Recovery from an eating disorder is a process. For people who see the world in very black-and-white terms, namely those with eating disorders, the concept of process is a tall order. It implies ups and downs, swings that feel very powerful emotionally and days when all seems for nought. Years of an eating disorder wear down even the preternaturally hopeful and binds any optimism into a vortex of doom. In such a dramatic place the whole idea of process appears incredibly naive.
But the process of recovery is what we clinicians have to offer. Put simply, simple tools practiced over time really do work. Write a food journal every day; plan your meals the night before; be active during the day, especially after meals; be around people, even when you want to be alone; and pay attention to your feelings for they are the best clues to stay on the path to recovery.
When the person in recovery knows that her therapist and treatment team are willing to go through that process too, she knows she's not alone. That makes all the difference in the world.
The concept of process implies another necessary component in recovery: resilience. The path of an eating disorder typically leaves people feeling completely powerless. The best laid plans falter from the get go. A day derailed early never gets back on track. The mantra of the person with an eating disorder is "I'll start towards recovery tomorrow," but tomorrow never comes. It's a new idea to contemplate resilience in the face of the eating disorder commands. That simple suggestions and support can alter the eating disorder symptoms feels miraculous. It feels impossible for a day to start off challenging and turn out all right. Yet experiencing resilience revitalizes true belief in hope again.
Once process and resilience become real to the person in recovery, she begins to experience something very new and raw. The despair connected with the lost time of an eating disorder and the numbing effect of the symptoms both limit any knowledge of the true emotional experience of daily life.
Regular people learn to cope with their own emotions through years of practice. They come to know themselves and how they can live with their feelings, some constructively and some less so. A person in recovery is suddenly thrust into a world of raw, intense emotions, ones she hasn't experienced in a long time. Even a crash course in personal exploration doesn't prepare her for the jarring blast of the panoply of emotions: sadness, anger, disappointment, shame, frustration and fear. The pull to use eating disorder symptoms and return to numbness is very strong, a salve for all the open wounds, but one that only leads back to despair.
When it comes to the emotional life of recovery, each person needs to understand the process too. Time will heal those wounds. Emotions may feel like a bottomless pit, but the bottom comes before you know it. Emotions for someone in recovery are, in the end, the same as everyone else's. It just takes time to get used to them. The simple things people do in order to weather emotions works for those in recovery: talk to someone, journal, watch a movie or just cry. These tools seem inadequate, perhaps even trivializing, at first, but emotions are just a part of life, a reality of being human. No powerful intellect or personal mastery allows anyone a pass on feelings. The mastery is akin to acceptance: the process of succumbing to emotions in the moment, even of you're unsure of the path ahead, is bearable when you remember you'll be all right in the end.
This last step points out one more step in the process, trust. A person in recovery doesn't know how to trust their own instincts or ability to make reasonable decisions each day, let alone trust anyone else to guide them. The eating disorder has been the only guide in life. Yet believing in hope, resilience and emotions requires trust in oneself, clinicians and family. This is not a path one can forge alone.
The ups and downs, moments of elation or panic and feelings of hopelessness and despair will be unbearable for a person completely alone. People to share these experiences with and shoulders to cry on will mitigate what feels insurmountable. That support enables the person with an eating disorder to work just as hard the next day until recovery starts to feel like it's paying off. Given the necessary time, the process of recovery works. People sick with eating disorders do get well.