374: What If Recovery Makes My Life Worse?

Chris Sandel: Hey, everyone. Welcome to Episode 374 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 I get started with today’s show, I just want to say that I’m currently taking on new clients. I’ve been working with clients now for 15+ years, and I’m good at what I do, and I’m good at helping people to reach a place of full recovery. This is true even if there are lots of fears that are present, and this is what today’s episode is going to be about. You can have a lot of fears about what may happen as part of recovery and still take action and actually end up reaching that place of full recovery.

Hopefully this episode gives you a sense of me and how I work with people, demonstrates my depth and breadth of knowledge, that I’m compassionate in how I work, and gives you some practical knowhow around recovery.

If you are wanting to get support and get help with your recovery journey, then I would love to be able to support you with that. You can send an email to info@seven-health.com or you can send a message on Instagram, send a DM, @sevenhealthcompany, and just put ‘coaching’ or ‘support’ as part of the subject line or as part of the message, and I can get the details over to you.

00:01:25

The common fear that recovery could make life worse

Let’s get on with today’s episode. What I want to do with this one is just look at a very common fear that comes up in recovery. This is the thought or the fear of “What if recovery makes my life worse?” You can have this picture of “I want more food freedom” or “I want more connection with my kids or my partner or with my friends” or “I want more mental space”, but when you then start picturing or trying to eat more or rest more or think about your body changes, whatever benefits could potentially happen just become very distant.

You feel immediately all the losses that could potentially happen as part of recovery, and they are very personal, they’re very front and centre; it feels like those are a given, and any benefits feel like “Well, maybe they might happen. I’m not really sure if that’s actually going to occur.” So it feels like the losses are a given and the benefits are a ‘it may happen’.

I want to go through this, because I think it makes sense that there are a lot of fears that come up as part of this, and I want to then look at, what are some other ways that we can start to explore this?

In the beginning, the eating disorder can convince you that things are going well, your life is better, I’m able to do this thing or I’m more confident or I’ve now got this identity” and there is this honeymoon phase with an eating disorder where it can be very easy to convince yourself that life is fundamentally better because of the behaviours you’re keeping up.

But there comes a point when this is no longer the case, and it is abundantly clear things are not going well. “I’m having these symptoms, I’m having these difficulties, I’m really struggling in all these different areas. I can notice that these things have fallen by the wayside. I’m not able to go on holidays, I’m not able to go to a restaurant. There are so many things that are now obvious to me that my life is being impeded because of this.”

This is where the eating disorder then comes in and says, “Well, if you think this is bad, things are gonna get worse if you make changes.” So the eating disorder in the beginning can convince you that it’s making things so much better for you, and later on it convinces you this is the best of some bad situations, and that if you try and do something different, it’s going to get a hell of a lot worse than it currently is, so you just need to stay put.

So even if it can acknowledge that these things aren’t as you would like, it works off the back of “It would get worse if you tried to change them.”

What I want to do to start with as part of this is just look at things from the eating disorder’s perspective or the things that it’s predicting or the fears that come up, and then I want to look at how this could be seen differently and how to work on this, even if those fears are there.

The first thing that comes up is the thoughts and the fears around “I want recovery, but I’m scared that it will leave me with a worse life.” There can be many different versions of this, like “What if I gain the weight and I still hate myself?” or “What if I lose this one thing that I’m actually good at?” or “What if I stop exercising and I just can’t cope with the anxiety that then comes up as part of that?” “What if I eat more and I just feel worse, it doesn’t work for me?” “What if I do all of this stuff and then my life still feels just as difficult, but now I’m living in this bigger body, now I don’t feel the safety that I used to get from this?”

I just want to acknowledge you can have all of these fears while also wanting recovery. I think there can be this mistake where “I have to have all these fears have disappeared”, or “It has to be so overwhelmingly obvious that I should do recovery, and even when these fears come up, I’m able to push them to the side and demonstrate how bad my life has become.” And that just doesn’t happen.

00:05:35

What is this fear protecting for you?

What I think can also be useful with this is looking at some of those fears that are coming up and understanding, what are they protecting for you? What is the eating disorder currently doing for you or what are the upsides of currently staying doing what you’re doing?

I’ll just say this doesn’t mean that this is where you need to stay forever, but I think it’s useful to explore what needs this is meeting or what upside it’s providing for you. Let me go through some options with this.

For you, there might be one that sticks out; it might be all of these things. But just understanding that “Hey, this is doing something for me.” And it might not be doing something for you real. It might be just a mirage, it might be this prediction thing. But “Hey, at least it feels really true to me in this moment, or the eating disorder makes it feel really true to me.”

One, it can be providing predictability and control. The food, the exercise, the rules, they give your day a structure, and then breaking them means you’re now facing a load of uncertainty without the familiar reassurance of knowing what’s going to happen and how the day’s going to pan out without these rules. So there’s predictability and control that it can provide.

It can provide a relief from emotions. This can be just doing things in advance of those emotions coming up, or when those emotions come up, “I know how to restrict, I know how to do the movement, I know how to do the food rituals, and this can temporarily narrow those things down and it can change my attention and it can help me to avoid those feelings. And if I didn’t have these things, I wouldn’t know how to handle them. When I start to eat or if I start to make changes, all these emotions are going to come up and I just don’t know how to deal with that, and I don’t know how to deal with the challenges of life and the emotions they bring up without the eating disorder. So this is this tool that I have, and it’s the best tool that I know in terms of relief from emotions.”

