Why People Love their Eating Disorder

Unlike most psychiatric illnesses, and most medical ones too, eating disorders are ego syntonic, a psychological term which means that the central thoughts of the disorder feel right and good, something crucial to one's ego. Based on my recent posts about the harsh thoughts associated with eating disorders, this idea may seem contradictory, but the negativity of the thoughts only become clear once someone starts recovery. Before that, as long as the person obeys the thoughts, the disorder makes a confusing and scary world very calm and peaceful, even as the illness destroys any chance at living a full life. 

It's hard for most people to understand how an illness can feel good, and therein lies much of the public confusion about eating disorders. 

The evidence abounds for this inherent trait of eating disorders: websites extolling the virtues and successes of having an eating disorder, the misguided envy of many adolescents of their peers with anorexia or bulimia, and the tenacious grip the person maintains on her eating disorder as a lifeline to safety. And that is just to name a few. 

Unfortunately, the nomenclature for eating disorders largely ignores this critical component of this group of illnesses. The list of symptoms focuses on restricting food, binging and purging with only a minimal reference to the powerful attachment to the illness and the lack of insight into the severity of one's impairment. 

Focusing on the eating symptoms themselves remains mystifying and intriguing to laypeople. The urge to resist eating and use compensatory behaviors to avoid digesting food masquerades either as a successful diet choice or completely perplexing behavior to people ignorant about these illnesses. The vast majority of available knowledge omits the intense connection between the ill and her disease, thus ignoring the central reason people cling desperately to their illness and the resulting difficulty of recovery. 

So the struggle between the afflicted person and her family and friends stays focused on the food. The struggle between external pressures to eat cannot directly compete with the powerful personal connection to the illness. Any successful intervention has to challenge this connection and reveal the lies that sustain it, not just convince the person to eat dinner. 

The calm and peace that comes with feeling together and close to the illness stems from a web of lies. The eating disorder limits personal life significantly. Although some people can enjoy some success, especially in the academic or professional arena, the end result is a severely limited existence. The opportunity for close relationships, personal connections and the full range of human emotions doesn't exist. The urge to engage in the eating disorder symptoms and retreat from life dominates daily life. 

The thought process that keeps someone attached to this existence repeats the same messages over and over: relationships are not reliable; people always disappoint you; you have figured out how to stay skinny and that's most important; nothing will ever work out for you; you're not worthwhile enough to anybody; no one really cares; I (the eating disorder) will protect you.

These thoughts feel absolutely true which makes the need to stay close to the eating disorder even more important. The way to challenge these lies is not to implore someone to eat. That only fuels the eating disorder further. An effective approach is to challenge the lies again and again, to point out that the lies themselves keep someone so sick. 

The next post will explain how someone escapes the ego syntonic experience of an eating disorder in recovery and how family and friends can support the process.


Ways to Counter the Eating Disorder Thoughts

The last post explored the power of eating disordered thoughts and why they exert a strong grip on people trying to recover. It's difficult for people without these illnesses to comprehend how thoughts about not eating can dominate one's mind. The combination of a seemingly inescapable thought process and the inexplicable nature of the mental illness leads to extreme isolation and despair. 

I realize that presenting the last post without some guidelines to face the thoughts can appear to be fairly demoralizing. 

There are three main ways to manage these thoughts through recovery: personal relationships, honesty and replacement thoughts. Although the concepts are relatively simple, putting them in place daily against automatic thoughts of the eating disorder presents one of the major challenges of recovery. 

A person fully engaged in the eating disorder with no intent of recovery finds the eating disorder thoughts largely comforting. The thoughts themselves may be harsh and critical, or even nonsensical, but they present an easy roadmap to follow for a predictable daily life. As long as the thoughts go unchallenged, the person experiences an enormous amount of comfort, often described by many as a best friend or partner. 

The existence of a risk-free relationship to an internal set of rules tends to obviate the need for any true relationships. The relationship with a thought process feels very real and predictable while real relationships are unpredictable and scary simply because they involve another person with their own thoughts, feelings and needs. 

There are obvious needs an eating disorder cannot fulfill, and even a small step into recovery exposes the incredible loneliness right below the surface of the illness. Opening one's mind to wellness involves re-engaging in relationships. The process of establishing and deepening those connections weakens the eating disorder thoughts each day. One step in facing the thoughts is consciously making the effort to create true connections in the world which highlight the emptiness of the illness. 

The thoughts thrive on secrecy and lies both to people in the world but especially to oneself. The fundamental messages of an eating disorder are similar for almost everyone: you don't really need to eat; you have found the comfort you need so who needs other people; people always let you down; the eating disorder is the best thing you'll ever have. These internal thoughts become one's reality. The sense that these messages are lies no longer rings true.

Either talking to other people or in relation to oneself, these lies are the basic philosophy of life. They become the bedrock of how to function day to day and lead to a life full of the illness but little else. Constantly working to question these lies and instead start to believe the reality of the eating disorder as an illness critically weaken the thoughts over time. 

By creating parts of one's life separate from the eating disorder, the person in recovery can recognize and identify other daily events and thoughts that compete with the eating disorder thoughts.

The person in recovery starts to be able to identify eating disorder thoughts as part of the illness rather than automatic, true facts. In doing so, it becomes possible to replace the illness thoughts with other realistic thoughts about daily life. This will weaken the thoughts as well and render them much more powerless in time. 

There are many steps in recovery that allow a person to face the eating disorder thoughts and continue the road to wellness. It's crucial for family and friends to work hard to understand the power of the psychological part of these illnesses and acknowledge the challenge of getting well. As the person better understands the ways to counter the thoughts, it will be easier to communicate their struggles and need for support. The better one understands this component of recovery, the more hope one can have of getting well.