Friday, 15 August 2014

EATING DISORDER RECOVERY

An article focusing on eating disorders and recovery tips/strategies. This information will prove invaluable for the practical element of this module.



Definition of Recovery


There is no universally accepted definition of what ‘recovery’ is. It is one of those terms and concepts that is open to interpretation and can mean different things, to different people, at different times. Recovery means different things to each of us. However, in basic terms it means ‘getting better’ and living and learning to live and cope with everyday life without an eating disorder. We looked at what other organisations thought ‘recovery’ meant and a small selection of these definitions has been included below.

The National Institute of Mental Health in America says that recovery is: 'The uniquely personal and ongoing act of claiming and gaining the capacity to take control of life that is personally meaningful and satisfying, with opportunities to perceive her/himself as a valued citizen. The person may develop and use their self-determination to grow beyond and thrive, despite the presence of the limitations and challenges invited and imposed by distress, its treatment and the personal and environmental understandings made of them'.

Anorexia and Bulimia Care (ABC) states that: 'Perhaps the most common difficulty with thinking about recovery is having a clear idea of what it actually is. For those in the middle of an eating disorder it can seem as if (for everyone else) recovery is about weight and eating - about gaining weight for those who are struggling with anorexia, or about regulating and controlling eating for those who are fighting bulimia or binge eating disorder. In fact, eating and weight are just a small part of recovery and really are more of a symptom of how well recovery is going rather than the main feature of recovery’.

According to Aceda: 'Recovery is a deepening process where you can learn a lot about yourself, relationships, food, and life in general. Recovery from an eating disorder is unlikely to mean restoration to the person you were before, but to a more enriched, resilient, capable and self expressive person'.

For Bodywhys, recovery requires 'a will to change; an acknowledgement that the eating disorder is a problem working to build up a strong sense of self and a new, healthy way of coping that does not need the eating disorder to feel safe. Recovery requires working on underlying issues, building self-esteem, and learning to manage and express feelings, as well as addressing the physical and nutritional aspects of the disorder’.

We discussed the definition of eating disorder recovery with many of the No Bodies Perfect service users. Carolyn Costin's definition of eating disorder recovery was voted as a very good summary of what 'recovery' is: “Being recovered is when a person can accept his or her natural body size and shape and no longer has a self-destructive relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life, and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on a scale. When you are recovered you do not use eating disorder behaviours to deal with, distract from, or cope with other problems.”


What is Recovery?


During one of the No Bodies Support Group Sessions, we talked about what 'recovery' and 'getting better' means to us. What is 'recovery' and what does this mean for us?

During this meeting, we had a creative/art therapy-based session. We had lots of art materials and pictures to make our own posters and collages representing ‘What Is Recovery’? What does our future without an eating disorder look like?

Such representations may act as a motivation to make changes and take small steps towards change and 'getting better' and seeing all the other things we can have in life that we may be missing out on because of eating and food difficulties and exercise dependence.

We followed our art-therapy session with some brainstorming and a discussion about what recovery means to us. We noted what the group brainstormed and have included some of their answers to the question, ‘what is recovery? Do you recognise any of these? What does recovery mean to you? Why not try making your own picture or poster? This was actually one of our busiest sessions, and everyone really enjoyed it and had fun. It also helped some members talk to other members they had not spoken to individually before and whilst doing the task, members chatted amongst themselves. So, while there was a serious element to this session, it was also very relaxed, lots of fun, very social and helped some members challenge their own social anxiety barriers. Give it a go – make your own poster – it’s fun!

Recovery is....

Admitting you have a problem                               
Being ‘ok’
Not worry about numbers on the scale                            
More confidence
Enjoy eating with other people                             
Adapting to change
Liking/accepting yourself                                               
Trusting yourself
Being able to express yourself in a healthy way    
Not being invisible
Being able to grab your dreams                            
Get your ‘sparkle’ back
Developing meaningful relationships                    
Good/balanced nutrition
Accepting you can be good enough, not perfect    
At peace with yourself
Not thinking about food all the time                     
Improved concentration
More mentally/emotionally stable                          
Being able to relax
Seeing 'failure' as an opportunity/learning           
Being good to your body                                      
Realising there are other important things in life   
Physically healthier                  
Being able to do things you missed because of eating disorder
Able to tackle other health issues                         
Being able to sleep better
Feeling connected with other people                     
Not being restricted       
Think/look after other problems                                      
Not feeling guilty  
Deal with problems in a ‘healthy’ way                   
Taking responsibility
Being able to ask for help/support and knowing/feeling it is ok to do so

