I’m glad you asked for thoughts and not answers, Casey! This is such a challenging issue.
Working toward becoming a mature, responsible, competent and self confident person is the developmental path by which we find health, the ability to deal with complex issues and the ability to tolerate ambiguity and stress while proceeding in our individual lives. When we are on such a path we are free to say “No,” to what is not good for us. That means we can stand up to forces, including people, including family, who press us to accept something that goes against our authentic needs and values.
A person with an eating disorder can’t do this very well because when her eating disorder started a section of her development stopped. The eating disorder takes care of discomfort, challenges, uncomfortable feelings and certainly helps block even the awareness that standing up for herself is necessary. When she can’t tolerate her feelings she might continually defer or be emotionally numb or seethe within yet be unable to be understood by others. She may be unable to contain her frustrations and burst out with weeping or rage, neither which communicates clearly to the people around her.
If our eating disorder person, let’s call her Cynthia, knows her family supports eating disorder beliefs and behaviors, then she has some self awareness about her disorder and her recovery needs. In early recovery she may tend to believe that once she is aware of something it’s easy and reasonable to think others should be aware too.
“Why can’t they understand”?
“Why do they push food at me?”
“Why do they talk about my weight?”
“Why do they watch what I eat?”
“Why do they keep talking about what I do and don’t eat and how much I eat?”
What Cynthia needs to appreciate is that she is working hard on her recovery. She is working to change not only her way of eating but her way of life, her vision and perspective on what is possible for her in life. She is working to gain a new appreciation of who she is as she develops her dormant potential into her independent and authentic personhood.
Her family, most likely, is not doing this. They are living, behaving, believing as they always have. Family culture does not change because someone goes into treatment.
But this does not mean Cynthia has to leave her family. If she loves them, and they love her they can stay in relationship. The wonderful thing about a loving family is that the culture may be powerful but the love creates some flexibility.
Does Cynthia live at home with her family or is she an adult who visits? That makes a difference in terms of how she will deal with the stress of making a recovery place for herself within this culture. But it doesn’t affect the options she needs to explore.
To communicate with someone you have to speak their language. Cynthia’s family may not understand eating disorder language. By that I mean they may not understand psychological issues Cynthia is exploring. They may not understand why a cherished food that they have prepared for generations for holidays or breakfast or birthdays or dinner is now unacceptable.
So part of Cynthia’s recovery work is to discover what language her family will accept if not understand. Her goal is not necessarily to be understood. Her goal is not to have her family be as informed as her therapist or members of her recovery community. Such goals are wishes that lead to sadness and frustration for Cynthia. For her family such goals are bewildering.
As Cynthia becomes more capable of tolerating her feelings she can find her way. A common fallback position is: “I’m allergic to …..whatever foods are being pressed on her. Another is, “My doctor wants me to eat this much and in this way.” Another is, “I’m doing a writing experiment for work (or school or community project) about thoughts and feelings. When I feel or think something that’s relevant I’m supposed to stop what I’m doing and write it down.” If this is something the family can accept then Cynthia can leave the room at any time and go to her journal.
Key to these possibilities is Cynthia’s taking responsibility for finding her way through the family culture to her recovery needs. She works to find her way to make her environment support her recovery. She creates an oasis for herself using language her family can accept.
2. Motivation to recover comes from many different place, but often people feel like they do not need to address eating disorder behavior unless they are at the brink of some sort of crisis, like passing out at work. How do you go about finding motivation when the eating disorder is telling you everything is fine and “You’re not that bad yet.”
This is a fabulous question. What is it that puts a person on their true recovery path? Recovery takes time, energy, money, commitment. It means letting go of a way of life that has protected you from unwanted feelings and knowledge. It involves joy and, especially in the beginning, a lot of pain and tears. Why would someone want to go through all that if, as you say, “It’s not that bad” or “not that bad yet.”
I believe the change from going deeper into the eating disorder to climbing out of the disorder and into life requires several components.
The person realizes that her eating disorder is endless pain going to darker places.
The person realizes that the pain in recovery can lead her out and into freedom. Her choice becomes endless pain or pain with the real possibility of freedom.
She has a sense of hope that recovery is possible. This might come from within her or from being inspired by recovery she sees, hears about or knows from people in her life or from books or YouTube testimonials or 12 step meetings.
This point I’m less certain of. It’s about the availability of real help. Some people need to discover a source of real help before they surrender to recovery. Yet others surrender first and then find their help.
I’m a psychotherapist specializing in eating disorder treatment for thirty years. Some of my patients have been committed to their recovery and searching for years, trying different treatment methods until they get to my office. They found me after they became motivated to their recovery.
Others come to me enmeshed in their eating disorder. They come to check me out. Only when I win their trust do they begin to let go of their rigidity and find their way to their recovery path. They come because they are looking for help. They want and hope for a way to heal. But they are not motivated and committed until they trust our relationship and trust that I will go the distance with them.Clearly, Joanna, you are very thoughtful and thorough in your answers! Much appreciated, I assure you. Given the depth of your thoughts, let’s continue this interview in the next post. Everyone, please stay tuned for the rest of the interview, to be posted on Thursday , November 7th, 2013. Until then, please feel free to share your thoughts on Joanna’s words. 1. What do you find helpful in dealing with family culture that doesn’t support eating disorder recovery?
2. What motivates you to stay committed to your recovery? 3. What parts of your family culture support recovery? 4. What have you found in recovery that keeps you moving towards change? Joanna’s website is: http://www.eatingdisorderrecovery.com Healing Your Hungry Heart, published by Conari Press, is available at Amazon, Barnes and Noble, Gurze.com, Books a Million and bookstores. Joanna’s private practice is in Los Angeles. She also does long distance Skype consultations. To reach her write Joanna@poppink.com