I often get questions about how to best support children with body image and food. When I did a quick google search, I didn’t find many resources, so I figured I would create my own! I made a list of 8 tips for caregivers to help support a healthy body image and relationship with food. So whether you have your own children or work with children, this post is for you!

Tip 1: Repair your own relationship with food and body.

Parents’ and caregivers’ behaviors and cognitions influence their children’s actions and attitudes towards food and body. If you struggle with disordered eating and/ or negative body image, it is important that you are working on these issues so that you don’t accidentally hand those beliefs to your children. No parent would consciously transmit these messages to their children, but kids pick up everything adults do! Commenting on your weight, continually skipping dessert, or living at the gym will become their norm if you aren’t challenging your own beliefs and behaviors.

Often parents don’t have time to care for their own mental health, but now that telehealth is bigger than ever before, it’s your time to bring therapy to your living room! Check out the Alliance for Eating Disorders to find a support group or Psychology Today to find a therapist who is offering telehealth services in your state!

Tip 2: Encourage food variety- all foods are good foods!

Often kids can be picky eaters, but introducing them to new foods at a young age can be a great way to prevent picky eating. Encourage kids to eat all food groups to fuel their bodies instead of focusing on “healthy” eating. Kids should never be focused on food rules, calories, or macronutrients. Labeling foods as “good,” “bad,” or “junk” gives food morality, which can translate how people feel about themselves when they eat those foods. Foods should never be “off-limits” unless there is a diagnosed food allergy.

Kids are born intuitive eaters, and through society, they learn to override that intuition. Helping our children tune into their hunger and fullness by offering all types of foods and encouraging variety is the best way to help kids learn to nourish and trust their bodies.

I recommend parents offer their kids meals and snacks at regular intervals throughout the day. If they want to eat outside of those times, let them know that it is not a meal or snack time and ask if they feel they can wait till that time. The kitchen should not be open 24/ 7, but it should be available when hungry. Offering an additional snack or at an earlier time is a great way to help your child learn to honor and experience their own internal cues!

Tip 3: Limit exposure to the media/ choose media that is diverse

We all know that the media is dangerous. I recommend limiting our children’s use of media to specific times of the day. Monitoring media for younger children is essential. If you notice your child watching shows that only display certain types of bodies offer more inclusive alternatives. Check out this link for diverse shows for kids.

Social media is probably the most harmful thing pre-teens, and adolescents face, and we must teach them to do so wisely. We must teach adolescents to understand how comparing their experiences to others highlight reels is unfair and dangerous to their self- esteem. Adolescents must also know that they rarely see an image that hasn’t been digitally altered. Comparing their bodies to something that doesn’t exist will never allow them to accept, let alone appreciate their own body. I encourage all adolescents and adults to watch the movie the Social Dilemma on Netflix to help them become careful consumers of social media and understand the negative effect social media can have on them.

Tip 4: Take the pressure off and encourage unique qualities and traits

 We all have different skills and talents, and we mustn’t squash our children’s talents and abilities while pushing our own beliefs and agendas. We all want our children to be successful and happy, but that may look quite different than you would have expected, and that’s totally ok! Encourage your children to express themselves; however, they do so naturally, even if it seems silly. It is important to offer children options and suggestions for extracurricular activities, but know that they might not love the sport you played throughout school, or they might not be the genius they hoped they would. We must take the pressure off our children to perform and allow them to unfold into the people they were meant to be!

If your child finds themselves in an extracurricular activity that is significantly weight focused, like ballet or wrestling, make sure you choose where they participate in these activities carefully. Not all dance studios are weight inclusive. Not all coaches are created equal. Have conversations with coaches and teachers about their idea of weight inclusivity and how they manage children who demonstrate warning signs of eating disorders. If they can’t answer these questions, continue to interview other professionals, and find a fit that will support all body types.

Tip 6: Do not comment on other’s bodies, including your own!

