Fear, food, and the need for control
A recent blog post I stumbled across talked about the relationship between phobias and the need for control. One of the key components of a phobia is a fear of loss of control. What if I'm stuck in a really small space and I can't get out? Or, for me in my anorexic days, what if I don't know exactly what's in my food? What if I don't know how many calories it contains? What if I don't do the exact same exercises in the exact same order?
"Control" was a qualitative feeling, yes, but I turned it into a quantitative one: pounds, calories, minutes, and miles. What it took me nearly a decade to connect was that this search for control was actually very closely linked to a search for relief from fear. If I could get everything "perfect" with regards to weight and food and exercise, then I felt that everything in life would be okay.
Except that perfection is a myth, and I never got things exactly right. I couldn't. That didn't stop me from trying.
Saying that an eating disorder is "about" control is, to me, a dramatic over-simplification. Control is an underlying theme. It's a major player. But it's not all that an eating disorder is about. The eating disorder didn't start as a search for something I could control. It started as a way to try and feel better. As I became more deranged and malnourished, the fear kicked in. With the fear came the need for control.
The anxiety was existential. It was related to food; it was related to everything. Life itself overwhelmed me and I couldn't cope. The eating disorder behaviors had both a psychological effect and a neurochemical effect. Not eating turned down the anxiety chemicals, at least short term. And the behaviors gave me the illusion that I was in control of my life.
The more entrenched I became in my disorder, the crazier my life got. This led me to search even harder for the fleeting sense of control that the ED behaviors brought me. A sense of control reduces stress. I remember listening to a lecture by biologist Robert Sapolsky on stress, and he said that when rats got a warning before they got an electric shock, their stress went down. The warning- in this case a flashing light- gave the rats a sense of control. Researchers have also found that stress makes us more vulnerable to superstitious beliefs.
One of the things that consistently stresses people out is not feeling in control. When we're not in control, we use elaborate mental gymnastics to try and convince ourselves that we are in control, or keep ourselves from doing something where we might lose control. A lot of these are superstitious beliefs: if I exercise for XX minutes, then everything will be okay. I will be in control, I won't gain weight, and everything will be just fine. They become mantras that we repeat, over and over and over. Those beliefs were how I organized my life.
Just as exposure to the feared situation or object is crucial to the treatment of phobias and panic disorder, exposure to ED-related situations is also crucial. Only by facing our fears can we learn that control is overrated. Ironically, by temporarily relinquishing control of my eating, I was able to make huge strides forward in recovery.
So yes, eating disorders are about control, but don't stop there. They're also about fear, anxiety, stress, nutrition, and lots of other things, too. You can't tie an eating disorder up with a neat little bow and explain them with a simple word like "control." The only simple way to explain an eating disorder is to say "It's complicated."
20 comments:
Thanks for this Carrie :)
I have always said that my AN was 'about' control - of anxiety and mood. I know some people are hugely opposed to the idea that EDs are 'about' control, because of the inaccurate (IMO) interpretation Hilde Bruch made of the behaviours and narratives of girls/women with AN. For me, at least, the control aspect had nothing to do with a desire to have power, or to manipulate other people. The control aspect was about order, predictability and avoiding change; all of which helped me to control anxiety.
You write: "As I became more deranged and malnourished, the fear kicked in. With the fear came the need for control."
My personal experience was rather the opposite. My existence felt chaotic because of anxiety and PTSD before I developed any signs of AN. I found that controlling my exercise and food intake - and hence ordering my existence - relieved that anxiety. The more starved I became, the more numb I became. At very low weights I was like a zombie who didn't think or feel. It felt to be a very effective means of controlling anxiety.
Thus, the illness itself (AN) didn't increase my need for control. That need for control (of anxiety) pre-dated the AN.
Everyone is different, of course.
You also write: "You can't tie an eating disorder up with a neat little bow and explain them with a simple word like "control." The only simple way to explain an eating disorder is to say "It's complicated."
I absolutely agree.
Right- I think the need for control (or the search for control) is a symptom of the underlying anxiety. I had "control issues" in lots of other areas of my life long before the onset of the ED, but the food control issues only arose after I started restricting.
