hand or walk  again after a stroke or injury, we can learn to speak new languages, soldiers returning from battle can overcome PTSD, and some can continue to function seemingly normally even with Alzheimer's Disease (as revealed by autopsy following death).  We can quit binging and purging.   Neuroplasticity is a remarkable thing.  Basically, to quote Ms. Hansen, "neuroplasticity refers to the brain's ability to rewire itself."

And she worked hard to rewire her brain.  She decided that she needed to do this.  I agree with her that others can, too.  She takes the reader through her disease and then recovery using knowledge of the workings of the brain as well as her discovery of what was driving her and why. 

She also thoroughly looked at herself through the lens of much of today's focus in eating disorders therapy and she concluded that the therapy doesn't really get at what started her disease in the first place.  She realized that getting to know herself and understanding her behaviors certainly helped in her development/her growing maturity but to her it was not a cure or a means of stopping the binge eating/bulimia.  I, too, turned to therapy after I quit binging and purging and found therapy to be instrumental in my personal development.  But, to repeat, by then I no longer binged and purged, either.  And she also believes, and so do I, that bulimia is triggered by something much deeper and at the same time simpler.

She has taken complicated information and presented it in a way that most should be able to understand.  The brain is complex.  Our anatomy is complex.  The media is also examining the workings of the brain thanks to the efforts I've outlined previously here on my blog in response to the needs of our returning military, of those who have suffered strokes, of those with brain disorders like schizophrenia, depression, and eating disorders, and more recently and quite tragically for us here in Arizona, of Representative Gabrielle Gifford's recovery from a point blank gunshot wound to her brain.

Ms.Hansen speaks an underlying truth that  her eating disorder was indeed about the food!  Or in her case, as with so many, with the results of the lack of it.

My own thinking has gradually come around to her thesis, too, which is that dieting in the sense of purposefully restricting one's caloric intake, sets off a chain of events in the brain that leads to the development of a potentially fatal disease:  an eating disorder.  She focuses on binge eating disorder (BED) and bulima.  

The word diet has been defined in our society not as what one eats daily  but rather the purposeful  change of eating patterns to lose or gain weight but that for some something goes haywire (interesting that the word "wire" is in this expression and the word haywire was used long before the workings of the brain became better understood) and leads to excessive restriction of food or to excessive eating and for some, death.  What is that something?  An imbalance?  An endocrine disorder?  An  immature portion of the brain?  Dr. Cynthia Bulik terms it a "negative energy balance."  Here is a link to Dr. Bulik's paper.

Once food is restricted, she proposes that the rudimentary part of our brain (she calls it the animal brain) recognizes that there is a threat to our organism's survival and the animal brain takes over.  One binges because one is starving.  One goes on to develop the habit of binging because it helps to feel better.  Sure it does!  You're no longer starving!  Remember, cells that fire together, wire together.

One purges because one who develops either BED or bulimia also either develops the habit to purge, in whatever way works, or continues to gain weight because they are caught in the habit of overeating.  The goal is to stop binging by eating rationally in response to the body's needs and therefore to stop purging (by vomiting, exercising, etc.) because one comes to understand -- to "get it" -- that they don't need to any longer.  Again, this can be hard work.  And, it can be done!

It would seem to me that for those who have the urge to binge eat without purging and who have developed the habit of binging, an underlying endocrine disorder in combination with, for some reason an uncontrollable urge to eat, must be addressed at multiple levels.

Some readers (and parents) will question how this process can work for a younger person.  I believe the parent needs to step in and learn about the brain, habits, and nutrition.  This book would be an excellent start.  The parent needs to serve their child as the light along the path and if the parent cannot or is not available, then the person with BED or bulimia needs to enter a residential program or live with a competent, knowledgeable and determined foster parent where s/he is monitored to eat well as well as not to purge until the new behavior becomes not only a habit but also believable.

This is not an overnight thing.  It's absolutely not easy.  But it sure does feel good to no longer be doing something that is so harmful and that interferes with a normal life.  I highly recommend this book as a valuable different perspective on overcoming bulimia and as a means of getting a handle on binge eating.

An important P.S. - this thesis does not address the difficulties encountered by those who are fighting other co-existing diagnoses such as Borderline Personality Disorder, Bipolar Disorder, Anxiety Disorder, or Obsessive-Compulsive Disorder.  I think this is where Dr. James Lock's recently published research will add much to the discussion.
P.P.S. - Kathryn has self-published this book.  It is available on Amazon.

