327: Full Recovery Is Possible For Everyone

Chris Sandel: Hey! If you want access to the transcripts and the show notes and the links talked about as part of this episode, you can head to www.seven-health.com/327.

Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist and a coach and an eating disorder expert, and I help people to fully recover.

Before we get started with this episode, I just want to mention that I’m currently taking on new clients. If you are living with an eating disorder and you would like to reach a place of full recovery, then please get in contact. I know full recovery can sound like this thing that is so far off and so difficult and so impossible – and this is actually one of the things I’m going to talk about as part of this episode. But I truly believe that everyone can reach a place of full recovery.

So if you are wanting help in doing this, then send an email to info@seven-health.com and just put ‘coaching’ in the subject line, and then I can get the details over to you.

00:01:17

Full recovery is possible for everyone

So, on with today’s episode. This one, I don’t know how long I’m going to talk here; this feels maybe like it’s going to be more of a little bit of a rant or a PSA. But the topic for this one is that full recovery is possible for everyone.

The impetus for this – this has happened on a number of occasions, but I’ve had a recent case where this has happened. I’m working with someone at the moment, and they’re working with me; they’ve also been working with the NHS in terms of helping them to recover. And unfortunately, the information they’ve been given by the other team that they’re working with is that this is the best that it’s going to get.

This person is in no way fully recovered. Things are somewhat better than when they were at their worst, but they are still in a state where they are very much at the mercy of the eating disorder. There is huge amounts of thoughts that are impacting them on a daily basis. There is huge amounts of anxiety connected to eating. There is just so much that their life is being impacted upon by living with the eating disorder.

And the reason that they’ve been told that this is as good as it’s going to get with them is because they have an autism diagnosis. They’re on the autism spectrum. The reality is that so many other people that I work with are on the autism spectrum, whether they discover that through working with me, they discover this later in life, they’ve known it for a really long time. But there is a huge amount of overlap with autism and eating disorders, and really just neurodivergence and eating disorders.

But what they’ve been told by this team is “Because of this diagnosis or because of the traits that you have connected to this, you’re never going to be able to recover. Basically, you should just start to get used to this is how things are going to be.”

The thing with this is that this client is someone who has recovered in the past. They had an eating disorder, they lived with it for a long time. They then recovered, and they had a period of 6 or 7 years where they were free from the eating disorder. And maybe there could’ve been some things that still needed to be worked on to really cement it, but for all intents and purposes, they weren’t at the mercy of an eating disorder on a daily basis, and nowhere was it impacting their life in the way that it is now. So for them to then be told, “This is as good as it’s going to get”, this really flies in the face of what this person has experienced at another point in their life.

The difficulty is that when you’re in the eating disorder, you are just so much more susceptible to stories and ideas and comments of other people, especially other people in positions of power or other people who have some level of authority. So even though in her better moments, in her clearer moments, when there’s more awareness, there can be this remembering of “Hang on, I’ve done this before. I have got to a better place with this. I didn’t stay stuck. I was able to recover.”

Unfortunately, that’s not always there, and there can be times where, when they’re hearing that this is as good as it’s going to get, that then has an impact on their beliefs, their perceptions, their choosing of certain actions. It has a really big impact.

I remember another client – this is from a couple of years ago, and let’s keep in mind that this person was in her early twenties. She was told in her early twenties, “This is just too complex. This has been going on for too long” – even though at that stage, when we say ‘too long’, yes it’s been long years for them, and anyone living with an eating disorder, if it’s been going on 5 years or 7 years, that’s a really long amount of time. But in the whole scheme of things, there are many people who’ve lived with eating disorders for much longer than 5 years or 7 years and have made a full recovery.

But this person was told that “This has been going on for so long that you just need to get used to it. This is it. This is how your life is going to be. Maybe you can make a little more progress in terms of these certain foods or being able to eat in this environment or whatever, but really you need to just get used to this is how it’s going to be.” And with this person, they even had their whole family invited in, and this was the information the team then told their family. Told their parents, told their siblings, “This is as good as it’s going to get, and everyone in the family should know this. This is how she’s going to be for the rest of her life.”

This information, for these clients, for other examples that I have, it angers me to no end, because it’s just not true. I truly believe that everyone can reach a place of full recovery. And when someone is told that because you have had certain trauma that has occurred, or because you have autism, or because you have OCD, or because you have high anxiety, or fill in the blank of ‘because you have’, you’re not going to be able to reach a place of full recovery, it makes me so angry. Because it’s just not true, and it then has an impact on that person and the choices they make.

00:07:12

Recovery is about restoring energy balance in the body

The thing is, if I’m reflecting on this and asking myself, “What is recovery really about?”, when I think about recovery, there are lots and lots of things that can be connected to it, but there are a handful of areas where this is the big area, and then underneath this are all the other things that are connected to this.

