No matter how far into my flesh I push the pin,
I can’t seem to hit the pain.
—CALLIE, age nineteen
THERE ARE six feelings that can bring us to our knees: anger, fear, worthlessness, self-pity, loneliness, and grief. (Do any of these sound familiar?) It can seem impossible to identify and begin to walk through these feelings while deciding to recover, but not doing so will bring you down faster than anything.
Let’s start with anger. For a long time I had no idea that underneath my anger was the fear of not being safe, of not getting something I believed I needed for my self-worth, wellness, and survival, and my feeling that I had been betrayed or maligned or that I was worthless, failing, and stupid.
Anger has a way of making us think the worst of ourselves and of others. And often, we don’t even know that we are angry.
Writer and therapist Dusty Miller says in her book Women Who Hurt Themselves, “What makes anger so deceptive and destructive is that it is often disguised as something else. Anger can easily masquerade as sadness, reluctance, aloofness, or even overcompliance.”
When we don’t have a way to deal with anger that’s safe, freeing, and effective, we go to what we know. And if the eating or self-injury disorder has you by the throat, what you know is how to binge, purge, starve, or cut.
Most, if not all of the young women I work with have a ton of anger. Some have no idea that they are angry, and others know it all too well. Most believe that anger is “bad” or at the very least frightening and overwhelming. Some are ashamed of it.
We glean most of our ideas about anger from our families. Maybe your family exploded with anger or suppressed it. Some of us have families who drink, drug, eat, or gamble to waylay their anger. Some young women have been hit, kicked, tickled, or screamed at in anger. Some have been left in anger or blamed, frightened, or denied by anger. Very few of us have been exposed to ways to deal with anger productively and safely. So without any real rubric for dealing with our own anger and the anger of others (whether it’s directed at us or not), we turn to our bodies to both quiet the rage and release it. We turn toward hurt in the name of safety.
There are studies that suggest that anger actually causes people to want more pain, think more painful thoughts, feel more painful feelings, and choose more painful actions. It seems that we humans, based on a combination of biology, culture, and character, use pain to relieve our pain. We don’t know how to comfort, relieve, or act with responsible compassion toward ourselves. And we often believe that if a person is angry with us, the anger is justified, or he or she is better than we are just because he or she sounds so angry or certain. We learn to repeat the anger of others inside ourselves and to ourselves, adding it to our own anger and directing our physical bodies to bear the burden of our emotional pain. Perhaps this is one reason why we hold on so tightly to our disorders—because we know of no other way. Anger is part of what drives us to harm ourselves, even—and perhaps especially—when we don’t know we are angry.
It hurts like crazy to feel angry with people we love or need, or who are supposed to be taking care of us. On one level, you don’t want to be angry, especially when anger has you scared that you will do something crazy to yourself or someone else. And when you are angry it can seem like you will never be “un-angry” again. Like a headache, when your head is pounding it’s hard to imagine what it feels like not to have one.
Many people with eating or self-injury disorders believe that being angry with yourself is synonymous with self-hate. But—contrary to this popular belief—you can be angry with yourself and still like yourself.
Some studies have shown that people who have eating or self-injury disorders get angry more often than people who don’t. It seems that we hear things through the ears of the disorder that make us more sensitive, irritable, critical, bothered, and afraid.
Think about it. If you are starving, stuffed, sugar-crazed, or high from purging, how can you possibly process anything clearly, especially if you filter things through your own poor sense of self? And since anger is also physical, it lights up your brain and you can feel it in all parts of your body, running through your blood, throbbing in your chest, pounding at your head, and straining your limbs. Even if you don’t know that’s what it is, it happens, and you need relief.
Think for a moment about the angriest you have ever been. At whom? Why? What happened to that anger? Where did it go? What happens to your body when you are angry? If you were not, just for a minute, tied up in the disorder—if you did not cut or binge or restrict—what might you learn about your anger? What do you think would really happen?
Think also about what your parents are like when they are angry. Was there—is there—yelling, hitting, threatening, name-calling, leaving, or denying in your house? Or silence—hard, cold, you-do-not-exist silence? Was it OK to express anger in your house? What happened when you sounded or acted angry? What kind of response did you get?
