When clients first come in for treatment at our program, they are palpably nervous. It happens without fail. Many will hypothesize the nerves comes from social anxiety, being surrounded by all these new people in treatment with them. But it’s much more. The anxiety stems from six essential risks associated with treatment of an eating disorder (ED), adapted from the work of Kathy Kater. Let’s review.
- The risk to trust the therapist
Many have tried therapy in the past and had mediocre or just plain bad experiences with it. Opening up those wounds again can be more than difficult. Others have never had treatment at all and used their eating disorder for years to mask or soothe their pain. We get that learning to trust someone with your story is scary. But when this risk is taken, it paves the way to trust others. It heals past relationship trauma. And it proves there is nothing unlovable about you due to your eating disorder. You are not your eating disorder.
- The risk to let go of the ED paradigm
The ED paradigm assumes the physical body requires management by following a series of external rules. Maintaining the lowest possible weight is the measure of success. The risk we ask of you requires taking back the power from external sources. Recovery is about knowing and trusting your own body. When you take this risk, you become educated about biology, explore where mistrust of your body started, and discover that your body is your home and not your billboard. You normalize eating for pleasure and satisfaction.
- The risk to identify the ED voice(s)
This ED voice, or voices depending on your own experience with it, have a purpose. They keep your inner critic busy finding new and inventive ways to kill your self-esteem. At the same time, you may be aware of another voice in your mind, one that wants to protect you – that identifies when you’ve been wronged or hurt. But the ED voice will keep that protective voice busy, and keep you from taking care of yourself leaving you silent and stuck. How? Either ED distracts you or soothes you with the idea you’re actually in control of everything if you can just control your body. If you control your body, maybe it will please others, you’ll be lovable, others will think more highly of you, and you’ll be the “good girl” or “good boy” after all. The truth is ED keeps you from working toward your real life goals and values. To know what those are, you have to tell the difference between you and ED.
- The risk to heal shame
Recovery means facing down behaviors you are ashamed of and led to beliefs like: I must deserve this eating disorder; I must have caused this; I am alone because I’m unlovable; My body is unacceptable. You are your own worst critic, and those beliefs have left you more susceptible to cultural messages. Over time, the inner critic takes the form of the ED voice and becomes a way to rebel, numb out or reinforce the feeling of being unacceptable. You don’t have to keep feeling this way.
- The risk to live your own life
If you have lost your way due to feeling unsafe or unloved, you are not alone. ED may have been your salvation for a time, but you can be your own hero. You can hear and follow your intuition/heart/wisdom, acknowledge you are safe, and differentiate past from present situations. You deserve to have needs, feelings and desires and have them be heard. Failures and mistakes do not have to impact self-worth. You can trust your body, be present without judgment, and notice feelings of calmness, steadiness, and awareness of all sensations.
- The risk to be a renegade
You have to be a renegade. Few clients go out into the real world and feel like they belong. Why? Because you’ve learned to value your body, not your weight. You find joy in what your body can do and not in what shape it’s in or clothing size fits it. And that is not the world we live in. You will have to rebel by: ignoring clothing size; stay off the scale; surround yourself with a variety of images (weights, colors, ages); when in doubt look at real people; get involved with body-positive organizations; hunt for good healthcare providers; wear what you love; embrace the physical and sexual self; and do what you would do in your “ideal body.”
These are not insignificant risks. Each requires time, energy, focus, commitment, and determination. But ultimately, what are you risking? Maybe the only real risk is not choosing recovery.
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 877-674-2843 or email firstname.lastname@example.org.