Brain Over Binge

BRAIN OVER BINGE

Why I Was Bulimic, Why Conventional Therapy Didn't Work, and How I Recovered for Good

Kathryn Hansen

Copyright © 2011 by Kathryn Hansen

Camellia Publishing

6825 S. 7th St.

Box 8305

Phoenix, AZ 85066

www.camelliapublishing.com

Printed in the United States of America

All rights reserved. No part of this book may be reproduced or transmitted in any form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the written prior permission of the publisher.

ISBN: 978-0-9844817-2-9

Library of Congress Control Number: 2010911736

NOTICE OF LIABILITY: This is a personal story of recovery. It is not intended to replace the services of trained health professionals or be a substitute for medical advice. You are advised to consult with your health care professional with regard to matters relating to your health and, in particular, regarding matters that may require diagnosis or medical attention. The author and publisher disclaim any liability arising directly or indirectly from the use of this book.

This book is for the 19-year-old bulimic who felt hopeless yet swore to conquer her problem one day and then write about it.

That bulimic was me ten years ago. ...

So now I dedicate
Brain over Binge
to my former self and to all those who want to be free of binge eating.

Contents

Preface

A Note to the Reader

Introduction

PART I: MY BULIMIA AND RECOVERY

1 A Typical Day's Binge

2 A Typical Day of Purging

3 Choice and Consequences

4 Introduction to Therapy

5 My First Binge

6 Accepting Therapy

7 Topamax to the Rescue

8 Some Things Change, Some Remain the Same

9 A New Book and New Hope

10 My Two Brains

11 I Had Control All Along

12 Resisting the Urge

13 The End of My Bulimia

PART II: MY BULIMIA REDEFINED AND RECOVERY EXPLAINED

14 Investigating the True Story Behind My Bulimia and Recovery

15 Was I Really Recovered?

16 Why Did I Binge?

17 What Caused My First Urges to Binge?

18 Why Did I Diet and Why Was It Such a Problem for Me?

19 Why Did I Continue Having Urges to Binge?

Reason 1: Persistence of Survival Instincts

20 Why Did I Continue Having Urges to Binge?

Reason 2: Habit

21 Why Did I Follow My Urges to Binge?

22 Why Didn't Therapy Work for Me?

23 Revisiting Recovery: How Did I Do It?

24 Brain over Binge, Step 1: View Urges to Binge as Neurological Junk

25 Brain over Binge, Step 2: Separate the Highest Human Brain from Urges to Binge

26 Brain over Binge, Step 3: Stop Reacting to Urges to Binge

27 Brain over Binge, Step 4: Stop Acting on Urges to Binge

28 Brain over Binge, Step 5: Get Excited

29 Is Relapse a Possibility?

30 Where I Am Today

PART III: THERAPY CONCEPTS REEXAMINED

31 Normal Eating

32 Body Image, Weight, and Dieting

33 Low Self-Esteem

34 "Coping"

35 Triggers

36 Purging

37 Coexisting Problems

38 Medication

39 Prevention

40 Bridges to Traditional Therapy

41 Conclusion

Notes

Bibliography

Acknowledgements

Preface

"[A]n eating disorder provides solutions to one's problems in life and is not simply about food and weight."
1

I
n November 2007, two and a half years after I recovered from bulimia, I visited my doctor about some stomach pain. I told him about my past eating disorder, because I thought years of binge eating could have caused some damage to my digestive system. Even though I made it very clear that I had not binged in a long time and was no longer bulimic, he asked me, "Do you think your eating disorder is—" He hesitated, so I finished the sentence for him: "Gone?" Then I answered my own question with a simple "yes."

"That's great," he said. "So I assume you sought help?"

"Yes, I did go to therapy, but then I realized it was just a habit and I quit."

A look of interest, or perhaps doubt, came across his face. "Well," he said, "I'm sure your bulimia was fulfilling some need."

Fulfilling some need ...
the words struck me, and suddenly, I felt as if I were sitting in a therapist's office again.

I was attempting to write this book at the time but wasn't making much progress. I found new motivation that day. My doctor's comment made me realize that there is a big problem with the way bulimia is viewed, not just among therapists and patients, but throughout society.

Today, eating disorders are primarily thought to be symptoms of psychological problems like depression, anxiety, low self-esteem, and family conflicts. Eating disorder experts assert that the destructive eating behavior signals an inner emotional crisis, just as fever indicates an underlying infection.
2
An affected individual supposedly uses the eating disorder as a coping mechanism to deal with issues and feelings she can't face in her life. In this way, eating disorders are thought to fill an important need or void in the person's life—a need that is much more than physical, which is why it's so common to hear that eating disorders are not about food.

I believe that the widespread view of bulimia as a complicated problem that helps victims fill some sort of emotional need is a shaky hypothesis at best; and in practice, it can be downright harmful to people suffering daily with incessant urges to binge and purge.

