Mental Wellness

By Dr. Rachel Lowinger

I am amazed by young women these days: they are so beautiful and capable, and opportunities for self-expression and accomplishment are seemingly endless. They have careers and are successful homemakers; they are fashionable and gorgeous, as well as smart and opinionated. With all that, however, comes the great burden of high expectations and mounting pressures for perfection. One place where some of the battles over competency, self-esteem, and success are fought turns out to be the body itself.

Aside from enabling us to achieve our goals and express our talents and serving as the vehicle through which the neshamah fulfills its purpose, the body, for some, can become a project of sorts–an intense focus of one’s ambitions, hopes, and disappointments, and a means for an embodied expression for that which is difficult to put into words. Media and cultural norms support this notion that the body must represent our better selves and be worked on and constantly monitored and modified to conform to fashionable standards of slimness and beauty.

For some, the capacity to restrict food intake and maintain a skinny figure is just one more path toward individual accomplishment and asserting one’s effectiveness in the world. For others, overeating and obesity is a form of expressing the mounting pressure and perhaps rebelling against a culture that dictates standards of behavior and looks that are extremely hard and even unrealistic to meet.

Eating disorders can sometimes represent an underlying struggle to master one’s feelings and sense of competency. Focusing on eating–whether too much or too little–can replace the battle to acquire coping skills and develop an independent adult feminine identity. Although feeling inadequate, pressured, or lost may trigger the initial focus on eating, the eating behavior then becomes dominant and acquires a life of its own, obscuring its emotional origins.

Although young women may turn to food initially as a way of expressing a certain type of feeling–such as rage, emptiness, incompetence, boredom, or stress–the eating disorder can, with time, develop a rhythm and life of its own, similar to an addiction. At some point, the individual’s behavior becomes dominated by addictive cycles and compulsions that involve restricting and resisting food in anorexia or indulging and dieting in bulimia. The emotional origins of these disorders can easily be submerged in the tidal wave of addictive destructive behaviors that are viewed as biologically driven.

It is important to keep this connection in mind for two reasons: first, to prevent us from reducing eating disorders to a biological defect, and second, to help us realize that despite the fact that much shame is associated with eating disorders, they are no different than other emotional disturbances such as anxiety or depression–which somehow as a culture we have come to accept and tolerate more easily.

So how do mothers–who may themselves focus on body image and may often be caught in similar conflicts–and their daughters develop coping strategies that render them resilient in the face of eating disorders and prevent them from turning to eating as a means of dealing with everyday life pressures, losses, and professional and relational challenges?

Listening To Your Body

An important skill that can be taught early on is the ability to listen to one’s own body sensations and to detect and differentiate between hunger and satiation, hunger and thirst, boredom, sadness, and anger. Mothers teach their kids that when they are cranky, it’s probably because they are tired and need to sleep, or comment on how they seem sad today and wonder if anything went wrong in school–teaching them to put words to their feelings and listen to their bodies. When it comes to food, however, this process might be colored by the parents’ own anxieties related to food and whether their child ate enough or the right types of food. In the process, parents may do a great job providing guidelines and instructions on how and what to eat but neglect to teach children to listen to their own bodies and trust their own internal cues as guidance for how much, when, and what to eat.

A seven-year-old bright little girl is a picky eater; she has always made her parents anxious around food. Was she getting enough healthy foods and why was she always in the lowest percentiles of weight? The little girl grew accustomed to being monitored and bribed to finish her (admittedly meager) meals. Being a good child who wants to please, she continued to ask her parents after breakfast and supper whether she ate enough, can she move on to dessert, etc. Thankfully, at some point, the parents realized that despite her modest and picky eating, this little girl was a well-adjusted happy child who could do her homework excellently, get dressed all on her own, and probably also figure out how much she needed to eat all on her own.

This was a difficult but worthwhile transition for both the parents and the little girl. When she would ask after two spoonfuls of cereal whether she was finished, the mother would simply respond by asking her “How does your tummy feel? Do you feel like you had enough? Do you feel hungry for more?” At first the little girl didn’t know exactly how to handle her newly found independence but soon she found herself asking for a second bowl of cereal some mornings, while continuing with her two-spoonfuls portion on other days. Eating transitioned from a power struggle into an opportunity to explore her feelings and discover what it feels like to be full versus hungry. What types of food does she actually enjoy eating and look forward to eating, not as a chore or a means to an end (i.e. dessert) but for their own pleasurable effects–yes, even chicken? It also gave her the important message that her parents trust her to make decisions about her own body and that if she listens to her own needs she is her own biggest expert.

This may sound easy–and it is. Nurturing your children’s capacity to tune into their bodily states and trust their gut feelings requires minimal effort on your part as a parent and is a magnificent gift they will carry with them for the rest of their lives. Physical activities such as dance, martial arts, and gymnastics are other great ways of letting your children become attuned to their bodies, the way they move and function, stretch and relax.

Developing Competence And Social Skills

Adults, children, and adolescents need to feel that they are effective in their lives, that things they say and do matter and have an impact on their environment. Self-efficacy is associated with well-being in many psychological studies.

