COUNSELING CENTER

Improving Self-Esteem: An Antidote to an Eating Disorder

Melissa H. Smith, PhD

 

What is self-esteem?

What is the relationship between self-esteem and eating disorders?  

• Development of Eating Disorders
• Role of Feelings & Food

 

How does one improve self-esteem?

How to help a friend

 

"Are you waiting to be skinnier, thinner, more toned, more tanned, better dressed,

sexier, more lovable, nicer, smarter, funnier, or wealthier before you really begin your life?  Millions of us are.  And it's a complete waste of time.  Body obsession and the quest for perfection are destroying our lives, and we are willing partners in this destruction."

- Jessica Weiner, in Do I Look Fat in This?

 

What is Self-Esteem?

Self-Esteem & Identity

• Internal Characteristics

- Know your heart

- Develop your inner qualities

- Honor your uniqueness

• Accomplishments

- What you are capable of

- Don't compare

- Don't judge what you can't do

 

Perfectionism          vs.          Excellence

         obsessive                                 consistent

         rigid                                            flexible

         unreachable                             obtainable goals

         secretive                                    self-disclosing

         productivity                                 process

         guarded                                      open   

         sensitive                                     approachable

         critical                                          kind

 

What is the Relationship between Self-Esteem & Eating Disorders?

• Diagnosable psychological, medical, and nutritional problems
• Among the most difficult disorders to treat and overcome
• Highest mortality rate of all psychiatric disorders
• Serious, all-encompassing illness

- Not about food

- Not about vanity

- Underlying emotional difficulties

• Development of Eating Disorders  
• Coping behavior for unresolved psychological distress

- Traumatic life experiences

-Difficult family and peer relationships

- Low self-esteem

- Depressive or anxious feelings

- Lack of positive coping behaviors

• Conditions for an Eating Disorder

- History of traumatic events

- Being ignored or neglected

- Sensitive, kind and tender heart

- Unclear sense of self & personal identity

- In need of healthy, happy role models and patterns for living

- Being sensitive to social messages & other environmental variables

- Feelings of insecurity, low self-esteem, confusion

- Unable to critically analyze messages & behaviors of others

- Perfectionism

- Distorted beliefs about self, others, situations, and events

- Emotional pain

- Lack of positive coping behaviors for emotional pain

• Danger signs indicating an Eating Disorder

- Caloric restriction, binge-eating, secretive eating

- Extreme preoccupation with food (preparing food for others, shopping for others, reading recipes and food magazines, thinking and dreaming about food or binge-eating)

- Distorted body image

- Abuse of laxatives, diuretics, enemas, diet pills

- Excessive exercise

 

• Signs & Symptoms

- Actions suggesting need for perfection

- Low self-esteem, which motivates need for achievement & perfection

- Extreme sensitivity

- Obsessive & compulsive behaviors

- Over-achievement

- Lack of self-confidence

- Drastic weight changes

- Changes in eating habits

- Excessive exercising or over-training

- Frequent trips to bathroom

- Refusal to share feelings

- Frequent excuses

- Lying

- Chewing a lot of gum

- Drinking a lot, especially diet drinks

- Avoiding food at all times

- Guilty feelings after eating

- Social isolation

- Watching what others eat

- Loss of interest in enjoyable activities

- Binge-eating with no weight gain

- Comments about purging food or calories

- Weakness, fainting, etc.

- Red eyes

- Calluses & blisters on knuckles

- Comparison of body, beauty, etc. with others

- Depression

- Tendency to order food in small amounts

- Solving other's problems, but ignoring one's own

- Avoiding any contention at all

- Self-harm or suicidal thoughts

- Wearing baggy clothes to hide

- Avoiding responsibility

- Preoccupation with food

- Defensiveness about food, weight, etc.

- Obsession with dieting, calorie-counting, low-fat foods, diet pills, laxatives, etc.

• Intersection between Emotional Pain & Development of Eating Disorders

- Learn to use food to distract, comfort, soothe, numb or sedate feelings

- Learn to use food to relieve tension & stress

- Belief that a certain look or weight offers a potential promise of helping one be happy, popular, beautiful, etc.

