I also help couples with what I call “conscious closure.” What do I mean by conscious closure? It is based on the idea that how you end something sets the stage for a new beginning. In this case, how you end a relationship creates a certain momentum for your next relationship. If you end a relationship without making time for self-reflection, you are in danger of repeating the same dynamic you had in your old relationship, albeit with someone new. If you’re noticing that you seem to be repeating the same dysfunctional dynamic in your own relationships, maybe it’s time to get curious about whether this might have anything to do with your own contribution.

For example, one of my clients kept attracting unavailable men. She really thought she wanted a long-term, monogamous relationship but she kept ending up with men who didn’t, even when they conveyed the exact opposite in the beginning. She was becoming frustrated and her self-esteem was hitting an all-time low. I gently suggested that perhaps these men reflected a part of her that was also saying “no” to the relationship. It wasn’t until we started to explore the “no” in her that things really turned around. By seriously reflecting on her own contribution to the end of one relationship, she was then able to create a different and more empowered dynamic in her future relationships.

But back to “To stay or to go?” This is a big question! There really are no generalizations I can make about this topic. It is a decision that is unique to each member of a couple. Sometimes it becomes apparent after working with a couple for a while that the best course for both parties is to end the relationship. This decision can be heartbreaking, especially if children are involved or one member of the couple is trying to hang on. Other times, even if everything in you is screaming, “Get out!” the best course might be to stay because there is so much growth potential for you in the relationship.

If you are entertaining the question “To stay or to go?” here are some things you might want to ask yourself:

Do I love this person?
This might seem obvious, but people stay together for many reasons long after the love has gone. You might stay out of convenience. Or maybe the thought of being single is too scary; you fear being alone or you are avoiding feelings of rejection or abandonment, even though staying in the relationship has you feeling lonelier than you ever would on your own. Sometimes couples stay together for the kids’ sake, although you have to wonder if the children really benefit from their parents’ loveless marriage. Sometimes it is pure habit that keeps a couple together, or emotional and financial dependency… The list goes on! If you don’t have a clear answer to this simple question, you might want to consider therapy to get some clarity, because there really is no happy relationship without this basic building block.

Can I grow with this person?
Sometimes people quite simply grow apart. You may realize you have very little in common anymore or very few places where you meet and can enjoy something together. This happened to a long-term couple I worked with who realized, sadly, that all that was holding them together were the kids.

Other times the relationship is pushing you right up against your “growth edge.” What do I mean by this? Your growth edge can take many forms, but basically it is when being in relationship forces you to look at the next step or stage in your personal and/or spiritual growth and development. This can happen when you realize that you need to look at some deeply rooted habits or beliefs if your relationship is to survive. Or when an old wound from your past surfaces in your relationship because it is ready to be healed.

For instance, I had a client who had finally found someone whom she really liked and felt very compatible with after many years of unsatisfactory dating. Her growth edge came up strongly for her at this stage, in the form of fear and the desire to run from the relationship. This made no sense to her until we started to explore her fear. She realized that she held beliefs that relationships were dangerous and had deeper beliefs that she was unlovable. Most of this stemmed from old, relational traumas from her childhood that involved physical, sexual and emotional abuse. These traumas were surfacing because her lover was getting “too close” and old alarm bells were ringing. It proved to be a wonderful, albeit scary, healing opportunity for her to address these old wounds. She was brave enough to stay in the relationship and face her demons. As a result, she grew tremendously and also found herself with the relationship of her dreams!

Is there passion or chemistry?
Passion and chemistry are those mysterious ingredients that are either there or not; you can’t really manufacture them. Sometimes passion is there for a couple in the beginning and then it just seems to evaporate. In this case, I encourage people to become really curious about when it disappeared and what was going on at the time.

Time and time again I see with my couples that when the emotional intimacy and safety in the relationship dies, so does the passion. Sometimes this happens abruptly and sometimes it happens very gradually. For instance, for one of my couples the passion started to dwindle after the birth of their first child. Although this is a common time for there to be a lull in lovemaking, they never recovered their physical intimacy and affection with one another. We had to go back to see what message each had internalized about the other during that time. Unfortunately, it had been so long that there really was very little juice left between them. All their affection had been directed toward their child while the bond between them slowly withered from neglect. They simply didn’t have enough love left for each other to salvage the relationship. It was a hard truth to face. In their case, if they had considered couples counseling ten years earlier they might have had a chance.

In closing, I would have to say that whether to stay or go in a relationship is a complex question that involves some level of self-exploration and the ability to be brutally honest with yourself. However, if I were to attempt to distill the essence of what you might consider in your exploration, you could ask yourself these questions: Who are you in this relationship? What does it bring out in you? Does it support your sense of self or does it detract from it? In other words, do you find yourself becoming someone you are not? Do you feel you are twisting yourself to fit the relationship or into the person you think your partner wants you to be? Does being in the relationship support you in being your biggest and best self?  

David Whyte speaks to this eloquently at the end of his poem entitled “Sweet Darkness”:

You must learn one thing:
the world was made to be free in.