Our society is incredibly weight phobic, and unfortunately, sizeism is a huge part of our world. Commenting on someone else’s body is wrong and puts a harmful emphasis on value and shape. Stop commenting on bodies, including your own! If you hate the way you look in a pair of jeans, toss them! If you’ve gained weight recently, so what? These comments are perpetuating fatphobia, and the stigma that changing our bodies means changing our lives. This simply could not be more untrue.

Tip 7: Create a safe and open environment

Kids that feel safe and accepted in their homes are generally happier and well adjusted. It is crucial that when your child brings something up, you respond in a way that will help them continue talking. Try to avoid solving problems or jumping to conclusions and allow your child to share their own thoughts and feelings. Ask them how they would like you to help them as opposed to immediately offering solutions. Be curious about your children’s views and opinions, and try not to assume how they feel. The more you allow them to express themselves, the better.

Tip 8: Talk to your child’s school about implementing a body image program

Many of my clients, both adolescent and beyond, have experienced or witnessed bullying due to size. Unfortunately, this is a shared experience, and to stop it, we need to educate our schools and help implement change! Consider reaching out to your child’s guidance counselor to discuss potentially implementing a program for the school. Check out these resources for ideas on how to do so, contact a local eating disorder expert, and see if they would be interested in giving a school presentation.

Unfortunately, our world is a hostile environment for children to develop healthy views of themselves and their bodies. Therefore we must curb our own beliefs, behaviors, and judgments around these topics to model healthy attitudes and teach our children to value themselves and their lives on more than their appearance!

Dear 17-year-old Kate,

On October 10, 2005, you’re going to walk into the doors of a treatment center completely terrified. They are going to ask you to do things that petrify your eating disorder. Right now, these things seem impossible, but know they will help you. They are going to ask you to speak up. They are going to ask you to be yourself. They are going to ask you to open your mind up to new ideas and concepts. And yes, they are going to ask you to eat cherry pie. Try not to think about the pie. Just do it! And honestly, Kate, you like desserts, and you need to learn how to eat them without bingeing or using food rituals, so take a deep breath and do it!

Keep your mind open and soak it all up. Treatment is your chance to learn that there is more to life than food. There is more to life than your body. And that you have more to offer those around you than being selfless and thin. No one cares what you look like! No one that matters cares if you do their homework for them or you go along with whatever nonsense they’re saying. If you think people care and they want you to do things for them and be someone you’re not, they really don’t deserve you. You are going to meet friends, some of which you have today, that will be there for you through it all, that will continue to love you and think you’re wonderful regardless of what you do for them and regardless of what you look like. You will find a partner who treats you well. He doesn’t scream or yell, and he will love you at any weight! 

You will learn that your body is healthy and powerful and can move mountains for others with your words. You will be unstoppable when you are well. Your life will not revolve around food, exercise, or weight. In the future, you won’t even own a scale or care what that number reads! You will be FREE of this. And no, that doesn’t mean you have “let yourself go” and are miserable! It means that you are living a life where you are present in the world. You will eventually live a life where you are able to laugh with your whole body, not just fake it while you think about what you can’t eat later. You will be able to walk around and not feel self-conscious, not always worried that others are judging your body. You will be able to speak up for what is right and be heard. You will be yourself without apologies. You will create art and will continue writing. You will be free to sing in the car as loud as humanely possible. You will be able to be your silliest self, go on adventures, and enjoy meals with friends without a second thought. You will truly, truly be yourself.

I know you are terrified. I know you hate yourself, but guess what, Kate! You aren’t as bad as your brain is telling you! You will never be this shy or socially anxious again. You will begin to like yourself! You will see how funny you are, and you will see how giving you can be; you will see that just because you aren’t the best math student DOES not mean you are dumb; you will learn to see just how brilliant you are! And guess what, you are intelligent in all the ways that matter. You will help so many people with your experiences and your wisdom. You will be able to offer insight and show love to people who have never experienced them. You will learn to master your demons and help people battle their own. You will be wildly and gratefully happy for the life you have. I promise. Believe that. Don’t rush your healing, take your time and learn as much as you can, stop being the perfect patient and be honest with your team, so you can get the support you need, and you will learn so much to help your future clients, some of whom aren’t even born yet! Your eating disorder is not your life, but the strength you find while fighting it will become your superpower. You are kind, funny, smart, creative, and unique, and SOMEDAY, you will believe those things. I promise. Hold on. This, too, shall pass.

