MORTY: Hello, Karen! How are you today?
KAREN: I’m fine. How are you?
MORTY: Great. Thank you so much for being willing to spend a few minutes with us. We’ve got a bunch of listeners and people who are going to want to read this interview, who are interested in how to stop overeating. They are interested in understanding better what has caused their emotional eating problem, what’s involved in it, and perhaps some new ideas on what to do about it.
Why don’t you tell us a little bit about your background, what makes you an expert in this area, and what you think you might be able to offer to our readers.
KAREN: I’m an expert both professionally and personally. I have a Master’s in Education, and I have a Master’s in Social Work, and I have been what I consider an expert on the psychology of eating, which is the how and the why, not the what, for more than 30 years.
Personally, I am a former chronic dieter, and what I consider a world-class binge eater, certainly an emotional eater, and I have been a relatively normal eater since the 1980s.
KAREN: I use my expertise that I learned educationally, and I use what has worked for me, and readings in the field to help people learn how to stop overeating.
MORTY: Okay. It sounds like an interesting background with some personal and professional expertise on it. Did you have an institute, a clinic, or are you a private therapist? How do you help people?
KAREN: I’m the author of four books on eating and weight. I can certainly talk about those.
MORTY: Would you please name your books, so that people can possibly check them out if they’d like to?
KAREN: Sure. These are in the order that they’re written. The Rules of Normal Eating is my first book, and that gives basic guidelines to connect to appetite, hunger, food preference, satisfaction, and fullness.
My second book is the Food and Feelings Workbook, which deals specifically with emotional eating and lays out what emotions are for, why do we have them, how can we use them, and how can we stop eating and connect with feelings, so that we have a better life.
My third book is What Every Therapist Needs to Know about Treating Eating and Weight Issues. It is for non-eating-disorder therapists, general therapists who have clients with eating and weight problems.
My fourth book is Nice Girls Finish Fat – Put Yourself First and Change Your Eating Forever. That is for all the women out there who take care of everybody else with their warm feeling and kindness and loving hearts and then, as I describe it, take care of themselves through multiple trips to the refrigerator.
MORTY: I got it. Okay, well, thank you. You’ve got a lot of material that we could take a look at. Let’s just start. I have called the problem emotional eating, and I’ve had a lot of therapists and other authors disagree and call it other things, such as compulsive eating or addiction, etc.
I call it emotional eating because it seems that the, although there are obviously differences with different people, the main source of the problem is that people have negative feelings—anything from boredom to feeling unlovable to anxiety to anger, etc. They use eating as a way to keep down, to get rid of, to cope with these negative feelings. I call it emotional eating because they’re compulsively driven to eat by their emotions.
Do you see it that way? Or, if not, how do you see the issue of compulsive overeating?
KAREN: I also call it emotional eating. I do differentiate between what I would call compulsive eating, you’re watching a basketball game, and your hands are in the chips, and you just keep feeding yourself. I think that’s when we sometimes just get out of touch with our appetite. I would call that compulsive eating. I think there can be a problem.
However, emotional eating has this specific intent to avoid or lessen internal distress through food. I think, as well, that people have bad habits that you can call it non-hunger eating. You could call it “cued eating.” A client was telling me she’s been really enjoying food, eating healthfully, and then there were five cookies leftover in the teacher’s room, and she just ate them all. I think that was just mindless.
MORTY: You don’t think there was an emotional reason? You just think that this was almost like accidental that it wasn’t being driven by some emotion that she wasn’t aware of?
KAREN: I don’t think in that particular moment that it was an emotional response. I think it just wasn’t thinking because for decades she has gone to the teacher’s room, and sort of “Hoovered” all the food that’s left on the table. I think in that case.
But, I do believe that most of the unwanted or troubled eating that goes on is emotional eating as you had described.
MORTY: How would you then describe from your point of view, the basic source of the problem, or how do you think the problem develops?
KAREN: Well, I think it develops when we are first held by a nurturing person, and we are fed and we feel contained and secure and comfortable and comforted. That makes the connection between food and feeling. Mother’s milk gets us drowsy. Carbohydrate, sugars, and fat do something similar. There is a natural relaxation response from certain foods.
We have a biological — most of us, not all of us– tendency to get that reaction from food; it changes our brain chemistry.
