Crisis Questions

Isn’t it odd how you sometimes need to binge for no apparent reason and yet function well during a major crisis? Have you wondered why sometimes you need to binge when nothing in particular seems amiss or when something tiny goes awry?

Perhaps you've wondered why you can move through part of a day or night without binging or purging at all. I think about these questions as they relate to my patients and to the people affected by an eating disorder who write or call me looking for help and understanding.

Crisis Response

I heard a bulimic woman say that she stayed abstinent for days when fire forced her and her family to evacuate their home. But she binged and purged herself into major relapse beginning one morning when, as she was getting dressed, her belt buckle broke. Is a broken belt buckle a crisis? What is a crisis?

What is a crisis to a person with an eating disorder? The broken belt buckle was a crisis to the bulimic woman but maybe not to you or me or another bulimic person. Or does the experience of crisis depend on when the buckle breaks?

I'll be exploring these questions around crises, what they are, how they are perceived, how and why a person with an eating disorder responds and what a person can do to respond with more health and skill in this six part article, "Eating Disorder Response to Crisis."

 

I  Crisis refers to an exquisite tipping point that leads to instability and then returns to stability or becomes drastic and imaginable or unimaginable change. Therefore, a crisis can relate to any situation because any situation can change. The situation involved could be physical, emotional or mental. It could be imagined and perceived as happening or it could be real.

Understanding the Binge Response

To understand an eating disorder binge response to crisis we must understand the person’s lived experience while she is in her precarious moment of instability and perhaps imminent change. It’s her inner lived experience, not the situation itself, that forces the binge response.

 

Focus is on understanding you and your internal world

Our focus is not about a particular crisis, trigger foods, eating disorder behavior or a description of a binge/purge episode. The human being is the focus. You, your experience, what happens in your mind, heart, body and psyche is what’s important. What happens to you when your mind narrows to a binge beam and your body screams for immediate comfort and soothing is where we bring compassion, knowledge, sensitivity and caring attention.

Crisis Definitions:

· An unstable situation of extreme danger or difficulty; "they went bankrupt during the economic crisis" · a crucial stage or turning point in the course of something; "after the crisis the patient either dies or gets better" · A crisis (plural: crises) may occur on a personal or societal level. It may be a traumatic or stressful change in a person's life, or an unstable and dangerous social situation, in political, social, economic, military affairs, or a large-scale environmental event, especially one involving an impending abrupt change. More loosely, it is a term meaning 'a testing time' or 'emergency event'.  

 

II  Crises that trigger binges and binge purge episodes

The critical incident that triggers binge behavior may be an event in life, the threat of an event in life, or a vivid thought or feeling that may or may not relate to reality. It feels so personal it reaches the emotional depths of you. When you believe you are in an unstable and precarious situation that threatens your sense of security you can feel that your very self is about to be obliterated. That particular internal experience ignites the binge or binge purge episode.

Changing nature of the eating disorder episode

Once you are in the obsessive compulsive episode, the actual and emotional experiences change form. The binge or binge/purge experience blocks your horrific feelings. It grounds your body so you feel more solid or gives you a sense of holding on to something that won’t go away. It also numbs your ability to think outside the binge. Your thinking stays rigid and only permits rethinking your catastrophic thoughts and how to continue your binge or binge purge behavior. As the episode continues you feel a strong sense of shame and despair. Physical pain enters the experiences, and once again, you feel a tremendous fear of annihilation.

End of episode

  If you are a compulsive binge eater you will eat till you pass out. If you are bulimic you will binge and move into a purge episode, perhaps many binge purge episodes. You try to flee your experience by vomiting the contents of your binge. No escape exists. The end of the episode comes with physical exhaustion. You remain with the shame and fear.

Why?

  What is the crisis experience that pushes a person with an eating disorder into such drastic behavior? Where does this overwhelming sense of annihilation come from? Why are drastic eating disorder episodes required to restore equilibrium? Why are you willing to pay such a price? Or are you willing? Do you have a choice?

 

III  Experience of Crisis

  If you have an eating disorder then you experience a crisis when you perceive, real or not, that the presence of a constant, reliable, important and nourishing something or someone leaving you. Your feeling of being adrift and alone in a vast emptiness with nothing to hold on to and where no one can reach you or even know where you are is unbearable. Regardless of what eating disorder you have you will feel the urge to do what works for you during periods of real or perceived loss.

Reaction

Depending on the severity of your disorder and the severity of the loss, real or remembered, you may binge on food or exercise or go into starvation mode.

You may cut or edge toward suicide. You can fall into a binge purge episode stretching across a range of once in one day to 15 or more episodes per day for many days. If you have some degree of recovery you may find yourself saying to a friend or your psychotherapist, “I don’t want you to worry about me. I’m not going to do this. But I feel like I want to tear the flesh off my bones. I want to poke out my eyes. I want to scream and pull out my hair. “I won’t. I’m not going to. But I want to.”

What’s happening?

You recognize present or imminent loss that will leave you in endless inconceivable danger. You tremble on the inside. You feel an endless energy wave descending on your skull which feels like it brings isolation, darkness and an endless fall. You rush or clamber, stretch or grab, march, run or drive to your binge experience to block out these horrible feelings.

