Apology or Amends?

Bloomingdales Winter 2015 Catalog Ad

In the new Bloomingdale’s 2015 holiday catalog an advertisement depicts a lecherous man peering at a woman with the caption: “Spike your best friend’s egg nog when they’re not looking.”

The suggestion of date rape threw catalog shoppers and the world at large into an understandable frenzy. As standard operating procedure in today’s marketplace, the New York department store issued an apology.

An apology? So what. This is not a radio or TV ad that can be pulled off the air. This is a print advertising message—one that remains in circulation until the publication is tossed or recycled, which is an action that should be taken right now.

This advertisement is more than offensive, despicable and beyond unacceptable. In what universe is such a message reasonable? Perhaps in a universe where men do what they want to get what they want, a universe in which intoxication is synonymous with easy sex.

The creators of this ad, and to a greater degree the people in charge of giving it the red light, might like to meet some of our female residents who had “a little something extra” put into their cocktails. These are women whose lives were nearly destroyed after being raped by a man, or many men. Let’s see how well that message sells in the marketplace.

The concept of date rape is bad enough, but did anyone at Bloomingdale’s pause to consider the ramifications of possible alcohol addiction? Imagine a woman in recovery sipping on pure egg nog, only to have her “best friend” spike it. “So, what’s the big deal; it’s just a little drop of booze.” Only one who has walked the arduous road of alcohol recovery can attest to the fact that any, even the smallest amount of alcohol, can undo years of sobriety—literally years.

Again, sometimes a plain old “I’m sorry” is simply not enough. We all know there is a difference between an apology (just words) and an amends (a healing action). Instead of a routine apology consisting of empty words, Bloomingdales might consider making an amend by donating a substantial monetary sum to a rape recovery organization or even to Alcoholics Anonymous. If their bottom line takes a little hit, perhaps they will think twice about the caliber and content of future advertising messages.

Cosmetic Surgery Hits a New Low

Are women in our society ever “good enough” just as they are? Evidently not.

Breast implants, liposuction, tummy tucks, face lifts, butt enhancements, fillers, Botox, fat sucked out of one area and injected into another—the list truly goes on and on.

The necessity for women of all ages to be beautiful, as narrowly defined by our culture, has been relentless for years. But now we have seemingly hit a new low, with low being the operative word.

According to the American Society for Aesthetic Plastic Surgery, during the last few years, demand for cosmetic labiaplasty, reconstruction of the female genitalia, has increased more than any other cosmetic surgery. In part, this is the result of altered grooming practices among women of all ages. In the past few decades, normal hair growth below the waistline has somehow turned into public enemy number one; therefore much attention has been given to shaving, trimming and waxing.

Women (and, possibly more relevantly, their partners) now see an area of their body that had previously remained concealed; alas, a whole new area to focus on and find fault with.

The female body is created the way it is for a reason. What is it about our culture that we just can’t leave it alone? Obviously, the lower half of a mature woman is not supposed to look like that of a prepubescent child. Unless of course, you live in a culture which idealizes pre-pubescent and ultra-thin as the sexual ideal.

Women, primarily in their 30s and 40s are requesting this reconstructive surgery, which costs on average between $3,000 and $6,000. Although some claim they want this surgery because they feel uncomfortable in tight clothing or embarrassed in swimsuits, I suspect many undergo this surgery to present a younger, more ideal “look” or feel to possible sex partners.

The fact that in certain markets this surgery is being promoted as “the Barbie,” only validates this suspicion. Indeed, there is a disturbing increase in teenage girls who are trying to get the procedure in order to achieve a prepubescent look. The results can be both disfiguring, and also potentially physically harmful.

While many plastic surgeons will provide the surgery on demand, others label the procedure as “a form of genital mutilation,” or “just another form of further exploiting the social vulnerability of women.”

At some point, every woman needs to discover that she really is good enough just as she is; her body is uniquely and divinely crafted to be exquisite and beautiful, AND quite capable of taking care of itself if everyone would just get out of the way!



