I explained in the last podcast how I used information from the FEAST website on Family-Based Therapy to kick start my own inner mealtime matron. That was probably the single biggest initiative for me in my recovery — establishing that my eating disorder was not “me”, which let to being able to foster a healthy hate of Anorexia, and develop an inner voice ordering me to eat.
But that is not the whole story. Eating disorders are dreadfully multi-faceted, so recovery tools and approaches have to be so also.
In this post, I’m going to explain how I used knowledge about the parts of my brain that control fear, to overcome the fight-flight response to eating.
You can listen to the podcast of this post here. What I have written below is the transcript, and without the intonation and emphasis of my voice to decorate it, it only tells half the story.
For those of you who are trying to understand an eating disorder but have never had one. Here’s an exercise to help you:
Close your eyes.
What are you afraid of? Snakes? Spiders? Heights? Flying? Donald Trump?
Think hard for a second, and I want you to identify one thing that you are genuinely afraid of.
Whatever it is I want you to keep your eyes closed and imagine it. What does it look like. How big is it? Where is it now? If it is a person or animal I imagine that you are in a room with that thing. You are sitting where you are and it is close to you now. Maybe within touching distance. Just a foot or so away now. Imagine touching it. Imagine it slithering over you.
Okay, you can stop now. Do a body scan and see how you feel.
If your heart rate rose, and you felt hot and sweaty, or panicky, you just experienced your HPA axis firing. That stands for Hypothalamic – pituitary – adrenal axis. In short it is your fear response.
Consider that the whole time you were imagining that thing you are afraid of you know that it was not in the room the whole time, didn’t you. Yet you still experienced fear, right?
So, if we look at this rationally: Even if there was a snake in the room with you, chances are it won’t try and hurt you or is not poisonous. It’s silly to be scared of a poor little snake who is minding his own business, you know that, but you still are.
What about spiders? My little sister runs screaming from the room at the sight of a common harmless house spider. As a child, my mum had to do a nightly spider check under the bed and in all the cupboards or my sister couldn’t sleep. And if she even thought there might be a spider in her bedroom that was it. She had to sleep in with me. That’s not rational, but many of you can empathize.
Well, that is how I used to feel about food.
Now of course I did not run screaming from the room every time I saw food. Nope, because I didn’t want people to know I was crazy. So I hid it. What that looked like is me on a daily basis was walking around with a huge amount of stress hormones rushing around my body. Especially around mealtimes I was tense, irritable. I was ghastly to be with because all my energy was being focused on the simple act of pretending that I was normal when the sirens were constantly going off inside of me.
Guess what. That is utterly exhausting.
When I had an eating disorder I was working all out just to hold my shit together. Ha, and people wondered why I didn’t seem as fun and carefree as I had been before. I was permanently on edge, and my body didn’t know what to do with all the stress hormones constantly being released. I think part of this is what led me to running and exercise in the first place, to run off the stress, but after a while that outlet was converted into another way for Anorexia to express itself.
So how did I overcome this?
Once I was far enough into recovery to identify that my Anorexia was not me, I was able to also identify the situations and circumstances where I was the least like myself: mealtimes. I analyzed my thoughts and behaviors at mealtimes to see if I could work out what was going on. Initially, I struggled to articulate what I was feeling, but I began to understand that it was fear, panic and stress. This is all fight or flight reaction stuff, so I began to research the processes behind this in order to possibly understand why I was getting this reaction to such a non-harmful stimuli such as food.
I knew it was not rational to feel fight-or-flight reaction towards food. What I learned was that the amygdala in your brain initiates this reaction, and the amygdala doesn’t give a shit about being rational. The amygdala only cares about avoiding whatever it is it is identifying as a danger. That’s how humans survive. Fear is a really important reaction to danger because is motivates us to remove ourselves from the path of danger — and fast. The whole point is that the amygdala reacts really fast, a reflex, as standing and thinking too long when there is something dangerous in front of you might get you killed — at least in evolutionary terms it would have.
But why oh why had my amygdala started to react to food as if it were a dangerous stimuli?
I don’t know now and I didn’t know then. All I know is that is how Anorexia corrupted that part of my brain. All I knew then was that I had to work out how to override this reaction if I was to have any hope of a normal life.
I started to learn about the part of my brain that can override the amygdala if you train it to. Humans have a long history of training their brains how to override fear responses. I was listening to this really interesting podcast on fear recently that explained the overcoming of fear it must have taken for humans to pick up a spear and start to hunt other animals rather than run away from them as we would have once been programmed to do. Other animals are less good at doing this, but we’ve domesticated enough of them to prove it is possible. That’s at our will more than it is at theirs, however, humans have an ability to access when overcoming a fear may lead to greater long-term gains than running from it does.
