9: A New Book and New Hope
It was a warm day in May 2005, the beginning of an extremely hot summer in Arizona. I had binged
horribly the night before and was driving to the gym, planning to do six hours of cardio and some
weights. I was exhausted and felt sick at the thought of working out; so instead of going directly to the
gym, I stopped to procrastinate at a bookstore.
I made my way to the psychology/self-help section—a section I'd visited many times before
looking for a solution to my eating problems. Over the course of my bulimia, I'd read about twenty
books that I thought might offer help or a cure. I'd read self-help books on eating disorders, books
about finding happiness, developing self-esteem, relieving stress, finding spirituality, and overcoming
depression. Although some of them helped me with other problems, none of the books stopped my
binge eating.
This particular day, I also wandered into the addiction/recovery section, thinking that I might find
something more useful there. I felt as though my behavior was indeed an addiction, not so unlike
alcoholism or drug addiction. I looked over the titles and came across Rational Recovery: The New
Cure for Substance Addiction by Jack Trimpey, which claimed to be an alternative to Alcoholics
Anonymous. I picked it up out of curiosity, because I had experienced Overeaters Anonymous (OA)—
a spin-off of Alcoholics Anonymous (AA)—about six months before.
I'd attended a few OA meetings and read some of the OA literature. But OA hadn't felt right to me,
mainly because the group advocated a very strict diet that excluded all white flour and sugar. I knew
that restricting food groups, like fats and sweets, had helped develop my problem in the first place, so
more restriction wasn't the answer for me. Certainly, I wanted to stop bingeing on sugar, white flour,
and many other things, but I didn't want to stop eating them altogether.
OA, as I understood it, asserted that eliminating those food groups was necessary because
overeating was a disease that caused one to lose control when eating white flour and sugar. OA's
position seemed to be that the disease could never be fully cured, only managed by eliminating the
problem foods. I already disliked being on a meal plan—which I thought was necessary for my
recovery—and I especially didn't like the idea of a meal plan that excluded foods I really liked. I
found the OA members to be very nice, but the meetings were discouraging to me. No one in the
group, except the moderator, seemed to have had much success with remaining abstinent from
problem foods or giving up overeating.
OA was also unappealing to me because of what I thought was a religious overtone. OA does not
claim to be religious, but I interpreted the "Higher Power" to mean God—the Judeo-Christian God that
I learned about as a child. I had turned to God for help with my bulimia in my freshman year of
college, but it didn't help. I had naively expected God to take away my desire to binge, but eventually,
I came to believe that God does not do favors; and although people can derive strength from
spirituality and prayer, we ultimately have to help ourselves. By the time college ended, I struggled to
have any belief at all and saw religion as primarily an academic pursuit. OA, then, seemed like the
wrong fit for me.
Because of my lack of interest in OA, I was very interested when I found Rational Recovery (RR).
Since the book claimed to be an alternative to AA, maybe it could be an alternative to OA as well, I
thought. One sentence on the back cover caught my attention. It explained that RR disagreed with the
idea of alcoholism as a disease and could give hope to those whom traditional treatment fails. This
simple synopsis was enough to make me want to buy the book. Even if it turned out to be useless, at
least it would distract me during the many hours on the treadmill, stair climber, and stationary bike. I
purchased the book and drove to the gym.
RR did much more than distract me from my workout. In fact, it did more to help me than anything
else I'd tried before over the years. RR finally made me take full responsibility for my binge eating,
then taught me how to do something about it—something specific and targeted to my real problem. I
didn't know it at the time, but the ideas in that book would lead me to complete recovery from
bulimia.
10: My Two Brains
Within five minutes of starting my workout, Rational Recovery in hand, I learned the book's central
tenet: anyone can recover from alcoholism or another addiction whenever they want, without
treatment. The author, clinical social worker Jack Trimpey, believes that AA does a disservice to
alcoholics by promoting the disease concept: the idea that drinking is not under an alcoholic's control,
but a chronic disease. The author points out that society at large also embraces this disease concept of
addiction, which only encourages and excuses addiction by failing to foster individual responsibility.
