Friday, April 1, 2011

Full recovery?

Is full recovery possible???

What does full recovery actually mean? Does it mean we never worry about food, weight, calories, numbers etc ever again? Does it mean we never have a 'fat day' or wish we were thinner or compare our bodies to others again? Does it mean that we will eat three meals plus snacks every day without panicking or choosing 'safe foods'? Does it mean we will look in the mirror and love what we see unconditionally?

I find it hard to believe that all or any of that would be possible. I mean I know plenty of women who do not suffer from an eating disorder, but who still have 'fat days' when they feel bloated with PMS, or who wish they could lose a little weight or envy others' figures. I know too many women who pick low fat options and who crash diet to fit into a new dress. Does that then mean they have eating disorders or that those things are just part of normal life?

I've heard that chronic eating disorder sufferers are less likely to fully recover. I remember when I was in treatment, there were girls who had been unwell for maybe a year but could still remember how life was before their eating disorder took hold. They knew how they wanted their relationship with food and their body to get back to. I remember thinking that I couldn't recall ever feeling 'normal' about food or 'happy' with my body and therefore how could I know where I wanted to return to?

I am a recovered alcoholic, and I know that in order to stay that way I choose not to drink and avoid situations where I might be too tempted. This would make sense for recovered addicts, gamblers, adulterers etc, but how does that work for us recovering from eating disorders? there are so many triggers for eating disorders and I remember declaring that surely I'd be cured if I just avoided food and eating... big obvious flaw there... while we can avoid alcohol and gambling for the rest of our lives, we can't avoid eating. Having to look at it from a different angle, figuring out and dealing with the reasons we want to avoid food and eating in the first place is a huge undertaking. I am not minimising other addictions - I know first hand how hard they are to kick, but i know that for me the anorexia is the one that lingers.

I would say that I am mostly recovered. I eat normally 95% of the time, my weight and health are restored, I eat in public, and the disorder doesn't stop me working or enjoying my marriage or having friends etc. I do still struggle daily with that chattering in my head telling me what is 'right' and 'wrong' and the constant thoughts about weight, weight loss, my body, and the links between me choosing to eat and my past trauma. It is always there. So yeh I am pretty much recovered, but I just don't know whether the rest will ever go away. I've been doing the right things for so long that I wonder if the rest really will fall into place like all the professionals told me it would, or if this is the way it is to be - if so that is OK, but I always wonder if things could get better...

I brought it up in therapy today as my therapist has extensive experience in treating eating disorders both here and in the UK, as well as personal experience of recovering from eating disorders. She agreed that for some full recovery is very real, and that for others it is not. That there is a big continuum, that there is not a yes or no answer to my question. As to whether I could full recover, we discussed my history - when I first remember using food to cope with emotion, my feelings about food and my body growing up, when I became unwell etc etc. Key to this was three things. One was that I recall clearly the day when I was 17 that I decided that I would stop eating (or purge what I did eat) and that my reason for this was strongly linked to a traumatic event. That day I linked food and abuse together very consciously and deliberately. The next key thing was that even though I have been funny about my body, about exercise and had occasionally experienced using food in a disordered way since I was 11, as well as having strong fears of gaining weight and issues with body image, for a long period up until I made that link when I was 17 I actually wasn't afraid of eating food and did not restrict it or purge it. Up until that day when i was 17 I was focussed on excessive exercise, body image and weight, but not food or eating, therefore I actually had experienced normal eating. The third key point is that I have successfully given up many other destructive things over the years, such as alcohol, self harm, purging and restriction and have a stubborn determination when i decide to take the plunge. These things my therapist decided stand me in a good position to kick this thing for real one day, once I break that link I made some 13 years ago between food and abuse. If only breaking that link was as easy as creating it.

Chatting with a couple of my friends while I was writing this, I asked them what they thought full recovery would mean:

One responded: Learning to be happy with who you are, and what you are, not caring about what you look like, not even thinking about what you are putting in your mouth when you eat, being independent and in control of your emotions, being able to resolve any issues you have without the use of food or lack of.

The other: I think full recovery is possible for some people, you do hear stories about people that claim they are fully recovered. For me though I just want to be at a point where I am not plagued by the thoughts so that I can function properly

I also asked the same questions of my husband. he has been with me since i was a binge drinking mess and stayed with me through the worst of my anorexia and my subsequent almost recovery. i thought it might be interesting to get his point of view.

He said that full recovery is: A state of being that means that you are no longer having to manage your life based on the disease. That doesn't mean that you dont think about it at all, any more than somebody who has recovered from PTSD in a warzone doesnt think about it anymore. But that you are not adapting your life to a set of rules designed to minimise the impact of it. Which means that you go to cafes, you eat ice cream, you have breakfast lunch and dinner every day in the same way that normal people do, you don't avoid situations where you know food will happen, so you'd be going to a family dinner without it overly concerning you. Yes I definitely think it is possible to get to that point in the same way that I suspect that some people that recover from war related PTSD find themselves in a situation where they are enjoying air shows. But I think that it is all too easy for people to turn the rules that keep them safe while they are still suffering, into habits they are no longer willing to break, using any number of justifications for it, often not related to their original illness, thats human nature. "thats alright, everybodys a bit weird"

I am still undecided on whether it is ultimately possible to full recovery from an eating disorder, but I would like to hope that it is. I am happy with where my life is and where it is heading, but I would hope that one day I will be free of what I still have in my mind. I am told that I need to work on my trauma issues in order to achieve this freedom, and so that is what I am currently doing in therapy, so perhaps watch this space, it is a work in progress.

what do you all think? is full recover possible, and if so what does it look like?


