So I'm trying to finish up my book. The manuscript is due in a little less than a month, and I'm trying to get the last little bits filled in, the references checked, and so on. It's tedious, hard work. I also don't really have much in the way of an advance (basically, the publisher pays the author $X amount in future royalties up front; the first $X of royalties goes to the publisher instead of the author. After that, the royalties goes to the author. It's basically a gamble on the part of the publisher as to how much money they think the book will earn. I'm working with an academic publisher who operates under a royalties only system. No advance, but once the royalties start rolling in, they're all mine.), which means I have to keep up my regular writing stuff, too.

So I devise daily tasks for myself, like finish Chapter 10, email so-and-so, etc. The most common task, however, is "Write XX words." I like numbers. I like tasks that are easily definable and clear-cut. Things like "work on references" are awfully vague, and I never know how much work is required to be able to check that SOB off my list. On the one hand, discrete goals like writing, say, 1500 words are easier to accomplish because they are so concrete.

On the other hand, 1500 words don't always come magically flowing off my fingers. Sometimes I get stuck, sometimes I spend several hours chasing down a single study that I need to make my point (PubMed is a contact sport...really...), sometimes I have other paying writing jobs that act as a giant time suck. My carefully scripted goal of 1500 (or 1000 or 2000 or 500) goes caput.

That happened on Saturday. I did several lengthy interviews during the day, which were all duly checked off. But I still primarily measure my progress in words per day, which was definitely lacking. I really meant to get more done in the evening, but I got in a groove cleaning my place and then some trashy TV came on, which made me keep cleaning so I could justify my occasionally questionable taste in television programs. As it happened, time passed and here I was at bedtime with hardly any progress made on my book.

I was beating myself up in my head for being lazy and not making progress and I was a crap writer so what business did I have trying to finish a book--a book for crap's sake! But then I started thinking. My interviews gave me a LOT of good material, and I can't really write without doing interviews. I got some cleaning out of the way, which was a good thing.

The problem was that my accounting methods weren't actually factoring in the other important work I was doing. It had become just about the numbers, when in fact, the numbers only tell part of the story of book progress.

I suppose this story says a lot about my focus on numbers and on details at the expense of the big picture. No doubt it does. But this focus isn't necessarily written in stone, either. I might gravitate to it rather naturally, but I also need to work on recognizing the problems I encounter when I do this and work on bringing my vision back to be more holistic.

A little over a week ago, I was writing about my unruly puppy dog brain.  A puppy chews on anything--it needs to chew. Just like my brain with thinking. It's why I don't do well with down time and being bored. This was the case a week ago, and things have become rather different in the past few days. I was traveling Thursday and doing the lengthy meeting thing on Friday. I'm staying with my friend this weekend and trying to get some work done in the off hours. Then tomorrow and Tuesday, it's back to the lengthy meeting thing, plus writing some press releases for them and trying to work on my book.

Phew.

It's good to have work to do. It makes me feel like I have a purpose. It pays the bills. And it also gives my brain something more productive to chew on.

I know I need to do a better job at making time to work on my book.  I was working on the bit about "analysis paralysis," which got me laughing because it's exactly why I'm a little a bit just a touch more than a little behind where I need to be on the writing. Starting the writing process is terrifying because I don't know if I can do it. I've never had to juggle this many interviews and references and all this other stuff before. I don't know if I can churn out that much writing, let along quality writing.

I also have to censor myself, as saying something is "bullshit" isn't likely to get high marks from my editor. It is still, of course, bullshit, but that's besides the point.

The solution, I've found, is simply to dive in.  Start writing.  Accept that there will be shitty first drafts and that this doesn't imply a shitty final draft.  And so now, I'm neck deep in PubMed references, pdfs of journal articles, interview tapes, and snippets of blog posts. But I banged out over 1000 words this afternoon, which is a pretty good clip.

So.

Being in the thick of a project makes it much easier to work because I've gotten over the most massive hump that's known as "Getting Started." I'm still petrified that there will be some scrap of research I've failed to factor in to all of my writing, and that it will essentially blow my book to bits. I know--how ironic that with all of the reading and researching I've done, I still have this fear. But there you have it: analysis paralysis in action.