Give up all the other worlds
except the one to which you belong.

Sometimes it takes darkness and the sweet
confinement of your aloneness
to learn

anything or anyone
that does not bring you alive
is too small for you.

Sound familiar?

Recently I’ve been talking a lot with my couples about practicing what I call “doggy medicine.” Doggy medicine can apply to almost anyone, regardless of whether you own a dog (or your dog owns you!) or there is no dog in your life.

What exactly is “doggy medicine”?

Doggy medicine is a tool I’ve developed to help couples improve the way they interact with each other. Let’s take Maggy and Rick for instance. They can barely make time for themselves let alone each other. It seems that fighting is the main way they currently connect. They are tired and angry and depleted. The following is a dialogue from one of our sessions where I explained to Maggy and Rick how to use doggy medicine to enhance their relationship.

“When you come home, who greets you?” I ask Maggy.

“Well, I guess Latte,” says Maggy, wondering where I’m going with this. Latte is Maggy and Rick’s dog.

“Yes, and how does she greet you?” I continued. “It’s all tails and wags, isn’t it? She makes it really obvious that she is happy to see you. How is that for you?”

Maggy smiles. She says softly, “It’s the best feeling in the world.”

“What happens when Rick gets home?” I ask.

“Well, yesterday I was tired and had a headache. I yelled at him from the other room if he’d remembered to pick up medicine for Lucy (their 3-year-old.) He hadn’t. This really pissed me off. We were fighting within two minutes of him stepping in the door,” Maggy says with a sigh.

“Here is where doggy medicine comes in,” I tell her. “I want you both to practice greeting each other just like Latte greets you, regardless of what mood you are in and before you say anything to each other about the to-do’s.”

What I am advising Maggy and Rick to do is to practice connecting non-verbally, with their eyes and bodies. It could be as simple as looking at each other and giving each other a hug. It can take a second or last a few minutes—it doesn’t have to take a long time. The important thing is that a heartfelt connection is made that is free from judgment and that also affirms their relationship as coming first and foremost before all those to-do’s.

Simple instructions, but does this work?

Research shows that when we are physically close with our partners, whether that is hugging, cuddling or having sex, our bodies are flooded with “the cuddle hormones,” oxytocin and vasopressin. These hormones tend to turn on reward centers in the brain, flooding us with calm and happiness chemicals like dopamine and turning off stress hormones like cortisol.

When is the best time for doggy medicine?

I recommend practicing doggy medicine during the four important transition times of the day:
1) When you wake up
2) When you part ways (usually at the beginning of the day)
3) When you reunite (usually at the end of the day)
4) When you go to sleep

Outside of these transition moments, doggy medicine can be applied anytime and anywhere. In particular, it is useful during moments of stress. Try it. It might not be your first inclination to ask for a hug when you are stressed and it might even feel very vulnerable, but I guarantee that it will produce much better results than yelling at your partner!

Try doggy medicine with your partner and fill your transition times with some cuddle hormones. Oh, and don’t forget to thank your dog (or your neighbor’s dog if you don’t have one) for such great modeling on keeping it simple and staying in connection!

So much of the holidays can be taken up with the busy stuff of gift buying, travel plans, and food and festivity preparations that we’re often left exhausted and depleted. It’s easy to forget what the holidays are fundamentally about: to connect and be with family, friends and loved ones. This holiday, offer the gift of your presence to both yourself and your loved ones.

What do I mean by “the gift of your presence”?

Simply put, being present is about being a human being as opposed to a human doing. It’s about being with yourself or your partner instead of busily doing something with your mind elsewhere. You can also practice being really present while doing something fun with your partner. For instance, you could be on a bike ride with your love, enjoying and participating in the experience, giving both your partner and yourself the gift of your full presence. On the other hand, you could be on that bike ride with your mind a million miles away, thinking about that turkey you have to buy or something else on your to-do list. In this case you are just “doing” the bike ride. And your lack of presence may unintentionally give your partner a really negative message about your value and appreciation for them.

Most of us fall somewhere in the middle of the spectrum between “being” and “doing.”

Some of us are more toward the “being” end and some more toward the “doing” end of the Being/Doing Spectrum. If, like me, you find yourself more at the “doing” end, some kind of mindfulness practice can really help, even if it is just for 5-10 minutes a day. Consider this a chance to work out your “being muscle.” At first, you may have a hard time simply locating this muscle! Then, once you locate it and start working on it, you may feel awkward and clumsy. Afterwards, you may be super sore! But over time it gets easier and easier to work that muscle, and eventually it even becomes enjoyable. This is what mindfulness practice is like. At first it can feel difficult and awkward. Your mind is racing a mile a minute. You have no idea if you are even doing it right. Eventually, it gets easier and you start to enjoy the practice. It becomes a way to connect with yourself that is different from your habitual “doing” mode. It’s really about being with yourself, with no agenda, nowhere to go, nothing to do. It can become a deeply nourishing space that you find you really miss if you skip a day!

