Things That An Eating Disorder Is Not

1.A fear of fatness
2. A diet
3. A choice
4. Stupid
5. Caused by Western media
6. Caused by beauty ideals
7. A new phenomenon
8. Understood
9. Anyone’s fault
10. Incurable
11. Easy
12. Sustainable
13. Irrational
14. A metaphor
15. Internalized fatphobia
16. Prejudiced
17. For white girls
18. A phase
19. Identifiable by size
20. Isolated from family/friends/society
21. Identical to any other eating disorder
22. Useless
23. About anyone else but the sufferer (and potentially close friends/family members whose emotions are deeply enmeshed)
24. For young people
25. For women
26. A ploy for attention
27. Trivial
28. Motivated by someone else’s body
29. Motivated by the sufferer’s body
30. Seriously, not about bodies
31. Isolated from other trauma/emotional issues that the sufferer might have
32. Fun
33. Shallow
34. Simple
35. Definable
36. Caused by any one thing
37. Entirely genetic
38. Entirely socialized
39. Making a statement (except possibly “help!” or “I can’t handle life!”)
40. About you
41. An epidemic
42. Getting more common (hey guess what more awareness does? Leads to more diagnoses!)
43. For you
44. To please men
45. To make women submissive
46. Weakness or powerlessness
47. A problem for you to fix
48. Something you get to define
49. An identity
50. A talking point or pawn for your theories about society
51. Manipulative
52. Blackmail
53. Seriously, still not about you
54. Gender roles taken to the extreme
55. Not really a problem
56. All in your head
57. Solved by “just eating” (or really by eating at all…that’s an important piece but really doesn’t fix the disorder)
58. A lifestyle
59. A fashion choice
60. Limited to anorexia and bulimia
61. Limited by your location, age, gender, race, ethnicity, religion, class, sexuality, education, or really anything else
62. The same as “wishing you were skinnier”
62. The same as weight discrimination
63. The same as skipping lunch that one time
64. Self-control
65. Submitting to patriarchal beauty ideals

Things that an eating disorder is:
1. A potentially deadly disease that is unique to each individual who has it.

Taking the Long View: On Recovery and Motivation

Recovery from a mental illness is a rough gig. I’ve written many times before about how I wish people would be more honest about just how difficult it is and what that difficulty looks like. Right now, my motivation is low. I want to be done with this stupid, frustrating, painful process. I want people to just leave me alone to wallow and make bad decisions. I want to be allowed to feel bad.

This is basically how I feel all the time right now

Now in the traditional narrative of recovery, this means that I’m slipping. It means the “eating disorder voice” or the depression is getting louder. It means that what I really need to do is double down and fight harder. It’s part of the “roller coaster ride” of recovery. If I don’t nip it in the bud though, then I’ll have given up, I’ll have wasted my progress. I’ll be back to square one, fallen harder than I did the first time and it’s all because I didn’t have “the proper motivation” or I didn’t “fight hard enough”. So if I’m slipping I need to keep my eye on the prize of recovery, think about how great I’ll feel, post a few affirmations around my house, and remind myself once again that I can’t live my life the way I have been living it (because who wants to live in the hell of an eating disorder if you can have recovery, amirite?)

If I was telling the story of my eating disorder, that would be the expectation of how I’d frame this. But that is not the reality. Here is the reality.

Recovery sucks. By most basic cost/benefit analysis standards, it’s a really risky, difficult, long venture. It takes flipping forever, and the time that you put into treatment is not fun. In fact it’s more than not fun: most of the time you feel even worse during treatment than you did when you were happily living out your delusion that starvation was the way to a great life. Things have suddenly gotten a whole hell of a lot more complicated and you can’t just rely on rules anymore. So say you’ve been trucking along in your mental illness and then treatment comes and hits you like a ton of bricks. You spend the next 2/3/4/5/forever years working through mountains of crap. And those years SUCK.

And the more you realize that they suck, the more you realize that a lot of the suckiness will still be there even if you do “recover” because life isn’t easy and being healthy isn’t easy and it’s hard work to enforce your boundaries and balance your needs with the needs of others and fight against sexist and damaging media and somehow put together a clear and cohesive identity that can stand up to the trials of life. So you get this picture that in the long run you’re going through a whole hell ton of suffering right now to maybe feel like you can cope with the fact that life is really hard later.