I couldn't agree more with the statement about exposure to eating disorder-related situations being essential. It takes desensitization to the feared experience of dining out, or trying a "risk" food, etc. No amount of reassurance from a provider will do it--it requires one's own experience to truly trust that they will survive (and ultimately thrive) following this exposure.
Wow, this is perfectly written. I definitely identify with the feeling of control reducing stress. And while the AN gave me sense of control, it really just made my life spin out of control. Thanks for sharing this!
Control isn't a bad thing though, is it? It's good to have one's books in order, finances lined up, schedule ironed out, obligations pinned down, etc. I think things just become unhealthy when control takes on strange forms that are not actually related to life- keeping up my books so I can pay my bills relates to life- but eating XX calories so that paying bills isn't so stressful maybe doesn't relate so well. ?
Either way- exposure is definitely necessary. Had an intense session this week at therapy during which my therapist was pushing me to expose some of my internal "rules" about food and then discuss my feelings about breaking them, what would happen inside and outside if I broke them, etc. It was incredibly anxiety-provoking. Afterwards, I felt amazingly clear-headed, and like perhaps I could begin to think differently... then within a few hours crashed mentally (maybe w/the exhaustion of trying to hold up a mental construct that was not my own, but had been laid upon me?) with panic attacks, anxiety, exhaustion.
Exposure is good, in theory- seems best in an in-patient setting, or at least optimal that way- b/c in a once or twice a week therapy setting, you have the support to handle it for that one hour, and then you have the rest of the week alone to try and pick up the pieces from the panic of it. Not exactly optimal.
Wow-love this post and the comments. So many of these points make me think of OCD and the associated compulsions. The ED seems so similar in that dieting, etc. acts as the compulsion for a sense of relief and control much like the compulsions in OCD serve to do. I understand there is more to it, however, EDs and OCD seem very parallel in this way.
From my daughter's experience, it seems that engaging in eating disorder behaviors, no matter how minor, seemed to be a way to control her worry thoughts, to push them out of her head by reassuring herself in some way. Part of this was to ask me if she was getting fat. At first I thought it helped to reassure her. But of course she isn't fat. Her use of the term "fat" has no relation to any medical definition of being overweight. After a very long time of considering the possible ramifications, I finally asked her if the problem was that she couldn't push the worry thoughts away, not that she was fat. She thought yes, that was true. Then I bravely asked her to change her answer from "no, I'm not fat" to "who cares if I am" and see if that worked better.
I think her brain is programmed for anxiety and worrying. When she was very small she would cry for hours every night before she went to sleep because she thought she had a cavity. That was the worse thing she could imagine. There was no way to talk her down from this. Then later, getting fat was the main concern. I think that's how she rolls-her set point for anxiety is set much differently than other people.
Can you change the set point? I think somewhat! Getting older and more mature does seem to help in some ways. The DBT has been very useful-control your thoughts so they don't control you was the first thing she learned. Those worry thoughts are very very controlling.
I wish there was a better understanding of anxiety in the brain, the neurotransmitters, why some people have it, etc. I wish no one had to suffer with this type of anxiety!
Rambling done!!!
so so true! my experience exactly!!
Hey really nice I love to read your post.
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Thank you for this. I never understood when other patients referred to "control" as the reason for their disorder, because for me it had more to do with distraction and the feeling of progress and achievement that no one else could interfere with.
It's interesting, however, that pre-ED I did deeply fear "losing control" in regards to social situations and relationships and hence furiously analyzed every aspect of my own behavior and emotions to exert "control" over. The feeling of "certainty" derived from absolute control (at least in my mind) assuaged my worries. And yet I didn't restrict because I felt out of control per se (at that point I no longer had social anxiety and had integrated my personality into my psyche) - knowing that I was eating less simply gave me that same sense of certainty. And it gave me a distraction from my third breakup. I did not fear food until I discovered fasting and all its "health benefits" though, and I think "control" - of eating perfectly on time and only when very hungry - at that point started playing an especially large part in appealing to my hunger for power, because restricting alone had simply made me feel "safe," not "powerful" in my denial of food as a necessity.
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