Examples of Loss that Can Trigger Perceived Crisis

  When friends leave your home after a dinner party or when you leave friends after a social evening, or when your date goes home you may feel that relentless wave descending. You do your eating disorder activities to find quick a quick rescue. Perhaps your psychotherapist or best friend or parents or favorite teacher is leaving town for a while. Perhaps a man is withdrawing from your life or left abruptly. Perhaps you changed your physical environment: you changed apartments or moved to a different part of town or different city, state or country.

Change as Crisis

Change means something new starts and something familiar ends. Change means something is not the same. Yes, this is simple reasoning. But to the deep psyche of a person with an eating disorder, change relevant to a person, place or thing that serves as a life stabilizer is a crisis and perceived as a catastrophe.

Reaching for Solutions That Don’t Work

  Will a binge bring forth warm understanding from a parent or spouse or romantic interest? Will a binge stop you from losing your job or bring back love from a man or woman who is leaving you? Will a binge help you pass an entrance exam or make friends in a new environment? Will a binge help you find a psychotherapist or doctor or lawyer or dentist or electrician or plumber or automobile mechanic or anyone else you need to help you work through your present challenges? No, of course not. You know that.

Why Reach for Irrelevant Solutions?

Eating Disorder behaviors will not solve the realistic challenge facing you. But you know you can’t bear the unbearable feeling of not just losing, but being lost. You feel untethered, unconnected, invisible, unheard, ungrounded. You feel and think you are in what could be an isolated, terrifying and endless free fall. You must binge or act out in other eating disorder ways, to make yourself solid, to find yourself through discomfort or pain, and simultaneously numb yourself to emotional oblivion. The solution that is irrelevant to your realistic challenge is effective in taking you out of your unbearable emotional experience. It works. You are flooded with pain and oblivion. You escaped your perceived crisis via drastic means which could even endanger your life. You won. Your frustrating problem is that the eating disorder behavior solution only works for a very short time. In fact, you might have to live your entire life bingeing, purging, starving and cutting to escape crises unless you make the courageous move toward healing.

IV The Paradox in Binge as Rescue

You know what you want. You want to be solid and alive. You want to capable of being seen and heard without going into anxiety. You want to be real and have a real life. But experiencing an emotional crisis drives you to save yourself from intense and immediate pain. You plunge into your eating disorder repertoire.

Eating Disorder Rescues

  The eating disorder rescue looks like this: You crawl under the covers trembling on the inside and afraid to come out. Or you sink into the television, binge and do not answer the phone. Or you binge in restaurants wearing what feels like your invisibility cloak or phony persona. Or you binge in your car, alone and unseen.

You want to be safe and alive yet consider suicide. Your goal is not to die, although some people die when they attempt suicide. Your goal in moving toward the suicide act is to get away from the sense of being completely alone, rejected, abandoned, invisible, frightened and in imminent danger. You may cut. Slicing your body, watching and feeling the blood flow feels like a relief from all the inner pressure and pain. Your experience of life is too intense to tolerate so you drain out some of your life by bloodletting.

Magnificent Promise

  These emotional and behavioral binges offer the opposite of what you want and need to live a full, rich and satisfying life. But, the eating disorder behavior offers one magnificent promise. It will stop you from feeling the horror of the descending energy wave that quickly erodes your mind, body and soul. In such a moment you are certain you would disappear, unseen and unknown, under the force of that wave unless the eating disorder behaviors save you.

Endless Anxiety Experience

This is the endless, lonely, and frightening experience of a person with an eating disorder. This is what you feel when you have not yet found your healing path or are in the early stages of recovery. If this is you, then you may be under even more stress now as the people and systems you’ve counted on to care for you are being strained by the current economic turbulence.

Rush for Quick and Easy Solutions

  Answers to your emergency questions are unsatisfactory. Effective ways of caring for yourself require time, healing and focus on developing relevant resources. You don’t want to hear about a seminar or psychotherapist or resume writing class. You jump at the chance to “talk to someone” in a meeting a friend may arrange. But you are horrified and thrown into despair when a well meaning person exploring an opportunity with you asks you about your credentials and experience. You struggle to maintain a calm persona while you are screaming inside. The would be helpful person describes study programs where you can get a certificate or a degree. Or he or she gives you a thick packet consisting of an application form that requires samples of your work. Or he or she describes the qualifications you need to gather together to enter a training program or gain membership in a relevant organization.

“No” to solution and “Yes” to deeper troubles (paradox)

You don’t want to hear these long range solutions. Anything longer than a few hours is too long a wait. You want to be rescued fast, right now. You want the money or the husband or the recognition or the car or the apartment or the job or the answer to all your troubles and peace of mind right now. The unhappy paradox you face is that the binge response will give you fast relief, but only for a moment. You will quickly return yet again to your anxiety.

Choices

The eating disorder rescue path leads to despair. Your only real choice that will lead you to what you truly want is the choice that gets you on your recovery path. Many people make that choice with committment, dedication and courage. They get well. They get a life. You could be one of them.