 

The Four Agreements - underpinnings to a better life

We subscribe to Inside Tucson Business, a local weekly business newspaper.  The June 24, 2011 edition carries an article written by Kathy Hibsman in the Women in Business section in which she reflects on the Toltec Four Agreements.  This link provides the full text of the agreements, as well.

I find it worthwhile to review these periodically and the book written by Don Miguel Ruiz sits on my shelf.

Agreement 1:  Be impeccable with your word.

Agreement 2:  Don't take anything personally.

Agreement 3:  Don't make assumptions.

Agreement 4:  Always do your best.

A reminder to those who tend towards perfectionism and get tangled up in it (like myself), doing your best does not mean doing something perfectly.  A wise Al-Anon saying is Progress, not perfection.

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.

Reflections on Taking Care of Myself - Signals that I'm Not

March 31 2019

My visits to my therapist have become less frequent for the most part.  I'm happy about that.  Her assessment with input from me is a reliable barometer of how I am doing in my battle (and it is a battle within) to separate myself from the what my loved one is doing without losing or demonstrating that sense of the unconditional love I have for my loved one.

One of the questions I'm always asked is something along the lines of "what are you doing for yourself?"

My list includes things like spending time with my husband, lunching with friends, taking a class, reading, working in the yard, not getting up at the crack of dawn to make an early morning board meeting, and seeing a movie.  The list used to include running but since a bad fall followed by x-rays of my neck that revealed a problem, I've turned to hiking/walking for my exercise.    Another activity is adding to this blog.

Since 1977 when I started running by putting on a pair of leather white and red swooshed Nike's, I've kept a running journal of sorts.  My entries usually included the miles I'd covered that day.  If I felt sick or sick enough not to run, I'd mention that.  If I was injured, I'd mention that, too (and not run).  I've had three injuries that got in the way of my running.  The first was a Morton's neuroma that was easily fixed with a wider toe box, lower dress heels, and inserts with a special pad.  I've successfully stayed away from surgery.  The second was IT band syndrome in 1981 that came about because I ran a marathon arranged to run in the direction of traffic so the cant of the road torqued my knee.  The third was more recent.  I wanted to run up Mt. Haleakala in 2001.  My training included miles uphill on the road up Mt. Lemmon here.  My plantar fascia rebelled.  We didn't go anyway because the run coincided with the awful events of that Fall and our flight was grounded.  

I worked very hard and continue to work to monitor my body in many, many respects.  As I've written elsewhere, my running brought me back to health.  I firmly believe that exercise, if incorporated thoughtfully and carefully, is very important.  I know I feel better having been out in the fresh air and sunshine.

Some folks will include things like the shoes they wore, the terrain they ran.  I'll usually note trail or a specific place like a nearby park that has a great walking path or the track when I used to do time workouts to increase my speed when I was racing. 

I've noticed that a great barometer of my focus on the exercise aspect of my life (which my parents ingrained in all of us at an early age as a means of keeping healthily fit) is not only exercising but also logging that exercise.  A member of the ultrarunning community (of which I used to be a member) created a challenge called the Million Mile Ultra and invited people to log their mileage.  I've been doing that since 1997 although I covered many more miles per year before that simply because I was always in training for an ultra or of our local trail runs that are calendared from September through May here.

One day, after first being startled to see that I haven't been keeping up with totaling my mileage in my journal,  I checked into the Million Mile site and was shocked to see that I had not logged a monthly entry since last August.  This lapse happened a few years ago when my loved one was failing rapidly and just getting out was an effort.  That lapse was three months.  This time the lapse was nine months.  I like making entries on this site because in the past it kept me motivated.   For me there's no competition involved; rather, it's a signal to several people on the list who I have known for a long time, that I'm still out there and somewhat kicking.

However this time, not only was there a lapse in logging, there was also a lapse in posting to my journal.  Fortunately, I am now am bicycling several miles once a week but thanks to many days of not posting in my running journal, there were weeks at a time when I might have put one or two entries if that.  Most lapses occurred early that year and recently I've gotten back on track.

