The Recovery Mama Guide to Your Eating Disorder Recovery in Pregnancy and Postpartum Interview

Linda Shanti McCabe, MA, PsyD, joined us for an interview on her book, The Recovery Mama Guide to Your Eating Disorder Recovery in Pregnancy and Postpartum. What follows are our questions in italics, and her thoughtful responses.

In your introduction to The Recovery Mama Guide to You Eating Disorder Recovery in Pregnancy and Postpartum, you remind your readers “Eating disorder recovery and new motherhood are both rites of passage that require time …” What are some of their shared components?

There are so many! So many aspects of eating disorder recovery are similar to new motherhood. The changes in sleep, changes in food (food cravings, different hunger and satiety levels, new food plans), changes in hormones, changes in body size and shape, changes in relationships, and changes in identity are all similar processes. With all this change, both externally and internally, it can feel like a roller coaster. Even if you have decades of eating disorder recovery prior to motherhood, pregnancy and postpartum can still challenge all these areas.

I remember when I was struggling postpartum (Side Note: Why is this not talked about more? That is largely why I wrote the book…), I asked myself what had helped me during other times of suffering previously. I looked at the eating disorder recovery work I had done years ago and realized much of it was applicable. Here are two tidbits that I took from recovery that applied to early motherhood:

  • Just do TODAY.

When you are obsessing about any aspect of future-tripping anxiety thoughts (ex: “I feel depressed. What if my baby becomes depressed? What if they grow up depressed? What if I’m f-ing them up already and they were just born? Should I put my baby into therapy?”) *, bring your mind back to this moment right now. This breath. Ask yourself What do I need to do- or not do- to take care of myself, right NOW?  Because we’re not in the future yet. The future is still being created. You create the future by taking care of yourself in the present, right now.

*Caveat: Perinatal mood disorders (anxiety, depression, OCD, psychosis) and eating disorders require treatment. Don’t try to do it alone. If you or your loved one(s) are concerned, set up an appointment with a therapist and or psychiatrist that specializes in perinatal mood disorders as well as eating disorder recovery.

  • Let go of shame. SHAME=Should Have Already Mastered Everything

People who tend to develop eating disorders can have a tiny bit of a tendency to be perfectionistic. With this character trait, there is a tendency to think “I should have already figured things out (that I’ve never done before).” There are various genetic, environmental/family, and temperament reasons for this. However, the learning is the same. This learning includes allowing yourself to be messier, more in-process, and less “finished.” Be as kind to yourself as you would be to your newborn. Newborns have very few skills. They can’t sit up, talk, eat solid food, walk, or even see very well. They basically cry, sleep, and poop with some milk thrown in every few hours. It takes them (on average) a year to learn to take a step. Would you say to your newborn “God! I can’t believe you don’t know how to walk yet!” I think not. Give yourself the gift of time, patience, and trial and error. Don’t expect yourself to be “killing” this motherhood thing right away (or ever?). Please, please, PLEASE don’t expect yourself to lose the baby weight right away. Do not, I repeat DO NOT get sucked into diet culture’s false belief system of “if I lose the baby weight, I will feel confident, competent, happy, and fulfilled.”

Please tell us more about the benefits of radical acceptance and body image during and after pregnancy.

It is likely that your body will never be the same again after having a baby. Why should it? You had a baby! This knowledge can feel devastating, however, especially for moms recovering from body image issues.

Magazines are filled with articles about “the right amount of weight to gain during pregnancy,” “losing the baby weight,” “mommy tucks,” or skinny celebrities strolling down the red-carpet weeks after giving birth. These images do not bear out in reality for most moms, and only make us crazy. They imply that losing the baby weight will make us feel worthy, competent, attractive, and qualified. Who wants to feel unworthy, incompetent, ugly (even though ugly, like fat, is not a feeling), or unqualified? And yet motherhood, especially new motherhood, is filled with the experience of feeling unqualified. No one is prepared. That is one of the lies: that some of us are qualified and glowingly sail into this rite of passage.