- Set of beliefs that promotes the use of disordered eating as healthy & useful

- Social pressure to participate in disordered eating patterns

• Emotional Consequences of an Eating Disorder

- Low self-esteem

- Distorted thoughts & feelings

- Loss of emotional equilibrium

- Feeling under attack

- Feeling of hopelessness & helplessness

- Becoming numb & checking out of life

• Low Self-Esteem

- An eating disorder produces feelings of shame & guilt, which perpetuate & increase one's feelings of low self-esteem & destroys one's sense of self

- Hypersensitivity

- Perfectionism

- Pleasing others

- Externally focused

- Feelings of shame & humiliation

• Distorted Thoughts & Feelings

- About family, friends, athletics, social activities, and just about everything else

- Distorted perception of self; assumes others share this distorted perception of the individual

- I am bad, therefore others think I am bad also"

• Difficulty developing accurate thoughts about anything

 

• Eating Disorder Belief System  
• During the course of an eating disorder, one's beliefs change to an almost opposite orientation from one's normal way of being

- Self-centeredness in contrast to a loving nature

- Extreme need to please

- Fear of social situations, resulting in withdrawal

- Extreme need for social validation or approval

- Irritability with mood swings impacting relationships

- Increased reliance on hiding, lying, secretiveness

- Reduced ability to say "no" & maintain healthy boundaries

- Lack of assertiveness

- Fears & avoidance of physical & emotional intimacy

- Decreased ability to ask for help

• Loss of Emotional Equilibrium

- Lack of balance or perspective in one's life

- Decreased awareness about the world around

- Confusion

- Feeling awkward & exposed in social & family settings

• Feeling under Attack

- Constantly on guard

- Paranoid about what others are thinking or saying

- General anxiety & fear of many social situations

- Difficulty relaxing & feeling peaceful

- Minds focused on negative thoughts & potential disasters

- Inner battle between fear of success & failure

- Anxiety makes it difficult to achieve with confidence

- Results in half-hearted attempts & failures

• Feelings of Hopelessness & Helplessness
  • With increasing life challenges, a felt sense of failure and hopelessness

- "I can't handle the pressure"

- "I can't succeed in school"  

• Experience of actual & perceived failures contributes to negative beliefs about self
• Lose hope for the future

 

• Becoming Numb & Checking Out of Life

- Pain of emotional consequences so overwhelming that individual stops feeling

- Dulled reactions & little interaction

- Eating disorder used to "numb out"

- Difficulty maintaining commitments

- Going through the motions of life

- Critical point. . . Increased risk of suicide

• Social Consequences  
• During the course of an eating disorder, most individuals turn away from social support because the perceived demands of relationships are overwhelming

-"I can't meet their expectations"

- "They think I'm a failure"

- "I'll never be good enough"

- "They would be better off without me"  

• Reduced interaction of any kind with others
• Strained relationships with family
• Loss of friends
• Loss of social interactions
• Fear of being in public
• Inability to engage in athletics or other social & school activities
• Inability to successfully engage in school work

 

• Role of Feelings

- Anorexia, Bulimia, and Compulsive Overeating never exist in a vacuum

- These disorders don't occur in an otherwise satisfied, productive, and emotionally healthy person

- It's a destructive myth to believe that the only problem is the eating behavior

• Hidden Feelings

- An eating disorder is not merely a problem with food or weight. It is an attempt to use food intake and weight control to solve unseen emotional conflicts or difficulties that in fact have little to do with either food or weight

- An eating disorder is never simply a matter of self-control

- Healthier eating habits or stronger willpower are not missing ingredients that will make the problem disappear

 

• External Solution to Inner Turmoil

- A focus on body size is a way to convert a worry about something inside to something outside.

- "Am I good enough?" becomes "Am I thin enough"

- The sufferer creates an external and measurable scale of her self-worth that offers her a less painful and more comprehensible way to cope with her fears

• Eating Disorders as Avoidance of Feelings   

"If you avoid certain situations because you're worried about the outcome, you never get to learn what would have happened if you had faced those situations.  You deprive yourself of the chance to see how you would have coped.  When you decide to avoid, you experience a temporary state of relief, but you're also feeling powerless and deflated, as if you can't control your own behavior.  Eventually you become discouraged and disheartened as a vague sense of feeling paralyzed sets in.  This is how avoidance slowly eats away your self-confidence over time. . . Push yourself to be vulnerable-this allows you to learn that you can handle whatever happens, and that even the most difficult of emotions can't destroy you."

