Discussing Eating Disorders

MSc Psychology of Mental Health, Foundation in Counseling and Psychotherapy. Looking to learn more about eating disorders. 
I’m a trans guy who suffers from anorexia
Have had purging anorexia 22yrs
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Paige
16:36, 14 Jun 20
Hey
Stephani
16:44, 14 Jun 20
Ok I think it worked
Paige
16:45, 14 Jun 20
I can see I'm here twice 
Joshua Summers
16:47, 14 Jun 20
Hi everyone and thank you for Taaalking. 
Just so we set the context for this Taaalk, would everyone mind saying what their eating disorder experience has been so far and where you feel you are on your journey?
Stephani
16:50, 14 Jun 20
Started Ed at age 10, diagnosed at 11.am 32now. Have been in and out of treatment with periods of no behavior. But currently in a rough relapse
Paige
16:55, 14 Jun 20
Overweight child, 16.8 stone at 13, started severely restricting and making myself throw up, went to 10.8 stone, met my first proper partner, very abusive relationship, by the end of our 4 years together I bumped up to 20 stone, started severely restricting again, then into starvation, dropped down to 8 stone but suffer severely with excess skin on my body from the fast and huge weight loss, suffered with bulimia to keep my weight stable, bouncing between starvation and throwing up. I'm now a month into being purge free, I have gained weight from it, which i am really struggling with, but being complemented by how much healthier I now look, so i try to remind myself of that. I was also diagnosed with body dysmorphia, which is extremely difficult as I still see the 20 stone girl staring back at me. 
Tamanegi
17:38, 14 Jun 20
Started to develop anorexia around 2 years ago. I’m not in recovery yet. I was always underweight but had started to become a healthy weight before I began restricting.
Joshua Summers
18:07, 14 Jun 20
Alright, thank you everyone.
As we discussed before starting the Taaalk, I haven't personally had an experience with an eating disorder.
If I were to find myself inside of your head, experiencing what it's like to be in your mind, what would the thoughts and feelings be like that I'd be hearing and feeling?
Stephani
18:24, 14 Jun 20
Constant chaos. Numbers nonstop. Weight, measurements, calorie calculation. Not believing the real amount of calories in stuff and trying to fig out how many I need to add to believe it. Feeling not worth love, time attention. Not believing my weight is what it is because I see how big I know I am
Tamanegi
18:24, 14 Jun 20
On my worst days everything revolves around calories and weight.
I sometimes weight myself 3 to 4 times a day. If I eat, I count the calories. Every calorie makes me feel guilty, like I’m failing. 
I look in the mirror and criticize myself because my legs are too big, or I can’t see my ribs enough. 
Joshua Summers
15:49, 18 Jun 20
It sounds like a tough and very critical environment.
I'm sure you have been given reasons why you have an eating disorder, but I was wondering what you feel yourself. 
Why do you think eating disorders happen, and what do you feel people get wrong when they make suggestions to you?
Stephani
16:06, 18 Jun 20
There are many reasons for Ed's. I know for me it was a control issue. There was some trauma in my life that I couldn't deal with but I could control how little I ate, how often I purge, etc. It gave me a way to release what was building up inside. Also it was a way to punish myself because I believed I did something to cause the trauma in the first place. one of the things that drive me nuts is when people just assume you have an Ed because you want to look like a model, it's only a phase, you are attention seeking. Becoming obsessed with weight, how you look, calories, etc is rarely why eds start but more of the symptom. You don't wake up and are like "I need to drop a few pounds before this event so I'm gonna be anorexic". I absolutely hate when people say "just eat. Or it's just a meal. You're missing out this tastes so good" for me if I take that one bite or taste that great dessert my mind will not stop racing with fear, regret, how weak I am for giving in, etc.
Tamanegi
16:36, 20 Jun 20
I relate a lot to what Stephani said. Control is a huge part of it for me too. When I feel out of control my ED gets so much worse. 
Although for me I also think it’s related to my dysphoria. I hate my curves and my chest, and it makes me want to lose weight. But it’s hard to explain because it didn’t start that way. I didn’t start restricting because of my body, but it’s still a big part of it.
And I think one of the assumptions that I hate most is when people think I’m doing it for them. I don’t starve myself because I want to impress people. Telling me that you think I’d be more attractive if I gained weight does nothing. It’s actually kind of upsetting.
Joshua Summers
18:50, 20 Jun 20
Why is that upsetting Tamanegi?
Tamanegi
19:00, 20 Jun 20
I’m not completely sure to be honest. I think it’s mostly because I didn’t ask. It doesn't feel any different than someone saying I’d look better if I lost weight.
Maybe because I don't feel like it’s something I can control anymore. I know I’m unhealthy and underweight, but I can’t stop.
And it also kind of irritates me, because of what I said before. I don’t restrict so that people will think I’m more attractive.
Joshua Summers
20:51, 20 Jun 20
Thanks for both your answers. I just wanted to check one thing with you Stephani; while you both mentioned control, and that in some way it's not to do with pleasing the beauty expectations of others, only Tamanegi mentioned a dislike of one's own body parts ("I hate my curves and my chest, and it makes me want to lose weight").
I was wondering if you also shared this type of thinking too?
Stephani
21:01, 20 Jun 20
It's really a mind trip. I hate having a "women's" body for myself. I hate having curves, breast, etc. But when I see another woman with a curvy body, nice figure, I think she looks great. I see the appeal in other women, I just can't handle myself looking that because for me it would be disgusting fat....I don't know if that makes any kind of sense
