Why ask why

It's a question I've asked and been asked many times: why did I develop anorexia? Of course, I wanted to know because of my own natural curiosity; I also wanted to know because I thought it was my key to recovery.

The idea was predicated on a simple assumption: if I could understand why I was starving myself, then I could stop.

The problem is that this assumption isn't correct.  After all, we know why the pancreas stops producing insulin in Type 1 diabetes, but that knowledge doesn't magically jump start insulin production.  Even from a behavioral perspective, understanding our motivations doesn't always mean we can just change. Most smokers know that lighting up isn't healthy, but this knowledge doesn't necessarily mean they'll quit.
Today's Fxck Feelings blog had some similar advice, to a girl who liked to date men already in relationships:

As such, asking why you’re attracted to pre-attached guys is about as dangerous as asking why you love Martinis; it allows you to study and indulge your predilection until you find an answer that will make it easy to stop, which won’t happen, and in the meantime, all your research is just fodder for rehab.

Accept the fact that the answer will never come or, if it does, it will change nothing, and it will never be easy to stop.

This comment answers the question of why so many of us get trapped in the never-ending quest for "why."  Simply put, the search for why doesn't require us to stop the problematic behavior.  After all, we can't stop (according to the theory) because we haven't answered the "why."  So there's no point in trying.  Yet we get to tell worried friends and family that we're in therapy, that we're "working on it."  Meanwhile, we don't have to challenge these behaviors.

I'm not saying that we shouldn't ask questions, just that "why" might not be the most useful.  I think better questions to ask might be:

  • When am I most vulnerable to using behaviors?
  • How can I get better? How can I stay better?
  • What are warning signs of illness returning?
  • What are the benefits I get from the ED?
  • How can my friends and family provide support?
I don't think understanding the why behind an illness hurts.  After all, understanding that my eating disorder is triggered by not eating properly helps me make serious efforts to actually eat properly.  My problem with asking why is expecting that the answer will automatically lead to significant behavior change.  It's a nice theory, but I think it's an overly optimistic view of how the brain works. 

It also makes the assumption that people with eating disorders are able to see their behavior rationally--and that's often not the case.  Nor are ED behaviors choices.  They're much more like compulsions.  When I have OCD compulsions, I don't give a damn about why I'm doing what I'm doing.  I can even understand it.  But in the moment, all I want to do is feel better.  Eating more and gaining weight freaked me out.  The why didn't matter.  My brain never even got to that point.

We don't need to understand exactly why we're doing something in order to stop doing it.  Understanding why might be a nice bonus, but it's not necessary.  Maybe my next question is: why do so many people insist on asking us why?

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Lucy said...

You're doing an amazing thing with this blog.

PJ said...

I think also the search for the answer to why is oversimplying the problem. As though there is one single reason causing this behaviour. I know in my own search for the answer to the original 'why' I could come up with half a dozen valid reasons - and these change from day-to-day.
It is vastly more complex than one simple answer.

Cathy (UK) said...

I agree that knowing and understanding WHY can be futile, Carrie, even though I really wanted to know why I developed AN.

I also agree that ED behaviours are compulsions and not choices.

In fact, I think an ED is a pattern of behaviours in which a person gets stuck; very similar to OCD. And there is huge anxiety associated with changing the behaviour pattern.

Your brain gets stuck, the thoughts stick and the behaviours stick.

Basically just 'stuckness', or maybe we could say 'poor set-shifting'.

Of course, we attach all sorts of thoughts to ED behaviours and some people blame our culture. But IMO these things are largely irrelevant. Recovery involves tackling/correcting the behaviours themselves

hm said...

Actions are what matters. Sitting around slogging through the slop in my head is useless- and neverending- what matters are my choices. I know there's shit in my past that I need to deal with- I know if I don't, then memories will surface that might give my ed fuel to restart its engine and start running. But looking at "what triggers me/has triggered me in the past?" is VERY different than "why did I get this damn ed?" It's how I'm made, it's how I'm built, it is what it is. I have an ed just b/c I have an ed, and I have to learn to live with it and be the one in charge in my head.

Katie said...

It is only natural for humans to want to attribute meaning to and interpret their experiences, and often therapists place great importance on the client's narrative. This approach doesn't allow for the fact that some groups of clients are not thinking rationally about their experiences, or if they are they don't have all the information. Buying into a faulty or incomplete narrative (I developed an eating disorder because I wanted to look like X celebrity/my parents divorced/exam stress was too much/etc) can do so much harm to the client, because it means they can sit around "exploring" all this meaning for week after week, while still killing themselves with eating disordered behaviours.

Drives me batty. I've been on the receiving end of this sort of therapy, and it certainly didn't do a thing for me other than keep me eating disordered for over ten years...

Long winded way of saying I agree with you, Carrie! I found looking at my triggers and obstacles to recovery invaluable, but only when coupled with some serious action.

esqueci a ana (ex-ana) said...

Thanks for this post. This 'why' question and recovery is really relevant. I will share in Portuguese soon.

Anonymous said...

when I was in treatment my therapist explained to me that I had developed an eating disorder as a kind of comping mechanism to deal with other problems in my life. So it kind of answers the question "why?", but only for practicle purposes. I think if I didn't know what kind of siduations make me resort to ED behaviours that I would be more likely to relapse. By focusing on what caused by ED, and not why, I have an understanding on the roots of my illness without making any excuses as to why this happened to me.

Angela Elain Gambrel said...
This comment has been removed by the author.
Angela Elain Gambrel said...

I've asked why for years. And I've asked why did I develop anorexia at 42, because to be dropped in the world of eating disorders after a lifetime of no real previous history is inexplicable to me.

I am beginning to get some answers as we slowly unravel things in therapy. But I don't know - and now I'm not sure I care - if I will ever completely know why. Maybe there are no clear-cut answers for any of us.

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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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Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com

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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