The reality is that transitions are difficult, uncomfortable, and messy. That weight loss will make you feel more competent/happy/qualified is a lie. I tell my clients recovering from eating disorders that there is no “normal.” There is peace with you and your own unique body. There is normal for you.

The same is true for pregnancy and postpartum. Each body in pregnancy and postpartum, as in eating disorder recovery, knows its own natural weight. This doesn’t come from a chart, and it certainly doesn’t come from airbrushed magazine images of pregnant celebrities. It comes from listening to your body’s hunger and satiety cues, your body’s needs for sleep, your body’s emotions, and your body’s genetic heritage. That being said, (remember: There is no normal: there is only normal for you), your body will change in pregnancy and postpartum. That is where radical acceptance comes in.

Given that you will gain weight and change shape during pregnancy and have a different body postpartum, the challenge becomes your attitude. Can you let your deflated balloon postpartum stomach become a source of pride rather than disgust? If you feel like a hippo, can that be OK? Can you continue on with your life without giving in to the temptation to isolate your (how shall I put this tactfully?) smelly and leaky self?

You don’t have to like your body but accepting it will cause so much less suffering. It can be so hard to surrender to this process! And yet, letting go of control is a huge component of pregnancy and motherhood.

Mothers in recover often worry their child will develop an eating disorder. What do you want them to know?

This is the million-dollar question I hear every week from moms with whom I work: How can I prevent my child from developing an eating disorder?  The short answer is – it’s complicated. Eating disorders have a complex etiology, including genetics and temperament (which are out of your control), as well as family-system dynamics, cultural dynamics, and trauma. The longer answer: genetics and temperament both play a strong role in the possibility of depression or an eating disorder developing, but they do not determine it. The hopeful answer: Even if your child develops an eating disorder, it is possible to recover.

The question I suggest asking is this: How can I build protective factors for my child? I say this because so many women and moms blame themselves for their own eating disorder, or their child’s eating disorder, and nothing helpful comes from the blame game. (Caveat: if you are a survivor of abuse, it is important to not blame yourself, and do trauma-specific recovery work with a professional.) You can build protective factors in your child by modeling your own non-eating-disordered relationship with your body and feelings.

Here are five things you can do (and some you can be conscious of NOT doing) to assist with building protective factors for your child to not develop an eating disorder. (For full descriptions, read the book!)

  1. DON’T diet. 
  2. DO eat intuitively.
    (See Evelyn Tribole’s work for definitions of and how to practice intuitive eating)
  3. Take care of your own body image.
  4. Follow the “Division of Responsibility” when feeding your child. (See Ellyn Satter’s work on this for definition of the division of responsibility and how to implement it.)
  5. Allow all feelings in your family (especially uncomfortable ones like anger, fear, and shame).

It is possible to prevent eating disorders. And it is also possible to build strong protective factors so that if your child develops one, they can recover with more ease. Do what you can; it will make a difference. Eating disorders are complex and develop from a unique and individual interplay of many factors. They are no-one’s fault, but everyone’s responsibility. Prevention and recovery are possible.

Can you offer some advice on the challenging question – “to breastfeed or not to breastfeed”?

As a Psychologist, I won’t offer advice. What I would say is there is no one right answer, there is the right answer for you, right now.

I remember sitting in a new-mom group myself, thinking What if I wasn’t breastfeeding? Where would I get support? So many new-moms’ groups are led by lactation consultants who (understandably) hold the belief that Breast Is Best. Breast feeding does offer benefits to mom and baby including but not limited to: providing optimal vitamins and nutrients for your baby, being easily digestible, providing antibodies against illness and infection, and, sometimes, providing a buffer from postpartum depression. But for many women, breastfeeding is not the best option. Moms who are survivors of sexual abuse can be triggered in many ways during the experience of breastfeeding. Moms on medication may be concerned about how this could potentially affect their baby (discuss this with your doctor or psychiatrist: some medications are safe). Working moms may find it difficult to pump at work (legislation is helping with this) or to pump milk while traveling. Many moms can encounter difficulties with breastfeeding and the list of difficulties that can arise is long.