Joshua Summers
21:05, 20 Jun 20
It is an interesting paradox. What do you feel the difference is between you and other women?
And Tamanegi, is the same paradox true with you too?
Stephani
21:11, 20 Jun 20
It's how my mind works. It's like one of those funhouse mirrors. If I stood next to someone normal weight, same height my brain shows me to be overweight, fat, and ugly. Even now being underweight I don't see myself how others see me physically
Tamanegi
21:15, 20 Jun 20
I would say so. I definitely hold my appearance to a higher standard than everyone else’s. I think other people are beautiful, but if I looked like that I would feel disgusting.
Stephani
21:16, 20 Jun 20
That's exactly how it is
Joshua Summers
21:16, 20 Jun 20
I understand. And moving away from what you see/thoughts on appearance, I was wondering if you feel there are any other differences between you and other women?
Stephani
21:23, 20 Jun 20
It baffles me how "normal" women can go to dinner w friends without worries about calories, fat, etc. If I have to go out to eat I have to Google the menu ahead of time to find something " safe" or if I can't find anything I refuse to go. Also dieting like a normal person where I have to take it to extremes. I would LOVE to be able to go out and be confident in clothes and not worry about how disgusting I look. Like women at the beach can hang in a bathing suit, play volleyball, tan, eat with no care in the world
Joshua Summers
21:26, 20 Jun 20 (edit: 21:30, 20 Jun 20)
And for you Tamanegi, when comparing yourself to other men, what differences do you feel there are beyond appearance?
Tamanegi
21:36, 20 Jun 20
Well, I agree with what Stephani said. Looking up the menu, feeling uncomfortable in my own skin.
A thing that surprises me when I talk to someone who doesn’t have anorexia is the lack of knowledge. I tend to forget that normal people don't have excessive info on calories, or don’t weigh themselves several times a day, or know their BMI. When I talk to my partner about my ED I almost always have to explain something new.
Joshua Summers
21:48, 20 Jun 20
Ok. Again, sticking with the theme of differences between you (with an ED) and others (without), and moving away from the "real world" (of looking at menus, checking calories, going out) and going into the emotional world - what do you feel the differences are?
I don't want to put any words in your mouth so I will use an example of something from my own life to try to explain the type of differences I'm getting at: 
I sometimes don't do a very good job of standing up for myself, but I meet other people who do a much better job. And when I thought deeply about the difference between us, I felt that they are "allowed" to "upset" others in order to protect themselves, but I'm not allowed.
(So that's not to do with what we are discussing, I just wanted to give an example of a difference that might exist in the emotional world.)
Stephani
22:55, 20 Jun 20
I have always, even pre Ed, had  an issue with feeling like my feelings or emotions are invalid. It's def gotten worse though. I apologise a lot if someone feels different than I do. If I'm angry at someone I don't care express it because I don't want to upset anyone
Tamanegi
02:22, 22 Jun 20
I have social anxiety, dysphoria, and my ED so it’s hard for me to separate which traits are because of anorexia. I’m so self conscious around people, I constantly check my posture, make sure my sleeves are over my wrists, make sure everything about me is perfect. Even my facial expressions are very measured and aware.
Joshua Summers
07:51, 22 Jun 20
You already mentioned this Stephani, but Tamanegi, did you feel those sort of feelings before your ED?
And for both of you, before you had your ED, did you share that you felt this way with anyone and/or receive any help to try to deal with these types of feelings?
Tamanegi
14:46, 22 Jun 20
Yeah I definitely felt that way before I started restricting, but it got worse along with my ED.
I told a few of my friends, but that’s about it. 
Stephani
15:32, 22 Jun 20
No. Normally I just always kept things to myself
Joshua Summers
16:51, 22 Jun 20
Perhaps this is going to sound like a bit of an odd question (and I'll get to why I'm asking it a bit later), but in your minds does thin = good (at least when thinking/feeling about yourself)?
Stephani
16:54, 22 Jun 20
Def not an odd question because that's how it is exactly. But I only think of it for myself. 
Tamanegi
22:46, 22 Jun 20
Absolutely yes, but like stephani said, only for myself. 
Stephani
23:34, 22 Jun 20
Tamanegi we seem to be very similar! 
Joshua Summers
00:22, 23 Jun 20 (edit: 00:32, 23 Jun 20)
I agree that there certainly seems to be a similar thread running through both of your stories and feelings.
Would you both mind telling me what the experience was like of other people eventually knowing about your ED (if they do)?
For example, going back to the start, having an emerging ED, which you may or may not have shared with others? To others knowing about it (if that's the case)? And then to eventually receiving treatment (again, if that's the case)? 
I'm interested to know how this process happened (if it did)? Were you "discovered" (perhaps people noticed your eating habits had changed) or did you tell people directly about what was going on (if you knew at the time)?
(Sorry for all the brackets(!), I just don't know your journeys yet, so don't want to assume anything.)
Stephani
00:38, 23 Jun 20
