When Is It Time To Speak Up?

Nancy Matsumoto (a freelance journalist who has contributed to the New York Times, Newsweek, Time, etc..) and Marcia Herrin (a nutritionist specializing in eating disorders who founded the Dartmouth College Eating Disorders Prevention, Education and Treatment Program), have co-authored a great book called The Parent's Guide to Eating Disorders. They also have a blog called Eating Disorders and Nutritional News. To read a little more about Nancy and Marcia, follow this link! I wanted to share a recent blog post written by Nancy because I think it is a very authentic post that addresses a topic that people often ask and wonder about. The title of the post is 'Knowing When to Express Concern About a Friend's Eating Disorder.' Follow this link to read it, or you can read it below (copy and pasted).

In other fun news, I had the opportunity to ask both Nancy and Marcia some questions recently about some different eating disorder topics which I am excited to share with you soon! :) :) Follow this link to check out their website.

Knowing when to express concern about a friend's eating disorder

A recent experience reminded me that even when we know what the right thing to do is, it’s still hard to know when to do it. Over the course of the past year, I have become friends with a woman, I’ll call her Jane, in my Japanese language class. I recognized the telltale signs of anorexia in her right away: the hollow cheeks, the clothes hanging off her skeletal frame, the way she liked to bring food for others, but didn’t want to eat much herself.

Later, Jane told me that she did not see herself as too thin, she thought she looked normal, maybe even a little bit heavier than she wanted to be. This, too, is a classic symptom of the body dysmorphic disorder that often accompanies anorexia.

I wondered if I should say something, to express concern and find out if Jane was in treatment. Had I been just half as emaciated as Jane was, I would not have been able to think straight; I would have felt dizzy and probably fuzzy-headed from malnourishment. But Jane’s mind was razor sharp. She was an encyclopedia of kanjicharacters, devoured the finer points of grammar that made my eyes glaze over, and read the appendix of our dry text book for fun.

Although she was always the most prepared person in our class, Jane was also always late to class. I thought she had a job that she couldn’t leave early. Later, she told me that she had no job; the digestive problems caused by her anorexia meant that she simply had to wait until she felt well enough to leave her apartment. Often, she didn’t arrive until the last 20 or 30 minutes of our two-hour class.

Then Jane went away to Florida on vacation. It was sunny and warm there, but she returned with a wretched cold and looked thinner than ever. She looked terrible. “Feel my hands,” she told me and another classmate. Even though our classroom was overheated as usual, her hands were icy cold. Suddenly, she had entered crisis mode. Being in Florida surrounded by friends who were healthy, fit, and enjoyed active, outdoor lives had suddenly made her want those things for herself. She looked in the mirror and for a moment saw how different she looked, how starved and unhealthy the woman who stared back at her was. It was a moment of clarity that lasted long enough for Jane to realize she needed help.

For the first time, Jane also opened up to me and a few others in our class about her eating disorder. She was desperately seeking a treatment center, she told me. Even though all the doctors she spoke to felt she should be hospitalized, she hoped to stay at home and find outpatient treatment. I was scared for her life, and I could tell she was, too. I berated myself for not saying anything earlier. Maybe I could have prevented this sudden and horrible downturn. I knew what was happening to her and I didn’t say anything.

I thought that she would think me too pushy, or a know-it-all. I worried that I would be intruding. After Jane spoke openly about her worries, I was able to refer Jane to Marcia, who then recommended a good psychologist in New York for her to see. When I saw Jane at class yesterday, she told me she liked her therapist but was worried that she would not be able to afford many more treatments. She couldn’t afford to spend the $5,000 out-of-pocket minimum her insurance plan required before it would cover 50 percent of the therapist’s bills. Even paying for half of the treatments would be a stretch.

When I asked Jane today whether it would have offended her if I had spoken up, she told me, “I wouldn’t have reacted negatively, because I know what’s going on with me. I’m not sure that I would have done anything about it; you have to be ready.”

The kind of epiphany she had recently, when she recognized what she looked like and how sick she was, Jane told me, has happened before, although it never lasts. “I want to do something, and then I’ll go into hibernation again,” she said. Two weeks ago she had a phone interview with the Renfrew Center in Pennsylvania, but then decided not to go.

