I am currently reading Joanne Poppink book, Healing your Hungry Heart. A former sufferer, now psychotherapist treating eating disorders, particularly in older women, her book is a delight. Sensitive, insightful and full of a lot of inside information into how eating disorder change and effect people, and recovery insights that other books miss.
Remember how our recovery team likened the journey of recovery to a boat and lifejacket?
It has nearly killed me, but it's also saved my life, I would not be here without it. It IS an armour for me - protecting me from the big bad world that has hurt me and is full of people who have hurt me. Peeling it off takes time as I discover more and more that it's also filled with good people and that I'm stronger now, safer, more able to protect myself, and that my fear of life is unfounded.
That was a really good article. It has always been my assumption that my ED is serving a purpose even though it also has negative consequences. And to have a gentle or gradual approach of ‘peeling off’ the armor seems kind and smart. But I’m curious just how one goes about applying that to stopping an ED?…..Does anyone with recovery from an ED care to share how they did it gradually?….Do you try to wean yourself off the ED behaviors?
I weaned my self off of caffeine after years of trying to stop cold turkey but then starting again. I did it by starting with noticing how much I was drinking, then asking myself if I was willing to cut back just a tiny bit today. Then after a few days of successfully drinking slightly less, I shaved off another tiny amount and so forth. It took a long time (3 months) to get down to 1/2 a cup of green tea a day. (I was drinking 6 to 7 cups of black tea every day). But when I got to that the half cup with the slow tiny step process it seemed to stick. And I’ve been able to go with out – or with very little caffeinated – beverages for a couple years now. (I’m super sensitive to caffeine, and I know it causes me insomnia and intense anxiety).
I don’t hear much about how people – who have gotten good abstinence from ED behaviors – actually did it….what choices, what stages did they make and go through? If the ED is serving a purpose(s) then what do they do as an alternative to serve those purposes in healthy ways? When ever I try to stop my b/p behaviors completely, it seems to actually get worse. In fact it has become part of the cyclic obsession to get desperate to quit totally. But as soon as I try I fail, even get worse…. Almost like “well if I’m really going to stop for good then I better get a few more binges in now”. Or: “You’re not taking that away from me” then I escalate. I’ve had better success by compromising and just asking myself ” Am I willing to cut back on b/p-ing or how long can I post pone b/p-ing.” I usually find a ‘yes’ to that and so for the last few years I’ve been able to reduce the bulimia behaviors by half or so. But I’m wanting to get full abstinence and I feel stuck at this plateau.
The article in this post uses the metaphor of armor….of the ED being like armor that protects us. This line:
“But like real armor it needs to come off piece by piece. Take off each section, …. slowly one piece at a time.”
I get the gentle, mindful gradualness that the author is pointing to here. But I wonder how this would actually apply to the ED behaviors…how do you take a behavior off a section at a time?….all I can think of is that you have to take tiny consistent steps of reduction of the behaviors, while ‘going through’ the hard feelings, while also trying healthy coping behaviors. Does this sound right?
Just wondering out loud….thanks for listening. Thanks Fiona, for another deep thought provoking post!!
Okay, I’ll try to write a helpful response to this.
From what you write, I read that you tried to tackle the ED mostly on the behavioral level: stopping the bingeing and purging by means of self-control and discipline. I’ve tried that many, many times, and always failed. I used to make “healthy eating plans” for myself (like, 1800 cals a day, nicely dispersed on several balanced meals), and the longest time I managed to stick with them was 5 weeks. Those were some of the most terrible weeks of my whole life, because I was at the edge of a panic attack 24 hours a day, and my allergy symptoms skyrocketed. (This was before I knew about my allergies, and I ate lots of “healthy” whole grain bread and dairy products.) When I couldn’t bear it anymore, I would always throw my well-meant plans out of the window and return to my chaotic eating patterns, immediately feeling emotional relief.
An ED is so much more than what you can see at the behavioral level! It also manifests itself at the level of thoughts and feelings. Looking for ED functions is a very good idea. For me, the main functions were these:
- emotion regulation: obsessing about food and being busy with ED rituals keeps emotions at bay
- stress regulation: if everyting got too much, I could just “give” myself into the ED, and didn’t have to pull myself together anymore (temporarily)
- tolerance of unpleasant body feelings: feeling “clean” after purging or by not-eating
- self-esteem: “I’m more valuable when I’m thin”
- general coping: “I’ll feel better when I lose some more weight”
- security needs: tragically true, but the more I got used to living with an ED, the more it gave me a feeling of security, because I knew what to expect
So you can already see some other things that are part of the ED armor: unpleasant emotions and feelings, dysfunctional coping strategies, self-esteem and body-image issues, insecurity in life, plus dysunctional thoughts, like the ones you described (I call them mind monsters): “I’ll never bear life when I don’t have the ED as an outlet” / “I’ll lose my mind and go up the walls” / “I won’t make it anyway, so I’ll just give up” / “I can have some more binges and purges before I stop ultimately” etc etc. These parts of the armor have to be put down as well, besides the behavioral changes.
