KEY 1:

MOTIVATION, PATIENCE, AND HOPE

If you think you can do a thing or think you can’t do a thing, you’re right.

—HENRY FORD

Hope was an incredible motivator for me. It is what kept me from giving up. It is what kept me on the road to recovery when I wanted to go back to my old ways. I had hope that the years ahead would hold a more joyful, fulfilling life for me and I didn’t want to go back into all the pain and sickness. I knew that the eating disorder would not get me the things I dreamt of and hoped for.

—KK

Recovery from an eating disorder will not be an easy or short-term project. There will be times—perhaps when reading these pages—when you feel hopeful and motivated. There will be other times when your patience is gone or you are discouraged and feel like giving up. Several times throughout our own recovery both of us thought we would never get better. Sometimes, it seemed too hard, and sometimes it seemed impossible. But it is not! The truth is, recovery takes a long time and lots of work, but can turn out to be one of the biggest triumphs of your life. We are both proof of that, but if you could have seen us in the various stages of our own illnesses, you would no doubt wonder how we ever made it to where we are today. This is a good reason why you need to look beyond where you are now or how you feel today. If nothing else, our individual stories can offer hope. In this book you will find plenty of others who were also in your situation, and who are recovered today, which is where you can be too. Our first key will take you through the important issues of motivation, patience, and hope.

What motivated you to pick up, purchase, or read this book? Did you search online or in your neighborhood bookstore because you are ready to face and deal with your eating disorder? Did you accidentally stumble upon it and are simply curious to see how you might go about getting well once you are ready? Did a concerned person press these pages into your hands, even though you don’t think you have that big of a problem? Or was it another factor altogether that motivated you to pick up this book? You may be unsure if you are fully ready or willing to recover, but on the other hand, you may be tired of obsessing about food and weight. You may be tired of avoiding social events and friends because of issues surrounding food, tired of feeling like you have to “pay” for every bite of food you eat, and tired of feeling as if life is passing you by. In essence, you might be tired of being consumed by your eating disorder.

You don’t have to be ready to get rid of your eating disorder to benefit from this book. We have rarely met a client who was totally ready and willing to stop their eating disorder behaviors, even if he or she initially said this was the case. Our clients, probably like you, have ambivalence, and this ambivalence affects motivation. Dealing with your ambivalence is part of the recovery process. We don’t consider lack of motivation a weakness or problem; we understand it and consider it a big part of our work as eating disorder therapists. It is our job to help motivate you and help you with the ambivalence we know is there.

Exploring where you are, discovering where you would like to go, and figuring out what it takes to get there involves an ongoing process. During recovery, your motivation, patience, and hope will come and go. This key is designed to help get you started and get you past obstacles that prevent you from moving forward. We begin by helping you get a good picture of where you are and what your life with an eating disorder is like.

Writing Assignment: Your Worst Eating Disorder Day

We have come to the first writing assignment, which means it is a good time to get your journal. Think back to the worst eating disorder day you can remember. Don’t get caught up in trying to figure out which day was the worst. The idea is to pick a particularly bad day. Write down in very specific detail the day’s events: what and how much you ate, any purging and the specific details involved, and any other eating disorder behaviors like body checking, laxatives, diet pills, or compulsive exercise. Write your feelings before, during, and after, any lies or dishonesty involved, how it affected you, and perhaps how it affected others. Be honest—this is only for you. We know that writing this down is something you probably never have done. It is also unlikely that you have shared this kind of detail with anyone or looked at it step-by-step yourself. After you are finished, read what you have written. Reading it may have a powerful affect on you. It might be hard to see yourself as the person you have become due to an eating disorder, but if you are able to face the truth and see how much your eating disorder has taken over, it could be the impetus for a new beginning. Know that this is not who you really are or who you want to be.

