Next time you look in the mirror and think you are fat, ugly and disgusting, say to yourself in a deep Darth Vadar cadence: LUKE, I AM NOT YOUR FATHER BUT I AM FAT, UGLY and DISGUSTING!! Or use a flirty Pepe Le Pew French accent: Cherie, kiss me, I am fat, ugly and disgusting! Yes?
No joke. Well, actually it is a joke. But one that is incredibly useful and being purposefully used in eating disorder groups to diffuse negative self talk and create an alternative perception of the words we often hear ourselves think and say whether we have an eating disorder or not.
If you prefer singing to acting, insert your self-wounding words into a popular tune (Mary and her little lamb won’t mind):
I am such a stupid loser, stupid loser, stupid loser.
I am such a stupid loser,
I have no personality at all.
In a group setting, these “exercises” first bring some levity to very painful disclosures and help connect the group within these humorous interactions. More therapeutically, they let the eating disordered voice stay a part of the client while giving the client a opportunity to turn down the volume and gravity of what the voice is communicating.
Danielle Doucette, PsyD and Jennifer Bradtke, PsyD of Insight Behavioral Health Centers in Chicago, IL., led a workshop Sunday at the Renfrew Foundation’s Eating Disorder Conference held in Philadelphia. Their topic: Humor.
They are real psychologists - not just playing them at the conference - and their message to the 50 or so clinicians, nutritionists, and physicians, was that humor as a therapeutic device can loosen up tightly held beliefs and myths that cut off air and circulation in the human brain separating it from the body.
“People with eating disorders are tightly wound and we have to help them loosen the verbal knots to make room for what else they might value other than being thin and beautiful,” Doucette says. “What did they value before the eating disorder? Family? Friendships?”
Humor helps induce less focus on the content of the thought and more focus on the relationship with the thought. The “I am fat” phrase fuses with the brain of a 16-yr-old adolescent girl and she makes it a truth, a part of her identity. As soon as she says it, she experiences immediate pain, judges herself and freezes in place. She avoids relationships and abandons her own dreams and goals. Her inaction, Bradtke explains, locks her into a narrow set of behaviors that dictate how she lives and how she includes others in her life. The toll this takes on current and future relationships further confuses the girl about her value to self and others.
To avoid the “I am fat” thought and escape the painful feelings and the isolation, the teen binges and purges, overexercises, etc. The negative evaluation becomes a negative day, negative self concept and negative life creating an internal experience with few options.
So, the goal of therapy - including peer group work - is to strengthen psychological flexibility and broaden cognitive and behavioral options. “Finger trap” puzzles confound the foolish who put in their index fingers in the first place then pull and struggle to get them out only to have them get more stuck. Doucette and Bradtke suggest “leaning in” like with the finger trap to release the hold an eating disorder has on the mind, body and soul of its sufferers young and older. When you relax your fingers, push in a bit, the trap releases and your hands are free again.
The leaning in simulates acceptance - don’t confuse with agreement - and gives the first glimpse of another option, one that releases the tension and makes room for positive - even humorous intervention.
“Embrace the painful thoughts,” Doucette insists, adding that when we resist something we spend a lot of time and energy that depletes us from experiencing new events and perspectives. Refuting negative thoughts is a struggle that initially is exhausting and often futile. Diffusing them with positive thoughts is slow but steady and begins with taking the edge off the painful perceptions with lighthearted experiential, yet psychologically sound, techniques. Disordered eaters carry an abundance of insignificant feeling about themselves that represent a variety of underlying psychological issues and events - neglect, abuse, bullying - that promote a negative internal representation.
“When we think good things, we feel good things and our behaviors are good,” Bradtke says, adding that patiently uncovering what else we value, what else is in our minds and what else are we saying will eventually turn positive and unblock the neural pathways set up by rigid, negative thoughts.
Other exercises that help group members embrace their thoughts is creating works of art with their painful feelings making them “beautiful and not as scary”. They take words and phrases and put them on paper then decorate them making them simply lines on paper that they can manipulate. Or, painful emotions can be poetic or a story with a happy ending or a zany ending creating collective and simultaneous understanding and laughter when read out loud.
The goal is to teach group members to create their own diffusion techniques and reuse them as needed in the outside world where triggers abound. Humor is proven to increase attention, recall and can alter how we experience negative thoughts so we can change them and find the positives.
LUKE, I MAY BE FAT, UGLY AND DISGUSTING ... BUT I HAVE THE GREATEST VOICE OF ALL TIME!!
The 23rd annual Renfrew Center Foundation Eating Disorders Conference runs through Nov. 10 here in Philadelphia. Diane Girardot, a Chester County based psychotherapist and health care journalist, will blog daily from the conference that this year focuses on complex patients, treatment variations, and the essential role of wisdom within the therapeutic relationship.