Food issues

At the start of 2020 many of us will turn our attention to exercise and healthy eating to shift those few extra Christmas pounds and re-energise ourselves into the New Year. However, for some there may be a much darker side to the resolution to look and feel better.

The rise of a form of disordered eating called Orthorexia is becoming increasingly mainstream, fuelled by the mania for healthy eating and our growing anxiety around obesity it lies somewhere on the blurred boundary between being health-conscious and a health obsessive. Defined as a “fixation with righteous or correct eating” – what begins as an attempt to improve one’s lifestyle can morph into an unhealthy fixation. It’s unknown how widespread the condition is because it is not currently recognised as a clinical diagnosis , however, it can be just as harmful psychologically as it possesses the same joyless preoccupation with appearance and food.

Eating disorders are a relatively common psychological illness but are not always well diagnosed. They describe illnesses characterised by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake, ultimately damaging an individual’s well-being by both physiological damage to health and psychological illness. There are also the more hidden negative social, employment and lifestyle effects associated with eating disorders.

As a defence mechanism they can represent a maladaptive approach to tolerating the unbearable, and perhaps demonstrate a continued conflict of desire. Those with anorexia may refuse food in order to maintain a space to keep desire alive. Those patients who eat junk food or partake in fad diets only to then indulge in violent bodily purges attempt to feel or subvert desire. These feelings are further complicated by the influences of culture and social media.

The NHS recently revealed that the number of teenagers being admitted to hospital with eating disorders has nearly doubled in the last three years. The Royal College of Psychiatrists has laid the blame for this unprecedented rise firmly at the door of social media and particularly pro-anorexia and pro-bulimia websites offering tips on how to avoid food.

As clinicians we may also become aware of the significant percentage of those with eating disorders who also struggle with alcohol and substance use disorders. In 2003, the National Center on Addiction and Substance Abuse issued the seminal report, “Food for Thought: Substance Use and Eating Disorders,” which highlights this relationship. The report established that Individuals with eating disorders were up to 5 times as likely as those without eating disorders to abuse alcohol or illicit drugs, and those who abused alcohol or illicit drugs were up to 11 times as likely as those who did not to have had eating disorders. Specifically, up to 50% of individuals with eating disorders abused alcohol or illicit drugs, compared to 9% of the general population. Other research has offered similar findings. Struggling with an eating disorder ¬ or a substance use disorder -increases one’s chances of developing the other disorder.

There can be many underlying issues which lead to an eating disorder, these may include, difficult relationships in early life, low self-esteem, loss of a loved one or the end of a relationship. Different forms of psychotherapy, such as individual, family, or group, can be helpful in addressing the underlying causes of eating disorders. Therapy can be fundamental to treatment because it the opportunity to address and heal from traumatic life events and learn healthier coping skills and methods.

Confronting a disorder is the first step of recovery. If you are suffering, it is important to admit that you need help. Though this can be the most painful and difficult part of the process, it is essential in order for recovery to begin. By reaching out for help and confiding in others trust about your struggles, you are taking the biggest step towards overcoming your eating disorder. If you have a loved one who is suffering from an eating disorder and are worried about their eating behaviours or attitudes, it is crucial to communicate your concerns in a loving and supportive way. Confronting the person you care about is a necessary step towards getting them the help and treatment they deserve.

If you are concerned about any issue related to an eating disorder then please consult your doctor or seek advice from a reputable website such as:
https://www.b-eat.co.uk/
https://www.nationaleatingdisorders.org/
http://www.nhs.uk/Livewell/eatingdisorders/Pages/eating-disorders-advice-parents.aspx ) http://www.nhs.uk/Livewell/teengirls/Pages/treatmentforeatingdisorders.aspx)

‘In the space between chaos and shape there was another chance’.

Jeanette Winterson, The World and Other Places:

Life transitions are challenging because they force us to let go of the familiar and face the future with a feeling of vulnerability. Whether positive or negative, a transitional space can force us to adjust to new ways of living, being and working. How we deal with these changes can feel quite challenging to our sense of well-being and our emotional health.

Many significant changes are triggered by regrets about unfulfilled dreams, a discontent or dissatisfaction with how life has turned out or a feeling that you are not at peace with the passing of time.

When we consider change in our lives, we might think about the work of the psychoanalyst Donald winnicott, who wrote about the important transitions an infant experiences in separating from her mother.

He believed that our sense of self emerged through our interpersonal relations, especially through early interactions between the main carer and her infant. In order for the infant to develop, the caregiver must gradually allow disillusionment so that the infant feels she is a separate individual but also feels safe and empowered. As this process occurs she begins to sense that her needs and emotions are not immediately met because her mother is not an extension of herself.

Healthy separation happens when the infant’s emotions are reflected back to her and adequately held without crisis occurring. This mirroring and holding creates what Winnicott called a transitional space, a container where the infant feels safe enough and powerful enough to navigate and integrate her needs and emotions allowing her to develop a stable sense of self that can develop authentic emotional connections in everyday interactions with others while still feeling some sense of control.

At some point we all have to deal with times of major life transition, which require adjusting to new identities and new perspectives. These changes are not always smooth, but it is helpful to appreciate that they happen for an purpose and can be important to allow us to grow as individuals developing resilience and self belief.

They perhaps attempt to signpost us in the direction of being closer to who and what we want to be and hopefully allow life to feel more meaningful and authentic.

Using Winnicott’s concept of a transitional space is helpful in navigating these times of change. The strength in these situations is knowing when we need to ask for support from those around us. – Whether that be family, friends or seeking the help of a professional. As I have gone through my own transitions in life, I have decided where I am going to focus my attention and what support I need. I know that I cannot manage significant change myself and I am open to help. Being proactive, aware and vulnerable are important characteristics to successfully negotiating the significant changes that life has a habit of throwing up.

‘The real issue with speed is not just how fast can you go, but where are you going so fast? It doesn’t help to arrive quickly if you wind up in the wrong place’. Walter Murch