New Research Regarding Psychedelic Agents

Psychedelics blasted their way into the public consciousness in the 1960s. They were all the rage among hippies and flower children of that era. Commensurately, they entered the field of drug research around that time; but due to myriad questionable practices, this research was suspended in the 70s.

Research regarding the efficacy of using psychedelics has returned. Several small studies have shown “success” in using these drugs to treat anxiety, depression, addiction, and post-traumatic stress disorder (PTSD) with very few discernible short term side effects. Current studies look at the benefits of using substances such as lysergic acid diethylamide (LSD), psilocybin (found in “magic mushrooms”), dimethyltryptamine (DMT), mescaline, and methylenedioxymethamphetamine (MDMA), which is known on the street as ecstasy. The thought is that as medical professionals we will be selling these alternative drugs as new options for treating mental illness and addiction in people who are not benefitting from traditional treatments and medications that are currently available.

The research regarding reduction in anxiety and depression utilized LSD and psilocybin. These studies were conducted in a specific population: those with end-stage cancer or other terminal illnesses. Participants showed improvement without any clinically significant adverse effects.

A variety of psychedelic agents are being studied for use in cocaine addiction as well as alcohol and tobacco dependence. MDMA in specific is being considered as a possible medication option for those with PTSD.

Of course, none of these studies have looked at long-term outcomes. Quick fixes for prolonged problems usually raise a red flag in the recovery professional community.

If we think we currently have a prescription drug addiction epidemic in our country, I shudder to think what is on the horizon when it becomes allowable, and even recommendable, for physicians to prescribe these types of drugs to their patients.



Fat Shaming in its Purest Form

In the past week, an abusive campaign was started–and thankfully stopped–on Facebook as well as Instagram.

Project Harpoon was launched supposedly to put an end to “skinny shaming,” claiming that: ”In current societal fashion, a recent trending surge of ‘pro-obesity’ and ‘fat acceptance’ have paved the way for many people to renounce exercise and personal healthcare in general.”

The alleged goal of this movement was to show people’s “thinner beauty.” Of course, to prove their point, they photo-shopped images of plus-size women to make them look skinnier. As if that was not offensive enough, beneath each post appeared an insulting, mean-spirited caption.

This is nothing but fat shaming in its purest form.

The irony is that the campaign itself was launched on the premise that size shaming, regardless of which end of the spectrum, is damaging and hostile to the parties who are targeted. And yet they engage in fat shaming and size shaming in their campaign against it for “skinny” people.

Fat shaming is real and extremely prevalent. Whether it’s celebrities on the red carpet who have not gotten rid of their baby weight fast enough, or young girls in high school who do not weigh 100 pounds, people, females primarily, are stigmatized, criticized and bullied every single day throughout our country due to their size.

Skinny shaming, on the other hand, if it does exist, exists as an extreme exception to the rule and on a small, skinny if you will, scale (pun intended). Skinny IS the ideal. It is what our culture pressures all women to be. It is what our society indicates is the answer to all issues. Want to be popular? Lose weight. Want to attract a husband, be successful at work, and be happy all the time? Wear a size zero. Want to be good? Go on a diet.

People are no more shamed for being skinny than for being wealthy. How many people are made fun of because they drive a top-of-the-line car, or wear a $5,000 watch? It just doesn’t happen.

In this project’s artificial zeal to encourage “skinny acceptance” through their campaign, they said: ”No shaming please. No hate speech please.”

The truth is if they had read their own words, Project Harpoon would have gone the way of similar detrimental ideas and never seen the light of day.




Treating Anorexia: Is Cannabis A Cure?

A recent issue of Cosmopolitan magazine included a lengthy article on the use of medical marijuana for those who struggle with anorexia. By and large, the article was positive regarding such usage and it provided several salient and supportive facts. These included such statistics as; medical marijuana is now legal in 23 states as well as the District of Columbia and a record 53 percent of Americans now favor the legalization of marijuana.

