This post is a long time coming. Ever since I was diagnosed with anorexia nervosa (AN) 12 years ago, I have heard the word “recovery” thrown around a lot. People are constantly saying that they’re “in recovery” or “recovered” (or “recoverED”). But what even constitutes recovery?
When I was 13, my doctor told me a story about someone she knew with anorexia who was now in her 40s, and was in “recovery” after struggling with the illness for decades. Apparently this woman would carry cottage cheese around with her and eat it when she “didn’t like” what was being served at others’ homes. That was the model that was laid out to me of recovery. Years later, I still think about that story. Is that what recovery is supposed to be? Carrying around cottage cheese for the rest of your life? (Caveat: there is no offense meant for cottage cheese. I go through phases of liking cottage cheese, and it is a good source of protein. However, if my years of nutrition therapy have taught me one thing, I believe that cottage cheese lacks most major food groups and is not a substantial or “normal” meal in and of itself).
On the other hand, I hear incessant narratives and stories of people who are completely over their eating disorder. The narrative goes something like this: “I was in the darkest place. I was going to die. But I got better. Now I am now recovered. I want to help others do the same, and I will devote the rest of my life to posting inspirational pictures on Facebook and writing self-help books!”
Both of these extremes really annoy me. One the one hand, I don’t want to be told that my best outcome in life is becoming BFF’s with a jar of cottage cheese. Living without a sense of hope of recovery is just depressing. I remember one therapist told me that I would probably struggle with my issues for the rest of my life. Do you know how I reacted to that comment? I stopped seeing her. Why would you bother going to therapy if life is never going to get better eventually? I find great hope in little moments, glimpses of wellness. I find great hope and energy when people believe in me genuinely.
On the other hand, I have a deep capacity to feel and understand pain. The roots of eating disorders go so deep, and I don’t want to trivialize or reduce someone’s experience to the happily-ever-after “I am recovered, and you can be too!” I don’t think that is taking into consideration what a person is going through, and the shame that can accompany someone who is NOT recovered hearing bubble-gum, happy-go-lucky self-help messages all the time.
In thinking through the question of what recovery actually is, I have encountered different, and often contradictory, answers, as is explored in this article from the NY Times. There have been a handful of studies looking at recovery from anorexia, and all of them use different measures and ideas of what recovery is. Carrie Arnold has explored this often elusive concept of recovery on her blog and also in the book Decoding Anorexia. Another article by Bardone-Cone et al. (2010) explores the idea of recovery from an eating disorder and concludes with the idea that definitions of recovery in research should include behavioral, psychological, and physical components. If researchers are unclear about what recovery is, and professionals given people contradictory messages about how well you can get, how are you even able to know when you’ve gotten there?
Some people are convinced that they are recovered from their eating disorder, never to relapse again, and I appreciate people who are authentically recovered. I had one therapist recently who would often talk about being recovered. It irritated me a little bit at first, but then I saw the way that she ate and lived her life, and I have no doubt in my mind that she is genuinely over her eating disorder 100%. That was healing to see a professional be so secure that her eating disorder was in her past; moreover, that she thought that I could get there as well. The reason why this therapist was helpful is not only that she is recovered but also because she didn’t cram it down my throat during every session, and she was able to meet me where I was without having this underlying self-help, fix-it-right now agenda. I see friends with whom I went to treatment going to school, having babies, getting married, and living their lives absent of their eating disorder. That is beautiful and redemptive to see.
At the same time, I am too familiar with what Aimee Liu calls the “half life” of anorexia, in which symptoms have been in remission but self-criticism, perfectionism, judgmentalism, and the restrictive mind-set persist. For people whose restrictive mind set has penetrated down to the core of their bones, or who perhaps have comorbid conditions, this “half life” might be someone’s dwelling place for a long time… if not forever. Full recovery from an eating disorder is a long process. Far after the symptoms subside, the underlying issues raise their ugly heads and must be dealt with. I am still dealing with those issues, and it doesn’t look like they’re going away anytime soon.
I resonate with what Suzanne Dooley-Hash says in the NY Times article, “I feel like I can’t ever be off guard,” she said. “The next time I’m overwhelmed and stressed, my first instinct is going to go back to restricting. I think I would be naïve to think it would ever not be a part of my life.” At this time of my life, I am always vigilant. Every cold, every flu, every stressful conversation, I must be cognizant of my eating patterns and making sure that I don’t slip. I don’t know if that amount of self-monitoring will be necessary forever, but for me, it is necessary for right now.
I hope that full healing is possible for me. I hope that someday, all psychological, behavioral, and physical symptoms of anorexia will be absent in my life. I hope that for others as well, and I have great hope in my faith and what I have seen happen to others in my life. Consequently, I am realistic and don’t want to belittle others or be condescending about what SHOULD happen. Eating disorder recovery is like a labyrinth, and usually there is not an easy way out. It takes a lot of support, a really, really good therapist, and love.
I love how Carrie Arnold starts the last chapter of Decoding Anorexia, “Usually in the last chapter of an eating disorder book, the heroine leaps off the page, recovered, and yammers on endlessly about how great her life is. She loves her body! and how she looks! and food is just this wonderful, delicious thing! and so on. This is not that book.” In keeping with her theme, this will not be that post. I am in a good place. I am so thankful to be where I am. Frankly, I’m happy to be alive. I’m thankful for Sour Patch Kids, macaroni and cheese, and my therapist. But I am not road-tripping across the country to tell people about how awesome and inspiring I am and how others can become like me. I still struggle in the “half life” stage of anorexia, better but not recovered. I want to be met where I am, not have my experience belittled, and receive hope and love that I need to move forward, albeit slowly.