The Way I See It: Combat Vets and The Problem with Coming Home

A recent article in People magazine asked the following questions “What’s happening at Fort Bragg?” and “Is the Army doing enough to protect its women?” Three female soldiers from the nation’s largest army base have been murdered in the past six months allegedly by spouses or boyfriends that have served time in Iraq. These homicides echo the Fort Bragg murders of 2002 in which four Army wives were killed by their soldier husbands-three having just returned from Afghanistan. I could focus on how the military fails by not taking domestic violence seriously enough. That’s clearly the case. However, in each of these cases there were warning signs which look eerily similar to symptoms of PTSD (post traumatic stress disorder). I believe many of these domestic violence cases are a direct consequence of untreated PTSD.

Violence is inherent in the military culture. If we couldn’t train soldiers to kill, we wouldn’t be in the position to defend ourselves as a nation very effectively. I get that. The problem becomes how do we, as a country, address the issues these brave men and women face upon their return from war, where violence was considered necessary, to home where violence is inappropriate yet still just as lethal? Here are a few examples to illustrate the vast differences between combat life and home life, and why it can be so difficult to adjust to civilian life:

In Combat: Maintaining control of weapons and gear.

At Home: Too controlling. Becoming angry when someone messes with your stuff. Nobody cares about doing things right. Back home, the small details are no longer important. Family decisions are best shared.

In Combat: No one understands your experiences except your buddies who were there (cohesion). Bonds with fellow soldiers that will last a lifetime.

At Home: Withdrawal. Avoiding friends and family. Friends and family changed while you were away; re-establishing these bonds takes time.

In Combat: Targeted aggression involves making split second decisions that are lethal. The enemy is the target.

At Home: Inappropriate aggression e.g. snapping at your kids, buddies, or your NCO; assault or spouse abuse. Back home, there are no enemies.

In Combat: Armed at all times. It’s dangerous to be unarmed.

At Home: Urge to be armed continues. It’s dangerous to be armed.

In Combat: Controlling your emotions is critical for mission success. Controlling emotions is necessary.

At Home: Failing to display emotions (detaching), or only showing anger, hurts relationships. Limiting your emotions lead to relationship failures.

In Combat: Talk about mission only with those who need to know (OPSEC).

At Home: Soldiers may avoid sharing their deployment experiences with loved ones. The need to know now includes friends and family. It is important to share your story with loved ones.

In Combat: Your responsibility in combat is to survive and do your best to keep your buddies alive. Life and death decisions…in the heat of battle.

At Home: Guilt. Feel you have failed your buddies if they were killed or seriously injured. Bothered by memories. Learn from what happened..without second guessing.

In Combat: Unpredictable fast driving to avoid IEDs. Driving fast avoids danger.

At Home: Aggressive driving leads to speeding, accident, fatalities back home, driving fast “feels right” but is dangerous.

In Combat: Survival depends on discipline and obeying orders. Giving and following orders involves a clear chain of command which does not exist in families.

At Home: Too rigid. Trying to order around family and friends causes conflict.

In Combat: Alcohol use was limited.

At Home: Alcohol is now plentiful. Many soldiers use alcohol as a way to cope with deployment experiences, but this is not healthy. Learn to relax without using alcohol. 1

After reviewing this information it was obvious to me why it is inherently difficult for combat vets to return home, not just for some, but for most. They have seen the horrors of war- images most of us cannot even imagine. Add to that exposure to IED’s (improvised explosive device) wherein the soldier is exposed to an explosive device that, if they survive, can leave permanent brain injury.

Then add to that, the suspension of “right and wrong” and the loosening of moral codes. The example I’m thinking of is the systematic torture by US soldiers and other government agents of the prisoners at Abu Ghraib. Make no mistake, these were not crimes perpetrated by a handful of rogue soldiers. These torture crimes were being committed by and condoned by the highest level of military intelligence. At first glance, I was disgusted by the pictures thinking that these men and women lacked any kind of conscience and morality. But when I heard the conditions of the prison were such that they were being bombed and targeted by enemy shells almost daily inside the prison, my PTSD alarm bells started ringing! These soldiers will not just miraculously recover once they are returned to “normalcy”. I heard one soldier say that “When we go over there, we consider ourselves already dead. If we return home, then we are lucky, but otherwise, we couldn’t do what we need to do unless we are already gone.”

The way I see it not only do we need more programs to evaluate and treat their PTSD, but in doing so, we need to help them acculturate to what has become a distant and foreign concept- home.

