47: Letter from a Listener—There are Times when Hope Seems Fleeting
Emily Fonnesbeck, RD and Marci Evans, MS, CEDRD, cPT are back on the podcast to have a discussion about a listener letter all about eating disorder recovery. Themes of home, black and white thinking, perfectionism, community and how to take steps forward are all discussed and more. You’ll love the words of this letter and the wisdom of the panel members!
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Text of the Letter:
There are times when hope seems fleeting. Anxiety, depression, guilt and shame can be so prevalent. There are also times where you just don’t feel worthy of an answer to anything especially an answer to prayer. I want to let you know that these are the times when we need to continue to pray, continue to have hope and lean on the knowledge that there is a purpose to everything.
I have experienced this and continue to experience this now. No one ever asks for adversity or challenges that can either break a person or through the experience will make them stronger, and in some situations you may have the opportunity to even be able to help someone whom is going through the same trials. This doesn’t make it any easier. Yet can make it bearable.
I have struggled for many years now with something called “an eating disorder” I call it the “Cloud” because this is how I felt, surrounded by a thick, dark and daunting, cloud. I have a difficult time calling it anorexia. Yet this is what it is. This can affect anyone, it doesn’t matter the size you are, sex, or age. Eating disorders do not discriminate. I was diagnosed a little over 2 years ago now. Yet now I understand it started many years before that. It starts small, and continues to develop into something that becomes out of control, the interesting part is control is what you think you are achieving. But you are actually in a downward spiral. I was in denial that anything was wrong and at times I still have doubts that I even had or have a problem.
I felt so alone, but this is the time when I was surrounded by those who loved me. I was blinded by shame and guilt. I wanted to be the perfect mom, wife, daughter and friend. As I strive for this, thinking that if I lost more weight people would accept me. I couldn’t have been more wrong. I received all the praise and accolades that go along with weight loss. Yet as the praise continued the guilt grew, I didn’t know when I would be able to stop. Or why I felt so ashamed. It has been said that if you had the ability to listen to others with the same disorder, our words, feelings of shame are the same, almost like a recording. Yet we have never met. How can this be? What is really the common thread through all of this?
As I continue to struggle, I have hope that things will someday get easier. There will be times when I have to rely on others; this is something that I’m not comfortable with. In fact, the disorder will actually try to deceive you into believing that only you can do this on your own. It will take courage; it will take all your strength to endure the times that seem impossible to overcome. Yet we need to understand we are never alone. Look around you, there is beauty in your surroundings, a sunrise, and the sound of a bird chirping or hearing a child singing. More than anything though we need to see the beauty that is within ourselves. We are all marvelous works of art. We can radiate glory, we can radiate love and we definitely radiate beauty. This has nothing to do with what society thinks as beauty. We are so much more. We have beauty that is immeasurable. We all have the light, some days the light may be dim, or just a flicker, yet will all have light.
I know I have so much more to learn. I know that there will be a time that my burdens which are upon my shoulders will someday lighten. With patience, love, and kindness for myself I will endure my trials. As I continue to have hope and the courage to continue to lean on the fact I have a purpose. There is so much more to me than what the eating disorder wants me to believe. I will conquer, I will hold fast to the knowledge that I am enough.
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Alright. Welcome to Nutrition Matters Podcast my name is Paige Smathers, your host. I am so excited. I have been anticipating this particular episode for a few months now. I’m excited to have Emily Fonnesbeck back as well as Marci Evans back on the podcast. Both of you have been here before and Emily participated in one of the very first episodes where she shared her story and some of her experiences with food. I think it was maybe episode 3-ish. So, if you haven’t listened to that one, do it. And then she also helped me out with the episode about resolutions and goals. And taking a different look at how we see the New Year. And we recorded that back in January of 2016. So, that was a really fun two episodes and I'm so glad to have her back. And then Marci helped me out with the food addiction episode we did. So, I called that one Food Addiction: Fact or Fiction. I have both of these wonderful registered dietitians back to talk with me today because I actually received a letter from a podcast listener who has written a letter about her eating disorder, or to her eating disorder. Or kind of helping her process her struggles with food. I just thought wow I want to assemble some awesome people who I trust and who I think could help her work through some of this. I thought of Emily and Marci and I actually have another letter I'm going to be breaking down with two other wonderful people who have also been on the podcast before. So, look forward to that coming up in a little bit as well. So, Emily and Marci do you want to both say hello really quick?
PAIGE: And that’s Emily.
EMILY: This is Emily.
PAIGE: Hi Emily. And then Marci do you want to say hello really quick?
MARCI: Absolutely! Hello everyone. Thank you for listening and I'm looking forward to it.
PAIGE: Ok! Me too. So, because all of you listen to my voice more than you probably want to I am having Emily read this letter for us and then we’re just going to have a discussion about it. I'm excited to see where this goes. So, go ahead Emily. When you’re ready.
