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Saturday, February 4, 2012

You’re Only Cheating Yourself


Her binging and purging has abated at last, only now she’s restricting. He’s finally increased his food intake, meeting the goals we had set. Only now he’s taken up running—with a passion. She’s adhering to her meal plan, eating all that her body desperately needs. But at present her self-injurious behaviors have flared up.

Carnival photos courtesy of Cate (see link below)
As I sit with my patients I feel a bit like Temple Grandin, the autistic woman depicted in the movie by the same name, who visualized most everything she heard. Whack A Mole comes to mind quite frequently as I hear their stories. No, nothing too sophisticated or deep—just Whack a Mole. You know, that carnival game where you have a mallet and the goal is to hit as many of those furry rodents as possible that pop up out of their holes. It goes like this—you hit one, and just when you’re feeling pretty good about it, rather accomplished in fact, another rears its head, causing you to pounce on that one, too. And so it goes. If you do reallywell, you get a small, cheap stuffed animal—one that costs about a fraction of the money you just spent entertaining yourself. Here’s where this analogy ends.



Real life Whack a Mole, aka eating disorder recovery, is anything but entertaining. But the reward is invaluable. And while it, too, may have its costs—time for appointments, increased anxiety, a sense of loss of identity and of control—the rewards are immeasurable. Surely you could come up with a list of the benefits?

The carnival game analogy crosses my mind with many non-eating disordered patients struggling with weight management, as well. This I visualize more like the shell game—the old gambling game also played on city streets. Three shells are placed on a table, with a pea beneath one of them. With rapid moves of the hands, the shell guy shifts around and around, and the player struggles to identify where the pea is hidden until all hope is lost—by the player, that is.

The connection, you’re wondering? Patients often start off frustrated that their efforts to shift their behaviors, to make a difference, are in vain. They trick themselves into believing that after completing their workout, a reward of a Starbucks frozen beverage topped with caramel and whipped cream is in order. Or while dining out, they choose an entrée they feel good about, only to eat a portion that significantly exceeds their need. Or they choose what they deem a healthy snack, consuming it mindlessly in front of the TV, failing to acknowledge or to experience the pleasure of what they’ve consumed, ultimately leading to more overeating. And as a result they feel hopeless, that they can’t win at this challenge.

Naturally, this is reasonable at times. But what is senseless is the assumption they have been deceived, like in the shell game. Their expectation is that weight loss should be occurring, given all the workthey’re doing, all the changes they’ve made. Yet in reality, sometimes they are simply just moving the shells around, so to speak.

Yes, it takes more than this for change.
Finally, we are sometimes likes hamsters in the wheel of life. We go round and around, doing nothing differently at all. And doing the same thing over and over when our experience tells us it just isn’t working for us, doesn’t move us forward. Uggh, more frustration.

It’s my hope that these visuals will provide you with more than just entertainment. Rather, may they inspire you to be more constructive—to act on your motivation, to challenge your thinking, to break from your behaviors—like Temple Grandin, who exceeded, I suspect, even her own expectations, living with a condition for which there is no easy fix.

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