“Mankind must put an end to war, or war will put an end to mankind….War will exist until that distant day when the conscientious objector enjoys the same reputation and prestige that the warrior does today.” John F. Kennedy

1 Walter Reed Institute of Research Land Combat Study Team, U.S. Army Medical Research and Material Command, Update 13 September 06 (www.battlemind.com)

The Way I See It: Thankfulness and Selfishness

The Way I See It – Thankfulness and Selfishness Go Hand in Hand

Last week I wrote about the benefits of selfishness, especially to those of us who are people pleasers. I had no way to predict the flood of responses I received from women expressing their gratitude that someone was giving them permission to take care of themselves FIRST. Here’s what Jessica from Texas had to say on the matter: “I have to say I am thrilled to be coming to the end of the year – it seems like there are a lot of days off, etc. And I would like to think that I have crafted my holidays to meet more of my needs than my imaginary obligations these days, and it most certainly didn’t used to be like that. I remember spending hours, days on hand-crafted gifts for all of my family members and then been totally shocked when I got something incredibly impersonal in return. I once got a hair chamois from my cousin – you do not want to know. Now my family goes gift less, except for the children, and I informed my husband last night that over the holidays we would all be making sandwiches for my synagogue’s sandwich drive and serving them at a homeless shelter. Including him. Because the children need to see the adults in their lives doing these things. In years past we would adopt a family and buy them toys, but you know what? I would rather serve food to homeless people because even buying other kids toys seems a little materialistic to me this year. This is probably way more than you wanted to know, but my point is, I love the fact that being “Selfish” can actually evolve into being more “selfless” since my selfish self actually wants to do things for others this holiday! So there!”

Here’s what Amy from Florida said: “Such an important reminder in a season when SO much obligation comes up. I would love to receive the needs list if you can send it. PS if anyone ever calls me selfish, I smile and say thank you! It sure has taken practice to become more full of self!”

Now having shared all of that, I’d like to now focus on the Jessica’s experience that having taken care of her own needs; she had the desire and the energy to focus on doing things for others this season. Let’s talk about the importance of volunteering our time. I think it’s wonderful and admirable if you are generously giving money to the myriad of charities and non-profits that need it. They couldn’t do their work without money. But if you’re looking for the ultimate “feel good” experience, there is nothing more potent than volunteering yourself to a worthy cause.

My personal experience is all I have to base this on. For much of my life I have battled depression, and for much of my life I have volunteered to help those that I felt were less fortunate than me. Even in my times of deepest sorrow, volunteering has given me the 

perspective that I needed to go on. Additionally, it added to my self-respect which was critical at a time when I felt I wasn’t worth very much. I once heard it said that self-esteem comes from doing “esteem-able “ things. I whole-heartedly agree with that.

If you are one of the millions that doesn’t have the ideal family, or the job or relationship of your dreams, please do not despair. Getting “out of yourself” by helping someone else can give you an immeasurable sense of connectedness and gratitude. Case in point: Every year my partner and I load up the Harley with toys and ride on over to the Glendale Harley dealer where we are met with hundreds of other biker enthusiasts. From there we all ride over to skid row downtown where we unload thousands of toys for the children living in the shelters there. Picture the toughest “biker dude” you can imagine with a little girl’s bike, pink tassels on the handle bars, flowered seat and pretty pink basket, bungee chorded to the back of his hog! I’m not joking. It happens every year. Teddy bears of all shapes and sizes strapped to the front of the bikes diligently guide their drivers to the awaiting children. It’s a sight to see. Then we spend hours handing out the precious cargo to chubby little hands and the sparkling eyes of the children, while their grateful parents help them make their choices. Okay, I’m getting a little teary just writing this!

This morning I came across an article about an amazing 11year old boy named Brenden Foster. For those of you who don’t know the story, Brenden had been told he was dying of Leukemia. On the way home from one of his clinic visits, he spotted a large group of homeless people. He said “I thought I should just do something”, but he was too weak to do it alone. So he and others started a food drive in his town and the story caught on so that many more towns and cities have since gotten involved. Brenden’s one wish in his remaining days was to help others that needed helping. My Lord, what an inspiration! Brenden died last Friday, but his legacy lives on. Sorry, tearful again. The way I see it is this boy is an inspiration to us all, no matter how much time left we have, no matter how much or how little money we have, we ALL have the choice to give of ourselves in making this crazy, wonderful, broken-down world a much better place. Try it this season. You’ll be very glad you did, and from a selfish point of view, you’ll get back so much more than you gave.

Saving the Lives of Those Who Save Yours

Saving the Lives of Those Who Save Yours

Doctors in the VA are under pressure NOT to diagnose PTSD, because a diagnosis of PTSD leads to increased benefits and disqualifies the soldier from re-deployment. Bodies are at a premium here, folks, with many soldiers being deployed to Iraq or Afghanistan numerous times. Hardball on msnbc.com reports that the VA docs are giving out the diagnosis of Adjustment Disorder instead. That’s like saying the soldier who shot up his comrades at an Iraqi mental health clinic was just having a bad day.

A 2006 study published in the Journal of the American Medical Association reports that nearly 74,000 former soldiers who returned from Iraq and Afghanistan between 2003 and 2004 sought VA treatment for mental disorders in the year after they came home. Many of those same men and women were sent back to the combat zone. The current figures must be staggering. Keep in mind that 30% of the army has PTSD or TBI (traumatic brain injury). According to Mark Benjamin who was being interviewed by Chris Mathers on Hardball, that means 30% of the army has no business carrying a gun. If we were to admit the truth of this, how would our military survive? But if we don’t, how will our military survive once they are “safe” at home?

