Seven Flew Over the Cuckoo's Nest

Unless you're an opera singer (or Beyonce), Bryan doesn't think the title of "Diva" is applicable (sorry, Shay).

What do you get when you take a group of seven fatties and make them go without sugar for two weeks? Total madness. Today at the gym the s*#% hit the fan (Never really understood that expression - why would anyone throw poop at a fan? Unless you have a poo fetish, but even then, it seems incredibly wasteful - not to mention terribly messy). Where was I, oh right - I think the lack of junk food combined with the hard workouts are starting to make everyone go a little bit batty. 

It all started when Doc Warner and Nurse Ramsay entered the gym with a prescription for tears and pain. I don't know what happened after I left those two alone at dinner the other night, but now they are completely enraged and taking it out on the group. You see, there are a few of us that are in this program who are giving it our all because we truly want to make a change and are grateful for this experience, but there are others who seem to lack motivation and discipline. Nikki, for example, was extremely late for today's workout because she had "food poisoning" from the night before…which is what happens when you drink an entire bag of fermented potatoes…I mean eat. 

Then there is Shay who has been driving down Lazy Lane most of her life and now has somehow managed to take a right turn on Delusional Drive thinking that she is a "DIVA." Seriously? Let me break something down - The word diva is derived from the Italian noun, diva - a female deity. The word entered the English language in the 19th century and is used to describe a woman of outstanding talent in the world of opera, and by extension theatre, cinema, and popular music. Now unless someone knows something I don't, I'm pretty sure that Shay is not planning on dropping a single anytime soon - hence why she cannot be called a diva. Titles have to be earned. You think that Ben Kingsley and Judy Dench just crowned themselves with the titles Sir and Dame, because they just happened to have some free time on a Sunday afternoon in July? No silly, a Queen gave them that title. And I'm here to say, this Queen has no intention of crowning Shay a diva - she needs to give that act a rest. 

And speaking of "acts" next up to the stage is Stacy. I'm proud to see that Stacy has begun her campaign for an Oscar nomination for outstanding dramatic actress at the gym. So far, she has a really good shot at winning, sorry Meryl. 

Needless to say the tension in the gym after our workout was intense. Our homework was to figure out a way to lean, rely, and learn from one and other over the next several weeks. Jackie suggested that we have a healthy potluck dinner and hash out our differences. Anyone have a gun? I had a feeling that evening was going to end like The Poseidon Adventure. Seven strangers trapped trying to figure out the best way to escape. PS - "Not it" to play Shelly Winters. 

Mandy decided to have us to her house and cooked an amazing healthy meal, only to be overshadowed by Jeana showing up with her own "chef." Really? Who brings a chef to someone else's dinner party? And if you're going to be that gauche, it might behoove you to bring someone that actually went to culinary school. I'm not saying you need to resuscitate Julia Childs and prop her up with a frying pan, but at least bring someone familiar with fresh produce. Jeana brought Allan. Really? Now I am sure he is a lovely man, he seems incredibly nice, kind and hard working, however serving spaghetti sauce out of a jar for a dinner party is a tell tale sign that he has no concept of the culinary arts. Chef Boyardee had a better game plan. I mean seriously...While we're tossing out make believe titles how about this one: "Snookie, congratulations you're now the CEO of Goldman Sachs and while I'm at it, what the hell, you're also a diva." I mean, seriously has the world gone completely mad? 

Now let's get to the actual dinner and the confrontations. Well, as to be expected Shay and Joe went head to head - one would have to be blind as a bat to have not seen that coming. I know what I am about to say might be slightly controversial, but I'm siding with Joe on this one. If Shay had acted like an adult at the table instead of an annoying, condescending and disrespectful child, I may have had her back, but she was acting as though the world revolved around her. I'd like to chalk it up to age, but I have met 12 year olds that have more maturity then that. It was frustrating to say the least. The one I was most proud of that night was Stacy. She was at least able to understand my point and acknowledge my frustrations. I appreciated the fact that she at least had Jackie's balls to listen to my grievances and process them. All in all dinner was awkward, but Mandy was a delightful host. Is it me or is Mandy the only sane one in this pack of lunatics? 

