Avoiding the Falls

I beg you, everyone: Life and death is grave matter. All things pass away quickly. Each of you must be completely alert: never neglectful, never indulgent. - Evening Message in the Zendo in the Zen Calendar (October 1, 2006).

Day 118. I have been working on an article for the Oklahoma Eating Disorders Association newsletter, and I feel all writ out. Decided to adopt the article for the blog. Sort of like using the same paper for two different classes. I like the idea of getting as much mileage as possible out of my efforts.

When I am working with a client who is well into recovery from her eating disorder, I often ask, “What has been most helpful in our therapy together?” In some form or another, she will inevitably answer that the metaphors we developed to depict and explore major themes in her life were especially meaningful. Metaphors are powerful tools with which to capture complicated dynamics underlying disordered eating. They provide potent, symbolic images that can be shared between therapist and client in an intimate, individualized way. Like a picture, an accurate metaphor is worth a thousand words.

For clients with bulimia, reducing the frequency of purging is often an initial goal. We begin by attempting to identify common triggers, situations, and feeling states that precipitate urges to binge and/or purge. Many clients have told me that there are times when nothing seems to help. One client put it this way: “I get in this state where it is too late to use the coping mechanisms I’ve learned. Nothing can stop me then. I know I’m going to eat, and I know I’m going to purge. It’s like I just check out and go on auto pilot. Once I’m in that place, it’s going to happen, no matter what.” We developed a metaphor for this situation called “Going Over the Falls.”

Most of us have seen a cartoon where some poor character is paddling a canoe in a river with an increasingly fast current. At first it appears fun, and the character temporarily looks like she is enjoying herself. However, as the rapids speed up and the water turns turbulent and frothy, she becomes distressed and begins to flail around in attempts to paddle to shore, look around for help, or even paddle backwards. In the cartoon version, these efforts always fail. Our heroine inevitably plunges over an enormous water fall and into the churning water below.

This scenario is an obvious metaphor for the purging episode described by my client. There comes a point when the “current” of her emotions flows too rapidly, and she is swept past the point of being able to use alternative coping mechanisms. Like white water rapids, the stream of thoughts and feelings becomes uncontrollable, and she is swept “over the falls,” which is powerfully symbolic of the act of purging.

To make therapeutic use of the metaphor, I ask my clients to practice identifying signals “up river” so that they can utilize effective coping strategies before the current becomes too strong. Like noticing signs on the riverbank saying, “Danger: Water Fall Ahead,” we explore “signs” of a potential purging episode such as boredom, loneliness, anger, stress, hunger, fullness, or relationship conflict. Next, we develop ways of responding to the signs, like the smart girl in the canoe who turns back upstream, paddles to the riverbank, or abandons her canoe for a river raft navigated by an experienced guide. When applied to eating disordered behavior, these responses symbolize avoiding purging through distracting, returning to the “solid ground” of a meal plan and/or coping strategies learned in treatment, and (especially!) contacting a trusted friend, group member, or therapist and asking for help.

Over the years, my clients have individualized this metaphor to make it applicable to their unique “signs”, “river conditions”, “swiftly moving currents” and strategies for avoiding the “fall” of a purging episode. Together, we create images and symbols that vividly portray elements of their eating disorder, and illuminate new solutions. Metaphor is a creative and effective method on the journey to recovery.

The article ended there, and I think I'll end the blog here, too. It doesn't take rocket science to generalize the metaphor to the myriad ways all of us have of "going over the falls." I think the idea of noticing signs of impending danger and taking active steps to avoid it is central to studying Buddhism. Noticing signs is simply Waking Up, and being Awake is always a good deterrent to danger.

Gassho,

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