The 5 Secrets to Quit Binging

At times, all of us have eaten a bit, or a lot more than is comfortable in our bodies.  Holidays, celebrations or sometimes mindless eating in front of the TV can leave us feeling overly full.  For some, this way of eating is more common and happens more frequently than we’d like.  The new DSM-V, the Psychiatric Association’s manual on diagnosis, has created a diagnosis under the eating disorder umbrella called Binge Eating Disorder or BED.  Whether you meet the criteria for this disorder, for bulimia, anorexia, or you just find yourself overly stuffed at times, these tools can be helpful:

1.     Notice what types of foods you’re binging on and write them down. 

It helps to look at your behavioral patterns.  Some people find themselves eating excessive sweets, some are more geared towards fats or starches.  Some people with emotional eating tendencies excessively eat any kind of meal including vegetables.  See if you can find a pattern in your binge choices. 

2.     Notice what you DON’T binge on. 

Are there any types of foods that you’d never consider in a binge or never feel the need to over-eat?  In a recent session, a client was relaying the guilt and shame he felt after a binge.  He reported that he doesn’t usually allow pastries in the house, but was feeling strong recently and thought it’d be okay.  He found himself finishing off the pastries he had in one sitting.  Upon further investigation into what foods he was allowing himself to eat regularly, the client determined that he felt very satisfied when he ate waffles and allowed himself to eat waffles multiple times per week.  I asked him if he ever binges on waffles.  He was shocked when he thought about it and said that – no – he never binges on waffles.  Ok, great, so there’s no waffle binging going on, but how does that help?  Follow me here.

3.     Take a look at what you ‘allow’ yourself to eat regularly. 

What foods do you consider safe?  In an attempt to be healthy, lose weight, or just get control over your food choices, you may be very rigid or restrictive about what you allow yourself to eat on a regular basis.  Perhaps your choices look benign enough like chicken and veggies multiple times per week.  Write down what you’ve eaten over the past 3 days to 1 week or track your food for a week.  What do you notice?

4.     What is missing from your regular eating habits? 

Take those same meal journals and notice what you don’t have there.  If we consider all the food groups: protein, fat, starch, veggies, fruits and dairy – are there any food groups missing?  Are there lots of repeated meals without much variety?

Now I know this might seem completely insane and a bit scary, but HERE’S THE KEY to quit binging.  Ready?

5.     Allow yourself to eat the foods you binge on.

Try adding a portion or 2 of the foods you don’t allow yourself to eat and some of the most common foods you binge on to your regular meal schedule.  I know this might seem counter-intuitive.  Our society tells us to resist, have discipline, diet harder, avoid sugars and carbs and fats and this may be the only voice you’ve ever heard that encourages these things, but just give it a try for a month or even a week and see what happens.  If you are on the anti-carb kick, but then you find yourself binging on carbs, try adding a normal amount of carbs to each meal and see what your body craves after a while.

Here’s the rub – We are creatures of desire. 

Food is part of life!  It’s nourishing and delicious and sensual.  When we restrict ourselves from eating foods we love, we may lose weight in the short run, but this does not happen without consequence.  Our animalistic nature, our Id, it craves pleasure and passion and vigor.  If we force ourselves to live inside a rigid box of rules around food and body, we will always desire to break free and stepping outside of that box causes immense shame and fear.  I am not telling you to overeat or teaching you how to binge differently, but what I am suggesting is that you try to take the power out of the foods that haunt you. 

If you regularly binge on entire cartons of ice cream, see what happens when you have a cup every night for a week.  What emotions come up when you eat it?  Can you journal about them and bring them into your therapist?  What do you find yourself craving after that week of glorious freedom with ice cream?

If you live near The Main Line of Philadelphia or West Chester and want to learn more about binging and how to quit, or you’re not sure where to find support for your feelings around food, you’re not alone.  Please feel free to contact me at 610.314.8402 – I’d be happy to help you find support.