EMILY: ‘There are times when hope seems fleeting. Anxiety, depression, guilt, and shame can be so prevalent. There are also times where you just don’t feel worthy of an answer to anything. Especially an answer to prayer. I want to bear witness that these are the times when we need to continue to pray. Continue to have hope and lean on the knowledge that there is a purpose to everything. I have experienced this, and continue to experience this now. No one ever asks for adversity or challenges that can either break a person or, through the experience, will make them stronger. And in some situations, you have the opportunity to even be able to help someone whom is going through the same trials. This knowledge doesn’t make it any easier, yet can make it bearable. I have struggled for many years now with something called an eating disorder. I call it the cloud because this is how I felt. Surrounded by a thick, dark, and daunting cloud. I have a difficult time calling it anorexia yet this is what it is. This can affect anyone. It doesn’t matter the size you are, sex, or age of the person. Eating disorders do not discriminate. I was diagnosed a little over two years ago now. Yet, now I understand it started many years before that. It starts small and continues to develop into something that becomes out of control. The interesting part is, control is what you think you are achieving but you are actually in a downward spiral. I was in denial that anything was wrong and at times I even have doubts that I even have or had a problem. I felt so alone but this is the time when I was surrounded by those who loved me. I was blinded by shame and guilt. I wanted to be the perfect mom, wife, daughter, and friend. As I strived for this, thinking that if I lost more weight people would accept me I couldn’t have been more wrong. I received all the praise and accolades that go along with weight loss yet as the praise continued, the guilt grew. I didn’t know when I would be able to stop or why I felt so ashamed. It has been said that if you have the ability to listen to others with the same disorder, our words, feelings of shame, are almost the same almost like a recording. Yet, we have never met. How can this be? What is really the common thread through all of this? As I continue to struggle I have hope that things will someday get easier. There will be times when I have to rely on others. This is something that I am not comfortable with. In fact, the disorder will actually try to deceive you in believing that only you can do this on your own. It will take courage. It will take all your strength to endure the times that seem impossible to overcome. Yet, we need to understand we are never alone. Look around you. There is beauty in your surroundings. The sunrise and the sound of a bird or chirping or hearing a child singing. More than anything, though, we need to see the beauty that is within ourselves. We are all marvelous works of art. We can radiate glory. We can radiate love. And we definitely radiate beauty. This has nothing to do with what society thinks is beauty. We are so much more. We have beauty that is immeasurable. We all have the light. Some days the light may dim or just flicker. Yet, we will all have light. I know I have so much more to learn. I know that there will be times that my burdens which are upon my shoulders will someday lighten. With patience, love, and kindness for myself I will endure my earthly trials. As I continue to have hope and the courage to continue to lean on the fact I have a purpose. There is so much more to me than what the eating disorder wants me to believe. I will conquer. I will hold fast to the knowledge that I am enough.
PAIGE: Thank you so much, Emily, for reading that for us.
EMILY: You bet.
PAIGE: Just to clarify, if anyone kind of missed the beginning, that’s not Emily’s letter. She was reading an anonymous letter for us. Just want to clarify that just in case anybody is confused. So, Emily, since you read that, just tell me what jumps out at you in a general way with that letter?
EMILY: In general, what I'm getting from it is it’s obvious she's starting to see that her disordered eating, eating disorder has been functional in a way. To help her feel more in control, to help her to reduce anxiety, or life stressors that seemed unmanageable and it seems to me that she's starting to realize there might be more effective ways to cope with life experiences. Which I would encourage her to continue to explore. Because I believe that to be true. Yeah, that’s, I think the general thing I get out of it.
PAIGE: How about you, Marci? Tell us a little bit about your overall impressions from reading the letter.
MARCI: Oh gosh. I have a lot of thoughts but my first broad brush stroke response is that she seems to be writing this letter almost to reinforce what she hopes to believe. She believes it but it hasn’t really sunk in deep inside of her and so it’s almost like this declaration of what she believes for herself, wants to believe for herself. Maybe believes for other people. It’s almost like she switches back and forth between writing an encouraging note to herself but also sort of declaring these certain beliefs that they apply to other people. I think that’s actually really beautiful. I think that as people are really trying to climb out of the whole of their eating disorder they have to do some re-programming. They have to be working on changing the internal dialogue of how they speak to themselves and if that happens through letter writing or journaling or talking that it’s ok to give yourself time to try to begin to internalize these messages until they feel deeply true inside. It’s ok to be in process with that.
PAIGE: Yeah, Marci that’s a really good observation. I think that’s really true. I got that impression as well. That there is this sense of “I’ve been told that this is what goes on. I've been told that this is the problem. I want to believe this but I'm just not quite there yet.” And maybe some of the shame she was talking about in her letter has to do with that very fact of like, why am I not there yet? I mean, what do you think? Is that a normal process of recovery?
MARCI: Oh, I think it’s a completely normal process of recovery. I think for her to be able to acknowledge where she’s been, where she's at right now, and where she wants to go and continue to have hope that if she puts one foot in front of the other she can continue to make forward progress. One of the things that I was thinking about, and perhaps we can explore a little bit more as we continue our conversation, is this idea of how you take forward steps and actions when your feelings inside of you don’t totally align. Those moments where maybe she’s feeling imperfect, or feeling shameful, or feeling undeserving. That those feelings will certainly arise inside of her and how do you continue to act in the direction of recovery even when you’re not fully 100% there in your internal feeling state.
PAIGE: I want to definitely go there. Let’s hear what Emily. Emily, what do you think? Is that a normal process of recovery?
EMILY: Yeah. You bet. I would totally echo what Marci just said and just add we know from the letter she talks about how she struggles with calling it anorexia. She really, it seems to still be in a little bit of a denial of what really the issue is. I find that to be very very common and normal. Especially because in the process typically, and I should say, generally maybe not typically, but what I find is individuals who have spent a lot of time focusing on the foods that their eating and possibly this perfectionistic mindset, almost feel like any sort of physical symptoms or issues that they have could be solved with changing how they’re eating or what they look like. And she mentioned that a little bit in the letter. So, for her to change, as Marci said, that internal dialogue or the way that she thinks about her story, to switch that mindset from my issue isn’t necessarily because I'm not perfect enough, the issue is trying to be perfect enough. Trying to manipulate food and my body this way. Or, trying to control some of the verbiage that she used, control or to feel in control. It’s definitely a mindset shift. And she's not alone in that. I think it’s very common.
