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The
Mindfulness & Acceptance
Workbook for Bulimia
A Guide to Breaking Free from Bulimia

Using Acceptance & Commitment Therapy
EMILY K. SANDOZ, PhD

KELLY G. WILSON, PhD • TROY DUFRENE
New Harbinger Publications, Inc.

Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is
sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional
services. If expert assistance or counseling is needed, the services of a competent professional should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2011 by E
mily K. Sandoz, Kelly G. Wilson, and Troy DuFrene
New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup

Acquired by Catharine Meyers
Edited by Heather Garnos
All Rights Reserved
Printed in the United States of America

Library of Congress Cataloging-in-Publication Data
Sandoz, Emily K.
The mindfulness and acceptance workbook for bulimia : a guide to breaking free from bulimia using acceptance
and commitment therapy / Emily K. Sandoz, Kelly G. Wilson, and Troy DuFrene.
p. cm.
Includes bibliographical references.
ISBN 978-1-57224-735-2 (pbk.) -- ISBN 978-1-57224-739-0 (pdf ebook)
1. Bulimia--Treatment--Problems, exercises, etc. 2. Bulimia--Psychological aspects--Problems, exercises, etc. 3.
Acceptance and commitment therapy--Problems, exercises, etc. I. Wilson, Kelly G. II. DuFrene, Troy, 1972- III.
Title.
RC552.B84S26 2011
616.85’263--dc22
2011007126
13 12 11
10 9 8 7 6 5 4 3 2 1
First printing
Contents
A Letter from the Series Editor v

INTRODUCTION Finding Hope 1
Exercise: Math Problems and Sunsets 3
CHAPTER 1 ome Things You Should Know About How We Eat
S
and How We See Ourselves 11
Practice: Reflecting on Binge Eating (Guided Meditation) 12
Practice: Reflecting on Compensatory Behaviors (Guided Meditation) 14
Practice: Reflecting on Body Image (Guided Meditation) 15
Practice: Sitting with Suffering 21
CHAPTER 2 A Different Way of Doing Things 29
Practice: Sweet Spot (Guided Meditation) 34
Practice: Picking Purpose 35
CHAPTER 3 Right Here, Right Now: Learning to Be 41
Practice: Noticing Being Present (Guided Practice) 43
Valued Practice 47
Practice: Finding Your Breath (Guided Meditation) 49
Practice: Touching the Now (Guided Meditation) 50
Valued Practice 53
The Mindfulness & Acceptance Workbook for Bulimia
CHAPTER 4 Where It All Takes Place: Noticing Self-as-Context 57

Practice: I Am/I Am Not (Guided Meditation and Practice) 59
Practice: Pull-Marking (Guided Practice) 63
Valued Practice 66
Practice: Noticing You Noticing (Guided Meditation) 69
Valued Practice 71
CHAPTER 5 A Great Big World: Looking Past Your Thoughts 73
Practice: Noticing Thoughts (Guided Meditation) 76
Practice: Thoughts on Parade (Guided Meditation) 78
Valued Practice 79
Valued Practice (Guided Meditation) 81
Practice: Lost in Sensation 83
Practice: Defusion Theatre 83
Practice: Go Public 84
Valued Practice 87
CHAPTER 6 Embracing Experience: Learning Acceptance 89
Practice: Listening for the “No” (Guided Meditation) 91
Practice: Not That Guy Again 93
Valued Practice 95
Practice: Noticing Avoidant Eating 97
Practice: Letting Go of “No” 100
Valued Practice 102
CHAPTER 7 etting Flexible: Finding Opportunities for Valued
G
Living in Everyday Life 107
Valued Practice (Guided Meditation) 111
CHAPTER 8 One Step at a Time: Choosing Committed Action 125
Practice: Baby Steps, Giant Leaps (Guided Practice) 126
Practice: Wondering, Hoping, and Dreaming 129
References 135
iv
Dear reader,
Welcome to New Harbinger Publications. New Harbinger is dedicated to publishing books based on
acceptance and commitment therapy (ACT) and its application to specific areas. New Harbinger has
a long-standing reputation as a publisher of quality, well-researched books for general and professional
audiences.
As part of New Harbinger’s commitment to publishing books based on sound, scientific, clini-
cal research, we oversee all prospective books for the Acceptance and Commitment Therapy Series.
Serving as series editors, we comment on proposals and offer guidance as needed, and use a gentle hand
in making suggestions regarding the content, depth, and scope of each book.
Books in the Acceptance and Commitment Therapy Series:
Have an adequate database, appropriate to the strength of the claims being made.
Are theoretically coherent. They will fit with the ACT model and underlying behavioral
principles as they have evolved at the time of writing.
Orient the reader toward unresolved empirical issues.

Do not overlap needlessly with existing volumes.
Avoid jargon and unnecessary entanglement with proprietary methods, leaving ACT
work open and available.
Keep the focus always on what is good for the reader.

Support the further development of the field.
Provide information in a way that is of practical use to readers.
These guidelines reflect the values of the broader ACT community. You’ll see all of them packed
into this book. This series is meant to offer professionals information that can truly be helpful, and
to further our ability to alleviate human suffering by inviting creative practitioners into the process of
developing, applying, and refining a better approach. This book provides another such invitation.
Sincerely,
Steven C. Hayes, Ph.D., Georg H. Eifert, Ph.D., John Forsyth, Ph.D., and Robyn Walser, Ph.D.
I N T RODUC T ION
Finding Hope
I f you think about life as a series of shifts, there are some that seem to be common to people’s experi-
ence, regardless of who they are, where they come from, or what they’re working toward. For one,
at certain times in our lives, we find ourselves stuck. We run up against something difficult—failure,
mistreatment, loss, trauma—and it stays with us. It creeps into our thoughts and grabs our attention.
Without even realizing it’s happening, we start to see our world differently. It seems more threatening,
emptier. Without ever choosing to do so, we start to live our lives differently: we make them smaller,
safer, more rigid. And one day we look around and notice that we’re struggling way too hard and
somehow not moving toward anything that really matters to us. We find ourselves stuck, often with
no idea how to break free.
There are other moments in our lives when we give up the struggle. We let that sense of how stuck
we’ve become fill us up. We go still. Truly extraordinary things can happen in those moments when
we give ourselves permission to be where we are, even if only for a moment. Often it’s only by letting
ourselves really be stuck that we’re able to see the possibility of breaking free.
This book is about the way you’ve become stuck in certain patterns of eating and about how you
can break free. Let’s start by considering where you find yourself right now.
LOOKING KINDLY AT YOUR STRUGGLE

Let’s assume that you aren’t reading this book by accident. If you’ve taken a look at the cover, you know
it’s not the kind of book you’d choose to pass the time while waiting for a plane. Chances are you bought
this book, picked it up, or were given it because one of the places you get stuck is in your relationship
with eating and the way you experience your body. Maybe a doctor has told you that you “have” bulimia
nervosa. Maybe someone’s referred to you as “a bulimic.” Maybe you’ve just noticed that the people
around you don’t seem to agonize over their weight or their food like you do. Maybe you’ve tried to get
over these problems, to just stop thinking about how you look or what you eat, and eat like a “normal
person.” Maybe you’ve got a sense that you’d better get over these struggles pretty soon—or else.
If the book in your hand were a typical psychology self-help book, we’d start by describing the
symptoms of bulimia. We’d explain how it’s different from “normal” eating and guess at how it got
that way. After that, we’d tell you about different skills you could learn and practice to manage your
eating better. We might advise eating moderate portions at regular intervals and give you tips on how
to manage urges to overeat. We might instruct you to use relaxation exercises or self-talk or affirma-
tions to relieve some of the stress you’ve been carrying. We’d offer this to try or that to try, all with the
intention of helping you solve your problem with eating.
We feel that we should warn you now: This is not that book. As we go, we’ll tell you a little about
what mental health providers mean when they say “bulimia.” And we’ll tell you a little about how we
think people get stuck. But when we get to the part on what to do about it, we’re going to take you in
a new and, we hope, better direction.
You see, most books and most doctors—most people for that matter—approach this struggle called
“bulimia” as a problem that needs solving. The thing is, in our experience, solving problems is hard
work, and it only works when the thing that’s got you stuck actually is a problem.
“Of course it’s a problem!” you might be thinking, “What else could it be?” It feels like a problem to
you. It looks like one to the people around you. It sure hurts like a problem. But is bulimia a problem
to be solved? The truth is, we don’t know. We can’t know for sure.
We would ask you this, however: Have you spent time figuring out how to quit fighting with your
body? Maybe a lot of time? Have you put energy toward finding the perfect solution to your problem
with eating? Maybe you’ve struggled to eat just enough without eating too much. Maybe you’ve tried
to hurry up and lose enough weight so you could finally let go of this struggle. Maybe it feels like if
you just struggled a little longer or a little harder or had a little more willpower, a little more time, or
a better diet, you could win this battle against your body.
Take a minute right in this moment to draw a long, deep breath and let the ways you’ve struggled
rise up inside you. We’re serious. Just stop reading and breathe for a moment. Make room for whatever
comes up. Don’t judge it; don’t try to push it back down or away. Hold whatever happens lightly and
with kindness.
Are you tired of this struggle? What has it cost you? What will you have to lose in order to let this
go? Maybe you picked up this book because you think you have an eating problem that needs solving.
Maybe you’re hoping that buried in chapter 7 will be the one solution you’ve yet to think of. We invite
you to think again about what this book might offer—this time, a little differently.
2
Finding Hope
EXERCISE: MATH PROBLEMS AND SUNSETS

