The Issue of Control in Eating Disorder Recovery

October 7th, 2011

If you’ve had an eating disorder, you know the fear of losing control: control of your body shape and weight, your eating, your emotions, your environment, your public image, people’s feelings toward you…The list of things you need to control is endless. The effort to control it all is exhausting. And it’s unforgiving. If you lose a little control of anything, it means you and your life are totally out–of–control (another of those all–or–nothing experiences).

How does control become such an all–consuming — you’ll pardon the term — issue to people with eating disorders? It probably won’t surprise you if I say it goes back to experiences you had growing up. Here are some of the more common scenarios that set the stage for control issues later in life:

  • Authoritarian families When control is enforced from the outside rather than cultivated from within, struggles over who’s the boss of me? often take on disguised forms, like an eating disorder.
  • Families that are preoccupied with issues of control When parents are anxiously focused on issues of control in their own lives, it is bound to get passed along to their kids.
  • Perfectionistic families When the bar for what is acceptable is set at perfection, anything less feels being out of control.
  • Chaotic families In families where no one is predictably in charge—for instance, due to alcohol or substance abuse — life really can be scary and it can feel like control is the only thing that matters.
  • Early trauma, such as catastrophic loss, abuse, neglect, or peer trauma. Trauma implies being overwhelmed, lacking sufficient support to protect you from the overwhelm, and helplessness to protect yourself from it. Being in control feels like the only way to avoid the unbearable feelings of overwhelm.

Okay, let’s say you identify with one or more of these scenarios. But what does this have to do with an eating disorder? Part of the genius of an eating disorder is that it seems to help you solve life issues that otherwise threaten to get the better of you. (Notice I said “seems ”.) When it comes to control, the genius ED move is to reduce the universe of what must be controlled down to weight and eating. If you stick to your current diet, or eat little to nothing, all’s right with the world. Ditto if you stay below a certain weight. And maintaining a certain level of discipline about exercise doesn’t hurt. In other words, sticking to the standards dictated by your eating disorder provides a false sense of being in control. Of course, if you’re in recovery you’ve discovered the giant paradox that the more you are run by your eating disorder, the more out–of–control you actually are.

If the paradox of an eating disorder is that it takes you out of control in the name of being in control, the paradox of recovery is that you need to accept lack of control in order to feel more in control.

How can that be? First of all, accepting lack of control means recognizing that life is big and complex and full of surprises. This is what John Lennon famously captured when he said: “Life is what happens while you’re making other plans.”  Frankly, to control everything would be to take the life out of it.

So what can you do if you’re terrified of not being in control, yet lack of control is a fundamental part of living? Your ”growth edge” in recovery is to reduce feelings of threat associated with situations where you lack control and to begin to build your sense of confidence about them. Confidence comes from discovering your capacity to figure things out, to stick with it when you’re uncertain, to develop new skills where they’re needed, to ask for help or support when necessary, and so forth. It requires knowing that not knowing is not shameful and learning is always an option. When you feel safer, curiosity can replace the sense of threat. Situations where you lack control can be invitations to growth. Ruling in the world of calories becomes less important and less interesting. Of course, gaining this kind of confidence can take a long time, but the freedom you gain for the rest of your life is well worth it.

Warm regards

Susan

Entitlement in Eating Disorder Recovery, Part II

September 17th, 2011

“Entitlement” means having rights, feeling deserving, having a sense of permission. A strong eating disorder recovery includes feeling entitled to:

  1. have and express your own needs (see “Having Needs of Your Own in Eating Disorder Recovery, Parts I & II”)
  2. comfortably be who you are, just as you are (appearance, personality, assets and liabilities, and so forth)

No one can confer these important entitlements upon you. Part of recovery will include learning to give them to yourself.

In my last post I invited you to start exploring your personal rules for entitlement. Exactly what do I mean by “rules”? Rules in this sense are guidelines—often unconscious—for how you should respond and what you believe you are allowed in certain situations. Social consensus only accounts for some of these guidelines. The rest are remnants of your personal history. They usually include conclusions drawn from your particular experiences plus the ways you adapted to them. For example, if your natural exuberance annoyed one or both of your parents, you may have learned you are too much as you are and to squelch your appetites and instincts.

