A reflection by Lindsey
This week is National Eating Disorders Awareness Week. Recognizing that it’s important for those who live with the effects of an eating disorder to share their stories, we wanted to use our individual reflection pieces this week to talk about our experiences with eating disorders. Sarah first developed bulimia at 12 and has been living with its effects even as Sarah has achieved a solid amount of recovery. I began supporting Sarah in recovery almost immediately after our friendship began. In today’s post, I share a reflection about supporting someone recovering from an eating disorder.
Update: you can read Sarah’s reflection here.
Sarah and I began our friendship talking on the phone. We were incredibly nerdy Ph.D. students intrigued by one another’s work, incurably capable of geeking out regarding various academic and spiritual topics, and immensely grateful to be able to talk with another person who seemed to “get” why various tough issues we faced in life were legitimate struggles. And really, you can strike “were” out of that last sentence because every aspect of it holds true to this day. As we started to settle into a conversational routine, eventually we migrated toward G-Chat so we could communicate as we worked on our academic projects. Online chatting with a friend can open up a new degree of vulnerability. In our first G-Chat together, Sarah opened up about being in recovery from bulimia.
Offering a listening ear is the first step of supporting someone in recovery from an eating disorder. Everyone’s experience of an eating disorder is different. While people with eating disorders might share a common set of symptoms, the reasons why they have developed the symptoms in the first place are as varied as the world’s ecosystems. Though there are many and varied types of eating disorders, most people understand these in three broad categories: anorexia (restricting food), bulimia (binge eating and purging), and binge eating disorder (binge eating without purging). Generally, I’ve learned to think of eating disorders as being characterized by disordered eating in the extreme. The broad eating disorder categories clue me in on what sort of patterns I might want to watch out for on a reasonably regular basis. It has been essential that I learn to listen when Sarah tells me how specific symptoms have manifested over the course of Sarah’s life. Just when I think I’m able to predict why something may have happened, I realize that there is even more nuance to Sarah’s story.
From my limited experience, eating disorder symptoms appear to emerge from two main roots–at least where Sarah is concerned. I’m offering my perspective because I think there’s a popular perception that the genesis of an eating disorder is easily explained. As I’ve gotten to know people seeking recovery, it seems that many can move between addressing two different kinds of root concerns. Again, what I’m about to describe needs to be interpreted in light of my initial point that listening is essential when you’re trying to support someone in recovery from an eating disorder–no two people are exactly alike. I’m also trying to discuss this issue from my perspective as a person providing support. When you don’t deal with an issue firsthand, it’s easy to say things that are incredibly hurtful and ignorant. I hope that sharing my perception of the roots of Sarah’s eating disorder will help other support people on their journeys.
In the beginning of my efforts at supporting Sarah, one key thing for me to realize was that trauma can lie at the root of an eating disorder. Towards this end, an individual develops eating disorder symptoms as maladaptive coping strategies for managing something distressing that is going on in his or her universe. Eating disorder symptoms may make a person feel powerful, in control, hidden, intelligent, skilled, resourceful, or any number of other positive attributes. Trauma can throw everything off-balance because a person is desperately trying to regain some sense of normal. For some trauma survivors, using eating disorder symptoms offers a way to make the trauma more bearable. I think it’s essential for support people to realize that the kinds of trauma that might lie underneath a person’s eating disorder can be incredibly varied. I have had to learn that I know nothing about Sarah’s trauma except what Sarah chooses to share with me. I cannot guess, I cannot assume, and when Sarah does feel like sharing I cannot make demands that Sarah disclose all details at once. I regularly ask for God’s help in being a safe person with whom Sarah can be vulnerable and a prayerful person as I try to intercede for Christ to aid Sarah in the midst of recovery.
Another thing I’ve had to learn to cope with is that sometimes it seems there is no easy way for a support person to describe why person might be likely to engage in eating disorder symptoms. My personal shorthand for this absolutely confounding nature of an eating disorder is “boredom” and I know there are a lot of problems with trying to suggest that word as a root cause for eating disorder behaviors. What I’m trying to capture is that I’ve observed eating disorder behaviors can produce their own sort of thrill, present their own sort of risks, and take advantage of a person’s fantastic ability to strategize and problem-solve. As an engineer, I know I personally take an odd sense of pride in being able to discuss the physics of any random object at the drop of the hat. I envisage some sort of similar pride if a person has managed to figure out which foods produce the best highs when purging. Behaviors themselves can produce a thrill. Purging and other means of manipulating one’s body can affect a person’s brain chemistry. Sometimes the thrill might be figuring out how to continue in behaviors after normal routes to those behaviors have closed or the body starts showing signs that it can no longer keep up with the symptoms. When an eating disorder develops a mind of its own, sufferers need to be connected with an appropriate level of care by trained professionals. There’s only so much a support person can do.