At this point, you might be a little confused, and that’s okay. We’re betting that we can serve you better by
taking you someplace new than by telling you things you may have heard before. And we’ll do our best to
explain where we’re coming from. But before we get caught up in explaining, let’s spend a little time with an
exercise below.
(A note on the exercises in this book: If you are reading this book on an electronic device, it’s more than
fine to do any of the exercises we offer in an ordinary notebook. If you like, you can also download versions
of the longer worksheets at http://20145.nhpubs.com.)
PART 1
S tart by finding a pen or pencil. In this exercise, all you need to do is consider what’s in the column on
the left. Then, in the blank on the right, just write whatever comes to you. These aren’t trick questions,
we promise. It’s not a quiz either. Feel free to use a calculator if you want. Get help if you need it. Just go
through the exercise and do what comes naturally.
2 + 3 =
15 – 5 =
36 ÷ 6 =
5 × 5 =
6 + 8 =
47 – 15 =
64 ÷ 4 =
347 × 19 =
3
PART 2
T
he directions for this part are exactly the same as for the first one. Just consider what is on the left. Then,
with the blank on the right, just do whatever comes to you.
=
So what was that all about?

Well, what was on the left in part 1? In part 1, we gave you math problems. And what occurred to you
to do? Most people don’t think much about it. Maybe you didn’t bother picking up a pen, even as you started
through the exercise. You saw “2 + 3” and without even thinking about it, you thought or wrote “5” and
moved on to the next one. Maybe you carefully wrote out “5” in the blank in a dark and lovely script. Maybe
you grabbed a calculator, just to check your work. Or maybe you took one look at the numbers and the
blanks glaring at you and thought, “Not a chance.” Whatever form it took, when we gave you a math problem,
chances are that you did, or thought about doing, what most people do with a math problem—solve it. One
by one, each problem was dealt with, handled, crossed off the list, never to be messed with again. And then
you moved on.
All day, every day, you’re faced with problem after problem, demanding to be solved. You’re just waking
up, and you’ve got class in twenty minutes. The cashier rings up all your purchases and you can’t find your
wallet. Your phone is ringing from somewhere at the bottom of your bag. Your friend is really hurting, and you
don’t know how to help her. Your car has splashed into a lake, and it’s filling up with water. Looking for and
solving problems is most of what you do. It’s most of what we all do.
And it’s a good thing, too, especially if your wallet is missing. Even more especially if your car is filling up
with water. Solving that one quickly and moving on makes a real difference in your life. But problem solving
isn’t always the most useful approach. Some of the things we face just don’t act like problems, although they
might be just as distressing. And this is where the second part of the exercise comes in.
What was on the left in part 2? In part 2, we gave you a sunset. So what did you do with it? Better yet,
what would you do if we could sit you down and have you look at a real sunset? If you could just open your
eyes and there, in front of you, was the sun setting in the west, the ocean on fire, and the sky a dazzling palette
of orange, pink, and violet?
4
Finding Hope
Would you solve it? Would you draw on your knowledge of physics to explain what causes that explosion
of color in the sky? Would you get out a timetable of sunsets to figure out why, exactly, this happened when it
did? Would you try to reason about why the ocean was the way it was? The palm tree? The clouds?
We’re guessing you wouldn’t. It’s pretty obvious that sunsets are different, somehow, from math prob-
lems. They don’t need solving. They don’t need anything. And if you’re kind enough to yourself to spend some
time with one, the only thing there really is to do about a sunset is simply stand there, under a sky ablaze, and
soak it all in.
Math Problems, Sunsets, and You

So what happens when the thing you’re grappling with is the pain you feel when you look in the
mirror? Maybe you’ve tried to solve that problem by rushing, or searching, or apologizing, or comfort-
ing, or escaping. How has that worked for you? What have you tried to do in order to take that pain
away for good? Is it the case that you’ve looked in the mirror and seen a problem, a big problem with
your name on it?
When you first saw this “problem,” you probably did what humans typically do with problems.
You probably worked harder; you tried to figure it all out, to get a grip on things. In other words, you
tried to solve the problem of yourself, just like you did with those math problems. And in the process,
you might have started to feel as if you were digging yourself in a little deeper, as if you were more and
more stuck all the time.
But what if your experience of yourself wasn’t like a math problem? What if trying to solve the
“problem” of yourself makes little more sense than trying to solve a sunset? What if they just don’t
need solving? What if you don’t need solving? What if all this time, you’ve been fighting these urges,
these fears, these doubts, this pain, as if they were math problems, when all along they were just things
about you, like sunsets, that could be seen and appreciated without being fixed, solved, or gotten rid
of? What if, in a world of problems to be solved, you are a sunset? What if standing back and taking
in the experiences that rise up inside could help you find the freedom to live a richer, fuller life of your
design without anything having to be solved first?
If you’re not convinced that this might be possible, good. We don’t want to convince you. At this
point, all we want you to do is let an idea well up inside you: that you might not need to solve your
“problem” with eating before you can get to the business of living your life. See what it might feel like.
There’s nothing wrong with being skeptical.
Let’s look at this a little more closely. Imagine this book was that book that it isn’t—that book that
was all about solving your problems. Imagine that you did every exercise perfectly and learned every
skill the book had to teach. Imagine that the skills you learned from this book worked really, really well.
5
Imagine that by putting these skills into practice, you were able to rid yourself once and for all of the
fear and frustration and regret and self-doubt that have had you stuck. Imagine you were able to work
hard enough to get rid of your distress about eating and your body. Imagine setting down your pencil
upon finishing the last page of the book, closing the cover—and finding that your problems with eating
and body images were just gone.
Well. Now what are you going to do?
Seriously. Where do you go? How do you move about your world? You don’t have to write anything
down just yet or tell anybody an answer. In fact, hesitate here a minute, just beyond the question, but
just outside of the answer. Let that question sort of resonate.
If you managed to solve your problems perfectly, the question posed by the book you’re actually
holding would still remain—and the answer you come up with for this question can be nothing short
of your very life. And we think that your time and energy are much better spent answering this great
question than they would be in trying to figure out the solution to all of the problems you’re going to
face from now on. Maybe you can find the perfect solution to your struggle. Maybe you can’t. But maybe
there’s another option. Maybe you can live your life richly and purposefully without getting rid of or
solving any problem. Maybe living the answer to this great question doesn’t have to wait for anything.
Maybe you can start living right now.
SOMETHING COMPLETELY DIFFERENT

It’s probably obvious, but we firmly believe that you can, indeed, start living a meaningful and sincere
life without getting rid of bulimia first. This book is our attempt to offer you a means to do it.
We’re basing this means on a kind of psychotherapy called acceptance and commitment therapy, or
“ACT” (said as the word, “act,” rather than the letters) for short. ACT offers an approach to living a
rich life with the kinds of experiences we often call “problems,” experiences that, when we try to solve
them like problems, often leave us stuck.
ACT was developed based on the idea that experiences like the ones we often call eating disorders,
anxiety disorders, or mood disorders emerge when we try to fix our experiences of ourselves and the
world. ACT isn’t popular or inspirational psychology. It grew out of a tradition in behavioral science
called behavior analysis. As you read this, ACT is being refined and tested in studies around the world,
and psychologists are discovering new ways to make use of it. Since its development, ACT has been
effectively applied to not only the difficulties we call “disorders” but also issues like physical pain and
disability, stress and burnout, and prejudice and discrimination.
6
Finding Hope
The Purpose
ACT breaks significantly from many other kinds of therapy by not focusing on getting rid of or
reducing the symptoms of particular mental health disorders. We’ve spent some time so far hinting that
you might be better off letting go of problem solving rather than chasing some kind of new solution.
This idea is consistent with ACT as a therapy. ACT isn’t about making symptoms of eating disorders,
anxiety disorders, or mood disorders go away. Regardless of the name you might choose to give it,
ACT is about letting go of whatever you’re struggling with so you can start building a richer and more
meaningful life. That richer, more meaningful life is the ultimate purpose of ACT—and we sometimes
call this purpose valued living.
“Okay,” you might be thinking, “that all sounds great and everything, but how exactly is that going
to happen? How am I going to go from where I am now to a ‘richer, more meaningful life’?”
If you feel that thought or another like it rising up and the world squeezing down as doubt and
anxiety overcome you—stop. Now take a deep, long, slow breath. And as you exhale, notice how easy
it was for you to lurch into problem solving. It may not have even been clear to you what the problems
were that might be obstacles between you and a richer, more meaningful life—or even that there were
such problems. But your mind did what minds do: you started working on a “solution.” ACT isn’t about
solving the problem of bulimia, or the problem with you, or the problem of a meaningless life. ACT
is about living that meaningful life. Fortunately, we’ve already started to hint at how that can happen.
The Goal
ACT takes a new and different perspective on psychological health. It’s not focused on solving all
problems or even on being particularly good at problem solving. From an ACT perspective, psychologi-
cal health involves opening up to your experiences in such a way that you get to take steps toward the
things you care about, even when fear or frustration or regret is present. The idea is to become fully
aware of the experiences that get you stuck, to practice letting go of attempts to change them, shifting
the focus of your actions to the things that matter to you. In ACT this is called psychological flexibility,
and it’s just the opposite of being stuck in your struggle.
Notice the difference between the purpose (valued living) and the goal (psychological flexibility). In
ACT, there’s this idea that even psychological health is not for nothing. Being flexible is not particularly
virtuous in and of itself. The only reason flexibility matters is because being open to difficult experi-
ences means you get to keep moving through and around those experiences, no matter what kind of
thoughts, feelings, or emotions show up. Being able to keep moving means being able to keep doing the
things that matter to you. In other words, psychological flexibility is important only to the extent that
it allows for valued living. In the same way, the skills we present in this book matter only to the extent
that they allow for your valued living.
7
WHAT YOU CAN EXPECT FROM THIS BOOK

