What Makes Anorexia a ‘Harder Case’ Than Bulimia?

What Makes Anorexia a ‘Harder Case’ Than Bulimia?

(From Biblical Counseling for Women blog)

Marie Notcheva, Author of Redeemed from the Pit:  Biblical Repentance and Restoration from the Bondage of Eating Disorders, shares with us today about Anorexia Nervosa and Bulimia. 

The two main eating disorders, anorexia nervosa, and bulimia are both relatively common in the Western world, with bulimia being 5-10 times more common than anorexia (especially among college-aged women). Broadly speaking, however, anorexic clients are much more difficult counseling cases than bulimics. Why is that? Why does ‘being transformed’ and renewed in her thinking seem to be that much more elusive for the starver than for the purger?

This was not a subject I got into in my own book, Redeemed from the Pit.”  I did not focus very much on the differences between the two disorders, but rather dealt primarily with the root sins contributing to both behaviors. Moreover, most Redeemed_Hi-Res_CoverSample-02a.jpg
anorexics end up becoming bulimic at some point. It is much more difficult to continue to starve than it is to give in to the urge to eat, and then purge as an “escape hatch.” However, there are women who maintain anorexia long-term without ever giving in to bulimia. I have known women to go well over a decade as anorexics, while their body tissues slowly disintegrate, still pursuing that elusive thinness. This scenario is much rarer than the more common one: A low-to-average-weight woman who binges and purges in secret, or an overweight lady who habitually overeats and cannot seem to moderate her eating habits.

The Depth of Deception

What is it about anorexia that makes it harder to counsel? Here is my theory (and it is just that – my somewhat-educated opinion): the level of self-delusion in anorexia is deeper.

A bulimic knows that what she is doing is wrong. She feels shame constantly, even when she has been purging for so long her conscience is desensitized. Even before she seeks counseling, inwardly she knows it is sinful to gorge and vomit up food. She knows the risks of laxative abuse, and is filled with disgust and self-loathing. She wants to stop the binge/purge cycle, but on the other hand is conflicted: The frenzied act of eating/purging retains some sort of reward to her that she is reluctant to give up, yet she is deathly afraid of gaining weight. As with her anorexic sister, the bulimic has made weight her idol. Nevertheless, she rarely has any delusions that bingeing and purging is anything less than sinfully self-destructive.

The anorexic Christian, on the other hand, is less likely to really see her self-starvation as wrong. Anorexia seems the more “noble, stoic” of the two eating disorders — after all, it takes enormous willpower to consistently refuse food. The anorexic is typically very proud of overcoming her baser human instinct – the need to eat for survival – and sees herself as of stronger, more self-controlled stock than other women. She has never eaten food only to “get rid of it,” so ‘what’s the problem?’ she may reason.

Distorted Body Image

Add to this the grossly distorted body image more common to anorexics, and you would have a hard time convincing them that they need to gain weight. I remember when I was anorexic in 11th grade, looking in the mirror (at 5’5″ and 90 lbs.) and seeing a normal-weight girl. Interestingly, in photographs of myself I saw how emaciated I was; but anorexics do not see themselves realistically in “real time.” For this reason, I highly recommend meeting with a nutritionist as well as a biblical counselor during the re-feeding process. A nutritionist provides an objective, science-based eating plan according to biological, nutritional needs. In my experience, this was helpful in giving me the confidence to eat nutritionally-balanced, if small, meals and to gain weight without freaking out.

Asceticism is Worshiped in Our Culture

A third reason anorexics may present tougher counseling cases than bulimics is the connection between asceticism and “religion.” I use ” ” around the term, religion to distinguish this way of thinking from true, biblical Christianity. The ascetics were an ancient group that believed in subjugating the body (believing all matter to be evil, like the Gnostics) in an attempt to reach a higher level of ‘spirituality.’ This way of thinking was also rampant in Medieval Catholicism (read about ‘holy anorexia’ and the contemplative practices of nuns of the time period) where flagellants and penitents would beat, starve, and sleep-deprive their bodies mercilessly as “penance.”

The notion of “penance” is antithetical to the Gospel, which teaches repentance. Repentance is godly sorrow over sin; trusting in Christ’s finished work on the Cross as atonement, and dependence on Him to turn away from the sin. Penance, on the other hand, is self-inflicted punishment or man’s attempt to “make it up to God” by performing some act. This is the height of pride (thinking that we can add something to our redemption, on top of Christ’s sacrifice). It is also a gross perversion of the true motivation for the spiritual disciplines (including fasting).

A Christian anorexic could easily justify her habit as “holy” by calling it a “fasted lifestyle.” The secular media certainly reinforces this mindset, by glorifying women who successfully lose weight through willpower, the secular term for self-control. Self-control is certainly a fruit of the Spirit, and fasting is something Christians are expected to do in seasons of intense prayer, but the anorexic mindset perverts them both. Although she is called, as a believer, to “put on the new self,” she is, in fact, giving reign to vanity and self-absorption. Paul writes:

“Therefore if you have been raised up with Christ, keep seeking the things above, where Christ is, seated at the right hand of God. Set your mind on the things above, not on the things that are on earth. For you have died and your life is hidden with Christ in God.”  ~ Colossians 3:1-3

The anorexic’s mind is most definitely not set on “the things above,” nor is she walking in the Spirit. Her mind is set on the carnal desire for unnatural thinness and adulation. She ruminates about food day and night. Her lifestyle and habits “sow to the flesh” (Galatians 6:8). However, it is much more difficult for her to see her true spiritual condition through the eyes of faith than it is for a bulimic, whose purging habit is more obviously sinful (gluttony, waste, destruction of the temple – 1 Corinthians 6:19). Anorexia is just as grievous a sin against the body as bulimia is, but for these reasons, I believe it can be harder to convince an anorexic that this is indeed the case.

What are your thoughts on this? I am especially interested in feedback from women who have counseled clients struggling with anorexia. Do they see this as a life-dominating sin, or something that makes them “purer” (even if only in their own eyes)? Do they consider jeopardizing their health by self-starvation to be as wrong as overeating, or do they see it as “virtuous” (even if only secretly)?

Advertisements

Review of “Redeemed from the Pit” by Julie Ganschow

This review of my book, “Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders” was written by author and biblical counselor Julie Ganschow. It originally appeared on The Biblical Counseling Coalition website on January 29, 2014. 

Redeemed_Hi-Res_CoverSample-02a
Redeemed from the Pit is a solid read for the biblical counselor who is looking to expand their understanding on this important topic and for anyone seeking to overcome an eating disorder or is ministering to someone who is enslaved to the lifestyle. The personal story victory and practical application of Gospel truth makes this a great resource.

In the Pit of Despair

As a biblical counselor and as a person who was once diagnosed with bulimorexia, I took on the challenge of reading Marie Notcheva’s book, Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders book for both personal and professional reasons. I have had a love/hate relationship with food all my life. Like Marie, I once struggled with binging and purging and I alternated those behaviors with starvation.

From the introduction to the end of the book, Marie makes it clear to the reader that eating disorders are not a physical disease from which a person recovers but a spiritual disease from which a person must repent.

Marie’s personal story is weaved throughout this great book. She gives vivid details of how her early years provided the perfect mental and emotional set up for the development of her eating disorder. The culture of the late 1960’s and early 70’s that subjected women to consistent expectations of thinness and beauty fueled the fires of shame ignited by her family’s careless words about her weight and appearance. Her mother in particular (who appeared to struggle with her own food issues) was exceedingly fearful Marie would be overweight and suffer consequences to her health. She enrolled Marie in a toddler dance class to slim her down and restricted her access to sugar and starches.

At age 11, Marie began taking gymnastics. By 14, with gymnast Nadia Comaneci as her idol, she began a lifestyle of severe calorie restriction and over exercise. The highly competitive worlds of gymnastics and dance fueled her desire to become sylphlike. While she got the desired results through constant exercise and living on Slim-Fast and vegetables, the following year she determined to eat as much as she wanted, eliminating the food binge through vomiting.

In a very short amount of time, Marie’s binge/purge lifestyle was out of control. It was clear to everyone around her she needed help. Her health was in serious jeopardy. While referred to psychologists, psychiatrists, and therapists, they were unable to breach the concrete protecting her heart.