Self-efficacy implies that a person feels capable to control, impact, and effect changes in their environment. It includes accomplishing goals they have for themselves, such as getting dressed in the morning or doing homework, as well as interpersonal goals, such as feeling heard and understood in relationships and being able to communicate clearly. Simple things like feeling understood by a parent or having the skills to tell another child that the jokes they are making on their account are upsetting them can give children and adolescents a sense of control over their environment.

The opposite is also true: lack of these skills can make them feel helpless and out of control. Exerting control over food can become a stand-in for feeling empowered in one’s emotional life (anorexia). Cycles of overeating and then dieting can also be a way of expressing the feeling of being out of control and attempting to master it through mastering one’s appetites and dieting. The types of skills you may be able to teach your children could be related to being assertive, asking for help, saying sorry when they make a mistake, etc. You can do this by role-playing certain situations with them, making up stories that represent real-life situations they are struggling with, or just listening to their stories and trying to understand their feelings and point of view.

To make your children feel that they count, you need only listen to their requests and feelings, validate them, and, whenever possible, show them you are taking them seriously and trying to address their concerns, fears, or wishes. For example, if your child tells you she likes a certain type of garment or dislikes being called by a certain nickname, make sure you notice her preferences and take them seriously.

Learning To Tolerate Emotional Upset

Many of the compulsions that people develop are a way to avoid doing something else that is difficult and scary, such as tolerating negative feelings. Individuals develop and engage in rituals or strict sets of rules around food, alcohol, drugs, and other types of compulsions, which are so all-consuming so that they obviate the person’s need to reflect on or feel usual negative feelings that we all encounter. This reminds me of the proverbial “I will give you something to cry about”–I can cure your sad feeling by hitting you on the head so that you no longer worry about your sadness because your head hurts so badly.

Distraction has its place, but when we realize that we routinely go to food (or other addictive behaviors) to avoid feeling what we are feeling rather than to satiate hunger, we know we are in the zone of unhealthy eating. To avoid this, you may need to learn how to sit with negative feelings and teach your child to do the same. The main rule here is to realize that negative feelings won’t kill. If left to run their course, they usually pass on their own.

In many families, negative feelings are not discussed and are quickly covered over with “fun” activities. It is important to acknowledge that everyone experiences sadness, anxiety, frustration, and disappointment, and that it is OK to express these feelings and share the burden and intensity of the emotion with other family members. Though it is a common belief, it is a misconception that if one acknowledges negative feelings one will become eternally depressed and cranky. While one need not delve into and intensify negative emotions, one doesn’t need to repress or ignore them either. When you model a sense of confidence that you can withstand negative feelings, you are communicating to your child that it is a normal part of life, it is not dangerous, and it will pass. You are empowering them to tolerate their own negative emotions without needing to block them out and resort to distractions such as eating or starving.

When your child comes home upset, try to validate her feelings, tell her it is normal to feel that way, and you probably would feel similarly if you were in her shoes; perhaps share with her an event that happened recently in your life that made you feel sad. Just keep her company and sit with her for a few minutes, and soon you will be surprised to find that she has moved on to the next thing and feels much better already.

Healthy Boundaries

Some environments can be neglectful and some can be overstimulating–both can be damaging. Food can become the language of separating oneself from an overinvolved family where boundaries are not clear and departing means devastation.

In some families, loyalty to the family means sharing opinions and maintaining a sort of common identity that doesn’t threaten the cohesiveness of the family. Deviation from this cohesiveness engenders feelings of guilt and badness. One has a hard time feeling separate and in need of personal space because it somehow connotes rejection and criticism of the family members who are also very much loved and appreciated.

As a parent, you can give your children permission to separate by encouraging their attempts to be independent, to separate, to have their own emotions and opinions, and still feel loved and accepted. You can communicate to them that even if they make choices that involve moving away from you (whether emotionally or geographically) you will still respect and love them just the same. You can help them shape their own opinions and values by listening to their questions and ideas, even when they contradict your own. Ask questions and remain open.

When I started working with patients with eating disorders, I was hesitant. I was worried about becoming an engineer of body parts and calories and about being swallowed by a world of biological urges and dangers that was both huge and reductionist at the same time. Eating can become just another form of self-expression when words and other outlets fail us. It can become a way of experiencing and tolerating our own feelings, as well as communicating silently to those around us; yet, instead of a creative outcome, it can turn into an extremely treacherous road to self-destruction. In Kafka’s short story A Hunger Artist, the protagonist seems to choose and at the same time be compelled to dedicate his life’s purpose and artful expression to a slow, proud, disintegration through starvation. As parents and healers, we can provide alternative outlets that are less dangerous, and help girls and women discover their voices in ways that are life-affirming while restoring eating to its original and ultimate function–one that is life-giving, nourishing, and pleasurable. v

Dr. Rachel Lowinger is a licensed clinical psychologist. She received her Ph.D. from Concordia University and has been a postdoctoral fellow at the William Alanson White Institute. She works in private practice in Lawrence and Manhattan, specializing in emotional disorders, personality disorders, trauma, and women’s and young adults’ issues of identity. She can be reached at


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