Click here for MyEDHelp Treatment Finder
Have a question about eating disorders? Ask Shannon--She can help!
Hello Shannon, I have struggled with an eating disorder for about 13 years. I am 28 years old, and have had amenorrhea for 10 years. I also have osteoporosis in both hips and my lower back as a result of my eating disorder. I am finally taking proactive steps to recover from my eating disorder. I know each case is different, but I was wondering, have you ever heard of someone so severe actually recovering from her E.D., and her body healing from the horrible effects of anorexia? I appreciate your time and hope I haven't put you in an awkward position. Thank you so very much. Dawn
ANSWER:
Dear Shannon,
Hi, my name is Ivana. I am responding to the letter from Shannon’s column. I am fighting anorexia myself and your letter really touched me, it is so similar to how I have been feeling especially the last month or two. I have been in recovery for almost 2 years and I just feel like I can not continue with it. There are times that I have no idea what the feelings that I am experiencing even are, and I am the type of person that thinks I NEED to know at that moment. I was supposed to go to in-pt care last summer and than last winter but we could not afford it and my insurance would only pay for 10 days. So I just said I am going to do this NO MATTER WHAT and so I have come along way since last Dec. All of my outpatient team members are saying how amazed they are with my progress and willingness to try new things, but I am almost at my wits end with all of this. I have been fighting several pounds of water retention since mid-December and I am planning on starving myself in June if it does not start to go away. I really don't want to do this, but I see NO other way out. I have a great support team and some say that they will not be able to see me any more if I do that. At that point I will GIVE UP recovery and go back to doing what "I THINK I" want to do. I am trying to deal with it as best I can but it just DOES NOT seem to want to leave. I don't know if I'm doing something wrong or what. Maybe you have some advise for me. I just feel like I CAN NOT and WILL NOT live like this for too much longer. The medical people I am working with say" it just takes time, and it's really only been a few months since I stopped the laxatives and prune juice," so just continue with what you know is best. Well that's easier said then done. They also say for me to get myself occupied with doing something else so that I am not ALWAYS thinking about it. So I have signed up for a class at the college for the summer to see if that will help. I do know that the only reason I have been able to hang on this long is because of GOD, but as I said before it's almost to my breaking point. I am praying more often then I was before, but like you said in your letter "at times it seems like GOD does not hear me" and so I ask everyone else to pray for me because their prayers will be heard. I then feel guilty for thinking like that. I myself HATE the food and am NOT hungry when they say to eat. I end up eating but just hours after the time it should be. I feel like if I DON'T FEEL HUNGRY than I should NOT be eating! I am trying to work on this with my dietition and hopefully can improve. At times I WISH I WAS NOT BORN because learning how to deal with feelings instead of COVERING THEM UP is REAL SCARY and I don't see how I am EVER going to be able to! There have been times lately that I desperately want to cover them up and pretend that they are not there and NEVER have been there, but as we know that is not recovery and I really want this (most of the time ) anyway. Well I have taken up enough of your time. Hope to here from you soon.
Ivana
Vancouver Washington
ANSWER:
Dear Ivana:
I appreciate hearing from you about where you are in your recovery journey. What strikes me immediately is that, while you express a great deal of fear about acknowledging and expressing your feelings, you are in fact doing just that all throughout your letter! I would like you to re-read your letter to me until you can start to see and own that accomplishment for yourself.
Sometimes what happens in recovery is that we experience a ‘lag-time’ – we literally have to ‘catch up’ with ourselves mentally. I suspect you have spent many months or even years being very afraid of feeling. So now, even though you are feeling your feelings, expressing them to others, and effectively moving through the emotional layers that have kept your eating disorder in action, you are not yet aware of doing this. You are stuck in your own past. Bring your awareness of the work you are doing and the achievements you have made in recovery to the forefront of your awareness, and you will no longer let your past fear of e-moting run your current life.
Another element that sings through loud and clear in your letter is IMPATIENCE. Oh my goodness are we impatient for recovery to end almost from the moment it begins! This is a common phenomenon, especially in recovery from eating disorders. Why? Because the personality profile of someone at-risk of developing an eating disorder lends itself naturally to experiencing impatience. One thing I ask every new woman I mentor is this – Do you know who you are? Do you know the personality profile of someone with an eating disorder?
