As far as I am aware, everyone has some sort of running inner dialogue that assists them as they go about their day. The same is true for people with eating disorders. However, the way in which these two conversations play out differ greatly from one another. Most people hear mainly the words of a supportive and sagacious life coach, one who is prepared to be critical where necessary but takes a mainly balanced approach in what he or she has to say. However, someone with an eating disorder is subjected to the words of a cruel and malicious bully, incessant in its drive to once tempt and force a person into taking what can sometimes be life-threatening actions.
At first, the eating disorder voice may be gentle and encouraging, such as drawing attention to the sudden calm a person may feel when they eat less. In this way, it almost seems as though it is guarding an individual's health and wellbeing. However, if the voice is disobeyed in any way, the voice becomes louder and more critical, shaming someone into trying harder next time in order to appease. To many, it may not even feel like a voice at all, just a new part of their normal inner dialogue, a very seamless transition into this new, eating disordered identity. The longer this goes on for, the harder it is to do the necessary ‘letting go’.
So what can be done? What may help, and what certainly aided me in my recovery, was personifying the eating disorder – I chose to give mine the deliberately reductive moniker 'ED'. In this way, the person with the eating disorder can begin to acknowledge 'ED' as some sort of foreign inhabitant who has merely hijacked one’s brain and can be removed with the right combination of tools. Knowing this can help to restore hope, not only in the sense that a life with it is no longer the inevitability it once appeared to be, but also in the sense that a person is capable of using their own resources (or rather, the resources they are given through treatment, for example), to conquer the ED once and for all.
I originally came across the idea of personifying my Eating Disorder when researching useful recovery resources, namely through Jenni Schaefer’s website. Jenni is a published author who writes predominantly self- help books on the topic of Eating Disorders, spurred on by her own success in overcoming both Anorexia and Bulimia. She herself learnt to define the Eating Disorder as a separate being with help from her psychologist, Thom Rutledge, and shares many of his techniques with her readers. Immediately, I was struck by the simplicity of the idea; eating disorders are difficult to understand but if I could view the Eating Disorder as nothing more than a scheming bully recomplete with its own agenda, I could at least begin to challenge whatever he or she was telling me.
Jenni, in her bestselling book Life Without ED, uses an approach that draws from CBT called ‘Writing Dialogue with Ed’. In this, she scripts out a conversation she has with her Eating Disorder where, instead of assenting to its commands, she challenges the voice instead. This is a really effective technique for noticing the absurdities ED throws up and helps to build mental flexibility. Instead of buying into what ED’s ‘truths’ are, you can begin to think of alternatives to what ED suggests. These alternative ways of thinking can then be used to challenge the voice on a more consistent basis.
You are feeling a little bit lonely at this new job. All of these people have known each other for years and it’s going to take aaaages before you feel comfortable with any of them. Plus, you are quiet and boring so it’s unlikely anyone will like you anyway. You should aim to eat reallysmall meals this week, think child-sized portions. It will help you feel better.
I know you think I am quiet and boring, it’s what you always tell me. However, I have many interests, you just don’t allow me to explore them as fully as I’d like. I mean, it’s not like you exactly give me the time to. Furthermore, whilst it’s true I’m initially quite quiet and that I take a while to warm up to my surroundings (it’s almost as if my brain is in a gathering data stage before it proceeds with chat), once you get to know me, I can be quite chatty. It all depends on the subject matter and how comfortable I am feeling. Also, I like to think things through before I speak. Is that so much of a crime?
The above exercise looks as though it could be taken straight from an Improve your self-esteem or Assertiveness 101 manual. But therein lies the answer. Someone with an Eating Disorder normally has a fragile sense of self, not surprising considering the relentless abuse. In terms of learning to be assertive, people with eating disorders also instead learn to acquiesce to their illnesses’ commands, at the expense of their personal happiness. This is not to say everyone with an Eating Disorder struggled with assertiveness before the onset of their disorder, but it certainly erodes a person’s ability to use it.