- Holly Hazlett-Stevens in Women who worry too much

 

Improving Self-Esteem  

• Awareness of Feelings

- Our negative feelings are more likely to lessen when we are able to talk about them. When we don't express them, they accumulate

- Present-day disappointments, losses, angers, and fears can become intertwined with the old disappointments, losses, angers, and fears, making it difficult to separate old issues from new issues

• Improving Self-Esteem

- Strive to understand your feelings

- Cultivate positive self-talk & quiet the inner critic

- Develop healthy body image

- Learn to trust

- Face your fears

- Take responsibility, & let go of the rest

 

• Understanding Feelings

- As you proceed to explore feelings, be aware that having a feeling does not mean you need to act on it

- How one feels and what one does with those feelings are separate issues

- First, just try and be aware of the feeling

- Try to view your feelings as part of you

- Feelings hurt most when they are denied, minimized or discounted

- As you own your feelings and begin to feel them, be aware that you don't have to be preoccupied with all of your feelings all of the time

- They aren't there to rule you, but to be cues and signals-there to tell you something

 

• Benefits of understanding your feelings

- When I know what my feelings are and am more honest with myself, I then have the option of being more honest with others

- When I am in touch with my feelings, I will be in a better position to be close to other people

- When I know how I feel, I can begin to ask for what I need

- When I am able to experience feelings, I feel more alive

 

• Cultivate Positive Self-Talk

- I don't need to prove myself to anyone-not even to myself-for I know that I am perfectly fine as I am

- I make my own decisions and assume responsibility for any mistakes. However, I refuse to feel shame or guilt about them. I do the best I can, and that is 100% good enough

- I am not my actions. I am the actor. My actions may be good or bad. That doesn't make me good or bad

- Whenever I am tempted to punish myself, I remember to be kind and gentle instead. I know that in order to be the best I can be, I need forgiveness and understanding

- I know that it is okay to need. I try to keep in touch with my needs so that I can respond to them

- I know that others cannot be expected to read my mind or to guess my needs. In fairness to them and me, I ask for what I need

- I deserve to be appreciated. When others show their appreciation, I embrace it with open arms. - I never try to deny or diminish my value

- I live one day at a time and do first things first

• Make Peace with your Body

- Don't compare

- Focus on your accomplishments

- Learn to take a compliment

- Self-Talk

- Affirmations

- Learn to compliment others

- Focus on the positives

- Stop fantasy thinking

- Heal your relationship with food

- Body movement

- Support

- Appreciate the abilities of your body

• Learn to Trust  
• Healing happens in relationships

- Spiritual perspective  

• Determine those who may be trustworthy

- Not everyone is trustworthy, but some are  

• Trust is contextual and gradual

- Happens slowly, risking in small ways initially  

• Take people at their word

- Stop mind-reading  

• Stop second-guessing

 

• Face your Fears

- Avoidance fails to address the original concern

- Avoidance only increases fears

- Avoidance creates more shame and guilt

- Facing fears allows the opportunity to develop skills, confidence, self-esteem, and resilience

- Feel the fear, and do it anyway

• Take Responsibility & Let Go of the Rest

- Take responsibility for meeting your own needs

- Identify what is your responsibility

- Address needs directly

- Ask for help

- Identify what is another's responsibility

- Refuse to take responsibility for another adult

- Refuse to take shame and guilt from others

- Recognize that you can't always meet others' needs, just as they can't always meet yours

- Grieve the loss

How friends can help  

• Learn about eating disorders
• Learn about treatment for eating disorders
• Seek professional help
• Help your friend recognize the problem
• Have meaningful communication
• Interact in ways that don't center on the eating disorder
• Develop a support network for yourself
• Be a good role model
• Don't blame yourself
• Take care of yourself and be patient

 

Resources

• Suggested Readings

- The Golden Cage: The Enigma of Anorexia Nervosa by HIlde Bruch

- Bulimia: A Guide to Recovery by Lindsey Hall & Leigh Cohn

- Making Peace with Food by Susan Kano

- Hunger Pain by Mary Pipher

- Inner Hunger, Anorexia & Bulimia by Marianne Apostolides

- When Food is Love by Geneen Roth

- Breaking Free from Compulsive Eating by Geneen Roth

- Intuitive Eating by Evelyn Tribole & Elyse Resch

- Surviving an Eating Disorder: Strategies for Families & Friends by Judith Brisman, Michelle Seigel, & Margo Weinshel

 

Internet Sites  

Many websites via search engines using key words "eating disorders"

 

Information Resources

• Gurze Books, which publishes many books about eating disorders

- www.Gurze.com

Courtesy of Center For Change