“What does recovery look like?” is a common question frequently asked by patients and families. Patients often fear being recovered just means gaining weight and still being unhappy. While the answer to this question may seem like it should be simple and succinct, it’s actually quite complex. It’s even a question being debated and researched within the eating disorders profession because there isn’t a standard answer – and I don’t know that there ever will be.
I truly believe that people can get beyond food and weight issues, no matter how bad they are, and live their lives with the freedom they deserve. I personally know, and have met, too many people over many years who have fully recovered to question whether it’s possible. My treatment is based on the philosophy that full recovery IS possible, even when patients feel it isn’t.
When I talk about the process of “recovery” with patients, our conversations typically encompass the following points:
There are phases to recovery, all of which are important and necessary. A beginning phase is to stabilize eating patterns and restore weight to a level where therapy can be effective. While this doesn’t seem hard (“just eat”), it can actually take many, many months to accomplish. During this time, trust between therapist and patient begins developing as fears about food and weight are managed together. Many believe that when a certain weight is reached, the ED is gone. A person is not recovered because a weight is reached or because ED behaviors subside, yet recovery can’t occur without these important milestones.
Another phase is to begin moving away from all of the “safe” foods and allowing oneself permission to eat whatever is desired. During this phase, letting go of the control over foods and numbers (weight, calories, fat grams, measuring, etc.,) allows the underlying feelings, memories and experiences to surface so they can be processed and resolved. Learning to eat when hungry, continue eating until full and allowing whatever is eaten to d
igest, is paramount to learning how to trust one’s body rather than follow all the rules of the ED.
Trying to improve self-esteem when there is no self is not possible. Another phase is to separate from the ED identity and develop beliefs about oneself and one’s body that will support normal eating and a strong sense of self. Identifying, admitting, accepting and seeking out everyday needs and wants is critical. Learning to accept all of the positive qualities others see, as well as believing that one is a deserving, worthwhile, valid human being capable of thinking, being, contributing, doing and impacting their world in ways no one else can, is also critical.
Without a solid sense of self, full recovery can’t happen. The more time spent in the confines of an eating disorder, the further away one gets from having any sense of self or true identity. This greatly impacts the ability to have healthy and authentic relationships, which is why learning effective communication skills is another critical phase in the recovery process.
These aren’t the only phases people work through since everyone’s life experiences bring different issues to treatment, but they are consistent in the recovery process. When patients have gotten “there,” I have asked them how they define recovery. These are the things they have consistently described over the past 25 years:
Recovery means learning to —
Believe in one’s value as a unique individual;
Trust one’s intuition and feelings;
Feel centered within oneself;
Define oneself in ways that have nothing to do with numbers;
Have meaningful relationships where both people give and take;
Develop and experience peace, fulfillment and contentedness;
Freely express thoughts and feelings;
Take care of the body in healthful ways;
No longer live in fear of rejection and failure;
Figure out, know and seek needs and wants;
See that letting go of control is the way to experience having healthy control;
Have real and genuine relationships;
Relish in one’s uniqueness;
Nourish the body with foods that taste good;
Trust, all the way, those who have earned it;
Feel truly deserving of love, attention and time given by others;
No longer live life in fear of the unknown;
Accept and trust that the body knows what it needs;
Take risks in new endeavors knowing they will turn out one way or another;
Do things purely for enjoyment and just because;
Have balance among all the important and fun parts of life.
Recovery is obviously an incredibly complex process that transcends the food and weight issues most people believe eating disorders are about. Real recovery takes a long time and moves through many phases – some expected and some unexpected.
Recovery can be hard and difficult to face, but it is truly worth it. Recovery means being able to live to the fullest everyday no matter what.
To each person suffering with an eating disorder – it is worth doing the work it takes to find recovery at some point in your life – whenever that may be – because you are definitely worth it. Find a therapist who understands the full process of recovery and take it one small step at a time. It is a decision you will never regret!