Authors: Kathryn Hansen
I intrinsically knew that binge eating really didn't help me cope with anything in my life; instead, it only made my problems worse. I knew that whatever temporary benefits binge eating gave me—like tranquil sleep, pleasure, excitement, or numbness—weren't worth the cost. I knew that binge eating only made my relationships suffer and wasted valuable time, and I truly wanted to stop; but I couldn't. It only seemed logical, then, to conclude that I binged for very complex psychological reasons. Otherwise, I thought, it would be easy to stop.
So, about six months after Greg and I moved into our new house, I began again to search for a complex answer to the question of why I binged. I asked myself:
What is the deeper reason for all of this? What is binge eating helping me cope with?
It wouldn't take me long to finally find the true answers to those questions—the answers that would propel me quickly into lasting recovery. Nevertheless, the answers were very surprising to me because they weren't complex at all. The answers were very simple, and they solved the mystery of my bulimia once and for all.
9
: A New Book and New Hope
I
t was a warm day in May 2005, the beginning of an extremely hot summer in Arizona. I had binged horribly the night before and was driving to the gym, planning to do six hours of cardio and some weights. I was exhausted and felt sick at the thought of working out; so instead of going directly to the gym, I stopped to procrastinate at a bookstore.
I made my way to the psychology/self-help section—a section I'd visited many times before looking for a solution to my eating problems. Over the course of my bulimia, I'd read about twenty books that I thought might offer help or a cure. I'd read self-help books on eating disorders, books about finding happiness, developing self-esteem, relieving stress, finding spirituality, and overcoming depression. Although some of them helped me with other problems, none of the books stopped my binge eating.
This particular day, I also wandered into the addiction/recovery section, thinking that I might find something more useful there. I felt as though my behavior was indeed an addiction, not so unlike alcoholism or drug addiction. I looked over the titles and came across
Rational Recovery: The New Cure for Substance Addiction
by Jack Trimpey, which claimed to be an alternative to Alcoholics Anonymous. I picked it up out of curiosity, because I had experienced Overeaters Anonymous (OA)—a spin-off of Alcoholics Anonymous (AA)—about six months before.
I'd attended a few OA meetings and read some of the OA literature. But OA hadn't felt right to me, mainly because the group advocated a very strict diet that excluded all white flour and sugar. I knew that restricting food groups, like fats and sweets, had helped develop my problem in the first place, so more restriction wasn't the answer for me. Certainly, I wanted to stop bingeing on sugar, white flour, and many other things, but I didn't want to stop eating them altogether.
OA, as I understood it, asserted that eliminating those food groups was necessary because overeating was a disease that caused one to lose control when eating white flour and sugar. OA's position seemed to be that the disease could never be fully cured, only managed by eliminating the problem foods. I already disliked being on a meal plan—which I thought was necessary for my recovery—and I especially didn't like the idea of a meal plan that excluded foods I really liked. I found the OA members to be very nice, but the meetings were discouraging to me. No one in the group, except the moderator, seemed to have had much success with remaining abstinent from problem foods or giving up overeating.
OA was also unappealing to me because of what I thought was a religious overtone. OA does not claim to be religious, but I interpreted the "Higher Power" to mean God—the Judeo-Christian God that I learned about as a child. I had turned to God for help with my bulimia in my freshman year of college, but it didn't help. I had naively expected God to take away my desire to binge, but eventually, I came to believe that God does not do favors; and although people can derive strength from spirituality and prayer, we ultimately have to help ourselves. By the time college ended, I struggled to have any belief at all and saw religion as primarily an academic pursuit. OA, then, seemed like the wrong fit for me.
Because of my lack of interest in OA, I was very interested when I found
Rational Recovery (RR).
Since the book claimed to be an alternative to AA, maybe it could be an alternative to OA as well, I thought. One sentence on the back cover caught my attention. It explained that
RR
disagreed with the idea of alcoholism as a disease and could give hope to those whom traditional treatment fails. This simple synopsis was enough to make me want to buy the book. Even if it turned out to be useless, at least it would distract me during the many hours on the treadmill, stair climber, and stationary bike. I purchased the book and drove to the gym.
RR
did much more than distract me from my workout. In fact, it did more to help me than anything else I'd tried before over the years.
RR
finally made me take full responsibility for my binge eating, then taught me how to do something about it—something specific and targeted to my real problem. I didn't know it at the time, but the ideas in that book would lead me to complete recovery from bulimia.
10
: My Two Brains
W
ithin five minutes of starting my workout,
Rational Recovery
in hand, I learned the book's central tenet: anyone can recover from alcoholism or another addiction whenever they want, without treatment. The author, clinical social worker Jack Trimpey, believes that AA does a disservice to alcoholics by promoting the
disease concept:
the idea that drinking is not under an alcoholic's control, but a chronic disease. The author points out that society at large also embraces this disease concept of addiction, which only encourages and excuses addiction by failing to foster individual responsibility.