If any of this is sounding strange or confusing, good. That means you’re paying attention. You’re paying
attention well enough to notice that this approach is different—not just different from most therapies
or self-help books but different from most people’s general outlook. This is not how we’ve been taught
to look at the world—and certainly not how we’ve been taught to look at our own pain. One thing you
can expect from this book is that there will be times when this perspective and this work feel really off
to you. There will be times when you feel really confused. This is a side effect of taking a completely
different orientation on the world than that you’ve been walking around with, probably for your whole
life. Like driving or walking in a new city for the first time, this can be disorienting for a while.
As you can probably guess, we don’t have a handy remedy for this confusion. Getting around in a
strange place is disorienting even when it allows you to see new and exciting things. Playing with this
new perspective is disorienting even when it allows you to see your life—your pain and your values—
more clearly.
So when confusion threatens your moving forward in this book, when you think, “This is just too
confusing to be helpful,” call to mind the things you really care about. Go ahead and do it now.
Take a minute and call to mind something that really matters to you, something you care about
deeply but don’t always feel you’re the best at working on. Don’t skip ahead here. Stop reading long
enough to draw a full breath and visualize that person or idea you care about. Now ask yourself if it
is worth being confused if there’s a possibility that this work could move you toward that something
that really matters to you. You don’t have to answer right away. Just let the question linger for a while.
You’ve probably noticed that we keep telling you to stop and breathe to consider this or that while
drawing a couple of full breaths. We’re big advocates of breathing, of noticing breathing. Everybody
breathes, but not too many of us take the time to notice that we are doing it. When things get hectic
in your head, taking a moment to stop and notice your breath can be a powerful exercise. Stopping to
breathe with awareness and intention when you just want to get moving far away from whatever is going
on for you can be a little mini-practice in that flexibility stuff we were talking about. Notice what’s here,
let go of struggling with it, and move forward with intention. Sometimes the next right step toward
valued living is just to let ourselves fall still for a moment and to draw that next breath. So we’re going
to drop in instructions like that even in the middle of explanations of this idea or that. And if you get
anything out of those quiet moments, we’ll ask you to go ahead and add some of your own, while you’re
doing the work here in this book and while you’re living life out there in the world.
Breathing isn’t the only thing we’ll ask you to do. We’ll be the first to admit that merely reading this
text, even reading it carefully without skipping a word, is not likely to have a noticeable or long-term
effect on your life. You’ve been practicing getting stuck for years now. Probably not always with eating,
but with all kinds of struggles. Ten, fifteen, thirty years you may have spent practicing getting stuck,
learning more and more things about yourself and the world to get stuck around. And you could read
the words in this book in a week or two. Mere reading isn’t likely to make the kinds of changes in your
8
Finding Hope
life we are hoping for. We don’t offer this book to tell you about seeing and doing differently. We offer
this book as an opportunity to see and do differently.
Folks have started to do the research to see who really benefits from books like this, and they’re
finding that it’s those readers who actually try the things they read about. So breathing isn’t the only
mini-practice we’re going to introduce. This book is going to have parts that tell you about a perspec-
tive, but the more important parts are going to be the parts that ask you to experience that perspective.
This book is going to have parts that tell you about a skill, but the more important parts are going to
be the parts that ask you to practice that skill. And, regardless of our great explanation of why this is
important, don’t do any of this because we asked you to. Remember, our purpose here is your valued
living. See if you can’t really engage in these exercises, not for the sake of doing what you’re told or what
makes sense, but for the possibility that this could be the next step in living the life that matters to you.
WHO WE ARE
As we will ask you about your life, and ask you to consider the things that matter the most and hurt
the most, it makes sense to us to tell you a little more about ourselves. Kelly is a professor in the
Department of Psychology at the University of Mississippi. A coauthor of the 1999 book Acceptance
and Commitment Therapy, he has been one of the people largely responsible for developing and helping
to shape ACT into what it is today. He’s a popular trainer and speaker, traveling often to engage with
people about ACT and behavior analysis. He has a fondness for coffee, guitars, Apple products, and
the tropical parts of Mexico—the latter especially when he gets to swim in warm ocean water with his
wife and his daughters.
Emily worked with Kelly when she was completing her Ph.D. in psychology at Ole Miss. She is now
a professor in the Department of Psychology at the University of Louisiana at Lafayette. In her time at
Ole Miss, Emily wrote, provided therapy, and provided professional training under Kelly’s supervision.
She also began a program of research on body image and disordered eating that she is continuing to
build now that she’s out on her own. Emily has crazy ideas about making the world a better place for
her kids, the virtues of dancing like nobody’s looking, and the essentials of a good margarita. And she
will talk about them to just about anyone.
Troy is a writer who, mostly by chance, has become a fellow traveler with the folks in the ACT
community. He started writing psychology and self-help books in 2006 with a book titled Coping with
OCD. In 2007, Troy stumbled into an ACT workshop Kelly was conducting in Houston, Texas. Troy
actually didn’t want to go to that particular workshop, but his first choice was full. So there he was.
Emily was assisting at that workshop, and she partnered with Troy in several of the experiential exer-
cises. Troy’s chance meeting with Kelly eventually resulted in their 2008 collaboration on the book
Mindfulness for Two, which is a book specifically about present-moment-contact issues in psychotherapy.
As Kelly’s student, Emily tagged along for the ride, offering some writing and role-playing along the
9
way. After that, Kelly and Troy worked together on a book about anxiety for general readers called
Things Might Go Terribly, Horribly Wrong. And at another conference in Chicago, the three of us started
talking about this book—and its professionally focused cousin, Acceptance and Commitment Therapy
for Eating Disorders.
Those little details of where we’ve been and where we find ourselves are one way of telling you
about us. And each of them is perfectly true. Another way would be equally true: We are people who,
at one time or another, have found ourselves stuck. The conversations in Chicago that resulted in our
writing this book were not about how horribly other people struggle and how we just don’t understand
how they get there. They were about the pain we struggle with and the pain our struggles cause us. We
are people who have known the struggle and who have known letting go of the struggle. And we think
there’s something precious that comes from letting go.
The details of your life we don’t know. Where you live, how old you are, what you do for fun. In
some ways, this makes it harder for us to write the book that would be most useful to you. If we had
to guess, though (and we do), we’d guess that you are not all that different from us: That you have
found yourself stuck. That you’ve known the pain you struggle with and the pain that struggle causes
you. That, in particular, the way you eat and don’t eat and struggle with eating is just not doing it for
you anymore.
COME AS YOU ARE: AN INVITATION

And so we’d like to offer you an invitation. It’s not like an invitation to a party, where we are already
there enjoying the beverages and entertainment. It’s like an invitation to accompany us on a journey.
And this journey is pretty unique. We’re not sure exactly where it’s going to take us. We are guided by
a few ideas that are more mission goals than directions—more like “find a leaf of the red oak tree” than
“walk thirteen paces due south.” And what’s really extraordinary about this journey is not where we
find ourselves at the end of it, but how we find ourselves moving along the way. You don’t want to miss
anything, so you move slowly, taking it all in. Our wish is that the time you spend with this book will
be time in which you can rest. We don’t know what will happen a year, five years, ten years from now,
but there will be time enough to get there. The journey we are inviting you to is one that is as long or
as brief as you want it to be. You might decide to part ways with us today and chuck this book into the
garbage can on your way out the door. You might find yourself taking the ideas we present and leading
yourself places you’ve never gone and maybe never thought you could find your way to. This could be
the first day of your life’s journey.
So when you’re ready, let’s get started. Know that we feel sincerely honored by your company
through these pages.
10
CHAPTER 1
Some Things You Should

