Treating Eating Disorders: The First Assumption

Let’s be clear from the get go, when it comes to getting help for an eating disorder there are a couple of assumptions to consider. Let’s look at a one of these and consider if this might “ring true” for you.

When it comes to best place to get help, people differ with respect to their own ideas of what they want and expect from a treatment program. Although, at first glance, you may tell yourself “I want to get better but I’m not willing to” [you fill in the blank]. It’s important to understand that any credible program will require some degree of, dare I say, “letting go of control”. Of course to anyone who has experienced the tyranny of an eating disorder this obviously means food and weight.

Assumption 1: Change your [eating] behavior first - the feelings and thoughts will follow.

In order for recovery to begin, we have to swallow hard [no pun intended] and raise a white flag. For those who are familiar with a 12-step program, this usually means “surrender.” For those unfamiliar with these support groups, it means a commitment to allow something other than you to drive the bus for a while. However, surrender does not equate with defeat but rather ironically, with the beginning of recovery.

It’s been suggested that “our best thinking got us here” when referring to all the attempts to do it our way. Surrender, then, is following directions without our “mental committee” rationalizing, modifying, and changing what someone [program, therapist, etc.] else has prescribed for us. From my standpoint its about doing “the next right thing despite how we feel” and no longer letting our distorted thinking and misaligned fears control our behavior – especially as it relates to our relationships with food and body image. In the language of cognitive therapists, feelings are not facts. From the perspective of those teaching principles of recovery, it means “doing is believing.”

One of the most dangerous beliefs people have when it comes to an eating disorder is along the lines of: “I’ll start to eat more when I feel [once again you can complete the thought], I’ll stop [binging, purging, restricting, compulsively exercising, etc.] when I feel or think, [blank]. At best, this only results in most people switching one form of their eating disorder for another. Examples include trading in binge eating and purging for restricting patterns, switching from compulsively overeating to restricting, starting to purge in an effort to loose weight after overeating. We tend to refer to this phenomenon as “switching deck chairs on the Titanic.”

Marty Lerner, Ph.D.
Http://www.MilestonesProgram.org
mlerner@milestonesprogram.org