More threads by David Baxter PhD

David Baxter PhD

Late Founder
Eating, Drinking, Overthinking: The Toxic Triangle of Food, Alcohol, and Depression ? and How Women Can Break Free

By Susan Nolen-Hoeksema, Ph.D.
Published by Henry Holt
January 2006; $24.00US; ISBN: 0-8050-7710-3

Depression is a common and debilitating problem among women, though it rarely occurs in a vacuum. Instead, as Susan Nolen-Hoeksema has found, depression often coexists with disordered patterns of eating and drinking. Three core problems ?- overthinking, unhealthy eating habits, and heavy drinking ?- lead to and reinforce one another in a toxic triangle that wreaks havoc on women?s mental well-being, their physical health, their relationships, and their careers ?- so completely they often find it very difficult to break free.

Breaking free is possible, however, both for women who are already aware that they suffer from a serious problem and for the hundreds of thousands of others who dance around the edges with only occasional symptoms. As Eating, Drinking, Overthinking shows, women can free themselves by transforming the very traits that make them vulnerable into strengths. Nolen-Hoeksema provides the tools to harness the energy of women?s reflective and interpersonal skills, creating more effective and healthy ways to counter their tendency to turn inward.

Eating, Drinking, Overthinking raises an alarm by revealing that the intersection of depression, unhealthy eating, and heavy drinking is, though common, all but ignored by scientists and the lay public. This book gives hope to women whose lives are in grips of the toxic triangle, as well as to their family and friends, that freedom is within reach.

Susan Nolen-Hoeksema, Ph.D. is a professor of psychology at Yale University. She has taught at Stanford University and the University of Michigan. She received her B.A. from Yale University and her Ph.D. from the University of Pennsylvania. The author of Women Who Think Too Much, she has been conducting award-winning research on women?s mental health for twenty years with funding from the National Institutes of Health, the National Science Foundation, and the William T. Grant Foundation. She was awarded the Leadership Award from the Committee on Women and the Early Career Award from the American Psychological Association. She lives near New Haven, Connecticut, with her husband, Richard, and her son, Michael.

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David Baxter PhD

Late Founder
Better Ways to Cope with Stress: Your Way Out of the Toxic Triangle

Better Ways to Cope with Stress: Your Way Out of the Toxic Triangle
By Susan Nolen-Hoeksema, Ph.D.
Author of Eating, Drinking, Overthinking: The Toxic Triangle of Food, Alcohol, and Depression?and How Women Can Break Free

Depressive symptoms, unhealthy eating habits, and heavy drinking unite to create a space that is so poisonous for women that I have called it the toxic triangle. Eating, Drinking, Overthinking will help you understand your own relationship to the toxic triangle. It is not just for women who have clinical depression, diagnosed eating disorders, or alcoholism. It is for women who dance around the edges of the toxic triangle, with moderate symptoms of depression, unhealthy eating patterns, or heavy drinking

Eating, Drinking, Overthinking teaches women how to transform their vulnerabilities into strengths, to help women develop the tools to change the way they cope with stressful circumstances. Here are some of the major steps toward positive change:

1. Step back and notice what you are thinking and feeling.
One way to do this is to use mindfulness techniques, which teach us to notice our thoughts, feelings, bodily sensations, and memories without immediately categorizing them as good or bad. We learn to be more compassionate toward ourselves, responding to our thoughts and feelings as a friend might, rather than as a slave to a master. By being able to step back and notice, rather than be overwhelmed or ruled, by our feelings, we become better able to choose how we want to feel and act in difficult situations.

Mindfulness techniques also teach you to be more aware of the present moment. By practicing ?being with? our feelings and thoughts we can become less frightened and overwhelmed by them, and thus less motivated to escape them with unhealthy behaviors. We can also learn a great deal about ourselves, particularly the ways we have internalized social pressures to cast ourselves in a certain way (for example, in terms of how much we weigh) or to behave in certain ways (such as always putting others? needs before our own).

