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NEDA Week 2019: Come as You Are

NEDA Week 2.25.19: Come as You Are | The Full Helping

Happy Monday, friends! As you probably noticed, I took a pause from weekend reading this week in order to reflect on National Eating Disorder Awareness Week. Each year, I use this week as an opportunity to reflect on my own recovery and to celebrate recovery with all of you.

This year’s NEDA week theme is “Come as You Are.” To quote the National Eating Disorder Association website:

Our 2019 theme, Come as You Are, highlights NEDA’s movement towards inclusivity in the greater eating disorder community and our goal of unifying the field of eating disorders. In particular, Come as You Are sends a message to individuals at all stages of body acceptance and eating disorders recovery that their stories are valid. We invite everyone, especially those whose stories have not been widely recognized, to have the opportunity to speak out, share their experiences, and connect with others….

So this NEDAwareness Week, come as you are, not as you think you should be.

I love this message of inclusivity. A lot of work has been done in recent years to shatter the notion that eating disorders look a certain way or affect only a certain type of individual; we’re coming to recognize that size and shape don’t always reflect eating behaviors, and we’re having a dialog about the fact that EDs impact all races, communities, and gender identities.

For all of the progress we’ve made, we still have a long way to go. In my private counseling practice, where I work with many people who identify as recovered or recovering, I continually hear invalidations of the struggle. “I was never really underweight,” people tell me as a means of explaining why they didn’t seek help sooner. “I didn’t lose my period.” “I only binged every now and then.” And so on. The shadow of a single, popularized eating disorder narrative/stereotype discourages a lot of people who need help from actively seeking it out. It’s time to change that.

I’m having my own reflections on the 2019 theme. I’m thinking about “come as you are” not as it pertains to ED treatment or seeking help, but rather as it pertains to recovery itself.

In the fall, when my DI peers and I had our ED-themed class, it got me thinking about the disjunction between my real-life experience of recovery and the experience I expected to have years ago, when I was at the start of the process in therapy. In short, it’s been a lot messier. In treatment, it’s commonly said that “full recovery” is possible. Treatment providers hold hope of this possibility for their patients, and patients hear the expression many times over, especially when the going is tough.

I’m of two minds about full recovery as an ideal. On the one hand, I believe wholeheartedly that a beautiful, full, and healed life after eating disorders is possible. I’ve experienced it myself: a life that is nothing like the life I could have imagined for myself when I was sick. A life that’s richer than I dared to hope for and full of freedoms that I never thought would be mine. Recovery has unlocked a relationship with food that is pleasurable and rewarding in ways I couldn’t have known were possible when I was eleven, nineteen, or twenty-four years old.

Everything I write and create nowadays is a testament to this relationship and the recovery that created it. In this sense, I hold hope every day, for myself and for others.

At the same time, my recovery is not without complexity, tension, or struggle. I’ve maintained physical health and nourishing food habits for over a decade now, but that maintenance has often felt like active work. I relish eating, but my struggle with body dysmorphia is ongoing, which can complicate my enjoyment and sense of freedom with food. I’ve learned how not to use food to “manage” or “control” my anxiety, but the impulse to control unmanageable feelings is still there, still problematic, and now that food isn’t my outlet, it shows up in other ways (rigid lifestyle routines, arbitrary rules, and hypervigilance about scheduling/time management, to name only a few).

I don’t know if “full recovery” is supposed to suggest a life that’s free of triggers, compulsions that have been rerouted, or pangs of longing for the disorder and the protection it seemed to afford. If it does, then I’m not sure my recovery, such as it is, fits.

I’ve always struggled with this question. Years ago, I asked my therapist why, if EDs were recognized as mental illnesses, the language around them seemed so much more rigid than with other mental illnesses. I’ve never heard an expression as finite-sounding as “fully recovered” when it comes to treatment of depression or anxiety, for example: my understanding is that the aim of treating both is to achieve management that affords for the best quality of life possible.

I wonder if the immediate physical dangers of eating disorders warrant a more aggressive, wholesale approach to treatment and the words we use to describe it. In addition, I’ve heard it said that one of the primary goals of recovery is to help people stop actively identifying with the disease, which would support a before/after language choice. (The opposite, I guess, of a person in AA identifying as an alcoholic whether sober for many years or not.) That makes a lot of sense to me.