PS- You end up living in Texas with four dogs and your fiance, yeah, I know it’s shocking, but you actually love your life. And we’re gonna get back to the east coast someday. Promise!

Love,

32- year- old Kate

When I was 7 years old, I noticed my stomach wasn’t perfectly flat like the other girls in dance class. For a moment, I remember contemplating taking a pair of kitchen scissors to trim off the “extra” flesh. I hoped that if I looked more like the other girls, maybe I would feel better in my neon spandex mid-drift bearing dance costume. I spent the next 15 years of my life at war with my body, developing a life-threatening eating disorder, which ravaged every aspect of that body in an attempt to distract myself from the emptiness and pain I felt inside.

After reaching a full recovery in my twenties, I was confident in my body, which was thin, white, and able. I identified my thin privilege and used it to spark conversations with clients and felt proud of my life as a recovered clinician. I often talked about set points, and how my weight had been stable for years and how, when we feed our bodies throughout the day, they level out and find the weight range that works best for them. As I worked in an eating disorder treatment center for several years and food was ever abundant, and I inched closer to thirty, I found myself handed a print out of a doctor’s office with my weight on it. I hadn’t seen my weight in years as I actively choose not to know it out of respect for the eating disorder clients I work with. I preach all day long, “I am not a number,” and I always try to live by what I preach. Those numbers on a clip art scale jumped out at me as if they were in bright neon. I was faced with the fact that I had gained weight since the last time I saw my weight, and I was faced with a surreal, out-of-body experience. I instantly knew how my clients had interpreted similar experiences. I instantly knew how my eating disorder would have taken this moment. I also heard diet culture ringing in my ear, I could lose the weight, I could diet. I remember going back to work and processing this moment with a co-worker and she looked at me and said, so what you gained weight? Instantly the uncomfortable feeling in my chest was gone. She was absolutely right. Who the fuck cares? I was happy in my personal life and career. I had finally reached a point in my life where I was content; there was no space for old tapes to play in my head. I knew my truth, and that was that being heavier meant nothing.

As I sit here writing this, I am 32 years old. I have no idea where life will take me, but I am often contemplating my age and my body and what it means to be female and how my eating disorder potentially could have jeopardized all of it. Recently, I participated in an online training done by Elizabeth Scott of The body Positive, and it got me thinking about my body and it’s history. As an able-bodied human, I was given everything I need to create and sustain life. The curve of my hips and breasts was passed down for generations to allow me to birth our future. My red hair is a nod to my pale and freckled family members who stood out with their fiery spirits and also had to hide from the sun. The scoliosis in my back represents my ancestors who also struggled with back pain. All of these body parts represent those ancestors. The men and women who went before me, who had their babies in war torn countries, who used their legs to walk on foot from Poland to Germany, the women who used their bodies to dance the night away as flappers in the 1920s, the women who used their arms to swaddle and cradle their children at night, the woman whose eyes saw unimaginable sorrow as they mourned the loss of two sons, the women who defied the gender norms by working and wearing pants instead of dresses because they were more comfortable, the women who used their voice to laugh and speak and be themselves when the world was attempting to silence them. Yes, my body is flawed and imperfect, but there are history and legacy in those flaws; this is not my body alone. This is our body. I carry their legacy and strength in each step, each meal, and each action I take.

