Nurturing Girlpower

By Sandra Susan Friedman

Nurturing girlpower: Integrating eating disorder prevention/intervention skills into your practice provides a comprehensive framework for prevention that addresses the changes in girls’ bodies and in girls’ lives during adolescence. It helps demystify eating disorders and provides a skill set to enhance your counseling practice so that you can relate to the girl instead of her problem.

• Language: English
• Publisher: Sandra Susan Friedman
• Release date: Dec 20, 2010
• ISBN: 9780986808708

Sandra Susan Friedman

SANDRA FRIEDMAN'S PROGRAMS TO HELP GUIDE GIRLS AND BOYS SAFELY THROUGH ADOLESCENCE. Sandra Susan Friedman is an educator, therapist and consultant in eating disorder prevention and intervention. Her facilitated group-discussion programs Just for Girls and Just for Boys are in use throughout Canada and the United States and have become the prototypes for a variety of other programs that address health risks and social dilemmas facing girls and boys as they mature. When Girls Feel Fat: Helping Girls through Adolescence provides girls and their parents with valuable information concerning the transition through adolescence. Nurturing girlpower: Integrating Eating Disorder Prevention/Intervention Skills into Your Practice evolved from professional training workshops on eating disorder prevention and intervention that Sandra developed and facilitated over a two year period in rural communities throughout northern British Columbia. Body Thieves: Help Girls Reclaim their Natural Bodies and Become Physically Active examines topics concerning girls in adolescence relating to body image issues and physical activity. It details how to encourage healthy self expression at a time when girls’ voices are in danger of becoming silenced, how to get girls off diets, how to normalize food, how to fight back against the tyranny of appearance, how to translate fat talk and how to defuse the propaganda of the media.

Book preview

Sandra Friedman's work provides an accessible, sensible way in which to understand the fears and frustrations of young women, and how to work with them toward a society in which individuals are valued for who and what they are, rather than how they appear. Ms Friedman encourages each of us to address our beliefs and prejudices in ways that bring relief and comfort, as we develop a deeper understanding of what it means to be female in North American culture. Her ability to integrate theory and practice in ways which are readily understandable encourages us to see the challenges of living in an image obsessed culture as opportunities for growth.

Merryl Bear, Executive Director

National Eating Disorders Information Centre

Toronto, Canada

As a counselor, I found Sandra's book to be an invaluable source of practical information for working with girls who experience disordered eating/and eating disorders. Sandra writes from a place of really understanding the world of adolescent girls. Her suggestions for how to build the kind of counseling relationships where girls can feel safe and understood have been indispensable in my work with clients.

Meris Williams, MA

Vancouver, British Columbia

NURTURING GIRLPOWER

Integrating eating disorder prevention/intervention skills into your practice.

by Sandra Susan Friedman, BA, BSW, MA

Published by Salal Books at Smashwords

ebook ISBN# 978-0-9868087-0-8

© 2000, 2003, 2010 Salal Communications Ltd.

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

First ebook edition: December 2010

Chapter: INTRODUCTION

It is difficult to grow up female today without ever worrying about weight, putting yourself down, dieting or experiencing some form of disordered eating. Eating disorders are a major chronic health risk to girls. Not only are incidents of eating disorders on the rise but the age of onset continues to be lower affecting not only adolescent but also pre-adolescent girls. Incidents of eating disorders are also increasing in boys.

The dramatic increase in eating disorders are a result of the same environmental and social factors that also make girls vulnerable to other risks that stem from a loss of girlpower — depression, smoking, teen pregnancy and sexually transmitted diseases.

Girls with girlpower...

Can express their feelings constructively.

Are able to set boundaries.

Have healthy connections with others.

Have good communication skills and are able to handle conflict.

Develop their self-esteem in areas other than looking good.

Have a strong sense of self.

Can feel good about their bodies whatever size or shape they are.

Are physically active.

Have a healthy relationship with food.

NURTURING GIRLPOWER is based upon the belief that disordered eating, eating disorders, and certain other health and social risks are coping mechanisms that girls develop in order to deal with feelings and situations for which they have no other means of expression—with the challenges of adolescence and the changes in their bodies and the transitional periods in their lives. Prevention is about promoting and sustaining healthy development or nurturing girlpower. Intervention means stopping the behaviours girls experiment with before they develop into eating disorders or restoring girlpower that is in danger of being lost.

