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.
When I first entered residential treatment, the time in treatment that saved my life and began my true recovery, I very much had the why bother, what's the purpose mindset. It's not that I was trying to be defiant or treatment resistant. I very much wanted recovery. I was told by therapist more then once, that I had been chronically sick with my anorexia for too long to recover. When the treaters that you trust say this, why should I have not believed it.
ReplyDeleteHere I was, in an exceptional residential center, with gifted therapist who are recovered from their previous eating disorders. I felt as if once again I was taking up too much space. There was a large waiting list to get into this residential. Why was I there, when someone else, someone who could recover wasn't? I was told that I did deserve to be their, that I was worthy. I was told that not being able to recover was not true. I didn't trust the process yet but, I chose to accept that I had the ultimate responsibility to choose to recover. My recovery was not preordained by another person, not even if the said person said, that I was chronic too long. I had an amazing supportive psychiatrist back home who believed I could recover.
Looking back, three years into my recovery I am grateful that I trusted that I had free will and, with that I deserved to exist in the world. The fact that I am no longer chronically ill isn't always enough for my no longer asking what is the purpose or more accurately, what is my purpose?
So many of the things I wanted for my life, things I recovered for, are not in my life now and will never be. I'm not going to be a Mom, I will never have a child. By stating this, it's not defiance, it's a fact. My therapist has said that I need to mourn the loss. Maybe, mourning the loss will help, maybe it won't. When he says this to me, I realize it's well meaning but, sometimes it feels like the cliche thing to say. Whenever I would picture what my healthy self would look like, I saw myself as a parent. The reality is, parent will never be my identify. So then, what is my identity? I'm not the anorexic any longer and, by no means do I want to identify as sick again.
When I spend time with friends that are the same age, my life and theirs is so vastly different. I see pictures of their children. I can't pull out pictures of my own kids and it hurts my heart deeply. I've had enough therapy to recognize, comparing is most often going to leave me feeling less then. Still, sometimes comparisons are just the facts.
The same friends and contemporaries who have children, have careers. For half of my life, I too had a career. My career was anorexia. My job was to be the very best anorexic ever. Being the sickest and the thinnest was a fine balancing act. If I went too far, poof, I would die and, loose my job. If I became well, my anorexia would fire me.
I don't want to go backwards, I never want to relapse. How then, do I answer the question of who I am and what is my purpose. I know that it's mainly up to me to figure this out, it's my responsibility. I'm frightened that a purpose, a real place in this world with meaning, isn't in the cards. I feel like there was a deadline, some sort of expectation date, that's long passed.