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  • Laura Machado, PsyD

Lasting Eating Disorder Recovery

I’m a recovered person, and I am a psychologist that treats people with eating disorders. And yet, I do not want to help you recover from your eating disorder. At least not in the way that most people are thinking of recovery.

The word recovery sounds like the goal is to go back to where you were before the eating disorder began. Recover: get your pre-eating disorder self back.

But I’ve always thought why would we aim to go back to where we were before the eating disorder? Why would we go back to a place when the eating disorder “got us?”

It is my firm belief that we shouldn’t aim to recover to where we were. Rather, in the healing process, we need to arrive at a new, sturdier place instead. In other words, to heal from an eating disorder in a lasting way, we need to discover a place we’ve never been before; a new way of being, of relating to self, food, body, others, and the world. We need a paradigm shift that allows us to live in a newer, sturdier place in which we are as safe as can be from any future relapses.

Lasting recovery is not a lack of illness; it is the presence of wellness.

As an aside, many people tell me, “I don’t want to recover. I wasn’t happy before.” And my response is: “I don’t want you to go back to where you were before either! That would definitely not be worth it. Let’s create something new.”

I’ve got a metaphor and two images I like to share with people:

  1. Imagine looking from above at some bright, green grass. All the blades of grass appear healthy; the grass appears vibrant and just as it should. What you can’t see, however, is that one of those blades of grass has no roots. It is a loose piece of grass just sitting there. You don’t know it’s not rooted down in good weather. But the second the wind comes through, it blows away. If this blade of grass is like a person with an eating disorder, why would we aim to get them back to a place where they “look good,” and they appear fine so long as no wind comes along?! No! We want to give this blade of grass roots! So that, sure, life can blow it around a bit but nothing will displace it and blow it away. A person who has sustainably recovered is not a fragile person. They can handle some wind because they are rooted in a way they never were before.

  2. Next image is a graph. The process isn't actually this linear, but for ease of drawing, it's depicted that way. Hopefully it is self-explanatory:

3) Here’s the other image I draw for people to illustrate the goal of recovery:

My point is this: simple recovery, as defined by getting back to how you were before, is dangerous. It cannot be the goal. And yet, it appears to be the goal in most of the research (and that’s at best. A whole ‘nother topic is how the research has so many definitions of recovery and some of them are super terrible and full of low standards.)

When treatments for eating disorders are studied, their effectiveness is, at best, defined by measuring recovery thought this way: does the person look, act, and think like most other people their age and gender? I’ve always thought: are you kidding me? No way do I want my college student female clients to recover to a place where they think and act like other college student-aged females as it pertains to food and body? No!

The message so many people with eating disorders get is that eating disorders are chronic. You will have to learn to “manage it” your whole life. Nonsense, I say! That is only if we set our goal at simplistic recovery and never pursue lasting, sustainable recovery, a.k.a. “discovery.”

This begs the question: What is discovery? That is, what is it that will make recovery lasting? I have a lot of thoughts on that. In fact, it was the entire topic of my dissertation. But to spare you a dissertation-length article, let me say this: identify what it was that made you a blade of grass without roots. Identify what it was that made you susceptible to the ED. Address that. Study the etiology and biology of eating disorders in general. And address that.

To get you started, Some ideas: you should look at…

  1. biological factors (such as your reaction to, even unintentionally, getting into a state of negative energy balance--meaning taking in too few calories);

  2. your temperament (learn how to harness it as a strength and step away from it when it becomes a weakness);

  3. issues of identity (such as thinking of yourself as “the small, fit one” or “the super nice one” or “the hardest worker of them all” or “the sick one,” etc.);

  4. issues of attachment (knowing how to voice your struggles and needs, make requests of others, receive care)

A future article will dive into these more deeply, but I hope in reading this you can shift your mindset. Let yourself imagine, be curious, design and discover your personal state of sustainable, lasting healing from an eating disorder. Let yourself go to a new and sturdier place than you’ve ever been in. And this is why I sometimes refer to this process as “the gift of the diagnosis.” For without the diagnosis being the thing that started this process, you may never have discovered this better way of living.

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