The Neurobiology of “We”

Your ability to be present for yourself in this mindful way not only radically shifts your relationship with yourself, it can also deeply affect your relationships. You may find that you are able to be present in a much fuller way with loved ones and that this deepens your relationships. Studies show that mindfulness increases empathy, which increases trust in relationship. As Daniel Siegel, a well-known neurobiologist, says:

If you can be open to what’s going on inside of you as it’s happening, then there’s a gateway to being open and present to other people as well… The more you are aware of your own bodily sensations, the more you could be aware of other people’s internal emotional states. It’s called the neurobiology of “we.”

Too Busy to be Present?

Does all this feel like something else to add on your to-do list? Some of the couples I see are so busy that they barely get a chance to connect with themselves, let alone each other! I saw a couple the other day who told me their session with me was the first chance they had all week to sit down and talk! In cases such as theirs, I suggest “connection rituals” that I encourage them to schedule into their busy lives. Prioritizing time together is as important for couples as going to a class or a business meeting. These connection rituals can become the lifeboat for a relationship that is drowning in to-do’s.

What is a connection ritual?

These rituals vary depending on the couple. There are 101 different ways to be together. The operative word here is be. A connection ritual is not a time to talk about the kids or scheduling. It’s a time to relax, play and enjoy each other. The couples I see have come up with a variety of connection rituals: going for a hike, playing music, taking a bath together, reading out loud to each other, having breakfast in bed, going out for a meal, having a coffee date, and so on. Be creative and see what you and your partner can come up with! And most of all, have fun!

I will leave you with this quote (and if anyone knows the source of it, please let me know!): “A beautiful marriage is built on a long series of little things you do for your mate for no reason on earth except the best reason of all, and that is that you love them.”

The Pleasure Principle is simply this: Our bodies are wired to move towards pleasure and avoid pain. We naturally gravitate towards things that taste, smell and feel yummy and delicious. We naturally avoid the opposite.

What if following and listening to our pleasure was really the secret to it all? What if by listening to our bodies instead of fighting them we started to come into a better balance around our weight and body image?

Impossible you say? Let me invite you to temporarily suspend your disbelief until you read the rest of this article…

Pleasure is the key to the practice of intuitive eating.

If you are practicing intuitive eating (which, in a nutshell, is to eat when you’re hungry and stop when you’re satisfied, and to eat what your body wants), then when you are hungry you ask yourself: “What is the most nutritious and delicious thing I can eat right now?” You need to have your pleasure muscle well toned and flexed in order to be able to answer this question. In fact the more tuned in you are to what will bring you pleasure, the better you will be able to intuit what your body wants and needs.

Left to their own devices, our bodies are naturally going to want to eat what will increase our chances of survival. Our default mode is for strength and health. Of course, if you have been dieting most of your life, some of these natural predispositions of the body might have become skewed, so it’s important to be patient with yourself.

So many of my clients who have spent a lifetime going from one diet to another are terrified at the thought of practicing intuitive eating. “I won’t be able to stop eating chocolate!” wailed one of my clients. Chocolate was her number one forbidden food, so of course once she considered legalizing it, that is where her mind went. There is nothing like scarcity to increase our desire for something.

Although this is a valid fear and one that might even get played out, in my experience, this phase of overdosing on forbidden foods is relatively short-lived. Once your body gets that it can eat what it wants, when it wants, and even as much as it wants, a forbidden food like chocolate starts to lose its grip on you.

In their book When Women Stop Hating their Bodies Hirschmann and Munter tell us:
Always having large quantities of the food you love at hand is critical to the process of legalizing. As a rule, everyone starts this process by doing just that—stocking up. There is no question that the biggest surprise for people in the early stages of legalizing food is that, contrary to popular belief, the more food you have at hand, the less you eat. Scarcity produces anxiety; surplus makes people feel more secure.

Pleasure can also be used as a barometer for when we’re starting to feel satisfied and have had enough. When we first start to eat, we are truly hungry; the food tastes that much better because we have an appetite for it. However, once we start to fill up, our pleasure begins to diminish. This is our sign that we have probably had enough food. If we know that there will be more food and plenty of it when we are hungry again and can really enjoy it, it won’t be so hard for us to stop eating.

If you’ve been trying diets and they haven’t been working, try using the pleasure principle. Our bodies don’t do well with deprivation and punishment; they are so much more responsive to pleasure. Like it or not, our bodies are wired for pleasure. Try working with your body instead of against it for a change.

What I am writing about here is completely counter-cultural to what most women have been spoon-fed since birth (pun intended). It’s certainly not what the dieting industry wants us to believe. They have spent billions of dollars convincing us that our bodies are battlegrounds to be controlled and conquered. Has this approach been working for you?

If you are going to try some of the suggestions I have outlined here, please enlist some support, whether it is individual or group therapy or both, because it is hard to change these deeply encoded messages on our own. The more support you can get, especially in the beginning, the better your chance of success.

Here’s to your pleasure!