12 Clinical Interventions for Eating Disorders

Here are some tips you might find helpful when working with clients with Eating Disorders, or Disordered Eating:

1.  Find a registered dietician who specializes in Eating Disorders.  It is important that your belief systems and theirs align when working together to treat a client.  For example, most people in the eating disorder recovery field believe that there are no "bad" foods and we work with clients to neutralize food.  However, some people believe in "abstinence" from certain foods or food groups.  When I am looking for a dietician, I make sure that they're not of the school of thought to tell my clients to restrict food groups as it would go against the work we are doing clinically.

2.  Buy large desk calendar and different stickers and create a behavior chart for meals and snacks well done according to their meal plan. Celebrate successes elaborately!

3.  If age appropriate, work with parents on making "no Foods bad".  Everyone in the family can join in on recovery by coming together to share with all food groups. 

4.  If age appropriate, look into the Maudsley Method for re-feeding process.

5.  Work with your client to create an art project around beautiful people, models, actresses, friends or family and others in Pinterest or print outs who are not super skinny.  Process what they find beautiful about these people.  Encourage clients to post up these images on their wall so that they get used to seeing ideal beauty images and other than emaciated models.

6.  Make a list of all clients fear foods and safe foods and medium foods and use CBT to debunk myths of fear foods. 

7.  Eat 'normal meals' together in session - especially with fear foods - exposure therapy.

8.  Find studies that show that whatever fear foods are - are not 'bad' i.e. - sugar is not as evil as everyone says. 

9.  Use ego state work to find out which 'parts' in clients psyche are telling them not to eat and have conversations with them using Gestalt Chair Work. 

10.  Use the books Life Without Ed by Jenni Schaefer as a guilde book, everyone involved should read and the book 8 Keys to Recover from an Eating Disorder by Carolyn Costin can be used for treatment and interventions as well.

11.  The therapist can have client draw their body in the size and shape she believes it's in, then have therapist actually trace clients body and process the difference. 

12.  If there's one body part the client is upset about like their waist, have client draw what they believe is their waist size, then use a string to measure (not using numbers) the actual size and trace THAT onto the paper and process the difference. 

Hope this helps!!

What else do you use as interventions for clients?  Please comment below!!  As always, if you have any questions or concerns, please contact me at 610.314.8402 or through www.TiffanySpilove.com

Dining Out ... With an Eating Disorder

I know, I know, it sounds TERRIFYING!  Yes, I'm serious - you will not die from eating food in a restaurant ... I PROMISE!  It might FEEL like you'll die, it might seem like you'll gain a hundred pounds just from eating the food that is cooked for you back in that kitchen you can't see.  

As my friend and colleague, Natalie says, "there aren't calorie ninja's back in the kitchen adding calories to your food"!  I understand the fear - I get that allowing somebody else to prepare your food is giving up control in a way that might not feel safe for you just yet.  Here's the rub, though - even though it might be hard to admit, I KNOW you want to be able to participate in experiences that involve food.  You WANT to be social.  You want to hang with your friends while they get frozen yogurt or try the food at the new cafe.  You want to live your life again... it's just that ED forbids it.  Here are some helpful tips for you to get more comfortable with dining out:

Practice

When you find yourself feeling fear about eating in a restaurant, it's sort of like a phobia - a very heightened anxiety around something specific.  The way to deal with and cure this type of phobia is through exposure - WITHOUT - re-traumatizing yourself.  So you don't want to push yourself to take it all on without practicing and getting comfortable with various aspects of it first.  

Use affirmations - they are wonderfully helpful ways to rewire your brain!

You might want to enlist the help of your therapist, friend or family member.  Tell them some food options that you consider safe.  Start small.  

It's better to have success with something less challenging than to get overwhelmed with something scarier.  

Your support team member could either get you food from a restaurant or give you food that they made without you present.  Or if you need to start even smaller, you could watch them make your meal so you know it's safe.  Eat with them.  Notice your feelings.  Use anxiety reduction and grounding techniques.  Keep breathing and do your best.  Keep practicing this step until your anxiety stays below a 7 on a 0-10 scale with 10 being the worst anxiety you've felt and 0 being no anxiety at all. 

