Addictions remove us from the pain we find intolerable. They provide escape routes away from the conflicts and dilemmas we find unsolvable. When we cannot bear to be in our own skins, in our own bodies, where we experience both pain and the wonder of being human, our addictions can throw us into a state of unconsciousness. When unconscious, we find nothing, know nothing of our pain, confusion and struggles. Anyone who has experienced a binge knows the trance-like state it can induce where all outer realities fade into the background, at least for as long as the binge lasts. Anyone who has starved knows the intoxicating ‘high’ that becomes more and more difficult to resist. Those addicted to running are familiar with the sense of euphoria it can bring.
Johnston, 2000, 32
Overcoming Disordered Eating is Overcoming an Addiction.
To overcome disordered eating is to overcome an addiction. There are many ways to do this and fighting seems to be a popular suggestion for approaching the recovery process. But is it the most effective way to think about embarking on such a task? I often hear the old cliché, ‘fight the good fight’ but remain suspicious of it because I can’t be sure that it’s always necessary for good to be accessed or attained through a fight. Especially when it comes to maladaptive behaviours in the form of addictions.
Maladaptive behaviour is not necessarily something one can kill without killing parts of the sufferer’s self. Furthermore, considering this particular addiction has to do with food which can’t be abstained from altogether, I’m not sure to ‘fight’ disordered eating works in theory or practice.
It is important to acknowledge that to overcome an addiction is commonly regarded as ‘fighting’ one’s need and blind desperation to follow through with a self-harming action. When one stops feeding the addiction, there’s physical discomfort, mental circling and fixation on getting what one has become dependent on and a state of increasing anxiety. Biologically, emotionally and mentally one needs to behave or consume in a certain way to feel well, function and maintain a sense of being ‘okay.’ When one stops feeding the addiction to say one feels wretched, disorientated and afraid couldn’t be more of an understatement.
Consequently, to ‘fight’ the addiction is to ‘fight’ the need to feel better, calm and safe on an emotional, physical and psychological level to eventually achieve this once the physical dependency has passed through the system. However, once this has been achieved, the ‘fight’ is actually neither won nor over. Unfortunately, it’s just not possible for it to be over when disordered eating is the presenting problem and not the core one.
Additionally, an addiction to food, abstinence of it, over-exercise and purging involves being dependent on elements, rituals and behaviours in life that are essential and therefore readily available, permissible and in many ways invisible. Food, physical movement and the bathroom can’t be altogether eradicated from one’s daily life so to not trust oneself and remain afraid of the high one can get from food, physical activity, laxatives, throwing up and skipping meals will never do. To live in war and fear of being overpowered by one’s capacity for disordered eating is not to be liberated from this ruthless condition. Which is why I advocate working with its strengths, traits and conviction creatively to direct such concentrated energy and potential elsewhere.
For the disordered eater to spend the rest of their life ‘fighting’ something they must also partake in on a daily basis makes overcoming anorexia, bulimia and binge eating exceptionally difficult and consequently very hard for mental health professionals to treat. Especially because disordered eating in anorexia and sometimes bulimia is ego-syntonic, meaning sufferers experience their behaviour as congruent with their personality and feel a certain amount of pride in the ability to restrict and exercise to the extreme; maintain a state of emptiness, lightness and low weight.
For the ego-syntonic, the addiction’s rewards are highly valued and aligned with the disordered eater’s thin goals. Therefore they have little or no motivation to change the behaviours of disordered eating or to ‘fight’ them. Instead, the ego-syntonic disordered eater is likely to dedicate themselves to their presenting problem regardless of being tired, mentally foggy, hungry and without the energy to do much.
To approach treatment of such a complex and challenging condition as the empowering transformative process, it needs to be to permanently work rather than one that attacks and enforces unwanted change on the disordered eater’s body seems logical. The primary aim is to have the disordered eater ingest healthy unprocessed food in adequate amounts to meet nutritional requirements and not to force them to eat ‘junk food’ that a) can be traumatic for them and b) highly taxing on the digestive system already depleted from the disordered eating. Pressure to immediately gain weight can also initially prove traumatic for the individual and too much for the body so rather than push this, to get adequate sustenance ingested should be enough until the suffering has become comfortable, accustomed to it and the problems bringing on the disordered eating have started to be addressed.
Reaching a healthy weight will happen as the body restores a state of equilibrium. Introducing foods that require more from the digestive system to process them can take place over time as, if and when the disordered eater feels comfortable to willingly do so. This will occur without a fight or enforcement because once the core problems are addressed and worked through, the constraints instilled and insisted upon by the presenting problem which is the disordered eating, will relax and lose their fixation on, and investment in, impossible and essentially illusory ideals.
