As with mental illnesses in general, responsibility is a major issue when it comes to eating disorders. Earlier this year I read a piece of research that highlighted a stark contrast in beliefs and attitudes towards individuals with physical illnesses, compared to those with eating disorders. As this research concluded, there is no consideration of blame when it comes to physical illnesses such as cancer or pneumonia. However, for mental illnesses, despite being just as debilitating, traumatic and life-changing, there’s a clear disparity. The origins of these illnesses are buried deep within the unconscious mind where, unfortunately, no examination or diagnostic test can obtain concrete answers. It appears that in the absence of an adequate explanation or cause, as a society, we often find it’s easier to dismiss the problem or throw suspicion onto the sufferer themselves than try and make sense of baffling illnesses like eating disorders.
The blame is directed at eating disorder victims not only by supporters and observers, but by the sufferer also. For years I felt like a prisoner to this torturous illness, a puppet to the voice in my mind that overrode my ability to make any rational decisions… and yet, despite feeling completely brainwashed and out of control, I knew deep down that no one forced an eating disorder upon me… my damaging and disordered behaviours were exactly that – mine.
Without any concrete understanding or evidence otherwise, coupled with the frustration portrayed by those close and my inability to articulate what was happening inside me, as I couldn’t even explain it to myself, I inevitably felt the eating disorder was my fault, and somewhat a choice I was making. The self-blame, guilt and confusion that surfaces from knowing what you need and somewhat want to do, but feeling powerless to make the steps is paralysing and, in hindsight, pushed me further into the grip of anorexia, distracting me from feeling the deep sense of shame that comes with an eating disorder.
It reached a point where I had no choice but to face reality and the myriad feelings I’d supressed that had been masked for so long. This came when I was spending my days as a day patient at the local eating disorder service following hospitalisation, where, through supported eating, the severe effects of starvation began to diminish; improved health and cognitive function enabled my mind to process information and thoughts other than food. With time to truly reflect on my numerous years within the eating disorder and process how consumed I had become by anorexia, I began to grieve for the time lost, and I overwhelmingly became haunted by the possibility that I was to blame for the years of agony I had caused my loved ones and myself. In all honestly, I didn’t want to accept any responsibility for that – I even began spending a lot of time reading books and articles on eating disorders, and reflecting on my life, aiming to figure out who, what, when, where, why and how I had got here. The truth is I wanted so badly to point the finger at a dysfunctional family, an unstable environment, the thin-obsessed culture… anything. I wanted to take out the anger and bitterness I felt on someone or something… and to a certain extent, I did. Beneath this frustration, however, I was still confused. I couldn’t precisely pinpoint the cause… and I still can’t.
I cannot even say the help wasn’t available when I recognised how out of control my behaviours were. As we know, mental health services are a postcode lottery – to say I wanted help but it wasn’t available would at least enable me to salvage my integrity. However, the amazing eating disorder service, where I’m continuing to receive treatment, has always been there, and offered support throughout the duration of my eating disorder. Each time I was referred, I walked through the doors adamant to change, to then leave and disengage, going straight back to my disordered behaviours and to the denial and secrecy that gave my eating disorder sanctuary. Since very limited people knew, it could easily continue to exist until severe external symptoms gave it away. The honesty here is I didn’t want the help then; I wasn’t ready to come to terms with the problem and prioritise recovery. Furthermore, as hard as it is to admit, when I was in the depths of anorexia, at times I liked what my eating disorder gave me; I liked the feeling of control I acquired through having anorexia. So… with my inability to find a cause, the chances I was given to attend therapy to receive the help I needed and the satisfaction I gained from some aspects of anorexia… I really am to blame, aren’t I?
Wrong… thankfully I can conclude I’m not!
