Talking to ED - the empty chair technique

As I mention often, I am in a master's program at the University of South Florida. Yesterday I had class - Group Theories and Techniques. Part of learning how to lead group therapy sessions is by being a part of a group - being both a group member and sometimes a co-leader with another classmate. We run two equal in length group sessions with our classmates at the latter part of every class. Today I was both co-leader and member.

During the first of two sessions yesterday, I was a member. I participated and some emotions were evoked during the process. Overall, it wasn't too deep and I felt put together when it was my time to plan to co-lead the 2nd of our two group sessions for the day. As I stood outside with my co-leader and our professor discussing our plan, something said put me in a whirl of emotion. It was so unexpected. I had no choice but to put it aside and put my co-leader game face on.

During this prep-talk, my co-leader mentioned a technique he was interested in utilizing. The technique is part of the Gestalt therapy modality and involves a sort of psychodramatic role play.

The Empty Chair.

The point of the empty chair technique is to allow a group member to process unfinished business or emotions with possibly someone in their life who has caused them grief or trauma. This person may be someone who has passed or someone they have disconnected from due to trauma or disagreement, or even perhaps an aspect of themselves that causes or has caused them a great deal of pain or anguish. The process is intended to allow the person to come to terms or find resolve regarding something in their distant or even recent past. Within this technique's process, the group member can talk to the person or the part of themselves to let go of some pent up expressions, emotions or statements they haven't yet been able to divulge to the party "sitting" in the empty chair. The group member can also switch roles as well as seats and reply or provide feedback to themselves that they might have been longing for or wanting from that person or part of themselves.

Well, next week I am going to be performing this empty chair technique as part of a small group assignment in front of my classmates. I am going to be talking to her, to ED. I am excited, terrified, anxious, heated... I have such a range of emotions towards her. No matter how far I have come in my recovery, I still have hatred towards her.  I often say and I truly believe that she plagued me for a reason. She was in my life for a purpose and she  has given my future career and life's work true purpose in which I am infinitely passionate about it. However, as much as I say I appreciate her for the hand's on knowledge she has provided me, I still hate her.  I still carry hatred for her for many things.

I can't wait to tell her how I feel - I can't wait to tell her that I hate her.

My hope, and the point of the therapy technique, is that by telling her all of the things I have been wanting to tell her that I will have hatred no longer and she will be permanently removed from my life, my head and my heart.

I am going to clear my mind now and wait for this empty chair experience so I can express true, raw and real hatred towards her in front of my classmates. Of course, I will blog about it next week.

Are genes or "jeans" more of a causal factor in ED and OB development?

As mentioned in my last blog post, Is Emphasis on Body Image in the Media Harmful to Females only?, I am in graduate school at the University of South Florida in the Rehabilitation and Mental Health Counseling Program and am taking a course that hits pretty close to home this summer. It is called: Obesity and Eating Disorders. 

Weekly assignments include discussion posts to a particular, possibly controversial topic in the world of body image, obesity and eating disorders. This weeks discussion topic:

 

Genes or Jeans?

A variety of professional disciplines, including medicine, pharmacology, biochemistry, psychology, psychiatry and sociology have investigated both obesity and eating disorders, focusing on that component of the disordered behavior most unique to that discipline's professional contribution. This promotes a unidimensional model and fragmentary view of what leads to, constitutes, and maintains the disorder. In a mechanical and reductionist paradigm scientist search for identifiable predisposing or causal evidence which contribute to the etiology of specific mental or physical diseases. A medical model of etiology may focus on the biological contributions and/or genetic factors whereas a psychodynamic model will target emotional or psychological variables. Sociology studies the sociocultural factors which are contributing factors. Which factor/factors do you believe contribute most to the etiology of ED and OB. 