We asked you to reflect on your worst eating disorder day because we want you to be fully in touch with what your life with an eating disorder is really like. We want to show you on a personal level why you want to get better. If you feel overwhelmed afterwards, think of that energy as motivation to get better, so you don’t have more days like your worst eating disorder day. On the other hand, if you believe your eating disorder is not that bad or is doing more for you than it is taking from you, think of the information in the rest of this key as designed to help you keep your eating disorder from getting any worse. No matter how bad you think your eating disorder is right now, the 8 keys will help you explore where you are and any thoughts, feelings, or fears you may have associated with change. Most importantly, try not to think of the process of recovery as giving up your eating disorder, but rather as getting yourself back.

Phases of Recovery from an Eating Disorder

We have identified several phases that people go through in their recovery from an eating disorder. You may have had an eating disorder for some time before you even realized that you had one. Once you became aware of the disorder, you might have gone on for some time before sharing this awareness with others. Maybe you believed your behaviors were not bad enough to warrant help or take action. Maybe you tried to get better, but it was too hard and you gave up. Knowing what the process looks like and what to expect can be very helpful. Below, we have outlined ten phases of recovery from an eating disorder, and under each we list some thoughts or feelings, which are typical for that phase.

Ten Phases of Eating Disorder Recovery

1.  I Don’t Think I Have a Problem.

•  It’s my body so leave me alone.

•  There are people who are a lot thinner (worse) than I am.

2.  I Might Have a Problem But It’s Not That Bad.

•  I only throw up once in a while.

•  My physical didn’t show anything wrong so I am OK.

3.  I Have a Problem But I Don’t Care.

•  I know throwing up isn’t good for me, but it’s working for me so I don’t care.

•  I could change if I wanted to, but I don’t.

4.  I Want To Change But I Don’t Know How and I’m Scared.

•  I want to eat normally, but I am afraid I will get fat (gain weight).

•  I want to stop bingeing, but I can’t figure out where to start.

5.  I Tried To Change But I Couldn’t.

•  I told myself that I would not (fill in the blank) but I found myself doing it again.

•  I don’t feel like I can really ever (change) get well, so why keep trying?

6.  I Can Stop Some of the Behaviors But Not All of Them.

•  I could stop purging, but I will not be able to eat more.

•  My eating has gotten better, but my exercise is out of control.

7.  I Can Stop the Behaviors, But Not My Thoughts.

•  I can’t stop thinking about food and bingeing all the time.

•  I keep counting calories over and over in my head and still want to lose weight.

8.  I Am Often Free From Behaviors and Thoughts, But Not All the Time.

•  I feel fine all day, but under stress I revert back to my unhealthy behaviors.

•  I was fine, but wearing a bathing suit triggered my eating disorder thoughts, and with it some related behaviors.

9.  I Am Free From Behaviors and Thoughts.

•  I feel mostly OK in my body and am able to eat things I want and not feel guilty or anxious afterwards.

•  Once I had stopped the behaviors for a period of time, at some point I realized that I was no longer having the thoughts or urges.

10.  I Am Recovered.

•  For a long time now, I no longer have thoughts, feelings, or behaviors related to my eating disorder.

•  I accept my body’s natural size. My eating disorder is a thing of the past.

What Does It Mean To Be Recovered?

Phase 10 of the process of recovery is when you are recovered. We both feel strongly about using the term “recovered” instead of “recovering” or “in recovery” to define the end goal. “Recovered” is how we feel and how we describe ourselves, and it is the end goal we pursue for all our clients.

The term and the concept of being “recovered” is important to us and we want to be clear regarding what we mean by it. There is no standard definition of what the term “recovered” means, and even researchers use varying definitions. One definition is when a person no longer meets the diagnostic criteria for an eating disorder. The problem with this definition is that a person can be symptomatic yet not meet the full criteria, and we would not consider that as being recovered. We prefer a definition that includes a variety of aspects we think are important to become recovered and stay that way.

Our definition of the term “recovered” is taken from Costin, 100 Questions & Answers About Eating Disorders. Read the definition over a few times, write it down, post it on your mirror, or carry a copy with you, to remind you of where you are going, and where you can be.