So...... why?  I attributed some of the lapses to being on more celexa than I needed and therefore I simply got lackadaisical about it all.  This lackadaisical feeling over-ran several activities which is why I decided to reduce the dosage while working with my doctor about it.  I eventually quit celexa altogether and now take a low dose of buproprion.  Like many people who start to feel okay again, it's not clear to me that I won't feel okay if I go off the meds.  At least I recognize this fact.  There are those with anosognosia who don't recognize this fact and get into serious trouble when they quit their meds.  [

Reflecting on all of this, and I think my therapist will concur, I get sucked back into the life activities of my loved one when my loved one loses ground.

I've continued to be a member of the therapeutic team and appreciate their including me for I can offer insight on some of the behaviors everyone is observing.  I've been a welcomed member of the team now for ten years.  In the past it was a struggle to advocate effectively because it was so difficult to get key people to listen and take action.  Now the team is more tuned in yet their resources are severely stretched.  For me, knowing what is going on obviously has its pluses and minuses.  Good news is wonderful; bad news is so saddening. 

I continue to monitor myself closely.    I've kept close to my heart the expression, hope for the best; prepare for the worst.  The reader will notice which phrase I put first.

One day at a time.

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?

Nothing like a nap!

This week has been wild, full of ups and downs connected with not only next steps for my loved one, but also arrangements for an extended family member who suffered a stroke almost two months ago and who lives in another state.  

The outcome in each case is to be determined as often happens, but things look promising.

At times like these, when life can get pretty unmanageable, I think of a very useful acronym:  HALT

Hungry, Angry, Lonely, Tired.  Here in the desert southwest T could also stand for "thirsty".  In fact, I just took a large glass of ice water out to my husband whose hobby is working on his car and he's been at it for a couple of hours on a rather hot afternoon here.

I, though, was tired.  After going to a meeting and then running several errands on my way home (including filling up my almost empty '03 Murano's gas tank and gasping at the total - $72. and change), I came home, had lunch, and climbed into bed.  A two hour nap was just the ticket so I could help my husband out in the garage by sorting things for Goodwill.  It has been a productive afternoon.

Back to the fill up for a moment.  As I stood there by my car looking at the receipt (I got 19 gallons, the Murano needs premium, and I had been running on air for about a mile), a woman who had just filled up her gas tank nearby remarked, "I'm going to frame mine.  This is the most I've ever spent on gas."

I guess there's a metaphor there.  My car was empty and needed gasoline; I was empty and needed a nap.

Thoughts on being a Mom

Today's New York Times carries a piece in the Modern Love column of the Sunday Styles section (Sunday, April 10, 2011, p. 6) titled, "Sharing the Shame After My Arrest."  The piece, by Brooke Rinehart, tells the story of a young woman very in love with her husband, a young enterprising man, who betrays her.  She returns home to her parents who love her and support her through the agony of the next ninety days.

My daughter's birthday was last month and mother's day is approaching.  Yesterday in a meeting I shared how difficult it has been for me to somehow construct a boundary between me and the woman who, as a baby, nursed at my breast and delighted my heart.  As I've also shared not only here but also in an IAEDP meeting with a bunch of therapists who treat those with eating disorders, I also sought therapy and attended classes and  gradually came to understand that I didn't cause my daughter's eating disorder.  The situation we all lived in may have contributed to its emergence, but genetically there it was.  As happened to many moms, I was blamed in an "earlier time" and carried guilt around like a wet blanket until I began to learn how to accept the past, understand what was and is going on, study the science of it, and move forward.

So, reading this piece in the New York Times today actually strengthened me, the mom who was declared in 2004 to be without boundaries and too enmeshed in the situation affecting my daughter.  

The writer shared that she could not lie in her bed in her old bedroom because it held too many memories.  I could relate to that.  After my divorce, the best thing I ever did was to sell my house and move to a different one.  And, it was a wonderful house but in our experience it held too many sad memories.

So Brooke slept on the couch for ninety days......  And along side her, in the love seat, slept her mother.  Brooke didn't ask her too; she just did.  Brooke writes, "At her lowest point, my mother spent a full day on the laundry room floor, slumped against the washing machine, unable to move.  The severity of my situation had consumed her.  Her heart had broken so severely that her body and mind broke, too."

Yes.