If mindfulness techniques don?t appeal to you, just try keeping a diary of key events in your day and how you think and feel about them. There may be something specific that triggers these urges and feelings ? a difficult interaction with another person, going by a restaurant, being alone at home. Or they may come from out of the blue. It doesn?t matter, just write down what is going on, and then get quiet for a moment and tune into what is going through your head.

It is likely that you may begin to recognize the theme of relationships or a certain relationship in your diary accounts. As you begin to recognize the role of key people in these difficult times, use your reflective abilities to consider what it is about them that contributes to your sad or anxious feelings, or to your desire to drink or eat.

2. Conjure up an image of the Positive You.
Shut your eyes, get quiet, and conjure up a very positive image of yourself. Watch that Positive You get up in the morning, get dressed. What are her interactions with her family like? What does she do for the rest of the day? Does she go to the same job you have? Her interactions with other people? What kinds of things does she do over the course of the day? How does she feel? At the end of the day, what does she do?

Now turn your attention back to the Real You and tune into how your body feels. Is there a sense of happiness or excitement at the prospect of the Positive You? Or frustration and defeat? Concentrate on what?s going through your mind. Some of the characteristics of the Positive You are likely to represent impossible goals that you have internalized based on society?s messages about what you ? and other women ? should be.

Then rewind the tape of the Positive You?s day. Shut your eyes, and before you play the tape again, say to yourself, ?Be gentle. Be kind. Accept who you are. Be realistic.? Then try running the tape again. How does the Positive You look different this time? Are there things about her that now look more like the Real You? Which characteristics of her or of her life bear little resemblance to the Real You? For example, perhaps the new Positive You still has quite a different relationship with her husband than you do. Or perhaps she has a pleasant evening without alcohol, when the Real You seems to need a drink to relax. Does she have energy and interest in what she does, while the Real You is always tired and unmotivated?

Rerun the tape a couple of more times, and each time begin by telling yourself, ?Be gentle. Be kind. Accept who you are. Be realistic.? Notice which differences between Positive You and Real You keep coming back over and over, because those are likely to be the changes you do want to make for yourself. Get a piece of paper and write each change down in the language of approach goals ? new behaviors or ways of living that you want to move toward, rather than things you want to avoid or give up.

3. Make a plan to move toward the Positive You.
Now you?re ready to begin working toward these positive goals. Make a list of simple, everyday things that you find enjoyable, and that are relatively easy to do. One of the most important steps to moving away from bingeing and toward a more positive you is to find things to do that can take your mind away from your urges, filling up the time during which you would normally binge. Plan activities for the times between meals and snacks when you otherwise don?t have anything to do. When you feel an urge to binge on food or alcohol, go back to something you?ve done, and enjoyed, before.

The activities you have come up with so far are meant to lift your mood, take you away from negative overthinking, and fill the time you would otherwise have spent bingeing. These are small steps, although critical ones, down the road to the Positive You. Now you are ready to take bigger steps ? ones that will begin to overcome the larger problems in your life that drive your unhealthy thoughts and behaviors, and that help you reshape the Real You into the Positive You.

Take one of your major goals, or a significant change you want to make in your life, and consider how you would apply each of the following steps.

a) Generate as many possible activities to move you toward your goal as you can think of without judging whether any of them is ?good? or ?bad?.

b) Rank order each of these activities, thinking about how easy it will be to accomplish it, and how effective it would be in moving you toward your goal. If you find yourself thinking, ?That won?t work! Nothing?s going to help!? try using your mindfulness techniques to slow yourself down and be more open and gentle with yourself.

c) Once you decide what would be most helpful in moving toward your goal, develop a plan to carry it out. For example, if you?ve decided you need to take some courses to improve your job skills and get a new job, then the first step is to investigate a local educational institution. The second step is to sign up for a relevant course. The third step is to take the course. It may also be helpful to consider the available resources for each step. For example, you may need to look into financial aid.

d) Schedule the first step in your plan. Scheduling simple activities such as ?Look up courses in the course catalog? may seem silly, but the act of scheduling will make you more committed to carrying out the activity, and will help insure that you find the time to do it.

e) Once you go through with your scheduled activities, evaluate how well they worked. How did they make you feel? Did they accomplish what you wanted them to?

f) At this point, you may need to revise the plan, especially if you didn?t get as far along the path to your goal as you hoped. Again, be gentle and generous with yourself ? you don?t get to the Positive You overnight, just as you didn?t travel into the toxic triangle overnight. You may need to go back to Step 1 and repeat the process of generating ideas that move you toward your goals.

g) Whether or not everything you tried was successful, reward yourself for just trying! For example, treat yourself to a meal at your favorite restaurant or to coffee with a friend.

