The EDIC (see previous post) reinforces a general falsehood about eating disorder treatment that recovery stems from a stable weight and a meal plan. Adequate nutrition and stabilizing eating disorder behaviors are necessary to get well but aren’t the crux of how people actually recover.
When profit-making financial firms look to outcomes for guidance, they rely on insurance-driven metrics, like weight, and not on what actually leads to real change.
The purpose of various eating disorder programs remains short-term stability for people unable to make necessary changes as an outpatient. Any expectation for a more complete recovery from a program is misguided. The one fits all approach of residential treatment is a blunt instrument that at best helps some people leave the program better off medically then when they entered and, hopefully, ready to engage with a treatment team.
Real recovery starts after a moderate amount of behavior change. Some relief from the eating disorder usually brings back the person’s thoughts and feelings underneath, all of which has been wrapped and sealed in a fog of the eating disorder. If the person can avoid slipping right back into the eating disorder as a coping tool, then the result is the start of a personal, individualized journey of recovery.
Reckoning with all of the thoughts and feelings subsumed by the eating disorder is extremely challenging. Sometimes, there is trauma underneath and for some it may be the social and emotional growth that halted when the eating disorder took over. And there are many, many other experiences that comprise recovery.
No matter what, the personal growth, extreme vulnerability and series of revelations all stem from the gradual release of the eating disorder and the experiences that ensue after freeing the thoughts, feelings and humanity underneath the person in recovery.
In my experience, no one truly gets better without this process of personal growth. The behaviors can subside, but without returning to the individual development that stopped because of the eating disorder, the effect of the illness lingers in various ways. I suspect that even if faster and more directed ways to recover emerge in the future, the personal element of recovery will remain necessary.
What this means is that everyone in recovery needs a way to feel capable of engaging with the intense emotional growth this process demands. The changes can happen in therapy, in personal relationships, in groups, with friends and in many ways which involve engaging in life. Recovery can’t happen in a bubble or in isolation.
By connecting in the world, each person finds out what they value and thereby their sense of self. Engaging with people again leads to the transformation necessary to make a true recovery.
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