Today,

I"ll be sad for awhile.

Today,

I'll be scared for awhile.

I am all that I am at the time that I am

Acceptance is acknowledgement without control. When I acknowledge my feelings, my pains, my likes, my dislikes, my needs, my limits, my choices, my opinions, and my thoughts without control, I'm accepting myself. And I know that the more I detach the more I'll accept myself and other people. I also know. . ., "That I know what I know at the time I know it." And that's going to change. Acceptance (acknowledgement without control) is love..

I am human. As human I am a social creature. I am not without feeling. I am not without pain. The experience of my life will be living life from the inside out and not the outside in i.e. I experience my life from inside of my body. Acknowledging this without control is acceptance. Acceptance is love.

In accepting myself there are constants available to me. One is "self definition" and the other is "change." I am always changing. I change minute to minute, hour to hour, day to day, and year to year. Today I want a hotdog for lunch. Tomorrow I don't like hotdogs; I want a salad for lunch. The next day I like hotdogs again and want some soup to go with it. I am always changing. Sometimes I don't like someone. Sometimes I do. Sometimes I don't like myself. Sometimes I do. Sometimes I don't like something. Sometimes I do. Sometimes I think _____. Sometimes I don't. I'm always changing and moving from one idea or feeling to another and though all the middle gray areas in between. I'm changing all the time, more quickly and less quickly, and all the middle gray area's of quickly and less quickly. This brings me to the next constant, Self- Definition. So who am I? I see that I am always changing. If I were to define myself, I'd say that I am all that I am at the time that I am (since I am always changing). I am all my likes, my dislikes, my opinions, my thoughts, my choices, my needs, my strengths, my weaknesses, my limitations, my feelings, my changes, my behaviors, my addictions, my knowledge, etc. and all the middle gray areas in between. I am not the definition91 of something or someone else. For someone to define me outside of myself is arrogant, absurd, and shallow. I am all that I am at the time that I am and not the definition of anyone out side of myself (I am not the perception of someone else's opinion of me). I am the only one who may define myself with any accuracy. I am all that I am as a result of being myself. And who am I?

I am all that I am at the time that I am

I am all that I am examples:

My Likes (at the time I have them)

• People who smile.*
• People who ask questions as a way to come to know me.*
• People who have a sense of humor similar to mine.*
• People who like to play and be creative.*
• To be held* (with permission).
• Kissing, hugging, cuddling on the couch, spooning, exploring.*
• Making love.*
• To listen to other peoples ideas and dreams.*
• To ski.*
• To dance.*
• Having friends and community.
• To play piano and drums.*
• Space and science fiction.*
• Athletic women* (with a personality).
• Creative women* (artists, musicians, etc., with a personality).
• Intelligent women* (with a personality).
• Men that aren't macho* (who don't maintain the warrior myth).
• To show off.*
• Cooking food alone and with other people for company and conversation.*
• To participate rather than watch* (sports, music, education, etc).
• Humor.*
• Comedy.*

My Dislikes (at the time I have them)

• People who judge other people and believe it.
• People who argue to argue or don't make sense to me.
• Women who are controlling and non-compassionate (bitches).
• Men who are controlling and non- compassionate (assholes).
• Bullies
• Cold (emotionally) people.
• People who explain excessively.
• People who seek hidden approval continuously (fish). excludes children.
• People who corrupt other people.
• People who have sex as a way to gain leverage or obligate (conditional love).
• People who censor, change, or discount what I've said as a way to repress me.
• People who rephrase what I've said as a way to control the conversation.
• People who require me to carry the conversation (do the work alone).
• People who are absent in the conversation (emotionally or verbally).
• People who intimidate other people to control them.
• Angry-hostile people.
• Scaring myself compulsively.
• People who deal in absolutes.
• People who label as a way to injure.
• People who label as a way to create expectation.
• People who label as a way to gain control.
• People who create chaos on a consistent bases.
• People who always look for something wrong.
• Doomsayers.
• People who judge other people as a way to bolster themselves.
• People who hide an agenda.
• People who don't respect boundaries.
• People who use coercion, control, rage, violence.
• People without compassion or concern.
• People who clean obsessively as a way to "look good" for others.
• People who organize obsessively.

My Needs (stable for the most part)

• Access to food, clean water, sanitation, clothing, shelter, and medical services.
• Income (for the first need) and the transportation to earn that income.
• Recovery and the income and transportation to maintain that recovery.
• School (education).
• Dreams.
• To say I can choose.
• To say I love you.
• To say I'm sorry.
• To say I need you to help me meet my need.
• To know that the screw-ups I have are healthy.
• To hold and be held.*
• To have approval (in direct and non-controlling ways).
• To express (expulsion) my "self."
• To allow my "self" choices and the possibility of choices that are unknown.
• To set boundaries (and no explanation is necessary).
• To allow myself honesty.
• To say, "I don't know" when I don't know.
• To allow my honesty to be earned and not shared indiscriminately.
• To practice safe sex.
• To practice eating as needed and not in a way to stuff or over eat.
• To stop and clear myself when I'm in chaos or subtle diversion.
• To detach.
• To be separate in order to be close.
• To know that the best I can do is too much (controlling, approval seeking).
• Acknowledging when I hurt.
• Acknowledging when I'm sore.
• Acknowledging when my stomach hurts.

My Limits (at the time I have them)

• The limits I have are not the same as the ability (I have) to do something.
• I'm unable to change the past.
• I'm unable to change the future by worrying about it.
• I have fears.
• I get tired.
• I'm unable to control what someone else is thinking of me.
• I'm unable to forcibly control someone else's actions without using destructive control behaviors. (to kill spirit)
• I can't control another person by being nice and accommodating.