Women?s empathy and strong emotional ties to others can lead them into the toxic triangle, but they can also help them escape it.

Copyright ? 2006 Susan Nolen-Hoeksema


By being able to step back and notice, rather than be overwhelmed or ruled, by our feelings, we become better able to choose how we want to feel and act in difficult situations...

By practicing ?being with? our feelings and thoughts we can become less frightened and overwhelmed by them, and thus less motivated to escape them with unhealthy behaviors. We can also learn a great deal about ourselves

That's all so true. I've been trying to "sit" with the feeling and it is OVERWHELMING in itself, but it really does make you think about why you're feeling the way you do and what it is that you're feeling instead of just trying to "stuff" it away by engaging in some kind of unhealthy behaviour...

just mary

I just finished reading this book. It was good, I recognized myself in many of her descriptions. What I liked about the book was it's relevance to people who aren't full-blown alcoholics or severely depressed or anorexic/bulimic. I think it would offer serious help to people who are only "dancing around the edge" - her words not mine.

The self-help part looks good, I know I'll have to read it a few more times before it all sinks in but I'm going to give it a shot. She talks about mindfulness meditation. I've been wanting to learn how to meditate for quite some time. She gives step by step instructions on how to meditate but it's hard to read the instructions when your eyes are supposed to be closed. Does anyone know of any good meditation CD's? I also think I'll join yoga, I did it in the early nineties and I just loved it but I quit for some stupid reason. She had other good suggestions which I'll try but one step at a time.

Thanks for the information on this book Dr. Baxter. :)

David Baxter PhD

Late Founder
I quit yoga a few years back for a stupid reason too: my life got too busy and too stressful and I didn't have time to keep going.

And yes, I know that's totally irrational :)


Being aware of your feelings instead of being ruled by them is one of the major reasons for meditating. I wish I could recommend some good meditation books, but I've only read different books off and on. It sounds like a very interesting book, and I'd like to see if I can get my hands on it in Korea. It's possible they would have it at one of the big book stores with an English section. I find the concept interesting, because I don't consider myself to be annorexic anymore, nor an alcoholic, but I get myself into unhealthy patterns sometimes. For example, if I'm exercising regularly I eat better and I try not to drink - at least not too much. Then, I'll go out one night and drink too much, not wake up early, not prepare my food, barely eat all day, not exercise, maybe drink again when I decide to eat, etc...Then the next day I'll feel guilty again and a little out of control.
One thing is my circumstances right now. I mean, I'll be going back to school next year to do a MA and I imagine that although there will be enough partying at the uni in Australia, I'm going to be busy and I'll have to be responsible. I think I'm ready for a bit of a change right now. I've been teaching in Korea for almost four years. It's a lot of fun and I've learned a lot, but I think I go out because I'm just bored. And, going out is usually coupled with drinking.
Anyway, sorry I'm just blabbing...I think I should check out the book.


Thanks. I'll check out the Amazon website. If I can't get it, I'll be in Canada by Christmas time and I can try to get it then. I went to a bookstore downtown last night. They have many popular English books there, but I didn't see that particular book.


This book sounds amazing.

Point one, about noticing what you're feeling instead of running away - sounds like my therapist talking. About allowing yourself to feel the feeling, without being consumed with anger, or overwhelmed by grief... but just acknowledging that you have this feeling, and that you also have the power to decide what to do with the feeling...

I'm also fascinated by yoga and meditation, and haven't yet tried either.
dancing around the edges, that is a very good description, i think that is what i am doing right now. i find it hard to focus on doing all the right things when i feel a little off.
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