I loves me some irony, and I have two updates that prove it.

Update #1: I was at Target yesterday, buying some lamps for my new place (the office doesn't have any overhead lighting, and so I need to seriously bulk up in the lighting department).  I painted my office a light plum, and I found a lamp to match the decor that I could sit on the piano. I also bought a cute purse on clearance for $6.  So I went through the checkout line, signed my receipt, and gathered my bags.  As the cashier handed me my copy of the receipt, she said, "Oh, you got an extra coupon!  For $2 off!  A...scale!"

I took it mostly because I found it funny, although I didn't explain to the poor lady exactly why I found this so hysterical.

Update #2: Another moving-esque update.  I'm packing up my books tonight, and I'm trying to figure out where to have the movers put them in my new place.  I'm still not entirely sure exactly where I want to put every last bookshelf (I have 4 folding ones and one really big one that my dad built me), so I was thinking and thinking about where to put the books.  I didn't want to drag them up or down the stairs too much, but space upstairs is going to be at a premium since there's already plenty of crap going up there.

I called my mom in and we discussed it.  Eventually, we both realized the best solution was to put the books in the dining room.  I have my table, but there's space against one or both of the walls to stash some boxes.  The books are definitely a Carrie Priority, but I also realize that there are lots of other practical things that need to be sorted first.

So my books will be temporarily housed in the dining room.

That's my update for now.  I'm exhausted!

A few minutes ago, I got this update from my friend Harriet Brown, author of the upcoming book Brave Girl Eating.

"The Good Morning America appearance was canceled after I refused to allow photos of my daughter at her sickest appear onscreen. Makes me ashamed to be a journalist."

Because there's no other way to talk about eating disorders and treatment and recovery than showing pictures of emaciated children...right?

Save the voyeurism for bad reality TV shows. We don't need it to show how devastating an eating disorder can be.

It's GMA's loss, really. The appearance would have been a great opportunity to educate people and dispel myths about eating disorders. And now, because of a producer's stupidity, that opportunity is lost.

Will people ever learn?

No, I'm not talking about bowel function for once...

Instead, I'm reading a book titled "The Geography of Bliss" by Eric Weiner that is simultaneously amusing and fascinating. The basic premise of the book is that author travels around the world to see how different countries find happiness. On his visit to Iceland, Weiner gets talking about how unhappy experiences are relevant to happy ones, especially in terms of art/writing/etc.

Crap plays an important role in the art world. In fact, it plays exactly the same role as it does in the farming world. It's fertilizer. The crap allows the good stuff to grow. You can't have one without the other. Now, to be sure, you don't want to see crap framed at an art gallery, any more than you want to see a pound of fertilizer sitting in the produce section of your local grocery store. But still, crap is important.

Crap, really, is important to life. I didn't start to deal with my anxiety and food and depression issues until they turned from a slightly sour bottle of milk that you could push to the back of the fridge and ignore to a grand, stinking compost heap. We all have these compost heaps in our lives. It's a matter of deciding whether you're going to let them sit there and attract rats, or use them to fertilize your life.

It's not about making the crap "worth it," because, hey, it's crap. It's about taking something that would otherwise go to waste (ie, the really bad times) and using it to help grow the good.

Last night I did something that I hadn't done in a really, really long time: I got lost in a book.

I know what you're saying. But Carrie, you say, I thought reading was your favorite hobby. I thought you read at least 2-3 books per week. And indeed, my dearest readers, this is all very true. I do read copious amounts, mostly geeky stuff with the occasional smutty novel thrown in for good measure. I enjoy my reading, and always have. I won every reading contest ever offered in my elementary school without hardly trying because I naturally read that much. My first job was at the local public library. I now go to the one that's a little farther away because I've already worked my way through most of their books.

You get the picture.

Most of the time, my reading is entertaining, interesting, and informative. I enjoy this part. But every once in a while, I stumble across a really good book that causes me to lose track of all time and place and almost literally fall into the pages. I re-read one of those books last night.