Trimpey explains how he once shared AA's and society's view of alcoholism and how this only
served to help him avoid responsibility for stopping his destructive behavior:
I believed that my desire to drink was irresistible, and that my own moment-by-moment drinking behavior was a symptom of
something unknown and beyond my control. I sincerely believed it would take something besides my own critical judgment
and self-control to take care of the problem. ... I surrendered to a highly gratifying belief that I drank for hidden causes and
would need outside help of some kind to stop.
21
When I read this, I immediately recognized that Trimpey's former beliefs about his alcoholism were
quite similar to my beliefs about my bulimia. Like him, I believed that my binge eating had hidden
causes and was a symptom of deeper problems. I decided to read Trimpey's words again using a
technique I'd learned from my brief experience in OA. I replaced the word drink in the text with the
word eat. OA members perform this word substitution when they read material originally meant for
alcoholics, like the 12 steps and the Big Book.
Read that way, it was as if the passage came straight from my own experience in therapy. An eating
disorder is different from an alcohol or drug addiction, but the similarities are plentiful. Whether
someone is addicted to binge eating, drugs, alcohol, or any other vice, that person wants to quit but
continues to drink/use/binge despite efforts to stop. Furthermore, the act of binge eating, the feeling of
pleasure, the relief from desire, and the numbing effect of large amounts of sugar and fat can certainly
be as reinforcing as the effects of alcohol.
I decided to read the rest of the book using the word substitution; however, I decided that for me, it
was more useful to substitute the words binge eat for drink and bulimic for alcoholic (OA members
traditionally replace alcoholic with compulsive overeater). I will use this word substitution throughout
this chapter and any other time I refer to RR, even though I realize that substituting binge
eating/bulimic for drinking/alcoholic does not create a perfect analogy.
As I read further, I began to think about my own treatment and how I'd come to believe that I was
flawed, defective, and not in control of my own binge eating. I thought about how I believed I ate
because of my depression, anxiety, and low self-esteem. I thought back to my first experience in
therapy when I was 16, when I'd first encountered the disease concept of an eating disorder. I
remembered the therapist telling me that my dieting and eating behaviors were merely symptoms of
more difficult problems and part of an illness called anorexia. I'd been so put off by this concept of
my eating disorder that I made a vow never to go back to therapy. Yet, when I'd returned to therapy in
college, I'd come to accept the idea that I had some sort of illness and ate to cope with more difficult
life issues. Even though my experience on Topamax had made me rethink what I learned in therapy, I
still clung to the disease concept in many ways.
Not only does the disease concept foster addiction, says Trimpey, but the treatments that stem from
the disease concept are not effective. This is because treatment for [bulimics] assumes [binge eating]
is the result of hidden causes; therefore, therapy attempts to treat those causes instead of the [bulimia]
itself and does not offer a direct way to stop [binge eating]. The treatments assume if you correct the
hidden cause, the [bulimic] behaviors will unexplainably disappear. This was, in fact, what I had been
trying to do in therapy for many years, without good results.
Trimpey says that therapists convince [bulimics] that [binge eating] is a symptom of another
problem. Therapists say that you cannot be free of [bulimia] until you reach other important goals, so
instead of working directly on your addiction, you work on reaching other goals in hopes that your
[binge eating] will go away. But the [binge eating] does not go away, Trimpey says. Even if you solve
such problems as "self-worth, self-awareness, relationships, and childhood conflicts, deprivations, and
traumas, you are still left with your original desire to [binge eat]."22
THERAPY'S IDEAS MAY HAVE BEEN HARMFUL
I was overwhelmed by what I was finding in RR, because this was the first time I'd read something
that contradicted what I'd learned in my own treatment. For so many years, I searched for a hidden
cause of my binge eating and tried to solve every problem I could think of; yet all my selfimprovement
work had done little to reduce my desire to binge eat. This was the first time I'd read
something that suggested I could stop my destructive behavior without therapy or a long journey of
self-discovery. It was the first time I'd read something that said recovery was not a difficult and lifeconsuming
process. In fact, Trimpey says that trying to solve personal problems before recovery only
wastes time and resources.
Part of me agreed with every word I was reading, because it explained why therapy had not worked
for me. But another part of me resisted the information in RR. Maybe alcoholics could just quit, I
thought, but eating disorders were more complicated. Wasn't it nearly impossible to self-recover from
them?
