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A New Way to Think About Body Acceptance

A New Way to Think About Body Acceptance

I am passionate about body acceptance work. I teach it, practice it, and continue to learn and evolve my understanding of how to do this work. The body acceptance journey is often described using the metaphor of a ladder. In fact, when I lecture about body acceptance, I use the following image to capture the idea: 

However, when we used this image in our Body Acceptance Group this last month, my understanding of this “progressive approach” was turned on its head. So many clients share about how they can be in a more accepting or healthy place with their body one day and, the next, feel right back at “ground zero.” Others describe how they can inhabit multiple places with their body at once. For example, they can feel grateful for their body while also feeling disgust for how it looks. They can feel compassion for what their body has gone through and also resent that it refuses to change the way they want it to change. It suddenly became clear in this discussion that the ladder doesn’t fit these experiences at all. I know body acceptance is a non-linear journey, but when we talk about progress, we talk about being in different places than we were before. It’s as if we keep arriving or stepping up to somewhere new, and different, and stable. The journey is so much more fluid and complicated than that. In this group, I suddenly envisioned a better way to conceptualize the body acceptance journey. And it’s one of bubbles. 

Our experiences and relationships with our bodies are deeply rich, historical, personal, complicated, and nuanced. In a holistic perspective, we always carry with us each of these lived feelings, perceptions, beliefs, and behaviors in our bodies. Sometimes certain bubbles expand and take up a lot of room. For example, an event or interaction in our lives may trigger more negative feelings about our bodies. Or maybe we are feeling more vulnerable in general and are more prone to feel amplified negative emotions about our bodies. 

Through body acceptance work, there is active movement to amplify and grow different ways of being with our bodies. There is choice in what works for you and what you value, and this journey involves a lot of trial and error and hard work. For some people they really resonate with amplifying body gratitude and find a lot of joy and relief in this. For others, maybe they want to focus even less on their bodies and so focus on identifying and living more intentionally, their values (valued living) and feel a lot of relief in doing so. Some enjoy experimenting, growing skills, and amplifying many different ways of being with their bodies and find at different times, different tools and orientation work better than others. In this work, you will notice these other experiences you are intentionally amplifying will take up more space in your lived reality with your body. And while this doesn’t make more painful experiences or beliefs disappear completely, it changes the overall experience with yourself. 

This lived experience in your body is a moving, changing, fluid experience. As we work, we build confidence and more stability in inviting and amplifying the experiences, feelings, and beliefs we want to have in our bodies. But this doesn’t mean hard days disappear where other feelings and experiences rear their heads and dominate the day. 

There is no “falling backwards” or “getting worse” with this framework of body acceptance. It is simply awareness that certain bubbles are larger today, or this week, and this affects how we feel. We can make conscious choices to use the tools and knowledge we have to attend to the bubbles we want to grow and amplify and have compassion for ourselves on days we are simply doing our best to get by. The body acceptance journey, just like mediation, is a practice, not a final destination. Over time it is easier and more and more rewarding, and it continues to invite us to work and be with ourselves in intentional ways as we move through this messy experience that is life. 

What does ADHD have to do with Eating Concerns? Part 2

What does ADHD have to do with Eating Concerns? Part 2

The more we learn about ADHD and eating disorders, the more we are coming to understand that the incidence of ADHD is actually higher in the eating disorder population and is not just eating disorders “looking like” ADHD. Something is happening here that warrants further understanding and exploration of how we approach eating disorder treatment when this comorbidity is present. 

There are biological, cognitive, and behavioral patterns inherent in both that can influence the severity and longevity of the eating disorder, as well as the recovery trajectory. People with ADHD and eating disorders have differences in how their brains process rewards, often looking for dopamine hits that can come from eating disorder behaviors. Disturbance in body awareness as an associated feature interferes with the ability to feel hunger/satiety cues and feelings. Difficulties with decision-making, planning, as well as time-blindness and difficulty with transitions, make it harder to meal plan and nourish oneself consistently throughout the day. People with ADHD often seek certain types of food making it more difficult to eat a wide variety of food. These are just some of the many nuances that show up with clients who have both an eating disorder and ADHD. 

The treatment for ADHD is very clear in the literature. We know that medication is incredibly helpful above and beyond therapy and behavioral modifications alone. As I mentioned before, it gets messy when someone also has an eating disorder as many ADHD medications are known to suppress appetite. But instead of concluding that medicating ADHD for someone who also has an eating disorder is contraindicated, we need to explore the nuances in this as well. 

While ADHD medication may compromise hunger cues, the medication may also help to overcome other barriers to recovery. For example, the client may be better able to strategize and execute on their meal plan as they suddenly have the brain capacity to do so. ADHD medication can relieve some of the symptoms that the eating disorder worked to mitigate, such as dysphoria, distress, feeling overstimulated and overwhelmed. Clients may be better able to tolerate the distress inherent in eating disorder recovery with the help of medications that can calm their minds. 

I am not “that kind of doctor” that can assert medication for clients. I am the kind of doctor who advocates for treating all the presenting concerns our clients face. And the more we understand about ADHD and its relationship to eating disorders, we understand the critical importance of treating both illnesses. If we only treat the eating disorder and neglect ADHD, our clients will likely struggle more on the path to recovery and in their ability to sustain it. Besides this, we would be neglecting ongoing and treatable pain that were treated, which would bring immense relief, increased confidence, self-awareness, and continued motivation. 

We have a lot more to learn and understand about ADHD and eating disorders. And what we do know so far, calls us in the field to look closely at the nuances these presentations bring to treatment, and how we need to be flexible, mindful, and deliberate in how we help treat our clients to optimize their success.