I didn't actually intend to stay up until 5am reading- it just happened. I only meant to leaf through a few pages until my eyes and brain tired out and I could fall asleep. After I flipped the first page, however, it stopped mattering how tired I became. At some point, I would have Scotch-taped my eyeballs open if it meant I could keep reading. I remember glancing at the clock at about 1 am. Then it was 3:30 am. Then? 4:57 am and my eyes were burning and my brain hurt and (this was what finally convinced me to close the book) I really had to pee.

It has been many months since I've done this. After about January or February of this year, this depression began to worsen and my reading stopped having that kind of deep, primal joy that could enable me to lose track of 4+ hours. Reading was a pleasant something to do, a way to distract myself while compulsively exercising, a means of passing the time on my subway ride to and from work. But I stopped looking up from my book with a start, realizing that oh crap, this is my stop, let's hustle it, baby! Instead, I stared at the blur of DC scenery rushing by me, at the rapid flicker of the lights in the tunnels.

As I slid back into the anorexia, the little concentration that hadn't been totally sapped by the depression was simply starved away. I couldn't lose myself in a book because the slightest mention of food would leave me drooling like an idiot. My stomach would grumble and knot itself up as coffee became the base of my "food pyramid," and these rumblings would rudely pull me out of my book and back to reality and the breathless anticipation of my next "meal."

Don't get me wrong- I read some mighty fine literature during this time. Reading was still one of the highlights of my day. But I wasn't with the book, I wasn't in it. The words were something outside of me and I was aware that I was reading.

Last night, it stopped becoming reading and started becoming experiencing.

One of the things I work on with my therapist is mindfulness, being fully in the present moment and not mentally running through a laundry list of Things I Need To Do or Things I Should Have Done. I'm not very skilled at this. To be honest, I kind of suck at it. Last night, though, I felt it.

True, I'm paying the price a bit today. I'm dead tired. My eyes hurt. But I'd say it was pretty well worth it.

Today, I had the great fortune of reading two great pieces from Australia on eating disorders.

The first is an article titled Anorexia's Lifelong Legacy from the Sydney Morning-Herald, about how eating disorder diagnoses are missed in many boys, simply because pediatricians aren't looking for them, and don't think that males get eating disorders. Because proper, quick diagnosis has a large impact on disease outcome, these kinds of stories are very important. Besides covering this timely and important topic, the article did so in a scientifically accurate way. Some of my favorite quotes:

"When kids are starved, their brains shrink, they're more likely to get depressed and anxious, their thinking slows down and memory falters," Madden says. "This affects their relationships with their friends. The effects can be reversed with re-feeding, but not always."

These serious complications can be prevented if children at risk are picked up early. "If children get the right treatment early, 70 to 80 per cent get well in 12 months and 90 per cent are better in five years. This is much better than in adults where the recovery rate at five years is less than 50 per cent," Madden says.

And

Whether an eating disorder can take hold and thrive seems to rest in the balance of risk and protective factors that a person experiences. In the last few decades, the increasing number of risk factors experienced by children - such as stress, anxiety, dieting, body image worries, and exposure to media images and messages that equate fat loss with happiness - may be creating an unhealthy tipping point.

And

The media comes under fire, not as the cause of eating disorders, but as a potent "enabler" of fat phobia, body discontent and restrictive eating in young people...Kohn agrees that children are being influenced by anti-obesity messages. "Vulnerable children hear them in the wrong way and take them to the extreme. Then a physiological mechanism kicks in, reinforcing the behaviour. Eating less and losing weight dampens down the serotonergic mechanism in our brain that processes emotional responses. This makes the children feel better, calmer, less reactive. Their behaviour improves and they get positive feedback, locking in the dieting behaviour."

I wish more articles on anorexia were like this, chock-full of the latest research and entirely lacking in sensationalism and parent- and sufferer-blaming.