If I’m thinking of recovery and what’s required as part of recovery and getting to a place of full recovery, one, this is about changing the energy balance that the body is in. The energy balance in the body has led to certain symptoms arising, certain thought patterns arising, certain beliefs arising, certain moods arising. All of this is being impacted upon by the energy state of the body.

So one, we need to change that. We need to change that through making changes to the amounts of foods, the types of foods, the timings of foods, all of these things in terms of the food that is being consumed, because that’s going to have an impact on someone’s energy balance. We need to do the same in terms of exercise or movement or low-level movement or all the other ways that someone is then using energy.

That is a fundamental thing that needs to happen as part of recovery, and that is in a lot of ways the most important thing that needs to happen as part of recovery, because if that piece isn’t happening, then every day is going to be a Groundhog Day repetition of the day before, because that is really what is driving so much of what is going on with an eating disorder.

If I then think about someone who has had trauma or who has autism or who has ADHD or, again, fill in the blank with whatever thing is going on, do I think that that can make that more challenging as part of making these changes? Yes, I do. I do think it can make it more challenging – and I also believe that that person is able to do that, and the more that they start to do that, the more that, one, they realise “I can start to make these changes, and I notice that I’m capable of doing this”, and two, it then starts to have an impact on the physiology of the body. Things start to upregulate, things start to repair, and we start to move the body out of the state that it’s in.

There’s nothing about that part of recovery that someone is unable to do. As I said, we may need to come up with more creative ways of dealing with this; we might need to do things a little differently because I have these things around the sensations piece, or I have high sensitivity, and this is impacting me in my ability to sit with other people while having a meal or to be in a very brightly lit room when I’m having a meal.

So okay, there are some things that we need to work on and look at as part of that, but there is always a solution. There is always a way that we can find that is in service of recovery and not in service of the eating disorder.

00:10:21

Recovery is about learning coping skills

Another component of recovery is learning coping skills, learning how to tolerate uncomfortable emotions, to tolerate certain thoughts or feelings, to be able to tolerate certain memories or beliefs or all of these different cognitions that arise within the body. And again, there can be certain situations that make that more challenging for someone to be able to do, and I do believe that everyone is able to learn how to be able to do that.

This is a really important skill as part of the recovery process, so having these tools or ways of being able to handle things allow someone to be able to take those actions in recovery because they’re able to help to minimise or soothe or whatever it is as part of the making the changes.

But it’s these life skills that are then important for the rest of life as well. So many of these coping skills are what someone then uses well and truly after the eating disorder is over because that’s what they then use when “There’s this thing that happened at work, or there’s this thing that happened with my mom, or there’s this thing that happened with my partner or my kid at school” or whatever it may be. We’re now finding other ways of being able to cope instead of using the eating disorder.

Again, I truly believe that everyone can learn to get to that place. So being told that “This is as good as it’s going to get” just doesn’t cut it for me.

00:12:03

Recovery is about doing life again

Then the final piece is really starting to do life again. So often, when living with an eating disorder, what starts to happen is your life falls by the wayside, or many aspects of life fall by the wayside, whether that is “I now just don’t do this thing. I had these hobbies I used to do and I don’t do them at all because they don’t fit in alignment with what the eating disorder is demanding of me” or “I’m able to do things, but I’m doing a half version of it. I can go out to a restaurant, but there’s a load of compensating before I go out to that restaurant. I have to pick the thing on the menu that has the lowest calories in it. After doing that, I have to then go and compensate for it.”

There’s all these adjustments to be able to then do something. So even if you’re, in essence, able to go to a restaurant, you’re not able to do it in a way that someone who doesn’t have an eating disorder has.

So much of recovery is, one, how do we start to bring more of life in? All the aspects of life that have fallen by the wayside, how can we bring them back in? And two, how can we bring them back in in a way that is not eating disorder compromised? How can we learn to do them in a way where we’re not compensating, we’re not appeasing the eating disorder, we’re not making these kinds of changes; we’re doing them in a way that fully adds to the quality of one’s life.

If I’m thinking about a lot of the aspects of recovery, those are what are included as part of this. And as I’ve said a number of times, yes, there are certain things that can make that more challenging, but I just don’t believe that there’s anything that fully prevents those things from being able to occur.

00:13:52

Getting extra support to help in recovery

It may be that alongside someone’s recovery or with someone’s recovery, they have more of a team to help them navigate some of these things. Maybe there does need to be some trauma therapy that is going on to be able to support the person in dealing with trauma and help the nervous system and support that aspect in a way that, for someone else who hasn’t been through that, that’s just not so important to them.

