EMDR stands for Eye Movement Desensitization Reprocessing. A big name for a relatively simple but highly effective method for dealing with trauma or what I like to call “emotionally stuck places.” It involves what is called bilateral stimulation of both hemispheres of the brain with a variety of methods. These methods can include eye movements to the left and right, an auditory tone in each ear or alternating vibrations in each hand. When I first started working with EMDR I was very skeptical that such a simple procedure would make any difference for my clients struggling with long standing issues around food, weight and body image. The results varied from incremental but profound shifts to complete turn-a-rounds. Here is the story of a client who experienced immediate results using EMDR.

Case Example: Using EMDR to address Pat’s Bulimia

. (Name and story altered to protect identity)

Pat came to me because she wanted to stop what she described as “wrecking my body.” She was binging and purging everyday sometimes a few times a day. Pat was 35 years old. She had a job she enjoyed but as a newcomer to San Francisco she missed having a friendship circle. Because her evenings were consumed with binge/ purge episodes she had little time for developing a social life. In any case she usually felt too awful after an episode to even think about going out.

The first step with EMDR is to develop a ‘target.’ I asked Pat what part of her destructive cycle around food felt the most emotionally charged and stuck? Pat did not hesitate: “After work when I open the door to my home, I just know that I am going to be going out within the hour to buy food for my binge. I know it’s messed up but I can’t stop myself!” This moment of homecoming became Pat’s target for her EMDR session because it was at this point that Pat started to feel the most out-of-control with her bulimia. It was a highly charged feeling that occurred daily. I have found that EMDR seems to work best when the target carries a lot of emotional charge and feels stuck.

After the preliminary set up for her target was complete Pat was ready to begin the bilateral stimulation. She had a headset that was emitting a tone in each ear, at regular intervals and she was holding vibrating pods in each hand. I prepped her to start with her target and then let her creative unconscious free associate. She immediately started to have memories from her childhood of coming home from school to an empty house after her parents divorce. I encouraged her to imagine she was on a train and to just let these memories go by like scenery. Memories came flooding back as she re-experienced the intense anxiety and loneliness around her parent’s divorce, having to move, losing her best friend and more memories associated with this time. Pat went through a whole array of feelings including anger and tears. It was as if a tightly wound ball of feelings and memories had started to unravel.

Periodically I checked in with Pat to measure the level of upset she felt around her original target on a scale of 0-10. When this level was down to 1 (i.e very little to no disturbance upon coming home after work) we were done. I instructed Pat to take it easy that evening and that she might feel more vulnerable or “raw” than usual.

Disclaimer: Although I have found EMDR helpful with most of my clients it is not for everyone. Some people feel little to no effect or change. More research is needed to evaluate why EMDR can be so effective for some and others not at all.

Follow-Up

A week later I saw Pat again. Her binge/ purge episodes had stopped happening every night. She had even started setting up some social events in the evenings. Pat told me: “It’s like someone turned the volume down on my bulimia voice. It just isn’t quite as loud as it used to be and it definitely does not have as much power over me!”

We explored the night that she did have a binge/ purge episode. This was after a particularly difficult day at work and had a different set of triggers associated with it that was more related to stress and perfectionism. We talked about using EMDR to address this different set of triggers for a future session.

Pat was beginning to peel away the different layers of emotions and triggers that fueled her bulimia. She was starting to free up her evenings for socializing and felt less alone as a result. As her “bulimia voice” became less prominent Pat started to feel that she could make healthier choices and had more options to dealing with challenging feelings. She was on the road to recovery.

Is EMDR for you?

Call or write Ondina Hatvany, MFT with any questions or concerns.
(415) 381-1065 Confidential Office line
Or e-mail: ondinah@gmail.com

She was very open about her struggle with compulsive eating and “trying every diet that had ever existed; including the fried chicken diet!” She confessed to believing she would never get out of “my personal food and eating Hell ever.”

The breakthrough for Geneen it seems is when she started to listen to herself and trust herself. This became “the open secret to almost everything.” She went on to say; “The thing we most want to get rid of is actually the doorway out. Nobody thinks that their issues around food are going to lead to the center of both yourself and everything!” She encouraged us to be curious and explore what happens in our relationship with food rather than judge ourselves. She is actually talking about applying mindfulness (a Buddhist meditation technique) to our relationship with food and our bodies. Mindfulness is about being with our experience rather than our ideas about an experience.

