At 25 years old, I checked myself into an inpatient unit after over 11 years of suffering with an eating disorder. What led to me having an eating disorder and the symptoms I was suffering with are unremarkable, sadly too similar to too many other people’s stories to be noteworthy. Far more interesting is what happened next.
I’d like to say something prosaic about walking boldly towards a better life, bravely facing recovery with admirable determination, despite my fears. I’d be lying, it didn’t happen like that. I was desperate. By the time I got there, my ED was making my daily life so miserable, I wasn’t scared as I didn’t feel I had much to lose. If anything, I was excited: I knew I needed something dramatic to help me and taking a semester out of school and committing to 4 months’ inpatient might just be dramatic enough.
Through all the drama and changes I wasn’t prepared for, here are 10 of the most valuable, exceptionally difficult lessons I wish I’d known before recovery:
1. If you keep getting worse, you aren’t recovering.
I’d considered myself “in recovery” for years – after all, I’d been seeing professionals, I’d attended groups, I’d wanted to get better and that’s what recovery is right? No. The decision alone to recover isn’t enough, the decision without action doesn’t produce recovery. That may sound harsh but, in saying that, I’m in no way dismissing the significance of the decision to recover – it’s absolutely vital. The rest of recovery can’t properly start without it and it’s an immensely difficult decision. But something being difficult doesn’t make it enough. Wanting to be better, no matter how desperate you feel or vehemently you defend it, won’t turn into recovery without action. More than that, the decision can’t be made just once but must be made repeatedly, multiple times a day, until it ceases to be a decision anymore.
All those years before inpatient, I was, unknowingly, trying to cheat and compromise my recovery so much – to pick and choose which parts of the ED to let go of – that I was left with such a crippled version of recovery, it was just an ED in denial.
There is an upside to the choice alone not being decisive. When I’m questioning recovery, ambivalent if I want it, even deciding it’s not worth it, that doesn’t undo what I’ve done. I can keep acting as if I want recovery, even when I’m not sure I do.
2. If you can’t describe how you feel, that’s an issue.
Disconcerted by being asked my feelings repeatedly in recovery, I responded ‘fine’ often – not out of dishonesty or with anything to hide, but with no better word to describe things I’d got into the habit of ignoring. Recovery is not supposed to feel fine – and if it does, that’s problematic. You’re either doing recovery wrong or feelings wrong. I wasn’t ready for the emotional growth that had to happen. In the space of a few months, I relived toddler tantrums and adolescent angst as all the barriers I’d put up came crumbling down.
But the shocking thing I learned was all those feelings, no matter how overwhelming or beyond my control they felt, couldn’t actually hurt me. Every wave of emotion felt like a near-death experience but I survived and every time learned to weather it better.
3. External successes don’t make an ED worth it or less serious
If you’re hanging your entire identity on big achievements, what are you trying to hide? I took pride in objective accomplishments – achievements that, if I reminded myself of them loudly enough, meant I couldn’t have a serious mental illness. But no matter how impressive, your CV doesn’t prove anything about your mental health. Early in treatment I read an excellent book by a Harvard-educated doctor who had had several psychotic breaks. That book shattered my argument that my ED couldn’t be that serious because of a million-and-one totally unrelated reasons. My favourite line from it was “I was so quickly in tatters, what was the good of all that overachievement? It should have taken longer for my proud crust of wellness to be so utterly gone” (Just Like Someone Without Mental Illness Only More So by Mark Vonnegut MD).
4. Having vulnerabilities doesn’t make you weak – it makes you human. Showing those vulnerabilities makes you strong.
Being good at hiding my weaknesses really came down to just being good at hiding, which is little more than cowardice with a noble facade. Being vulnerable is unremarkable but being willing to let people see that vulnerability, opening myself to their judgement, risking their scorn and giving them something to use against me, giving away that control - that was bravery.
(I get the hypocrisy of publishing this anonymously – but hey, I’m a work in progress.)
5. Not everyone is against you.
How I’d been treated by some people was a reflection of them, perhaps me, and our relationship, it didn’t dictate how everyone would treat me. Some people are against me – some people will judge me, blame me, resent me, but it won’t kill me. But extrapolating from that to assume everyone will, to live constantly on the defensive for attacks I imagine coming, compounds the initial harm tenfold.
I felt hopeless about recovery and was almost waiting to hear it confirmed. I expected the team treating me to give up on me. That way I could give up on myself, knowing I’d been right all along that I couldn’t recover. Thankfully – amazingly - despite my determination at times to resist their help, they didn’t. At first, I found this persistence frustrating and confusing. I’d always reasoned that, if people really knew me, really knew about the ED, they wouldn’t like me and never tested that belief by opening up to others. But at some point, I tried trusting that they were genuinely trying to help me. They saw me and my ED, with all the anger, fear and ugliness I didn’t bother hiding, and they didn’t think I was hopeless. Somehow, the team saw something better in me and I started to see it in myself.
6. The trite and the petty do matter.
Recovery can feel glaringly obvious, but obvious isn’t the same as easy. I felt like I was arguing over the most insignificant, easiest things in treatment. But if I was arguing over them, they were neither insignificant nor easy. If they were so small, I’d have given in. But the ED doesn’t win with big decisions – I’d never decided that weight loss meant more than almost anything – it wins with tiny things enough times that they build up to the big things: losing a bit of weight, skipping this snack, lying about that meal. Those little things are worth fighting with the ED over.
