What Remains: Psychological Effects of a Pandemic

Sleep difficulties. High anxiety and deep-seated fear. Denial. Depression. Anger. Our reactions to our current state of affairs are as unique as we are. Universally, the pandemic is revealing on both individual and societal levels. Masks alone have become as divisive as political beliefs. The pandemic has stripped away our illusions of safety and security, leaving behind feelings, behaviors, and existential questions we might not have expected. Even for those who feel like “they have no reason to be stressed” because of good health and financial stability, are finding their reactions perplexing. For those who thrive on control and routine, our current situation is highly unsettling. The loss of normal and the implosion of perceived control have significant effects on our sense of safety on the world. Meanwhile, those who have their identity tied to busyness and productivity feel adrift. Who are we when we can no longer recognize ourselves by what we do? Who are we when we can only be? The extroverts are grappling with the loss of their energy source. Those who were already living close to the line financially are more stressed than ever. People who cope through denial are likely to be “under-responding.” Meanwhile, those who regularly witness suffering and trauma seem mentally unaffected as they accepted their lack of control before the pandemic began.

For many of us this is the first time our lives have been turned upside down on a large-scale. While our reactions vary widely, one thing is clear: this crisis reveals us. And like any life crisis, we are invited to self-examination and growth. When you are stripped of normalcy, what remains? Where does your mind go? What are your actions saying? How are you judging yourself or others? Are you feeling it or are you numbing it? We are invited to self compassion and compassion for our neighbors, including those whose behavior we struggle to understand. Can you see the complexity of the person underneath their choices? 

If we allow ourselves to be refined by this situation rather than struggle against it, what might we learn? What will you welcome back into your life and what will you happily discard? What can you no longer hide from yourself (e.g. the state of that relationship, the severity of the addiction, just how short your fuse is, how burned out the kids were)? Personally, I will happily reject burnout and continue more simplicity (unstructured time for myself and the kids, evening walks, meditation, slower pace). And I will welcome back the opportunity to hug people, travel, host friends, and support my clients in person. I hope we can use our newfound recognition of the fragility of normal life to practice gratitude for all the good we experience, all the love we receive, as well as the pain that brings growth.

Into the Unknown

“You can’t go back and change the beginning, but you can start where you are and change the ending.” -C.S. Lewis 

This time of year always reminds me of life transition. Equal parts promise and terror, change doesn’t allow for much comfort. Whether wished for or not, change shakes things up, causing us to question ourselves and our circumstances. Take, for example, the transition to college for which many of my clients are in preparation. We spend time in session discussing what they hope to study, how they will cope with roommate issues, and how they can find emotional supports, yet much of the time it is evident they have no idea the magnitude of change heading their way. There is simply no way to fully prepare for something you have never experienced. All the planning in the world does not negate the moment when the reality of the change hits. I vividly recall, and sometimes share with my clients, the sheer panic that hit me when my parents’ minivan approached the exit for Notre Dame on move-in day my freshman year of college. Up until that point, I had been overflowing with excitement and not at all hesitant about being hours away from the familiarity of home. And yet, when the familiar was pulled out from under me, I desperately wanted to drive as far from that campus as I could. In the midst of transition, hope and excitement coexist with, and sometimes even feel overshadowed by, anxiety and uncertainty. 

Life is filled with endless changes big and small. Be it going off to college, getting married, having children, losing loved ones, building a career, ending a marriage, kids leaving the nest, illness in ourselves and those we love, and so on. Some changes we know are coming and some are unexpected, but none can be perfectly planned for. Our ability to sit in the midst of deep discomfort without either running back toward familiarity or hiding determines much of how a transition plays out. Welcoming uncertainty with all of its inherent opportunities and risks is one of the biggest tasks in a life well lived. Feeling uncertain, anxious, or unsettled does not mean we are coping poorly or making the wrong move. Rather, in the midst of life transition, these emotions signal growth and transformation on the horizon. Beautiful, gut-wrenching, courage-inspired growth. 

So the next time a wrecking ball crashes into life as you know it, breathe deeply. Expect intensely mixed emotions and trust that the inner turmoil of change is there to facilitate growth. Life often doesn’t look or feel quite how we thought it would. But if we are courageous enough to allow for change and have faith in ourselves to evolve, life might just turn out to be more fulfilling than we could ever have imagined.

