Paulson V Veliyannoor, MS
Pre-Doctoral Intern/ Clinical Staff
Susan B Krevoy Eating Disorder Program
Khalil Gibran famously wrote in The Prophet: “In speech, truth is half-murdered.” Well, there is much truth in this statement. Yet the inability to speak may leave the truth fully murdered with its remains leaking through the pores of one’s being.
An Eating Disorder is one such leakage which results from, among other things, the difficulty to verbalize one’s needs and feelings. In other words, eating disorder is one form of maladaptive communication.
Learning to communicate, then, is one of the ways to deal with the eating disorder. A simple model for effective communcation is the Non-Violent Communication a.k.a. Compassionate Communication Model developed by Marshall B. Rosenberg. Let us take a look at the components of this model, adapting it to the context of eating disorders. There are four steps to this Model of effective communication:
(1) OBSERVATION without Evaluation: Often our speech—towards ourselves as well as others—is evaluative and judgmental. E.g.: Jennice walks into the kitchen and her mother says, “Look at you! You look so miserable.” Immediately Jennice tells herself: “She hates me.” This is an self-condemnatory statement. The correct way to speak to oneself would be: “Mother tells me that I look miserable.”
(2) Identifying the FEELINGS: The next component is to state the feelings generated by the observation. E.g.: “When I hear my mom telling me that I look miserable, I feel sad.” It is important to note that often times we mistake a “thought” for a “feeling.” E.g.: “I feel unloved” is not a feeling, but an evaluative thought.
(3) Identifying the NEEDS that generate the Feeling: Feelings are generated when one has unmet needs. Hence, the third component is to identify and express your need that is not being met by the other. E.g.: “I feel sad because I need my mom to love me and be accepting of me.”
(4) REQUESTING Concrete Action that would meet the Need: But what does it mean by “I need my mom to love me…?” It is unclear what loving means. Hence the need to identify a concrete action that meets the need. E.g.: “I would like my mom to smile at me, hug me, and occasionally tell me she loves me.”
Once you put these four components together, then the communication – to oneself as well as to the other – becomes effective and clear. The above example was one of self-talk. Now, let us see how Jennice can communicate the same to her mother:
“Mom, I hear you say I look miserable. When I hear you say so, I feel sad, Mom, because I need you to love me and be accepting of me. I would like you to smile at me, hug me, and sometimes tell me that you love me.”
However, no communication is a one-way street. When Jennice’ mother says, “You look miserable,” she is making a judmental statement which gives no idea to Jennice as to what need of her mother is unfulfilled. Jennice cannot be sure of her mother’s true feelings either. Hence, it is also important to REQUEST the other to clarify the four elements detailed above. Hence, Jennice may ask: “Mom, when you say I look miserable, I do not understand what you mean. Can you tell me what you are observing in me that makes you think so?” Once Jennice gets her mom to state her observation, then she can ask, “Mom, when you see this in me, how do you feel?” Once her mother identifies her feeling, then Jennice can explore mother’s unmet need and the concrete action she would want Jennice to do to meet the need.
Nota Bene: This is easier said than done! Such communication can initially be hard to practice, and be confusing to the other: precisely because one is not used to this sort of communication. Hence, the need to apply the good old rule of “practice, practice, practice.” Results will show gradually and definitively. And lives change. In the context of eating disorders, if you can learn to express as well as request observations, feelings, needs, and actions clearly, then you may not need to use the eating disorder to defensively communicate what you always wanted to, but couldn’t.
At Susan B Krevoy Eating Disorders Program, we help patients practice these skills in the CBT (Cognitive Behavioral Therapy) Group.