Wow, I could go on about this for days... here is my response:

I have to begin with a neutral answer as I believe it is ignorant not to consider both "jeans" and genes and then some in the development of any psychological disorder. Psychological contributing factors to obesity and eating disorders include but are not limited to compulsivity/impulsivity, depression, perfectionism, narcissism, anxiety, etc. Other biological factors that may contribute could include metabolism, body type, etc. Psychosocial and other factors that may contribute to the development include parental eating habits, education on proper nutrition (or lack there of), the fashion industry and, my personal favorite (not) MEDIA.

OK. Now that I stated there are multiple possible causal factors to consider for the development of OB and ED, I will get into my humble opinion...

"JEANS" = Media. Advertisements. Billboards. Magazine covers. The "diet" business. Commercials. Movies. TV Shows. Music Videos. Pornography. 

...shall I go on?

What do all of these "jeans" have in common?? 

-Ans: Digital enhancements.

What does that mean to some people who, perhaps, have more genes that make them more susceptible to internalizing digitally enhanced media? It means OBESITY and it means EATING DISORDERS along with possible body dysmorphia, probable slim-to-no self-esteem, etc.

You see, digital enhancements mean that the images were "photoshopped" and changed and "perfected"... that means they aren't even real. So, in the world of "jeans", if you are someone who internalizes these images and makes a firm self-worth-dependent decision that, unless you look like what you see (fake images), you aren't good enough. What do you think happens when people strive to become what they see in the world of "jeans"? They fail. They fail because its impossible. You know what failing to achieve what one sees in the world of "jeans" does to someone who has decided they MUST look like the fake and the impossible? It creates a vicious, ugly cycle called OBESITY and EATING DISORDERS.

I'll give you just one detrimental example of what the world of "jeans" and media did for me in my former eating disordered perspective:

Picture a popular gossip magazine cover. Picture the "best and worst beach bodies" edition cover. You see sand and beach chairs, designer bikinis and wedge sandals, 6-pack abs and perfectly flowing hair.... and then you see a zoomed in shot of cellulite. You know what I have? Cellulite. And, lots of it.


But, wait...What is cellulite anyway?!?


You know what my biggest trigger to developing and maintaining bulimia? ...feeling worth LESS and scared to DEATH of my body because of magazine covers just like this one...

Is emphasis on body image in the media harmful to females only?

I have mentioned to my fans at Eating to Live, Not the Alternative on Facebook that I am currently enrolled in an exceptionally interesting and personally meaningful course this summer. If you don't know, I am in graduate school at the University of South Florida in the Rehabilitation and Mental Health Counseling Program. I am taking a course that hits pretty close to home. It is called: Obesity and Eating Disorders.


Well, weekly assignments include discussion posts to a particular, possibly controversial topic in the world of body image, obesity and eating disorders. This weeks discussion topic: 


Is emphasis on body image in the media harmful to females only?

There is a significant body of knowledge out there that addresses the impact of the media on body image on adolescent girls. Social comparison significantly influences girl’s attitude about themselves. However in the last few decades males are exposed to imagers of their idealized body type and these images have an impact on the male psych as well. Adolescent boys as well as girls are pressured to engage in potentially unhealthy behaviors to achieve these idealized body sizes and shapes. Is this just another “catastrophizing “ of a situation that affects just a very small minority or is it an alarming trend in our culture that has ongoing and exacerbating psychological implications for boys. Discuss.

Hmm... Here is my two cents worth of a response:


I have done tons of research on the effects of media on body image. It is absolutely true that there is a significantly larger amount of research dedicated to the effects of media on female body image rather than male. However, the amount of research studies does not take away from the data that IS available. That data shows that the emphasis on body image has an impact on both genders. 

Although data shows that a larger percentage of females develop eating disorders, males are not immune to the effects of images in media. Media is a multi-billion dollar business for a reason. It works. And, its not going anywhere. Photoshop and digital enhancements will only become more digitally enhanced. Fashion will only continue to evolve and create trends "to die for"...or, to diet for... or, to bulk muscle up for... or, to slim down for... or, in the case of ED's, to starve or purge for. What happens when a male or female "fails" at achieving the body type or image they see in digitally enhanced mass media? They either become obsessed with it or, they lose hope. Hence, the cycle of eating disorders and obesity for BOTH males and females.

