could spirituality ever actually *hurt* recovery?

“I didn’t eat breakfast, but it wasn’t restricting behavior because I was having a spiritual experience. God told me that he was sustaining me, so I didn’t need to eat.”

When a former client said this in a group, the other women didn’t know how to respond. From their vantage points (and certainly mine), this was clearly disordered eating and thinking. Though her peers tried to gently ask more questions to better understand where she was coming from, this client was just not in a place where she was ready to give up her eating disorder. She frequently quoted scripture and said she was always very connected to her faith and spirituality, and yet, had blinders on regarding the reality of her disorder and how it was affecting the parts of her life that mattered the most.

Spirituality is often a highly valuable component of recovery. In any kind of 12-step program, acknowledging and turning your life over to a higher power of your choosing (steps two and three) is a foundational element of working the steps. Of course, a person’s chosen higher power may be less spiritual and more about “Good Orderly Direction,” but spirituality of some sort is highly common. Even aside from the 12-step model, spirituality can offer strength and hope to people during the most difficult times in their lives. The most frequent benefits my clients identify about connecting to spirituality in recovery are:

  • Helps me know that I’m not alone, and that I am already enough
  • Connects me to a sense of hope that everything will work out okay
  • Reminds me of the fact that I’m not in control, and that the control my ED gives me is an illusion — so I can surrender to recovery even when it’s hard

To read the rest of the post, including 2 ways that misuse of spirituality can be harmful to recovery, head on over to Recovery Warriors. 

You might also be interested in my post on what it means to "be spiritual." 

video blog: self-forgiveness and letting go


As Yom Kippur or the "Day of Atonement" approaches, I'm inspired by ancient Jewish traditions such as Tashlich ("casting off" and letting go of wrongdoings from the past year) and the majestic Aramaic prayer, Kol Nidre. In this video I discuss these traditions, how they connect to self-forgiveness, and I share an excerpt from Franciscan priest and author Richard Rohr's The Art of Letting Go. Thanks to First Unitarian Universalist Church of Nashville for the inspiration for this video from today's service, and for being my home for spiritual education and expansion. (And leave it to UU to beautifully blend Jewish, Christian, and non-traditional messages and practices into the service!)

**Sometimes embedded YouTube videos can get a little finicky in mobile browsers, so if it's not playing from this page, click here to view it directly on YouTube.

As mentioned in the video, I highly recommend listening to a Kol Nidre recording if you're not familiar with it. I particularly love this one arranged for cello and harp and this also-amazing-and-entirely-different a capella version.

As the earth shifts into a new season and the trees let go of their leaves, what are you needing to let go of? What do you need to forgive yourself or another for (or ask forgiveness for) in order to be fully honest with yourself and present for each new day?

recovery spotlight: eating disorders and religious fasting


<<I originally wrote this post for Adios Barbie -- if you're not familiar with the site, they have an awesome mission. Go check them out. Occasionally I'll post and cross-post spotlights on various topics related to recovery (eating disorders, addiction, etc.), so I hope you enjoy the variety!>>

Over the past several years, a number of controversial articles and research studies have explored the relationship between eating disorders and religious traditions. Several years ago, there was a significant focus on the Jewish tradition, in particular the Orthodox community. Some studies and health experts concluded that the rate of eating disorders (EDs) in this community was substantially higher than in the general population, while other studies and articles challenged these findings. In 2008, the Orthodox Union produced a 40-minute documentary exploring the topic, Hungry to Be Heard(click to view it for free.) More recently, there is an increased focus on the Muslim community and how the Islamic tradition of Ramadan may correlate with eating disorders.

My goal is not to contend whether or not a particular religious culture has a higher rate of eating disorders, but rather, to explore how religious rituals and traditions that involve fasting may contribute to or exacerbate eating disorders.

In the book Treatment of Eating Disorders: Bridging the Research-Practice Gap(2010, Maine et al), the authors define fasting as an inappropriate compensatory behavior (ICB) that involves “not eating food for extended periods of time due to body shape or weight concerns.” They explain further, “Eight consecutive waking hours is probably the lower boundary for considering a period of time without eating as a fast (Fairburn, 2008). During this time, individuals may drink fluids without breaking the fast, but if they have eaten very small amounts of food, their behavior is better considered to be restriction.”

It is important not to pathologize religious fasting outright; cultural insensitivity would certainly harm therapeutic rapport from a treatment standpoint. Exploring motivation for fasting is key. That said, some might state religious tradition/ritual as their motivation for fasting, and also have eating disorder-based motivations. Maine and her colleagues write, “If individuals indicate that part of the reason they fasted was to affect their weight or shape…the fast may be considered an ICB… if manipulating weight and shape underlies religious-based fasting, it may be considered inappropriate.” Thus, when the motivation for fasting is solely based on religious beliefs, it is not considered an ICB (according to these authors).

