The acceptance part of Acceptance and Commitment Therapy

I've mentioned before that I'm applying Acceptance and Commitment Therapy ideas and practices to my binge eating and overeating problems. I think the Wikipedia article on ACT is fairly informative and it will help any readers out there make sense of what follows.

I recently finished Get Out of Your Mind and Into Your Life: the New Acceptance and Commitment Therapy by Steven C. Hayes and Spencer Smith. Reading this book has made me realize several things, and I believe the advice in the book can help me carry out the high-level instructions contained in Brain Over Binge.

In Brain Over Binge, Hansen describes how she started viewing her urges to binge as "neurological junk" emanating from her lower brain, and how that new perspective allowed her to stop acting on those urges. She explains that she stopped fighting the disturbing thoughts that encouraged her to binge and purge (she was bulimic): she stopped arguing with them and stopped engaging them altogether, instead treating them as not even worthy of her attention. She was no longer frightened of whatever her lower or "animal" brain threw her way because she understood her real self, her Highest Human Brain, to be way more powerful than the animal brain. She could listen to the lower brain chatter as if it were a tape recording and remain calm, and she understood herself to be safe from her urges because her Highest Self was in charge of motor control: no urge could MAKE her use her arms, hands, mouth, and throat to gather food, put that food into her mouth, chew it, and swallow it.

These were (and still are) really exciting concepts for me. For several weeks after reading Brain Over Binge, I enjoyed a very new, very profound sense of security. I am more powerful than my urges! Those seemingly scary urges can't MAKE me do anything! I had never thought or felt that way before.

But as time went on, things got a little messier. I had trouble distancing myself from my urges. I had eating episodes that made me feel unsafe: even if my Highest Human Brain was more powerful, even if "loss of control" was only perceived loss of control and thus an illusion, my lower animal brain was one hell of a contender. Hansen's point, however--and it's a perspective I encountered again in Buddhist meditation training as well as in ACT--is that the tug of war is supposed to stop. It's not supposed to be lower brain versus higher brain in a gruesome fight to the death. A lighter touch is called for here.

On one level, I understood it then and I understand it now. On another level, don't I want my Highest Human Brain to triumph? Don't I want the old addiction wiring to fade away, to leave me in peace? Sure I do.

And that's a big part of the problem. After reading the ACT book, I had to face up to the fact that I never truly ACCEPTED my binge thoughts/urges/cravings. I wanted to disassociate from them and ignore them as fast as possible, because I thought that would de-fang them: Lower brain junk, not worth my attention, moving on... In other words, I would quickly acknowledge "I'm having the thought I want to binge on x or y" but only as an attempt to control or manipulate my internal experience by creating distance between myself and the thought. I used meditation practices with the same intent. In truth, I remained frightened of my thoughts and urges, irritated by their repeated intrusions into my consciousness, and very anxious to eliminate them once and for all.

Honestly, I'm still scared of my cravings and urges. I haven't learned to accept them "fully and without defense". I'm not yet "willing to welcome them unconditionally", in the parlance of the ACT book. (Again, because I still find them threatening and ugly.) I don't really want to listen to what they have to say. Thus far, I've tried to silence my lower brain and its contents in two ways: give it what it's asking for immediately (i.e. binge) so it won't go on howling, or disassociate from it as quickly as I can.

ACT suggests I stop trying to silence it, period. And to be sure, ACT does talk about creating distance between ourselves and our thoughts--the book I just finished calls this process "defusion", because you stop fusing with your thoughts and start looking AT them rather than FROM them. But before you can defuse from the thoughts in your head, you must accept what's there. You must give up the problematic habit of experiential avoidance--of attempting to avoid unpleasant thoughts, sensations, urges, feelings, etc.

So I'm working on acceptance right now. I'm trying to maintain a stance of curiosity: What are my binge thoughts? What are the urges? How can I experience them as fully as possible? How can I get acquainted on all levels? I admit I don't know exactly how to do this, but the ACT book has exercises I can try as a starting point. I'm hoping I can get to a place where I accept that the thoughts and urges might be with me forever, or at least might pop up regularly for the rest of my life. This kind of acceptance is supposed to happen without a hidden agenda; you aren't supposed to "accept" troublesome thoughts or urges on the basis that doing so will make them fade away, for example.

It's REALLY hard to not have a hidden agenda such as this.

I guess, right now, I have to accept how confusing and complicated this all seems to be. I have to accept that a problem 30 years in the making will not vanish overnight.

postscript: To be clear, Hansen's book is not the reason for my struggle and I don't mean to misrepresent anything the author has said. I may have missed some of the nuances of her arguments or I may be having trouble following through with her advice for any number of reasons (differences in temperament, differences between binge eating disorder and bulimia, etc.). I see ACT and Brain Over Binge to be highly complementary: they talk about many of the same ideas and techniques, but ACT provides specific exercises/practices to try while Brain Over Binge illustrates how the underlying principles can help someone overcome an eating disorder. It is an informative memoir rather than a step-by-step manual.