Increase the challenge slowly

Once you get comfortable with eating meals made by others, up the ante.  If you're still not ready for restaurant dining, try getting take-out or try eating foods you didn't see being prepared.  Use an affirmation like "This food is safe and nourishing; I am safe and I can eat this food".  Make sure you start off each experience with some breathing and relaxing techniques so that you don't associate fear with the experience.

Dining Out

If noise bothers you, choose a restaurant that's quieter or a time of day that's less intense like lunch.  See if you can get a table that's against a wall, in a corner or in a quieter area of the restaurant.  This reduces over-stimulation and feelings of vulnerability.  

Have a plan

In earlier recovery, it's helpful to have a plan.  If you know which restaurant you'll be going to, look up their menu online.  Work with your therapist or dietician to determine which menu item you'll be selecting.  Most restaurants have portions that are significantly larger than the exchanges on your meal plan.  If this is the case, you could anticipate eating half the meal.  One tip is to ask for a to-go box at the beginning of the meal so that you can put half away for later and just focus on what's on your plate.  

Go with someone supportive

This experience is hard enough, don't add to it by going with someone who doesn't "get it" or tries to sabotage your recovery.  Some therapists or dietitians will conduct sessions at the restaurant with you so that you can talk through it as it's happening.  If that's not an option, or you're ready for the next step, choose a member of your support group who understands your recovery.  Let them know the plan beforehand and maybe come up with a code word in case you need to abandon the mission.

Remember to breathe

Keep taking those deep belly breaths and know that this is just one meal.  One meal won't make you fat.  If you notice yourself starting to get overwhelmed or anxious, just come back to your breath.  While you're eating, try to focus the conversation on something else like the weather, the new movie just out or anything fun.  Take a sip of water, feel your feet.  You got this!!

Do's and Don'ts:

Do:

• Keep the conversation light
• Have some topics in mind to talk about while you're eating
• Get the food down
• Chew thoroughly
• Focus on the conversation, the beautiful setting or anything but the food and body
• Wear comfortable clothes
• Stay at the table for the entirety of the meal
• Set your pace to about 30 minutes to complete your meal

Don't:

• Count the calories
• Compare your dish to anyone else's
• Body check while you're at the table
• Talk about food, weight, exercise or anything triggering while you're at the table

Keep your eye on the prize!

This experience is not just about today or next week.  You are engaging in this exercise so that you can enjoy your life - so that you can HAVE a life!  Spending all your time in isolation, feeling lonely, not participating in social events is no way to live.  Remember that you are doing this so that you can be happy and free of your eating disorder.  

One day at a time

One meal at a time

One bite at a time

You CAN recover!!  Recovery from an eating disorder is not a linear process.  It goes all over the place, it's messy at times and sometimes you need to take 5 steps backward so that you can get good 2 steps forwards.  Even one success is worth celebrating, so give yourself credit for EVERYTHING you do right.  

If you're still feeling anxious about dining out and you'd like some support, I'd be happy to schedule a time to help you reach your goals.  Contact me now at 610.314.8402 to learn more about how to dine out with an eating disorder.  Please feel free to share this post with anyone who is looking for help with eating and body issues.

Good luck and enjoy!!

If you have any questions or need support, please feel free to call me at 610.314.8402 for a free 15 minute phone consultation.

Please comment below and tell us your story!

It’s Here! The Fundamental Tips for College Survival

College sounds so glorious at the start – getting away from parents and rules, living on your own or with friends, getting to party all night or just being able to do whatever you want WHENEVER you want.  It’s gona be AMAZING!!

And then you get your syllabi!  The work starts to pile up.  You’re exhausted and strangely malnourished even though you think you’re eating alright.  You’ve watched the sun come up one too many times this week and your body is starting to give out.

So how do you manage to juggle the whole ‘being an adult in college thing’? 

Tools you will need:

• Paper Calendar
• Highlighters in various colors
• Syllabi

Here are some tips that can help:

Paper calendars are your friends! 

