ANNIVERSARY EPISODE! My Signature Approach to Eating Disorders
Eating disorders are complex and multi-faceted, but what if they’re far more connected to our emotional experience with the world than we realize?
First of all: This is episode 55… our 1 year anniversary! Happy anniversary, guys! 🎉🎉
I am SO excited to start another year with all of you. I have loved getting to know all of this past year. I love putting this show together, and connecting with you via emails, DMs, and comments… I’m so grateful for every single one of your listens. ❤️
I decided to start the new year with my approach to eating disorders… meaning, the way I’ve come to conceptualize eating disorders and therapy based on all the information I’ve gathered. In essence, if you had to boil it down to one idea, it’s how everything connects with our emotional experience.
Listen to the Episode Now
You know me: you know I’m not an emotional, mushy-gushy person. I’m not going to be that person who says, “Hey! Why don’t we talk about how you feel?” Eww, no. 🤷🏻♀️
But I guess the way that I approach emotions is probably coming from an emotion, too. Emotions run the gamut from positive to negative, strong to “weak,” and they’re all significant. Emotions drive everything about how we interact with this world.
And if we leave them in code language without really getting to know them, then we let our relationship with our emotions drive every one of our decisions – we aren’t in the driver’s seat if we don’t shed more light on our relationship with our emotions.
Eating disorders are very complex. They’re obviously not just caused by one thing – like, you don’t have one difficult time and that’s the sole cause of the eating disorder.
Sure, there are different environmental pressures and genetic predispositions… but in this post, we talk about how eating disorders are developed and maintained, and how it’s all connected with emotions. We’ll talk about how our desire to dissociate from painful emotional experiences is connected to disordered eating and basically everything we do.
So, let’s dive in!
Painful Emotional Experiences
When we try to figure out where the symptoms of an eating disorder are coming from, it’s so difficult when you’re in the throes of your disorder.
For example, if you’re struggling with binge eating, and you binge on Monday night, we can look at what happened Monday morning that might have led to a binge. But if binging is happening all the time, that’s much more difficult to determine.
If you’re in that place, we have to zoom out. It’s not just one binge or one incident you have to try to understand; it’s more that you have to understand your overall relationship with food, which is connected with your overall desire to remove yourself from painful emotional experiences. Guys, I cannot emphasize this enough. Read that again.
It Starts as Toddlers
Think about toddlers, kids, and adolescents. We learn how to interact with the world based on the information that’s internalized from our environment and the people who are around us. If you think about a 2-year-old – they have HUGE emotional experiences.
If you’ve ever watched a toddler have a tantrum… you know what I’m talking about.
They’re feeling something. If a toddler is not getting the lollipop he wants, for example, it’s a BIG deal to him. It feels physically overwhelming and frustrating – even if he can’t define that he’s frustrated – and he doesn’t know how to soothe himself.
As we grow, if we don’t get information from the outside world about what we’re feeling and how to soothe ourselves, we continue to operate that way.
How often do we see adults try to stop a child from feeling a certain way, either by saying “stop crying” or “you’re ok”? A lot of people mean well, but if a child doesn’t internalize that the way that he’s feeling is ok (not that he FEELS ok, but that what he is feeling is tolerable)… then he’ll never learn how to soothe himself.
And so, if we think about a 29-year-old who is met with any kind of hopelessness, sadness, loneliness, rejection, anger, or anything undesirable… if they haven’t learned the blueprint of how to navigate these difficult emotions, then these emotions will become intolerable.
What’s the Purpose?
I’m not saying that these “negative” emotions will EVER become comfortable.
They’re obviously uncomfortable. That’s kind of the point. Their purpose lies in being uncomfortable: and that’s to teach us something.
If we feel guilt, for example, we have to try to learn: what is this guilt telling me? Did I hurt someone? If so, what can I do differently next time? What do I need to do now?
But if we take an emotion that’s supposed to have a learning experience attached to it and we move it into a category of “intolerable,” then we begin to make decisions based on how to avoid that emotion.
If you’re the kind of person who feels “negative” emotions too often [ahem, guilt], more on that in a future episode.
What if I’ve Dissociated?
If you’re reading this and you think: “Well, so maybe I do feel this way, but if I’ve dissociated from my painful emotional experiences and I’m no longer aware of them, isn’t that OK? I don’t feel them, and I’m totally fine with that.”
To you, I say… our emotions don’t just dissipate. They go SOMEWHERE.
And so, if we cannot communicate what’s going on internally with our words, then our body is going to communicate in some way, shape, or form, FOR us.
So when we think about an eating disorder, that’s our body trying to communicate something – and it’s coming out in our relationship with food. If the communication is not happening verbally, then we have to try to figure out what our symptoms are telling us.
Our body is sending messages via our behaviors and urges, whatever that might look like – a binge, restriction, an urge to self-harm… you name it, it’s all a message.
If we continue to push our emotions away, we get further and further away from our ability to get in touch with ourselves.
We continue to not be in the driver’s seat of our decisions, whether it’s in our relationships, career, or life. And then, we need more and more to communicate – and that’s when eating disorders get worse and worse.
When we lose our ability to communicate, we use eating disorders to communicate louder and louder when it’s not heard. We all know this: disordered eating can go to eating disorders, which can turn into something medically serious in a very short amount of time. And it’s extremely dangerous.