Getting to know your anger and how to deal with it is key to wanting recovery for a few reasons:
Acknowledging your anger actually calms down your amygdala, the part of your brain that holds emotions. Even if feelings, especially anger, take a long time to pass, recognizing, naming, and allowing your anger is like putting a cold compress on your overcharged, throbbing brain so it can decompress.
While it hurts to be angry, it hurts you more to try not to be angry when you are angry; eventually it catches up with you. Even if you don’t know yet how to be angry and survive it, or how to survive others’ anger toward you, trying not to be angry when you are angry is like not having enough air when you’re swimming up to the surface of the pool.
Ignoring anger causes us to rebel. We cut off our noses to spite our faces. Maybe you can go to college, but you don’t because it would make a difficult parent happy. Maybe you hang out with a bad crowd when you might otherwise walk away. Maybe you get into drugs, violence, or bad sex to get relief, but also, deep down, to punish yourself, your parents, or your boyfriend. Or maybe you are willing to begin to recover but you don’t because someone with whom you are angry is pushing for it—because it seems like recovering will make all the things that person is angry about seem relevant and all the things that you are angry about seem irrelevent.
Anger causes severe cases of the “forget-its” and the “screw-its.” It gets in the way of wanting recovery. When you are angry you are more likely to sink into worthlessness, self-pity, hopelessness, and self-sabotage. You start thinking things like “Who cares anyway,” “I may as well just do it,” “Nothing matters anyway,” and “Why bother?”
You can’t deal with something you believe does not exist. I’m not saying that anger is the only block to wanting recovery, but if you really think that you are not angry at anything or with anybody and that the obsession with food and body is only about food and body, what then do you believe is keeping you in it?
Feeling healthy anger can help you clarify what you believe in and what you stand for. Processing your anger properly can allow you to act sanely and safely in response to the things you believe are worth your time and energy. It can help you stand up for justice, for humanity, and for compassion.
Despite the pull to get relief by hurting yourself, rebelling against others at your own expense, or continuing to believe that the disorder will solve your issues, you can do it differently. And in fact, you must. Somewhere deep inside you know this, too.
I once heard a story about a young man in his thirties who was dying of cancer. As he was facing his final days, he asked his brother to help him plan his funeral. He made his brother promise to locate his fifth-grade teacher and ask him to deliver the eulogy.
When his brother asked why, the man explained that as a young boy he felt very bad about himself. He was awkward looking, not good at sports, and not especially good academically, either. One day, as part of a class project, the fifth-grade teacher asked each student to write down one good quality about each of the other students in the class.
One by one, the teacher read out loud what had been written. The boy heard that he was a loyal friend, lent a helping hand, told funny jokes, and had a nice smile. The man told his brother that it was the first time he thought he was worth something. From that point on he tried harder in school and his grades improved. He never became good at sports, but he discovered that he could draw well and felt good about that. He stopped thinking the worst of himself, and when he started to slip backward he always recalled not just the good words that were written about him but the warm smile and kind look the teacher had on his face as he read them. He remembered feeling like he mattered, and he carried that feeling with him from that day on.
“That teacher changed my life by helping me to change how I saw myself,” he told his brother, “and even though my life is ending sooner than I had hoped for, it has been a life well lived because of that teacher.”
Here is the definition of worthless: Having no real value or use. Having no good qualities. Deserving contempt. Useless. Good for nothing.
If you do not believe you are worth anything, how can you believe that recovery is worth the effort? How can you believe that you are worth the effort? Here’s the conundrum: You are wrapped up in the disorder because you feel worthless, and you feel worthless—in part—because you are wrapped up in the disorder. I know this because feelings of worthlessness, and its followers, self-pity and profound loneliness, are no strangers in my office and in my own emotional life. It’s a tough trio.
I am a recovered bulimic and a recovering food addict, and I am well acquainted with emotional pain. I used to be convinced that every feeling I had was a fact. If I felt like trash, I was trash. If I felt fat, I was fat. If I felt ashamed, I was shameful. I believed, too, that if people sounded angry or sure of themselves, they were right, better than me, or more worthy than me. Even if part of me was frightened or in disagreement, I felt “less than.” And since feelings were facts to me, that meant that I was less than. I remember believing that not knowing what I wanted to do or could do with my life meant that I really was nothing, and that the feelings I had—when I could name them—would last forever. I believed that my pain was permanent.
