eating disorder therapy

The Messy Side of Clean Eating

Food can be complicated these days.

We are bombarded by messages about what's healthy and that can change on the daily. First, fat's wait, carbs are bad, fat is great, don't eat carbs just bacon and butter...all day...oh, but not coconut oil, it's the devil! Ok...maybe they don't say all that, but they might as well, at least then we'd know how whack those headlines are! So what are you supposed to eat to be healthy these days?

In the midst of all the noise, a lot of people have adopted "clean eating." Great. Reduce chemicals and highly processed food. That makes sense. And it does, but with all good things, balance is still needed and people can take it too far.  And that's where orthorexia can sneak in.

The National Eating Disorder Association states that someone who has "an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity." (

So how do you know you're dealing with orthorexia?

  1. Your gut nags at you sometimes when you're quiet and dialed in and whispers that something is off. Maybe even now you're fighting that voice or wanting to click to the next blog.
  2. Clean eating has taken priority over other values and goals and commitments. Maybe you don't go out with friends as much. Maybe you lie or make excuses to avoid situations where it's not organic or clean food. Maybe you're more focused on the food than the fun or connection in life.
  3. You're dealing with anxiety. Managing food or making sure you only take in clean foods makes you anxious. Or you have extreme anxiety or guilt over eating something non organic.
  4. Food takes on value and dictates your value. Food gets judged as "good" or "bad". And since you are what you eat, you label yourself "good" or "bad" based on what you eat. Maybe you've become judgy of others who don't eat like you. Maybe you punish yourself by being mean or super restrictive if you stray from your rigid rules.

Being healthy means being mentally healthy too. If the way you're managing your physical health is impacting your mental health, we can help. Contact me today. You're worth it!

Adventures in Neurofeedback - A Case Study

A 25 year old female came in for neurofeedback training at request of her therapist. This client was dealing with anxiety, an eating disorder, and difficulty tolerating and expressing emotions. These symptoms were chronic, since she was a teenager, but exacerbated by grief over her best friend's suicide. She had been doing intensive individual and group therapy, but kept noticing internal walls and blockages that kept her feeling stuck and frustrated.

Enter neurofeedback.

After 5 sessions she was sleeping better and able to complete a shift at work with only one cup of coffee (instead of her previous 4-6 cups). A month into our 2x/week treatment, her therapist called and said she cried in session. Typically she would get squirmy, use humor, or dissociate, but instead she was able to stay in her emotions and connect. After about 10 sessions, she reported that she had eating disorder urges, but she was able to notice them, evaluate them and label them as urges, notice underlying emotions driving her behavior, and often, not act on the urges.

By helping her brain regulate itself through neurofeedback training, she was able to use the tools offered in therapy and make major changes in her life.

If you think you might benefit from neurofeedback, shoot us an email or give us a call.


Food for Thought: Eating Disorders and Relationship Patterns

I've heard it said that "how you do one thing is how you do everything." Patterns we build permeate our lives. In my work with people with eating disorders, I have seen that people's relationships with food are often similar to their relationships with people. If "how you do one thing is how you do everything", then it follows that it would be helpful to notice relational patterns, put them in line with values, and capitalize on the potential for that change to influence other aspects in your life. Sometimes when you move social relationships towards values your relationship with food shifts as a byproduct.

Anorexia Nervosa

Relationship with food characterized as: avoidant, fearful, rigid, insufficient, shame around size and hunger.

How do those patterns show up in relationships? Maybe you isolate or avoid people or avoid situations (likely ones involving food, but probably others as well). Maybe you have social anxiety. Maybe you are rigid with socializing and keep a tight schedule or get nervous as plans change or interactions aren’t neat and tidy. Maybe your social interactions happen infrequently or are surface level and don’t sustain the human need for true connection. Maybe you are scared that being in relationships will feel suffocating or heavy or cause discomfort so you avoid them. Maybe you have a fear that you will be too much or need too much and end up people pleasing or keeping a distance in an attempt to stay small.

Bulimia Nervosa

Relationship with food characterized as: conflicted, chaotic, secretive, shame based.

How do those patterns show up in relationships? Maybe you seem to have a lot of conflict in relationships. Maybe you struggle with boundaries and when to say "yes" or "no" or "I've had enough". Maybe you experience extremes in relationships of being very close then very distant. Maybe you have guilt and shame over what you want or need or have done in relationships. Relationships may scare you and you struggle with keeping them in balance and tolerating the discomfort they can sometimes bring.

Binge Eating

Relationship with food characterized as: lacking boundaries, lacking sense of control, soothing or escapist.