Start Putting Words to Your Experience
Obviously, feeling your emotions is easier said than done. So what do we actually do about it?
Similar to a toddler, the first step is putting words to your experience. And not just your emotional experience, but your physical experience, too.
Some of the tools I like to use are:
Use a head-to-toes scan. Go from your head to your toes and go through every body part. Ask yourself: “What am I feeling?” Put words to it: my throat feels dry. My chest feels tight. There are butterflies in my stomach. My leg has extra energy. My hands are closing into fists.
Use the emotion wheel. It’s a wheel with the equivalent of primary colors of emotion in the middle that branch out into more subtypes of that emotion. For example, anger branches out into resentment, annoyance, etc. Once you see it on the screen, you can choose what you’re feeling – which is sometimes easier than conjuring up an emotion on your own. (Think about true/false or multiple choice exams as opposed to open ended questions.)
Once you practice these over and over again, you begin to develop a foundation of vocabulary for yourself. There is something organizing about being able to put words to your experience. Even if you’re not a craving organization type of person, there's something soothing about the organization of your words and emotions.
Get the Soothing You Need
After you have the organization and identification of your emotions, the next step is to get the soothing that you need and deserve that you didn’t get in the first place.
Sadly, learning how to soothe yourself is not rocket science (although we’d like it to be – because if we don’t do it currently, shouldn’t it be complicated?). It’s simple, but it’s also really difficult.
Part of what’s difficult is being able to sit with your experience — and especially, have your therapist sit with you in your experience – and not change it at all.
If we go back to the toddler with the lollipop example, part of learning to tolerate frustration is the parent implying, “I’m not going to fix it for you. I’m not going to give you a lolly (because I don’t have one now, it’s dinner time, etc.) , and you’re going to be okay. Even if you don’t have this thing, the world won’t end. I’m going to sit with you because what you’re feeling – the frustration – is really, really difficult. And I’m just going to sit in it with you.”
Then, a couple of things happen. You learn that you don’t need the lolly (and insert 32 year old version here) to feel better. You learn that you can tolerate frustration.
And you learn that your emotions cannot possibly last forever. They come and go in waves – and if you ride the wave, they will ALWAYS pass.
But they won’t if you keep throwing fire on it. If you throw judgment on your emotions and think, “I shouldn’t feel this way” – THAT stuff actually prolongs the emotional experience. But if you ride the wave, it inevitably will pass. Not because you did anything… but because you allowed time to pass.
And in doing that, you teach yourself (and your therapist teaches you) that we don’t have to do anything drastic to make this go away. And that is the key to taking an emotion that was once intolerable… and making it tolerable.
Bridging the Gap
Once your mind and body begin to work together – you’re bringing more awareness and soothing, and learning how to communicate with your words – then you’ll no longer need to use your eating disorder symptoms to communicate.
Obviously, this is a pretty package with a bow. 🎁 If this sounds like, “Welp, that’s all you gotta do for your eating disorder, bye!”... Please understand that of COURSE I know that this often takes years, if not longer, in therapy
I know this is easy for me to talk about conceptually when I’m not in it. But I do think that if we can conceptualize your eating disorder journey, or your journey with healing your relationship with food, as a journey of healing emotionally… then we can understand what’s going on (a) in therapy and (b) how you can see progress for yourself.
Over time, you’ll find small, small changes, and THAT’S what will feel like it will make the difference.
I do have a few episodes that talk more about some of the specifics of this, like about the mind/body disconnect, using metaphors, using curiosity to develop resilience, understanding psychoanalysis, and the inner workings of therapy. I’m really excited to have more of that coming up this year, and some of my favorite analytic authors coming on for year #2 of our podcast 🎉
But I’m hoping at the very least, this will lay the foundation for your understanding of (a) how your brain works and (b) how you can work toward recovery. ❤️
Tweetable Quotes
“[Emotions] are encoded in us. And if we leave them encoded, then we let our relationship with our emotions – our history – drive every one of our decisions… we are not currently in the driver’s seat if we do not shed more light on our relationship with our emotions.” – Rachelle Heinemann
“We have to zoom out. It’s not just one binge, one desire to restrict, or one workout… it’s more so your overall relationship with food is connected with your overall desire to remove yourself from painful emotional experiences.” – Rachelle Heinemann
“If someone has not learned the blueprint of how to navigate difficult emotions, then [those emotions] will become intolerable.” – Rachelle Heinemann
“Our emotions don’t just dissipate. They go somewhere… and so, if we can’t communicate what’s going on internally with our words, our body is going to communicate in some way, shape, or form for us.” – Rachelle Heinemann
“Your emotions cannot possibly last forever. It just doesn’t. They come and go in waves – and if you ride the wave, they will always pass.” – Rachelle Heinemann
Resources:
Related Understanding Disordered Eating Episodes:
2. Understanding the Concept of Psychoanalysis with Meredith Glidden, LCAT, LP
25. Using Metaphors to Understand Eating Disorders with Courtney Dowdell, LCAT, CEDCAT, RDT/BCT
27. Eating Disorders and the Mind/Body Disconnect with Danielle Novack, Ph.D
36. The Inner Working of Therapy with Jack Heinemann, LCSW-R