But feelings are not facts; even when they seem to be, they are only feelings—overwhelming, unrelenting, out of control sometimes, but still just feelings. It took me many years to stop believing that what I felt in any given moment was the gospel truth. It took even longer to come to know what I was feeling, or even that I was feeling. And then even longer to understand that my feelings—while guideposts to my desires, instincts, beliefs, and morals—were human and survivable and OK.
Finding healthy relief, however, was a whole other level. For years I simply ate till it hurt and then threw it back up. I vacillated between the grip of the eating disorder, the issues of life, and the legitimate pain of both. Either way, I knew hurt, confusion, escape, being overwhelmed, and self-attack. I knew the call of food, the fear and hatred of fat, and the pursuit of thinness. I know all about ordering takeout for five, telling the cashier (as if she cared) that you hope your family isn’t too hungry waiting for you to come home with their dinner, and then eating it in the car and throwing it up when you get home. I know about saving all your calories for ten o’clock at night and then turning on the TV and eating through boxes, bags, and bottles. I counted the calories in a box, not a single serving. Unless I was restricting, I never ate a single serving of anything. I knew how to hide food, dump food, and put what looked like forkfuls into my mouth that actually went into my napkin.
I never knew where my eating disorder started and stopped and where my life issues started and stopped. They were separate, equal, and overlapping. It was often a lonely, desolate place to be. Emotional pain has so many folds and bumps, and worthlessness is a thread that often runs through them all.
I don’t believe it’s possible to recover from eating and self-injury disorders, even when you want to, without taking a serious look at your self-worth. To move forward toward a lasting recovery, you have to be willing to find at least enough self-worth to make it worth your while to get started—not a simple matter when you are in the thick of it all.
I want you to get curious about why you feel worthless. If you could whittle it down to one or two things, what would they be? Or is it a combination of stuff? Were you hit? Ignored? Belittled? Were your basic human needs seen as too much or too burden some? Were you hurt by caregivers, teachers, mentors, peers, or siblings? Can you think of any one event that made you feel bad about yourself? Did media messages, images, and cultural expectations influence your thinking and skew your idea of what is beautiful, valuable, and worthy? Are you under the impression that you must be competitive with your looks and your accomplishments in order to matter? Do you distrust those who reassure and support you?
What kind of messages did you get about your feelings, your ideas, and your place in the world? Do you actually believe you are worthless, or do you just seem worthless to yourself sometimes?
And finally, is it in some way better to be worthless? Does that work for you somehow? If so, how? If you could feel different, would you? Are you willing to decide that you do matter just because you do? Or is it a question of experiences, accomplishments, and achievements? Are some of us worth more than others? And if so, how much, and why? If you are in fact worth something, does that mean that you should decide to recover in earnest?
Finding real self-worth requires us to face our fears and learn about what we believe, what we truly value and why. As painful as worthlessness is, when we are hurting it can seem better than its flip side: self-worth. Self-worth brings with it the notion that we and our actions matter, and that we have substance and responsibility. Self-worth means having a place in the world; but that place in the world can seem far too demanding and overwhelming at times.
Self-pity follows closely on the heels of worthlessness. It’s not easy to admit feeling pathetic. But on some level—before you are well into recovery—you likely feel sorry for yourself for your troubles and for not being able or willing to do things differently. You might even turn that pity into a defiant stance of indignant worthlessness.
Worthlessness and loneliness give you a certain power. You can isolate yourself and stay hidden from all the people who hurt, neglect, or fail to understand you. You can duck under the anger and frustration and keep hurting your body in ways that steer you just slightly clear of all the pain you know you are in and cannot face head-on.
Since we tend to think that what we feel in any given moment is what we will always feel, our motivation to find real self-worth can be sketchy. We need to be open to believing that worthlessness, self-pity, and loneliness—however valid those feelings are—are obstacles to deciding to recover.
If you are thinking at this point that I have forgotten how important the food is, or how important your weight is, or how important your cutting is, I have not. Just for now, I want to talk to you about the hurting.
