The 5 Secrets to Quit Binging

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

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

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

2.     Notice what you DON’T binge on. 

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

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

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

4.     What is missing from your regular eating habits? 

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

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

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

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

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

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

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

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

How to Find an Expert on PTSD & Trauma for Therapy on The Main Line of Philadelphia

The Main Line of Philadelphia

is a very special place to live.  If you already live here, you know how unique this place is - if you don't live here, you are in for quite a treat.  The suburban area to the west of Philadelphia has been referred to as The Main Line because of the main train line that connects Philadelphia to all the beautiful towns built up along the train tracks: Lower Merion includes Overbrook, Merion, Bala Cynwyd, Wynnewood, Narberth, Ardmore, Bryn Mawr and Rosemont.  Further out we have Radnor, Villanova, Wayne, St. Davids, Berwyn, Paoli, Malvern, Exton and Frazier.  Each town is unique and has it’s own spin on charm.

Finding an expert trauma therapist on the Main Line of Philadelphia

seems harder than it should be.  With Bryn Mawr's Graduate School of Social Work close by, Villanova University, Rosemont College, Saint Joseph's University, Widener, Immaculata, Cabrini, Ursinus and not to mention University of Pennsylvania, Swarthmore and LaSalle, we have so many talented therapists, social workers and counselors.  So, how do you find the therapist who knows just how to help you manage your post-traumatic stress symptoms?  How do you find the counselor you can click with and trust to guide you through an evidence-based method of healing your past traumatic memories?  Choosing a therapist is a very personal decision.  You can have three great therapists, but if you don’t feel safe with them, what’s the point?  If you are looking for a counselor, psychologist, life coach or therapist - I'd like to help you find someone who can help.

Here are some ways to search

Educate Yourself About Methods that Work for PTSD

When you have PTSD, there are only a few ways of treating your symptoms that have been studied and proven to effectively reduce or eliminate symptoms.  Those nightmares you’ve been dealing with, the heightened startle response, hypervigilance, and avoidance of triggering situations – those are the things that get in the way of your life.  These are the issues you’ll want to be sure your therapist knows how to help you manage and heal, not just talk about.  One of the top researched methods for eliminating these symptoms is a method called Eye Movement Desensitization and Reprocessing (EMDR). 

EMDR has been studied and proven as an evidence-based treatment method.  You can learn more about EMDR and how it works here.  Here is a short explanation: when we have traumatic memories, the memories tend to get stuck on one side of the brain and our body tries to heal it by re-playing it over and over, but it stays stuck.  EMDR is a technique that stimulates each side of the body alternately while the patient processes the traumatic material.  This technique helps the brain move the traumatic memory from one side of the body through to be able to process it so it’s not stuck on a loop any longer.  You can find therapists who are trained and certified to utilize EMDR by going on the EMDRIA.org website or asking people who know therapists in the area.  Think about asking friends who have or know therapists, your doctor or someone at your school.  Therapists that come highly recommended and are known to work with PTSD through EMDR methods are a good way to make sure they have a good reputation.  

Google

Type into Google your town and the issue you are looking for help with.  For example, "Bryn Mawr and PTSD" or "Rosemont and Trauma" and see what comes up.  In the top listings that come up in your search, you will hopefully see some links to therapists that specialize in your particular need and are trained in EMDR.    

Psychology Today

What you will most likely see is a result that links to a Psychology Today profile for therapists in your area that have indicated these specialties.  Psychology Today is a great site that is most commonly used for therapists to post their profiles and for clients to find a therapist nearby.  It’s very helpful that you can refine your search by specialty.  The unfortunate thing is that therapists can indicate that we specialize in as many topics as we'd like.  Although a therapist might indicate that they specialize in PTSD, if it's really something we know a lot about, we obtain specialized training in evidence-based methods specifically for PTSD and we will often note areas we are trained in on our websites, so don’t stop with Psychology Today, make sure you read through the clinician’s website as well.

Websites

Check out the websites of potential therapists.  If you are looking for help with flashbacks and the website you are visiting talks a bunch about flashbacks, that's a great sign!  If you are looking for help with a heightened startle response and you're on a website that doesn't mention this symptom, you might want to keep looking.  

Phone consultation

Some therapists offer a free 15-minue phone consultation which is a great service and an excellent opportunity for you to interview your potential trauma therapist.  You are going to be spending a good amount of time and finances on effective therapy, it is very important that you find the right fit for you.

Here are some questions to help you navigate your phone consultation:

1.     What methods do you use to treat PTSD?

2.   How do you help your clients manage overwhelming emotions while they work on traumatic memories?

3.   What do you do to treat the symptoms versus the root of the problem?

4.   How long does it usually take before your clients start to see relief from their symptoms?

5.   How effective are the methods you use?

6.   Given my specific set of symptoms and needs, do you think you can help me and have you helped many others’ with my specific symptoms before?

