I am a nutrition therapist in private practice. People come to see me because they are eating too much, too little, and/or things that aren’t so good for their bodies. What they all have in common is their suffering and their desire for happiness. They pay me a professional fee, fervently wishing that I would help them feel better and lose weight, not necessarily in that order! It is a big responsibility. It is wonderful that I have Buddhist teachers, teachings and practice as tools to be helpful.
The Bodhisattva Promise
I have been seeing clients with eating disorders for about 25 years. In the beginning, I made a rigid separation between “their time” i.e. in my sessions with them, and “my time.” If a client called me between sessions, at night, or especially on weekends, I would feel a little resentment that they were taking “my” time. I saw my nutrition counseling as service, but I viewed myself as needing a lot of “down time” to relax from my work.
When I had the opportunity to take the Bodhisattva promise, I considered it carefully. I asked my Lama what it means to come back into human form endlessly to help liberate and enlighten limitless numbers of beings. He said that we are promising to come into form to help the beings with whom we have connections or bonds. He always points out that when we focus on ourselves we have problems, and when we focus on others we have lots of exciting things to do. That sounded good to me, because I find it an honor and a lot of fun to help people, and I realized that it is not just my family and friends I have bonds to, but everyone I meet professionally, even if I am merely guest lecturing in a university.
It was surprising to find that after taking the Bodhisattva promise, everything changed. Immediately I saw my work as my means for helping others awaken, my clients as beings I have bonds with, both now and in lives to come. Suddenly there was no more “my” time—all my time is Bodhisattva time. If a client or anyone one else needs me, I have the pleasure of being able to help. My genuine availability diminished the number of calls I receive. I think my clients can sense that I truly care and am there to help, and so they need to prove it to themselves less.
The View
Mandy is a composite of many people I have worked with over the years. She described herself as “successful in every way except my weight.” She completed law school while a single mom of three small children and soon after graduation, founded her own flourishing law firm so that she could have flexible hours. Her kids were grown when I met her, doing well, happy, and grateful to her. She has a loving husband, good friends, and is active in cultural and charitable causes. She was finding herself eating compulsively at night and like many people I see, the harder she tried to stop, the more she ate. It was beginning to affect her blood pressure, cholesterol and knees. She had dieted and regained the weight she lost, plus more, several times. More than once, pulling her suit jacket closed in an attempt to hide her size, she would exclaim, “I feel like a failure, a stupid, powerless pig!”
But for me, when I see a client, whether he or she is starving themselves half mad, or eating themselves into illness, almost always I see their awareness of what they are doing as their innate wisdom, regardless of how distressing it is for them. I see their awareness itself as their mind’s clarity, and all the feelings, events and people in their lives as their mind’s play—in other words, what I see, is their Buddha nature. I recognize the problems and help my clients
work with them, but what is always more obvious to me are their strengths. In Mandy’s case, no matter how she felt about herself, in my eyes, what were most apparent are her immense kindness, her warmth, her intelligence, and her quick sense of humor. I typically don’t have to try; it’s just how I see it, thanks to the Vajrayana transmission from my teachers. Usually I can see people from the highest view, even as I also see the relative reality of their concerns and suffering. I know that without trying, I convey this view as acceptance and admiration, and confidence in their potential. Mandy’s sense of repeated failure and her self-loathing didn’t frighten me because I know that even if nothing else comes of our time together, through me she will have a bond to our lineage, and whether it is now or later, at some point this will be liberating.
Mindfulness
Like many people, Mandy had very little idea of whether she was hungry, and when she ate, she didn’t notice when her body felt satisfied. She didn’t notice when she was tired, and used food to compensate for her fatigue. She unconsciously and habitually used food to suppress negative feelings, procrastinate or reward herself. I know that if I simply do what she and many clients do to themselves—tell them not to eat so much, to exercise more, etc.– it will have the same effect as when they say that to themselves—more harm than good.
So instead, I was curious about her experience and wanted to help her become curious as well. I asked her repeatedly, “How hungry were you when you ate that? Did your breakfast last until lunch or were you too hungry? Did anything happen just before you ate the donuts? How much sleep did you get the night before? If you weren’t hungry, what do you think you were really needing?” Over time she began to describe things: “I notice that I am starved by 3:00 on the days when I just have coffee or a scone for breakfast, then I can’t stop eating cookies at night,” or, “I kept eating because I was trying to get energy, but what I really needed was sleep.” She began to notice that when she “spoke” unkindly to herself, she ate more to console herself. I didn’t have to tell her to change her patterns—she observed herself and knew what to do. Gradually she would report, “I was mad because I told that guy I would finish his project even though I didn’t have the time, and I found myself eating the leftover cake from my secretary’s birthday.” As her mindfulness grew described it as “…like detective work, I know when I am not hungry but eat anyway and what to do, and I know what foods make me feel good and energetic and which don’t. I don’t like the feeling of being stuffed.”