Being recovered is when the 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 the scale. When you are recovered, you do not use eating disorder behaviors to deal with, distract from, or cope with other problems. (pg. 164)

Writing Assignment: Exploring Your Phase of Recovery

Look at the 10 phases of recovery and try to determine which of the phases most accurately describes where you are today. Knowing the phase you are in can help you identify what is going on now, where you might be stuck, and where the recovery process will take you in the future. Write down the thoughts or behaviors you have that helped you determine what phase you are in as well as any feelings you have about it, where you have come from, and the road ahead.

Your Reasons for Change Will Change

We cannot know the reasons you might have for wanting to get better. Motivation to change comes in endless forms and changes over time. You might want to get better for someone else, or you might want to do it for yourself, or this might fluctuate. People sometimes start treatment because of a push or an ultimatum from a friend or loved one, but then later end up doing it for themselves. You might find yourself sick of being sick or you might be looking to the future and wanting a bigger life. You might be motivated by the desire to improve a current relationship or you might just want to get rid of your own incessant internal critic. Whatever your reasons for wanting to change are right now, just know that they may change over time. Clients often describe their shifts in motivation throughout the recovery process.

“I didn’t want to change for a long time, but eventually I just got fed up with how things were. At first I was motivated by what I was trying to avoid like feeling sick, guilty, tired, cold, having no friends, and dying. After awhile I noticed that my motivation started being more about what I wanted to be able to do: concentrate, make friends, and go to parties again. Now I am noticing that I am motivated by what I want in the future. I want to travel, get married, and have children. Every change in motivation helped me along.”

—CR

“It really helped to look at the things that I thought were motivating me a little bit closer…because it turned out I was really scared of those things, and getting better would mean I’d have to face them. They were all kind of double-edged swords—work, relationships, living back in a big city—I wanted them, but was so scared I’d fail at them, so even though I thought they were my motivation, being sick gave me an excuse to avoid them and the possibility of not getting what I wanted. When I realized that—and that really, in my old life I’d had all those things, I’d just been so empty inside that none of it had really mattered to me, and I was always going to want more and expect more from myself—I had to find something else.”

—SL

When your reasons for changing change it can affect your motivation. For example, if your desire to get better stems from a wish to appease a friend or loved one, your motivation level might be low. If at some point you find a reason more compelling to you—for example, wanting to have a baby—your motivation might be very high. Everyone is different. Reasons for motivation and the degree of motivation varies from person to person and changes over time.

Ready or Not

What brought you to these pages is important because whatever it was, it helps illuminate where you are in terms of your ambivalence and motivation. When reading this key, you can gauge your own readiness to change and modify the activities and exercises accordingly. If you know you are ready to overcome your eating disorder, you might, for example, dive into this book, complete every exercise, and share your progress with a trusted friend or therapist. If you still feel unsure, you might read through the whole book before you decide to complete a single exercise. Either approach—or any approach in between—is fine. Simply opening up this book suggests at least some small part of you is ready for something to be different in your life, and we believe that is enough to get started. You will take in what you are ready for and make changes in some areas, and at a pace that feels right for you. No matter how you came to this book, working through the keys will help you develop more insight and awareness into yourself as well as your situation. You can begin by assessing your own current level of motivation or readiness to change.

The Five Levels of Motivation for Change

DiClemente and Vasquez (1991) came up with a model for helping people understand and change addictive behavior, and Geller (2002) has used this model to research motivation and its relationship to eating disorders and success in treatment and recovery. Their work suggests that for any type of problem requiring change, your motivation or readiness to do so can be categorized into five main levels:

1.  Pre-Contemplation: You don’t think you have a problem and/or don’t want to change.

2.  Contemplation: You realize you have a problem and are thinking about changing, but you don’t know how to start or what to do.

3.  Preparation: You are getting ready for change. You look into different options, research online, or buy a self-help book.