We also conducted a small online survey asking people the question ‘What is Recovery?’ We received a lot of response and have included some of the responses from both males and females. If I asked you the question, what would you tell me; what would you write? Try this exercise for yourself. Write on a piece of paper: What is Recovery? Answer your own question. Write down the answer: it might be bullet-points; it might be in first-person; it might be a random assortment of thoughts, feelings, behaviours, goals and dreams; it might be a story; it might be a song. Whatever method you chose, ask yourself the question – then you begin to realise just how much you are actually missing out on in life because of the eating disorder. It doesn’t have to be like that. You only have one life. Live it to the max!
  • Being recovered from an eating disorder for me is the ability to be comfortable in my own skin without having to change it. To not to have to use the destructive behaviours of an eating disorder to cope with life’s stressors and the ups and downs of life. And to know that I am so much more than just this body, and accept and embrace all of me, both the light and dark sides.
  • Recovery for me would mean no more pain, no more sleepless nights due to worrying about how much exercise I NEED to do! Recovery would mean the world to me. It just seems so far away though at the moment. I can’t take it!
  • Recovery to me is peace of mind and loving ALL of me unconditionally. It is acceptance that I am (and have always been) perfect just as I am.
  • Recovery for me is to live each day with a sense of happiness within myself, for who I am and not who others are.
  • Recovery to me is accepting ourselves for who we are. It is realising and acting upon the strength we have within ourselves for the health and happiness that each of us deserves.
  • Recovery is, to me, learning to live life without letting this disordered behaviour take over: living life without actually bingeing/purging and adopting healthy eating patterns again.
  • To me, recovery means freedom. Being able to live my life because I’m not bogged down by thoughts of food or exercise. Being able to complete my university degree. And being able to be happy.
  • Recovery is physical and emotional freedom: it’s the ending of a battle between your body and your mind. And most importantly, it’s completely possible!
  • Recovery is not caring anymore.

Tips for Recovery


The following is a list of No Bodies Perfect 20 Tips for During Recovery. Some of these are our own ‘tips’ and some are from our array of ‘tips’ collected by volunteers, service users and Recovery Representatives. Try them out – some will work and some won’t, but there will be at least one you can try and find useful in your days of recovery.

Recovery is a long process, and no one said it was going to be easy. However your choice in taking this challenge on is a testament to your will and your belief that life can and will be better. So congratulations on choosing your health and life, and just remember you aren't alone! You CAN do it if you really want to: believe in yourself, believe in your inner strength (because it is in there) and believe you CAN have power over your eating disorder. If you really do want to change, then you can. No-one will say it’s easy, but the only person standing in the way of change is you. Go for it – you deserve the best!

1. Adopt the Boy Scouts' motto, 'Be prepared'. Before taking each new (small) step, do your homework. Find out what you need to do, where you need to go, what resources do you require, whether you need support or extra information and acquire the relevant knowledge. Ninety per cent of the outcome in any activity depends on the quality of the preparation undertaken. Goals and steps that work and are successful are called SMART goals with support. SMART stands for: SPECIFIC, MEASURABLE, AGREED, RELEVANT and TIME-BOUND. Write down each step you want to take – no matter how small it is. Do your homework; write the goal down exactly as you wish to achieve it and in what timeframe. However, when working on your small goals and steps, ensure you have appropriate support at hand for when you need it. Being prepared in this way will lessen any disappointment you may experience if a step or goal doesn’t go to plan – you will know what didn’t go to plan, learn from it and perhaps you just need to take a slightly different approach. All the time you are learning, even when mistakes or set-backs occur.

2. Do something practical to increase your self-esteem and self-confidence every day. Write down a list of all the small things you would like to do, try or, learn or experience again – things that you enjoy and that will challenge you just a little bit. Perhaps you used to love horse-riding or cycling or visiting the theatre or always wanted to try one of these activities – plan to try it within the next week or month – it gives you ‘me’ time to do something you really enjoy, allows you to have fun, feel good about yourself and do something that does not involve your eating disorder.