If not, you must get to know yourself, deeply and intimately, so that you can learn to work WITH yourself rather than against yourself in your own recovery process. If you struggle with an eating disorder, there is almost a 100% certainty that you also possess the following characteristics:
1) You have a Type AAA personality – what I call the ‘Energizer Bunny’ personality type. Achieve, accomplish, perform. Perfectly. These are the requirements you have for yourself – they come as naturally to you as breathing, and you probably have never even given them much thought. They are simply expected. (That other people may not hold themselves to the same stringent standards has probably also never crossed your mind.)
2) You are highly intelligent with an over-active brain that never turns off. You have the capacity to mentally comprehend the world around you at a level few others have access to. Conversely, you are in danger of quite literally thinking yourself to death.
3) You are highly socially conscious. You have a strong drive towards equality – for others, for yourself. You want to make a difference in your achievements – you want your life to count for something. You have never believed you are just here to take up space till you die, yet you fear just that more than most, and more than anything else you fear.
4) You are emotionally oversensitive and hyper-aware of your surroundings and other people, often to the exclusion of all else, including yourself. You may also possess poor boundaries and inadequate coping mechanisms to protect yourself from the strong emotional lives of those around you. Hence the entrance of your eating disorder.
Once you know your personality profile, you are less likely to intimidate yourself, bully yourself, guilt or shame yourself right out of what you want and value most. You are less likely to behave as your own worst enemy because you are a fast learner who applies what you learn on the spot. Because of this, impatience is your worst nightmare – your worst enemy. Of course your eating disorder ‘does not want to leave’. But this is only because parts of you aren’t READY for it to leave! So instead of getting terminally frustrated with what you perceive as ‘its’ refusal to leave, identify which parts of YOU feel frightened of life without the eating disorder for a companion. List out those parts and then brainstorm ideas for other coping mechanisms you can gradually build in to replace the eating disorder.
Next, grieve for what your eating disorder has been to you – a toxic presence in the end, yes, but nevertheless a ‘best friend’ in the beginning, back when you had no other idea of how to cope with life. Go through all five stages of the Kubler-Ross Grief Process around letting your eating disorder go – denial, anger, bargaining, depression and acceptance. So you say you ‘can not and will not live like this any longer’ – then it becomes clear what you must do. You must thoroughly replace your current unhealthy coping mechanisms with newer, life-affirming skills, one memory at a time, one emotion at a time, one challenge at a time, one relationship at a time, one circumstance at a time. You must build a new foundation for yourself, FROM THE GROUND UP. This takes courage, perseverance, discipline, self-effort and support from others, but more than anything else, this process requires TIME. Without adequate time to lay the groundwork for change, even the best-laid plans will fail to properly coalesce. Rush through the process and risk leaving essential pieces unaddressed. Rush through, and expect to fail. Take your time, recognizing that no thing truly worth having ever comes overnight, and expect brilliant success.
It is important as well to recognize that your past actions have current, but temporary, consequences. So you made a past choice to use prune juice and laxatives? Well, then it comes as no surprise to yourself, your treatment team or me that you currently experience bloating and so-called ‘weight gain’ that is really just water weight that needs to be discharged. But recognize that as you make a current choice NOT to use prune juice and laxatives, then in the future you will reap the positive results of this choice as well. You are building a different future through the choices you make NOW, just as you have built your present by the choices you made in your past. Every day you should wake up and strive to live in the moment, but also envisioning and expecting a brighter tomorrow from the fruits of the good choices you are learning to make today. Your motivation and enthusiasm for tackling the challenges of recovery will grow exponentially as you work to hold this awareness in your mind at all times. Understand as well that if you make the same life-negating choices you have already made in the past, you will once again experience the same unwanted results in your future as you are experiencing now. Have you ever heard that the definition of insanity is ‘doing the same thing over and over again, expecting different results’? How can you take this phrase and apply it to the choices and decisions you are setting up for yourself right now?