MORTY: If it’s something that everybody starts with, if the source of it is breast milk from a mother and how we respond initially, then, how come only half the people, or perhaps even less than that, end up with an emotional eating problem? If the source of it is something that’s common to everybody, then what else is there for people who ultimately develop the problem, and those who don’t? What distinguishes them?
KAREN: Okay, that’s a great question. I would speak to two fronts. One is that we are not all born with the same complement of neural transmitters that are mood regulators. Some people have a more high-strung or sensitive temperament from their genetics, and not having enough self-soothing neurotransmitters. They’re more likely to go to food.
Other people have a deficit of life skills, or self-soothing, or self-stimulation, whatever it is that food happens to do for those people.
Unfortunately, many people have both. They have the genetic propensity to be unable to self-soothe, relax, or stimulate with themselves, and they didn’t learn the life skills. That’s what I call a “double whammy.” Those are the people for whom it is really hardest to overcome emotional eating.
MORTY: What do you do when somebody calls you up? You’re basically a private therapist working with individuals. Somebody calls you up and says, “I find that I can’t stop eating. I need help.” Basically, what is unique about what you do to help people overcome the problem of emotional eating?
KAREN: I work in several areas. One is I’m very interested in their beliefs about food, eating, emotions. We do a lot of identifying irrational beliefs, and how do you change them to rational beliefs? In that sense, I do a lot of cognitive behavioral work.
I help them build up life skills, how to say no, setting boundaries, problem solving, critical thinking skills, learning how to play, and relax, and let go, how to find passion and engage in life. Because when you can do these things effectively, you don’t want to turn to food. You just don’t think of it. I work on the life skills front.
One last front that I work on is I find many of my clients have mixed unconscious feelings about becoming a normal eater. It may be part of their identity. An eating problem may be a way to say, “Look how I’ve suffered in life.” They may have mixed feelings about how hard they want to work on this, and just want it to be resolved quickly.
I work on the issues, the unconscious mixed feelings that they have. The major one I find is rebelling, that people will say, “I know what I should do, and then that little voice says to me, ‘Oh, eat the cookie. No big deal’, it’s telling you what to do. “
I call this section the boomerang effect—when we are told to do things over and over, we do two things, we tune out the information and then, we also rebel against it. I work a lot with clients on this whole idea of rebelling.
MORTY: Yes. I have found that a specific belief, people who feel powerless as one of their beliefs, I am powerless, then have the belief the way to be in control is to do what I want, when I want regardless of what I should or shouldn’t do, or regardless of what anybody wants me to do, or regardless of even what’s good for me. Basically, by eating what you want when you want regardless of what makes sense, it gives you a sense of power and being in control what you don’t experience most of the time. I find that what you’re describing as that rebellion is actually the result of a specific belief.
KAREN: Yes. The belief is the result of whatever happened to people in childhood. Their sense of self was annihilated because they had very controlling, domineering parents. They’re going to want that part, sometimes called the wild child or just the self, to come out, and they do battle between that and the “should” and the “shouldn’ts.” I try to help them develop a nurturing self, which only has one goal, and that is to do what is in the best interest of the person. And–
MORTY: And … I’m sorry, go ahead. Keep going. I’m sorry.
KAREN: I was just going to say, and by developing that, this whole ping pong between I should, I shouldn’t, or rebelling, that whole ping pong match gets tossed out and you’re just focusing on what can I do now that is going to be best for myself.
MORTY: Your main technique is, you say, is cognitive behavioral therapy. That’s your main approach in working with these people?
KAREN: It’s a big part of it. Another approach that I use is trauma resolution that really has to do with people understanding, because there’s such a high correlation between eating problems, and trauma. It’s helping them understand them, when they have really intense feeling that they are generally from recall, not reality. Once they understand that, then the drive to eat lessens.
KAREN: Would you like me to explain that a little more?
MORTY: Sure yes.
MORTY: I’m not sure that I understand what you mean.
KAREN: Okay. Let’s say that your father was alcoholic and came home, and you were scared the minute you heard him come in the house, and just the sounds of his feet on the stairs frightened you and then, he walks in the room, and somehow you got hurt.