FEW in review: Mar 19-25

Monday, March 19:
7:45 am - turkey jerky, coconut-almond KIND bar
12 - deli turkey slices with gouda cheese slice
note: I fell to pieces after this. Horrible day emotionally: feelings of depression, serious fighting with husband, PMS, and total lack of mindfulness or even the capacity to care about my eating and habit change goals.
many graham crackers with chocolate frosting--maybe 4 total crackers?
several pieces of toast with butter, jam, etc. I think 4 pieces.
It's not that I was trying to comfort myself with these foods so much as there wasn't much in the house, I was totally unwilling to cook, and this was the easiest thing to grab. So I did. I just didn't care.
turkey-guac-spinach-cheese sandwich that tasted like nothing, since I had been crying. (Food always tastes bland or terrible to me when I've been crying.)
Water? No idea. No exercise.

Tuesday, March 20:
KIND bar; 2 pieces of toast--one with butter, one with a slice of gouda
2 graham crackers with chocolate frosting
13 Cadbury mini-eggs (mindful) with a glass of milk. OVEREATING.
burrito made with chicken breast, green and red peppers, onions, tomatoes, carrots, and avocado. Good! I'd never made this before but it easy and filling.
went to BodyPump class
gym scale says: 254
Eating attentive today. Not enough water.

Wednesday, March 21:
half a turkey & bacon panini, half a small piece of quiche, coffee
chicken-pepper-onion-carrot burrito; 12 Cadbury mini eggs (mindful)
pasta with peppers, kale, and meatballs
KIND bar and a few more mini eggs. OVEREATING.
Eating mostly attentive, but had dinner in front of TV because I was with someone else who wanted to do so. I need to learn how to say no in these situations without feeling embarrassed. I still feel like a fat person that doesn't want to be difficult or weird about food and eating because doing so will draw more attention to my problems. One way of minimizing attention is to go with the flow and just do whatever everyone else is doing, whether it's actually working for me or not.

Thursday, March 22:
egg McMuffin, hash brown, orange juice
potato chips and Cadbury mini eggs (mindful)
burger, fries, and Sprite
Ate some fries while driving, which was inattentive eating. Experiencing more and stronger cravings than usual tonight, and there's mental chatter about not drinking enough water, not exercising enough, and everything else I'm not "enough" at in the dieting realm. Honestly, I think hormones are contributing to my moods and urges today.

Friday, March 23:
Cadbury mini eggs & chocolate malted candy eggs: BINGE.
KIND bar
roasted cauliflower
Can't remember the rest of my meals!

Saturday, March 24:
Cadbury mini eggs & chocolate malted eggs
horrible piece of cake with strawberry sauce and whipped cream: BINGING.
spaghetti with kale, peppers, cheese, meatballs; eating in front of TV.

Sunday, March 25:
ham, cheese, and baby spinach sandwich
angel food cake, strawberries, and whipped cream: BINGING.
half a mocha
leftover veggie spaghetti and meatballs

I've been binging the last three days

And it's awful. It's not fun or pleasurable. It's highly distressing.

In terms of amounts, my binges are way smaller. The first two days, it was Easter candy and today it was angel food cake and whipped cream. But smaller amounts are little consolation. And frankly, I'm GLAD my standards are changing. I want them to. I'm glad I now find eating 6 servings of malted milk balls in a day to be alarming and depressing instead of no big deal. (The package contained a total of 7 servings, and it was hard for me to not finish the box just for the sake of finishing it.)

One of the frustrating things about blogging is that I say something one day, and truly mean it--such as when I declared the other day that "I no longer feel compelled to finish things just for the sake of finishing things"--and then days like today, I have to turn around and announce that I was wrong. Something will occur that shows me I haven't moved entirely past this issue or that behavioral tendency, and then I feel embarrassed about my earlier statements. I try to be conservative in my proclamations to avoid this very thing, but it still happens.

How did I fall into binging again? Well first, I felt urges to binge for three straight days. On the evening of the third day, I developed a killer headache. That was my breaking point. I was beyond frustrated that the urges did not abate for three days despite my efforts to ignore them, neutralize them, distract myself, calm myself through meditation...none of my regular techniques worked. I was already raw from that, and add a bad headache and a really monstrous period and I just didn't care anymore. I wanted relief from the urges to binge NOW and there was one surefire way to accomplish that: binge.

So, I now know what my current breaking point is. It used to be I couldn't withstand the urges for mere hours. Now I can tolerate up to three days of irritating urges before giving in, but I can't tolerate four days or five days. And I guess can't tolerate the urges coupled with severe physical pain. When I say "can't", I mean that my firsthand experience indicates I cannot YET do it; that my skills and strength aren't sufficient for that level of challenge.

The next time I face a real challenging stretch of days, I may do much better. Maybe I'll be better at disassociating from the urges, better at calming myself, or better at interrupting my behavioral patterns by then.