This is a very adult process you are choosing to embark upon now. Recovery is not for the immature. Your choices have consequences. No one else can fix your life but you. No one else can stay your course. Nor can you do anyone else’s hard work for them. And even the Higher Power/God of your own understanding will not experience the sting of disappointment and self-hatred that you will feel if you knowingly act against your highest wellbeing. In ignorance you may find some protection from the consequences of what Twelve Step circles call ‘self-will run riot’. But with awareness there is nowhere left where you can hide. So instead, turn within. Take this rare and precious opportunity to get to know yourself – really know yourself – in a way that no other human being will ever know ‘unrepeatable you’ in this lifetime. Become your own best friend. Find out what you are really made of and grow into a deep feeling of self-love that allows you to be proud of your progress even as you respectfully acknowledge that you have further yet to go.
The process of nutritionally providing for your body’s needs must be, at this point at least, unrelated to actual physical feelings of hunger. It is very clear after reading your letter that you are far and away intelligent enough to recognize for yourself that your feelings of ‘hunger’ are skewed by the eating disorder’s demands, not to mention repeated applications of what I call ‘using food for purposes other than that for which it was intended.’ Food has one purpose, and one purpose only, and that is to provide fuel for the body. When I began learning to re-feed myself, I drew up my own nutritional requirements accordingly. I knew I needed so much protein, vitamins and minerals, fruits and vegetables, liquids for hydration, etc. I knew that smaller snack-meals more frequently worked better for me and stressed me out less than three larger meals. I knew that eating every 2-3 hours kept my metabolism and blood sugar functioning at levels that allowed me to feel more consistent energy and mental wellbeing. I knew that I was committed to keeping my physical body around for awhile, because without it I would not experience a quality of life that motivated me to want to stick around. I knew that I couldn’t have both – the eating disorder AND the rest of my life, and I knew this at a level that brooked no argument for what the right decision would be when mealtime came around again.
And I came to crave the intense feelings of self-respect that were generated every time I responsibly fed myself healthily. You must learn from your doctor and dietician what your calorie and nutrient requirements are for your age, gender, height/weight ratio, and current deficiencies. Then, just like a loving parent would, you must consistently require yourself to ‘do the difficult thing’ and ingest sufficient quantities of nutrients each day at appropriate times to meet your physical body’s nutritional requirements. It really is that simple. And it must be done. All recovery work starts here. You address this first, and then move on to address your recovery needs emotionally, mentally and spiritually.
My wish for you is that you embrace the life you have so obviously chosen to live. Your choice is obvious through the stark, vulnerable honesty in your letter. Do you realize how much courage it takes for a human being to admit that she sometimes wishes she had never been born? Do you realize how much potential that unlocks within you to reach for and eventually grasp the fullness of your own life? Your current struggle has given you the secret access code to the secret of life itself. You know this – in a place beyond your mind, you are aware of how profound the questions and choices you are faced with really are. You are, as Nelson Mandela once stated (and I paraphrase), not so much afraid of your inadequacy as you are deeply afraid of your power, your light, your ability to ability to tap into and make manifest the essence of what makes you and those around you so precious and irreplaceable.
Don’t waste any more of your own precious time stamping your foot like a little child and playing childish games with yourself and your support team. Don’t tell yourself you are ‘doing your best’ when you are planning to self-starve again, and whatever you do, don’t allow yourself to believe your own carelessly constructed lies. You know better. You know your best is better than that – you have already proven that to yourself, and whenever you doubt, your support team will back you up on that. You deserve better, you know it now, and you are capable of so much more. Respect yourself for your honest doubts and fears, respect your right to revisit your past one more time to solidify your decision to make a new choice now. Then pick yourself up, dust yourself off, remind yourself that if others like myself have healed then you can too, and KEEP GOING.
You can do it. I believe in you.
Warmly,
Shannon
QUESTION:
Dear Shannon,
I'm writing you today for some advice....I've had several of my kids talk to me about cutting. Can you shed some light on this for me?
