Reality! Who needs it?

Individuals in recovery have generally spent a lot of time avoiding their painful, shameful or fearful reality. Using chemicals, relationships, busyness, spending, eating, not eating, fantasy, gambling, sex, etc. to escape reality.

What is your reality anyway?

As a baby, your brain was in a receptive mode and you downloaded and duplicated everything around you. As you grew up, you kept imprinting within you, all of the thoughts, feelings, beliefs, and things that happened and you became you.

From Pia Mellody’s Model of Developmental Immaturity, we learn that this programming creates a belief system. You interpret everything that you perceive through your own belief system, particularly as you interact with others. That’s why people frequently disagree about a shared experience. For example, let’s say that Jason had a disagreement with his sister while they were at a social event and shared about it with several friends. Sara identifies with Jason’s sister, feels empathy, and defends her. Jennifer is reminded of being embarrassed by her mother in public and feels pain and shame. Mark feels annoyed about the very topic of conversation and thinks about something else. Everyone has his or her own reality.

In emotional recovery work, it is extremely helpful to understand your reality and how to work with it. First, your reality is your experience in the present moment and includes your body, thoughts, feelings, and behaviors. Think of a recent time when you felt reactive in an interaction with someone and experienced some strong feelings come up. Now, breathe, take a moment, and fully experience the sensations in your body. Those sensations inform you about your feelings. Identify what the feelings are. Is it pain, hurt or sadness, or is it fear or anger? If you are not used to identifying your feelings, it can take some practice. Truthfully, your feelings are generated by the thought you had. When you are reactive, it’s hard to think straight and it can take some time to identify what the actual thought was, or where in your history it originated.

The most helpful way to think about this is with curiosity and owning it rather than judging yourself or blaming someone else. You are in a disempowered victim mode when you blame someone else for your reaction and that keeps you stuck. When you own that your reaction came from your own programming, then you are empowered to understand yourself better and can change.

So how do we do that? How do we change our reactivity, our thoughts, and feelings, and why go through the trouble? 

Scott Peck wrote, “Mental health is staying in REALITY at all costs.” You’ve had those experiences when you are fully present, connected with yourself, aware of your senses, and feeling alive. Joy, passion, love, and the sense of connection with yourself are present moment experiences. You miss out on life when you are not present. Everyone checks/spaces-out at times; it is the human condition. However, the more present you are, the happier and healthier you will be.

Here are the steps to working with your reality when you are triggered or become reactive:

• Take slow deep breaths and be curious about what you are experiencing and why it is coming up.
• Notice and describe to yourself the sensations you are feeling in your body and identify the emotional feeling word or words that fit. (Hurt, fear, anger, irritation, shame, guilt, for example.)
• Stay present and curious about the feelings or issues that are underneath the surface feelings. It could be abandonment, feeling threatened or unsafe, used or manipulated, blamed, shame, guilt, or a memory of an incident from your past. You could discuss this with a therapist.
• When appropriate, you can own your own experience in the present moment and share it with that person you were reactive to by using your talking boundary. For example, in the previous story, Jennifer becomes very quiet and moody. She might share with Jason, “When I heard you say that your sister made a scene at the family dinner, what came up for me was a time when my mother was embarrassingly loud and rude in public and I’m feeling some shame and pain.” In sharing her reality in this manner, Jennifer’s friends will understand her better and she will likely have a sense of relief from the pain and shame.

Only do this when you feel like a functional adult. Listen to the other person’s reality. Be open to getting to know them and to learn about yourself.

Practicing this will likely bring insight as to how the programming in your brain hijacked the situation and gave you a distorted reality. That insight creates a new reality, even a new neuropathway in your brain. This practice begins to create a new, healthier, happier reality, which makes it easier for you to be present. So who needs reality? We all do.

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Understanding the Difficult Eating Disorder Patient

By Vicki Berkus M.D., Ph.D., CEDS, Remuda Ranch Medical Advisor

When they first begin treatment, patients often struggle and insist on “doing treatment their way.” I tell my patients’ families that they can typically expect a phone call after two or three days, during which they are likely to hear, “Get me out of here! They don’t understand me!”

