The Space Between Stimulus and Response

Reflections on addictions counseling and creating change

So what’s my “drug of choice”?

7 Comments

I have been fortunate, my life has never become unmanageable or out of control because of addictive behaviors.

As an adolescent, however, I developed moderately disordered eating. I believe these symptoms were triggered by other health issues I faced at the time. I avoided almost all fat in my diet, and restricted my caloric intake. I exercised more or felt guilty and awful when I could not motivate myself to exercise. I lost weight and briefly stopped menstruating. Further, I felt proud of myself on days that I rigidly adhered to these restrictions. My self-definition was largely based on body image, and comparison to others. These symptoms eventually abated on their own as I matured and entered a new school. As an adult, residual symptoms like attention to weight and calories/ quantity of food have largely been replaced with attention to being healthful. How does food nurture by body? How do I feel mentally and physically when I attend to my body through moderate exercise? Will I feel better or worse if I just sit here instead of moving around? Still, there are occasions when I find myself focusing on my physical appearance perseveratively, or I return to restrictive eating, eating… permissively, or under-exercising. Often these are times of vulnerability— emotional unfulfillment or stress.

I notice addictive roots in my attitude/behavior when I eat poorly, because the abstinence violation effect kicks in— “I didn’t any vegetables today and I had brownies and soda, so I might as well go all out. F@#$ it.” Or a bad day of shopping, trying clothes on in front of a mirror, and judging can become a trigger for other poor habits (eating junk or eating too much) that do not nourish me. Disappointment and guilt fuel negative behavior, rather than those behaviors that would get me back on track. Further, stressful days accompanied by consumption of high fat, high sugar foods (which trigger dopamine release) perpetuate my craving for these kinds of foods. I no longer seek out healthy foods. With respect to exercise, I also notice black or white thinking that can discourage healthy habits and keeping a routine— “If I went to the pool now, I could only swim for 25 minutes not 45, so I might as well not do it.” When I am at my best, I can use positive self-talk to counter these unhelpful attitudes. (“The really important thing here is that you stay in your routine of exercise, and that you allow yourself to exercise even if you can’t do it “perfectly.”) I also notice roots of obsession if I start checking my appearance in the mirror. I begin to notice how this one issue begins to define my sense of self for the day. I have to set rules for myself or I can tell these behaviors could take over. (“For whatever reason this is a vulnerable day, you need to take care of yourself, so you can’t look in the mirror any more. You only feel worse when you do this.”) These kinds of behaviors are harmful because I become estranged from my other healthier behaviors and because they fuel negative self-evaluation.

Though these behaviors are not pleasant, they are familiar. And as one might welcome back depression as “an old familiar friend,” I occasionally welcome back these old coping strategies when I am feeling vulnerable (down, anxious, tired, worn out, and so on). Eating poorly and not exercising are temporary periods when I release myself from high expectations (“who cares anyway”), though guilt sometimes follows. Further, rich foods are pleasurable and comforting in themselves— stimulating in both their scent and taste. On the other end of the spectrum, on days when I am restrictive, I feel a greater sense of control and self-discipline. Overindulgence and deprivation go hand-in-hand. Deprivation fuels desire and perhaps biological need, which can set off overindulgence. Overindulgence can create negative emotions that make it harder to get back on track. In trying to regain control and to assuage guilt we often overcompensate by depriving ourselves, and thus the cycle starts over.

While these behaviors are not helpful, they are infrequent and not pathological, and so I have not sought treatment. However, I do address perfectionism and self-image issues in periodical individual therapy. What I have found most helpful, as I said, is to focus on the standard of what is nourishing and healthy for body. I feel better about myself when I practice self-care, and when do what I need instead of what I want. I try to use positive self-talk to divorce myself from “the committee” of critics in my head and to reinforce moderation. And when I crave rich or unhealthy foods, I remind myself that a thought or feeling is temporary phenomenon, rather than truth or a call to action. I also find that a period of total abstinence from rich and innutritious foods is sometimes necessary to get back into healthful eating habits, and then I can typically return to incorporating these more luxurious foods into my diet. Further, after periods of uninterrupted balanced eating, I find I do not miss rich foods nearly as much. Time and self-care do ease craving and preoccupation. 

Advertisements

7 thoughts on “So what’s my “drug of choice”?

  1. Hey Meg,

    Thank you so much for sharing such a personal topic. I think this blog post may be helpful to young men and women.

