This post was submitted anonymously. The writer sensitively describes how she understands her difficulties with eating in the context of a wider psychological formulation.
When I was asked recently, via the wonderful Little Em to consider writing something around what many people understand as ‘eating disorders’ and ‘recovery’, I felt immediately quite strongly that yes, it was definitely something I felt I could contribute to, but, I warned, that it may not be the ‘All Star’, triumphant, cheerleading, ‘TA DA!’ picture of health, recovery-esque, emblazoned banner that perhaps folk want to read. I understand that need, of course I do, it’s what anyone who is dealing with this horrific cacophony of essentially self-flagellating feelings, thoughts and behaviours, whether in their first six months, or 20th year, wants to read…To hope, to find balance, to envisage a world free from this exhausting, macabre merry-go-round of dieting, binging, broken promises, therapy and weighing scales….To broker peace in the war waged on the self, whereby food is the weapon of choice. And, of course, there are elements of hope, progress and new found resilience in this account, otherwise I wouldn’t be writing it. I guess my reservations were about potentially producing an overly sanitised piece of writing that might not necessarily convey the real challenges of this thing they call ‘Recovery’, which, for me, is neither linear, nor round, but more akin to the art work you might expect when you let a toddler loose with crayons for the first time. Fundamentally what this piece is about is how I have come to understand my eating difficulties within the context of a wider psychological formulation, and how valuable that has been, both in regards to understanding that ‘eating disorders’ are, actually, so little to do with weight, that they are communications of our relational patterns and internal dialogues, and do not exist as separate entities outside ourselves, and in learning to take a more compassionate approach towards myself in order to overcome…ok, manage them.
I am now in my mid thirties, and I can trace my first dalliances with eating behaviours that might not be healthy and were arguably emotionally motivated, though I wouldn’t have recognised that then, to around 11. Looking back now, and through the lens of therapy it might sound quite obvious and mundane to suggest that if you take a precocious and intelligent eldest, much wanted child, place extremely high expectations on them educationally and socially, prioritise attainment over emotional expression and then throw in a little middle school bullying and parental relationship difficulties in for good measure, that they might develop unhelpful ways of striving to keep everyone happy AND be accepted by the ‘Mean Girls’, but hey, it was the 80’s….I was a typical high achiever, more Monica than Rachel, and had had instilled in me, subconsciously, from Day One that you got your needs met by pleasing people wherever possible. Comply. Control. Restrict. Mediate. Fix. Rescue. Subjugate. Which, for someone who, it transpires has a naturally emotionally sensitive temperament and two parents with wildly different attachment styles, was quite a feat. I will now reflect that none of this was truly about weight. But there is no denying that I can’t remember a time when I didn’t know the calorific content of any food item on the planet, and that at some point, seeking acceptance from my peers which was not forthcoming, my brain started to make connections between control, desirability and weight. My first forays into eating difficulties then, were restricted dieting and obsessive calorie counting, which was boosted by a happily coincidental bout of significant physical illness just prior to my GCSE’s. The internal dialogue which whispered quietly at first, gradually grew in strength, and, akin to having the radio on in the room next door, could generally be heard with a regular stream of berating put downs, calorie intake updates and rumination…think world’s worst cheerleader or best ever heckler at a comedy gig. Despite this, on some level, it all ‘worked’, for approximately five years. My weight never got quite so low that I required hospitalisation (don’t get me started on the use of BMI as an assessment for the need for support), and despite the on going rejection from my peers (Geek Chic is a new phenomenon, trust me), things remained relatively in tact. I never responded to criticism or my unmet needs, and buried any ill feeling deep within. My ‘restrictive, perfection seeking, anorexic’ ‘role procedure’ was cemented.