Rose Bowl workout was a serious ass whopper. Not sure if I will ever walk again, but I was incredibly impressed with the fact that the last two standing were Shay and Joe. I think something may have resonated with Shay from that dinner, because she really brought her "A" game and busted her ass. Maybe there is hope for her after all, however she is still YEARS away from that diva crown. 

After the workout, we decided to invite Stacy to dinner. Clearly, Nikki, Joe, and I all suffer from "Catty Mad Cow" disease. That being said, I would like to set the records straight about dinner with Stacy. Yes, we were being catty and at times somewhat mean, but it was all done in humor and fun. Maybe some of the things Nikki and Joe were saying were downright shocking and cruel - but if for one second I had the impression that Stacy was upset or about to cry or took anything we were saying seriously - I promise you that I would have put a stop to it right there and then. But Stacy was laughing right along with us. She is a comedian after all. She knows how to take a joke. I like to think of that dinner as an homage to the roasts of Dean Martin or Pam Anderson, take your pick. It was like being heckled from the crowd, and I think it did some good for Stacy. I think that if you don't have thick skin (no pun intended) and can't make fun of yourself - exit stage left IMMEDIATLEY. The world of stand up is BRUTAL. Stacy took it like a champ. It was actually a fun night and it was nice to get to hang with Stacy and hear all about her P.C.O.S. It also made me thankful to have a penis.

Therapy and Weigh In this week was very insightful. I know for me, self-deprecation is the easiest way to deflect when you are overweight, beating others to the punch, etc. It's much easier to make fun of the elephant in the room (literally) especially if that elephant is you. I think that is true for most overweight people. It's been a survival tool for many of us. Nikki is one of the most self-deprecating people I have ever met (next to me of course) and it was incredibly powerful to catch a glimpse of that hurt child inside of her during therapy. It really humanized her. I felt like it was the only time that I saw an actual person instead of all the affectations that she constantly displays. 

I was also really able to relate to Joe's childhood – I too came from a broken home and had little time with my father. While Joe had the pleasure of sharing burgers with his dad in a nice park, I had the pleasure of growing up watching my father get hammered at the local neighborhood bar. 

At the end of the day, my heart really broke for Jeana when she started to open up. Jeana is a beautiful woman, with a kind heart, but she is NEVER truly present in therapy and I have no idea of who she is. There seems to be this constant need for her to want a man in her life and for that man to have money. It just seems so shallow. I mean yes, whomever you date should have a job, but there is so much more to a relationship. Like someone treating you with kindness and respect and love. Material things cannot make you happy. It is clear to me that Jeana has a giant heart and knows how to show love to everyone around her, yet she doesn't know how to turn that love inward towards herself. I think in some way we all share that issue, or else we all wouldn't be sitting in this room. Her story really resonated with me the most. You cannot love someone fully, until you love yourself.

So what have I actually learned this week? 1) I have to push myself to intensity and fatigue to get a good burn. 2) Diva is a four-letter word but is NOT spelled S.H.A.Y. 3) Never bring your "Chef" and "Driver" to someone else's dinner party and if you do- please do me the favor and introduce him as your "Cheriver". 4) If someone asks you to not interrupt them while they are speaking, don't interrupt them…unless of course you are a diva and can hit a high C-. Then by all means, sing away like a canary. 5) Running the bleachers at the Rose Bowl made me limp for several days and fall in love with Vicodin. 6) If you can survive dinner with three "catty mad cows" then welcome to the club. 7) Never talk to a child like Stacy's grandma did or it will leave you in a pool of Stacy's tears. 8) Most importantly and all jokes aside - I need to learn how to truly love my inner child. Sounds kind of corny and hokey, but it was an incredibly powerful lesson. Jackie and Dr. Ramani were right, I would never tell a child they were ugly or fat or not worthy. So the key right now is to really learn how to love myself. And take care of myself. Put myself first for a change. It's the only way to begin the process of healing and setting myself free of all the bs baggage that I carry around, physically and mentally. 

I am immensely grateful for these tools, and they have really made me rethink how I perceive the world and those around me. The only way I can create change in myself is to really focus and push through the pain. I have to stop beating myself up for all the mistakes that I have made in the past and figure out a way to nurture that little boy inside. And to know that I am not alone in this group is extremely helpful. We may all come from different backgrounds: race, creed, age, gender - but we all share the same issue of not fully loving ourselves and putting our needs first. Well, here's to a new beginning and may the healing begin for all of us.