The other good read from Down Under is the book "My Kid is Back: Empowering Parents to Beat Anorexia Nervosa" by June Alexander. The book arrived in the mail on Monday, and I've been steadily chipping away at it ever since. As the title suggests, it is more intended for parents than sufferers, and contains the stories of several families who have helped their children conquer their eating disorder. Filled with wisdom and hope, it will be a great read for people needing encouragement along this long journey of recovery. It officially arrives for sale in the US in September, and you can pre-order your copy from Amazon.

Enjoy your Down Under reads- I know I am! Now, about that duck-billed platypus...

I read an interview in the New York Times with Susie Orbach, author of Fat is a Feminist Issue and Hunger Strike, and the newly released Bodies. Although I don't agree with her assertion that feminism will 'solve' eating disorders (as EDs are biologically based mental illnesses), I do believe that they are a feminist issue. Why? Eating disorders do affect women which makes them a feminist issue.

And I think many of her points are relevant to today's society: that corporations stand to make a lot of money when women hate their appearance. Also that a pervasive dissatisfaction with your appearance ultimately takes away from our culture. Who knows what things I might have thought if I weren't preoccupied with food and weight.

What Orbach touches on, but doesn't expressly say, is that we are equating what you look like with who you are as a person. Think about the literature on obesity. "Fat" doesn't just mean "more adipose tissue." On a cultural level, "fat" means "lazy," "no willpower," "gluttonous," "stupid," etc.

Stereotypes about eating disorders hurt, maim, and kill.

Ask the family who thought their daughter was "too young" to have anorexia.
Or the family who thought their daughter couldn't be anorexic because she came from a "loving home."
Or the guy who wasn't diagnosed.
Or the African-American woman whose food concerns weren't taken seriously.
Or the mother who was discharged early from treatment- and then died.

Early diagnosis and treatment, as well as continued support for full recovery, is crucial. And if our blinders are on, we won't see everyone who needs our help and support.

A lot has been said about the new book "Going Hungry," by Kate Taylor, about how it "shatters stereotypes" about eating disorders. Why? It includes stories by women over the age of 30, women who aren't rich and white, and even by two men.

All of this is good, very good. However, my appreciation for the "good" ends there. Why? Because it still rejects a lot of the current science and goes back to the anorexia-is-about-control* or about-such-and-such, when I'm not sure that's the case.

Anorexia isn't about wanting to fit in. Can weight loss bring you attention and make you "feel" like you fit in? Yes. Can it make recovery harder? Yes. But that's not to say this is what an eating disorder is "about." And it is not about "Disappearing in order to be seen." It sure as hell feels that way, but there's something a lot more primal going on, something way deep down in your insula, in your hippocampus, in your synapses.

In the NY Times, reviewer Gina Bellafonte writes:

The happy family is, of course, rarely the anorexic’s breeding ground. Anorexia is considered a disease of control, but it is also, notably, a disease of differentiation as the anorexic tries to occupy a separate and autonomous emotional space, as if the act of shrinking will ease the fit.

Yet another harmful stereotype. Because no one, really, has a happy and perfect smiling family. My family didn't go to pot until after I got sick (and quite possibly, because of it). If you have a family member with a deadly illness, is happiness even called for? Hope, yes. Happiness? Not as much.

Says Kate Taylor (editor of the anthology) in an interview with the New York Sun about the genetic influences on eating disorders:

I think the research so far is very preliminary and doesn't show much — certainly not as much as some popular articles have suggested. Clearly, genes are a significant contributing factor, just as they are for depression, obsessive-compulsive disorder, and other mental illnesses. But whether there is a specific gene for anorexia — frankly, I doubt it.

Well, the last part is correct. It's highly unlikely anorexia--really almost any illness--is going to be controlled by one gene. Because genes don't cause disease. They just make proteins. But the research isn't preliminary, either. Is it as good as we would like? No, but if a family member has an ED, you are twelve times more likely to develop an eating disorder. Which is quite a ways from "preliminary" if you ask me.

Anorexia and bulimia have a cultural context, no doubt. But they're not a cultural illness. Which is another harmful stereotype, and certainly contributes to men and minorities being overlooked.