A study published in the January 2014 issue of the International Journal for Eating Disorders explores the implications of religious fasting for Muslim adolescents. During Ramadan, the Islamic month of fasting, participating Muslims refrain from eating, drinking, and smoking from dawn until sunset. The study’s authors state, “for the past 2 years, we have noticed an increase in patients with disordered eating patterns that have applied to Hacettepe University, Division of Adolescent Medicine during or shortly after Ramadan. We document [sic] six of these patients… We argue that the possible effects of a drastic change in ones diet such as that which occurs during Ramadan, play an important role in triggering ED’s [sic] in adolescents with a predisposition or may exacerbate an eating pathology.”

In a July 2014 editorial on Vice’s “Munchies” website, contributor Safy-Hallan Farah shares her own experience:

“For young Muslim women struggling with eating disorders, Ramadan can be the worst time ever. I know this firsthand. As a teen girl, I would intermittently starve myself and vigorously work out… In between being normal and being the version of myself that had what medical professionals call Eating Disorder Not Otherwise Specified (EDNOS)*, I’d spend a ridiculous amount of time on pro-anorexia and -bulimia sites. This intensified during the summers and during Ramadan, so I know what young Muslim girls with eating disorders are going through right now. Many don’t know if they’re fasting for Allah or for anorexia.”

Though Christianity lacks a specific tradition of fasting, the ritual of Lent does encourage restriction (often of certain foods), which could certainly pose a trigger for people with eating disorders. I work at a residential treatment center (for eating disorders, addiction, trauma, and co-occurring disorders), and recently one of my clients with anorexia (also a devout Christian) said that she restricted at breakfast that morning but was proud that “it was not because of my eating disorder. It was because I was reading scripture and God was sustaining me, so I didn’t need food.” If that’s not an eating disorder manipulating someone in the name of religion, I don’t know what is.

We’ve had several Orthodox Jewish clients over the past few years, and my experience has been that when a woman’s Rabbi knows she is in treatment for an eating disorder, the Rabbi fully supports the treatment team in making adjustments to rituals or traditions to prioritize her health and recovery. In researching for this post, I found a lovely article at Ritualwell by Rabbi Debbie Young-Somers in which she shares an alternative ritual for those who are in eating disorder recovery to participate in Yom Kippur:

“For individuals who suffer, or are in recovery, from an eating disorder, eating on Yom Kippur is a holy act. Rather than finding ‘purity’ or ‘spiritual growth’ through denying themselves food, the act of eating itself is an act of teshuvah. This was not something I had considered until I was approached this year by a friend seeking a liturgy that helps her acknowledge the holiness of the act of eating on Yom Kippur, having found little that helped online or in our traditional liturgy. This was developed together with her, in the hope it might also help others.” (Click through for the full text of the ritual.)

Additional resources that may be helpful are the book The Religion of Thinness: Satisfying the Spiritual Hungers Behind Women’s Obsession with Food and Weightby Michelle Lelwica, and her corresponding blog at Psychology Today. For anyone struggling to determine whether certain behaviors are motivated by religious devotion or eating disorder, an important question to ask is, “Has my eating disorder/the need to be thin become my higher power?” Michelle also writes about how spirituality can support recovery once a person is ready to “relinquish the holy grail of thinness.”

Numerous cultural factors can contribute to the risk of eating disorders, and while religion is only one of those factors, it should not be overlooked. It is possible to be both respectful of a religious culture and cautious about how certain rituals or traditions could be risk factors for those with eating disorders or predisposition for them. As Elizabeth Claydon writes at,

“just as healthy eating can act as a slippery slope into orthorexia for certain people, fasting for religious or cultural reasons could transform into longer-term disordered eating or an eating disorder. It is important that clinicians are aware of this risk so warning signs aren’t conflated with religious practice.”

The important takeaway on this topic is that we (especially clinicians and religious clergy) need to be aware of the possibility for religious fasting to impact an existing eating disorder or someone who is predisposed to an eating disorder. However, making a generalization that “religious fasting is bad” is a harmful blanket judgment that could alienate many people and make them less likely to reach out and get the help they need.

*In 2013, the DSM-V replaced EDNOS by OSFED (Other Specified Feeding or Eating Disorder).

Photo by Kelsey Weaver via shared under a Creative Commons license.