Side note: resisting something for the sake of principle only works if the principle itself is worth the fight.
7. I didn’t really know who I was beneath the ED.
I didn’t really like the person I was then. I wasn’t the kind of friend, student, daughter I wanted to be. All of that would be fixed when I was thin enough of course. Except it never was.
As I pulled increasingly away from the ED, more of my real personality came through. Things about myself I saw as lost parts of my childhood resurfaced: my sense of humour, being relaxed and outgoing, even my laugh. These changes amazed me, far outweighing the physical changes that accompanied them. Even more, I liked the person I was uncovering, something I’d long ago given up on.
8. What recovery looks like can change.
I entered treatment with one goal: to stop purging. That’s all that was needed to cure me, that was my only problem. How easy if that were true. In the event, stopping purging turned out to be biggest catastrophe that never happened. Having dreaded it and built it up to be impossible, it was over relatively quickly. It was replaced with so many more things I hadn’t thought of touching – relationships, emotions, perceptions around food and weight (somehow, I was convinced that didn’t need altering).
With this, my whole plan for recovery changed. It outgrew what I had imagined and left me flailing and fearing the loss of control. Here, I was fortunate to have a team I’d come to trust – I knew how to do the ED, they knew how to do recovery.
Getting more ambitious about recovery made it harder to settle for anything less. I didn’t really imagine my life could look how it does now. I didn’t think I could actually not be striving to lose weight, not chasing the next diet, not counting calories. Rationally I knew other people didn’t do that but seeing people who were a healthy size and not dieting felt kind of like seeing a unicorn: I’d look for the catch as I couldn’t believe what was right in front of me. As for achieving that myself, I wouldn’t have started recovery if that were my goal as it would’ve seemed impossible. I’m not there yet but I’m closer than I ever imagined I could be. My recovery is still changing and I’ve learnt to be okay with that.
9. You’re not in control, and you can learn to be okay with that when you realize nobody is.
Initially recovery meant giving up control over a lot: food and weight (obviously), but also movement, who I interacted with, where I was, what I did with my time – my independence. That was one of the toughest things for me to accept. I’d been used to being so isolated and independent, I felt I had complete control over my life. Whatever I couldn’t control didn’t matter nearly as much as weight which I could (I believed).
Having to give up so much control showed me just how important it had become for me. For the sake of getting better, for the opportunity I was being given, I shouldn’t have struggled so much to temporarily, reasonably, volitionally give up some of my freedom. The fact I did, while perhaps understandable, nonetheless proved a good lesson in how much I hated having to trust other people and just not be in control.
The more you re-engage with your life, the more control you realize you never had. The ED takes all your little problems – family, relationships, work, school – and replaces them with one big problem: food/weight. It becomes a panacea for everything you can’t fix but recovery makes you realize they were never solved, you just stopped caring about them. Recovery involves returning to those things, caring about them again, but still with the lack of control that made them tough in the first place. What’s different now is how okay I’m learning to be with that.
10. There are so many ways to fail - and succeed - at recovery
The start of every recovery looks fairly uniform: symptom interruption, normalization of eating, perhaps weight restoration. It’s what you do after that that makes it unique – and worthwhile.
Throughout recovery, I wanted a guarantee that this would all be okay in the end, that all I was doing would lead to recovery. I still do. I was used to the ED’s promise of safety and happiness that weight loss would bring. Letting that go meant losing that certainty, accepting this might not work but being willing to try anyway.
With more freedom in returning to my life, I’ve found how many ways there are for the ED to sneak back in. There are all the things I used to do as well as new hurdles to trip me up; novel behaviors, beliefs and patterns to invest in. Sometimes it scares me how many ways there are to relapse. It’s not a case of “don’t do X”, it’s a case of “don’t do X, Y, Z…oh now you’re considering W? Don’t do that either”. But there’s also so many things that are part of recovery that don’t initially feel like it – relationships, hobbies, the rest of my life. They’re too individual to list in a generic relapse prevention plan but building those things are part of my recovery, just as much as meal plans and not purging. They’re also the things that have made all the rest of it worth it for me.
Would it have changed things to have known all this before? I certainly wouldn’t have believed it if I were told. I’d probably have run back into denial a bit longer if I’d known just how much there was to work on. I went in blind and maybe that was best, otherwise I might not have gone in at all.
I’d love to say that was the end of it: I left inpatient, never to have another thought of weight loss again. A much tidier ending but a lie, it didn’t happen like that. I was more scared of leaving inpatient than I had been of entering it. I had built something worth losing. I was afraid all the changes I’d experienced would only work within the unit, that they weren’t lasting or really ‘me’. Coming out, returning to my life – my relationships, school, city – feels like coming to it anew. It’s all the same in many ways but I’m living it so differently that it’s unrecognizable. It’s not easy or finished but I’m cautiously hopeful that the steepest learning curve is over. Now I need to sustain and develop it, with my recovery shifting from a sprint to a marathon.