One difficult part of recovery from an eating disorder is letting people close again. It's hard to tell which comes first: the illness or the lack of intimacy. Being so sick at a young age with an obsessive disease completely eliminates any ability for closeness, but, for some, the eating disorder replaces the need for relationships by providing reliable comfort and solace. The food, or starvation, has a powerful calming effect that for the time replaces the need for others in life. No matter the type of eating disorder, recovery necessitates finding close relationships again in order to help the person both find connection, a vital part of being human, and remember what the illness has taken away.
The transition from isolation to intimacy is rough and rocky. The eating disorder may be punishing, treacherous and dangerous but, above all, it's reliable, and that's very hard to give up. Starving or binging and purging or overeating all lead to predictable comfort and effectively numb any feelings from day to day life. The calm may be brief and followed by guilt and anger, but in the moment the symptoms feel worth it. Life stops for a moment. The escalating swirl of emotions and frustrations of daily life, which overwhelms someone with an eating disorder, temporarily fades. All that's left are the simple rules of an eating disorder and the powerful chemical brain effects created by the symptoms around food.
But no one recovers alone in a bubble. Without relationships and support, the internal urge to return to the eating disorder is too strong, and a slip or relapse is all but inevitable. What confuses many people, both those recovering and friends and family, is why relationships feel so hard.
It's not obvious why an illness focused on food and weight has anything to do with closeness and intimacy. The confusion can easily trigger disputes and arguments. Often people accuse those in recovery of being too sensitive and needing to develop a tougher skin. Another common complaint is that the person isn't being honest or forthright. Even if these comments are meant to be helpful advice, anyone in recovery would interpret the statement as, "You're too much of a bother for me."
Although the solace from the eating disorder symptoms are short-lived and ultimately unsatisfying, it's very consistent. This known quantity helped eliminate two dangers of being close to others: dependence and disappointment. Most people in recovery find those feelings unbearable, largely from a lack of experience. Years of isolation limited their ability to learn how to navigate these normal parts of relationships. Similarly, people in recovery haven't had any practice expressing their emotions or frustrations to others. And so family and friends try to engage with the person in recovery as if they haven't been sick. Expecting someone with a broken leg to run five miles the day after the cast comes off is completely unrealistic. Similarly, it takes time to understand and handle the ups and downs of close relationships. Finding comfort in closeness with others is something to get used to, not an automatic experience. Expressing emotions or needs clearly in a relationship takes practice. Patience, kindness and understanding go a long way to expedite the process.
The caring from another person feels terrifying and miraculous to someone in recovery. Having been so alone, hopeless and lost, the person has gotten used to loneliness and feeling misunderstood. The illness has consumed their mind and taken even the closest people away. The fear of getting close and then losing the intimacy back to the illness is overpowering. Every misstep feels like the end of the relationship. Any trust feels like it will be instantly taken away. Every moment of caring feels fleeting. Any disappointment seems to foreshadow the end of this brief respite from the disease. It's easy to minimize the magnitude of each moment. Building relationships over time will gradually ease these fears and allow stability of community to replace the shaky foundation of the eating disorder.
The best advice both for the person in recovery and friends and family is patience. Starting to eat means feeling less numb to the world. Every moment of daily life is raw and intense. Each interaction in a relationship feels fraught and fragile. The urge to go back to the familiarity of the illness is ever present. Sustained patience and and understanding of the process of relearning how to live and love without the eating disorder is what the person in recovery needs. That room to learn, grow and get better is often the difference between aborted treatment and full recovery.