To change the story of life with an eating disorder to one without it is to acknowledge where those with an eating disorder started, ended up and where they are going by:
a) Exploring the original role, meaning, ritual and value placed on food and the body in one’s family, community and friends as well as the evolution of particular personal fears, associations and obsessions that have occurred with certain foods and body parts at various stages.
b) Confronting the challenges recovering from an eating disorder presents and the degree of difficulty involved in learning to live without this condition by breaking these obstacles down and listing a set of coping strategies for each.
c) Putting words to the emotional reality to be persisted through rather than retreated from.
d) Acknowledge how incredible, capable and strong those that find themselves walking this vulnerable and painful line are.
For anyone who has the strength, skills and character to survive the ruthless demands of an eating disorder has the capacity to achieve anything they set their mind to and this includes recovery. If the energy devoted to maintaining an eating disorder is redirected elsewhere the most fulfilling reality may eventuate.
Those struggling to overcome their eating disorder are likely to benefit from a shift in focus to something that is of interest but has nothing to do with the negative preoccupation towards the body or food such as:
- A love of landscapes (being outdoors, city, suburban, parks, lakes, beach, mountains)
- Music (live, recorded, making your own mixes, playing an instrument)
- Volunteer work (spending time assisting others)
- Meetups (google search for local meetups focused on your particular interests)
- Keep a journal, blog, vlog or scrapbook
- Join an art, acting, meditation or yoga class… this may take place in the shape of YouTube classes and online forums associated to it
- Start photographing people, objects and settings that make up your world and write about the meaning and significance of this person, place or thing
- List all the things you’d like to do, experience, be part of and have and what would have to happen in order for you to do these things; have these experiences; be part of these activities or communities and attain what you’d love to possess. Then on a separate page list all the things that are in the way and what needs to be done in order to remove them. Write down people, books and organisations that can help you as well as things you can do to help yourself. On a separate page break these things down by prioritizing and listing what can be done this week, month, year and years from now, if you choose to.
- Try laughing at how ridiculous and insignificant some of the things you take very seriously are by looking at them from a different point of view or questioning whether what you think matters actually does. After having done this return to the issue and inquire into the story of why this detail, situation, obsession or exchange had the power to mean so much to you. Take a moment to respect the reasons and empathise with why you felt and reacted the way you did and once you are finished doing this re-evaluate whether or not it can live differently in you now. Can it matter to you without it feeling like there’s so much at stake that it disrupts your day?
- Please feel welcome to put your suggestions in the comments section.
Eating disorders are often comorbid, meaning the individual also suffers from one or more of the following: Depression, Anxiety, Obsessive Compulsive Disorder (OCD), Bi-polar disorder, substance abuse, Post-Traumatic Stress Disorder (PTSD), Schizophrenia, self-harming behaviour… or a medical comorbidity such as bone disease, cardiac complications, gastrointestinal distress and diabetes.
It is estimated that 1 in 10 receive treatment for their eating disorder which is hard to treat; a reason being because the consequence of breaking the contract with an eating disorder unleashes the unwanted feelings it has kept at bay, numbed and split off.
Without an eating disorder to come between the individual and the unwanted feelings, all these negative emotions initially flood the individual trying to recover. It can feel as though they are alone, drowning in pain that shows no sign of passing. However the pain, discomfort and unease does eventually subside and ultimately saves them from the eating disorder that has the potential to destroy the mind and body to a premature death.
To overcome an eating disorder involves a commitment to abstain from disordered eating behaviour, preoccupation and ritual every hour of every day until it becomes–at some point– an automatic way or at lease partially natural way of living. This is a lot to ask of someone who has been exhausted and hallowed out by the addiction so motivation and a reason is very important to get clear on. Keeping in mind that to live is not necessarily reason enough to one who does not find life pleasurable, kind, fulfilling or manageable. This is why an eating disorder became possible in the first place.
In females, adolescence and pregnancy are considered major triggers so are periods of increased stress, loss and death of a significant other and relationship difficulties. For young women who develop disordered eating, the body transforming its shape into that of a woman might elicit feelings of disgust, shame, discomfort, fear, horror and an intolerance of physically taking up more space. In instances where the individual is a survivor of childhood sexual abuse, this stage of human development can be very triggering. Also, statistics show that bulimia is the most common eating disorder found in childhood trauma survivors and 34% of those diagnosed with bulimia report having experienced sexual abuse.
Eating disorders create a numbing effect or dissociation that enables a distancing from the overwhelming problems in interpersonal relationships, sexual intimacy, work, study and social obligations. They consume one’s time; mind; are addictive and ultimately unsustainable. This maladaptive behaviour is described by sufferers as painful, scary and miserable and not how they wish to continue despite doing all they can to do so.
Why does the disordered eater proceed to lose everything to their eating disorder?
How is it that they get swept up in this physically painful and exhausting routine?
- They know of no other way to cope with how devastating life feels to them. They are yet to develop effective internal resources to emotionally and cognitively process their situation and effective schema to assert wants and needs with efficacy. They are over-investing in the way things look to compensate for the unacceptability of how things are.
- This is compulsive behaviour, a predominately unconscious set of reactions to circumstances, emotions and the body.
- Eating disorders are addictions that over time become a way of life that is known, insular and familiar. There’s a certain relief, high or euphoria in numbing oneself out though the state of emptiness achieved through starvation or purging or the ‘carb coma’ from a comfort food binge.
- They feel confused, afraid and powerless and don’t know what else to do.
- Negative core beliefs and schema informing self-hate, rejection and need to inflict punishment and deprivation on the self.