Paul Rieckhoff, a U.S. Army veteran, who led an infantry platoon on more than 1,000 combat patrols in Bagdhdad, founder of the nonprofit Iraq and Afghanistan Veterans of America (IAVA) says “The reality is that mental health issues are probably one of the greatest threats facing Iraq and Afghanistan veterans. But our country is not ready to care for them. Contrary to what our president keeps telling us, we’re not a country at war. Less than 1 percent of this country is at war. Our military is at war. Our military families are at war. Everyone else is shopping or watching American Idol.”

I couldn’t agree with Paul more. What are YOU doing to show our military personnel that you support them? Are you making sacrifices so that our freedom can be protected? Even if you don’t agree with the war, you can still support the sacrifices made by these men and women. As a citizen you need to ask how you can be involved. If you don’t have money, volunteer your time. If you don’t have time, then donate money, goods, or services. If you don’t have any resources whatsoever, write a letter to congress supporting more programs specifically designed to increase benefits to those combat vets who need them, be they mental health or otherwise.

You see the problem is that we don’t treat our military personnel as the Warrior class they are. We treat them as expendable soldiers, and once we are done with them, they are of no use to us. You need 

only to look at the statistics of alcohol and drug abuse, homelessness, spousal and child abuse, depression, anxiety, divorce and suicide among veterans to see the truth.

Edward Tick, author of War and the Soul, reminds us that every soldier’s inner warrior needs to be “called forth and honored by the tribe (our society). A need does not disappear because the culture does not evoke it.” “The final step in the long road home for the veteran is completing this initiation as warrior. A veteran does not become a warrior merely for having gone to war. A veteran becomes a warrior when he (she) learns to carry his war skills and his vision in mature ways. He becomes a warrior when he has been set right with life again. A warrior’s first priority is to protect life rather than destroy it. He serves his nation in peace as well as in war making and dissuades his people from suffering the scourges of war unless absolutely necessary. He uses the fearlessness he has developed to help keep sanity, generosity, and order alive in his culture. A warrior disciplines the violence within himself.”

But the warrior should not be expected to do this alone, or in isolation. Disciplining the violence within oneself requires the support of the community to which they belong. That’s the whole point, how do we help our veterans integrate back into their communities?

Rieckhoff makes the point that the system needs to be more proactive. He says, “The biggest problem I have is that at its core, it’s a passive system. Say you have PTSD. First of all, you have to self-diagnose. And then your wife or girlfriend, if you have one, needs to ride your ass. ‘Go to the VA, go to the VA, go to the VA.’ If you’re on a wait list, you have to keep going back. But maybe you can’t’ go during work hours. And maybe the VA medical center near you is one of the 50 percent without a PTSD clinic. It’s a system you’ve got to push and push and push through just to get in the door.”

So, if I’ve done my job, you see the hurdles these brave men and women face in healing their battle-wounded psyches. Anything anyone of us can do to help integrate these brave men and women back into society is helping to restore the dignity of the warrior.

To read more of Colleen’s blogs about mental health in the military go to:

“The Way I See It: Combat Vets and the Problem of Coming Home”

http://www.huffingtonpost.com/colleen-perry/the-way-i-see-it-combat-v_b_151255.html

“The Way I See It: Let’s Make PTSD a Household Name”

http://www.huffingtonpost.com/colleen-perry/the-way-i-see-it–lets-ma_b_148957.html

Renewing Yourself for Spring

Renewing Yourself for Spring

I was asked to write about ways to renew yourself for spring. My first thought was, “Oh no, am I doing anything that would count as ‘renewal’ aside from chasing down my accountant to get my taxes straight (from 2007 no less)”! Or having the urge (I didn’t say I did anything about it) to clean out every one of my drawers. Then it hit me like a bolt of lightning, I have been on a personal journey of major renewal for the past 3 weeks.

I’m not talking about getting out more to walk because it’s lighter at the end of the day or trying to fit in a yoga class or two. No, I’m talking about radical personal transformation. I am cleaning out my body and my mind in completely new ways. There is nothing subtle about going to a new doctor thinking they might have some easy little trick that will leave me feeling so much better, and instead walking out with a treatment plan that includes overhauling everything I currently put into my body, flushing out the junk that has already accumulated with supplements and de-tox shakes, giving up my favorite food group: cookies, cupcakes, and brownies, and a total spinal re-alignment program. Yikes!!!! I left with an agreement to see the doctor 3 times a week for the next 4 weeks. That was just week #1.

Week #2 brought about a less than delightful, unexpected surprise. While at a conference for the current approaches to treating trauma, I was triggered emotionally, in a big way. All of my un-healed “stuff” came bubbling up to the surface and refused to re-submerge. I chose to reach out for help and asked my trauma-expert girlfriend, Barbara, for a referral. Sometimes it helps to have therapists as friends! In the midst of all of this, I’m trying to limit my gluten intake, take all these infernal supplements, gulp down the gritty “health shake” twice a day, and make sure I’m doing my neck -traction exercises! All the while moaning to my doctor about how difficult this is, and how I’m not doing it perfectly as I refuse to feel like I’m on a diet.