Rethinking the Dialogue on Weight, Size, and Shape

“To focus on (size) as the way we rate people or the facet of their being we comment on, is insanely random and a reflection of our society rather than any actual truth”

How often do we as a society use weight, shape, or size as a proxy for someone’s worth? Answer: Often. Comments about our bodies and other people’s bodies are so commonplace that they can be overheard in nearly every generation’s conversations. Teenagers admire each other for being thin or criticize themselves or others for being fat. Adults endlessly complement others on their successful weight loss. Dinner table conversations about how “so and so” has gained weight since the last class reunion are commonplace. Even pregnant and postpartum women’s bodies are prone to receiving “flattering” (or not so flattering) comments about their size. For many, these comments are so automatic or even well intentioned that their effect goes unquestioned. And yet, the damage is done. It’s time to address weight bias, rethinking the way we talk about these things or why we feel the need to comment on them at all, because:

  1. You may have no idea why the person looks the way they do. The girl you see as having the ideal body may have starved their way to it. The man who has lost so much weight may be exercising excessively or eating very restrictively (i.e. disordered eating). The woman who has gained weight might be dealing with the effects of a health condition or a necessary medication. Complementing or judging someone based on weight or size runs the risk of reinforcing unhealthy behavior or causing body shame.
  2. Others are listening. That lovely compliment on someone’s weight loss? Overheard by your daughter, sister, friend. That comment on how only people of a certain body type should wear that clothing item? Again, overheard by your loved ones. These comments systematically become ingrained in our minds, reinforcing the belief that size matters. Comment by comment, we are taught that “if you want to be liked, or at the very least not be the object of others’ judgements, you need to be small.”
  3. Weight, shape, and size are not accurate indicators of health. Contrary to popular belief, small does not equal healthy and large does not equal unhealthy. It’s time that our conversations caught up to science.
  4. Weight, shape, and size are not indicators of intelligence, work ethic, fitness, or even eating habits. To focus on this as the way we rate people, or the facet of their being we comment on, is insanely random and truly a reflection of our society rather than any actual truth. And, to focus on size alone, simultaneously does a huge disservice to someone’s far more meaningful qualities.

All of that being said, it’s time to take a good honest look at ourselves. If you are aware that you make comments about physical appearance (or think these things), it’s time to gently ask yourself why. Where and from whom did you receive messages about physical appearance? Who in your life do you need to find new ways of appreciating? Is there anyone you have put into a certain box unfairly?

When we know better, we can do better. Let’s create a world where our children aren’t afraid of their growing bodies, where people look forward to seeing longtime friends without fear of judgment, where people don’t dread riding on airplanes with judgmental strangers. Let’s create a world where we build each other up based on meaningful things. My clients deserve this, you deserve this, and I deserve this.

Wishing for A Quick Fix? The Realities of Eating Disorder Recovery


No quick fixes in Eating Disorder Recovery

Frequently, when we are ready to acknowledge that something in our lives needs to be changed, we decide it needs to be changed NOW! Urgency related to eating disorder recovery seems to be a common denominator among my clients – after all, who would want to remain in pain for even a second longer than they have to? And yet, wanting something to change quickly, especially an issue that may have been around for years, does not mean that the recovery process can occur quickly.

Where does this urgency come from? Often, I find that the urgency to “get (eating disorder recovery) over with” comes not only from wanting to be out of pain quickly, but also from our society’s marketing of quick fixes for weight-related issues. Unfortunately, this also means that many people lose all hope when change does not occur in fast, dramatic fashion. They fear that if change is not swift, this way (therapy) of dealing with food/weight issues won’t work for them either. Yet, nothing is further from the truth. When we are walking alongside a client on the bumpy, indirect route of recovery, we regularly witness that small, deliberate steps create long-lasting change. In fact, in my experience, the hardest part of eating disorder recovery is not taking the steps, but developing patience and faith in the process.

If you are having a hard time tolerating the pace of your recovery, ask yourself these questions and consider whether you might be on the right – albeit slow and steady – track.

1) Do you feel different than before? Typically, even before any behavioral change occurs with food, changes are noticeable in our emotional state. Maybe we don’t feel so anxious about food or we are more aware of the emotional triggers for eating disorder behaviors than we have been in the past?