    It is important that you are able to identify your feelings towards eating habits and exercising. It is also important that you are able to identify your triggers as well. I really liked that you shared the self-care aspect of your “addiction.” Self-care can oftentimes be overlooked.

    I have struggled with my weight and body image still til this day. I will use this blog to help myself with this struggle. I found your blog post to be helpful for me. Thank you so much for sharing.

    • Thanks for your comment, Adam. You’re right, like with any other addiction, knowing your unique triggers is super important. In substance addiction they also advise HALT– never let yourself get too H-ungry, A-ngry, L-onely or T-ired. It’s good advice for all of us, I think.

      As I said to Kimberly, I hate to hear that anyone has suffered, but I find comfort in knowing that many others have had struggles similar to my own. It makes me feel less alone, less odd. 🙂

      How have you dealt with your own battles with weight and body-image? I’d love to hear what has been helpful to you.

      Take care, Meg

  2. Meg,

    Thanks for such a frank and thoughtful post. As someone who has had disordered eating behaviors for years, your description of the struggle to self-regulate food intake and refute cognitive distortions really resonated with me. I can especially relate to your experience with the “committee of critics” in your head that steer you towards self-defeating thoughts and behaviors. I think that you have done a fantastic job of capturing the “A-B-C” of what compels people to binge, purge, or abstain from eating altogether. Far too often people tend to adopt overly simplistic explanations about why people have disordered eating patterns, so that people who binge without compensation are labeled as “fat,” “lazy,” or “stupid,” or people who abstain from eating are “preoccupied with being skinny.” I believe that CBT can help counselors develop some great interventions for people with disordered eating, but for some people, the complex etiology of their behaviors might require a different, insight-oriented approach to helping them change their behaviors.

    Most recently I have become really intrigued by the concept of intuitive eating. There are several dietitians who have articulated their own theories of intuitive eating, but the basic underlying premise is that we are born with the innate ability to self-regulate our food intake, but that biopsychosocial factors can interfere with our ability to self-regulate our eating. For example, the parent who encourages a toddler to “clean” his/her plate when the child has already determined that he/she is full. Or the parent who is overly-restrictive about what the toddler is able to eat, so that certain foods the toddler enjoys become off-limits. Eventually both these small children may begin to over-eat- either through learned behavior, or because emotions about deprivation becomes a trigger for over-indulgence (there are a lot of interesting research studies about the relationship between parenting styles, attachment, and childhood obesity). With intuitive eating, individuals learn how to eat until they achieve satiety, while also learning to identify and work through the emotions associated with eating. One of the leading proponents of intuitive eating, Evelyn Tribble, believes that intuitive eating can be part of an effective recovery plan for people who have a diagnosis of AN, BN, or BED (https://www.evelyntribole.com/uploads/Tribole.IntuitiveEating.Eating%20Disorders.2010.pdf). I think that she might be right.

    Thanks again for such an honest exploration of how disordered eating behavior can become addictive.

    -Kimberly

    • Hi Kimberly,

      Thank you too for your honest and informative comment. Though I would never wish you or anyone else suffering, I appreciate your disclosure that healthful eating habits have been a struggle for you too.

      Such an interesting link you shared with me. I will share a link also for a dietician, Deborah Kauffman, with whom I met not too long ago. I did not meet with her as a client, but instead as someone who thought she might like to go into dietetics. Still, I was so moved by how compassionate and bright she is. She too follows an intuitive /mindful eating approach, which I love. http://www.nutritioncounselingforintuitiveeating.com/

      I am drawn to therapies that assume, humanistically, that people know innately how to live and to direct themselves, and that they need assistance because they have somehow strayed from these habits. It sounds like these therapies resonate for you too.

      Take care, Meg

    • An interesting link on disordered eating and the brain: https://www.sciencenews.org/article/anorexic-brain (brain physiology can be so fascinating!)

  3. Hi,

    Thanks for sharing something as personal as your battle with an eating disorder and perfectionism. I have family members that suffer from this very same thing. For them it is a constant battle to recover and remain on a healthy path. Slips show up in the strangest places and they are constantly on guard. Supporting them was hard at first. We did not know what to say or more importantly how to say it. We have settled on, “You are perfect just like you are… ”

    Just like you…

    -Tom

    • Thanks, Tom, for your kind comment. I think that is a perfect thing to say; it’s so unconditionally loving… You’re right slips can show up anytime. And on one hand this could be discouraging, but managing an illness in a largely effective way, I think, can also build self-esteem and be part of how you define yourself. Take care, Meg

Leave a Reply to kwoodar3 Cancel reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s