When I first really sought treatment for my ED I was physically, mentally and emotionally very sick. I couldn’t choose recovery or take responsibility for my own care – that’s why I’d finally reached out in desperation, with the last of my energy, to people I hoped could save me.
They of course told me I needed to “choose recovery” and take responsibility for my health. I was bereft! Seeking help was about all the responsibility I was able to take at that point and I needed guidance and help. Instead I kept hearing that hateful phrase “What do you want to get out of this?” I had no answer of course. Not to feel shitty? Not to die?
I wish healthcare providers would stop trying to foist responsibility on ED patients who are not ready to shoulder it. Treat the illness, save the person. Don’t try and give them “coping tools” or encourage them to save themselves. They can’t. Nobody chooses to become anorexic, it’s a complex illness with neuro/bio (& psycho/social) causes. Likewise, you can’t just choose to get better. That’s just hurtful victim blaming.
…However, I’m also quite keen on the Jungian ideal of treating the person as a whole, as opposed to focusing on just exorcising their pathological symptoms. Clearly, most people’s psychic malodies, their disorders and neuroses weren’t caught like someone might catch a cold. They’re part of the person and their maladjusted approach to life, an SOS from the subconscious. Just because they might have only shown up recently that doesn’t mean they weren’t bubbling under the conscious surface for a long while.
I’m convinced that by the time you show symptoms of an ED something has been Not Right With You for a long time. And ED is a last, desperate attempt to cope from someone who is struggling. I personally think my AN was a big “NO”. Overwhelmed by life for many years I eventually ran out of energy and had to put up boundaries. Nothing went in, no feeling, no food. It was a symbolic way of pushing all that messy, invasive, scary life away.
But does that matter by the time you show up, dull-eyed, starving and suicidal at the Dr’s office? No. At that point they need to get you medicated, medically stable, furnished with emergency phone numbers and intensively helped with the basics like how to eat, how to leave the house despite your anxiety and get to the therapists.
I wasn’t unmotivated or reluctant to recover, I was incapable and terrified.
Like Carrie Arnold says in one of her excellent blog posts – the recaltriant non-compliant patient is a myth – it’s just that a lot of us can’t take the help offered. We can’t pick up those tools and make use of them. We need people to take that responsibility and do it for us.
So what am I blogging about here? I guess I’m saying that people with active EDs need nuts & bolts basic help, handholding and direction when they reach out for help. Sure, you’re just treating the immediate symptom of a deep psychic malaise but it’s important to provide help, not just the opportunity to pursue help. Because otherwise, many of us would actually be dead before we even made it to the top of the psychotherapy waiting list.
And the deep psychic malaise can be explored later. I’m in therapy now and I’m able to make use of it because I’m not starving and I’m more mature. This is me taking a responsible step to cement my recovery. I wouldn’t have been here to do this if I hadn’t got the basic nutritional and medical support (eventually) when I reached out for help.
So, to finish I’d just like to emphasise – developing an ED wasn’t your choice or your responsibility or your fault. Fuck anyone who tries to tell you you chose it and you just have to choose to get better. You’ll probably need to reach out for help, be that in the Dr’s office or from online support or from your friends. Do that, do it sooner rather than later and stand up for yourself and your needs. You deserve it. Yes, even you.