4.  Action: You know you want to change and you are taking action, making plans, and doing things differently.

5.  Maintenance: You are working to continue doing the new behaviors, and not slip back.

When clients feel stuck, or can’t find the motivation to keep trying, it is often because they are having difficulty moving from one level to the next. We use the following questions to help our clients evaluate their current situation and move forward. Read through them all and then do the assignment that follows.

Levels of Motivation: Asking the Important Questions

1.   Pre-Contemplation

If you are reading this book, you are already past the pre-contemplation level. You might not be ready or want to change, but you know you have a problem.

2.   Contemplation - If you are unsure whether you want to change:

•  What are the pros and cons of staying the same vs. changing?

•  What will your future likely be if you do change and what will it be like if you don’t?

•  How does continuing in your eating disorder help or hurt your health and happiness?

•  What are the risks to your relationship(s) if you stay the same and what are the risks to your relationship(s) if you recover?

•  Are there things that you know you will be giving up if you recover versus if you don’t?

3.   Preparation - If you know you want to change, but can’t get yourself started or don’t know what to do:

•  What are the obstacles you can see that keep you from trying? Or moving forward?

•  What would you need to overcome these obstacles?

•  Who are the people who are supportive to you in this process?

•  Who else might be a support? How could they help you?

•  Why do you want to recover?

•  What small step toward change could you take at this time? (Even the slightest movement is helpful.)

4.   Action - If you are stuck, feel defeated, and can’t find the motivation to keep trying:

•  What progress have you made so far, no matter how minimal you think it is? (Remember, it is hard to remain motivated if you never give yourself any credit or positive feedback.)

•  What progress might other people notice?

•  Can you remember a time when you didn’t feel stuck or defeated? What were you doing then? Who helped you get there? How did you get there?

•  What are your fears or other feelings about giving up your eating disorder?

•  What do you feel like you will lose by giving it up? (Even if you recognize your eating disorder is unhealthy, giving it up will feel like a loss, and losses bring up other feelings for everyone.)

•  What do you want your relationship with food to ultimately look like?

•  What do you need to practice in order to get there?

•  What are you willing to give up for your eating disorder? What are you not willing to give up?

•  Is there any small step or decision you could make right now that would support your recovery?

•  Where can you get additional help?

5.  Maintenance - If you are struggling to figure out how you can continue or maintain your new behaviors once you have made changes:

•  What kinds of situations—physical, situational, relational, or emotional—make you vulnerable to falling back into your behaviors?

•  Are there any similarities or patterns that you see when you find yourself struggling to maintain your recovery?

•  What tools or skills do you need to develop to maintain the progress that you worked so hard to achieve? What do you need to do to start working on those skills?

•  What kind of structure do you need to best support your recovery?

•  What would be the first behavior or feeling state that can signal to you that you are slipping?

•  What can you do now that will prevent you from falling backwards?

•  Who can you share this with? Who can you call when you are overwhelmed and need someone who can help you through it? How can you help yourself reach out to this person?

Writing Assignment: Identifying, Exploring, and Enhancing Your Motivation

Look back at the 10 phases of eating disorder recovery and be sure you have selected which phase best describes where you are right now. Now see which level of motivation best matches your recovery phase. For example, if you are in phase 5 of recovery, “Tried to change, but couldn’t,” the motivation level that most closely matches is level 3, because you are trying to take action, but feel stuck. In your journal, answer the questions for the motivation level that best matches your phase of eating disorder recovery. The questions are designed to help you evaluate your thoughts and feelings in areas where you feel stuck or unsure, gain insight into potential obstacles, or connect to some unexamined sources of motivation. Whenever you feel your motivation lagging, or if you think you need a little push to move further in your recovery process, come back to the levels of motivation and the questions associated and go through them to explore in detail how you can move forward. Exploring these issues, however long it takes, is most likely what is necessary for you to progress. Looking at your motivation and readiness begins to challenge you to think in new ways. You may already feel a bit frustrated, not know some of the answers, or feel like if you knew these things already you would not need this book. Have patience. As you go through the keys, you will gain new insights and skills, all of which will help your readiness and your reasons for wanting to change.