PAIGE: So, I love this point about, this observation of it sounds like she wants to believe these things and maybe has moments where it’s resonating and just is like, yeah today is a good day. This all really sinks in and feels good and then, you know, you hit a roadblock. Whether it’s a comment someone makes or a thought that just turns into more and more negative thoughts throughout your day, or week. That sometimes you lose sight of it. But, that’s ok and that’s normal. Eventually as you do this work things start to sink in truly in your heart and it’s more a part of you rather than something you’re hoping to believe. Is that a good summary of what we’ve said so far?
MARCI: Absolutely, I think so.
PAIGE: I want to sort of go down some of my observations and I’ll prompt a few questions here or there but I want this to feel really informal. I want you both to feel very comfortable bringing stuff up along the way. So, Marci, I wrote down your thing about the how do we take steps forward even when our feelings maybe don’t align or aren’t quite there yet. I want to start with one of the first things she says in the letter. For anybody who’s interested I’ll post the actual words of the letter in the show notes so that if you want to reread it you’re welcome to. But, one of the things that she says that I think we all, before this conversation, we all kind of mentioned how it’s interesting how she refers to her eating disorder as the cloud. I wanted to hear what you both think about that. Marci, do you want to go first?
MARCI: Sure. I’m happy to chime in. I think it’s interesting. She describes a cloud which when I think about a cloud, what comes to my mind is sort of this light, fluffy, sort of white thing in the sky that feels more sort of ethereal and lovely and yet she describes it as thick and dark and daunting and almost heavy. My first thought about that was a little bit of what Emily spoke to actually. This idea of being able to appreciate both the lightness and the darkness. That is a huge theme of what I was going to bring to the conversation. About being able to appreciate that we have both parts. The dark parts of the anorexia that really made her life difficult and clearly was connected to feelings of, perhaps, I mean she doesn’t state it so explicitly here but, really negative feelings. Sort of spiraling. Perhaps depression. Perhaps disconnection from people in her life. That she describes it as a cloud in this negative sense. I would be interested also for her to maybe flip it and call to mind some of the up sides of the eating disorder and give herself some space to be able to appreciate ways in which her eating disorder has been useful to her so that she can be appreciative of how it served her but then also use that information of guidance of what she needs to be able to replace that function. To find some healthier, more life affirming coping mechanisms. But to know that eating disorders come in and one of the reasons why they can be pretty tough to recover from is that they can be quite effective. To say, yes, it’s this dark cloud. This cloud of anorexia which caused her turmoil and sadness and heartbreak and it’s also something that has probably been helpful to her in ways. And so, to be able to acknowledge, express gratitude, go through grieving process of letting that go and then developing the skillsets of what’s going to come in in its place.
PAIGE: I think that’s a really good point Marci, about the imagery of the light and the darkness and I'm excited to explore that as an overall theme throughout the letter. I don’t even know if it was intentional to talk about that dark cloud. And then at the end she sort of ended with this idea of we all have light within us and sometimes it’s dimmer and sometimes it’s stronger. I think that’s a really cool literary tool she used. So, that’s a good point. Emily, what do you think? What were your impressions about the cloud she talks about?
EMILY: Well, first of all, I love this idea of kind of continue with this light and dark theme. It would be really good to talk a little bit more about that. The way that she described the cloud. She talked about it being, as was mentioned, thick, dark, daunting, and I got the idea that she felt kind of stuck in it, right? This actually kind of reminded me of, there’s an author whose name is Dan Seigel, and actually my own therapist, a few years ago and Marci, actually, both recommended his work to me. And I read three of his books, and the way that he, he’s a neuroscientist for those that. He works in psychiatry. He’s developed this idea of mindsight, which takes mindfulness techniques and applies it to mental illness. And the way that he describes, his definition I should say, of mental health is balance between rigidity and chaos. And that’s what came to mind as I thought about this cloud. She probably feels very stuck. Her mindset probably feels very inflexible and stuck and it’s hard for her to wrap her mind around something like recovery or the steps to get there. What I think recovery’s aim to do is to make her mindset more integrated and more flexible and more willing to see multiple sides of the issue. So, I feel like the way she described it, it felt like, to me, she was saying she felt kind of stuck in this dark cloud and didn’t really know how to get out of it.
PAIGE: So, I love this dark, light idea and it also relates a lot to these themes that we talk about all the time in eating disorder or even just disordered eating or helping people with their relationship with food. A big thing that comes up over and over again is all or nothing thinking, or another way of saying that is black and white thinking. When you mentioned, she really needs to work on becoming more flexible. How does someone do that when they’re probably, I hate to generalize here but, a lot of people are very not flexible and very rigid just sort of in most areas of their life, just kind of naturally. A lot of people who struggle with food have that as part of their personality. So, how do you both, I'm curious, how do you both work through that with people who have that just sort of part of their make up?
EMILY: I’ll jump in here first. First of all, there’s probably a lot of steps in order to get to a more flexible mindset. Something that comes, an overarching theme, that comes to my mind in my experience is being less judgmental and more curious. So, it’s not necessarily to say that we’re not still observing and drawing conclusions, but we are developing more of a curious mindset rather than a judgmental mindset. And, you know, obviously the work that we do, specifically with eating disorders, is around food and being less judgmental about food and increasing variety of foods and flexibility with foods. But, it’s natural that practicing that with food naturally will carry over to many other areas of a person’s life. Where they just learn how to be in practice in general, less judgmental and more curious. And I think that really helps get out of that really black and white mentality. Whether it’s right or it’s wrong. It’s good or it’s bad. There’s a little bit more grey area.
PAIGE: Great point. How about you Marci? Tell us what you think about that.
