It Can’t be Coincidence!

I’m in New Zealand today, where I have been for the past three weeks. It has been a privilege to work with a number of bariatric professionals from different disciplines associated with the Foundations Healthy Living Retreat. During this five-day retreat, a small group of post-operative bariatric patients live together, eat together, exercise together, learn together and share with one another. Various staff members share their expertise about healthy living. Topics include much more than how to eat well and exercise. Participants learn the importance of focusing on personal values in all areas of their lives, discover the importance of positive self-talk, address self-sabotage and learn the importance of living mindfully. Coping skills, communication skills, and boundary setting skills are discussed. The topics of shame and vulnerability are explored, as well. Participants get what all bariatric patients in all corners of the world need following bariatric surgery: the Foundations of Healthy Living. Hmmm… good name for the retreat!

What I think as I look around me are the many “non-coincidences” in my immediate surrounding. I do not believe that my being here, halfway around the world, is a coincidence. To begin with, Dr. David Schroeder, a bariatric surgeon, and his wife, Andrea, are, in many ways, absurdly similar in personality to my husband Steve and myself. David and Steve are both kind, intelligent, rational, left-brain thinkers who are mild-mannered and soft-spoken. Andrea and I, on the other hand, while also kind and intelligent, are passionate, passionate and more passionate. Translated, we are thinkers and DO-ers, we are upfront and direct, and are most definitely whatever the opposite of soft-spoken is. Oh, loud. That’s it!

Andrea and David are passionate about their work in the bariatric field. They are zealous about the physical health of surgical weight loss patients, and are also super passionate about the patients’ psychological health. The Schroeder’s know that the journey of recovering from obesity takes a lifetime and includes the physical and the psychological wellbeing of each person. Andrea created the Foundations of Healthy Living Retreat and they have been hosting the retreats for the past five years.

It is definitely not a coincidence that David reached out to me after reading my first book, Eat It Up! Our professional philosophies are very much in sync. My work, with great help from Steve, is all about addressing the psychological needs of patients while their physical needs are being medically managed. David and Andrea, like Steve and myself, dedicate much more than our careers to providing bariatric patients with education and support. We address the WHOLE person, pre-operatively and after weight loss surgery. We put our hearts and souls into the work we do because we are convinced by the feedback our patients provide that they want and need much more than the surgical procedure can provide in order for them to live healthy lives, both physically and psychologically following bariatric surgery.

Since meeting in 2011, I have learned a great deal by working with both Andrea and David. The Schroeder’s have twice brought me to New Zealand where I have had the opportunity to learn from, and contribute to, the lives and education of their patients and staff.

Andrea and David, as well as every person presenting information at the retreat, address bariatric patients from a whole person perspective. Each participant is treated respectfully and compassionately, as a human being who is much more than a bariatric patient. Their emotional support needs are emphasized, as success following bariatric surgery involves more than dealing with a person’s biological innards.  

Is it a coincidence that Andrea and David, in New Zealand, know the same things that Steve and I know in the US? We all know, and work toward, helping patients and bariatric professionals realize that bariatric patients have tremendous emotional and psychological needs that require attention. Behavior modification by itself is not enough when it comes to sustaining weight loss. If it were, well… wouldn’t more people have kept weight off after diets and bariatric surgery?

Is it a coincidence that the bariatric patients I have talked with during individual sessions, along with the participants at the retreats, all from New Zealand, talk about the exact same issues as the bariatric patients I have worked with in the US for the past 15 years? I’m not talking about the physical problems. I’m talking about the lack of self-care this population acknowledges. Not just in their eating and exercise behaviors. These people talk about a great lack of self-value that translates to a lack of proper self-care. The greatest common denominator, aside from the physical co-morbidities of the bariatric patients I have spent time with in both countries boils down to this: I don’t believe I’m good enough. That, my friends, is the definition of shame.