It can be part of your identity and your sense of achievement that you get from it. You’re the disciplined one or you’re the fit one or you’re the healthy one or you’re the person who never misses a workout, and this has become central to who you are. I think this is true the longer an eating disorder goes on, because so much of our identity is just, how do we spend our time? And if you’re spending your time where it’s about food, it’s about exercise, it’s about following the eating rules, of course so much of that becomes your identity because it’s what you’re spending your time on.

There can be this feeling of like “If I lose this, I’m going to be in a situation where I don’t know what my identity is, and that feels really scary. What if this is the one thing that I’m really good at and I don’t have something else? I need to just stick with this because this has become how I identify myself.”

I think this is particularly true if you’ve developed this during your teenage years or before being a teenager. It’s not that this can’t still be a thing if you developed it in your thirties; it can be, but especially if you haven’t had a chance to really develop that independence and that sense of identity before the eating disorder started. If this is something that started when you were 12 and you’re now in your mid-forties and it’s still going on, it can feel like “Of course this is my identity, because it’s gone on for so long.”

It can be giving you belonging or approval. Sometimes for people who are living in their eating disorder, they’re afraid of losing compliments. They’re afraid of not being the person that people think of as being the fit one, or if your whole community has been built around exercise, like “I’m now going to lose this community. How am I going to deal with doing recovery and not being able to be part of the running club or be part of the rock climbing gym?” or be part of whatever it may be.

So there can be this genuine fear of like “I’m going to lose a whole chunk of people in my life. How will I be able to deal with this?” So there can be this fear of belonging and approval and all that being removed.

There can be this removal of a sense of purpose. Food and body goals and the things that one does with exercise, etc., can provide a real sense of purpose, or at least ‘how I fill my time’. When that is removed and there is now this void of time, it’s like, “Who else am I? How else do I fill this time?”

I’ve had conversations with clients where they can recognise “This isn’t a real purpose. It doesn’t feel like if I was talking to my 10-year-old self, they would think this is the purpose in life that they want to be fulfilling. So I can recognise that, and in the moment when I’m doing these things, it does feel like that day of restriction had a purpose, and I can feel good about the fact that I was able to keep that up.”

So even though in some moments there can be this disconnect and you can see that this doesn’t really fill a purpose, in other senses it actually does, and in those moments it feels like, “No, this is really important, especially if I’m comparing it to what the alternative could be of me spending the day eating and then feeling uncomfortable and resting and not knowing how to spend my time. Actually, I prefer the micro purpose that I get from doing the day of restriction.”

There can be this feeling of “I’m going to lose my explanation for why life hasn’t gone well.” This, again, comes up a lot, especially when the eating disorder has gone on for a longer amount of time or when it started at a younger age. It can feel like “these are the reasons why I have the limited relationships that I do” or “I have lots of relationships but there’s not the depth to them”, or “I’m either not in a career or I’m in a career but it’s not really what I want to be doing.”

There’s just these parts of life that haven’t turned out the way that one would like, and there’s this frightening prospect of “I do recovery, and then these things still continue to occur. I still struggle in this area or that area. How would I deal with the fact that I’ve now lost this as an explanation? At least at this stage, I can hold on to the fact of ‘you’re just not able to do that because of the eating disorder’. But if that’s gone, I lose that as an option.” That can feel really scary for someone. It can feel like “I don’t know how I’d be able to cope with this.”

Another fear that I’ve encountered is the fear of “I get over this and then there is so much grief connected to it. There’s so much grief about all the years that were lost connected to this thing. This has gone on for 20 years and those 20 years, I was in my eating disorder, and that’s time that I didn’t get to go travelling, or that’s time I didn’t get to develop my career, or that’s time I didn’t get to have kids” or whatever it may be. “I’m going to feel so much grief connected to this thing. How will I be able to cope with everything that I’ve lost?”

I know, again, from talking to people that this can be even more the case when it feels like it’s connected to “and I need to change my eating or I need to change my exercise to get there”, especially if it feels like those things are really simple. There isn’t some complex idea for why I’ve stayed in this thing for such a long time. “You mean I just need to change my eating and I just need to change my exercise and I can get out of this?”

And let me just say that eating disorders are never quite that simple – and in some ways, there are a lot of those big things that do make a lot of difference for people. I know, again, there’s this feeling of “I will be struggling so much to accept the fact that I should’ve done this 5 years ago, 10 years ago, 20 years ago. I would just be so besotted with that feeling that it feels better and safer to me to stay where I am than to have to deal with the fears and the feelings and the emotions that come up connected to this.” From that position, staying ill feels like the safer thing to do.

This is not an exhaustive list; there can be lots of other reasons that come up. But I wanted to just demonstrate that you can be in a situation where you can desperately want change, you can look around and you have moments of clarity of realising “This is just not how I want to live”, and at the same time, it feels so hard to then actually let go. When you just think about letting go of these behaviours, it feels so threatening, and it feels like “I’m not able to cope.”

