Supporting yourself through eating disorder therapy
By Leslie Becker-Phelps, PhD
Choosing to enter therapy for your eating disorder means choosing a difficult, though rewarding, path. Whether or not you realize it, you are probably struggling with conflict about the decision. While part of you wants to change, another part of you isn’t ready to be different. It’s still holding tight to those familiar patterns, even though you know that they are also destructive. With each obstacle – whether it is within you or in the “real” world – you will probably feel frustrated and lose patience. You may become harshly critical of yourself – and this can prove to be your biggest problem. When you turn against yourself, you become your own worst enemy and your biggest obstacle to becoming healthier.
Rather than waging an inner war, try a gentler, more understanding approach. By being kind to yourself and attending to your difficulties in a compassionate manner, you become your own friend, support, and advocate.
To clarify, consider the following scenario: You come across an abandoned child (or dog) in an alley. He cowers fearfully in a corner. And you want to help him. If you approach him as you might approach yourself – with accusations and anger – he will probably respond with pulling back further into the corner or attacking. So, instead, you approach him slowly and with a quiet, reassuring voice. With time and patience, you can probably win his trust and guide him to getting more help.
This is the same approach that you need to take with yourself. Using this analogy, do the following:
Identify a self-criticism: Think about a trait or situation that prompts you to be self-critical. For instance, you might focus on how you tend to be extremely critical about your body. (Limit your time thinking about this. You want to identify your self-critical thoughts, but not get pulled into repeating and reinforcing them.)
Imagine the victim in you. As a third party observer, watch how your ‘inner bully’ criticizes your ‘inner victim.’ See the victim part as a hurt or scared child. Then try to really connect with, and have empathy for, what that victim part of you is feeling.
Practice self-compassion. Choose to be gentle and reassuring with her. You might find it comforting to imagine hugging that part of you, or just placing your hand on her shoulder. If you have trouble doing this, visualize the scene with someone else feeling victimized and approaching that person with compassion. When you’re able to feel compassionately toward that person, you can practice showing the same compassion toward your child self. With practice, you can then develop the ability to feel compassion for your present-day self.
Take time to practice this exercise. Repeat it. And just as you can calm, reassure and embolden a frightened child or stray dog with kindness and patience, you can be the same loving force in your own life. Share your experience of this exercise with your therapist, who can help you build on the developing self-compassion or overcome obstacles preventing you from feeling self-compassion. By nurturing this inner love and support, you will feel better about yourself and will have the resilience to persist in the journey toward a healthier you.
About the author –
Leslie Becker-Phelps, PhD is a licensed psychologist who treats individuals and couples in her private practice in Basking Ridge, NJ and presents nationally to lay and professional audiences on relationship problems and self-criticism. She is the relationships expert on WebMD’s Relationships and Coping Community; writes for WebMD’s “Relationships” blog; and writes another blog called “Making Change” for Psychology Today. She is the author of Insecure in Love: How Anxious Attachment Can Make You Feel Jealous, Needy, and Worried and What You Can Do About It (New Harbinger Publications), which was released in May 2014. She was also the consulting psychologist for the book Love: The Psychology of Attachment (DK Publishing, 2016). Read more at www.drbecker-phelps.com.
As therapists, we learn so much from our clients. When individuals are diagnosed with an eating disorder and are members of a marginalized community, I have learned these persons live lives of “marginalization multiplied.”
NEDA in partnership with Reasons Eating Disorders Center has taken on the compelling work of their Marginalized Voices Campaign. The goal of this effort is to challenge “the prevailing myths about who struggles with eating disorders, underscoring that everyone’s experience is equally as valid and deserving of care and recovery.” (To learn more, please go to https://www.nationaleatingdisorders.org/marginalized-voices)
With much gratitude to Lori Price for her commitment to the eating disorders community and her powerful words in the previous article that describe her experience as a marginalized voice, I follow with thoughts on another layer of marginalization with which people with eating disorders co-exist, based on some practice wisdom.
A number of years ago, when sitting with some of my ED clients, I realized that one impact of their eating disorder is what I call “living in the margin.” I would ask my clients to picture a regular sheet of loose-leaf paper. We likened the day-to-day, internal and external processes of living life with an eating disorder as existing in the margin of the loose-leaf. We would use this metaphor to imagine a different life and what it would mean to take up the full page – to be free to find and actualize their true selves. Always, a scary thought, yet, oftentimes quite motivating. No one ever denied living “in the margin.” Some found the safety of the ED margin to be a comfort, yet they also knew their authentic self was being squeezed out of the picture by the compulsions, the rules, the demands, and the commands of the ED. Some felt their voices were powerless against the ED voice and its spewed messages of hate, disparagement, and malicious criticism. Some viewed their position in their world of family, school, and friends as meaningless, insignificant, and worthless. In other words, they lived in “the margin.” Developing the courage to use one’s skills and voice in recovery takes savvy, courage, moxie, grit, persistence, strength to face adversity and setbacks, and determination to be on an equal footing with the rest of humanity – pretty similar to the members of our ED community who also experience marginalization.
These clients’ ability to articulate the potential differences between lives “in the margin” vs. “on the full page” led to some lively discussions about hope, recovery, and their future. Sometimes, this image led to an assignment. I would suggest they simply draw or fill the full space on their loose-leaf paper with colors, abstractions, or collage cutouts for follow-up conversations.
We all “get this.” To complement the work of The Marginalized Voices Campaign, have we taken the time necessary to “see” if we might play a part in marginalizing any of our members of the ED community? How do we challenge the “ideals” culture promotes? Did the previous article by Lori Price strike a chord? Can we all open our minds and hearts and those around us to “get it?” Lori’s is one voice. We know there are many more. Each is valuable and deserves opportunities and access to recovery.
We are all in life on this planet together and, hence, in the pursuit and establishment of equality for every individual. We welcome your comments to this article to offer suggestions for advocacy, education, research, prevention, treatment, the experience of visibility devoid of judgment, and more, so that “marginalization multiplied” is reduced and perhaps extinguished.
About the author –
Kathy Cortese, LCSW, ACSW, CEDS, has worked as a clinician in the eating disorders field since 1989, and now also serves as president and editor-in-chief of the Gürze/Salucore Eating Disorders Resource Catalogue.
Kathryn Cortese, LCSW, ACSW, CEDS, began working with individuals with eating disorders in 1989. She is committed to the beliefs that recovery is real, support is essential, and hope matters. In 2013, along with her son, Michael, Kathy purchased the Gürze Catalogue. They offer the annual Gürze/Salucore Eating Disorders Resource Catalogue, a monthly ENewsletter featuring articles specifically written for this as well as a Book Interview, the edcatalogue.com website, EatingDisordersRecoveryToday.com, the ED Pulse, and in the fall will launch their podcast, called ED Matters.