2) Are there changes happening in how you engage with food or your body? Small changes are the key here. For example, are you bingeing less frequently? Or, are you considering stopping a behavior even if you are not yet effective in preventing it?

3) Are you thinking about your body or food differently? Eating disorder recovery gives us the rare gift of developing self-compassion for our physical self and physical needs. Finally learning to listen to what your wise body has been trying to tell you all along is a big step for someone who has been imprisoned by their eating disorder.

If you can see your perspective, your feelings, or behaviors starting to shift, give yourself the gift of time. It takes time to rebuild a relationship, especially if that relationship is with yourself. Take the next step, however small, and you will be rewarded.

Finding the Right Eating Disorder Specialist For You

Finding the right eating disorder specialist

Certain areas, like eating disorders, addictions, and trauma, are true specialties. You should feel comfortable asking questions about someone’s experience in a certain area – this is your treatment!

Almost nothing upsets me more than hearing someone resist getting the therapy they need because they have had unhelpful, or worse yet, damaging eating disorder treatment in the past. It takes so much courage to reach out for help that you want it to be worth the risk, right? So, how do you know that the eating disorder specialist you are seeking treatment with is likely to be a good fit? Although there are no guarantees, the following points are worth considering when you looking for a treatment provider or team:

1) It might seem obvious, but do they specialize in the treatment of eating disorders? Eating disorders pose unique challenges and demand a unique set of skills and knowledge. If you encounter someone who states that they specialize in eating disorders but they also specialize in everything else, ask about their specialty further. Most therapists are trained as “generalists” and therefore have the resources to help you recover from many common mental health concerns like depression, anxiety, relationship issues, and life transitions. Certain areas, like eating disorders, addictions, and trauma, are true specialties. You should feel comfortable asking questions about someone’s experience in a certain area – this is your treatment!

2) Can the eating disorder specialist describe their approach in a deep, yet understandable way? Good therapists are able to boil down their “theoretical orientation” or treatment approach into terms that not only make sense to you, but fit the issue(s) for which you are seeking treatment. If the therapist seems overly general, inquire further, or move on in your search.

3) Is the therapist up-to-date on current research? Psychological science is constantly changing and therefore, so is our understanding of the development, maintenance, and effects of eating disorders. Your eating disorder specialist should know where the research currently stands on the role of families, biology, and other factors in eating disorder recovery. For instance, we now know that family is often a huge asset to treatment, whereas historically parents of minors were encouraged to stay out of their child’s treatment. Getting to know the research yourself will enable you to identify when a therapist is up-to-date.

4) Is the therapist a good match for your style? This is a consideration for anyone seeking a therapist, not just an eating disorder specialist. The relationship between therapist and client is central to the effectiveness of treatment. Finding a therapist that you find to be sincere, trustworthy, credible, non-judgmental, and a good personality match creates the perfect situation for growth and recovery.

Although it might be frustrating to meet with a few different therapists or take the risk to start treatment again after a negative experience, finding the right fit therapeutically is key to regaining your health -time well spent!

For detailed information on our training, specialities, and treatment methods, visit our website at www.clearhorizonsaz.com.

5 Signs That Your Relationship with Food is Out of Balance


It is estimated that a mere 10% of people with eating disorders seek treatment – at least in part a commentary on what we label “disordered eating” and what we think is “normal” eating these days. Although most people will never reach full criteria for an eating disorder, not having a diagnosable disorder does not necessarily mean that our relationship with food is healthy. Wondering if your relationship with food could use some work? Ask yourself how many of these common signs apply to you:

1. Guilt after eating

Guilt is an emotion meant to be reserved for immoral behavior and yet many of us have learned to judge not only our eating behavior but often our character based on what we eat. Eating (whatever it is or however much) is not an issue of morality. It is a matter of meeting physical, and sometimes emotional, needs. If we are meeting emotional needs with food, it is simply a sign that we need to take better care of ourselves, NOT a cue for self-judgment.