 Eating disorders are a family disorder; everyone in the family is impacted. Regardless of how the eating disorder presents, family members are often worried, angry, and find themselves in various situations that prompt intense emotional reactions from the sufferer. Typically, when clients enter treatment, they involve their parents and significant others, but siblings are often left out of the equation. I am often surprised to hear from my outpatient clients that their siblings have never been involved in their family therapy. When I was working at an eating disorder treatment center, we worked hard to get siblings to join our family group and sessions, but we often were met with hesitation.  

The excuses are vast as to why siblings are not able to or uninterested in attending treatment. There is often a mixture of reasons: they’re too young, they have their own mental health issues, there is discord between the siblings, the client doesn’t want them involved, the sibling doesn’t want to be involved, etc. The problem is, those excuses may be hindering the sibling and client from truly processing the experience and the effect on the family system. Siblings are often left feeling powerless, helpless, and invalidated throughout their sibling’s eating disorder. As a result, the conflict between siblings may potentially exacerbate eating disorder symptoms.

 In many families, the eating disorder takes over relationships by halting communication, placing unrealistic expectations on family members, and increasing the likelihood of ongoing family discord. Research suggests that siblings who endorsed a balanced caregiving role towards the sufferer felt more satisfied with their role in the family dynamic. Avoiding siblings in treatment can perpetuate sibling discord and overall ruptures in the family dynamic.

This topic is near and dear to my heart. When I was 17, I was undergoing eating disorder treatment; my brother, 10, and my sister, 14, where highly aware of my eating disorder. Although I never talked to them about it directly, eating disorders hold families hostage. Each time my parents had to leave them to take me to an appointment, each time my parents had tearful, hushed conversations about my care, each time I ruined a family dinner or vacation with my outbursts over a meal, I took a tiny piece of their childhoods with me. Sufferers are often not aware that this is happening, and when they are, it often adds to their guilt and shame about the illness. I was not myself. I was surviving a deadly illness, and I had no idea how my behaviors could affect my family. And, although it’s been 14 years since I embarked on my recovery journey, my siblings still resent me for taking away a portion of their childhood. Despite the drastic effect, my illness had on my entire family, and my siblings were never involved in my treatment.

 Despite them never being involved therapeutically, they were probably my strongest allies in recovery. Both of them, never having struggled with disordered eating, served as role models for me as to what healthy relationships with food could look like. They both ate when they were hungry, stopped when they were full, and never thought about it again. Of course, I doubted if that was possible for me, but I was intrigued by their carefree attitude towards food, and although it was hard to admit it, I wanted that life. How powerful it could have been to have them involved in my treatment! Having my siblings in family therapy may have allowed me to communicate how they inspired me and consequently help them feel empowered in the process, and maybe chip away at some of their fear!

As with most things in life, balance is vital. In no way am I, implying that it is a sibling’s job to save someone with an eating disorder. Instead, I am requesting that we get rid of the elephant in the room. Siblings know far more than parents, and sufferers realize that. By involving them in care and helping them process their own experience related to the eating disorder, we can perhaps prevent a lifetime of resentment and decades of secrecy!

My younger brother and sister at my graduate school graduation back in 2012

We all know those people who seem to be put in our lives just to trigger our eating disorders. You know the ones, the people who can’t help but mention the calories in their snack bar, how many miles they ran yesterday, or how carbs are the number one threat to society? Yeah, those people. Some of them are our family members and friends, some of them are the people we work with, and some are the random people in line while you pick up your morning coffee. Regardless, they’re everywhere! We obviously can’t control all of the people on the planet, but we can choose who we have in our inner circle.

So many of my clients mention friends and coworkers they spend time with who constantly trigger their eating disorders. They mention them all the time: “Sarah is training for a marathon, which is making me feel super lazy.” and “It was hard to eat today when Laura never eats lunch”. Whenever I hear these comments, I think, Jeez, you need new friends!  Obviously, that is easier said than done, but not one of my close friends adheres to a strict diet. I just have no interest in spending my free time with people who ascribe to diet culture and talk incessantly about food and exercise.  In fact, I often tell my clients there is nothing I would rather talk about less than food. It’s a part of my job so it’s necessary, but the thoughts and feelings around the food are far more important to me. I was explaining this thought to a client this past week when I came up with the following analogy which she helped me develop.