Week #3 I’m a little better at taking the supplements, cutting out bread when given the choice, but explaining firmly to my doctor that I WILL be eating anything I want for my birthday weekend. All bets are off! Besides, I’m sluggish, ill-tempered, and I have a headache everyday (caffeine withdrawal most likely). I’m back in psychotherapy with a woman who specializes in somatic experiencing and EMDR (eye movement deprogramming and reprocessing) which are the latest in cutting edge techniques for relieving trauma. I’ll admit that I used to consider EMDR nothing more than voodoo. But now I’ve had to eat my words since there is hard science behind its use. Then again, I also thought I had already “done my work”. So here I go…again!

Am I renewed? Well, all of the cells in my body soon will be. And while my mind and spirit are on the path to renewal, patience has never been my strong suit. In the meantime, I felt the need to be revived, inspired, and refreshed. My answer came in the form of a People magazine article.

Besides all the action I’m currently taking to “renew” myself, I’ve found someone who is doing something in the world that inspires me. Mickey Cassellas is a physical therapist for Children’s Hospital in Boston and for the dancers of the Boston Ballet. 7 years ago she started an innovative dance program teaching ballet to children with Down syndrome. With help from some wonderful dancers at the Boston ballet and physical therapists from Children’s Hospital the adaptive dance program has been giving children who otherwise would never have had the chance to dance an experience to blossom.

I finished the article and was convinced that “I can do this too.” I’m a psychotherapist with 17 years of ballet training. Although that training was many years ago, dance never leaves your soul. I’ve since been on a mission to secure a studio space, contacted the executive director of The Down Syndrome Association of Los Angeles who was absolutely thrilled with the idea, and am trying to find a ballet company that is committed to bringing dance to some very special children with some very special abilities. I was fortunate enough to speak to Mickey Cassellas herself this week and have her blessing to continue her work in Los Angeles. My advice on renewing yourself for spring is to try something completely new. I did, and I’ll let you know how it’s going.

Please let me know what inspires you and what form renewal is taking in your life. We all have different paths, but for me, walking hand in hand with a Down syndrome child who knows nothing but love and acceptance, is the path for me.

Why Diets Don’t Work

New Year’s Resolution: To Be Happy in 2009 Stop Dieting!

It’s that time of year again folks…time to make that all-important New Year’s resolution. I feel like the odd-one-out by having a different goal for myself than to lose weight. In fact, the phrase “On Monday I’m starting my diet” has become so common place in our culture, no one bats an eye when they hear it…no one but an eating disorder specialist, that is! When I hear someone say they are “dieting” my skin crawls and I want to shake some sense into them. How can millions of Americans STILL be lulled into dieting by the promise that “this time it will work?” It’s like a mass delusion we are allowing ourselves to buy into. It truly makes me crazy!!

In order to break out of our delusion, we must acknowledge the crucial fact regarding dieting and weight loss- DIETING DOES NOT WORK. At any given moment, some 20 million Americans are actively dieting, and 95% of them will regain that weight and probably more. Most people will blame themselves for their failure to lose weight, without seeing that they were set up to fail by thinking that losing weight by dieting was plausible. Here are 2 main reasons why dieting doesn’t work:

1. Set Point- The human body has a variety of survival mechanisms designed to maintain its optimal weight. These mechanisms perceive a restriction of food intake as an emergency, like starvation, and make adjustments so that the body holds on to precious pounds instead of letting them go. Everyone’s body has a particular weight range of between 5 to 10 pounds at which our bodies are the healthiest and work the most efficiently. This “set point” can be influenced by diet, heredity, age, health, and activity level; but generally speaking, each of us has a natural weight our bodies want to be. In fact, our bodies fight to maintain this optimal weight (homeostasis).

When we restrict our calories through dieting, this is interpreted as starvation, which causes our metabolism to decrease and our body to slow down to preserve calories. On the flip side, a larger amount of food is a signal to speed up the metabolism to compensate for calories that are not needed. This is the way our bodies are designed to work in order to keep us at a natural, healthy weight. Now this weight might be higher or lower than you think it should be, but it’s the one your body wants to maintain as optimal. As long as you are not starving (dieting) or stuffing (binging) yourself, you can eat a variety of foods- more on some days, less on others- and stay a stable (homeostasis) size. This is the hard part for most of us…this size is not yours to determine, it is only yours to accept and ultimately love. This is where all of your hard work needs to go, self-acceptance and self-love, and not be wasted on dieting.

1. Water Balance- Rapid water loss accounts for almost all of the weight decrease during the early stages of a restrictive diet. When the body is deprived of blood sugar via restrictive carbohydrate consumption, the liver will first break down its own stored sugar (glycogen), and then converts amino acids from muscle protein into sugar. Now, here’s the “science” part; the glycogen and amino acid molecules are both surrounded by water which is released from the 
2. cells, passes to the kidneys, and is excreted as urine. This is the reason dieters initially can lose several pounds of (water) weight quickly. However, the kidneys adapt to this loss of water by retaining sodium and consequently, water. It’s this adaptation of the kidneys that causes dieters to experience a weight loss “plateau.”