2. Food on the brain

Find yourself thinking about food a lot? As in, planning what you can have, should have, shouldn’t have, or wish you hadn’t had? Spending a lot of energy planning your food intake or compensating for your food intake is a sure-fire sign that food issues are taking up too much space in your life. Most of the time we only need to think about what we are going to eat in the moments before and during our eating experiences, as in “Am I Hungry?,” “What Am I Hungry For?, or “Yum!”. How often do you trust your body to make food choices for you in the moment? This leads us to #3…

3. Ignoring hunger signals

How often do you find yourself delaying eating because you don’t feel that you should be hungry again yet? Or, it’s not convenient to eat? Or, because you are trying to control your food intake? Not only does ignoring hunger indicate that you don’t trust your body, it teaches your body that it can’t trust you and slows metabolism to prepare for what it believes may be impending famine.

4. Ignoring fullness signals

There are so many reasons that we eat past fullness that I will save those for another post! The bottom line is that eating past fullness is only occasionally about the food itself being so absolutely amazing that we can’t pass it up. If you find yourself consistently ignoring these signals, there is more to the story.

5. Food rules the day

Does your mood, enjoyment of events, or the whole tone of your day depend on how things went at breakfast (or what the scale said)? Any one factor in our life setting the tone for the whole thing suggests that we are out of balance.

Life has too much to offer to spend it fixated on food or totally ignoring our body’s needs. A healthy relationship with food is governed by trusting your body’s cues and having compassion for yourself when it becomes tempting to use food to solve other issues. If you regularly experience any of these signs, it might be time to take a closer look at your relationship with food!

Recovery is Worth It!


Getting healthy, putting faith into a treatment team and a future that you can’t even imagine, takes incredible strength – but the payoff is absolutely unbeatable.

Many times, especially early in my work with someone who is in recovery, be it from depression, anxiety, or in eating disorder recovery, I find myself trying to “sell” them on getting healthy. It’s so hard for someone who has felt down and potentially malnourished for so long to imagine that the hope of recovery actually applies to them. “I’ve seen people recover from a very similar place,” I say, hoping that my expertise lends some credibility to the healthy self inside them. “I know you didn’t always feel this way,” I say, encouraging them to recapture their former selves. “That is the disease talking,” I say, urging them not to take their hopelessness so seriously. It is nearly impossible to imagine that the dawn will come when the darkness of night has been so long.

And yet today, in more dramatic ways than typical, I saw that hope and that future take on concrete form. All in one day, I learned that three (!) of my amazingly strong, brilliant clients got into the colleges of their choice. The joy literally could not be contained, spilling out into the waiting room. Days, weeks, semesters of pent up anxiety suddenly dissipated, promises of (in this case) eating disorder recovery coming to fruition, hope reborn in an instant. It turns out, that recovery is in fact worth it. It turns out that facing your fears and “going all in” often turns out well.

Getting healthy, putting faith into a treatment team and a future that you can’t even imagine takes incredible strength, but the payoff is absolutely unbeatable. Ask yourself, if you went “all in” by letting go of shame, self-judgment, and fear of vulnerability, what might you be capable of? I dare you to find out what your recovery looks like…

Finding Joy Amidst the Holiday Chaos


“More than anything, finding joy in the holidays is about giving ourselves permission to slow down and savor the little moments”

Tis the season for holiday events and parties of all types. These days it is harder than ever to actually enjoy all the festive opportunities this season offers. Whether struggling with depression, anxiety, disordered eating, or just everyday busy-ness, the holidays can amplify stress rather than provide a reprieve from it. So, how do we set aside the chaos and make room for joy?

While the holidays may feel like a landmine at times, building in time for your own favorite festive activities is a sure fire way of balancing out the potential for stress. For some that might be spending low-key time with family or friends, for others it might be quiet time in a house of worship, for others still the best holiday memories are traditional activities like decorating the Christmas tree. Making time for yourself and finding joy over the holidays doesn’t have anything to do with making sure you attend every event and complete every task on your to do list. In fact, more than anything, finding joy in the holidays is about giving ourselves permission to slow down and savor the little moments instead.

So, go ahead and take a moment – even if you feel you don’t have one – to reflect on what you actually are looking forward to this holiday season. Choose a few activities or people that consistently bring you joy and truly protect the time you spent engaged with those things or people. Savoring those moments, however fleeting, will leave you feeling fulfilled rather than purely exhausted come 2015.

Wishing you moments of joy and peace this holiday season.