Finding Hope in the Hardest Moments of Eating Disorder Treatment

Helping people with eating disorders who are also severely hopeless and suicidal doesn't mean just sending them to a hospital. It is important to recognize how serious the suicidal thoughts are while simultaneously seeing that developing trust in treatment is the only way to make progress. 

Many patients with eating disorders are scared to bring up suicidal thoughts to their treatment team. Not infrequently, the team responds by immediately recommending hospitalization or even calling 911. As much as I respect the need to focus on patient safety, everyone is different. Often, overreacting sends a message to the patient not to reveal their deepest and most painful thoughts and feelings. As I have written many times in this blog, secrecy strengthens the eating disorder. 

If the patient is imminently planning on committing suicide, then it is important to consider all options. But if the person has thoughts without any immediate intent, the next step is to try to talk more openly about these thoughts. The hopelessness and suicidal thoughts are almost always a window into the most powerful parts of the eating disorder, and exploring these thoughts can be an important step towards recovery. 

The circular reasoning of an eating disorder leaves patients trapped. It feels impossible to change eating patterns, challenge the thoughts and live a fuller life. The eating disorder thought process is intent on blocking all avenues of escape. After years of being trapped in this maze, it is common for patients to think that ending their life may be the only way out. 

Revealing that level of desperation can be a sign to a clinician that perhaps there is an opening for change. It is important to engage both practically and emotionally with this hopelessness and challenge the false beliefs of the eating disorder. It's hard to face that fear of change, but it is also possible to summon the courage to live life differently and alter deeply ingrained patterns. 

Sharing the intensity of hopelessness is often a sign of impending movement in recovery. Safety is clearly a priority but so is respecting the openness and trust in treatment along with acknowledging that clear, consistent support makes even he most challenging steps possible.