What sets humans apart, is our prefrontal cortex. This is the executive function part of the brain, and it can override emotionally-based thoughts. With some effort!
As I was able to understand that somehow this disease had corrupted my HPA axis and was causing it to fire at the sight of food, I started to work on challenging it. For those of your afraid of snakes, this is the equivalent of sitting in the room with the snake and overriding that impulse to run. Exactly. Not easy
I know some of you are still listening to this thinking that it would be impossible to have that level of fear towards food, but remember this, everything in our perception is controlled by the brain. If the brain tells you that a slice of pizza is more dangerous than a black widow, you will feel and believe it to be so. Remember, just a minute ago when I asked you to visualize that snake slithering over you, you shivered as if it was. And that was just because of my words. Nothing physical, no real threat, yet you still responded as there was danger because your brain imagined it.
And dreams. If you have ever had a nightmare you are well aware that the brain can create very real and very frightening non-realities. If you have woken from a nightmare in a sweat with your heart racing, you know that the brain can produce very real physical reactions to imaginary constructs.
What I had to learn to understand, was that my brain was lying to me. I had to learn not to trust my initial reactions to food and instead, override them using that prefrontal cortex executive function. It is not easy, but it is possible.
Without getting too woo, I will tell you that the one thing that was a game changer for me in my ability to override my thoughts was yoga and meditation. Meditation works to quieten the amygdala and strengthen the prefrontal cortex. In light of what I have just explained about the brain, I am sure you can understand how this is a very useful tool.
If you don’t believe me, just Google it. Studies with MRI scans show that after an eight-week course in meditation the participants’ amygdala activity decreased significantly. At the same time, as the amygdala shrinks, the pre-frontal cortex becomes thicker. Bigger. Link to study here.
Yoga classes can help you learn how to deal with a stressful situation without losing it.
I’ll elaborate: the anasas or yoga postures in a vinyasa or hatha class are often quite difficult. What happens in yoga is that you put the body in a rather stressful position, say, a really deep lunge, and you stay there. In a matter of seconds the body may start to panic a bit, and what you are taught in yoga is to breathe long and slow deep breaths. What this does, is it takes you out of the fight or flight sympathetic nervous system response and puts you into the parasymphatic nervous system. The key to it all is this: it is impossible to freak out if you are breathing long slow deep breaths. So, I was able to practice this technique in yoga, and then apply it when I felt the panic arise with food.
I’ll let you into a secret. Yoga had such a profound effect on me that I became a yoga instructor. For a while I thought exclusively to veterans with PTSD and survivors of domestic abuse. These days I still do a lot of yoga.
I don’t like yoga. The whole scene is just not me. I’m cynical, I swear, I don’t like all the huggy-lovely-dovely-ness of the yoga community. But I have to go to yoga, because all that aside it helps me slow down my thoughts, pick out the ones that I think are worth listening to, and bin the ones that are not.
There are other ways around improving your executive functioning. Ironically most of them are not friends with eating disorders so are hard to kick off with. Eating fat is one example. Fat is good news for brain functioning, but that one is a bit of a catch 22, isn’t it?
Sleep. Sleep is another good one. CBT. But at it’s core, you have to learn to sit through fear. You have to sit there and let the snake slither over you. And you have to breath long and slow deep breaths was you do so in order to signal to your body that this is not something worthy of panicking about. And, you have to do it enough times that your amygdala gives up and stops calling the fight-or-flight reaction.
The good news, is that it gets easier every time. Remember, your brain is like a computer. It is mostly reliable, but when it gets a virus it does some really weird shit and cannot be trusted. Anorexia is that virus, and it makes your brain lie to you. You can fix it, but you have to really understand and believe that what your brain is telling you is not the truth in order to challenge it.
I found the “food is medicine” mantra helpful in times when I wanted to turn and run. I often put a “Fuck you Anorexia” in front of it for good measure.
I must admit that I’m a lot more tolerant of people’s irrational fears than I used to be. When I was 15 and I knew everything, I looked askance at people who were scared of the dark, or snakes. I was a horse-rider. I rode horses over fixed wooden fences at a gallop for fun. I sneered at the other yard girls who jumped every time a rat ran over the hay. I was still scared of none of those types of things when I developed my deep fear of food. Oh, the irony.