A Way Out

In her sophomore year at college, she joined Campus Crusade and put her faith in Christ. She continued her secret lifestyle while active in Cru, Bible study, and discipleship. A job abroad followed college and her slavery to bulimia remained an active part of everyday life. She also began to drink heavily as a way to medicate the constant guilt and shame she lived with.

Marriage and children did not expose or alter her bulimia, although her husband did express concern about her drinking.

Marie writes at length about the self-disgust she experienced. It caused her to question her salvation and consider herself a hypocrite. She felt hopeless and at times she feared God had rejected her. However, she had such a desire to return to Him that she continuously tried to turn away from her sin. In desperation, she met with a small group of Christian women who prayed over her. It was then that she began to find freedom from alcohol and bulimia.

From this point forward in the book, Marie develops the inward battle of change at the heart level. She describes her battle with overcoming her eating disorder both on the physical and spiritual level and does not shrink away from describing the difficulties she faced or her failures in overcoming the desire to binge and purge. She notes, “Overcoming an eating disorder requires our constant, active commitment to inward change” (7).

Living Free

She urges the reader to “be one who believes” in the power of the Gospel as the means to transform life from victimhood to victorious in Christ, rightly emphasizing the critical need for repentance in overcoming an eating disorder.

“Forgiven, cleansed, and given a new start, He expects you to get up off your knees and get started—walking in repentance” (6).

Marie carefully breaks down the numerous issues of the heart that a person with eating disorder behaviors must repent of to overcome this sin and live victoriously. There is an entire chapter devoted to the believers position in Christ, which is very important for a woman with an eating disorder to understand since so much of her thinking is performance oriented. Marie brings forth the truth about the role emotions play in how a person thinks about food. This is vital since those with unhealthy eating habits believe many lies about food.
Throughout the book, there are application steps that make use of charts and Scripture memorization. There is also an entire chapter on practical issues that a person with disordered eating faces. Marie highlights the refining benefits of a biblical counseling relationship and involvement in a local church.
This book is a solid read for the biblical counselor who is looking to expand their understanding on this important topic and for anyone seeking to overcome an eating disorder or is ministering to someone who is enslaved to the lifestyle. The personal story victory and practical application of Gospel truth makes this a great resource.
julie

Hope and Healing for Eating Disorders

This article originally appeared in the December 2013 issue of “Ilira Revistë” magazine. Read the Albanian language version here.

© Marie Notcheva

Is there a point where a diet becomes deadly? Can a desire to look thin and “fit” become an unhealthy obsession? Is it possible for a woman’s behavior to be totally controlled by fear of gaining weight?

While it shouldn’t surprise us that the answer to these questions is “yes”, what is truly alarming is that eating disorders such as anorexia and bulimia affect many Christian women around the world. If we are set free from the power of sin, as the Bible says, why do so many believers become enslaved by addictions? Women in the Church often feel ashamed to seek help, and hide their struggles with eating disorders. However, there is great hope to be found in the power of the Gospel. First, let’s look at what anorexia and bulimia are.

Anorexia nervosa is the clinical diagnosis given to individuals who starve themselves (and often exercise excessively) in attempt to maintain a lower than healthy weight, usually defined as 20% lower than average for one’s height. Extreme dieting and fear of weight gain (along with viewing one’s self as fat when actually underweight) can lead to cardiac damage, interrupted menstrual cycles, premature osteoporosis, kidney failure, hair loss, and other health problems.

Bulimia nervosa describes the binge-and-purge cycle of consuming large amounts of food, then expelling it by vomiting, laxatives, diuretics and/or excessive exercise. Many bulimics were anorexics first, or combine the two behaviors to control their weight. Once the difficulty of self-starvation becomes so great that a woman gives up and eats, purging becomes her “safety latch”: the only way to indulge the appetite (that has been denied for so long). She now feels completely out of control. Bulimics are usually aware of the health risks, which include electrolyte imbalances (which can lead to heart arrhythmia and kidney damage); esophageal ruptures and dental problems.

Another long-term consequence of both anorexia and bulimia is infertility. The average woman’s body fat percentage is between 14-20%. When it drops below 8-10%, sufficient estrogen is no longer produced and ovulation stops. Often, sterility and miscarriages are the result of eating disorders. A high price to pay for wanting to be thin!

What Causes Eating Disorders?

Although the media is often blamed for equating thinness with beauty, the truth is that women of every era have wanted to be considered attractive and desirable. Preoccupation with having the “perfect” physical attributes is what the Bible calls vanity, and we women are notorious for comparing ourselves to others!  While some blame modern advertisement for the message it sends women, psychologists label eating disorders “mental illnesses” and many people consider them diseases. This is wrong, however; there are no organic or genetic causes of either anorexia or bulimia. We cannot blame the media or biology. Eating disorders result from idolatrous desires and sin-deceived hearts (Jeremiah 17:9). They are learned behaviors, which by the grace of God can be unlearned.

Every action and decision we make is preceded by a thought. Then another thought, and another. “I am ugly. I need to lose weight”. Eventually these thoughts become a meditation. The meditation sooner or later leads to an action. “I ate too much…I will purge it.” Very often, a woman does not realize at this stage how serious it really is, and how trapped she will soon become. The action is repeated; others are added; and habits are formed. “That has many calories…I cannot eat it unless I run for an hour.” Weeks, months, and years of thinking food-obsessed thoughts and performing eating-disordered behaviors go by, and the bondage becomes deeply entrenched.

For a woman struggling with anorexia or bulimia, weight has become her idol. An “idol” is anything that we want badly enough that we are willing to sin in order to obtain it; a “must-have; will-do-anything-for; only-happy-when-I-have” craving. Both anorexia and bulimia are self-destructive means to attain an idolatrous goal: being thinner at all costs. When this mindset controls a daughter of God, she needs to remember her position in Christ. The believer whose “mind is set on things above” (Colossians 3:2) is focused on things of eternal value, and will not fall prey to the unbiblical thinking that fuels eating disorders. However, realizing that Jesus Christ died for this sin too should give the Christian great hope! It is never too late to turn around, and God gives us clear instructions on how to “renew our minds” with His Word in order to live lives pleasing to Him.

How Does the Gospel Apply to Eating Disorders?

When I was a child, I loved the story “The Ugly Duckling” by Hans Christian Anderson. I dreamed of turning into a swan as the maligned “duckling” did in the end, and being accepted into the ranks of the beautiful. By the end of high school, I had not been transformed into a swan. At 39 kilograms and on the verge of death, I was a teenager in desperate need of Christ. What needed transformation was my heart. The Apostle Paul tells us in Romans 12:2 that we are, indeed, to be totally transformed: Do not conform to the pattern of this world, but be transformed by the renewing of your mind.” This means that we are not to copy the behaviors, mindsets or priorities of this world (including valuing thinness and physical appearance over our relationship with Christ).  We “renew our minds” (learn to think God’s thoughts and share His priorities) as we meditate on His Word.

God has given us all we need to align our thinking with His will, and live Holy Spirit-empowered lives (2 Peter 1:3). How does this look in the life of a woman who wishes to forsake anorexia or bulimia? First, she must realize the truth about her position in Christ: she is no longer a slave to sin. In 1 Corinthians 6, Paul reminds believers of what they were – drunkards, idolaters, homosexuals, etc. But when they came to know Christ they were completely changed! That sinful behavior was left in the past. The same is true for an eating-disordered Christian. Although the craving and urge may seem overpowering at times, she can choose to overcome her obsession with food and weight forever.

Do you struggle with anorexia or bulimia, but long to be free? The Savior Who cleansed the lepers is willing to heal your heart, as well. Here are some keys to walking in victory, with His help:

  • Agree with God that the eating disordered behavior is wrong, and commit to turn away from it.
  • Accept God’s grace daily. No matter how many times we fail, God’s mercy never runs out. Women with eating disorders are typically perfectionists. This performance-driven mindset runs counter to the Gospel, which demands that we humble ourselves as children (Matthew 18:4). Trust that His forgiveness is greater than your sin.
  • Renew your mind. Pray and read the Bible daily to develop a godly way of thinking about food, appearance, and true beauty.
  • Take every thought captive to make it obedient to Christ (2 Corinthians 10:5). Every time you are tempted to binge or purge; compare yourself to a model on a magazine cover; or take offense to a comment (to use a few examples), stop and re-align your thinking in light of Christ’s teaching.
  • “Put off” your old, eating-disordered behaviors and thoughts; and “put on” the God-honoring alternative (Ephesians 4:22-24).