Know About How We Eat and
How We See Ourselves
A s you’ve probably noticed, the struggle we’ve talked about in this book isn’t just disordered eating.
Some folks struggle by pulling the covers up over their heads, some folks struggle by limiting the
places they go, and some folks struggle by eating a certain way. So there will be times when the things
we ask you to think about or try out are really general and would apply to most people. There are other
times when we focus on the topic of this book—a struggle some folks call “bulimia.”
WHAT IS “BULIMIA”?
You might be thinking it’s a little strange for us to have quotation marks around a diagnosis. The doctor
doesn’t sit you down in his office to tell you that you have “cancer.” He tells you the name, then he
tells you what your body is doing that’s causing you problems. Psychological problems are a little dif-
ferent, though. When we say “psychology,” we’re referring to the science of behavior. (Just to be clear:
this isn’t exactly what everyone means when they say “psychology.” But we come from a tradition of
behavioral science, and when we say “psychology,” that’s what we mean specifically.) Behavior is any-
thing a person does. People come into therapy because they keep doing things that are causing them
problems. Whether the behavior that brings them in consists of the way they’re feeling, the way they’re
thinking, or the actions they’re taking, something they’re doing just isn’t working. Our diagnoses don’t
explain what’s going on underneath the problems people show up with, they simply describe what those
problematic behaviors look like.
What Bulimia Looks Like

“Bulimia” (or “bulimia nervosa”) is a name for a particular category of problematic behaviors. When
doctors and other providers say “bulimia,” they’re referring to three main behaviors: binge eating, com-
pensatory behaviors, and body image difficulties. Now, you might have some idea of what each of these
means (or you might be thinking, “What language is this?”), but we’re going to go ahead and describe
what these terms mean to the providers who use them.
BINGE EATING
The first term, “binge eating,” means eating more food than most people would eat in a similar
situation, along with a feeling that you lack control over this eating. This is from the current technical
definition. Many have noted, however, that it doesn’t seem to be the amount of food that’s important.
A “binge” might be better defined as any time you eat what, for you, seems like an abnormal amount of
food. If you have a very rigid diet and rarely eat meats, dairy, or white bread, then eating three pieces
of pepperoni pizza might be as much of a “binge” as three whole pizzas for the person who eats pizza
regularly. Psychologists who do research on how bulimia looks and how we should best think about
these categories have suggested that the more important part may be the lack of control that comes with
a binge. It may not matter if it’s three bites of pizza, three slices, or three whole pies. If it feels like you
ate way more than you intended, it may be accurate to call it a “binge.”
PRACTICE: REFLECTING ON BINGE EATING

(GUIDED MEDITATION)
We invite you to pause for a moment now and consider what “binge eating” looks like for you. We don’t
expect this to be easy, but we do ask you not to rush through this practice or skip to the next piece. We often
do whatever we can to push difficult things like this out of our minds. We hide our behaviors from others, and
we try to forget that they happen. This is part of what keeps us stuck.
You can read through the instructions to this practice first, get a feel for them, then set the book down to
do the work. Or you can do the practice along with the first guided meditation on the CD (or the download,
12
Some Things You Should Know About How We Eat and How We See Ourselves
if you bought the e-book), titled “Reflecting on Bulimia.” Note: The audio that accompanies this book was
recorded spontaneously, and although it is similar to the text in the book, it doesn’t follow the text exactly, so
you may not want to read and listen at the same time.
Take a slow, deep breath. Close your eyes, and call to mind a specific time when you felt a real lack of
control over your eating. Maybe you were completely unaware of what was going on while you were
eating, then suddenly realized that you’d eaten way more than you intended. Call up this memory from
the moment just before you started to eat, and watch yourself. See if you can stay with the memory
long enough to let that experience rise up fully inside you. And breathe.
When you find yourself turning away from you and your experience, take a slow, deep breath and turn
back. When you find yourself rushing through the memory, trying to get it over with, take a slow, deep
breath and turn back to the beginning. Don’t you deserve to be seen, even in your weakest moments?
When you’ve settled into this specific memory, let yourself consider your pattern of “binge eating” over
time. Are there certain “forbidden” foods you tend to binge on? Are there certain situations in which
you tend to binge eat? Do you tend to binge eat in a certain place? During certain times of day? Are
you more likely to binge eat after a certain kind of experience? When you’re feeling a certain way? What
is it like for you during a binge? After?
Take a moment now and let yourself see clearly the details that seem important about what is going
on for you before, during, and after a binge. And breathe.
When you’re ready, let your eyes slowly open.
If you’re using the paper book, take a few moments and write about your reflections in the space below.
If you’re using an electronic version of the book, do the same thing in a notebook or journal.
What “binge eating” looks like for me:
We’d like to take a moment here and acknowledge how difficult recalling the details of these experiences
can be. If you took the time and energy to do this, we applaud you. Sitting with these difficult experiences will
serve you well in this work. If you left the lines above blank, we encourage you to just notice how hard it is to
even think about this. Yet here you are, seeking help. Now we invite you to take a slow, deep breath and let
those difficult thoughts and feelings pass gently as we turn to the next thing.
13
COMPENSATORY BEHAVIOR
The second term in our definition of bulimia, “compensatory behavior,” means repeatedly respond-
ing to binges by doing things to avoid weight gain. This doesn’t mean just eating less next time that
situation comes up; it means doing something specifically to compensate for the way you ate before.
Many people associate bulimia with vomiting, but this is just one example of compensatory behavior.
Some people take laxatives, exercise excessively, starve themselves, or use diet pills.
As in the last section, we invite you to take a moment to reflect on what “compensatory behaviors”
might mean for you.
PRACTICE: REFLECTING ON COMPENSATORY BEHAVIORS

(GUIDED MEDITATION)
C
all to mind the things that you might do to make up for your binge eating. Take a slow, deep breath.
Close your eyes, and call to mind a specific time when you reacted to a binge in this way.
C
all up this memory from the moment your binge ended, and watch yourself move into trying to make
up for it. See if you can stay with the memory long enough to let that experience rise up fully inside
you. And breathe.
W
hen you find yourself turning away from you and your experience, take a slow, deep breath and turn
back. When you find yourself rushing through the memory, trying to get it over with, take a slow, deep
breath and turn back to the beginning. And we ask you once more—don’t you deserve to be seen,
even in your weakest moments?
W
hen you’ve settled into this specific memory, let yourself consider your pattern of “compensatory
behavior” over time. What are the different ways that you make up for binge eating? Are there certain
situations in which you tend to react in this way? Certain times of day? How do you typically feel as
you carry this out? After?
When you’re ready, allow your eyes to gently open.
If you’re willing at this moment, write down below or in your notebook the details of what is going on for
you before, during, and after your compensatory behavior.
What “compensatory behavior” looks like for me:
14
Again, if you took the time and energy to do this, we applaud you. This is not easy work, but you’ll find
that everything we do will build on these small, brief practices. We invite you to take a deep breath and let any
difficult thoughts and feelings that you are hanging on to pass gently as we turn to the next thing.
BODY IMAGE DIFFICULTY
Binge eating and compensatory behavior often come with what we call “body image difficulties.”
This makes a lot of sense. How you feel about your body can have a large effect on how you feel about
yourself. If you’re feeling thin, you may feel good about yourself—confident and secure. If you’re feeling
fat, you may feel bad about yourself—unsure and insecure. Because weight and body shape can change
quickly when your eating is imbalanced, this often can mean that your feelings about yourself change
often and quickly. One minute you’re feeling great about yourself, like you’re beautiful and competent,
but the moment you feel bloated or catch a glimpse of a certain part of your body, you suddenly feel
ugly and like everything could fall apart at any time. Some research has suggested that this instability of
feelings about yourself is even more harmful than feeling bad about yourself most of the time (Melnyk,
Cash, and Janda 2004).
Now let’s take a few moments to consider how body image is working in your life.
PRACTICE: REFLECTING ON BODY IMAGE