By working with the sufferer’s story, engaging with and contesting their image or metaphor system to reconfigure the meaning, significance and therefore trajectory there simply will no longer be a need for rules, rituals and expectations of disordered eating. The obsession with food and body will no longer carry the same importance; fear of impending consequences nor be constrained under the same rules. To transform and therefore deactivate one’s addiction to food and the rituals surrounding the consumption of it can be done so long as the disordered eater wants to do it and is willing to accept help in a way that empowers them.
‘Fighting’ Disordered Eating Is Not Resolving the Core Problem
To understand this, it is important first to be clear that the addiction to food and excessive preoccupation with the body is a problem pointing to, and trying to save the disordered eater’s self from, a much larger one. In short, disordered eating is not the enemy but the symptom of a serious emotional and developmental problem. To ‘fight’ disordered eating will not resolve the core problem and because it cannot get rid of the inciting affliction the disordered eating, as a symptom will resurface.
Consequently, this article is preoccupied with why to ‘fight’ doesn’t seem like the right action to be evoked in response to disordered eating and the benefits of thinking differently by getting clear about what the role of the presenting problem is and how to most effectively engage with it in order to reach the core problem.
Disordered eating is known to continue through cycles of subsiding only to return at stressful periods throughout a sufferer’s life. Why? Maladaptive behaviours take action and therefore manifest in reaction to feelings of fear, pain, guilt, shame, unworthiness, disgust or threat to emotional and psychological survival. They are compelled to do their job regardless of the cost to the sufferer’s physical well being.
Maladaptive behaviours such as disordered eating function to protect the sufferer from unbearable emotions. They are compelled to operate in this manner because the individual knows no other way of dealing with such difficult emotions and lacks the necessary inner resources to cope with how unbearable, confusing and alienating their experience of reality is.
So again, why ‘fight’ what is compelled to return until what it is a mask for, is resolved? Especially since to break down this maladaptive behaviour it becomes evident that it has a lot of positive, even admirable traits that would benefit the individual should they be alternatively employed. Instead of ‘fighting’, perhaps more might come of approaching the condition like a mystery to be solved? To engage with disordered eating like a detective determined to uncover the larger problem it is acting as a symptom too is to simultaneously learn the story it is a primary metaphor in, and recognise how to transform the disordered eating into adaptive behaviour.
Transforming Addiction into Adaptive Behaviour
In light of the power, loyalty, dedication and capacity a maladaptive behaviour such as disordered eating has it makes sense to question how beneficial it actually is to wage war on parts of the self that are devoted to preserving the inner self. Yes, the effects are adverse, but imagine what the results could look like should the capacity demonstrated be positively employed.
Once the disordered food behaviour habits and rituals are not practised, the individuals have more time and energy on their hands, and from this internal space, they are going to begin to make contact with what it actually is that the disordered eating is a symptom of. That is if one can stay still and present long enough to listen to it. Regardless of whether one is anorexic thinking and dreaming about food and over-exercising; a bulimic on an endless cycle of buying, consuming, purging and cleaning; or a binge eater consuming until they’re too full to move, disordered eating is always a full-time preoccupation involving rituals and social withdrawal. Ultimately it’s function is to distract attention away from one’s true feelings, thoughts and circumstances.
And so I ask again, why ‘fight’ the addiction when disordered eating is not the real battleground but a distracting illusion? Of course, the addiction needs to be managed and stopped, but there’s a significant chance this can be achieved if the coping mechanism is transformed rather than attacked. In addition to this, the person suffering from disordered eating is thoroughly exhausted, depleted and not necessarily in a position or with the resources and energy to ‘fight’. Instead of ‘fighting’ why not have the sufferer and disorder collaborate their strengths, know their image/metaphor system, story and mythology to integrate and transform the remaining course of life into something good, fulfilling and life-enriching? Why not let the disordered eater explore what if and write the story they want to live out and how exactly it is that transforming their eating disorder takes place?
What If in Life Can Function as Powerfully as it does in Fiction
What if instead of a person with disordered eating putting their last life force and energy into fighting against the compulsion, they took from Cognitive Behavioural Therapy’s strategy of behaving differently? For example, instead of drinking multiple servings of chocolate thick shake for breakfast and then throwing it up, they lie down on the floor, relax, look at the ceiling and feel the need to do this without acting upon it? All that is required is to rest, breathe and feel the need to do something that in actual fact the person with bulimia is too exhausted and depleted to continue doing.
