Depressive symptoms, unhealthy eating habits, and heavy drinking unite to create a space that is so poisonous for women that I have called it the toxic triangle. Eating, Drinking, Overthinking will help you understand your own relationship to the toxic triangle. It is not just for women who have clinical depression, diagnosed eating disorders, or alcoholism. It is for women who dance around the edges of the toxic triangle, with moderate symptoms of depression, unhealthy eating patterns, or heavy drinking

Eating, Drinking, Overthinking teaches women how to transform their vulnerabilities into strengths, to help women develop the tools to change the way they cope with stressful circumstances. Here are some of the major steps toward positive change:

1. Step back and notice what you are thinking and feeling.

One way to do this is to use mindfulness techniques, which teach us to notice our thoughts, feelings, bodily sensations, and memories without immediately categorizing them as good or bad. We learn to be more compassionate toward ourselves, responding to our thoughts and feelings as a friend might, rather than as a slave to a master. By being able to step back and notice, rather than be overwhelmed or ruled, by our feelings, we become better able to choose how we want to feel and act in difficult situations.

Mindfulness techniques also teach you to be more aware of the present moment. By practicing “being with” our feelings and thoughts we can become less frightened and overwhelmed by them, and thus less motivated to escape them with unhealthy behaviors. We can also learn a great deal about ourselves, particularly the ways we have internalized social pressures to cast ourselves in a certain way (for example, in terms of how much we weigh) or to behave in certain ways (such as always putting others’ needs before our own).

If mindfulness techniques don’t appeal to you, just try keeping a diary of key events in your day and how you think and feel about them. There may be something specific that triggers these urges and feelings – a difficult interaction with another person, going by a restaurant, being alone at home. Or they may come from out of the blue. It doesn’t matter, just write down what is going on, and then get quiet for a moment and tune into what is going through your head.

It is likely that you may begin to recognize the theme of relationships or a certain relationship in your diary accounts. As you begin to recognize the role of key people in these difficult times, use your reflective abilities to consider what it is about them that contributes to your sad or anxious feelings, or to your desire to drink or eat.

2. Conjure up an image of the Positive You.

Shut your eyes, get quiet, and conjure up a very positive image of yourself. Watch that Positive You get up in the morning, get dressed. What are her interactions with her family like? What does she do for the rest of the day? Does she go to the same job you have? Her interactions with other people? What kinds of things does she do over the course of the day? How does she feel? At the end of the day, what does she do?

Now turn your attention back to the Real You and tune into how your body feels. Is there a sense of happiness or excitement at the prospect of the Positive You? Or frustration and defeat? Concentrate on what’s going through your mind. Some of the characteristics of the Positive You are likely to represent impossible goals that you have internalized based on society’s messages about what you – and other women – should be.

Then rewind the tape of the Positive You’s day. Shut your eyes, and before you play the tape again, say to yourself, “Be gentle. Be kind. Accept who you are. Be realistic.” Then try running the tape again. How does the Positive You look different this time? Are there things about her that now look more like the Real You? Which characteristics of her or of her life bear little resemblance to the Real You? For example, perhaps the new Positive You still has quite a different relationship with her husband than you do. Or perhaps she has a pleasant evening without alcohol, when the Real You seems to need a drink to relax. Does she have energy and interest in what she does, while the Real You is always tired and unmotivated?

Rerun the tape a couple of more times, and each time begin by telling yourself, “Be gentle. Be kind. Accept who you are. Be realistic.” Notice which differences between Positive You and Real You keep coming back over and over, because those are likely to be the changes you do want to make for yourself. Get a piece of paper and write each change down in the language of approach goals – new behaviors or ways of living that you want to move toward, rather than things you want to avoid or give up.

3. Make a plan to move toward the Positive You.

Now you’re ready to begin working toward these positive goals. Make a list of simple, everyday things that you find enjoyable, and that are relatively easy to do. One of the most important steps to moving away from bingeing and toward a more positive you is to find things to do that can take your mind away from your urges, filling up the time during which you would normally binge. Plan activities for the times between meals and snacks when you otherwise don’t have anything to do. When you feel an urge to binge on food or alcohol, go back to something you’ve done, and enjoyed, before.

The activities you have come up with so far are meant to lift your mood, take you away from negative overthinking, and fill the time you would otherwise have spent bingeing. These are small steps, although critical ones, down the road to the Positive You. Now you are ready to take bigger steps – ones that will begin to overcome the larger problems in your life that drive your unhealthy thoughts and behaviors, and that help you reshape the Real You into the Positive You.

Take one of your major goals, or a significant change you want to make in your life, and consider how you would apply each of the following steps.

a) Generate as many possible activities to move you toward your goal as you can think of without judging whether any of them is “good” or “bad”.

b) Rank order each of these activities, thinking about how easy it will be to accomplish it, and how effective it would be in moving you toward your goal. If you find yourself thinking, “That won’t work! Nothing’s going to help!” try using your mindfulness techniques to slow yourself down and be more open and gentle with yourself.

c) Once you decide what would be most helpful in moving toward your goal, develop a plan to carry it out. For example, if you’ve decided you need to take some courses to improve your job skills and get a new job, then the first step is to investigate a local educational institution. The second step is to sign up for a relevant course. The third step is to take the course. It may also be helpful to consider the available resources for each step. For example, you may need to look into financial aid.

d) Schedule the first step in your plan. Scheduling simple activities such as “Look up courses in the course catalog” may seem silly, but the act of scheduling will make you more committed to carrying out the activity, and will help insure that you find the time to do it.

e) Once you go through with your scheduled activities, evaluate how well they worked. How did they make you feel? Did they accomplish what you wanted them to?

f) At this point, you may need to revise the plan, especially if you didn’t get as far along the path to your goal as you hoped. Again, be gentle and generous with yourself – you don’t get to the Positive You overnight, just as you didn’t travel into the toxic triangle overnight. You may need to go back to Step 1 and repeat the process of generating ideas that move you toward your goals.

g) Whether or not everything you tried was successful, reward yourself for just trying! For example, treat yourself to a meal at your favorite restaurant or to coffee with a friend.

Women’s empathy and strong emotional ties to others can lead them into the toxic triangle, but they can also help them escape it.

Copyright © 2006 Susan Nolen-Hoeksema

Author
Susan Nolen-Hoeksema, Ph.D., is the author of Eating, Drinking, Overthinking: The Toxic Triangle of Food, Alcohol, and Depression—and How Women Can Break Free (January 2006; $24.00US/$31.95CAN; 0-8050-7710-3) and is a professor of psychology at Yale University. She has been conducting research on women's mental health for twenty years. The former director of the Institute for Research on Women and Gender at the University of Michigan, Nolen-Hoeksema was awarded the Leadership Award and Early Career Award by the American Psychological Association and received an Excellence in Research Award from the University of Michigan. She lives in Connecticut with her husband and young son.