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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Augustina on March 16, 2005, at 10:50:00
Dr. Steinhauer,
I'm currently seeing a therapist but have just started talking about my eating disorder with him--I have a history of bulimia,laxative abuse, compulsive overeating, chronic dieting, compulsive exercise. I've been a dieter since age 10yo and am now 38yo.
Right now I'm considered a "normal" wt. for my height but have strong tendencies to overexercise and restrict and I suffer from amenorrhea. I guess I'm classified as EDNOS at this point.My question is this: is it considered "normal" to flip-flop between the desire to want to get better and the desire to want to keep losing weight, get thinner, restrict, etc...? I think deep down inside I do want to just let go of this ED and all my rules and body image distortions but then a part of me still wants to keep my way of thinking b/c I'm afraid of losing control and gaining weight.
How does one even start to make changes? Does recovery start with the behaviors that I do or with examining my emotions first?
Sorry for such a long winded question but I'd appreciate any feedback you have to offer! Thank-you.
-Augustina
Posted by Dr. Beth Steinhauer on March 18, 2005, at 22:04:06
In reply to Steinhauer: How Do I Want to Get Better?(long), posted by Augustina on March 16, 2005, at 10:50:00
Dear Augustina,
First of all, I am happy to hear that you are beginning to talk about your eating concerns with your therapist. You have been struggling with your body image and with food for many years, and I hope that treatment can help relieve your suffering.Second, it is EXTREMELY common for people with histories of Anorexia Nervosa to be quite ambivalent about treatment. After all, when you have been coping with difficult issues through restricting, bingeing, laxative abuse, etc., it is frightening to contemplate giving up this familiar (if ultimately unhealthy) set of symptoms. It also may seem far from clear what will appear in their place. Certainly, everyone I have known while they were struggling with A.N. oscillated between wanting to lose weight at any cost and wanting to regain their emotional and physical strength. The balance shifted from day to day, or from week to week. Most anorexics who recover eventually find that their commitment to getting well is robust enough to override their life-threatening commitment to thinness. Caroline Knapp, an author who died a few years ago (NOT of A.N.), wrote eloquently about her struggles with A.N. in her memoir DRINKING: A LOVE STORY, and in other published essays. She said that at a certain point, she became sick and tired of being sick and tired, and this propelled her in her recovery from her eating disorder.
Do not be discouraged, in other words, because you have mixed feelings about giving up these symptoms. How could you not? They have been a part of your life for 28 years! It may feel like you are going one step forwards, two steps back at times, but I wish you courage in your journey.
Cognitive-behavioral therapists often urge their clients to BEHAVE as though they don't have fear, even if they do, and eventually, their fear will diminish. I think the same is true for people with eating disorders. For a time, you may have to put into place behavioral prescriptions, guided by your therapist/nutritionist/doctor, and eat what is determined to be healthy, life-sustaining amounts of nourishing foods. As you've seen, even having restored your weight to a normal level doesn't necessarily mean that your body image and brain have caught up. However, if you can regularize your eating and sustain a normal weight, you can expect and hope that your acceptance of your body will be enhanced, and you will one day enjoy a peaceable, healthier relationship with food and eating.
Best of luck to you in your recovery--ES
Posted by gardenergirl on March 19, 2005, at 20:26:56
In reply to Re: Steinhauer: How Do I Want to Get Better?(long) » Augustina, posted by Dr. Beth Steinhauer on March 18, 2005, at 22:04:06
Dr. Steinhauer,
I'm not sure how long you are going to be a guest here, but I hope you are still answering posts. I am working as a psychology intern treating clients in a college counseling center, and your response here reminded me of one of my clients who was also quite ambivalent about her AN. I like to use Prochaska's Transtheoretical Model of Change when trying to understand ambivalence regarding behavioral change of any kind.Are you familiar with Prochashka's model? The literature I've seen on it in regards to eating disorders seems mixed. I would love to hear your thoughts on it.
Thanks in advance,
gg
Posted by Racer on March 20, 2005, at 15:16:59
In reply to Steinhauer: How Do I Want to Get Better?(long) » Dr. Beth Steinhauer, posted by gardenergirl on March 19, 2005, at 20:26:56
Not Dr Steinhauer, but I'll bet you'll forgive me for that...
The workbook I'm using right now, "Eating Disorders Journey to Recovery Workbook" does use the Prochaska scale of change, and I know that I find it pretty danged helpful -- although also rather unpleasant to find that even after all this time I'm still in the Contemplation stage for a lot of this stuff!
xoxo
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