(GUIDED MEDITATION)
L et your eyes gently close, and just notice your own “body image.” When do you feel good about
your body? You may feel good about your body when your mood is good or when other things are
going right.
W
hat do you see in the moments you see your body as “good”? Maybe you focus on seeing the
bones in your hips or seeing your clothes hang in a certain way. What do you feel in your body in the
moments you feel your body is “good”? Maybe you focus on tightness in your muscles or your stomach.
Take a moment here and write down the things you’re seeing, feeling, or otherwise experiencing when
you feel good about your body.
W
hen do you feel bad about your body? For example, some people notice they feel bad about their
bodies when their mood is bad or when other things are going wrong. What do you see in the
moments you see your body as “fat” or “ugly”? You may focus on seeing your stomach stick out or
seeing your clothes pull in a certain way.
15
W
hat do you feel in your body in the moments you feel your body is “fat” or “ugly”? Some people
tend to focus on a full feeling in their stomachs. And breathe.
P
ause here and notice the role that your body image has in your life. What else do you feel when you
feel bad about your body? What kind of thoughts come up for you? How do you see yourself as a
person when you’re feeling bad about your body? What else do you do differently?
When you’re ready, allow your eyes to gently open.
Now, if you’re willing, take a few moments to record what came up for you in the practice by writing in
the spaces below or in your notebook.
When I feel good about my body, I feel:
When I feel good about my body, I think:
When I feel good about my body, I see myself as:
When I feel good about my body, I tend to:
When I feel bad about my body, I feel:
16
When I feel bad about my body, I think:
When I feel bad about my body, I see myself as:
When I feel bad about my body, I tend to:
Now, we invite you to take three slow, deep breaths before moving on. These are simple questions we
are asking, but they’re not easy.
About Categories
Now let’s talk some more about definitions. When folks say “bulimia” (if they know what they’re
talking about), they’re talking about a pattern of binge eating, then trying to make up for binge eating,
along with a self-image that’s based mostly on the body. When this occurs in a person’s life at least
twice a week for three months and gets in the way of her life, if the person is not underweight, she
can be diagnosed with “bulimia nervosa.” If she is underweight, she can be diagnosed with “anorexia
nervosa.” (Anorexia has its own description, but quite a bit of that description overlaps with bulimia.)
If the behavior described has occurred less often or for a shorter amount of time, or if the person more
often binges without compensating, she can be diagnosed with “eating disorder, not otherwise speci-
fied,” which is abbreviated as EDNOS.
17
Random documents with unrelated
content Scribd suggests to you:
Malleco, south of Bio-Bio, is peculiar in the fact that it alone of the
Provinces touches neither the Pacific nor Argentina, having a strip of
Bio-Bio and Cautín on the east and Arauco on the west. The
mountainous eastern section is heavily wooded and the fertile
central plain with a mild damp climate is celebrated for its crops of
wheat.
Cautín, extending all the way across the country, touches three
Provinces on the north, Arauco, Malleco, and Bio-Bio. Here are
plains, mountains, and valleys, with much rainfall and luxuriant
vegetation of forest, grass, and agriculture. Excellent timber and
tannin extracts, fruit and cattle, produce wealth, and coal and gold
await exploitation.
Valdivia, south of Cautín, also extends across the country. Here
are lower mountains, many passes into Argentina, extensive forests,
several lakes, much rain; but a healthful climate, luxuriant
vegetation, with profitable agriculture, forest products, and cattle
breeding.
Llanquihue follows, extending south to the Gulf of Ancud and
beyond. The present southern terminus of the Longitudinal Railway
is the capital, Puerto Montt, at the head of the Gulf. This is largely a
forest region, though in the valley of the lakes are fertile lands suited
to grazing and agriculture, both of which industries are increasingly
followed. The climate is rather cool but equable.
Chiloé, the last of the Provinces, consists of the large island of
that name covering about 560 square miles, other islands much
smaller, and a long archipelago called Chonos extending to the
peninsula of Taitao. The island, Chiloé, is largely covered with
forests which, strange to say, have a somewhat tropical character,
with fine timber, dense undergrowth, and trailing vines; for the
climate, with excessive rainfall, is extremely mild for the latitude,
which corresponds to that of Massachusetts. Cereals, potatoes, and
fruit are grown, and many pigs are raised; though forestry, and
fishing are of greater importance.
The Territory of Magallanes extends from the 47th parallel south
including the mainland and islands, with mountains, rivers, forest,
and plains. On the coast the climate is not severe; in the interior it is
more rigorous. Cattle and sheep raising are the most profitable
industries; whaling and forestry are important.
CHAPTER XXXI
CHILE: PORTS AND TRANSPORTATION
Ports
Although Chile cannot boast of many excellent harbors, with her