And then, what I came to understand, is that something shifted which prompted a new ‘procedure’ for navigating life, and made everything just that little bit more complicated. Post physical illness my exams weren’t quite the stream of A*s that were predicted, though still enough to lead to the path of university, no matter how much mediation I did, my family were far from harmonious, and I was certainly no more popular. Being perfect was not a guaranteed recipe for success, or seemingly even a viable option any more, and I began to feel a wave of increasingly difficult emotions about myself and the world around me. I despised my appearance, began to question my relationships and identity, and feel the weight of my early invalidating experiences that little bit more rawly. Recently, I read someone describe their difficulties as being born “without an emotional skin”, and that feels pretty close to how I began to experience the world. I became, not necessarily aware of it, more chameleon like, desperately trying to please others in varying ways, but each time felt consequently a little less sure who I was. And, again, I guess it’s not ground breaking to predict that when a previously highly disciplined country girl, with attachment issues, reaches the big city for university, things are going to go a bit rebellious and awry, particularly when you add alcohol to the mix, but alongside the usual ‘finding yourself’ activities which many of engage with at university or away from home for the first time, I found myself progressively erratic in my eating behaviour. The restrictive eating was interspersed with periods of binging of thousands of calories worth of food, particularly cake and ice cream, and the feelings of disgust and revulsion as my weight increased soothed by consuming laxatives at doses which were clearly dangerous. At the same time, my approach to relationships became more destructive, in many ways, and words which I had so carefully kept within me for fear of hurt or rejection would tumble out in a manner that was mind bogglingly unhelpful. I began to procrastinate with regard to academic work and attending classes, and really did not take good care of myself emotionally or physically. The radio had been not only brought into the same room as me, but turned up to deafening levels. My ‘destructive, sabotaging, ‘bulimic’, rebellious’ role procedure was born.
And thus the dance between these two, almost polar opposite states of being ensued, for what was actually years, with very little awareness on my part, and certainly a sense that my eating was just a law unto itself. Periods of ‘stability’ (which actually were overly restrictive and controlling, but more socially acceptable), whereby I’d ace a new job and acquire the ‘nice’ boyfriends, and be painfully thin, were then followed by a growing sense that I couldn’t maintain such perfection, and increasing low mood…Which were then punctuated by periods of emotional over eating, purging, inappropriate relationships…Inevitably this lead to immense feelings of remorse and guilt, and the promises that I would sort myself…and the whole thing would start again. Not so neatly, cleanly and ‘formulation like’ as I’m writing this now, but not far off. And, it’s important that I write at this point, that I am acutely aware that, actually, much of this has been, ostensibly an internal experience, although I have undoubtedly hurt and worried those close to me at times, and that from the outside, my life looked pretty lovely. It WAS pretty lovely in many respects, and in the grand scheme of things, and the heart breaking experiences that we hear, I have very little to complain about. But there is something there about validating every individual’s experiences in their own right, and so I am just trying to make sense of that here. Neither do I want to suggest that mine has been a life without joy, or that this has been a non stop siege of eating struggles and relational dysfunction. My life has been filled with many sparkling moments and beautiful relationships. Just that this sense of unease, this unrest is never far away, and whilst most of the time it constitutes a damp drizzle, there have been many times where it took on the form of a full on storm.
In the mid 2000’s, during a particularly poor choice of relationship, my well being deteriorated to the extent that I finally saw my GP, though not about my weight per se. I had been prescribed anti-depressants twice before, to little real effect, though they helped me maintain the façade of the ‘perfection’ procedure for a little longer. This particular GP, who I will always remember for his compassion, warmth and common sense, noted my low (though not the magic BMI for support ‘low’) weight and asked a few pertinent questions. He felt strongly that I should be referred to the local eating disorder service and begrudgingly I attended the appointment. I should reiterate that this was still over 10 years ago and perhaps there have been developments since, but what I remember most vividly from that appointment was the letter that arrived in the post a few days later which stated: Eating Disorder Not Otherwise Specified. The letter went on to say that whilst they could offer me some group work, they didn’t really feel that I met the service criteria, due to my ‘healthy’ weight, mixed eating patterns, and reluctance to engage. In short, I didn’t fit. In any sense. There are several moments in my professional life that I reflect on with regard to influencing my views on diagnosis as a wider issue, but that was up there with all of them and I can honestly say it was a pretty rejecting and belittling experience.