MARCI: First I want to say I love everything that Emily just said about the curiosity and I think that’s incredibly important to practice. One of the ways I do this with my clients is I have them think about how they would be speaking to their child self. So, if they would imagine somebody saying this, you know, about imagine themselves as a five-year-old. It’s like, how would you speak to that five-year-old? The really interesting this is that we all have that capacity to tap into our own inner wisdom. Sometimes shifting focus as if you were speaking to your younger self or you were speaking to, if you have a son or a daughter. If you were speaking to your best friend, is that you have a greater capacity, typically, to shift out of that very black and white, often very cruel, thinking to something that’s much more nuanced. Much softer. Much more, typically, grounded in reality and less black and white. One of the things that I want to say is that as human beings our minds have evolved to put things into categories because it helps us sort through the world to know what’s safe and what’s not safe. So, it’s a very human tendency and some of us are more prone to black and white thinking than other people. So, to not sort of add another burden on top of yourself for judging yourself for the black and white thinking, but just being able to be like, “oh, there I go again making a really sort of black and white statement I wonder how I can soften this?” or “I wonder how I could frame it to my son?” or “how would I talk about this with my friend?” To lighten it up and careful not to add, sort of, another layer of judgement because you find yourself really struggling with that black and white thinking.
EMILY: Can I jump in?
PAIGE: Marci that’s a great tip. Yeah, go ahead Emily.
EMILY: I love that and I just want to mention something in addition. Often times, as someone’s moving forward out of this all or nothing mentality and into this more flexible thinking it’s easy for them to feel an increased level of anxiety because it is their mind protecting them. As Marci described we’re evolved to that place where we are making judgements to keep up safe and our mind is often keeping us safe. So, for example, if someone chooses to eat something or to do something that they have made prior rules around it’s likely that their anxiety will increase. Now, typically an individual would retreat. Naturally we don’t want to go to that place where we feel more anxious. We’re really aiming to feel more peace and calm. And that’s where this can be really hard work because you’re moving forward even though you’re actually feeling more fear and more anxiety because your brain is trying to keep you safe. As Marci has just talked about, it’s really wise to say things like, “oh, thank you mind for trying to protect me but I'm wondering if this is maybe a wise decision.” Or in some way really acknowledging that you are trying to keep yourself safe. It’s not like you are, again, adding more layers of judgment to yourself for being in this mindset or getting yourself in this mindset or any number of conclusions you could draw.
PAIGE: Yeah. That’s so true. I see a lot of people that I work with sort of on top of everything else they’re struggling with, now we talk about all or nothing thinking and now they’re like, “oh man. That’s another thing I need to work on. Or another thing I'm terrible at.” Another source of shame or guilt in this whole process. I loved both of your suggestions. I definitely use that tip from Marci with people I work with too. Just how would you talk to someone you really truly love, like your younger self, or your child, or your niece or nephew or something like that? How would you talk them through this if they were expressing that? And so often it’s easy to get out of that black and white thinking and more into that compassion and nuance and gentleness that we all need. We all need that especially from ourselves to get through this really difficult life. So, great points.
MARCI: Absolutely. Hey, Paige, do you mind if I jump in?
PAIGE: Please do.
MARCI: I think this really connects to another piece of the letter that I really noticed. And it connects to this idea of allowing for greater messiness in life. So, when we think about developing less black and white thinking, we’re moving out of the black and white into these different shades of color. And that can feel a little bit unnerving for people who like order, and precision, and exactness and sort of guarantees. One of the things that I was really thinking about is her second to last paragraph where she’s talking about radiating love and beauty and all of these positive things. I think that that’s wonderful however, one of the things that I’d like her to think about, and I’ll ask listeners to think about, is that as human beings we aren’t all just love, and beauty, and glory, and all of those positive things. We are a mix of wonderful things and not so wonderful things. We’re a mix of strength and deficits. Things that we’re really great at and things that we really struggle with and that’s ok. So, to make room for being a whole, messy, beautiful person. There’s a book that I love and it’s actually one of my favorite books that I've ever read on eating disorders and recovery. It’s called Sensing the Self and it’s written by Sheila Reindl and there’s a chapter in her book called Beauty and the Beast and it talks about how that beastly part of ourselves often we want to put underground and we want to hide and we don’t want people to know. Often that’s, kind of, we go underground or people who develop an eating disorder take those parts of themselves underground and they’re expressed through the eating disorder. Whether it’s starving or bingeing or purging or over-exercising and when we can learn to embody all of our selves. All of the good stuff. All of the not so good stuff and say yep this is what makes me human and I'm working to be the best version of myself that I can. But I'm never going to be perfect. I'm going to have flaws. I'm going to have things that I'm great at and things that I'm not so great at and that’s ok. That it doesn’t have to be all positive and all pretty and all lovely. That we’re just a big mix of all of it and to kind of get more comfortable with that.
PAIGE: Yeah. I mean, that touches on something she talked about towards the middle. When she says, “I was trying to be the perfect mother. The perfect daughter. The perfect wife” and she’s talking about this idea of perfection which is sort of the trap that gets you really REALLY wrapped up in this all or nothing thinking. And if you fall short of perfection, which we all know we all do every single day. That can give you license to further damage your relationship with food or further participate in behaviors that aren’t conducive to overall health and happiness and can get you down this rabbit hole even further. So, you touched on the idea of perfection in context of the end when she’s saying, “I want to radiate love and beauty and glory” and all that. I loved your point that, like wait a minute, that’s not our only thing we do. That’s not the only part of us that’s worth showing because the whole messy parts of being human is actually what’s really beautiful about us. I love that. It’s so important.
MARCI: Right. And that we have true comfort and safety and security in relationships when we show all of ourselves and we’re accepted for being our whole self rather than being parts of our self. We remain really vulnerable in relationships when a person, whether it’s a partner or a friend, knows only the part of ourselves that we want to show them or that feels like the good parts to show because then that can sometimes cause us to put false fronts forward. This false notion of being perfect and that creates a lot of distress and a lot of tension and makes it hard for us to really embrace our whole selves. Which is really what we have to do in order to fully recover.