00:15:29

Eating disorders as avoidance

If I think about this bigger picture, connected to all of those things I just talked about, I think of eating disorders as being like anxiety disorders and about avoidance, and eating disorders are a way for one to avoid certain thoughts or certain feelings or certain sensations or different situations that are threatening, and I’m able to then use the eating disorder behaviours and the rules to be able to avoid doing that.

So when all of these things come up, whether it’s the fear about losing belonging or my identity or my way of being able to deal with my emotions, etc., the eating disorder then helps me avoid all of that and helps me to do it in a very simple way.

I think connected to this is also the idea that even if you’re able to acknowledge that the eating disorder is creating a lot of damage and is creating a lot of areas of your life where you’re not able to do certain things and there’s a lot of smallness that has happened in terms of your life, there can still be the thought of the eating disorder taking credit for what is going well.

So even if I can recognise how bad these things are, the things that are here in some ways are because of the eating disorder. For example, “If I didn’t exercise, then I wouldn’t be able to cope with work. Controlling food is the only thing that is keeping my life together. At least I still have this thing.”

So the eating disorder doesn’t need to convince you that you still have a good life; it just needs to convince you that it needs to remain, and that it needs to remain because otherwise things are going to be getting better. So it’s able to say, “Hey, as bad as these things are, the things that are good, they’re good because of me, and this is why I need to stay in your life.”

00:17:32

Why taking action in recovery can feel like confirming these fears

The difficult part with all this is that the first stages of recovery and the early stages of taking action can actually confirm a lot of these fears, or at least it feels like it confirms a lot of these fears. So you start to take action and the fears are very much activated. The things that you’ve been trying to avoid start to feel like they’re coming true.

For example, you eat more and you feel more anxious, or you rest and you start to feel more restless and have more eating disorder thoughts come up, or you stop a particular ritual and you feel this real panic that hits you. There can then be this conclusion of like, “See? I was coping better before I started to make changes.”

And it’s not just “I was coping better”; the eating disorder then extrapolates that current situation of what you’re trying to change and how it feels in that first moment and makes it that this is what it’s going to be like forever, and it’s going to be a permanent feeling when you do this.

So you eat more and you feel anxious and the eating disorder says, “This is what eating more will feel like and will always feel like. This is how it’s going to be. Do you want to have this be your experience every single day?” You rest more and you feel more overwhelmed and the eating disorder says, “See? This is what a life without exercise is like. Do you want to have your life be like this every single day?”

It takes that first experience that you’re having of doing something different and it presents this as the preview for what is going to happen forever and that this is your entire future. It’s not just “Oh, this is what it’s like in the beginning.” It’s like, “This is what it’s like forever. Do you really want to make that change?”

So the eating disorder from a bigger picture perspective warns you about all these things that are going to get worse and your life is going to get worse when you make changes, and then at the first turn when you do make a change, it can feel, in the short term, terrible. And the eating disorder says, “See? It feels terrible now and it’s going to feel terrible forever.”

It can very much feel like it’s confirming the eating disorder’s position, that it is only going to make life worse.

I also want to acknowledge that perhaps you’re listening and you’re thinking, “But I have actually tried. I did eat more. I did stop exercising. I felt awful.” So it doesn’t feel like this is just some hypothetical fear. It feels like something that you’ve already experienced. It can then feel like this is true, and that this is how it’s always going to be. So it can feel like “Hey, what you’re talking about sounds like it’s for someone who hasn’t really tried anything, and yet I have tried things and that was how it felt.”

And I would also say that this is why, when you have those very early experiences, you can then retreat back to the eating disorder. You can have this feeling of “You know what? I would prefer the familiar suffering because that feels safer than the uncertain alternative. I know what it feels like to live this way. I know the rules, I know what to expect, I know what to do when I feel anxious. I might hate my small life, but at least I know how it works. Recovery asks me to stop having this certainty about these things, and it just feels too much to be able to try and do something different.”

The first change seemingly makes things worse, so it just reinforces “Hey, this is why I need to stay where I am.”

00:21:25

This fear can continue throughout recovery

I also want to acknowledge that this fear can then continue on throughout recovery. As I go through this more, I’m going to show how to start to challenge this fear, how to keep taking action even though it’s there, but I want to just acknowledge that this fear isn’t just about the early stages of recovery. This isn’t just the first handful of weeks that this fear is here. I think this is a fear that continues to come up a lot throughout recovery.

Let’s say you’ve made some changes and you may be able to notice improvements. You’re able to notice that you’re less anxious in certain situations, or you’re able to eat foods that you weren’t able to eat before, or you’re able to eat earlier than you were able to eat before, or you have more energy or you have more mental space or you’re more present with your kids or the people that you love. You can notice that these things have changed.

You can notice certain symptoms have improved. You’re able to sleep through the night in a way that you weren’t able to do before. Your digestion’s got better. Maybe your period’s come back. There are things that you can say, “These have genuinely improved as part of me doing recovery.” But even though that has happened, the eating disorder will continue to warn you against continuing on.

It will come up with, “But what happens if you gain even more weight than now?” or “What happens if this extreme hunger never ends?” or “What if the eating that you’re doing is actually making you less healthy, and this is actually not a good thing for you to be doing?” “What if these thoughts and these fears and how you’re feeling and the rumination and all that, what if this stays forever, and all that you’ve done is move into a bigger body?”

