According to the contemporary medical model, recovery from an eating disorder often is viewed in terms of objective criteria…numbers: when he reaches his “treatment goal weight” or when she ceases using purging behaviors. As soon as this criterion is reached, all too often, and at times too soon, we stamp in thick black ink: RECOVERED. Good to go! Breathing a huge sigh of relief, we think, Glad that’s behind us…
Perhaps equally common is the idea that formal or “conventional” eating disorder treatment (consisting of psychotherapy, nutrition counseling, and medical monitoring and, if needed, higher levels of care such as residential or partial hospitalization) leads—along a stable, linear path—to recovery. Though sometimes a more varied or creative path is needed. The path to genuine, long-term recovery addresses aspects such as mental, emotional and/or spiritual “hunger” in ways that a treatment approach emphasizing objective criteria alone may not fulfill.
In my work to promote eating disorder recovery, I continue to be deeply inspired by an article that I encountered early in my career. In this qualitative study in a peer-reviewed journal, investigators Matusek and Knudson (2009) used semi-structured interviews and an interpretive biographical method to depict women’s experiences of long-term recovery from compulsive overeating and anorexia. The study highlights the women’s self-identified turning points in recovery, portraying its richness and complexity and making a strong case against the notion that removal of physical symptoms alone is enough. As a whole, the women’s narratives suggest that long-term eating disorder recovery involves an ongoing transformation motivated by engagement with communities larger than the self—ultimately, cultivating a life purpose and sense of direction.
Among the narratives that the study authors chose to highlight (that of Pamela, Virginia and Heidi, respectively), community engagement included: creation of and activism within a college feminist group; participation in both a spiritually-inspired yoga and meditation practice and the hippie and New Age movements of the time; and teaching evangelical Sunday school to 7th and 8th grade girls meanwhile finding joy and support in the church community at large. The study authors state (p. 704):
To leave the worlds of anorexia and compulsive overeating,
Heidi, Pamela, and Virginia actively sought alternative ways to make sense of the world
And find value in life beyond the prison of their eating disorders.
Defined this way, full eating disorder recovery is so much more than symptom removal: it involves truly flourishing as a human being. (I cannot think of anything more hopeful than this, and this faith keeps me in this field.) When I relate Matusek and Knudson’s article to my work with CNC 360, I am reminded of our recent group discussions about Acceptance and Commitment Therapy (ACT), a form of psychotherapy uniting values-inspired living with present-moment engagement. Applying the ACT formula to nutrition therapy involves: (1) allowing my clients to clarify their values, that which is significant and meaningful to them, (2) reminding clients that values may encompass caring for others but also must involve caring for and nourishing self, and (3) helping clients to notice that eating disorder behaviors do not nurture these values. In the tougher moments of recovery, I might ask, “How can we redirect our focus toward behaviors that are aligned with your values?”
Getting to the heart of what is truly meaningful, I feel nourished as a clinician to know that the recovery I help my clients find is the long-term, genuine kind, fed by self-care and purposeful engagement with the world around them.
Matusek, J. A., & Knudson, R. M. (2009). Rethinking recovery from eating disorders: Spiritual and political dimensions. Qualitative Health Research, 19, 697-707.
Harris, R. (2008). The happiness trap: How to stop struggling and start living. Boston, MA: Trumpeter Books.