In an ideal world, you would find a therapist who has special training and expertise in the methods that show the best results and someone who has tons of experience working with eating disorders and trauma.  Unfortunately, this is not an ideal world.  So you'll need to search a bit further.  You'll be searching for someone that you connect with, who you feel comfortable talking to, someone who will be honest with you and you'll know you can be honest with them.  

I hope this helps you in your search for the right therapist on the Main Line of Philadelphia.  If you want some tools to help now, sign up for my newsletter to get some tips and tools for managing PTSD and eating disorders.  If you are still feeling stuck, feel free to call me at 610.314.8402 for a free 15 minute phone consultation.  I am available to listen to what's happening and help direct you to the right person.  If you are looking for help with eating disorders or PTSD, you can read more about how I can help here.

3 Keys to Finally Make Peace With Food by Geneen Roth

Geneen Roth, eating disorder guru, discusses the following topics with Claire Zammit: 

• - How your struggles with food might be impacting other areas of your life such as relationship, finances and career
• - The common misconceptions about the root of weight issues and the truth you must embrace to finally overcome them
• - The practice that instantly changes your relationship with yourself as a foundation for creating a new relationship with food
• - Why uncovering the deeper, positive reason you've been keeping the weight on is a key to releasing it forever
• - What can become possible in your life (and in our world when we do this as women together!) when you make these 3 shifts
• - How you can make 2017 the year you reclaim your power and make peace with food forever

You can hear the 60-minute seminar here: http://bit.ly/2mdrClK

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

Please comment below and tell us your story !

For Therapists: On How to Conduct a Therapeutic Challenge Meal

Exposure therapy can be very effective when done in a way that gives a sense of empowerment and helps people defeat their fears.  If you have a client who has avoided eating normal meals or meals out at restaurants, challenge meals can be a great intervention for them. 

Assessment

Challenge meals are something that I usually suggest to a client after we’ve been working together for a while.  We’ve sat in the therapy room a number of times and I’ve built a therapeutic alliance with them.  I assess for their fear foods.  I find out what their “red” foods are – their biggest fear foods, their “yellow” foods are foods that are moderately anxiety provoking and their “green” foods – ones they eat regularly and don’t usually feel guilty about.  They’ve relayed their goals, their history and are comfortable in the room with me.  Once this stage has been set, we begin working towards their goals.  Often times, their goals include a desire to normalize their eating habits or to be able to eat in social situations without sinking into extreme guilt afterward.  When I see that the client is motivated and willing to take some risk in order to accomplish their goals, I present the idea of a challenge meal to them.  I let them know that sometimes I go out to eat with my clients in order to help them find normalcy around food and restaurants.  I ask if this is something they might be interested in trying.  If fear, other types of resistance or hesitancy comes up, we process that.  I may use Motivational Interviewing techniques in order to help them find benefit in pushing themselves towards their goal.

Preparation

Once the client has agreed to a challenge meal, I start with the easiest scenario first.  We start with green level foods and see if we can make a “normal” meal out of them.  So for example, if they’re regularly eating tuna fish, but eat it with vinegar instead of mayonnaise, and with vegetables instead of bread, we see if we can create something a bit more normal and a bit more challenging.  So I might suggest tuna with mayo on bread or if bread is too scary, perhaps we’d start with a cracker or tortilla.  During the preparation phase, I negotiate with the client and their eating disorder on what would be challenging yet doable. 

The goal is for the client to feel successful so that they desire to try again.  It’s like learning to lift weights at the gym, we start with lighter, easier weights until our body gets used to it and builds up to the heftier weights.  The first few challenge meals may be done in the office and the client may bring the food or the therapist may bring the food. 

Restaurants

When the client is ready to eat at a restaurant, we prepare by negotiating where they want to eat.  We also decide what we will say if we bump into anyone we know in order to keep their confidentiality.  Sometimes we agree to say we know each other from school or a friend or sometimes a parent’s friend.  I am very careful to speak quietly and refrain from any intervention when others’ could overhear.  I usually ask them if there’s a restaurant they’ve been wanting to try or if there’s a type of food they’d like to get support around.  Once we pick the restaurant, then we look at the menu.  When eating a challenge meal in a restaurant, depending on that particular client, we may decide what they will be ordering before we go to the restaurant or we might negotiate once we get there.  Depending on what would most ease the clients’ anxiety, we may do this right before going to the restaurant or the week before.  I wouldn’t want them to fret all week about what they’ll be eating, but sometimes it helps ease anxiety to get used to the idea and sit on it for a week.  Timing of this is at your and your clients’ discretion.  