And so it is that this water-retaining principle combined with a decreased metabolism can cause a weight rebound when you begin to eat normally and your body perceives that it is no longer in danger of starvation. In order for any type of weight loss to be successful, your body needs time to adjust to a new way of life, whether that means incorporating more movement and less overall calories or movement and calories coming from healthier sources, wherein the balancing of water and metabolism are crucial. (Bulimia: A Guide to Recovery)

Oprah’s weight struggles exemplify this principle. The major problem Oprah faces is not obesity, but body-acceptance. It’s clear that Oprah’s body was never meant to be comfortable at a set-point that makes her a size 6. Unfortunately, with each new “failure”, the desire to be this unnatural size consumes her. I recently read an interview where she states how disappointed she is with herself for gaining back the weight she had lost…and why did she gain it back? Because she was fasting on liquids which her body interpreted as starvation, her metabolism slowed down, so that when she began eating solid foods again, her metabolism wasn’t prepared to make use of them. Oprah has done vigorous exercise and healthy eating regimes to lose weight as well. I suspect this has not worked in the long run for her because of the time commitment to exercise, not prioritizing her life around exercise, and her inability to incorporate her favorite “comfort foods” regularly enough that she doesn’t feel deprived. If she doesn’t have the experience of “deprivation” she most likely will not need to binge on these foods later on. Then comes the work around self-acceptance and love. This is so important to self-worth that unless this is in place, no amount of weight loss is going to make her happy. Clearly this is the challenge before her…not looking for self-esteem through an idealized body image.

Her struggles with weight and dieting must be a cautionary tale for all of us. It’s the dissatisfaction with self that leads so many from dieting to eating disorders. Over the next 12 weeks, I will be laying out a recovery plan that, if followed, may free you from the chains of dieting for good. Originally I called these The 12 Steps of Recovery from an Eating Disorder, but you don’t need to have an eating disorder for them to work for you. You are welcome to write me here at HuffPo or on my website www.colleenperry.com to share how these steps are working in your life. After all, as the famous cat, Garfield once said, “Diet is Die with a T.”

The 12 Steps of Recovery from an Eating Disorder

1. Admit you have needs that haven’t been met.
2. Seek help and support.
3. Look for answers…don’t stop until you’ve found them.
4. Look for solutions…stop submitting, stop rebelling.
5. Practice gratitude daily.
6. Develop a balanced point of view.
7. Share your stories with others…you are not alone.
8. Clear away the wreckage of your past…mourn the lost opportunities.
9. Continuously revise your life story.
10. Practice honesty and compassion for self and others.
11. Meet your needs..communicate honestly and directly.
12. Knowing that you are not powerless, food will fall into its healthful place.

5 Steps to a Better Thanksgiving

1. Begin your day with a good breakfast full of protein and full of gratitude. Take a moment to yourself and write down all of the things and people you are grateful for. This is the real reason for the holiday and aside from a brief meal-time prayer, not enough attention is paid to it. Eating protein in the morning will help you from feeling overly hungry when the turkey comes marching out to the table. This simple exercise will help you stay connected to your true self by taking care of your physical and emotional needs.

2. Plan to spend your day with people who support, nurture and “get” you. “But I have to be with my family, and they don’t fit that description at all!”You say. Then choose to limit the amount of time you spend with them. For instance, don’t be the first to arrive, and be courageous enough to be the first to leave. So what if they talk about you after you’re gone? Chances are you don’t respect those people anyway! If you are a people pleaser, or if you have what my friend calls the “disease to please”, you often act out of duty and obligation. I believe this is one of the reasons people tend to stuff themselves by overeating (also unconsciously “stuffing” down negative feelings). Over-eating can produce a euphoric and numbing effect which can be preferable to dealing with the feelings that arise whenever you’re in the presence of family.

3. Question our culture’s obsession with restriction (dieting) and binging. Who says you can only have turkey, stuffing, mashed potatoes, candied yams, gravy, and pumpkin pie on Thanksgiving? We treat this day as though it were the magical day of food. Couldn’t you choose to eat turkey next Tuesday and make some mashed potatoes to go with it? Try living on the edge and break out the cranberry sauce on an ordinary Monday? I’ve been eating all of my favorite Thanksgiving foods for the past two weeks thanks to fabulous supermarkets that make all this great stuff for me now! I can promise you that come Thursday, I’ll have no need to stuff my face as if I were never going to get this food again for another year.

4. I can hear you thinking, “But that’s what makes this meal special- the fact that we only have it once a year.” Okay, so put everything on your plate that you want to eat, but put half the amount that you piled on last year. Check in with yourself to rate your hunger/fullness level before grabbing a second helping. Ideally, if 1 is the hungriest you’ve ever felt, and 10 is so full you’re about to be sick, then you need to stop eating when you’re at a 7 in order to avoid overeating. Just as importantly though, you need to start eating when you’re at a 3. DO NOT fast the morning of Thanksgiving. Undereating and overeating are two ends on a continuum.

