Eating disorders (ED’s) don’t develop out of nowhere, for no good reason. Even the link between social media and ED’s is a little pushed in my opinion. Whilst social media can have a negative impact on a person’s perception of themselves, I have yet to work with someone whose difficulties began directly because of it. Being a complex mental health problem, the reasons underlying are usually complex too.
There is, however, often a trigger for behaviours relating to food and body image to begin. My spiral into anorexia was seeing a photograph of myself aged 17 that brought a lot of negative thoughts relating to how I looked, but was this the cause of my ED? The contributing factors actually started at around the age of 6, with a number of events and my own inaccurate perceptions building up over the years. And actually, whilst unrecognised, an unhealthy relationship with food started when I was 13; I just didn’t see what was going on.
It took several more years for me to begin exploring the factors. I have now worked at First Steps ED for a decade, and a question that comes up a lot from professionals, to parents, to the sufferer themselves, is why? Why has an ED developed here? Usually alongside emotions such as frustration, anger, bitterness. But what would it be like to embrace the ED, to listen to it, and to try and understand it?
This may seem like a strange concept. Why would you want to embrace the ED when instinct says to get rid of that horrible voice. After all, who wants to live day in day out being berated and bullied, and why would you want to give that the time of day?
Eating disorders usually begin behaviourally by a person manipulating food or their body in some way. This could be overeating, restricting, purging, overexercising, body checking, the list goes on. There are reasons as to why someone begins to do these things, and as you’ll see below, what these behaviours could be in response to.
We all need to be comforted at times. This is a basic need from birth and in infancy, and whilst it becomes less critical for survival, all of us want feelings of grief or distress to be alleviated. Hopefully most of us are able to turn to self-care, friends or family for comfort. But this is not always the case. It may be that those things aren’t available, the person doesn’t feel safe, or they don’t have the awareness or ability to tap into these. It may also be that food is easily available to eat, potentially a quick and easy release.
The term ‘comfort food’ is not uncommon. I am sure most of us relate to feeling stressed and eating something sweet like chocolate to give us a boost. When we engage in something enjoyable, which may include eating something that tastes good, we are releasing dopamine (a neurotransmitter that creates a feeling of pleasure) and endorphins (hormones released when your body feels pain or stress). Receiving such a boost therefore demonstrates how eating for comfort initially has a positive effect. It is easy to see how this can become addictive.
There are so many things in life that we have little or no control over. If I were to ask you, what in life do you have complete control over? Can you 100% influence the thing(s) that come to mind? Or are there other influences, so many variable factors? This lack of control can in itself can feel difficult for people. The anxiety is then heightened when someone’s had decisions made for them which has a direct impact, or if they have negative experiences or trauma which usually involved an element of some or complete powerlessness. In trying to grasp something in life to regain the sense of control, many turn to food or exercise. I can control what I put in my mouth. I can control how many miles I run. I can control how hungry I feel, how my body looks. These changes may impact how someone is viewed as well. “You have so much self-control” or “I admire how committed you are to the gym” or “I wish I could lose weight like you” – all music to the ears of an ED. The high that’s felt in these scenarios adds fuel to the feeling of being back in control.
Feeling inadequate, not good enough or like we have failed at something, are experiences many of us have had at some time or another. We may even beat ourselves up with thoughts like “You should have done better” or “I am such an idiot”. It isn’t too far to imagine having these thoughts regularly, and how they can start to infiltrate into behavioural responses. Many view ED behaviours as self-harm, responding to guilt and filling the desire to self-punish.
This can link in with the above, with an underlying belief of not feeling worthy or deserving. I’ve seen this a lot in those who have had sexual trauma; by heavily restricting, or binge eating to gain weight, others may be kept at bay which can help a person feel safe. Sometimes low weight can be associated with a childlike body, a coping mechanism for someone not to feel like an adult, to limit feeling responsible, or to lower the risk of another adult causing them harm. Therefore, the ED may be an attempt to keep themselves safe from further harm.
Understanding how the ED has comforted us, made us feel in control, or responded to anxiety and threat, allows us to see how it has helped us. Exploring what the reason(s) might be for using food means turning to the eating disorder to help us understand. There are many ways this can be done which can be facilitated in therapy, but a starting point is listening to the ED to speak instead of pushing it away, which usually doesn’t work anyway. Whether the ED voice feels external or part of our internal voice, we can invite a conversation to take place – that ED voice likes to speak up anyway so let’s invite it in.
What does it want to tell us?
What is fuelling the anger or other emotion connected to the ED?
What does the ED feel it is needing?
How was it trying to help us?
Once this conversation is happening, in time we can begin to thank the eating disorder for trying to help and meet it with empathy and compassion – something we need to do for all our parts, and therefore ourselves as a whole. We can say thank you for trying to keep me safe, I am now going to try some new strategies and responses to stress or distress.
I have seen how healing going through this process can be, within myself and the people I have worked with. And now, when that little voice comes into my head, I simply say “Hello again! What brings you here…? Thank you for coming and trying to help me deal with this stress. Today, I am going choose a different way to respond”.