Jane said she wanted so much to be healthy and active but added, “I don’t know how to be active, to sleep and to squeeze food in. I can’t eat because it makes me feel bad, and I’m afraid I will get sick. I’m like a child; I want to be taught to eat again.” Then, she added, “I don’t know if I’m going to make it. If this can help someone else, please write about it.”

I asked Marcia if she thought I had done the wrong thing by waiting to voice my concerns to Jane. Marcia responded, “You have to trust your instincts on when to speak up, and it sounds like you did. I have reminded other concerned friends in similar situations that you can trust your instincts if your motives are pure. We all need to remember that we can't force another adult to take action (without taking legal action first). What Jane needs now is encouragement to hang in there long enough to benefit from treatment. Sometimes this is a good time to suggest or lend a book. Maybe Life Without Ed byJenni Schaefer or, Gaining: The Truth About Life After Eating Disorders, byAimee Liu. Good books can lead to good discussions, too. “

As a nutritionist who often sees eating disorders patients who cannot afford professional treatment and/or have difficulties with insurance issues, Marcia told me, “I have lots of thoughts about this.” The first is that Jane’s dilemma is typical of our insurance system, which slaps large deductibles on eating disorders treatment and follows with inadequate reimbursements. The patient goes without treatment and, in the worst cases, ends up hospitalized in an intensive care unit at upwards of $1,000 a day.

Marcia’s second thought was that it is often hard for patients make recovery their number one priority in life; everything else should be secondary. This is not easy in cases where the patient doesn’t have the complete support of loved ones, however.

Jane’s comment about feeling like a child who needs to learn how to eat again, Marcia noted, is a perfect description of what a good nutritionist can help an eating-disordered patient do, and why seeing a nutritionist or dietitian who specializes in eating disorders is so important.

“Another thing that can be inspiring,” Marcia said, “is to help the other person see that her life is important to others—children, spouses, families, friends, even pets, and to you!”

I will tell Jane that she is important to me, and to our class. I hope that if you are concerned about a loved who is in despair over an eating disorder, you will do the same thing.

Take care,

Nancy

Marcia Herrin and Nancy Matsumoto, co-authors, The Parent’s Guide to Eating Disorders, Gūrze Books, (www.childhoodeatingdisorders.com).

Bring Change 2 Mind

I just started watching a TV show recently called Modern Family. It is hilarious. I've only seen it a few times, so I'm not sure I can do the premise justice, but it's essentially a sitcom that chronicles different members of an extended family and their interactions. (If you're curious, follow this link to check it out.) Anyways, I really do like it, but last week when I was watching, one of the characters made a joke about eating disorders. It's hard to explain what happened since I don't really know any of the characters names, but one of the children was annoyed with his mother and said- "mom, go tend to your eating disorder or something." I'm not sure if this was supposed to be funny, but after the day I had, I was NOT laughing. An eating disorder is a mental illness, and there's nothing funny about that. I didn't turn off the TV and refuse to watch the rest of the episode, but it just struck me that if you replaced 'eating disorder' with any other mental illness- say, schizophrenia- it probably wouldn't be funny either. So why did someone think making a joke about an eating disorder would be funny? This just reminded me that eating disorders aren't widely viewed as psychiatric illness yet.

I think one of the biggest myths about eating disorders is that they are a lifestyle choice- not a mental illness. Yes, there is choice involved in recovery- you have to choose to take steps to recover. But an eating disorder is a mental illness, so it's not as simple as 'just eating'. Glenn Close, the actress famously known for playing Cruella Deville in 101 Dalmatians (ha ha, just kidding- I think she is famous for her role in Fatal Attraction, which I've never seen-- and some other movies too..), started a non-profit called Bring Change 2 Mind. The mission is to raise awareness about mental illness, to work towards de-stigmatizing it while also providing support for those who deal with mental illness. Close's sister and nephew, who both suffer from different mental illnesses, were the inspiration that fueled her to initiate this endeavor. PsychCentral wrote a little article awhile back in October when it launched - to read it, click HERE.

