Food and Feelings

When I started treatment for my eating disorder, I was always given the line, "It's not about the food, it's about the feelings."

As I've moved along in my recovery, I've learned that an eating disorder IS about the food as long as you are starving yourself, bingeing, purging and/or underweight. Your brain isn't functioning right.

However, I'm learning that feelings are involved, though not in the way I think the therapists meant.

I don't know that my eating disorder was ever a "coping mechanism." And if it was, it certainly never was intentional. I didn't stop eating to "cope" with feelings of inadequacy, emerging sexuality, or enmeshment with my family. That just wasn't how it worked. I thought that losing weight would make me happy and healthy. And then...I don't know what. It blurs together, stops making sense.

Anorexia and bulimia both are self-perpetuating illnesses. In a person predisposed to anorexia, a small amount of starvation feels...good...somehow. And the person keeps going. The same with bingeing and purging. They perpetuate themselves. Once you pass a certain point, you literally can't pull yourself out. You just can't. The disease takes on a life of its own, and you're simply along for the ride.

But the feelings.

Ah, the feelings.

Starvation and over-exercise are very numbing. They do neutralize those feelings of inadequacy and anxiety. They neutralize all feelings because the brain can't afford to produce those neurotransmitters involved in emotions. They're unnecessary.

Research has shown that people with anorexia* have inborn difficulties with processing emotions, with anxiety, with appreciating pleasurable things. If you're starving, you have no emotions to process. Losing weight is the ritual that helps decrease your anxiety. So the system works, in a sense.

Then you regain the weight and all of the same stuff is there, only you don't have that starvation neutralization effect going on. This is the part of ED treatment that really gets me: why therapists and hospitals and everyone seems so willing to back off once a sufferer gets to a healthy weight and stops behaviors. The worst is over, they think. They've done it. It will get better now.

Only the sufferer is more miserable than ever because there's no buffer from the eating disorder, and they still don't know how to deal with all of these crappy feelings.

This is where I spent years searching for answers. I was told that if I could understand where all of these feelings and behaviors came from, I could overcome them. "Why are you starving yourself?" I was asked. "Hell if I know," I said. So we would search and search for answers.

Insight wasn't my problem. I knew from the start that I was anxious, depressed, a perfectionist. I knew I was brutally hard on myself, but I thought I had to be. Learning that- shocker of shockers- I needed to be gentle with myself got me precisely nowhere. Except another visit to the psych unit.

What I needed was skills.

Do I understand why I developed anorexia? I had a genetic predisposition. That I know. The OCD and mood disorder didn't help things, either. Neither did perfectionism. But why I thought that losing weight would make me happy? I don't know. And I don't need to know. Maybe there is no answer, no good reason why. Maybe I just got dealt a shitty hand of cards, and I have to play the hand I was dealt.

Could eating disorders be women and men trying to be perfect? To live up to society's expectations? To look like models? I doubt it. That's part of it. It's the cultural context of the illness. In the Middle Ages, women (most of the recorded cases were in females) who starved themselves were considered saints. They fasted to get closer to God. Some, like Catherine of Siena, got hooked. It felt good. Her explanation was of faith. Ask a sufferer today, and a lot of it seems to be 'healthy eating' and images of supermodels and the idea that you can Have It All. It's no more a reason than faith. But it is a context. It does explain the triggers, the psychological environment from which an eating disorder develops.

One of my OCD fears was that I was going to catch AIDS from someone, or that I already had AIDS and was going to give it to someone else. Regardless, it was OCD. But if I was about 15 years older (the OCD AIDS stuff started in about 1993-1994, when I was 13-14), AIDS wouldn't have been on the radar. It might have been another disease. It might have been something else entirely. A person with schizophrenia would not have feared the CIA listening in on phone calls 100 years ago. First off, they probably wouldn't have had a phone, nor would there have been wire taps, and lastly- there was no CIA. Diseases have a context. But that doesn't mean that AIDS fear mongering caused my OCD, nor that the CIA causes schizophrenia.

My recovery had to begin with weight gain. That is still the foundation. Think Maslow's hierarchy here. If you're not eating right and taking care of your basic needs, learning how to handle setbacks isn't the most useful of things.

Will I ever be less anxious? Less depressed? Well, with medication. But that is my personality. I don't think I have it in me to be a total slacker. Can I learn to be more tolerant of my mistakes? I hope so.

*Unfortunately, research on bulimia lags far behind that on anorexia, though I'm assuming my assumptions will hold true for all people with EDs.


Laura Collins said...

