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.

Twitter Digg Delicious Stumbleupon Technorati Facebook Email

29 Responses to “What it means to choose recovery”

  1. This is really wonderful. Thanks for sharing it.

  2. I think this is my favorite post by you ever. The whole “choosing recovery” thing has always bothered me too and I could not have said this better myself. Thank you, once again, for sharing your perspective with all of us.

  3. I think this is probably the most relevant post you could have possibly posted today. (In my humble opinion ;) )
    Thank you, Carrie.

  4. Thanks for this, Carrie. I think another reason why professionals throw up their hands and blame the patient might be b/c it’s so damn hard on them. My therapist says it’s ok if I can’t choose recovery for myself sometimes and that at those times she will choose it for me. She says she’s ok being the bad guy and I can be mad or feel however I need to towards her. In my good times where I DO want recovery (which are few lately as we’ve just increased my meal plan AGAIN) I think of how hard I am on her, how I fight her, get angry at her, and I think, “Damn, I’d never want to be a therapist!” It would exhaust me emotionally to have to keep fighting the same battles w/people, and be cursed for it to boot- and maybe in the end have all that work go down the drain if the person terminates therapy. I think carers who can do this are amazing. I’m going to make a point of telling mine thank you while I am seeing this clearly- maybe write it down- b/c I will probably not be feeling this by tomorrow.

  5. And another comment I want to make… I cannot possibly tell you how I am “YES”ing what you wrote about how it is NOT “A choice” but rather a bazillion choices- endless choices- all day, each day, each meal, over and over and over again. It is so not as simple as just “a choice.”

  6. This post really resonated with me because I am struggling so much and I have been in treatment for 12 months at a certain facility. My doctor says he just doesn’t know what to do for me because “I’m not following recommendations” it’s not that easy and I don’t know what to do to help myself!!!

  7. So, SO true, and particularly applicable to me right now as I’m trying really hard to ‘haul myself up my the bootstraps’ on my own, to avoid yet ANOTHER hospital admission and I keep reading blogs about how ‘I chose recovery’…and wondering how does one just choose it when that choice is so full of fear and uncertainty and what-ifs that it eventually becomes not really a ‘choice’ at all – who would actively CHOOSE to go to hell (ie. recovery!!) and not know whether the ‘and back’ will be there at the end of it? Your insight and viewpoints on everything ED related always astound me and please keep on blogging, Carrie!! Thank you

    • +1…Everything Mo mentions. The sheer terror implicated with the removal of ritual and shelter…and no “guarantees” of the ‘and back’ can paralyze..and there is clearly not one pat “choice”…but constant barrage of choices, daily, especially at every single meal. We need to be compassionately prepared and “steeled” to face the incredible difficulty of an on-going, evolving desire to recover. Deeply affecting, reflective post Carrie. I second Mo’s plea to “please keep on blogging. Brilliant.

  8. Yes. To all of it. Something my ex never understood: how I could get through one meal, one day, sometimes even a whole week; and then just run out of energy to keep trying and be back to square one. Or worse, because then I’d be trying to make up for all the times I’d “failed”.
    What’s helping at the moment: being told not to give myself choices. I hate it because it’s not me; and I don’t think it’s a long-term plan, but at the moment, it just has to be that way.

    • And if anyone told me that I’d be hitting my 30′s and that the hardest decisions in my life involves getting breakfast and choosing what yoghurt to buy, I’d have laughed.

  9. Yes so much to all of this, even said from someone who hasn’t been choosing the best way to go as of late. I agree with all the comments, especially from C. I’m an educated, funny adult woman who can pass for having all her crap together, yet my hardest decisions are on a minute-to-minute basis–what to eat, to rest, to sneak in exercise, to actually be functional–not to do my job well or be responsible with my bills, etc. as those things come naturally.

    It’s second to second, and yes, it’s a choice. But good lord, I’m tired of having to work at it so hard. Great post.

  10. From a standpoint of someone who does not have an ED I can totally understand.For those of us who don’t know what it is like I think of it this way,If a doctor told me I had this horrible disease and I had to take medicine 5 to 6 times a day that tasted really bad and looked disgusting what would I think?After all I feel fine,surly they must be wrong.But everyone is saying I look sick,I am not acting like myself,but to me I am the same as I always have been.How would I chose to recover,I don’t recognize that I am sick,who do I trust?I imagine it is the hardest thing everyone here has ever done and I applaud you all for your braveness in not only sticking with it but for sharing

    • What is harder is when you don’t look sick (as in many cases of EDNOS) – it makes it ever more difficult to convince yourself that you need the “medicine.”

  11. I just wanted to say thank you – I felt you were speaking for me, too. ED is my normal, even though I know it’s sick – it feels like I’ve been wired backwards and what other people find intolerable – hunger – is the only state I really find tolerable, and I find being full extremely anxiety-racking, or even just being comfortable. And I totally am with you on the travelling being hard. A hard -won period of stability went out the window on 10 days of travel – no foods I was familiar with, and overestimating what i was eating – it wasn’t long before my thinking was out of whack and I was in a hole.
    You are right, choosing recovery isn’t just a one off thing, but it happens constantly. I also get very frustrated because not only do I have to choose to eat each meal, it’s not over then, but up to several hours afterwards can take but one split second to undo all that hard work by purging.
    thank you for your blog and for sharing your journey – and your hard-fought-for recovery.

