What’s a therapist to do?


Alex asked the question below over on the Ask AG page and I am going to offer my take on it.

I am wondering if you have any insight on a psychotherapist’s role when a patient is demonstrating persistent, self-destructive behaviors? I’m referring to damaging, non-suicidal behaviors that artificially regulate emotions– such as self-injury, eating disordered behaviors (restricting, purging, etc.), reckless impulsivity, or drug/alcohol abuse (though this last one might be slightly different, I guess, since it compromises your mental capacity more extremely).

This is a really excellent question and in some ways goes to the heart of what therapy is about. I do want to be upfront though in that I am still working through my own behaviors with food so I approach this topic with fear and trembling. I would recommend approaching this post with some skepticism, dear readers, as I may be speaking out of the wrong orifice. 🙂

This is a tough area and involves some complicated issues around boundaries. One of the long repressed needs that came roaring to life for me in my work with BN was my desire to experience a caregiver the way we are supposed to as a small child. Our parent is idealized as all-powerful and all-knowing, able to keep us safe and solve all our problems. I seriously idealized BN at the beginning of our work. (If I’m honest, I still do, but to a much lesser extent. I do at least realize he is an actual human being now. :)) We discussed it once and he said that I needed to see him that way for a time so I felt safe. The problem arose, just as it does for all human beings, when I realized that while he is a safe person, he can neither guarantee my safety nor fix all my problems instantly (or even over the long haul). Like all teenagers when they realize this about their parents, I had to struggle with feelings of anger that he failed to be the all-powerful Wizard I wished him to be (although come to think of it he does look good in gray; but I digress. :)). These lessons are difficult enough to learn as a child, as an adult they are even harder.

A normal part of human development is that we are dependent on our caregivers to get our needs met but as we grow and mature, our caregivers teach us how to identify our needs and act to get them met. Full maturity is reached when we understand and accept that our needs are our responsibility. We have to reach out to other people to get them met but it is our job to make them known and ask for what we need. If all goes well, this does not feel threatening, because our experience was that of getting our needs met consistently and being soothed when we couldn’t have what we wanted. Childhood neglect or trauma often short circuits this process, so that we are ‘frozen’ at the point of looking for someone to take care of us and meet all our needs.

And because we were never taught to regulate our emotions or identify our needs, we often adapted behaviors to cope that have now become maladaptive such as the ones Alex mentioned in her question: eating disorders, self-injury, alcohol abuse, etc. These are strategies that at one time helped us to survive but that now we recognize are hurting us. Combine all of this and the solution that we long for is for our therapist to take over and fix us. We want to hand these behaviors and problems over to them the way a child would bring a broken toy or skinned knee to parent and say “make it better.” In fact, at times I believe most of us can sometimes use these behaviors in a manipulative manner to attempt to force the therapist to care for us in the way we long to be cared for. It’s as if we are saying “see, see how bad this is! You must do something or I will be severely hurt and it will be on your head.” We use the threat of self-destruction to force their level of care to rise to where we wish it to be. That is also why this can be such an important area for a therapist to clearly hold their boundaries, despite how cruel or callous that can appear. They must not hold out the promise of being able to do more than they are capable of actually doing. Having the hope awakened of those unmet needs being met, only to be failed again, is even more damaging in the long run than our self-destructive behaviors.

An example: In the beginning of my individual work with BN, when my attachment was awakening and these unmet needs were pushing forward, I think I unconsciously tested him. I made an emergency call to him and told him, truthfully, that I was struggling with thoughts of suicide. I felt desperate and that he HAD to do something. Guess what his response was? He quite calmly told me that if I did not believe I could keep myself safe, then I should go to the hospital. Then he said he would see me at our next session and ended the call. I was SO pissed at him for being so calm about it and not getting upset and doing something that I forgot to feel suicidal. 🙂 I never tried that again. I did talk to him at times when I struggled with those feelings, but I never tried to push him past his boundaries again. Oh and another side note on manipulation. I get really freaked if someone says I am being manipulative (somehow in my mind, it is a really terrible thing to do) and BN and I were discussing it in session. I think I was expressing my fear that I was trying to manipulate him. He quite cheerfully told me that I had every right to try to manipulate him. His job was to make sure I didn’t succeed. 🙂

But as much as a therapist might wish to do so, and no matter how strongly they long to keep us safe, they cannot change our behavior, only we can decide to do so. They provide a safe place by accepting us exactly as we are, problematic behaviors included, so that we can choose to change. (See Accepting the “not so pretty” parts for more details.)

What can get blurry is the fact that therapists are also committed to our safety. There is a need to address really problematic behaviors which are seriously threatening our well-being or our lives. In many places, a therapist is legally obligated to take action if you are an imminent danger to yourself or someone else. You can be hospitalized against your will for 72 hours in NY state if a medical professional believes your life is in danger. So there is an obligation on a therapist’s part to monitor these behaviors. But the solution is not for them to force us to behave correctly (most of us have experienced enough coercion from caregivers) but to point out and challenge our unhealthy behaviors and beliefs, to bring them to our attention so that we can decide for ourselves to change them.