Trimpey explains how he once shared AA's and society's view of alcoholism and how this only served to help him avoid responsibility for stopping his destructive behavior:
I believed that my desire to drink was irresistible, and that my own moment-by-moment drinking behavior was a symptom of something unknown and beyond my control. I sincerely believed it would take something besides my own critical judgment and self-control to take care of the problem. ... I surrendered to a highly gratifying belief that I drank for hidden causes and would need outside help of some kind to stop.
21
When I read this, I immediately recognized that Trimpey's former beliefs about his alcoholism were quite similar to my beliefs about my bulimia. Like him, I believed that my binge eating had hidden causes and was a symptom of deeper problems. I decided to read Trimpey's words again using a technique I'd learned from my brief experience in OA. I replaced the word
drink
in the text with the word
eat.
OA members perform this word substitution when they read material originally meant for alcoholics, like the 12 steps and the
Big Book.
Read that way, it was as if the passage came straight from my own experience in therapy. An eating disorder is different from an alcohol or drug addiction, but the similarities are plentiful. Whether someone is addicted to binge eating, drugs, alcohol, or any other vice, that person wants to quit but continues to drink/use/binge despite efforts to stop. Furthermore, the act of binge eating, the feeling of pleasure, the relief from desire, and the numbing effect of large amounts of sugar and fat can certainly be as reinforcing as the effects of alcohol.
I decided to read the rest of the book using the word substitution; however, I decided that for me, it was more useful to substitute the words
binge eat
for
drink
and
bulimic
for
alcoholic
(OA members traditionally replace
alcoholic
with
compulsive overeater).
I will use this word substitution throughout this chapter and any other time I refer to
RR,
even though I realize that substituting
binge eating/bulimic
for
drinking/alcoholic
does not create a perfect analogy.
As I read further, I began to think about my own treatment and how I'd come to believe that I was flawed, defective, and not in control of my own binge eating. I thought about how I believed I ate because of my depression, anxiety, and low self-esteem. I thought back to my first experience in therapy when I was 16, when I'd first encountered the disease concept of an eating disorder. I remembered the therapist telling me that my dieting and eating behaviors were merely symptoms of more difficult problems and part of an illness called anorexia. I'd been so put off by this concept of my eating disorder that I made a vow never to go back to therapy. Yet, when I'd returned to therapy in college, I'd come to accept the idea that I had some sort of illness and ate to cope with more difficult life issues. Even though my experience on Topamax had made me rethink what I learned in therapy, I still clung to the disease concept in many ways.
Not only does the disease concept foster addiction, says Trimpey, but the treatments that stem from the disease concept are not effective. This is because treatment for [bulimics] assumes [binge eating] is the result of hidden causes; therefore, therapy attempts to treat those causes instead of the [bulimia] itself and does not offer a direct way to stop [binge eating]. The treatments assume if you correct the hidden cause, the [bulimic] behaviors will unexplainably disappear. This was, in fact, what I had been trying to do in therapy for many years, without good results.
Trimpey says that therapists convince [bulimics] that [binge eating] is a symptom of another problem. Therapists say that you cannot be free of [bulimia] until you reach other important goals, so instead of working directly on your addiction, you work on reaching other goals in hopes that your [binge eating] will go away. But the [binge eating] does not go away, Trimpey says. Even if you solve such problems as "self-worth, self-awareness, relationships, and childhood conflicts, deprivations, and traumas, you are still left with your original desire to [binge eat]."
22
THERAPY'S IDEAS MAY HAVE BEEN HARMFUL
I was overwhelmed by what I was finding in
RR,
because this was the first time I'd read something that contradicted what I'd learned in my own treatment. For so many years, I searched for a hidden cause of my binge eating and tried to solve every problem I could think of; yet all my self-improvement work had done little to reduce my desire to binge eat. This was the first time I'd read something that suggested I could stop my destructive behavior without therapy or a long journey of self-discovery. It was the first time I'd read something that said recovery was not a difficult and life-consuming process. In fact, Trimpey says that trying to solve personal problems before recovery only wastes time and resources.
Part of me agreed with every word I was reading, because it explained why therapy had not worked for me. But another part of me resisted the information in
RR.
Maybe alcoholics could just quit, I thought, but eating disorders were more complicated. Wasn't it nearly impossible to self-recover from them?
That warm spring day at the gym, I realized that the answers weren't clear and had never truly been clear. I had sensed something was wrong with eating disorder treatment when I was 16; even after I'd accepted the idea that binge eating was a coping mechanism that fulfilled inner emotional needs, a small part of me had remained unsure. The doubtful part of me didn't know how to express the problem I sensed in therapy through the years; but
RR
finally made me understand why therapy had not been effective for me. Therapy was not solving the real problem.