PAIGE: Marci, these are such great thoughts. Emily, I'm sure you have stuff to say so go ahead and chime in if you’d like.
EMILY: Yeah. I agree with everything Marci said. Something that came up for me as Marci was talking is this idea of what is perfect? I think that’s super subjective and most of us have an idea in our mind of what is perfect. Something I maybe encourage her to think about is all of us have different personality types and sometimes we end up in a low functioning version of our personality type. Usually, we’re in a moderate to high functioning area of our personality type. I think what’s super important is, as Marci has mentioned, that we all have our strengths and we have our weaknesses but it’s what makes us human. What’s kind of, as I read through this letter, I really thought about the fact that I think what she’s kind of wanting, and I know that I'm probably drawing conclusions here, but what I'm kind of getting from this is, it’s almost like she wants this weakness, this darkness to be turned into a strength. I think that’s a great goal. What I consider is that it can, a weakness or something she really struggles with can turn into a really great strength, but that doesn’t necessarily make it any better or any worse. It makes it her story. It makes it who she is. But I think it’s super important to recognize that she is a whole person right now. It’s not something she has to become eventually. That drive for perfectionism can be super super tricky that way. It’s almost like, I won’t be ok, I can’t accept myself as I am right now until I am that perfect person and this is the mentality that can easily to continue to feed an eating disorder. That might be something to think about. This idea of acceptance right now for where she is at right now. Knowing that she still wants things to change and improve and to feel more at peace with herself.
PAIGE: So, one thing that stood out to me about her letter. This is probably the biggest thing that stood out to me personally. Was when she says, and I'm paraphrasing, but when she says that somehow it seems like when you really get inside someone else’s head or you hear what other people are saying in their own head it’s the exact same thing that you’re saying in your head as well. That stood out to me because as someone who sits across from people at a table and talks to them about food, and weight, and body image, and struggles, and all these different things, I relate to that. I hear, I mean just the other day I heard two women say the exact same thing that just blew my mind. I experience this all the time. There’s these thoughts of isolation and “oh my gosh. I'm the only one that’s ever thought this. How can I be such a terrible monster for having these thoughts? How could I be such a horrible human being for doing these behaviors?” Shame and shame and shame, right? And no one could possibly understand where I'm coming from. And so, we hide it and like you were saying earlier, Marci, we put only the beautiful, perfect part of ourselves out there for people to see and for people to interact with. What I loved about this part, for me, was I was cheering when she says it’s been said that if we all had the ability to listen to others, our words and our feelings of shame are the same almost like a recording yet we’ve never met. I see that because I have this advantage of talking to all kinds of people all the time about their thoughts and feelings and struggles. Where I was going with this and where I was thinking is I wish we could have these conversations more. I guess that’s definitely why I do the podcast but how healing and beautiful is it to know that you aren’t alone when you feel so isolated. How wonderful is it to know that there are people out there who understand you and who have been through the same things? That just really resonated with me because so often I find myself saying I wish you, this one client of mine, knew this other client of mine because your stories are so similar. I wish you guys were best friends and could talk and could help each other heal because you’re not alone. I wanted people to hear that message.
EMILY: I completely love that. I think what we all recognize on this call, and for those who are listening who aren’t really, isn’t familiar with Brene Brown’s work on shame. We know that shame thrives in secrecy. So, the feelings that she’s having of shame or isolation are going to continue unless she’s opening up which she’s doing here by writing this letter. Obviously, she’s taking steps to do so. I think as she continues to find ways to share and to open up and to not feel so isolated those feelings will change for her as a result of what Marci’s already described as being more vulnerable. Being willing to show up. Being willing to show all parts of her in a way that she feels good about. To people that she feels like have earned her vulnerability are willing to support her in a way that she needs to not feel so isolated. I think that it’s also super important to recognize that the eating disorder is going to want to keep her isolated. That’s how it’s going to stay. It definitely is going to tell her that it’s not ok. It’s not ok to tell people this. We’ve got to keep it a secret. If we tell anyone then we aren’t going to be able to stay in this nice little place where we feel safe from everything else. Journaling, if that’s something that’s effective for her. Writing letters, seeing a therapist and a dietitian. Having a treatment team that she feels is in her corner.
PAIGE: Yeah. Thanks Emily. Good point. Marci, what are your thoughts about this?
MARCI: Oh gosh. I have a lot of thoughts so I'm going to try to organize them as best I can and I really like what Emily was saying about reaching outside of herself to people she feels has earned her trust. So, safe people. She says in her letter, there will be times when I have to rely on others, this is something that I'm not comfortable with. I'm going to give her a little news flash. There are going to be a lot of times that she’s going to have to rely on others in her recovery and in order to really, fully recover, she’s going to have to continue to do that because that’s what we as human beings have to do in order to get through this thing called life. Being able to develop a healthy dependency on other people to say, I need help can you do this for me, or I'm struggling with this thing could you lend a hand. That’s not just a recovery, that’s a life skill. That’s never going to go away. Her recovery gives her an opportunity to begin to practice that and it’s something that she's going to have to sustain and hopefully over time get a little bit more comfortable with. But, going back to this piece of, “do other people really feel what I'm feeling?” And I, Paige, have had the exact same experience of sitting with clients and literally in a day saying, “well you wouldn’t believe I had basically the same conversation, verbatim with my last client” or my client who I saw earlier. I hope I can explain this, or articulate this in a way that makes sense to the listeners, but this happens not only. It’s not only specific to eating disorders. Yes, there are similarities and threads that are, across the board for people who have an eating disorder. But if we dig a little bit deeper, these are human condition struggles. They’re struggles of not feeling good enough. Struggles of not fitting in. struggles of fear of rejection. There isn’t a human being that doesn’t struggle with those things because it is wired inside of us as human beings to worry about those things. Being able to connect to this human condition of really wanting to be in, to be accepted, to be loved and not to be rejected is something that all of us, as humans, struggle with. And it just so happened that her way of managing those feelings showed up in the context of an eating disorder. But it shows up in different ways for all of us. She just happened to have the genetic risk factors, and the temperamental and psychological risk factors that her way of managing that anxiety showed up through her eating disorder. But, underneath hopefully we can have a lot of compassion and empathy for one another because we’re all struggling with those things.