Many of these behaviors are essentially about emotional regulation; they are attempt to manage pain or anger or grief. Any feelings that feel threatening to us or that would overwhelm us. It is at this point where I think a therapist’s role is the most crucial. Our work in therapy should help us to understand ourselves and what is driving our behavior. For example, my personal self-destructive behavior of choice is binge eating. I am significantly overweight to the point, here in my 50s, where it is impacting my health. Ironically enough, I started therapy decades ago to deal with my weight problem. I am just now starting to approach this. In examining why I eat, I have run into a huge tangle of issues involving the deep shame about my body (having one as well as how it looks), being overweight to “protect” myself from being attractive as that leads to men doing bad things (yeah, that one has Dad written all over it), turning to food to comfort me when no one was available, punishing myself for the terrible person I believed myself to be, pushing my emotions down and long-standing habits. Well at least so far. There is so much shame surrounding my feelings about my body that so far it has been oblique work, sort of sidling up to the issues, glancing at it as long as I can stand, then wandering off again. So the work is two-fold: undoing our reliance on an unhealthy coping mechanism and learning healthy ways of accomplishing emotional regulation. Our therapist is often the model for learning emotional regulation.

Change is difficult even when we are committed to it (and frankly I’ve never met an embedded unhealthy behavior yet that I haven’t been ambivalent about changing. These behaviors started with a purpose and were at one time effective, so letting them go can feel scary). I think one of the most important things about changing these behaviors is the need to be able to be honest about what is going on, to see the reality of what we are doing, to pull our unconscious beliefs into the light of day and rob the lies of their power. But in order to do this, we need to feel safe. I think a therapist’s role is to provide a place where it is safe to be honest about what we are doing to ourselves without feeling like we will be judged for what we are doing. So a therapist walks a fine line of accepting that we are the person we are and that these behaviors need to be looked upon with compassion while still helping us to see that they are not good for us. So they cannot make us change, but they can provide a safe place for us to see the need for change and act on it, while helping us contain the feelings that arise from changing our self-destructive patterns.

I do not believe that it is effective for a therapist to act in a shaming, punishing or threatening manner around these behaviors. If you are going to be truly free to speak your feelings instead of shoving them away, you need to know that all of who you are is acceptable, as is. A therapist who uses shame or punishment around these behaviors only succeeds in sending a message a client has heard too many times before. “You are not ok and if you do not change your behavior to please me, you will be abandoned.” Only when we know we do not need to change for the other person, do we truly feel free to change for ourselves.

So the therapist provides a safe, caring, accepting environment where you can talk about these struggles without fear of condemnation or rejection. They cannot fix you nor are they responsible too. But they can help provide you the tools you need to change what you are doing. They can provide you someone to be accountable to, not because you will be sent away if you don’t behave properly, but because they care about your well-being and will be clear about when they think you are endangering yourself. Honestly, I think this is a tough area for both the client and the therapist. The therapist has to manage their anxiety about your behaviors and not step in to fix you to make themselves feel better while still conveying to the client a sense of caring about what you are doing to yourself. And the client has to look to the therapist for things they can provide while facing the difficult realization that there are some things they cannot and that the hard work of change is theirs to do. There’s a reason it can take so much time to change these self-destructive behaviors.

  1. Karel
    June 28, 2013 at 2:34 am

    I’m hearing here that boundary issues are painful (for me included). I’m concerned to hear that a T would deflect a possible life-threatening call so completely. But it’s not a surprise: I know all T’s think differently about boundaries. What’s a good or bad boundary? I’d like to think compassion and empathy would rule the day in which a T is actually contacted by phone in an emergency. You say you would think twice before calling again in that situation. That just breaks my heart. I’m wondering if this T was helpful here? It sounds like you got through it the hard way. My comment to this post would be that T’s differ in their approach. My T has strong boundaries, but when I had a bad panic attack and needed help I was grateful he saw that I needed compassion. He kept in communication with me that day (I went to the hospital because I felt so distressed) and called to check on me the next day at home. I give him credit for knowing when its serious for him to respond. I wasn’t just calling him to talk about the weather and he was flexible with boundaries when it was helpful to me. I can honestly say that had he not done that I wouldn’t have continued to want to work with him: it would have struck me as impersonal and detached. His kindness was comforting, and by helping he also tracked what I was going through that awful day. This was good information for him to have for my therapy treatment and for my file. I felt supported by him which helped recovery. It’s a fine line T’s have to walk, to be helpful without being enabling? T’s also have other clients and their own lives to deal with and some may have a more distant approach–especially if they see many clients every week. I’ve heard some may see forty in a week. I think the therapists’ role ideally is one of listening and responding with empathy, making observations and doing what is helpful for the client’s needs. Some T’s discourage any contact between appointments. To me, I find it helpful knowing he will be there for me though I rarely call him between appointments. I need that for a strong therapy connection and relationship. I like feeling supported. Most patients already feel bad about themselves and are sad about their relationships. T’s who who are too distant can add to that. They control the boundaries, and I guess the end test of their role is whether they actually help you to get better. What will help YOU personally is the standard for their role.