Through case examples, the article revealed that cannabis helped reduce anxiety and irrational thinking while facilitating food acceptance and consumption in those who used the drug. In other words, it helped women eat.

Here’s the problem. Anyone who has spent any appreciable time treating women with anorexia knows one simple truth: anorexia is not about eating. If it was, then effective treatment would be as easy as forcing a person to ingest X amount of calories each day. There would be no need to understand the “whys” behind the disorder, what purpose it serves in the individual’s life, how the family is involved, etc.

The truth is, anorexia is a highly complex psychiatric disorder, and as such, certain therapeutic interventions are necessary to help a person truly heal. If we do not examine and alter the underlying emotional and cognitive issues, the person is quite likely to eventually succumb to relapse or develop another self-destructive coping mechanism, very possibly addiction. We know that up to 50 percent of those with eating disorders also have substance use disorders.

Another issue that was frequently alluded to in the article related to perception. Several of those interviewed spoke of their dislike of pharmaceutical medication—they rebelled against taking pills. However, this antipathy did not extend to marijuana. The usual expressions, “it’s from the earth,” and “weed is natural,” were heavily relied on. The problem is, marijuana, even if it comes from the earth, is a drug; and in many markets today, it is not a well-regulated drug.

Are psychotropic drugs often used in the treatment of anorexia? Yes, but every physician knows, when using medications, certain general principles apply, such as choosing the drug that provides the greatest benefit with the least harmful side effects. When used chronically, marijuana has been shown to increase risk of depression; also it is neurotoxic, which means it kills brain cells. This makes it a less than ideal “medicine.”

One of the more disturbing aspects of this article was the reference to marijuana as a “cure” for anorexia; this reference was made by a physician. The only cure for anorexia is recovery. In fact, that is the ultimate goal of treatment. Recovery is synonymous with freedom. Freedom from being bound to a substance or a behavior to make your way through life. Being able to find and remain connected to the wisdom within, the Higher Power within that provides a sustainable power source to live abundantly.

This is true freedom. This is recovery.

Say No to the “J” Word

Ellen Leanse, Apple and Google alum, recently posted a commentary on the word “just.” She illustrated how often, and in what contexts, women utilize and rely on this word. Not only do women use the “J” word far more than men, but by and large, they do so in a deferential or apologetic fashion. “I was just wondering if …” or “I just needed a minute of your time …”

It seems that women still feel the need to continually provide justification for their existence and ask permission for their presence in the world.

I, and many of my female colleagues, found her post to be personally revelatory. Like untold thousands of other women who read the message, we are now monitoring the “the “J” word in our day to day texts, emails and conversations.

Yet, I could not help but take this concept to another level – the world of treatment and recovery.

How many women and girls come to us every single day because they have been told by parents, peers, advertisers, the media, that they are “just” not good enough. They are not pretty enough, smart enough, popular enough, and let us never forget, definitely not skinny enough. Then how many hours, days, even months do we work to convince them that they deserve to take up space in the world, to live BIG, that they are more than good enough, that each one of us has profound value and worth; that each individual is meant to be her unique self, not an “idea” of herself, the female she will finally be once she gets inflated lips, breast implants, and loses enough weight.

I encourage you to read this post, then consider dropping the “J” word from your interactions.

This is one example of a little word with big psychological implications. Be aware of what we say, how we say it and what that says about our sense of self. Make a change and drop the “J “word, or at the very least be conscious about using it. Little steps can and do lead to big changes.


My Story is Your Story

Motherhood immediately changed my perception of many previously held beliefs. For example, I quickly learned that sleep has far more value than money, showering every other day is reasonable, and wearing the same outfit two days in a row is more than acceptable.

But, it is in the months following childbirth that profound and life-changing truth is actually revealed, such as the intricate beauty and vastness of love.

Like most women, I have given and received love throughout my life. In recent years, my husband, step-kids and dog have been the primary recipients of my affection. David, William, Suzanna and especially, Lily, have returned that love in their own special ways.