Things rumbled on for a few more years, and then, during one of my more peaceful periods, I was fortunate enough to gain access to further training. I genuinely believe that the learning that I accessed during that training and the people I met, who gave me the confidence to question my life at that stage, were pivotal in developing an holistic understanding of myself, and in moving towards this tricky term we call ‘recovery’. You may have sensed by some of my terminology in this piece that I am a Cognitive Analytic Therapy advocate, and you’d be quite correct. During training we were fortunate enough to be offered our own personal therapy using CAT as a model, and for me, alongside the attachment based placements and learning I completed, this was a complete revelation in how I conceptualised my eating habits. Once unruly pinballs careering around with no sense of foundation, my eating behaviours and the feelings associated with them could now be linked to my early experiences, and a much wider set of states of being. CAT helped me to formulate all of my thoughts, feelings and behaviours, into an integrated model, which helped me to understand them, not only in the context of wider relational patterns, particularly the relationship with the self, but to recognise the attachment triggers which may insight them, and what can be done to prevent that from happening. As someone who is quick to criticise themselves, what this approach also helped me to recognise, was that neither of these procedures are particularly compassionate or peaceful, and that one is not preferable to the other, just because perfection seeking may ostensibly appear more socially acceptable, particularly in 2016, capitalist Britain.
Thus, my goal for ‘recovery’ has become that dreaded word ‘balance’. Relationally that means developing some positive self-regard, picking the middle ground in relationships, work, family, and throwing some water on the world’s worst inner cheerleader occasionally. From an eating perspective it means trying to maintain a ‘healthy’ weight, and not engaging in destructive behaviours such as purging, starving or bingeing. And things are better. Much, much better. But this thing we call ‘recovery’? Am I recovered? I’m not sure that finish line exists for me. More the toddler with the crayons. The pendulum between my two states still swings, though it is fair to say with less frequency and severity than before. It is, without doubt a daily decision, and one that I am sometimes more keen to engage with than others. If I’m honest, being an ‘ok’ weight, and maintaining a middle ground existence bores the shit out of me, and the urge to destroy good things is sometimes still there. Being more aware of your relational patterns means that you can become exhausted at some of the realisations that come. The other thing they don’t necessarily tell you is that if you stop the ‘behaviours’ the ‘feelings’ have to go somewhere and so I am frequently left with very complex emotions that I have to sit with instead of soothing through less helpful means like extreme dieting or purging. The radio never switches off, not for even one second of the day…but maybe it is a little quieter and easier to ignore. The physical ramifications of the years of abuse to my body are, sadly, quite significant. I have a number of physical health issues and tiredness is a huge issue. And yet…I am doing more exercise than I ever thought my body would be able to do. So…I am doing it. Day by day, I am becoming more aware and more accepting of who I am, and maybe a little kinder, and carving out a wider, rounder, loving life for myself and those around me.
If I could say anything to those who experience any kind of emotional distress, particularly around eating, then it would ultimately be to urge them to seek psychological support. There is something about the way in which our relational patterns come to utilise food that is so persistent and assaulting and subversive, both physically and emotionally that it is staggering, particularly over extended periods of time, and alongside a society that ghoulishly normalises low weight particularly. Simply going through the motions of either gaining or losing weight, without truly understanding how this relates to our personalities and how we view ourselves and the world around, whilst a vital first step for many, does not equate to a life worth living, thus does not, to me, come close to the word ‘recovery’, however you choose to make meaning of that word. These patterns of mine have taken over 20 years of my life, have deeply hurt the people that love me, and have caused me untold pain, and yet it took psychological formulation to really give me a lens through which I could envisage real change.
Recovery? Perhaps not.
Acceptance, movement, hope? Definitely.
For me, personally, reading this was heartening. I think we often have a view of ‘recovery’ which can be unrealistic and so unattainable. The writer above demonstrates how we can understand our difficulties in the context of our relational experiences, and so make space for the complexity of this. To me, it is possibly more validating and actually more hopeful than the traditional often simplistic ‘recovery’ narrative. I hope other readers gain as much from this as I have.