I think what is important to recognise is that, again, this isn’t just at the very, very early stages of recovery; the eating disorder keeps moving the goal posts about the point where things can supposedly go wrong. So if it didn’t stop you in the very, very beginning, it’s like, “You haven’t gone far enough. You just wait. Once it gets further along, then you’re going to really experience the backlash and you’re going to experience all the things you’ve been dreading.”

So yes, you can get through something frightening, and yet then the eating disorder just picks the next thing to make you uncertain about. I think eating disorder recovery, especially in the early stages, is somewhat like a game of whack-a-mole. It doesn’t matter if you’re able to get past this thing; another one is going to come up because that’s just what the eating disorder does. I think it’s useful to manage expectations around that.

I had a call with a client recently and she was talking about the fact that “I have gained weight, and I’ve noticed I’ve been able to deal with that. I’ve noticed that my fitness has changed and I’ve been able to notice that. And yet there is still this fear here.” She was like, “I just don’t understand why this fear is here, because I’ve been able to make these changes and because I’ve been able to recognise that I’m able to make it through.”

My response was like, hey, part of this is just that eating disorders are illogical. We try and make sense of them by looking at “I’m afraid to eat this food, so let me come up with an explanation of why that would be.” And you can have experiences where you’re able to prove some of those things wrong, but something else will just pop up in its place.

For this client, it’s not that I believe there are going to be these fears for the rest of her life. It’s just about where she is in recovery. But I think it can be helpful to recognise, “Oh, I was able to make it past this one and this one and this one and something else comes up” and recognising that that’s just what the eating disorder does. “It was never really about this first thing. Or even if it really was about this first thing and I was able to get past it, there’ll be something else that will come up because that’s what the eating disorder does.”

So just recognising that this is part of what happens in recovery and that it will just keep moving the goal post about when the thing’s going to go awry and everything’s going to blow up in your face.

What this means is there can be a point where it then starts to say, “Hey, you’re doing better now. Surely you’ve done enough. You don’t need to push it any further.” This is often where people get stuck. They get stuck in that place where “Hey, I used to exercise a lot more than this, and I used to eat a lot less than this, and I used to have these rules that I’m now able to break. I can see that my life is better – and I just can’t keep pushing forward with this because I’ve started to buy in too much to the eating disorder’s threats around ‘it’s gonna get worse if you keep going’. So I’m just going to settle here. It’s not as bad as it used to be. This feels like a win. I’m just going to settle here.”

I think that’s often a place that people get stuck, and it’s not somewhere you have to get stuck. There is much better things ahead, despite what the eating disorder is saying.

So far, I’ve really described the eating disorder’s perspective around this and why its predictions can feel so convincing and why it’s very easy to then stay put and to keep doing what the eating disorder is asking.

What I want to do now is widen the perspective and look at what are the things that the eating disorder is leaving out as part of its predictions and how you can move towards recovery even though some of those fears are still there.

00:27:19

Some of the eating disorder’s predictions will happen

Let me start by acknowledging that some of the experiences that the eating disorder is predicting and creating a lot of fear around, saying this is going to happen – it will happen for you. You may feel more anxious. You may notice your body has changed. You’re most likely going to gain weight. You’re going to experience grief and uncertainty and shame and regret and a whole host of very uncomfortable emotions.

Those things are pretty much a given in recovery. With the eating disorder predicting these things are going to happen, I want to say, yeah, they are going to happen. I’m not debating that.

But what I think the eating disorder leaves out is what happens when those things come up. Because what the eating disorder predicts – or if it’s not saying this explicitly, what is being meant with this – is that you’re going to face all of these things with your current resources, your current exhaustion, your current ability to cope, and none of those things are ever going to change. It doesn’t account for the fact that as you get in more nourishment, as you get in more support, as you get in more practice, as you learn different tools, etc., your experience will actually change.

For example, you picture eating more while being just as preoccupied with food as you are now and that going on indefinitely. Or resting will feel as difficult as it does on the first afternoon and all of that restlessness and that discomfort being there. Or your body changing and your relationship with your body never changing at all, and you feeling just as bad, and possibly worse because now you’re in this different body. Or you’re facing these difficult emotions and you’ve never developed any other ways of being able to cope.

It’s as if where you are and your capacity and your abilities are just frozen in time, and that any changes you make, you’re still going to be in that place. And that’s just not the case.

Part of recovery is that you develop resilience. These things that you didn’t think you could cope with, you learn that you can actually cope with. “Yeah, that was really hard and it’s really difficult, and it still feels uncomfortable to do that – and I recognise that I can actually do that.”

Or you realise that that initial response with eating a new food or eating at a new time or making some particular change, as you do it time and time again, you response to that actually changes. After you’ve done it 5 times or 10 times or 15 times, it feels very different to how it did when you did it that first time. And it might be after you’ve done it however many times – 10 times, 15 times – it’s like, “Oh, that’s not a big deal anymore. That thing feels very neutral, very natural. It feels normal now to have breakfast in a way that it didn’t before, or it feels normal that that is feeling now more like a safe food because I’ve done it so many times.”

If I’m thinking about an eating disorder, it is your mind and your nervous system that is making predictions, and often those predictions are wrong, and it’s registering things as a threat that are either not a threat at all, or they’re not a threat to the degree that the eating disorder is making out.