I'd encourage you to check out her site! I'll be honest- right now, there is a slightly annoying pop-up when you access the site, but that's just because Bring Change 2 Mind recently partnered with NAMI (National Alliance on Mental Illness) for NAMIWalks Campaign (a walking campaign to raise money for and awareness of mental illness!). The pop-up is a video, and even though it's slightly annoying, it's actually worth watching :) Once you get past the video, the site is great- there are resources for those who want to learn about mental illness or find support if they are struggling with one, there are videos of people sharing their stories, and there is additional information available that serves to encourage real understanding of mental illness! Right now, eating disorders are not part of their featured mental illnesses- they feature depression, post traumatic stress disorder (PTSD), bipolar, and schizophrenia. However, there are many mental illnesses, eating disorders included, that will hopefully be added as their non-profit grows! At this point, what seems important is that this is an organization that is dedicated to promoting awareness and knowledge about mental illness to de-stigmatize... which is awesome. If you are interested in finding out how you can be involved in any capacity, you can check out the 'be involved' tab on their site!

Maybe the Grinch Was Depressed... ?

Merry late Christmas everyone! Better late than never, right? :) I have been so busy and wish I could have posted sooner, but again... better late than never!!

Even though this post has to do with the holidays, and Christmas is now 364 days away, I think that we are still on the heels of the holiday season. We still have to make it through that awkward week after Christmas/week before New Years- a time that is often used to reflect on the past year while pondering the new one. While we all have things to be thankful for, sometimes the holidays can be overwhelming and the thought of a new year can be daunting.

For this reason, and many others (family stress, financial stress, eating disorder/body image stress), the holidays are not an uncommon time for people to feel sad, grumpy, irritable, ... depressed! I came across an article about depression in which psychologist Cynthia Bulik uses the Grinch as an example of one who exhibits symptoms of depression. In this article (which is titled, Grinch Likely Depressed, Suffers From Lack of Love, Joy) she says, "Everybody's always down on the Grinch. But one of the things I've always asked myself is whether the Grinch himself might be feeling kind of down." She uses him as an example (and it's so cute) which helps to illustrate the different forms that depression can take. What is important to realize is that while often we associate depression with people who are sad, people that are depressed may exhibit little sadness and more irritability, general feelings of misery, and/or social withdrawal.

To read this article, and to find out more about depression, follow this link. And to read a great blog post on assessing depression written by one of my favorite therapist friends,Whitney, follow this link.

Kids, Mental Health and Hope

I like to think that I am a 'glass half full' kind of person. Generally, I try to see the good in people and situations, and am hopeful about change- if I weren't, I'm not so sure that counseling would be the best field for me! All that to say... I noticed the other day that while I was reading an article about young people and mental health, I found myself taking a 'glass half empty' mentality. Why??

Well, according to a survey funded by the National Institute of Mental Health (NIMH) which will soon be published in the journal Pediatrics, 13 percent of all children and young teens have at least one 'mental health disorder.' And of that 13 percent, only half have been evaluated and treated by a mental health professional. These facts indicate that while one half of young people are being treated, one half are not. This is a staggering number when considering that half of all youth with mental illness are receiving no treatment or help at all.

This survey sampled 3, 042 children between the ages of 8 and 15, and the findings were based on assessments of these children for six common mental disorders--anxiety disorder, panic disorder, eating disorders (anorexia and bulimia), depression, ADHD (attention-deficit/hyperactivity disorder) and conduct disorder. For a bit of perspective, imagine if half of young people who deal with diabetes or asthma were living without medical treatment. To think about the number of children and teens who are suffering from untreated mental health issues is alarming. And sad! Research indicates that when mental health issues are not treated, they typically persist and become more severe with age. (I wrote a blog awhile back on teens and depression that addressed this issue- follow this link to read it and to learn some of the symptoms of childhood/teenage depression.) This is concerning because young children and teens who suffer from eating disorders, for example, and are not being treated are at serious risk for many physical and psychological problems. This is a serious issue!

The article suggested that part of this problem is due to the fact that there is a shortage of mental health workers that specialize in treating children, specifically psychiatrists. So what is a parent to do?? Perhaps we need to focus on educating more parents and teachers about the symptoms of anxiety, depression, eating disorders, ADHD, etc.. in children and teens so that they are able to notice the warning signs and advocate for their treatment. While mental health professionals have the tools and knowledge to diagnose and treat, parents and teachers are able to notice patterns of behavior in children over time that a professional is not necessarily capable of seeing when sitting with them for 30 minutes. To read this article in its entirety, follow this link, as well as this one for more info!

The Truth About Dieting..