Personal Reflections:

Gwen: One of the biggest challenges for me in my recovery was maintaining the positive changes I made, thus I relapsed on three different occasions. It turned out that I was stuck in eating disorder recovery phase 6: “I am free from some of the behaviors, but not all of them.” The motivation level that best matched where I was stuck was level 4 (maintenance), “Working to continue new behaviors,” which addresses maintenance or preventing relapse. I would have enough motivation for long periods of time to free myself from the strict rules regarding what foods I allowed myself to eat, to resist the urge to lose more weight, to stop weighing myself, and many more, but I kept slipping. After going through and answering the questions related to maintenance level of motivation, I realized that there were other behaviors that I kept up, and kept private. I convinced myself that my workout schedule (compulsive exercise), my determination (perfectionism), and my propensity toward privacy (dishonesty when triggered or slipping) were harmless or actually helping me, when in reality they were really keeping me stuck.

It looked like this: Something would happen that would bring up thoughts and feelings of unworthiness, fear of judgment from others, or a fear of not measuring up. My thoughts would then trigger intense feelings of fear, insecurity, and self-doubt, which would catapult me back into my eating disorder thinking and the belief that losing weight was the solution instead of the problem. The situations which started me slipping were not that interesting or even unusual, but my habit of keeping my feelings to myself and handling my feelings “my own way” continued to lead me down the same road over and over.

Going through and answering the motivation questions is what helped me realize that all of my relapses started with a painful experience, which created painful feelings that were not shared with anyone. The belief that I should handle the feelings “my way” had to be reexamined honestly. When I did, I could see that I had several people ready and willing to be helpful and the only reason I wasn’t sharing my feelings was because deep down I knew that “my way” wasn’t really a way to help me work through my feelings as much as it was a way for me for me to avoid them or get rid of them. If I shared my feelings I would have to feel them and become “vulnerable,” and I was afraid I wasn’t strong enough for that. If I believed that I couldn’t tolerate my feelings, it’s easy to understand why I would want to protect myself and reduce my vulnerability by handling things in whatever way would help me avoid feeling: restricting food and compulsively exercising. After identifying this theme in my relapses, I realized that by not talking to anyone about my fear of the unknown, my deep-seated insecurities, and my desperate need to feel more in control, I was actually fueling and protecting my eating disorder. I needed to talk about my feelings instead of shutting down if I wanted to stay well. As I became more open in my therapy, and then with others, people were able to support me emotionally, reassure me when I needed it, and validate my feelings.

Carolyn: One of the things I helped Gwen do was remind her and continue to point out to her that restricting her food or doing anything else to change her weight or body was not going to “fix” the problem, or make her invulnerable to pain. In fact, Gwen had to begin to open up with me, in group, and with her husband, in order to learn that being vulnerable in this way actually helped her fight off her eating disorder voice, instead of listening to it and giving in to the behaviors it suggested would help her feel safe. Gwen learned that what she was most afraid of was exactly what she most needed.

Try and Try Again

Chances are you are in for a long journey and it will take trying many things many times. We say this not to discourage you, but to tell you the truth, so you don’t expect too much of yourself or give up too soon. We have seen people get better in a few months, while others have taken many years. We have no way of knowing what the process will be like for you, but we do know that you can have some control over that. As you work through this book, you will be riding the ups and downs of motivation, the swings between determination and acquiescence, the vacillation between confidence and doubt, and a myriad of other feelings that go along with recovery. It is easy to become discouraged when you are trying to change your old eating disorder thoughts and behaviors. If your feelings become too overpowering, you might begin to believe it would be easier to just give up and stop trying. You might think if you don’t try, you are protecting yourself from feeling like a failure or a disappointment. Truthfully, this might work, but only for a little while. You may retreat back to your eating disorder behaviors, back to what feels familiar and manageable, but very soon feelings of hopelessness will bubble up because now you feel bad about your eating disorder behaviors and you feel bad for giving up or not trying.