A bulimic typically seeks therapy because she can't seem to stop eating large quantities of food. But in therapy, she learns that food really isn't the problem—the problem is her personality, her inability to cope with life, her childhood, and/or her relationships. In short, she learns that she is psychologically unwell. No one tells her exactly how to stop the behavior she so desperately wants to stop. There are no specific directions, no pinpoint cure. No one tells her that she has the power to stop binge eating anytime she chooses. Instead, she learns she doesn't have much control over her own behavior—that is, until she addresses the underlying emotional issues.

So the bulimic sets out on a path of self-discovery, hoping to find some answers to why she binges, hoping that if she makes some changes in her life, heals past hurts, or builds new relationships, the incredible urges to binge and purge will go away. She learns to deal with depression, reduce anxiety, and build healthy self-esteem. She works on her nutrition, battles her perfectionism, and learns to cope with the events and feelings that supposedly trigger her binge eating episodes. She tries to figure out what purpose the bulimia serves in her life. But all the while, she continues to binge and purge.

This was my story for six years. After an initial reluctance, I embraced therapy. I embraced the view that my bulimia was about something more than food; I embraced the idea that I was using my eating disorder to cope; I embraced the idea that I was ill, that I needed professional help to get well, that I needed to get to the root of my problem before I could quit. I did everything I was supposed to do in therapy, and when it didn't work, I tried different therapists, slightly different approaches. But all this had the same result: I remained bulimic.

I don't blame my therapists because, after all, they were only trying to help me and they were always sensitive and supportive. Therapy simply didn't empower me to stop binge eating, and there are many like me who have had the same experience. Although there is a wide range of recovery rates in the available literature, current therapies for binge eaters do not come close to curing everyone. There is no consensus on exact recovery rates because of problems in research, including a limited number of studies, study design flaws, differing definitions of eating disorders and recovery, different treatment types, and patient withdrawal from studies.
3
However, bulimia recovery rates are not encouraging, and "we still have much to learn about providing truly effective treatments for eating disorders."
4

One study showed that, after treatment, 50 percent of bulimics maintained bulimic behavior with episodic remissions and 20 percent remained symptomatic.
5
Another showed that, three years after treatment for bulimia, one-third of women binged every day, one-third binged less than once a month, and one-third fell somewhere in between.
6
Even the treatment considered most effective for bulimia—cognitive behavioral therapy—eliminates binge eating and purging in only 30 to 50 percent of cases.
7

These statistics show that although therapy does help some bulimics, it does not help them all. Therefore, alternatives are needed. After talking to my doctor that November day, I felt a strong desire to provide an alternative. I realized the view of bulimia as a coping mechanism is so pervasive in our society that it is generally accepted as fact, even by those outside of the therapy community, like my medical doctor. I decided that a new voice was urgently needed—a voice to challenge this orthodoxy and reach those who are not being helped by this view of bulimia. I also want to give hope to those who are not currently seeking therapy, because about nine out of ten people do not receive treatment for their eating disorder.
8

Fulfilling some need
... I thought about those words over and over, trying to understand why my doctor's simple and innocent comment kept lingering in my mind. I reflected on my experience in therapy and how the experts led me to believe that by binge eating, I was using food to cope with my problems, stuff down emotions, or fulfill a more complex psychological need.

Then I thought about the way I changed once I'd decided to view my eating disorder differently: by dismissing the belief that I ate for deeper, more profound reasons and, in turn, completely changing how I approached my problem. I'd discovered another path to recovery, a simple and quick way to stop my bulimia—without therapy. I have completely stopped bingeing, and I have had no desire to do so in years. I believe that I am at zero risk for relapse, even during stressful times in my life. My bulimia is over.

When I was consumed with my struggle with bulimia, I vowed that if I ever found a way out, I would write a book to help others find their way too. Sometimes I still can't believe that I've now written this book, because for a long time, recovery seemed so elusive. But my recovery is real and permanent; and now I want to share my story with others so they can end their own struggle. I want to share my alternative approach, in hope that I can be a voice of change, a voice for those who are frustrated with therapy or who simply can't afford it, a voice that helps many escape the daily torment of bulimia.

When you are caught up in bingeing and purging or starving, you don't grow and you miss moments you'll never get back. I lost valuable years to my eating disorder, and I don't want anyone else to do the same. I am here to tell you it's possible to end your eating disorder right now and get on with your life.

Maybe traditional eating disorder treatment hasn't helped you thus far. Maybe self-help books you've read, while inspiring, haven't truly empowered you to stop your binge eating. Maybe you've tried many paths to recovery that only led to dead ends. Maybe you've realized, like me, that it may take a lifetime to transform into the person you want to be; but you are quickly grasping that you can't wait a lifetime to stop your bulimia.

Granted, we all want to become something greater than we are. We want to live with grace, love ourselves, and pursue our dreams unhindered. But that may not be possible for you right now. Maybe you can't even think about flourishing in other parts of your life until you conquer the most pressing issue—the thing that's holding you back: your destructive eating habits.

I hope my personal story of recovery can give some people who are plagued with bulimia the courage to expect a cure, and I hope my practical advice will give many bulimics their lives back. I hope I can change some people's attitudes about what bulimia is all about—people like my doctor and my therapists who believe that bulimia
fulfills some need.
If I can change one person's mind, give one person hope, or save one person's life, I will have done enough.