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    • June 28, 2013 at 11:23 am

      Hi Karel,
      I think you misunderstood what I was trying to say. 🙂 I used that example, because I believe that I was trying to be manipulative and BN correctly held that boundary. I have since been trained in risk assessment for suicide and I was presenting as low risk. There was no lack of empathy or compassion, but there was also the clear presentation of reality which was that I needed to take steps to keep myself safe. That IS my responsibility. And when I said I wouldn’t try that again, I meant that I would not attempt to use my distress to try to get him to bend or break his boundaries. Please trust me that the first place I turn to in distress is calling BN. He has an extremely liberal contact policy. I can email him or call 24/7, including vacations or when I am on a break from therapy. The only time he has ever been out of touch was a trip to Europe during which he had no cell phone and only intermittent access to the internet. But he was sure to tell me the day he would be back on US soil and accessible again. I called. And that would include if I was feeling suicidal. But I do so knowing that he will help me regulate my feelings. The crucial difference that I was trying to convey is that while he is available as a resource, it is my responsibility to meet my own needs.

      The truth is that boundaries are idiosyncratic to every dyad and must be negotiated between the client and therapist. In my case, strong clear boundaries have been crucial since I experienced none as a child. The boundaries help me to feel safe expressing all of my feelings because I know it will NOT change BN’s behavior towards me. And I want to be clear that strong boundaries does not mean that BN is a blank slate, or cold. He is the one of the gentlest, warmest, most compassionate people I have ever known and has walked with me in places I never thought anyone would go. I have looked up many times to see tears standing in his eyes. This is not a man unmoved by my pain. Some of my most treasured memories are about things he has said to me.

      So I agree that a T being too distant can also cause problems, but so can a T that takes on too much of the client’s stuff. And I do not think that T’s completely control the boundaries. They control THEIR boundaries, we control ours. There is power differential in therapy which the T holds, but we do make choices and are able to set our boundaries. I think we tend to see them as having all the power because often we want things they have to withhold for our own good. But I can walk at anytime if I decide I don’t like what BN is doing. But I also want to be clear that while these boundaries have very much worked for me, I do not think they would be a good fit for everyone. I have never prescribed to a “one size fits all” option of therapy. I offer my own experience here, knowing that it will not ring true for everyone. I just hope the underlying principles translate well. ~ AG

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    • liz
      June 29, 2013 at 4:44 am

      In defense of BN, that didn’t sound like deflecting at all to me – I have done the exact same thing with my T and got the exact same answer, and then I wanted to throw things at him, and then I finally understood what he was doing. (actually, it took me a couple of years to get from the wanting to throw things part to the understanding part, but anyway :-D)

      Boundaries are incredibly annoying and incredibly important (in this order) during the initial phase of therapy when we all so desperately want to be cared for. Fortunately, if all goes as it should, all that attachment and neediness and that “Oh my god I finally found the perfect person who will now make me feel cared for and worthy, yay!” will eventually fade away.
      (the whole fading away thing is extremely weird too – I am starting to believe there is not a time in therapy when things are just plain obvious)

      What I wanted to say was: hang on. Boundaries are your friends! 😛

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      • Karel
        June 29, 2013 at 12:06 pm

        Some very good points, well taken! Sounds like my T and I may have a countertransference issue. It’s hard for me to tell. Sounds like tough love from a T is better than responsiveness as a rule so the T is able to kick the birdie out of the nest. That I totally understand, because the end goal of treatment is to be independent after all.

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  2. chewingtaffy
    June 28, 2013 at 8:49 am

    You sum this up this tension well — a therapist cannot fix you or change you. The change must come from inside of you. When I first starting seeing my therapist, I was desperate to stop drinking, yet felt completely powerless to do so. He stayed steady and consistent while I floundered around, never shaming me for my behavior, but instead guiding me to think more rationally about what I was doing. Encouraging me to think about how I was feeling when I picked up the drink, so we could talk about it in session. When I would declare that I was “done with alcohol,” he would often respond, “Let’s hold that desire loosely…” He knew the underlying issues and emotions needed attention for the behaviors to change.

    He did insist that I come to all sessions clean and sober, and once he even smelled my drink when I came in. He clearly stated that if I came to session drinking or drunk, he would not be able to see me, since the therapy simply couldn’t work if I was intoxicated. I never crossed that line because I knew he was serious.

