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!

Hats off to a Better Christmas: 8 FREE Tips for Eating Disorder Support

Holidays may be happy and exciting for some of us and for some, they are also very stressful.  Food is definitely a big deal during the holiday season for most people.  Gym memberships go up afterward, people are often found dieting or “cheating” on their diets.  Some binge, some restrict, some over-eat and some fall apart.  I’d like to help you find a bit of peace from my corner of the world during this time when Christmas is fast approaching.  If you haven’t already read them, check out some free tips on normal eating, getting grounded, reducing anxiety, navigating the grocery store… They should prove useful for you as well. 

Here are some tips specific to Christmas:

1.     Create an intention for this holiday

Remember that Christmas can be about celebrating spirituality.  It can be about enjoying family or giving.  It can be about service, love, bundling up on a cold day or anything you want it to be! 

What would you LIKE your intention to be for Christmas this year? 

Find a purpose and go for it.  If your purpose is about service, think about how you’d like to be of service.  It could be as simple as helping to set up or clean up the party.  You could help the less fortunate through a soup kitchen or donating gifts to children who need them.  If you’d like your purpose to be about reading a great book and drinking tea, then go for it!  Any intention you’d like for Christmas is yours to have!

2.    Get Grounded:

BEFORE you leave your house.  Think about what grounds you?  Do something that feels very grounding for you and set an intention to keep checking in with yourself during the day.  One of my favorite ways to get grounded is to ask myself

“Where are your feet?”

– then look down at them; wiggle my toes, feel my feet on the floor or in my shoes.  When I do that, I can rest assured that right here, in this moment, I am safe.  In this moment, where my feet are, I am okay.  Here are some other examples of grounding activities:

• Prayer and meditation
• Aromatherapy: earthy smells like cedar, bergamot, and pine can be particularly grounding
• Yoga
• Coloring mandala’s or other coloring
• Going for a walk
• Make a list: of anxieties, gratitude’s or plans, etc.
• Have a bit of a plan for the day – perhaps write it down in the morning.
• Journaling

3.  Create Foods You Love

Try a new recipe you've been thinking about.  Bring safe foods for you to the event you go to so that you have at least one option while you're there.  

4.  Don't Push Yourself

This is not the time for major challenge meals.  While I encourage you to taste some of every food you're interested in, if you know that a certain food will completely set you off, just avoid it for now.  Challenge meals are best done with the support of a therapist or a support community.  You can practice eating challenge meals until they're no longer as challenging.  Once you've accomplished taking the power out of the challenging foods, THEN you can incorporate them into your holiday festivities.  In this instance, it might be better to be safe than sorry - don't push yourself so hard that you find yourself wanting to act out in a binge-purge cycle.  Support yourself in enjoying Christmas as much as possible rather than pushing yourself into discomfort.

5.  Contain the food

Do your best to eat meals at the normal times you usually eat them.  So instead of skipping breakfast and going to Christmas hungry, eat your normal breakfast. 

When you get to your event, check into your hunger cues.

On a scale of 0-10, with zero being extremely starving, 5 is having a light sense of satisfaction – being neither hungry nor full and ten being the most stuffed you’ve ever experienced.  How hungry are you?  Aim for letting yourself empty out to a 2-3 before eating a meal.  See if you can stop eating at a 5-7. 

Once you are hungry, rather than grazing on all the different foods, make a plate. 

Allow yourself to put at least a little bit of each food you love on the plate or foods you’d like to try. 

Skip the foods that don’t interest you much.  Sit down and really savor the foods you chose.  Check in with your hunger and satiety signals a few times while you eat your plate.  Once you are satisfied, tell yourself that you can have more when you are hungry again and follow through.  Making a practice of using hunger and satiety cues is extremely helpful in finding balance with food.

6.  Keep Your Boundaries

People tend to project their OWN food and body issues onto others’.  So if you notice yourself engaged in a conversation with someone who’s trying to talk you in or out of eating or commenting on your body, take a step back. 

Check in with yourself and see what YOU NEED, rather than what this person is trying to get you to do. 

Saying you need to use the bathroom is always an easy out to give yourself some time and space to check back in with yourself and get grounded.  Take some deep breaths, splash some water on your face and ask yourself what you need in that moment to take care of yourself before you leave the bathroom.  Here are some examples of things you can say to people who are pushing you:

• “No, thank you”
• “I’m okay right now”
• “Yes, I’m going to enjoy this food right now”
• “I’m not hungry”
• “I’ll let you know when I’m ready for ...”
• “I’d rather not discuss my body with you”

Practice saying these boundaries out loud BEFORE the holiday, so that when you’re in the moment, they flow easily and effortlessly.

