Carolyn Costin and Gwen Schubert Grab joined us for an interview on their workbook, 8 Keys to Recovery from an Eating Disorder Workbook. What follows is our questions in italics and their thoughtful responses. Each response is designated by the individual who is responding.
What are some of the merits of setting weekly goals in eating disorder recovery?
Dealing with an eating disorder involves a myriad of behavioral changes, not to mention all the psychological issues that need to be dealt with. The amount of things one has to focus on can seem overwhelming and make people not even want to start. I found early on in my career that setting weekly goals with my clients, no matter how small, helps break down recovery into manageable steps, brings things into focus, directs energy to one or two tasks and helps clients achieve progress in making changes.
Carolyn, you share that “the battle you have to fight to get better … is between you and you, your Eating Disorder Self and your Healthy Self.” Can you please provide some examples of what the “Healthy Self” sounds like?
The healthy self is the part of the person who he or she was born with, before ideas got distorted or fear took control. The person’s healthy self knows the right answer. It is the same answer or advice that person would give anyone else but for some reason has stopped listening to/for themselves.
For example, a client’s eating disorder self might tell her she is going to get fat if she eats a piece of pizza. A goal is to get the client to practice what her healthy self knows. Ask her, “What would you tell a 7 year old child who said that to you?” Clients always can come up with what to say if it were someone else they were talking to. Having clients do exercises like this helps them practice speaking and listening to their healthy self and then learn to apply this to challenge their eating disorder self.
In your discussion and assignments relating to an individual’s biological make-up that contributes to the development of an Eating Disorder, you introduce the concept of a trait as an asset and a liability. Please explain.
Researchers will tell us that there are certain traits that are likely to be found in people who develop eating disorders. For example, anxiety is common. But the energy that creates anxiety, seen as negative, can be channeled into making that individual highly energetic, which is positive. I always approach clients from the attitude of how their trait is a positive and can work for them, and then get into how it has hindered them.
Working with any trait you can do what I call taking the trait from liability to asset or from darkness to the light. Think of a person who is very impulsive, which is often found in individuals with bulimia nervosa. Where or how can being impulsive be an asset? It probably won’t take anyone long to figure out that the up side of being impulsive is being spontaneous. Being around someone who can be spontaneous is fun and exciting. On the other hand, people with anorexia are very controlled and perfectionistic and not very spontaneous. Yet, the upside of their traits is they are responsible and detail oriented; these are people you can count on to show up on time and get their paperwork done. This can be fun but it is also a serious way to help show people who they are in a way that they can take in and use for their best good. We don’t focus on the traits as bad or that we need to get rid of them, we focus on transforming them to an asset.
You include an interesting phrase, “surfing the urge.” How can “surfing the urge” aid Eating Disorder recovery?
Surfing the urge means riding the wave of an urge. When trying to stop a habit, it is difficult to get through the urge to engage in the habitual behavior. It is also important for clients to know that if they can ride the urge wave, the urges will get less and less and become easier to resist. Furthermore, the more one resists, the more that person is building new synapses that are helping disconnect the behavior from being automatic. For this reason we talk about learning to surf the urge.
This concept of “surfing the urge” can be very helpful because it introduces the idea that all of our feelings, compulsions, or “urges” do not need to be acted out in order for them to go away. When emotions or urges are escalating and getting stronger, we tend to think we need to act on them to make them go away. When we “surf” the urge instead, we become aware of how urges intensify and then recede after some time without having to act on them. It helps to slow down the process and allow for change to happen.
Some of your assignments ask your readers to explore and understand their relationship with food. For those who never considered they had “a relationship” with food, what can you tell us about why this matters?
Fair and funny question. My guess is that anyone with an eating disorder is not confused by this at all because when you have an eating disorder you are in a constant relationship with food and your body, but it is a dysfunctional one. The reason this idea is important is that clients get to see how their temperament and traits (also discussed in question 3) can play out when it comes to food or other things like relationships. For example, if someone is very picky about food, they are picky about people. If they are very chaotic with food, they are usually chaotic in relationships or with money, too.
Gwen, you describe the terror you experienced during your first therapeutic meal session. Yet, something shifted. Can you please tell us about the value of a meal session and/or eating with a support person?
There are many ways meal sessions can be beneficial in recovery. Usually, it is a way to slowly face fear foods, break rigid food rules, and work on normalizing eating behaviors. In the meal session I wrote about, it was about breaking through my denial. I had in my mind that I was in control, could stop or act “normal” whenever I wanted, and was fully expecting to fake it through this meal session. My reaction scared me and there was also a witness so I could not go back into denial. That was the first moment when I realized I needed help.
What is the difference between “the healthy self” and “ the soul self”?
The term soul self is actually a deeper more spiritual concept that I started to use over the years. I felt that soul self brought out the features of one’s wise mind or consciousness that goes beyond the healthy self but encompasses it. Honestly, these two terms can be used interchangeably but talking about the soul self helps clients distinguish this part of self from their ego mind.
This concept of the soul self was so crucial in my recovery and it has evolved over the years. What it meant at the beginning of recovery was simply being my authentic self. My healthy self/voice was more connected to fighting my eating disorder thoughts and behaviors and my soul self felt deeper than that. I had created a very convincing false-self, always trying to be who I thought I should be, who others wanted me to be, or who I wanted others to think I was. It took awhile for me to see beneath all of those layers of expectation to my authentic/soul self, but this dismantling of my false self was a turning point in my recovery.
About the authors:
Carolyn Costin MA, MEd., MFT, CEDS FAED, is a world renowned, highly sought-after eating disorder clinician, author, and international speaker renowned for her expertise, passion and accomplishments.
In her twenties, Carolyn recovered from anorexia and became a teacher and a psychotherapist. After successfully treating her ﬁrst eating disorder client in 1979, Carolyn recognized her calling was to treat people with eating disorders. After her success in private practice as well as developing and running several hospital eating disorder programs, Carolyn opened the first residential program in a home setting, Monte Nido.
Carolyn’s humanistic, relational approach, her knowledge base, her numerous books, and the outstanding success of Monte Nido all spurred Carolyn to international acclaim.
Having left Monte Nido in 2016, Carolyn maintains her private practice and remains very active in the eating disorder field lecturing, training, teaching, writing and supervising.
In 2017, Carolyn founded The Carolyn Costin Institute, which offers Eating Disorder Mentor and Coach Training, on line and in person Continuing Education for clinicians, and other specialized trainings.
Carolyn’s newest book, 8 Keys To Recovery From an Eating Disorder Workbook will be available in March 2017 and can be ordered through her website.
Visit: Carolyncostin.com or email: Carolyn@carolyncostin.com
Gwen Schubert Grabb is a highly skilled psychotherapist specializing in all facets of eating disorder treatment. Her private practice is in the Los Angeles area where she treats individuals, families, runs groups and provides consultation. Gwen is known for her rare ability to deal with the most difficult situations with authenticity, compassion and humor.
In 1996, Gwen was one of the first to be treated at Monte Nido under the care of Carolyn Costin. After successfully battling her own eating disorder, Gwen became a therapist for others struggling to recover from this complicated illness. She worked for many years at a multi-level eating disorder treatment facility creating over 100 group therapy guides. More recently, Gwen helped to develop and also serves on the board of the South Bay Eating Disorder Coalition.