If you’re in a situation where perhaps you’re waiting for someone, and you’re not knowing how they’re going to react when you see them, maybe you’re just in a job interview, and you hear that person coming up the stairs slowly, about to open the door to meet with you. You might have intense fear feelings, but it’s not because of the person who is going to interview you. It’s because you’re stuck in recall. That’s what you’re reacting to.
I help people identify what’s stored in there, and what’s recall, and what’s reality. Once they’re in reality, they do much better managing them.
MORTY: Yes. I see that as conditioning, and we have a specific process to work on that. For me, the two major changes you’ve actually talked about are the same we work on, namely beliefs and conditioning. I found about twenty triggers that when those triggers come up, as I say, which are mainly negative feelings, when they come up, you just find yourself eating because that is the way you’ve conditioned yourself to deal with those negative feelings.
KAREN: Yes, absolutely. It is a form of conditioning. I’ve been saying to clients, “You know we’re all rats at heart.”
MORTY: That’s right.
KAREN: We really are.
KAREN: We respond to rewards and punishment.
MORTY: What would you say, do you have any sense to any follow up, not necessarily formal research on some informal basis, do you have any sense of what the effectiveness is, the recovery rate?
KAREN: I couldn’t give you numbers, but I will say that it is a long process, and that the people who stick with it, which are, I don’t know, many of clients do make changes in their eating, and in their lives.
MORTY: Do you follow up six months later to see, or do you have them call you? Or, do you have any?
KAREN: I do not.
MORTY: I don’t mean necessarily on a formal basis, but just for your own satisfaction to know how it’s going or you just basically, when you’re done, they seem to be in good shape, and you assume they’ll call you back if they still need you, and if they don’t, you assume all is well?
KAREN: Yes, to the latter. I don’t do for any formal or informal follow up. I do, it’s interesting, I run a Yahoo Food and Feelings message board. A good number of the people have been on it for a number of years, and so I can track their progress that way.
MORTY: Uh-huh, okay.
KAREN: That has been very interesting to see people who came on the board with no skills, and no clue how to stop emotional eating. Now, having resolved a lot of their issues, they are now helping new members on the board.
MORTY: That’s great. You said a moment ago, you said, if they stay with it, how long a process, I was talking with someone the other day who said, she has four 90-minute sessions, and that seems to handle the psychological element, and she has some nutritional and other kinds of work. How many sessions would you say, for the average person again, I know that everybody is very different and there’s a wide range, but roughly, what would the range be? If they stayed as long as you thought they needed to really get over the problem so that it’s gone, how long would you say your average client needs to stay?
KAREN: I don’t think in terms of sessions because I start off maybe with two or three weekly sessions, and I do mostly telephone and Skype for calling all over the world. I have a small private practice in here in Sarasota. After that, people go to every two weeks, three weeks. For me, it’s not the number of sessions, but I would say from many months to a few years. Now, that doesn’t mean they need to be working with me that whole time.
I give people a treatment plan after the first session, and once they understand what the work is, some of it they do on their own. But, for me, it certainly was not a quick process. It was a thorough process, an organic process of changing, and not everything starts at the same place.
I’m thinking it takes quite a while for people to really be what they want to be, which is normal eaters, or relatively normal eaters.
MORTY: Where can people get some more information? Obviously, you’ve stated the names of your four books, but what website can people go to, to get more information about you and what you have to offer?
KAREN: The main website is http://www.eatingnormal.com.
KAREN: Yes. They can go to http://nicegirlsfinishfat.com, and I write eating blogs that you can find at http://bulimia.com. They can access my twice-weekly blogs, and if they go to Yahoo, and put in Food and Feelings message board, they can come up with my message board. I also have a free Facebook app on Emotional Eating, as it happens. If they put in Appetite Facebook app, they should be able to get it.
MORTY: We have a lot of ways to find you Karen.
KAREN: Yes, anyway.
MORTY: Thank you so, so much. I so appreciate your time today. This is Karen, do you pronounce it Koenig?
KAREN: Koenig is fine.
MORTY: Yes, Karen Koenig, thank you so much for your time. I’m sure that my readers and listeners will be fascinated with your particular approach, your particular way of thinking about the problem of emotional eating. I’m sure that some of them will check out your books, or possibly get in touch with your directly.
Have a great day, and I look forward to talking to you at some point again soon.
KAREN: Okay, thank you so much, Morty! Bye.