extended coast line her ports are naturally numerous; 59 is the
official number, of which 15 are primary ports with custom houses,
while the rest are dependent, save Punta Arenas, which is proudly
apart as a free port, the only one in this part of the world. The
primary ports are not necessarily those with the best harbors, but
were made such on account of the demands of commerce.
The service along the coast is similar to that of Peru except that
the boats of the Peruvian Steamship Line do not go beyond their
own shores, while there is additional service by Chilian steamers.
Before the War 40 per cent of the engaged shipping was British.
Service to and from Europe, formerly by way of the Straits, long
ended at Valparaiso, later extending to Callao, and for one or two
sailings to Panamá. The exigencies of war interfered with the
execution of plans which are now being carried out or modified.
European express service below Panamá is likely to be confined to
the ports of Callao, Mollendo, Arica, Iquique, Antofagasta,
Valparaiso, and Punta Arenas, with a possible call for coal at
Coronel. Other express service may include Coquimbo and
Talcahuano. Aside from the leading coastal lines a few companies
operate smaller ships locally; on the sea, and 843 miles on the
several navigable rivers at the south. There is also service among
the southern islands and to Juan Fernandez, 400 miles to the west.
Valparaiso, as the most important Pacific port south of Panama,
deserves especial attention. This rapidly growing city, population
about 200,000, to one coming from the north seems quite European,
with an atmosphere more crisp and businesslike than that of courtly
Lima or picturesque La Paz. The semicircular bay is called a good
harbor except when the north winds blow, as they are liable to do in
winter. Some years ago a British steamer lying at anchor, in an
unusually strong blow was sunk with all on board. A breakwater
expected to avert such danger, has for some time been in
construction; but the depth of water off shore has made the work
difficult. Freight was formerly discharged into lighters and people into
rowboats, the steamers anchoring at some distance from shore.
Now, however, a fiscal mole 100 feet long, one half with a depth of
water of 43 feet, the rest of 36 feet, provides all facilities. Valparaiso
has fair hotels, providing insufficient accommodation for the rapidly
increasing travel and business. In many respects the city is quite up
to date, but unhappily here and in Santiago Americans in winter
suffer more with the cold when sitting indoors than in La Paz and
Lima, though for walking outside it is comfortable enough with the
temperature near freezing. As a rule dwelling houses have no
heating apparatus, no stoves, but in some hotel dining rooms electric
heaters are employed, and oil stoves may be provided for Americans
in their rooms. While Chile has coal mines, their production is
insufficient for the use of shipping and of their varied industries, and
the people are not accustomed to use either the native or the
imported article for heating purposes.
The business section of Valparaiso is on a narrow strip of shore
between the bay and the amphitheatre of hills, the level sector
varying in width from two blocks to half a mile. Climbing up the
slopes and crowning the hill tops is most of the residential district.
The business section, largely destroyed by an earthquake in 1906,
has been rebuilt in a more substantial manner, and it well compares
with other cities of its size. Ascensors run by cable on inclined
planes are in general use for the ascent of the bluffs, though paths
and a few carriage roads wind steeply upward in the cañons here
and there separating the hills, some of which rise to a height of 1000
feet. The suburb of Viña del Mar, population 34,000, a fashionable
summer resort with a fine beach and club house, distant a half hour
by rail, is much frequented by the foreign devotees of golf, tennis,
and other athletic sports.
Other Ports. Of the other principal ports we have observed that
Arica is the terminus of the Arica-La Paz Railway, that Iquique is
important for nitrates, Antofagasta for nitrates, copper, and as the
medium of commerce with Bolivia by the old railway to Oruro and
now to La Paz; Coquimbo as the port of a province with both mineral
and agricultural wealth. Below Valparaiso are better harbors.
Concepción, the largest city south of Santiago, 350 miles distant, is
spoken of as the outlet of the rich Province of that name, but being
12 miles from the mouth of the Bio-Bio River it is not a real seaport
and is served by Talcahuano, 9 miles away, which has one of the
best harbors on the coast. For this reason, though a much smaller
city, population 24,000, it was selected as a military port and for the
Government dry docks. A little farther south on Arauco Bay are
Coronel and Lota, both important coaling stations, at one of which all
steamers call; Lota, the larger city, has all conveniences for shipping.
At the tip of the mainland in the Straits is Punta Arenas, not visited
by the regular coasting steamers, but a port where every passing
ship is likely to make a brief call.
Railways
While the Chilians have always cultivated a taste for the sea, for
strategical more than commercial reasons railway construction has
of late been strongly favored. In this medium of traffic Chile in
proportion to her area is far ahead of the other West Coast countries.
It is true that the difficulties of topography are less. The oldest
existing line in Latin America was here constructed in 1849 by a
Bostonian, William Wheelright, who later founded the Pacific Steam
Navigation Company, the earliest giving regular steamship service to
Europe from the West Coast. This first railway line was from the port
Caldera to the mining town Copiapó. The line from Valparaiso to
Santiago, also constructed by Americans, was finished in 1863.
Government ownership is popular in Chile, and of the 8000 miles of
road in operation the State owns over 5000, with considerable
extensions planned. Unfortunately six different gauges have been
used, varying from 2 feet 6 inches on the Antofagasta Bolivia Line to
5 feet 6 inches on the Central Railway.
The Central Railway. This is a Government Line connecting
Valparaiso with the capital Santiago, express trains with American
parlor cars making the run of 117 miles in four hours. The road is
now to be electrified. South along the rich Central Valley, the same
Railway runs through sleeping cars to Valdivia and to Puerto Montt,
the latter city 750 miles from Santiago. This section is well worth a
visit, whether from a scenic or a business point of view. A bridge
1400 feet long and 300 above the bed of the Malleco River cost over
$1,000,000.
There are many branches from the main line, some of these
privately owned; most of them to coast ports, a few towards the
Cordillera. Valdivia is the most southern ocean port to which a
branch extends. Farther north, the third city of Chile, Concepción, is
favored, and Talcahuano near by. From Concepción a coast road
leads south to Lota, Coronel, and beyond. From Talca a line goes to
Constitución, of some importance for agriculture, shipyards, and gold
mining. Another branch goes to the port Pichilemu; from Santiago
one extends 72 miles to the port San Antonio, nearer the capital than
is Valparaiso but a secondary port to be improved by the building of
docks. The Central Railway obviously forms a very important part of
the real longitudinal railway, but the section which has the name
Longitudinal begins farther north.
The South Longitudinal. From Calera on the Valparaiso-Santiago
Railway a branch leads 45 miles to Cabildo, where begins the
Longitudinal proper. This because of construction difficulties is of
narrow gauge, one metre. On account of poor equipment and
service, and the competition of steamship lines along the coast, its
traffic is at present small; but with better facilities and increase of
population it will be of much value. At last accounts there was weekly
service to Antofagasta with two changes of cars, not counting the
one from Valparaiso or Santiago in order to reach Cabildo. Here,
three hours from Santiago, the South Longitudinal is taken to the city
of Copiapó; for the Longitudinal has two sections. The ride is through
a fairly pleasant country with varied scenery, the region being partly
agricultural and partly mineral. In this section are heavy grades,
rising to 6 per cent, requiring 28 miles of the rack system. Branches
or other connecting lines here and there reach the sea. The road
passes through the important port Coquimbo, and the adjoining
Serena, at which point, 200 miles from Valparaiso, the desert land
begins; though in river valleys there is still some verdure. From
Vallenar on the main line a branch runs 31 miles to the port Huasco.
A private line from the port Carrizal, 92 miles north of Huasco and 73
south of Caldera, crosses the Longitudinal. At Copiapó we come to
the old line from Caldera, a fairly good port, shipping copper and
doing considerable other business, though not a port of the first
class. A branch in the other direction extends to San Antonio.
The North Longitudinal. At Copiapó we change to the North
Longitudinal from which there is a branch to Chañaral, about 50
miles north of Caldera, on a large but exposed bay in one of the
richest mineral districts of Atacama, with large smelting works, and
exporting gold, silver, and copper. A private (British) railway system
of 184 miles, crossing the Longitudinal, serves a nitrate district and
the port of Taltal, 100 miles south of Antofagasta; a primary port on a
well protected bay, with piers fitted with steam cranes, a centre of the
nitrate and copper industries. Taltal is a modern town with important
business houses. Besides gold, silver, and copper, the Province has
some undeveloped nitrate land.
Farther on at Aguas Blancas, a railway belonging to the Bolivia-
Antofagasta Company runs to Caleta Coloso, a port six miles south
of Antofagasta and connected by rail with that city as well as with
various nitrate properties. Farther still the Longitudinal crosses the
Antofagasta-Bolivia Railway at Baquedano, where some traffic is
exchanged. It is the intention of the Government to construct its own
line to Antofagasta and to the port of Mejillones some miles north.
Beyond this crossing, from Toco on the Longitudinal, the Anglo-
Chilian Nitrate and Railway Company’s Line branches to the port of
Tocopilla. At last Pintados, the one time terminus is reached, where
connection is made with the Nitrate Railways, which go on to Iquique
and Pisagua. But in spite of this the Government Line is now being
prolonged to the former city. It is intended ultimately to extend the
main line to Arica, 175 miles farther, a section likely to be
unprofitable commercially but desired for other reasons. From Arica
there is a railway to Tacna, near the Peruvian border, hence on
completion of this section there would be through rail service from
near the northern border to Puerto Montt in the far south, a primary
port on the Gulf of Reloncavi. The length of the road from Puerto
Montt to Jazpampa the present terminus, east of Pisagua, is 1902
miles; to Taratá, the most northern town in the mountains, the
distance is 207 miles more.
The Antofagasta-Bolivia Railway. The Bolivian section of the
important Antofagasta Railway has already been referred to. That in
Chile deserves further consideration. British owned, like most of the
Chilian railways not belonging to the State, it is the longest and most
important of these. Although uncommonly narrow with a 2 foot 6 inch
gauge, the sleeping cars are more comfortable than some with
double the width. The road operates 835 miles of main track to La
Paz, 518 of these in Chile. There is semi-weekly service to La Paz in
practically two days, besides local trains. One thousand, two
hundred and fifty miles of track are controlled by the Company. The
climb begins at once, the road in 18 miles getting 1800 feet above
the sea. At km. 36 a branch 70 miles long goes to the Boquete
Nitrate Fields, altitude 5622 feet. At Prat, km. 59, a branch goes
down to Mejillones, a new port, opened by the Company in 1906,
called the finest harbor on the coast, capable of holding the fleets of
the world (it was said when these were smaller) and so protected
that shipping suffers no inconvenience from bad weather. Tocopilla,
37 miles north of Antofagasta, has direct rail connection with that city
by a line 43 miles long. The main Antofagasta line, crossing the
Longitudinal at km. 96, at km. 116 enters the principal nitrate district
of this region and leaves it 35 miles beyond. In this section are 24
oficinas, as the nitrate plants are called, some of them models of
their kind.
Going in either direction this part is traversed at night; otherwise
one might be refreshed by the sight of a little green at Calama, 149
miles from Antofagasta, at six a.m. This was a copper mining centre
in Inca days and a smelter is here now. At this altitude some persons
stop a day, a good plan if one is not sure of his heart; though oxygen
is now carried for use in emergency. At km. 254 is a short branch, 6
miles, to Chuquicamata, to be referred to later. Just beyond the
Conchi station is a graceful viaduct with six lattice girder spans of 80
feet each, supported on steel trestle towers. This, called the highest
viaduct in the world, is 336 feet above the water of the Rio Loa, at an
altitude of nearly 10,000 feet. Here a branch line runs to the copper
mines of Conchi Viejo. At San Pedro station, 195 miles, at 10,600
feet altitude, are reservoirs blasted from the solid rock, on which the
Company spent $6,000,000 to supply Antofagasta, the nitrate fields,
and the railway with water. The water comes from three different
places, one of them 37 miles northeast and 14,500 feet above the
sea: this source capable of supplying 6000 tons of water daily
through 11-inch pipes.
The road now passes two snow capped volcanoes, from one of
which smoke may be rising, and crosses a stream of lava one-third
of a mile wide and several miles long, to the summit of the main line,
13,000 feet. Soon after, a borax lake belonging to a British company
may be seen; 24 miles long, it is the largest single deposit in the
world and the chief source of the world’s supply. At Ollague, where
snow storms occasionally impede traffic, is a branch to the rich
copper mines at Collahuasi. The Bolivian frontier is soon afterward
crossed, and at Uyuni a change is made to the broader gauge line to
La Paz.
The Trans-Andine Railway. Of all the railroads of Chile, the
Trans-Andine is naturally the most famous, as a part of the only
trans-continental railway south of Panama; but financially, as yet it is
hardly a success. With post-war increase of traffic, there will
doubtless be an improvement. The Trans-Andine section of metre
gauge begins at Los Andes, altitude 2723 feet, 88 miles from
Valparaiso. A change is here made from the State Line, 5.5-foot
gauge. It is a distance of 43 miles to the tunnel, a steep climb up the
Aconcagua River Valley, with a maximum grade of 8 per cent; 20
miles of rack railway are employed. There are 25 tunnels, and on the
Aconcagua River or its branches, 118 bridges. The scenery is wild
and the journey delightful. Sheds have been erected against snow
and land slides. Up to 1916 the road was closed for several months
each winter; but with an increase of sheds and with a force of men
continually digging, the road was kept open through the years 1916,
’17 and ’18; it was seriously blocked in July, 1919. While previously
passenger traffic was the more remunerative, in 1916 unusual efforts
were made for the benefit of important freight which it was
impossible to ship by sea.
The tunnel is at a height of 10,486 feet, its length is 10,385 feet,
each practically two miles. The boundary line is near the middle,
each country building to that point; but the whole is operated as one
line from Los Andes to Mendoza. The line was opened in the
Centennial year, April 16, 1910, in time for the Exposition at Buenos
Aires. The cost of the Chilian section was about $15,000,000.
Operation is at a loss, interest being paid by the Government. The
capitalization is $317,000 a mile. Fifteen Trans-Andine projects have
been put forward, most of them for the south, one from near Puerto
Montt. One in construction is from Talcahuano to Bahia Blanca by
way of Temuco. A road from Punta Arenas to the Loreto coal fields is
the most southern railway in the world, as that is the most southern
city. The early construction is expected of an important road at the
north from Salta in Argentina by Huaytiquina on the border to
Antofagasta. Of wagon roads there are said to be 20,000 miles.
The Arica-La Paz Railway is described on page 222.
CHAPTER XXXII
CHILE: RESOURCES AND INDUSTRIES
Although Chile is often compared to California, to which State it

has some but not a close resemblance in length, partial dryness,
earthquakes, and fruit, the specialty of Chile is not shared by
California. Chile and nitrates are almost synonymous terms. A
thought of one suggests the other. The greater part of the nitrate
country earlier belonged to Peru, some also to Bolivia; and both
countries still bewail their loss.
Mining
The Nitrate Fields we know are in the north, chiefly in the