It’s through you continuing to take action and do the things in your recovery, through the nourishment, through the consistent action-taking, etc., that your brain and your nervous system then re-learns that “Oh, that thing isn’t actually a threat and I don’t need to be responding in that way.”

Because it’s not that someone when living with an eating disorder is causing these things themselves. You’re not willing yourself to be terrified about having a particular food or making a particular change. This is just where your brain and your nervous system goes. It just instantly fires and reacts in this way.

But what I’m saying is the more that you start to do those things and do them consistently and do them without compensating, that’s how your mind and your nervous system start to re-learn “Oh, this thing isn’t actually a threat, so when I do it, I’m not having that same nervous system and mind reaction in the way that I was previously.”

00:32:13

Staying the same has consequences

I also want to say that living with an eating disorder and it going on longer and longer and you’re dealing with it now for 3 years and then 5 years and then 10 years and then 20 years, staying the same has consequences.

The eating disorder can often present it as like “Stay here, where you know how to cope, where you’re not taking a risk with your recovery” – but staying where you are also has an impact on your life. Time continues on and the behaviours then start to affect your health and your attention and your relationships and your opportunities.

It can be useful just to reflect on some questions connected to this, like what does maintaining this sense of control require from you every day? Because it can feel like “Oh, it’s just what I do on autopilot. I don’t have to think about it” or whatever, and that’s just not what I see when I talk to people about their day to day. “Every day just is an eternity to get through, and it feels like a real slog, and then I go to sleep and I’ve got to do it again the next day.” There’s the saying “the days are long but the years are short.” Having to do this day in and day out, and it feels like a lot.

So really reflecting on, what is it requiring of you to maintain this sense of control in everything that you’re doing as part of the day? Because i’ts not nothing.

How much relief do the behaviours provide for you, and how long does it truly last? Because again, when I talk to people, the relief is pretty short-lived, and then the fear comes back about the next meal or the next thing. So “It feels like I’m getting this little bit of relief that gets me to keep doing the eating disorder”, but I don’t speak to people and it feels like they’ve had such a really chilled, calm, easy day because of following the eating disorder’s rules. It’s like, “I’ve had so much fear, so much anxiety, so much worry, so much having to white-knuckle it to the next meal, etc. I have these moments of relief, but they don’t last particularly long.”

So when there’s this idea of like the eating disorder’s providing this relief, really reflecting on, how much relief is it actually providing for you?

And what happens when you can’t follow the rules? Because there are going to be days, there are going to be weeks, there are going to be things that happen in life. How uncomfortable is that when that has to occur, your inability to deviate from the rigid set of rules and ways of doing things?

What are you missing out on? What are you postponing because of this? As I said, the days are long but the years are short. You blink and your kids are much older. So what are the activities you’re missing out on being able to do with the kids? What’s the role model that you wanted to be with your kids that you’re unable to do? What are the relationships that you have and how is this affecting those relationships? What are the holidays or the vacations or the travel plans that you had that aren’t happening?

We can even make it into smaller things, the little moments where “I’m just not able to be present. I’m not able to have a conversation in the way that I would like to have.”

And I know the eating disorder is very good at convincing you that these things don’t matter and it doesn’t really matter and “It would be so much worse if we did do recovery”, but being able to recognise how much this is actually costing you and what you’re missing out on because of it.

And if this continues, what would this mean for the life that you want? It’s very interesting when I’m working with people who are in their early twenties. There’s almost this feeling of like “Oh, I’m not going to be one of those people who’s still got this eating disorder in their thirties or forties.” And most people in their thirties or forties never thought that that would be them either.

So there can be this idea that “Oh, at some point this’ll sort itself out”, but the reality is, that only happens if certain action is taken, and you don’t just wake up one day and “I no longer have an eating disorder, I don’t know how that happened.” It’s “I don’t have an eating disorder because I spent time really focusing on these things and doing the things that were necessary.”

So reflecting on, “If I continue to have an eating disorder, in 5 years or 10 years or 20 years, what are the aspects of life that I would like to have occur or I’d like to be doing that I’m going to be missing out on?”

And I know the difficulty with this can be that you are somewhat constrained by the state that you’re in. If you’re in a pretty depleted state that the eating disorder has affected, you can convince yourself “Oh, that thing doesn’t matter” or “I was never really interested in it” or “It’s never going to happen anyway”, so there can be this constraining that happens with the eating disorder in your capacity to even imagine what could be different.

But if you do have the capacity to imagine what could be different, I think that can be helpful. Or if you can remember back to a time when you did think differently, when you did feel differently, when you did have other hopes or aspirations or things that felt really important to you, being able to remember “Oh, there was a time that this felt really different” and being able to connect with that again.

Because I think two things can be true at the same time. One, the behaviours can provide something that is important to you or feels really important to you because it’s the best way of you being able to do a certain thing in that moment that you know of – and “If I continue to rely on these things, it can carry a cost, and it’s a cost I’m continuing to pay, day after day.”

00:38:25

You don’t have to feel convinced before you begin

The next piece I want to add with this is that you don’t have to feel convinced before you begin. I think what can often happen is you can have this feeling of like “I need to wait till I feel like I’m really ready for this or that I can really say that recovery is going to be worth it, and I can feel it in my bones that recovery is going to be worth it. I just know it to be true.”