In addition to the feelings directly related to the eating disorder behaviors, people in recovery also have to work on tolerating the feelings that are associated with trying. This usually includes fear of failure or of facing an unpredictable outcome. These fears can provoke a lot of anxiety, but your life will be greatly improved when you learn how to tolerate this particular anxiety. Many of the most meaningful parts of life are dependent on learning the skill of tolerating your feelings. You will get specific help with this in Key 4.

Sometimes our clients come to therapy and gain insight into destructive eating or other weight-related behaviors, family of origin issues, difficult life experiences, and current fears and beliefs, but resist making any actual changes. To get better you will eventually have to do something different even if you are unsure, afraid, feel guilty, or in some other way are uncomfortable. Key 6 specifically deals with helping you make behavioral changes.

What is helpful to remember is that even if you are not making any changes in your behaviors, you can still be making progress. Sometimes it takes several attempts to accomplish a goal. Just by continuing to try—by not giving up—you are actually working on a very important aspect of recovery. Most everyone who recovers goes through periods of feeling discouraged and hopeless. After all, a change which requires you to completely reevaluate your current lifestyle, overcome significant obstacles, step out of your familiar patterns, and proceed into an uncertain future, could not occur without some self-doubt, fear, and setbacks along the way. It would be unrealistic to expect otherwise of yourself. To succeed you need to try and keep trying.

Recovery is Not a Linear Process

Don’t be alarmed if your progress does not follow the identified phases in a linear fashion and you are not always moving forward. You will likely experience ups and downs, stalls, slips, and maybe even relapses. If you have been using your eating disorder behaviors to manage everything from food to feelings, it will not be easy to stop all at once. In fact, it’s quite unlikely that you would be able to stop quickly and easily. You might make some progress, and feel OK about how your recovery is going, but then find yourself reverting back to old behaviors when life presents you with a new or stressful situation that you haven’t learned to manage. You might find that you take care of yourself when with friends and coworkers, but then a visit home for the holidays throws you right back into old feelings and old ways of coping. Unfamiliar situations, like starting a new job or a new relationship, are likely to trigger or provoke feelings of insecurity and anxiety, which could lead to eating disorder behaviors if you haven’t yet learned how to manage in healthier ways. All your experiences help to illuminate areas where you still need work. There is no way to know or predict how you will feel and react in every situation, so the best approach to adopt is trial and error. Slips and relapses can be very discouraging; they can also be informative because they show you where you are vulnerable in your recovery. Many people feel so badly when slips occur that they give up, but learning from your mistakes is the only way to know how to protect yourself the next time. Setbacks in recovery do not mean that you are back where you started, or that you should not try new things, or not go home for the holidays, but rather that you had an experience that you were unable to cope with at that point in time. Once you know that, you can start to look at the situation and figure out what happened. We want you to know that even if you are doing great and then end up falling back into your eating disorder behaviors, there is still plenty of reason to hold onto hope. We let all of our clients know that relapse is often part of recovery. We do not say this because we are trying to make excuses or make our clients feel better about slips or relapses, but because this is the truth.

We Have Been There

Our own recovery process came with good doses of resistance, doubts, fears, slips, and even relapse. There were many times when we ourselves experienced periods of no change, were filled with doubt, felt too afraid to take a step, became discouraged, believed we just couldn’t do it, and worried we would never get better—and yet, we are both here today fully recovered. We made it through these periods of inaction or slipping back, and we offer ourselves as reminders of hope that you can too. Using our own recovery, our experiences as eating disorder therapists, and our past relationship with each other as therapist and client, we offer readers a very personal account of the process of going from disordered to recovered. We believe that sharing our own recovery will provide you with:

•  A tangible example of someone who has recovered.

•  Insider details of what the process of recovery is like.

•  Warning signs for some of the common pitfalls people experience during recovery.

•  Ideas and strategies that work to better prepare yourself for challenges.

