How Do You Say Goodbye to an Eating Disorder?

A chronic eating disorder with a prolonged course well into adulthood invariably becomes intertwined with one's identity. A girl who learns how to master food and experiences the praise and envy of those around her will find solace in the eating disorder. The typically adolescent, intermittent and painful growth of self-awareness and self-worth will pale in comparison. Before long, the eating disorder will become her sole identity. Once the brief window of triumph subsides, and the eating disorder lingers and festers, praise turns into hushed whispers and horrified stares and finally into nothing. People stop noticing. All that remains is the misery of chronic illness: a bottomless pit of guilt and regret fed by profound hopelessness. And all for the empty promise and glory of being thin.

Returning to life again means, first and foremost, reclaiming identity from the illness. The gradual process of teasing the eating disorder apart from the long buried sense of oneself is arduous and painstaking. It can be both liberating to disarm the punishing thoughts and horrifying to recognize the destruction left in the eating disorder's wake. Every patient in recovery who comes to understand how completely an eating disorder can hijack the mind and turn an entire person into a shell of oneself spends weeks if not months in shock at the discovery. The realization leads to two important thoughts. First, the psychological torment, which feels self-inflicted, really is the core of illness even more than the eating behaviors. Second, recognizing an identity separate from the eating disorder is a profound step towards wellness.

Not long after, perhaps the most curious and painful step in treatment comes to the fore. The more one's identity sharpens into focus, the more clear it becomes that saying goodbye to the eating disorder is no easy feat. While recovery has been a desperate wish for years, the actual parting doesn't feel like the anticipated relief and joy. Surprisingly, it feels more like the end of a tortured relationship with a dear friend.

In the abstract, equating the eating disorder with personality traits or even a person seems absurd. Surely, it's an illness or a choice or the twisted joke of a society turned on its head. But truly understanding the meaning of an eating disorder means getting this point through and through. The rules, behaviors, punishment and reliability of an eating disorder ironically provides as much comfort as it does pain. In a confusing, pressured and unforgiving world, an eating disorder makes things as plain as day. The calm of knowing what you should or shouldn't eat, of knowing what is right and what is wrong is irreplaceable. Anyone living in the modern world knows that believing in right and wrong or good and evil is a luxury of childhood. Adults grapple with endless uncertainty and strive, day in and day out, to muddle through and hope for the best. The dreary, endless gray of life is a bitter pill to swallow for an adult accustomed to the satisfyingly black-and-white world of an eating disorder.

The two points from the last posts--that children are expected to make up for parents' disappointments and the subsequent lack of freedom of childhood--both trap children in a very adult conundrum. Combining the open and curious mind of a child with this kind of inflexibility is a setup. Children may be physically adaptable and even eager for new experiences but do not have the psychological sophistication to sort through complex, covert family expectations. In other words, they just won't get it. Stuck in the morass of mixed messages, kids will think their parents' wishes are their own. They will just get lost and yearn for a simple system with easy answers, like those provided by an eating disorder. Without any coping skills, the world will look like a scary place, one much safer with satisfying rules about eating and food.

So, take this adult in recovery searching for her old identity. If the eating disorder saved her from all of this fear and confusion in the past, what can she expect after saying goodbye? Part of the experience is something everyone can identify with. In this moment, a person with a fully developed, adult mind is thrown into the disorientation and intensity of one aspect of adolescence: finding oneself. Certain formative memories make an indelible mark on self-image. The pangs of regret, embarrassment and ultimately nostalgia create lines we won't cross in the world. It is a universal experience to wish to relive youth with the knowledge of an adult. In many ways, that is the experience of someone with an eating disorder who reclaims her identity. But the old adage doesn't ring true in the slightest. Every step of the way is painful.

The next post will extend this last idea to a different philosophy of parenting. Saying goodbye to the eating disorder leads to a deep exploration of identity separate from adolescent strife and family pressures. The growth of self-image in the cocoon of recovery occurs in a setting with flexibility and freedom, both clearly lacking for today's children. So I'll begin with a question: what might kids raised in this new world be like?