How do those patterns show up in relationships? Maybe you struggle with knowing how much to give in relationships and end up people pleasing or going past your limits with relationships. Maybe in relationships you feel like you don’t have a voice or that voice isn’t respected when you set boundaries or express needs. Maybe you have a difficult time being alone and find people to fill your time, even when you know those people aren’t "good" for you. Maybe you have codependency traits and regulate your mood through focusing on others.

These lists aren’t exhaustive by any means and don’t account for individual differences. My intention is simply too spark curiosity. It’s not helpful to judge or justify patterns. Better to simply observe and then do what you can to align food and relationship patterns with long term goals and values.

If you notice that you resonate with any of these food or relational patterns, we are here to help. Please reach out by phone or online and we will be happy to talk with you.

Thanksgiving Day Tips for People with Eating Disorders

Thanksgiving can be hard for everyone.

It's a lot of people, a lot of preparation and clean up, and of course there's all manner good old f-ed up family dynamics. But this food focused day can be exceptionally hard for people with eating disorders to navigate. Here's a few quick tips to help you deal with an eating disorder during the holidays.  

  1. Keep your routine as normal as possible. Don't restrict or skip meals before dinner. Doing that may make it feel more safe, but it actually sets you up to be more anxious, less present, and more likely to struggle with diner if you go into the meal super hungry.
  2. Don't spend extra time around the food. Limit time in prep and clean-up of food. Being around the food more than necessary may keep you focused on food and more likely to be anxious, calorie counting, or triggered to binge. Instead, see if you can spend time with friends and family outside the kitchen. When possible, before and after the meal, distract, distract, distract.
  3. Don't drink much, if at all. That will make staying centered and grounded and connected more difficult.
  4. Remember that it's just one meal. Regardless of culture and family messages, thanksgiving doesn't have to be a gluttonous free for all. It's just a meal. No need to eat past fullness. That being said, it's just one meal. Even if you eat more than you usually do, you may feel uncomfortable and at the same time you're safe. Your anxiety and fullness will pass. One meal doesn't make or break your life or your body. Usually bodies are far more flexible and forgiving with food than your eating disorder mind is.
  5. Try to redirect your focus from food to gratitude and family. Food doesn't have to be the centerpiece of your day. The day originated as a way to celebrate friends and family and give thanks. Don't let your anxiety and eating disorder rob you of that. The meal can be challenging AND you can still feel and focus on gratitude. Be grateful that you have a meal to attend, that you are brave for showing up, that you have values you are moving towards (connection, family, love, humor, integrity, etc.) that are more important than your eating disorder.

If you or a loved one are struggling with an eating disorder, we are here to help. Contact us to schedule a consult.

That's Not Paleo

The paleo diet is about getting back to doing things how our ancestors did them. Great concept, but, thanks to marketing and bro-science, it may have led some people astray.

Just like with the Paleo diet, I believe we should be mindful of eating processed, packaged foods. I think we should be thoughtful about eating nutrient dense foods and not just eat whatever hyper-palatable shit pops up in front of our face. But at the same time, I don’t think we need to be food phobic and weigh and measure food, including every grain of quinoa, count every calorie we consume, and eat exactly the same meals day after day. That’s not what the cavemen did. They didn’t prove worth or exert control by being restrictive or disciplined with food and they probably didn’t freak out about how a night of consuming bear, berries, and beer around the campfire would fit into their prescribed macros. Cavemen  ate to survive and have energy to do tasks. They ate communally and were grateful for food.

I also believe in a healthy exercise regimen. I think we should move around, run, and lift heavy things to stay healthy and fit. Cavemen did those things to provide food and shelter and to play, not to punish themselves,  to compensate for the food they ate, or to compete to the point of injury. They probably didn’t say "well, my garmin says I ran five miles at 10mph yesterday to catch that deer, so today I have to run at least that far and I need to run it faster."

Several of the clients that see me for eating disorder therapy reported their eating disorder started innocently, in the name of going paleo. It then blossomed and was concealed in the context of restrictive diets and excessive crossfit workouts. Without a solid sense of self we can find identity in diet and lifestyle trends. Without mindfulness and ability to trust our intuition we can fall prey to relying on rigid rules, restrictions and regulations. The Paleo diet goes bad when we focus on  "WHAT cavemen did" and forget  "WHY caveman did it". They did it probably for two reasons: 1. Survival and 2. Community. If your diet and exercise are not helping you live your best life and connect with your family and community, it might be worth looking at it and asking yourself "what would a caveman do?"

If you are struggling with an eating disorder, or think you might be on the brink of an eating disorder, call us and we can help you work through it.