Authors: Kathryn Hansen
It can be very difficult to convince yourself that there is a monster, an evil woman named Mia, or an abusive man named Ed living in your head. Even though the characters are just metaphors and can be useful for some people, many simply can't embrace the idea of these characters seriously. It can be quite a leap for some people to think that their urges to binge are manifestations of a foreign personality who wants to see their demise.
On the other hand, it is fairly easy to see bulimia or BED for what it really is: a habit—a physical expression of a binge-created brain-wiring problem. It's not a monster; it's only neurons firing automatically because of repeated binge eating. It's not an abusive husband; it's the lower brain, doing its job to maintain a habit.
But for those who like the idea of giving their bulimia or BED another name, if it helps conceptualize the fact that urges to binge are not really the true self, then great ... so long as the eating disorder sufferer always remembers that Ed is the binge-created brain-wiring problem—not the "I," but also not a being with bad intentions, not a malicious or abusive ogre aiming for her demise. Ed is only doing his job—driving the bulimic to maintain the habit she's created. She has taught Ed well, and now he automatically does what he's been taught.
2. Current Separation Techniques Allow the Avoidance of Responsibility
"Ed made me to do it." This can become the motto of someone who uses current separation techniques. When a woman separates her true self from Ed, she may then feel she is at the mercy of Ed and so can blame him for her actions. This does not help the woman assert control over her problem; it only helps her assign blame to something other than herself. In short, it can help her avoid responsibility. I am not claiming that Jenni Schaefer's
Life Without Ed
does this, because it is indeed a powerful story of someone who stood up to her eating disorder and took back her life. However, it is possible for a woman to use the persona of Ed/Mia/the Monster to avoid accountability for controlling her own behavior.
The binge-created brain-wiring problem—or whatever term is used for the habit—has no ability to control the binge eater. Her ability to make conscious choices and to control voluntary muscle movements is unaffected by bulimia and BED. The habit cannot make her go to the refrigerator and put food in her mouth; it can only urge her to do so.
3. Current Separation Techniques Require Unnecessary Battles
Imagining an eating disorder to be an evil persona, a monster, or an abusive man living inside your head means you have to believe you need to defeat it. In my opinion, this causes unnecessary battles. If the bulimic believes Ed/Mia/the Monster is out to get her, it follows that her job will be to counter the attacks with attacks of her own, with fighting back. As already discussed, fighting with urges to binge is useless and can therefore make the bulimic even more frustrated, more angry, more tired. In the long term, it is simply an ineffective strategy.
Not only that, but such battle tactics are likely to make the urges stronger, consequently making the bulimic more prone to follow them. Why? Because by fighting the urges head-on, attention is being turned to them, and this gives them strength. As I talked about earlier, when you focus attention on urges, it amplifies the neural firing that produces them. This, in turn, makes the neural connections that produce the urges even stronger. By fighting with the urges to binge, you are telling your brain to sharpen its awareness of that urge—to pay attention to it; and this only serves to make the urges stronger and the fight more difficult in the long run.
It is a fruitless war. You cannot simply argue your way out of urges to binge. The thoughts and feelings are so automatic that no matter what rational reason there is for not bingeing, the brain will produce a compelling counterargument. Further, it's nearly impossible to lay out a convincing argument to Ed when part of the bulimic fully agrees with him.
I believe it's much more useful to listen to the lower brain's seemingly logical reasons to binge without giving those thoughts any mental focus. This means not fighting with thoughts and feelings, not white-knuckling, not arguing with a fictional mental character. This means not giving urges any attention and simply letting them come and go instead of allowing them to draw you in. This means creating as large a gulf as possible between the highest human brain and the urges.
4. Current Separation Techniques Do Not Draw the True Self/Disorder Separation Line Clearly
Another danger of current separation techniques is that too many problems, thoughts, and emotions are often assigned to the character/persona. A woman may begin attributing all her negative thoughts and feelings about her body, and all of her food issues, to Ed/Mia/the Monster. For example, she could imagine the Monster to be behind any craving for sugar—whether or not it's a craving to binge; she could assign all anxious and depressive feelings to Mia, all negative body concepts to Ed.