    Somehow in the midst of all that mess, and a rock bottom clinical depression, I was able to let go of the alcohol abuse. Learning new ways to cope and that feelings can be felt and managed were key. But as much as I credit my therapist for this change, at the end of the day, I had to decide to take a completely different path in life.

    Thank God I did.

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    • June 28, 2013 at 11:25 am

      Chewing Taffy,
      Thank you so much for sharing your experience. You very eloquently described the truth I was groping towards. I find this very difficult to articulate because it is so much a “felt” experience. I think your T displayed that balance between holding you accountable while not condemning you. I think that safety is what allowed you to let go of the drinking. I am very glad that you have the T you did. That was really powerful to read, thank you. xx AG

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  3. blackbird
    June 28, 2013 at 10:05 am

    You are so right- I had a therapist who let me cross those lines, and it totally messed with me. I showed up intoxicated for a session once, and he was all nice and understanding and “loving” about it, until I started to get angry at him- and then he let me have it with all his anger. When I called him on it he said- “never, ever, do this again.” When I asked him why he let me do it in the first place, his response was “I thought, maybe it could work. Now I see I was wrong.” My current therapist is so boundaried that I just.wouldn’t.go.there.ever. And I’m getting better, slowly.

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    • June 28, 2013 at 11:27 am

      (((Beebs))) Its good to hear from you! I remember your first therapist and how confusing and damaging that was for you. I am really happy to hear that Cowboy T is holding steady and that you are getting better. I totally relate to what you said about not just going there. I am so clear about BN sticking to his boundaries that there is no longer any need to test them.

      And if there’s another way besides slowly. please let me know your secret. 😀 xx AG

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  4. Ann
    June 28, 2013 at 10:08 am

    Amazing post. In defense of BN ‘s choice to have AG call the hospital, we don’t know the circumstances. Perhaps AG’s husband was with her when she called, indicating she was not alone and safe. If BN was sure she was safe and felt she was panicking, them he made a wise choice. Maybe showed her she had more internal resources than she knows. Only AG can make that judgement, but it sounds like BN has her best interests in mind. I appreciate the depth AG goes into her posts and she is a terrific communicator. Ann

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    • June 28, 2013 at 11:34 am

      Thanks Ann, I truly felt, as I said above to Chewing Taffy, that I was really groping to express what I wanted to say. I was with my husband and you’re right, BN knew I was panicking. I think he did the equivalent of throwing a cold bucket of water or calling my bluff. I think the fact that my reaction was to get angry at him was pretty telling. And your comment about letting me know I had internal resources is very insightful. BN NEVER initiates contact with me unless it is about a schedule change but is very responsive if I contact him. We have explicitly discussed this and he has told me that he trusts me to understand my needs and reach out when I need to. That it has been very important for me to learn to do that. In my case, I think his checking on me and taking the initiative would have confirmed my belief in my own inadequacies and lack of efficacy. I can’t say as I have always enjoyed it and there have been times when it has felt cruel or uncaring, but in looking back, I know just how wise he was. xxx AG

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  5. GreenEyes
    June 29, 2013 at 5:16 am

    Hi AG, I think you did a really great job with this post. Ive struggled a LOT with this stuff and I had a few extra thoughts to share.
    Firstly, as you said in your post, I think self destructive behaviours are often an enactment of enormous psychological pain and suffering. I also think they are more common in those with alexithymia or the inability to recognise and accurately label different feeling states. As individuals work with their T’s and their T’s are able to put words to their experience, the need for self destructive behaviours can lessen because there is now a different way to communicate the inner pain. The other important aspect is that self destructive behaviours are often addictive which can make them very, very difficult to disengage from. And there is often a truckload of pain that comes crashing down when that happens and it can be incredibly frightening and disorientating. One common emotion behind self destructive behaviours IMHO is shame and humiliation which have to be some of the most torturous feelings to have to bear. I seriously think its one of the worst thing to inflict on anyone.
    And if its any consolation, I’ve called and texted my T in a semi-suicidal state more times than I can remember and he’s always called my bluff! Grrr!!! These T’s are too clever sometimes 🙂 xxx

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    • June 30, 2013 at 10:19 pm

      GE,
      Thank you so much for this comment. I think you are making really excellent points about the dynamics and why we turn to these behaviors and how we find relief. I should have consulted you when I was writing the post. 🙂

      Holy moly, am I with you on the shame and self-humiliation. Out of all that I have had to face in therapy (which is not a short list) shame is the absolute worst. And forgive me if I presume too much, but can I tell you that it has been just amazing to watch your growth and progress. I know you have been struggling very courageously with terrible pain and I so clearly see the results of your hard work. xx AG

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      • GreenEyes
        June 30, 2013 at 11:26 pm

        My door is always open to you my friend 🙂
        Thank you for your kind words of encouragement. Some days I think Im really getting somewhere and other days I feel back at square one. Such a hard process 😦

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        • June 30, 2013 at 11:33 pm