PAIGE: Marci, that’s so true. That is so so true. Thank you for that comment. I loved everything you guys have said. Thank you for this wonderful discussion. I'm hoping this will be so helpful for the letter writer. I wanted to go to your point, Marci, that you made in the beginning. Let’s talk a little bit about how you take steps forward when the way you’re feeling inside doesn’t really align with what you hope to feel. Kind of how we started off our conversation today. Marci, do you want to talk about that first?
MARCI: Sure. I'm happy to. I’ll just share some of the thoughts as they come into my mind. I think one of the things that makes recovery from an eating disorder so difficult is that you have to continually choose actions that run counter to your feeling state. So, the things that you have to do, often in the moment, feel wrong or feel bad. And that’s a really hard…
PAIGE: Can I give an example?
MARCI: Yeah. Yeah sure. Absolutely
PAIGE: Just to make this really concrete. So, I have one in mind unless you do.
MARCI: Oh great. Go for it.
PAIGE: So, let’s just take a for instance. Let’s say someone who is struggling with anorexia has, and I hope this isn’t too triggering for anybody listening. But, let’s say that inside they want to experience hunger and fullness, they want to regulate their eating and they want to rely on those ques. Those natural bodily cues. But, for some people who struggle in that way, eating can feel so anxiety provoking that you’re just so out of touch with those cues that almost when you don’t eat you actually feel better, right? And so that to me is a really good example of I want to feel this way but instead my body’s giving me sort of a dysfunctional cue and a dysfunctional response to something that doesn’t really make sense to the normal way of looking at it. Does that make sense?
MARCI: Yeah. Absolutely! I think that’s a great example.
PAIGE: So, how do you eat when it makes you anxious? And when you don’t eat it makes you feel better? How do you move forward?
MARCI: Right. Or when you do do it all of the thoughts and feelings that flood in afterwards are negative and judgmental and shame based.
MARCI: And it feels really bad. One of the ways I work on this with my clients is I ask them to do a values assessment. And you can go online and Google, give me a list of values and you will find lists of values that are really long. This is a difficult assignment because what you’ve got to do it find a list of values and choose 20 that really resonate to you. Then take that list and reduce it down to ten, then reduce it down to five and then pick your top three. And it’s really tough because once you start reading values all of them sound pretty good. Yeah, I value honesty. Yes, I value connection. I value, you know, having fun. I value hard work. But what you get down to are your top three core values and write those on a Post It note or a card or have it somewhere visible. What the practice is is when you’re having a hard time in terms of your feelings moving forward. The trick is not to respond to the shame or respond to the guilt as a way to dictate your actions. I think a lot of times that’s what people in the process of their recovery react to feeling states rather than to those internal values that they have inside of them, like that internal compass. So, when they start to waiver or start to second guess or that eating disorder voice starts to come in, they go back to that value and say, “What’s my value directed action?” If I value honesty, and I'm having the urge to, after dinner, sneak away to go use the bathroom to go purge, that’s not in alignment with my values. So, every fiber of my being might be saying get rid of it get rid of it. But, you say, “what’s my value?” My value is being honest. If I go sneak away that’s not honest and that doesn’t feel good. So, you start to use those values as your compass rather than those automatic eating disorder thoughts and those feelings.
PAIGE: Marci, that is so beautiful. I'm so glad you articulated that in that way. I've never heard it expressed that way. Thank you. Emily, what do you think?
EMILY: First of all, just to expound on what Marci said which I loved. I find this to be overwhelmingly helpful as a way to move forward outside of the guilt and the frustration and the shame and the anxiety that comes up as you’re moving forward. In particular, recognizing that that thought is different than who you are. Like, it’s just an activity of the mind versus who you are. As Marci said, you can really cling to these values as a way to be your compass because really the goal, maybe I shouldn’t say the goal, maybe the overarching goal of recovery if to help you become more self-directed versus needing a lot of outside validation or direction in terms of making decisions. Now that obviously is in terms of food but also in a lot of other areas as well. Just something that I would add to the conversation about what are steps forward. Something that I would strongly encourage anyone listening, like anyone listening, eating disorder or not, is to really evaluate the media that they’re letting into their lives. In fact, I spend a lot of time actually in sessions with clients doing a social media detox. Thinking about TV shows, even, or magazines that they’re reading. The way they’re talking to friends or family members about food. Just really looking at creating an environment that’s conducive to recovery. I cannot emphasize enough how so vital it is to help you not wake up in the morning and have to combat not only your own feelings about the situation but then everyone else’s, right? Like all of this media that could be coming in it’s so much noise when you’re trying so hard to listen to that internal value system that Marci’s described. So, that would be a key tip I feel like, eating disorder or not, anyone listening to this should really evaluate the things that they’re listening to and reading and scrolling through during the day.
PAIGE: Yeah. I had a conversation with someone just this week who, we were trying to assess where all these negative body image thoughts were coming from and I said ok well is it your peers, is it trying to attract someone of the opposite sex, is it parents, is it…what is it? And every answer was like no, no, no, I'm totally confident with that and I don’t have any issues with that. And then I asked the social media question and said well who are you following on social media and how do you feel that’s affecting you? You could tell that she was like, whoa that is totally it. I'm comparing myself to these people I don’t even know who I'm following online and who aren’t even showing me, like we’ve been saying this whole time, their whole selves. So, yeah. That’s something we, it’s kind of a trope to even say social media is so hard for people, for anybody, and for our body image and for our sense of self-worth but man, it’s so true. It’s almost like we forget about it sometimes when we’re assessing what’s going on with us. What do you think Marci?