7.  Ask for Help

Enlist a member of your support group to be ‘Holiday Buddies’ to practice what I call ‘Book Ending’:  Have a few agreed upon times you with check-in with one another throughout the day – perhaps before, during and after.  You could plan to call or text one another to report how things are going.  If you don’t hear from your buddy, shoot them a text to see what’s going on.  In this way, you have another person who has your best interest in mind to be accountable to.  This practice is also helpful in getting your mind off yourself and your own difficulties.

8.  Breathe

Remember that Christmas is only one day out of the year.  Breathe into the gifts you receive whether they are material or spiritual, gratitude or emotions - breathe into this experience of life and know that you can get through this.  You don't need to be perfect and neither does your holiday.  When you feel yourself getting overwhelmed, focus on your breath.  Remember you can start your day over at any time.

I hope you've found these Christmas tips helpful.  If you're still feeling overwhelmed, please feel free to give me a call at 610.314.8402 - I'd be happy to help.

Merry Christmas from Tiffany Spilove Psychotherapy in West Chester, Pa!

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How to Navigate the Grocery Store: 7 Useful Tips for People in Recovery from an Eating Disorder

When you’re working on your recovery from an eating disorder, the grocery store can send you into a panic.  Here are some tips to help you cope with grocery shopping in West Chester, Pa:

1.     Get Centered

Before you even head to the grocery store, get grounded.  Get your nervous system regulated and mindfully notice where your emotions are, especially anxiety.  Visualize your shopping trip in entirety.  Imagine yourself successfully choosing foods that fit right with your recovery and getting through the store successfully without panic.  This trains your brian and helps it to practice the event in actuality.

2.     Come prepared

Make a list.  Look through your kitchen and see what you have.  Notice if you’re out of one of your staples like your favorite cereal.  Think about the exchanges in your food plan: protein, starch, fat, fruit, vegetables and dairy.  What are you in the mood for this week?  Will this be the week to branch out a bit and try that turkey melt you’ve been hankering for since you had it at that diner weeks ago?  If so, jot down the ingredients on your list. 

Create a list that is full, yet manageable.  Make sure you have staples and perhaps a few extra things that you could freeze if you don’t end up eating them.  Shoot for at least 3 items from each food group.

Don't go too hungry or too full - it will mess with your ability to make good choices.

3.     Stay Grounded

When you get to the store, take a deep breath, take a sip of water and give yourself a time frame to shoot for.  Grocery shopping shouldn’t take more than an hour and should probably take at least 15 minutes. 

Go through the aisles in order from one side of the store to the other – if possible.  If you notice yourself getting overwhelmed, get re-centered by taking a few deep breaths.  Remember you can leave at any time.

4.     Stay focused

It is easy to get overwhelmed, so when in doubt, stick to your list. Don’t get side-tracked reading labels.  If a new brand or food looks interesting to you, just grab it.  If you notice yourself fretting about which item to choose, take a deep breath, and grab the one that your inner child wants.

5.     Set healthy limits

If you’re newer in recovery, limit yourself to 1-2 challenge foods for that trip.  You don’t want to get too many and then sabotage later. 

6.     Get in and out

This does not need to become an activity that takes up your entire day.  If you’re overwhelmed and you don’t get to your entire list, that’s ok.  Try to make sure you’ve at least grabbed the basics, then scadaddle.  There’s always next time.

7.     Reward yourself

When you’re in recovery from an eating disorder, the grocery store is no joke.  Give yourself a reward like a hot bath, an hour with your favorite book or a new yummy smelling candle.

In case you’re overwhelmed by the grocery list, here’s simple generic example list that you can print out and circle items on, then fill in some specifics for your preferences:

Dairy:

• Eggs                       
• Yogurt
• Cheese
• Milk

cereal

Meat:

• cold cuts
• to cook

Fruit: 3 types

Veggies: 3 types

Condiments

Nut butter

Canned food:

Frozen food:

Baked items:

• Bread
• pastries

I hope you've found this helpful.  If you're still feeling overwhelmed, feel free to give me a call, I'd be happy to help.  610.314.8402.  If you have any more tips or comments, please comment below :)

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.