This can cause constant confusion about who is talking in your head. It's very possible to lose the abilities to trust one's own thoughts and recognize one's own voice. This is why, in this book, I want to draw a very clear line of separation: your urges to binge are on one side of the line, and you—your true self, your highest human brain—are on the other side. Sure, there may be some problems on the "you" side, such as low self-esteem, perfectionism, anxiety, body image and food issues, and it may be desirous to change some of these things. But to start, the binge eater needs to stay focused on the one problem she's trying to solve, clearly drawing the line between her urges to binge and her self.
5. Current Separation Techniques Can Be Too Playful
Bulimia and BED are dangerous and potentially deadly disorders, and giving the problem a playful name or persona doesn't capture its seriousness. Some women who binge say that the disorder becomes their friend or becomes like a child or pet they need to nurture. Giving the habit a playful name can sometimes contribute to befriending or nurturing bulimia or BED. In reality, bulimia or BED has no personality—it is an automatic function of the lower brain. It is not the bulimic's friend. It is holding her back and endangering her life.
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: Brain over Binge, Step 3:
Stop Reacting to Urges to Binge
O
nce I separated my highest human brain from my urges to binge, it became possible to stop reacting to my urges, meaning that I stopped letting my urges to binge affect me emotionally. Until I separated from the urges, I was emotionally overwhelmed by them. I let them make me mad ("I hate having these cravings!"), frustrated ("I am doing everything right in therapy—I can't believe these urges aren't going away!"), depressed ("Poor me, I want to eat so much, but I know I shouldn't"), anxious ("I am scared that I will binge tonight"), desperate ("I need to binge—now!"), or—when I was on the brink of giving in—excited ("I can't wait to eat").
Reacting emotionally only gave my thoughts power, strength, and the ability to influence me. When I let my thoughts and cravings make me mad, frustrated, depressed, anxious, or excited, I allowed them to take over my whole body and state of mind—and usually lead me right to food. However, after I separated my highest human brain from my urges to binge, I stopped paying attention to these thoughts and feelings, and I therefore became emotionally numb to them.
With distance between myself and my urges to binge, I could experience them as if they were playing on a tape recorder, as if they were not my own thoughts and feelings. They were only the results of neurons firing down well-worn pathways in my lower brain, and they didn't have any power to affect me. Once I stopped relating to them, my urges to binge stopped upsetting me.
As long as I stayed apart from my urges, they had no power over my emotions, and I no longer had to fear them. I could experience them without it being a big deal. I could go on with my life, do what I needed to do, despite those little buzzing thoughts and feelings encouraging me to binge. I didn't need to get upset that my urges were there—because I knew they would burn out before long.
When I say I stopped reacting emotionally, I don't mean I was always able to control my emotions, nor was I trying to. Indeed, emotions, which originate in lower, more primitive parts of the brain,
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cannot always be controlled and are often resistant to higher-order, rational thought processes.
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I didn't try to rationalize with or will my emotions away; I simply changed my perspective so that the harmful emotions naturally settled down. I didn't tell myself,
Don't get mad at the urge,
because angry feelings sometimes arose beyond my control. Instead, I visualized distance between myself and my urges so they no longer had the power to make me angry. I didn't tell myself,
Don't be depressed that you can't binge,
because depressed feelings sometimes came without my conscious effort. Instead, that new gulf between myself and my urges meant that they no longer had the ability to make me depressed.
This step also involved giving up the idea that I had to figure anything out. I no longer attempted to determine the deep psychological reasons for an urge; I didn't try to find out what triggered my automatic thoughts and feelings; I didn't try to solve any of my other problems to make the urge go away; and I didn't seek out other forms of emotional nourishment in an attempt to suppress the urges. I simple let the urge be, without getting caught up in it.
The ability to stop reacting emotionally to urges flowed naturally from my new knowledge that the urges were separate from my highest human brain. In other words, Step 3 flowed naturally from Step 2. In turn, Step 4 flowed naturally from Step 3, and Step 4 was the cure for my bulimia.
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: Brain over Binge, Step 4:
Stop Acting on Urges to Binge
N
ot only did separating myself from my urges give me the power to stop reacting emotionally to them; more importantly, it gave me the capacity to stop acting on them. This fourth step defined my recovery, because once I stopped acting on my urges to binge, I was no longer bulimic. I was cured.
