Playing tug of war with ED

Playing tug of war with ED

The Maudsley Approach is the best, evidence-based chance for most children and adolescents to nip their eating disorder – particularly anorexia nervosa – in the bud and get their life back on track in the quickest possible time.

But what about those of us whose eating disorders developed before the Maudsley Approach – also known as Family Based Treatment – became an option? Or those who have missed out through lack of access, or perhaps were among the group for whom this treatment has not been appropriate?

Most of us who developed anorexia in childhood or adolescence survive ‘somehow’; some miraculously recover anyway and move on, but many of us live part lives and struggle along, trying to put on a brave front to those around us, while fighting the torment within.

But the struggle can become acute. It can become like a daily tug of war. By the time we reach our late 20s and early 30s, we are starting to feel fed up. Frankly. Desperate to find a way out of this eating disorder war zone that is in full flight in our brain. We are pulling towards trying to live up to normal expectations in our role as girlfriend, wife, employee, mother, daughter, sister.  And our eating disorder is pulling us back the other way.

It is confusing, tiring, chaotic, depressing and all the other words we generally don’t want to know about. What riles me is that a QUARTER OF A CENTURY has passed since I wrote, at age 36:

… for years I have been seeking my identity, purpose, meaning, in life. Years. I am a prisoner to myself. If I don’t take a stand, I will live my life feeling frustrated, and unfulfilled; I will not know the joy of inner peace, or the achievements I can enjoy if my energies are set free.

… since falling prey to anorexia much of my creative energy has been wasted; this private obsession with food has robbed me of my true self. ( (must) accept my mistakes and bad experiences can be the catalyst, the seed, for new beginnings and fulfilment. 

Twenty-five years later, in 2012, I receive these heartfelt letters, which indicate eating disorders have not changed much if at all over the years – despite all the talk about the influence of media and obesity on the illness – and neither has the effect of many treatments, especially for adults:

I am 32 years old and have been battling anorexia and bulimia for 23 years. Its too long and I am hoping this is the last time I go through the recovery process. I am a wife, mother, artist, teacher and I just want to live life. I am really struggling right now with the aspects of weight gain. My mind plays tricks on me and makes everything seem way bigger then it is. I feel like people notice the changes and it’s so hard for me to get dressed and go to work.  I think you’re wonderful and your profile picture makes me smile, seeing you successful and thriving.  – “M”.

I am 33 and have suffered from eating disorders of one kind or another since the age of 16. I’m so tired, hopeless, and scared. I am seeing a therapist and doctor, but feel so frightened that the physical damage i have done to my body is irreparable…I get so confused and unsure what and how to eat even when I get a mealplan, and I’m still in pain…is there a chance that I can come right?…have you any advice or tips on how to heal your body and cope with the physical discomfort…I’m so proud and in awe of what you have achieved… I’d be honored if you could share some recovery advice.  – “N”.
I want to hug everyone who is struggling and say ‘yes, yes’ you can recover, you can. I did, and you can too. This is not to say it is easy. But even after many years with an eating disorder, it IS possible to recover. I, and others, are proof of that. Not easy, but the reward of freedom makes the effort indescribably worthwhile.
It is a tug of war to be sure. Letting go of our eating disorder, even when in the care of trusted health professionals, can be very, very scary. Apart from refeeding, one of the biggest challenges for me was when I reached that stage of enlightenment – where I was aware that I needed to avoid a trigger, to regain me. I became aware, for example, that I was staying in a relationship that was not good for me. The reason I was staying in the relationship, if I was candid with myself, was because it gave me a reason to continue with my eating disorder. If I did the right thing by me and ended the relationship I feared I would have no distraction, no excuse, no reason for not confronting the emptiness created by my eating disorder within. Yes, this stage of recovery was a battle of wills, it was a tug of war, between my eating disorder and me. I sometimes made up the weakest of excuses to prolong my illness – not that I wanted to prolong it, but because the fear of letting it go was immense. I would avoid appointments with my therapist or psychiatrist, with my self-talk going like this:
* I can get better on my own. I don’t need Dr So-and-So any more. I know what I need to do to manage.
* I mucked up good and proper last night when I ate like a starved elephant on a picnic – I feel terrible. I feel too terrible to see my therapist. I will call and say I can’t get time off work for my appointment today.
* On my previous appointment I agreed with my therapist that I would end the relationship with “J” by today. But I haven’t been able to bring myself to do it. I’m cancelling the appointment, that’s what. I can work it out, I can manage, without ending the relationship. I will count calories and exercise and everything will be manageable. Besides, the money that I would be spending on my appointments will meet the cost of my sons’ school camp fees.
Does this sound familiar? I could always justify my decision. Always. And after a moment of defiance and euphoria, I would start to feel terrible, and the little slip would become a downward spiral, swiftly descending into an avalanche. This stage, where the chips are on the table – when we are awake to ED’s game plan, when we are aware and yet not quite able to do what we know we need to do (because facing that perceived emptiness without ED is so damn scary), is a sign we are near the end of our recovery marathon.
How did I manage to climb to the summit, get over the line? Eventually accepting that the only person I was fooling was myself. I learnt, over a number of years, to trust my recovery guides. I learnt to allow them to support and keep me afloat while I severed the strings of ED, one by one, and strengthened the strings of perseverance. Refusing to give up. Holding on to hope. Trying and trying again. No matter how many times I lost my foothold and slipped down the mountain, I would get up, dust myself off, and start climbing again. Gradually the slips became less frequent, less severe; and the climb to regain me became easier.
Sometimes I did want to give up and  would tread water for a day or two while I caught my breath, replenished my fighting spirit. But giving up was not an option. I wanted to live. Life and freedom beckoned.

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