An extra from A grown-up approach to treating anorexia
Carrie Arnold endured more than a decade of anorexia before finding a way to understand it that helped her loosen its grip on her life.
When I was first diagnosed with anorexia more than 15 years ago, no one told me anything about biology or neuroscience or genetics. The reason I continued to starve myself despite my failing organs and being forced to drop out of school, they said, was that something was wrong in my family. And as soon as that was sorted out, my eating disorder would be out of a job and I would get well. One therapist told me my parents were too controlling. Another said that there was too much pressure on me to be perfect. Yet another suggested that I just didn’t want to grow up, and my mother was afraid to let me leave the nest.
The problem was that none of these things were true. The other problem was that, despite discussing these factors at length, I remained profoundly ill. I would eat in the hospital or at a residential treatment centre, where I was sent when my condition deteriorated, but then I would return to my old ways upon discharge. I was 29 years old, and despite two advanced degrees, I had to come to terms with the fact that I didn’t have the first clue as to how to feed myself appropriately. My once-vibrant life had narrowed to the number on the scale and my next meal. Nothing else mattered, and no one could figure out why.
It wasn’t until nearly a decade after I was diagnosed that a therapist told me that, not only was my eating disorder no one’s fault, the personality traits that were driving the anorexia (perfectionism, attention to detail, a drive to achieve) could actually be beneficial. I learned about some of the biology that explained why I was so vulnerable to anorexia, and why not eating actually made me feel less anxious and less depressed. Instead of demonising my parents as the cause of the anorexia, we needed to utilise them as supports to help me get better. The shift was profound. What we created was a specialised anorexia treatment programme with a clientele of one: me. Food was described as medicine, and I was expected to eat everything I was served. I would rather have jumped out of a plane without a parachute, and if I had known someone with a pilot’s licence, I might have. Meal by meal, snack by snack, however, the eating disorder began to loosen its grasp.
Now, nearly six years later, I don’t describe myself as ‘fully recovered’. I still follow a food plan that helps me decide how much I need to eat. I have entered into a fragile détente with my weight, grudgingly accepting that I am mentally and physically healthier in my current state even if I feel like evidence of a new species of land whale most of the time. Nor am I free of relapse. I have had two major relapses in the past few years, one of them rather recently. My organ systems are no longer nearly as forgiving as they were when my disease started. My bones are irreversibly damaged, and it takes little to throw my heart into complete chaos. Despite all of this, I have managed to create a life worth living and that, in and of itself, is a feat for someone who was repeatedly written off as uncooperative and untreatable.
In my years of being involved with the larger eating disorder community, I have seen a profound shift in the way we think about eating disorders. Although far too many people are still told that their disorder is ‘about control’ or that there’s nothing anyone can do until a person chooses to get well, many parents and sufferers are learning about the complex web of biological and environmental ingredients that come together to create an eating disorder. I recently spent a week in Ohio observing a treatment programme that brings this all together – the NEW FED TR programme that I wrote about for Mosaic. It was a sea-change compared to what I experienced so many years ago.
Other adults with anorexia like me need programmes like NEW FED TR. We also need other options, too, like meal coaches and halfway houses and tailored inpatient and outpatient programmes. The people I’ve met both online and off have amazing potential, fuelled by the very same traits that also fuel their disorders. Learning to use those traits “for good instead of evil”, as my therapist likes to say, is one of the major tasks of recovery.
I may never feel at ease with food or learn to love my body, but my recovery doesn’t have to be perfect to be wonderful.