By this point in
the year, many people have already tried more than one diet program in order to
achieve their New Year’s resolution to lose weight. Others have been trying to
keep their daily promise of not using their eating disorder behaviors. They all
may be wondering, “Why can’t I do this? Why can’t I eat in a healthier way, no
matter how hard I try?”
This is also often
one of the first questions our clients ask when they begin therapy. “Why do I
have this eating disorder?” They’re convinced that if they know why they do
what they do with food, they’ll be able to stop doing those things.
Knowledge is
helpful, and we definitely spend a lot of our time in therapy helping you gain
knowledge and insights about yourself. Yet knowledge alone doesn’t give you
what you need to make the necessary changes, especially without support.
On the website of
NEDA, the National Eating Disorders Association, they offer an overview of the four basic causes
(contributing factors) of eating disorders. Over the next few weeks, I’ll
present each factor and go into more detail about what’s involved.
Their first point
is that eating disorders are very complicated, and it’s never just one thing
that’s the cause. If it was, there would be just one form of treatment, and as
we know, there are many.
The first set of
factors that may contribute to eating disorders are psychological factors.
If eating
disorders are a method of coping with what’s not working in your life, what are
the psychological factors you are coping with? Someone may feel low
self-esteem, or a lack of control over what’s happening in their life. They may
be experiencing other mood disorders like depression, anxiety, loneliness,
grief, abandonment or resentment.
Recovery is not
just about eating differently, it’s about looking at your underlying emotions,
so that you can begin thinking different and acting differently. 12-step
programs, therapy and treatment centers are all places you can go to do this
important emotional work.
Workbooks can be a
very helpful tool. For example, for low self-esteem we recommend The Self-Esteem Workbook by Glenn
R. Schiraldi, 52 Weeks of Esteemable Acts
by Francine Ward and Ten Days to Self-Esteem by David
D. Burns, M.D. In our experiences, however, workbooks are only helpful if you
share your work with someone else.
An eating disorder
can be a form of rebellion for someone who feels a lack in control in their
life or is feeling angry at someone but is having trouble expressing the anger.
It’s as though they’re speaking with the food, saying the things they can’t say
with words.
Therapy gives you
a place to say those words. Sometimes a more intensive level of therapy is
needed, where someone visits our office three times a week. In essence, we
become their outpatient program.
For some people,
inpatient treatment is the best option. I recently visited the Castlewood
Treatment Center for Eating Disorders in St. Louis and learned about some
of their treatment methods. For example, they use Internal Family Systems Therapy
(IFS) to help their clients integrate different parts of
themselves, in order to access their inner compassion, confidence and
curiosity.
The IFS process
also helps the person see the eating disorder as just one part of their
identity, not the sole definition of who they are. This concept was also
covered in the book Life Without Ed, by
Jenni Schaefer. Your eating disorder may have actually helped you survive and
get through traumatic events, but once you go into recovery it’s because the
eating disorder is not working for you anymore. It’s definitely not helping
your health.
For reducing depression,
anxiety and phobias, we may apply a number of different techniques such as thought
stopping, cognitive behaviour therapy, mindfulness or thought restructuring. We
often recommend that people incorporate movement
into their day, in particular things that get them outdoors in natural
light.
These
psychological factors are only one of four interrelated factors that may
contribute to eating disorders. Future blog posts will explore the other sets
of factors.