She writes that her mother sought therapy for a number of reasons, not the least of which was to "stop making this about her."  I so understand that.  I was consumed by the agony of watching what was happening with my daughter.  As I said to the group of therapists, "How could I not be enmeshed?"  Yet, this was and is not about me.  Yet, from another perspective, it is.  And, I had to learn how to detach with love in order to be a better advocate for her.

Time has past since yet there's still a part of my heart that finds it so hard to accept what has happened to this joyous, creative, and intelligent little girl.  She's in another rough patch and I know she can make it through to the other side of this -- after all, one has to go through something rather than skirt it.  She has the support; she needs to do this.

So can I.  As my little plaque says, "Life is all about how you handle Plan B."

Thoughts about running and being....healthy

Reading a post by Carrie on her Ed Bites blog about mind vs body and then seeing a graphic portrait of a skeleton running on a treadmill published by CBS the other day (I am not going to link to it as I was shocked by it), reminded me of all the times one of my adult children admonished me for continuing to buy my loved one a pair of running shoes as one present for Christmas and another for birthday. I just didn't "get it."

My epiphany on this issue came one or two months ago when I realized that I was an enabler by providing the shoes.  After all, my loved one loves to run and go on long walk-abouts, as we call them.  I figured (incorrectly; see most recent post) that my loved one was running for the exact reasons that I love to run and now walk.  Actually, I am sure that part of her does for the very reasons I do -- incorporating what can be a healthy habit into one's day to get some fresh air and sunshine as well as to get the heart going, the lungs expanding, the hormonal systems moving, etc.

But running came into our lives differently. 

As I've written here on my blog, my parents always encouraged sports and outdoor activities.  We lived overseas in the tropics/subtropics for most of my growing up so outdoor sports happened year round.  Sports was a part of my life and part of my during school hours life, too.  I raised my children the same way.  Living in Tucson with its wonderful year round weather helps that. 

But I did not "discover" long distance running until I saw a friend of mine running around the neighborhood and asked her a few questions about it.  I learned that it was an activity I could pursue early in the morning before my children woke up and needed to get ready for school.  I came to love it very quickly for reasons I've also written about.  But, for me, most importantly I wanted to keep doing it and I realized that to do so, I needed to be smart about it.  Having a medical background (nursing student) and a keen interest in physiology helped me realize I needed to eat well.  I also had just begun my own recovery from bulimia and soon learned that putting a few more pounds on did wonders for me in terms of strength and in terms of fighting my frequent bouts with bronchitis.  In fact, I learned as time went on that as soon as I went under what was still a very healthy weight for me (this happened when I was stressed), I'd get sick with bronchitis or a cold.  It was my body's warning system going into action and I heeded it.  My doctor was very happy about the change, too, and encouraged me to aim for a weight that he felt was even healthier.  I did that. And, I felt even better.

My loved one, however, was introduced to running while very young - nine years old.  Running became a part of her life which I thought was a good thing.  However, as she reached her mid-teens, exercise became one of the ways she dealt with anxiety and later assisted her along into anorexia.  She continues to use it as a tool to keep herself there or get herself back there.  She also incorporated what we called the walk-abouts.  These were very long walks around town to avoid binging and purging and other behaviors.

Each time she has been released from a residential facility or hospital, she has returned to running/walking even when her electrolytes were horribly skewed and/or her weight was low enough that she reported people would yell out their car window at her to "gain some weight."  She would come home very upset by these remarks yet could not connect the dots to see why others were reacting to her physical looks.  She just didn't see it. 

Now I have gotten beyond my denial to understand that she is incapable, at this point, of using running for just a healthy purpose.  She still craves it.  One of her hurdles will be to understand the difference.  My role  is to set a boundary by not purchasing her running shoes and by standing firm with her team and asking her to not run and not walk long distances until she figures all of this out.

As a former runner (I walk now as I have arthritis in my neck), I do remember at times getting injured with tendonitis like symptoms and experiencing what is called "withdrawal" because, let's face it, running and or walking/hiking for those who love it, feels good.  I get out, away from cares for awhile, I can think things through without being disturbed by the phone, or I can just simply enjoy the sounds of nature. 

For those who find that exercise can undermine them, and are cognizant of it (like Carrie), stopping for awhile is necessary.