How can those with an eating disorder learn to trust in other sustainable strategies to deal with anxiety, confusion, self-hate, inadequacy, insecurity and pain and stop relying on their eating disorder to hold at a safe remove, unbearable feelings and states?
For those who have not experienced disordered eating, addiction or the effects of childhood complex trauma, bullying… it might be difficult to understand why someone might cling to their eating disorder with all that they are even though it’s killing them. For people wishing to understand, it may prove helpful to keep in mind that those caught in this excruciating lifestyle are not experiencing life as something fun, easy, full of possibilities, safe, benevolent and valuable.
Rather life has the tendency to be experienced as predominately threatening, full of insecurity, incongruence, demands, confusion, loveless, judgmental and with impossible standards. If this is indeed the case and these individuals internalise their experience of the external world they can only treat and perceive themselves the way they perceive themselves treated and regarded.
Considering this, it is understandable that many with an eating disorder have expressed wanting to die and to in fact mention preferring death to gaining weight or the discomfort of bloating, constipation and discomfort of having to digest food. The power of the high and release one gets from being empty after purging or not eating is the one thing that makes their life bearable cannot be underestimated.
To take the eating disorder away in order to prolong a life that is unbearable is rarely going to work without offering a convincing vision or story of how good their life could be and how this might be achieved. Why should it? What it takes to recover is asking a lot off a person without offering sufficient immediate payoff and relief.
The aim is to have those with an eating disorder taking in and keeping the nutrition they need and this can be done gently with foods that cause the least amount of physical discomfort or strain on the digestive system. If the patient is not underweight, she or he doesn’t necessarily need to gain weight but they do need to satisfy their nutritional requirements so they have the energy to get on with life.
An eating disorder consumes the individual from the inside long before it becomes visible and symptomatic of the deeper emotional and psychological sickness shadowing the individual’s personality, hope and spark. By this time much internal, emotional and psychological damage has incurred in addition to the initial wounds considering what an eating disorder puts a person through is traumatic. For example: sleepless nights from hunger, tears in the esophagus, pushing the body past exhaustion to maintain an impossible exercise regime…
Destructive thought patterns, OCD-like rituals surrounding food, exercise, daily routine and eating reinforce negative schema. I treat myself like a machine that needs to be punished because that’s all I deserve for being stupid, ugly and useless. I don’t deserve to eat and hate my body for feeling hungry and my mind for always thinking about food. I hate that I got weak and ate a carrot with coffee for lunch because I promised myself not to eat more than one meal a day until I reach my goal rate. Grrrrrh!
People with an eating disorder are cruel to themselves and use their relationship with food to act out this self-contempt, convinced they deserve this kind of treatment as well as using it to tolerate their daily life. The question is why do these people have these core beliefs about themselves? What is the story of their eating disorder and what would their life-story be without it?
Not All Eating Disorders are Visible
Not all eating disorders are visible. For example: bulimia, where the body often remains within a deceptive healthy weight range, showing nothing of the dangerous dance they’re in with an electrolyte imbalance, arrhythmia, stomach ulcers, esophagus tears and extreme dehydration. Signs of bulimia are easy to hide and for its story remain unknown.
These individuals can and do die in their sleep from cardiac arrest; high level of acid building up in their blood inducing a sudden coma and death; seizures or fits that can cause brain damage or even death; pancreatitis where digestive enzymes attack the pancreas in reaction to an excessive use of laxatives or diet pills; electrolyte imbalance which offsets cardiac arrest and death; suicide and depression. Furthermore a gastric rupture can occur when huge amounts are consumed during a binge. Although they are not common, they often result in death; hypo and hyperglycemia caused when blood sugar levels are too high or too low from bingeing and purging/fasting and Gastroesophageal Reflux Disease which can lead to cancer in the esophagus.
For bulimics and binge eaters that are overweight, feeding the body nutrient dense food may actually result in weight loss that can be maintained once it has reached a point within their healthy weight range. While this can be achieved none of it means anything until the patient’s life is actually bearable and something they want to live through without an eating disorder. In other words what is making their life unbearable needs to be addressed with as great urgency, consideration and devotion as the maladaptive behaviour around food.
Without doing this all that is happening is that they are loosing their eating disorder and because it is all many of these individuals have in this very compromised and damaged experience of life, they are likely to find themselves in it again. To take away a survival mechanism requires replacing it with something that works better, feels safer and serves the disordered eater in the way that their anorexia, bulimia or binge eating served them. Obviously, the new strategy should not have the same negative life-threatening effects.
Without a replacement strategy that empowers the person with an eating disorder, it seems naive to ask them to let their eating disorder go. Something must be given back in return. To offer life to someone who finds it so hard they’d rather die is redundant. They need to be offered strategies and ways of seeing life that make it seem like something they could be part of and enjoy.
Someone with an eating disorder has a mindset that is negative, vulnerable, afraid and threatened and recovery must transform this self-destructive energy into something positive, strong, confident, independent and assertive. This is why recovery benefits from including:
- education of the disorder, self, integration and effective ways of dealing with conflicts throughout life;
- the dignity and integrity of choice
- and letting the disordered eater speak for themselves as to what it is they need.
What are the symptoms trying to say?
Those with an eating disorder can speak for themselves should they wish to. If asked, they receive the opportunity to say it on their terms, in their words and at their own pace.
If this article has been useful to you please like it and/or share it with those it would interest and benefit. Also, please use the comments section to share your thoughts on the subject.
Dr Angelina Mirabito
PhD on the therapeutic value of reading and writing trauma fiction and its potential value in the post-traumatic growth process.
To book a complimentary ‘Meet and Greet’ session over Skype to discuss the possibility of working together on your writing project, idea or interest please feel welcome to contact me via https://writingthroughtrauma.org/contact/