That warm spring day at the gym, I realized that the answers weren't clear and had never truly been
clear. I had sensed something was wrong with eating disorder treatment when I was 16; even after I'd
accepted the idea that binge eating was a coping mechanism that fulfilled inner emotional needs, a
small part of me had remained unsure. The doubtful part of me didn't know how to express the
problem I sensed in therapy through the years; but RR finally made me understand why therapy had
not been effective for me. Therapy was not solving the real problem.
If it hadn't been for my experience on Topamax in the summer and fall of 2003, I probably would
not have been as open to the ideas in RR as I was. I probably would have resisted the concept that I
could stop binge eating without solving my personal problems and without therapy. However, when
Topamax was working, it temporarily corrected something in my brain that was generating my urges
to binge, even as my other problems remained. Although the medication's effects weren't lasting, the
experience had caused me to leave therapy, even though I still held to many of therapy's ideas.
Reading RR made me wonder if those ideas were actually hampering my recovery instead of
helping it along. I began to wonder why therapy had led me around the problem instead of targeting it
directly. Maybe I could get better, I thought, only if I stopped believing that I needed to travel a long
journey of self-improvement in order to stop binge eating. Maybe I could get better only if I stopped
trying to cure myself in a roundabout way. Maybe I could get better only if I stopped believing that I
was using food to deal with unsettling emotions. Maybe I could get better only if I stopped believing
that I had an illness and that I needed to become whole or become happy before I could give up my
bulimia. I realized that solving my other problems might take a lifetime, but I needed to solve my real
problem quickly.
ADDICTION IN LIGHT OF THE BRAIN
RR suggested that this could be done by first understanding my own brain. Trimpey says that addictive
behavior is understandable when viewed in light of this remarkable organ. He explains that addiction
comes from a part of the brain that is older in terms of evolutionary history. This area, which Trimpey
calls the "animal brain" or "beast brain," is responsible for maintaining our basic biological functions
and ensuring our survival. The animal brain/beast brain is the primitive brain region that generates our
survival drives for food, water, sex, oxygen, and other things that it senses are necessary for survival.
The animal brain is automatic, unthinking, and irrational. It is buried in the central region of the brain
and surrounded by the wrinkled outer layer—the cerebral cortex.23 The animal brain is often referred to
as the subcortex because it lies below the cortex; but I will continue to call it the "animal brain" and,
later, the "lower brain." The animal brains of humans are nearly identical to the brains of animals, as
well as to much older species.
The animal brain's function in humans is indeed fundamental to our survival as individuals and as a
species; but when it comes to addiction, the animal brain works against us. When someone is addicted,
the animal brain falsely believes that the addictive substance is necessary for survival and therefore
drives the addicted person to the substance, as though it is just as vital as water or oxygen.24 In my
case, my animal brain believed that binge eating was a necessity, so that an appetite for binge eating
got mixed in with all of my other valid survival appetites.
The animal brain expresses itself through what Trimpey has termed the Addictive Voice (AV). The
AV is "any idea, feeling, or behavior that supports [binge eating]."25 He says that a [bulimic] must be
able to recognize her AV and separate herself from it, because the Addictive Voice is not really her
voice. It is merely the voice of the animal brain. My animal brain was in control, directing my life as
if large amounts of food were oxygen; I blindly followed the messages urging me to binge eat,
unaware of their origin.
Trimpey encourages [bulimics] to observe their own thoughts and feelings using a thinking skill he
calls AVRT® (Addictive Voice Recognition Technique). The thoughts and feelings that encourage
[binge eating] are the AV, and those that support quitting are the true self. When a [bulimic]
recognizes and understands her AV, then completely separates herself from it, recovery becomes
effortless. She must get apart from it, Trimpey says, realizing that "it" is merely an appetite that
originates in the "biological, animal side of human nature."26 "It" is not really you.