Coping with Mr. Toad's Wild Ride and Guest Post on Coping by Marjie Ruth

One of my favorite books when I was little and again when I read it to my children was and still is The Wind in the Willows by Kenneth Grahame.  I so enjoyed the parts where I could mimic the car and explore the feelings on the page with my children.  In fact, I'm tempted to go pull it off the shelf and read it again - so many "human" emotions in that story.

Depending on one's point of view, Mr. Toad's wild ride describes mine these past few years.  It also describes my loved one's whose experiences have often seemed like a wild ride from which she could not get off.  She is and has been learning techniques to help her deal with these things.  As I've share here in other posts, so have I.

My posts usually focus on the parent and this one is no exception.

I was very fortunate to connect with a therapist who has worked steadily with me to learn how to set boundaries and, as well, use behaviors to keep myself safe in a variety of situations.  By safe, I mean in the sense of taking care of myself.  Things have been pretty rocky for several years now and since my mother's death almost two years ago, I lost my bearings a bit until I started sessions with her and later when I finally made the decision to use a medication that has helped me in my quest to stay grounded, no matter what.

I am delighted to synchronize my current state of being with a post by Marjie Ruth, whose earlier guest post on Boundaries received a lot of visits both here and on other sites.  This one is about taking care of oneself, specifically coping with so much that comes along when a son or daughter is overtaken by an eating disorder or other brain disorder/mental illness.  

Here's what she has to say:

This week's topic is coping. It is the fifth (the real 5th ~ sorry about the goof in last week's Subject line of the email) in our series of "C" words, and a vitally important step in our struggle to come to terms with having an ED in our lives. A huge facet of coping has to do with caring for ourselves. And in the interest of taking care of myself, I'm going to take the easier road this week and share with you a meditation written by Sue Patton Thoele in her book The Woman's Book of Courage - meditations for empowerment & peace of mind (1991, Conari Press).  Her book includes many great thoughts (even for all of you guys), and I have shared from it before. Hope this one speaks to you:

Filling Ourselves First

    We know it is important for our sense of well-being to give. In fact, there has been scientific study which shows that the immune system responds positively when we help others, and can be activated by merely watching a film about someone helping others.
    But it is not healthy to give until we feel drained, used, and deprived. Such giving can be laced with hostility, resentment, anger and the unspoken message: "Now you owe me!" This is not loving; this is bartering. We love best from a sense of overflow. When we are brimming with the energy that comes with having the courage to take care of ourselves first, our love and caring are freely given gifts, with nothing expected in return.
    Our minds may tell us that filling ourselves first is an act of selfishness--it seems to go against society's dictum, particularly addressed to women, that it is more blessed to give than receive. It takes a tremendous amount of courage to realize that filling ourselves is essential. It takes even more courage to know how to do it, especially if we are out of the habit of thinking about nourishing ourselves.
    To help move into the healthy pattern of filling yourself, ask yourself these questions and jot down the answers: What replenishes me so that I can love freely? What small step can I take today to allow time for myself to fill and refill?
    We can do ourselves, and those we love, a favor by having the courage to fill our life's vase; by making a commitment to ourselves that, in order to be a free flowing, clear fountain of love, we will fill ourselves first.

Hope you will take the time to read this passage at least once more in the week ahead. There is so much to consider. And perhaps you will begin to think more about how you can responsibly take care of yourself first. This is not selfishness. It's what you wish for your loved one to do. It's your primary responsibility. The airlines know this and that's why they instruct parents and caregivers to put on their own oxygen mask first. You can't be of use to others if you don't take care of yourself. Taking care of ourselves is the most important first step we can take in caring for our relationships with others.

Perhaps this is a change you need to consider in your own life--the notion that in the midst of stress all around you, it's important to think not only of how to "fix the situation", but also it's crucial that you think about taking care of yourself. We are no real good to others and may even be harmful when we are exhausted, poorly nourished, and over extended. Maybe what you need right now as a starting point for change is the permission to do so. OK, read these words: consider yourself commanded--by a power and authority much higher than the one typing these words--to treasure and care for the gift of life and the vessel it came in that has been entrusted to you for your time on this earth.

Get adequate rest. Eat healthfully. Make time for some type of regular moderate exercise. Have some moments of relaxation in each day. Allow yourself to heal.

And if your mind is telling you that you can't do this, it is the surest sign that you must!Marjie Ruth
727-244-9011 (c)
sruth1@tampabay.rr.com

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