NURTURING GIRLPOWER: Integrating eating disorder prevention and intervention skills into your practice evolved out of my participation in Eating Disorders Project North during 1999-2000. The project built capacity in rural and remote communities in northern British Columbia so people there could address prevention, intervention, psychological treatment and medical diagnosis and management at the local level. My role was to develop and facilitate three-day workshops on prevention and on intervention. The project and the original manual drew upon the professional skills I developed during my lifetime practice as a teacher; a psychotherapist working with girls and women with eating disorders (and with issues around food and weight); a program developer; a facilitator of professional training and as an author.

In 1992 I developed JUST FOR GIRLS, a group discussion program that made girls aware of their grungies—a term coined to describe feeling fat and other aspects of their negative voice. It encouraged them to tell the real stories that lay underneath their behaviour and taught them healthy self-expression instead of self-repression.

My book WHEN GIRLS FEEL FAT: Helping Girls Through Adolescence (1997, 2000) was originally written for mothers and other mentors who wanted information and skills for their own use, and it continues to be popular with an unexpected audience—the girls themselves. BODY THIEVES: Help Girls Become Physically Active and Reclaim Their Natural Bodies (2002) addresses the increase in obesity in our society and the war on fat, eating disorder prevention, and how to get girls physically active. In 2007 I developed JUST FOR BOYS a group activity/discussion program to help boys develop resilience and learn skills to deal with the stressors and health risks of adolescence. With the exception of WHEN GIRLS FEEL FAT, all of these publications are available as ebooks.

In 2003 I revised the NURTURING GIRLPOWER manual in order to integrate my further experiences and additional learning. Because most of the participants in my professional training workshops are women and it is mainly girls who develop eating disorders, this manual is women-centered. It models the relational and contextual way in which many girls and women learn and reflects how I hope that we will, in turn, work with girls.

The information and skills are linked with practical applications, and it includes little tests you can try out by yourself and then use with girls, and various learning activities. The manual can be used by men who want to expand their knowledge of female culture and try out new ways of working with girls. I have included some information about boys, but if you are interested in working with boys you will benefit more from my JUST FOR BOYS program and manual.

The material in this manual is structured for cumulative, incremental learning. That means there is an underlying logic and there will be a certain amount of repetition of concepts. It begins with a theoretical framework that is based on gender and development to help you understand what happens to girls (and boys) as they grow, and the effects of societal pressures on them.

Section 2 provides you with basic information about eating disorders including eating disorders in boys and men including compulsive exercise and muscle dysmorphia. Section 3 presents a comprehensive framework for addressing eating disorder prevention. Section 4 helps you implement basic elements of prevention in your individual practice, provides you with check lists to assess eating disorder prevention in your schools, helps you create a body-friendly environment in your schools and community, and helps you develop and evaluate community strategies and build teams of local practitioners.

Once you have the background and a firm understanding of prevention, Section 5 provides you with information, skills and strategies to address the particular issues that arise from the physical changes in girls’ bodies and the issues that arise from the behavioural changes in their lives. These include decoding the language of fat by teaching girls about the grungies (their negative voice) and body image and body awareness, teaching communication skills, exploring myths and the prejudice around fat, empowering girls who are fat, getting girls physically active, the effects of dieting, dealing with stress, teaching media literacy and activism, and addressing bullying. Much of the material presented in this section can also be adapted for intervention and for use with boys.

Section 6 helps you apply prevention skills to classroom lessons, teachable moments and presentations to elementary, middle and secondary school girls. It describes how to organize and structure a Girls’ Day and provides basic information about groups.

NURTURING GIRLPOWER then moves to incorporate intervention. Section 7 helps you demystify eating disorders by breaking down the dynamics and behaviours into small components, so that you can relate to the girl instead of her disorder. It helps you understand how eating disorders develop within a social context as well as within the more intimate context of the realities of girls’ lives and experiences. It presents the Golden Rule of Counselling as well as basic counselling skills.

NURTURING GIRLPOWER is designed for use by women (and interested men) coming from diverse orientations and differing levels of experience. You don’t need four PhDs to practice eating disorder prevention and intervention. You will find that you are dealing with material that you can already relate to, and working with girls with whom you already have some connection.

What you need is a lot of personal curiosity, the ability to listen to the voices of girls, the ability to share yourself and a willingness to try out different approaches to things. As one participant in the Eating Disorders Project North workshops taught us, practice doesn’t make perfect—it makes improvement. A sense of humour also helps!