Goodbye and Good Luck!

Dr. Ramani shares her final wishes for the group.


It's time to say goodbye, or as we call it in therapy, "termination." 

As a psychologist, this has been therapy fantasy camp. All psychologists are voyeurs. Under normal circumstances, when you do therapy, you see the world through the client's eyes. You construct images of their partners, homes, parents, friends on the basis of their descriptions, and you almost never get a chance to see the reality. For me to have conducted group therapy, and then after we were done to go back via television and see their husbands, families, and homes has been a sort of secret dream come true –- to see if my "construction" matched the reality.  Thanks, Bravo! This is and will remain one of the most compelling clinical experiences of my career. 

I was on the fence about whether I would be able to do clinical work of any depth under lights and with cameras rolling. Time limits meant you didn't see most of the therapy, which is where these clients did heavy lifting and sweating of a different sort. They learned about why they eat what they eat, when they eat, how they eat, and where they eat. They unearthed old demons, and learned about respecting others and themselves. They learned how to talk about their feelings instead of numbing them. They were called on their BS and made to take ownership. If they sustain these weight changes, it will be because they were willing to do it from the inside out.

Shay revealed that her struggles with weight were more complex than initially thought. There is a frequently held misassumption that ethnic minority women don't get eating disorders. That is patently wrong, and the rates of eating disorders in African American, Latina, and Asian American women are on the rise. Laxative abuse can be done secretly, and many who do it report that the feeling of "emptiness," the "flat stomach," and the sense of "clearing out" following laxative use is gratifying despite being dangerous. They erroneously believe they can eat what they want and then get rid of it. Shay showed us that the psychology of weight goes well beyond ab crunches and protein shakes. These are VERY difficult and complex issues. Her revelation was courageous, and it will take time for her to make these changes.

As we sign off, let's review what we learned about weight loss. It's about respecting your body with healthy food instead of punishing it with junk. It's about pushing your body to new limits, and then finding out you can push your life to new limits. It's about realizing that your history may tell you why you eat what you do, but it doesn't own you, and everyone has the capacity to make these changes. It's about realizing that food is not a substitute for love. It's about accepting yourself, and engaging in the process of weight loss authentically. 

When I end with a client, as they leave the room, I wish a silent wish for them. They have done the ultimate bravery by allowing me into the most private rooms in their hearts and minds, and I am always grateful to have been part of their journeys. 

Here are my wishes for them:

Mandy –- May you stay healthy and be an active part of your family's life. Mothering is about taking care of yourself. I can already see you hiking with the grandchildren that will grace your life someday.

Bryan –- May you stay on the authentic loving path you have been following all your life, despite stumbling a few times. You brought breathtaking commitment to the program, and I hope that you see yourself in the loving and beautiful mirrors offered by the husband, friends, and family around you.

Joe –- Now that you are respecting yourself and others, I hope it leads you to a respectful relationship with a woman. Keep taking care of yourself and learn that a vocabulary of respect, not abs or bad bar banter, will indeed get you the best chick in the bar.

Shay –- You saved your most courageous song for the end, and I wish for you to keep dancing and enjoying your youth and your body. You are stronger than you think, and when you reflect on being there for your mom, and now being there for yourself, realize that you can do this on your own.

Jeana -– I want you to stay in touch with your feelings. Your vulnerability sits right under the surface, and as you trust your feelings and learn to express them, I hope they are met with respect and warmth from those around you. 

Nikki –- You get it even when you pretend you don't. I wish for you to stay "fabulous" without the snarkiness and the cocktails, you don't need them. Dig deeper and see what you find. 

Stacy -– I hope you keep laughing and keep others laughing and stop laughing at yourself. You had the biggest odds against you, and you never said die. I wish for you to persist, no matter what is put in front of you. 

So as we say goodbye, I thank Bravo and Jackie Warner for the opportunity to sit alongside you and for your recognition that psychotherapy is as integral to weight loss as diet or exercise. 

We all have inside of us a warrior, a leader, and a vulnerable child. Nurture them all.