Taylor also referred to Hilde Bruch as founding the "modern" perspective on anorexia. If modern was the 1970s, then maybe. But the twenty-first century perspective belongs to other people, using science and compassion to break down those stereotypes that continue to be built.

I've read the book, and the essays are well-written, but they're not particularly novel. Maybe the book isn't particularly meant for people with eating disorders- I don't know. But I didn't walk away with a better understanding of eating disorders. And despite all of my reading and researching (which borders on the compulsive at times- shocker, I know), I don't know everything.

It was the same stereotypes (parents, control, society), just dressed in new clothes.

*I have conflicting thoughts on the "about control" part, but that's fodder for another post.

The prime onset of eating disorders is adolescence. Why? No one knows for sure. Some of it is likely hormones, turning on some genes, turning off others, and generally scrambling things. Some of it, too, might be a young person's search for identity. If a genetically predisposed person embarks on a quest "to be healthy" or fit or trim or a better athlete or student, it might spark that chain of events that can result in an eating disorder.

In her book Woman: An Intimate Geography, Natalie Angier writes:

As the brain stumbles toward maturity, and as it is buffeted by the output of the adrenal glands at age ten and of the gonads a year or two later, it seeks to define itself sexually and socially. The brain of a prepubertal girl is primed to absorb the definitions of womanness, of what counts and what doesn't, of what power is and how she can get it or how she will never get it.

...At the same time that hormones challenge the pubertal brain, they change the body. A girl's high estrogen content helps in the deposition of body fat on the breasts, hips, thighs, and buttocks, subcutaneously, everywhere...We can look at the deposition of body fat that comes with womanhood and say it's natural for girls to fatten up when they mature, but what natural means is subject to cultural definition, and our culture still hasn't figured out how to handle fat...we are intolerant of fatness, we are repulsed by it, and we see it as a sign of weak character and sloth. Contradictory messages assail us from all sides: we must work all the time, the world is a competitive place, and technology requires that our work be sedentary, cerebral, but we must not get too fat, because fat is unhealthy and looks self indulgent. So we must exercise and control our bodies, because our natural lives won't do it for us.

Girls, poor girls, are in the thick of our intolerance and vacillation. Girls put on body fat as they pass into adulthood. The put on fat more easily than boys do, thank you very much, Lady Estradiol. And then they are subject to the creed of total control, the idea that we can subdue and discipline our bodies if we work very very hard at it. The message of self-control is amplified by the pubescent brain, which is flailing about for the tools to control and soothe itself and to find what works, how to gather personal and sexual power. Dieting becomes a proxy for power, not simply because girls are exposed through the media to a smothering assemblage of slender, beautiful models, but because adolescent girls today are laying down a bit of fat in an era when fat is creeping up everywhere and is everywhere despised. How is a girl to know that her first blush of fatness will ever stop, when we're tearing our hair out over how the national fat index deeps on rising and we must wrestle it to the ground right now?

Go read the whole book. I've been enjoying it all weekend.

Michael Pollan is one of my favorite writers. He has a new book out, "In Defense of Food," which is a follow-up to his fabulous 2006 book, "The Omnivore's Dilemma." I'm still reading IDoF, but it's good. I don't agree totally with all of his points, but he does make a good case for eating wholesome food, not food products (butter as opposed to margarine, cheddar instead of Velveeta).

The tenant who was in my apartment right before me was an avid subscriber to magazines. I have already enjoyed several. Yesterday, I received Health Magazine. It's not a magazine I typically read, or even am really interested in, but it was there, so I started flipping through.

There is a new book out on dieting. Shocker, huh? It's by Judith Beck, a cognitive behavioral therapist, daughter of the creator of CBT, Aaron Beck. The title of the book is: The Beck Diet Solution Weight Loss Workbook: The 6-Week Plan to Train Your Brain to Think Like a Thin Person. I've heard of this book before- it was hyped in Oprah's magazine (as found in my therapist's waiting room). But this article went a little more in depth, which allowed me to be even more astounded than before.

Problem One: Thinking like a thin person.

