I’ve been in and out of eating-disorder treatment since 2004. Back then, recovery meant compliance, not connection. My first therapy was CBT with an eating-disorder nurse practitioner - practical, structured, focused on unpicking thoughts and behaviours. It helped for a while, but I couldn’t sustain it once life’s noise crept back in.
No one knew I was autistic and ADHD. Neither did I.
Some of my earliest memories are of food as conflict: green beans I couldn’t swallow, roast dinners that made my stomach turn, family meals that felt like battlefields. It wasn’t fussiness. It was sensory overload and the panic of not knowing the rules.
Silence shaped so much of it. My family didn’t discuss food or feelings. I might hear the occasional “you’re looking a bit too thin” or a teasing comment about chocolate, but nothing more. Everyone was trying not to make it worse. Silence seemed safer for everyone.
Over time, that silence turned into rules in my own head. If I eat that, I can’t have this. Certainty felt safe. Perfectionism promised protection from criticism and rejection. I clung to it.
For years, the illness disguised itself as discipline. People praised my willpower and tidy eating. Inside, I was quietly disappearing behind rules that gave me a sense of safety and belonging.
Two friends once came to my house with leaflets, urging me to get help. They were right - and I did - but I barely saw them afterwards. They worried about saying the wrong thing. I don’t blame them. People often don’t know how to respond, and that uncertainty lets eating disorders thrive in the quiet.
CBT made me think differently, but it didn’t reach the roots. I was expected to name emotions I couldn’t always find or describe physical sensations I barely recognised. At the time, no one talked about interoception, alexithymia, or executive function.
I worked in HR and was thriving on paper - high-functioning, articulate, efficient – but exhausted. Structure and scripts helped me mask how fragile I felt. From the outside, I looked fine. Inside, I was lost in the noise of perfectionism and self-criticism.
Years later, I was diagnosed as autistic. Three years after that, I entered MANTRA therapy. Knowing my neurology changed everything about how I approached treatment. I finally understood why rigidity, sensory overload and rejection sensitivity had wrapped themselves around food and control.
MANTRA looked at the whole system that “feeds” disordered eating - relationships, values, sensory experiences, thinking styles, the critic’s voice. During those sessions I was invited to externalise the illness, and that’s when Tina was named - a way to recognise the part that promised control but punished me for taking it.
Halfway through MANTRA, I was also diagnosed with ADHD. Suddenly the executive-function chaos and restless energy made sense too. The two diagnoses reframed decades of self-blame. I wasn’t broken - I was wired differently.
Services today feel more neuro-informed, and it makes all the difference. Occupational therapists advise on lighting, smells and textures in treatment spaces. Clinicians adapt plans for sensory needs and executive-function challenges. Sessions are paced slower, with clearer language and more flexibility.
The goal is no longer to break a person to fix a symptom. It’s to understand the system that made the symptom necessary.
My life is gentler. I still like structure, but it works with me rather than against me. I eat snacks. I move because it helps me think, not because it earns me food. I notice my critical thoughts sooner and choose “enough” instead of “perfect.”
Tina still speaks, but she rides in the passenger seat these days. I’m driving.
If you love someone with an eating disorder, say something. Even “I care, but I don’t know what to say” can open a door. Silence feeds the illness far more than clumsy concern ever will.
If you’re in treatment and also neurodivergent, tell your team. The missing lens might explain why “just eat normally” has never felt possible.
And if you’re in the thick of it, please know this: you’re not impossible, or difficult, or a burden. You’re a person in pain, doing your best to survive. Recovery isn’t about never hearing the illness voice again - it’s about learning to answer it with kindness.
The road isn’t straight, but the view keeps widening.
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