If it hadn't been for my experience on Topamax in the summer and fall of 2003, I probably would not have been as open to the ideas in
RR
as I was. I probably would have resisted the concept that I could stop binge eating without solving my personal problems and without therapy. However, when Topamax was working, it temporarily corrected something in my brain that was generating my urges to binge, even as my other problems remained. Although the medication's effects weren't lasting, the experience had caused me to leave therapy, even though I still held to many of therapy's ideas.
Reading
RR
made me wonder if those ideas were actually hampering my recovery instead of helping it along. I began to wonder why therapy had led me around the problem instead of targeting it directly. Maybe I could get better, I thought, only if I stopped believing that I needed to travel a long journey of self-improvement in order to stop binge eating. Maybe I could get better only if I stopped trying to cure myself in a roundabout way. Maybe I could get better only if I stopped believing that I was using food to deal with unsettling emotions. Maybe I could get better only if I stopped believing that I had an illness and that I needed to become whole or become happy before I could give up my bulimia. I realized that solving my other problems might take a lifetime, but I needed to solve my real problem quickly.
ADDICTION IN LIGHT OF THE BRAIN
RR
suggested that this could be done by first understanding my own brain. Trimpey says that addictive behavior is understandable when viewed in light of this remarkable organ. He explains that addiction comes from a part of the brain that is older in terms of evolutionary history. This area, which Trimpey calls the "animal brain" or "beast brain," is responsible for maintaining our basic biological functions and ensuring our survival. The animal brain/beast brain is the primitive brain region that generates our survival drives for food, water, sex, oxygen, and other things that it senses are necessary for survival. The animal brain is automatic, unthinking, and irrational. It is buried in the central region of the brain and surrounded by the wrinkled outer layer—the cerebral cortex.
23
The animal brain is often referred to as the subcortex because it lies below the cortex; but I will continue to call it the "animal brain" and, later, the "lower brain." The animal brains of humans are nearly identical to the brains of animals, as well as to much older species.
The animal brain's function in humans is indeed fundamental to our survival as individuals and as a species; but when it comes to addiction, the animal brain works against us. When someone is addicted, the animal brain falsely believes that the addictive substance is necessary for survival and therefore drives the addicted person to the substance, as though it is just as vital as water or oxygen.
24
In my case, my animal brain believed that binge eating was a necessity, so that an appetite for binge eating got mixed in with all of my other valid survival appetites.
The animal brain expresses itself through what Trimpey has termed the Addictive Voice (AV). The AV is "any idea, feeling, or behavior that supports [binge eating]."
25
He says that a [bulimic] must be able to recognize her AV and separate herself from it, because the Addictive Voice is not really her voice. It is merely the voice of the animal brain. My animal brain was in control, directing my life as if large amounts of food were oxygen; I blindly followed the messages urging me to binge eat, unaware of their origin.
Trimpey encourages [bulimics] to observe their own thoughts and feelings using a thinking skill he calls AVRT® (Addictive Voice Recognition Technique). The thoughts and feelings that encourage [binge eating] are the AV, and those that support quitting are the true self. When a [bulimic] recognizes and understands her AV, then completely separates herself from it, recovery becomes effortless. She must get apart from it, Trimpey says, realizing that "it" is merely an appetite that originates in the "biological, animal side of human nature."
26
"It" is not really you.
"It" is housed in the animal brain, but the real you is located in a different part of the brain. The real you, or the true self, resides in the newer and more sophisticated part of the brain—the human brain, which is the part of the brain that developed most recently in evolutionary history. The human brain makes you yourself because it gives rise to your consciousness, self-awareness, identity, reason, memory, and intelligence. The human brain also controls your voluntary behavior because it houses the voluntary motor center, which controls any body part you can move voluntarily, including arms, legs, hands, mouth, and swallowing muscles.
27
To stop [binge eating], Trimpey says, you must know that your animal brain cannot make you do anything, because it doesn't have control over your voluntary muscles. Because the human brain houses your true self
and
your voluntary muscle movements, you—your true self—have ultimate control. In the case of bulimia, "it" cannot control whether or not the bulimic will open the refrigerator or drive to the nearest fast-food restaurant to binge. The only thing the animal brain can do on its own is send messages urging the bulimic to binge eat, but ultimately, the true self—residing in the human brain—is in control of what that person does upon hearing the call of the animal brain. Trimpey says that given the right information, the human brain is "able to suppress any appetite, able to defeat any addiction, any time you choose."
28
Trimpey says that once you decide to quit and fully commit to stopping your [binge eating], all you have to do is recognize the AV, realize that is not really "you" but instead "it"—the voice of the animal brain—and simply stop listening to it and letting it direct your actions. Even though you can hear and feel the AV urging you to [binge], you know the animal brain cannot act on its own, so you know you can always choose whether or not to binge.
Attempting to argue or reason with the AV is futile, he writes, because the animal brain is not rational and doesn't listen to reason. You only need to recognize it, ignore it, and it will soon fall silent. Trimpey says that once you learn to separate yourself from the animal brain and realize you are in control, your urges to [binge] begin to taper off, and stopping your addiction for good becomes easy.