Eating disorders often have a ‘voice’ to their victims. Dietitian Lucy Carey provides insight into how to be louder than the eating disorder.
“From my perspective, everything is going really well,” I told my client.
She gave me a wispy little smile that didn’t reach her eyes.
“In fact,” I carried on, “It’s going so well I think it’s actually too good to be true.”
Her smile fell flat.
“I know you’ve been eating without a fuss. Which is great. But I suspect you’re just waiting this out. Just waiting until the spotlight isn’t on you anymore, no one is supervising your meals, and you can go back to being alone with your eating disorder.”
She fumbled for a response, her mouth almost opening but not quite. I could see the anorexia was trying to come up with an excuse for her, but I had put her on the spot and it had rocked her normally smooth eating disorder.
She looked at me and whispered, “You’re not meant to know that.”
Now it was my turn to smile, although I did so a little sadly. “This ain’t my first rodeo,” I replied.
To see someone struggle with anorexia is a fearsome thing to behold. When you’re talking to them it can sometimes be hard to know if you’re actually talking to them, or if you’re talking to their eating disorder.
I know it sounds strange, but sometimes I think I see the eating disorder come out. Perhaps it’s just my imagination, but I think I can see their eyes change. A kind of manic energy fills them and I swear a sinister shining comes forth. But who knows, I could totally be imagining it.
What I know for sure is that my clients themselves often feel this kind of evil alter ego. Every time they even think about eating, this voice is there in their head to convince them why they shouldn’t. Everyone’s is different, but it’s common that over time the voice stops it’s logical-sounding arguments and just blatantly screams obscenities at its victim instead.
“It’s a real b****,” one client said to me. “It sometimes wakes me up, just screaming about how fat and lazy I am. Making me get up and exercise.”
Often I see people before they’ve gotten to this point. The voice in their head is still quite friendly, just chipping away at them, telling them that everything is better when they don’t eat, or eat very little, or eat very clean. And they’re surprised that I know about the voice, and utterly flabbergasted that I know what it says to them.
“I know it makes all these points that kind of make sense and you want to listen. But I also know that there’s a part of you over here that knows what utter crap it is.”
“Yes, that’s exactly it!” I could see how validating it was for my client to hear this, so I carried on.
“For most people, they don’t eat and they just feel like crap. But for some people, it seems to relieve their anxiety, it can trigger a sort of euphoria even.”
“Yeah it’s like I’m on this whole other level when I don’t eat. I’m better than everyone else.”
I nodded. “It starts off feeling good most days, but then it’s one good day for 10 bad ones, then one good day for 100 bad ones, then 1000… Let me ask you something, when you get dressed, do you have to do things a certain way?”
“Yeah… How do you know that?”
We talked about it and she discovered that almost every aspect of her life was completely routined-out. She had to put her belongings in the right place, sit at the right seat at the dinner table, put her shoes on the right foot first.
This is really common. Eating disorders and perfectionist OCD-style traits often go hand in hand. Which is why I often like my clients to do some homework that isn’t at all related to food.
It’s an exercise I saw once in a training video. You list out 3 things you always do, and 3 things you never do. You might always put your right shoe on first and you might never leave the house without makeup. Then you do the opposite.
You pick the small things because they’re the low hanging fruit. Putting your left shoe on first isn’t going to cause the sky to fall down, but it can actually feel that way for some people. This exercise gets them used to that low level discomfort, and opens them up to change a little bit at a time.
It works.
I know because I’ve done it myself. I didn’t have the nicely written out exercise at the time, but nevertheless I started to do things differently because I could feel that I was trapping myself in these little routines.
I admit that I still have a full routine that I need to do before I do squats at the gym, but at least I can now get dressed without having to always put my left arm in my cardigan first.
If you think that sounds utterly insane, I’m glad! It means you don’t suffer from the thing! You’re probably someone who just feels like crap when they don’t eat, someone who has never heard a voice in their head lying to them that life is better without food. Telling you to just make it through until everyone leaves you alone, because no one understands the way the voice does.
Until your dietitian, or your therapist, or your health coach or whoever it is, shows you that they do, in fact, understand.
It seems small, but I think it puts a crack in the smooth service of the eating disorder. And sometimes my clients start to wonder, if it lied about no one else understanding, what else is it lying about?