What treatment has taught me, and the aspect I continue to work on, is that things are not as black and white as I tend to interpret them with my perfectionist mindset: eating a balanced diet will not make me inflate overnight, feeling a sense of loss as I move away from anorexia doesn’t make me crazy, relapsing doesn’t make me a failure, and asking for help doesn’t make me weak. Eating disorders are complex, multifaceted mental illnesses. No one individual or event is to blame for an eating disorder. When life presents its inevitable challenges we all seek relief in any way possible… and, like with any stressful situation or event and the intolerable feelings that may surface from it, the coping mechanism we unconsciously use depends on a variety of elements, including our personality, what we’re taught, our beliefs, and what we have available. Unfortunately, this relief is sometimes found within maladaptive behaviours that offer short-term relief and long-term agony – like an eating disorder. The difficult and most worrying aspect of eating disorders, however, and numerous other mental health illnesses, is their power to obscure the reality of things from their victim… where the irrational becomes rational, danger becomes safe, self-harm becomes self-soothe… and, scarily, this is out of the conscious awareness of the sufferer. I don’t remember much about my descent into my eating disorder. I didn’t see it coming; I didn’t recognise it until it was upon me.
So… I know now, through increased knowledge and understanding made of what has seemed senseless for many years, that I am not responsible for this illness – because it is just that – an illness, not a choice, a weakness or vanity.
What I have come to recognise, though, is that this does not unburden me from all responsibility. Yes, an eating disorder is an illness that can be as debilitating, life-changing and traumatic as a physical illness; however, unlike many physical illnesses, eating disorders cannot be extinguished through medication or through surgically extracting the source. Recovery only truly happens when the sufferer makes the conscious decision to let it. Eating disorders are an outward sign of inner distress; additionally, they’re an illness of contradictions, so deciding to recover means the sufferer needs to wholeheartedly commit to the journey, and grieve the characteristics of their eating disorder they find comfort in – whether that is the starvation high of anorexia, dopamine rush of binge eating, or any number of eating disorder behaviours. A careful exploration of what was missing at the start of the illness and to what an eating disorder has been the apparent solution is paramount if the sufferer is to survive and thrive without it.
The harsh reality is there is no quick fix to recovery, and nobody can be forced to recover… yes, physical intervention can be forced upon the sufferer, but symptom reduction (support with weight gain/following a meal plan) will not necessarily amount to recovery. This responsibility belongs to the sufferer.
The turning point in my recovery came when I found this balance in responsibility, accepting responsibility where it’s warranted and relinquishing it where it’s not… assuming too much responsibility caused self-blame, shame and total powerlessness when I realised I couldn’t simply eradicate my eating disorder alone; however, assuming too little fooled me into believing I had no control over my thoughts or behaviours – which also ended in helplessness. In order to strike a balance and begin letting go of my obsessive and destructive behaviours, I had to learn to cultivate acceptance, compassion and empathy towards myself. I had to, with guidance, treatment and support, create a vision of how I want to live my life and be accountable for moving forward.
Of course, this is easier said than done, and I don’t want to trivialise the sheer exhaustion, stress and anxiety that recovery entails. Given the amount of years I lived with anorexia, there wasn’t much of me left – physically or mentally – so I had to hand myself over to the treatment process: trust professional recommendations, work to develop healthier coping strategies, explore and identify my values and desires aside from what is commonly held by an eating disorder, and take every step necessary to take me a little further away from anorexia – no matter how overwhelming, terrifying and trivial it seemed.
It is coming up to a year since I started my recovery. As I, scarily, move away from the intensity of guidance and treatment, I’m not sure whether I will ever recover in a way that is complete and forever, as I originally hoped, but what I do know is that I do not want anorexia to take centre stage in my life anymore. I have been reminded numerous times that recovery is not a linear process; it is a journey, so – at the most basic level – I am trying not to fixate on reaching a specific destination, but rather take the lead and cultivate a life that is not dictated by food or numbers.
I didn’t choose to have an eating disorder, but I am choosing to recover from it.
“It is hard to admit that many good years were wasted on things that didn’t really deliver what seemed promised. You might be tempted to hang on and just try a little harder or maybe a little longer to reach those old goals, but at some point, you have to come to terms with the truth about what the behaviours are doing for you versus what they are taking from you… Your eating disorder will never really make you more lovable, a better person, or invulnerable to pain. As difficult as this realisation is, it opens the door for creating a better life… you can’t go back and change the beginning, but you can start where you are and change the ending.”