So, "is this just another “catastrophizing “ of a situation that affects just a very small minority or is it an alarming trend in our culture?"

--First of all, disordered eaters and obese Americans are NOT a small minority. MILLIONS of people suffer from ED's.

From the National Eating Disorder Association:

"Did you know...

Nearly 10 million females and 1 million males in the U.S. are battling an eating disorder such as anorexia or bulimia, while millions more suffer from binge eating disorder?"

How can you consciously label 1 million males seriously suffering from an eating disorder as a "small minority"? And, allow me to point out that these statistics are based on the DIAGNOSED eating disordered population. Trust me, there is surely a sadly large amount of people who suffer from ED's that never get diagnosed. I know this to be true because I was one of them and I know more that fall into that same undiagnosed category.

--Secondly, how could the internalization of mostly-impossible-to-achieve and wildly unrealistic digitally enhanced FAKE images in media which have empirically been shown time and time again to be a huge causal factor in eating disorder development not be considered something with an alarming trend? Did you know eating disorders are the #1 psychiatric KILLER? Is that NOT alarming?

I am alarmed...

Eating Disorder Awareness Week: Everybody knows somebody...

Did you know? Everyone of you coming across this blog knows somebody...

Are you wondering what kinda somebody I'm talking about?

Someone like me. Someone like a couple Facebook friends of mine and a couple old Kappa Delta sorority sisters of mine. Someone like Victoria Beckham or Paula Abdul, Kate Beckinsale or Diana the Princess of Wales, Calista Flockhart, Elton John or Janet Jackson, Oprah Winfrey, Portia de Rossi, Mary-Kate Olsen or Tara Reid.

All of these somebody's have one thing in common: having suffered from a potentially deadly EATING DISORDER.

Everybody knows somebody.

Did you know?

-Eating Disorders are the deadliest of all psychiatric illnesses.
-Approximately 8 million people report suffering from an eating disorder; this includes about 1 million boys and men and 7 million girls and women.
-81% of 10 year olds are afraid of being or becoming "fat"
-Half of girls 11-13 years old consider themselves "overweight"
-22% of college women admit to "always" being on a "diet"
-Only 1 in 10 people suffering from an Eating Disorder will ever receive treatment
-3 in 100 women in America suffer from bulimia; 1 in 100 suffer from Anorexia.

Everybody knows somebody who has fallen into the statistical categories above.

Eating disorders do not discriminate by weight, color or gender. Everybody knows somebody who is suffering or who is vulnerable to suffering.

"Everybody Knows Somebody" -NEDA, 2012, Eating Disorder Awareness Week

[I realized this blog was never posted -- it is from February 2012 during Eating Disorder Awareness week. Rather than not posting it, I am posting it now, just  tad bit late :) ]

How bad do you really want it...?

I’ve had many a sufferers come to me and say: “I want recovery.”

Well, the first question that comes to present mind is: “how bad do you really want it?”

When the sufferers know I have recovered, they say they want to be in recovery just like I am.

Well..... I realize this may seem harsh but:

Is it really because you can't?? Is it really that you won't?? Are you really ready for life outside of ED and poor body image??


If you are REALLY ready, how bad do you really want it?!?

I think to ask this question because I know what it takes to recover. I know what it takes, and I know that that question is key. 

It’s so key because you have got to really, seriously want it. You have to want it bad. In fact, you have to want recovery more than anything. You have to want recovery more than you want to eat, more than you want to restrict, more than you want to binge and more than you want to purge. 

You have got to want recovery so bad that you no longer listen to ED. In fact, you don’t just stop listening to ED, you shun ED, you curse ED, you get angry at ED. You don’t just turn your back on ED, you kick ED the hell out. You have to want it so bad that you are no longer willing to allow ED and its voice to control you.