What if they did something radical and gave themselves permission not to do what they always do? Yes, it may be terrifying and require effort to not obey the compulsion but what if that was okay and they did it anyway? What if they became the author of their own story and decided as the leading character it was time to begin the change bound to happen through what takes place in the middle and achieves a point of no return by the end? What if the story they gave themselves involved their liberation from their disordered eating? Fiction is essential in transformation because it requires imagination, visualisation and encourages the realisation of where what if can indeed take one.
For example without entertaining what if the disordered eater’s life stays the same. To gather the ingredients, prepare the thick shake, drink the thick shake, clean up after it, throw it up, clean up the bathroom and end up feeling hungrier than before. Only to repeat the cycle by continuing to binge and purge until collapsing asleep in the evening. Each day like the one before is how the bulimic’s ‘repetition compulsion’ goes. No matter how much the bulimic wants, it to be enough or the last time it never is. All their energy, life and financial resources go into living out this endless cycle of waste and self-hate. More is the only demand disordered eating makes. And it will take everything, everything including the sufferer’s life precisely because there’s no such thing as enough or satiation. There can’t be. It’s neither food nor a ‘perfect’ body that one is truly ravenous for. Yes, the body needs to eat, and everyone appreciates feeling beautiful, but this excess is commonly speaking to a formative unsatisfied hunger for a sense of being loved, valued, wanted and as belonging.
But what if the disordered eater woke up one morning and said yes I feel the need to binge, purge, starve, but I’m not going to. The disordered eater proceeds to feel restless energy tempting them to get up and just do it, so the need stops hassling them. But perhaps he or she doesn’t act on the compulsion but instead says: no, I’m tired and so bored of no longer being able to even taste what I eat and then spend hours with my head in a toilet bowl chucking. I’m just going to lie here feeling the soft warmth of the carpet and enjoying the white space of the ceiling above me and rest and see if natural, subtle energy to get on with today happens. And if it does, I’m going to go and sit on the grass in the sun at the local gardens and observe what comes up for me. I’m going to drink water and wait until I can recognise my genuine hunger for food that will feed my body breakfast I will digest. I will feed my body an adequate amount of nutritious food to get me through the four hours until lunch, so it’s not so much that it hurts my stomach and I have to throw up. Every day I’m going to say no to disordered eating until this becomes my reality. I don’t care how long it takes or how hard it is. I am ready to change like the character in the story I’m writing.
When a person’s life is taken over or consumed by disordered eating, this approach is actually in practice less complicated and time-consuming than one’s compulsion, so one has what it takes to do it. The challenge is in not following according to habit and for the bulimic accepting the discomfort of not emptying the stomach after consumption and having both the energy and time to do other things. For anorexics, it’s breaking the habit of not eating and over-exercising, and for binge-eaters, it’s breaking the habit of using excessive amounts of comfort food which is highly addictive for the coma-like state it chemically induces.
Using Story to Empower the Disordered Eater to Transform their way out of Addiction
As already stated disordered eating as a maladaptive behaviour has positive attributes that are adversely employed. However, the demonstrated capacity for focus, discipline, strategy, structure, precision, love of beauty, eye for detail, intelligence, creativity, effort, loyalty and sensitivity to subtext is everything the sufferer needs to reverse the situation. First, the value of such attributes needs to be acknowledged, second, their story is known, and thirdly it needs to be rewritten in a way that they are assigned a different role so all that energy can be redirected upon different tasks and preoccupations that produce positive outcomes.
Each disordered eater must learn to answer precisely what this is for them because it is unique to who they are and what they want out of life. The energy needs to be channelled towards the positive and be part of creating the kind of life that they would find fulfilling. This is precisely why for the treatment of disordered eating to be adequate it must include more than just a sole focus on food and the body. The underlying, symbolic causes of the eating disorder are equally if not more important. To understand the story, mythology and meaning behind the skewered relationship between food and the body in disordered eating are to learn how to give one’s capacity for focus, discipline, strategy…a different job. This is possible once the desired destination, goals and aspirations have been identified and broken down into bite-sized pieces that make it possible to arrive at in time.
Disordered eating is a problem that will not naturally go away, and left inadequately treated the addiction will conclude in premature death. It is essential for the disordered eating to be intervened upon and transformed into one obstacle within their full life stories where journeys throughout all the stages of human development are had.
There is no need for an eating disorder to be fought but a great relief to be had in giving a disordered eater the permission to say no to their compulsion. The knowledge needed to understand and challenge their addiction and celebrate their demonstrated capacity by identifying ways they can employ their self-discipline, eye for detail and sensitivity… to transform their life story into what if there was no role for my maladaptive behaviour to play anymore?
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