Existentialism and Recovery, Part 3

Modern life does not often force us to rethink our basic philosophy years into adulthood. There are certain circumstances--such as illness or tragedy--that do so, but many of the comforts of the western world mean basic necessities are a given.

Granted, it is easy to be lulled into a deep sense of complacency and live out our days, and many of us do live that way. However, the process of eating disorder recovery mandates a profound inward exploration.

Meaning for someone with an eating disorder always revolves around food and weight. Whether positive or negative, food and weight are the primary aspects of life that matter. Everything else is secondary.

It often takes years to realize that prioritizing food and weight pushes everything else down the list. There is no room for meaningful life changes in these circumstances. That realization is usually very painful because it begs the question of what is lost by ignoring so much of life for the disorder. It's often a triumph of the mind to even engage in this conversation.  

At this point any discussion of recovery has to avoid the discussion of regret, bitterness or unfairness. These feelings or thoughts may have a role in the long run but threaten the real discussion of life right now. An existential discussion must focus on what is important at the moment, how to start down a path that will make those things possible and how the eating disorder limits living one's life fully. 

But the discussion has no clear guidelines. There is no specific type of therapy or plan that makes a conversation about the human condition any easier. I, like any other therapist or any other person, am just another human engaged in this challenging and scary topic.

But an honest, heartfelt, genuine experience discussing these issues can make several things clear. Life cannot move forward without changes in priorities. This is our chance to live. Decisions we make now matter more than anything. 

The final aspect of existentialism lies in living in the present moment. Eating disorder thoughts co-opt one's mind to spend the present focused only on food and weight. Any other thoughts are relegated to the future, which is put off indefinitely.

All we have is now, and blind pursuit to remake the past or focus on the future clears the way to ignore the present. In recovery, eating sufficiently means facing the thoughts of the illness now in order to live in a new way. It's a leap of faith to trust that this new direction will create true, deeper meaning in life.


Existentialism and Recovery, Part 2

The rules and laws of an eating disorder give order and direction to one's life. Even if the end result is punishing and unpleasant, there is something powerful to ending a day knowing you have done everything correctly. 

The sense of purpose to eat less, lose weight and follow the rules solves the existential struggle for many people with eating disorders. It's such a relief to escape the tyranny of judging the value of life and instead rely on food and weight as clear markers of success and failure. 

Describing an eating disorder as a calling or set of rules to live by is incredibly confusing for non-believers. How can food and weight replace all the other aspects of life that matter?

Fundamentally, these disorders create an entirely new world to escape to. The rules are clear. The purpose every day is obvious. The reason to live and strive self-evident. There are other people in the world who become so attached to a movement or cause that it justifies their existence so why not an eating disorder?

What the mental health world seems to have trouble seeing is that eating disorders could just as well be a movement. In fact, that component of eating disorders reveals itself in pro-Ana and pro-Mia websites. I don't support them at all as I have written many times in this blog, but the belief system of an eating disorder can be that powerful. 

Take away this purpose to live and the existential crisis of recovery is evident. Years of having a clear reason to live cannot just disappear overnight. The sense of loss of a direction and also the thought that this direction has never been as meaningful as it appeared are enormous. 

The process of recovery must allow for the breadth and scope of reevaluating the most basic and most potent aspects of life. Relationships, family, love and career all become secondary to the eating disorder when someone is sick. Disobeying the rules by eating and nourishing one's body begs the question of why bother even considering either one? What is the purpose of eating like everyone else and still living each day? Are these other aspects of life worth fighting to get well?

The answers aren't obvious or clear. I don't pretend to know why each of our lives matter. A psychiatrist or clinician can have those conversations but cannot pretend to know the answers. 

The next post will delve more deeply into these questions, not for answers but to explain why the conversations are so important.


The Role of Existentialism in Recovery

Eating disorder recovery is, by its nature, an existential exercise. Once someone has found an answer, if imperfect, to so many personal struggles through the disorder, it feels impossibly hard to give up that success for the uncertainty of daily life. The underlying questions behind the painfully difficult stages of treatment are what is the purpose? Why should I go on?

There are a series of trite answers that minimally trained clinicians or poorly run programs use. It's fairly common for these practitioners to label this ambivalence as a psychological obstacle and to end treatment until that person is "ready" to comply with all the conditions set for recovery. 

These rigid guidelines reveal the discomfort therapists or programs have for painful existential crises that create deep ambivalence and painful decisions of the value of life without the eating disorder. 

The only way to process this confusion is through it. There have been moments in recent decades when psychotherapy and psychoanalysis have embraced the philosophy of existentialism, but recent years instead leaned towards short-term cognitive therapy: face the thoughts and feelings, place them in an organized structure and fix the problem. This approach has a lot of merit, even in the treatment of people with eating disorders, but is completely invalidating for those deeply struggling with the meaning of their own life. 

Because eating disorders grow with the burgeoning identity of the sufferers, there is a complex interweaving of oneself and the illness. The subtlety and compassion needed to be willing to see this conundrum are very significant.

The next few posts will outline what this existential crisis looks like and how it is at the heart of eating disorder recovery. Few illnesses intertwine so closely with emotional and psychological maturation. Undoing and then reconfiguring the sense of oneself are heady and very challenging endeavors.