You have to want recovery more than you want to be “perfect”, “skinnier”, “prettier” - whatever those mean... You have to go minutes, days, hours without allowing ED and it’s irrational thoughts to control you. You have to want it so bad that you start taking control of your own life and your own recovery. You have to want recovery so bad that you take a stand; you take a strong, firm powerful stand. You have to want it so bad that you make that choice and you NEVER look back; you NEVER give in to ED; you NEVER allow that voice to be louder than your own EVER again. Never, ever again will ED control you. You have to want it that bad.

If you really want recovery, you don’t care about anything else as much as you care about recovering. When you get to the point that all you want to do is recover from ED, then you might start a real road to recovery. When you want recovery as much as you want to breath, then you might be successful.

Do you want recovery? 

Do you REALLY want recovery?

Well... How bad do you REALLY want it?

That whole "good enough" thing...

That whole not feeling "good enough" thing... the concept really gets to me sometimes. Sometimes I feel it is self-induced, sometimes I feel like its encouraged by outsiders. Either way, I suppose, its my choice and its my responsibility to choose the way I feel about myself.

Society and those within it always have something to say. Isn't that the truth? Sometimes its people you know, people you'd like to know, people you'd like to not know... always someone. There is always someone or some billboard or some advertisement that wants to get in our sensitive heads. They point out that there is just always something missing...

But, what is it? What's missing?

Let's talk about what "good enough" means. Or, does it even have a meaning? Could you look it up in the dictionary and find one? Let's see:

Good: of favorable character or tendency; attractive; pleasant; competent; useful


Enough: as much or as many as needed; adequate; sufficient for the purpose


Perfect: flawless and faultless; unblemished



I had to throw in the the definition of perfect. Perfect... you have got to be lying to yourself if you say you or anyone you know is perfect. Flawless? Faultless? Totally unblemished? Not a soul besides Jesus Christ can claim those silly words. So, why the heck are we striving for the impossible? And more importantly, why are we so damn surprised and feel defeated when we can't achieve what is impossible to achieve? Doesn't make sense, right?

So, "good enough"... if I had to combine the above definitions of good and enough to define "good enough", it might go like this:

Good Enough: sufficient favorable character and tendency; as useful and competent as needed for a purpose


Well, shoot! I have sufficient favorable character... at least I think I do, most of the time :)
I am useful and competent for a purpose, or multiple purposes...
I have favorable tendencies! I also have unfavorable ones, but hey, I ain't perfect!

Am I perfect? Heck no I'm not. Newsflash for all: neither are you. You aren't perfect or flawless or faultless or unblemished. And, you never ever will be. RELAX, you never ever have to be!!

Am I good enough? Heck YES I am! I have good character and I have mostly favorable tendencies! I feel I have a purpose and I do things along the lines of that purpose. I try and I smile while I'm at it! And, THAT is "good enough"! It's good enough for ME! Therefore, it should be good enough for YOU and for the society in which I am a part of.

If society tells me I am not "good enough" because I don't look a certain way or do a certain thing, I might want to ask myself a question... Who the heck decides what a certain way or certain thing is?! The dictionary doesn't define "good enough", why should society? Yo society, what the heck do you mean?! Can ya be more specific?!

Better yet, To SELF: Who am I allowing to set an undefinable definition of what is "good enough"?! WHY am I allowing it and WHEN am I going to get a common sense clue that "good enough" is all within my control, my character, my tendencies, my purpose...


Good Enough is ALL about ME. Good Enough is ALL about YOU. 


Good Enough is not a societally defined concept. Heck, its not a Webster's defined concept either!

So, if something is always missing per society or per ourselves, what the heck is it? I know!! A definition...

Do yourself a favor... create your own definition and LIVE by it. Adjust it as needed. Do what YOU want with it. After all, if you create it, you own it! You can do whatever you want with it.

Take control of what is YOURS to define. If "good enough" comes with your own personalized definition, only YOU can be the JUDGE. Now that sounds like having some power and control over your life, doesn't it? I like the sound of that. Don't you??? Well, GO CREATE IT!

Meditating via the "5-minute rule" to avoid her...