I finally realized that I had the ability to stop putting too much food in my mouth; and I felt powerfully that my actions were not out of my control. My brain, my neurons, my habit couldn't make me do anything. I could finally hear my faulty brain activity for the farce that it always was, and it became relatively easy not to act. My recovery was nothing more than learning to say no.
I didn't have to substitute any other activity for those inappropriate motor actions my lower brain had me doing in the past, like standing by an open refrigerator putting too much food in my mouth, or driving to fast-food places and gas stations to waste money on binge food. I didn't have to distract myself with a hobby, physical work, phone calls, or journaling. I didn't have to do anything productive. I didn't have to find a way to meet my emotional needs. I just went about my day as if I were not experiencing an urge to binge, and sometimes—if I had nothing else to do—I just sat or lay down to listen to my brain with detachment.
I actually came to enjoy hearing thoughts and feelings that encouraged me to binge without acting on them, because it gave me a great sense of power. I liked to simply listen to those urges with complete detachment. I often thought back to the days when those urges had controlled me, and I reveled in the fact that I was back in the driver's seat. I loved that I could trust myself again.
It wasn't a struggle for me to not act on my urges. Sometimes it wasn't an enjoyable experience, either, but it was never a fight. When I was first getting used to viewing my urges as "not really me," there were a few times when I doubted my ability not to act on them, when I temporarily lost the separation of my highest human brain from my urges. If I started thinking it
was
really me who wanted to binge, I could get wrapped up in my cravings; and this is why I binged one more time after making my commitment to quit. After my slip, I was able to look back and see when I had stopped listening as a detached observer of my lower brain and had started relating to my cravings. I saw that I had simply failed to put brain over binge and thus had been swept away by a wave of faulty neural activity. I was even more determined not to let it happen again.
WHY THE URGES WENT AWAY
My urges to binge tapered off quickly after I stopped acting on them. In
Rational Recovery,
Jack Trimpey says this will happen. He writes that the voice encouraging use of the addictive substance will fall silent if it is ignored. However, I still wondered,
Why did this happen? How did my urges simply disappear? Is my bulimia merely hiding out somewhere in my brain, waiting to take control again?
Jeffrey Schwartz's OCD study, discussed earlier, finally gave me an answer to these questions. Schwartz's work explained why my urges to binge had disappeared and taught me that my bulimia was certainly not waiting to take control again. By avoiding acting on my urges to binge, I had physically changed my brain so that my bulimia no longer existed.
By teaching his patients to use mindfulness and think differently about their urges, Schwartz gave them the power to turn attention away from the urges, stop acting on them, and improve their OCD behaviors. What is more, he found evidence that these improvements were accompanied by real, measurable, physical changes in their brains.
When the treatment began, the pathological brain circuitry of the OCD patients dominated, and they were submitting to their OCD urges. However, over the course of several weeks, as they changed the way they "thought about their thoughts, "
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they were able to produce "systematic changes in the very neural systems that generate those pathological messages. "
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The result was not only a change in their behavior, but also a dampening of metabolic activity in the regions of the brain whose previous over-activity caused the OCD symptoms.
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Schwartz gave his patients what he called "an avenue to self-directed neuroplasticity."
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Neuroplasticity, as you will recall, is the ability of the brain to physically change based on our thoughts, experiences, and actions.
Thus, the patients' willful choices not to act on their urges fed back into their brains, creating the physical changes that made the choices subsequently easier and easier. Schwartz says, "Though OCD symptoms may be generated, passively, by the brain, the choice of whether to view those symptoms as 'me' or 'OCD,' whether to become ensnared by them or focus on a non-pathological behavior, is active. The choice is generated by a patient's mind, and it changes [the] brain."
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This was the first study of its kind to show that therapy without drugs can change faulty brain chemistry.
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Indeed, the changes Schwartz identified on the OCD patients' PET scans "were the kind that neuropsy-chiatrists might see in patients being treated with powerful mind-altering drugs."
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I believe that, just like Schwartz's OCD patients, my mind (my true self) changed my brain. My highest human brain vetoed each and every urge, and in doing so, I rewired my lower brain. My lower brain learned that I no longer binged, and it therefore stopped urging me to do so. Again, when it comes to the brain, what you no longer use, you lose.
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Once the neural connections that fueled my binge-created brain-wiring problem were no longer useful, my brain weakened them and pruned them. In other words, once I put brain over binge, my bulimia was over.