Imagine waking up every morning, and the first thoughts that cross your mind are centred on how fat you feel, how disgusting you are, what a failure you are, how you need to lose weight, change the way that you look, or exercise for a certain amount of time to make up for a mistake you made the day before.
How would you feel about yourself? Imagine getting out of bed and standing in front of the mirror every morning, scrutinising your every perceived flaw. Your heart pounding faster and faster with each self-critical thought, the anxiety building until you feel paralysed. The only way you can get yourself to move is by listening to the voice inside of your head that's telling you that you'll feel better if you punish your body through food, exercise, or self harm. How easy do you think it would be to "just stop" listening to that voice? Imagine if you weren't able to leave your house, or engage in social situations without fear of being judged and rejected for your appearance, behaviours, or for just being you. Wouldn't the world feel like a pretty scary place? I've just described some of the emotional, cognitive, and behavioural symptoms associated with eating disorders. Having researched and worked with individuals who struggle with disordered eating for the past 5 years, I can say that my brief vignettes only scrape the surface of my clients' internal and external struggles. Unfortunately, whilst under the influence of an eating disorder it can feel impossible to see beyond these symptoms. When this happens it's easy to get caught up in a narrative of self-blame and self-loathing: to assume that you're petty, selfish, indulgent and vain for focusing so much on your appearance and feeling ashamed and guilty for your thoughts and behaviours. And sadly, public perception of eating disorders only reinforces and perpetuates this narrative. So much so that I feel the need to brace myself each time I respond to strangers' queries about my choice of career. My role as a therapist is to support my clients to see who they are beyond their symptoms and to uncover what lies beneath them. In reality, their symptoms are creative and well-founded ways of coping with emotions and experiences that feel overwhelming and otherwise unmanageable. They are ways of trying to communicate feelings and to protecting themselves from vulnerability and pain. Thus to focus solely on reducing or eliminating symptoms is like taking away someone's perceived life support, leaving them feeling stranded and alone. This is why I don't subscribe to the idea of "treatment resistance" -- in my experience, it's just a medicalised term for fear (and a well founded fear at that ). Recovery involves understanding the function and purpose of the eating disorder by uncovering what fuels it in order to find new and less self-destructive ways of coping with distress and vulnerability. It must also incorporate ways of identifying and nourishing the person that exists underneath the mask of the eating disorder so that self-compassion and a sense of worth can emerge. Recovery is a process of discovery and growth, and as such it involves a lot of trial and error. In this sense, with the right support, "relapse" can be redefined as a learning process. Every person is unique, and when recovery is focused on identity and subjective meaning it enables an expansion of self beyond identification with illness. We are all striving to become the best possible versions of ourselves, and I believe that recovery facilitates this process. Eating disorders are about so much more than body image and food. Equally, recovery involves more than addressing the overt symptoms. So whether you're struggling with an eating disorder or know someone who is, I urge you to try and look beyond what you see on the outside and challenge your ideas about eating disorders and recovery x