 

V The answer to the binge response dilemma:  Grow your way out

You have to grow your way out. Eating disorder healing and recovery are directly related to nurturing and supporting young and wounded aspects of your psyche to health and maturity. A more sturdy, healthy and realistically confident inner world then allows you to use self growth and stress reduction methods to cope well in the world. Developing that kind of inner world is the goal of eating disorder treatment. Stress reduction programs, inspirational and practical task lists, articles including some suggestions on my blog are practical and helpful to people who can use them.

 

Need for Solid Inner Core

But, if you experience an inner shattering under stress you can’t yet make use of such reduction resources. For example, if an abusive person continually makes hurtful and undermining comments to you and you cannot stop that behavior or withdraw from that person you have a revealing and inadequate or even dangerous way of responding to crisis. You may not even recognize that the person is being abusive because the person is a parent or spouse. Your helpless inability to recognize the abuse or care for yourself in the situation is a reflection of what is undeveloped in you.

So if you are in collapse and acting out mode because of real or perceived crisis, then even holding a book or reading words can be too much for you. Your eyes can blur. Your hands can tremble. Your inner experience of anxiety can compel you to run in whatever form your way of running takes.

Many women with eating disorders accept abusive treatment because they sense with a deep knowing that they will collapse and drown under a devastating wave of eradicating isolation. It’s a horrible feeling that must be avoided at all costs.

If this is you then before you can take effective action based on the guidance and advice of stress reduction and self growth programs you need a more solid inner core so you can tolerate what feels to you like moments of great risk.

Healing Work Required

Please do not underestimate the depth of the work required for healing. Your eating disorder is not based on vanity, poor nutrition, hunger, weight concerns, body image, desire for praise or acceptance or validation. Your eating disorder is based on deep psychological wounds you may not even know about because the disorder works to keep you oblivious to your own experience.

See Lisa Ann Schnepfer's article which gives an excellent breakdown of the situations that contribute to the development of an eating disorder.

Each person must find her way to recovery her way. Finding a knowledgeable and experienced psychotherapist who will honor you and help you in creating and developing your personal recovery journey is vital.

Finding Your Healing Path your way

12 step programs can be helpful in teaching you a more healthy daily life structure and giving you an opportunity to hear and meet inspiring people who are dedicated to recovery. You may discover more than one program that can help you.

Meditation practice is taught now in spiritual and non spiritual ways. Learning mindful practices in life, teaching your body, mind and heart to be still and aware, even for just a few minutes a day, will help your recovery process.

See: The Center for Mindfulness in Medicine, Health Care, and Society (CFM), established in 1995 by Jon Kabat-Zinn, PhD. The Center is a natural outgrowth of the acclaimed Stress Reduction Clinic founded in 1979 at the UMass Medical School.

Go to "Other MBSR programs". You’ll find it toward the bottom of the left hand list of contents and enter your zip-code, or simply go to this page.

(By the way, I’ve taken the eight week MBSR course in Los Angeles and am still reaping benefits.)

Nourishing your body can give your brain the food it needs to function properly. Distorted thinking and flooding fantasies can diminish when you feed your brain properly.

For starters, look at the work of Julia Ross: her book, the Diet Cure, and her website. Exercise, not compulsive exercise, but regular joyous movement, preferably outdoors, can reawaken your senses and connect your mind, spirit and body.

Just a daily 20 minute walk in a pretty or interesting place can make a huge difference in your state of being.

Combine walking and meditation by learning about walking meditation.

Dancing is great. If you have any inhibitions at all, dance alone in your home to music you love. Just ten minutes will lift yourspirits and remind you of whom you forgot you were.

Health benefits from dance

A thorough description of eating disorders is in the Student Eating Disorder Awareness Guide, a rich resource of information and sources of help.

And, for finding your psychotherapist, see: Academy for Eating Disorders (AED) International Association of Eating Disorders Professionals (IAEDP) Edreferral.com 

My book, Healing Your Hungry Heart, offers many specific actions you can take on a regular basis to help you grow your way to your health and freedom.

I wish you a successful recovery journey and a rich rebuilding of your inner core.

 

What actions do you take on a regular basis to help yourself heal and grow?

What can you add?

 

Eating Disorders:  Response to Crisis

part 1  Overview  http://www.eatingdisorderrecovery.net/index.php/help-yourself/coping/263-response-to-crisis

part 2  http://www.eatingdisorderrecovery.net/index.php/help-yourself/coping/264-response-to-crisis-part-ii-of-vi

part 3  http://www.eatingdisorderrecovery.net/index.php/help-yourself/34-coping-strategies1/265-response-to-crisis-part-iii-of-vi

part 4  http://www.eatingdisorderrecovery.net/index.php/help-yourself/34-coping-strategies1/268-response-to-crisis-part-iv-of-vi

part  5  http://www.eatingdisorderrecovery.net/index.php/help-yourself/34-coping-strategies1/269-response-to-crisis-part-v-of-vi

part  6  http://www.eatingdisorderrecovery.net/index.php/help-yourself/34-coping-strategies1/271-response-to-crisis-part-vi-of-vi