TABLE OF CONTENTS

INTRODUCTION

BUILDING THE FRAMEWORK

Gender and Development

The Story of GRIT—the Prototypical Boy

The Story of RICA—the Prototypical Girl

[Stressors in Adolescence] - chart

Putting Gender Development Knowledge into Practice

EATING DISORDERS

[Progression of Disordered Eating/Eating Disorders]

Developing an Eating Disorder

Anorexia Nervosa

Bulimia Nervosa

Binge Eating Disorder (Compulsive Overeating)

Compulsive Exercising (Obligatory Exercise)

Eating Disorders in Males

Muscle Dysmorphia (Bigarexia)

PREVENTION

[Girls with girlpower]

[Risk Factors]

Prevention Sets in Place Protective Factors through K.I.S.S.

[Major Components of Prevention]

Body Issues

Life/Self Issues

IMPLEMENTING PREVENTION STRATEGIES

Addressing Prevention Individually

[Schmoozing]

Implementing Prevention in Our Schools

The Collaborative Model of Prevention

Implementing Prevention in the Community

Developing a Community-based Model of Prevention

ACQUIRING PREVENTION SKILLS

grungies–When Girls Feel Fat

[Grungies]

DEAD FLOWER CEREMONY

Building Communication Skills

Our Bodies

Dieting Myths

When Girls are Fat

Physical Activity

Media

Stress

Bullying

APPLYING PREVENTION SKILLS & STRATEGIES

[The GOLDEN RULES OF PREVENTION]

Sample Presentations on the Grungies

Teaching Sense-of-Self

Holding a Girls Day

Facilitating Groups

INTERVENTION

[The GOLDEN RULE OF COUNSELLING]

[Early Warning Signs of Disordered Eating]

Applying Counselling Skills

THE LAST WORD...ACKNOWLEDGMENTS

BIBLIOGRAPHY

RESOURCES by subject

Chapter: BUILDING THE FRAMEWORK

It is impossible to grow up female today without ever worrying about weight or feeling fat. Dieting and ‘healthy eating’ often in the form of food restriction have become the national pastime as little girls watch their mothers and copy what they do. Six and seven year old girls express concern with how they look. Nine year old girls talk about wanting to be thinner even before their bodies have begun to undergo the changes of puberty. Fat prejudice is at an all time high. Eating disorders are acknowledged as a major health risk to girls and they are beginning to affect boys.

In order to prevent eating disorders and to intervene with girls who have begun to experiment with the behaviours, we need to know what happens to them in the process of growing up that silences their voices and places so much of their self-esteem and self worth on how they look. We need to know what happens to boys that makes them want to bulk up or to reduce their body size in order to feel strong in their lives. We need to understand society and the role that it plays in shaping who we are. The framework that provides the foundation for our understanding and upon which this book is built is that of gender, brain sex and development.

GENDER AND DEVELOPMENT

Sex refers to the biological differences between males and females including anatomy such as body size and conformation, and physiology such as hormonal activity and organ functioning. Gender refers to the array of socially constructed roles and relationships, personality traits, attitudes, behaviours, values, and relative power that society ascribes to the two different sexes. Gender teaches us how to act and behave separately as girls and boys and later as women and men. In fact, as girls and boys grow up they inhabit two different gender cultures using different languages and with different ways of interpreting and responding to the world.

As you begin to read this section on gender and development please keep in mind that I am describing averages. If you or someone that you know doesn’t fit the descriptions it may be because while we share many characteristics that are common to our specific gender as individuals we also occupy varying places on the continuum of human behaviour.

Differences Begin in the Womb

For the first six or seven weeks after conception all fetuses develop along female lines and appear the same. Then chemical messengers in the form of sex hormones (steroids called androgens and estrogens) ensure the designated genetic programs are carried out. A fetus that is destined to be female develops cells that produce and bath it in estrogen. By the thirteenth week of gestation gonads appear in the form of ovaries. These produce tiny amounts of testosterone that influence the development of the female brain. In fetuses that are genetically male the male androgen testosterone stimulates the development of male genitalia. Testosterone interacts with the nerve cells (neurons) that make up the brain and stimulates dramatic changes that alter the brain from one that is female into one that is distinctly male. It is estimated that twenty per cent of girls have boy brains and vice versa. Regardless of the sex of the fetus, the more testosterone that bathes the brain at this time, the more that adult will exhibit male behaviour. The lesser the amount of testosterone the brain receives, the more feminine the behaviour will be.