          (((GE)))) I really understand that bouncing between feeling like you’re making progress and feeling like you;’re back at square one, I struggle with those feelings often. That’s why I wanted you to hear what it looks like from out here. 🙂 Hang in there! xx AG

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  6. Alex
    June 29, 2013 at 11:53 am

    AG: Thank you so very much for writing this response. It’s very timely for me and gives me a lot to think about. I, too, am horrified by the thought of acting in a manipulative way (because it’s like an abuser? because it’s demanding? I dunno exactly…); your therapist’s reply to that fear is priceless. For some reason I think it’s hard for me to imagine trusting anyone to withstand my manipulation, even if I don’t mean to do it– how tangled and silly. It really does sound very teenager/parent, which is painful and shameful, but I suppose it also makes sense for someone who never had any safe caregivers.
    The eating/body issues feel nearly impossible, and I certainly empathize there. Food is, of course, one drug of choice that must be moderated, and these darn bodies are just so stupidly necessary for survival…. 🙂
    I need to do more ruminating about all of this, but I wanted to thank you and the thoughtful commenters above, as well. Have a nice weekend!

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    • June 30, 2013 at 10:26 pm

      Alex,
      So glad that its giving you food for thought, it was good to write also, as I am not all that clear myself on the topic, so thanks for asking. I think for me manipulation feels so bad, because I am not supposed to ask for anything I need and if someone calls me manipulative, not only have I been caught asking, but I’ve gone about in a disrespectful manner. I love how cheerful and matter of fact BN is about it. Actually his ability to be matter of fact about a lot of things has been very helpful. 🙂 And I truly understand the fear that someone cannot tend to their own stuff, I did a massive amount of work with BN around that, including with struggling with whether I had “made” him take me on as an individual client. Its a theme we return to again and again. It is common among abuse survivors to worry about other people’s boundaries because we weren’t allowed to have our own. It’s a very strange, but important experience, to trust our therapists to take care of themselves. If you have more questions after ruminating, please feel free to come back and continue the conversation. ~AG

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  7. Marijke
    July 4, 2013 at 11:23 am

    Hi Attachment Girl,
    The adult me respects and understands my T’s boundaries, but the wounded child just HATES them. It’s hard to keep those feelings at bay sometimes while at the same time needing to keep in contact with them to recognize them as the – often destructive forces – that drive my behavior. I’m working up to tell my T about the very intense transferential feelings I have towards her. But I also struggle with confusion about being manipulative. We have discussed my need for maternal care and she has even met some of it – she’s a body psychotherapist and touch is part of the therapy – but I have not yet told her how badly it gets for me at times. She probably knows, I guess, and is just waiting for me to bring it up.
    I’ve been a food addict for 37 years (I’m 44 now :() and have tried countless times to break this terrible addiction and lose weight. As you, I had dissociated severely from my body and retreated safely to my head. I have two – important – things to share about that. One is that in doing body therapy, I am finally getting in touch with my body and all the secrets it holds – Bioenergetic analysis acts on the theory that all our experiences are withheld in the body’s musculature and can be released and dealt with by exercises, postures and verbal therapy. This growing awareness of my body is tremendously helpful in my healing process. The other thing is that we cannot underestimate the importance of our body’s biochemistry when it comes to food addictions. Sugar, caffeine, gluten, casein, and innumerable more obscure substances in our food just keep food addicts like us keep coming back for more. Even if it will eventually kill us. Dealing with the emotional/behavioral aspect of it never really worked for me. Working on the biochemical side does… for the moment… after two weeks . Hang in there AT, I know I will!

    Greetz from Belgium

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  8. July 7, 2013 at 9:32 pm

    Hi Marijke,
    Welcome to my blog and thanks for commenting! I really do know just how terrifying it is to talk about these feelings, but I also know it led directly to so much of my healing. I say stuff now to BN without blinking an eye that I would have thought impossible a few years ago. It really does become easier as you are met with understanding and acceptance. As for whether your therapist is already aware, I once asked BN if he knew before I told him and his reply was that no, he wasn’t sure, but he also wasn’t surprised. 🙂 I thought that was quite diplomatic of him, don’t you 😀

    And thanks for the information about the biochemistry side of things. It sounds like the body work has been really important for you. I am feeling quite adrift right now and not sure where I am heading next. There is a strong feeling of wanting to just step away but I am having trouble discerning if I need a rest, or I am running. Where are those great big direction signs when you need them? I really appreciate the input. 🙂 ~ AG

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  9. Marijke
    July 8, 2013 at 7:54 am