Some of us have been hurt so often or for so long that we are simply, unconsciously, used to being hurt. You might gravitate toward hurtful people, hurtful situations, and hurtful scenarios simply because your mind seeks a familiar, even if painful, status quo or a chance to somehow right the wrongs. Your mind can make you gravitate toward situations that result in familiar feelings, even painful ones, in an effort to try to work them through to different outcomes. We are not usually aware that we do this. But no matter how overpowering your emotions might seem, it is ultimately you who must decide to claim yourself and your life.
In the pit of loneliness, you most likely feel the totally human ache to be understood, to be connected, to be soothed and loved. But when you are in the pit, you do not believe these longings are normal, and getting them satisfied seems like a very remote possibility.
When you agree, even a little, to move out of the pit of loneliness and surround yourself with the voices of recovery, the voices of healing, and the voices of comfort, you will see that leaving the loneliness is not leaving safety, but rather traveling toward it.
I’ve heard it said that recovery is not a team sport, and I could not disagree more. There is no way to travel this road alone. It is too long and scary. While you can learn to nourish yourself, the fact that you need nourishment from others is indisputable. You might not know how to achieve either, even when you know you want to, but if you are still reading, you have begun—because part of the solution to self-pity, worthlessness, and loneliness comes from our own willingness to take a look at ourselves and be open to self-reflection, not self-attack, early in our journey. Even though it sounds hard, we have to learn how to give to ourselves in ways that heal, not hurt. Some of the solution comes from outside. We do need love, validation, acceptance, and acknowledgment of our good traits. We need connection and emotional sustenance from others.
We have to be willing to seek out people who can offer us healthy relationships—the voices of comfort I mentioned above. Positive feedback and reassurance are part of your recovery, even if this flies in the face of your self-protective loneliness. Being open to other points of view and different ideas can help us adjust our sometimes skewed (disordered) version of reality. You need people to believe in you when you don’t believe in yourself and to help you see when you are blind. Validation from others does not replace your own efforts, internal sustenance, and validation, but it does help you access them.
In your struggle to understand if and how to begin the journey of recovery, concede to a journey of discovery as well. As part of that journey you have to regard the eating or self-injury disorder as your current voice of legitimacy. If you believe your feelings don’t matter or are foolish, silly, or unacceptable, the disorder you have serves the function of legitimizing them. You and your feelings are taken far more seriously when they are under the umbrella of the disorder. The disorder seems to put a “For Real” stamp on feelings that also reads: “She means business and you can no longer dismiss her or her feelings.” People have to notice. They have to acknowledge that you are real, that you have feelings, and that you have to be taken seriously even if you are not sure you want them to notice you at all. In emotional pain, and with an eating or self-injury disorder, you often scream for both.
Your feelings matter, disorder or not. But there are, you will see, better ways to establish your credibility than through the disorder. Finding self-worth starts here. It starts now. It starts with you reading these pages. Because some part of you is open to a steadier truth than the one you are operating on now.
“I could choke on the emptiness,” Wendy tells me. “I can feel its nothingness slide up into my throat and swallow me.”
No one can understand this who has not experienced it, I think as I listen to her. No one.
“I am alone in the woods. There is no path, no direction, no way out,” she tells me.
Wendy came to see me last year after she had been caught shoplifting. She was five-foot-nine by the time she was fourteen. Nineteen now, she has been cutting since she was fifteen and vomiting since she was sixteen. It has been a slow and steady war against her feelings, on the battlefield of her body. Her long, dark hair is always neatly pulled back in a nondescript pony, which makes her dark brown eyes look like huge frying pans.
“I took eighty dollars out of my parents’ dresser one time,” she tells me. “I bought laxatives, gum, and chocolate. And I thought about how good my family is to me. And how bad, too, sometimes. I thought about how upset they’d be if they found out that not only am I not who they think I am or want me to be, but I’m also a thief. And no matter how much I chew, spew, or poop, I can’t seem to get rid of the emptiness.”
Wendy describes walking through the woods in her mind, sometimes seeing blue skies through green leaves towering above her. She feels a strange comfort in her own solitude. But then comes the choking. The leaves shrivel and turn brown, the sky darkens, the trees seem to tower and lean in and out, and she is small and frightened and cold. Way too cold.
