Couldn't not...is that English? Or is that nit picking...hehehe!

I am glad to see I am not the only one who uses the double negative....you did say you were from where....deep south somewhere right?
I have the excuse I was educated here.

As for nitpicking, no such animal...it is being observant, forthright, organized, managerial, authoritative, organized, capable, ...did I say organized?....It's all of that, and checking it thrice, so there! I am sure I am not OCD, but none of my friends seem to agree...OCD is the Hallmark of a good nurse. LOL. Is it nitpicking if it's my own post? Okay, NOW I'm obsessing.

(This EDS post has really done well in all seriousness. I have really gained alot from it).

Mockingbird, I've always been the same way. My mom used to drag me to nutritionists and my basic response to each of them was, "Hell no, you're not telling me what I can and can't eat!"

Mockingbird thank you, hmmm, 'glutton', i will rethink that and maybe journal this issue, i've not faced it before, we'll see what comes up.
lol, don't get me started on words or grammar, sometimes the wrong words just come out, you are too funny. lol

In Dr. Costin's book, she also addresses the question whether a nutritionist should tell a patient exactly what to eat. Costin's proposed best answer is:

"Sometimes I develop meal plans for clients. In other cases, after the initial assessment, i find certain clients would be much better off without a specific meal plan. In those cases, I usually suggest other forms of structure to help clients move through their eating disorder. Those who most desire a structured meal plan, for example, compulsive eaters, will benefit the least from them, while those who tend to prefer not to have a structured meal plan, such as anorexics, often benefit from them.

I have an ED patient in my group right now, with bingeing disorder (no purging). She tells stories of being told as a girl that she was too heavy to get married, and how "you'd be sooo pretty if you just lost weight!" She was the typical ED girl: caring for all others but feeling selfish when someone cared for her; expecting to be exploited if others were kind to her; feeling clumsy and foolish and stupid in public, and terrified to speak up for herself.

I told her last week that frankly I wasn't worried about what she ate, and wasn't going to tell her to change a thing about it. (this, incidentally, is usually a necessary first step with an EDS, or else they won't trust you and will see you as someone trying to control them). i said that instead I wanted to see her become stronger. Her homework assignment was to speak up at least once a day in group and express a need to us, and once a day to "stand up" to me and challenge me in some way. That could mean disagreeing with me, pressing me for clarification, giving ME homework, etc. The rationale was to break the habit of being long-suffering and silent, while using food to suppress emotions.

Well, it worked BIG time. I also noticed that she likes to stay "in her head" with her emotions: she want to know why she feels what she feels, etc. This kind of curiosity is really healthy when it's someone who hasn't let herself think before, but in her case it was safety: "I'm hurt because..." followed by an analysis of why she feels something. As long as she kept asking the question ("why did this happen? why do I feel this way?"), she was subtly avoiding the real, painful fact that things DID happen to her--period.

I told her in group that it was time for her to reconnect with those feelings and not condemn them as selfish. I said "instead of saying 'I'm hurt because...' and then explaining your emotions, I want to you just express them. Look me right in the eyes. Now simply say, 'I'm hurt...I'm hurt...' over and over. Nothing else, just that."

She looked me in the eyes, and as soon as she said the first "I'm hurt", she melted into sobs. She tried to get back into her "safe" mind by adding, "I don't know why I'm feeling this way, I just..." I cut her off and said "you're spinning out back to that 'mind' stuff. Get back to those feelings."

As she wept, you could have heard a pin drop in the room. Later, the other women said they were each feeling, "I need to do that same thing too, but I'm sure glad Matt didn't call on me." For some of them, the words would be "I'm scared...I'm scared..."

After she was done she said a weight was lifted. Her headache was gone, she could breathe. I cautioned her that later she might feel selfish for "taking up group time" and "being so open" and "forcing others to take care of her." She reported the next day she had indeed felt all those things, "but I remembered what you'd said, and I didn't let myself do that to myself." She also ate veggie sticks instead of cake when she felt that way, and I hadn't even told her to do that!

wow, that's a great strategy.

it's the really simple things that trigger those types of emotions for me. honestly i wish someone would ask me to do the same.

thanks for sharing this.

gasp..... all so familiar

I'd love to work more extensively with ED, but treatments typically take 2-5 YEARS (!!!), not the 2-5 weeks that insurance companies pay. I see these articles like "New trends in psychotherapy offer short stays" at http://dailystrength.org/blog/129-new-trends-psychotherapy-offer and I just want to scream! Not at the author of the article, but at the ridiculous idea that these are new trends in therapy, when they're not. They're new trends in insurance company profit management! Therapy hasn't changed! This is so frustrating to me because I know what would work in treatment of an ED, and I'm at least competent, but what we see are patients who get a minimum of treatment (unless they come from a millionaire family that can pay $1000/day for the specialized in-patient services) which merely stabilizes them and then discharges them.

