We all need a narrative of our lives, something that creates a picture of who we are and where we have come from. It keeps us in the present moment and connects us with our place in the world.
For people with an eating disorder, their own story was abruptly halted when they first got sick. One step towards health is to circle back to that time and resume the narrative with a simple question: what caused the disorder in the first place? Since patients so often feel robbed of the time taken from them, piecing together the story is of the utmost importance. It is a way of reclaiming that lost time. The immersion in the isolating world of the eating disorder erases both identity and personal narrative. Picking up the pieces and retelling that story over and over again until it is right are a means to recover.
Practically, this means a significant portion of therapy involves looking back. The girls who first started to get sick seem so different from the women escaping the disorder years later. Those girls were in the throes of adolescence. They were inundated with the physical and emotional shifts in their lives. They battled the cravings for independence while clinging onto the lack of responsibility and freedom of being a girl. Whether they stumbled upon the high of a diet or the release of a purge or whether someone introduced them to it, these girls were much too young, confused and desperate to know what was happening. It can be hard for an adult struggling to recover not to get angry at that girl and at herself. Shouldn't she have known what was coming?
In hindsight, the answer is clearly no. However, after years of being sick, it is a big hurdle for the person in treatment to accept the utter confusion and helplessness of the girl who got sick. But that acceptance is a crucial step towards restarting one's story. It is much easier to avoid these painful memories altogether and instead stay focused on the search for a straightforward, simple cause of the eating disorder. In fact, the burning desire to answer that question can take on symbolic meaning. People often think the answer will cure the eating disorder in the magical way an adolescent mind works. I wish that were the case. Realistically, the answer will help someone stop blaming themselves and try to see how this painful experience was both an abyss she never saw coming and a trap she did not know how to escape. More to the point, she needs to see that the disorder has become part of her story.
Needless to say, a patient in recovery wants to eliminate the disorder and never look back. The idea that it actually needs to be incorporated into the story is never welcome news. Answering the question is supposed to put the experience to rest once and for all. Instead, the treatment begins to review the painful memories of the transition from adolescence into the disorder--the time when the narrative stopped--and from that point formulate the rest of the story up to the present moment.
But from the perspective of treating and also preventing eating disorders, I find myself circling back to a related but different question: why are more and more women derailing their own life story and curtailing their own personal momentum by turning to food? For these girls who first got sick, there are places in which threads of each individual story blend into a larger theme. I have tried to address some of the societal changes that preceded the increase of eating disorders and disordered eating such as the change in food supply, loss of a food community, increased freedom and opportunity for girls and the media's influence on weight and self-worth. In upcoming posts, I want to use the knowledge, perspective and experience of those stories to address the girls at risk now. What can be done to help those girls susceptible to falling into an eating disorder? How can their narrative withstand the bumps and continue without a long detour into food? Why do girls turn to food to create their own story? What other options do children and parents have?
I want to start the next post addressing the role personal story and narrative have in children's lives and what purpose an eating disorder psychologically and emotionally serves in that regard.