ANSWER: Hi - Cutting happens for similar reasons to any other addiction - it is a way to displace feeling onto something with immediate, measurable results. I do not know if, like eating disorders, it has any genetic basis to it or not. But I do know that, once started, it is habit-forming.
I myself have never turned to cutting, so my thoughts on this important subject will necessarily be second-hand information I have gleaned from discussing it with young women I know who do cut.
The young women I know who cut have shared with me that they view it alternately as a form of self-punishment, as a way to 'feel' emotions that otherwise feel too strong (believing they couldn't bear it on an emotional level they channel their inner pain to a physical experience instead), or even as a 'proof' that they exist, because they have grown so numb that they have no real experience of themselves anymore outside of creating a physical wound and watching nature take its course. They tell me that the temporary physical pain is like a wake-up call where for a moment they, like the cursed soldiers in the ‘Pirates of the Caribbean’ film, can feel human sensation again. I hope that this explanation makes sense.
There are skilled treatment professionals who can intervene and help the cutting to cease. I unfortunately am not one of them - I understand the drive to do it and the reasons why, but I do not know the techniques these particular treatment professionals are trained in.
One helpful suggestion I can make is something I do with those I work with who have eating disorders, and that is finding alternate means of expression to help them begin to 'rewire' the brain to disconnect the associative link that has been made between two unlike things - i.e., food and managing painful emotions, or cutting and managing painful emotions. I have seen therapeutic tools like painting or drawing on the area where a cut would have taken place that have had some success. Also, displacing the need to act out through cutting onto craft projects or service work sometimes helps. I believe that what is ultimately needed is a new set of coping skills to replace the cutting as the primary means of making it through difficult periods of life. So in this way it is like anything else we struggle with that is self-injuring....we just have to enter into a sincere effort and determination to do things a new way, and not stop till we get there.
I hope this helps. If you want to read about the subject of cutting by an expert in the field, I recommend this book - it is by Steven Levenkron, Cutting: Understanding and Overcoming Self-Mutilation.
Shannon
Reader Talks Back: Hi Shannon! I just wanted to give some input for the recent question about cutting. It's more common in people with EDs than most people think. I spent 20+ years with anorexia and bulimia and am in long-term recovery, thankfully. I was a cutter for a lengthy period of that time. Some of the cutting came out of anger since I didn't know how to handle extreme anger- handling entreme emotions of any kind were not something that I had learned how to do yet. I also used it to counteract the numbness, as you said. As we know, there are biological reasons that people who are active in their EDs feel numb- bingeing, purging, and starving all bring about changes in the brain chemistry that cause endorphin rushes followed by numbness so cutting does serve to puncture that feeling of "non-reality." Punishment is another very real reason. I even had some therapy sessions where I felt like my therapist should punch or hit me as punishme nt for the thoughts/ feelings I was having. Part of recovering was being able to put voice to those thoughts and feelings even though it felt "crazy." My therapist offered compassion even though that seemed exactly wrong at the time. Some of the techniques that have been suggested to me and that I have used include the following:
- get a stuffed animal and cut on it, stab at it, whatever
- instead of cutting, use a marker (red) to draw where I felt like cutting
- physically exhaust my anger by hugging (really hard) something. A hanging boxing bag is an example- hug it as hard as you can until you can't anymore
- beat on a mattress with a tennis racket or bat- it makes a great noise and is physically tiring
- throw glass things into a dumpster- use some energy in the throw and listen to the shatter
- "free write" open a blank document on the computer or get some blank paper and just start writing. Write whatever comes to mind and ignore everything you learned in school- spelling, punctuation, etc. Keep writing until you feel spent. If you can't think of what to write, write that you can't think of what to write. Just keep going until you have it all out. Use any language/words you want.
I hope that this is helpful. I was just having this conversation with a young woman who is in early recovery yesterday. She's learning to identify her feelings and she wrote to me and said that she had been at work and identified that she was angry but didn't know what to do with it. I remember being at that point. Another book about cutting that I highly recommend is "A Bright Red Scream" by Marilee Strong.