She tells me that fear seeps into her veins like warm milk, only it is not soothing. It runs up and down her limbs and through her body, takes over like a harness, and squeezes around her. There is no difference between what she feels and who she is. Her feelings are a huge jumbled mess, an unidentifiable black knot somewhere inside of her.
Wendy is terrified of the emptiness. She is afraid, too, of being hurt, caught, humiliated. She is afraid that she is not safe, not valuable, not capable. She is afraid of people, of food, of her own body. She is afraid of not having, not doing, not being, and just as afraid of having, doing, and being.
Sometimes a frightening darkness washes over her that we identify as dread—the feeling that something awful, unidentifiable, and uncontrollable is about to happen. Fear and emptiness collide into a sickening, unbearable pain.
Fear-filled questions come like missiles: “What’s the point?” “What if I’m empty inside?” “What do I want to do with my life?” “What’s wrong with me?” “Why are my parents the way they are?” “Why doesn’t anyone understand?” “What if my body is really awful?” “Who am I?” “What if I can’t do it?” (Whatever “it” is.)
There are more fears, so many more. But instead of presenting themselves as guideposts to insight and better feelings, they attack. They sit heavily on our hearts, spurring on emotional pain and pushing us further and further into unrelenting battles with scales and food and razors. Our own fingers become both our enemies and our saviors as they inflict pain on our bodies yet bring relief, however temporary, to our minds. We are left sitting clueless in a cyclone of questions and feelings without any safe route to relief or answers.
In the Big Book of Alcoholics Anonymous, the narrator of one story says that for him “not drinking was not an option, but drinking didn’t help.” When we are in intense emotional pain from fear in its many forms, along with all the other pain, and the pain seems unbearable, we cannot see any options. Eating, starving, cutting, bingeing, (plug in your own) is not not an option, even with all its complications.
When our feelings do not get taken care of properly we get stuck, and we do not want to be told that we cannot have what we want—what we believe we need to survive. We do not want to be told that what we believe is truth is not necessarily truth, or that our solutions are not working, or are not the path to relief. We might not be able to hear more objective truths or different realities. We do not want to have to figure things out or change what works, even if it doesn’t really work. And we don’t really know how to do that anyway, nor do we want to have to learn. It’s almost impossible to believe that there is anything better out there anyway.
We are understandably, intrinsically skeptical. As one young woman I work with put it: “I don’t feel comfortable having a basic conversation with anyone. How can I ask any questions of myself for myself? I’m not comfortable eating. I dread getting dressed. It makes me want to sleep. I hate my body. I’m mentally obese, and I feel physically larger with every meal. I’m uncomfortable in my skin, my mind, my lack of understanding of my purpose. I shudder when I see my reflection because I see the wrinkled waste of everything I could have been. I’m practically settling for hating myself—in advance—for whatever it is I’m missing, and I dread having to find that missing piece. It’s not as easy as figuring out ‘what I’m missing’ in my life; I need to determine the shape of the missing puzzle piece. Can an unsatisfied, unhealthy person ever have a life? I want to be myself, not another layer of this broken shell. I just have no idea what to do.”
We are afraid of knowing ourselves—what we were, what we are, and what we are not. And we are afraid of what we will be and what we think we will be. We are afraid of a future we have not even encountered yet, one that we have not even attempted.
We are not dead, but we are afraid to live. Even when there is a hint of hope, we are afraid it will be fleeting.
Often young women tell me, “I can’t do this. I do not have the energy, strength, or ability to do this or anything else. It is too much. I am too scared.” They are afraid that if they try and fail, there will be nothing left to try. Even hope can be scary.
Deciding to recover means that though you have not yet learned how to take mindful good care of your inner world and your fears, you agree early on to be open to the new thought that it is possible to work with and through your fear and not be stopped by it. It means realizing that though you have not yet had enough positive experiences or been able to hold on to the ones you’ve had—to fill up the space inside of you—that you are open to new possibilities.
Deciding to recover means that you are willing to believe that many of the answers will come from living life and opening up the vault inside of you to allow new ways of thinking and new voices of recovery to settle in and stay. It means being open to the idea that often thoughts are just thoughts and can come and go like trains at a train station. And that you do not have to get on and ride every one, especially the negative, fear-based, self-attacking ones. You can let them pull in and let them pull back out all on their own.