One might wonder why I felt urges to binge for three straight days in the first place. I think many of the things that have historically triggered my urges to binge simply happened simultaneously: hormones and a very atypical period, problems in two of my closest relationships, health worries, exhaustion from special errands I was doing for someone this week, rumination over career concerns, and more. It was an uncharacteristically bad week. Yet these triggers didn't make a binge inevitable. All these triggers would have amounted to nothing had I dealt with the urges they sparked in a more skillful way.

All this has reminded me of what Hansen says in Brain Over Binge--

1. Life is messy and it's impossible to control or avoid triggers, especially when you have lots of potential triggers. So the answer lies in dealing effectively with the urges you experience, not in directly managing/tackling triggers.

2. I binged to get rid of my urges to binge. The urge to binge IS the disorder itself.

3. By binging, I reinforced my brain's problematic wiring. Each day of binging was more extreme than the day before, and I felt increasingly out of touch with my Highest Human Brain/Highest Self as the binging went on.

I must become calm and non-reactive in the face of my urges. I'm trying to figure out how to do that consistently. It's led me to try meditation, work on Acceptance and Commitment Therapy exercises, and more. I marvel at how Hansen was able to just...stop. So quickly. She understood how her brain was tripping her up, decided to look at the urges she experienced through a different lens, and made rapid progress from there. If I play the comparison game too much, I start to get scared that I'm "doing it wrong" or that "this approach won't REALLY work for me." But rationally I know that just because something is difficult doesn't mean my approach is faulty. (Quite the opposite, usually!)

I admit I miss the honeymoon period I enjoyed when I first finished reading the book: things seemed very clear and easy to me for a few weeks. I still consider Brain Over Binge a fantastic resource and a trusty map forward! But more and more, I feel like the real work is just beginning for me.

Julia Kozerski

I just saw these amazing photos-- self-portraits taken by a young woman who has lost 160 pounds. Her honesty and bravery amaze me, and she was featured on cnn.com today.

Check out her work!

Not-so-merry go round

I went to the grocery store nearest my house for the first time in awhile. I used to get most of my binge foods from there, but this store was never my choice for actual comprehensive grocery shopping because their stuff is overpriced.

The store was always good for picking up an item or two in a pinch, though. Yesterday I needed to pick up milk and tortillas quickly, so I went there. I also knew I wanted Cadbury mini eggs; I love them and enjoy a bag around this time every year. I entered and walked to the left, through the produce section, then looped around the perimeter of the store to get to the tortillas and the dairy aisle at the rear of the store.

Later, when I reflected on having walked to the left, I was surprised and pleased. I used to enter and head right immediately and unthinkingly. The ice cream aisle is the rightmost aisle in the store, so I would go there and check out if Ben and Jerry were dealing anything new before proceeding to the other sections of the store. I would do this whether I was on an official binge run or had come to pick up garlic and oranges.

After my grand entrance, the trip still had its little challenges. I did look at many of my old favorites and feelings of longing did crop up. I wanted to buy several things and not necessarily polish everything off in an hour of frenzied eating, but at least sample a bunch of different sweets. This is that new gray area I keep talking about--where binge eating tendencies blend into overeating tendencies and I'm unsure what to call certain things. Was that an urge to binge? Was it a craving to overeat?

Does it matter? Probably not. Neither one should be acted upon.

I considered many purchases: various types of Easter candy, Little Debbie Nutty bars, ice cream and popsicles. But nothing was compelling enough, besides those Cadbury mini eggs I had already planned to buy. And the thought kept occurring, as I looked at one thing after another, that I could always come back and get it later if I really wanted it. The limited edition ice cream will be there tomorrow. I could find all the same Easter candy next week. And they'll still be selling Nutty bars when I'm dead. Those aren't going anywhere. As I passed on each thing, I thought "Eh. Maybe later."

That's a new thought for me. I mean, I always "understood" the food wasn't going anywhere, but I'd tell myself that--and tell myself I could get it later--in the harsh tone of an exasperated adult talking to a bratty child. In this internal conversation, the adult was mean and impatient, and the child didn't really believe the adult. 9.9 times out of 10, I would end up buying the food.

Last night and earlier today I was patting myself on the back for my unattached attitude in the store. More mental and behavioral progress! Hooray! But then tonight--oh, you guessed it!--I felt the urge to go buy a box of Nutty bars and eat half the box before my husband gets home from work. A clear urge to binge. I believe I know what triggered this urge and I'm not acting upon it--in fact, I noted my unpleasant urge and then promptly sat down to write this post to pass the time until my husband arrives--but I felt dismayed at having experienced such an urge at all. And I felt scared, like this (fleeting!) craving was proof that a potential binge still lurks around every corner.

Yet reacting emotionally and labeling an urge as "bad" or "threatening", or labeling oneself as a failure for having various urges, is exactly the kind of thing that one must gently train themselves to stop doing.

Round and round and round it goes.