My advice? I don’t have to say anything, except to continue to encourage people to pay attention to their bodies and the effects of their food choices, with as little judgment as possible. All beings naturally move toward that which feels good, and away from what feels bad. As Mandy learned to mindful: to say no when she didn’t want to do something, or to rest when she was tired, and treated herself with kindness rather than contempt, she naturally began to eat when she is hungry and to stop before her body felt too full, because it was a more pleasurable experience. When she tried to force herself to eat differently it backfired. When she paid attention without judging her experience, she naturally made choices that allowed her to feel good.
It is very much like what we are instructed to do in meditation practice. If we cling to good experiences and try to have more of them, or judge ourselves when our practice seems mundane or distracted, we know that it is just another experience of our attachment and aversion to the way things are. I know from experience that when I allow my meditation to be what it is, gradually over time I notice change. It has never worked to force it. This gives me
confidence that my clients, as they learn to pay attention to their own experience, will make changes naturally, changes that last.
Impermanence
Liz, another composite of many clients, had been “relentless pursuing slenderness” for many years. She had no friends because all her time was spent working, spinning on a stationary bike, or cutting her tiny “meals” into even tinier bites to prolong the minute pleasure she took in eating. Her hair and skin were dry, her color a little gray. She was cold even in a warm room because she had no fat under her skin to insulate her. Her physician described her as a “skeleton covered with skin and designer underwear.” He pleaded, “Can’t you get her to eat?”
“I feel so fat!” she would declare. I know that feeling fat masks a realm of pain. Her suffering filled my office like a cloud. Telling Liz that she’s was not fat, or to eat more, as her family, physician, and former friends had done endlessly, would have been less than useful.
But I knew that underneath it all is her mind, clear and free as the vast sky. I didn’t say it, because she couldn’t have understood, but I knew that it was not up to me to “save” her. No condition, even one so apparently chronic as this, can last forever. With the help of her physician and psychotherapist, I helped her set small goals she had a good chance of accomplishing. I inquired in a friendly way about her experience of herself and her life. No matter how crazy she appeared, I had confidence that gradually she would see that her fierce desire to lose weight was really a desire for happiness and freedom. I helped her recognize the relative pleasure she had having more energy, and helped her have the courage to discover and pursue what truly gives her life meaning. If I had seen her as hopeless, stuck in an unremitting condition, I would have felt only despair for her.
And, as Liz, Mandy, and other clients start to feel the emotions that their eating helps mask, I can help them be aware that the feelings are temporary and won’t kill them. I say, “I know you know you won’t feel this way forever, even if it seems like you will.” I know this from watching my own thoughts and feelings come and go. And I know that the conditions that came together to create their lives as they are now will dissolve on their own accord at some time in the future. I don’t need to use words to convey this.
Cause and Effect
Helping professionals can experience “burn out” and lose their ability to care. There are many ways suggested to prevent this, including regular meditation practice. When I was first in private practice I thought I could never continue until retirement age—it was just too draining. I felt tremendous pressure to “cure” my clients. However, because of the Buddhist training I’ve received, I know that everything my clients and I experience is the result of habitual patterns formed over limitless spans of time. I know that their current condition is the results of actions, words and thoughts from incalculable time before he or she ever met me and that their time with me is very brief in relation to all the time they have spent forming these habits.
This frees me to be with the people who come to me for help and truly accept them the way they are. I can be very patient with the progress and relapses that are an inevitable part of healing. I can genuinely delight in every small triumph and help them savor the smallest sign of
improvement so that it generalizes and gives them confidence. This patience is not something I was born with! It is the result of the view and the methods we are given to practice. I don’t feel that it is up to me to change my clients, I am only there to help facilitate their healing as well as I can.
All this said, this afternoon as I was revising this article, it was difficult because I had just seen a new client, “Joy,” a dumpling dressed in a flowered tent with a government clerk job and no friends except food and television. I could see some potential in her, but the words in this article felt like good reminders. I know as I get to know Joy her beauty and strength will be ever more apparent to me. Impermanence in the realm of relative reality!
It is a great blessing to be able to form strong bonds with people as a part of my “work.” Few people are willing to look into their experience, see the ways they create their suffering, and work hard to learn to change it. My clients are heroes, people of tremendous courage and persistence. It is an honor to accompany them for a little while as they recover. Without the knowledge, meditation methods and view that I have been given by my teachers, my counseling practice would be difficult and not much fun. As it is, I can think of few things I’d rather be doing. My work is the perfect place for me to practice.