5. After dinner, ask to help clean-up. I know that may sound nuts, but you’ll feel good helping out and you’ll burn calories too. Then, because you’re already feeling so good, you can suggest that everyone go on a walk, play touch-football, or go ice skating…yes, there are rinks that are open in some areas. The point is when you feel good about yourself; you’ll want to do something different than plopping your butt down on the couch immediately. Come back and have dessert after some activity. You’ll enjoy it more and may remember…”Gee, I can have pie whenever I feel like it. I’m an adult darn it!” You don’t have to eat every type of pie woman-kind has ever invented on this one day!

Cutting and Self Injury

Cutting and Self-Injury is Never “No Big Deal”.

“Cutting”, burning, head banging, gouging at your skin are all forms of self-injury, which I will refer to as SI for the purposes of this article.  SI behaviors are basically impulse control issues.  When a person is experiencing negative feelings, the need to alleviate the emotional pain is a normal response, but when these feelings are perceived as being “too much to handle” or are overwhelming, then the impulse to get rid of these feelings NOW can lead to SI behaviors.

There are some who SI because they feel too numb, and the pain caused by the act of SI can be a welcome counter-balance to not feeling anything at all.  If this describes you, you probably feel “detached” as though you are outside of your body looking in.  Things often don’t seem real.  This is a form of dissociation, and the chemicals released from SI can give the person the sense that they are back in their body.

If you are cutting yourself, you may have experienced trauma sometime in your life.  What we know is that child abuse, sexual, physical or emotional abuse leads to changes in your brain and your nervous system.  Many teens that have experienced abuse or have had significant losses i.e. death of parent or best friend, divorce, find it more difficult to “regulate” their emotional states than those that have not had past trauma in their life.  It’s not your fault.  You did not bring these changes upon yourself.  BUT, you do need help.  It’s not easy to stop SI once you have started.  “Why is that?” you may ask.

In response to physical pain, the brain releases endogenous opiods, basically “feel good” chemicals to protect you from the pain.  If we are in danger or our life is being threatened and we are injured, we need to act, so our brain has this way of making sure we can harness enough energy to get out of harm’s way.  If we didn’t have this type of chemical protection, we would be immobile and possibly die (if there is a real and present danger).  Our species has survived because of this ability. So, cutting changes brain chemistry and the person experiences a sense of “relief” or a “high” from the behavior.  The problem is that cutting yourself is not a good long term solution for managing emotional pain.

For one, SI behavior becomes reinforced by the brain as I’ve stated already, so you’ve now limited your options of how to handle negative feelings in different, more creative ways.  For instance, exercise has been shown to release these same types of endorphins, and so has physical touch.  So, talking to a friend and getting a hug as a form of soothing and social connection can feel just as good.  “But what if I don’t have any friends and that IS the 

problem?”  Then you need to talk to an adult you can trust.  If you are being bullied and this is one of your problems, I implore you to tell someone.  Your feelings of isolation and “aloneness” are only contributing to the problem.

Secondly, what works at first to relieve your emotional pain starts working less and less and you need to do more and more of it to get the same results.  What starts as a habit can become addictive and the behavior is meanwhile getting reinforced by the brain. Think about what you know of drinking, drug use and addiction.

Thirdly, SI isn’t a socially acceptable way of expressing pain, so the person who is “cutting” is even more of a pariah and less likely to feel understood or to want to reach out for fear of being judged.  Maybe you’ve hear others say, “You’re just doing this to get attention.”  For the majority of people who are cutting, nothing could be further from the truth.  They wear long sleeves even in the summer, or wrist bands and bracelets to hide cuts on their arms.  This isn’t the only place I’ve seen people SI before, but it’s probably the most common.  And along with SI not being understood by many for what it is…a cry for help; it scares the crap out of people…especially adults.  Here’s a list of 5 things to keep in mind if you know someone who is self-injuring:

1. If you have a friend who is cutting, don’t think that it’s “cool”.  It’s not “cool” and it IS a big deal no matter what she says.

2. Don’t you start doing it too.  This behavior can become “contagious” if no one is taking it seriously.  Your job as her friend is to convince her to get help before it’s too late.  Remind her that SHE is not the problem, but SI is the problem now.  Always keeping in mind that this is the best your friend could do in response to how badly she is feeling.

3. Never judge the person who is cutting.  If they could have thought of something more effective and more fast-acting to relieve their pain, they would have.

4. Encourage them to talk about HOW they are feeling even if they don’t know WHY.  It’s not important to have all the answers.  Being able to find solutions to help them cope is much more important.

5. Just because someone is self-injuring doesn’t mean they are suicidal.  Many people cut to keep from killing themselves.