1) Yvonne & Angela: How homophobia ruined our romantic vacation

After I asked a lesbian couple why they hadn’t taken a vacation together in five years, this is what they told me:

Yvonne:
I took her on what was advertised as a “gay-friendly destination” but as it turned out, we were the only queer couple in sight! Consequently she was really paranoid in public and wouldn’t hold my hand on the beach or became really uncomfortable if I suggested a restaurant that looked slightly romantic. She’s a butch woman, so people were staring at her anyway because they couldn’t quite place her on the gender spectrum. It pretty much killed the romance factor out in public, and unfortunately it translated into the bedroom as well. She just couldn’t make that transition when we were alone. It was as if she didn’t take a breath until we got home. Needless to say, we haven’t been on an overseas vacation since!

Angela:
I think on some level I just didn’t feel safe. I didn’t speak the language or know the people. They stared at me all the time. I think they couldn’t figure out if I was a guy or a girl. It might sound ridiculous, but I was expecting to be attacked at any moment. Consequently, my guard was up at all times.

This couple had to deal with a whole set of stressors that a heterosexual couple would probably never need to consider when planning their holiday (like having to find a “heterosexually-friendly destination”). So much of the travel industry is geared towards the romantic getaway, but those getaways are mostly aimed at heterosexual couples. This omission of queer couples is part of what is termed “heteronormative assumptions.”

[Heteronormative assumptions] refer to automatic unconscious beliefs and expectations that reinforce heterosexuality and heterosexual relationship as the ideal norm. Thus, heteronormative assumptions create a society where only heterosexual relationships are visible (McGeorge and Carlson, 2011).*

Although the travel industry has become savvy to a whole previously untapped market and there are now ads for gay-friendly destinations on every queer travel site, the truth is that this can also be a marketing ploy. As Yvonne and her girlfriend found when they got to their “gay-friendly” destination, the locals hadn’t been informed!

2) Gloria & Maria: A pregnant lesbian couple’s first birthing class together

Gloria:
I was so uncomfortable that we were the only queer couple in the room! On top of that the trainer had us do an experiential where she asked the fathers to go on one side and the mothers on the other. She at least corrected herself when she saw me standing there awkward and alone. I felt so humiliated!

The rest of this session was spent processing Maria’s feelings about the class and her ambivalence toward attending more classes. Although Gloria was sympathetic to Maria’s dilemma, she was also clear that she wanted Maria’s support at the birth and needed to know that Maria had the knowledge to provide it. In the end, despite the stress the first class had caused, they did go back for another class and found to their delight that there was a new trainer who was much more GLBTQ savvy and aware. What a relief!

Again, these are not stressors a heterosexual couple would ever have to deal with. Being part of mainstream culture, it is easy for heterosexuals to take for granted the safety net that is automatically available. This is part of what is coined as “heterosexual privilege.” Furthermore the lack of affirmative mirroring that queer couples receive has both subtle and gross implications. “One of the less visible, but potentially most influential privileges that heterosexual individuals receive is an increased self worth that comes with being part of the dominant socially sanctioned group” (Hoffman, 2004; Worthington, Savoy, Dillon & Vernaglia 2002). When who you are and how you love is not reflected in your world, whether on TV, in films, books or other forms of mainstream media, the effect on self-esteem is persistent and corrosive, once again creating more stressors for queer couples

3) Disturbing comments from well-meaning family members

Even family members who are normally respectful toward a gay couple can fall prey to heteronormative assumptions. The following occurred during a session with a gay couple, one of whom was unemployed and looking for work. He had been offered a position overseas but had decided to turn it down because it meant being too far away from his partner.

Mike:
Can you believe my Dad encouraged me to take that job in Singapore with no regard for how it would affect my partner who has a full practice here? It was as if he saw me as a single man, living with “a good friend,” but certainly no one to consider if I was being offered employment overseas. He would never say that to my heterosexual brother and his wife!

Bill:
Your dad is always friendly to me when he sees me but hearing that makes me feel invisible.

Mike’s father was unintentionally hurtful by omission. The undermining quality that this lack of mirroring creates has a corrosive effect on self-esteem. Mike is left with the message that his relationship is less visible, less valid, and less valuable than his heterosexual brother’s.

In summary…

When I hold space for a queer couple in session, I am also considering factors outside the couple dyad, such as the effects of heteronormative assumptions and privilege that can exacerbate existing stressors in the couple. For instance, Gloria and her wife have all the stressors of being pregnant but not the knowledge that they are seen and held in a supportive community. Yvonne and her girlfriend finally find the time and money to take a vacation together only to discover they have to keep their guard up and don’t feel safe enough to express their affection and love for one another. Then, there is Mike having to deal with the crushing effects of unemployment on his self-esteem, only to have his father exacerbate this problem by unintentionally disregarding his long-standing partnership.

Queer couples simply don’t have the safety net that heterosexual couples can take for granted. The society at large does not provide the validation and affirmation that a queer couple could rely on for support during difficult times. The need for this validation and affirmation first has to be acknowledged by the individual or couple and then self-generated. While many queer couples have been very resourceful in generating their own safety nets by building their own communities and support systems, the freefall, in terms of the stigma of being an outsider and the resulting isolation, is ever present for those who do not.