When we come to know Christ, we reject, or “put off”, things that belong to the old, sinful nature (such as lying, stealing and anger.) In their place, we are to “put on” speaking truthfully; generosity; and kindness. An anorexic or bulimic Christian must consciously reject the lies she has internalized, and replace them with the Truth of the Gospel. For example:

“Put Off” “Put On”
Number on scale determines my value I am made in the image of God (Gen. 1:26) and my purpose is to glorify Him (Ps. 86:9; Isa. 60:21)
Counting calories Food is necessary to sustain life; receive with gratitude (1 Tim. 4:4)
Fear of gaining weight God created my body; I can trust Him as I eat the way He intended (Psalm 139:13)
Some foods are forbidden or “dirty” No particular food is unclean (Acts 10:15)
No one cares about me; I may as well

comfort myself with a binge

God cares about me, and I can turn to Him (1 Peter 5:7)
  • Lastly, regular worship and fellowship are especially important as the Lord draws you out of the pit of an eating disorder. Don’t be afraid to share your struggle with another believer who may counsel, encourage, and pray with you.

The God Who redeems us from sin is still faithful to transform His daughters’ lives. In Christ, there is true and lasting freedom from addictions. Anorexia and bulimia are bondages that may be left at the foot of the Cross forever!

Marie Notcheva is a Christian author and conference speaker from Massachusetts. A certified biblical counselor, she is a regular contributor to The Biblical Counseling Coalition website. In 2011, Calvary Press published her book, “Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders.” She is currently writing a second book, about evangelism, discipleship and counseling in the internet age. 

Hir ungjilli për gratë me çrregullime në të ngrënë, Pjesa II

Ky artikull ishte i parë në Koalicioni i Këshillimit Biblik Shqiptar.

Autore: © Marie Notcheva
Përkthyes: Juxhin Alia
Redaktore: Arta Cesula

Fjalë hyrëse nga ekipi BCC : Ju po lexoni pjesën e dytë të një blogu me 2 pjesë te miniserive Hir & E vertetë  mbi çrregullimet në të ngrënë nga Marie Notcheva. Në pjesën e parë të kësaj serie, ne trajtuam mendësinë e gabuar dhe “idhujtarinë” që qëndron pas çrregullimeve në të ngrënë. Në të dytën, do të trajtojmë disa dallime të përqëndruara në ungjill, mbi mënyrën e këshillimit të grave anoreksike dhe bulimike. Pjesën e parë mund ta lexoni këtu

E pranuar nga Hiri

Në librin e saj, Good News for Weary Women (lajm i mirë për gratë e shqetësuara) Elyse Fitzpatrick  heq një paralele interesante mes këshillave ekstra-biblike që gratë e krishtera marrin mbi të qënurit “të perëndishme” dhe Galatasve të cilët Pali i qorton pse i shtonin rregullat e tyre besimit në krishtin. Fitzpatrick me të drejtë vë në dukje se përpjekja për të jetuar sipas standarteve të tua në një tentativë për ta bërë veten “të pranueshëm “ për Perëndinë do të çojë drejt fajita, dështimit dhe dënimit të vetes. Disa shembuj të këtyre rregullave të pashkruara qe injektojnë fajin përfshijnë presionin për të qënë meuese shtëpiake, për të mësuar femijët në shkollën e së dielës, dhe të ushqejë familjen e saj me vakte organike, të gatuara në shtëpi rregullisht. Të gjitha këto janë zakone të mira por as nuk janë urdhëresa biblike dhe as na fitojnë “pikë” me Perëndinë. Ajo çfarë Fitzpatrick po thotë është se kur ne(gratë) I shtojmë barra të tepërta listës sonë te “vet-përmirësimit” ne po e vendosim veten sërish nën  “robërinë e ligjit” , duke u përpjekur që ta bëjmë veten të dukemi “mirë në sytë tanë” dhe duke refuzuar nevojën për hir.

Për një grua anoreksike ose bulimike, robëria prej rregullave dhe ritualeve të vet-vendosura, rritet në mënyrë eksponenciale. Ushqimet “e lejuara” bëhen gjithmonë e më pak, regjimet e ushtrimeve të detyrueshme, bëhen më të gjatë dhe më të vështirë, dhe marrja e kalorive bie në nivele drastike mos-ushqyerje.

Për një bulimike, të hash “më shumë seç duhet” (edhe një kafshatë më tepër) e bën atë të justifikohet për ta vjellë të tërën : “Unë tashmë e bëra lëmsh këtë punë… më mirë po i shkoj deri në fund”. Kjo mënyrë e të menduarit “të gjitha ose asgje” nuk lë vend për hirin, gruaja ndihet e ndotur, e dobët dhe fajtore kur “dështon”.Michelle Myers, ish-anoreksike, shkroi se u ndikua nga fjalët e një miku të vet ndërsa kishte ngecur në mëkat si kurrë me parë “ bën stërvitje apo jo, Perëndia të do njelloj”. Fakti se nuk je më pak “e vlefshme” kur nuk ushtrohesh njëherë apo kur ha karbohidrate, është një koncept i vështirë për tu rrokur nga një subjekt qe këshillohet për çrregullime në të ngrënë dhe eshte një shembull konkret se ku ka nevojë ta aplikoj ajo ungjillin në jetën e përditshme.

Dallime në këshillimin e klienteve anoreksike dhe bulimike

Ndërsa diskutoni “rregullat” e të resë që keshilloni, dhe çfarë ndjen ajo se mund të arrijë duke i mbajtur ato, ju mund të hasni një larmi përgjigjesh që varen nga sa thellë janë ngulitur sjelljet e çrregullimeve në të ngrënë tek ajo. Gjithashtu vini re se anoreksiket janë përgjithsisht raste më të veshtira këshillimi sesa bulimiket për një numër arsyesh:

  • ·        Shpesh(por jo gjithmonë) ato janë më të brishta fizikisht, puna e rëndë e ndryshimit biblik mund të kërkojë më tepër energji sesa ato kanë.
  • ·        Niveli i të gënjyerit të vetes është më i madh tek anoreksiket.
  • ·        Frika nga ushqimi dhe idhurjtaria e dobësimit është bërë shteruese për to.  Anoreksiket shpesh fillojnë keshillimin me pak shpresë për tu transformuar.

Nëse po këshilloni një femër që është diagnostikuar klinikisht me anoreksia nervosa (çka do të thotë se ajo është  të paktën 20% nën pëshën ideale trupore të saj), unë do të sugjeroja seriozisht për ju të kërkoni që ajo të kontrollohet të paktën çdo javë nga një mjek dhe të bëjë analiza laboratorike rregullisht. Mungesa e balancës së mineraleve elektrolitë janë fenomen i zakonshëm si mes bulimikeve ashtu edhe anoreksikeve, por rreziku i mos-funksionimit  te zemrës apo veshkave  është më i madh në anoreksi kronike.

Së dyti, jini të pregatitur për rezistencë nga subjekti anoreksik që keshillohet kur pëqrpiqeni ta bëni atë ta shohë sjelljen e saj si “mëkat”. Kjo është një nga dallimet më të mëdha që kam vënë re gjatë këshillimit të grave me çrregullime në të ngrënë : një bulimike tashmë e di se sjellja e saj eshtë e gabuar dhe vetë-shkaterruese, dhe i vjen zakonisht turp nga  “humbjet e kontrollit” që ka. Në kontrast me këtë një anoreksike ndihet e fuqishme kur arrin të privohet. Ajo beson se sjellja e saj e ngurtë është vetë misherimi i “të shëndetshmes”, e justifikon si “vetë-disiplinë”, dhe ndjen përbuzje për pëshen normale (që në sytë e saj është shëndet I tepërt). Kur ajo sheh veten në pasqyrë, pavarësisht se sa e dobët mund të jetë, ajo sheh një person obez përballë saj. Një bulimike mund të ketë një pikëpamje idhujtare mbi peshën(duke dashur të jetë e dobët aq shumë sa është e gatshme të mëkatojë per t’ia arritur) por zakonisht pesha e saj është afer normales dhe pamja e saj nuk është aq e shtrembëruar. Anoreksikja krenohet me “mbajtjen e ligjit” te vet, kjo është bërë identiteti i saj. Dëshira për të qënë e dobët me çdo kusht mbizotëron deri në atë pikë sa frika e saj nga ushqimi është bërë e pa-arsyeshme. Vetë natyra progresive e anoreksisë bën që subjekti I këshilluar të ketë frikë të gëlltisë ushqim.