My Choices (at the time I have them)

• I choose to confront at my own discretion.
• I choose to amend at my own discretion.
• I choose to end a relationship at any time that it becomes un- healthy.*
• I choose to know that there are choices unknown to me.
• I choose to say I'm ok with myself.*
• I choose to avoid affirming or meeting another person's needs for a self prophecy of inadequateness (Doing my "your not good enough" routine in response to an action that is unconsciously carried out by the other person to look or sound inadequate i.e. action, communication, etc).*

My Thoughts and My Opinions (at the time I have them)

• This guide is my opinion.
• I'm uniformed on occasion, I'm informed on occasion, I am neither absolutes the rest of the time (shades of middle grey).
• I empower women indiscriminately with the power to heal and nurture.
• There are many myths about life and relationship.
• I lost a sense of safeness in childhood.
• My belief system is terror based.
• I'm afraid to let people like me.
• I don't know what I thought I knew.
• Someone complaining to me about my opinions is giving up their own power to me. If we are equals why would they do this?
• Moving from a victim standpoint scares me.
• When I scare myself, I become my own expulsion inhibitor.
• It scares me to set boundaries.
• It scares me to ask for my needs to be met (it comes off as being pissed off with the other person).
• I use my head a lot to stay a way from feeling bad.
• This guide takes my own inventory and the inventory of other people.
• Words are words. Words are symbols whose meaning is worthless except to the user. Words are interpretations and not facts.
• When I complaint consistently about something , I probably don't like what I'm complaining about and need to decide if I want to change.
• I am not what I do.
• Males are trained to be disposable. I've felt disposable. Males have been trained for war for many centuries. They get judged on their ability to go to war and provide security.
• I need my addictions while I learn how to feel better for myself (how to nurture myself).
• The "Anxiety" is the looking for something to feel better.
• When I feel intense terror or shame, someone is probably playing an intense victim similar to my mother, my father, my sister, my brother, etc.
• Asking before giving feedback is a loving gesture.
• "Being afraid not to," has a lot of sadness in it for me.
• The greatest gift I give another person is to listen and acknowledge without controlling what I've heard.

* Signifies the opposites and shades of middle gray too.

"All that I am is me. I am myself today,

and I'll be changing tomorrow."

I can choose to accept (acknowledge without control) the change.

As a young infant I was able to love without controlling. Today my ability to love is as available to me as it was then except that I know "something" different which scares the love away. The "loss of control" is the "something" different that scares me. Relearning to love without control is a gift that's available to me.

I am also my recovery issues. I am my fears, my myths, my rage, my old baggage, my chaos, and my looking behavior. I accept that I'm afraid to feel. I accept that I'm afraid to set boundaries. I accept that I'm afraid to ask for my needs to be met. I accept my difficulties in trusting people. I accept that acceptance is an on going and confusing process. And in the mean time, acceptance of . . .

"I am all that I am at the time that I am"

. . . . is the key

next: Back to Basics: Male and Female
~ all Art of Healing articles
~ addictions library articles
~ all addictions articles

Stealing Behavior

Closely linked to OCD is an aspect of impulsivity seen in eating disordered patients. In anorexia nervosa symptoms, stealing behavior was first connected with the sometimes strange habit of hoarding foods or objects (Norton, 1985). The association of stealing and anorectic behavior even in non-Western countries has stimulated various interpretations, ranging from biological to psychodynamic views (Lee, 1994). In early reports on bulimia, a connection was made between compulsive eating and stealing (Ziolko, 1988). Some reports have made mention of stealing behavior as an aspect of "impulsivity" in eating disordered patients (McElroy, Hudson, Pope, & Keck, 1991; Wellbourne, 1988). However, Vandereychen & Houdenhove (1996) proposed that stealing is more likely when the eating disorder includes "Bulimia-like" behavior (binge eating, vomiting and laxative abuse).

The majority of bulimic shoplifters reported stealing something which was involved with their eating disorder (e.g., food money, laxatives, diuretics, or diet pills) and they indicated that embarrassment and shame over buying these items was the main reason to shoplift (Vandereychen, et al, 1996).

From the opposite viewpoint, in recent years studies on kleptomania paid attention to its frequent connection with eating disorders (McElroy, 1991). Stealing has been related to the new phenomenon of "compulsive buying," a lifetime diagnosis of an eating disorder was found in 17% to 20.8% of these subjects (Christenson, Faber, de Zwaan, Raymond, & Mitchell, 1994; Schlosser, Black, Repertinger, & Freet, 1994).

Deborah J. Kuehnel, LCSW, © 1998

Substance Abuse

Impulsivity is a key feature of both bulimia and substance abuse. The self-medication hypothesis suggests that eating disordered individuals begin abusing chemical substances in an effort to treat their eating problems, as a means of coping with the worry caused by these problems. Additionally, an association between eating disorders and familial drug abuse, usually alcoholism, suggests the possibility of biological similarities or links between substance abuse and eating disorders (Holderness, Brooks-Gunn, & Warren, 1994).

Deborah J. Kuehnel, LCSW, © 1998

next: The Food Guide Pyramid
~ eating disorders library
~ all articles on eating disorders

A recovery issue I've been dealing with lately is letting go of the compulsion to:

• predict the future
• figure out situations in advance
• obsess about alternative paths
• calculate every move to perfect timing
• avoid risk by remaining indecisive

While I realize that planning ahead is both smart and beneficial, for me planning can easily disintegrate into second-guessing the "what ifs" to the point that no plans get made and nothing gets accomplished. Before I know it, I've spent days or weeks procrastinating over the outcome rather than making a decision. Some of my "what if" demons about future outcomes include:

• What if I lose my job?
• What if there isn't enough money?
• What if I can't make my child support payments?
• What if the car breaks down?
• What if my kids don't like this decision?
• What if so-and-so doesn't love me?
• What if so-and-so leaves me?
• What if so-and-so says no?
• What if the next relationship is worse than the first?