  1. To give everyone a little "food for thought" so to speak, I am going to quote a psychiatric paper. This was written in May of '08, but as far as I know they have gotten no where closer to defining it.
    "Of all these issues, perhaps the most important is the lack of consensus in defining recovery.

    We have been able to identify predisposing, precipitating, and perpetuating factors and are continuing to move forward in our understanding of predictors of outcome, but the wide variability in how recovery has been defined makes it difficult to pool available research data in order to draw sound conclusions. The question of defining recovery becomes even more difficult to answer if we consider from whose point of view recovery should be defined. Should it be defined from the point of view of patients, families, treating professionals, third-party payers, or other stakeholders? This may be a particularly sensitive issue given that there are likely to be different expectations of what constitutes recovery among these groups.

    The time to resolution of different eating disorder symptoms among treatment responders can be quite varied. This needs to be taken into consideration as we define recovery. A study by Clausen1 in 2004 found that symptoms such as restriction or purging may improve or resolve within a few months after the onset of treatment, while other symptoms, such as body dissatisfaction or nonpurging compensatory behaviors, may take years to resolve. In order to effectively look at long-term treatment outcomes we need to establish a consensus in the definition of recovery, at least from a research perspective."

  2. Full recovery is VERY much possible in my opinion (and experience). To me, it looks like: peace with and acceptance of who I am, inside and out, and the day-to-day decisions to reject disordered thinking whenever it arises (and oh how it does). The effort it takes to do these 2 things continually lessens as each new day of my recovery dawns.

  3. So I was thinking about this as I was grocery shopping... I know, odd, eh? And I think I will finally voice my opinion.

    I feel like there is an implication being made here, that needs to be further investigated: whether or not fully recovered is the same as being struggle free.

    I personally think the two things are QUITE separate and, in fact, that the notion of the latter being a possibility is almost eating disordered thinking in and of itself.

    Let me explain myself: I believe that recovery means at the very basic level that you are functioning. You are living. You are controlling your own destiny. The eating disorder is not doing those things for you.

    I think that every one struggles with negative thoughts about themselves. I think we live in a culture that thrives on negative self talk. I think if you are managing to live your life and are not preoccupied with eating disordered thoughts - and doing this consistently to the degree that it has become natural 90% of the time, then you're probably living your life as majority of non eating disordered people do.

    I think there's this belief that recovery means thinking highly of yourself all the time. Eating well balanced meals all the time. Never missing a meal.

    The fact of the matter is though that even the non eating disordered sometimes struggle with things. The question is whether or not you let that internal struggle become an external one... and whether or not you allow it to perpetuate.

    I don't think being fully recovered means you have a perfect relationship with yourself and food nor that you're struggle free. I think it means that you realize that doing XX is not the solution and that you move on. That you are capable and willing to move on and away from that - instead of, as I said earlier, perpetuating the cycle by engaging and continuing to engage in negative self talk or negative behaviors.

    Just my two cents...

  4. What an incredibly thought provoking post, serra! I, without a doubt, believe that full recovery is possible. Sometimes I get days where I hardly think about food at all and I don't give a damn about what I eat. I still hear the chatterbox but it's just become second nature for me to ignore it that I even forget it's there sometimes.

    To me, full recovery is not having any urge or inkling to engage in any unhealthy ED behaviour. It's about not associating emotion with food. It's about having your OWN thoughts in your head. It's about accepting yourself, even though there are parts of you that you still may not like, you accepted that change just isn't an option.

    I know for me that I have succeeded in many aspects in recovery. I just still struggle with the idea of exercise and I know that I will for quite some time. But not acting on those thoughts is step 1 of the process.

    I believe that full recovery is possible for you, as well, serra! And by that i mean that i believe that the voices will eventually cease. It takes a long time for them to disappear. You just have to keep fighting every unhealthy thought until they are no more.


  5. this is an interesting discussion.

    i am beginning to think that full recovery has very much to do, as others have said, with the fact that we do still struggle, because hell everybody struggles, but something qualitatively changes...
    i don't care if i'm always vulnerable.
    but if i can get to a place where i am not redirecting my emotions into destructive things because i am just feeling them moment to moment ...
    that will be recovery for me, i think. from there i think i can defend against the demons and i think they will get less convincing and more 'oh sod off, you.' over time ...

    and honestly? i think that's possible for everyone. just probably really hard to achieve and sustain... and i wonder if the reason the stats are dismal is because nobody can tell from the outside if a change has occurred, so many who get to some kind of stale-mate with food and seem to be eating kinda ok and aren't doing anything obviously bad would get classed as 'recovered-ish. like probably as recovered as you're likely to get'. even though... it's beyond that...




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