Reward and Shame

Reward and shame are powerful shapers of beliefs about personal entitlement. Maybe you were praised or got attention when you took care of a caretaker, but ignored when it came to your own needs.  You probably feel most confident and worthy when you focus on others, but become anxious, uncomfortable, even guilty about focusing on yourself.

Caretakers are the most obvious sources of experiences about entitlement. But peer responses, especially in adolescence when you first are focusing hard on how to make your way in the social world outside your family, can have major impact on beliefs about how a person gets accepted or rejected. At least half the women I treat for eating disorders experienced some kind of peer trauma as teens, resulting in or reinforcing sharp restrictions on how they think they can act, look or even think, and still be accepted by others.

Modeling of Caretakers

A caretaker who can’t treat his or her own needs as important makes an indelible mark on  entitlement learning. This seems to be especially true for the caretaker of the same sex as you. A mother who can ask for nothing for herself makes it very hard for a daughter to feel entitled to more.

Identifying Unconscious Rules

When you experience anxiety, guilt, shame or any other sense of discomfort in relation to your own needs, wishes, desires or preferences, this is a sure sign you’ve bumped up against a restrictive entitlement rule. Sometimes the threat associated with such feelings is so great, it’s caused even the feelings to go underground. I often run across people with entitlement issues who can’t even risk knowing they have preferences. Or who believe they honestly would always rather do what the other person wants. In these instances, you recognize entitlement problems by a consistent pattern of behavior. (I believe these one–sided patterns can only go on so long before resentment starts to seep in and corrode a relationship. This is the source of a lot of what we call passive–aggressive behavior, when the doer can’t risk knowing or expressing anger more directly.)

It’s common to project limiting rules of entitlement onto others, meaning you believe other people view the limits of your entitlement in the same way you do. If you project your rules, you will experience other people as potentially dangerous, as if you are still as vulnerable as you were with your caretakers as a kid. Others’ opinions can feel way too powerful if seen from a kid’s eye view where rejection and disapproval can be disastrous.

Expanding Your Range of Entitlement

Let’s go back to the exercise I offered in my last post. Remember to honor your felt sense of what you can do without being triggered or overwhelmed. Start with whatever you filled in for yourself for each sentence.

I have to be thin to be entitled to _________________________.  (wear a bathing suit; wear a short skirt, dance in public, eat an ice cream cone in public, get my way, get angry…)

I have to ____________________________ to be entitled to eat. (lose 10 pounds, run 5 miles, skip a meal, be perfect…)

I have to (be) __________________________ to be entitled to __________________.

For each statement, try to come up with the following substitution: I prefer to believe_______________________________.

For example, if you believe: I have to lose 10 pounds to be entitled to eat, you might decide you prefer to believe: I deserve to treat my body with respect and care whatever my weight or I deserve to take up space, or My weight doesn’t determine my worth or entitlement to anything.

Sometimes a preferred belief can seem unrealistic or unattainable. If so, you might try one or more of the following steps and notice if you feel a little closer:

  • Think of someone you know and admire who is not model slim but eats with enjoyment and treats her body with respect.
  • Consider what makes you think of other people as worthwhile that has nothing to do with their weight.
  • Think of situations in which you have felt others responding to you as a worthwhile person that had nothing to do with your weight.
  • Try to imagine just for a moment that your weight and your worth are two entirely separate things.

In the opening paragraph of this post I said that recovery involves learning to entitle yourself. A better model still might be found in the Cowardly Lion and the Tin Woodsman from the “Wizard of Oz.” In the end Oz reveals to the two seekers that they already possess the qualities they are asking him to confer. They have only failed to recognize them! So I invite you to imagine that the entitlement to validate your own needs and wishes and to be who you most truly are as you are is already there for the taking.

Warmest wishes as you continue in recovery,

Susan

Labor Day Break

September 2nd, 2011

Wise Words is on vacation this weekend. Be sure to check back in two weeks for my second post on Entitlement in Eating Disorder Recovery.

Meanwhile, wishing you all a refreshing break as we honor the nation’s labor force, wind down the summer and head into fall.

Warm regards,

Susan