About a yr into my Ed, I had to have my gallbladder removed emergency surgery. It's extremely uncommon for someone so young to have their explode from stones but it was a result of rapid weightless, purging etc. No one knew at the time I had an Ed but my aunt whose an rn came to visit and accused me flipping out while my parents were out of the room. I completely denied it. Told my parents she was completely wrong etc. They believed me. About a yr later we were on vacation w my older cousin who is bulimic but was  known about her and after I purged  my mom asked about smell, I blamed cousin (disgusting I'm sorry,) not long after that I passed out during a dance competition, taken to er and I admitted it to a friend who was like a second mom and she helped me tell my parents. I think they knew all along but we're in denial and didn't know how to "fix" me before I told. All the signs were there. Weightless, running any chance I could, became extreme about diets. they had me admitted countless times. I went to college and lived on campus later on. It was close to home but I made them let me experience dorm life. I didn't come home often and one time I did and looked so sick and lied I was doing well. My mom drove to my dorm got let into my room and saw my walls with "thinspo" no food, diet pills galore, etc and that was the first time she was not understanding or willing to try to understand and completely flipped out
Joshua Summers
00:42, 23 Jun 20
And did any treatment happen after that?
Stephani
00:45, 23 Jun 20
After I came clean the first time I was admitted to a pediatric pysch Ed unit. Didn't help. 2 yrs after I did resident for 6 months and did intensive outpatient right after. Did ok for a period of time and then relapsed. It's been an in and out of various centers, programs since then
Tamanegi
04:00, 24 Jun 20
I haven’t told any of my family, only my friends, and I’ve never been to any real treatment.
My family knows I tend to “forget” to eat, but to them its not serious, and I’m good at keeping up appearances. My family kind of jokes about my eating a lot, in two ways. They make jokes about how I would only drink coffee if they didn’t remind me, and they make jokes about how much I love food. 
When I started to restrict I talked about it with my then best friend. I was never very serious about it, just casual jokes that weren’t really jokes. And since I acted like it was no big deal she wasn’t too concerned.
My now closest friend has gotten more concerned, especially recently. When I tell them about my ED they mostly understand. I usually don’t talk too much about it tho, I feel guilty for making them worry.
My partner doesn’t quite understand everything, but he’s very supportive. He listens and even though I feel like a burden a lot of the times he tries his best to help.
Joshua Summers
21:23, 24 Jun 20 (edit: 22:59, 24 Jun 20)
Please correct me if you feel that I am wrong, but would you say an ED is noticeable? Or rather, risks being noticed even if you don't want others to find out about it?
If you do feel that, what are the kinds of behaviours or visuals to do with your ED that others tend to pick up on? 
Stephani
01:19, 25 Jun 20
Yes. Of course the obvious...weight fluctuations, but here is a list i experienced...
Cutting food into tiny  pieces and pushing it around to look like I've eaten more than I have, anxiety around food and figeting in my seat (bouncing legs wringing hands, racing for the bathroom after meals, hiding food anywhere possible.being the one to cook but not eat the food, taking stairs instead of elevators, organizing and reading the labels on foods in my house.
Tamanegi
14:31, 25 Jun 20
I’m not sure if it’s always noticeable.
Sometimes I’ll have to eat with my family and I’ll eat a normal meal. When I’m trying to act normal I can. But after I eat, when I’m by myself, I just completely lose it. 
When I’m not with my family I just don’t eat. If I go with a friend somewhere I’ll just get a drink.
I think if I tried to hide it from my friends they would notice though. And they’ve definitely noticed my weight. 
Joshua Summers
10:51, 26 Jun 20 (edit: 10:53, 26 Jun 20)
Ok. Thank you for telling me.
I was wondering if you would mind if I pulled together some of the things you've told me and sort of tell them back to you with a new perspective in mind? This would add a psychological idea or two to some of the experiences hat you have had in common (maybe not ideas you have heard before, but ones that I personally have found from dealing with my own experience of mental health issues [I had a lot of anxiety and ~8 years of therapy], and not come across much while studying mental health).
I'm asking for your permission as, in the same way that I'm sure it's very upsetting/frustrating when someone dismisses your ED by telling you something that you know is not right (e.g. you want to look like a model/you are doing it for them), I think this risks doing that too. From listening to you I do feel there is an idea worth exploring which could explain some parts of developing an ED, but my current explanation of aspects of your ED might be incorrect (like the other explanations you have come across), and I want you to know that I would not be sharing it with a "dictators" mindset, but just as an idea to explore and get feedback on. (It just could also be wrong, and I know that can be upsetting.) So if you would be ok with me discussing it with you, please say so, and if not, please say that too. For me it's not problem whatever you choose.
(If you do say yes, I might share it in stages because it rests on some ideas that might be important to discuss first. But I'm not sure yet as I'll have to see how it flows out of me if I write about it.)
Stephani
15:07, 26 Jun 20
Yes I'm ok with it. Actually really interested
Tamanegi
05:29, 27 Jun 20
Sounds good, interested in what you came up with !
Joshua Summers
12:36, 27 Jun 20 (edit: 14:12, 27 Jun 20)
Well the first thing I want to discuss is something that I believe very strongly. I've noticed it with my own mental health, my friends and people I've done a little therapeutic work with. It might not even sound mental health related to start with, but I hope it will make sense towards the end.
Do you know how air always moves from areas of high pressure to areas of low pressure? (Here are a few very non-mental-health related diagrams to help:)