But I’d also like to note that Sarah’s working on recovery has helped me with my own relationship with food. It’s never been exceptionally problematic, but like most young adults, I can sometimes forget that Sour Patch Kids and Diet Coke are not the healthiest of snacks. I’ve learned how to pack my lunch as Sarah has shared meal planning resources from different dieticians. I have developed a taste for fish as Sarah’s high protein need means we eat protein in virtually every meal and snack. Sarah has even managed to turn me on to the idea of “Breakfast” and I have no idea how that happened. We can laugh about our various food quirks, appreciating them as a part of being human. We have decided that fish tastes better when the sauce is baked on, peas can only be tackled successfully with a spoon, and it’s totally okay to use your tongue to get the last bit of hummus still on the plate. Eating together is a great joy. I honestly look forward to every meal. We have restaurants we love, cupcakeries that are “our” cupcakeries, and a multiplicity of late night dinner options.
I’ve come to see recovery from an eating disorder as battling a constantly regenerating hydra. Just when you think that you’ve cut off one head, it can spurt afresh from a new spot. If I can be so bold, I think the only way to slay an eating disorder effectively is to slash off the heads and then try to address the root issues as expediently as possible. The existence of ever-regenerating heads means that you often have to “rinse and repeat.” It can be easy to get bogged down. Even if a person has had a very long time free from engaging in behaviors, he or she can still be staring the hydra in the face minute-by-minute. You can’t look only at the externals when you want to declare victory.
As a support person, I’m struck by the persistent nature of the regenerating hydra heads. I know Sarah works hard to address the roots and to resist any symptoms. I regard myself as Sarah’s biggest cheerleader while knowing full well it is Sarah’s recovery, not mine. Nonetheless, the eating disorder can throw curveballs. During a meal, Sarah might grab my hand in a way that says, “I need your support right now.” When we’re in a grocery store, Sarah might ask me to pick up some items that are down a surprisingly hard aisle. I might get a phone call where Sarah says, “Please talk to me so I can stay present on my drive home.” I never know exactly what Sarah might need at a given moment, but we’ve talked at length about what I’m willing to do in order to support Sarah. We’ve also identified other “go-to” folks when Sarah needs the kind of support that someone else is better suited to provide.
Helping someone beat an eating disorder means listening, encouraging him or her as he or she does the hard work to slay the hydra, knowing your own boundaries for supporting him or her in stopping active behaviors, being patient, and continuing in hope. Eventually, the hydric nemesis will be no more. Freedom is possible, but gosh, it’s a really, really, really hard fight.
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Another insightful post. I think one thing that people might not realize this, but a lot of men struggle with eating disorders (and even a lot of priests and religious as well). During my time in religious life I’ve seen two extremes: on the one hand there are men who are severely overweight, and eat as a way to deal with stress and pressure. On the other hand, there are men who exercise and diet so much that it becomes compulsive and destructive to their bodies. And what makes things worse, is a lot of guys don’t think of eating disorders as “male” problems, so they’re less likely to seek help. In the end I think it takes courage and humility to fight the hydra. Courage to stand up to it, and humility to ask for help.
Hi Br Jude, thanks so much for this comment. It is absolutely critical that you cannot tell who has an eating disorder just by looking at them. Eating disorders cross all demographics. Everyone has to eat, and many people find food offers forms of escape or relief. Finding the right kind of help can be challenging. I’ve benefitted tremendously from reviewing what’s out there by searching ED Referral: http://www.edreferral.com/ If anyone reading this comment feels inspired to reach out for some support resources, please feel free to Contact Us so we can add you to our prayer list.
I really am curious, do you think your partner would have an eating disorder still if you all weren’t celibate?
Hi Kay, your comment here is patently offensive but I’m choosing to respond to it because many people providing support to people recovering from eating disorders try to pursue “silver bullet” solutions. Support people can think, “If I change this ONE THING, then my loved one will get better.” It’s not that simple. The point of the hydra metaphor is to recognize that the eating disorder has complex roots where a person’s needs change throughout time.
Now, let me tell you more why your comment is patently offensive. It’s offensive to tell a person “You’re only having this kind of big problem because of (another thing that is true about your life).” Can you imagine a person suggesting that Sarah wouldn’t have an eating disorder if only Sarah were straight? Your comment is also patently offensive because I don’t think it at all registers with you why someone might rejoice, relish, and thrive in a celibate vocation. You seem absolutely stuck on problematizing our celibacy and do not seem to hear for an instant that we’re thriving.