"It" is housed in the animal brain, but the real you is located in a different part of the brain. The real
you, or the true self, resides in the newer and more sophisticated part of the brain—the human brain,
which is the part of the brain that developed most recently in evolutionary history. The human brain
makes you yourself because it gives rise to your consciousness, self-awareness, identity, reason,
memory, and intelligence. The human brain also controls your voluntary behavior because it houses
the voluntary motor center, which controls any body part you can move voluntarily, including arms,
legs, hands, mouth, and swallowing muscles.27
To stop [binge eating], Trimpey says, you must know that your animal brain cannot make you do
anything, because it doesn't have control over your voluntary muscles. Because the human brain
houses your true self and your voluntary muscle movements, you—your true self—have ultimate
control. In the case of bulimia, "it" cannot control whether or not the bulimic will open the refrigerator
or drive to the nearest fast-food restaurant to binge. The only thing the animal brain can do on its own
is send messages urging the bulimic to binge eat, but ultimately, the true self—residing in the human
brain—is in control of what that person does upon hearing the call of the animal brain. Trimpey says
that given the right information, the human brain is "able to suppress any appetite, able to defeat any
addiction, any time you choose."28
Trimpey says that once you decide to quit and fully commit to stopping your [binge eating], all you
have to do is recognize the AV, realize that is not really "you" but instead "it"—the voice of the
animal brain—and simply stop listening to it and letting it direct your actions. Even though you can
hear and feel the AV urging you to [binge], you know the animal brain cannot act on its own, so you
know you can always choose whether or not to binge.
Attempting to argue or reason with the AV is futile, he writes, because the animal brain is not
rational and doesn't listen to reason. You only need to recognize it, ignore it, and it will soon fall
silent. Trimpey says that once you learn to separate yourself from the animal brain and realize you are
in control, your urges to [binge] begin to taper off, and stopping your addiction for good becomes
easy.
11: I Had Control All Along
This theory of two brains—the human brain and the animal brain—that Trimpey presented seemed
reasonable to me. It seemed to explain why I sensed my urges to binge were not really me, but instead
an imposter taking control of my mind and body until I gave in and binged. It seemed to explain why
part of me wanted to binge more than anything and part of me truly wanted to quit. There were two
brains in conflict within me.
The most important thing I learned while reading RR at the gym that day was that I had ultimate
control over my actions. My human brain—the seat of my intelligence, reason, language, and
voluntary movement—was the only part of me capable of the voluntary act of binge eating. This new
and rather simple information gave me a feeling of power. It gave me new hope that I could overcome
my urges to binge eat. It gave me reason to believe I had a choice when the urges arose.
In a sense, the information in RR was something I already knew but hadn't been able to express. I'd
already known that I didn't have to act on my urges to binge even before reading the book; but until
that point, I'd felt powerless against them. In therapy, I learned that I needed to develop alternative
coping skills or fulfill my emotional needs in other, noneating ways. Yet when the urge to binge arose,
it always seemed that nothing else but food would do.
MY URGES WEREN'T REALLY ME
RR seemed to explain why my urges were so irresistible. Maybe it was because I thought those urges
signaled a real need, whether that need was physical, emotional, or even illness-based. Maybe I
believed the thoughts and followed the feelings that were urging me to binge because I thought they
were my thoughts and my feelings. It only made sense that I believed this, because the urges certainly
seemed to be coming from me.
When I had the urge to binge, I heard enticing thoughts, in my own voice, saying things like, It
won't hurt to binge just one more time. ... You can work out tomorrow and then start over. ... You've
had a hard day and need to relax. ... You've done so well for the past three days, so you deserve it. I
heard myself giving all the reasons that it would be OK to binge just one more time, and sometimes
they seemed like very logical reasons. As the urge grew stronger, my feelings of anxiety and craving
mounted and I felt I truly needed to binge in order to feel normal again. My feelings felt like my own
as well, and like my thoughts, they expressed what I sensed to be a true need.
RR made me realize that perhaps the thoughts and feelings that encouraged binge eating didn't
correspond to any of my needs—real or symbolic—and that maybe those thoughts and feelings didn't
even come from me at all. Maybe they were an automatic and unthinking voice coming from the more
animalistic part of my brain and didn't have any power over me or my actions. Maybe all I needed to
do was separate my true self from that lower part of my brain for the urges to go away on their own.