Përveçse e ndihmoj atë  ti përballë këto frikëra në mënyrë biblike, unë kërkoj nga subjektet anoreksike të takojnë një dietolog(duke supozuar që sjanë të tillë) dhe këtë takim e inkurajoj edhe për rastin bulimik.  Takimi me një dietolog ndihmon anoreksiken të fitojë besim për të konsumuar ato çfarë trupi i saj ka nevojë në mënyrë të ushqyeshme, ndërsa përball bashkë me ju, këshilluesin biblik, mashtrimet që ajo ka përvetësuar.

Si rregull, unë nuk ju kërkoj as subjekteve anoreksike, as atyre bulimike të mbajnë ditar ushqimi, megjithëse dietologu mund ta kërkojë diçka të tillë. Të shkruajturit e çdo gjëje që ajo ha përqëndron një vëmendje të panevojshme tek ushqimi, sesa tek zbulimi i motiveve të zemrës së saj dhe tek ripërtëritja e mendjës së saj.

Duke i dhënë shpresë dhe duke i mësuar asaj ta çmojë Krishtin

Sido që të shfaqet sjellja e çrregullimeve në të ngrënë  të subjektit që këshilloni, ti japësh shpresë në sesionin e parë është vendimtare. Ajo mund të ketë përvetësuar shumë mite rreth çrregullimeve në të ngrënë nga “psikologjia e popit” siç janë “Ti kurrë nuk shërohesh, gjithmonë në përmirësim” përballeni këtë me 1 Korintasve 6:11 ku Pali këshilloi ish- grykës, pijanec, homoseksual, dhe të tjerë “të varur” nga mëkatet e tyre se ata janë “Larë… shenjtëruar… drejtësuar në emrin e Zotit Jezus” Ndihmojeni atë që të shohë se po e përdor ushqimin në një mënyrë që Zoti nuk e caktoi, dhe se po dëmton trupin që Ai i dha asaj për ti shërbyer dhe për të nderuar vetë Zotin. Një prej ngjashmërive mes anoreksisë dhe bulimisë është se në të dyja çrregullimet, kjo sjellje po shërben si “shpëtimtar i rremë” – Ato e bejnë të vuajturin të ndihet mirë (përkohësisht) prandaj është e vështirë të rreshtësh. Kur rehatia dhe Dobësimi janë prioritetet kryesore të saj, mendja e saj nuk “është vendosur tek gjërat qiellore” (siç vërejtëm në pjesën 1), dhe zemra e saj priret drej vetes (Mateu 6:21). Në mënyrë që të transformohet, ajo duhet të mësojë të ripërtërijë mendjen me Fjalën e Perëndisë dhe ta kthej zemrën e saj drejt Krishtit (Romakëve 12:1-3 , 2 Korintasve 3:18) Si në gjithë mëkatet jetë-zotërues, besimtarja duhet të mësojë ta shohë Jezus krishtin si më të bukur dhe më të dëshirueshëm se “idhulli” i saj. Detyra juaj është ta ndihmoni të dallojë cili është vullneti i tij I menjëhershëm për jetën e saj( një mendje e transformuar, shëndet, kthimi i ushqimit në rolin e vet jetik)  dhe ti besojë Perëndisë dhe atyre që ai i ka vënë pranë për ta ndihmuar(Proverbat 3:6)

Duke përballur tundimin

Të kapërcesh një çrregullim në të ngrënë nuk është e thjeshtë, edhe për një të krishterë që sinqerisht dëshiron të ndjekë Krishtin. Femrat shpesh mund të kenë drojë për t’i zbuluar “sekretin” e tyre dikujt kur vijnë për herë të parë tek ju, me turp për sjelljen e tyre, dhe me dëshiren e dëshpëruar për të ndalur por të tmerruara se Fjala e Perëndisë nuk do të “mjaftoj” për to, dhe ato nuk do mund të bëjnë kthesë nga çrregullimi i tyre në të ngrënë. Pregatituni të ri-vizitoni ungjillin ( Personin  dhe veprën e Jezus Krishtit për to) shumë herë dhe të tregoni, shpirtërisht, hir për çdo dështim (Luka 17:4 është një varg i fuqishëm për mëkatin që jep varësi, po ashtu Romakeve 7). Mësojini asaj ti kthejë sytë nga Krishti për ndihmë dhe ngushëllim në kohë vështirësie(Hebrenjve 4:14-16, 1 Pjetrit 5:6-7, Mateu 11:28-30) çdo herë që ajo është e aftë t’i drejtohet Perëndisë në momente dobësie dhe t’i rezistojë tundimit për t’iu përmbajtur ushqimit apo për të vjellë, ajo do të fitojë vet-besim dhe do të fillojë ta shohë veten duke kryer një fitore shpirtërore.

Shërim në trup, mendje dhe shpirt

Sapo subjekti që këshillohet ka filluar të hajë rregullisht, vakte të shëndetshme dhe te zhvillojë modele të reja të menduari, nevoja për t’u përmbajtur apo për të vjellë priret të largohet brenda pak muajsh. Anoreksikja tashmë e ka përballur frikën e saj më të madhe, të shtuarit peshë, dhe sheh një përmirësim në shëndetin e saj. Shtimi në peshë do të rrafshohet shumë shpejt, por këmbëngulni që ajo te vazhdojë të ndjekë planin e vakteve “të mirëmbajtjes” si pjesë e një detyre shtëpie. Shih kapitullin 13(konsiderata praktike) te librit tim, Redeemed from the Pit: Biblical Repentance and Restoration from the bondage of Eating Disorders( Shpengim nga bataku, pendesë dhe ripërtëritje biblike nga robëria e çrregullimeve në të ngrënë)

Një bulimike sheh se dëshirat e papërmbajtura të saj largohen teksa mendja e saj ripërtërihet, pjesërisht edhe sepse ajo po mban ushqimin që trupi isaj kishte aq shume nevojë. Energjia dhe përqëndrimi i saj përmirësohen drastikisht, pothuaj ne te njëjtën kohë që rresht së vjelli, pasi niveli i sheqerit ne gjakun e saj nuk leviz pa fre cdo orë. Emocionalisht, anoreksiket dhe bulimiket priren të jenë në të njejtin nivel sapo të ngrënët e tyre normalizohet, dhe nuk fiksohen aq shpesh tek ushqimi.

Eshte jashtëzakonisht inkurajuese, si për gruan që kalon çrregullimin në të ngrënë, ashtu edhe për këshilluesin, të shohë transformimin të ndodhë ndersa ajo mëson t’I mbajë syte në Krishtin dhe ta lërë robërinë e saj perfundimisht tek këmbët e kryqit.

Bashkoju bisedës

Kur i referoheni vështirësive me çrregullimet në të ngrënë, qoftë në jetën tuaj apo të subjektit që këshilloni, si mund ta aplikoni hirin e ungjillit të Krishtit?

Gospel Grace for the Eating-Disordered Woman, Part 2

Gospel Grace for the Eating-Disordered Woman, Part 2

This article originally appeared on The Biblical Counseling Coalition’s website.

© Marie Notcheva

A Word from Your BCC Team: You’re reading Part 2 of a two-part BCC Grace & Truth blog miniseries on eating disorders by Marie Notcheva. In the first part of this series, we considered the faulty thinking and “idolatry” behind eating disorders. In the second, we will consider some gospel-centered differences in how to counsel anorexic and bulimic women. You can read Part 1 here.

Accepted by Grace

In her book, Good News for Weary Women, Elyse Fitzpatrick draws an interesting parallel between extra-biblical advice Christian women receive on how to be “godly” and the Galatians whom Paul was chiding for adding rules onto faith in Christ. Fitzpatrick correctly points out that trying to live up to our own standards in an attempt to make ourselves “acceptable” to God will lead to guilt, failure, and self-condemnation.