What does ADHD have to do with Eating Concerns? Part 1

What does ADHD have to do with Eating Concerns? Part 1

Attention Deficit Hyperactivity Disorder (ADHD) seems to be the diagnostic soup de jour. We all heard about the Adderall shortages that started in late 2022 and still aren’t fully resolved now in 2024. Everyone is talking about ADHD and more and more people are getting diagnosed with it. Diagnoses are especially escalating among adults, with rates of adult diagnosis increasing four times faster than diagnostic rates for children. 

A lot of people are skeptical about this rise in diagnosis. Are smartphones making everyone develop ADHD? Is it the plastics? Is it our stressful lifestyles and chronic inflammation? Are there really that many more people with ADHD today? Or have there always been this many people with ADHD and we are now better at catching it with increased awareness and access to resources? 

Just as rates of ADHD increase, our field is continuing to grow in its own understanding of this diagnosis. As it relates to my interest in women’s issues, we know that females have historically been underdiagnosed for ADHD given the nuances of its presentation in females and female’s ability to compensate and mask symptoms. 

ADHD also has a unique and messy history with its association to eating disorders. When I started working in the field of eating disorders over a decade ago, I was implicitly and explicitly taught to be skeptical of clients who self-ascribed as having ADHD in addition to an eating disorder. I was taught that 1. Malnourished and starved brains present in similar ways to people who have ADHD, and 2. Our clients are incentivized to claim themselves to have ADHD so they can be prescribed a stimulant that would curb their appetite and further their weight loss goals. I was taught that when clients are re-nourished, their “ADHD symptoms” would resolve, confirming the above assertions. Our clients would then understand that their experiences with ADHD symptoms were really just manifestations of their eating disorder and they would feel the relief that comes with a nourished brain and be incentivized to stay in recovery. 

Join me next week for Part 2 as we discuss more about ADHD and eating disorders. 

The Year of Self-Compassion Goals

The Year of Self-Compassion Goals

Maybe this is the year…

  • You make memories instead of resolutions
  • You count smiles instead of calories
  • You cut the sizes out of your clothes instead of cutting out sugar or bread
  • You sign up for more sleep instead of more fitness classes
  • You step into your own abundance instead of trying to shrink yourself in all possible ways
  • You practice self-compassion instead of shame
  • You move your body how and when you want to and not how and when you think you “should”
  • You get a new friend instead of a new PR
  • You find curiosity instead of judgment
  • You collect resiliency instead of counting failures
  • You find joy in the details instead of stress in the big picture
  • You find unconditional self-love instead of conditional expectation
  • You see your wholeness and strength instead of your brokenness 
  • You recognize your unconditional, unchanging worth instead of the hustling to prove your value to the world
  • You slow down instead of speeding up
  • You breathe into the unknown instead of trying to control all the outcomes
  • You scream for fury, rage, grief, and joy instead of holding it all in
  • You decide to “want to” instead of “have to”
  • You take things OFF your To Do List instead of chronically adding to it
  • You connect with yourself and others instead of metrics and milestones
  • You look back and celebrate how far you’ve come instead of looking ahead at how far you think you still have to go
  • You step into 2024 knowing you are complete, whole, beautiful, and loved, just as you are

Welcoming Darkness

Welcoming Darkness

Have you ever thought about the reality that almost everything that has life began life in darkness? Giant Sequoias began their life as small seeds nestled into the dark, damp earth. Potatoes and carrots start and finish growing inside the dark earth. You and I, we began life enclosed in the soft, rich, and profoundly dark wombs of our mother’s bellies. As I contemplate all the variety of life that I know of, I can hardly come up with any exceptions to this reality: It is in darkness that growth begins.

The environments we all began in were full of everything we needed to develop and progress. They were nutrient-dense lodgings that infused us with all we needed.  Was the darkness a bystander witness to our processes? Or a necessary, intimate part of that development? 

I like believing that darkness is a vital companion in our growth. I like believing that darkness is an insulator, a protector, and space holder for the hard work that is growing. It helps me reframe the sense of foreboding I feel as daylight savings ends and we are officially plunged into the darkness of impending winter. And not to be the harbinger of bad news, but for those of us in the northern hemisphere, we will continue to march toward more darkness until December 21st.

Darkness is the hardest part of winter for me. I can handle cold and wet and ice and snow. It’s the darkness that feels the heaviest to hold. 

But maybe darkness isn’t something that weighs me down but rather offers to enfold me? Maybe the darkness isn’t a foe or force that is somehow “against” me, or something to endure. Maybe the darkness is actually a companion and source of potential growth? Maybe it’s in this space that more growth awaits and invites me? 

It is cliché but often true, that the most profound growth always happens in the deepest, darkest moments of our lives. Darkness offers us the most beautiful gifts this way. Darkness believes in us and holds us as we do the work that is ours alone to do. 

We’ve all heard the quote spoken by Martin Luther King Jr. said, “But I know, somehow, that only when it is dark enough can you see the stars.” Stars are found in the vast galaxies of space. They are far beyond our solar system and realm of existence. We have to be plunged into darkness to find them. In this metaphor, it is the darkness that reveals them. It is in darkness that we connect to these inspiring, expansive sources of wisdom. 

Darkness is here. Instead of wishing it away or fighting against it, I am going to let it hold me and invite me toward my work. May we all pass these upcoming months with less suffering in this way. May we be gentle with ourselves and be held in the darkness that encourages our growth. May we all look up on cold, dark winter nights and breathe in the stars revealed to us.