To gain some insight into what a patient’s experience was like I went undercover and entered a treatment program as a patient struggling with laxative abuse. I packed my suitcase, hid laxatives in my hair and in the handle of my suitcase and walked through the front door.

My process as a patient started with the intake interview where I had to tell a complete stranger some of the most private things about me.

Once I was admitted, I was given an exam gown and my luggage was removed to be searched. I had to change into the exam gown in the shower so that the nurse could see whether I was hiding anything. Then, I was again questioned and went through a physical exam. I had blood drawn, an EKG, and weight taken without hearing or seeing the results. I then was allowed to eat and read the orientation packet.

I was exhausted after three hours of being somewhere I didn’t want to be, talking to people I didn’t trust and having no support (or perceiving that I had no support.) Throughout my stay, I was told when to eat and when to sleep, and had most of my personal items taken from me and locked away.

Finding Empathy for Struggling Patients

I knew as a doctor and eating disorder treatment professional that the purpose of all of this wasn’t to make me feel like an infant, but to make sure I was medically stable and safe in that environment.

Many of our patients don’t quite understand that. They are angry, tired, lonely, and scared. It takes courage to go through treatment.

My insight increased over the next few weeks as I ate with peers, attended Family Week, and sat in process groups observing the patients’ progress. Overall, it wasn’t an entirely pleasant experience for me; I can’t imagine having an eating disorder in my head and trying to go through this process. I’m glad I had a chance to experience it first-hand so that I would not longer have to base my assumptions on my limited perception.

Today, I tell my patients that I don’t expect them to like treatment or even want treatment; but, if they know deep down that their way isn’t working to just do it anyway. I think the key when trying to help eating disorder patients is to set boundaries and be firm while including incentives in their treatment that they can earn.

Starvation, biochemical changes in the brain and body while re-feeding, and co-occurring mood disorders all exacerbate the disease and the lack of control over emotions and behaviors. I think back to my residency days when I was on call every other night (at age 43) and remember that without proper sleep and nutrition, I was not fun to be around.

Think about the last time you were trying to function without the right amount of sleep or food, and try to remember how you felt when dealing with your patient or loved one as they enter into eating disorder treatment.

Remuda Ranch Can Help

The experienced staff at Remuda Ranch at The Meadows understands the pain that eating disorders can bring. There is hope. We can help you or your loved one get on the road recovery.

Our beautiful campus in the heart of the Sonoran Desert offers patients large rooms, indoor and outdoor horse arenas, a swimming pool, and a challenge course. Among the lush landscapes, patients are surrounding by peace and tranquility while they work with our team to overcome their eating disorders and dual diagnoses, and find peace within. Call us today 866-390-5100 or reach out online.

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Q & A with Remuda Ranch Senior Fellow Jessica Setnick

What led you to Remuda Ranch?

As far back as I can recall I have been intrigued by the behavior of people around me, and trying to understand why we fall into certain patterns. This led me to major in anthropology in college, studying the long-term development of human behavior. When I took nutrition as an elective, my interest was piqued by the individual psychology of eating behavior. My fascination with the combination of cultural and personal influences on eating brought me to a desire to help individuals with eating disorders.

I was hired out of school by Children’s Medical Center in Dallas, as it began to develop an eating disorders treatment program. I started out spending half my time in pediatric psychiatry and the other half in endocrinology. Within two years, the eating disorder program had blossomed to the point that five dietitians replaced me when I left.

In 2000, I opened Understanding Nutrition, my private practice, which I loved. As other professionals came to me for advice, I started teaching Eating Disorders Boot Camp workshops, writing The Eating Disorders Clinical Pocket Guide, and traveling the country as a speaker. After 13 years, I closed my practice in order to concentrate on providing professional education. My hope was and is to educate primary level providers to identify dysfunctional eating behaviors in their early stages, so that no one goes for 20, 30, or even five years alone and afraid with an eating disorder.

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