Basic differences in brain structure account for many of the differences in behaviour in boys and girls. These differences become evident shortly after birth and are most pronounced until the age of 8, by which time the gender gap begins to close. Girls show a tendency to be interested in people and communication, while boys tend to be interested in dynamic activity and in inert objects. Studies of babies 2-4 days old show that girls pay attention longer when adults are speaking and spend almost twice as long maintaining eye contact. While girls lose interest when the connection is broken, boys are equally happy to jabber away at toys and look at abstract geometric designs. The female brain responds more intensely to emotion. Feelings, especially sadness, activate neurons in an area eight times larger in the female brain than in the male. Even before they can understand language, girls seem to be better at identifying the emotional content of speech. As girls grow older they can detect the emotions of others more accurately than boys can. Because the male brain is specially designed for logical problem-solving, it can often take boys up to seven hours longer to process emotional data.

Boys tend to be interested in dynamic activity and in objects. Male babies will continue to jabber away at toys long after the adult has ended the contact. Boys are more active and wakeful than girls, more sensitive to bright light and focus more on depth perception and perspective than on the wider picture. Because the male brain is more compartmentalized than the female brain boys can focus more intensely on doing one thing well. They are task-oriented because their brain turns on and off between tasks. Their attention span and motor activity are shorter than those of girls but are made up of more intensely active periods. They have better hand-eye coordination and better spatial relations.

It is important to remember neither brain structure is superior to the other. Nor are girls and boys restricted in what they can do. Because different parts of the brain grow at different times and at different rates, girls and boys acquire certain skills at different times. As well, the ways they learn to perform these skills are different and are influenced by their environment and the society in which we live.

THE STORY OF GRIT—THE PROTOTYPICAL BOY

I have named the prototypic boy GRIT because he is Goal-oriented (or task-oriented), Rational, Independent and Tough. In order to understand how he became that way, we need to understand male psychological development, male gender culture and the influence of society on his behaviour.

Many psychological theories of development tend to see male development as occurring in progressive stages. They believe boys must separate from their mothers in order to develop a male identity that is based upon becoming independent and standing on their own two feet. (There is much debate today about the necessity of making this separation at a very early age because of the psychological cost to boys.) Psychological theories also hold that boys develop their sense-of-self based upon their individual accomplishments and how well they perform in the world.

Recent literature about boys describe them as growing up with tremendous energy and exuberance, a willingness to venture into the unknown, to take action, and a need to test their limits. Boys tend to play in groups where they can exercise their need for physical activity and for controlling their territory. Team sports teach them about winning and losing and being on top. Boys are able to deal with and depersonalize conflict better than girls. When boys enter into new situations they measure themselves in terms of their sense of adequacy and where they fit in. Loyalty and fairness play a big part in boys’ friendships. They support each other by diffusing emotional intensity and cheering each other up. Boys feel most comfortable with interpersonal communication when it takes place in the context of an activity or when boys are side-by-side, rather than face-to-face. Boys tend to solve problems on their own rather than make themselves vulnerable by talking to someone else.

The Impact of Society on Male Development

As infants, boys are more emotionally expressive, more sensitive and cry more easily than girls. By the time that boys are around five years old, they are pressured to close down the relational half of their emotional range. Being male is defined as oppositional to traditional female qualities—as not being female. While it is all right to be a ‘Daddy’s girl’, ‘Mama’s boys’ are sissies. Society prepares boys to become men by ‘toughening them up’ and disciplining them through the use of shame. Boys are expected to measure up to other boys, to show that they are ‘real’ boys—and real boys don’t cry.

The Trauma of Adolescence

Boys experience immense pressure to conform to a rigid ideal of masculinity that is action-oriented and focuses on physical prowess and achievement in external, measurable activities. Because boys are encouraged to repress all of their feelings except for anger and rage, they learn to detach from their own experiences and to ignore or ‘suck up’ fear and pain. Boys who are ‘cool’ keep their feelings of hurt and anxiety and inadequacy bottled up inside. They act tough, hide their empathy, and laugh their feels off.

Adolescent boys enforce the code of masculinity on one another through a culture of cruelty. Boys who don’t measure up are bullied by their peers and are called fag, wuss and ‘girl.’ The code of masculinity prevents boys who are going through puberty from sharing their fears and concerns over their changing bodies and the numerous hormonal surges they experience. Lacking adequate information many boys feel these changes are not normal and they