As I continued exercising and reading RR, I came to a significant realization. All through the years
of therapy, I had been trying to make my urges go away or prevent them from ever arising. But what if
that was the wrong approach? What if I didn't need to make them go away, but just needed to change
how I reacted to them? What if I could separate myself from my urges and choose not to follow them
anymore? Perhaps, I thought, in spite of even the most powerful urge, I could choose not to open the
refrigerator, not to drive to the convenience store; and maybe if I did that over and over, the urges
would simply go away on their own.
I decided to try what I'd learned from RR and my own insights that day. After all, what could it
hurt? I wasn't having much success resisting my urges any other way. I decided to view any thought or
feeling encouraging binge eating as an automatic function of my animal brain, believing that it had no
power to affect my actions. I decided I would separate myself from my urges to binge and use the
power of my human brain to choose not to follow them.
IT WAS ABOUT THE FOOD
When my day of working out was complete and I had nearly finished reading RR, I drove home with a
new perspective. This was not the same "new perspective" I usually had after successfully purging by
working out—that feeling was all too familiar, and it never lasted. This perspective was different
because, during the seven hours I'd spent at the gym, I had reinterpreted my eating disorder. Thanks to
information from RR and my own self-reflection, my bulimia suddenly stopped being a mystery. I felt
as though a curtain had been lifted and I could finally see my behavior for what it was: a terrible habit.
That evening in May, I stopped believing, once and for all, that my urges to binge were about
anything more than food. I decided that there was no deep emotional meaning there. I began believing
that I binged because I'd created a habit—possibly an addiction—by doing it so many times. I began
to see that I binged primarily to relieve my cravings and also for pleasure, but certainly not to satisfy
some symbolic inner need. A part of my brain had become dependent on binge eating, and that was
why I found it so hard to stop.
As I now understood it, a lower part of my brain—my animal brain—believed I needed to binge to
survive and was therefore generating urges for this beyond my conscious awareness. I couldn't control
these thoughts or feelings, but I could recognize them for what they were. Although I knew binge
eating was wrong and unhealthy, my animal brain thought it was as necessary as oxygen, because I'd
taught it that by binge eating so many times. Although I couldn't talk my animal brain out of these
demands, I didn't have to follow its lead. I, residing in my human brain, could control my actions.
As I approached home that night, I decided that I was going to try to stop reacting emotionally to
my urges and stop acting on them. I decided I would just let my thoughts and feelings about food
surface, then observe them as if they were not coming from me. Then I would not do what they told
me to do. This seemed like an easy plan, and part of me thought it was too simple and would never
work. But little did I know as I got out of my car that evening, my bulimia was almost gone forever.
12: Resisting the Urge
It didn't take long for me to get the opportunity to practice my new strategy. I walked into my house
after my day at the gym, put my workout bag on the floor, placed Rational Recovery on the kitchen
table, and began making dinner. Greg called and said he was running late, so I was left alone to eat.
After I finished a normal meal and dessert, I began hearing a few enticing thoughts encouraging me to
continue eating. What happened then was truly surprising. I heard all the familiar reasons I should
binge, and I felt the craving, but I told myself those thoughts and feelings were not my own. I told
myself those thoughts and feelings were coming from an automatic, unthinking part of my brain that
mistakenly sensed that I needed to binge to survive.
I told myself that I was completely separate from the part of my brain that generated these cravings,
and I reminded myself that I had complete control. I pictured myself standing outside my own brain
looking in, listening to those thoughts as if they were distant from my own, and knowing that my
cravings had absolutely no power to make me act. I reminded myself that I—my higher brain, my
human brain—was the only one who could walk to the refrigerator and begin to binge. And I chose not
to.
It felt strange to form a divide between me and my urges to binge, but it also felt empowering. As I
experienced my urges with detachment, it became immediately apparent that I didn't have to make
them go away. I didn't have to try to talk myself out of my thoughts or feelings; I didn't have to reason
with them or fight them; I didn't have to try futilely to distract myself; I didn't have to try to figure out
what triggered my urge; and I didn't have to determine what emotional need my urge symbolized.
Observing my brain in this way allowed me to see that my urges to binge symbolized nothing. They
were not laden with deep emotional significance or hidden meaning. They simply were automatic
functions of my brain, expressing an appetite for binge eating, an appetite I'd been feeding for much
too long.