    Well, for starters, you’re a great big sign post for many seekers out there, and I thank you for that from the bottom of my heart. The web has a lot of –BIG understatement coming – redundant information on offer, but with effort, and lots of time, I find there are other direction signs out there in cyberspace. An inspiration for me in my latest attempt to honor my body foodwise is http://en.wordpress.com/tag/mardy-roux/. It’s not a simple diet blog, but the remarkably intelligent and eloquently words of a fellow eating disorder sufferer and her struggle with that. And of course, like with any information coming from the outside, the importance is to write your own recipe with the ingredients you gather.
    Closer to home – in the most literal meaning of the word possible – I’ve found that the most useful direction signs are often quite small and it’s all about mastering the trick to recognize them.
    I live in Brussels, where most people speak French. I’m part of the Dutch speaking minority, which makes up for about 10%. There are exactly 3 (three!) independent Dutch speaking therapists in this city. Three years ago, I had found some info about one that practiced bioenergetic analysis (BEA). I chose to go elsewhere . About a year ago, my very modest and earnest homeopath/GP mentioned bioenergetics (BEA) to me as a possible therapy.. Well, it took me another six months of contacting therapists from Colorado to California, seeing a brief therapist an hour and half busride away, before I contacted the one practicing BEA again. And it’s like a homecoming! She’s completely what I’ve been looking for in a therapist… Sometime the great big direction signs are small and right under your nose…

    Getting in touch with our bodies is quite a task when we’ve been fleeing from them for a very, very, very long time. The paradox is that we actually can’t really. They are there, they are part of our psyche and hold all our experiences within them. And in a way, that quite reassuring also because it gives us something to work with, when there are no words to express our pain…
    My modest advice to you is to rest. A body that has suffered from excess weight and malnutrition, is ill and ill people need to rest in a first phase of recovery – read all about it on the above mentioned blog, it’s truly inspirational.
    My heart is with you, AG. Big hug from Belgium

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    • July 9, 2013 at 9:44 pm

      Marijke,
      Thank you so much for the link, I have been reading through her blog and it is really resonating with me. I had a session with BN yesterday and realized that I am dithering around waiting to want to face this and realized I will never feel ready to face this. 🙂 BN is being very patient. I so appreciate the support. I have never heard of Bioenergetic analysis (and must confess to prejudice against things with names like that :)) but you are speaking so highly of it, I will look to see if anyone practices in my area. I think I could benefit from some body work (if I can bring myself to do it). It really does help to know I am not alone. And I have to tell you, your English is amazing! xx AG

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  10. George
    July 10, 2013 at 11:59 am

    Truth: there’s so much of it here and it goes so deep, AG. Your analysis not only of the boundary dance but of your (and my, and our) feelings is amazing and helpful. I wish I could say this in more detail in case specific feedback from your readers helps you, but I’ll have to let this subject (which is, as I’ve mentioned, close to me) go for now.

    But one thing happened recently that I’ll mention that I think is different from your experience: my shame about having a body at all and the specific one I have (what it looks like, mostly, rather than what it can and can’t do), and my retreat into my head, recently got a little wake-up call and a knock on the head when something my “BN” said gave me the idea that it might not be just shame but disappointment–and lack of recognition–at not having the body/appearance I want. Further, the lack of recognition of myself in a physical sense may include the feeling that it’s not good enough for the more perfect “me” I have inside. I don’t mean ANYthing like a fat body isn’t good, or pretty, or that it’s shameful. No, no. By saying “not good enough,” I’m talking about those internalized toxic beauty standards from our culture and ways in which I don’t meet them. That’s the lack of “attractiveness” I feel on my outside. This latest insight via my local “BN” is about having eventually gotten to the point where I can recognize that a fixation on my less-than-“perfect” looks is at odds with the idea that what’s inside (who “I” “am”) might really be worth something. I might actually think well of myself and be frustrated that I don’t have external gorgeousness to match, and I may need to accept that what this body and face look like are not the important part. It’s a simple, ordinary truth arrived at by myself in an arcane way.

    I don’t know if that makes sense to anyone else, but it does to me. 🙂 It’s kind of opened up a little breathing room in my head.

    P.S. Marijke, do you know the Jacques Brel song “Marieke”? Is that the same name as yours but spelled differently? I love how he blends the two languages in it. I hope the question isn’t too trivial in this context.

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  11. Ann
    July 10, 2013 at 3:28 pm

    George, I totally get where you are coming from! When I was young, I thought being old( I thought 35 was old!) meant not thinking about your looks or body anymore and that would be a relief. Now, at 56, I am surrounded by women who obsess about their wrinkles, waistlines and adornment. Botox, facial peels, lipo—they do it all. One friend says she will die if her hands get wrinkled, because there is no surgery for that. Honestly, I think no matter how close a person is to the “ideal beauty”, they still feel subpar. It is difficult not to judge your outer self when everyone around you is obsessed. The good news is that they are so busy worrying about their bodies, they probably don’t even notice yours! I think part of the challenge is to recognize that your inner beauty can increase with age and experience. I think most of us have felt our bodies have betrayed us in some way.(abuse, physical pain, poor body image etc.) I try to ignore what I can’t control and focus on the things I can. I try not to give away my power. I have mentioned earlier that I refuse to be weighed at the doctor’s office, because it triggers such bad memories. Some nurses act like I’ve killed their oldest child when I say no. But they will survive.:) Sorry about the rant. AG-I hope you aren’t pushing yourself too hard. Listen to your heart and to those who love you. You have come so far and are so brave to share with us. Put you health first. If writing triggers you then don’t write. If it helps we are here to read and learn alongside of you. You rock! Xoxo Ann

