A few weeks ago in Barnes and Noble I came across the Eating Disorders for Dummies book. I don’t know what I expected, but it was actually pretty good.
Here are some parts I particularly liked/could relate to:
From the first chapter, “Understanding Eating Disorders:”
“The solutions seems simple and obvious from the outside looking in…[but] a central quality of of the eating disorder is the compulsibity of the symptoms…to the point that the person no longer feels they are a matter of voluntary control (ever tried to quit smoking?)…Nobody has an eating disorder for the fun of it…Your eating disorder is a vote of no-confidence in your personal ability to solve problems, manage feelings, or create a life to be proud of.”
As I discussed in a previous post, the eating disorder serves as sort of cop-out when I feel like there is no way for me to achieve the my life goals or live the kind of life I value. I don’t want to engage in the behaviors, but it seems like the only choice when I feel like I suck too much to make a life worth living. Unfortunately, all that engaging in the behaviors does is reinforce that I suck at life, which creates a vicious cycle that moves me further away from my goals. As for the first part of the quote, I have had so many people this year say something along the lines of “don’t you realize this is ruining your life, why can’t you just stop?” And in response I would say “I don’t know.” I think liking it to quiting smoking though is a good analogy – just because you know that what you are doing is bad for you and can kill you, there is an addictive nature to it that is hard to simply stop.
In the Chapter “Eating Disorder Risk Factors” she mentions two personality traits that I can definitely see in myself. The first is shame, which she differentiates from guilt. Shame is “a chronic sense of personal inadequacy…shame is different from guilt. When you feel guilt, some behavior…gets put in the hot seat…[and] you can think of ways to set things right with whatever is making you feel guilty…[but] with shame, your entire self is judged and found unworthy.” I definitely feel the chronic personal inadequacy that she describes.
The second personality trait I see in myself is needing external approval. She writes, “some people listen to their own internal guiding voice to make decisions and form opinions…others achieve confidence only when they get a seal of approval from others. Their own voice…is either untrustworthy or doesn’t count.” Those words describe me exactly, although this problem of mine doesn’t drive my eating disorder in the way that she describes. She says that those who trust outside sources more than themselves are vulnerable to getting sucked in by cultural messages to be thin. This does not fit for me. Rather, the way I think this manifests in my eating disorder is that it makes it hard for me to make decisions, which spurns lots of anxiety and ruminating thoughts. I then funnel this anxiety into an obsession with food, weight and calories. In addition, it makes it hard for me to trust any decisions I make regarding treatment, fueling the voice that says “you are not sick enough,” which causes me to keep the behaviors going as a way to prove to myself (via other people telling me as they notice weight loss or behaviors) that I do warrant help. Furthermore, I always feeling like I am disappointing others, which feeds back into the shame.
The last thing I found particularly insightful was in one of the chapters about treatment. In the section on “Making Good Use of the Approach You Choose” she discuses the importance of giving up the longing for both a quick fix and an outside fix. She says “living right alongside fears of giving up your eating disorder is a small volcano of urgency that says you must get over your symptoms now….[and] longing for someone or something outside of you to fix the eating disorder…reflects your vote of no-confidence in your own worth and abilities.” Your therapist can serve as a source of guidance and support, but “hoping your therapist or the therapy process can be the outside fix is just another in a line of efforts doomed to failure.” As I have experienced many times, the quick fix expectation makes you vulnerable to relapse because it makes you want to turn to something that makes you feel better now (like restricting) rather than keep plugging away at treatment. Regarding the desire for an outside fix, she emphasizes that only you can heal yourself, and makes the analogy of a therapist being like a personal trainer – your therapist can guide you and support you, but you are ultimately the one who has to do the workout. Some signs that you are looking for an outside fix are: “1) You regularly wait for your therapist to suggest something to make you feel better, 2) you resist your therapist’s efforts to engage you in self-soothing or other emotion management techniques, 3) You frequently try to convince your therapist that expecting you to make the kind of changes in your life that the two of you are discussing isn’t reasonable.” Check, check, and check. I am getting better at this though, and I think months of convincing people that it didn’t matter where I went to treatment, it mattered what I did, helped me to realize that while a good therapist is important, it is ultimately up to me.
All of the things that I brought up tie together for me. I have no confidence in my ability get where I want in life, and I channel that anxiety into the eating disorder. That then brings me further away from the life I want to live, and also pulls down my confidence in my ability to recover. Likewise, because I am always needing external approval, I have a hard time trusting myself and the recovery process, especially when I am getting messages from friends/family members that amount to “why aren’t you better yet?” Another component is that black and white thinking accompanies the need for external approval. For example, I am concerned about what others think of my decisions and goals because I worry that my decisions or goals are “wrong.” Always being worried about making the wrong decision leaves me very stuck, as I have mentioned in many previous posts. Also, this thinking is often accompanied by what I call “problem/fix” thinking, meaning that when something goes wrong I expect there to be a solution to that problem. This directly links to the idea of a “quick fix” and frustration when either a) I can’t identify the problem or b) I feel like I have uncovered lots of problems/underlying issues and solutions to them, but the ED still persists (how I feel right now)!