The truth I have to remember is that life includes so much risk-taking. I want to avoid the extreme of jumping into situations without pausing to think. But I also want to avoid over-analyzing a situation to the point of paralysis. Both extremes are equally dangerous.

So the solution for me has been to find that position of positive, healthy balance. Somewhere between leaping and procrastinating is the calm, balanced center. A place where I am capable of making sound decisions (rather than reacting). A place where I can weigh the risk of moving forward with the risk of remaining static. A place where I can separate and determine God's will from my egotistical self-will. A place where my final decision rests on what is best for my life rather than what is best for today.

Most of all, I must remember that life cannot always be perfectly calculated. Sometimes it is OK to wait, and sometimes, it is OK to leap spontaneously into the unknown.

Obsessive suicidal thoughts drove author Susan Rose Blauner to multiple suicide attempts. She sees suicidal thinking as an addiction.

Susan Rose Blauner knew the killer stalking her for 18 years: It was her own mind.

During that time, obsessive suicidal thoughts drove her to three drug overdoses and three confinements in psychiatric wards.

Through a combination of spirituality, 10 years of intense psychotherapy, her own fierce determination, and the loving support of family and friends, Blauner gained control over what she terms an "addiction" to suicide.

Addiction to Suicidal Thoughts

"I see suicidal thinking as an addiction. For me, it became an addiction just like alcohol is to an alcoholic. With stress, I reach for suicidal thinking," Blauner says.

She recounts her experiences and offers advice in her new book, How I Stayed Alive When My Brain Was Trying To Kill Me: One Person's Guide to Suicide Prevention. Blauner calls it a hands-on guide for those plagued by suicidal thoughts, their families and friends, and mental health professionals.

"I started writing the book about 10 years ago, and I was actually suicidal through most of the time I was writing it," says Blauner, 36, who lives on Cape Cod, Mass.

As she wrestled with her self-destructive demons, she searched for a book on suicide prevention that was written by an ordinary person with firsthand experience. "I wanted a book that would tell me how not to kill myself," Blauner says.

She couldn't find the kind of book she wanted, so she decided to write one herself.

"It gives a very unique perspective in that it's coming from the mind of a suicidal thinker. The book is very empathetic and compassionate. It's really a conversation between myself and the reader, whether they're the suicidal thinker or the caregiver," Blauner says.

She wants those haunted by suicidal thoughts to know they're not alone, and that they shouldn't be ashamed to reach out for help.

"It's a real in-your-face book. The thing I realized is that most suicidal thinkers don't want to be dead, they just don't want to feel the pain anymore in their brains," Blauner says.

Her book, which carries a foreword by Dr. Bernie S. Siegel, provides suicidal thinkers with ways to keep from taking their life so they can buy the time to learn how they can reduce their emotional pain. It includes a list of coping strategies that Blauner calls her "25 Tricks of the Trade."

Those strategies include asking for help, using suicide emergency hotlines, having a crisis plan, gaining an understanding of your feelings, signing no-harm-to-self agreements, therapy, exercise and keeping a journal.

What Family Members and Friends Should Know About Suicide

The book also has important messages for family and friends of suicidal people. It includes letters from Blauner's family and friends describing their experiences and feelings when Blauner was actively suicidal.

"Caregivers can see that they're not alone and that it's OK to be angry and still love the person. It's OK to be confused. It's OK to not have all the answers," Blauner says.

People who have lost a loved one to suicide can find some solace in the book and ease their guilt that they could have done more to prevent suicide.

"They see that, at that moment, there's such constricted vision and tunnel vision for the suicidal thinker that the rest of the world doesn't even exist. It's just you and this brain that's telling you that you want to be dead," Blauner says.

Writing the book was a form of therapy for her.

"It helped me make sense of why I had to struggle for 18 years. There's a reason for this. So now I can give back to the world so that someone else does not have to struggle."

She says she'll donate 10 percent of any royalty profits from the book to the National Hopeline Network, Kristin Brooks Hope Center, a suicide prevention hotline.

Blauner says she recently experienced an "epiphany" that suicidal thinking doesn't have to be a part of her life anymore.

"I'm as healed as I can be in the moment," she says. "I'm pretty convinced that I'm never going to kill myself, but I can't say that those thoughts won't ever occur to me again in my life."

Her life is now one of ongoing vigilance. For example, she has to ensure she doesn't create any undue stress that may trigger suicidal thoughts. Those stressors include such things as being tired and hungry.

Blauner admits that suicide is still a difficult subject for people to discuss.

"One of my goals is to really bust it out in terms of the stigma of mental illness, and just get people talking about it," she says.

Each year in the United States, about 30,000 people commit suicide and there are about 730,000 suicide attempts. Suicide is the second leading cause of death among college students and the third leading cause of death for people aged 15 to 24.

The National Hopeline Network 1-800-SUICIDE provides access to trained telephone counselors, 24 hours a day, 7 days a week.

Or for a crisis center in your area, visit the National Suicide Prevention Lifeline.

When I talk about living mindfully and respectfully of others, don't misunderstand.

Treating others with respect never means we have to become a doormat. We never have to demean ourselves in the recovery process.

Just the opposite, recovery is about redeeming our self-esteem enough to respect others and ourselves. Recovery is about our freedom to stand up for ourselves when others treat us disrespectfully.

When you think about it, co-dependency is the ultimate demeaning behavior. Co-dependency saps us of our self-esteem and self-respect. And we do it to ourselves when we let others treat us as less than. Recovery gives us back our power and our right to esteem and respect ourselves. To expect esteem and respect from others. And recovery gives us the power to choose to respect others and esteem them—not so they will love us (or even like us) in return—but because respect is the key to effective human interaction.