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Well the brain is just like that too. But the pressure isn't air pressure; it's emotional pressure. And just like the rules of physics don't care about what people are thinking, even if You* as a person don't decide that you want it to, the brain will try to move your emotional state from one of high pressure to one of low pressure. You have no choice, you are just subject to this process (in the same way you don't get to choose if you obey gravity or not).
*I'm using a capital letter, because the You I'm talking about is the bit you interact with in your own mind (the bit you have discussions with), which even though it can feel like it, might not be the full you. The full you includes all the unconscious processes going on - including the high pressure to low pressure one discussed so far. (Please let me know if this is confusing at all.)
And even more strangely, this will still happen even if You don't realise that a lower pressure environment could exist. You might be convinced that things are how they are, but the brain seems to know that it could be more relaxed. The result of this is that a high pressure mental environment is an unstable one. It's obviously not a pleasant one, but what I'm saying is that even if You wanted to keep things in that unpleasant state, the brain would not let you do this easily.
In fact it becomes increasingly difficult. It's almost like the pressure builds on top of itself to make it harder and harder as time goes on, as if you were trying to pull an air-filled balloon further and further underwater - the deeper you go the harder it is to keep it there and the harder it is to pull it down further.
What I'm saying is that, if it's before your ED, with your ED, or for someone without an ED, the brain is trying to get to calm. Now there might be reasons why getting to calm/low pressure is very scary (even more scary than staying in the unpleasant state of high pressure/stress), and we will get into the details of how this adds a great deal of friction to the high-to-low process later. But most importantly, as discussed, the physics-like nature of this high-to-low process means that the brain does not care if you are scared or not. It will still try to force its way out of the high pressure environment it is in.
Without getting into how that might relate to an ED, is this making some sense so far?
Tamanegi
00:15, 28 Jun 20
I think so
Stephani
01:19, 28 Jun 20
Yup makes sense
Joshua Summers
22:33, 29 Jun 20 (edit: 12:21, 30 Jun 20)
Ok, now the next thing to establish is what good mental health looks like in the context of this force that we all experience. (The high-pressure-to-low-pressure force is not something that only people with bad mental health have, it's a universal experience. It's how comfortable we are with this process which determines our mental health.)
If we look at someone who has excellent mental health we can get clues about what this looks like in practice when the mind isn't interfering with itself. The 14th Dali Lama is alive and kicking, heavily meditates and has excellent mental health. Watching videos of him giving lectures, we can watch a well functioning high-to-low-pressure process take place in real time.
Check out this one where the Dali Lama is discussing compassion. He goes from:

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1) "Normal"
...to...

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2) Crying
...and back to...

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3) "Normal"
in under one minute, without even acknowledging (apologising to the audience, for example) that he is doing it.
His brain can quickly and effortlessly release pressure.
What does this mean for a brain to be able to "quickly and effortlessly" do this?
First, let's imagine that we could put all of your possible emotional expressions onto a map (maybe not the ones You currently express, but all of the ones the "full you" could). All of them: love, joy, confidence, happiness, frustration, fear, anger, hate.
Let's use this to represent the map of them all:

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So the Dali Lama, and anyone with excellent mental health, can quickly, and without experiencing any internal stress, go to anywhere on the map.

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That's what we saw happen in the video. Sadness emerged in him, so he went there instantly, without any worries about trying to keep this expression hidden, the emotion came out, the pressure was released (high to low), and then he was back to a calm state.
Is this making also making some sense so far?
Stephani
13:49, 30 Jun 20
Yes
Tamanegi
18:19, 01 Jul 20
Yep! 
Joshua Summers
14:54, 06 Jul 20 (edit: 18:12, 26 Jul 20)
Right, so life would be lovely if we could just wonder all over our own maps. (Or rather life wouldn't be lovely, but we would have good mental health in the face of the troubles and pleasures that life throws at us all.) However, for very good reasons not all of us can wonder all over our own maps.
You see the human species if faced with a problem and eliminating or exaggerating areas of your emotional map is the solution to it. That problem is this:

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These little humans sure are cute, but they are not able to look after themselves. They are slow. They are weak. They are not very clever. They need other people to take care of them if they are to survive. [And I really want you to think about the word need here. I'm not using it in the casual sense, like "I need a glass of water" or "I need those new shoes" etc. I'm using it in its strongest possible sense. As if you found yourself trapped underwater, you would quickly start to scramble your way to the surface because you and your body know you need air to survive. Or if you had been walking in the desert for days you would actually need that glass of water, in a way that you normally don't.]
So the problem the species faces is: given that every single human out there starts off needing the care and protection of other people, how do I maximise the probability that weak little humans keep their caregivers around (and keep their caregivers happy, or at least keep them paying enough attention that the little humans survive)?
And the brain has an excellent solution, or rather a solution that works perfectly well given the limitations on the infant brain.
Let's first imagine you were an adult and you had this same problem, you could think about what the other person wants and act in a way that might keep them around. It might be a bit annoying to feign interest in what an uninteresting person says, or to keep the conversation light with someone you know to be easily irritable, but it would be a primarily intellectual exercise - i.e. you would have an internal monologue saying "oh my gosh, this person is soooooo boring" or "damn, this person is so touchy", a comfortable separation between your external expressions and your internal emotions - so while it would be a bit annoying, it (hopefully) wouldn't be too stressful.
But look at this:

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Little kids "hiding"*. They can't see you, so how could you see them?! Little kids do not have very good "theory of mind", that is the psychological term for ability to think about someone else's mental state. It normally develops seriously between the ages of three and five, and even though that sounds like it's very on in life, it still leaves a healthy chunk of time before it's present; a time when you are at your most vulnerable. So if an infant can't think well, it can't act well. So the intellectual exercise method (described above) of keeping people there is too big of a risk for the species when it's dealing with its infants. Very little kids can't be trusted to keep themselves alive using that plan, and being alive is what the species wants**
*This is a slightly exaggerated example, as I have read that when things are really scary and kids do need to hide, they can do so effectively - but the point about lower levels of cognition when it comes to intellectually predicting the behaviour/thoughts of others is very much true. The "hiding" is just a neat visual example.
**I'm using the "wants" of the species to represent the general theme of evolution: species tend to optimise for their own survival.
So, another plan is needed. And that plan, unfortunately for the adult versions of us that are forced to deal with its consequences, is a distortion of the emotional map.
The process behind this is quite simple. In the same way that it would be extremely stressful if you were trapped underwater, missing the air you need to breath, as an infant it is extremely stressful if you feel the caregiver you need to take care of you is not able to do so in a way that feels right. And the magical trick the infant brain pulls is to attach moments of high stress to deep memory formation***. It does this by filling our brains with certain neurotransmitters (chemicals that help our brains and body adjust to what is going on) when we are stressed, and, as well making our mind's and our body's reaction appropriate, these neurotransmitters result in memories being created.
***https://royalsocietypublishing.org/doi/10.1098/rsbl.2010.0565, this is a good paper with an example for a group of children under one year old learning through stress caused by seemingly mild breakdowns in communication between them and their caregivers.
I am sorry this is so long winded, but we must pause for a moment to discuss what memories mean in this context too. I am not talking about your "first memory", I'm talking about a basic reaction forming in your brain. The type of reaction you naturally develop when you burn yourself with a candle flame; flame = bad, avoiding flame = good. It hurts, it's stressful, so don't do it.
So now we are about to get to the interesting stuff, and the stuff that might relate to your situation. Let's say you have a parent who (because of their own strange internal stresses and confusions) can't help but overreact when a child is "bad", and is therefore nice and calm when the child is "good". Even though it might look innocent enough from the outside, as the infant needs contented caregivers, the overreaction is going to feel traumatic. A break down in the relationship needed for survival; like someone turning the air off. Traumatic moments mean high stress, and we know that high stress means memory formation. If this pattern of behaviour repeats (the caregiver always acts this way when you are "bad"), this is going to teach the child a very strong lesson: you being bad causes terrible stress 😰, and you being good means things calm 😊; being bad is forbidden, and being good is the only thing that's accepted.
We can watch all this play out on our emotional map:
Let's say that the map had territory which made it like so:

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(Being good happens when you are in the green-blue-yellow area of the map, and being bad happens in the red-orange-pink area.)
And if every time we found ourselves naturally**** venturing into the being "bad" area to reduce our emotional pressure in a healthy way (like the Dali Lama was doing; walking all over his map without a care in the world) our caregivers, the thing that we needed to survive, started acting scarily, we would quickly learn that it was dangerous to go there:
****We are naturally venturing there because occasionally life makes you go there. Sometimes things happen which justify being bad/angry/upset. So, even though you are being "bad", it's not really bad that you are. It's good, as it fits with what is happening to you.

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If it's always scary to be "bad" (above), we learn we must NOT do that (below).

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And conversely...

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If being "good" is what keeps the calm (above), then we must be it (below).

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And after enough "lessons", taught to us through our caregivers scary emotional reactions to our natural emotional expression, our emotional map is going to change. It is going to perfectly match what was needed to keep our caregivers calm. Some areas might be gone all together (because they caused trouble/are forbidden), and others might be exaggerated (because they generated calm/are essential). At the end of it all, your map could look like this:

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And sadly for us all, these emotional maps don't naturally fade back to normal - they stay in their distorted shape. They help us get through childhood, but then they stick around. And if everyone's (no matter their emotional map) adult life throws situations at them which mean they need to walk all over their emotional map to adequately release the emotional pressure (see ****), we can see how someone with a distorted emotional map is going to have a harder time being an adult/teenager than someone who has a fully accessible map.