She advised us to try and understand what was shaping our beliefs about food because “the shape of your body obeys the shape of your beliefs.” Beliefs are based on a combination of past conditioning and what it took to survive. Beliefs lead to thought, which leads to action. To really change we have to start at the unseen level. She goes on to say; “spiritual hunger can never be solved at the physical level.”

It all sounded like a good idea but what really started to bring some of these concepts home was when she had us try a few exercises: We had to write down 3 beliefs we had about food and share them with the person next to us. The hall was buzzing and later there was tears and laughter as people shared their beliefs about food: “It’s dangerous!” “There is never enough.” “It’s my best friend.”

The next exercise was a visualization of a table loaded with our favorite foods. This revealed more self limiting beliefs. Furthermore the connection between physical nurturing and emotional nourishment became abundantly clear as people shared their experience of the exercise: “I had to walk away, it was too much.” “I felt so guilty!”

My personal favorite was the eating exercise where we practiced mindful eating with a raisin, a chip and a piece of chocolate. This was aptly timed just before lunch. I love chocolate but that piece of chocolate eaten mindfully was pure nirvana! The smell, the taste, the texture were extraordinary. I saw how I could make much more room for mindful eating in my busy life. When someone complained about how much effort it took to eat mindfully. Geneen pointed out: “It takes effort to become effortless.”

Geneen emphasizes that breaking free of the obsession with food is our birthright. She encourages us to look for the emotional reality being played out in our physical battle with the food and weight. She then dares us to take it to the next level; what if it’s really about our spiritual hunger?

She is a powerful role model for people who struggle daily with food, weight and their body image. She too was once someone with these struggles. She found a way out and it became her doorway to curing not only her food and weight issues but also healing her emotional life and opening her  spiritual life. Her message is strong and heartfelt. She is living proof of its’ validity.

Plenty of food for thought… pun intended…: )

Mary was a client of mine who had been working with me to manage her compulsive eating and consequent weight gain. She had come a long way. She was practicing eating mindfully and exercising regularly. She had discovered she enjoyed tennis, after our discussion to find an exercise she liked. She was losing weight without dieting and loving it. The party was a big set back for her. She felt like she had gone back to her previous unconscious patterns with food. She didn’t understand why.

“Let’s unpackage this,” I suggested. “If we back track maybe you can gain some insight and awareness about what was happening around your relapse.” I also reassured her that the road to recovery is paved with relapse. If she could look at her relapse with some compassion for herself and curiosity, not only would it increase her self knowledge, it would lessen the likelihood of a relapse happening again.

Comfort Eating or using Food to Self Soothe

What Mary found out after some honest self exploration, was that she had been eating in an attempt to handle the anxiety that came up for her when she walked into the party where she barely knew anyone. The food table also felt like an easier place for Mary to strike up conversation with a total stranger. Mary was engaging in comfort eating or using food to self soothe.

Most of us have engaged in comfort eating at some time in our lives. Feeding was often used to soothe us as babies. For instance when a baby cries she usually gets the bottle or breast. Or if a child falls it’s typical for her to be given a sweetie or a treat to make it better. The media knows how to capitalize on our fixation as a culture with oral forms of comfort. You only have to watch 5 minutes of commercials to see an endless array of oral form of soothing; things to drink, eat, smoke, pills to pop etc.

There is nothing wrong with comfort eating, we all do it but Mary wanted to have more choice. She didn’t like feeling so powerless. The first step towards empowering her was to help her become more aware of her anxiety and how it manifested for her.

The first Step towards handling Anxiety: Naming it!

“What did you notice in your body when you walked into the party?” I asked her.
Mary wasn’t sure initially. She wasn’t used to tuning into her body in this way.
Eventually she was able to name the tightening in her chest and the shortness of breath that became her indicators that she was experiencing anxiety.

The Second Step: The Top 10 Soother List.