You put that SO well. Zowie.

A :) said...

I don't know if you can say that ED's are fully about genetic predisposition and that therapy/searching for answers would not help. . .

I know I DID lapse into AN because of feelings of inadequacy, lonliness, perfectionism, etc -- Of course, I am probably genetically predisposed to AN, but if it wasn't AN it would have been something else.

I am on meds -- but I believe therapy is still VERY important to correct beliefs regarding lonliness (yes I can't spell!) /inadequeacy and other issues and develop coping strategies to deal with these feelings.

So ED's are likely not about models and looking fantastic -- more likely a biological mental illness brought on by environmental factors -- but these factors need to be explored for recovery to take place.

In treatment I needed to explore my fears about being lonely and inadequate, my family situation and my perfectionism -- this helped me to gain insight and to gather logic to combat ED thoughts. . .

Just some thoughts. . .

another anonymous said...

I must agree with a:) ED being so different for each person means of course there are a wide range of reasons for them. I'm certain I had that ED propensity as well. I did have a shitty home life. I don't blame my parents for my ED but the breeding ground was definitely there. I had no support or guidance, was often belittled and the idea of nurturing was a joke. It was a scary, unstable world in my house. I was okay with my body until my own father told me I was "getting a little heavy...big there aren't you? You might want to watch that" when I was just at the beginning of puberty. I have been on a "diet" ever since. It was my first trigger.

I did find comfort in my ED. It gave me what I couldn't find anywhere else. It helped me smooth over anxious times. It also made me feel that I was okay. If I was small, I was acceptable, if I was big I was not. It was never about an ideal of beauty. I knew it was ugly when I was a sickly low weight, but it made me feel good enough. It was never just "I'm fat." It was always, "I'm too big, I *need* to be small."

It's always been my security and I feel frantic without it. It was when I understood that I had created security out of a need to have that in my life that I understood that things were different now and I could create security in other ways. It was when I realized that I don't need to live up to my dad's standards that I could let go of the need to be very, very small. At an extremely sick weight my own mother said to me, "you don't look that skinny to me." When I learned that that was her issue, it wasn't about me I could move on. The most important thing I learned in therapy was to stop looking for support in places I wasn't going to get it. And when I did that, it made a huge difference for me. I'm not mad at my parents but my home life played an instrumental part of my ED. I wish I had the kind of supportive parents that I see here when I was a teen. But they couldn't be that for whatever reason.

Eating is important, no doubt at all about that. But for some people, myself included I was able to eat once I understood I could let go. For dying people and teenagers there is no way to wait for that. For me, a now independent adult they couldn't legally force me nor convince me to eat. Which I can see now sucked for all of us. But with my therapists help I was able to finally stop fighting the eating and do it. Eating physically saves a life. But my therapist saved my life by getting me to do so when I could not convince myself to let go of "small."

So interesting how ED play out so differently in different people.

Your blog is fascinating and I enjoy reading your perspectives.

A :) said...

I don't think its exactly finding the "why" of an ED -- but shedding light on preciptating/maintaining factors CAN help to combat the ED in ways that simple eating cannot.

In the program I was in nutrition was FIRST and therapy was SECOND -- but therapy is an extremely important aspect of recovery -- not only skills such as CBT or DBT, but studying family relationships and my own feelings about myself.

Oddly enough, being gentle with myself DID help me -- Because I am almost instintively intolerant of my own mistakes, etc -- learning to let go as anonymous said, was instrumental in my recovery.

Yes, coping skills taught in therapy helped 100%. However, the insight was an equally valuable piece. Without the insight into the functions of my ED and the environmental "whys" the coping skills were meaningless and I could not tailor them to my specific situation.

Is any of this making sense?

A :)

Laura Collins said...

I don't think biological illness and therapy are in opposition.

Heart disease patients and breast cancer survivors get therapy - there is a need for support, tools, strategy in recovering from any illness.

The danger in saying something causes something is that the focus becomes that thing. If the thing is wrong, or the thing is done, or the thing can't be changed, you're using precious energy.

And the fact is that we've been chasing the wrong reasons for this illness for a long time.

Cynical Nymph said...

I just found your blog tonight. I'm truly enjoying both the skill of your writing and your discussion of EDs. I had to leave my initial comment on THIS post because I'm a recovering bulimic, and though I'm not diagnosed with OCD, I have never heard of anyone else with - I swear to God - my SAME exact obsessive AIDS fear. I feel like I just joined an anxious, irrational little club. Thank you for putting that in writing (and all of this on your blog, really).

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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