The Dos and Don'ts of Parenting a Child in an Eating Disordered World--Part II

In an increasingly homogeneous and anonymous world, we all seem to be interchangeable pieces on a chess board, shifting back and forth according to abstruse rules, awaiting the inevitable endgame. In the end, a rook is just a rook, a bishop just a bishop. The qualities that might have made someone unique years ago in a small village are a dime a dozen in the wide, interconnected world. The hope of being special or extraordinary--the unspoken dream if not expectation of modern-day parents--is just a mirage, completely out of reach. Reasonable goals of comfort, companionship and even personal satisfaction are too humdrum to mention. They are the bare minimum, what's to be expected.

The building urgency to be special and recognized above all else has taken over a large swath of childhood. One stark result has been to complicate relationships, for parents and children alike, from the barest acquaintance to the most dear family member. Cooperation and even altruism have been critical to the evolutionary success of humans. The growth and complexity of our social system along with the sophistication of our minds distinguished us from all other species and led to the astounding development of civilization, a continuing process we witness every day. Within this framework, the value of the individual needed to be acknowledged to provide incentive to work for the greater good. Only in recent generations has the scale of the world become so large to essentially eliminate any sense of the individual and leave a growing set of driven, albeit privileged, people competing in a race to nowhere. Yet the larger changes in human society cannot extinguish the personal desire for purpose, identity and recognition. With no outlet for these basic urges, the frustration, especially among the young, has acceded to a blunt disregard for others' well-being. Taking responsibility for one's actions seems to be a thing of the past. Intention is now the bellwether for responsibility: if you didn't mean to do it, then it doesn't really matter. The experience of being an indistinguishable player on a chess board has relegated cooperation a thing of the past.

Nowhere is this change more clear than in families, especially those of privilege. With unrelenting pressure on children to accomplish, excel and succeed, competition is drilled into a child's development almost instantly. The societal pressure to expose infants to stimulating classical music videos, track early educational milestones like a stock trader glued to the latest market report and craft extracurricular activities to ensure a child is gifted in something valuable drowns out the freedom and creativity that embodies this stage of life. As panicked parents watch the acceptance rates at elite universities gradually diminish, effectively approaching zero for all intents and purposes, the mantra goes that a child has to achieve something valuable, something extraordinary, something miraculous in order to gain admission, and thus an entree into any semblance of success. And so the disappointed parent turns a child into the family pawn, the most mundane of all chess pieces, to achieve something noteworthy, redeem the family name and, of course, experience nothing but personal satisfaction. And the parent will be sure to make this happen with no regard for others along the way.

Looking back to the end of the last post, the question of how not to micromanage as a parent becomes absurd. How can a child come close to achieving these results unsupervised? Who will watch how this child works, plays, sleeps and eats? Each minute is precious to reach the family goals.

There are two points to take from the undoing of a child's freedom. Several times in the last few posts, I have referred to personal responsibility, namely that the personal drive for recognition and the family urgency to rectify past failures means that personal gain trumps all. As the privileged youth largely ignore the growing inequality of our society, unless volunteerism as a graduation requirement makes a difference, the group most likely to shed light on our failures instead slaves away at the mundane tasks that lead to personal success. A parent, aware of the luxury privilege brings, would do well to reflect on the responsibility that comes with such good fortune and realize that a child needs to be taught to look outward at the world around them. Inculcating civic duty, a deep sense of fairness and an ingrained sense of personal responsibility may not follow the current doctrine for parenting success but can shift the focus from the cult of family and recognition to the molding of a good person.

Second, there is hubris in believing that everything a child needs to learn and do can be mapped out by devoted parents. The freedom to be a child, to be allowed to think and create and grow and learn also has value in society. Undoubtedly, each generation adds a new perspective to the current state of society and helps us all see and understand things a little differently. The value of a new and agile mind piecing together the facts of the world opens up unseen paths and helps the world become a better place. The expectation that good parents will force children into a scripted world, with every moment and activity accounted for, devalues the voice and legitimacy of new ideas and thoughts. A parent would do well to squeeze freedom, exploration and creative thought into the daily lives of children and encourage them to develop and trust their budding point of view.

If the parents breeding children mired in disordered eating instead focused on raising responsible, thoughtful, reactive minds, would this really lower the in incidence of kids with eating disorders? Any answer to this question is likely a blind prediction and at best an educated guess. Nevertheless, the next few posts will explore the possible results of a shift in parenting in the context of another question: why is it so hard to give up an eating disorder?