Now pile on the fact that it often looks as if you’ve made no progress whatsoever. Seriously. I’ve been at this for about 3 years (with the same therapist), through intensive programs, groups, dieticians and many, many, many hours of therapy, and a lot of commitment. Three years is a long time to be spending at least 2 hours every week in therapy and most of the time in between wrestling with all the hard questions. And yet when I think about the things that really get in the way of feeling content or grounded, I see no change. Perfectionism still drives me. I still feel unlovable. I still cannot accept praise and focus exclusively on the negative. I can still be flattened emotionally by one negative comment. I still personalize, I still tend towards black and white thinking, I still feel anxiety for no reason, I am still afraid of social interactions…

Logically, it makes sense to be a little low on motivation when there is little evidence of how far you’ve come, much evidence of the pain you’ve suffered and will continue to suffer, and no guarantee that things will be a whole lot better if you continue to work (for another 3/4/5 years?). Part of recovery is trying to make sense of what is worth it and what isn’t, what life can or can’t be like. This isn’t some sort of slip, this isn’t an indication that I just need to fight harder. This is coming to grips with reality.

But there’s another truth and it’s one that I’ve had a really hard time accepting. It’s about the long view. I spent the better part of 20 years developing these really bad coping strategies. It will take me a long time to change them, nearly certainly more than 3 years. For many things that I care about I am willing to invest huge amounts of time (schooling as an example), often because I can see that the end goal is worth it. And many times I can make these investments on faith (when someone tells me that I’ll get a diploma at the end as an example). With nearly everything else in my life, I can take the long view; I am willing to put up with the pain of the now to get something in the future, even when that something isn’t happiness or a perfect life. Why does the pay off for treatment have to be held to a different standard?

Now there are very real differences here. I like school, the pain that I’ve experienced while in treatment far outstrips anything else I’ve ever felt, and the evidence I have of the benefits of recovery aren’t as strong as the evidence I have of many other things (that, for example, a higher degree would make my life a lot easier). Recovery is harder than anything else I have done in my life because when I look at it logically I can’t guarantee that I’m making the right choice to pursue it. But if I look at the long haul, I can see that I can’t come to the conclusion that it’s failed yet. The experiment has to continue. And I do believe that when people are waning in their motivation, it’s because they are re-analyzing the long view and that view is scary.

But I hope others can join me in realizing that it has to be long, but we are capable.

 

 

 

NAMI Week: What Can I Do?

Welcome to National Eating Disorder Awareness Week 2014! I’m going to try to spend this week blogging about issues surrounding eating disorders and eating disorder visibility as my own small part of eating disorder awareness.

To start out the week, I want to try to make eating disorders a little less scary. Oftentimes when we try to shine a light on mental health issues, the average joe who does not have whatever condition we’re talking about gets overwhelmed. What am I supposed to do? If I see someone who seems like they might be dealing with this how do I help?

These are important questions because we are just scratching the surface of psychology and neuroscience, and for the most part we don’t have good understandings of the etiology of mental illnesses. It’s hard to tell someone what to do to help fight a particular illness when we don’t know what causes it. It isn’t like diabetes where we can promote healthier eating and more exercise. Eating disorders are complex beasts that can react negatively to almost anything you throw at them. So during this week of heightened awareness, what sorts of things can you commit to to improve relationships with bodies and fight against eating disorders?

To me, the best place to start is at home. We learn from each other and there are very few models of healthy body image and healthy eating. In a world filled with shitty messages about how you should treat your body and how you should relate to your body, the hard work of feeling at home in your skin is fairly radical.

Fight against Cartesian dualism and see if you can’t learn to see your body as an integral part of yourself. Practice less negative self-talk and judgments. Try engaging in activities that ask you to take up space, like dancing, and revel in taking up space. It may not seem like a lot, but your good mental health can be great for someone else. Some really concrete ways of doing this can be cutting out calorie talk. It’s one thing to say you want more protein and less sugar, but calories are actually really unhelpful at assessing the healthiness of a food and feed into diet culture.

Another thing to try to cut down on is “bad food” talk. Many people like to say things like “Oh I’m being so bad” when they eat something sugary or fatty. No, you’re not, you’re eating something tasty. There is no such thing as bad food and it is not a moral failing if you eat more fat or sugar than is maximally healthy. See if you can stop putting moral judgments on any food. It’s hard. You will see how ingrained size, food, and morality are. The more we can cut those ties the more we create a healthy environment.