*McGeorge, C. and Carlson, T. S. (2011) Deconstructing Heterosexism: Becoming an LGB Affirmative Heterosexual Couple and Family Therapist. Journal of Marital and Family Therapy, 37(1), 14-26.

“Spring is the ideal time to cleanse and rebuild from the sluggishness and inactivity of winter. According to Chinese Medicine, spring corresponds to the liver and gallbladder organs in our bodies. During the winter we tend to consume diets heavier in protein, fats and dairy, which can all overburden these organs. When congested, the liver and gallbladder can also cause more feelings of depression, irritability and anger. Spring is the time to detoxify, give the liver a good cleansing and boost our digestion, resulting in better moods and increased energy levels.”

But what if you are someone who already struggles with simply trying to establish stable and consistent eating habits? Doing a cleanse could be the thing that pushes you back into your binge/purge cycle or your under-/overeating patterns with food. If you are someone who struggles with food, weight and body image issues you’ll want to ask yourself very honestly: What is my intention in doing a cleanse?

If your intention is for anything other than your health and well-being, don’t do it! However, if the focus of your cleanse is for better health and perhaps to establish more mindfulness around your eating habits, then a spring cleanse could be just the thing that gives you a jumpstart in the right direction or helps you fine-tune an already healthy regime.

In either case, do not begin a cleanse without first consulting a nutritionist or other professional. There are many different cleanses as well as a lot of misleading information out there, and it’s important to choose the cleanse that’s appropriate for your unique needs. If you have a predisposition towards food, weight and body image issues, you may want to find someone you trust who can keep you on track.

Cleanses are used worldwide not only for their physical health benefits but also as a form of spiritual practice. Freeing yourself from the constant preoccupation with what to buy, cook and eat can allow your mind to focus on other nurturing sources, such as your spiritual and energetic health and wellness. Breaking your food routines can also help you establish more mindfulness around your food habits because you’re taking yourself out of your automatic, habitual mode. For example, if you change what you eat for breakfast, you might pay a bit more attention to how you start your day with food.

Chalita’s 5 Tips for Simple Cleansing are easy steps that anyone can implement into their daily routine:

• Upon waking, drink 1 TBS of fresh lemon juice in 8 oz. of water to stimulate digestion.
• Drink your greens. Add 1–2 cups of green vegetables (chard, spinach, kale, cucumber and/or celery) to your favorite smoothie recipe for a boost of energy.
• Drink 1–2 cups of dandelion or milk thistle tea a day to cleanse the liver and gallbladder.
• Limit or avoid caffeine, alcohol and white sugar to support detoxification.
• Get regular acupuncture treatments to help your body’s cleansing and rebuilding process.

Here’s to your health and wellness this spring!

With the eating-disordered population, however, the connection between food and relationship can become a troublesome link. When there is a lack of safe, connected, nurturing relationships in an individual’s life, food and food rituals can easily become a substitute.

As Susan H. Sands, PhD says:

“It is now generally accepted that eating disorders serve essential self-regulatory functions. The disordered relationship to food has been viewed, essentially, as filling in for a missing bond with a self-regulating Other.”

(Sands, S. H. The subjugation of the body in eating disorders. Psychoanalytic Psychology, 20(1), 103-116. 2003)

What exactly does Sands mean? Let’s take the first phrase:

“It is now generally accepted that eating disorders serve essential self-regulatory functions.”

What does it mean to self-regulate? Most of us have learned how to emotionally self-regulate; for instance, if we are upset we find ways to calm down. The ability to calm or self-soothe is usually learned in relation to a calming and soothing Other. For example, when a child falls down and hurts her knee and is crying, Mommy picks her up and comforts her. But what if Mommy doesn’t do this? What if she yells at the child and blames her for being so clumsy? Then the child has to turn elsewhere for soothing. Here is where turning to food in order to self-regulate or self-soothe can begin.

I have yet to meet someone suffering from an eating disorder who does not also suffer from a relational trauma, by which I mean that the person grew up without the experience of a caregiver being attuned to them and their needs and acting as a source of comfort when they were stressed or hurt. The caregiver was either absent or blaming and generally not attuned to the child. As Susan Sands so eloquently puts it: “The disordered relationship to food has been viewed, essentially, as filling in for a missing bond with a self-regulating Other.”

Let me illustrate the above ideas with some client stories:

Emma was a 21-year-old client who had grown up being her mother’s main support in a dysfunctional marriage. Dad was absent and not very involved in her life. Her mother was lonely and turned to Emma for a shoulder to lean on and someone to talk to, but the conversation was always about her mother and her mother’s needs. Emma had little experience of her mother being there for her. So, Emma learned how to have few needs or none at all. She identified with being a caretaker and had little awareness of her own needs. This dynamic also played out with food. Emma would cook meals for her mother but she rarely ate a full plate herself. By the time she was 16 years old she’d been hospitalized for anorexia.

