Posted by Dr. Beth Steinhauer on March 18, 2005, at 22:04:06
In reply to Steinhauer: How Do I Want to Get Better?(long), posted by Augustina on March 16, 2005, at 10:50:00
Dear Augustina,
First of all, I am happy to hear that you are beginning to talk about your eating concerns with your therapist. You have been struggling with your body image and with food for many years, and I hope that treatment can help relieve your suffering.Second, it is EXTREMELY common for people with histories of Anorexia Nervosa to be quite ambivalent about treatment. After all, when you have been coping with difficult issues through restricting, bingeing, laxative abuse, etc., it is frightening to contemplate giving up this familiar (if ultimately unhealthy) set of symptoms. It also may seem far from clear what will appear in their place. Certainly, everyone I have known while they were struggling with A.N. oscillated between wanting to lose weight at any cost and wanting to regain their emotional and physical strength. The balance shifted from day to day, or from week to week. Most anorexics who recover eventually find that their commitment to getting well is robust enough to override their life-threatening commitment to thinness. Caroline Knapp, an author who died a few years ago (NOT of A.N.), wrote eloquently about her struggles with A.N. in her memoir DRINKING: A LOVE STORY, and in other published essays. She said that at a certain point, she became sick and tired of being sick and tired, and this propelled her in her recovery from her eating disorder.
Do not be discouraged, in other words, because you have mixed feelings about giving up these symptoms. How could you not? They have been a part of your life for 28 years! It may feel like you are going one step forwards, two steps back at times, but I wish you courage in your journey.
Cognitive-behavioral therapists often urge their clients to BEHAVE as though they don't have fear, even if they do, and eventually, their fear will diminish. I think the same is true for people with eating disorders. For a time, you may have to put into place behavioral prescriptions, guided by your therapist/nutritionist/doctor, and eat what is determined to be healthy, life-sustaining amounts of nourishing foods. As you've seen, even having restored your weight to a normal level doesn't necessarily mean that your body image and brain have caught up. However, if you can regularize your eating and sustain a normal weight, you can expect and hope that your acceptance of your body will be enhanced, and you will one day enjoy a peaceable, healthier relationship with food and eating.
Best of luck to you in your recovery--ES
poster:Dr. Beth Steinhauer
thread:471656
URL: http://www.dr-bob.org/babble/eating/20050314/msgs/472676.html