-Amy
QUESTION:
Dear Shannon Cutts,
I am sorry to bother you especially when I know you probably get a lot of e-mail but I just want to ask one simple question. What do you when you have lost hope after ten years of struggling and am about to just give up rather then have to fight through another day. This is where I am right now and I am kind of scared because at times I would rather just die and wish I had the guts to do something more quickly them starve myself since it is not working fast enough. If you can help me in any way or have any advice before my last string is drawn and I decide to just give and not allow others to save me anymore. I don't want to be saved. I just want to die. What do I do when I can't stop thinking I just wish I would not wake up in the morning. I don't have the energy to wake up and do it all over again. I am tired, I am sick and out of ideas. For I been to 12 treatments, 6 therapists and many doctors. Nothing seems to help and I just want to give up and say I lost allowing ed to put me in his victim column. It seem so much easier than having to go through another day. What do I do?
Rebecca
ANSWER:
Dear Rebecca –
Thank you so much for writing – your question is deep and powerful and I am honored to share my thoughts with you.
So….what do you do? Isn’t that the question to end all questions! Well, for starters, let me tell you that I do understand from the inside out how you feel because I have been there. And the most important discovery I have made out of that time in my life is that nothing worth having is ever easy to come by – and if it ever looks that way, it is only because the years of hard work and dedication behind it that are well hidden behind the glow of victory surrounding that person.
What do I mean when I say I have been there? I mean I endured years of what I would call ‘lightly to moderately suicidal’ thoughts and behaviors – ED among them. I mean I would wake up each morning with a jolt of anxiety, dreading another day. I mean I would allow the mean, negative, self-hating thoughts to run rampant and unchecked in my head, such that I would rather kill myself than listen to myself for one more minute. And I mean I would have to call a friend or a sponsor to sit on the phone with me for hours to make sure I didn’t do harm to myself.
Because of this, first let me say this – if you really wanted to kill yourself, you would have done it already. When I realized this, when I realized I had chosen the coward’s way to suicide by ‘letting’ my sore loser of an ED feel like it was ‘winning’ for awhile, I got off my butt, took a good hard look in my EYES in the mirror, and asked myself what was up. You don’t really want to die, just like I didn’t really want to die. You’re just not sure why you should want to live. THIS is the work before you – to create for yourself a life worth living, that is worth fighting for.
So this is my advice to you. Get up and KEEP FIGHTING. Anything worth having – like your life – is worth giving a lifetime to achieve. Study the lives of the great humanitarians in this world – begin to identify your struggles – and similar probability of success - with theirs. Read about Mother Teresa, who worked for years serving the poorest of the poor, all the while doubting whether God even existed! Read Corrie Ten Boom’s story, about how she persevered and survived, in part by helping the others she was interred with in the concentration camps, even though she wasn’t a even Jew! There are so many inspiring examples of people who, like you and me, have faced death eye to eye and have survived – because they DECIDED they would!
When I began fighting my anorexia, I didn’t even have a name for my disease. And it took me fifteen years to gain the upper hand over my ED and finally blast out of that prison for good. But I knew one thing about myself from the first moment I began truly fighting – from that ‘aha’ moment I described above – I knew I wasn’t a coward. And I decided I’d rather die trying and have the chance of succeeding than die never knowing if I could have overcome it. I decided that no matter what, I wasn’t going to just lay down and die and let ED have me.
You have to decide who you are – you have to create an identity that is free from your ED that feels powerful, compelling and real to you, and then you have to fight for HER – for that identity who is locked in hand-to-hand combat with an assassin named ED. You have to pull out all the stops. When your mind won’t stop thinking in ways that pull you down, then you have to climb on top of your mind and arm wrestle it to the ground and FORCE it to think positive, high, optimistic, hopeful, faith-full, determined thoughts of yourself, recovery and life after ED. You must become the master of your mind, working around the part that is still working for ED’s cause and using it to overcome, not further, your disease. You must turn your mind from your enemy into your ally, and you must turn all of that misdirected potential you have been using to get very good at your ED and use it to get very good at OVERCOMING your ED.
