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As a therapist specializing in the treatment of eating disorders, posing the question, "Who are you without an eating disorder?" often evokes feelings of unease and uncertainty for my patients. The eating disorder may have woven itself so profoundly into their sense of self that it blurs the boundaries between the individual and the illness.

The inclination to over-identify with the illness is understandable, especially for those whose eating disorders developed during their formative years and persisted for decades. The eating disorder may have initially emerged as a response to emotional pain, acting as a mechanism to soothe, numb, express, or communicate that pain. To take that coping mechanism away may be akin to taking away a security blanket or a life raft.

The Intersection of Identity and Eating Disorders

Early psychodynamic theorists identified eating disorders as disorders of the self, where symptoms manifested as a response to inner turmoil.¹ The over-identification with an eating disorder can make it challenging to discern the person from the illness. Particularly in cases like anorexia nervosa, where behaviors align with societal ideals, the disorder becomes integrated into one's sense of self.

However, it's essential to recognize that these behaviors, no matter how entrenched, are coping mechanisms rather than defining characteristics. Eating disorder recovery demands a nuanced understanding of self, distinct from the eating disorder.

Developing Discrepancy

Values play a pivotal role in the recovery process. Uncovering personally held values incongruent with eating disorder behaviors allows individuals to recognize the dissonance between their true selves and the disorder. As individuals embark on the path to healing, developing discrepancy emerges as a crucial component. This therapeutic technique operates on the premise that our core values represent the essence of who we are and what truly matters to us; when individuals find themselves entangled in behaviors associated with eating disorders that are incongruent with these core values, a profound dissonance surfaces.

 

Source: Photo by Jordan Madrid on Unsplash

This cognitive dissonance becomes a potent catalyst for change. The aim of developing discrepancy is to highlight the discord between actions and values and gently guide individuals through a reflective process. Through tailored therapeutic interventions, such as reflective exercises and open discussions, individuals are encouraged to explore the misalignment between their true selves and the behaviors perpetuated by the eating disorder.

The beauty of developing discrepancy lies in its non-judgmental and empathetic approach. It doesn't cast blame but serves as a mirror, reflecting the impact of the eating disorder on various aspects of life and well-being. This heightened self-awareness becomes a powerful motivator for change. As individuals grasp the stark contrast between their authentic values and destructive behaviors, a natural inclination to move away from the clutches of the disorder takes root.

Building Willingness Through Acceptance

Willingness is a crucial element in overcoming an eating disorder, involving the acceptance of complicated feelings instead of suppression. Acceptance and commitment therapy (ACT) emphasizes reconceptualizing and embracing distressing thoughts. The goal is not to eliminate these thoughts but to develop behavioral flexibility aligned with one's true values. Various methods, such as values clarification exercises, can be used to recognize one's values and foster willingness to navigate the discomfort of recovery.

The Power of Heroes in Recovery

Shifting the focus from appearance to character is proposed as a decisive step in eating disorder recovery. By reflecting on someone admired, individuals redirect their attention from superficial aspects to the qualities that make a person truly admirable. This shift serves as a catalyst, challenging distorted beliefs associated with body image and self-worth. Identifying a hero encourages the reevaluation and possible redefinition of values, aligning actions and choices with what truly matters.

Final Thoughts

Overcoming an eating disorder involves navigating the complexities of self-discovery and aligning behaviors with core values. Recognizing the distinction between yourself and the illness and fostering a willingness to embrace change can lead to a more authentic and fulfilling life.