The reality is that that’s just not going to happen, especially in the beginning. It’s very rare that someone’s like, “I feel 100% sure and certain about this and that’s why I’m going to do it.” It is always there’s ambivalence around it. There are all these fears, this uncertainty, this “I don’t know how this is going to end up.”

So my encouragement with this is that you don’t need to wait. And actually, what’s more important is that you start to take action and you start to make changes, because it’s through those experiences that the confidence develops, or it’s through those experiences that you actually get to see what is true versus what the eating disorder is just predicting.

This is something I focus on so often with people – that action-taking is the more important piece rather than certain beliefs changing in advance. And being able to have those things happen at the same time, where I’m going to take action despite the fact there are certain thoughts that are still there.

So “I’m going to eat adequately, I’m going to follow my meal plan, I’m going to eat every X number of hours because that’s what I’ve agreed to. And I’m going to do this even though there is that thought of ‘this is too much, you shouldn’t be having this, what’s going to happen’, etc. So that thought is there, but I’m still taking action.”

Or “I said I wasn’t going to exercise; I’m not going to exercise. And even though there’s this real urge that’s now come up to compensate because I had that particular lunch, I’m still going to continue to not exercise.” So just being able to have these thoughts or these feelings or these sensations come up and “I’m still going to do the thing that I need to do as part of my recovery.”

Because the goal isn’t to force you to be positive. It’s really just to practise, “How do I take action that supports recovery even though those thoughts are there?” Because again, this is what then develops that resilience. This is where you learn that “Oh, I can actually do this. Just because that thought is there, it doesn’t mean that I have to take this particular action.” That’s how those thoughts then start to have less and less impact on you; they can feel less big because you’re like, “It’s just a thought, and it’s because I’ve been able to have that thought and take action consistently that I can recognise that thought in and of itself isn’t able to hurt me and it doesn’t dictate what I do.”

The good thing with this is this has then a knock-on effect in other areas of your life. Because it’s not that this is just connected to food or this is just connected to exercise; this is also connected to having that difficult conversation with a partner or going through that challenging thing with my kids or applying for that role at work even though I feel unsure or there’s imposter syndrome coming up. I’m able to do the challenging thing even though there are doubts that are here.

This is why I think recovery can be so helpful for lots of other areas of life, and so many of the tools and things I work on with people, it’s not that you get through recovery and then you just bin them all because you’ll never use them again. It’s like, “Oh, actually I use these always. I use these for the rest of my life.”

00:42:30

Recovery is learning how to live without relying on eating disorder behaviours

The next piece I want to add with this is recovery is really just learning how to live without relying on these behaviours that maybe you’ve been doing for a really long time.

If I return to the functions piece that I talked about earlier – because it’s not that someone says “It’s doing these functions for me” and I just say “Stop doing that, it’s not important.” It’s looking at, “Okay, if it’s doing these things for you, let’s find other ways of actually meeting those needs or meeting those functions” – and with the caveat of “I know it won’t feel exactly the same to start with.”

So me doing restriction or me doing this thing with exercise or me having a binge or me having a purge or me doing some behaviour may feel so much more instantaneous. It may feel so much more impactful in terms of helping me to avoid a certain feeling or change my state or whatever in that moment. And the thing that we’re offering as an alternative isn’t quite as strong in the beginning – and the reality is that it might not be as strong, but it has a lot less of a downside connected to it compared to the eating disorder behaviours.

If I come back to some of the things that I’d referenced earlier, if the eating disorder provides structure, we can then figure out a way of “How do we have structure throughout the day? How do we have a day that does support the eating and the rest and the other parts of your life?” The worst thing for an eating disorder is a ton of idle time with not knowing how to fill it, because what tends to happen in those moments is the eating disorder swoops in and says “Let’s just go for a walk” or “Let’s do this behaviour.”

So yeah, structure is important. It doesn’t mean you have to do the eating disorder structure. We can find this other structure.

If the eating disorder is the thing that helps to manage your emotions, we can then find other to practise experiencing those emotions and responding differently. So rather than using restriction or rather than using an eating disorder behaviour, we’re going to start to practise these other ways of doing it.

And again, in the beginning it might not feel quite as effective, but the goal is, how do you just make it through to the next meal? Or how do you make it through the next handful of hours or to the next day? And being able to recognise, “Oh, that was able to take the edge off enough that I was able to make it through without continuing on with the behaviours.”

If it provides a sense of identity or achievement, we can start to create space for you discovering or returning to certain interests or certain values or certain meanings beyond food and exercise. And sometimes this happens from the very beginning, sometimes this comes a little later. But recognising there are ways that we can start to meet this need for identity or achievement that don’t rely on the eating disorder.

If, for example, the eating disorder has been your explanation for disappointments, it’s then again finding other ways to be able to be with those disappointments or the vulnerability of being in certain situations or the emotional difficulty of feeling these things. It’s having those tools that you can then rely on in those moments to be like, “Yeah, I can feel a lot of grief coming up connected to this, or I can feel a lot of shame that is coming up connected to this, and I’m able to deal with that in a way that is not the eating disorder.”

Let me just mention a client that I’m currently working with to make this a little more clear or give some more specific examples connected to this. We’ve been really explicit when making changes of her finding ways of how to spend her time because we’ve put a pause on her exercising.

