What's Eating Us by Cole Kazdin

Author:Cole Kazdin
Language: eng
Format: epub
Publisher: St. Martin's Publishing Group

Managing Your Brain

At my first meeting with Laura Hill, she asks me a series of questions about my eating disorder: Was I able to physically sense hunger back then? Did I have to be famished for hunger to register? Do I have a high pain threshold? Did I experience guilt or anxiety around eating? As I responded to each question (no, yes, yes, yes), I sensed pretty quickly from her reactions that I was acing this test.

“Wow, Cole,” she took some notes, then finally looked up, “You are answering everything that literally UC San Diego’s brain research is showing.”

Hill and her colleagues have been working with Kaye and his team, incorporating research into the development of a new treatment, Temperament Based Therapy with Support, or TBT-S.

TBT-S takes a “harness your superpowers for good” approach, looking at the traits that made a person primed for developing and sustaining an eating disorder, and redirecting them in a positive way. Beginning with awareness of our individual temperamental traits along with what is and isn’t firing in our brain, we can create a new system for ourselves.

Hill is not officially treating me, but she agrees to guide me through the initial questionnaire she uses with patients and to continue to meet to help me build what she refers to as my “toolbox”: a unique-to-me set of habits, skills, and coping mechanisms for navigating my brain.

“Individuals genetically inherit a temperament, a set of personality traits that can be your best friend or your worst enemy,” she told me. “Your traits will be with you forever, and in a very biological way, the vulnerability could be there forever. But in a practical, productive way, it’s your best asset.”

We begin with a diagram of a brain that Hill calls “Gertrude,” and she walks me through what she suspects may be going on in my head, much in the same way you might point out streets on a map to a tourist asking directions.

First, the insula, which seems too tiny to be able to affect me so deeply, the area that doesn’t get the information about hunger. Next stop, the amygdala, this tiny kidney bean that starts the fear and worry, Maybe I shouldn’t have eaten, maybe I should have only eaten half, and then a signal that arrives at the front of the brain, the reasoning part, the destination, Why did I do that? What should I have done differently?

Is this how people feel when a psychic nails it?

As Hill is speaking, she’s basically reciting an inner monologue I wrestle constantly. Instead of a crystal ball, Hill is reading my thoughts, fears, and worries in this diagram of a brain. Not my brain. Gertrude. But it may as well be.

“The biggest misnomer about eating disorders is that it’s an illness of overcontrol. The reality is, the brain doesn’t have the signals in order to control,” she said. “So, you don’t have the fundamental signals that are necessary to affirm every bite you eat, affirm if you’re hungry, affirm if you should eat another bite.

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