Health knowledge made personal
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Her binging and purging has abated at last, only now she’s
restricting. He’s finally increased his food intake, meeting the goals we had
set. Only now he’s taken up running—with a passion. She’s adhering to her meal
plan, eating all that her body desperately needs. But at present her
self-injurious behaviors have flared up.
As I sit with my patients I feel a bit like Temple Grandin, the autistic woman depicted in the movie by the same name , who visualized most
everything she heard. Whack A Mole comes to mind quite frequently as I hear
their stories. No, nothing too sophisticated or deep—just Whack a Mole. You
know, that carnival game where you have a mallet and the goal is to hit as many
of those furry rodents as possible that pop up out of their holes. It goes like
this—you hit one, and just when you’re feeling pretty good about it, rather
accomplished in fact, another rears its head, causing you to pounce on that
one, too. And so it goes. If you do really
well, you get a small, cheap stuffed animal—one that costs about a fraction of
the money you just spent entertaining yourself. Here’s where this analogy ends.
Real life Whack a Mole, aka eating disorder recovery, is
anything but entertaining. But the reward is invaluable. And while it, too, may
have its costs—time for appointments, increased anxiety, a sense of loss of
identity and of control—the rewards are immeasurable. Surely you could come up
with a list of the benefits?
The carnival game analogy crosses my mind with many non-eating disordered patients struggling
with weight management, as well. This I visualize more like the shell game—the
old gambling game also played on city streets. Three shells are placed on a
table, with a pea beneath one of them. With rapid moves of the hands, the shell
guy shifts around and around, and the player struggles to identify where the
pea is hidden until all hope is lost—by the player, that is.
The connection, you’re wondering? Patients often start off
frustrated that their efforts to shift their behaviors, to make a difference, are
in vain. They trick themselves into believing that after completing their
workout, a reward of a Starbucks frozen beverage topped with caramel and
whipped cream is in order. Or while dining out, they choose an entrée they feel
good about, only to eat a portion that significantly exceeds their need. Or
they choose what they deem a healthy snack, consuming it mindlessly in front of
the TV, failing to acknowledge or to experience the pleasure of what they’ve
consumed, ultimately leading to more overeating. And as a result they feel
hopeless, that they can’t win at this challenge.
Naturally, this is reasonable at times. But what is senseless is the assumption they have been
deceived, like in the shell game. Their expectation is that weight loss should
be occurring, given all the work
they’re doing, all the changes
they’ve made. Yet in reality, sometimes they are simply just moving the shells
around, so to speak.
Finally, we are sometimes likes hamsters in the wheel of life . We go round and around, doing nothing differently at all. And
doing the same thing over and over when our experience tells us it just isn’t
working for us, doesn’t move us forward. Uggh, more frustration.
It’s my hope that these visuals will provide you with more
than just entertainment. Rather, may they inspire you to be more constructive—to
act on your motivation, to challenge your thinking, to break from your
behaviors—like Temple Grandin, who exceeded, I suspect, even her own expectations,
living with a condition for which there is no easy fix. |
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