I chose to take a different approach to a discussion post I was asked to complete on Meditation and Relaxation strategies in therapy. I took a personal approach. Below is my experience with "meditation" before I even knew I was meditating. Meditating helped save me from her on multiple occasions. 5 minutes was sometimes all it took. Sometimes...

I have used meditation in my past without even realizing I was doing "meditation". I suffered from an eating disorder for many years. I used to utilize a "5 minute rule"; this is what I have named the treatment tool in more present time. When I felt the compulsive urge to binge and/or purge, I would sometimes get myself together enough to say "OK. Just give yourself 5 minutes. Just breath for 5 minutes..." Multiple times, deep breathing while trying to calm the thought saved me from my eating disordered thoughts. 

Now-a-days, I realize that my "5 minute rule" was a meditation technique. It allowed me to become more aware of the greater world around me and less aware of my compulsion driven mind. The process of meditation stated in the book is almost exactly what I would do:

1. Sit quietly and alone, usually seated on my bedroom floor and between my bed and the wall.

2. Comfortable clothes... usually is the wardrobe of a disordered eater. Yep.

3. My body would be relaxed... actually it was most likely limp. My eyes would be closed.

4. "Breathe through the nostrils and down into the abdomen. Make sure your breathing is regular, slow, and rhythmical." (p.457). Yep. All of that. Deep breathing; deep breaths that I would hear inhaling through my nose and exhaling fully out of my mouth. My exhale would usually be blown out, slowly, as if I was blowing through a straw. This would calm me and would provide me with a breath to hear to drown out my thoughts.

5. "Dwell on a single...word, phrase, or your breath." (p.457). I usually would repeat a mantra of sorts. It may have been different in wording from time to time, but it always came with the same underlying idea -- "You don't have to do it". "It's okay...it'll be okay."  "It's okay...tomorrow is a new day." Those mantras or just the sound of my breath was my source of concentration.

6. Be passive to distractions. Yep. The only distraction I needed to avoid in this meditation practice was my disordered eating thoughts. In fact, I dubbed the disordered eating thought source myself in the 3rd person. She needed to be ignored. Her thoughts were my distractions. Thats where the previous, number 5, step became so necessary in order to achieve a successful "5-minutes"

7. Practice Regularly... Yep. Unfortunately, I had to do this quite regularly at some points in my struggle. FORTUNATELY though, it worked sometimes! And sometimes avoiding a binge/purge was a HUGE victory.

See, the point and my rule, if you haven't gotten it yet, was to give myself 5 minutes before I acted in bulimic behaviors. If I could succeed, it was hopeful that I may avoid her that time. If I couldn't, well... I won't go into that here.

Mindfulness Meditation:

I have used mindfulness many times during my journey towards recovery. It is amazing what mindful eating can do for an over or binge eater. Being aware and in the here-and-now when you eat provides an entirely different experience then just eating. Noticing every bite, the textures, temperatures, feel, smells, the way it looks and is presenting, the sweetness or savory tastes... 

Rather than judging yourself for the food you are eating, just being in the moment and enjoying it provides an eating experience that is much more filling. The experience is filling in the sense that you will likely eat slower this way and allow your brain to register the food you are consuming in the speed in which it does so. This can help an overeater feel full in stomach and in brain to avoid eating too much before its too late. The experience of mindful eating is also filling in the sense that you will be enjoying it more fully with every sense.

A mindful eating exercise is something that could prove so useful in therapy. It is relatively easy. It doesn't involve any specific tool; just some food of choice and maybe a piece of paper to capture the experience is all the client would need.

Meditation - an extremely valuable and FREE tool to use in therapy. In my opinion, addicts, regardless of their drug of choice, should almost always be treated therapeutically using some level of meditation utilization. Addiction recovery is all about making choices. You can use, or you can not use. If an addict can give themselves just a 5-minute chance to avoid using and reflect on those 5 minutes of sobriety, they could quite possible avoid the urge and walk away sober, too.