•  Patience, because our struggles were real, long, and hard.

•  Motivation and hope, because if we can do it, you can too.

Working With Someone Who is Recovered

In the data collected from our clients in our private practices, graduates of the Monte Nido treatment program, and research studies on people who have recovered, one thing is clear: recovered people report that working with others who “have been there” was one of the most helpful aspects of their recovery. We are not saying you have to work with a recovered therapist. We do think that you need to find connection with someone recovered to help you in your journey whether it is a professional, friend, mentor, or otherwise. We hope the following quotes from clients will encourage you to find someone who has recovered.

“Working with people who were recovered gave me the motivation I wasn’t capable of finding inside myself. When I was feeling absolutely horrible in the beginning stages of recovery, to hear someone whom I admire and respect tell me that they had gone through a similar feeling or situation, and by persevering they are now on the other side of it, helped me realize this feeling was only temporary. To be able to see people who have been scared or in pain, but have pushed through it, and are now some of the healthiest, wisest people I have come across in my life, is what made the difference for me.”

—AA

“To make the commitment in my recovery, I needed more than a leap of faith; I needed to know that being recovered is possible. I needed to see real examples that there is a life of being recovered that is more rewarding than what the eating disorder allowed me, and that it is worth the pain of the recovery process to get there.”

—LK

Looking Ahead

Just as there is not a day you can point to and say, “That is when I officially got an eating disorder,” there is no specific day when you will be recovered. Getting and getting over an eating disorder involves a long process. You will have glimpses of being recovered along the way and then for increasingly longer periods of time you will feel free of your eating disorder. Eventually you will realize that you are living your life according to the definition of “recovered” we described earlier in this key. Nobody but you can decide this or determine if you are there. When you are fully recovered your eating disorder will feel totally gone, a thing of the past, but you will not be the exact same person you were before it started. Think about it—if you went back to being the exact same person you were prior to developing an eating disorder, if you thought the same and acted the same, you would develop an eating disorder again. Through the recovery process you will come to a new understanding of yourself, let things go, use new coping skills, engage in different behaviors, and discover how to lead a more authentic life.

Writing Assignment: A Day In My Life When I Am Recovered

Try to create a picture in your mind of what being recovered might look like for you. It may help to read over our definition of being “recovered.” Take some time to imagine a day in your life when you are fully recovered. Visualize in as much detail as possible what you are doing, what you are wearing, who you are with, how you feel about life, how you feel in your body, what profession you are in, what hobby or activities you enjoy, or whatever else you would like to be true for you. (Remember, sometimes we are afraid of the very same things that we want. Even if you are afraid of the recovered life, try to do this assignment anyway.) Imagining yourself as recovered is setting an intention for the future. Having a clear picture in your mind where you see yourself successful, happy, and doing something you love, such as having a child, hanging out with friends, or even just feeling comfortable, can provide helpful visuals and reminders when things feel tough. It might help you to know that research on visualization shows that it works. Visualization actually helps your brain to perform a task. Olympic skiers will repeatedly visualize themselves skiing down the mountain as a way to practice before the event because doing so actually enhances performance. Visualization helps set your mind up to accomplish what you want.

Personal Reflections:

Carolyn: Even before I was sure I could get better, I started taking time to visualize what it would be like. It was hard, but I had read about the power of visualization and thought I would give it a try. I would visualize myself doing specific things in relationship to my eating disorder that I found very hard to do, such as going out to dinner with friends and ordering whatever I wanted on the menu instead of the least caloric item. I visualized how I was dressed and who was there with me and how I would choose exactly what I liked, not what seemed “safe.” I would see myself eating it and having fun with my friends. I also remember imagining myself ordering an appropriate meal on a date, right before the date took place. I also actually imagined myself teaching high school. I saw myself helping students and serving as a healthy role model and making a difference in people’s lives. Teaching actually then did become my first job before I became a therapist. My visualization practice helped me go through some difficult times. I teach this technique to my clients today and continue to use it in my life.