Well, that’s my story and my interpretation of the brain events that are behind it all. I’m not a professional, and I am not a neuroscientist, so I’m going to work to get a real professional who knows more about this sort of brainwork than I on the show next week.
As an elder (67) with a recurring ED you are very inspiring for me. Because I am an elder, and have had Anorexia, Exercise bulimia cyclically for more than 50 years, and was disordered since very early childhood and all the times between active ED and recently cycling again I am unable to find treatment or even a therapist. I know you treated yourself, and while you do not recommend that (I agree) I feel at least trying to do that myself for myself is far, far better than no treatment at all. Thanks for all you have shared.
Yes, if that is your only option you should really try!
Feel free to email me info (at) tabithafarrar.com if you want any help with finding local resources too, the advocacy network might know of someone good near you – you never know!
Your experience is interesting, but I am coming from a different perspective, as a carer for an 18 yr old who is now a ‘functioning anorexic’. She sees absolutey nothing wrong in her approach to life, she says she is happy, and if she refuses to eat fear foods, whose business is it anyway? She does eat well, but refuses point blank to eat anything ‘unhealthy’ ie chocolate, biscuits, crisps, anything she previously enjoyed. We have been here for 3 years now, and I am just waiting for the relapse, because without full recovery, there has to be one. I can’t do this again. She will not engage in any sort of therapy or help, and I am at my wits end, she really thinks life can go on like this.
Carolyn, I was a functioning anorexic for ten years. Onset at 17 and only began recovery at 26.
I spent those ten years adamant that I was alright. I was very vocal outwardly that I was alright, and arranged my whole career around fitness and health.
There was a turning point for me when I knew that I wasn’t really okay, but I still would never admit that to anyone else. Also, the disease functions as to not allow the sufferer to know that he or she is sick.
I tell the entire story in my book, but have hope and faith. That said, do all you can do to let her know that she is not okay. Never allow that very manipulative illness to debate with you otherwise. You may be her least favorite person in the world as a result of it, but you will also be the person who helped her the most, and once recovered she will see that.
Next weeks podcast – I’ll publish on Sunday – we discuss this parent to child relationship in detail with a parent who got her daughter to full recovery. Have a listen, and then afterwards if you have any further questions reach out and we will find you some help.
I too had been functioning with disordered eating/ anorexia/ orthorexia whatever, for over a decade from 2002 and I am now in the weight restoration phase desperately using my local service and your supportive work to get me through. But it’s taken absolutely ages to get over the muddy waters to realise that, while I am eating better, and eating some fear foods, I have routines and rules about when I eat them as well as still not being able to tackle lots of the fear foods. I am concerned about how I succeed with this part. I don’t want yo just be weight restored; I want to eat normally. But how do you do that? For me, if I can succeed there, I know a relapse is less likely than if I’m still omitting foods.
I feel really strongly about this subject. Like I said before, I’d been functioning like Carolyn’s daughter and you, Tabitha, for over a decade too before my body actually started to slowly become weaker. I’ve attended a local unit for a couple of years now (had some cbt, had it stopped for not working, been seeing a nutritionist to help me gain weight, been up/down etc) and read your book along with other research. But I used your tip of meditation the other day and I managed to increase. I’ve booked a yoga lesson and been doing relaxation stretching, which helps. I am going to continue the tips because I don’t just need to but WANT to. This has been my turning point. I know I’m feeling I’m back to being able to function while still being under weight. But I am scared to death of being weight restored with only eating ‘good fats’. Because of my healthy but restrictive and rigid routine, to let go and believe that eating ALL fats, eating sugar, eating whatever isn’t on the good list, will be the only way to retune and rewire the brain. It’s hard because I compare it to shoving a bottle of wine at a person with alcohol problems. Only fir people with ED, it’s about seeing that balance, body wants, health, all should be about your choice of having what you really feel like having. I think I need to expose myself to the unhealthy as well as the healthy foods in order to eventually trust my body will tell me I want a piece of toast or a croissant, a cereal bar or a chocolate bar. I’m trying to have trust and faith even though I’m not religious. It’s early days but I’m prepared to give it a go. Rereading your book, from my marked chapters of motivation has helped. Walking in nice places while meditating helped me the other day eat more with my lunch. But it was the right time. I am an adult sufferer doing this alone but with my hubby when he’s at home. I need his support abd tell him. I’m also grateful he us there. Even when he says things I don’t want to hear. But ultimately you can only keep trying.
So great! You are doing so well!