Beginning the meal

If the challenge meal is in the office, begin the meal as soon as possible in order to leave the most time afterward to digest and process and reduce the risk and desire for a purge.  The client can use the bathroom before the meal begins so that they won’t need to use it for at least an hour after the meal. 

Ordering from a menu

If the food needs to be ordered in a restaurant, help the client decide what to order, ask if they’d like an appetizer or a side dish and assure them they will only need to eat an appropriate amount.  So if they get an appetizer and a main course, they might only eat half of each, depending on their satiety cues.  Eating a variety of foods is good practice to combat ED.  If they’re getting overwhelmed by the menu, help them to narrow it down by quietly reminding them of the original goal they had in mind.  For example, “well, when you chose this restaurant, you wanted pizza, so let’s stick with that – and you can get a vegetable to go with it and that will provide all the food groups: starch, fat, protein and veg.  So which type of pizza looks or sounds the most appetizing to you right now?”  This way they still have choice, but the overwhelming choices are paired down for them.  Pay attention to what they’re ordering to make sure it’s an appropriate meal.  If they’re ordering an appetizer only, be sure it includes all the food groups and possibly suggest they order 2 appetizers or have a roll with their appetizer to supplement their meal or they may just need an entre.  Salads are usually not an appropriate challenge meal, but a salad with a challenging appetizer may make sense.  Diet foods are not appropriate for challenge meals, so eliminate any diet drinks or egg whites, protein bars, etc.  Make sure the food YOU order is also not triggering to your client.  They are watching you.  If you order the same meal as them, it may make things easier on them.  When they have progressed further along, this may become part of the challenge – to tolerate your food item while they eat theirs. 

Hunger signals

Set the stage for the meal by activating the body signals that have been shut off for so long.  Ask the client on a scale of 0-10 with 0 being supremely starving and 10 being so stuffed they feel sick and unable to move – the most full they’ve ever felt in their life – what number are they at right now?  You can use a hunger cue card like the one shown here.

Identify their hunger signal and yours and if you’re in a group, have each member identify how hungry they are both emotionally and physically. 

Meal guidelines

The actual process of a challenge meal should not be emotionally heavy or food focused.  Try to steer the conversation away from inspecting or commenting on the food or body or fullness.  Instead, talk about lighter appropriate topics like the weather, the atmosphere in the room, how their day was, sports – a movie or TV show.  In a group, playing a game can be very helpful.  Some favorites are “contact” or thinking up famous peoples’ names in alphabetical order. 

Eating the meal should not take more than 30 minutes.  Sometimes clients will try to cut food into tiny pieces or take very small bites or eat very slowly.  This will require an intervening prompt from you.  Something like “please take normal bites” or “that’s cut small enough, let’s start the meal now” or “we’ve got 15 minutes left, please keep up the pace so we can finish the meal on time” are some prompts you might use.  It is our job to help them contain and combat their ED voice.  We state the prompt clearly, yet quietly so others’ don’t over-hear and we say it neutrally and without judgment.  If they’re still playing with their food and interventions aren’t working, I usually just let it be rather than getting into a struggle with them in public and process what happened later. 

If they’re getting an especially challenging meal and they’re anxious about it, I will suggest they can cut their meal in half and just start with the first half.  After the first half, we can check into hunger cues and see how they are with continuing.  I often tell clients that I believe it is more important that they feel successful in eating a challenge meal, but perhaps less of it, than eating too much and feeling overly full and triggered to purge.  This is true in an outpatient therapy setting.  Residential or partial hospitalization has more containment and ability to monitor clients after the meal, so that’s a different story.  But for my purposes, I don’t believe feeling overly full is in the client’s best interest. 

After the meal

Once the meal is complete, be sure to sit at the table for a while and discourage any bathroom use.  You can ask them how their meal was and how they feel emotionally.  Ask what the experience was like and if they’d get the same meal next time or if there’s something else they might like to try next time.  Focus on their success and offer any authentic praise for challenging themselves and their ED.  If they have some regret or guilt, help give them the words to combat the guilt internally.  Something like: “This is one meal, it was enjoyable and my body knows how to process it.” Or “I’m defeating ED one meal at a time.  I need food to nourish my body.  I am proud of myself for standing up to ED.”  Another favorite “this is what normal looks like.  People go out to eat and enjoy food and they’re okay so I can be okay too.”

The more exposure, the more the client will get used to eating food and eating it in challenging settings.  This helps lay the foundation for less social isolation and more ability to tolerate food and restaurants.  Really and truly, one meal at a time really does make a difference.  Supporting a client through a challenge meal shows them that they are capable and gives them a successful experience to remember when they’re ready to try it on their own. 

What have been your experiences with challenge meals?  Comment below.

If you want to learn more about challenge meals, I’d be happy to help.  Contact me at 610.314.8402 or TiffanySpilove@yahoo.com

Please comment below and tell us your story!