Our bariatric patients need to heal from the shame that draws them back into unhealthy habits. Healing from shame requires much, much more than a bariatric procedure in an operating room, or “theatre,” as they call it in New Zealand. It is not coincidental that bariatric patients across the globe suffer from shame. It is tragic that so few bariatric professionals around the world are willing to provide the full spectrum of care that patients require in order to be able to follow through with behavior modification techniques. Deep shame will eventually extinguish behavior modification efforts.

How long before more bariatric professionals get it? How long before more than a handful of patients get the emotional support and psychological care they need after bariatric surgery? How long before we provide a truly comprehensive program to help our patients eliminate shame and establish self-acceptance?

The shame belongs to the programs and professionals who do not provide a comprehensive program… because those programs simply aren’t good enough. (Along with the Schroeder’s, I will be offering residential retreats through bariatric centers in the near future. For more information, contact me at connie@conniestapletonphd.com.)

I’m grateful for the non-coincidences that have led to meeting Andrea and David Schroeder. I am not surprised to see and hear that the patients in our very distant geographical countries are so very similar. Mostly, I am thrilled to know that there are professionals and patients who know that the Foundations of Healthy Living go way beyond medical care alone!

For now, patients can participate in the GAIN While You Lose 10-week program. This is a great way for patients around the country (and the world) to have access to the same topics discussed in the Foundations of Living Retreat. This class includes an hour and a half “lesson,” taught live but available online or via recorded session, followed by weekly homework to make the information applicable to each person’s life. (http://www.conniestapletonphd.com/online-services/weight-loss-program)

Why aren’t we currently doing retreats in the US? Are you, the patients, willing to pay to attend? Are you willing to take the time and spend the money to invest in yourself? Do you value yourself enough to work on your emotional issues? You’ve most likely been willing to pay hundreds to thousands of dollars for weight loss programs, powders, gimmicks and scams. What about actually finding a way to find self-acceptance, a requirement for being able to follow through with behavior modification tools?

Patients: there is no shame in having problems. It is tragic to me if you know there are problems, but choose not address them. Please seek the help you need! After all: YOUR HEALTH is YOUR RESPONSIBILITY. THIS DAY. EVERY DAY.

Laugh At Us... WITH Us!

Laugh at Us… WITH Us!

One really has to laugh... especially if you ever plan to travel with us. We left Atlanta at 7 PM on Friday evening. That morning, minutes before we had to leave to meet the builders at our house site, the Lovebug realized his passport expired in four days... while we would be in Sydney. I told him it wouldn't be a bad place for him to have to live. While in panic mode, searching online about how to update his passport immediately, the Lovebug discovered that a person must have a Visa in order to enter Australia. Panicking further, he CANCELED our hotel reservation (yes, he did)! We raced out to have our meeting with the builder and then Steve headed downtown to the Atlanta passport office to see if he could get his passport updated. In the meantime, Kelsey and I looked up the Australia Visa thing. Turns out it's a form you complete online, pay $50, and there you have it - a Visa to Australia. Not a trip-canceling ordeal by any means.

By 2 PM, goober Lovebug had a brand new passport for a mere $190. Visa – CHECK. Passport – CHECK. Hotel room – NO! He called Hotels.com to try to get our canceled room back, but ... you guessed it. No longer available. The Hotels.com person said there were only three hotels with any availability in all of Sydney. One at $500 a night and the two others were for backpackers. "Can I cancel the $500 a night room if I need to?" asked the Lovebug, who planned on conducting his own hotel search. Since the answer was yes, he could cancel, he booked that $500 a night room (BA HA HA HA HA)! And yes, he canceled that same room, after finding a place that got 4 stars and had good customer reviews. All of this was happening unbeknownst to me, as I was getting all groomed up for the trip (mani/pedi and haircut, all horribly overdue). I felt like Humpty Dumpty being put together again. Steve did confer with me before booking our stay at the Art Hotel. At that point in time, I didn't care where we stayed and I felt so bad for him that I would have agreed to just about anything so he would be able to relax.

So we fly our 20 hours on three planes to get to Sydney and upon arrival, we have a text on my phone that reads, "I have your bag. Call me." There was a US number that had come from a 202 area code. Steve recognized it as D.C. number and we laughed it off, joking that we had all of our bags with us and how is it scammers figure out so quickly where you're at, etc. etc. etc.