Some of the examples of guilt-inducing, unwritten “rules” for Christian women include the pressure to homeschool, teach Sunday school, and feed the family organic, home-cooked meals regularly. All of these are good practices but are neither biblical commands nor do they gain us “points” with the Lord. The point Fitzpatrick is making is that when we (women) add additional burdens to our “self-improvement” lists, we are putting ourselves back under the “bondage of the Law,” attempting to make ourselves look “okay in our own eyes” and denying our need for grace.

For an anorexic or bulimic woman, the bondage to her self-imposed rules and rituals is exponentially worse. “Allowed” foods become progressively fewer, mandatory exercise regimes become longer and more arduous, and calorie intake drops to starvation levels.

For a bulimic, eating “too much” (even by one bite) causes her to justify an all-out binge: “I’ve already blown it now…I may as well go all in.” This all-or-nothing thinking leaves no room for grace; the woman feels dirty, weak and guilty when she “fails.” Former anorexic, Michelle Myers, wrote of being struck by a friend’s words when she was most stuck in her sin:  “God loves you just as much whether or not you work out.” Being no less “worthy” by skipping a workout or eating carbs is a difficult concept for an eating disordered counselee to grasp and is a very concrete example of where she needs to apply the gospel in her daily life.

Differences in Counseling Anorexic and Bulimic Clients

When discussing the young woman’s “rules” and what she feels may be gained by keeping them, you may encounter many different responses according to how deeply entrenched her eating-disordered behavior is. Also, be aware that anorexics generally are more difficult counseling cases than bulimics for a number of reasons:

  • They are often (but not always) more medically fragile; doing the hard work of biblical change may require more energy than they have.
  • The level of self-deception is greater in anorexia.
  • Fear of food and the idolatry of thinness has become all-consuming. Anorexics often begin counseling with little hope of being transformed.

If you are counseling a young woman who has been clinically diagnosed with anorexia nervosa (meaning she is at least 20% below her ideal body weight), I would strongly suggest you require she be monitored at least weekly by a physician and have labs drawn regularly. Electrolyte imbalances are common among both anorexics and bulimics, but the risk of cardiac or renal failure is greater in severe anorexia.

Secondly, be prepared for pushback from the anorexic counselee when trying to get her to see her behavior as “sin.” This is one of the biggest differences I have noticed in counseling young women with eating disorders: a bulimic counselee already knows her behavior is wrong and self-destructive, and she is typically ashamed of her “loss of control.” An anorexic, by contrast, often feels empowered by restricting. She believes her rigid behavior is the epitome of “healthy,” justifies it as “self-discipline,” and feels revulsion for being a normal weight (which in her eyes is “fat”). When she looks in the mirror, no matter how emaciated she may be, she sees an obese person looking back at her. A bulimic may have an idolatrous view of weight (wanting to be thin so badly she is willing to sin in order to obtain it), but typically her weight is close to normal and self-image is not quite so skewed.

The anorexic takes great pride in her “law-keeping”—it has become her identity. The desire to be thin at all costs takes over—to the point where her fear of food has become irrational. The progressive nature of anorexia nervosa leaves the counselee literally afraid to swallow food.

Besides helping her counter these fears biblically, I require anorexic counselees to see a nutritionist (assuming they are outpatient) and strongly encourage it for bulimics. Meeting with a dietician helps the anorexic gain confidence in consuming what her body needs nutritionally, while countering the lies she has internalized with you, the biblical counselor.

As a rule, I do not ask either anorexic or bulimic counselees to keep food diaries—although a dietician may require it. Writing down everything she eats focuses undue attention on the food itself, rather than on uncovering her heart motivations and renewing her mind.

Giving Hope and Teaching Her to Treasure Christ

However your counselee’s eating disordered behavior manifests, giving hope in the first session is crucial. She likely will have internalized a lot of myths about eating disorders from “pop psychology,” such as “You’re never fully recovered; always in recovery.” Contrast this with 1 Corinthians 6:11 where Paul admonished former gluttons, drunkards, homosexuals, and others “addicted” to their sin that they have been “washed…sanctified…and justified in the name of the Lord Jesus.” Help her to see that she is using food in a way that God did not intend it and that she is harming the body He gave her to serve and honor Him.

A similarity between anorexia and bulimia is that in both disorders the behavior is serving as a “false savior”—they make the sufferer feel better (temporarily) so stopping is hard. When comfort and thinness are her top priorities, her mind is not “set on things above” (as we saw in Part 1), and her heart is drawn to herself (Matthew 6:21). To be transformed, she must learn to renew her mind with God’s Word and turn her heart to Christ (Romans 12:1-3; 2 Corinthians 3:18). As in all life-dominating sin, the believer must learn to see Jesus Christ as more beautiful and desirable than her “idol.” Your task is to help her discern what His immediate will is for her life (a transformed mind, health, restoring food to its proper, life-sustaining place) and to trust God and those He has given her to help her (Proverbs 3:6).

Facing Temptation

Overcoming an eating disorder is not easy, even for a Christian who sincerely desires to follow Christ. Women may often be fearful of revealing their “secret” to anyone when they first come to you, ashamed of their behavior, and desperately wanting to stop but terrified that God’s Word will not be “enough,” and they will not be able to turn from their eating disorder.

Be prepared to re-visit the gospel (the Person and work of Jesus Christ on their behalf) many times and to demonstrate, scripturally, grace for each failure (Luke 17:4 is a powerful verse for addictive sin, as is Romans 7). Teach her to turn to Christ for help and comfort in times of struggle (Hebrews 4:14-16; 1 Peter 5:6-7; Matthew 11:28-30). Each time she is able to turn to God in her moment of weakness and resist the temptation to restrict or purge, she will gain confidence and come to see herself as waging a spiritual victory.

Healing in Body, Mind, and Spirit

Once the counselee has begun to eat regular, healthy meals and develop new patterns of thinking, the urge to restrict or purge tends to subside within a couple of months. The anorexic has now faced her greatest fear—gaining weight—and sees an improvement in health. The weight gain will usually plateau relatively soon, but insist that she stick to her “maintenance” meal plan as part of her homework assignment. See chapter 13 (“Practical Considerations”) of my book, Redeemed from the Pit: Biblical Repentance and Restoration from the bondage of Eating Disorders.

A bulimic finds her intense cravings subsiding as her mind is restored, partly because she is retaining the nutrition her body desperately sought. Her energy and concentration dramatically improves, almost as soon as she stops purging, as her blood sugar is no longer spiking wildly every few hours. Emotionally, anorexics and bulimics tend to be on a much more even keel once their eating normalizes, and do not find themselves fixating nearly so often on food.

It is tremendously encouraging, both for the woman overcoming an eating disorder and for the counselor, to see the transformation take place as she learns to fix her eyes on Christ and permanently leave her bondage at the foot of the cross.

Join the Conversation

When addressing struggles with eating disorders, either in your own life or in your counselees, how can you apply the gospel of Christ’s grace?

Të kuptosh “përbindëshin përbrenda”: Ç’rregullimet në të ngrënë, pjesa I

Ky artikull ishte i parë në  Koalicioni i Këshillimit Biblik Shqiptar.

Shkrimtare:  Marie Notcheva 

Përkthyes:    Juxhin Alia

Një fjalë hyrëse nga ekipi BCC: Ju po lexoni pjesën 1 të një blogu BCC 2-pjesësh të miniserive Hir&të vërtetë mbi çrregullimet në të ngrënë nga Marie Notcheva. Në pjesën e parë të serisë, ne do të trajtojmë mendësinë e gabuar dhe “idhujtarinë” pas çrregullimeve në të ngrënë; në të dytën, do të vërejmë disa dallime të përqëndruara në ungjill, mbi mënyrën e këshillimit të grave anoreksike dhe bulimike.

