Much has been written by acclaimed clinicians who treat people with eating disorders about the desire to disappear. One central wish for many people who suffer from these illnesses is to fade away and simply vanish from the world. The mere act of starvation is the process of wasting away in order to take up less physical space, but the wish to be gone represents more than that concrete manifestation.
The underlying tenet of this fantasy is the concept of not having personal value as a human being. For most people, a sense of self-worth pervades the way everyone goes through the world. Waking up and living each day implies a sense of meaning and value. Meaningful relationships or even simple, human interaction give a sense of purpose to our days. There are many more ways people see their increased value but I am trying to point out the most basic self-worth we have as human beings.
There are more subtle ways people express how they value themselves. Speaking up for your own wishes or rights is a way of expressing self-worth. Emphasizing self-care can send a message to yourself and others of valuing yourself. Talking about one's life day to day implies value in the quotidian tasks. Even the basic concerns like sleeping and eating show a sense of value in ensuring one's body is prepared for the day.
People with eating disorders can have trouble with all of these things: speaking up, self-care, taking about oneself and ensuring basic needs are met.
The result of struggling to prioritize these concerns represents the figurative process of disappearing. Even if the eating disorder does not cause a literal disappearance or diminishing, the psychological underpinning of these illnesses is one's own disappearance.
In terms of support and treatment, the implications for these truths are very clear. Therapy, but also support from friends and family, needs to emphasize self-worth in the world.
Personal characteristics and positive traits that may be obvious to most people are almost impossible for someone with an eating disorder to see. That person may need their own positive attributes repeated dozens of times before they start to process the information. Self-deprecating comments need to be contained and questioned again and again. It's critical to identify these thoughts as untrue and caused directly by the eating disorder.
Although the actual causes for the intense self-negation for someone with an eating disorder are varied, figuring out that cause is not always necessary or central to treatment. It maybe useful for some people, but the important idea is to undermine those thoughts and help the person to find their own voice and learn to see themselves clearly in the world.