Say you bought your first home; you remodeled the entire thing, from top to bottom. You picked out everything – all the fixtures, trims, paint colors, and then carefully selected each piece of furniture. As your final accent rug is delivered and you put it in place, you invite some friends over. When they show up to your front door, they are holding kindling, lighter fluid, and matches. They tell you they’ve got a better idea for your home – make it into a massive bon fire! You decide to let them in, after all they are your friends!

More than likely, you would never do that, right? Well, that is what you are doing when you invite people into your life who ascribe to diet culture. You are saying, eh, to hell with this life I’ve built for myself, I’m going to risk it all in the name of friendship! The home in this analogy correlates to our lives in recovery and includes our bodies, minds, souls, relationships, hobbies, and passions. In recovery we have carefully resurrected and recreated these facets of ourselves. Think about that the next time you are with one of these people. Are they helping you burn down your hard work, or are they contributing to your recovery and overall life?

For some of us, we don’t have the luxury to kick diet-loving folks to the curb and in that case it’s important to remember that you are playing with fire. How do we control a fire? We have fire extinguishers, we have smoke alarms, we are careful with how close we get to the flame. These are some of the skills we need to employ when spending time with the diet lovers in our lives. We need to make sure we don’t get burnt by not eating with them or not spending time with them alone. We need to listen to our own internal “smoke alarms” and use some positive self-talk or leave a situation that is triggering. We cannot sit and let it all burn by engaging with their diets, exercise, etc. We have to know and truly believe that we have tried things their way. We have tried to control the food, we have tried restrictive diets, we have tried excessive exercise, and it led to illness, obsession, and misery. We must remember that their way will burn our “homes” completely to the ground.

Recovery can have so many ups and downs, with heart wrenching moments where it feels nothing will ever be ok again. In these difficult times, I find it helpful to seek out small moments that can bring us grounding, joy and gratitude.

A simple “joy points” journaling practice can be an easy way to start seeing the gifts of recovery and what makes life worth fighting for! Start journaling about what brings you joy, it can be the simplest things in the world: a cup of warm coffee outdoors, your dog resting it’s head in your lap, the sound of birds chirping, anything, try to bring at least one of these things on your list into your every day routine. At the end of each day try to think of at least three things that brought you joy. These are your joy points for the day.

Soul moments are a concept I was taught while working at Monte Nido, and is a moment where you feel completely present and feel completely yourself. It doesn’t have to be a happy moment, but just a time that you feel truly able to be present and alive. It might not seem like it, but we have soul moments everyday, just tiny moments where maybe someone held the door for you, or you noticed a sunset,  or had a heartfelt conversation, it doesn’t need to be profound. Try jotting down some soul moments, keep a running list.

Gratitude lists are a therapeutic tool as old as time, but only recently did I start getting into them. Write down some things you’re thankful for right now in this moment. Go ahead, I’ll wait…

I bet it’s more than you even realized isn’t it?! I have been trying to do this daily (ahem- ok, maybe a few times a week) and have found it super helpful in boosting my mood.

These simple concepts can do so much for our mental health and our mood, take five minutes a day to utilize one of these tools, and notice the benefits over time!

Just a snap shot into what brings me joy:

My Dog Lima Bean 🙂

The world has turned upside down since last I posted. COVID-19 has posed countless challenges and pain for so many across the world, but surviving this crisis and navigating recovery is particularly challenging. With grocery stores running low on staples, social distancing and the future being incredibly uncertain, how can someone focus on recovery?

I always remind my clients, that what we put in front of recovery we lose. It’s important to remember that without your mental and physical wellness it is impossible to live a fulfilled life, so recovery MUST be a priority. So how do we do that in such an uncertain time?

