the author


Ashley Solomon, Psy.D is a psychologist who specializes in the treatment of eating disorders, body image, trauma, and serious mental illness.

post categories

nourishing body image awards

Nourishing Body Image Awards Badge

Category: Ideas to Consider

10 Jun

Could Naming Your Eating Disorder Help or Hurt?

Ideas to Consider 267 Comments by Ashley @ Nourishing the Soul

On the heels of a wonderful #aedchat, I’ve been spending a lot of time thinking about the concept of externalizing eating disorders. (If you missed the tweetchat, you can read the entire transcript here.) To grossly over-simplify, externalizing an eating disorder refers to the technique of considering the eating disorder as a separate entity from one’s self.

Jenni Schaefer, author of Life Without Ed, is often credited as being the first to really popularize this idea. In her book, now ten! years old, she talks about assigning her eating disorder the name Ed and coming to think of Ed as an abusive boyfriend, one that she loathed but was also afraid to leave. Jenni shares over the course of the book how creating this distance between herself and the eating disorder allowed her to garner the strength to begin fighting back, eventually making real change and forging a path to recovery. Creating “Ed” was a starting point for her in changing the way she saw herself and the disorder.

Many other therapeutic traditions have adopted a similar approach. Narrative therapy teaches individuals to reconceptualize their disorders garner a new sense of strength and the power to rewrite their stories. to In Family Based Treatment, for instance, practitioners introduce the eating disorder as a separate entity, a grave disease, to patients and families. The rationale is that the family needs to be united against this “intruder.” Indeed, many families come to this on their own. They observe how this awful “being” has seemed to come to posses their child, leaving at times a shadow of their loved one’s former self in its wake.

In my own work, I’ve heard from countless individuals how externalizing their eating disorder helped them begin to distinguish between their own thoughts and those of the eating disorder. Over time they began to recognize their true (“healthier”) self as distinct from this disorder who’s goal was to trick and deceive them. Once they were able to recognize this distinction, they could begin to attend more to the true self, letting the Ed or Ana or Mia fade further into the background (or kicking him or her to the curb).

While I observe how powerful an intervention this can be, I do find myself concerned that it has become almost an expected part of the treatment process. When one group member in an eating disorder group I run expressed that this didn’t resonate for her, other members told her that she would “get there” and seemed to indicate this as a sign of her not being further along in recovery.

Eating disorders can be so insidious and I think externalizing and visualizing them can be helpful in undermining their strength. But this doesn’t work for everyone. And not only that, I think there are some potential costs that come for some with treating the eating disorder as a separate entity. Hearing Dr. Kelly Vitousek talk at a conference a couple of years ago, I was struck by a number of these costs.

For one, I worry that it oversimplifies a very complex and nuanced issue. One of the issues that we continually challenge in eating disorder treatment is the practice of dichotomous (“black and white“) thinking, and creating two selves – healthy/sick or good/bad — seems to perpetuate that approach. It could be more powerful, in some cases, to consider the complexity of the disorder and acknowledge that the traits we may associate with each “self” — e.g. perfectionism with the anorexia — are not solely good or bad. Those traits are part of the person himself or herself and can be used in pursuit of more or less workable goals.

Further, while they are painful and destructive, eating disorders often emerge initially as a means of self-protection and safety. For some, a the world has become too dangerous or chaotic or unpredictable and the eating disorder serves an important function. To separate it from one’s self and villainize it could prevent one from fully acknowledging the role the eating disorder has played.

Some individuals end up feeling invalidated by this approach, that what they think or feel is treated by others as “just Ed talking” versus him or her. When I once remarked to a patient of mine that it felt like “Ed” was the loudest person in the room and I wished I could hear her instead, she became very upset and reminded me that she was the person behind all of the words, and it was important that I hear them all, not dismissing any because they were “Ed’s.” It was an important learning moment for me, and I’m cautious, even when a patient externalizes her own disorder, to not treat what is shared in that way.