3. Feeling tense, stressed, angry, upset or worried about something? Put on your favourite music on loudly and dance about like you were 6 again. It will help release the negative feelings and tension and will make you laugh. Try it – it’s fun and you will end up smiling and feeling much better.

4. Make a telephone list of people you can call for support – family, friends, a counsellor, colleague, helpline or support group. Keep it handy and allow yourself to use it when you need to – people are there to listen and provide support.

5. Write a letter to the person or problem upsetting you. Don’t mail the letter though. Once you have written it, scrunch it up, tear it up, stamp on it, scribble over it, throw it away, bury it, or set it on fire. It will help you to express lots of thoughts and feelings you have inside that may really need to get out. It will help you deal with these feelings and destroying or defacing the letter in some way after you have written it can help you put the feelings in the ‘right’ place inside of you so you can deal with them and manage them more effectively in the future. It can be a very cathartic exercise.

6. Try to think of healthy ways of getting out your feelings and emotions. Write these down on a little card or something small that you can carry around with you in your pocket or purse as a reminder of positive ways of expressing your thoughts and feelings. Some ‘positive’ ways of expressing the thoughts and feelings you may be experiencing includes: writing a diary, journal, story or letter about what you think and feel: writing; reading or writing poetry; being creative, such as drawing, painting or photography; exercising (moderately); going for a walk alone; dancing; learning self defence; record your thoughts and feelings by talking into a voice recorder (playing it back can be very effective, as things often sound different once we can verbalised them – it can be very helpful for looking at things from a different perspective).

7. Plan regular activities for your most difficult time of day. Do you find morning a difficult time? Or maybe evening is a difficult time of the day for you? Rather than dread this time of day and perhaps feel down or unhappy during these periods, change it – interrupt the automatic response we often have towards certain times, days, places and situations. For example, if you feel upset, down or alone in the evenings, plan ahead to fill in this time. The list is endless and there is so much you could do – it depends on what you enjoy, what interests you and so on. Read a book; call a friend and go to watch a film; join a jewellery-making class or drama class; do some writing, visit someone. It doesn’t matter what it is, as long as you enjoy doing it and it’s something you are interested in – don’t choose something that seems like a chore.

8. When you are feeling upset or down or perhaps that ‘recovery’ seems to difficult and you want to give up, take you mind of these thoughts and put on your favourite film or watch a comedy that will make you smile and laugh for a little while.

9. Build a support network around you when you are working toward recovery. This might involve friends, family, a therapist, making a list of useful telephone help-lines, bookmarking valuable resources on the internet, buying some ‘recovery’ books, or attending a support group or online chat-room for eating disorders.

10. It is ok to ‘feel’ feelings. This is absolutely allowed and part of recovery. A large part of recovery is acknowledging your feelings and allowing them to express themselves and be felt by you. Often we keep our feelings hidden inside for so long that releasing them can seem like a scary prospect. However, it’s part of recovery and while these ‘new’ feelings may seem intense and overwhelming at first, that’s ok and normal – that’s just because they have been kept inside for so long. It won’t always be like that though – you will start to get used to these feelings over time and they won’t seem so overwhelming. Feeling these emotions will help you work towards a healthier, fulfilled way of life, without an eating disorder and bring you new ways of thinking, seeing and experiencing things. So spending quiet time with your feelings is very important during recovery. If you find them difficult to deal with, try writing them down, writing a diary or journal, singing the feelings, talking into a voice recorder, crying, using relaxation tools or creative visualisation – anything that will let the emotions out but help you to cope with them and no feel so overwhelmed.

