Clinicians, including me, often lay out the broad strokes of eating disorder recovery when someone is first starting treatment. The steps often include at first some form of higher level treatment like the hospital, residential treatment or outpatient group programs. Following the initial stabilization of food intake and medical health, the longer and more challenging part of recovery involves an outpatient team with one or several appointments per week. This stage of recovery reinforces regular eating and focuses on the emotional and psychological transformation that inevitably comes with meaningful recovery.
The second part of treatment sounds clear and streamlined. It is anything but. As difficult as the initial food stabilization can be, the personal transformation that accompanies a new life in recovery is inevitably a lot more challenging.
As a clinician, I know that any new patient who is truly engaged and determined to take the path of recovery will reach many points along the way of frustration, sadness, confusion and loss. And even if I describe what this course may look like, no words can prepare someone for the feelings of going through this existential, deeply felt and often wrenching change.
Eating disorders don’t simply comprise a series of eating behaviors and thoughts about food and weight. They represent a philosophy about how to live, about what feels truly meaningful and a moral guide to what is right and wrong. Since eating disorders usually start at a young age, people tend to develop their understanding of themselves and the world through the lens of the eating disorder beliefs.
Hence, recovery demands shedding one’s full understanding of how to live and necessitates starting fresh almost creating a new sense of identity. It’s hard to conceive of reimagining who we are after years of developing an identity based on the life and values we already know. No other recovery means starting over in quite the same way.
A clinician’s role is not to devise a new identity, explain new values or imply they know better. Instead, the clinician needs to be along for the ride and ready to embrace any feelings and experiences the person in recovery goes through and concomitantly provide comfort, support and understanding.
Life with an eating disorder will always be limited in scope and devoid of space for true connection and meaning. The eating disorder takes up so much energy and time that there is no room for a more complete life experience. The road to recovery is not an easy one, but it does make possible the ability to create one’s own sense of meaning, not just the eating disorder’s, in one’s life.
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