We got to our hotel room at the Art Hotel and were anxious to get outside for two reasons: 1) we needed to WALK after all that sitting, and 2) the weather forecast was "a shower or two." The sun was, at that moment, peeking out from behind the thick clouds and we wanted to enjoy the sunny, shower-less time outdoors.

I opened my suitcase to get my walking shoes and immediately realized the items inside were not mine. "Steve! This isn't my suitcase!" We tried for about 30 minutes to contact the luggage department of the airline and couldn't get an answer. We decided we'd deal with it later and off we went to see Sydney Harbor and the Opera House. We actually squeezed in a lot of beauty in a short afternoon. We walked through a magnificent city garden and an amazing botanical garden on the way to the Opera House. We marveled at the Opera House and then took a ferry boat to "Manly Beach." We walked around there and had Starbuck's (yes, I have become a Starbuck junkie) before ferrying back at dusk. It was on the ferry that the Lovebug had an epiphany. “’I HAVE YOUR BAG. CALL ME.’ Oh, my God! That was from the person whose bag we have!” We can be pretty slow sometimes. All I could do was laugh.

We decided to take the bus back to the hotel as it was dark by the time we got off the ferry. We asked a young woman at the bus stop for assistance and learned that our hotel is in a "colorful" area of town. When we got off the bus, a few blocks from our hotel, we started noticing some of the names of the local establishments. Our two favorites were the liquor store, cleverly called "Lick-Her Here," and "the Tool Box." We still think the gay bar in Atlanta wins the title contest, though, with “Swinging Richards.”

Back in our not-$500-a night room, we made arrangements for the woman’s suitcase to be returned to the airport in New Zealand in the morning. Turns out she’s a reporter in D.C. (I Google’ed her!).

I was able to buy an inexpensive pair of walking shoes and some socks – at the drug store - so I’m good, at least until tomorrow when I can maybe buy some undies and a tee shirt. (Now I understand why they encourage people to have all of your medications on your person when you travel – which I did, along with all of my electronics and cords.)

All in a day’s play! As long as we’re all healthy and happy, what’s to get worked up about? I’m not sure who’ve I’ve become, actually, but I didn’t get upset about any of the Murphy-ism’s we’ve brought upon ourselves in the past 48 hours. I’m becoming like Pete the Cat (without the pot)… “Did Pete worry? GOODNESS, NO!” ‘Cuz it’s all good!

Remorseville

For many years I watched only one television show on a regular basis. Life was too busy with activities I deemed to be more of a priority… like raising active children with my hubby, completing my PhD program and engaging in work I enjoy! Now, being empty nesters, with grown children who have families of their own, Steve and I have started watching a few programs. One of our daughters urged us to watch NCIS; the other twin daughter pushed us in the direction of Bones. We started watching both. Having caught up on all episodes of these programs, we have slowly ventured out into the world of Netflix. Our son encouraged us to watch Breaking Bad. Steve completed the series but I only inquired about character updates after watching five or six episodes of the too-dark and too-violent drama. Next, we started House of Cards. Although I love watching Kevin Spacey, the day he threw the reporter with whom he was sleeping onto the train tracks, was the day I quit watching the show. Many people suggested we watch Mad Men, but neither of us was smitten with the content or the acclaimed cinematography.

Somehow, we came across The Blacklist.  It, too, is overly violent for my taste, but I quickly become intrigued by the uncertainty of who is trustworthy and where the story may roam. James Spader is remarkable, as are many of the other cast members.

Spader plays Raymond Reddington on The Blacklist. He’s one of those “good guy/bad guy” characters, heavily leaning on the bad. The writers of this show come up with some brilliant lines and speeches. This one, spoken by Spader’s character, “Red,” particularly caught my attention:

“People say youth is wasted on the young. I disagree. I believe wisdom is wasted on the old. All you can do is part with it, but very few will take it, least of all the people closest to you. They want no part of it.”

