3. Going into a higher level of care can be a terrifying and distressing process but so can leaving a treatment center. Treatment centers provider 24 hrs of support and validation. How do you help clients “take that home”, for lack of a better phrase?
They can’t take that home. They have to build support and validation within themselves. And they can’t do that until they are in solid recovery. It’s a shock to leave a safe place and enter the unsafe world we all live in.
A quality eating disorder treatment center gives clients tools to use when they are in trouble. It shows them the kind of support and validation they can receive from community. It shows them they are lovable and that they are not their symptoms. It shows them that they gain respect from others and perhaps themselves for working toward recovery no matter how they fall and act out their disorder.
It shows them that they are not alone, that some people have more health than they do, and some people are more sick and troubled. Clients discover they are not unique and isolated because of their disorder.
And, if they are lucky, they will see someone go through a crisis with supportive and understanding professionals who work with that person as she descends and emerges with new learning and a stronger sense of self. All this adds to a realistic sense of hope and a determination to continue recovery work.
If she thinks she can go to a treatment center and come out healed and ready to be on her own she is in a fragile and unrealistic position. If she can use what she’s experienced to be able to tolerate her feelings more without acting out as much she can appreciate the ongoing work that is necessary for her full recovery.
Then, if she’s working with me, we can draw on her residential treatment experiences to add understanding and strength to her every day living as she learns to stand on her own.
It’s very difficult to stand on your own when you have an eating disorder. That’s why clients are so afraid of recovery work. They don’t realize that recovery means you can stand on your own because you don’t have an eating disorder anymore. It’s difficult to imagine being without an eating disorder when you’ve had one all your life. But, step by step, day by day, appointment by appointment and achievement by achievement, recovery comes.
4. Many in recovery are terrified of feeling hungry and go to great lengths not to feel it, whether that means restricting or binging. As the author, “Healing your Hungry Heart,” what are your thoughts on facing hunger?
Ah, hunger. It’s such a natural word to go with food and eating, isn’t it? People with eating disorders usually have no idea what hunger is. They eat for emotional reasons. They are hit with massive cravings. They may be ravenous from starvation yet not recognize a normal feeling of hunger. They will use the word, hunger or hungry, but it’s not connected with genuine hunger. It’s more about filling themselves up completely so there’s no room to feel anything.
Or it’s about keeping themselves empty and feeling at home with that feeling, even if their bodies are shriveling away.
I remember a client who called with me great happiness and excitement. She was at a sushi restaurant with friends, eating one mouthful of food at a time. She said, “I lifted the next morsel to my mouth and didn’t eat it. I was hungry when I started the meal and then I wasn’t hungry anymore! I knew that the last bite satisfied me. This next bite could be the beginning of a binge, and I didn’t need it.”
She was elated because she found out what hunger was.
Your question addresses the real situation of people with eating disorders who are terrified of feeling. It’s difficult or impossible for them to distinguish physical feelings from emotional feelings. Almost any feeling needs to be avoided.
Your readers may object to my saying this by responding, “But I do feel. I feel angry or sad or scared at times. I feel happy when I do something right and get praise. I love to dance and workout.”
My response to that objection is, yes, of course you have those feelings. They are a narrow range of what a human is capable of feeling. Most of the time what you feel is a great intensity, a rush that can be overwhelmingly good or bad. Overwhelm is the operative word. A surge of intense feelings overwhelms the broader range of human emotion. Those emotions give you information about your life, your experiences, and your relationships. They call attention to what is good in your life and what needs correcting. As you develop your own stability, sturdiness, sense of self and inner competence you become able to face what your authentic feelings are showing you about your life.
In writing Healing Your Hungry Heart: recovering from your eating disorder, I thought about this question hard and long. It’s key to recovery. Like so many parts to recovery work, this issue needs to be approached gradually, gently and at a pace that is tolerable to the individual.
My book has exercises after each chapter. They look similar, but they are tweaked to help you go more deeply into your psychology in gentle stages. If you do the exercises in Chapter 2 every day for a month you will learn more about yourself, and you will develop new strengths. Those strengths you will use when you do the exercises at the end of Chapter Three every day for a month. And so each chapter exercise equips you to move to the next with more recovery than you had before.
When you finish the book you can start again. The Appendix has more exercises for each chapter. Healing Your Hungry Heart is designed to be a long time companion on your journey to recovery. You can use it as a fresh experience for years. I hope you will write to me and let me know when you discover your real feelings of hunger so I can celebrate with you.
Thank you so much, Joanna. I deeply appreciate that you took the time to answer my questions and I am excited to see how the responses from our readers and clients!
Thank you, Casey. It’s a pleasure to respond to your thoughtful questions. Your readers are lucky to have found such a caring and conscientious clinician who works on their behalf.Please share your thoughts on Joanna’s answers. 1. What can you share about your experience in coming out of residential treatment that might help others? 2. What are you learning about hunger and learning the difference between craving and feeling hungry? 3. What is working for you? 4. What kind of support do you need now? 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