There are so many other considerations to these disorders, however, in a brief few paragraphs, I share some of my observations, some of what I’ve learned . In my experience working with clients with bulimia & anorexia for over 15 years and authoring Chasing Hunger, the 90-day bulimia breakthrough challenge; there is a unique demographic here, and I think NLP really helped me ask “better questions”. Trying to treat these challenging “addictive brain patterns” through weekly talk sessions, were inept at best. Before the week was out the behaviours returned, and clients were devastated, guilt-ridden, and panicking about an outcome that they feared, was not going to be theirs. I had to be prepared to “go deeper” for several reasons, and treating this as a “breakthrough” intensive, changed everything for both the client and myself.
Just by accident a client was coming to Vancouver from a distance and wondered if we could do all the sessions over two days! We did, and that changed the course of the program permanently. In this way, the bulimic behaviour is not given a chance to engage again. Inviting the “bulimia part” to the table we found some unique properties that maintained behaviour with the client, often held hostage, often attempting to negotiate from a deeply depleted state.
Initially, the client is in deep distress, fearful that is won’t work, and equally, just as terrified it will work. I cannot tell you how many times I’ve hear “I was terrified to come and see you, not because it wouldn’t work, but what I was going to do without bulimia in my life”
And we work all that through, really we do, reframing and utilizing timeline, perceptual positions, anchors and collapsing anchors, all help the client reclaim their lives.
We start knowing this:
1: The brain is exhausted, they can’t remember the details of their personal yesterday.
2: They are in starvation mode, which is based survival, long-term strategies, thought forms and goals are not possible, there is no deeper structure, and really their “capability” is super challenged.
3: They are exhausted from lack of sleep and many experiencing low-grade depression
4: their body systems have begun to “work against” them, and it’s starting to do things to keep them alive. ie: reproductive changes, which trigger loss of estrogen production, blood sugar levels, insulin imbalance, gastroparesis – inflammation of the stomach lining, bowel sensitivity and weakening of their bones, and this doesn’t reveal the really challenging issues until we do some blood workups.
4: ANXIETY ON HIGH ALERT system 24/7 which even interrupts rest and any kind of sleep restoration. Leaving them on high anxiety levels at burn out levels.
5: their chemistry is going to be deeply distorted, with heart rates erratic and unpredictable, Electrolyte abnormalities create pain in their very bones, and muscles and oral and dental issues are prevalent.
This is an unfortunate “handoff” to the therapy model and really presents it with challenges, as most therapists are not nutritionists, nor are they running weekly blood work and ensuring the client is paying attention to their recovery 24/7. No indeed, and in the Medical approach to these disorders, they are handling it with challenging outcomes too. Presenting in an emergency room for racing heart and feeling just deathly, clients can experience a vast array of treatment, depending on the awareness of staff. In Australia, the team there do not start with a potassium drip, to recover dangerously low levels, they use a feeding tube with 4000 cal and start treatment, only when a member of the Eating Disorder team is called on site. Their methods have been adopted by more and more ER’s globally as their success rates, have proven the path. The overfeeding syndrome produces issues in recovery as well.
So we are caught somewhere between the therapy model, handed this hot potato, and the medical model, that is designed to FIX the broken leg JUST ONCE, and when the patient keeps returning – with apology, “I’m so sorry I broke it again” after the 11th or 12th time, every week? Same broken leg? Same fracture, same procedure? Frustration. This is not to discourage someone from using every medical skill at hand to resolve this. People die from this, and not as infrequently as we think.
Asking different questions:
1: A review of behaviour, beliefs and values,
2: Who are you?
3: What’s most important to you?
3: What would your life be like without this?
4: What do you think or believe bulimia gives you? (people with this disorder have to force themselves to vomit several times a day, and get past that, in order to make it work for them- there is no room for the squeamish here) So the pay-offs have to be substantial.
The answers get us deep into the details of their decisions, and then as we extrapolate those decisions out and place them on pages around the room, right there in front of us both, we see the whole Map of the experience along with the places where it actually created double binds, and impossibly loose justifications essentially no longer meeting the criteria, the reason for the bulimia in the first place, is often no longer even present.
Then we ask deeper questions:
5: Is this really a weight loss program? – NO, that’s what outer world believes is the cause and continued use, however, that’s not what it is doing for them
It is something completely different: They are doing it for the HIGH, and there is one. Anyone with bulimia will tell you, it’s not about weight loss, in fact after a while it stops working as weight loss, however, it’s the response that gets other people to go within and start that inner affirmation. “Right I need to lose 10 pounds myself, I wonder if that might actually work for me ….?” and we’re off on our own thoughts, with an exceptionally handled redirection, and the client with this KNOWS it.
So what’s this addiction about? Starving for a full day, then Consuming over 3700 calories in under 20 minutes, then vomiting = a MASSIVE chemical release in the body. First its the long wait and work up to the binge, through thoughts, preparing getting ready to do the binge. And one must starve, so you can eat everything really fast. Once it starts the binge is underway, and the foods of choice high carbohydrates, cheap food, sugary, coke/pop a whole giant pizza, and every kind of junk food you can imagine. Now the insulin levels go crazy, dopamine releases with the “pleasure seeking part”
Plus the endorphins and tryptophan, serotonin, – all part of the “feel good cocktail” and that propelled with the massive insulin RUSH, floods through the bloodstream and they are HIGH for about 40 -45 minutes, in the ZONE. One girl who had tried cocaine said Bulimia was better because the high lasted longer and it was only food, in fact, this is considered the “good girl addiction” and there are web pages and chat rooms that teach how to do it. I know it sounds frightening and people who are trying to help them need to know this. It’s an addiction. They will tell you. Sometimes it’s such a huge relief to them to finally tell someone.
There are cover-ups in place, and when you think, why would this be an addiction of choice? Well, it’s free – its just food, no one needs to know unless I tell them. There are no drugs involved, and I can use this “addiction” to support my life because it’s “always there for me”. if you treat this as an addiction then your results will improve helping them recover.
Think of your process for treating smoking addiction? Or drug addictions? This is a profoundly useful approach.
Many clients don’t even realize it’s an addiction, however, they do know they can’t “live without it”. It might sound simple, however, it works. The profile of clients that choose this kind of behaviours often like the novel idea this ‘impossible disorder’ that is stumping the world, they healed themselves with a book! These amazing people they love novelty and seek high-risk experiences, they are intelligent, high achievers at school and often parents advise they were little to no trouble when growing up. They have an inner powerhouse. They are strong and dynamic and generally very good at achieving whatever they set their mind to. I cannot even say how many of my hundreds of clients shared with me they smoked and just quit. Just like that.
And for those of you that think this is so hard to stop, I’ve also had clients sitting across from me with a completely different issue and they share “oh yes I had bulimia and then one day I just realized it was a waste of my time and so I stopped, it just didn’t make any sense anymore”. Just like that.
Really!