I have noticed over the last few days that there have been a LOT of advertisements on the radio that have mentioned the so-called 'consequences' of holiday eating and the word diet has been uttered many times in this context. One of the ads that I heard yesterday went something like this: "My pants aren't fitting me.. they are too tight and I can't get them on.. must be all that extra turkey and stuffing I ate. I really need to go on a diet and lose this weight fast. At least jeans are on sale at (-----) for 15$ so I can buy some new jeans until I lose all of this weight." I left out the name of the store not because I have a problem with jeans being 15$, but because the point is not about jeans- it is about how I have been hearing a lot about dieting lately!

Continuing to hear about diets and dieting over the last few days led me to want to post some information about dieting that you may or may not know. This post may be a little long, so bear with me- I think this info will be beneficial. Let me be clear though. I am not saying it is wrong or bad to want to be healthy or to want to feel good about yourself. What I am saying is that there are healthy and appropriate ways to pursue this goal, and drastic measures, unhealthy behaviors, and diets, are not included. Typically, diets promise quick weight loss with no regards to how much weight you actually want to lose, and the end result is that you turn out looking amazing. Diets are deceptions, because they are not capable of such guarantees. Here are some diet myths that help to point out the deception (thanks to Remuda Ranch for providing some of the information below):

Myth #1= You will lose weight. This is why most people pursue a diet in the first place, right? It may surprise you, but research shows that in the long run, 98% of dieters actually end up gaining weight. Why? Because the real issues behind food consumption and understanding metabolism are rarely addressed with a diet. And when unhealthy means are used, the weight loss is usually not maintainable.

Myth #2=You will look amazing as a result of your diet. If your goal is to look like someone else, or to look like some of the images that we regularly see on TV, in magazines, etc.. then you are chasing a goal that is not attainable. These images are altered by computers (check out this video for an example- yikes!). What is more is that a diet will not change your facial features, it will not make you taller, it will not make your legs longer, and it will not make your boobs bigger. Sorry:).

Myth #3=Diets are not dangerous. Whenever you restrict or cut out entire food groups (sugar, carbs, fat, dairy, etc..), this is dangerous-- especially for young people. Our bodies require a variety of foods in order to fuel our organs and keep us functioning effectively. Not to mention that studies show that dieting is an indicator of future eating disorders. A girl who diets before she is 14 is eight times more likely to develop an eating disorder. There are many health risks associated with dieting as well, such as weakened bones, dehydration and decreased heart rate.

Myth #4=Certain foods are bad. Often times, when we diet or approach food with a diet mentality, we label food as 'good' or 'bad.' We may even determine what food we consider to be good or bad based upon which particular diet we are on. The fact of the matter is that all foods are created equal and all foods can fit into a healthy lifestyle. There are no bad foods, only bad diets.

Myth #5= Diets give you control. Having a defined set of rules, especially when it comes to food, may convince you that you will be in control of what you put in your mouth. However, what often happens when you eat the same foods, or follow similar rituals each day with food, you begin to crave foods you have labelled 'bad' or 'outlawed.' This can lead to overeating and binges, which ultimately take you to a place you were trying to avoid to begin with. Also, diets usually make you cranky, they tend to decrease your energy, and they leave you feeling tired and pretty irritable. When you get to this point, the diet is controlling you, and you have little control.

Myth #6= Diets are safe and healthy. Maybe a little repetitive (myth #3), but if you chronically diet, you risk potentially altering the natural weight of your body. Over time, if your body weight fluctuates from higher to lower, and lower to higher, your body generally settles at a higher weight than it would have needed to be if it was not altered in the first place. Our bodies become confused, because they do not know if they will get what they need nutritionally, or if they will not receive any food at all. Our metabolisms slow down because our bodies think we are starving. The irony in this is that the exact opposite of what is intended is likely to end up happening.

Myth #7= You need to follow a diet. Here are some healthy guidelines to follow (compliments of Remuda Ranch) that are not diet-centric. Eat a variety of foods in moderation. Having variety allows for you to meet your nutritional needs; we cannot get all we need from one single food, or from a small number of foods alone. Listen to your body, and your stomach. Eat when you are hungry, stop when you are full. You don't need to eat food just because it is in front of you. Find out if you are eating because you are physically hungry or emotionally hungry (more on this to come..).

To conclude, Karen R. Koenig wrote a book called The Rules of Normal Eating. It is an extremely helpful book for anyone who has struggled with chronic dieting, overeating, undereating, emotional eating and anything in between. I wrote a post on her book awhile back and provided some suggestions that she outlines in her book as they relate to 'normal eating.'. Follow this link for more information.