11. Just as a car needs petrol to run smoothly, the human body needs food to work properly and optimally. If a car is running on the last few drops of petrol, the engine will not run as well and will eventually cease up when the petrol runs out. Allowing the petrol to keep running low in this way will eventually cause unrepairable damage to the engine. We can replace a new car engine, but we can never replace a human body. It needs nutrients from food to keep it healthy - by starving yourself and restricting your eating and type of food you eat will leave you feeling more tired, have less energy, having more headaches, feeling more depressed, and vulnerable to colds and infections because your immunity is so low. In the long term you could be causing damage to your internal organs, and under-eating could lead to infertility problems and osteoporosis. Food and eating can seem frightening at first, especially when, during our eating disorder, we have attached all sorts of labels to different types of foods: good, bad, healthy, safe, dirty, pure and so on. There is no such thing as bad food in the strictest sense of the word. So often it can be helpful to look at food purely from a scientific viewpoint. Take each type of food, and don’t think of it as ‘good’ or ‘bad’, but investigate it, get information on it, like a scientist would. What nutrients, vitamins and minerals does it contain and how much? What is the benefit of these to my body? What foods will make my hair grow and shine; what types of foods will give me energy; what foods will strengthen my teeth and bones; what foods will help me to have clear skin; what food will strengthen my muscles and so on. Look at what food REALLY is and not the distorted labels we attach to them.

12. Try not to put too much pressure on yourself. You don't have to be perfect and nobody is perfect. Who wants to be perfect anyway – how boring! If we were all perfect, we would all be the same, and we would get bored with each other and probably have less fun generally in life. The real beauty of life comes from the uniqueness and differences that exist around us. Everyone makes mistakes, everyone has off days, and everyone at some time in their life wishes they had done things differently or better. Trying your best is the best thing you can do – we are all different remember, and so it’s impossible to compare ‘like with like’ because it doesn’t exist. Be YOU!!

13. Be kind to yourself - talk to yourself as you would talk to a friend. If you are having a tough time or perhaps something you did didn’t go to plan, don’t beat yourself up about it – it’s part of the learning curve – and learning is constructive, not destructive. During hard times, think about what you would say to a friend who came to you with the same problem. Take yourself out of the situation and look at it from an objective standpoint – what would your friend or a stranger say?

14. Be prepared to say ‘no’ to food or invitations that you know you are not ready to handle yet – don’t put yourself under pressure. It is fine to do this – why put yourself under unnecessary pressure. There will be invitations in the future that you CAN accept when you are in a better place within yourself – and when the time is right.

15. Take time out. If it is all getting too much for you, remove yourself from the situation. Go for a walk, take a relaxing bath, listen to some relaxing music, go to the park, call a friend and go shopping, visit the library. Look after yourself. Remove yourself from the situation – by doing this, YOU are gaining control and taking responsibility.

16. Learn when you need space and take it. Space can mean anything: personal space, emotional space, physical space – leaving a location, person, situation or event. Space might mean being alone or with other people. It’s different for everyone – but take it when you need it.

17. Making lists of good things you have done. I can hear you all saying now ‘I haven’t done anything good’. You have – everyone has done something good in their life. When you really get down to thinking about it properly and taking the time and space to do so, you will see all the good things you have gone – I bet there are lots of things. Write them down. Write down what you have achieved in life. It might be difficult to start with, but you CAN do, because you have achieved so much and done many good things. You have!

18. Avoid any negative encouragement. What about the magazine you read? Do they have pictures that trigger you or made you feel ‘bad’? Avoid buying it or cancel the subscription – you don’t need it – and think of the money you will save to spend on things you enjoy doing and that DO actually make you feel better. Don’t visit any triggering the websites – much of what you see on these is distorted and manipulated anyway. Avoid reading books or watching television programmes that you feel might trigger or encourage your eating disorder or make you feel guilty or bad in any way – just don’t watch them – watch a funny comedy or an interesting documentary instead. Extreme as it may sound, ban all of these from your life, starting now! You don’t need them....ever!

19. Avoiding mirrors on ‘bad’ days is avoiding the problem. Uncomfortable as it may sound initially, try this instead. Set aside a decent 5 to 10 minutes to go over your body from head to toe, and try to describe yourself out loud without being negative. You don't have to say you ‘love’ anything. Just make regular observations such as: “my eyes are green, my hair is blonde, my face is oval, I have 2 thumbs and 8 fingers, my hair is straight, my lips are pink and so on.” Looking at yourself objectively can help overcome the negative feelings and make it easier to face your reflection.

20. During recovery you may have days where you slip back into ‘old habits’. It is important that you don’t see these lapses as failures and give up. They are a natural part of recovery and you can learn from them.