            Lord, how many times I wish other people could or would, learn from my mistakes! And how I wish I had learned from the mistakes of others who preceded me.

            Then again… what would I have learned about myself had I not gone down the wrong path a time or two… or ten or…! Do I regret some of the behaviors in which I engaged? I very much regret having negatively affected people I love as a result of my inappropriate/hurtful actions. I also regret the emotional and spiritual harm I caused myself by betraying my values.

            If you’re thinking, “Don’t live with regret,” or, if you don’t have regret for things you’ve done in the past, please hear me out. The definition of regret is “to feel sorrow or remorse for (an act, fault, disappointment, etc.).” Thank you, dictionary.com! (I always like to thank them. They are one of my online BFFs.)

            So yes – I feel sorrow and remorse for hurting others because of my actions. I do not LIVE THERE, in a constant state of sorrow. That’s not living. That would be staying stuck. That would be using my poor choices as a way to remain a victim or to get sympathy. No. I do not live in Remorseville.

I use my 4 ACES to address my “mistakes,” my unhealthy choices. Then I move on and live in the present. You can use them, too. Here’s an example of how. I’ll use the example of driving while under the influence of alcohol, something I (very remorsefully) did regularly when I was in college.

            AWARENESS:

·      Driving while intoxicated:

o    is dangerous

o   is irresponsible

o   jeopardizes myself and innocent others

ACCEPTANCE:

·      I accept:

o   I had other options that I failed to utilize

o   I was irresponsible and acted dangerously

o   I put myself and others in jeopardy

ACCOUNTABILITY:

·      I, alone, am fully responsible for the choice I made to drive while under the influence.

ATTITUDE:

·      I have a remorseful attitude at this time about the choices I made to repeatedly drive under the influence.

·      I have a grateful attitude that, but for the Grace of God, I never harmed anyone as a result of my driving under the influence.

·      I have a positive attitude about having sought help for my addiction and working to help others to find a life of Recovery.

COMMITMENT:

·      I am committed to my sobriety and life of Recovery.

·      I am committed to helping others find sobriety and Recovery that others may refrain from driving under the influence.

EFFORT:

·      I am committed to, and willing to put forth ongoing, daily effort into my program of Recovery

·      I am committed to not driving under the influence of any mood-altering substances, to include any medications

·      I am committed to working with others to prevent others from driving under the influence of mood-altering substances

SELF

·      I value myself enough to work for improvements in all areas of my life.

·      I value my loved ones enough to work on my Recovery every day in order to have the healthiest relationships I can with them

Try using the 4 ACES in your life and see what happens!

The show I have watched for years on a consistent basis? The Young and the Restless. DUH! (Since it started, when I was 10 years old!) Talk about Remorseville! Some of those characters could live there for sure! J

Heal from the SHAME that binds you.

“Empathy is the antidote to shame,” according to Brene Brown, PhD. whose research on vulnerability, courage and shame is internationally acclaimed. I wholeheartedly agree with Dr. Brown. I am grateful to her for bringing talk of shame onto the stage of public awareness.

Many people use shame and guilt interchangeably, but they are really very different concepts. Guilt involves feeling remorseful for doing something wrong or against our values. Guilt serves the purpose of reminding us not to repeat offensive behaviors. If loyalty is something you value, then you would likely feel guilty if you talked badly about your friend behind her back. Your guilt would hopefully remind you to refrain from doing that again.

Shame, on the other hand, is the feeling and the belief that you are not good enough. Shame is a deep, painful feeling that there is something inherently flawed about you, that you are not worthy of love or being accepted. You believe you are somehow unacceptable.

Shame, I believe, is the result of an interpretation we make about ourselves basedon the way we are treated by others. For example, if kids at school regularly exclude a child, the child wonders, “What is wrong with me that the other kids don’t want to play with me?” If a parent abandons a family or fails to pick a child up on their visitation days, the child wonders, “Why doesn’t my parent want to get me? What did I do to make them stay away?” If a child is neglected or abused at home, at school, at a babysitter’s, by a coach, a scout leader or a bully, the child believes there is something wrong with who they are. They believe they are flawed.