Turkey Day Anxiety: Part 2

Thanksgiving is tomorrow- and it seems like most people are either running around, making last minute preparations to host family and friends, or making sure that all the essential ingredients are present in their kitchens for cooking, or are packing/en route to be with family and friends. As I mentioned in my previous post (scroll down, or click here to read it), this time of the year is often accompanied by a significant amount of stress. Whether the holidays are stressful due to family tension, financial strain, or other difficult circumstances, one thing is certain- Thanksgiving has become a food holiday, meaning that food has become the main event.

What do we know about stress and eating? Well, for some people, stress during the holidays can lead to emotional eating, overeating, and/or binge eating, while for others who have struggled with restrictive eating, this tension may manifest in restrictive behavior with regards to the amount of food eaten or a preoccupation with what is being consumed. In addition, the heightened awareness that the media and our culture have placed upon food, weight, and our bodies has strongly impacted our beliefs about food. Therefore, a holiday that is centered around food can be triggering for anyone, but especially for those who are currently struggling with an eating disorder or eating issue, as it is not uncommon (unfortunately) for people to observe and make comments about who is eating how much, and how much weight so-and-so gained/lost since last year. If you are reading this, I would challenge you try to make it through this Thanksgiving without making any comments about what other people are eating, or how much they are eating, or any other comments along these lines. While this may seem like a minor adjustment to make, it would probably surprise you to find what an impact such a small change can make on others around you. If you are someone who struggles with an eating disorder, have struggled with one in the past, or struggle with body image issues, OR you will be spending this Thanksgiving with someone you love who you know or suspect struggles in any way with food, here are a few helpful tips, courtesy of NEDA, that may serve to alleviate the stress of such a time.

1. Worry more about the size of your heart than the size of your (fill-in-the-blank-body part). Think about how you can serve someone or do something nice for someone else- and do it. It helps to focus on others, and it helps to consider what you are thankful for.

2. Have conversations with your loved ones about things that matter to you all--dreams, goals, faith, relationships, concerns, fears, challenges, etc-- rather than focusing your energy and thoughts on food or body concerns.

3. Designate someone to be your 'support' person who you can call if you are struggling, or who you can talk with to encourage you to get through the tough moments.

4. Make goals for the day, and try to follow through with them. If you make goals with food, make sure you also make other non-food goals as well.

For more tips, follow this link for NEDA's complete list.

Here are some suggestions for families from Marcia Herrin and Nancy Matsumoto, authors of The Parent's Guide to Eating Disorders:

Try making your family’s holiday traditions more about relationships and activities than about food.

· Don’t skip meals or plan to undereat or diet the day following a family holiday.

· Talk to other family members in advance about not pushing food or commenting on diets, calories, or weight loss. Even too much emphasis on trying to make healthy choices at holiday meals can add to the stress.

· It is particularly important if your child is recovering from a serious eating disorder to have pre-warned family members about the kind of talk and attention that is appropriate. I suggest that parents develop a kind of code or signal that tells family members or other guests, “change the subject, and fast!”

· Because meal schedules may be altered and more snack foods and desserts are served during the holidays, it’s important that parents of an eating-disordered child be extra-solicitous and vigilant. If circumstances conspire to create a level of stress that interferes with your child’s recovery, you and your child should sit down and prioritize the extras in your lives. Remember that the first item on your list of important things to accomplish – even during the holidays -- should be your child’s recovery.

I think the most important thing to remember in all of this is the real meaning of Thanksgiving! No matter what we are going through, we always have things we can be thankful for. This doesn't minimize the tough things that some of us are going through or dealing with, but practicing gratitude does wonders for your outlook. Maybe you can make a list of all the things you are thankful for, or maybe you can make a point to discuss with your friends and family what you have been thankful for as you reflect on the past year. I hope everyone has a wonderful Thanksgiving!! I am so thankful for those of you who have been reading my blog, and for those of you who have encouraged and inspired me.

Turkey Day Anxiety: Part 1

Thanksgiving is rapidly approaching- it will be here in just a few days.. which is kind of hard to believe! It seems like time is flying by, doesn't it? Sometimes it is difficult to know how to prepare for the holiday season because it sneaks up on us so quickly and it is a time that elicits very mixed emotions- excitement, stress, happiness, sadness, irritation, hopefulness, etc.. There are so many different reasons for the range of emotions that are typical at this time of year, but I think the NY Times said it best today in an article entitled Food, Kin and Tension at Thanksgiving:

For Thanksgiving dinner, what side dish would you prefer to accompany your turkey — a serving of well-marinated conflict over how much or how little you eat, or some nice, fresh criticism of your cooking skills?