When I was hospitalized in NO, there was one woman there who had been hospitalized going into her fifth month of treatment. She was still struggling with some issues, but, she was doing so much better than the newer ones who came and went while she was still there. I have great faith she will be one who recovers, but I think they played the insurance game by using her various diagnoses to allow her more time.

It was really sad to me, but one of the women whom I grew very close to while I was there, she just couldn't force herself to eat. She hid the food in her milk carton, and in her jacket pockets. Then she'd go and empty out her pockets in the toilet. I didn't have any idea how to help her. We were given a packet of info, one page told us things NOT to say, but we maily just suffered for them in silence. I did tell my nurse about my friend so maybe they could see what she was doing. It made me feel bad to do it though.

It sounds like the staff knew what they were doing. The WORST thing you could do is engage in a power struggle over her eating. I see this in families a lot: they may believe (or a misguided therapist may even instruct them) that they should control her diet, monitor her, and negotiate and cajole her into eating. This simply forces her to begin more clever ways to hider her disorder, or to fear that you are conspiring to make her fat, or that you don't understand. A better approach has been to address underlying beliefs and values that relate to the ED, while not engaging in surveillance and commentary about her eating. If a woman with an ED feels attacked, she spends her energy reinforcing the walls of the fort rather than rebuilding her own strength. Families have a hard time accepting this because they fear that the therapist is misguiding them in some way that will tolerate their daughter's/sister's slide toward death.

#58 if I didn't know better I would swear that was me........maybe I'll try that next week, I need to do something.

Bump, for person who asked for help with Anorexia Nervosa

This is stupid but I like to cook and sometimes when I'm cooking I'll kind of zone out and then think about the past and then when the food is done I won't eat it. I'll tell my husband I already ate. I just don't want the food anymore. Its like its poisoned. I've gone once it was 2 days without eating anything because of that. I don't think it's really an ED, because it's not about my weight, though.

I need help with something related, and I can't talk to my therapist about this yet. I want to bring it up but each time I even so much as think about it I get sick to my stomach. This is disgusting, I'm sorry, but I can't stand the sight of stuff like mayo or egg whites or white sauces. I know its gross and I don't mean to be disgusting but its like that triggers. I know I have a whole lot of stuff I"m still not dealing with, and I know I need to, but I don't know how to bring this up and I can't talk about it with him but it really really bothers me. I was thinking about writing it out and giving it to him in a letter and saying I'm not ready to talk about this. Is there a smarter way of doing this? I want him to know I am actually TRYING. Thank you.

Hi Ronnie...fancy finding YOU here...lol. First, I'll respond cuz nobody else seems ot be here right now. The issue with cooking the meal and then not wanting the food...well, there is more than just the not eating that you are saying here. First, it is that you "zone out" about the past, THEN you don't eat. Like, if 'A' didn't happen, would 'B' happen? If you weren't raped...you'd have nothing to be zoning out over, so you would still cook, but you'd eat it. SO YOUR ISSUE WITH EATING IS DIRECTLY RELATED TO YOUR RAPE. Eating disorders aren't about weight or body image....they happen because of other issues than that, so you can't discount the possibility because you aren't distressed about your weight.

Your second issue I share. I throughly understand that egg whites and things of the like can be triggers for you. I have that issue as well. How I handle it is...shoot, I guess it is by avoidance. I'd like to state some great and wondrous way I have beaten that as an issue, but, simply put - I don't like anything that reminds me of certain aspects of the rape. I avoid those things. Not a fix, mind you...so hold on to this part until someone else responds here.

I have a huge issue at work. I am a Nurse and I work in Urology. I had decided I could come back to this field because I had done it for so many years unaffected....now, not so easy. We do tons of surgery, most in the hospital, but one very easy, in-office procedure is a vasectomy. So, the surgery isn't the issue. BUT, the semen samples after the surgery are a huge issue for me. I try to avoid making the slides for the doctors. To set up a slide, you have to mix the sample with two long sticks...they 'pick up' the semen, and you dot it onto a slide, then put a cover slip over the sample so it can be viewed under the microscope....just opening the specimen cup can put me in a semen-induced haze. I can't stand the viscosity, the smell....none of it. So, again, I avoid dealing with it as much as I can, without it being noticed. But, when no one else picks up the sword....I tend to try to do it and mentally think of it as a challenge to get through. Perhaps someone has some better ideas here.

Mockingbird thank you SO MUCH for saying you have the same issue. I hate feeling like I'm a freak, so to know someone else feels the same way makes a HUGE difference!!! Thank you so so much. Avoidance works for me so far. The other issue I'll talk with my therapist about next week I guess.