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    • George
      July 10, 2013 at 5:22 pm

      Hi, Ann. Thanks for your reply. 🙂 I won’t be weighed at the doctor’s, either, or if they insist, I tell them not to tell me what it is. My psychological problem with looks comes from the fact that I convinced myself long ago that only the beautiful are loved and that’s why I haven’t found love. No idea where that idea gets its staying power, because there’s so much evidence in the world to the contrary, and my own standards for attraction to other people are completely relative: I’ve admired all types, sizes, heights, ethnicities… And the weird thing is, I know that there are many people who see me as a good-looking person, but I just don’t agree. It’s dysmorphia tied in with the self-condemnation, I think.

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  12. Ann
    July 10, 2013 at 6:27 pm

    George, I enjoyed reading your response. I am the oldest of 5 and the only girl. Being raised in the South with a mom who has always been insecure with her looks and a narcissistic dad, I was given horrible messages about my body and worth. Once my mom said she wished she could get me to smoke cigarettes to lose weight( I was 16), but maybe it was not worth the cancer risk. After a while these messages get internalized, and nothing is good enough.( At one point I was jogging everyday and weighed about 125–my mom looked at me and said, ” I guess you will always have big legs!!). I am learning to set boundaries and shut out these voices. It is hard to learn trust and be in a relationship when you feel so bad about yourself, but it is possible! I have been married 29 years to a very loving spouse. I never had a real boyfriend before that, but it only takes the right one! Never give up on yourself. Ann AG I am sorry for hijacking your blog. 🙂

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  13. George
    July 11, 2013 at 11:58 am

    Hi, Ann (And AG! 🙂 )Thanks for your kind response and understanding. I’m happy that you have a loving and happy relationship. 🙂 I’m sorry your mom was like that, and I know how hard it is to overcome. My mom has softened up and become so mellow in her later years, but I know–because of things she says to me about my sister, herself, and other people–that she still judges others based on their weight. My sister and I (BTW, I’m a woman, too, despite my screen name) went on a crash diet (Dr. Stillman, I think?) when we were about 12 and 13, and no one saw anything wrong with that. I still remember the taste of the sugar-free Jell-O with a shudder.

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  14. Ann
    July 11, 2013 at 9:55 pm

    Amen to that. I hated Tab,metracal, and was prescribed speed at 14, my family doctor gave me pills to speed my metabolism. Weight watchers at 12 or 13. My life was focused on diets with no break. But now the power is out there for me to seize and my values are based on less superficial aspects of life! I don’t always sustain it, but come darn near close to it.

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  15. July 11, 2013 at 10:29 pm

    Ann and George,
    Just wanted to pop in and say that there is NO hijacking taking place, I love that you are talking and supporting each other, that is a very good thing. Sorry not to respond more substantively, but am a bit triggered and anxious tonight so I’m having trouble focusing. Regulating my emotions without overeating is proving to be lots of fun! But I emailed BN and will be fine, just need a little space. So carry on and i’ll be back later! Much love, AG

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    • George
      July 12, 2013 at 11:15 am

      Hi, AG,
      ❤ back to you. No need to say more! 🙂 Take care of yourself.
      George

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  16. Marijke
    July 12, 2013 at 4:25 am

    Hi Ladies,
    Our perception of our bodies is a very strange and incredibly complex phenomenon, which I feel gives very different mixes in different people. But the way our mothers saw us, and communicated this to us, seems common as to how we perceive ourselves. I once read that a mother should just not make an comments whatsoever about her child’s (especially girls) appearance. That is what we need from our mothers, total acceptance for what we are. I try to do this with my girls – which is not always easy, given their sometimes ‘eclectic’ dress styles :). And if they should ever – god forbid – develop disturbed eating patterns, I would try to help them in a way that doesn’t undermine their self worth.

    My way of ‘coping’ with the disastrous influences of the culture we live in, was dissociating completely from my body, safely retrieving into my head. I looked as terrible as I felt, but became an expert at denial and withdrawal. I remember my teenage years as the worst, followed by even lonelier twenties. I met my wife (I’m gay) when I was 27 and she was the first ever to express any physical desire towards me. But I have never, and still don’t feel physically attractive in any way whatsoever. My T recently tried to convince me I am and that attractiveness has nothing to do with bodily appearance, but when she tells me stuff like that, it’s like she’s from another planet. I just don’t get it.