Over the last 16 months of our partnership, I’ve watched Sarah grow towards in incredibly sustainable recovery from bulimia. It’s not easy, but I can tell Sarah is doing work on those really tough roots. Sarah can only do that tough work because Sarah feels safe, supported, and encouraged. Our celibate vocation together helps Sarah thrive when doing the tough work associated with battling the hydra. The fact that enjoying food together has become a hallmark of the intimacy we share is a testament to how Sarah’s recovery is thriving. You can read more about the role of food in our relationship at http://aqueercalling.com/2014/01/23/of-sacredness-intimacy-and-lentil-soup/ (Sarah’s reflection) and http://aqueercalling.com/2014/02/05/sometimes-i-just-need-a-date-night/ (my reflection).
I didn’t mean to sound offending. I just think a lot of people with these problems are afraid of having sex. They don’t want to have sex because that’s about being grown up, and they don’t want to grow up. They want to stay in a little girl’s body forever. It’s the truth. Even a counselor will tell you that a lot of girls with eating disorders don’t have normal sex lives.
It’s A truth that is true for SOME people. As I stated in my post, “Everyone’s experience of an eating disorder is different. While people with eating disorders might share a common set of symptoms, the reasons why they have developed the symptoms in the first place are as varied as the world’s ecosystems.”
One problem that support people often have is that we can do a bunch of research about eating disorders in general and assume that the specific person we’re supporting deals with that issue. For instance, it’s generally assumed that a person with an eating disorder has difficulty being in a place that has mirrors. It’s not a bad question to ask a person you know who has a history of an eating disorder: “Are mirrors something that you have a problem with?” If the person answers no, then okay fine, that’s not a part of his or her experience with his or her eating disorder. While it’s A truth that SOME people with eating disorder histories have issues with mirrors, it’s absolutely inappropriate to assume that applies to ALL people with an eating disorder history. That’s why my first point is that listening to the individual person is absolutely, positively essential.
Correlation does not mean causation. Many people suffering from ED, self harm, or other less than ideal coping mechanisms have a variety of problems in different aspects of their lives. Wanting to avoid growing up could be one reason for issues pertaining to ones sexual behavior, as could a past of sexual trauma, self-esteem issues, or any number of reasons. Choosing a celibate lifestyle also is not equal to having a disordered sex life. I won’t call it normal because (though I do not know statistics) having that vocation probably would place one in the minority, but it is completely different from avoiding sex for a negative reason.
Thanks for providing a richer description of the various casual elements of less than ideal coping mechanisms. Thanks for reading, and we look forward to hearing more from you in the future.
Kay, I’ll add one thing to what Lindsey has already said. My personal struggle with an eating disorder has had nothing to do with not wanting to grow up. I know many women with eating disorders who *would* say that part their struggles are, at least in part, related to fear of adulthood, so that is a real issue but has never been my own struggle. I’d say quite the opposite about my own experience of life: when I was a child, I couldn’t wait to grow up, and I can’t remember myself ever thinking, “I wish I was a child again.” I wouldn’t relive my childhood even if someone paid me to do it. If you’re genuinely interested in hearing about how this issue became part of my life, my own reflection for NEDAwareness Week will be released on Thursday. -Sarah
Eating Disorders are not limited to one group of people. Gay, straight, bisexual, lesbian, trans* people, men and women, people of different backrounds and races and abilities, people who have sex and people who don’t – anybody can suffer in this way. To think you have the right to make these assumptions about someone you don’t know id breathtakingly offensive and proves that you are not willing to engage in a respectful way with this blog. I admire L & S for responding in such a grace-filled way and not just banning you.
I thought your discussion about eating together was cute. Eating disorders have a high recidivism so it is wonderful that Sarah has someone like you who is aware of this and can be a steady support. I love the hydra analogy I remember them from biology class. 🙂
Hi Kathy, thanks for the comment. I appreciate you raising the issue of relapse. Part of the big issue here is that even when people can receive treatment for eating disorders, it can be difficult to get adequate treatment. Many insurance providers don’t classify eating disorders in such a way where people can get support paying for necessary services. For instance, insurance could pay for 5 days of residential care if a person is battling bulimia but once the person has gone more than 5 days without behaviors, insurance cuts out. Even the very best of insurance plans tend to cover 30 days of residential treatment. Most doctors who specialize in treating eating disorders recommend 6 months (or more) for serious cases. And let’s be real… the vast majority of people in residential treatment facilities have a very serious, very well-developed, very lethal hydra threatening their lives.
Step-down care resources are also extremely limited. People can go from 24-7 in-hospital care to living on their own in minutes. Food is an everyday need and so people need to stare the hydra in the face everyday. Without involving and educating a person’s support network, a newly discharged patient may find himself or herself trying to do everything alone. It just doesn’t work.
Another thing that can happen is that higher levels of care focus on getting a person medically stable. When a person is not medically stable, doing work on the root causes is next to impossible so the treatment facilities zoom in on trying to stop behaviors. You can cut off the hydra heads, but without going for the roots the hydra will regenerate.