But there’s a lot more to eating disorders than food and food discomfort. Obviously. So is there anything you can do to help create a positive environment that will help combat some of the underlying fears? YES! Something that I’ve noticed over and over with my friends and acquaintances who struggle with eating disorders is feelings of inadequacy, feelings that our emotions are bad and wrong, feelings that we will never be good enough or perfect enough.

A great thing to practice towards all people in your life is validation. Validation at its most basic is just letting someone know that what they’re feeling is real. It’s acknowledging their emotions and not passing judgment on those emotions. It can be as simple as saying “wow that sucks” when someone tells you they’re having a rough day. This can be done in conjunction with all sorts of other types of interactions like problem solving, but I’d suggest practicing validating all kinds of people for all kinds of things. You never know who needs it and it’s a good skill to get in the habit of doing. Your coworker says they’re swamped. Instead of one-upping or asking if you can help, start by simply saying “wow that sounds exhausting”. This may not seem like a lot but if you make a practice of it you can do a lot for other people by sending them the message that their feelings are valid, real, and acceptable.

Another good idea might be to educate yourself on some of the basics of mental illness. NAMI has some good resources. I would suggest in particular getting a basic understanding of depression since it’s one of the most common mental illnesses out there. A little bit of understanding can go a long way. Hand in hand with that it’s a good idea to keep your own mental house in order. If you’re struggling, be willing to see a therapist. Take some time to think about how you communicate and how you can improve your communication skills. Make sure you’re taking responsibility for your own emotions and learning about how to keep yourself stable and content. Tall orders yes, but the more we all work on these things the easier it is for people who have serious hurdles.

So say you’ve done all of this and made your best effort to keep yourself and your environment validating and fairly healthy. You’re paying attention to your friends and family, trying to be a helpful person, and you start to notice some of the signs of an eating disorder in a friend. They’ve suddenly become obsessed with food, they’ve started to isolate themselves, they avoid situations that involve food. They may have lost weight suddenly or just become secretive about their eating habits. You hear them making cruel remarks about their body. They start going to the gym ALL THE TIME, or eating huge amounts and then disappearing suddenly. You can tell their mood is down. What on earth do you do now that you’re faced with the real beast that is an eating disorder?

One of the most important things to remember in these kinds of situations is that you cannot fix your friend. It is not your responsibility nor is it possible. Hard to accept, but super important. It can be hard for someone who’s depressed or in the midst of an eating disorder to reach out for help. One good thing to do is offer yourself and your time. Ask them to hang out instead of waiting for an invitation (mustering up motivation and intention to do these things can be nearly impossible when depressed), make sure they know you’re available to talk to, offer to go for a walk with them or do something else you know appeals to them.

It’s important to remember that confronting someone about food is probably the least helpful thing you can do. The eating disorder will interpret this as a threat, double down, and make life hell for everyone. If you’re extremely close to the person you  might suggest that they see a therapist because their mood has been off or down and you’re worried about them, but food is a scary place for someone with an eating disorder. Provide them with options, make sure you’re eating enough and that you’re offering them opportunities to eat, and validate the hell out of them.

There is no one perfect answer to what you should do to support a friend or family member. These are some places to start, but there are also support groups available for friends and family members at some eating disorder clinics and that’s a great place to get yourself if you want some additional ideas and people to rely on. If you can spend some quality time with your loved one, try to listen to what’s really bothering them underneath the food. That may be the most helpful thing you can do.

Mocking Thinspo

Note: trigger warning for eating disorders and thinspiration. In addition, I recognize that the messages in thinspiration are damaging and untrue, however this post is not about the messages contained in thinspo but about the individuals who make up thinspo communities.

Thinspo is stupid right? We all know it. It’s totally and utterly crazy for skinny white girls to sit around looking at pictures of even skinnier white girls and then whining and beating themselves up about not having an eating disorder? It’s utterly mindless and a waste of time and energy. Of course rich teen girls would have the time for this, but who else does? I just have to laugh at these idiots. They just want attention, they’re just trying to do it for boys. Don’t they know that anorexia is ugly? Don’t they know that curves are sexy? Don’t they know they’re damaging themselves and everyone around them? I hate them, but they’re so stupid sometimes I can’t even care.

As you might imagine I don’t agree with any of what I just wrote. However it took me a grand total of about 30 seconds on google to find quotes similar to all of what I said. Mocking thinspo is something of a national pastime and many people feel no qualms about viciously ripping into the people who engage in thinspo. I think we all need to come clean about it: we’ve probably made fun of thinspo as some point in our lives, we’ve probably thought that it’s sick and disgusting, we’ve probably thought that the people who do it are dumb and hurting others.