Provinces of Tarapacá, Antofagasta, and Atacama. If this desert land
does not blossom as the rose, it produces the wherewithal to make
other fields blossom, and the wealth to purchase the roses. The
richest deposits are mainly along a stretch of 300 miles from Pisagua
in Tarapacá, to Coquimbo. With an average width of 2¹⁄₂ miles, the
fields are at a distance of from 10 to 80 miles back from the coast,
and at a height of 2000-5000 feet. The deposits, which are not in
continuous fields, are sometimes on the surface, but oftener overlaid
with strata of earth several feet thick. The raw material called caliche
contains from 20 to 65 per cent nitrate of soda. After pickling in tanks
8-12 hours, the liquid, caldo, is run off, the sand and refuse dropping
to the bottom. When ready for export the article carries 15-16 per
cent nitrogen and 36 per cent sodium. Commercial nitrate is a white
cheese-like substance, which is used in manufacturing the highest
grade of gunpowder, also to produce nitric and sulphuric acid; but
the bulk of it in ordinary times is employed as a fertilizer, doubling
and tripling the harvest. Within recent years the demand and in
consequence the production has greatly varied, the partial recovery
in 1920 being soon followed by a depression.
A by-product is a yellow liquid, which being chemically treated
leaves a blue crystal, iodine, which costs as much an ounce as
saltpetre per 100 pounds. Being worth $700-$800 a cask it is
shipped in treasure vaults with bullion. The nitrate establishments
called oficinas provide good salaries, and the best possible quarters
for their officials, and they are interesting to visit. As a mineral, the
nitrate is distinguished from guano although believed by some to
have the same origin. British companies have long been engaged in
this industry. American interests have more recently acquired
holdings. The Du Ponts have three properties covering 14,000 acres.
The chief ports of this region are Iquique and Antofagasta,
Pisagua being a smaller port visited only by the caletero or the
strictly freight boats. Iquique is a more agreeable city than in former
days, when water was sometimes $2 a gallon, and people drank
champagne, they said, because water was too expensive. Now the
dust of the streets is laid by sprinklers, some people have bath
rooms, a few even fountains in patios. Antofagasta is also a desert
place, unattractive to look at, but with good shops, business houses,
and fair hotels. The water comes a distance of nearly 200 miles, the
source more than two miles above the sea.
Potash. In addition to nitrates Chile possesses extensive beds of
useful potash one of which is estimated to contain nearly 7,000,000
tons easy of exploitation.
Copper. The property of the Chile Copper Company (one of the
Guggenheim interests) at Chuquicamata is said to be the largest
copper deposit known in the world. About 2000 of the 9600 acres of
the claim are mineralized. The outcrop of copper is one and a half
miles in length. It has been proved below to a width of 1800 feet and
a length of 7500 feet. Ten of the 2080 shafts are over 1000 feet in
depth, and at 1500 feet the ore is of commercial value. Over
700,000,000 tons of positive and probable ore have been developed,
carrying an average value of 2.12 per cent copper. The reduction
plant has a capacity of 15,000 tons a day, the refinery of
180,000,000 pounds a year. With a 90 per cent extraction the yield is
96 pounds of copper per ton. At the port of Tocopilla, north of
Antofagasta, the Company has a power station where oil from
California is used to generate a power of 24,000-27,000 kilowatts
needed at Chuquicamata. This is transported by wire across country
a distance of 100 miles. At normal prices the cost of copper
production with delivery in New York or Europe is $121 a ton, or
about 6 cents a pound; higher with war time conditions which still
obtain (1921). From the 15,000 ton plant in full service 175,000,000
pounds of copper would be produced annually. In 1920, 55,617,000
pounds were produced, the largest amount from any mine in Chile.
In 1916 important mines belonging to the Calama Mining Company
were added to the Chile Company’s holdings.
The Braden Copper Company, another Guggenheim interest,
owns about 2300 acres in the Province of O’Higgins. They have a
concentrator, a smelting and converting plant, a hydro-electric power
plant with 800 kilowatt capacity and an electric and a steam railway;
the latter, 43 miles long, connecting the property with Rancagua,
which is on the Central Railway 43 miles southeast of Santiago. The
ore is of concentrating copper, a sulphide in brecciated andesite,
around an extinct volcano. It runs about 2.5 per cent, with an earlier
production cost in New York of 6.5 cents a pound, but now higher. In
1916, 1500-1800 men were employed. The plant, recently enlarged,
is not working to capacity. In 1917, 64,000,000 pounds were
produced, over 77,000,000 in 1918, with diminishing demand,
40,000,000 in 1920.
Another American syndicate has acquired the Tamaya Copper
Mines in the Province of Coquimbo between Ovalle and Tongoy, the
latter, a minor port 27 miles south of Coquimbo, sheltered from north
winds, with smelting works in the place. With an efficient pumping
plant and other improvements installed, the mines are expected to
yield large production. Other companies, native, British, and French
are engaged in copper mining at Carrizal and elsewhere.
Iron. Coquimbo, a Province with local importance for agriculture,
is notable for its deposits of iron ore, said to amount to a billion tons.
Only one of these has been worked, a deposit located at Tofo, about
four miles east of Cruz Grande, and 30 north of the city of
Coquimbo. This property was leased in 1913 by the Bethlehem Steel
Company from a French Company which had developed the mine to
some extent and produced ore. The ore appearing as the top of a
large hill will be mined by electric shovels and transported by an
electric railway to docks at Cruz Grande. The amount of ore is very
large though with exact tonnage undetermined. The Company is still
exploring the deposit at depth.
The mines and railway are completely equipped. At Cruz Grande a
basin dock has been constructed with large storage pockets into
which the ore will be discharged from the railway cars, and from
which it will go directly into the vessels. The Steel Company is
constructing steamers of 20,000 tons to carry the ore to the United
States for use in their furnaces. The ore is very pure averaging about
67.50 per cent iron. It is a dense ore reddish black in color, a mixture
of magnetite and hematite.
The French Company formerly controlling Tofo had erected a steel
plant at Corral intending to transport the ore thither. There is no iron
ore near there and the plant is not operating.
Of the other deposits in Coquimbo and farther north some are of
considerable size, but none is located so near the coast as Tofo and
none has been developed.
Other metals existing in Chile are at present of less importance
and slight operation. A moderate gold output accompanies the
production of copper, and there is some placer mining, especially in
the south. Deposits are known to exist in many Provinces from
Tacna to Tierra del Fuego. Silver too exists, but its production is
chiefly as a by-product. Lead, zinc, molybdenum, and tungsten are
exported in limited quantities.
Coal, following nitrates, is of the first importance among ordinary
minerals, a source of large wealth though the production, about
1,700,000 tons yearly, is insufficient for the needs of the country.
Little is therefore exported and a good deal is normally imported from
Great Britain and Australia; until recently a little only from the United
States. Most of the mines in operation, owned by ten companies, are
near the ports of Talcahuano, Coronel, and Lota. The coal is not
equal in quality to the British, but it has been used by steamships,
railways, and mines with fair results. Coronel or Lota, five miles apart
on Arauco Bay, one or the other, is a regular port of call for
steamships. The Cousiño property at Lota was purchased in 1852
and later was conducted by the son’s widow, under her
administration the greatest financial enterprise carried on by a
Chilian. At her death she was called the richest woman in the world,
leaving a property of $70,000,000. The capital of the company is
$20,000,000. The mines are one-fourth of a mile deep and extend
under the sea, where there is good rock and no drip. Here are
streets, restaurants, offices, stalls for horses, blacksmith shops, etc.
A British Company, the Arauco, in addition to coal properties
operates its own railway with 62 miles of main line and branches,
besides mining spurs. It has four daily trains from Concepción to
Lota, Coronel, and beyond, passing over the Bio-Bio River by a
bridge of 1¹⁄₄ miles, the longest in South America. Of coal about 1¹⁄₂
million tons are produced and as much more is imported.
Petroleum is believed by Chilians to exist in large quantities, but
the present development is infantile. It has been found in southern
Chile, on the Island of Chiloé and in the Patagonas district, as well
as in the north near the Bolivian frontier. Large quantities are
imported principally from Peru, normally about 400,000 tons a year.
Oil recently found in the Magallanes Territory is stated by experts to
be equal in quality to that found in Argentina. The extent of the
deposits seems to rival that of the famous fields of Comodoro
Rivadavia. Legislation to regulate the well drilling is proposed to
prevent inundation of deposits by subterranean streams, to restrict
the ownership to native Chilians or foreigners with Chilian families,
and to secure to the Government a 10 per cent royalty. A strong flow
of petroleum of great purity from a well about 300 feet deep has
recently been reported from Chiloé.
Sulphur comes from a largely producing mine at the foot of Mt.
Ollague, and from one of growing importance at Tacora on the Arica-
La Paz Railway. The deposits of Tacora are believed to contain 10 to
45 million tons of sulphur. In 1915 about 10,000 tons were produced
in Chile.
Salt. From various salt deposits, the salinas of Punta de Lobos
and several mountain lagoons, about $300,000 worth of salt was
produced, supplying the domestic market.
Borax is important, Chile furnishing about half of the world supply.
Agriculture
Of large importance and value are the agricultural interests