    Anyway, this body therapy I’m in, is about how I FEEL my body and not how it looks. Learning to be more in touch with my body, makes it feel better and helps me to treat it better, which I hope, in time will make it look better also, but that’s not a priority.

    Yes, George, I know the song. Marijke stems from the same root, which is Marie, and means something like ‘little Mary’. That’s why I never really liked my ‘belittling’ name. Furthermore, I’m only 5,3 feet – which doesn’t help with the weight either, grrr.

    Keep listening to those wise inner voices, ladies,

    Hugs from Belgium

    Like

    • Karel
      July 12, 2013 at 6:32 am

      Very wise words. I was lucky enough to find a spouse who doesn’t criticize my body. My dad often disparaged my mom for her weight (she considered herself to be 50 lbs. over). One year, when i was a kid, she went on some popular liquid diet from her doctor and lost the weight. Then for Christmas she made a present of a gift-wrapped 50 lb. box of fat she got from the butcher and gave it to my dad as a surprise-as if she was losing weight just for him! Disgusting. Then she gained it back over the next two years, so you can imagine the stress her body went through, not to mention the shame. I don’t remember anyone outside our family considering her to be in attractive and she is now a fairly healthy 85 year-old–with the weight. She wasn’t comfortable with herself until she was around 70 and finally loved and appreciated herself (and that shut my dad up). I guess it’s just being part of a dysfunctional family system–which has also contributed to other family members having alcoholism and a myriad of other heartbreaking coping problems. Therapy has helped me cope with severe depression. These problems go back a few generations but thank God we are all more knowledgeable now as a society! Your advice is extremely helpful–we have to focus somehow on compassion: for ourselves first. Appearance is one of those things that becomes almost a non-issue, in a good way, in the best relationships anyway. I think we could all agree on that. Personality can make anyone beautiful, regardless of age or anything–we all know examples of that from some people in our lives.

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  17. Ann
    July 12, 2013 at 6:42 pm

    AG, I’m sorry you are having a rough time. Anxiety sucks!!! Personally it helps to hear other women dealing with these issues. I totally understand what it is like trying to stay in your head and disconnect from your body. A year ago I told my T that ” I was socially available, emotionally hidden and physically invisible”. At least that is how I coped with my issues. I still get triggered by my elderly parents. I have lost weight to help deal with blood sugar problems so now that is their focus. On my last birthday, my family took my husband and me out for dinner. When the waitress asked if I would like dessert, my dad interjected, “She doesn’t eat dessert.” .??? I felt WTF? He is still trying to micromanage my food and I am 57 years old.(interestingly they are both overweight). Even on my birthday I get no slack. I am still working on boundaries. Thanks for “listening”. I hope all have a good weekend. Especially you, AG. Xoxo Ann

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    • Karel
      July 12, 2013 at 9:55 pm

      And on your birthday!! Jeez that sounds painful–it would be nice to be able to answer a question yourself as an adult. Or at least celebrate with a little pampering from them (and cake).

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  18. Ann
    July 15, 2013 at 4:11 pm

    Just a quick hello to AG. Hope all is well.xoxo Ann

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    • July 15, 2013 at 4:21 pm

      Hi Ann!
      Thanks for checking in, I hope you are well also. I’m doing alright and am stable but bracing a bit. I know I’ve posted about the heart box that I gave BN in recognition of being able to trust our connection. Well a little while back, someone, I assume another client, added something to the heart box (small ceramic object, haven’t really figured out what it is) and it kept eating at me until our last session I said something. We had a short, and for me evidently not a completely satisfying discussion about it. It continued to bother me after our session. After our last session I decided it was time to actually start grappling with the food issues, so I am eating only when hungry and trying to stop when I am full and trying to be conscious of when I am using food for other purposes than sustenance. There are a lot of feelings coming up and I am struggling to deal with them in healthier ways. This whole issue around the heart box kicked up a LOT of stuff and got kind of confusing. I ended up writing a very long email to BN examining the issue from all kinds of issues (I am running the gamut from being angry at the other person, feeling embarrassed I am being so immature and trying to determine if this is just a legitimate boundary issue for me). We are going to discuss it at my next session on Wednesday. It should be a fun one! 🙂 And either way I am facing another three week break after this one. I am working on a post about grieving now I hope to have up soon. We’re also having a busy summer so I am finding it difficult to keep up with all my writing. But it feels good to have at last committed to dealing with the food. I’m sure I’ll be posting about it at some point. Thanks again for asking. xx AG

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  19. Ann
    July 19, 2013 at 1:19 am

    AG, I hope all is well with you, and the weekend gives you some rest time. I also hope your session yesterday was productive. I admire you for being able to take 3 week breaks from therapy. I am working towards two weeks! I have recently recognized how important it has been to have a T to witness and acknowledge who I really am. Now I need to learn to start internalizing some of this. I am hopeful. Thanks for your blog.xoxo

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