Now that she had developed some more awareness around her anxiety cues she could start to address other options for handling it. We worked on one of my favorites: The Top 10 Soother List. This is a list of options for self soothing that provides alternatives to comfort eating. It didn’t mean that Mary could never comfort eat again but now she knew she had other options.

Her Top 10 Soother list was as follows:
1/ Breathe!
2/ Visualize my ‘safety anchor’ and/ or ‘safe place’
3/ Hold the ‘Little Mary’ (who was traumatized by going to a new school in the second grade and didn’t like new settings with new people) Reassure her.
4/ Practice gratitude exercise (i.e What am I grateful for right now? It activates the brain to scan for ‘good things’ versus threats)
5/ Smell some lavender oil (Mary carried around a vial because she found the smell calming.)
6/ Practice mindful eating (i.e really noticing the taste, smell, texture etc. of the food and savor the pleasure of it)
7/ Call a friend and let them know I’m feeling triggered…
8/ Leave (She wanted to give herself this option as a last resort)

There is space for 2 more! Can you think of something that would work for you when triggered to comfort eat?

The Top 10 Soother List is personal to each individual. It can include ways to talk to oneself in a comforting, reassuring way, much like a loving adult would talk to a frightened child. It is about activating the brain to respond differently in a perceived stress inducing environment. It does this by bringing in as many of the senses as possible (taste, sight, smell, touch etc.) to ground the body and calm the nervous system. Connecting with a trusted friend or loved one can also provide that same calming effect.

In Mary’s case the next time she was at an unfamiliar venue with people she didn’t know she tried #7. She found that having a friend to talk her down while at a party filled with strangers, really helped. She was able to feel less anxious and more grounded in her body. She actually ended up meeting some really interesting people and to her surprise enjoyed herself!

The Third Step: Practice! Practice! Practice!

Now the trick is to implement the wonderful list you have created for yourself. I advise making a copy that is small enough to carry around with you in your wallet or purse. Some of my clients copy it onto their cell phones. Wherever it is you want it ready and accessible at a moment’s notice.

In order for change to happen you need to practice implementing these 3 steps over and over. It takes lots of repetition to start to change how we are wired to react.

In the beginning just noticing the signs your body gives you that you are anxious is a big step in the right direction. The first time you remember to access your ‘Top 10 Soother List’, instead of reacting in the same old way, is also a big step. Give yourself lots of positive encouragement as you venture on this new road of literally rewiring how you react to anxiety and remember practice, practice, practice!

Body image is a mental idea about your physical body and how you look. Body image is something that constantly changes as it is based more on feeling than fact. This also makes it very vulnerable to distortion.

Let me illustrate just how vulnerable your body image can be with this story…I had a client Marge, who was working hard on improving her body image. She was taking better care of herself. She was eating healthier foods. She was also creating other sources of nurturing for herself by fostering a more caring, supportive friendship circle. She had found an exercise she enjoyed and was doing that regularly. She was really starting to feel better about herself; her self esteem and body image were improving daily and it showed. She had a bounce in her step and an excitement about her that was contagious. She started to get more attention One day she announced to me that she had been asked on a date! She was very excited.

The following week she wasn’t doing so well. I asked her what had happened? She told me that the date didn’t go as she had hoped. Marge had what I refer to as, “A Fat Attack” She felt rejected and blamed her body. “I suddenly felt so fat and ugly!” she told me. “It was the way he looked at me, I knew I’d never see him again.” Marge went into the date and left it with the same body but somewhere in there she felt like she had put on 20lbs.

How the Media Cashes in on our Vulnerability…

The media really knows how to cash in on this vulnerability. We are constantly being bombarded with images that tell us that if we look a certain way we too can enjoy success, love, happiness etc. The problem with this excessive focus on externals or how we look is that it takes us away from our internal felt sense of what has true value and meaning for us. When people move away from their truth they become disempowered. It is also really disempowering to be in a constant battle with your own body. Your body then becomes your battleground or ‘shame container’ instead of home for your psyche and spirit. It is a modern tragedy.

Narrow versus Wide Base for Self Esteem:

What exactly do I mean by ‘a narrow basis for self esteem’?

It is when your self esteem is based solely on one thing, such as how you look or how much you weigh. With such a narrow base, your self esteem is much more vulnerable to collapse.

