Most people, often including clinicians not knowledgeable about eating disorders, consider the physical symptoms of restricting or binging as the central element of these disorders. The psychological component of the illnesses remains confusing and elusive to most.
People suffering from eating disorders most often perceive the eating disorder as a powerful barrage of critical and demanding thoughts that dictate daily life. The thoughts typically focus around the need to restrict food and loss weight or to find a way to justify binging no matter what. The thoughts feel so powerful and insistent that they are impossible to ignore.
Everyone has various thoughts their head, but not everyone knows what it is like to have such powerful thoughts that run counter to one's own logic. In addition, these thoughts don't feel foreign. They feel like one's own true thoughts.
Imagine for a moment what that last sentence means. The thoughts that serve as the engine of a destructive illness feel like one's own deep and intimate thoughts. The illness itself penetrates to the core of one's own self and literally takes it over, almost as if one has been brainwashed by the illogical, painful thoughts to manipulate food and feel sick.
After processing this information, it becomes clearer why eating disorders are so confusing to people and why recovery is so hard. The actual symptoms make little sense to people who aren't sick, but recovery to those who don't understand simply means stopping the symptoms. In fact, families and friends usually try to make sense of eating disorders exactly with that philosophy: just eat food.
But the idea that foreign thoughts dominate one's mind and dictate how someone lives their life is anathema to how normal people live. The internal struggle between the desire to live a full life and the eating disorder determined to be thin or use symptoms at all cost leads to a fraught and challenging life. The process of successful recovery demands an enormous amount of energy separating the eating disorder thoughts from oneself by any means necessary. True recovery means quieting the eating disorder thoughts enough to then be able to focus on life more freely.
The next post will discuss the most successful ways to separate one's own self from the eating disorder in therapy and in practice.