Expert Advisor to Monte Nido Jennifer L. Gaudiani, MD, CEDS is nationally known for her work on the medical complications of eating disorders. She recently opened the Gaudiani Clinic, a unique outpatient medical clinic specifically dedicated to adults with eating disorders. Dr. Gaudiani shares her work with clients who are faced with “that voice in their head” in this week’s blog post.
That voice in your head is as familiar as it is judgmental and unkind: “You’re not good enough. You’re not thin/disciplined/organized/accomplished enough. You’re not meeting expectations as a partner/sibling/parent/child/professional/student. You haven’t done enough today to deserve rest and self-care.” So many people walk around every day with some version of this voice in their heads. And all too often, the next step is to take it out on your body, imagining the voice could be satisfied, or “good enough” could be achieved, if somehow the ideal body shape/size/nutrition plan/exercise regime could be accomplished.
Of course, this logic is pure nonsense, borne of endless marketing schemes, haunting images of people who don’t even look like that themselves, and a society that seems to keep getting more demanding while offering less compassionate support. The truth is: when you eat a wide variety of foods, and plenty of them, practice moderation (most of the time), and move your body in ways that bring you joy and help you stay strong, your body will take the size and shape that was pretty much genetically predestined. Love it or not, that’s the body you have, and only you can be its caretaker over the years. Totally separate from your body (really!), you can learn to use a kinder voice in your head, gently recognizing accomplishments and disappointments without judgment. Everyone needs self-care, just like everyone needs air to breathe.
I’ve been an internal medicine physician who specializes in eating disorders for eight years, and I’ve taken care of some of the sickest adults in the country. I’ve listened to a lot of stories from extraordinary people who developed a life-threatening mental illness as the voices in their head became intolerable and forced them to numb themselves through starvation, purging, binging, and substance use. Everyone’s story is different, but almost everyone I’ve cared for talks about that voice in their head.
You might be one of the lucky ones who rarely hears the voice, or who naturally (or after lots of work) has learned to answer judgment with kindness, and keep emotional struggles separate from body image. Or you might have struggled for years with this relationship between soul and body, going on diets (that aren’t sustainable and don’t work but sure cause a lot of crummy days in the process), thinking a certain size or shape will make everything else better. (They don’t.) Or you might have developed disordered eating or an eating disorder like anorexia nervosa, bulimia nervosa, or binge eating disorder. You’ve suffered terribly, as have those who love you, as the eating disorder turns the voice in your head into a fiendish, cruel, jealous, and insatiable presence. Even as that voice tells you nothing bad will happen to you as long as you just keep restricting, binging or purging, you actually end up with a disorder that carries the highest death rate of any mental illness.
My message is this: the voice in your head can be costly, really costly. You can choose to answer back to the voice when it tries to play its same old song: “I am enough. I’m doing what I can. I’m proud of the way I stood up for myself today. It was painful when I had that argument with my boss/mom/daughter, but I think I learned something, and I didn’t aim to wound. I’m going to put my feet up now even though there are a ton of things on my to-do list, because I need a break.” Your body deserves enough delicious, varied food to fuel it adequately, and the activity you do should be a celebration of the ways your body can move…never a punishment or an atonement. Keep working to untangle the voice in your head from the care you give your body. Body and soul will thank you in the long run!
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