Tug of war with an eating disorder

Tug of war with an eating disorder

Family Based Treatment is the best, evidence-based approach for most children and adolescents to get their life back on track when they develop an eating disorder – particularly anorexia nervosa.

But what about those of us whose eating disorders developed before Family Based Treatment (FBT) became an option? Or those who have missed out on effective support through lack of access, or perhaps for whom this treatment has not been appropriate?

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

Despite part of our brain being high-functioning, 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 start feeling fed up. Frankly, sometimes, sadly, the tussle within our minds can get too much to bear.

We can become desperate to find a way out of this eating disorder war zone that is in full flight in our brains. On the outside, we are pulling towards living up to normal expectations in our role as students, relationship partners,  employees, parents, children and siblings. On the inside, our eating disorder is pulling us 24/7 back the other way.

The healthy part of our mind is in a constant tussle with the uninvited eating disorder voice. The messaging is confusing, tiring, chaotic, depressing, and full of other feelings we generally don’t want to know about. I wrote, at age 36, in a sudden burst of insight:

… 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. I (must) accept my mistakes and bad experiences…(so they) can be the catalyst, the seed, for new beginnings and fulfilment.

A lesson in not giving up

Beyond that diary entry, I took another 20 years of slip-slide-climbing to succeed in rebuilding my healthy self to more than 51 per cent. At that point, recovery accelerated, and I attained my longed-for new beginning and fulfilment.

Correspondence from families and individuals today indicates eating disorders continue to wreak havoc when a child develops an eating disorder. Accessibility to evidence-based treatments, especially FBT and multi-family therapy (FBT), can be hard to find. The situation is more dire for adults:

I am 32 years old and have been battling anorexia and bulimia for 23 years. It’s too long and I am hoping this is the last time I go through the recovery process. I am a wife, mother, artist, and 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 than 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 I 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 meal plan, and I’m still in pain…is there a chance that I can come right?…have you any advice on how to heal your body and cope with the physical discomfort…I’m so proud and in awe of what you have achieved….  – “N”.

‘Yes, yes’, you can recover

I want to hug everyone struggling and say, ‘Yes, yes’, you can recover; you can strengthen your health self and develop healthy coping skills to manage daily stressors. 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 bad relationship, if I was candid with myself, was because it gave me a reason to continue with my bad  but powerful eating disorder. Note: two negatives.

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. My healthy self had to repair and get strong enough to do this.

Overcoming the fear of letting go

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 — 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 saved on my appointments will meet the cost of my son’s school camp fees.

Does this sound familiar? I could always justify my decision. Always. My eating disorder was an expert at negativity. 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.

Severing the strings of the eating disorder

How did I manage to climb to the summit and get over the line? Eventually, I accepted that the only person I was fooling was myself. I learnt, over a number of years, to trust my recovery guides when fear stopped me from trusting myself. I learnt to allow them to support and keep me afloat and be strong for me when needed 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 sit on a ledge for a day or two while I caught my breath and replenished my fighting spirit. But giving up was not an option. I wanted to live. Writing in my diary helped as a training ground for new healthy-me thoughts. Life and freedom beckoned.

Don’t give up.