What does ‘a wide basis for self esteem’ mean?

It is when there are other qualities that form a foundation for your self esteem. These qualities might include your fabulous personality, your talents and gifts, your smile, your contribution to your community, your culture etc. When you have a number of different things that you value about yourself your view of yourself will also be more stable, steady and solid.

Healthy body image means that you are comfortable with the body that you have. It does not mean that you think your body is perfect, rather that you accept and commit to loving and caring for it. Healthy body image means having a relationship with your body that is based on more than what you weigh. It is built on a wide basis for your self esteem. The irony is that when we feel better about ourselves research shows we also take better care of ourselves, this means we are more inclined to feed and exercise our bodies too. Our bodies can be like kids; they respond better to positive reinforcement rather than constant criticism, nagging etc. Try focusing on talking more lovingly to and about your body for a day and see if you don’t notice a difference.

Can Food Really Be About Pleasure?
Try Something Different This Holiday:
Mindful Eating – A Way To Enjoy More Quality vs Quantity

Mindful eating is about paying attention to what you eat. Actually focusing on the flavors, textures and subtleties of what you are putting in your body. It is not about eating while you are thinking of your bills, the kids, how many calories, watching TV etc. For most of us this is a tall order. There are so many distractions and people, places, things pulling on us, who has time to really pay attention to what they are eating? What is even the point?

The point is pleasure. When we are really present with what we choose to put in our body we experience the subtleties of what we taste. We experience the food more intensely. We allow it to nurture us more deeply. We are not thinking about our next meal because we are too busy enjoying this meal. We are not reaching for the next piece because we never really tasted the first piece. In this way we end up enjoying more quality and needing less quantity.

For the eating disordered population or those with food, weight and body image issues mindful eating is key. If you allow yourself to enjoy what you eat and practice being present, you will need less to feel satisfied. If on the other hand you are so consumed with guilt while you eat that piece of chocolate and thinking of all the ways you are going to have to make up for this misdemeanour, you are barely going to taste that first piece of chocolate and need another and another.

Next time you want chocolate or that * “forbidden food” try this exercise. You might find you enjoy more and eat less as a result…

Mindful Eating Practice with Chocolate:

Next time that chocolate craving hit,s close your eyes and ask yourself with focus;

What kind of chocolate do I want exactly?
Is it dark, milk or white chocolate?
Is it crunchy or smooth? Gooey or hard?
If it’s crunch you want, ask yourself: What kind of crunch exactly?
Is it a nutty crunch, candy crunch or a rice crispy kind of crunch?
What kind of  gooey? Is it a caramel gooey or a fruit gooey?
And so on…. See if you can define exactly what you want. Be specific!

When you have defined exactly what it is you desire, you are ready for the best bit!

Find a space without distractions. Unwrap the chocolate slowly, enjoying the crinkle of the paper and the smell of sweet cacao being released. Look at the chocolate, smell it, lick it. Notice the texture and sensation of biting into it. Let the chocolate melt on your tongue, dissolving in deliciousness. Enjoy the feeling of this chocolate luxury, decadence and pleasure and let it sink deeply into your being.

After awhile the feeling of pleasure starts to become less intense. This is your signal that you are nearing the end of this delicious excursion into chocolate. If you are practicing *’intuitive eating’ you know you can put the chocolate away with the sure knowledge that when you want some more you will let yourself have more and fully enjoy it.

Nb.
This mindfulness practice can apply to ALL your eating not just chocolate/ “forbidden foods”

*      *      *      *       *

In the book ‘Intuitive Eating; A Revolutionary Program that works’ Trobole + Resch encourage making all activities pertaining to food pleasurable ones:

“When you eat what you really want in an environment that is inviting, the pleasure you will derive will be a powerful force in keeping you satisfied and content… You will find it takes less food to decide you have had enough.”