MARCI: Oh Paige. Ugh. I just am dying to chime in to underscore everything that Emily said about regardless if you have an eating disorder or not, I mean, literally, I so fully agree with her. If you could take one thing from our conversation today, is to really think about the environment you’re creating. I agree. It’s like caps lock, underline it, highlight it. It is so true. I was just reading something online just last night that said some of the research shows, after reading women’s fashion magazines, less than 3 minutes for women to start feeling significantly worse about themselves. Depression score is worse. Anxiety score is worse. We are inundated with all this crap already that’s not our choosing, just sort of walking around the street and being in the world. Being so intentional with what you can control is so vital. What shows are you watching and how does it make you feel about yourself? What are you reading? Who are you following on Instagram? Who’s on your Facebook feed? How much time to do you spend when you’re checking out at the grocery store scanning the magazines that are there? Don’t do it. Really creating an environment that is supportive to your healthiest most authentic self and then filling up your life with positive. Filling up. There is so much positive social media. Positive body messaging. Online blogs and communities that are supportive to your recovery. Really finding those resources. My gosh, this podcast! There are so many resources out there. But, really getting very serious about committing 100% to taking the stuff out that shouldn’t be in there. I had a situation with a client last week who’s really come so far in her recovery but she kept kind of going back to the waters of the eating disorder. We kind of compared it to, she’s also in recovery from alcoholism, and we talked about it almost as an analogy of a dry drunk. So, going up to the bar but not getting a drink. What are ways in which she was doing that? And she felt so ashamed to admit this that it turned out when she was feeling guilty about her foods she’d get on her Instagram feed and start looking at articles. We had to just cut that all out. So, what are the non-negotiables in your media life that you can comment to? And I’m just so glad Emily that you brought that up.
PAIGE: Yes, and I have to say, anybody out there who isn’t following Emily or Marci should be because they’re both amazing and they post such uplifting and interesting articles and little sayings and mantras and things like that. So, I’ll link to both of your social media accounts because there are people out there who are really trying to put good things out there for us to be exposed to. It’s not all bad. But, again, we have to just be careful with things we can control because there’s so many aspects of life and media that we can’t. So, yeah. Great points, both of you.
EMILY: So, I actually, I was, this was a client, just this week that talked about how even though she has unfollowed or hidden certain feeds on social media, she still finds that it’s still just a lot of noise. Even if it’s body positive or a lot of food positive accounts. She still feels like it’s a lot of noise and I think that’s something to consider here as well. Even though you might be following a lot of positive things, it might just be too much noise at the time. So that it’s still interfering with your ability to be really intuitive and connected to your own core values, as Marci mentioned. So, that’s something to take into account too. I love that Marci brought up this client that was going back to social media when she was feeling anxious. It’s what we do. It’s so natural to seek out that, like, that thing that’s going to take away our anxiety. I find this happens with the scale, you know? People want to get on the scale and make sure they haven’t gained any weight. It’s almost this compulsion to find something to reduce the anxiety. So, social media tends to be one of those things that I find it can be a distraction or a way to decrease anxiety. Or a perceived way to decrease anxiety. So, spending some time looking at other ways to reduce anxiety. Which, I know, is kind of a big topic so I don’t necessarily…
PAIGE: Adaptive ways to reduce anxiety because sometimes the ways we figure out that help us to reduce anxiety are things like restricting or bingeing on alcohol, or, you know what I mean? So, what I'm trying to say is, if you just are looking at which tool can I use to help with my anxiety that doesn’t always lead you to a good spot. Finding really adaptive ways for you that are actually helpful and life affirming and healthy for you is a big distinction in my mind. I'm just thinking about the idea of “well, when I eat I get really anxious so I'm just not going to eat.” Well, that’s clearly, ok, we’re not going to argue that that does give you anxiety but that method you’re using to reduce the anxiety is just not an adaptive way to approach it. I feel like I'm not articulating myself very well, but. Fill in the blanks for me guys.
EMILY: I think that’s the point. We just want to find healthy, and effective ways to reduce that that aren’t harmful.
PAIGE: Right. And even sometimes things like exercise can be a great anxiety reducer. But, maybe not very healthy for every person because some of us can let that get out of hand as well and let that become compulsive just like restricting can be compulsive or other behaviors that reduce anxiety can become compulsive. Again, this is not a black and white thing where exercise is good and restriction is bad. You’ve got to look at how does this affect me and my life long term and my health long term, right? Anybody want to add anything to that?
EMILY: No, I actually think you articulated that great. I think that’s awesome.
PAIGE: Ok. Sometimes I think I ramble and then I listen back and like ok I did alright. Sometimes while you’re talking ‘you’re like what am I saying. Well, I want to end with the idea of hope. I think that’s a big part of her letter and we started off this way so I think this is going great that we’re going to be able to end and tie it all together this way. We all articulated the feeling that we had that she has this hope or this desire to want to feel and think and believe these things and she does a lot of days and she struggles with it some days. What do you both think about the idea of hope in eating disorder recovery? Is there hope? What does hope look like? How do we foster it? How do we keep it around? How do we develop it? I’ll give you a minute to, sort of, think about that. I want to hear your thoughts on hope. I think it’s a big big part of this equation.
MARCI: Absolutely. Emily, do you want to go first? Take a stab at it?