They carry this sense of being unacceptable or unworthy deep inside. They may “fake it” around others, but they are aware of this internal sense of being “less than.” Shame is painful. People try to stifle the never-ending gnawing sense of shame that nips at their heels, trying to get some attention in order that it can be dealt with and healed. We try to numb the shame with alcohol, drugs, food, shopping, gambling, sex and too much time on the internet. We punish ourselves with those same chemicals and behaviors because we believe the shame that tells us we are unlovable and unacceptable. Our shame is self-perpetuating. We eat too much, gain weight and reinforce that we are unlovable. We drink too much, behave in ways that embarrass us and remind us that we are flawed. We sleep around, seeking affirmation and acceptance, only to feel rejected and ultimately, even less desirable. Shame begets unhealthy behavior, which begets increased shame.

Around the time I went to treatment in 1989, John Bradshaw was a very popular speaker on topics related to addiction and recovery. He wrote a timeless book titled, Healing the Shame That Binds You. I cannot think of a title for life that better states what the secret to happier, healthier living is: HEALING the SHAME that truly does bind us.

Until we work through our shame and the neglect, abuse, and loss precipitating the shame, we are bound by it. Until we heal from believing that we are unlovable, worthless and unacceptable, we cannot have truly healthy relationships with others. If you struggle with food issues, you cannot have a healthy relationship with food until you have learned to have a healthy relationship with yourself. That means healing your relationship with yourself. Learning to appreciate, accept and treat yourself in kind and healthy ways.

How? Through therapy, a formal program of recovery, support from sponsors and friends, by addressing unresolved neglect, abuse, and loss, and developing healthy self-talk.

The process of healing from shame begins with empathy. Empathy for yourself related to the experiences you suffered that left you feeling shame-filled. Empathy for being a child who was being bullied, neglected, abused, abandoned, criticized, picked on, or laughed at. Allow yourself to feel what those experiences were like for you and talk to someone about what happened and how it felt. Realize you were a child and could only think like a child. You did what you could and what you had to do at that time.

You are now an adult. Healing from shame means you must treat your mind and your body in healthy ways. Use positive self-talk and stop beating yourself us with negative thoughts. Put healthy food in your body and give it exercise. Choose healthy friends and a solid support team. Stick with the winners. Be a winner.

My Health. My Responsibility. This Day. Every Day.

The New “F” Word: Fat-Shaming

Fat-Shaming sucks. Addiction-Shaming sucks. Bald-Shaming sucks. Shaming-Shaming sucks. There’s no way around that. It’s just plain true. There is too much shaming going on all around.

My question is: As good as it is to call the world out on their shaming behaviors, would we maybe be better off working on ourselves and, if we are health care professionals, working with our patients, to focus on the ways they shame themselves? AND OTHERS? At least simultaneously to trying to put an end to “Other-Shaming.”

The purpose of this post is twofold:

1. To have each reader assess themselves in regard to their own shaming-ness, and

2. To suggest we help individuals stop shaming themselves while we simultaneously encourage the masses to stop.

There are Tweets and Posts galore inviting us, inciting us, and urging us to help stop the Fat-Shaming done by society! I agree these are worthwhile efforts and must be done.

What I don’t see very often on Social Media are statements encouraging people to get help to stop shaming, bullying, and beating up on themselves. We want an end to shaming, an end to bullying and an end to domestic violence. Check it out! All of that occurs within many an individual’s head!

Here are some recent posts from social media, along with my posted responses:

“Stand up to #weightbias! Sign the #petition to end fat-shaming and weight bias today.”

      My response: “Yes, please! Also work to stop #SelfShaming and #SelfBias. Sign up for therapy in your    

     community!”

“Why We Need to Ban the F Word: Fat-Shaming”

        My response: “If you believe people deserve to be treated well (and I do), please start by treating yourself well

        in your thoughts, words and actions.”

“Once a person has obesity, it’s too late." One more way to #dismiss people with #obesity.”

