Eating disorder symptoms are incredibly complex. Often they are ego-syntonic (part of one's ideal self-image), making it hard for the person to recognize them as symptoms to begin with (denial), or not wanting to give up symptoms that are serving them well. For example, someone with anorexia may like the feeling of restricting because it creates a 'high' or sense of control. She may also like being underweight. Convincing her to start eating enough to gain weight on purpose is no easy task.
As a clinician, it is tempting for me to want to 'fix' a person's symptoms by getting rid of them. However, this may be completely invalidating and unproductive for someone who isn't ready to give up the very thing that has saved her. Often the ED behaviors are a resourceful solution to a person's problems in that moment. A daughter's eating disorder may keep her parent's marriage together because the focus is on her illness. Binge eating may numb and distract from traumatic memories of sexual abuse. Abusing laxatives may relieve intolerable feelings. Overexercising may be a way to manage overwhelming anxiety. An external emaciated appearance may be the only way to communicate internal struggles. Throwing up may get the attention of family members in a way that words hadn't.
We must honor the symptoms and what they are saying. Abstaining from the behaviors may create the illusion that everything is fine. But a bandaid doesn't fix a broken leg. We must go deeper. Sometimes during the healing process a person will need their ED symptoms to cope or communicate. It is essential to stay in tune with this, and to be compassionate. Compassion for the fact that the person needed the ED in the first place. Compassion for the grueling recovery process. Compassion for the pain.
When compassion is given and modeled for the person with the eating disorder it gives them permission to be compassionate toward themselves. Eventually this compassion becomes more natural, allowing the individual to tend to their needs more directly.
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