What has helped me to tackle the ED at its multiple levels of manifestation were these things:
- mindfulness meditation: a meditation technique that works without a mantra, just by focusing on your breathing, and letting thoughts and feelings pass by without judging them (sounds easy but is not, haha) – this has helped me incredibly with emotion and stress regulation (I still don’t do longer sessions but countless short – a few seconds or minutes – practices during the day, to keep the bad stuff from building up, and I couldn’t bear doing longer sessions at first anyway)
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- mindful eating: eating as an active mindfulness practice, i.e. doing nothing but eating your food and experiencing it with all your senses (how it looks, smells, tastes, etc) – *crucial* for me to develop a good relationship with food and eating again, although it was *very* hard in the beginning (I couldn’t do it longer than for the first one or two bites and then needed to turn on my laptop and read while eating, but it got better within a couple of weeks) – DON’T EAT WHILE DOING OTHER THINGS!
- learning to enjoy a moment and activities: mainly by means of mindfulness (see above)
- starting activities to improve crappy body feelings: everything that makes you feel more comfortable in your body is fine, but it should not be related to or aiming at weight reduction – for me: yoga, walks in the nature to catch sunlight and fresh air, bubble baths, sauna, massages, gym (I still have to work on the gym)
- improving self-esteem: learning or doing something that you find valuable and that is *not* ED related (for me: piano, now also guitar, and I’m starting to learn improvisation, songwriting, and composition – so everything that has to do with music, this also serves emotion and stress regulation purposes)
- social life: spending time with friends or family (people you like and who like you as you are and make you feel good when being in their company), also internet friends (great support for me to exchange thoughts with these lovely girls
- time management: setting aside me-time (schedule it if necessary!), planning breaks, organizing unstructured time (evenings) by filling it with (planned) activities or relaxing time
- joyful activities: necessary to make your life worth living and to have something to look forward to – you’ll have a lot of spare time when you don’t engage in your ED, so you need something to do in that time (I find it helpful to do something creative, other people like gardening or so)
- changing my diet: since my ED behaviors are triggered by feeling unwell in my body, it was crucial that I learned about my allergies and sugar addictions, and stay away from those foods to get better – this means no dairy, no soy, no grains (except a little brown rice on occasion), generally carbohydrate-reduced, very little sugar, balanced meals with lots of veggies, protein, healthy fats
- cooking: related to changing my diet, because I can’t rely on what I get so easily, and have to prepare most things myself, and this has helped me as well to develop a good relationship with food again, and to see it as something nourishing and a source of energy – it also helped me to do something good for myself by putting effort and devotion into creating a meal
- being a friend to yourself: being kind with yourself and forgiving relapses and imperfections, caring for yourself and saying nice and encouraging things to yourself – imagine you were a good friend of yourself, and then treat yourself accordingly
I guess there are more things, but those are the ones that come to my mind at first. If you work on those things, you gradually deprive the ED of its functions. The idea is to build up alternative behaviors that serve the same funcions, but not in a destructive way. Then, it gets easier to tackle the behaviors.
But of course, the behaviors are still there. The strategy is to reduce the relevance of those behaviors to the minimum, so in the end there’s nothing left, no function, just plain, conditioned (during many years of “practice”) behaviors. Finishing off the rest of them *still* is a challenge, but much less of a challenge when those behaviors are the only ones that help you to get through your day. The last step is absolute and honest ACCEPTANCE – acceptance that there will be fear, there will be insecurity, there will be unpleasant emotions and body feelings. If you embrace and anticipate that, you’re equipped for what is actually to come, and you won’t be surprised anymore. You should learn to (literally) sit through those feelings from mindfulness practice.
Another thing you can do (a strategy my therapist has told me, and it works well with anxiety in general) is not to get carried away into an anxiety spiral by your thoughts and worries! The trick is to draw your attention on your *body* as soon as you feel the slightest sign of anxiety, away from your mind. It’s crucial to do that as early as possible, before the anxiety is getting too big, because then the chances are the greater that you can calm the anxiety down. Go through your whole body and try to locate where the anxiety is (in your stomach, your throat, your chest, etc), and how it feels there (tense, pulsing, etc). Then look for parts of your body where no anxiety is (if it’s just your ear lobes or the tip of your nose – anxiety is never in your whole body), and observe how it feels there. By doing so, the anxiety should already decrease. You can then actively try to carry the feeling from the non-anxiety regions of your body into the others, so you decrease the size of the anxiety regions starting at the periphery. The goal is *not* to reduce the anxiety to zero, but reduce it to a level that you can bear and that doesn’t trigger you into ED behaviors.
