A confusing part of treatment for an eating disorder is the need to avoid certain feelings. That is not the usual method therapy applies and seems counterintuitive for a set of illnesses that enable people to avoid feelings. The underlying reality is that certain feelings reinforce a sense of hopelessness which can sabotage any real attempt at recovery.
The most insidious of these feelings is regret. In the safe confines of the eating disorder mindset, all decisions about food are paramount and, accordingly, everything becomes secondary to the primary goals laid out by the illness. It's problematic that many of those other concerns are much more important when it comes to daily living than the short-sighted, fruitless tasks of an eating disorder.
But understanding the power of an eating disorder means making sense of this powerful driving force. The thoughts feel incredibly meaningful and give order and structure to the scary emotions, relationships and decisions that are a part of every day life.
Even a small step away from the eating disorder can open a person's eyes quickly. That immediate awareness, like a screen suddenly lifting, illuminates the emptiness of life run by an eating disorder and the missed opportunities that abound during the years lost in illness.
It's tempting to follow that path of regret both for the patient but also in therapy. Mourning and a sense of loss are often critical parts of adult life and are very hard for even people who are emotionally healthy. The pain and struggle are easily avoided in the daily routine so any therapist would feel compelled to explore these emotions.
For people with eating disorders, regret is a bottomless pit of shame, a detour right back into the self-loathing that can start a full relapse. Recovery takes so much attention and focus on current emotions and on each meal and snack. Sometimes, hope can be hard to find in the daily slog but a sense of purpose or at least delayed promise can serve as enough drive just to get through each day.
That amount of resolve cannot withstand a period of dwelling on loss. That time has passed and reviewing the pain wrought by the eating disorder leads to a strong urge to rely on the illness to cope with the emotions.
Once the person is ready to face the sense of loss, life has already taken over. Moments of regret might pop up at times, but the pressing moments of life instead take center stage.