Recovery Stories


It is always great to hear from other people and to learn about their own recovery and share it with others. If you would like to write your Recovery Story, share your experience with other people and publish it on our website, please get in touch via email: info@nbp-eating-disorder.co.uk


A Story of Recovery

by Anne-Sophie Reinhardt


I was a whirlwind of a kid, always creating something, whether it was choreographies, circuses with lots of friends, drawings, songs, plays or even movies. I was beaming with confidence when performing, but terribly insecure and filled with self-loathing during other times. That was in the early and mid 90s.

Fast-forward almost 2 decades.

Back in October of 2010, I was in a very desperate place. Weak, tired, vulnerable, hopeless and at my wits end. I had been fighting an eating disorder for more than half of my life and I had come to a point of utter exhaustion.
Yet, I could not stop. My anorexia was telling me to continue on my path down self-destruction. Only after I hit my lowest point to date did I wake up and was able to see that I needed help. Fast.

I'll never forget that day and the mind shift that occurred. I suddenly realized that I was very sick and that my behaviours were neither normal nor healthy. However, telling you that I was cured from anorexia going forward would be a lie.

It was only the beginning of a journey towards a healthy and fulfilling life that would bring me peace of mind. Finally.

After many restless nights and deep conversations with my husband and family, I admitted myself to a treatment facility to give myself a break from the stress of the world and to build a solid foundation for my future, healthy life.
The beginnings of recovery were rough and rocky. I was continuing to lie and betray - not only my treatment team, family and friends, but - even more harmful - myself.

My anorexia was still holding me in its powerful grip, determined to see me die.
Only after I left the treatment facility and found the most wonderful psychotherapist was I able to slowly and gradually come to a place of honesty with myself and those people so important in my life. Saying out loud that yes, I had anorexia and that yes, I was still using methods to purge was freeing and scary at the same time. Admitting this truth to myself, to my husband and then the rest of the world (literally as I was writing it on my blog and explaining it on my podcast) was hard, but so very necessary.

This was a huge turning point and helped me let go of many anorexia inflicted lies, self-doubts, thoughts of worthlessness and the ever-present belief that recovery was not really possible after all, at least not for me.

In the coming months, I was gaining weight, stopped my destructive methods to get rid of calories and slowly began to retrieve my energy and lust for life. I began to see that I had so much to live for: my husband, my family and my future kids. In fact, the chance of losing my ability to have kids was the driving force behind the early days of my recovery.

The wish to one day have a big family with a house and a bunch of children playing in the garden was bigger than the strings that attached me to my eating disorder.

I held on to this dream in my darkest hours and often repeated it as my personal mantra.

I read many inspiring books of hope, journaling about my own recovery and helped others by blogging and podcasting about the many coping skills I learned from all the wonderful people in my life and the resources I found online.
The power of a positive community and the help of my support system carried me whenever I stumbled and took steps backwards or sideways.

By focusing on my many unique characteristics unrelated to my body, I learned to love myself again. By rediscovering my love for creating art, I learned to believe in my strengths again. By receiving positive feedback from family and friends about the long-lost positivity and sparkle in my eyes, I learned to see that life, relationships and love is not about having the perfect (= emaciated) body or chastening yourself because of your undeserving nature. Life is about living, growing and transforming and the joy of food, rest and leisure is part of it.

The life I live today cannot be compared to the life I knew for 14 years. The freedom I experience on a daily basis is more than I could have ever wished for. The realization that my worthiness as a person is not related to having lean upper arms despite my contrary genetic predisposition was like walking out of a self-imposed prison. The experience that I am worthy of love even at a weight that I had been terribly afraid of for so many years is the biggest gift I ever received.

Instead of the compulsive counting of calories, my mind is now free to write and build my business. Instead of wasting hours upon hours in the gym, I can now treat my body to the movement it enjoys. Instead of feeling weak, I am full of creative energy. Instead of avoiding social invitations, I have rediscovered my love for being with friends, sharing special experiences and having a great time. Instead of surrounding myself with toxic role models, I have eliminated all of the people who triggered harmful behaviours. Instead of obsessing over my body, I have focused on what really counts in life.

Instead of holding myself to unrealistic bodily standards, I have learned to be kind to myself and am continuously reaffirming myself and my body with positive mantras.

Instead of existing, I am now living. Fully.

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