What we have been focusing on – and a lot of this is guided by her – is her tapping into previous interests and previous hobbies, and often finding things that are also regulating. So being able to co-regulate and being able to regulate her nervous system because of these different interests and hobbies. Looking after cats or pets or animals and getting that co-regulation from those animals because that (1) helps in terms of her nervous system, (2) is connecting to these hobbies and these interests and things that she’s done throughout her life. So coming back into this thing that is important for her.

As part of this, it’s also helping to strengthen her identity. It’s helping her to feel like “I’m living more in alignment with my values” because this is what has been important to her throughout her life.

We’ve been looking at ways for her to be able to deal with the emotions that come up connected to the changes in her exercise, but also the fact that she’s eating more, she’s eating more often, she’s eating fear foods, she’s challenging herself. So naturally, these things are going to bring up lots of different thoughts, feelings, emotions, etc.

There’s practices like dropping anchor that she’s been using. She’s using an emotions wheel so she’s able to pause and look at what emotions are actually coming up. And this has been especially helpful connected to body image because she can have these feelings where there’s intense body image that are coming up, and then she’s able to sit and look at, “What is the actual emotion that is coming up or emotions that are coming up?”

What can be interesting with this is that once you can get beneath that, you can see that it’s not the same thing every time. So often with eating disorders, body image is simple answer for everything, and once we can get beneath that, we can recognise, “Oh, in this instance it’s connected to loneliness. In this instance it’s connected to feeling like I’m behind in life. In this instance it’s connected to a difficult conversation I had with my dad. In this instance it’s connected to this other thing.”

So rather than it always being about body image and we need to work on body image, it’s being able to pause and say, “What else is going on?” And there will be times where it is explicitly connected to body image. It might be “Okay, we need to do something connected to that. Let’s cover up the mirror or let’s stop doing the checking of yourself in photos, on the phone, etc.” And then there are other times it’s “Hey, it feels like it’s body image, but actually there are other things that are going on.”

And as part of this, she’s making progress to because we’re dealing with all of these as if they were abstract ideas; it’s because she’s taking action in recovery. As I said, she’s put a pause on the exercise. She’s eating, and she’s eating a lot more than she was before. She’s eating really regularly; every hour and a half, every two and a half hours, somewhere in between there, that’s how often she’s eating. She’s going to restaurants. She’s going to have fast food and having more calorie-dense foods.

And she’s repeating these things regularly, so she’s getting to have the experience of noticing, “What happened on Day 1 compared to what’s happened on the seventh time that I’ve done this thing?” And it’s not that by the seventh time it’s completely easy and it feels like a normal thing, but “Hey, I can notice that the intensity with this thing is drastically reduced. It’s just not as hard as it used to be.”

The thing with all this is we’re then able to deal with what genuinely comes up, because so often there can be the “But what happens if this happens, or what happens if this thing happens?” You’re then dealing with all of these ‘what ifs’ and you’re dealing with all these theories about what may happen, and that’s a really difficult thing because even if I can offer, “Maybe this thing will happen and then you’re able to do this thing”, there’s then the “But what if this thing happens?” You just get stuck in all of the eating disorder’s predictions.

Versus with this person I’m talking about, she’s doing the things, and then we’re able to deal with what actually came up. So “I had this incident and this was really intense”, and it’s like, “Okay, cool. Next time, how about trying this? What do you think would’ve been helpful beforehand?” We’re actually dealing with the realities of the situation as opposed to all of the predictions.

And that’s a whole different thing, because if you can deal with the realities, you’re able to then run the experiment, you’re able to test doing something slightly different next time and what actually happened there? That’s how you’re then able to learn, and all through this process, you’re developing that resilience. You’re realising, “I can take action even though those thoughts are there.”

You’re making progress to be able to start to see that contrast between how things are now and how things were 2 weeks ago, 6 weeks ago, 2 months ago. It’s giving you more and more time because of the action-taking to start to realise that “this symptom has improved, my capacity to do this has improved and there is an actual difference and a benefit to the quality of my life by doing these things.” And you just can’t get there without taking action. If you’re just trying to do the writing exercises, if you’re just trying to feel more motivated, none of those things happen and get you there in the way that actually taking action does.

What about grief?

The next thing I want to talk about is, what about the grief and the fear of never forgiving yourself and all the wasted years and all of that? Because again, this is a thing that comes up very often, not just as a prediction, but yeah, there is a lot of grief connected to recovery.

Being able to just acknowledge, yeah, you’re going to experience grief as you go through this process. It makes absolute sense that you would experience grief connected to so many aspects of this. And being able to recognise that, hey, you can experience this and you can also recognise “It’s worth me recovering, and I’m glad that I’m doing this” or “I’m experiencing grief and I can recognise that I’ve been able to tolerate it.”

I think it’s just really important to be able to recognise that there are going to be lots of uncomfortable thoughts and feelings and emotions that come up. I never want to tell someone “No, it’s going to be just amazing. You wait, it’s going to be so great.” I want to be honest and manage expectations. Yeah, there are going to be a lot of challenging things coming up – and there’s a lot of benefits connected to this.

