Catch 22 in Getting Effective Eating Disorder Treatment
Calling for Help
Many people with eating disorders call or write to me asking for help. They often face a dilemma. I wonder about the people who don’t call or write because they may be in a state where they the dilemma prevents them from reaching out.
Positive Opportunity
Here’s how it goes. A woman of any age or social or economic or educational level says, “I’m suffering. I can’t live this way anymore. I need help.”
Okay. That sounds good to me. The woman realizes her eating disorder makes a fulfilling life impossible. She has reached the limit of her tolerance for pain. Her denial system is breaking down. She is ready to commit to the deep and sustained psychological work that can result is deep and sustained recovery. The next step is to discuss her experience in detail to determine what kind of treatment would best serve her given her life situation. Then I refer her to professionals in the field who I think may be a good match or she makes an appointment to see me if that seems right to both of us.
Opportunity Glitch
But. She goes one. “I feel so guilty and ashamed. I try to stop this and I start again. I was better for a week (or a month, or two days, or five months) but then I started again. I have to stop being so weak and just do it.”
Uh oh. Now she is succumbing to symptoms. Guilt, shame, sense of personal failure are symptoms that accompany an active eating disorder. If those symptoms are given power she will continue to attack and criticize herself. She will refuse treatment because she feels certain that she should be able to stop her behavior from strength and will power.
She doesn’t appreciate the fact that she is trying to stop a symptom through will power in much the same futile way as a person who attempts to use will power stop lung congestion or a fever. Will power cannot cure illness or disease. The belief that she can use will power to stop her eating disorder is one of the symptoms of an eating disorder. This is a powerful dilemma.
When her will power fails to stop or cure her eating disorder she will feel more guilt, shame and fear. She certainly will experience more suffering. And that can cause her eating disorder behaviors to increase. This is the road to despair.
She continues. “I don’t want anyone to know. I can’t tell _______(my husband, parents, friends, doctor). Can you help me?”
Wanting to keep her agony a secret is part of increasing shame. It’s also related to keeping up a good front to others. She does this because she is afraid other people will be disgusted with her if they knew the truth of her life. She fears that they would pull away. She would then be more isolated, alone and afraid.
This fear of instilling disgust in others and therefore making it necessary for them to abandon her is also part of the symptoms that accompany eating disorders.
The Catch 22
She asks for treatment which would hopefully include symptom reduction. But those symptoms prevent her from getting the help she needs. A woman needs to get past some of her symptoms on her own in order to reach out for effective treatment.
Getting Through the Obstacles
The good news is that she doesn’t have to cure herself before she can enter treatment. That doesn’t make sense and is not required. Her pain will push her to seek help.
If she hears often enough that some of her feelings are symptoms she might entertain the possibility that this might be true. She might rally her courage despite her fear and shame and risk putting herself in a healing environment. With a competent and caring mental health professional who understands people with eating disorders she can begin real recovery work.
She doesn’t have to believe that some of her feelings are symptoms. Wanting to believe may be enough to get treatment started. That desire to believe breaks the lock on the dilemma.
When that lock breaks and real treatment begins she can start making her desire for recovery a developing reality.
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