I know you love your smart-phones and nifty electronic apps that can do all sorts of fancy things, but the problem is they can be too neatly tucked away and forgotten about.  Like vegetables in the vegetable drawer, if you don’t see your schedule, you will forget it’s there and it will get moldy!  So a nice big calendar that has whole months you can look at, all at once - that's what you need. 

Once you've got your calendar, then take your syllabi and start plugging in the TURN IN assignments ONLY! 

This means papers, tests, essays, projects – things you need to actually hand in - to the teacher.  Write each assignment in the date that it is due.  Select your pink highlighter (or any color, really, this is just an example).  HIGHLIGHT each TURN IN task in pink. 

Next, look at the weekend BEFORE the project or paper is due and write in the assignment in that weekend. 

THAT is your target due date.  So for example, if the paper is due on Tuesday the 15th, your target due date is Friday, the 11th.  Here’s the rule I implemented for myself that worked very well through grad school: IF I finish my assignment by Friday the weekend BEFORE it’s due, THEN I can play and relax the rest of the weekend.  If not, I target Saturday to finish it, then I can play Sunday, etc.  I made my target due dates the weekend before so it gave me time during the week to edit or catch up on any other assignments, readings, etc and not feel like I was rushing to get the assignment done. 

So highlight the TARGET DUE DATE for each assignment in another color.

Now that you have things that you actually need to turn in scheduled, you can write in reading assignments and other “passive” tasks and highlight THEM in yet a 3RD color. 

Once you've plugged in these due dates, target dates and reading assignments, you’ve got your priorities scheduled and color coded.

Make school your “job”

One of my favorite high school teachers told us as seniors that if we just made college our “9-5 job”, we’d be successful.  What she meant was this: when you are in high school, you have a structure GIVEN to you.  You must be awake by a certain time and go through each class at a certain time and be home by a certain time (typically).  So when college freshmen enter school, it can sometimes look like a free-for-all and people who are pre-disposed to anxiety or depression can find themselves struggling to keep up because of a lack of structure.  So you can look at it this way:

College work is a full-time job:

Work on your assignments and reading and classes from 9-5 every week-day, even when you’re not in class.  Get your stuff done before it’s due, that way your evenings and weekends can be fun times for parties, relaxing with Netflix or hanging with friends.

If work is left uncontained, people with anxiety tend to feel like they can never relax. 

You’ll find, as you move into adulthood, that ‘work’ is never done.  So, if you don’t contain your work into ‘work-time’ and contain your free time into ‘play time’, then you’ll never truly be able to relax and never truly be focused on work.  

What does ‘play-time’ look like?

For some extroverts, play-time comes naturally and easily.  They enjoy socializing in the hall of the dorm, on campus, at frat parties, etc.  For others’, it may provoke anxiety and insecurity.  If you’re introverted or shy or haven’t been exposed to many social situations that you feel comfortable in college can be a difficult experience.  Here are some tips on finding ‘your people’ and your version of play time.

For more information, contact me now at 610.314.8402

Sure Fire Ways to Get Grounded and Reduce Anxiety

Your body feels jittery and like you want to crawl out of your skin.  Your heart races, your mind goes a million miles a second and you can't sleep.  Sometimes, you just wish you could find a little peace - a little reprieve from this constant state of feeling charged up.  Anxiety, social anxiety and panic are such difficult things to have to deal with.  The good news is that there's hope and some sure fire things you can do to help calm your nervous system.

What grounds you?

Getting grounded, as in, feeling your feet on the earth rather than in your head - starts with your intention at the beginning of each day.  The things that help people feel grounded can be different for everyone, so you need to find things that work for you.  The first place to start is to think about what you can do each morning, upon awakening that will help you get centered and begin your day with a peaceful intent.  Some mindfulness meditation could be helpful, reading from a daily book of inspirational readings, praying, doing some deep breathing, singing, chanting, walking or exercising in a mindful way - these are a few ideas you can begin with.  

As far as inspirational reading goes, I personally like these two:

A Deep Breath of Life by Alan Cohen

The Language of Letting Go by Melody Beattie

Whatever you choose to do to help you get grounded in the morning, make it into a ritual.  

