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.