And finally, could seeing the eating disorder as distinct from one’s self impair accountability? I’ve observed this go various ways with individuals with whom I’ve worked. I do think there can be a risk is over-externalizing, to the point where an individual feels that they are actually powerless over this much stronger being. The person feels that he no longer has any control, so why bother? It requires energy to fight a monster, and if someone is physically malnourished and weakened by the symptoms, they could feel unable to take on Ed, finding it easier to submit.

The bottom line is that this is an intervention that should be used judiciously. It’s not a one-size-fits-all approach, and one has to consider the individual or one’s self before determining if creating an “Ed” is the right way to go.

Have you used this technique in your work or recovery? If so, what was your experience?

02 Jun

What It Means When McDonald’s Sponsors Dietetic Conferences

Ideas to Consider 10 Comments by Ashley @ Nourishing the Soul

mcd{image credit :: thomas hawk}

I promise I don’t go to conferences for the food – at least not solely – but when I’m forking over a large sum and spending all day in educational seminars in alternately chilly and stuffy conference rooms, I could use a good meal around noon-time. So I would be a bit miffed to get a plastic-packaged meal from an everyday fast food joint. If I was attending the annual conference of my state’s dietetic association, I’d be downright irritated.

Nutritionists and dietitians at the annual California Dietetic Association conference in April were treated to lunch by McDonald’s, the premier sponsor of the event. If you cocked your head and raised your eyebrows in reading that (I’ll say it again… premier sponsor), you’re not alone. Nutrition professionals in attendance – and I – had the same reaction.

McDonald’s is now sponsoring dietetic conferences? Where will Big Food not go?

And lest you think that McDonald’s is an anomaly, other exhibitors included Nestle and Better Buds, maker of an enzyme-modified butter product with the benefit of “flavor masking” (yum…?).

Now, just because McDonalds supported the conference and gave out free lunch doesn’t mean that the actual educational sessions the dietitians were attending were influenced, right? Well, Mother Jones reported that sessions included talks about the safety of genetically modified foods, the value of Walmart in communities, and the defense of high-fructose corn syrup.

The bottom line is that there are many sides to every debate, and none of the above topics are clear cut. Personally, I would be frustrated to think that dietitians in our communities are hearing only one perspective on any of these ideas. Villainizing any one food or food group – whether it’s wheat, sugar, dairy, or something else – isn’t an approach I would support. So I’m not suggesting that all the points made by Big Food are inherently wrong.

But we all know that it’s hard to argue with a giant, especially a giant with billions of dollars who are primarily invested in keep shareholders happy.  Not healthy, but happy. Decreased sales because of panic around trans fats is a crisis for thousands of companies in the U.S. And trying to reduce the panic by changing public discourse is a hell of a lot cheaper (and less risky) than changing their entire product line. I get it. Business has an agenda, and that agenda is not always in line with public health.

But we trust our dietetic professionals to sift through the noise of and tell us how to navigate this chaotic world of food – a world that’s unparalleled in its range of options and misinformation. And when those professionals get caught up in the agenda of Big Food, I get concerned.

And it’s not just some dietitians in California at a convention that I worry about, it’s the larger scale canoodling between organizations like the Academy of Nutrition and Dietetics (AND), the largest of its kind, and companies like Coca-Cola and Mars.

Put simply, how can an organization whose primary objective is to enhance the public’s health make reasoned recommendations when dependent on organizations with a completely different mission?

Back to the real world where money is what makes it go round… The reason the AND and the School Nutrition Association and so many other similar organizations accept these sponsorships is because they need money to survive and do their work, and it’s easy to submit to the allure of cold hard cash coming from Big Food with plenty of it.

So if our dietetic organizations need money to exist and enact their missions, and other sources aren’t available, what happens? We get our dinner served with a slice of Big Food agenda. Maybe it’s better than going hungry… Perhaps only time will tell.

What do you think? Should corporations like McDonalds be sponsoring dietetic events?

15 May

Would you wish your life on someone else?