including fruit, although the imports of such products are nearly
double the exports in value. About one eighth of the area of Chile
consists of arable land. The production should be greatly increased.
Twenty million acres are still available, and with better methods
excellent results might be secured. In 1914-15 about 25,000,000
bushels of wheat were raised, half as many potatoes, and more than
half as much hay; besides barley, oats, beans, corn, etc.
Considerable wheat is exported with some barley, oats, rye, and
legumes. Of 15,000,000 acres suitable for wheat, only one fifth is in
cultivation. It grows well from Aconcagua to Cautín inclusive, but
farther south the crops are uncertain. They average 15-20 bushels
an acre. Six hundred thousand acres are devoted to alfalfa, which in
favorable places gives three crops a year and has roots ten feet
long, a distinctive variety being formed here. In irrigated valleys from
Coquimbo north, corn gives two fine crops annually. Potatoes
flourish from Concepción south, in Chiloé yielding 250-350 bushels
to the acre. Flax and sugar beets might be raised. Some agricultural
machines are now employed, in the neighborhood of 30,000.
Fruit. Delicious fruits of all temperate zone varieties and some of
the subtropical are raised, chiefly for home consumption, but with
export possibilities. Drying and canning of these is practised to some
extent, but might be done on a much larger and more profitable
scale. Excellent table grapes are raised; many vineyards devote their
product to wine making, the industry being especially developed in
the Provinces of Santiago, O’Higgins, and Colchagua. In the north,
wine is made of the port and sherry classes; in the central section
light wines of excellent quality, some of which are exported to the
neighboring countries. More wine however is imported of expensive
varieties. The vineyards are in general owned by natives, and
according to location are worth $200-$1000 an acre. Raisins are
produced in quantity.
Forestry
This might become a more important industry, though now

practised to a considerable extent. It has been customary to burn a
section of forest at the close of summer, February, to get rid of the
underbrush, and later to cut down the trees, which must have
suffered some injury. The forest area is below the Bio-Bio River. On
a tract of 100 square miles extending from near Valdivia north to
Temuco, the timber averages about 9000 feet to the acre. Farther
south the woods are denser, as on the Island of Chiloé. The greatest
extent of forest is in Valdivia, the next in Llanquihue and in Chiloé.
On this Island a 60 mile railway was constructed by the Government
from Ancud at the northwest to Castro south, on the east side,
making a part of the forest accessible. Oak, Chilian mahogany,
laurel, ash, pine, and other hard and soft woods are available. There
are in Chile 3000 saw-mills and some pulp and shingle mills. The
first and second grades of wood, used for floors and finished boards,
bring $12-$18 per 1000 feet, ash $25; the third grade is worth $8.
Shingles are $3 per thousand. From the forests comes the quillay
bark with a soapy substance for cleaning silk and fine linen, of which
$200,000 worth is annually exported to France, after being prepared
by two Chilian factories. Tannin, of which 15,000 tons are annually
used, is derived from bark of several kinds. With additional railways
planned and Government data furnished, there is opportunity for
good investments with moderate capital.
Stock Raising
Stock raising of various kinds is carried on quite extensively by

some large companies under British, German, or Chilian control,
often paying 20 per cent dividends. Sheep are in the lead,
numbering probably 6,000,000, cattle 3,000,000, horses 725,000,
half as many goats, a third as many pigs, fewer donkeys, mules,
alpacas, and llamas. The horses are good, larger than those in Peru,
and noted for their excellent trotting, some making this as easy as a
good pace or canter. In 1916, 20,000,000 pounds of wool were
produced, half of this in Magallanes Territory not far from Punta
Arenas, where there are more than 3,000,000 sheep. The meat is of
the finest quality; the farther south the better the wool in thickness
and length of staple.
The cattle are improving with the introduction of Shorthorns and
Herefords; there is some export, especially to Bolivia. The 3,000,000
at present might be increased ten fold. A British company is
constructing a frigorifico at Puerto Montt. The dairy industry is
important, with good cheese, bottled milk, and some condensed.
Goats are numerous in the mountains. Apiculture is practised and
fine honey is made. Fisheries are of great importance and value, at
Juan Fernandez, as also along the coast.
Manufacturing
Such industries are more developed in Chile than in any of the

countries previously considered. The 6200 manufactories with
80,000 operatives and an investment of $250,000,000 show great
diversity. There are saw mills, flour mills, breweries, sugar refineries,
some coarse sugar being imported from Peru, tanneries, furniture,
and shoe factories, with others commonly found. A cement factory
pays a quarterly dividend of 5 per cent, a brewery gave a semi-
annual dividend of 15 per cent. A new one is planned for Arica. More
than $12,000,000 are invested in the leather industries, with an
output worth $20,000,000. Twenty-two or more shoe factories are
scattered in various cities. Clothing and textiles are next in value of
production, followed by $10,000,000 worth of furniture and
woodwork. Ship building is important.
Investments
Activities in Chile in the immediate future for which about
$15,000,000 have been appropriated by the Government include
work or equipment on railways, roads, bridges, barracks,
waterworks, sewer systems, building construction, and port works.
These furnish opportunities to which many others may be added.
The possibilities in agriculture, fruit raising and canning are obvious;
those in fisheries, saw mills and lumber, development of water
power, in factories of various kinds may be noted, as well as for large
capitalists in mining. A $10,000,000 contract for the electrification
and equipment of four zones of the Government railways has been
concluded with a combination of several American interests.
THE EAST COAST

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A Guide to Breaking Free from Bulimia

EMILY K. SANDOZ, PhD

New Harbinger Publications, Inc.

Distributed in Canada by Raincoast Books

Cover design by Amy Shoup

All Rights Reserved

Printed in the United States of America

A Letter from the Series Editor v

CHAPTER 4 Where It All Takes Place: Noticing Self-as-Context 57

 Orient the reader toward unresolved empirical issues.

 Keep the focus always on what is good for the reader.

LOOKING KINDLY AT YOUR STRUGGLE

EXERCISE: MATH PROBLEMS AND SUNSETS

So what was that all about?

Math Problems, Sunsets, and You

SOMETHING COMPLETELY DIFFERENT

WHAT YOU CAN EXPECT FROM THIS BOOK

COME AS YOU ARE: AN INVITATION

Some Things You Should

What Bulimia Looks Like

PRACTICE: REFLECTING ON BINGE EATING

 When you’re ready, let your eyes slowly open.

What “binge eating” looks like for me:

PRACTICE: REFLECTING ON COMPENSATORY BEHAVIORS

 When you’re ready, allow your eyes to gently open.

What “compensatory behavior” looks like for me:

BODY IMAGE DIFFICULTY

PRACTICE: REFLECTING ON BODY IMAGE

 When you’re ready, allow your eyes to gently open.

When I feel good about my body, I feel:

When I feel good about my body, I think:

When I feel good about my body, I see myself as:

When I feel good about my body, I tend to:

When I feel bad about my body, I feel:

When I feel bad about my body, I think:

When I feel bad about my body, I see myself as:

When I feel bad about my body, I tend to:

Although Chile cannot boast of many excellent harbors, with her

Although Chile is often compared to California, to which State it

The Nitrate Fields we know are in the north, chiefly in the

Of large importance and value are the agricultural interests

This might become a more important industry, though now

Stock raising of various kinds is carried on quite extensively by

Such industries are more developed in Chile than in any of the

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Orient the reader toward unresolved empirical issues.

Keep the focus always on what is good for the reader.

When you’re ready, let your eyes slowly open.

When you’re ready, allow your eyes to gently open.

When you’re ready, allow your eyes to gently open.