Recovery is not difficult, mysterious, or dark in what it seeks to accomplish in us and through us.

If others don't have to put up with our controlling, manipulative behavior that we practice when acting out our co-dependency, then neither do we have to put up with the same stuff when others dish out similar behavior to us.

In everything I have said about co-dependency over the past four years, my message is simply this: We are individuals; we are worthy of respect. In our relationships, who we are looking for are other people who will offer us co-equal respect—not as a favor or to get something from us in return, but simply because they acknowledge us and recognize us as fellow human beings. We are all on the same road, but of each us carries our own load. And when each of us is mindful enough to offer supportive and encouraging treatment to others on the journey, we become restful, sunlit vistas along their path.

Dear God, thank You for teaching me to treat others the way I wish to be treated. Amen.

Today Linda and I celebrated our first year anniversary!

As part of our anniversary weekend together, we took a drive down to the beach where we were married and looked through our wedding vows, giving ourselves a kind-of report card on our first year together. The past year had its rough spots, its ups and downs, it doubts and fears, and its co-dependencies. But we have hit the one year mark and that is an achievement that stands on its own.

I've finally learned that, yes, relationships really can be full of fun and excitement. But I've also learned that a "meaningful" relationship with Linda requires putting my whole self into the effort of creating and sustaining the meaning and love that relationship offers to us. Good, healthy relationships simply don't happen by accident. Nor are they merely the by-product of attraction.

I must credit Linda for her deep level of commitment. Many times I wanted to quit or regress to the safety of my past. But she kept loving me unconditionally through it all. She kept offering me acceptance and forgiveness.

Taking a Step Four inventory of myself, this marriage has helped me see that I still have many, many miles to go on the recovery road. But that's OK. What makes recovery exciting is the fact that this journey never ends. Every day offers new insights and new puzzles and new glances in the mirror. Every day offers new opportunities to grow and mature. Every day is the beginning.

My job is to stay mindful and respectful and keep learning from the experience. And this holds true not only for my marriage, but for all the relationships in my daily round.

Maybe that is the essence of recovery - learning to live in mindful respect every single minute of the day, seizing every opportunity to show kindness and good will to each person I encounter. At least, that is the goal I am striving to attain through recovery.

Dear God, thank You for my wonderful marriage and the many lessons You are teaching me through my beautiful wife. Amen.

next: What I Believe

Julaine suffered from severe depression and anxiety disorder. She received ECT treatments and antidepressant medications. Here's her ECT story.

One Woman's Story of Hope and Recovery

I tell this story, not out of a desire to call attention to myself, but because I want mental health consumers, family members, friends and their professionals to know there IS hope and recovery for those who experience the painful and often terrifying experience of having a mental illness.

It started out with a simple panic attack one night. As a young mother, I had struggled for three long years, combining full-time work and caring for my family. My husband, Dennis and I, were enroute to Washington, D.C. on a short vacation, celebrating the acquisition of his new job which would allow me to stay at home with our young son.

I awoke suddenly in the middle of the night, breathless, heart pounding - feeling like I was suffocating. Pacing the floor until the attack subsided, I returned to bed mystified. The panic attack returned the next day and the next, increasing in frequency and severity.

Severe nausea then invaded my body, landing me in a hospital emergency room. Physicians there admitted me twice during the following week, treating me with intravenous feedings and medication for anxiety. Searching for intestinal problems but finding none, doctors released me and I returned home with my husband. Retreating to my bed, I began to feel worse and worse.

My third admittance to a hospital (that time locally) proved fruitless again. I returned to bed, sluggish from medications that seemed only to induce sleep. My weight plummeted to a dangerous level, along with my spirits. I could no longer function--neither did I have a desire to. An ominous weight pushed down on me. Powerless to escape its clutches, I began to think about dying.

One night, I awoke feeling as if someone were injecting me with toxic adrenaline. Sobbing and frantically pacing the floor, I began to think I had lost my mind. My frightened husband once again rushed me to a hospital, this time to a university medical center. There, a diagnosis was finally made. I had severe depression and anxiety disorder.

Admitted to a psychiatric in-patient center, I was heavily sedated. Weeks inched by as I endured various antidepressant medication trials and ECT treatments. Many times, I felt I could not go on. The battle seemed interminable. Finally, following various treatments methods and two hospitalizations in six months, I was able to resume a normal life again.

For the next few years, I was successful battling various minor episodes of recurrent depression. It was during this time, I discovered a wonderful support group for depressives and manic depressives (DMDA/San Antonio, Texas), where my family resided. Not only did I find friends and support, but received life giving education and coping skills concerning clinical depression.

Upon relocating to Florida soon afterwards, my participation in the San Antonio DMDA Chapter aided me in establishing DMDA Mid-Orlando in 1992. The group flourished and began to exert a positive impact on Orlando's mental health community. When I experienced a major depressive setback soon after, a DMDA support group friend and member stayed with me day-after-day, taking care of my physical and mental needs while my husband went to work.

For months, I fought a downhill battle of medication trials and treatments, only becoming increasing ill. My family grew exhausted from the tremendous strain I was putting on them. Time-after-time, I came close to losing my struggle with depression. Only the perseverance of my doctor, loved ones, friends, and countless prayers in my behalf, kept me fighting to overcome this illness that seemed to want to devour me.

After three years of constant battling, I finally responded to a successful medication combination. It was as if I had risen from the dead! In 1, I celebrated my fourth year of major recovery from severe depression. The recent years since my recovery have been filled with struggles, yet have been the best time of my life.

Because of the excellent training and support provided by DMDA on a local, state and national level, I was able to resume active DMDA leadership and help train others to in the same pursuit.

Resulting employment as an information and referral specialist at the Florida Mental Health Association increased my knowledge about mental illness, its treatment, and advocacy. Participation in mental health seminars, programs and contacts with professionals further honed my skills.