Betty was addicted to compulsive binge eating.

Her nightly ritual was to binge on chips or ice cream while zoning out in front of the TV. She had experienced mostly neglect growing up with an overwhelmed mother and an alcoholic father. There was never any room for Betty and her needs. She learned how to take the need out of her relationships with Mom and Dad in order to preserve those relationships. Later, when she became an adult, food replaced her need for friends and relationship. She started to gain a lot of weight and then was too embarrassed to go out. She became stuck in a self-reinforcing loop.

The good news is that both Betty and Emma healed and overcame their eating disorders and in doing so, they also found that their relationships improved. As they began to acknowledge their needs and find healthy ways to take care of themselves, they also began to develop more nurturing relationships. As my client so succinctly put it: “It’s about relationships, not food!”

The antidote to exhaustion is not rest but heart-felt activity.
—Source unknown

I love this quote (even if I can’t remember its source) because it works! The best way to combat stress and exhaustion is not necessarily sleep. In fact, if you’re really exhausted, sometimes you can find you’re too tired to sleep—or if you do sleep, you sleep fitfully. The real cure for feeling strung out and stressed is to find something that touches your heart and nurtures you—something that is enlivening, silly and even a waste of time. Something that is about play, not work or your to-do list. Children know this one really well. Why do you think they have so much energy?

A fast track to knowing what would be a heartfelt or nurturing activity is tuning into the child in you. Ask yourself: “What does the child in me want?” or “What is purely about fun and play for me?”

Then see if you can make some time and space for “your inner child.” You will be amazed what a difference this can make! There is something powerful that happens when you turn your attention and focus toward what is pleasant and enlivening. It’s as if what your radar is focused on is what you end up seeing more of, simply because you are tuning in. See if giving “your inner child” some time and space this year doesn’t change the whole flavor and tone of the holidays for you.

My favorite questions to clients at this time of year are: What is heartfelt activity for you? What would be nurturing?

I have found that women in particular can have a hard time giving themselves permission to focus on their own fun and pleasure. We are so often encouraged to focus on everyone else but ourselves, so it’s no surprise that at the end of all the festivities we can find ourselves feeling resentful and depleted! Yet if we focus on ourselves we think we are being selfish. So I encourage my female clients to reframe “selfish” and instead be “self-full.” If you are giving when your glass is full, it’s a very different experience than when your glass is nearly empty.

For the eating-disordered population, needs and self-care are especially crucial during the holidays. Ignoring one’s needs is a set-up for a relapse. I focus almost exclusively on needs and self-care with my eating-disordered clients at this time of year. Otherwise, it is too easy for food or rituals around food to become the only attempt at self-nurturing. (Look at my article “Food, Family and the Holidays” for more about ways that those of us who struggle with food, weight and body image issues can take better care of ourselves during the holidays.)

Here are some of my favorite ideas for self-nurturing during the holiday season:

* A hot bath with your favorite tunes and scents
* Curling up with a good book
* Calling a loved one to chat
* Playing with your pet
* A cup of hot cocoa by the fire
* Playing a game
* Drawing, painting, beading or doing something creative

* Spending time in nature

What are your own favorite ways to nurture yourself? Remember don’t forget to ask “your inner child”!

The story of Anna and how anorexia provided the perfect “asexual solution”

Anna was hospitalized for anorexia at age 16. She had been struggling with her eating disorder since the age of 12, and she realized she was queer when she was 19. She talked about the stormy period between ages 12-16 as her attempt to be as “asexual as possible” because, as she said, “I didn’t want boys to be attracted to me.” She was thrilled when her anorexia stopped her breasts from developing and eventually stopped her periods, because with that came less unwanted attention from boys.

It wasn’t until Anna realized she was queer that her anorexia started to make more sense to her:

What better way to stop the problem of boys and all that pressure to be a heterosexual than to stop eating? Once I got control of my eating I suddenly had control of everything! My period stopped, my breasts stopped growing and best of all, no more unwanted attention from boys. I didn’t realize why at the time, but I do remember feeling such a huge relief!

Part of Anna’s healing process from anorexia was to embrace her queer sexuality, suppressed by growing up in a heterosexual and homophobic environment. Once she realized what she was saying no to, her body didn’t have to do it for her.

The story of Margaret and how she used her weight to keep away sexual attention

Margaret came to me because she suffered from compulsive binge eating. She had a history of yo-yo dieting—gaining and losing weight over and over again. Her self esteem was at an all time low. She couldn’t understand why despite having the will power to lose the weight, she always put it back on.

After only a short time of working with me, Margaret went on a six-week trip to India and came back 25 pounds lighter. Part of the reason for this rapid weight loss was that she had caught a stomach bug, but mostly it was due to her friend Debbie’s eating patterns: Debbie ate when she was hungry, stopped when she was full and didn’t eat again until she was hungry. Margaret, who had lost her ability to read her hunger signals from repeated yo-yo dieting, followed Debbie’s rhythms and found that her own eating stabilized. With time Margaret discovered her own cues for hunger and satisfaction; this further helped to improve her relationship with food and her body.