I always encourage clients who are going through hardships or transitions to go back to the basics, whatever they might be. The basics include showing up for ourselves by taking care of our mental and physical wellness. So what would that mean for you? Think about what you need to stay safe emotionally and physically and what would help you find hope in each day. Pick 3 or 4 things that can help keep you on track and stick to these intentions. So what might that look like? Perhaps sticking to a meal plan, weekly telehealth therapy and dietetic appointments, and journaling daily? Or maybe daily 15 minute walks with your dog, sticking to eating at about the same times, and connecting with others daily, or eating a “safe meal” when you feel particularly anxious about meal prep. Whatever it is you need, write them down, in a place you can see them and stick to them daily! If you forget one, add it in to your routine as soon as you can. If you’re feeling low, ask yourself how can you utilize one of your intentions into your routine?

Recovery is a huge task that takes months and often years to conquer, but breaking it down into small manageable steps to withstand a particularly difficult season can help us feel empowered and in control of our efforts!

If you don’t have a therapist or dietitian, this is a great time to try out a new provider via telehealth without having to worry about finding a new office or parking on a busy street. If you need additional support check out NEDA for treatment providers, a help line and free support resources. If you are looking for an ED provider try calling the nearest eating disorder treatment center to you and ask for a list of referrals. If you are in the Texas, NJ or Pennsylvania area feel free to email me (kate@katefunkmft.com) and I would be happy to find some resources near you!

Remember, we’re all in this together and we can do hard things!

 

A few weeks ago I had the chance to meet Amy, (@joyoverdestination) a recovered therapist in training, who uses her creativity to give back to the eating disorder community. Amy makes earrings, key chains, and bracelets and attaches them to motivational quotes.  She donates her colorful and inspiring goodies to treatment centers all over the country! She even brings her creativity and joy to the centers and makes her creations with the clients in treatment. I am completely enamored with anyone who uses their authentic gifts to help others, and so, of course, I love her mission. When I reached out to thank her for her service, she was gracious and lovely and donated her heartfelt creations to my clients! It has been super special for my clients to have the opportunity to choose a handcrafted recovery creation that speaks to them! As you can tell, I am a huge fan of Amy’s, and when I saw her coming to the Houston Eating Disorder Specialist’s conference I was excited to hear her speak!

At the conference she spoke about realizing that her thinner self wouldn’t have been able to truly be there for her niece and nephew. She said something like “thinner Aunt Amy” wouldn’t have been crawling on the floor with her niece and nephew and playing with them. Through her recovery she learned that her eating disorder’s values and her own values weren’t in sync, and that in order to prioritize her values she had to let go of her eating disorder. I remember feeling a similar way in my recovery. I loved helping others, but I wasn’t going to be able to do that if I couldn’t help myself. I realized that my eating disorder was going to hold me back from my goals of becoming a therapist and helping others.  Like Amy, I had to move towards my values and away from the eating disorder.  I had to realize that each time I didn’t engage in ED behaviors, I was moving towards the life I wanted! Leaving the eating disorder behind was excruciating, but it was also empowering! I was choosing the life I wanted, instead of the life my eating disorder had predetermined for me.

In her workshop Amy had her participants write down their top three values on the adorable and signature Joy Over Destination cards. I was struck with how my own “shoulds” told me to write down family and friends and education, because those seemed the most socially acceptable, but that wouldn’t be the authentic me! I pushed the shoulds out of view and wrote down four words that spoke most to me: creativity, authenticity, passion, and connection. Those four words pretty much sum up how I chose to live my life today. When things in my life don’t align with those values, I feel it in my gut and in my soul. So, thanks Amy for the food for thought, all of your amazing service to the eating disorder community, and bringing my focus back to the things that truly matter!

 

As the Texas eternal summer fades into fall-ish/ winter here in Texas I can’t help but get excited for cozy knit sweaters and scarves, holiday goodies and enjoying time with family and friends. For our clients, we know the holidays often means extra stress and plenty of triggers; excess food everywhere you turn, countless social gatherings, hectic schedules, not to mention less sun light each day which can bring its’ own struggles.  In this post I will explore some holiday tips for anyone in recovery.