  12. This is so perfect! Thanks for posting this. It’s so hard to explain how much the ED takes over the brain and really does “normalize” things. Restricting/exercise/weighing/rigidity became *just what I do, no questions asked* and I think that’s really hard for outsiders to grasp. It’s tough when using ED behaviors no longer feels like a choice but rather a compulsion, but recovery also doesn’t feel like a choice I can make. But I will say, at least for me, the one thing I CAN choose to do is to hand over my decisions to qualified professionals who can decide these things for me (re: why I’m starting IP next week). Spot-on post!

  13. Thanks Carrie one more time for sharing you experiences it makes me feel more sympathetic for my d. knowing what she must have to go through.

  14. Wow, Carrie. This one resonates with me.

    I have said and felt every day of the past 9 years I’ve been in recovery that I feel like I run a marathon every single day. All the choices, all the energy it takes to “choose recovery” over and over and over again, every single meal on every single day. It’s exhausting!!

    In my experience, it is so hard for others to understand how exhausting recovering is and why restricting (with no choices – because you just don’t eat) is so tempting; especially when one feels overwhelmed.

  15. I love this. I remember waiting and waiting and waiting for that lightbulb moment to come. Recovery means doing the next right thing, no matter what happened before, and sometimes blindly trusting that things will get better with each next right step. Then after a long time of struggling and frustrations and not feeling any different then you did before, you’ll look back and realize how far you’ve actually come. Thanks for writing!

  16. I really enjoyed your article. It helps me to understand some of the statements I am told by the ED person I have come to know. The 20+ years of ED becoming the norm.
    The strength this woman has to have when she doesn’t want it, or have it, has to come from her support. The loving, caring support of people who truly care for her.
    Thank you very much for the eye opener.

  17. This single paragraph spoke volumes to me:
    “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.”

    It’s so true! Yes, you can ‘decide’ that you want to recover, but it’s not like the hard work is done in making that decision..it’s the daily challenges, the daily reminders to oneself what you are working towards that’s the hard part!
    Reminding yourself that binging/purging/restricting/overexercising may be what you are used to, but that they are NOT good for a healthy recovery, THAT’S the hard part!

  18. Thanks for this post. The breakfast paragraph made me laugh, this morning there were no bananas and so I had to change my routine and OH LAWDY, we almost had a core meltdown. I calmly took myself back to bed to regain composure and decide my next move. It took everything in me to not just throw in the towel and eat nothing. It completely threw off lunch though and so late in the afternoon I had to call my mum to bring me something to eat because I knew I could no longer make the choice.

    Even when you want to recovery sometimes you can’t make that choice.

  19. Thanks for this post. I kept thinking something in me was irreparably broken because I have struggled so much with this. I’m just really grateful to read this and realize that I’m not so alone.

  20. I appreciate this because right now I am teetering on the brink of choosing recovery and can’t make the final push to get there. I know I will, but I keep stalling. This was a good post to show my husband to help him see that it’s not just my therapist (who costs a fortune), but I have to want to make the leap. I know I will, I just need to get there.

  21. This really resonates with me especially at the moment as I’m leading up to leaving IP and getting more and more of the responsibility to ‘chose’ recovery back and it’s an exhausting constant process of making that decision over and over that I don’t think a lot of people without experiencing it understand. I had been told before that no one could do anything for me until I wanted to recover more than I wanted my ED. An almost impossible thing for me to comtemplate when I was told that. My family often repeat too that I’d be better if I really wanted to be. I would never wish experiencing the life of an ED sufferer on anyone but really do wish sometimes I could explain how draining and complex it is to stay well when my default setting is still ED. It’s always hopeful and encouraging to hear that making the choice to recover over and over gets easier and more natural with persistence and time xxx

  22. I have read this post over and over. It’s really helping me because I kept thinking after leaving in-patient, day treatment, IOP, that it would be so easy to recover.,recovery must be easier than treatment, right? But two years later, 25 years with an ED, it’s only just occurring to me that recovery is one billion times harder. Every bite that goes in my mouth is a choice, and I hate it.

  23. This is an excellent post. but what if you cannot choose. Some people get so angry with people who want them to choose to ‘get better’ when they don’t want to make that choice as it sometimes seems easy to maintain the status quo. What can we do to help someone choose?

  24. I totally agree with you when you say that putting “make the choice to recover” gives the therapist an excuse or a reason to throw up their hands and let them off the hook to trying to help. Making the choice to recover over and over and over is really the only way to really recover. When someone is sick with an eating disorder, as you so eloquently point out, that person just cannot make rational choices. Sometimes other people, as “hm” says, have to make those choices for us when we can’t make them ourselves. I can’t help but blame the insurance companies too. They throw people out of treatment just when they get healthy enough to take advantage of good therapy. But that’s a whole other story! Thanks for your honest and vulnerability in writing this piece.

Trackbacks/Pingbacks

  1. On getting breakfast | Gourmetpenguin's Blog - May 3, 2013

    [...] Something on EDbites this week really struck home: http://edbites.com/2013/04/what-it-means-to-choose-recovery/ [...]

  2. recovery is every day, every moment | surviving anorexia - February 5, 2014

    […] 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. (ed-bites) […]

Leave a Reply