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(On the left, someone with a full emotional map can express whatever they need to release emotional pressure. On the right, someone with a distorted map is trapped by a reduced amount of expression, causing emotional pressure to build.)
Luckily for us it is perfectly possible to get back to having a complete map, although as a society we are not very good at this yet. Just as we seem to be designed to distort our emotional map, we are just as able to untangle those distortions and have gathered - but more on that soon...
Is this still making sense so far? (Feel free to ask any questions you want.)
Tamanegi
18:55, 06 Jul 20
makes sense 
Stephani
08:09, 15 Jul 20
Makes complete sense
Joshua Summers
09:24, 15 Jul 20
Right, that's good.
Before we go on do you have any reflections on what your own emotional map might look like? (If you don't, and want to hear more first, then that's fine too.)
Stephani
03:20, 17 Jul 20
Definitely the one on the right of the 2 maps in the last pic you posted
Joshua Summers
19:17, 26 Jul 20 (edit: 11:38, 27 Jul 20)
Ok, from what you have said so far that makes sense.
It's been a while since I last posted so a quick recap on the concepts we are building on:
  • The mind naturally wants to go from high emotional pressure (stress) to low emotional pressure (calm)
  • The best way to do this is to go to the right place on the emotional map (using ALL of your emotions to help you express what you need to).
  • Not everyone has access to their full emotional map. Due to the caregiver environment we have, we might have to exaggerate some areas and completely ignore others. This means we are not as good at a relieving tension as we could be.
  • For Stephani, you have an emotional map which allows for a lot of "I'm good" expression, but very little "I'm bad".
So before we tie everything together into a final idea, there is one more important, non-ED, thing to understand about mental health: mental health is a multiplayer game. Deep down your brain knows that other people are required to help you solve your mental health problem.
Humans are social beings at their core. It's obvious when we think about other parts of our lives; for example, babies are born looking cute because cute features activate instinctual caring attention in adults (the species knows there are other adults about, otherwise babies would not be so cute), infants naturally focus on faces (or shapes that look like faces), and we are born so weak that we must depend on others (so deep down the species must know that there are other people outside of the womb to depend on).
But when we think about mental health, we often think about it as if it's a battle that you are meant to fight alone. It's your mental health right?
But just as the infant is not designed to handle infancy in isolation, the process responsible for mending mental health is not one that you are meant to do on your own. How others are used in improving mental health is different from infancy. Mental health problems tend to emerge when the brain thinks the child is at least of "adult" age (this is when core functionalities within the brain are substantially developed, and is around age 13). (This does not mean mental health problems all emerge at age 13, but that they rarely become highly visible beforehand.) Unlike when we are babies, other people are not required to perform the basic caring duties for the 13+ year old dealing with a mental health problem. Instead they are there to gently challenge the individual's thoughts and feelings; highlighting the parts of the sufferer's emotional map that they don't realise they are missing or have exaggerated, so the sufferer can gain some emotional territory back and have improved pressure reducing functionality to help them deal with every day life more easily.
It's essential to involve others because the adjustments we have had to make in order to survive childhood in a caregiving environment that can't handle certain emotions took place at the emotional level. This level is extremely deep down. It's so deep down it impacts perception. This means it's extremely hard for you to see where your own emotional map might be distorted as it's (nearly) all you've ever known. And to maximise your chances of survival, everything you feel feels very real to you (even if you consciously know that it doesn't make sense). This means it's almost essential that someone else helps you see where your map is right and where it's gone a bit wrong. Mental health is multiplayer.
Now because your feelings feel perfectly normal to You (I'm using the same capital-letter-You I defined earlier - the You that you talk to, that might not be the full you), even if they aren't very useful when it comes to high-to-low pressure reduction, You don't know that you need to signal to someone else that the map has gone wrong. So the last important thing to know is that even without Your conscious consent, your brain is trying to signal to other adults that it is struggling. It is doing this because a mental health problem is not just for you to solve on your own. Instead it is a group challenge, and even though You don't know it, you are trying to build yourself a group to help tackle it.
(That mental health is multiplayer might come as a bit of a surprise, but modern society comes as a bit of a surprise to the human brain. While we can conceptualise the fact that we live in big cities and inside closed-off houses, the brain's design took place when we were living in tribes. In a closed-off house in a busy city you mainly are stuck with your parental caregivers up until the age of 18. In a tribe you would have been in regular contact with many people, some of them old and wise; able to pull you aside because they had seen subtle signals that all was not well with your emotions. While your parents might over/under-react to your mental health problem, meaning it's not that useful showing them what's going on, a wise elder member of the tribe might have been very useful to signal to. These signals are not conscious decisions - just like the high-to-low pressure process isn't either. This poor-mental-health-signalling is unconscious and not something You might be aware of.)
This brings our final list of concepts to:
  • The mind naturally wants to go from high emotional pressure (stress) to low emotional pressure (calm)
  • The best way to do this is to go to the right place on the emotional map (using ALL of your emotions to help you express what you need to).
  • Not everyone has access to their full emotional map. Due to the caregiver environment we have, we might have to exaggerate some areas and completely ignore others. This means we are not as good at a relieving tension as we could be.
  • For Stephani, you have an emotional map which allows for a lot of "I'm good" expression, but very little "I'm bad".
  • Mental health is a group process. Emotional map distortions are so "deep down" that other (hopefully wise and kind) people are needed to help solve them. Even though You might not want to, your brain is trying to find a way to communicate that something is not right to the outside world to hopefully begin and/or improve the map readjusting process.
So you, and I am now talking about someone with an emotional map that looks like