I’m in it with Sarah for the long haul. I’ve enjoyed being able to get better at supporting other people in their recoveries. But golly ned, these fights are HARD and it’s absurd that so many people have literally NO ONE to support them in their recovery efforts. Even when family members get involved, they need to do work on their own side of the street because they have likely contributed to the environment that fostered the development of the hydra. At least with Sarah, I have the benefit of coming in on the “tail side” of things where I know for sure that I didn’t cause Sarah’s eating disorder.
Hi, Lindsey (and Sarah). This is one of the most insightful pieces of writing on EDs from the “first outside, and only second inside” (I do not think ‘secondhand’ applies) perspective that I’ve seen. Just a thought:
About “boredom”–I don’t mean to paint over your personal word choice, but I think what you describe *after* that is really, REALLY important, rarely discussed, and not really about “boredom” at all. EDs are absolutely a way to compete with others/with oneself, a chance to do things “right” and “better”, a private source of “victory”. This is often lumped as a need for control in psychology writing, but it’s more than that, it’s about *success*–and it’s a very socially acceptable, even desirable form of success. (“You lost weight! Congratulations!” why is that something worth congratulating?) In my experience, the social approval of ED behaviors and outcomes, more so than generic “pressure to be thin”, is where the most insidious outside influence comes into play.
Thanks for sharing this post. :o)
Hello! Thanks so much for adding your voice to this important discussion.
It’s funny that you should mention the word “boredom” as Sarah let me know that people might have objections to my choice of the word. I think my choice of “boredom” was influenced heavily by Sarah’s experience were boredom is a part of the causal mix as to why Sarah’s engaged in behaviors in the past. It’s not as though Sarah is bored with life, but Sarah has a real thrill-seeking tendency. For Sarah, the thrill of the purge itself became addictive.
You’re absolutely right when you suggest that praising thinness (and its corollary: shaming fatness) can create a vicious feedback cycle that only strengthens the hydric nemesis. I honestly consider constant fat shaming as a potential traumatic root of a person’s eating disorder.
However, not everyone with an eating disorder loses weight through their behaviors. Sarah’s body size has never been significantly impacted by eating disorder behaviors (although medical complications from the eating disorder have impacted Sarah’s body size). Additionally, Sarah has never been motivated to manipulate body weight or body size. Sarah is going to share more about directly experiencing an eating disorder tomorrow. We hope to see you in the comments again.
I’m looking forward to tomorrow’s post. One thing, though–I used “weight loss” as a shorthand example and it was my error for not noting that it was only to be an example, but: **in my personal experience** there has also been a certain casual way of talking about bulimia, or at least the purging side of it (guess nobody wants to glamourize bingeing?). Or maybe this was just my group of friends back in high school? (I find that hard to believe). Sorry for not being clearer. 😉
Hi there! This is Sarah. Lindsey might respond to this later too. I just wanted to say thanks for reading Lindsey’s post, and I hope we can have some good discussion tomorrow when mine is released. I can also relate to what you said about bulimia (at least the purging part of it) being discussed casually. I’ve sensed that in conversations at times. Looking forward to hearing from you again! -Sarah
For the sake of anyone who has subscribed to the comments on this post, Sarah’s reflection is now live at: http://aqueercalling.com/2014/02/27/encountering-the-mirror-of-erised/
I am part of a fellowship group that is pretty much uniformly made up of women 65 and older. I’ve started to refer to them as The Aunties and we’ve toyed with the idea of starting a kickball team called The Matriarchal Mamas. Their combined wisdom and spiritual practice is a perfect mix of love, life affirming direction, strength and sticktoitiveness. They’re so supportive but they also give structure to my life which has been really helpful with dealing with my depression. They also emulate a practice of mindfullness that I’m trying to incorporate into my life. I try to emulate their style of listening when helping friends in tough places too as I’ve realised that I can often just say what I think someone wants me to say. In a recent discussion The Aunties and I were talking about the need for fellowship and companionship that helps restore the vital energy we need to do things in our lives, especially the more difficult things. It seems like you can offer that life affirming replenishment to Sarah while she continues her recovery. It’s really refreshing to hear about these things from the point of view of a supporter/carer as that struggle isn’t often heard. Thank you so much for sharing
The Aunties sound awesome. I think you’ve hit the proverbial nail on the head when you say “Their combined wisdom and spiritual practice is a perfect mix o love, life affirming direction, strength, and sticktoitiveness.” So much of my own journey has been supported by elders who have shown me that it is possible to go through what I’m going through and come out on the other side.
I appreciate the kind words about supporting Sarah in recovery. We recently watched a great short from Brene Brown on empathy: http://www.youtube.com/watch?v=1Evwgu369Jw that I think ties everything together. We grow and receive healing in the deepest places when we encounter empathetic people willing to journey alongside of us through just about anything.