This is a very interesting subject. I've thought about this before, though not as articulately as you have. This really hits the nail on the head:

"I was trying to seal the hole in the Titanic with bubblegum- a noble endeavor, perhaps, but entirely futile. The ship was sinking, I was aware of this, but at least the bubblegum made me feel like I was doing something."

I think I've clung to that "doing something" part of my anorexia. It's the productive busy-bee in me. Anorexia was a wonderful distraction. I guess, in that sense, it did help me cope. But I think what you say about choice and control is very illuminating.

You've just nailed something I've puzzled unproductively over for a long time. That "coping mechanism" idea has always rankled me. It is hard to dispute that EDs have secondary benefits, and I think that's where the coping mechanism thing can serve to confuse the issue and stymie recovery.

But categorizing the ED as a coping mechanism IS calling it a choice. It is making it a poor response to normal circumstances. And it ISN'T normal circumstances. The thing one is coping with is a TSUNAMI, not normal life/response stuff. To call it a coping mechanism is to say that there was some other lifeboat in the water - and I don't think there is. I can only believe that people with this idea about EDs just, frankly, underestimate the enormity of what the eating disordered brain functions do to the rest of the brain. And I find it cruel that we concentrate on triggers and "better coping skills" as a primary treatment.

As an adjunct, as the final stage, as relapse prevention, as simply life skills that make life more livable: yes.

Thank you for the extremely clarifying distinction!

I think this post really reinforces eating disorders as addictions, especially in light of your last post. It's such a blurred line between a social drinker and an alcoholic, a "casual" dieter and an eating disorder victim. In the beginning, it IS a choice - because we're not nursed with a bottle of Jack nor taught to walk on treadmills - but I think what's interesting is when and why it stops becoming a choice and starts becoming a compulsion. I don't believe it's ever a fully conscious decision to "cope" via a dangerous behavior but more, as you suggest, circumstance, physiology, and society culminating in a dangerous experience making life FEEL more bearable. To write off addictions and eating disorders as MERELY coping mechanisms is an oversimplification; if it were really as easy as substituting one behavior for another, neither addictions nor EDs would have such a high recidivism rate. However, I do think you are playing at word gymnastics here. What is penicillin but a means of coping with pain? What is a diet but a means of struggling against weight? It's just, for the addict and the ED sufferer, what that pain is, what that weight means - they're two very different things, and therein lies the difference in what the behaviors are really addressing.

That said, I'm very intrigued by the neurological link between addictions, EDs, and OCD. I'm sure the satisfaction derived from the former two is similar to the satisfaction experienced by the latter: clearly, all of these conditions interfere with a person's everyday life, but the experience of these routines is still preferable to a life without them. No one would ever suggest treating OCD by telling someone to "just stop" (which frankly, I think is how the "substitute a different behavior" method comes off); and yet, one can't ignore the fundamental difference in the onset of OCD vs. addictions/EDs: choice. I would be very curious to see treatment approaches developed with this kind of perspective in mind.

Well said. There is too much oversimplification with this disorder, saying anorexia is a coping mechanism is one of many.

My thoughts are provoked - this post was very well-written. Thank you.

This is interesting, but the thing that concerns me, is that you say you have no choice in illness -- that you cannot prevent becoming ill. Does that mean you have no choice in recovery -- that you are incapable of changing because you cannot control the pathology of the illness?

This is a grey zone I think. I wholeheatedly agree that ED's have biological origin and cannot be treated by therapy alone. I know you found it empowering to realize that AN was not a choice and not your fault and that this was liberating -- but my fear is that many could use this as an excuse to engage in their illness.

My arguement is always that, I have seen people recover on their own from very low weights and I have seen women enter IP programs at very low weights and embrace the program whole-heartedly. Many of these women went on to have full recoveries. This type of remission would be impossible if the illness (like cancer) was out of the individual's control. . .

Is an ED a purposeful coping mechanism? I would like to think that it can become a perpetuating factor of the illness once the ED is in motion -- like you said, it "feels good" and DOES relieve anxiety and may give the sufferer a reason to stay sick. However, the person needs to have the predisposition for the illness and find starvation enticing -- this only occurs in a minority of individuals, otherwise, the prevalence of EDs would be much higher.

Does a symptom need to have a trigger? I am not sure -- for some it could just be a preferable way of coping with life -- it is EASIER to stay ill than face real life.

I don't know, I'm rambling :)

A

This is definitely a difficult question to answer. My theory has always been that the Ed evolves. I think it originally serves a purpose, similar to like a survival mechanism. However, that purpose changes in functionality over time.

I think there is always an element of "choice" somewhere. Whether that means providing "coping" is hard to say. For some people, it might be, for others not at all. We can't really make a generalization either way, and this is partly where the problem lies. It's probably one reason why people do try to simplify it to just a "coping" mechanism, or just about weight, etc.

I think the another problem is how the word "choice" is used. I think there are conscious, deliberate choices we make, and others that don't fit that realm necessarily.

This is great. I agree, my ED isn't a coping mechanism, though I know that when I am having a hard time coping with life it's easier to let everything else fall away and ferret into the disorder. S-I on the other hand, is definitely a coping mechanism. I choose to cut to lessen the stress and get a high.

A,

Your points are very good, and I still grapple with much of this. What I'm realizing is that EDs aren't a matter of choice vs. no choice. I think there's a continuum of ability to choose. I agree- I have had moments of supreme clarity, even at my lowest weight, that spurred me to try and get well. But there were also plenty of moments when I was essentially unable to make that choice.

It's like if you're being robbed at gunpoint. Did you *choose* to give the robber your wallet? I suppose, because you didn't have to. But how much of a true choice was that?

I don't think there's a simple answer, and I don't think there will necessarily be just one.