As awful as that sounds, you kind of have to laugh because there is a lot of truth in such a statement. Whenever families gather together around the holidays (as well as for other celebrations or events), tension and stress are not an uncommon part of the experience. What can add to that stress is the fact that Thanksgiving in our culture has become a food holiday- and if you have struggled with any kind of food issue- anorexia, bulimia, binge eating, disordered eating- even being a picky eater- then the stress can be overwhelming. Or, if you have a loved one who has dealt with any kind of food issue, then you also experience stress at the thought of how to behave and what to say or what not to say come meal time. It can be a tough time for all parties involved.

I am going to provide a few suggestions for how to approach Thanksgiving in light of some of these stressors, but I am going to do that in another post- soon to follow and before Thanksgiving! So check back. In the meantime, read the rest of this article from today's NY Times by following this link. PS- my favorite local hero, Cynthia Bulik, is quoted. She is popping up everywhere these days and that makes me so happy.

A Few More Thoughts- Girls and The Triple Bind

In my previous post, I wrote about girls losing their sense of self and the importance of helping them to see their worth and value by creating circles of protection around them. I came across a book this week that I wanted to share because I think that it complements some of these ideas. It is called The Triple Bind, which Dr. Stephen Hinshaw, the author, says is a term that represents a triple threat to young girls-- societal expectations, cultural trends and conflicting messages. He states that young girls are growing up in a momentous time- they have more opportunities than ever, but also more pressure than ever. He says that they are not only expected to excel at 'girl skills' (friendships, relationships, empathy, etc), but with increased opportunities, there is an expectation for them to achieve the same things that boys have historically succeeded in (sports, demanding careers, etc), AND do both while looking perfect in the process. That is a LOT to live up to.. It is no wonder girls are struggling to cope these days! Hinshaw states that by the age of 19, 1 in 4 girls will have either developed major depression, made a suicide attempt, participated in self-harming behaviors such as cutting, or practiced binge eating or other eating disorders. I would be surprised if this number were not higher.. For more information on his book, access Hinshaw's website here.

The Chicago Tribune published an article back in April about Hinshaw's book and made the point that any parent who has a daughter may want to read this book because regardless of age, all girls face these struggles today. The article, which can be read here, suggests that parents have a large role in helping their daughters develop healthy identities. So, as parents, what are some practical ways that you can help your daughter? I received an email in response to my last blog post asking a similar question as to what action to take to help young people navigate these pressures. An excerpt of the email is below:

Helping teenagers find their voices is also the reason I'm working towards teacherhood. I am aware of the difficulties facing young women, but as a public school educator, and a male one at that, what can I do to help specifically address these issues?

This is a great question. While the roles of parents and teachers are certainly different, I think there are a few suggestions that Hinshaw writes about that apply to both. First, encourage girls (as well as boys) to be discerning and critical of the media and the messages that are portrayed. Second, and this relates more to parents, spend quality time together over dinner; eating dinner together, while tough for many families to practice, has been shown to reduce the risk of eating disorders, as well as depression and drug/alcohol use. Third, encourage girls to volunteer and be involved in the community- whether it be community service, or involvement at church, being involved in something greater than yourself often helps one to gain a sense of purpose through a higher calling in your life. Talking and communicating with your daughters is SO important- talk to them and get feedback about the kind of support that they may need or want. Being able to communicate is so crucial, for both you and your daughter. For a few more pointers and helpful suggestions, follow this link to read some tips for communicating about body image, compliments of the Girl Scouts.

Circles of Protection

The other night I went to an event where I heard Becky McDonald speak. Becky McDonald is the founder of Women at Risk International (WAR), a nonprofit organization that serves women at risk around the world. Her goal in creating this organization was to create circles of protection around young women who are at risk of being sold into slavery and trafficking, as well as to rescue women from these situations, empower them, and communicate the message that they were created for purpose and dignity. She has a passion for giving young girls and women a voice and has worked hard to bring healing to women in over 18 countries.