Just be aware that all of this is a process that takes time, and it won’t be linear. You’ll have relapses, and it won’t always be easy. The impulses to binge and purge will still be there, but you can learn not to act on them anymore, and then they’ll get less. And it won’t work every day, but the important thing is that it *does* work, and things get better overall. And it’s possible to get out of it completely.
Also, this is written from my personal perspective, and your way may look different. But probably you find something helpful in this response.
If you have any more questions, please know that you can always write to me.
OH MY GOSH!! Kath what beautiful writing and thank you especially for taking the time to write all this. This really touches my heart that you would spend the time to do this.
You have given me a lot to think about. I love how specific and practical your ideas are. I need to mull it over. There is much that rings true to my experience. You have just articulated it so well.
Blessings to you!!!
Gel, I’m very happy you liked my response! Many of the things I’ve written have emerged from my therapy (which is cognitive-behavioral therapy, but with an emphasis on systemic therapy). It often happens that you understand things on a rational level, but in the end, you also need good strategies to imply them, and thereby develop understanding on a deeper level … That’s why I wrote it. If it can help you in any way, it was definitely worth the time.
This is what I love about blogging – sharing of what’s worked for us, sharing of ideas, sharing of hope
Oh wow! I just noticed your reply to Gel, Kath.. this is amazing, really helpful! thank you so much. In fact I’d like to reblog your entire comment haha. I think you should write a post about this as it’s extremely helpful stuff – and makes a lot of sense. I am definitely cutting and pasting it into a word doc to keep for further reading. Thank you for sharing such insight xx
Hey Gel, thank you so much for thinking out loud, it means that I got to do a lot more thinking about this myself!
xx
Hmm… I know I’m a bit of a black or white person and I am pretty sure a lot of us with ED are. I think that’s a reason why the gradual step by step thing is so hard for us, we tend to swing between all and nothing. That’s me – restrict or binge. I’ve never been able to find the middle ground. Why? Because as you have said too, I need to do it step by step. I’ve been trying to ‘just do it’ and that has not worked. All these years that’s been staring me in the face and I honestly never noticed!
Yes, I strongly believe myself in the ‘going through the hard feelings’ bit you have mentioned. Because our behaviours ARE short-circuiting those feelings for us. We have taught ourselves that we ‘can’t’ tolerate feelings. And we haven’t had to because we have an ‘easy’ way out of them. So when we try to ditch the behaviours, it all comes in a flood, we freak out, drop the whole ‘trying’ thing like a hot potato and run!
So yes, doing it a bit at a time builds up our tolerance and lets us know bit by bit that we can do this step, we can do the next step, etc. Rather than “I tried, I failed, I can’t do it”.
How do you take behaviour off a section at a time? For me that’s been delaying too, delaying, trying to have a meal instead of a binge, cutting out food rituals like chopping things up, overcooking/burning food, counting and weighing, orders it’s eaten in, etc etc etc. Trying to put breakfast in every morning is a good start if you don’t have that – it’s important to add in meals if you are trying to cut down bingeing or you will NEED to binge and/or have swung over into restriction.
Interesting – very interesting – thank you for making ME think in turn
PS. Fiona, it is spring here and I’m sad it’s too warm now for our cat to want to cuddle on our laps. But I’m happy for her that she gets to go out into her yard, which she doesn’t do much in the winter.
She’ll be back in your lap next winter, of course. In the meantime you can enjoy the sunshine with her!
I definitely believe that an ED serves a certain function. During some times of your life, it may be the armor to protect you and prevents you from falling apart. But ooh, the price is so high! And the times change, and you may not need it so much anymore, but you still wear it and keep paying the price …
I like the armor analogy very much, because it also implies that it takes courage to put it down. You feel so vulnerable when you do, so naked an exposed. And that fear retains you from doing it. But then think of the burden. Think of the weight of that armor that lasts on your shoulders …
Perhaps putting it down bit by bit will work?
Yes! It is a burden!! I don’t remember if you are Christian or not, but you reminded me of God asking that we give Him our burdens and accept His in return. My understanding of that is that His yoke is light – it’s for guidance only, not the heaviness of our own burdens that weighed us down.
xx
I like also that you said “you may not need it so much anymore but you still wear it and keep paying the price”
Yes! It’s like how they’ve shown that when a living creature is used to being trapped in a cage and suddenly that door is left open for it to escape if it wants to, it can’t/won’t go out. Because in it’s mind it’s still trapped. That is so true of myself with the ED. The door has been wide open for a while now, and I still crouch inside. Thank you for this amazing insight, Kath
[...] couple of days ago, I reblogged Surviving Anorexia’s post about how our eating disorders (or whatever coping mechanisms are yo…, that they do serve a purpose for us, and that when it comes to taking that armour off, we need to [...]