Group: Voices within the Journey of Eating Disorder Recovery

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An Excerpt from Group: Voices within the Journey of Eating Disorder Recovery


Fear

Fear is another common struggle for those who are dealing with an eating disorder. It is often fed by the underlying worry and anxiety that accompanies the actual disorder. As humans, we have a true physiological response that occurs when we sense fear, and it directly affects our thoughts and emotions. This healthy response may not be processed correctly in individuals with disordered thinking. In my experience when someone is entrenched in fearful thoughts, the worried mind tends to spiral out of control contributing to this feeling of fear.

Many of the girls in the eating disorder groups have explained to me that they often feel there is always a danger or catastrophe at every turn or step of the way, and therefore their life experience feels unsafe. It’s as if they feel they always have a “gloom and doom” over them. What makes this more challenging for many girls is their emotional gauge in not registering correctly, as I mentioned in Week One. They often feel flooded with fear, which makes life feel more dangerous and therefore there is a greater need to protect themselves. Many of the young women struggling with recovery rely on their obsessive behaviors to manage these feelings of fear. Some also use self injury or cutting as a way to gain control over the chaotic emotions and internal chaos. They often become attached to the temporary release of endorphins that comes with these unhealthy forms of coping. These obsessive/compulsive behaviors may deceptively offer them the comfort or safety they are craving. It often appears as if consciously or subconsciously, they are attempting to shrink away from life and all of its challenges.

I have realized when a young women is entrenched in an eating disorder she truly feels unequipped to handle the circumstances of life. Because of this, her eating disorder becomes a way of shielding herself from life and protecting herself from the challenges she feels she cannot overcome. This explains why during recovery many women express great fear over the change and unknown of not having their eating disorder to hide behind anymore.


Managing Fear

Throughout my experience in facilitating groups with young women dealing with eating disorders and body image issues, I find that using concrete strategies and tools is most effective when helping them manage their fear. For example, visualization and balloon breathing tend to tame the worried mind, calm the body, and gain control over anxiety and worried thoughts. Some young women require a crisis plan to help them be prepared for heightened moments of emotion. These tools can be utilized anytime and anywhere which is critical when somebody is struggling through recovery.

It is important to help young women realize that the fear is present for a reason. Through therapy and integrating new ways of coping, the fear can be examined safely and then released.

As you continue through the recovery process it is important to face your fears with the assistance of a therapist or someone you deeply trust. Often the fears you have, are created by past experiences. Talking openly about this allows your feelings of fear to become more bearable and less terrifying. Do you notice a pattern of obsessions that you think helps to minimize your fear? Or do you think the obsessions actually add to your fear? As you continue learning about yourself you will understand the purpose fear has had in protecting you and someday you will not need its destructive protection. In recovery a new fear may develop around life without your eating disorder. This is not unusual and as you read on, the group will reveal their truths about this and demonstrate hope in managing it.


My therapist asked me if I ever think about my sister dying, and then she asked me if I was afraid of dying. But I guess I'm just afraid of living.
– Stephanie