EMILY: Sure. I love hope. I think that sometimes all we have is hope. That’s the thing that we hang on to. It’s something that I often tell people to do is to cling to hope. I think what hope is, I guess I'm speaking from personal experience because I feel, I have felt hope before. What hope feels like to me is that real innate feeling that this is going to get better that sometimes we’re afraid to believe. Especially when all signs are pointing to “no this is really really looking bad” but there’s something that’s kind of inside of us that feels hopeful and feels like you know what, there might be a way out of this. Those are the things, that feeling is something I’d encourage her to really cling to. What I hope that I can do is to help her solidify her hope in that recovery is absolutely possible. I know from personal experience myself that that can often feel like you can say but is that really true for me, you know? You might be able to, you might have been able to do it but am I really going to be able to do it? I think that hearing other people’s recovery stories and hearing that full recovery is possible can keep that hope alive. But at the end of the day I think that hope is something that is super personal. That she needs to really actually cultivate hope by possibly doing a few exercises like writing down, at the end of the day, things that went well, things that she's grateful for. Kind of focusing on the positive experiences she's having in the midst of a lot of negative ones too. Just seeking out the light as she’s mentioned and really cultivating the hope and making it grow stronger by paying attention to it, and thinking about it and recording it and journaling about it and I think it’ll get stronger and stronger and brighter and brighter until it becomes more of her disposition than the doubtful, maybe, feeling that she might be having now.
PAIGE: Or, the cloud, right?
EMILY: Right. Exactly.
PAIGE: Emily, thank you. That was a really great way to say it and really good advice. I appreciate that. Marci, let’s hear you take a stab at it.
MARCI: I feel like we could just end it there because that was just so beautiful. That was fabulous, Emily. What I was thinking about when you first suggested what do you guys think about hope. The thing that came to my mind was, I don’t know her and I have absolute, not just hope, but confidence that she can recover because I have that confidence inside of me about recovery in general that isn’t specific to an individual because if I didn’t have that hope and I tell this to my clients. They’ll ask me, do you really think I can recover and I’ll say, yes, I do. I couldn’t do my job if I didn’t believe in the human spirit’s capacity to heal. I just at baseline believe that with help and with effort, that we have the ability to just get a little bit better and to get a little bit better and get a little bit better. One of the things that I would encourage her to think about is think about what is her vision of recovery and how would she define it? And what would it look like? What would her life be like in recovery? What recovery is is kind of a controversial topic in the eating disorders field. People feel really differently about it so I really like to have my clients define it for themselves. One of the things that I encourage my clients to do is to again not have a perfectionistic view of what their recovery is. I absolutely loved what Emily said earlier in the podcast. I wrote it down. She said, “thoughts are the activity in the mind. They’re not who you are.” And I think having a realistic idea of what recovery is. Which means, does not mean ‘you’re never going to have a bad body image day. It doesn’t mean you’re never going to have an eating disorder thought. It’s how you relate to those things and how you respond to them. So, for her to have an idea of what her recovery looks like that isn’t based in a perfectionistic attitude and to then think about and keep her eyes on what’s the next small thing. So that she can maintain hope and not get overwhelmed on this sort of big quote unquote finish line because I actually don’t think we’re ever finished I think we’re all continually in process and that process just shapes and changes over time. But, sort of have that vision out in front of her but then to think my work is what’s my next step. How can I take that next step and what do I need for that next step? I think that’s what helps to keep hope alive is that the expectation isn’t too big and isn’t too daunting it’s just that thing that’s right in front of her. I think, also, being able to tolerate the fact that her hopefulness about her recovery is going to wax and wane just as her other emotional states will wax and wane. So, to be able to practice getting comfortable with, oh I'm feeling a little bit less hopeful right now, I'm not going to attach to that too strongly because I know last week, or when I was sitting in my dietitian’s office that I was feeling more hopeful. These are states that are going to wax and wane and then I'm just going to focus on what’s my next step and keep my vision and then keep all of those things that are this supportive environment and the people around me who believe in the possibility of my recovery and really surrounding herself with that positivity. You know, when she needs to, or whenever the listeners need to, coming back to this podcast and listening to it again and again and again.
PAIGE: Holy smokes. I'm sure all of you listening know exactly why I had Emily and Marci come on to talk about this letter. I just am in awe of all of the things that have come out of both of your mouths today. I love this conversation we’ve been able to have. I feel, in my heart that this is going to be helpful for the letter writer but also so many people out there who resonate with her struggles and her thoughts and her worries and concerns and her journey. I'm so glad that all of you, both of you were able to come on and share your wisdom. But also, be vulnerable yourselves and set that example of what we’re trying to talk about here. So, thank you both for being here and incredible job.
MARCI: Awe. Thanks for having us. It was my pleasure.
EMILY: Mine too. Thank you.
PAIGE: Ok, so everybody who’s listening I want you to know I'm going to post the letter in the show notes as well as I'm going to post a link to the book that Marci mentioned as well as if any of you are wanting to keep in touch with Emily or Marci on social media. Emily do you want to just quickly spell your last name and tell them what your website is and things like that? And then Marci you can go next.
EMILY: Sure, yes. Definitely want to spell my last name. So, it’s Emily Fonnesbek. It’s F-O-N-N-E-S-B-E-C-K. And my website is emilyfonnesbeck.com. I blog there and my handle my handle on social media is @EmilyFonnesbeck.
PAIGE: Perfect. And then Marci.
MARCI: Sure. All of my social media is connected to MarciRD. So, my website is marcird.com. My Twitter handle is @MarciRD. My Facebook is \MarciRD. So, it’s fairly straightforward.
PAIGE: Easy to find you. Perfect. Well, I am so grateful you both were here. I'm so excited to hear the thoughts and feedback roll in about this episode. I'm stoked about it. I think it was a great conversation and I definitely took furious notes as both of you were talking and I'm excited about this content. So, thank you, again so much.
MARCI: You’re welcome. Good Luck.
EMILY: Thank you.