I genuinely thought I had a solid grasp of what love embodied and entailed. Then my son entered my life, ushering in a whole new level and knowledge of love.

Often, Samuel naps on my chest. The simple sound of his breathing, the squishy weight and warmth of his body, the softness of his perfect skin all conspire to catapult my love into the 4th dimension. I feel such an overwhelming and fierce love for him that my heart actually burns. I love this child, not due to anything he has done or ever will do. I love him simply because he is him.

In these moments I often reflect on the love of my parent in Heaven. God loves me as I love my son, probably far more, which is beyond my capacity to fully comprehend. And God does so due to nothing I have done. God’s love is not for sale–it cannot be bought or earned. God loves because that is who God is and that is what God does.

This vast love serves as a message of extraordinary hope to every woman in recovery. I spent years severely abusing my body through alcohol and eating disorder behaviors. I hated my body—the feelings it held and the memories it stored. By any reasonable estimation, the harm I exacted on my physical being should have been profound and permanent. And yet, it is this very same body that offered safety, security and shelter to my son for nine months, and now continues to nourish him long after his birth.

For every woman who is in recovery, or moving toward it, please remember this: my story is your story. Whatever you have done in the past regarding your body, behaviors or choices in NO way defines you today. Those chapters are written, those pages are permanently turned. Our bodies and souls were created with a tremendous capacity to be born anew, to be fully restored to wellness.

In recovery, we are living a whole new chapter, with many more to come. Each of us has the ability to author the remainder of our story with power and positivity. Life can be abundantly good.

Treating Co-occurring Disorders Together: It’s Time for Change

A tragic story was reported in the news earlier this month; it centered on a young man’s effort to obtain treatment for alcoholism and bulimia. After getting bounced around from clinic to clinic in Arizona and California, Brandon Jacques ultimately died of sudden cardiac arrest. He was the victim of negligent treatment and multiple flaws in the health care systems from which he sought help.

These flaws involved clinical ignorance in the area of assessment and treatment of dangerous co-occurring disorders, such as eating disorders along with substance use disorders. Additionally, he was on the receiving end of shockingly unethical admission procedures, rooted far more in making money than helping people.

Although Brandon died four years ago, the story only came to light recently due to the settling of a law suit by his parents. They won a substantial judgment for their son’s wrongful death.

I believe this tragedy underscores the absolute and dire necessity to treat co-occurring disorders simultaneously. We know a strikingly high rate of co-occurrence exists between eating disorders and substance use disorders. Despite this knowledge there is a paucity of training programs to equip clinicians with the tools to identify and treat both. As a result, very few treatment centers offer the expertise required to truly recognize and effectively treat both disorders. Add to this already grim picture the fact that those with anorexia nervosa have the highest premature mortality rate of any mental illness, and of that population, those most at risk of sudden death are those with binge-purge behaviors who also abuse substances, and the stage is set for more tragedies.

Eating disorders and substance abuse are both addictions, and as such, similar therapeutic approaches can be utilized to achieve recovery. Addressing them together not only makes sense, but research studies indicate that this strategy yields better long term outcomes for patients.

Honestly, why would a program help an adolescent beat an addiction to cocaine, only to return home still an anorexic? Why would a facility treat a man with binge eating disorder without addressing his addiction to alcohol? In each of these examples, treatment is simply inadequate.

Even more important than incomplete care is the need to have a treatment team that understands the complex medical, physical, psychological and spiritual issues inherent to each illness as well as the entire package of illnesses. In the case of this 20-year-old man, he died from ramifications of bulimia (low potassium levels and other electrolyte imbalances) while receiving treatment for alcoholism in a substance abuse clinic where the focus was detox. No doubt, those providing “care” were unaware of Brandon’s co-occurring eating disorder, which essentially resulted in his death.

Those with more than one addiction or disorder deserve quality care and thorough treatment, and quite literally, their lives depend on it. It is time for simultaneous treatment of co-occurring eating and substance use disorders to serve as the rule throughout our country, rather than the exception.




