The Competing Forces in the Mind of Someone with and Eating Disorder

In more severe eating disorders, there are competing forces inside the person vying to determine the course of daily life. One side is focused on living a full life replete with personal and professional goals. The other side is solely preoccupied with food, calories and, above all, weight.

Intractable eating disorders occur when the eating disorder forces dominate thinking and thereby daily decisions and behaviors. The short-term goal of treatment may be medical and nutritional stabilization, but getting better ultimately means quieting and weakening the eating disorder forces.

Similarly, developing a successful plan for recovery also involves competing forces when caring for the person with the eating disorder: compassion and firmness.

The true forces aimed at living life are grounded in the actual person themselves. That side of the person is extremely saddened and frustrated by the inability to focus on daily life and pursue long term goals. Any human being would experience powerful compassion for this person and how much suffering has come with a severe eating disorder. In the face of so much confusion and criticism during the illness, compassion provides sorely needed caring which is necessary to nourish the person emotionally back to health. It also helps bolster the energy needed to combat the eating disorder forces.

On the other hand, firmness, directness and even strength are necessary to combat the eating disorder forces. They are wily, stealthy and insidious. If subtly ignored, the eating disorder will take weakness as a sign to only push forward. Their sole purpose is to ignore actual life and magnify food and weight into the only things that matter.

The person is often ignorant of the difference between their own thoughts and the eating disorder and will take attacks against the eating disorder as personal attacks. Even in the face of this kind of rebuff, continuing to push back against the eating disorder is essential.

The combination of compassion and directness is a delicate balance. It will only be successful when a therapeutic relationship has a strong foundation of trust. Differentiating between these forces and approaching them in the correct way is the most important way to care for someone working in recovery.