Ideas to Consider 12 Comments by Ashley @ Nourishing the Soul

A few months ago, my mindless scrolling through social media brought me upon an article urging me to ask myself if I would wish my life on my children. The post addressed why so many parents tie so much of their own happiness and self-worth to their children’s success. It was an interesting read, but what stuck with me was not the content but the question itself.

Would I wish my life on someone else? 

Truly, this question has followed me around like a basset hound for the last few months, nipping at my heels when I least expect it.

To me this question isn’t about the details of my life — my condo in little urban neighborhood, my daily commute to work, the amount of money I have to spend on groceries — but rather it’s about the way that I’m living my life. If I could unzip my shell and let someone else step into my world, would I let them? Would I feel proud of the way that I’m treating myself and my loved ones? Would I feel that I’m being kind to allow someone to live my existence and assume my habits? Would I want the other person to share the goals and values towards which my actions are pointing me?

The busyness of life sweeps us up in its torrent and before we realize it we’re miles from where we started. In its wake is sometimes left the remnants of the life we thought we would be living. For me this question is a compass. It’s asking me to recalibrate. The road back to where I veered off might be long, but with my feet pointed in the right direction, I can get there.

Would you wish your life – the way that you’re living your life today – on someone else? What might you change? Would you be kinder to yourself? Engage in things that make you happy more often? Slow down the pace?

12 May

The Chocolate Milk Monster

Ideas to Consider 3 Comments by Ashley @ Nourishing the Soul

choc milk

{image credit :: maria pontikis via flikr creative commons}

I get it. I really do. Get the sugar-laden milk out of the schools so that we can get our kids to drink more water and kale juice and we can curb the tide of the childhood obesity epidemic and we can all pat ourselves on the back while eating our bowls of ice cream on the couch at home.

Okay, so maybe I don’t get it.

I’m not arguing that chocolate milk is the prima beverage for kids or adults. It can add a significant amount of sugar to a child’s daily intake and potentially unnecessary calories. There are plenty of other foods and beverages that can pack a more nutritious punch ounce for ounce.

But recent research is showing that banning chocolate milk in schools leads to overall less milk consumption — in one study, approximately 10%. In 11 Oregon schools where Cornell researchers examined what happened after the ban, they found that while some kids did replace the chocolate version with white milk, they ended up throwing away 30% of it. And thus down the drain goes healthy protein, calcium, and Vitamin D.

Despite my mini-rant above, I do understand the urge on the part of schools to weigh the benefit of reducing sugar consumption heavier than the consumption of the nutrients in the chocolate milk. However, I worry that this reflects our greater cultural focus on eliminating the “bad” versus introducing and promoting the “good.” (Ugh, I hate labeling foods and bad and good and am only doing so here to reflect the way society tends to view certain items.) We’re so concerned with getting rid of trans-fats and pop and white bread and spend such comparatively little effort teaching kids to enjoy nutrient-dense foods.

To really know the net “benefit” of eliminating chocolate milk, we also have to better understand how kids are reacting to the change. Are they bringing cans of pop to school as their beverage instead? Are they replacing the sugar and chocolatey goodness they would have gotten from the milk with cookies or another slice of pizza? We have to consider what the compensatory behaviors are.

And perhaps most importantly, I worry about setting up a feeling of deprivation and restriction for kids around any food or beverage. These are kids… when you tell them they can’t have something, they’re going to react, rebel, and potentially even sneak and binge. For example, an important study showed that kids that had parents with more restrictive eating tended to eat many more marshmallows when offered. They didn’t know how to regulate themselves because they were always being denied.

In a few years when my son goes off to kindergarten, perhaps chocolate milk will be as ancient as pop rocks. (And maybe part of my reaction is born out of my particular fondness for the chocolate milk of my youth.) We could all be so glad that our kids have switched to kale juice and have lower glycemic indices. Who knows… But for now, I hope that schools work to truly better understand the implications of banning an item before doing so.

Do you think schools should stop selling chocolate milk?

Related Posts Plugin for WordPress, Blogger...