Power, Productivity and Pills: A Dangerous Triad

Adderall is the prescription drug that just keeps on giving, regrettably continuing to give treatment centers like Timberline Knolls more profoundly addicted people to treat.

Adderall is an amphetamine. It’s legitimately used to treat narcolepsy and Attention Deficit Hyperactivity Disorder (ADHD). For years, this drug was typically misused by college students to facilitate studying. Then, it moved on to busy moms, who had too much to do, too little time, and existed daily under the unforgiving superwoman myth.

Now, Adderall, and similar stimulant medications, have permeated many areas of the work force.

According to a recent article in the New York Times, stimulant abuse, addiction and overdose is escalating at an alarming rate. A 2013 report by the federal Substance Abuse and Mental Health Services Administration found that emergency room visits related to nonmedical use of prescription stimulants among adults 18 to 34 tripled from 2005 to 2011, to almost 23,000.

Those taking stimulants claim they use them to increase work performance and productivity; many believe these drugs are imperative to succeeding in today’s competitive work force. The thought process goes like this: “If my counterpart is possibly using a stimulant to maximize her productivity, or even just because she actually has ADHD, I better get some for myself to level the playing field.” Obtaining a prescription is as easy as visiting a doctor and reciting a laundry list of ADHD symptoms (easily found on the Internet).

The numbers alone indicate that the ploy works. About 2.6 million American adults received ADHD medication in 2012; this is a rise of 53 percent in only four years. Use among adults 26 to 34 almost doubled. It is unlikely that the prevalence of ADHD legitimately escalated that rapidly in the general population.

The truth is many individuals are addicted to perfectionism, competition and winning in the workplace. They will go to any lengths to get that, including putting their lives at risk. And, they are applauded for doing so. They are viewed as a dedicated, productive and efficient employee.

What employer would NOT love someone who works that hard?

Stimulant abuse can fuel work addiction. Underneath it all is a lie: you are not good enough as you are; you are only worthy if you perform better than anyone else and work at breakneck speed; you only have value if you achieve a certain salary, position or title.

These success imperatives are born of shame and based on lies that someone or society tells you about yourself.

At the end of the day, the question always remains: what is the price of success? If it is jeopardizing a person’s immediate and long-term health, then the price is clearly too high.

The French Government Has Got My Vote

People talk endlessly about fashion models – how they are far too skinny and serve as an unrealistic example of what women should look like, which of course, is all true.

But, now the French government is actually trying to do something about it. They are working to pass legislation that would require models to present a doctor’s certificate indicating that they are at a healthy enough weight to work. This would be predicated on the model’s body mass index, or BMI. All models would have to fall into the normal weight, not the underweight range in order to work.

Evidently, the famous Paris fashion houses are not speaking out one way or another on this proposal. Conversely, the union of modeling agencies is fervently opposed to this law, claiming it is very unfair and inaccurate. This objection may be less about the law and more about the consequences. It seems that anyone employing models without such certificates would be penalized, both financially and potentially with six months in jail.
The government is not confining legislation to the modeling industry. They are also seeking to outlaw Internet sites that promote the practice of anorexia. Additionally, they want to require any computer-generated alteration of photos to be acknowledged. So, if a models waistline is reduced or her legs are lengthened through artificial means, it must be stated.

As far as I am concerned, this pending legislation is overwhelmingly positive on every possible level. Runway models epitomize the “sick” ideal that is also reinforced daily in fashion magazines throughout the United States. The concept that pro eating disorder websites would cease to exist is beyond wonderful. And imagine living in a world where there was real truth in advertising? If a photo was “improved” by someone wielding a mouse, we would know it. The great hope would be that no longer would insecure women and girls look at a model with a 15-inch waistline and wonder why they could not achieve that goal. Even better, now that the proverbial cat was out of the bag, perhaps the advertising industry would stop doing it altogether.

We applaud the positive action taken by the French government; if successful, perhaps American legislators will consider doing likewise. It’s time for all of us to partner together to end the eating disorder epidemic.