This is something I struggle with as I try to separate from Ed and identify myself as a different person:
Ed's voice is internal. Sometimes, he even sounds like me.
I mean, it seems like I'm the one saying restrict, barf, run, take pills, etc. Yet, I know it's my illness.
I think I know.
Then again, I don't know that I think I know.
See, here's the thing: is my eating disorder a choice or an illness? I am firmly of the belief that it's an illness, as are my OCD and mood disorder*. So it's an illness. Those thoughts aren't me. They're not representative of who I am. It would be the same with schizophrenia- a person who hears voices or has paranoid thoughts might not be able to understand that it's a psychiatric phenomenon and the CIA really isn't after them. Time and perspective (and meds) help, though.
I think part of the other difference is that the eating disorder thoughts are so freaking common in the general culture. If I say, "God, I'm fat today," most women will take a look at their own butts and say "No, you're not. I'm fat today." And so on. It totally reinforces the fact that what I'm thinking isn't all that out of the ordinary.
However, even I knew I had begun to crack when I had the Sweet N Low folks on the phone and were screaming at them for false advertising because those little pink packets did, indeed, have a fraction of calories. I still feel bad for that lady.
My understanding of the ED voice was improved a day or two ago as I worked on the first of my books from my reading list. The said book was An Anthropologist on Mars by Oliver Sacks. One of the essays was about a surgeon- named Bennett- with Tourette's Syndrome and his views about living with the illness.
"I don't think of it as a disease but as just me. I say the word 'disease,' but it doesn't seem to be the appropriate word."
It is difficult for Bennett, and is often difficult for Touretters, to see their Tourette's as something external to themselves, because many of its tics and urges may be felt as intentional, as an integral part of the self, the personality, the will. It is quite different, by contrast, with something like Parkinson's or chorea: these have no quality of selfness or intentionality and are always felt as disease, as outside the self. Compulsions and tics occupy an intermediate position, seeming sometimes to be an expression of one's personal will, sometimes a coercion of it by another, alien will. These ambiguities are often expressed in the terms people use. Thus the separateness of "it" and "I" is sometimes expressed by jocular personifications of the Tourette's: one Touretter I know calls his Tourette's "Toby," another, "Mr. T." By contrast, a Tourettic possession of the self was vividly expressed by one young man in Utah, who wrote to me that he had a "Tourettized soul."
It was long complicated paragraph, but when I got done reading it, all I could think of was, "Holy crap! This is me! This is just the way I feel about my eating disorder!" It makes sense. It completely makes sense. I was always under the impression that I could control my eating disordered behaviors. And there was a yes and no to that. Physically, I could eat. Mentally, not so much. In treatment and at home, I still had to make the choice to eat, to pick up the freaking fork and put it in my mouth. But the choice was easier: eat, or sit at the table until you finish.
Ed still goes yakity-yak a lot. Just yesterday I was sitting in the car, finishing up my snack, when my mom went back to grab something she had forgotten in the house. So there I am, just me and my string cheese and a garbage can about 10 feet away. And it was then, in that split second, that I heard Ed: "You don't have to eat that, you know."
I said: You know what, Ed? You're exactly right. I don't have to eat this. But I'm going to.*They can't quite seem to decide whether I have some form of bipolar disorder, or just major depression and really moody. ::shrugs:: It's basically the same, really.