Our bodies find comfort in repeating the same actions on a regular basis.  You will be teaching your body that every morning, you find peace through grounding and it will set you up to stay grounded and calm through the rest of your day.

Here is an example of a morning ritual:

• wake

• go to comfortable spot in home designated to meditation

• light a candle or incense

• drink warm lemon water

• read from daily inspirational book

• say a few simple prayers for help with staying calm through the day

• set timer for 5 minutes 

• practice deep belly breathing for 5 minutes while focusing on flame of candle

• After breathing, spend 5 minutes making a gratitude list

• blow out candle and go for a 15-minute walk

Something as simple as this can really get your day off to a great start.  

Maintaining Balance

As you go about your day, when you notice your anxiety rising, come back to the breath you started with at the beginning of your day.  

Feel your feet

This is a tip I learned a while back that always seems to help.  As yourself "where are my feet right now?" and then look down at them and see them there on the earth.  Wiggle your toes a bit and feel them moving around in your sock.  Acknowledge that right now, in this moment, your feet are right there and they are safe, therefore you are safe.  When you start to feel panic and your thoughts race, remember to ask "where are your feet?"

Reduce or eliminate caffeine

caffeine is addictive and it's very activating.  If you are trying to eliminate anxiety, you might want to consider eliminating caffeine.  Many people will say that they use caffeine to help them find energy throughout the day and keep them going.  Well, it's a catch 22 because when we use caffeine, our bodies use cortisol to help regulate our adrenal glands.  When we over tax this part of our systems, it leaves us depleted and more tired than we started.  Therefore, if we eliminate caffeine, we may be a tired for a few days while detoxing, but after your body adjusts, you will find that you have more energy and that you sleep better.

Speaking of sleep

A large part of mental health when dealing with anxiety is getting a good amount of sleep.  When we sleep, our bodies do a lot of healing.  Our organs do their cleansing, our hormones rebalance and we are able to function more effectively during waking time.  Also, dreaming is very important for our psyches to process material from our conscious and integrate it with our subconscious.  

Here are a few tips on sleep hygiene:

• target bedtime for the same time every night

• eliminate all electronics from the bedroom

• reserve your bed for sleeping and sexual activity only - don't do work in bed

• if you are having trouble falling asleep, get up after 15 minutes and do something non-electronic for 15 minutes, then go back to bed and try to sleep again

• create a wind-down routine for the last hour before bed

For more information on sleep hygiene contact me at TiffanySpilove@yahoo.com

Anxiety reducing techniques

Here are some proven techniques to help your body and mind relax:

Tense and release

Tighten every muscle in your body.  Start with your head. Tense up your face, your jaw, your eyes, your neck.  Tense up your shoulders, your chest muscles, your stomach, your biceps, make fists as tight as you can.  Tense up your butt muscles, your thighs, your calves, your ankles, your feet and your toes.  Keep all these parts of your body as tense as possible and keep them  tensed up for a full 60 seconds.  Then release.  This tense and release will help your body reduce anxiety symptoms.

Deep Breathing

Put one hand on your belly and the other on your chest.  Take a deep breath in and try to push your belly hand all the way out with the breath into your diaphragm.  Inhale slowly to 4 counts, then hold for 4 counts, then release slowly for 4 counts and repeat.  When you practice breathing slowly, it will help to slow down your heart rate, thus reduce anxiety.

Bi-Lateral Movement

Any kind of bi-lateral stimulation can help reduce anxiety.  Here are some examples: walking, biking, shifting weight back and forth from one foot to the other, tapping your thighs alternately.  Some others: drumming, swimming, scanning your eyes from one side of the horizon to the other, back and forth.  The butterfly hug is an EMDR technique where you hook your thumbs together so that your hands form a figure that looks like a butterfly.  Put your hands on your chest and tap alternatively around your collar bone area.  This is a great way to self-soothe or find relaxation in times of stress. Here's a video on how to do a different version of a butterfly hug.