Full recovery may also be more possible with EDs than with other mental illnesses because measurable behavior change is such a critical part of recovery. My recovery certainly involved a close examination of familial/psychological factors that predisposed me to anorexia. But at the end of the day, the recovery processes really resided in behavior change: eating balanced meals at regular intervals, increasing my energy intake, learning to rest, and learning to sit with uncomfortable feelings. There were also physical/biological changes—weight restoration, resumed hormone function—that amounted to a firm before and after.

Still. I know well from two relapses that one can be weight restored and abiding by healthful eating patterns without having truly made peace with food, so behavior change isn’t everything. Conversely, I’ve learned that a harmonious relationship with food can accommodate dissonance, which is something that I didn’t know in my early twenties. I believed that, once I was “fully recovered” food would be “just food” (another expression I picked up in treatment) and the struggles around it would vanish entirely, forever.

I wish I’d been better prepared for the non-linearity and ongoing surprises of recovery when I was at the start of the process. The “full recovery” ideal gave me something to strive for, and—just as I believe it’s intended to—it gave me hope. It also contributed to a problematically one-dimensional vision of recovery, a binary between “before” and “after” that couldn’t always accommodate or account for my lived experience. The irony of this is that so much of recovery is about learning to let go of binary thinking altogether, to dwell comfortably in areas of gray.

Today, having made it to the other side of a lasting recovery, I believe that full recovery is possible and that it’s complicated. I believe that recovery looks from person to person, and in spite of the benchmarks we use to define it, its true meaning is created by each individual who lives through it. Most importantly, I believe that being recovered does not mean never struggling again. It means facing struggle—less often with time, if we’re lucky—and handling it in a new, more self-loving way.

A reader and friend articulated this in a way that resonated with me. She said,

I don’t know that we are ever finished with anything. We have growth spurts and setbacks, circle back to something. I think many of us eventually get to a point where some old stuff just can’t hurt us anymore. We won’t let it. And the part that is heartening and reassuring is that we acquire ways of solving problems and dealing with things along the way so that when we find ourselves back in a bad situation that we thought we conquered, we have new ways of dealing with old problems.

If you’re in recovery now or have been recovered for some time, and you feel yourself sometimes struggling to resist the behaviors that made you feel safe for a long time, you’re not alone. Resurgence of struggle or the temptation to flirt with old habits is a part of many peoples’ process, whether publicized or not.

It’s important to use your coping tools—therapy, self-expression, art, friendship, deep breathing, being in nature, or whatever works for you—to resist those familiar, destructive behaviors. It’s also important not to feel like a “failure” if this happens. And what matters most of all is to stay the course. Recovery is every bit as non-linear as it’s said to be, but it gets richer and more beautiful the longer you stick with it.

Given the “come as you are” theme, it also feels important to say that recovery can feel idiosyncratic and personal. The way you experience might be very different from how friends you made in treatment experience it, or people you read about online experience it, or how you were told you’d experience it. The longer I work in this space, the more people I talk to about recovery, the more I realize that there is no archetypal narrative.

The part of my own recovery that registers most differently than others is how important food has remained to me. In spite of several good faith efforts to regard it as “just food”—which didn’t push my recovery forward at all—I ultimately allowed myself to accept that food will always be a big deal to me. A much bigger deal than it is to a lot of other people. The question for me became whether it could be a big deal in a way that was productive and life-giving, rather than destructive and imprisoning.

Today, years later, I can say that it is. Food is a great love of my life. I take outsized pleasure in eating and making and thinking about food. It isn’t “just food,” and it never will be. This isn’t what was advised to me in anything I read about recovery. Yet I believe with all of my heart that transforming my relationship with food, rather than diminishing it, is what has made my recovery possible.

Today, on the first day of NEDA week, I celebrate my own perfectly imperfect recovery, and I celebrate yours, too. One of the many wonderful things about writing this blog is that I’ve gotten to hear about so many recovery stories over the years: through email, conversations had in person, and the green recovery series. I’ve had a chance to witness recovery in all of its incredible, ever-unfolding complexity. I’ve learned to celebrate recovery experiences that look completely different from mine. I’ve learned how to support others in their efforts to make peace with food and their bodies on their own terms. It’s such a gift.

To anyone whose life has been touched by disordered eating: I wish you the “fullness” of recovery and of life. You are loved and supported. You can and will find your own way. It won’t always be easy, and it’s not supposed to be. But it can and will be beautiful.

Thanks for reading today and any day.

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