I think this can be a tremendous therapy tool, and have tried it myself, except for one tiny detail: my eating disordered voice sounds exactly like me. I can be sitting in the car and driving, trying to figure out how many miles I have left before my destination, whether I should pull through the car wash, whether I might need the oil changed, and slide seamlessly into a diatribe of self-loathing about how much I ate and how much more I should have exercised. It sounds like me and it talks like me and it can talk for me...so is it me?
What makes it even harder for me is the fact that I've been hearing this voice, in one form or another, since long before I ever had an eating disorder. It was the voice that told me I was a loser because I couldn't write the cute bubble letters like the other girls my age and that no one would like me. It was the voice that scolded me for not getting a perfect score on my spelling test. It was the voice that said no one would ever want to be my friend, so I may as well get over it. It was the voice that told me my high school graduation honors were a matter of luck.
If I could condense down everything the voice told me into one simple phrase, it would be: No, don't. Should I go to the party? No, don't. Should I eat that cookie? No, don't. Should I speak up? No, don't. Should I break out of my routine? No, don't. Should I buy those jeans/that book/that expensive bar of chocolate? No, don't. It's a life of "No, thank you, I shouldn't, I couldn't, I would never." There are situations when this is a sensible path to take--it tends to protect personal safety, and that's not a bad thing. But when that's your life, when that's all you know and all you will let yourself know, it's not quite so universally positive.
I was at a get-together last night with a friend of mine. I was visiting L for the weekend (I'm sitting on her floor as I write this), and she was invited to a small party with some friends of hers, and I tagged along. I had previously met almost all of the people there, and they were all really nice people. I knew that weren't judgmental or anything--that wasn't what I was worried about. I hesitated to join in on the conversation because I was afraid I would say something stupid, afraid I would offend someone. Should I join in on the talk? No, don't. It was when someone broke out the karaoke machine that I really started to shut down. I didn't know many of the songs, and even when I did find a song I remembered, I knew I would never ask to sing it. I was too afraid of embarrassing myself. The other girls who were singing seemed to have quite a bit of talent, and I was certain I would sound rather terrible next to them. I can't belt out lyrics- my voice just doesn't seem to go that loud. The clincher was the fact that the computer system gave you a score at the end of your song. I was certain that I wouldn't get the highest score, and I knew that if I didn't, I would hate myself. So I didn't sing.
There was a part of me that just didn't feel like standing up and singing, which is fine, but I've never really been able to cut loose, be goofy, and just have fun. I'm always thinking ahead and anticipating what might be next, how I could look like an ass. Although these thoughts have nothing to do with food and weight, they still seem like a product of the anorexic voice, of the perennial chatter I hear in my head that seems to come from within.
Perhaps one of the hardest parts is this: it's not always mean. Sometimes, the voice is kind and reassuring, like "Yes, I know. It's okay. I'll do better tomorrow." The unsaid piece is that there will be hell to pay if I don't shape up, but still, I'm not berating myself, I'm encouraging myself to do better, to eat less, to exercise more, to study harder. Most of my major relapses started out this way: I started to cut back on food, and if I slipped up, I gave myself a pat on the back and said that tomorrow would be a better day. As the relapse progressed, the voice became harsher and more demanding.
It turns out I'm not the only person with anorexia who has seen this progression. A recent study in Psychology and Psychotherapy asked anorexia sufferers to describe their experiences living with the "anorexic voice" and found that:
These data underlined the positive and negative attributes individuals bestowed upon their anorexic voice; the former appeared stronger during the early stages of their eating disorder, the latter coming into force as it developed. In spite of their voice's harsh and forceful character, participants felt an affiliation towards it. The bond between individuals and their anorexic voice could explain their ambivalence to change. Therapists must persist in their endeavours to penetrate this tie, whilst acknowledging the hold this entity has over those with anorexia. Interventions that address this component of the eating disorder could prove fruitful in helping people towards recovery.I'm not sure I have a quote-unquote "bond" with the voice in my head, but I do know I'm used to it, and its presence doesn't really bother me. Furthermore, I find it hard to say for sure whether this voice is external or internal. Since it seemed familiar even at the outset of the eating disorder, it feels like it's always been there, even if I wasn't harping at my food intake and weight. It seems ultimately like a perfectionistic voice that happened to become utterly myopic about food and weight.
Do you have an ED voice? How do you experience it? In your comments, I want everyone to feel they can be open and honest; however, I'm also aware that such discussions can be triggering, so keep that in mind as you share. Thanks!