Posts Tagged: thanksgiving
Hungry For The Holidays
One population dreads the time from Thanksgiving to New Year’s: people with eating disorders.
Consumerism explodes at the holidays, so, too, does literal consumption. People with eating disorders, often students returning home from college, are faced with a double-whammy. They have to navigate the usual regression to family dynamics we all feel but also, have to figure out food.
I’ve spent hours these past 10 years planning someone to get through cracker-and-cheese time without binging. Guiding and wondering and counseling someone who has not eaten dessert in years and faces a buffet piled high with pies and cakes.
For a few years I worked on at a psychiatric unit for the holidays. I loved Christmas there; we kept the spirit of it well in that old wooden-raftered building in the woods. Surrounded by snow and bowed evergreens, the small group of patients and staff were polite and hushed on Christmas Eve or New Year’s Day. Insanity seemed to have taken a small vacation. We were an isolated group out there, needing the containment of the hospital or the distance from our families to stay sane.
The lines between patient and doctor changed as we clustered in the snow for a rushed cigarette or marveled to see our footprints appear in each luminous dusting of the night. Fellow travelers, we were all at this inn for the night.
I’ve frequently thought about renting an inn for the holiday season. We crave community but one that is compatible. What if we could be assured that behavior,) around food at least, will be regular? What if the focus were on talking, thinking and doing rather than consuming?
Hiding food, eating leftovers, doing the dishes, midnight refrigerator raids can turn holidays into a desperate time. Patients return in January like tired anthropologists out in the field for too long. They often want to punish themselves by binging and purging relentlessly; some are worn from trying to appear cogent when they are starving in plain sight of their families.
From where I sit, holidays haven’t changed much in 20 years.
Few people in America eat because they are hungry. We eat because we are bored, sad, angry or anxious. We browse the bright refrigerator shelves looking for something that will not be found there. Food is everywhere–now in pictures on Instagram, Facebook, Pinterest and more. Surrounded by this overload to the senses we are supposed to buy ‘zen’ or ‘mindfulness’ as easily as purchasing a yoga mat. It’s not that simple nor that easy.
Breaking bread with people with love is wonderful. Proust knew that a Madeline brought back childhood. Holiday smells and tastes are the same. But hungering for childhood is not the same as eating it. Whatever we want will be there today, tomorrow and next week. Remind yourself as you eat:
Do I want this or is this rather a socially condoned binge?
We confuse feeling full with filling ourselves. Try connection instead. Interview your grandparent. Pretend you are an anthropologist visiting our culture. Observe the family traditions and taboos. Stay in touch with your outside life. Use the nearest Starbucks or the public library in your town as place to regain perspective. Step outside your family into nature and be absorbed in something larger.
Invite a family member to make a new tradition with you. My brother and I started going for a walk after a particular tense Thanksgiving. We stopped at a lovely hotel with a piano bar not far from where the Boston Marathon ends. We went inside and sat down. Two newly-minted adults breaking free.
Holidays are not a cage that holds your family rules and a bowl of food. They must be recreated and reinvented to hold meaning.
The most cherished Christmas holidays I made was in Mexico. All I had in that tiny town was a Walmart and my ATM card. But I had my then-husband and our daughter. The small village was thrilled by the new Walmart and buzzed with activity on Dec. 24. Dazzled by the sequins on the swimsuits, the toothbrushes that lit up, the candy in exotic flavors I went up and down the escalators in a daze. We scattered mango chips and guava candies that night for the reindeer. Christmas morning we opened stockings on the roof in the morning after our daughter trundled up the spiral staircase.
We ate that day, of course, but it was the newness of Mexico that drew my small family close like a small silk sack. I was reminded of the holidays at the psychiatric hospital. We make our happiness when we can and where we find it. We cannot capture it with things and we cannot consume it. Make it new.
Caring For The Caregivers: The State of Mental Illness
This is a reprint from an earlier blog. I thought with Thanksgiving and other holidays so near, it would be the perfect time to highlight the work of so many that goes unnoticed so often. —Katy
As the nation held its breath, waiting for news about health care, violence has occurred to caregivers of mental health and from them. The psychiatrist in Fort Hood who shot military men and women was pre-ceded by a more intimate tragedy. At Mass General Hospital a bi-polar man, in an outpatient appointment, attacked his psychiatrist, a female doctor and was killed by a security guard who happened on the scene. The following day I sat in my office and wondered, not for the first time, if I might get killed by a patient or have a death on my hands. And I thought, how amazing it is that these events do not happen daily.
Mental illness shows no prejudice: It is invisible and slippery. Progress is difficult to measure and the care is given by people who are tired, severely underpaid, suffer compassion fatigue, and vicarious traumatization. We live in two worlds—often at the boundary of madness. Then we walk back onto the bright well-lighted rooms of our homes or children’s school and try to forget what we know.
But at such an important moment of change, as we contemplate our American “system,” we need to review the state of mental illness. Thirteen years ago I began treating young women who were dying from eating disorders. I was tremendously optimistic, then, about change in my field. Taboos were lifted and therapy became widely acceptable as did new and effective psychotropic medication.
Yet, in fact, the opposite has happened. I see more and younger women, succumb to eating disorders. We know what treatment is but there are fewer places for this treatment. I also see the power of our culture, as it speeds up its demands and feeds us less.
Mental illness, the invisible dark cloak of depression, the shaking hands of the anxious, the rude voices of schizophrenia are one of America’s untouched frontiers. We believe that people with cancer are due every bit of bone marrow they can find. Yet we leave our ill to sit in squalor with demons in their heads and no one visits or calls. Loneliness is the chief complaint of most of my patients. Something in us still dares not name mental illness when we see it. Others of us trust everyday that the relationship we have formed with our patients—the web of connection thrown over an abyss, will hold. The anxiety, depression, and psychosis caregivers metabolize is staggering. We do it because we are curious, compassionate, and believe there we are not doing hospice work. I remain deeply troubled as to why this profession goes undervalued when it is lifesaving and life-affirming. Our country is still adolescent, We believe death will not happen to us. We believe that unattractive aging is optional. We believe there is an ‘us’ and a ‘them.’ Until that prejudice is dropped and we understand that mental illness is often a cruel accident of birth, we will never provide adequately for mental illness in those we care for or those who give care. The valedictorian of the class, the doctor’s wife who seems a bit ‘off,’ the college roommate who kills himself writing and in love … all of these are just the a few cracks in the pavement away from us. There is nothing especially ‘other’ about mental illness. Perhaps that is why it scares us so.