Psyched in San Francisco: RecoverED vs. RecoverING

Recently, I had a respectfully spirited discussion with a colleague of mine. Together, we have 39 years of professional experience (25 for her; 14 for me) in treating eating disorders. And together, we have over 50 of personal recovery experience, both of us having solidified our own eating disorder recovery and being led into helping others as a way to give back what we had been given/worked for ourselves. We were debating the terms “recovered” vs. “recovering.”

Carolyn Costin, a well-known expert in the field of eating disorder treatment is adamant about the position of being “recovered.” She states:

Being recovered to me is when the person can accept his or her natural body size and shape and no longer has a self destructive or unnatural relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size or reach a certain number on a scale.

http://montenido.com/to_the_client/recovered_recovering

This makes sense to me and I agree. However, I ALSO think of recovery for myself as a larger picture. I don’t see recovery from an eating disorder limited to food, exercise, and weight. I see these aspects of recovery as doorways into an ongoing journey of life-long growth. Losing weight and over-exercising to the point of becoming anorexic in my college years long ago and discovering this was a misplaced way to journey through a rite of passage into adulthood was my entryway into self discovery and recovery. And, in the early phase of my recovery, when I struggled with bingeing and purging, I was entering another phase of the journey. Though I was still struggling with eating disorder behaviors, I was also doing the difficult work of looking at family of origin dynamics, cultivating a food plan and spirituality that worked for me, developing tools to “tolerate distress” and “regulate emotion” in ways other than using food, navigating how to keep myself and share myself in relationships, and finding a whole new identity of who am I without an eating disorder; who am I as a woman; who am I as a human being on this planet?

Owning the Shadow and Dis-identifying from an Overdeveloped Superego

I worked a 12-step program for the first ten years of my eating disorder recovery. In this program, one identifies as a “bulimic/anorexic/compulsive over eater” whether one has 1 day of abstinence from eating disordered behaviors or 20 years. The thought behind this, as I understand it, is that owning this part of one’s self (shadow) gives one the choice to be free of it and integrate its wisdom without “acting it out.” It is a practice of beginning to dis-identify from this aspect of the self enough to allow other parts of the self (the “Healthy self/Recovery Self,” Wise Mind, Playful self, Embodied self, Self that experiences sadness, anger, joy) to be discovered/re-covered.

I don’t engage in bingeing, restricting, over-exercising, or purging behaviors. I haven’t in a decade and a half. However, I do still see very clearly these parts of myself, of my brain, of my multifaceted Self. As I say to clients, you have to give that part of yourself a voice: you don’t have to act on it and you certainly don’t have to believe what it is saying. I use the metaphor of what 12 steps call “the itty bitty committee” in your head. Each member needs to be able to share. But that doesn’t mean that certain members get to run the show or be the dictator. The voice of an Eating Disorder, “ED” as some call it, can be very dictatorial. It is an extremely overdeveloped Superego, Critical voice. Giving it a voice is important, but dis-identifying from it enough to see that there are many, many, MANY other aspects of the self that need an opportunity to speak as well is crucial. I love how Eating Disorders Anonymous (EDA) holds the position that “People can and do fully recover from having an eating disorder.” And “In EDA, we help one another identify and claim milestones of recovery” that celebrate a newly growing recovery self. http://www.eatingdisordersanonymous.org/about.html

The Importance of Humility vs.

Allowing yourself to be “big,” visible and have a self

In the history of the12 step Program, and in my clinical experience working with people recovering from substance use/dependence I see there is a necessary “ego deflation” aspect to recovery. The founders of Alcoholics Anonymous (AA), Bill W and Dr. Bob, had years of narcissistic denial and grandiosity in their capacity to pause from acting out on “self-will run riot” in their alcoholism and how it was causing damage. Their philosophy of recovery stresses the importance of pausing and reflecting on how their actions would potentially hurt themselves and others before taking action. This is a necessary and essential skill for people recovering from impulsivity mixed with a lack of ability to empathically imagine how their actions will affect others. However, I see see a temperamental difference in people recovering from substance use and people recovering from eating disorders. (Please excuse that this is a generalization that is not always true and that many people have both, one or neither of these tendencies.) People recovering from eating disorders have been called the “silent screamers” that are “starving for attention.” In other words, people with disordered eating often care-take others in their family system and relationships at the expense of themselves. They often have overdeveloped empathy for others and their eating disorder has prevented them from attending to the importance of caring for and developing the self. In this sense, eating disorder recovery is more about developing an ego rather than deflating it.

In this self-discovery, there is a necessary aspect of breaking through denial that both substance use and eating disorder recovery require. Both require “rigorous honesty” with challenging old beliefs. In eating disorder recovery, though, there is a necessity of the process of recovering that is less black and white than substance use recovery. You can abstain from alcohol and drugs. You can’t abstain from food. And you can’t abstain from your body and the beliefs you have around your body. In eating disorder recovery: “it is about the food and it’s not about the food,” “it’s about the food until it’s not about the food,” and “it’s about the body and it’s not at all about your body.” In the words of Geneen Roth, who has been travelling the path of recovery and teaching others for decades,

"You begin by understanding that your relationship to food is a doorway, not a wall, an opening, not a closing," she said. "That itself, just that, is a leap because most people don't want to hear that. Most people want to fix it and be done with it. They want to wake up at their natural weight tomorrow.

"But until you work on the unseen level first, no amount of change in your eating is going to last. The very beliefs you have are going to drive you to doing the same things over again. What I say…is the body obeys the shape of your beliefs. If you want to change the shape of your body, you must first change what is shaping it."

Ending the harmful behaviors of an eating disorder is essential to recovery and completely possible to end. As Jenny Schaefer, author of the books Life Without ED and Goodbye ED, Hello, Me, says, “I am recoverED. Period.” However, inquiring into the underlying beliefs that led to these behaviors is a life-long process of recovering. I welcome this process, again and again.

The author: Linda Shanti McCabe holds a doctorate in Clinical Psychology and works with women (including pre and postpartum) recovering from food, weight, and body image issues. She holds SoulCollage® groups for women (including pregnant and postpartum) using expressive arts to find and express the many parts of the Self.