Everything was fine until Margaret returned to the States and started to put the weight back on. We explored what had shifted for Margaret now that she was back in America. She confessed that she was binge eating again. When I explored with her what was triggering these binge episodes, it seemed that the main trigger for Margaret was feeling more attractive and getting more sexual attention. It unnerved her.

Margaret began to tell me about a rape she had survived 10 years ago. She started to piece together that she was putting weight back on because she was uncomfortable with the sexual attention and still suffered trauma from her rape.

The rest of Margaret’s treatment was focused on healing from her rape trauma and learning how to voice her need for boundaries so that her body didn’t have to do it for her. Once Margaret was more conscious about the need to establish sexual boundaries, her weight came off and stayed off!

Sue’s bulimic cycle and how it mimicked her childhood abuse cycle

Sue had suffered from bulimia for 15 years. She was scared about the effect it was having on her teeth, hair and skin. She wanted to get healthy again. Sue had also been repeatedly incested by her father from ages 5-9 years old. At the time it was the only attention she got from an adult. Her mother was an alcoholic and neglected her. When Dad gave her attention, it was confusing; some of it felt good and some of it felt really toxic.

The turning point in Sue’s recovery happened when she realized that the relationship she had with food mimicked the relationship she had with her Dad as a girl. Sue barely ate all day and when she did she usually binged, then purged. In a similar way, she got little attention growing up, and when she did, it was usually in the form of sexualized attention from her Dad that was overwhelming and confusing.

On the one hand I was getting the attention I so desperately needed, but at the same time it felt really toxic. I do this with food; I overwhelm my body with too much food and then throw it up because it feels toxic.

Once Sue identified the cycle of abuse she was inflicting on her body and how it mimicked the abuse she suffered growing up, she was able to start healing her bulimia.

Each of these clients had different stories and suffered from different trauma, yet all of them suffered from a battle with food, weight and negative body image that had its roots in sexual trauma. Once the roots were discovered, their healing began. This is why when working with clients I always have enormous respect for “the problem.” Problems don’t persist unless they serve a function. Once we discover the function the problem serves, we can develop more choices for healthier ways to replace that function.

For Anna it was learning how to say no to the pressure to be heterosexual so that her body didn’t have to do it for her.

For Margaret it was learning how to create sexual boundaries so that she didn’t need the weight to make the boundary for her.

For Sue it was making the connection between the abuse she suffered as a girl and the abuse she was inflicting upon herself as an adult.

More research is needed to fully understand the correlation between eating disorders and sexual trauma. For now, I will continue exploring the link client by client.

Some inconclusive research on the correlation between eating disorders and sexual trauma:

1) Adverse sexual experience in childhood and clinical eating disorders: A preliminary description.
R. Oppenheimer, K. Howells, R. L. Palmer and D. A. Chaloner (1985). Journal of Psychiatric Research 19(2-3), 357-361.

Abstract
Seventy-eight eating disordered patients were asked systematically about any history of adverse sexual experience. About two thirds gave such a history. The events reported were often distressing and significant to the subject. It is unclear what role such events play in the causation of later eating disorder.

2) Reported sexual abuse and eating psychopathology: A review of the evidence for a causal link.
Joanne Everill B.Sc., Glenn Waller D.Phil. (1995). International Journal of Eating Disorders 18(1), 1–11.

Abstract
It has been claimed that there is no specific link between a reported history of sexual abuse and the eating disorders. In particular, studies and reviews investigating the relationship between reported sexual abuse and the eating disorders have concluded that the prevalence rate of abuse among eating-disordered women is similar to the rates found in other psychiatric groups and in the general population. However, it is argued in this review that such a conclusion is based on an inappropriate level of analysis of the phenomena of sexual abuse and diagnosable eating disorders. When these two relatively blunt constructs are considered in finer detail, there appears to be a complex link between the nature of sexual abuse and specific bulimic symptomatology. This relationship is discussed with particular reference to important mediating factors (including dissociation, self-denigration, borderline personality disorder, and disclosure experiences), the functions of the bulimic behaviors, and the particular cognitive schemata that the victims of abuse may develop. The clinical implications of this relationship are considered, and suggestions are made for further research. © 1995 by John Wiley & Sons, Inc.

3) A meta-analytic examination of the relationship between child sexual abuse and eating disorders.
Linda Smolak, Sarah K. Murnen (2002). International Journal of Eating Disorders 31(2), 136–150.

Abstract

Objective
This study had two goals. The first was to assess the magnitude and consistency of the relationship between child sexual abuse (CSA) and eating disorders (ED). The second was to examine methodological factors contributing to the heterogeneity of this relationship.

Method
Meta-analysis was used to examine both questions. Fifty-three studies were included in the analysis.

Results
A small, significant positive relationship between CSA and ED emerged. The relationship was marked by heterogeneity. Effect sizes were largest when CSA was the grouping variable, the Eating Disorders Inventory (EDI) or the Eating Attitudes Test (EAT) was used as the measure of eating disorders, and nonclinical groups were compared with clinical samples.