Messages From Others

We offer the following quotes from clients to bring home messages of patience, motivation, and hope. We purposely have selected individuals who had long hard struggles with their eating disorders. Every one of them suffered with an eating disorder for over 10 years and had treatment failures and relapses. All of these individuals had loved ones who had lost their patience and given up on them. These are individuals who at one point had given up hope as well. The point is, all of them are well today! They offer words of encouragement that no matter how long it takes or how hard it is, it is possible.

“I would read stories of people who were in recovery or people who had got past the demeaning and controlling voice inside their head, but I did not and would not accept that I could be one of those people who survived and lived to tell the story. Don’t let that voice tell you the same lie. Life is so good and if I had known how good it could be and that full recovery was possible I would have changed a long time ago. I won’t paint a pretty picture; going through the process is torturous at times. However, it is also the most rewarding and most insightful experience you will ever have. I feel lucky to have gone through it because I am a stronger, wiser, and healthier person now, and I feel I have skills to navigate this world that are far greater than those who have not had my experiences. I believe in myself now, and because of that I know I can continue into being fully recovered.”

—JW

“When I first met Carolyn I told her I did not want to recover, that it was not possible for me because I knew that my eating disorder was stronger than I was. I was sure of it because, at 22, I had already been through three unsuccessful attempts at recovery in treatment programs and had been suffering from my eating disorder since I was nine. Carolyn told me then, and I came to see, that my eating disorder could not be stronger than me because it was me. Then I met many others, like me, who had also previously failed treatment, and yet were recovered. That gave me hope. I began to realize I could do it too and thinking otherwise was an excuse not to try.”

—PM

“People often wonder how I got better after so many years and so many slips and lapses. There are a few things that stand out and I offer them as hope because if someone like me who suffered for 15 years can get better, I think anyone can. I had thought my eating disorder showed my strength and willpower, but I realized that the harder thing to do was not engage in behaviors and notice how much stronger I felt each time I disobeyed my disorder. When I noticed how much more people genuinely enjoyed my company when I was not using my eating disorder behaviors and how much more love I got when I was doing the harder thing it was extremely motivating. I finally realized that I wanted to live and have relationships more than I wanted my eating disorder.”

—MP

“Feeling hopeless didn’t mean I was hopeless. The only difference between someone who gets better and someone who doesn’t is whether or not that person gives up and stops trying. I had many opportunities to give up since I had multiple treatments that did not work. My parents stopped talking to me and I felt sure I would not recover, but I did not give up trying. After years of thinking I would never get better and looking for an answer outside myself, I finally realized it was up to me. I learned how to use my healthy self to fight off my eating disorder self and internalize the process, which I had needed all along. This helped me see that it was possible. Knowing that it was hard, and that hard times didn’t mean I wasn’t getting better, was also really helpful. People do get better. There’s a point when you just have to start believing you can get better. I learned at Monte Nido that energy follows thought. When I thought I could do it and I started to see results, no matter how small, I gained more faith in myself and more strength to keep going.”

—PK

Some Final Thoughts

Change is not easy, it is not a linear process, and your motivation to change or recover isn’t something that you “get” once and then never have to work on again. We hope you are reassured that ambivalence or reluctance are normal and do not mean you cannot recover. We hope you have assessed where you are and where you want to go, accepting what is now and committing to not giving up. In our experience, people who don’t get better are the ones who, for whatever reason, stop trying. Stay with it and you can recover from your eating disorder, reclaim yourself, and create a life that includes peace, joy, and fulfillment. Of course, nobody will be able to force you to keep trying or make changes (at least lasting ones) unless you ultimately decide you want to change for yourself. Even if you are not completely ready to give up your eating disorder, there is some part of you that wants to get better, is interested in a better life, or at least is willing to explore the possibility. It is this part of you that is reading this book and it is the part of you that we call your “healthy self.” Key 2 will discuss how to strengthen your healthy self so that it can be in charge and help you recover.