Helping women (and especially adolescent girls) to find their voice is something that I have been passionate about for a long time. It is one of the reasons that led me to become a counselor. The context in which this has played out is pretty different than that which Becky speaks of, however, I believe that her message is especially relevant for the women and girls that I work with. Her message of God's hope and healing is one that we all need to hear, regardless of our circumstances or what we have been through.

So often, young girls in adolescence begin to lose their voices as they worry more and more about fitting in. They may pretend not to like certain things, or they may pretend TO like certain things. Sometimes girls silence their voices so much that they lose their sense of self; they hardly remember what they like, what they think or what they want. Many girls that have eating disorders experience feelings of powerlessness, and with powerlessness comes a silencing of the self. Other self-harm behaviors, such as self-mutiliation or cutting, are becoming more prevalent in the lives of young teenage girls as they seek to deal with their emotions and their inability to express who they really are for fear of not being accepted.

As a quick aside, To Write Love on Her Arms is a nonprofit that is dedicated to providing hope and light to people who are struggling with depression and self-harming behaviors, which are both so common in girls with eating disorders. Apparently, November 13 is To Write Love on Her Arms Day, although my source for this is facebook :). Whether or not this is a sanctioned day of awareness is pretty insignificant to me- I think any day is a good day to raise awareness-- and because it is November 13 and the theme of this post is giving girls a voice, I wanted to make sure to mention this. To read more about this organization and what they are doing, follow this link.

Creating circles of protection around young girls in our society is SO crucial- whether it is to protect them from slavery, or from cultural messages about body image, or both. How do we create circles of protection around girls? By restoring dignity, showing them their purpose, empowering them through education and skill building, as well as working to impact change on a large scale through advocacy. For more information on Women at Risk, visit www.warinternational.org.

Disordered Eating: The Disorder Next Door

In a previous post, I mentioned a website called Finding Balance that specifically addresses disordered eating. Finding Balance is an awesome faith-based nonprofit whose goal is to provide resources, support, information and encouragement for those struggling with disordered eating. The creator, Constance Rhodes, was inspired by the statistics of a study published in SELF magazine in 2008. The article in SELF, which discussed these statistics, was entitled Disordered Eating: The Disorder Next Door.

The article begins by stating that 6 in 10 women are disordered eaters, and 1 in 10 have eating disorders. This means that 70 percent of women struggle with food issues!! And I actually think that this number is even higher. Here is an excerpt from the article:

Eating habits that women think are normal—such as banishing carbs, skipping meals and, in some cases, even dieting itself—may actually be symptoms of the syndrome. Although disordered eating doesn't have the lethal potential of anorexia or bulimia, it can wreck your emotional and physical health, says Cynthia Bulik, Ph.D., director of the eating disorders program at the University of North Carolina at Chapel Hill and SELF's partner in the survey. And it's everywhere, afflicting women like your sister, your friend, your coworker—or you.

The online SELF survey garnered responses from 4,000 women ages 25 to 45 to a detailed questionnaire about their eating habits and found that most disordered eaters fall into one or more of six categories. Calorie prisoners are terrified of gaining weight, tend to see food as good or bad and feel extremely guilty if they indulge in something that's off-limits. Secret eaters binge on junk food at home, in the car—wherever they won't be found out. Career dieters may not know what to eat without a plan to follow; despite their efforts, they're more likely than other types to be overweight or obese. Purgers are obsessed with ridding their body of unwanted calories. Food addicts eat to soothe stress, deal with anger, even celebrate a happy event; they think about food nearly all the time. Extreme exercisers work out despite illness, injury or exhaustion and solely for weight loss; they are devastated if they miss a session. Bulik explains that many disordered eaters piece together a painful mix of destructive habits. Others may shift between categories over the years, ricocheting from restricting to bingeing to purging, for instance.

The article goes on to provide examples and illustrations of these different types of disordered eaters. One of my favorite quotes in this article from Cynthia Bulik, (who has been on Rachel Ray, the Today Show, etc and who is a local hero of mine, who I love), stands out--"Imagine what women could accomplish if they spent that time and energy on things other than body issues." This is SO true! I am not going to pretend that it is easy to change your thoughts and simply make this happen. This often requires some form of therapeutic intervention, or distraction skills and tools, or other coping methods. But think about what we could do to change the world with all of the energy, effort, emotion and thoughts that go into our struggles with food! Just think of the possibilities:)

To read this article in SELF magazine's May 2008 issue, click HERE. And for more info on Finding Balance, follow this link to explore the website and click here to see my previous post on it.