The image of the glowing mother feeding the perfectly latched on baby suckling with euphoria rarely matches up with reality. Breastfeeding problems are extremely common and increase the possibility of abandoning breastfeeding altogether. I write that to affirm it is ok to choose not to, have difficulty with, or be unable to breastfeed!

What I would say is, listen to your intuition. The right answer for you may change at different times (you may breastfeed longer or shorter than you first planned, you may supplement with formula, you may not breastfeed). I think it is important to get information and feedback from your baby, partner, doctor, therapist, evidenced-based medicine, lactation consultant, moms’ group. However, ultimately, I would encourage you to listen to your mommy intuition to make your decision. I would remind you to keep in mind there is no one-size-fits-all answer, only the right answer for you, right now.

You include a chapter on Spirituality. Why?

We are not static beings. If nothing else, motherhood teaches us that! Look at how your body has changed and is changing. Spirituality and spiritual practice can be a place to find peace within the discomfort of change. Can you embrace change? In what ways do you need to learn to practice kindness with yourself and others?

In an eating disorder, the self-critical voice is often very over developed, and the voice of self-compassion is very often underdeveloped. Spiritual practice can be a way to turn toward that underdeveloped part and build a compassionate mother for yourself. In this way, you can have an inner mother to call on in your moments of distress in recovery and parenting.

Spiritual practice does NOT need to be two hours of sitting meditation daily. I don’t know any mom who does that! It can be two breaths of mindfulness. Just noticing how the air coming in the nostrils is slightly cooler, and the air leaving on the exhalation is slightly warmer. Your body warms the breath with each inhalation and exhalation. The breath can be a gentle link back to your body and the present moment, as it is, rather than as you want it to be. This can be a way to just notice, rather than judge and criticize, your experience.

My wish for all new moms and recovering women is to find, again and again, practices that connect you with your inner wisdom. Your inner wisdom has the capacity to allow for messiness, learning, being in-process, and being kind and protective of vulnerable parts. The best gift you can give your child is the practice of returning to this place, again and again, so they can develop it, too.

Please share the key points of “The Good Enough Mama Recovery Pledge.”

The New Mom Recovery Pledge:

  • I will not measure my worth on the scale.
  • I will listen to my body’s hunger and satiety cues.
  • I will not try to do it alone. I will reach out for, and say yes to, support.
  • I will sleep when I can, in the way I can.
  • I will treat myself with as much kindness, respect, tenderness, and fierce, protective care as I do my newborn.
  • If I make a plan, I will be perfectly imperfect with implementing it.
  • I will lower my expectations.

The Recovery Mama Guide to Your Eating Disorder Recovery in Pregnancy and Postpartum (Paperback)
by McCabe

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About the author:

Dr Linda Shanti (“Recovery mama”) holds a doctorate in Clinical Psychology and is a Licensed Clinical Psychologist. She has worked in the field of Eating Disorder, Chemical Dependency, Anxiety, Depression, and Codependency Recovery since 1999. She served as a therapist in residential, intensive outpatient, and, currently, outpatient private practice level of care with women. She has presented on Eating Disorders, Expressive arts, and the intersection of Eating Disorders and Perinatal Mood Disorders at International Association of Eating Disorder Professionals (IAEDP) and Postpartum Support International (PSI) conferences. Most importantly, this work is her true labor of love. She knows the terrain of eating disorder recovery and “new mommy bootcamp” because she has been there. She recovered herself twenty-one years ago. She is a therapist that believes “you can’t keep it unless you give it away, but you can’t give it away unless you have it.”

To read more/connect with her, visit DrLindaShanti.com

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