Have there been any studies that have said that thin people actually think differently than not-thin people? I know lots of thin people who enjoy their food and don't give it a second thought after "What do I want to eat right now?" Is there a "fat brain circuit"?

Problem Two: Assuming that fat people are fat because of their thinking/eating patterns.

Um, apparently Dr. Beck is unaware that body size and shape are largely determined by genetics. Yes, there's a lifestyle portion to it as well, and I'm not saying you should neglect your health for any reason. If you binge eat for emotional reasons, it's not that you "thought your way fat." It's that there are underlying emotional issues to be resolved. Again, working on your emotions is quite different than "thinking your way thin."

Problem Three: Reasons to lose weight

The "official" anti-obesity propaganda says that being fat is a health risk. It rarely, if ever, says anything about fashion or appearance. However, losing weight in the popular culture is as much (if not more) appearance and self-esteem issue as it is a health one. Top weight loss comment? "You look great." Not "I bet your cholesterol levels really took a tumble, Betty!" The sample checklist given in the magazine is the following (I'm reading as I type so this is word for freaking word):

• I'll look better and more attractive
• I'll have more confidence
• I'll be able to wear a smaller size
• I won't feel so self-conscious
• My blood pressure will go down
• I'll have more energy
• I'll make a better impression on people
• My family won't remark on my weight or eating
• I'll feel more in control
• Add your own reasons below!

Get the idea? There's ONE health reason for losing weight. Here's a solution: your family comments on your food and weight? Tell them to stop it. That's their issue, not yours. Maybe Aunt Susie has good intentions, but you can tell her that you appreciate her concern but please knock it off. You don't have to lose weight.

Problem Four: Stick to "The Plan"

According to Beck, you can't screw up at all if you want to lose weight. Craving something? Suck it up, buttercup. You can't eat that. Screw the crummy boyfriend, house fire, hormones. No chocolate for you (like the Seinfeld soup Nazi). The cheese you were planning to eat turns moldy? Eat the cheese anyway. Or go without. But god forbid eat something similar. To quote, "It's not okay to eat something you didn't plan to eat. Don't rely on making up for it later. If you want to lose weight permanently, you have to learn to stick to your plan."

Problem Five: Sabotaging self-sabotaging

Another part of the plan is countering "sabotaging thoughts." I kind of see that part. Kind of. I know I self-sabotage sometimes. It's a real phenomenon. But these ones? Ha! "It's okay to skip exercising today. I'm too tired." I hate to break it to you, but you're going to continue to be tired unless you give yourself a freaking break. Besides, I don't want someone who's coughing 8 liters of crud out of their lungs working out next to me.

Or "It's okay to eat this food even though I hadn't planned to because everyone else is eating it." Your reply should be: No it's NOT okay to eat that because my goal is permanent weight loss. If that's the case, then your goal is also perpetual insanity. And continuing to feel self-conscious. I've been there, where everyone else is celebrating something, eating like real humans do, and I'm standing against the wall, drooling like a rabid skunk and sipping my Diet Coke. That's self-conscious.

Problem Six: What this diet does to your thinking.

At the end of the day, you don't think like a thin person. You think like a food-obsessed dieter. Here are some comments of successful losers:

"Every time I'm tempted to put something in my mouth that isn't planned, I feel like I have the option in that moment of getting stronger or weaker, not just heavier or thinner."

"I used to be a spontaneous eater, eating whenever and whatever I wanted. But being hungry is not an emergency. Dr. Beck taught me that I have to plan what I eat and stick to it if I want to be thin."

Talk about society at work there. Because fat people are weak and thin people are strong. Right. That's how it works.

Oh, and hunger is an emergency. So is thirst. Your body doesn't give you those signals for fun. It gives you those signals because it needs fuel, dammit. Believe me, hunger can be an emergency. Not being able to honor my hunger nearly killed me.

So, what I've learned from this book is that you may or may not be able to think like a thin person, but you definitely will be able to drive yourself completely insane.

Sorry, Dr. Beck. Save it for someone else. I have better things to do with my time and money.