If you are hurting yourself it’s because YOU ARE HURTING INSIDE.  If you can’t put your finger on what’s exactly bothering you now, that’s not uncommon with painful experiences from our past.  You may have no memories of being hurt or traumatized as a child, but that doesn’t mean it didn’t happen.  A professional therapist (and there are those who will work at little or 

no cost) can help you to sort through your feelings and help you cope in new and more effective ways.  In the end you will feel more empowered and will have better self-worth than you will ever get from SI.  SI promises you the world and delivers more hurt and pain in the long run.  There is help and you are NOT alone.

Treating Chronic Pain- There is a Better Way!

http://www.huffingtonpost.com/colleen-perry/treating-chronic-pain—t_b_265351.html

Plagued By An Inner Critic

Are you afraid to feel angry, jealous, lonely, helpless or anxious?  It’s no coincidence that four out of seven clients I have seen this week have all had the same paralyzing fear about expressing their feelings to someone they love, be it a parent, lover, friend, or wife.  What they all have in common is a very strong inner critic.  Often, those of us with this difficulty feel overwhelmingly vulnerable just saying what is on our minds and in our hearts to someone we love.  Why is this?

Many people grow up with a critical parent or parents.  What criticism does is teach the child that their feelings aren’t valid, or that they are “overly sensitive or emotional”, and in some families, negative feelings aren’t tolerated at all.  How many times has a client said to me “When I cried in front of my mother/father, I was told to stop it, or I would be punished further or sent to my room.”  “I remember my father saying to me that if I didn’t stop crying, he was going to hit me.”  This lack of empathy and acceptance on the parent’s part teaches the child that negative feelings are dangerous and therefore need to be suppressed.

In some cases the child grows into an adult who unconsciously chooses a partner that is also critical or judgmental of their feelings.  And in some cases, the client simply assumes that their loved one is going to meet their expression with derision or scorn which keeps them from being able to get their need for emotional safety met at all.

I recently discovered a wonderful website dealing with this issue called www.forthelittleonesinside.com.  Here is what the author has to say on the subject of the inner critic: “Our inner critic, although it now seems only to torment and batter us, originally came into being to protect our small and vulnerable selves.  It came to prevent us from doing things and being ways that threatened to bring upon us more frightening and dangerous external criticism…criticism that might have led to the withdrawal of the love and support that were so essential for our survival. “

I think Alice Miller said it best in her well known book, The Drama Of the Gifted Child, The Search for the True Self  “…for a child can experience her feelings only when there is somebody there who accepts her fully, understands her, and supports her.  If that person is missing, if the child must risk losing the mother’s love or the love of her substitute in order to feel, then she will repress her emotions.  She cannot even experience them secretly, ‘just for herself’; she will fail to experience them at all.  But they will nevertheless stay in her body, in her cells, stored up as information that can be triggered by a later event.”

My clients feel ashamed and confused about their feelings because acknowledging and accepting their full range of emotions have never been safe, but we are “feeling creatures” by nature.  Denying and suppressing our feelings leads to emotional pain and physical pain.  Science confirms that there is an area in the brain responsible for detecting cues that may be harmful for survival, such as physical danger or social separation, and that this area shares a common pathway with cues for physical pain.  In a meta-analysis by Eisenberger and Leiberman out of UCLA, the authors state that “It has been suggested that, in mammalian species, the social attachment system borrowed the computations of the pain system to prevent the potentially harmful consequences of social separation.”

So I assure my clients that they are not crazy or defective for feeling so fearful.  I help them to understand the basis of their fear of feeling, and encourage them to question their inner critic rather than to accept outright its insistence on pushing us to do more, be better, faster, smarter, and thinner in order to feel loved, worthwhile, and valuable.  The only thing we need to change about ourselves is to stop holding ourselves to these unreasonable standards and begin to risk ourselves by being honest with those we love.    As I remind my clients: “Those who never risk themselves, never fully become themselves.”

Blog on Step #4 Look for Solutions…stop submitting, stop rebelling.

Do you hate your body?  Do you try to diet thinking that if you just lost 10 pounds, your life would be miraculously improved?  Are you sick and tired of being sick and tired of your struggle with weight?  Then practicing step #4 on a daily basis is your answer.  Look for solutions…stop submitting, stop rebelling.    

In my last blog about step #3, Look for answers…don’t stop until you’ve found them, I invited you to ask yourself what needs of yours were being met by food, and I shared with you some of the places that I have looked to find MY answers.  Step #4 is similar in that looking for our answers sometimes leads us to our solutions in overcoming body dissatisfaction, body loathing, and the drive to thinness through dieting.  But unless you are familiar with the concepts of compassionate communication, you must be wondering what the heck I mean by “stop submitting, stop rebelling”.  Simply put, whenever you submit (disregard, ignore, repress) your needs, you are doomed to rebel in some way.  Rebellion takes on many forms.   It may look like passive-aggressive comments or behavior, over eating or binging, under eating or restricting, over drinking, compulsive shopping or gambling, showing up chronically late, calling in sick to work, having an affair, the list goes on.  Whenever you say “yes” and you really mean “no” you are submitting some need of yours.

