What it means to choose recovery
No one knew what to do for me. The array of psychologists, dietitians, psychiatrists, physicians, and others that had been seeing me had essentially thrown up their hands. I needed to choose recovery, they said, and it was something I clearly wasn’t doing. Until I did so, there wasn’t anything they could do. I would recover when I was ready.
I have, of course, many problems with that viewpoint. For one, there’s the ability of someone who is acutely ill to actually choose recovery. The other issue is that recovery is a choice- a single choice that you make and then the magic can happen.
The problem is that you don’t just choose recovery. You have to keep choosing recovery, over and over and over again. You have to make that choice 5-6 times each day. You have to make that choice even when you really don’t want to. It’s not a single choice, and it’s not easy.
Most medical treatments are predicated on a person seeking and wanting (or at least accepting) treatment. When it comes to mental illness, when it’s not infrequent for someone to have a hard time understanding just how warped their thinking and behavior has become, we do a crap job at treatment in part because the medical system doesn’t know how to cope with someone who has zero interest in getting well. Rather than re-evaluate a system that requires immediate buy-in from the patient, it’s much easier, cheaper, and more convenient to simply tell the patient that “we can help when you’re ready.”
The problem with this model, and with applying it to eating disorders, is that one of the cardinal symptoms of eating disorders (anorexia in particular) is that the sufferer isn’t always welcoming of treatment. The reasons are quite varied as to why ED sufferers are frequently less-than-enthralled with the idea of treatment, whether it’s not wanting to give up the adaptive functions of the disorder, being too terrified of stopping behaviors, or thinking that the behaviors aren’t that serious and not worth the hassle of tackling. A decision that’s thoughtful and rational as to the necessity of care is all well and good, but that’s not the case for many of the ED sufferers I’ve talked to.
So we all sit back and wait for the person to be “ready” to recover. The problem is that the longer a person is left to the machinations of their eating disorder, the more difficult it becomes to choose recovery. The longer you’ve been sick, the more difficult recovery is, generally speaking. Eating disorder behaviors rapidly become reflexive. We binge on Food X because it’s just what we do when we eat that food. We exercise at specific times because it’s in our schedule and it’s habit. Those are the rules. We only eat certain foods at certain times in a certain order.
The eating disorder becomes our new normal.
Amnesia rapidly sets in. You forget what it feels like to have energy. To not lash out at those you love for really dumb things. To not assess every bathroom you pass for its purging potentials. You just…forget. At first, you usually remember that, at one point in time, you weren’t scared of food. Then, even those memories become so hazy that it seems life was always that way. You forget.
The phrase “choosing recovery” irritates me for any number of reasons, but a large part of that is because it makes recovery seem like a one-off choice. Like I chose to wear yoga pants today. I made the choice, it’s over and done with. Recovery isn’t that simple. It’s not just a single choice.
Take breakfast. There’s the ever-entertaining Shakesperian debate of to breakfast or not to breakfast. Then there’s deciding whether you have cereal, and if so, what kind. How much. Type of milk. With fruit or without. Juice or no. Anything extra with it. Coffee or no (actually, that’s a dumb one, because the choice is always coffee). And that’s just one meal on one day. What happens on those days when you really don’t want breakfast. What happens then? How do you make that choice?
I just got back from 6 weeks of living out of a suitcase. I was on vacation for two weeks, home for a week (where I stayed with my parents, not my own place so I wouldn’t traumatize the cat bringing her back and forth between her “homes”), then gone for three weeks on a journalism fellowship. Parts of the trip were fine, and parts were really challenging. I do well when I have a routine, when I get into a cadence of work and food and leisure. Travel, as fun as it can be, disrupts that. For a really long time, traveling was a total disaster from a recovery standpoint. I was so overwhelmed with all of the other changes in my environment that dealing with the blow back of recovery-oriented choices just didn’t happen.
Just as the ED was my new normal at one point in time, recovery has now become my new normal. Choosing recovery, time after time after time, has finally gotten easier. It has meant sitting with the discomfort of doing things I didn’t want and often didn’t feel were necessary. It meant having other people make my choices for me because I just couldn’t do what I needed to do. You don’t ever get to stop making these choices. It’s not exactly the most heartening realization. But when recovery becomes almost as reflexive as the eating disorder, it’s stops being such a fearsome burden.