Yes, thinspo at first glance is disturbing and terrifying. But there’s a lot more going on in thinspo than you might think, and mocking it is really like kicking someone when they’re down. It’s not promoting the feminist agenda, it’s not promoting health, it’s not promoting mental health: it’s stigmatizing mental illness, it’s playing into the same dumb ideas that whatever teenage girls do is useless and stupid, and it’s actively ignoring the cultural milieu that might lead women to seek something like this, instead blaming them for trying to survive in a culture that glorifies thin.

So first and foremost what mocking thinspo ignores is that thinspo originated out of communities made up of individuals with eating disorders, and that the messages contained in thinspo are almost verbatim the things that an eating disorder will say to someone. Mocking someone for their mental illness is far more fucked up than having a mental illness.

People with eating disorders get mocked all the time anyway. This is a big part of the reason they feel the need to hide their behaviors and part of the reason they’re so isolated. Because not eating is so antithetical to basic biological drives, many people want to be able to write it off with sarcasm and cruel jokes. But those sorts of responses don’t provide any help or alternatives to the people being mocked. It provides more of the bad feelings and shame that they probably were trying to escape from in the first place, rather than giving them constructive help.  When mainstream culture tells you you’re stupid for feeling the way you do, you look elsewhere for support: usually to other people with eating disorders or disordered eating.

This is how thinspo communities get started in the first place. People with eating disorders can’t find community or support anywhere else and so they end up in an extremely destructive community. Mocking thinspo simply reinforces that the only “safe” people are those who also have the same beliefs and behaviors. When you make fun of the messages, you ignore some real and strong reasons for individuals to seek thinspo: loneliness, fear, shame, and self-hatred.

In addition, most people never make it beyond the front door of thinspo. They google skinny and come up with some disturbing and painful images, then spew hatred towards the people who created them. In reality, when you delve deeper you find some unexpected things. Many thinspo sites are a place of community and support, talking not only about weight and meals, but also about emotional difficulties. And oftentimes when someone in those communities makes the decision to seek treatment or recovery, they get support and kind words. Of course there are a myriad of negative messages in thinspo, but there are also people behind those messages who are often willing to provide friendship and a shoulder to cry on.

Let’s put the blame where it’s deserved: on advertisers who keep glorifying skinny, on modeling agencies that put pressure on their models to lose weight over and over, on messages about health and weight that remind us over and over again that thin is healthy. The women and girls who have internalized these messages are trying to survive in a hostile society and are using the available coping methods to allow themselves to deal with the toxic messages society sends them about their worth. It’s really easy to target people who are already hating themselves, but maybe we should look a little more critically at where those messages are coming from.

One of the final problems that a lot of people cite with thinspo communities is that they’re harmful and they glorify hurting yourself. That might be true. It’s entirely possible that thinspo has caused an eating disorder before (although I seriously doubt that it’s ever done it on its own).  But keep in mine who has created these spaces: people who are hurting, people who are lonely, people who are likely coping with a serious mental illness. I absolutely agree that we should work to dismantle the messages that are promoted in thinspo and that we should create and promote competing messages that help people find a measure of peace with themselves. But aiming our guns at the individuals who are already in so deep that they truly believe the words they’re saying? That is one of the most cruel things I could imagine.

As a last note, a lot of the mocking of thinspiration seems to be built on the back of “oh my god look at how disgusting that person is I can’t believe they’re so skinny”. Body shame of any kind is not ok. No bodies are disgusting. If you think otherwise, you can get out.

I’m going to be really open here. I’ve spent a lot of time looking at thinspo in my life. It’s never contributed to my eating disorder, but it was a clear indicator of when things had gotten bad for me. It made me feel less crazy. It made me feel safe.

I have a thigh gap. I’ve spent a lot of time thinking about my thigh gap. When it gets smaller, I get anxious. I also used to have a bikini bridge. I loved it, and I miss it and whenever I look at myself and see I don’t have it anymore I hate myself a little bit. I spend time and energy worrying about my body and there is nothing wrong with telling people that.

Because here’s the real honest truth. Anyone who wants to shame me for looking at thinspo or tell me that I’m disgusting, crazy, fucked up, or stupid because I internalized many of those messages knows nothing about me and certainly not enough to make those judgments. They don’t know why I engaged in those behaviors, and they clearly have misplaced their empathy. And if they truly believe those things about someone just because that person had an eating disorder? They can go fuck themselves.

