Anorexia, recovery, and walking without crutches.
I was driving in my car on the way home from Starbucks the other day, red cup in hand, when I realized that Thanksgiving is a mere week away. Thanksgiving is one of my favorite holidays, and not just because it provides adults with a socially acceptable excuse to wear stretchy pants and eat diner at 2 pm. On Thanksgiving, I love pulling my children onto my lap and talking about what they're thankful for. Sometimes their answers are silly, sometimes introspective - but always memorable.
This Thanksgiving I myself have something to be very thankful for. It marks the two year anniversary of my discharge from an inpatient treatment center for anorexia and bulimia. It was two years ago this week that I left, still underweight and medically compromised, to begin my tenuous journey towards recovery. Two years since I sat in endless hours of group therapy, two years since I was woken up at 5:30 to get weighed in a hospital gown, two years since I argued over meals, refused to drink water, and cried over a half pound weight gain.
Recovery is a very difficult thing to classify. Most mental health professionals are hard-pressed to define exactly what recovery means, and within the field, there is debate and no consensus on how to do so. Is it enough to restore to an appropriate weight and begin menstruating again (i.e., physical recovery), but still be having eating disordered thoughts (i.e., psychological recovery)? Other improvements may be behavioral (e.g., cessation of restricting food, excessive exercise, binging, and purging), and social (e.g., ability to create and maintain meaningful relationships and be successful in school or work).
I can't deny that there have been slips in the last two years - brief periods of a return to eating disorder behaviors. A slide towards symptoms is sort of automatic response for me when I'm feeling stressed, lonely, angry, or overwhelmed. Almost involuntarily, my brain turns to the eating disorder to “heal” these feelings.
Many mental health professionals have described an eating disorder as a crutch. For me, anorexia helped me self-regulate (or self-medicate) my often crippling anxiety. Some of this was the response to starvation unique to eating disorders – not eating altered my brain chemistry and made me feel better. Some of the response was psychological and related to the meaning I attributed to my anorexia: that it made me special and unique, that I could tell myself it didn’t matter if I screwed up at X because at least I could be good at losing weight. Self-starvation was a compulsion I used to alleviate the anxiety of, well, pretty much anything.
Some psychologists believe that you are using a crutch because you are hurt somehow. But I just can’t buy the theory that eating disorders are solely some kind of metaphorical attempt to heal a past hurt. I may have been off-kilter before the anorexia came around, but that doesn’t hold a candle to how whacked out my brain and life are now. Yes, the eating disorder made me feel better in profound ways, but I’ve known people who were very well-adjusted before they got sick.
I guess the best comparison is this: being susceptible to an eating disorder is like being prone to bone problems. There’s a greater likelihood that something is going to throw you “off course,” either in terms of stress or mood or whatever, and so you’re much more likely to find yourself using a crutch, just as someone prone to fractured or broken bones is probably more likely to wind up using crutches at some point.
But I realize that the only way to learn how to walk without crutches isn’t really to sit around and ask what is hurting and why and acknowledge that part of you. The only way to walk without crutches is to…walk without crutches. That translates to an absence of eating disorder symptoms, end of story. That’s not to say that you won’t need a lot of support and training to learn how to do this, but the analogy of a psychological disease to a broken ankle isn’t 100% perfect. You do need to stay off of a broken ankle to let the bone heal. In that case, the crutches are serving a good purpose. They’re benefiting you. An eating disorder has many functions, but it’s far from beneficial.
Recovery is similar to rehab from a physical injury, like a broken leg, in that it involves the repetition of a lot of seemingly basic behaviors (such as eating) until my “recovery muscles” are strengthened. I can’t get there, though, unless I abandon the crutches. Understanding why I’m using them isn’t much use unless I actually stop depending on them. Using actual crutches to let your leg heal is a legitimate purpose and helps your body heal. Using an eating disorder as an “emotional crutch” might make me feel better, but it’s not helping my mind heal. The eating disorder essentially broke my leg and than gave me crutches to “help” me out.
So where am I now? The crutches are still there, though I rely on them a lot less than I did a year ago. Ultimately, the decision to recover, to learn how to function without eating disorder symptoms, is mine and mine alone. That means eating with friends, eating foods that occasionally terrify me, and making myself vulnerable to stress. It also means living fully, walking independently, and being thankful for my progress.