“I won’t be able to stop eating!”
All of this might seem really scary for those of us who have been steeped in the diet ruled mentality that advocates controlling our body’s appetites and desires at all costs. We have a $40 billion dieting industry in this country that advocates this way of thinking. It can seem unfamiliar and scary to consider listening to our body and having our body be our friend instead of our battleground. I hear clients voice fears around the concept of intuitive eating all the time:

“I won’t be able to stop eating!” Or “I don’t know how to listen to my body’s appetites.” Be patient with yourself and get some guidance. If you are getting your nutritional needs met you won’t go crazy on the chocolate. If you practice listening to your body it becomes easier and more fluid. It also helps to have some guidance/ therapy especially in the beginning.

Here’s to a Pleasure-Filled Holiday and 2010!

* “forbidden foods”
Intuitive eating principles propose steering clear of rigidity around food.
Labeling food as either “good” or “bad” causes food obsessions and contributes to eating disordered thinking.

* “intuitive eating” encourages a ‘bottoms up approach’ of listening to your body versus the ‘top down approach’ of using your mind to rule your body

Yes, I was once a food addict and at the whims of emotional eating bouts that left me exhausted and filled with self loathing. At the time I thought I would never find a way out of the not so merry-go-round of the fasting/ feasting cycle that had it’s grip on me. The breakthrough was when I first began to make the connection that perhaps it was not about the food… so, what was it about then? Here’s that story:

1985 in London, during the throes of my compulsive binge eating days, I was invited to a community in Scotland called Findhorn that was famous for its’ unexplained phenomenon of being able to grow record sized vegetables and fruits out of sandy soils. I spent a magical week living close to the land, eating fresh fruits and vegetables and meeting many interesting people. Needless to say, this was a welcome break from my unhealthy London life!

However, as soon as I was back in London, I hit the sweet shops driven by a compulsion that seemed stronger than me. I was on a massive sugar binge. Miserable and filled with self hatred, all of the magic of Findhorn disappeared. I was right back to square one, except now, it was worse because I had tasted something different. I felt trapped by the prospect of a future with this constant battle against food and my body.

That night I got a call from a new friend I had made at Findhorn. When he asked me how I was doing I decided to tell him the truth. Being at rock bottom, I figured I had nothing to lose. I shared with him hesitantly because I was so ashamed by my excursions.

His response was simple but it changed everything: ” Maybe you are looking for more sweetness in your life?”

It was an “Ah-Ha!” moment that changed everything: I felt seen!

I suddenly got that I was trying fulfill my emotional needs from food. There was a lot more going on here than mere over-eating.

Discovering the link of this emotional component with my struggle around food was the beginning of my healing journey. A journey that continues to this day as I explore with clients ways to break through compulsive binge eating, bulimia, anorexia and all the variations of emotional eating and food addictions.

Gone are the days waking up and dreading facing another day around food. Nurturing myself has become a great pleasure in life. This has created more freedom with food and my body image than I ever would have believed possible!

I share my story in the hope that others who struggle with emotional eating and food addiction might realize that freedom from vicious cycles of food, weight and body image issues IS possible. You might want to start with getting curious about the question: “What if it’s not about the food?”

I was talking about all of the above, with my client, Mary who came to me for food/ weight/ body image issues last year. I asked her if she was interested in trying something different? She said “Yes!” She was tired of her “excess weight” and poor body image … So I suggested she try a more right brain approach that would not only be more pleasurable but also most likely more successful. Needless to say she was very curious!

We tried the following 3 steps in session and then she practiced them at home everyday:

Step 1:
To state out loud each of her intentions and most importantly believe she can really have them/ deserves them. The latter part is important as it is often what can consciously or unconsciously trip us up.

Step 2:
To imagine herself having already obtained each intention. Notice what this feels like in her body. How is she walking, talking, acting differently? I encouraged her to really ground the feeling in her body and flesh it out as much as possible with details using all her senses. I call this “ creating a body memory.” The more detailed your ‘body memory’ is the more powerfully it will work!

She really enjoyed this part as she imagined fitting into a red dress she wanted to buy, how it would feel on her skin, the looks and comments she might receive etc.

Step 3:
To recall this ‘body memory’ periodically throughout her day, especially when she was feeling her intention was being challenged.

Mary practiced the above in session and over the next few weeks I checked in with her.

