Your Role by Tony Paulson

Hiring the Subcontractors

Who are your subcontractors? Who are the people you are
going to invite to be part of your team that will guide you to recovery? This
is where many people struggle because they believe they should be able to build
a house (recover) by themselves. They don’t need help nor do they deserve
it.  We can spend considerable time talking about where these thoughts come from but the issue is you cannot successful build a house of recovery on your own. The illness is too strong to
take on by yourself. You need someone to push you, hold you accountable, cry
with you, and celebrate your accomplishment as you build your recovery.  Surrender to the support you need to live the
life you were intended to have.

Planning the House You are Building

The first step in building a house is to
draw up plans of the type of house you want to build. Unless you are an
architect and have designed houses before an expert is needed to make sure the
plans for the house (the plans for your recovery) are sound. The plans should
specify how you are going to go from where you are today to full recovery. Once
you have the plans in place its time to hire the contractor and subcontractors
you are going to need to get the house built. The expert you hired to design
and plan your house often times becomes your contractor. This is the person who
will lead your treatment team and make sure the plans for your recovery stay on
track. Subcontractors have specialties that are needed to build the type of
hour you want. To build a house you need a subcontractor to pour the cement for
the foundation, someone to do the actual building of the walls, a roofer,
plumber, and an electrician. In building your house of recovery your subcontractors
may include a physician, psychiatrist, dietitian, family therapist, or a yoga
instructor. Each subcontractor brings a special skill to the task of building
your house of recovery. Without them the likelihood of finishing the house and
it turning out as you planned is very small. More later. . .

Building Your House of Recover

I was talking to a colleague today about recovery and ways
we can emphasize the importance of support. 
We started talking about how recovery is like building a house and once
you have it built turning it into a home. The steps of building a house
include:

1. 
   Designing the type of house you are going to
   build
2. 
   Recognizing what you can do on your own and what
   you need help with
3. 
   Hiring a contractor to take you through the
   process and who will hire the subcontractors to do what you cannot do on your
   own
4. 
   Getting as much help as possible  

Once the house is built the next step is turning it into a
home. What is the difference between a house and a home? A house is simply a
structure a home is where people do to feel accepted, wanted and loved.  Over the next couple of weeks I will be
writing about how building a house and turning it into a home is very similar
to recovering from an eating disorder.

The good and the bad

I had a great conversation today with someone who was so clear in her ambivalence to get better. She recognized the bad of the eating disorder (risk to her physical health, effect on relationships, etc) but struggled with letting go of the good of the eating disorder (helping her feel less bad). I think so many people want to minimize their eating disorder (get rid of the bad) but never completely let go of it because that would mean letting go of the good. Without ED how does one deal with distressing emotions and thoughts? The eating disorder is convenient and effective in that its there with you every moment and it does what it promises (minimizes or numbs you from your emotions and distressing thoughts). Life without an eating disorder seems so much harder and it is. Life without ED means you feel your emotions, you take risks in relationship and in general live your life. That can be scary for most people. The reward for facing this fear is the experience of love in your life. Once you let love in your heart is begins to shrink the fears that drive ED.

The rollercoaster of recovery

The process of recovery sometimes seems cruel. At least initially the better you do the worse you feel. Its so hard for many people to fight through that initial stage because the more they distance themselves from ED the more anxious they feel. Eventually the anxiety subsides but how do you sit through the initial anxiety associated with recovery? I think an important piece of getting through it is to have someone supporting you through the process. Someone who will be sympathetic to your struggles but still be a barrier to you engaging in your eating disorder.

A powerful reminder

I recently hosted some community workshops for families who wanted to learn more about eating disorders. Through these events I was reminded how much families struggle in dealing with eating disorders. I hear again and again that they wish there was more information and guidance about what they need to do to best help their loved one. Moreover, I often hear that they didn't think their loved one's eating disorder was as serious as it was. No one told them that eating disorders are potentially fatal and the sooner you get the right type of treatment the more likely you are to recover. Many of the families I talk to are in a panic to learn more about eating disorders and to find the right type of level of treatment for their loved one. I know we are getting better and there is more accurate information out in the community, I was just reminded that we still have a lot of work to do. 

We need to take this more seriously

Why is so easy for not only patients but
also most of the world to minimize the seriousness and significance of eating
disorders. They have the highest death rate of all psychological disorder as
one in 10 people suffering do not survive their illness. For those who survive
their eating disorders the quality of their lives is significantly impacted.
Worse case scenario for patients who do not recover from their eating disorder
is death and best case scenario is a miserable life. Yet many people still
minimize the importance of effective treatment. I still see people with
relative frequency suffering from serious eating disorders who are in
inadequate treatment or who remain in ineffective treatment. Because the severe
risk eating disorders pose to a person’s physical health the first stage of
treatment has to focus on creating an environment in which patients cannot or
are less likely to engage in their eating disorders. The eating disorder
behavior has to be contained and the physical risk to health minimized before
treatment progresses to addressing underlying psychological issues. If
treatment is not effectively accomplishing this its important to consider other
types of treatment. Its important for outpatient providers not to accept into
their practices patients who are too ill to benefit from weekly outpatient
psychotherapy. I hear from providers that they accept these patients because
they refuse higher levels of care and the providers believes some treatment is
better than no treatment. I can understand that reasoning in that the therapist
are wanting to be helpful. However, I think this water downs the message that
eating disorders require intensive, specialized care. Sometimes saying "no
I cannot treat you because you are too ill" is the best thing a patient
can hear.

Perspective

Its so easy to lose perspective- to give time and energy to things that in the long run are not very important. Somehow in the moment they seem important and they suck us in and next thing you know they become a high priority in our lives. An eating disorder certainly can become the most important thing in a person's life at the expense of everything else. I have met many people where their lives are put on hold as the struggle to overcome their eating disorders. All the while though they are hanging on to the very thing they are trying to get rid of. When its brought to their attention that they are hanging on to their eating disorder, the most common response I get is their afraid of what life will be like without it.

 

Well what will it be without it? What do you imagine? What is the fear that drives your eating disorder?

Time to yourself

What do you do when you have time to yourself and your ed thoughts feel like a dozen monkeys living in your head jumping from one thing to the next? This can be a very difficult time for many people suffering from eating disorders. Your time to yourself becomes a barrage of ed thoughts that seem to increase in intensity and frequency with every passing moment.

Distraction is often a useful tool in these moments. Recognizing that your ed is doing its thing and you cannot simply turn it off. What you can do is attend to something else other that whats running through your head. Eventually your ed with tire and take a break but for the moment to protect your own sanity try attending to something else while accepting the fact that your ed is doing its thing. Things that I have seen work include going on a walk, talking to a friend, doing a crossword puzzle, focus on your breathing, and even doing homework. The key is not to try and stop your eating disorder thoughts because that will only make them worse. Instead recognize that your ed thougths will eventually run out of gas and need to take a break. They certainly will return again but as you get better at distracting yourself from them they tend to stay for shorter periods.

Example of some small steps

This week I heard of several great examples of people taking small steps toward recovery. For example, one person called her friend when she felt like engaging. Another person walked her dog while yet another didnt let herself be alone when she knew she was most likely to engage in her eating disorder.