They may need to discover that there are certain aspects of their life that were being chalked up to the eating disorder that actually aren’t the eating disorder – that’s a personality trait or that’s a part of who you are. For example, anxiety. For many people who develop an eating disorder, anxiety really predates the eating disorder, and anxiety is going to be there long after the eating disorder is over and someone’s fully recovered. Their baseline anxiety levels are just higher than the average person.

So being able to understand, “That is part and parcel of me, and I need to learn ways of being able to cope with this that aren’t the eating disorder.” The same with – I started this talking about autism. There can be pieces of the autism picture that, when you recover, are still going to be there, because that’s part of the traits of who you are and how your body is wired.

Understanding that that is still full recovery – even though anxiety is there, that is still full recovery, even though there are certain traits there, that is full recovery. But I think all too often, what happens is that because those traits are there, it means that we don’t even move forward with other things that are really important in recovery that actually could be moved forward with. Like the idea that if someone’s having that high anxiety, we couldn’t possibly ask them to eat this food or we couldn’t possibly ask them to have a break from exercise. That’s just not true.

We can do these things, and people can learn how to cope with this. And I say this with all the compassion in the world. I understand that so much of this is really, really hard, and could possibly be the hardest thing that you will ever do. And that doesn’t make it an impossibility. It doesn’t mean that you just can’t get there.

00:16:23

The danger of believing full recovery isn’t possible

As I keep coming back to, it really angers me when people are told this information. The reason for this is when someone is told this, the eating disorder just uses it against them. What may happen is that someone’s able to maintain a point of functioning with an eating disorder. That’s in some ways best case scenario. But typically what happens is that as time goes on, things regress.

The reason this happens is because of the way that the eating disorder is. The time that you skip that snack or miss that meal, the next day, that has to be the new norm. So it’s very easy for things to start to ratchet up in terms of movement and certain behaviours, or it’s very easy for eating to start to be diminished and this become the new norm. When someone feels like, “I’ve been holding steady”, when they really reflect back on what they’re able to do now versus where they were a year ago or 2 years ago or 5 years ago, “actually, I’ve lost my ability to do those things.”

And then added on top of that is the body’s inability to keep going and going and going indefinitely when it’s not getting what it needs. The longer this goes on, the more of an impact this starts to have on your bones, or on your digestive system, or on your hormonal system. The body is not designed to be in this state indefinitely, and the longer it goes on, the more symptoms start to arise.

This is why it then becomes dangerous to be telling someone this, because as I said, the best case scenario is that they are able to keep functioning and hold steady, but it typically doesn’t even work like that.

As a practitioner, this is really hard work. I understand working in this field is a challenge. It’s really horrible to see someone in pain and to see someone suffering with an eating disorder and for things to not be improving, and to see that someone is finding it really frustrating and disheartening and maddening. They can feel like, “I’m trying so hard and I’m not really getting anywhere.”

So maybe there’s this feeling of “If I tell this person that this is the best they’re going to get”, there’s going to be some kind of relief to that. They can start to settle into “Okay, cool, if this is the best I’m going to get, let me get used to that” versus “Hey, I’m trying to make these changes and then I feel disappointed when I’m not able to do it.” So maybe this is coming from a good place, or that’s the intention anyway, that “This makes it easier for this person if I tell them this, because it means they’re not constantly having their hopes dashed in this failure to actually make the changes that they’re trying to make.”

And maybe it’s to help the practitioner. It can help them not feel like so much of a failure. Instead of being able to say, “I’ve been unable to make any progress with this person or I’ve been unable to make any changes”, it feels easier psychologically to say, “This is the best anyone’s going to get to, so I haven’t failed this person. I haven’t made any mistakes. This is just how it is.”

I don’t know the reasons that someone is telling this to someone. There could be multiple reasons why this is occurring. But for me, whatever the reasons, it’s just not the right approach. Personally, I think it’s fundamentally inaccurate. I don’t know who needs to hear this; I don’t know what advice you’ve been given in the past. If you’ve had times in inpatient and outpatient, working with this therapist or this dietitian or what your history is in terms of recovery.

But what I’ve found again and again is that for many people, especially as an eating disorder has gone on for longer and longer and they’ve been connected with different services, at various points along the way, people have uttered something along the lines of “This is as good as it’s going to get. You’re never going to get there. Full recovery is not something that’s on the cards for you.”

I just want to say, if that’s what you’ve been told in the past, I vehemently disagree with that. I truly believe that if you want to reach a place of full recovery, you can get there. It’s not a matter of “I did all these things and then it didn’t work.” If you do the things that you need to do, you will reach a place of full recovery.

So, that is it for this episode. As I mentioned at the top, I’m taking on new clients. If you do want to reach a place of full recovery and what I’ve shared with you today has resonated with you, then please get in contact. You can send an email to info@seven-health.com and just put ‘coaching’ in the subject line, and then I can get the details over to you.

All right, that is it. Take care for another week, and I will see you soon!

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