She was exercising more as she had applied the same ‘pleasure principal to other areas of her life. Now instead of trying to make herself go the gym, (which she realized she hated) she was going for walks with a friend, who welcomed the opportunity to take out her dogs. Mary enjoyed the walking and felt the benefits nearly immediately. It wasn’t a chore to exercise anymore. She actually looked forward to walking and connecting with her friend. Exercise was fast becoming an increasingly pleasurable activity. This was definitely new for Mary!

She also used the visualization she had practiced in session, on numerous occasions. For instance to pass up on that second helping at the dinner table. It didn’t feel like such a sacrifice as she enjoyed the feeling of pleasure she got from imagining wearing her red dress and the responses she might receive.

One day she came in wearing the red dress and thanked me. I could tell her self esteem was improved and so was her body image. It showed in her increased confidence and how she carried herself. She was working with using pleasure as a motivator instead of ’shoulds’ and most of all having fun with it!

Try it you might be surprised…; )

Following are some tips for dealing with the food, family and holidays dilemma:

1) Identify your trigger foods and situations:

A ‘trigger food’ is food that when eaten makes someone feel out of control or compulsive with food. Figuring out which foods put you in that “I can’t stop” mode is really important. For some, it’s the first taste of sugar that gets them craving for more. For others, it’s the carbs (bread, cake etc.) that jump starts the “bottomless pit feeling.” Surprisingly, trigger foods are often linked to allergies. It’s worth getting a nutritional evaluation just to be sure. For now just try and avoid your trigger foods altogether.

There is a catch, however. Ironically we often crave our trigger foods or those foods to which we are most allergic! Here’s a quick tip if you find yourself dealing with an irresistible craving for that trigger cookie: eat some protein (especially important for sugar/ carb addicts) or a fresh piece of fruit, a vegetable, or drink lots of water.

Trigger situations and people can be trickier to identify. This is a skill that develops over time and with practice. Food addicts often use food as a way to suppress or divert from difficult feelings. So when you find yourself obsessing about that last slice of pie or can’t stop munching on the chips, see if you can back-track to what happened just before you started to obsess or feel out of control. This investigation can provide you with important clues about what feelings you might be using food to avoid.
For example: I had a client who binged every time anger came up for her. At first it was a week or more before she could link a binge to its’ trigger. Eventually she could recognize within a few hours what event and/or person had triggered her feelings of anger and consequent binge. When she was finally able to identify her anger more quickly and find constructive ways to give it voice in the moment, she found that the urge to binge disappeared.

2) Find ways to self-soothe

For food addicts, food can be the primary way to self-soothe. Often this imprint was created long ago when, for instance mummy gave you a lollipop to stop you crying over your hurt knee. But there are a million other ways to self-soothe: Taking a bath, going for a walk, calling a friend, listening to music, going for a drive and so on….Try creating your own ‘Top 10 soothers list’.
One crucial point: Create your list before going to your holiday events and take it with you. If you’ve thought about it beforehand and your list is as readily available to you as that box of chocolates, then maybe instead of eating half the box you’ll just eat one chocolate before going out for a breath of fresh air with your I pod and some of your favorite tunes. It takes a bit of consciousness to initially change old habits. Help yourself by taking your‘Top10 soothers’ list with you whenever you go out. It really works and is much more fun than yet another holiday when you end up feeling down on yourself.

3) Keep your blood sugar stable. Eat at least every 4 hours.

In order to avoid a blood sugar crash or the fast/ feast cycle space mealtimes and snacks throughout your day. Think of your meals as rocks helping you cross a river (i.e getting through your day). If you space the rocks too far apart you can slip and fall. However if the rocks are evenly spaced you can cross the river without getting wet.

Try eating 3-5 snacks/ meals a day with at least one of them containing protein. Keeping your blood sugar stable will help enormously to keep food compulsions at bay.

4) Avoid overly rigid rules around food

Rigid rules around food will only make you more preoccupied with food. Expect to slip up. Don’t expect perfection. See if you can allow yourself the pleasure of food while staying connected with yourself and reconnecting with loved ones this holiday season. After all isn’t this the best present of all to yourself and others? Follow these 4 simple steps and see if it doesn’t make a difference…. Here’s to a happy holiday!

* The definition of a food addict is someone who either overeats or undereats for emotional reasons.