Recovery is a full time job and in order to manage recovery and the holidays it’s important to look at your schedule realistically and see what you can put on the back burner for now.  You therapy appointments is not something that can wait till after the holidays! I often see clients that forget about treatment during the holidays, but that simply isn’t an option! This is the time of year when you need your treatment team the most! Saying no to obligations in order to put your recovery first, isn’t easy, but it is necessary in order to prioritize your recovery! Ask yourself if going to that holiday party will serve your healthy self, if not, skip it. If going the extra mile is typically your go to, consider sitting that one out. Prioritizing your recovery means being gentle with yourself. The last thing your eating disorder wants you to do is to be gentle with yourself and that’s exactly what you should do!

A new season is a great opportunity to create new habits and routines. Instead of focusing on past behaviors think about how you could create new habits that are promoting your recovery. This thought can bring up lots of ideas, but maybe look at where some of the harder moments you had in the past and see how you could replace those moments with structure and support. There are countless things you can do to prioritize your recovery in your daily routine; maybe hanging a quote in your car to remind you to stop for lunch, listening to a soothing playlist on your way to school, sitting with friends or teachers at school/work that have a healthy relationship with food, decorating your bedroom with art work you made in treatment, preparing to go snacks at the beginning of the week, etc. Recognize that you are in charge of your own actions and how you can you act as if recovery is your number one priority, even when it feels like the furthest thing from a priority. Getting into recovery oriented routines early in the season will make it easy to continue moving forward.

Living with an eating disorder is like living in a fog, unable to connect with the world around you. One thing I liked to think about in my own recovery, was what would “baby Kate do?” and this would especially apply to a change in seasons. Would baby Kate want to go cut down a Christmas Tree or try a favorite holiday dessert? Would baby Kate want to spend time with friends and family? Of course she would! This was a great way for me to get in touch with my soul self and what was really important to me instead of what my eating disorder wanted to do. The holiday season is a great time to challenge your recovery with new routines, new activities, and new flavors, but during change and challenges I think sticking to the basics is always key.

Prioritize your treatment, set a schedule and stick with it! Meal plan with your dietitian and supports. Keep your doctor appointments! Life will come up and threaten to shake things out of place, but committing to these basics can help you feel grounded. Stepping back from activities that do not enhance your recovery can only promote your wellness. Look at where you’ve struggled in the past, and see if you can put support in those places. Fall is a time of transition, but transition is an excellent opportunity to step up your recovery and see how you can rewrite old scripts and step into healthy change.

 

I was recently talking with the dad of a teenager with an eating disorder; his pain and anguish were palpable as he tried to appear tough and matter of fact. He mentioned to me, over and over, that although he endlessly loved his daughter, he knew he couldn’t help her and he knew that this may be a lifelong battle. 

We spoke for about forty minutes about his family’s history of mental illness and my own. I am always honest with my clients. Of course I curtail some of their questions when need be, but, for the most part, I answer them honestly. He asked me how long it took me to recover. I paused, thought about that question, and answered honestly. I told him that I was diagnosed at about 16 or 17 years old and consider myself to have been fully recovered at about 24 or 25. He became exasperated. “Nine years, oh dear God, we haven’t even done this for one year yet!”

I felt horrible. In no way had I attempted to squash his miniscule amount of hope any further, but somehow I did. But here is the thing: recovery is not linear. We hear this all the time in the treatment world, but what does it truly mean? Over the course of those nine years, I was not deep in the throes of my eating disorder. I wasn’t completely stuck in the torturous dialogue with my eating disorder. I wasn’t isolated and alone. I wasn’t lashing out at my supports when they expected me to eat a fear food with them. I just wasn’t recovered. Eating disorders take time to be ingrained into someone’s daily life. They don’t just start over night, despite what you may observe. They are insidious and slowly trickle into someone’s life. Maybe they first start by telling the person they are ugly and need to lose weight in elementary school, or by encouraging them to count calories or fat grams. And slowly, over time, they begin to take over the person’s daily life. Recovery is the same gradual process but in the opposite direction. 