All the proof you will ever need that you can do this – you can heal – is already there for you. All you have to do to find it is to look at the seriousness of your ED. If you can do that, imagine what you could do if you turned all that power around to healing from it!
And most of all you must create for yourself a battle cry in all this – what I call a ‘key to life’. For me, this was my music – when the ED stole my ability to write, play and sing music, I got mad enough to put my foot down. I swore an oath that I would never let that lying, scheming ED get away with stealing what mattered most to me. So my ‘key to life’, the thing that mattered MORE to me than what my ED had to offer, was my music. And even as young as I was at that time, I had the maturity to realize that I had to make a choice – I could not have both. I could not have both my ED and the rest of my life! This caused a lot of denial, rebellion, grief and bargaining in me at first – I went through a classic grieving process in letting my ED go. But on the other end of my grief was the new life I have now. It was worth it – it is always worth it.
This is the most fundamental truth you must understand before any real healing can begin. I know that sometimes it is difficult to find appropriate, helpful treatment options. But if you have been to that many facilities and have consulted with as many professionals as you describe, and you are the constant in an otherwise changing landscape of treatment team members, then it is not that the treatment hasn’t worked. You, for reasons only you know for sure, haven’t been fully participating in your own recovery journey. Often this has to do with not knowing who and what waits for you when ED is no longer in your life. This can be solved, as I discussed above, by creating an identity for yourself that is your ‘impossible dream’ of who you want to be – and then by designating one or more ‘key to life’ battle cries that are motivational enough to keep you fighting for a lifetime to get your life back. And then you go back to work – and this time it’s for keeps!
This is how it is done. The work starts now. Now is when you take your first step out across the Grand Canyon, into the great unknown of recovered-life, in faith that I have done it, many others in this support network have done it, and so there is no reason in the world you cannot do it too. You said it yourself – you are the one to decide whether to help yourself and let others help you. If you think you can’t, if you think it’s not worth it, then you can’t, and it’s not worth it. If you think you can, if you think it’s worth it, then you can, and it is worth it.
It really is as simple as that. This is how it is done – this is the only way it can be done. My thoughts are with you in this tough time – let us know how we can help and support you.
Much love,
Shannon
Question:
Hey I don't know if you remember me or not, I went to a couple of the ED meeting at Cadwalders (also the last time you were there). Anyways, my question is, I have recently been giving some thought into become a motivational speaker. I had been struggling with cutting since i was 11 years old and anorexia/ bulimia on and off since i was about 15 due to flashbacks from incest and from being raped. However, through my higher being, i have been fully healed and i can say that i no longer have a feeling or thought about harming myself in anyway. I have a passion to help those around me who are struggling with what i went through, i just have no idea where to start. So if you could give me some pointers i would greatly appreciate it!!! Thank you!!!
-Brianna
Answer:
Hi Brianna
It is nice to cross paths with you again – I am so glad to know that your recovery process is going well.
I do get this question from time to time from those who have healed and want to help others. I can tell you that I absolutely did NOT go looking for this work I do now. It came looking for me. Which is not to say that you cannot deliberately craft your future around the passion to speak publicly about your story….but just so you know that that is not where I was coming from when I started speaking. It actually took almost a full YEAR to convince me to share my story with a group of anorexic women in treatment. And, once I had given my first few public programs, somehow the invitations just kept coming. In time, I met my manager/agent and we got organized around the obvious need for someone who could share articulately about the experience of recovery. At that point, we began actively soliciting opportunities for me to share various programs we’d developed. But that came much later.
So, reflecting back on the process we have gone through, I think the best way to approach it would be to sit down and identify your Mission and Vision – what you feel your particular message is, and what audience(s) might best identify with your story. Next, in outline or bullet point format, begin to highlight important points you want to convey. Build your program, and find a few relevant venues who will allow you to ‘practice’ your speaking skills on them. Most public speakers do a lot of pro bono speaking work when they start – this is a good way to give back, and at the same time receive valuable experience to hone your craft. Schools, non-profit organizations and (if this is an interest) religious organizations are often grateful for pro bono speakers. You might start there and see how the first few events go, and see how you like it.
Warmly,
Shannon