have a problem...
How do you signal to others that you are bad, if being bad is the one thing you are not allowed to be?
Stephani
00:40, 31 Jul 20
I might be completely wrong and not understanding (lack of sleep and increased Ed)...are you saying that we use our eating disorder behaviors as a way to signal that mentally we are struggling and need help? That we need someone other than ourselves to help deal with the stress/ emotions we don't know how to internalize?
Joshua Summers
12:13, 31 Jul 20
In a way I am saying that, but with a few added conditions/subtleties.
I'm saying that every human being whose emotional map is not as useful as it could be, and who is not in a successful process of improving it, is unconsciously signalling to the world that things are not right. And both because it is actually the most useful way to signal what is wrong with one's map, as well as being the only way to signal what is wrong given the map you have (as the parts you might need to signal differently are missing), the mind will exaggerate the map's distortions until it it becomes clear that something odd is going on in the exaggerator's mind.
When it comes to a map which contains too much "being good" and doesn't allow any room for "being bad", you only have one tool at your disposal to communicate: being good.
But it's very difficult to communicate stressful feelings if your only tool is communicating that you are good! So I'm wondering if the only way your mind can signal to the world that it is a space where stress exists and it needs help being allowed to express more of it (i.e. your map is a bit off) is by being too good. And we know that your mind thinks thin = good. So if your mind needs to send a signal to the world and it can only send "good" signals out, then making you so thin (so good) that other people start to notice that something is wrong is a method to do that.... And it worked... It forced people to take notice of you and start to work on your mind; as you said earlier, it was the eventual discovery of your ED which led to you going to the pediatric psych ED unit.
So now for some sad parts (some more sad parts in what has already, no doubt, been a very difficult story). I believe there are two:
The first is that just because you are discovered, it does not mean that they will treat the right thing. As a society we have a terrible understanding of mental health. The scientific tribes of psychology love cognitive behavioural therapy, but it normally does not address the right thing, and softer psychotherapists can often miss the mark meaning progress is not made.
The mind does not make it easy for them; it is filled with so many strong thoughts and ideas that it seems obvious what you need to work on - "you need to learn that it's ok to not be thin", "you need to learn you deserve to have self esteem", etc. But these ideas are not at the core of what is going on (at the core there is the map, and the fears reactions associated to going to forbidden areas of it). So working on what seems obvious to work on does not always result in progress. That is sad. It's sad that even when the immense subconscious struggle to get help has worked, the help it got isn't the help that was needed - so the struggle must go on.
And the second sad part is that if other's had been listening more closely to you (perhaps not to your words, but to all of you), then the ED would not have been needed. Remember when you said:
I have always, even pre Ed, had  an issue with feeling like my feelings or emotions are invalid. It's def gotten worse though. I apologise a lot if someone feels different than I do. If I'm angry at someone I don't care express it because I don't want to upset anyone
(the bold is my own emphasis)
In this idea we are exploring, an ED is one of the most extreme ways you can communicate by being too good. But I would guess that before your ED, this type of "too good" communication was happening too. But if the main adults that you were coming in to contact with were your caregivers, whose own terrors about your "bad side" caused only "good" to come out of you, then their lack of hearing is no surprise. They were probably extremely pleased to have someone so "good" as their child. But if we could wipe their mind's clean of their unconscious fears about your expression of "bad", or throw in a wise adult who understood that every emotion is ok, then perhaps they would have picked up on all the too-good that was being communicated in a less brutal way than an ED communicates it.
If they noticed, then they could then have encouraged you to experiment by adding a few more "bad" emotions to your everyday expressions; to get more emotional space on the map for you to live in. They could have helped you to try these scarier "bad" expressions, show you that they can do it too and it's safe, and you could have practiced doing it together in a secure relationship, where you knew they wouldn't mind if your "badness" went too far by mistake. But this did not happen. So if the small signs of too-good are being ignored, the mind must make them bigger and bigger, until they dominate your mind, and an ED is one symptom of that domination.
At the root of this idea is the need to change your map back. To get more emotionally territory for you to comfortably express. To go from keeping to a tight area on your map:

image.png 202 KB

To being able feel comfortable wondering all over it whenever you want to:

image.png 339 KB

The ED both communicates what the map looks like (too much "good") and communicates that you need some help, with the hope that you find someone/a group who will help you do the map-rebuilding work that's really needed.
The result is that this idea has strong views about how to treat an ED: which is to slowly try out more "bad" emotions in the real world and to realise that you can survive their expression; a process which will be very scary at first. There is a more detail to go into when it comes to the treatment side of things that the concepts put forward suggests, but I will stop for now.
But as I said earlier, this is just an idea - and not precious one - but one to be played with. So, I wonder how you feel about it so far? Are there bits that feel right? Bits that don't? Etc.
Stephani
13:12, 31 Jul 20
Ok I reread everything along with added part and now I'm getting it. And I def agree with alot of it
Joshua Summers
14:18, 31 Jul 20
OK cool. Even though I hinted at it, but would it be good to move onto the details (and science) of what the implied treatment is? Or do you have any questions you'd like to ask first?
Stephani
14:21, 31 Jul 20
Yeah I'm following the right direction so it's safe to move on on my end
Joshua Summers
21:17, 01 Aug 20
It just occurred to me that there was something that I failed to specify. When it comes to "bad", I am not talking about only "obviously bad" types of expression.
It could be as simple as saying "I'm sad about this" or "I'm feeling worried about that". It is not exclusively the "bad" emotions of being angry/aggressive (although those emotions are not always bad, they wouldn't exist if we didn't have a good reason to use them sometimes).
The emotional areas that are bad are any ones that contain emotions that your caregivers couldn't handle comfortably. If they couldn't handle you feeling sad, for example, that would will also be missing from the map and force you further into the "good" corner.
I'll write more on treatment soon, but just wanted to clarify that as I realised that I hadn't.
Stephani
23:25, 01 Aug 20
Yea I'm following now. I think that was my confusion previously
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