I have been privileged not only to work as an Orange County, Florida guardian advocate for psychiatric inpatients but to be a team member of the first official Guardian Advocacy pilot program in the state of Florida. My great desire to help educate and support others dealing with mental illness has expanded even further.

I have also aided in National Depression Day Screenings, and participated in the following as an organizer and speaker: Orlando and Daytona, Florida's Mental Illness Awareness Week and Mental Health Association of Central Florida's Statewide Conference for Mental Health Consumers and their families.

I was also privileged to be a Board Member and active volunteer for NAMI of Greater Orlando during the last 3 years I lived in Orlando, Florida.

One of my favorite activities is addressing professional, community and school classes about my struggle to overcome serious depression. Additionally, in October 1998, my husband and I appeared on a nationally broadcast program at Universal Studios, relating the story of our family's struggle to successfully survive my life threatening illness, depression.

The highlight of my victory, however, occurred just recently when I entered graduate school to become a licensed mental health counselor. Today, as a masters student at Denver Seminary, I see clients in my counseling practicum program. I look forward to the day I can further serve others as a consumer-oriented professional in the community, churches and mental health support organizations.

Winning the 1998 Beth Johnson Scholarship from the Mental Health Association of Central Florida helped confirm my belief that mental health consumers can join the ranks of professionals, positively impacting not only clients and family members, but coworkers, as well.

The recovery and victories I have attained, are largely due to the support, education and skills I received from being a DMDA member and leader.

Today, I can reach out to others in a more effective way. Truly, I have "walked the walk!"

Julaine

next: Electroconvulsive Therapy (ECT): An Effective Treatment for Depression
~ depression library articles
~ all articles on depression

Eating Disorders: Not For Females Only

It is generally assumed that the problem of eating disorders is a female issue because, after all, appearance, weight, and dieting are predominately female preoccupations. Magazine articles, television shows, movies, books, and even treatment literature dealing with eating disorders focus almost exclusively on females.

Binge eating disorder is seen somewhat differently than the classic eating disorders anorexia nervosa and bulimia nervosa. Males have always been included in the literature and in treatment programs for compulsive overeating. Compulsive overeating, however, has only recently been recognized as its own eating disorder - binge eating disorder - and it still is not accepted as an official diagnosis. Because anorexia and bulimia are official diagnoses, the term eating disorder usually refers to one of these two disorders.

Males do develop anorexia and bulimia, and, rather than being a new phenomenon, this was observed over three hundred years ago. Among the first well-documented accounts of anorexia nervosa, reported in the 1600s by Dr. Richard Morton and in the 1800s by the British physician William Gull, are cases of males suffering from the disorder. Since these early times, eating disorders in males have been overlooked, understudied, and underreported. Worse still, eating disordered males seeking treatment are turned down when requesting admission to most of the programs in the country because these programs treat females only.

The number of females suffering from eating disorders far exceeds that of males, but in the last few years reported cases of males with anorexia nervosa and bulimia nervosa have been steadily increasing. Media and professional attention have followed suit. A 1995 article in the Los Angeles Times on this subject entitled "Silence and Guilt" stated that roughly one million males in the United States suffer from eating disorders.

A 1996 article in the San Jose Mercury News shocked readers by reporting that Dennis Brown, a twenty-seven-year-old Super Bowl defensive end, revealed that he used laxatives, diuretics, and self-induced vomiting to control his weight and even underwent surgery to repair bleeding ulcers made worse by his years of bingeing and purging. "It's always been the weight thing," said Brown. "They used to get on me for being too big." In the article, Brown reported that after making such statements in an NFL-sponsored interview session, he was pulled aside and reprimanded by coaches and team officials for ". . . embarrassing the organization."

The following research summaries, provided by Tom Shiltz, M.S., C.A.D.C., from Rogers Memorial Hospital's Eating Disorder Center in Oconomowoc, Wisconsin, are included here to provide insight into the various biological, psychological, and social factors influencing male eating disorders.

• Approximately 10 percent of eating disordered individuals coming to the attention of mental health professionals are male. There is a broad consensus, however, that eating disorders in males are clinically similar to, if not indistinguishable from, eating disorders in females.
• Kearney-Cooke and Steichen-Asch found that men with eating disorders tend to have dependent, avoidant, and passive-aggressive personality styles and to have experienced negative reactions to their bodies from their peers while growing up. They tend to be closer to their mothers than to their fathers. The authors concluded that "in our culture, muscular build, overt physical aggression, competence at athletics, competitiveness, and independence generally are regarded as desirable for boys, whereas dependency, passivity, inhibition of physical aggression, smallness, and neatness are seen as more appropriate for females. Boys who later develop eating disorders do not conform to the cultural expectations for masculinity; they tend to be more dependent, passive, and non-athletic, traits which may lead to feelings of isolation and disparagement of body."
• A national survey of 11,467 high school students and 60,861 adults revealed the following gender differences:
  • Among the adults, 38 percent of the women and 24 percent of the men were trying to lose weight.
  • Among high-school students, 44 percent of the females and 15 percent of the males were attempting to lose weight.
• Based on a questionnaire administered to 226 college students (98 males and 128 females) concerning weight, body shape, dieting, and exercise history, the authors found that 26 percent of the men and 48 percent of the women described themselves as overweight. Women dieted to lose weight whereas men usually exercised.
• A sample of 1,373 high-school students revealed that girls (63 percent) were four times more likely than boys (16 per-cent) to be attempting to reduce weight through exercise and caloric intake reduction. Boys were three times more likely than girls to be trying to gain weight (28 percent versus 9 per-cent). The cultural ideal for body shape for women versus men continues to favor slender women and athletic, V-shaped, muscular men.
• In general, men appear to be more comfortable with their weight and perceive less pressure to be thin than women. A national survey indicated that only 41 percent of men are dissatisfied with their weight as compared with 55 percent of women; moreover, 77 percent of underweight men liked their appearance as opposed to 83 percent of underweight women. Males were more likely than females to claim that if they were fit and exercised regularly, they felt good about their bodies. Women were more concerned with aspects of their appearance, particularly weight.
• DiDomenico and Andersen found that magazines targeted primarily to women included a greater number of articles and advertisements aimed at weight reduction (e.g., diet, calories) and those targeted at men contained more shape articles and advertisements (e.g., fitness, weight lifting, body building, or muscle toning). The magazines most read by females ages eighteen to twenty-four had ten times more diet content than those most popular among men in the same age group.
• Gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers are vulnerable to eating disorders because their professions necessitate weight restriction. It is important to note, however, that functional weight loss for athletic success differs from an eating disorder when the central psychopathology is absent.
• Nemeroff, Stein, Diehl, and Smilack suggest that males may be receiving increasing media messages regarding dieting, ideal of muscularity, and plastic surgery options (such as pectoral and calf implants).