Jillian: Welcome to the fourth week of our group. This is actually the midway point of our nine weeks together. It seems hard to believe.
I was reflecting on this as I drove here this evening. I then began noticing the subtle changes that nature is exhibiting as the seasons shift from Winter to Spring. These changes remind me of the many shifts I see at this point in each of you.
I brought in this small tree branch with leaf buds on it to symbolize what I see occurring. Each bud is unique and is faced with its own set of challenges. Yet every bud, at its own unique time, will begin to break open and flourish into a strong, vibrant leaf, along with the promise of a new season. This tree branch reminded me of the strength I see in you, every time we meet. I do believe that each of you amazing young ladies, at your own individual times, will also have the opportunity to bloom, leaving behind all the pain and struggles that you have endured.
Thank you all for joining me here again tonight. How was everyone's week?
Carly: Before I begin, may I please sit on the floor with a pillow? I am feeling so uncomfortable today as I have all week.
Jillian: Sit wherever you are most comfortable.
Carly takes a seat on the floor,
wringing her hands together.
Would you like to share what is happening right now for you?
Carly: Well, I'm really in a difficult place. I am so glad that it's finally Tuesday because I've had a really hard time, and I need to talk to someone. I have so many thoughts racing around my head right now, and I'm not sure where to begin. I'm feeling so overwhelmed. I haven't been able to sleep, and I'm feeling wired and tired at the same time. Sounds crazy, right?
Jillian: No, it doesn't sound crazy.
Is there anything that has been occurring in your life lately that may be contributing to these overwhelming thoughts and feelings you are experiencing?
Carly: My parents came up for parents' weekend. Of course, I wasn't in the swim meet because my coach won't let me compete, and I think they were really disappointed. My mother and I had a long talk about school, my eating disorder, and other deep things. She said that I looked “healthier”, which is the non-offensive way of telling someone with an eating disorder they've gained weight. She said that she and my dad have been really worried about me and told me how relieved she is that I look better. I immediately felt like a fat failure. I was so angry that she said I looked “healthier”. On top of that I wanted to crawl out of my own skin. I hated myself so much more. Now I feel guilty about everything that I've put them through.
Why is it so hard to just accept myself the way I am? I know I'm fatter, and I can't stand it! My stomach folds over my pants when I sit down, and I can feel my thighs rubbing together when I walk. I feel so disgusting! I am so afraid to let go of my eating disorder behaviors, because if I can't tolerate these feeling now, what will happen in the future?
Jillian: Carly, it sounds like a very challenging weekend for you. I'm glad you are here and are able to share some of the difficulties that occurred for you.
I believe it is very challenging when somebody is struggling through recovery and people offer comments about how they look, what they are eating, etc. I realize when people do this they mean it to be helpful. Yet when you are working on new thoughts and behaviors while moving away from old ones, that may have kept you feeling safe for many years, it can feel very threatening.
I understand you are afraid to give up your eating disorder behaviors. They have allowed you to cope for many years. I am not saying that it was a healthy form of coping with your feelings, but it worked for you for that time in your life, for whatever may have been occurring. All of this can make your life feel very out of control.
If possible I wonder if you could talk a little more about what has been happening for you and how you have been able to handle all these intense emotions?
Carly: I wouldn't say I have handled anything.
I was hoping not to give in to the eating disorder behaviors – and I didn't, but I'm miserable! I don't know if I did well on my SATs, I can't swim, I'm a failure, and I can't even use exercise as an outlet. And I did something to myself that I haven't done in many years and something I promised myself I'd never do again. I cut myself. I can't believe I am crying right now, I feel so stupid. God, I am such a mess!
Carly begins to sob.
Stephanie: If it's okay, Carly, I would like to sit next to you on floor.
Stephanie joins Carly on the floor
and places her hand on Carly's back.
I'm right here if you need me.
Carly: Thank you.
Jillian: Carly, it took a lot of courage and determination on your part not to give in to the eating disorder behaviors. By doing this, you gave yourself the opportunity to feel your feelings, and this was overwhelming and painful. Try to be patient and gentle with yourself. This is an arena that is relatively new for you, and you have not yet learned to utilize alternative ways of coping with feelings.
I'm wondering if you have considered having a crisis plan so that if you ever become overwhelmed like this again, you can have a support system in place to help you get through it.
Carly: I'm not exactly sure that I know what you mean.
Stephanie: Carly, my therapist and I have worked out a plan so that I could follow specific steps if I was feeling like hurting myself. I carry people's phone numbers that I can call pretty much at any time of day if I need extra support.
Jillian: That's a really good idea. Have you found you have needed to rely on it?
Stephanie: Not very often. I think just knowing it's there gives me a lot of comfort.
Jillian: I can see how it can do that. Thank you for sharing this important information.
Carly, I wonder if you are able to take a moment and think of what your own crisis plan might look like.
Carly: I'm really not sure but I think creating a contract with myself on paper and signing it, saying that I will not cut myself and if I get to the point that I feel I need to , I will reach out to my support system.
Jillian: Carly, you have just exhibited so much strength being able to create this safety agreement for yourself. I realize this must be very difficult. It is very important that your crisis plan is something you are comfortable with and you feel you can follow through with.
Please continue to discuss this with your individual therapist, also with myself or the group if you need to.
Carly: It is so helpful for me being here tonight.
I also want to thank you for lighting that salt candle like you said you would. As I was talking tonight I would look over at it and it helped me keep on going.
Jillian: It is important that the environments you surround yourself in are comforting and helpful. If there is anything else you think could be helpful when you are here, let me know.
How is everyone else doing right now?

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