I would also just add with this, let’s imagine 5 years in the future. Let’s imagine that it’s 5 years in the future and you’re fully recovered and you’re living your life and you’re able to do all the things that you want to do. Or it’s 5 years in the future and you’re still in the depths of an eating disorder. Same behaviours, same groundhog day every single day. Which is the better of these options? Yeah, you can still have some of that grief of the years that were lost, but you’re recovered – versus “Hey, I’m still in this.”

I think the eating disorder makes out that that’s going to be so hard to deal with and there’s going to be so much grief while ignoring the fact that actually, there’s often a lot of grief already. Like “I often feel bad about how much of my life I’m missing out on and how much I’m not able to do the things that I want to do.” So it’s not that you’re avoiding any of those things; it’s just that it could be about a slightly different thing, and the eating disorder makes out that if it’s about that thing, it’s going to be so unbearable, but if it’s about this other thing, “I’m used to that. That’s just fine.”

I can imagine someone’s hearing this and they say, “Well, you don’t know that I’m going to be fully recovered in 5 years. There’s no guarantee that that’s going to happen.” My response is, 5 years is going to pass either way; if you fear that you’re going to regret the fact that time has passed by, what’s going to happen in 5 years’ time?

If you’re still stuck in the eating disorder in 5 years’ time, there’s still going to be regret about that. There’s still going to be regret about missing the time with the kids or the holidays or the bone health or the whatever may come up. There’s still going to be those regrets. So my suggestion would be, what could become possible if you started getting support and doing recovery and taking action and all of these things, and starting to see things could be different.

Taking action in order to see change happening

Another thing with this is I think the eating disorder is very good at making assessments based on the very immediate feelings that occur, and the feelings of doing this the first time or the feelings when it’s at its worst after a difficult day. What I want to suggest is focusing not just on that very specific moment and when it’s at its worst, but having a wider view connected to it.

Starting to look at, “Can I concentrate or engage in conversations more easily than I did before? Do I have more flexibility around my plans compared to where I was before? Am I more available in my relationships than I was before? Are food decisions taking up less time than before? Can I do something that is difficult while that thought and fear and everything is present that I couldn’t do before?”

Obviously, with all of these examples, this requires taking more action than just one day or one change. It involves doing things repeatedly and for long enough to start to notice a contrast. But this is where you start to actually notice a difference. It’s by doing things repeatedly that you can start to recognise “Things are actually moving in a better direction” or “These things are actually improving.”

It’s also through taking action that your realise “Oh, I actually need to adjust this thing. The plan that I’d set was a good starting place, but it’s not what I need to keep doing now. I need to add this extra thing in, or I need to adjust this thing, or I need to bring in this tool because I’m realising how important that thing is.”

Again, if we’re just talking about things in the abstract and the predictions, you never get to that place. You never get to discover that “Oh, I can make some changes, I can realise some of it’s working, some of it’s not working; I need to bring this other thing in, I need to change this other thing, and I can keep going with this.”

And again, the thing I just keep coming back to – it’s through recovery that you develop that resilience. You develop that capacity, you understand what now starts to make more sense as you move forward.

I will just say that, again, you don’t have to be certain about all of these things to decide that “Oh yes, I’m worthy of doing recovery now.” Especially when working with clients, I want you to bring all these parts with you. I want you to bring all the hopes and freedoms and everything that you want to have happen, and I want you to bring all the fears that you have connected to this. Tell me where the eating disorder feels protective to you. Tell me the grief that you’re frightened of. Tell me about the previous attempts, and now how you feel doubtful because “I’ve tried this so many times in the past.” About the fact that you understand that you need to change, but you just can’t seem to follow through.

These are the things that I work on with people, and these are the things that then make a difference in recovery – being able to acknowledge the good, the bad, the ugly, and where you’re struggling with these things. So when I’m working with you, I can explore, what is keeping you stuck? What are the behaviours that you’re doing and what are they doing for you? And what happens when you try to change them?

So we can then use that understanding to work out, what does it make most sense for a practical plan for the next two weeks to get started with this thing? Where does it make most sense to say this is the goal or the two goals that we’re focusing on right now because they’re the things that are going to make the biggest difference for this next little amount of time, the next week or two weeks?

It’s not that you’re solving every problem on Day 1. It’s like, “What needs my attention in this moment? Let me start there and put my focus there.” And then you’ll review or we’ll review what happened and then figure out, what’s the next thing that needs to get our attention, and what support is needed as part of that?

You don’t have to solve all the fears in advance. That’s the point of getting the support and the point of working with someone who can then look at what’s going on and help you figure out what makes the most sense.

I just want to say, if you’ve recognised yourself in this episode, if there’s a feeling of “Yes, I really get stuck in that idea of recovery’s going to make my life worse” and hearing this has been helpful, I would love to support you. As I said at the top, I’m currently taking on new clients. If you want to reach a place of full recovery, even if that feels like some far-off distant dream or doesn’t even feel like a full possibility but “Hey, I just know that I can’t keep living like this”, please reach out.

You can send an email to info@seven-health.com. You can send a message @sevenhealthcompany on Instagram. As part of the show notes, there’s links to different things to be able to get in contact as well. But yeah, just get in contact and I would love to then be able to help you with your recovery.

So that is it for this week’s episode. I’ll be back next week with another episode, but until then, take care, and I will see you soon!

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