The increase in articles and media reports on males with eating disorders is reminiscent of the early years when eating disorders in females first began to get public attention. One wonders if this is our early warning of how frequently the problem with males really occurs.

The studies indicating that somewhere between 5 and 15 percent of eating disorder cases are males are problematic and unreliable. Identifying males with eating disorders has been difficult for several reasons, including how these disorders are defined. Consider that until DSM-IV, the diagnostic criteria for anorexia nervosa included amenorrhea, and since originally bulimia nervosa was not a separate illness but rather absorbed into the diagnosis of anorexia nervosa, a gender bias existed for both of these disorders such that patients and clinicians held the belief that males do not develop eating disorders.

Walter Vandereycken reported that in a 1979 study, 40 percent of internists and 25 percent of psychiatrists surveyed believed that anorexia nervosa only occurs in females, and that in a 1983 survey 25 percent of psychiatrists and psychologists considered femaleness fundamental to anorexia nervosa. Being overweight and overeating are culturally more acceptable and less noticed in males; therefore, binge eating disorder also tends to go underrecognized.

As it now stands, the three essential requirements for the diagnosis of anorexia nervosa - substantial self-induced weight loss, a morbid fear of becoming fat, and an abnormality of reproductive hormone functioning - can be applied to males as well as females. (Testosterone levels in males decrease as a result of this disorder, and in 10 to 20 percent of cases, males remain with features of testicular abnormality.) The essential diagnostic features for bulimia nervosa - compulsive binge eating, a fear of fatness, and compensatory behaviors used to avoid weight gain - can also be equally applied to males and females.

For binge eating disorder, both males and females binge eat and feel distress and out of control over their eating. However, the problem of identification continues. Males with eating disorders have been so rarely acknowledged or encountered that the diagnostic possibility of anorexia nervosa, bulimia nervosa, or binge eating disorder is overlooked when males present with symptoms that would lead to a correct diagnosis if presented by a female.

Diagnostic criteria aside, the problem of identifying males with eating disorders is heightened by the fact that admitting to an eating disorder is difficult for anyone, but even more difficult for males due to the perceived notion that only females suffer from these illnesses. In fact, males with eating disorders commonly report fears of being suspected of homosexuality for having what is considered a "female problem."

Gender Identity and Sexuality

As far as the sexuality issue goes, males with all variations of sexual orientations develop eating disorders, but studies have indicated a possible increase in gender identity conflict and sexual orientation issues among many males who do develop eating disorders. Dieting, thinness, and obsession about appearance tend to be predominantly feminine preoccupations, so it is not surprising that male eating disorder patients often present with gender identity and orientation issues including homosexuality and bisexuality. Tom Shiltz has also compiled the following statistics on sexuality, gender identity, and eating disorders, reprinted here with his permission.

Gender Dysphoria and Homosexuality

• Fichter and Daser found that male anorexics saw themselves and were seen by others as more feminine than other men, both in attitudes and behavior. In general, the patients appeared to identify more closely with their mothers than their fathers.
• Homosexuals are overrepresented in many samples of eating disordered men. While the proportion of male homosexuals in the general population cross-culturally is estimated to be 3 to 5 percent, samples of eating disordered men are commonly twice as high or higher.
• Several authors have noted that homosexual content preceded the onset of the eating disorder in up to 50 percent of male patients.
• Conflict over gender identity or over sexual orientation may precipitate the development of an eating disorder in many males. It may be that by reducing their sexual drive through starvation, patients can temporarily resolve their sexual conflicts.
• Body image concerns may be important predictors of eating disorders in males. Wertheim and colleagues found that a desire to be thinner was a more important predictor of weight loss behaviors than psychological or family variables for both male and female adolescents.
• Kearney-Cooke and Steichen-Asch found that the preferred body shape for contemporary men without eating disorders was the V-shaped body, whereas the eating disordered group strove for the "lean, toned, thin" shape. The authors found that most of the men with eating disorders reported negative reactions from their peers. They reported being the last ones chosen for athletic teams and often cited being teased about their bodies as the times when they felt most ashamed of their bodies.

Sexual Attitudes, Behaviors, and Endocrine Dysfuncion

• Burns and Crisp found that male anorexics in their study admitted "obvious relief" at the diminution of their sexual drive during the acute phase of their disease.
• A study by Andersen and Mickalide suggests that a disproportionate number of male anorexics may have persisting or preexisting problems in testosterone production.