It means acknowledging that while you are busy bingeing and purging out all the bad stuff, the good stuff often gets washed away with it.
It means that emptiness, while sometimes painful, also creates a space for new and better ideas and feelings to move in.
It means bearing in mind that you have an unconscious mind that has been shaped by genetics and biology and culture and spirit; that tending to the emptiness means tending to the parts of yourself that are not always obvious or sitting out in the open.
You cannot stop the pain from presenting itself. But you can survive it, survive it well, and use it for good, growth, a safe fullness, and a good life that you cannot—just yet—imagine.
Grief is the emotional suffering we feel over loss—loss of people, relationships, hope, control, opportunities, faith, direction, knowledge; loss of things that comfort us, soothe us, nurture us, and make us feel safe; loss of our sense of self. It is wanting what we don’t have, and having what we don’t want.
There are so many different kinds of grief. There is grief over not having sober parents. Grief over having good parents who drive us crazy. Grief over fat. Grief that there is not enough food in the world for us. Grief that we cannot eat all we think we want and not get fat. Grief that we have to eat to live. Grief that we have to brush our teeth, wash our clothes, do our homework. Grief that we have an eating disorder. Even grief that it can get better, because that too seems to come with a cost. Grief that we are going to have to take care of ourselves. Grief that we don’t really know how. Grief that we make mistakes; that life is unpredictable; that we don’t always know who we are or what we want.
There is grief over our own shortcomings and flaws. There is grief when you have nothing to look forward to and when you see only burdens, obstacles, and expectations looming ahead. There is grief over what you have done, what you continue to do, what you want to do but believe you cannot. There is grief when you have been well loved and cared for but are still so sick. There is even grief over what you don’t know; grief that you have been hurt, mistreated, or neglected; and grief that there exists in this world beautiful music, stunning sunsets, kindness to strangers, innocent children, and oceans so blue they hardly seem real—and here you are in so much turmoil.
“I can’t do this anymore. It’s too hard,” is the voice of defeat. And of grief. But this kind of grief is a beginning. When you say this, it is the beginning of the end of the part of you that is hiding out. It’s like saying, “OK, I give up. I’ve got this disorder, this family, this body, this life—whatever this is. I’ve got it; I get it. I’m tired, but there has to be a better way. I’m willing to look.”
There is a certain amount of grief that comes up naturally as part of recovery itself; yes, on top of all the other things you are grieving. This is the grief of reckoning with and acknowledging that there is loss involved in recovery itself—the loss of ideas and behaviors that used to protect you but that in fact hurt you, or don’t work well enough anymore. It’s the grief that you cannot go on not knowing you are angry and believing that you and your feelings don’t matter, or that they only matter in the context of the disorder. It’s the grief that we have to give up using food the way we do and give up the idea that we are helpless, hopeless, and worthless. Losing the disorder and all the parts of ourselves that believe in it is a loss. Even necessary losses can still make us grieve.
The point at which you decide to recover is where, despite your grief—or perhaps because of it—and despite the seeming impossibility of it all, you can accept your willingness. It’s where you cross some invisible line inside your psyche even though you are grieving; even though you are terrified.
I know that you are afraid that the grief will kill you, and that sometimes you hope it does. And what if you do get better? Who around you will change? How will they feel, or be, or act toward you? Will they be jealous or distant or angry with you for your progress? Will they feel left behind or left out if you move forward? Will you have to grieve that, too? Haven’t you felt left back when others seemingly moved forward and made progress when you could not? So how can your grief work for you? Is there any such thing as good grief?
I believe there is. Recovery is not about undoing the grief or slamming up against it again and again in your heart. It is about allowing it and working on your willingness to expand, grow, and believe in a better way to live because of your grief. It is about honoring all the truths of your grief enough that you become willing to exist both despite those truths and because of them. It is about agreeing to begin even when you do not yet know a better way; even though you are skeptical and scared, heartbroken and hurt.
We do this slowly, tenderly, and with a new attention to what is possible. We ride on the wings and words of those who have done it. We remember that what we feel in any given moment matters, but it does not have to dictate our actions. We embark on the idea that we are more than our pain, but because of it, we are open to discovering ourselves.