Most diet programs focus on extinguishing the rebelling behavior, but that is totally backward.  If you give yourself the time and energy to know what your needs are, and are then willing to ask for them to be met, you will no longer be in the submit/ rebel cycle. Since I gave you a clear example of the submit/ rebel cycle last blog by sharing Lisa’s story, let me give you a couple of examples from my clients that have nothing to do with dieting.  I have a client; we’ll call her Betty, she works as a nanny.  She loves her job and the family she works for, but Betty also loves her Sunday’s off.  She looks forward to this one day a week where she has no commitments or responsibilities to anyone else.  A few weeks ago her employer asked her to attend the birthday party of the little girl she nannies for, and guess what, it was on a Sunday.  Betty, feeling that she “should” say yes, said “sure” and then came to her session with me that week and complained about it.  First of all, whenever your self- talk includes a “should” or a “have to”, you are probably submitting.  Betty was submitting her needs for rest, choice, and peace and harmony.  I gently tried to point out the set-up she created by saying “yes” when she meant “no”.  That was pretty much the end of it until today, the day after the party when client described feeling miserable and wanting very much to “call in sick” to work.  This was her “rebellion”.  Again I pointed out her part in the submit/ rebel cycle.

Another client, let’s call her Veronica, clearly states that her partner does not meet her need for appreciation, acknowledgment, and emotional safety.  She wonders why sex has become so physically painful to her (now she avoids it).  And then there’s Carly.  Carly is a client who is engaged to be married.  As it often happens, family issues that aren’t often discussed rear their ugly heads when it comes time to plan a wedding.  Her fiancé’s brother, in a jealous rage, threatened to kill him last year.  Now, his family not only thinks he “should” be invited, but that he should be part of the wedding party.  Carly and her fiancé do not agree with his family.  I asked Carly what she thinks would happen if the brother where to come (submitting their needs).  Without skipping a beat she admitted that her fiancé would most likely get drunk and that would ruin the night for both of them.  I congratulated her on recognizing the rebellion (over-drinking) right away.

For the many of us that were raised to be kind, sensitive, compassionate, generous and people-pleasing, saying “no” means risking the discontent, anger, or judgment of others.  Many of us learned to say “yes” to avoid the guilt or negative consequence of saying “no”.  Submitting our own needs was encouraged when our needs were at odds with our parents’ needs.  Alice Miller’s book, The Drama of the Gifted Child  explores this phenomenon using other terms, but makes the point that growing up in a family environment in which the child had no choice but to acquiesce to the emotional needs of the parents, results in the child ignoring his or her own needs, which results in the disappearance of the “real” self.  The “false” self that emerges is interested foremost in pleasing others.  This dis-connect from the self is often what leads us to binge eating, chronic body dissatisfaction, and eating disorders.

“Okay, I get it now” you say, “but what do I do from here?”  Knowing your needs is step#1.  Looking at your resentments is another good step so that you can clear them out of your way.  It’s no accident that the fourth step in my recovery plan corresponds to the fourth step of most 12 step programs which is “Made a searching and fearless moral inventory of ourselves.”  I don’t recommend doing this part on your own.  Find someone whom you can trust and ask for their support, preferably someone with 12 step experience.   They are there to bear witness as you work through this step.  They are not there to comment or to pass judgment.   In order to clear away resentment I recommend making four columns.

1.       I’m Resentful At                        2. The Cause           3. What it affects                            4. My Part

(people,institutions,principles)           (why I’m angry)    (self-esteem, pride,pocketbook,   (selfish, dis-

                                                                                                     Ambition,personal relations,sex)  honest, self-

                                                                                                                                                        seeking,frightened)

I like to replace “What it affects” with “What needs were not met”.  This reinforces your needs as being a part of the process.  The 4^th column, “My Part”, is usually the most difficult as it asks you to take responsibility for the exact nature of your wrongs.  For this reason, it’s recommended that you do all the examples you can think of for column 1 before moving on to column 2- the cause.  Complete that column before moving onto your unmet needs in column 3.  When you have finished with your unmet needs (for each example you listed in column 2) then and only then are you ready to look at your part. 

As I’ve said before, breaking free from chronic dieting, learning to love and accept yourself, isn’t always easy.  I make no promises that this step will be easy, but if you are willing to be honest with yourself and others, you will put an end to submitting your needs, there will be no reason for you to rebel, and the result is lasting self-acceptance and self-worth.  For more information on step #4 or any of the previous 3 steps, please visit my website www.colleenperry.com.   You are not alone!

1. Admit you have needs that haven’t been met.

2. Seek help and support.

3. Look for answers…don’t stop until you’ve found them.

4. Look for solutions…stop submitting, stop rebelling.

5. Practice gratitude daily.

6. Develop a balanced point of view.

7. Share your stories with others…you are not alone.

8. Clear away the wreckage of your past…mourn the lost opportunities.

9. Continuously revise your life story.

10. Practice honesty and compassion for self and others.

11. Meet your needs..communicate honestly and directly.

12. Knowing that you are not powerless, food will fall into its healthful place.