In my experience working with clients and my own personal recovery, I believe the process often starts by decreasing and eventually eliminating eating disorder behaviors. That is where treatment often comes in. We work to help the client develop a healthy relationship with food by eating throughout the day and help them to keep their food without compensatory behaviors. We work to uncover underlying causes and explore the function of the eating disorder while rehabilitating the client’s behavior with food.  We implement healthier ways of getting their needs met that do not include food, body, and appearance. When a person begins this process, they experience mental anguish as their eating disorder lashes out at them with severe urges to use eating disordered symptoms. It encourages them to ruminate regarding their lack of symptom use and perceived consequences of not doing so (losing what makes them special, weight gain, loss of identity, becoming out of control, etc). As the client works through these urges and obsessive thoughts, they begin to re-wire their thought processes, but this takes a great deal of time. 

The next stage of recovery often includes incorporating newly learned skills and mentalities into daily living. This is often where lapses occur, and this stage takes the most time to master. It’s easy to stay recovery-minded in treatment, but incorporating recovery into every day life is challenging. I was told by a recovered supervisor of mine that she overcame this challenge by creating a life that was more interesting to her than her eating disorder. This was similar to my experience. I had to create a life that could not include my eating disorder. For me that was easy – becoming an eating disorder therapist. I wanted to help others more than I wanted the comfort of my eating disorder. And I knew that no matter what my eating disorder promised, I couldn’t have the life I wanted and an eating disorder. This stage is challenging because sufferers are faced with all of the triggers and events that allowed the eating disorder to thrive, but they have to consciously choose to do things differently. This is very difficult. If you have always written with your right hand, and now you have to right with your left, it would take time to master that skill. You would need practice to build the muscles and ability of your left hand. At first the handwriting would be illegible, but, as time went on, it would become clearer. This is a simplistic way of thinking about the time it takes to embrace and create a life in recovery. It doesn’t happen overnight, and it takes time to become more natural. This stage is often where symptom swapping occurs. A client will start restricting instead of bingeing and purging, or drinking heavily instead of using behaviors. Symptom swapping is usually not conscious, but it is a way to cope with the discomfort extinguishing behaviors can cause. Clients live in this stage for the longest period of time. It can take months or years as they learn to incorporate recovery into their lives and find motivators for living life without their eating disorder. It takes time to strengthen their belief in themselves to become recovered. 

The next stage is where the client is committed to recovery but still battles thoughts related to the eating disorder. Most commonly, I see this with thoughts of body image. The client may desperately want to be recovered but still worries about their body and how others will perceive them if they completely let go of their eating disorder. They are completely committed to being in recovery but still struggle with some of their thoughts. Over time this stage becomes less obvious and the thoughts become less severe. Instead of feeling urges, they just notice the thoughts. Years into recovery I still had tidbits of my eating disorder that I held onto. For example, I had always chosen Diet Coke. When only regular Coke was offered, I would drink it, but I felt a strange pang of Oh, I shouldn’t do this. When I was with a friend and they wanted to eat pasta for lunch, I would hear my old eating disorder voice say, “Pasta is a dinner food only.” Those thoughts didn’t alter my behavior, but they were strange – almost like ghosts of my eating disorder. For me, these thoughts lasted for years after completely stopping behaviors.  

Each of these three stages lies on a gradient of severity, and they are different for everyone. In my experience, recovery typically follows a trajectory with dips back into previous stages from time to time. The more you feel the fear and do the right thing anyway, the more you move towards recovered! Recovery is not linear, but the process does get easier over time. The sufferer will be able to gain more and more freedom from the eating disorder as they challenge it and build a life they want to live with healthy relationships, coping skills, and passions!