Dinamikat sociale dhe një diagnozë biblike

Në fillim të viteve 80′, termat “anoreksia nervosa” dhe “bulimia” u bënë fjalë të njohura në Shtetet e Bashkuara. Pa vonuar shumë, psikologë të sjelljes dhe ata klinikë nxituan të gjenin një “kurë” për këtë fenomen të ri – të vdesësh urie dhe të vjellësh në mes të bollëkut. Libri i Cynthia Rowland, The Monster Within: Overcoming Bulimia  (Përbindëshi përbrenda: Të mposhtësh buliminë)(1985) ishte një ndër dëshmitë e para të publikuara të llojit të vet. Vdekja në 1983 e këngëtares së popit Karen Carpenter ishte një faktor në valën e vëmendjes mediatike që i’u dha çrregullimeve në të ngënë. Një tjetër, ka mundësi të ketë qënë rritja në popullaritet e atleteve femra në disiplina si gjimnastika dhe patinazhi artistik, që dolën hapur me vështirësitë e tyre. Cilado qofte arsyeja, sjelljet e mosushqyerjes dhe të vjellët nga grykësia nuk janë sjellje të zhvilluara vetëm kohët e fundit, dhe as nuk janë të kufizuara vetëm në vendet e pasura perëndimore.

Është e dobishme për çdo këshillues biblik që punon me të rejat, të kuptojë mendësinë pas çrregullimeve në të ngrënë. Megjithëse personi që ju këshilloni mund të mos jetë diagnostikuar klinikisht me anoreksi, bulimi, ose çrregullime në të ngrënë prej grykësisë, shumë të reja do të tregohen të hapura në privacinë e dhomës së këshillimit për pasiguritë e tyre rreth peshës, pamjes së jashtme dhe zakoneve të ngrënies apo ushtrimeve fizike të çrregullta. Do të na ndihmonte të ishim në gjendje të pikasnim mendimin jobiblik dhe ta ballafaqojmë me hir dhe të vërtetë përpara se të çeli plotësisht në një çrregullim në të ngrënë.

Vini re se çështjet e imazhit trupor dhe pasiguritë rreth pamjes nuk kufizohen vetëm tek të këshilluarat femra, te rinjtë meshkuj vuajnë gjithashtu, prandaj të njëjtat parime vlejnë edhe për ta. Gjithsesi duke patur parasysh se sa më të theksuara janë ruajtja e peshës dhe mbizotërimi i çrregullimeve në të ngrënët mes femrave, do ti referohem subjektit te këshilluar me përemra femërorë.

Cfarë janë anoreksia dhe bulimia?

Përkufizimi mjekësor i anoreksia nervosa është :

“Një çrregulim në të ngrënë që karakterizohet nga refuzimi për të mbajtur një peshë minimale trupore, frika nga të shtuarit peshë apo të kthyerit në obez, turbullim i imazhit trupor, mbështetje e tepruar në peshën apo formën trupore për vetëvlerësim, dhe amenorrea(mungesë e menstruacioneve)”

Bulimia nervosa përkufizohet kështu :

“Grykësi e përsëritur që zakonisht ndiqet nga veprime që synojnë të refuzojnë marrjen e kalorive të ushqimit të gëlltitur, më së shpeshti veprime spastruese siç është provokimi I vjelljes dhe abuzimi i laksativëve por nganjëherë edhe metoda të tjera si ushtrime fizike të tepruara dhe argjërim.”

Për një shpjegim më të plotë të anoreksisë dhe bulimisë në kritere klinike, si dhe komplikimet mjekësore që pasojnë, jeni të lutur të lexoni kapitujt 2 dhe 13 të librit tim Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders. (E shpenguar nga bataku: pendesë dhe ripërtëritje biblike nga zgjedha e çrregullimeve në të ngrënë))

Me pak fjalë anoreksia është një imazh i shtrembëruar i trupit që çon në vetë-mosushqyerje(shpesh i shoqëruar më ushtrime të dëmshme fizike – anorexia athletica); bulimia është cikël grykësie-vjelljeje që çon në “varësi ushqimi” dhe humbje të kontrollit. Të dyja këto sjellje janë shteruese, kërcënuese për jetës, dhe megjithse kanë shumë komponente, në thelbin e tyre janë me natyrë shpirtërore – siç është gjithë jeta. Ka shumë ngjasim mes dy çrregullimeve, dhe shpesh sjelljet mbivendosen. Në pjesën e parë të kësaj serie, ne do të shohim mendësinë e gabuar dhe “idhujtarinë” pas këtyre çrregullimeve; në të dytën, do të vërejme disa dallime në mënyrën se si i këshillojmë gratë bulimike dhe anoreksike.

“Më mirë të më kalojë sipër kamioni”

Në librin e tij të fundit, Eating Disorders: Hope for Hungering Souls(çrregullimet në të ngënë: Shpresë për shpirtra të uritur) Dr. Mark Shaw citon profesorin Glen Gaesser kur thotë, “Mbi 50% e femrave te anketuara të moshave të intervalit 18-25 vjeç do të preferonin më mirë t’u kalojë sipër kamioni se sa të jenë të shëndosha, dhe 75% do të zgjidhnin më mirë të ishin budallaqe apo të këqija” kjo deklaratë e vetme tregon për madhësinë e kushtëzimit të prioriteteve të femrave të reja. Nëse i referohemi Biblës, edhe në Testamentin e Vjetër ne mund të shohim vlerën që i jepej bukurisë fizike – edhe në kohët e patriarkëve( mendoni per Lean vs. Rakelës, Esterin, Danielin, Absalomin dhe të tjerë që dalloheshin për pamjen e jashtme). Ne gjithashtu shohim një Perëndi me një set krejt të ndryshëm prioritetesh – dhe përkufizimin e tij të bukurisë në vargje të tilla : 1Samuelit 16:7, Isaia 53:2-3, Proverbat  31:30, dhe 1Pjetrit 3:3.

Të shpenzuarit kohë duke shpalosur pozicionin që ka në Krishtin subjekti i këshilluar (1gjonit është një detyrë shtëpie e shkëlqyer) fillon rrugëtimin e saj drejt rrokjes të së vërtetës se ajo nuk është më një skllave e mëkatit. Ku qëndron lidhja? Nuk ka asnjë çështje në jetë me të cilën subjekti i keshilluar po përballet, që nuk mund ta tejkalojë në Krishtin . Nuk ka asnjë mëkat që e këshilluara po e lufton nga i cili nuk mund të pendohet. Nëse Perëndia e ka thirrur atë që të “zhvesh” çfarë i përket mishit dhe “të vesh” shenjtërinë, atëherë, e fuqizuar nga fryma e shenjtë, ajo është e aftë ta bëjë këtë.

Ky ndërgjegjësim është zakonisht një pikë kthese për subjektet e këshilluara me mëkate jetë-zotëruese (varësitë) përfshirë anoreksinë dhe buliminë. Shpesh, ato kanë besuar për kaq gjatë se janë “nën kontrollin” e kësaj sjelljeje saqë të jesh në gjendje të “zgjedhësh” lirinë – në bazë të pozicionit të tyre në Krishtin –duket një koncept shumë liberal. Ajo mund të mësojë të “zhveshi” sjelljet jo të shëndetshme duke ripërtërirë mendjen e saj.

Ku Qëndron mendja e saj? 

Një prej vendeve të para ku i çoj të rejat që vuajnë prej anoreksisë ose bulimisë është

Kolosianëve 3:1-3: “Në qoftë se ju jeni ringjallur me Krishtin, kërkoni ato që janë lart, ku Krishti është ulur në të djathtë të Perëndisë. Kini në mend gjërat që janë atje lart, jo ato që janë mbi tokë, sepse ju keni vdekur dhe jeta juaj është fshehur bashkë me Krishtin në Perëndinë.”

