FCYU-Feature Story

Starting To Feel Again
Where eating disorders come from, and how to recover

Mary Hopper, MA, is a primary therapist on the adolescent team at The Renfrew Center, a research and inpatient treatment center for people with eating disorders.

Q: Why do people develop eating disorders?

A: It’s complicated, and it’s different for everyone. But in general, eating disorders appear to be a way to cope with feelings that feel intolerable. Things like abandonment, hurt, sadness, anger, fear and so on. It can stem from trauma, because traumatic memories are horrible and no wants to feel them or deal with them. An eating disorder keeps you so preoccupied, it’s so consuming, that it helps you not have to remember stuff from your past that’s traumatic.

Manipulating food, and your weight, is a way of rescuing yourself from having to feel anything. Being able to focus on all this stuff (when to eat, how much, when to throw up) is like a full-time job. It helps distract you from all the things in your life you can’t control. It can even be physically numbing, and certainly it emotionally numbs the person

Also, eating disorders can be a way of wanting, usually unconsciously, to show people how bad you feel on the inside. Maybe you can’t talk about it, or no one is listening. But if you make yourself look like a skeleton, people are going to pay attention.

Q: What does it take to recover?

A: You really need a treatment team: a nutritionist, a psychiatrist to help with meds, a therapist to help you identify what needs you’re trying to get met by using the disorder, and a family therapist to help parents or siblings really listen and try to make changes so you don’t feel so alone.

Q: What are the first steps?

A: You first have to learn how to keep yourself safe: by eating, following your meal plan and taking care of your body. Then you can focus on what was causing these behaviors.

If you’re still restricting and bingeing and purging, you can’t engage with anything, because you can’t feel anything. That’s what’s great about inpatient treatment: there is all this attention paid to making sure you are eating, so then you can start feeling and doing the emotional work.

Q: How long does it take?

A: Once you decide that you want to get better, it can take between three and seven years to fully recover. You’re really changing a lifestyle pattern you’ve had for years. Eating disorders don’t happen overnight. They’re usually a culmination of many years of pain and suffering. To recover, you need to change how you relate, and the way you deal with conflict or sadness, as well handling the changes in your body. It takes ongoing therapy.

The good news is our experience shows that if patients are committed, their symptoms will not be as severe all the way through. It will get easier.

Q: How do you know you’re really recovered?

A: Some people feel that with an eating disorder, like with an alcohol or drug addiction, you can never consider yourself fully recovered. Because an eating disorder is a response to intense feelings, someone might be fine for 10 years, then a trauma happens and they’ll return to the disorder. Usually it’s brief, and not as severe as it was originally, but that’s why it’s hard to say someone is recovered.

One way to keep yourself safe is with therapy. Eating disorders are fueled by unconscious stuff. Therapy is a way of helping the unconscious become conscious, making you aware of what your issues are so you can do something about them.

Q: How can you manage your recovery once you leave a supportive environment like Renfrew?

A: What we find works best is that after a patient leaves an inpatient center, they should gradually step down first to a day treatment program (where you live at home but attend every day for most of the day) and then to less intensive outpatient programs.

Often, people with eating disorders think they can do everything alone. But you can’t recover alone. You really need your family, your friends and a treatment team. The more support you get from the more people, the better you’re going to do.

For more information, visit www.renfrewcenter.com or call 1-800-RENFREW. You can ask questions and get advice from others in recovery at www.RUhungry.org.