One problem with eating disorder and gender studies is that what are often considered feminine traits, such as a drive for thinness, body image disturbance, and self-sacrifice, are the hallmarks of eating disorders in both males and females. Therefore, using these traits to determine the degree of femininity in anyone with an eating disorder, male or female, is misleading. Furthermore, many studies involve self-reporting and/or populations in eating disorder treatment settings, both of which may provide unreliable results. Since many individuals find it difficult to admit they have an eating disorder, and since the admission of homosexuality is also a difficult matter, the actual incidence of homosexuality among males with eating disorders in the general population is an unclear and undetermined issue.

Andersen and other researchers, such as George Hsu, agree that the most important factor may be that there is less reinforcement for slimness and dieting for males than for females. Dieting and weight preoccupation are precursors for eating disorders and these behaviors are more prevalent in females. Andersen points out that by a ratio of 10.5 to 1, articles and advertisements concerning weight loss are more frequent in the ten most popular women's versus men's magazines.

It is more than interesting that the 10.5 to 1 ratio parallels that of women to men with eating disorders. Furthermore, in subgroups of males where there is a great emphasis on weight loss - for example, wrestlers, jockeys, or football players (such as in the above-mentioned case of Super Bowl defensive end Dennis Brown), there is an increased incidence of eating disorders. In fact, whenever weight loss is required for a particular group of individuals, male or female, such as in ballerinas, models, and gymnasts, there is a greater likelihood that those individuals will develop eating disorders. From this it can be speculated that as our society increasingly places pressure on men to lose weight, we will see an increase in males with eating disorders.

In fact, it is already happening. Men's bodies are more frequently the targets of advertising campaigns, leanness for men is increasingly being emphasized, and the number of male dieters and males reporting eating disorders continues to rise.

One final note is that, according to Andersen, eating disordered men differ from eating disordered women in a few ways that may be important for better understanding and treatment.

• They tend to have genuine histories of pre-illness obesity.
• They often report losing weight in order to avoid weight-related medical illnesses found in other family members.
• They are likely to be intensely athletic and to have begun dieting in order to attain greater sports achievement or from fear of gaining weight because of a sports injury. In this respect, they resemble individuals referred to as "obligatory runners." In fact, many eating disordered men may fit another proposed but not yet accepted diagnostic category, referred to as compulsive exercise, compulsive athleticism, or a term coined by Alayne Yates, activity disorder. This syndrome is similar to but separate from the eating disorders and is discussed in this book in chapter 3.

Treatment and Prognosis for Males

Although more research needs to be done on the specific psychological and personality features of males with eating disorders, the basic principles for treatment currently promoted are similar to those for treating females and include: cessation of starvation, stop binge eating, weight normalization, interrupting binge and purge cycles, correcting body image disturbance, reducing dichotomous (black-and-white) thinking, and treating any coexisting mood disorders or personality disorders.

Short-term studies suggest that the prognosis for males in treatment is comparable to that for females, at least in the short term. Long-term studies are not available. However, empathetic, informed professionals are necessary, due to the fact that males with eating disorders feel misunderstood and out of place in a society that still doesn't understand these disorders. Even worse, males with eating disorders are often made to feel uncomfortable and otherwise rejected by females similarly afflicted. Although it may turn out to be true, it is often mistakenly assumed that males with eating disorders, most particularly anorexia nervosa, are more severely disturbed and have a poorer prognosis than females with such disorders.

There are good reasons why this may appear to be the case. First, since males often go undetected, only the most severe cases come into treatment and thus under scrutiny. Second, there seems to be a contingent of males with other serious psychological disorders, most notably obsessive-compulsive disorder, where food rituals, food phobias, food restriction, and food rejection are prominent features. These individuals end up in treatment mostly due to their underlying psychological illnesses, not for their eating behavior, and they tend to be complex, difficult-to-treat cases.

Strategies for Prevention and Early INtervention of Male Eating Disorders

• Recognize that eating disorders do not discriminate on the basis of gender. Men can and do develop eating disorders.
• Learn about eating disorders and know the eating disorder warning signs. Become aware of your community resources (e.g., eating disorder treatment centers, self-help groups, etc.). Consider implementing an Eating Concerns Support Group in the school setting to provide interested young men with an opportunity to learn more about eating disorders and to receive support. Encourage young men to seek professional help if necessary.
• Athletic activities or professions that necessitate weight restriction (e.g., gymnastics, track, swimming, wrestling, rowing) put males at risk for developing eating disorders. Male wrestlers, for example, present with a higher rate of eating disorders than the general male population. Coaches need to be aware of and disallow any excessive weight control or body building measures employed by their young male athletes.
• Talk with young men about the ways in which cultural attitudes regarding ideal male body shape, masculinity, and sexuality are shaped by the media. Assist young men in expanding their idea of "masculinity" to include such characteristics as caring, nurturing, and cooperation. Encourage male involvement in traditional "nonmasculine" activities such as shopping, laundry, and cooking.
• Never emphasize body size or shape as an indication of a young man's worth or identity as a man. Value the person on the "inside" and help him to establish a sense of control in his life through self-knowledge and expression rather than trying to obtain control through dieting or other eating disorder behaviors.
• Confront others who tease men who do not meet traditional cultural expectations for masculinity. Confront anyone who tries to motivate or "toughen up" young men by verbally attacking their masculinity (e.g., "sissy" or "wimp"). Dem-onstrate respect for gay men and men who display personality traits or who are involved in professions that stretch the limits of traditional masculinity (e.g., men who dress colorfully, dancers, skaters, etc.).
• Research has shown that a man who develops an eating disorder presents the following profile: he appears to lack a sense of autonomy, identity, and control over his life; he seems to exist as an extension of others and to do things because he must please others in order to survive emotionally; and he tends to identify with his mother rather than with his father, a pattern that leaves his masculine identity in question and establishes a repulsion of "fat" that he associates with femininity. With this in mind, the following suggestions for prevention can be made:
  • Listen carefully to a young man's thoughts and feelings, take his pain seriously, allow him to become who he is.
  • Validate his strivings for independence and encourage him to develop all aspects of his personality, not only those that family and/or culture find acceptable. Respect the person's need for space, privacy, and boundaries. Be careful about being overprotective. Allow him to exercise control and make his own decisions whenever possible, including control over what and how much he eats, how he looks, and how much he weighs.
  • Understand the crucial role of the father in the prevention of eating disorders and find ways to connect young men with healthy male role models.

