People with eating disorders, of any type, usually go through a process of eating disorder treatment and recovery to attain what I refer to as a recovered state. Eating disorder treatment includes intense learning about how the eating disorder serves as a coping mechanism, and what feelings are being coped with, using the eating disorder. In recovery, the patient uses new coping skills to deal with emotional issues that arise when the eating disorder is gone, and feelings that were suppressed rise to the surface. Recovered is moving through life’s challenges, not related to the eating disorder or recovery.
Recovery is a phase similar to eating disorder treatment in that it is very much a process of dealing with emotions previously controlled by the eating disorder. Recovery in many ways is more challenging than eating disorder treatment. Eating disorder treatment might be getting over the fear of eating bagels, whereas a recovery challenge might be “Who am I now that I don’t have my eating disorder?”
Patients going through recovery receive one-on-one consultations and group sessions. One-on-one consultations deal with the individual goals and recovery challenges, whereas in group sessions, patients get support from others going through the same process of recovery. Group support comes from sharing similar challenges and instances that have less to do with food, and more to do with emotions. Recovery group is full of people trying to find themselves without the eating disorder.
Patients with eating disorders often experience a lack of identity, safety, or control, all which produce pain. Patients often think, “If I allow myself to feel, it will be too painful and if I focus on food, I’ll have control over my feelings.”
People with eating disorders often think about food related things 95% of their day, so the idea of not having an eating disorder can cause fear, due to losing 95% of their day, control, coping skills, etc. Now they have to fill that gap with an identity that they are not familiar with, and have to figure out who they are in recovery. It is a very different challenge going through “Who am I” and What is my identity?” versus “How many carbs are in this bagel?”
During recovery, a patient can be triggered without actually going into the eating disorder. For example, a patient is triggered to binge and purge and comes into recovery group and says: “I’m really really urged to do this and I’m triggered by the stress of my father in law, but I didn’t do it, because I used another coping mechanism instead.” They could also be in recovery and use their eating disorder, but be processing through it emotionally. In recovery, patients learn how to use healthy coping skills and put them to action.
Recovered people have graduated from the recovery group. Coping skills start to come naturally, and they seem to know who they truly are and what they need to have good self care. They are who they want to be and feel safe in the world with all the world’s stimuli that used to trigger, charge, or inspire their eating disorder.
They are now living the way they strived to in recovery. A person who is recovered rarely attends group or individual sessions. This is discouraged due to wanting them to practice living in the recovered state.
The goal for my patients with eating disorders is empowerment to deal with challenges that life has to offer, without having to continue eating disorder treatment or maintain recovery for life.
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