Cilat janë prioritetet ditore të subjektit që po konsultoni? Për çfarë mendon? A është duke u përqëndruar tek gjërat që kanë vlerë të përjetshme? A po prehet ajo në veprën e përfunduar të Krishtit në kryq dhe në dashurinë personale të Atit për të? Çfarë i’a shkakton ankthin? Në këtë pikë, përdorimi i pyetësorëve “Zbulo Modelet Problematike” si rregjistër javor ndihmon për të zbuluar “shkëndija” specifike që e bëjnë atë të përmbahet apo të kalojë në një tjetër episod grykësie-vjellje. Për shembull, një grua bulimike mund të ndihet e sulmuar nga kritikat e bashkëshortit të saj, dhe të arrijë në përfundimin që nuk “meriton” të ketë ushqim në bark, e më pas të vjellë për të dënuar veten e për të mpirë ndjenjat e saj të lënduara. Dhe sigurisht, kjo do të çojë në rritje të depresionit dhe ndjenjave të dështimit dhe me shumë mundësi e përgatisin për grykësinë e radhës. Një grua që po triumfon mbi anoreksinë e që po pendohet, mund të ndihet e frikësuar prej komplimenteve të kolegëve mbi shtmin e saj në peshë -mund t’a zërë paniku- dhe mund të fillojë t’a limitojë ushqimin sërish. Media është një burim i vazhdueshëm i përkufizimeve sekulare mbi bukurinë, dhe tundimi ndaj kotësisë sqimatare është për një grua, që është duke u penduar prej një çrregullimi në të ngrënë, aq i vërtetë sa “presioni i moshatarëve” tek një adoleshent.

Tani… hajde ta transformojmë këtë mendje!

Ndërsa subjekti i këshilluar bëhet gjithmonë e më i aftë  ti njohë keto mendime si  jobiblike (madje irracionale), ajo po mëson çfarë do të thotë të “ nënshtrosh çdo mendim dëgjesës së Krishtit” (2Korintasve 10:5). Ajo mund të sfidohet të dallojë mendësi të tilla si : “ashkush nuk më do mua. Më mirë po ha si grykëse” ose “ numri mbi peshore përcakton vlerën time”.

Pastaj ajo mund të fillojë ti ballafaqojë këto me të vërtetën biblike: “Perëndia më do, dhe unë jam krijuar në imazhin e tij. Ai ka premtuar se kurrë nuk do të më lerë apo braktisë” (Zanafilla  1:27, Hebrenjve 13:5). “Vlera ime vjen nga qëndrimi im në krishtin, dhe Ai më quan ‘mike’. Qëllimi im është të jetoj për të” (Gjoni 15:14)

Kapitulli “Zhvish/vish” i Biblës, efesianëve 4, bëhet një ushtrim ditorë për një grua që po transformon mendësinë e saj prej një çrregullimi në të ngrënë. Boshllëku dhe frika e njeriut( pasiguria, dëshira për tu pranuar, për tu parë si “më e dobëta”) janë dy motivet e zemrës që qëndrojnë pas anoreksisë dhe bulimisë. Përgjatë kursit të këshillimit, këto dhe të tjera shfaqje të krenarisë duhet të përballen butësisht me një këndveshtrim më të lartë për Perëndinë dhe një perceptim korrekt të vetvetes(ajo është një bijë e dashur në nevojë për Shpëtimtarin). Perëndia shpesh shihet si i zemëruar ose i largët nga gratë që vuajnë prej varësive. Hebrenjve 4:14 na ndihmon të ilustrojmë faktin se Krishti e kupton dobësinë dhe mëkatin e saj, dhe është i gatshëm ta forcojë atë.

Roli i hirit

Moralizmi, në thelbin e vet, është përpjekja e natyrës njerëzore për të bërë veten “të drejtë” në vetë sytë tanë. Ne e bëjmë këtë përmes hapave, rregullave, dhe listave Si-të, shpesh duke bërë “rregullat” tona mbi çfarë do të thotë të jesh i mirë, i suksesshëm, apo tërheqës. Kjo sigurisht, na mbrujt për të dështuar dukë qënë se ne në mënyrë të pashmangshme do ta thyejmë një (ose ndoshta të gjitha) nga keto rregulla të vet-caktuara. Perfeksionizmi-përpjekja për të arritur drejtesimin prej veprave sipas vetë standartit tonë-largohet tej kur përballet me ungjillin.

“nëse të qënurit ‘e dobët’ është mirë, të jesh ‘më e dobët’ është akoma më mirë” thërret xhelati i brendshëm. Zakonet “Spartane” të të ngrënit dhe të regjimeve ushtrimore mund të marrin një jetë te tyren.

Vazhdimi i historisë së fitores në Krshtin

Gratë me çrregullime në të ngrënë janë tejet perfeksioniste si natyra. Çfarë “vepra të ligjit” krijojnë ato per veten, dhe si mund t’i këshillojmë ato? Ne do ta trajtojmë perfeksionizmin, dhe si të tregosh hir besimtareve anoreksike dhe bulimike në pjesën 2.

Bashkoju bisedës

Kur trajtojmë vështirësitë e çrregullimeve në të ngrënë , qofshin këto në jetën tënde ose të subjektit të këshilluar, si mund të na ndihmonte të dallojmë mendësinë e gabuar dhe “idhujtarinë” pas çrregullimeve në të ngrënë?

Understanding “The Monster Within”: Eating Disorders, Part 1

Understanding The Monster Within--Eating Disorders Part 1

This is the first of a 2-Part article I wrote on counseling eating disordered women biblically. It first appeared on the Biblical Counseling Coalition’s website. You can read the Albanian version here, which ran on the Koalicioni i Këshillimit Biblik Shqiptar.

© Marie Notcheva

In the first part of this series, we will consider the faulty thinking and “idolatry” behind eating disorders; in the second, we will consider some gospel-centered differences in how to counsel anorexic and bulimic women.

Societal Dynamics and a Biblical Diagnosis

In the early 1980’s, the terms “anorexia nervosa” and “bulimia” became household words in the United States. Soon, behavioral and clinical psychologists rushed to find a “cure” for this new phenomenon—starvation and purging amidst affluence. Cynthia Rowland’s book The Monster Within: Overcoming Bulimia (1985) was one of the first testimonies of its kind published. The 1983 death of pop singer Karen Carpenter was one factor in the surge of media attention given to eating disorders. Another, likely, was the rise in popularity of female athletes in sports like gymnastics and figure skating who came forward with their struggles. Whatever the reason, self-starvation and binge-purge behavior are not recently-developed behaviors; nor are they limited to wealthy Western nations.

It is helpful for any biblical counselor who works with young women to understand the mindset behind eating disorders. Although your counselee may not have been clinically diagnosed with anorexia, bulimia, or binge-eating disorder, many young women will open up in the privacy of the counseling room about their insecurities regarding weight, appearance, and erratic eating/exercise habits. It will be helpful to be able to spot unbiblical thinking and counter it with grace and truth before she develops a full-blown eating disorder.

Note that body image issues and insecurities about appearance are not limited to female counselees—young men also struggle; thus the same principles apply to them. However, given the greater emphasis on weight maintenance and the prevalence of eating disorders among women, I refer to the counselee with feminine pronouns.

What Are Anorexia and Bulimia?

The medical definition of anorexia nervosa is:

“An eating disorder characterized by refusal to maintain a normal minimal body weight, fear of gaining weight or becoming obese, disturbance of body image, undue reliance of body weight or shape for self-evaluation, and amenorrhea” (loss of menstrual periods).

Bulimia nervosa is defined as:

“Episodic binge eating usually followed by behavior designed to negate the caloric intake of the ingested food, most commonly purging behaviors such as self-induced vomiting and laxative abuse but sometimes other methods such as excessive exercise or fasting.”

For a more complete explanation of the clinical criteria for anorexia and bulimia, as well as resultant medical complications, please see chapters 2 and 13 of my book, Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders.

In short, anorexia is distorted body image leading to self-starvation (often combined with compulsive exercise—aka anorexia athletica); bulimia is a binge-purge cycle leading to “food addiction” and loss of control. Both behaviors are all-consuming, life-threatening, and while they have many components, at their core they are spiritual in nature—as is all of life.

There are many similarities between the two disorders, and often the behaviors overlap. In the first part of this series, we will consider the faulty thinking and “idolatry” behind both disorders; in the second, we will consider some differences in how to counsel anorexic and bulimic women.

“I’d Rather Be Run Over by a Truck”

In his recent book, Eating Disorders: Hope for Hungering Souls, Dr. Mark Shaw quotes professor Glenn Gaesser as saying, “Over 50% of females surveyed between the ages of 18-25 would prefer to be run over by a truck than be fat, and 75% would rather be mean or stupid.” This one statement speaks volumes about how young women’s priorities have been conditioned. If we consult the Bible, even in Old Testament times we can see the value placed on physical beauty—even from Patriarchal times (think of Leah vs. Rachel, Esther, Daniel, Absalom and others who were noted for their appearance). We also see a God with a completely different set of priorities—and His definition of beauty in verses such as: 1 Samuel 16:7, Isaiah 53:2-3,Proverbs 31:30, and 1 Peter 3:3.