By Carolyn Costin, MA, M.Ed., MFCC - Medical Reference from "The Eating Disorders Sourcebook"

Source: Used with permission of Tom Schlitz, M.S., C.A.D.C., of the Rogers Memorial Hospital Eating Disorder Center.

With more time and research devoted to analyzing and understanding the sociocultural, biochemical, and gender-related factors in the roots of the problems of males with eating disorders, optimal prevention and treatment protocols will be revealed.

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Biometics - (Water-Soluable Vitamins) - Natural Remedies for ADD / ADHD

Jane wrote to us about Biometics....
"My son is ADHD (diagnosd at age 5) and was taking Ritalin and Catapres for a year. They were not helping much. He had a loss of appetite, eye twitches, stomach aches, upset tummy and headaches. I found a brochure with information about water-soluable vitamins, got the information and ordered the products for 30 days (30 day money back guarantee for any reason). Within 2 weeks my son's progress was great. After being on the vitamins for one month, he was off his Ritalin and Catapres. I notified his doctor and also sent info to her office as well. He will be in 1st grade this year and he will be going to school without any Ritalin just his vitamins which are liquids and powders mixed in his favorite juice, Grape Kool-Aid. My husband also tested for ADD and tried multiple medications but had one reaction after another to the meds. He was advised by his doctor to discontinue his medications and since these vitamins were working to continue to take them.

The web site for these water-soluable vitamins is www.biometics.com. It is a great place of information about the company and the products and what they can do. They make no medical claims but I have testimonials from children and adults (who are either ADD or ADHD) and their success with these products.

I got in this home based business because the products were so great for my son and husband and to let others know that they do not have to go the route I did with the meds and still be in the same position down the road."

Calm Child

Sherrie writes:......

"I wanted to add a product to your listing. It is called Calm Child by Planetary Formulas. It comes in both a capsule and a liquid formula which was great as my 4 year old always tries to chew up pills. It is administered 2 to 3 times a day, but I found good results with doses, 6 hours apart.

My son is extremely afflicted with ADHD. I was unwilling to continue prescription drugs as they left him zombie like, or he wouldn't eat. A lot of prescription ADHD drugs are not really well documented in young children with the disorder as it is usually not diagnosed until school age.

It really worked well. He became almost a different child while taking it. You can mix it with any cold liquid (great for kids who will NOT take a pill) . The only thing I would recommend is that while taking this medication, avoid food which can cause diarrhea, as Licorice root, is a mild laxative. We forgot to give him is second dose once and the change was astounding!!!!

Sherrie"

Victoria from Alabama writes:......

"I have 4 children. One of my boy's is ADD (with hyperactivity), he is 5years old. The other is 9, he is also ADD but without the hyperactivity. I give both of them "Calm Child" by Planetary and "Attentive Child"by Source Naturals. They are priced very reasonably on iherb.com. The 9 year old I give the max of the Attentive Child 1 to 2 times a day, especially before school along with 1 tablet of the Calm child -it says it also helps for focus. I think both are helpful natural medicines.

We have noticed the most change in the hyperactive 5 year old with the "Calm Child". It has been a life-saver, especially on long car trips. We usually give him 2-3 tabs of the Calm Child at least twice a day. We also have to look on the ingredients label of everything he eats. He goes nuts when he has any food coloring especially yellow-which seems to make him get too aggressive and also red. Although, for some reason blue doesn't bother him. We have to really watch those dyes, though. That along with taking the calm child make parenting our hyperactive child much easier and more pleasurable. The dyes seem to be in almost everything, most sliced cheeses, almost all boxed macaroni, many cereals, sodas, cake mixes, pudding, jello and lemonade drinks. He can never have candy unless it is from the Health Food Store. Also, caffeine in sodas and chocolate wig him out. We buy him carob covered almonds and raisins instead of chocolate, or white chocolate.

I feel sorry for him sometimes because it seems cruel not to let him have whatever the other kids at school are eating, but I know it's for his own good. Because when he does eat it he can't control his behavior, the he gets in trouble and of course punishment is no fun, then we are upset him and the whole family is disrupted because of a stupid piece of candy. So, I try to keep the end result in mind. It's just not worth the upset. I try to plan ahead if there will be a special treat at school, I will send something special that he can have. And I always tell every teacher, whether at school or church that he is "allergic" to these things. I believe the more medical term is that he has a "reaction" to these things. But teachers don't seem to understand the importance of watching out for these things unless you call it an "allergy". You say "he has these allergy's" and they will write it down and make sure he doesn't get those foods.

Hope this helps someone. It has been a long road with 2 ADD boys and I hope my experience will benefit you. If you see your child has these type reactions after eating something, write it down so you won't forget and get used to reading ingredients labels and have patience, patience, patience!

Victoria"

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Learn about different herbal treatments, herbal remedies for mental health conditions such as depression, anxiety, stress, Alzheimer's Disease, dementia and more.

• Important Information About Herbal Treatments
• Harmful Substances in Herbal Products
• American Ginseng
• Asian Ginseng
• Dandelion
• Ginkgo Biloba
• Gotu kola
• Kava Kava
• Lavender
• Lemon Balm
• Licorice
• Passion Flower
• Roman Chamomile
• Rosemary
• Skullcap
• St. Johns wort
• Valerian

next: Important Information About Herbal Treatments