Discussion
Models of CSA and ED need to more clearly specify what aspects of ED (e.g., body image or binge eating) are most influenced by which types of CSA. These specific relationships then need to be examined empirically. © 2002 by Wiley Periodicals, Inc. Int

4) Childhood sexual experiences with adults reported by women with eating disorders: an extended series.
R.L. Palmer, R. Oppenheimer, A. Dignon, D.A. Chaloner and K. Howells (1990).
The British Journal of Psychiatry 156, 699-703.

Abstract
A total of 158 women presenting with clinical eating disorders have been investigated using a self-report questionnaire and subsequent interview concerning their recollections of sexual experiences with adults before the age of 16 and later adverse sexual experiences. About a third reported events in childhood and over half described some adverse experiences. It may be that these experiences are relevant to the subsequent illness in some cases, but greater certainty must await further research. In the meantime, inquiring about such matters would seem to be advisable in the assessment and therapy of eating-disordered patients.

Following are some client examples of the above. Names/stories have been altered to protect identity:

“Ice cream is my best friend”

One of my clients Laura calls ice cream her “best friend” and claims that as long as she has a good movie and her ice cream she doesn’t need anything else to entertain herself in the evenings and during the long weekends. This habit started after a painful break up. She since has put on so much weight that she doesn’t feel confident enough to go out. Instead she stays home and eats. Laura is caught in a self-perpetuating cycle of social isolation and comfort eating.

“Bulimia has taken over our marriage!”

I also work with a client couple who struggle in their unhappy marriage. The husband Bob complains about the lack of touch or affection in their relationship; “She doesn’t need me. She doesn’t want me! I think she’s happier when I’m not around.”

The truth is that his wife Sue turns to food, not to him for comfort. Research shows that the binge purge cycle releases serotonin “a feel-good hormone” that is produced naturally during hugging and cuddling. Sue has learned to turn to food for all her needs related to comfort and soothing and thus has taken these needs out of her marriage. It is slowly dying as a result.

Let’s not put all of the blame on Sue. There are other complicating reasons that food became a “safer option” than her husband for meeting her emotional needs. Furthermore, this is complicated by a pattern that Sue is repeating from her childhood where she learnt not to depend on unreliable, alcoholic caregivers for comfort.

So how do Laura, Bob + Sue break out of these destructive cycles?

Step 1: Breaking Free from Shame and Secrecy

Laura took this first important step when she broke out of her denial that ice cream could replace her need for relationships and sought guidance. Bob and Sue took this first step when they realized that their marital issues weren’t going away by themselves and decided to seek professional help. Coming out of denial and actively seeking assistance is an enormous step because it sets in motion the wheels of change.

For Sue, there was also the added step of letting her husband in on her “secret.” Although he already knows about her binging and purging, I encouraged her to be more open with him about her triggers to “act out.” For instance she could let him know when she feels the urge to binge or share it with him after the fact.

This is important because it starts to break the shame and secrecy that keeps the eating disorder in control behind the scenes. Laura and Sue are breaking the power their eating disorder has over them by bringing it out into the open. This is often the most difficult step.

Step 2: Got support?

Support is crucial to keep the ball of recovery rolling and there are a myriad of ways to get this reinforcement. Initially Laura, Bob and Sue all chose therapy. Laura also found an eating disorders support group to supplement her individual therapy. She was really motivated and wanted to speed up her recovery. Other ways that Laura got support was by developing a network of people she could call when she felt she was in a dangerous place. She arranged to have a friend she could walk with after work and before it got dark. This had previously been her time to buy ice cream and choose her movie.

Laura started to feel that she had more options. She found more walking buddies. Sometimes she would go out for dinner with a walking buddy or invite them over for a movie. She began to break the isolation her eating disorder demanded of her.

She started to feel better about herself and go out more. Without dieting, Laura’s body started to correct back to her ideal weight. Laura began to feel more confident about herself and as a result became more social. She was on the road to recovering her life and relationships.

For this step Sue learned to enlist the support of her husband by sharing with him when she felt the urge to binge. He could then remind her of other ways to soothe besides turning to food. Sometimes a hug or cuddle with him was enough or they would go for a walk together until the urge was gone.

It was extremely vulnerable for Sue to let her husband support her in this way. She had always feared his judgment around her eating issues and was surprised to find that he actually welcomed this opportunity to support her!

Bob appreciated feeling less shut out by Sue. Inadvertently, by Sue trusting Bob enough to let him in on her “deepest, darkest secret”, more intimacy started to develop between them. It was enough to give them a taste of something different and now they wanted more!

In Closing…

I hope that in sharing these stories you are encouraged to explore the link between your relationship with food and how it might have parallels to other relationships in your life… In closing let me leave you with these two questions to consider:

1) Do you have a nurturing relationship with food?
2) Do you let your relationships nurture you?

Please share your thoughts and ideas on this important topic…