Spending time unpacking the counselee’s position in Christ (1 John is an excellent homework assignment), begins the counselee’s journey toward grasping the truth that she is no longer a slave to sin. The implication? There is no life issue your counselee struggles with that she cannot overcome in Christ; there is no sin that your counselee battles that she cannot repent of. If God has called her to “put off” what belongs to the flesh and “put on” holiness, then, empowered by the Holy Spirit, she is capable of doing so.

This realization is usually the turning point for counselees with life-dominating sins (“addictions”) including anorexia and bulimia. Often, they have believed for so long that they are under the “control” of the behavior that being able to “choose” freedom—based on their position in Christ—is a very liberating concept. She can learn to “put off” the unhealthy behaviors byrenewing her mind.

Where Is Her Mindset?

One of the first places I take young women struggling with either anorexia or bulimia is Colossians 3:1-3:

“Since, then, you have been raised with Christ, set your hearts on things above, where Christ is, seated at the right hand of God. Set your minds on things above, not on earthly things. For you died, and your life is now hidden with Christ in God.”

What are your counselee’s daily priorities? Where does her mind go? Is her focus on things of eternal value? Is she resting in Christ’s finished work on the Cross and the Father’s personal love for her? What is causing her anxiety? At this point, using the “Discovering Problem Patterns” worksheet as a weekly homework log is helpful in uncovering specific “triggers” that lead her to restrict or fall into a binge-purge episode.

For example, a bulimic woman may feel attacked by her husband’s criticism, conclude that she does not “deserve” food in her stomach and then purge in self-punishment and to numb her hurt feelings. Of course, this will lead to increased depression and feelings of failure and will probably set her up for the next binge. A woman finding victory over and repenting from anorexia may feel frightened by a colleague’s compliment on her recent weight gain—panic—and begin restricting again. The media is a constant source of secular definitions of beauty, and the temptation to vanity is as real to a woman repenting from an eating disorder as “peer pressure” is to a teenager.

Now…Let’s Transform that Mind!

As the counselee becomes increasingly able to recognize these triggers as unbiblical (and even irrational) thinking, she is learning what it means to “take every thought captive to make it obedient to Christ” (2 Corinthians 10:5). She can be challenged to identify specific thought patterns such as: “No one loves me. I may as well go ahead and binge” or “The number on the scale determines my value.”

Then she can begin to counter them with the biblical truth: “God loves me, and I am created in His image. He has promised never to leave me nor forsake me” (Genesis 1:27, Hebrews 13:5). “My value comes from my position in Christ, and He calls me ‘friend.’ My purpose is to live for Him” (John 15:14).

The “put on/put off” chapter of the Bible, Ephesians 4, becomes a daily exercise for a woman being transformed in her thinking from an eating disorder. Vanity and fear of man (insecurity, desire for approval, being seen as “the thinnest”) are two heart motives behind anorexia and bulimia. Over the course of counseling, these and other manifestations of pride need to be gently countered with a high view of God and an accurate view of herself (a dearly beloved daughter in need of a Savior). God is often viewed as angry or distant by women struggling with addictions. Hebrews 4:14 is helpful to illustrate that Christ does understand her weakness and sin and is willing to strengthen her.

The Role of Grace

Moralism, at its core, is human nature’s attempt to make ourselves “right” in our own eyes. We do this by steps, rules, and how-to lists—often making our own “rules” on what it means to be good, successful, or attractive. Of course, this sets us up for failure as we will inevitably break one (or possibly all) of our self-imposed rules. Perfectionism—trying to attain works-righteousness by our own standard—flies in the face of the gospel.

“If being ‘thin’ is good, ‘thinner’ is better,” the inner taskmaster screams. “Spartan” eating habits and exercise regimes can take on a life of their own.

The Rest of the Story of Victory in Christ

Eating-disordered women are notoriously perfectionistic by nature. What “works of the law” do they create for themselves, and how do we counsel them? We will examine perfectionism and how to speak grace to anorexic and bulimic believers in Part 2.

Book Review: Redeemed From the Pit

rftpThis review of my first book, “Redeemed from the Pit: Biblical Repentance and Restoration from the Bondage of Eating Disorders” (Calvary Press, 2011 (c) ) was written by Amelia Arnold. You can read the original at her blog, The Sacred Pursuit. **************

Redeemed From the Pit: Biblical Repentance and Restoration From the Bondage of Eating Disordersby Marie Notcheva

Interior Publications, imprint of Calvary Press, 2011

Forward is written by Martha Peace

Marie is a certified Biblical Counselor under Jay Adams’ Biblical counseling program.

Marie’s Blog: http://redeemedfromthepit.blogspot.com/

Video testimony: https://www.youtube.com/watch?v=rPOHvay61Lc

In her book, Redeemed From the Pit, Marie gives her personal testimony of her obsession with being thin and struggle with bulimia and then how she found victory and freedom in Christ. She counsels her readers of what the real issue is: sin; and what the only real solution is: realizing what Christ has done for you, repenting of your sin, and trusting and believing that you are in Christ and that He has given us what we need to have freedom and victory over the desires of the flesh!

While this book is written most specifically for women dealing with bulimia, Marie gives some great insight and counsel for women struggling with disordered eating of any kind (anorexia, overeating, struggles with weight, etc.). It is a strong Biblical guide to what our attitude should be towards our body, towards food, and points the reader towards the only One who can satisfy, comfort and perfect us: Jesus Christ. While she recognizes that outside causes can sometimes lead to eating disorders she clearly teaches that that is no excuse. We make our own choices and we’re responsible for them. She discusses root sins (like vanity, anger, bitterness or unforgiveness, jealousy, fear of man, pride, selfishness) that can lead to one’s disordered eating and that they need to be dealt with and repented of. She also discusses how this sin (like all sins) is rooted in idolatry – the worship of something besides God and teaches what true repentance is and how we should walk in repentance on a daily basis. There’s a chapter dedicated to seeking godly counsel (how to know who to go to, who to seek counsel from), and she discusses the role of the church in counseling and the sufficiency of Scripture to give us the answers. She talks about what the Gospel is and what it means practically for the Christian that we are “in Christ”. There’s a chapter on the importance of our thinking and what it means to put off sin (or wrong thinking), and put on righteousness (or right, Christ-centered thinking). There are two chapters on the importance of forgiveness (not holding on to bitterness), a chapter on the practical side of things (like health problems that can be the result of eating disorders), and another chapter on why it’s important to tell someone about the struggle you have.

To share a few quotes:

“I had to deliberately choose, over and over to lay my wrong thinking (preoccupation with food and weight) down on the altar and reprogram my mind with the truth of God’s Word.” (p. 52)

“ ’In Christ’ clearly refers to our justified position, and carries with it the implication of obedience and being conformed to the character of Christ – not seeking to find ‘meaning’ or personal fulfillment.” (p. 99)

“Take comfort in the fact that the same Lord Who was willing to heal the lepers of Judea is also ready, willing and more than able to cleanse you. In fact, as He works in your heart, you will conquer this sin because He has already conquered it.” (p. 153)

“Throughout His Word, God assures His Children that if they will change their thinking and attitudes toward sin, He will enable them to turn around and change their ways.” (p. 175)

“God wants us to change and to bear fruit for His glory (John 15:8). The Gospel, not ‘self-help’, is the key to change (Rom 6:11, Isa 55:1-2), and we, His redeemed children, are responsible to exert effort in our sanctification (Phil 2:12).” (p. 193)

“Effective counseling grows out of discipleship, the mentoring necessary for a new Christian to grow to maturity.” (p. 199-200)

“…the best-equipped, most doctrinally sound facility in the world will not be able to help someone who does not truly desire to forsake her sin.” (p. 204)

“Just as one sin very often leads to another, disciplined training in righteousness (learning to forgive, even though it goes against our wills) can likewise lead to changed behavior and ‘putting on’ of self-control in another (overcoming food addiction).” (p. 249-250)