Thinspo doesn’t make me stupid or anti-feminist, my actions and beliefs towards the patriarchy do. Thinspo doesn’t make me stupid and is not a valid reason to mock me, because what I do in my off time is none of your damn business. My use of thinspo doesn’t harm others (with the exception of my close friends and family who are invested in my well-being). Thinspo is an expression of a mental illness that is not my fault, that is not disgusting, and deserves not to be stigmatized. It is not ugly, wrong, or cruel to have a mental illness.

The vitriolic hatred of thinspo seems to me to be a veiled attempt to pass off body shaming, stigma of mental illness, and the relentless mocking of anything related to teenage girls as feminist. That’s bullshit. Mocking thinspo is a cruel action that drives people with eating disorders further into isolation. Full. Stop.

 

How Do We Talk About Eating Disorders?

I’m currently working on a post for Teen Skepchick about eating disorders in a cross cultural perspective. At the moment, I’m just in the research stage of this post, so I’m reading a lot about the research that’s been done about cross cultural eating disorders and about the differences in symptoms, causes, and etiology of eating disorders in different cultures.

And I have to say that I am deeply upset by the way we talk about eating disorders. I am particularly upset because I’ve been reading academic articles, pieces by graduate students studying psychology, and other articles that are surveys of the literature on eating disorders. These should be held to the best standards we have. Unfortunately, no matter where I look (except for in very particular blogs written by people with eating disorders, particularly Science of Eating Disorders), I hear the same things over and over and over again:

“When we expose our girls to thin models and beauty ideals they develop eating disorders”

“Girls of African American descent aren’t likely to get an eating disorder because their culture values voluptuous bodies”

“Eating disorders only crop up in other countries as they become infiltrated by Western beauty ideals”

I am SO sick of the conversation around eating disorders being dominated by conversations about models and images of women in the media and the desire to be thinner. It cannot be that difficult for people to understand this, but I’ll say it again: an eating disorder is a mental illness. It is not a diet. It is not even an extreme diet. It is not a desire to lose weight. It is a coping mechanism to deal with difficult things in your life that you can’t cope with otherwise.

There is VERY little evidence that eating disorders are caused by skinny models. What there IS evidence of is that eating disorders are caused by low self-esteem, family disruption, trauma, other mental illnesses (depression, anxiety, OCD, BPD, bipolar, and addiction are common), abuse, or other difficult situations that you need a way out of. It is such a cliche by now that eating disorders aren’t about food, but I cannot stress it enough: eating disorders aren’t about food! They aren’t about looking pretty or beautiful. I have YET to meet someone with an eating disorder who says they just want to be pretty. I hear them say that they’re depressed, that they can’t cope, that they’re lonely, that they don’t feel acceptable when they’ve eaten, that they feel out of control around food, or that they use food to numb out emotions and manage other parts of their lives.

It is not helpful to keep refocusing the conversation on how someone’s body looks and the beauty ideals. This continues to reinforce them as what’s important, and it focuses the issues on the body again, instead of addressing whatever mental stress has occurred. It simplifies the matter to a point that is unhelpful, and makes treatment and self-understanding very difficult because it doesn’t allow us to reach the real etiology of the disease. It even reinforces those negative suggestions that a woman’s worth is in the beauty standards she does or does not strive to live up to.

Instead of these things, it would be far more helpful to talk about the sexism that makes women feel inadequate no matter what they do, or the bad family systems that don’t allow for good communication or healthy emotions, or the abusive relationships that many women are in, or the trauma and depression of daily life, or the failure of our mental health system to provide us with good coping techniques for when we do start to feel over our heads. If we want to talk about cross cultural eating disorders, maybe we should talk about the different family roles that exist, the different expectations of women in different cultures, the common mental illnesses in those cultures, the differences in guilt and shame in different culture (these feelings are huge in eating disorders), and the relationship that these cultures have to food as symbolic, relational, or positive.

Eating disorders are mental illnesses. They are not an attempt to be skinny. They are not a reaction to the media. They are not the desire to look like a model. They are serious. They are life-threatening. They are painful. They come with depression, constant mental stress, trauma, self-hatred, difficulty with relationships, isolation, loneliness, feelings of guilt and inadequacy, and all sorts of things that ARE NOT simply reactions to the media, but are about how we relate to ourselves and how we relate to others. Can we please start talking about them in terms of the mental situation of the individual suffering, because that is what makes something a mental illness?