That night, I decided not to feed the urge, and a remarkable thing happened: the urge just went
away. I remained detached from those thoughts, and they simply subsided on their own. I didn't get
caught up in my feelings, and they died down. I'm not saying it was completely effortless, but it was
certainly not the painful struggle that resisting binges had been before this night. I experienced the
urge to binge for only about an hour at most, which was a major improvement. Furthermore, the hour
wasn't distressing. It was actually quite interesting to observe the thoughts and feelings that had gotten
the better of me for so long.
Listening with detachment made the urge to binge infinitely less intense. I did not get anxious,
fearful, or angry as in the past; instead, I just listened without reacting emotionally. I went on with my
normal activities: I watched TV, did some dishes, and checked my e-mail. Then I spent some time just
sitting on the couch paying attention to what was going on in my head. I didn't feel I needed to do or
not do anything in particular while the urge was present. The only thing I needed to do was not binge.
Throughout my urge, I truly felt the control I had over my actions. I didn't try to convince myself I
had control without truly believing it, as I had done in the past. This time, my control was tangible.
Maybe it was because I knew—based on the simple discussion of the anatomy and functions of my
brain in RR —that I really did have control. I knew that no matter what crazy reasons my animal brain
generated, I didn't have to act on them, because my human brain gave me the power to say no.
I realized there was no hidden disease, underlying emotional problem, or trigger that could make
me walk to the refrigerator to take that first bite. There was no mysterious force that could take
control of my body and commence the binge. It was my choice, and it had been my choice all along. I
simply hadn't known how to exert that choice over the intense messages coming from my brain. I
realized I was the only one to blame for keeping up my behavior, and I was the only one responsible
for stopping it.
I BINGED TO COPE WITH MY URGES TO BINGE
After my urge to binge subsided that night, I thought about something I'd read in RR. Trimpey said
that the only thing a [bulimic] is coping with when she [binge eats] is not [binge eating].29 When I'd
read this statement earlier at the gym, I wasn't sure I quite understood what it meant; but now, after
experiencing an urge and riding it out successfully, I saw exactly what Trimpey was talking about.
Throughout my years of binge eating, I had binged primarily to deal with the negative effects of not
bingeing. When I'd tried to resist urges to binge, I'd experienced anxiety and discomfort, and bingeing
successfully, albeit temporarily, had quelled that anxiety and discomfort.
In the past, binge eating had immediately turned off my urges to binge; it gave me relief from
irrational but unremitting cravings; and it brought me immediate relaxation because I no longer had to
struggle against my urges. It was the only thing that satisfied my desire, so in effect, I'd binged to
cope with my urges to binge.
I binged to cope with urges to binge, I thought over and over that night, wondering how such a
simple truth could have eluded me for so long. It made so much intuitive sense; but it also seemed too
simple compared to all the explanations of binge eating I'd gleaned during therapy. However, none of
those explanations had ever helped me simply resist an urge to binge, as I had done that night after
reading RR.
After over six years of binge eating, I seemed to finally have a viable answer to the question I'd
been pondering for so long: What was binge eating helping me cope with? I saw clearly that if I had
binged that night, it would have been primarily to turn off the thoughts and feelings urging me to do
so. It would not have helped me cope with any of my other problems or emotions; it would have only
served to quiet the messages from one part of my brain. But I hadn't felt desperate to quiet that part of
my brain that night, because I'd stayed detached from it. I hadn't reacted emotionally to my urge to
binge, so I hadn't had any extreme anxiety or discomfort that I wanted to get rid of; and I hadn't felt
the need to make my thoughts or feelings go away. In other words, I hadn't needed to cope with my
urge by binge eating; in fact, I hadn't needed to cope with my urge at all.
This was not the answer I expected to find after all those years of therapy. I expected the answer to
be far more complex, possibly related to my past, my depression, my social anxiety, my brain
chemicals, or my personality. But every complicated answer I'd come up with over the years did not
ring true to me. This simple answer did.
I realized that I was healthy, my brain was healthy, and I'd been healthy all along. There was no
longer a mystery as to how I would stop my bulimia. Now that I knew my urges were the real problem,
and now that I knew these urges weren't really me, I realized that all I had to do was completely
separate myself from them and not act on them.