      My response: “I hate that people dismiss those with obesity. I hate even more how those with obesity often      

      dismiss themselves in so many ways.”

“I believe that the morbidly #obese population is stigmatized, abused, neglected and mistreated by most facets of

society.”

        My response: “I hate it, but those suffering from morbid #obesity also abuse, neglect, and mistreat themselves

       through negative self-talk, self abuse.”

“Don't blame the person, rather treat the disease.”

        My response: “Don't blame patient for factors related to obesity they can't influence. Hold them accountable for

       those they can.”

Please be clear about the message I am sending. I do hate the very real fact that society shames people who suffer from obesity. I hate that many people, including doctors and other health care providers, solely blame individuals for being obese. It’s horrible that a person is dismissed because they carry extra weight. No doubt.

I know from both my personal and professional work, as well as from life experience, that I can influence my own behavior a lot more quickly than I can influence the masses.

Typically, a person has an emotional connection to an issue if they are working to right some wrong related to that issue. Not all, but many people fighting to end societal Fat-Shaming, have “some skin in the game,” as they say. I am one of those people. Much of my work is done in a bariatric center where we aim to help those suffering from obesity, both physically and emotionally. Many health care providers, people who are personally struggling with their weight, along with family members and friends, all work together to try to end fat-shaming. Keep on keeping on with those efforts because they are worthwhile!

In the meantime, are you, regardless of your size, weight, color, or religion, looking within yourself in an attempt to “clean your own side of the street?” Do you have biases about other groups of people being stigmatized? And more importantly, are you aware of, and working on, the ways you stigmatize, dismiss and shame yourself?

Calling a person who suffers from obesity an ugly name, overlooking them for a job, dismissing their opinion or making a critical comment to or about them is wrong. It is equally despicable that people say things like, “I wouldn’t date a bald man,” or “He wouldn’t be right for the job. He’s bald.” My husband is bald and he struggles emotionally because of it. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made ugly comments about bald people?

It is disturbing that subjectively unattractive people are considered less intelligent, are helped less frequently by the public if they have a flat tire, and are hired secondarily to “beautiful” people. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made ugly comments about unattractive people?

How dismissive it must be to be a person who is part of an ethnic minority to have people call you a hateful name, to overlook you for a job you are very qualified for, or assume negative things about you. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made disparaging comments to or about minorities?

Religions are always good fodder for shaming, dismissing and bashing. Have you partaken?

“You don’t look like one of them,” said my doctor to me when I shared that I am a recovering alcoholic and addict. One of them.

A patient in a therapy group of people suffering from obesity said, “I cannot, for the life of me, understand why an alcoholic doesn’t just stay away from the bar.” To which I responded, “What is it like for you when someone asks why you can’t just push away from the table?”

Wrong is wrong and it is wrong when any of us engage in dismissive or shaming conversation or behavior. Check yourself. You’re human and that means you have your own prejudices. You’ve likely engaged in your own dismissive comments about groups other than the one(s) you’re most closely aligned with. Relax, I’m not shaming you! I’m asking you to look at your own side of the street. Does it need sweeping? We all need to keep a broom nearby because we are all guilty of judging others at times.

In my work, it is a priority to help people stop shaming themselves. Negative self-talk is a powerful way in which we shame ourselves. Yes, you do it, too! “I’m such an idiot!” “How could I have done such a stupid thing?” “What is wrong with me?” “I don’t know why I even bother. I never follow through anyway.” The list of examples illustrating negative self-talk, or stinkin’ thinkin’ is endless. Every single negative statement you make about yourself is dismissing the value of the person you are.

Ironically, the shaming statements people make about themselves are representative of their own internal shame. The negative self-talk says, “There’s something wrong with me.” “I don’t feel ok about myself.”

Isn’t it odd that we run around making a fuss about stopping the masses from shaming people when we spend some much time shaming ourselves? I’m thinking we would all be better off if we “swept our own side of the street” first. When we treat ourselves more tolerantly and we are accepting of others who we tend to dismiss, then it’ll make more sense to focus on what the masses are doing wrong.