By Hesther van 't Pad Bosch
Why did I have an eating disorder at age 14? That question has haunted me all my life. First to heal yourself. Later as a therapist to support others in their process of recovery. My recent experience as a therapist has made me stop further on how we deal with eating disorders. First, the number of people with an eating disorder experience is increasing, comparable to an increasingly younger age. Secondly, recovery is still difficult and lengthy for many. I hope by sharing my experience in contributing to the possible surrounding the meaning of an eating disorder and its recovery.
The eating disorder experience The experience of an eating disorder is really no fun. The condemnation and the misunderstanding. The sneaky stuff, the guilt and shame. The obsessive. It takes over you and takes complete control of your life. It is a difficult experience with often serious consequences. The treatment mill that many find themselves in can be traumatic. I can personally relate to that and I still see it happening all around me: being forced to eat, having to relive past traumas over and over again, the frequent and contradictory advice, the interpretations of the causes of the occurrence. You can hardly escape having to have a 'legitimate story' around the origin of the eating disorder, and if you don't have such a story, you soon doubt whether it is real. For many, it is a long battle with the eating disorder itself, the therapists and the social environment. What makes someone eat too little or too much? Eat so little that you become thinner, smaller and more invisible and take up less and less space. Or eat so much that people can no longer get around or through you and stay far away from you. Where does this reaction come from and what does it want to tell you?
What do you want The initial question is whether someone wants an eating disorder. From my own eating disorder experience and guiding hundreds of people, the answer to that is, as expected, always no. The question then is, what would you like instead? In the end, the answer is actually always 'being myself'. And that is also the starting point of the investigation and recovery process. Not being able to be yourself is enough reason for an eating disorder experience and almost always its meaning. Why not be yourself? And what is being yourself anyway? What is the relationship with an eating disorder? Be yourself Being yourself is perhaps the easiest thing to comprehend as what you desire. What makes you happy. What is in you wants to be and to be experienced. Call it your life destination or passion that really makes your heart beat faster. Just thinking about it makes you happy. That feeling of happiness tells you that it suits you and that it is what you want in your life - whatever it is. For many people, including those with eating disorders, the question of what you want in life is a difficult question to answer. You've forgotten.
Forgetting Why did you forget? This goes back to the time when the idea that you could not or should not be yourself originated. When it wasn't safe and there was no room for what you wanted. When an aspect of you was compromised. When there was no attention, understanding and recognition for what you wanted and needed. You weren't really seen. This belief, and the reaction to it, moved you further away from the sense of being yourself, and therefore from knowing what being yourself is. Not being yourself means being different from what you want to be. You have started adapting or pretending to be different than you are. Maybe to be accepted, not to stand out, to be seen or to protect yourself. Something gave you the impression that being yourself was not okay or safe. That you had to be different, think, act, feel or behave differently. That you should have other desires and interests and were limited in your space to find out for yourself. It was filled in for you by others in their image of how you should be, think, feel and act. And you have come to believe partly or wholly in a self- and worldview formed by others or circumstances, forgetting in it your own truth - even your own ability to find your truth within yourself.
Harmony What happens when you are no longer yourself? My experience is that when you are no longer who you want to be, something starts to gnaw at you. Because on a deeper level, you still want to be yourself. That is your natural and harmonic state of being. When you deviate from this, disharmony arises, and you want to restore it. That makes sense. Not eating enough or eating too much is a reaction to that disharmony, and thus a messenger telling you that you are experiencing disharmony. You are not who you want to be. You have adapted to such an extent that you are no longer yourself. Your perspective has changed to your distorted self and worldview as a response to your outside world. Adjusted neat or inappropriate contrary. That would mean that the eating disorder is there as long as you are not yourself, to tell you that you are not quite who you want to be.
Remembering
The road of recovery therefore starts with remembering who you are and want to be. Your passion. Your desire. What makes you happy. Feeling it again. Experience your own compass again. Finding, remembering and acknowledging it within yourself. And then also accept and love yourself unconditionally in it. So bring the attention to what you do want, instead of giving all the attention to the eating disorder and what you don't want. That is the faster way to restore harmony. How do you know who you are and what you want? What is being yourself to you? Who else would know that but you? This is where the approach often falls short. Firstly, it is often not focused on what you want in life. It focuses on what you don't want: the eating disorder experience. Secondly, it is offering and directing, not self-discovery. As if the other has the answer. The way in is rarely shown. Instead, advice is given. You have to eat so much and so many times a day. If your weight increases or decreases that much, then we stop. You have to stay at this weight. You have to go to therapy with your mother and father. You have to live through your emotions. You have an eating disorder for such and such a reason. You have to do this and that, think, feel, find and say. It was conceived by others and filled in from their perspective. And that is exactly what made you move away from yourself in the first place. Again you let others tell you how it is, what you want, how to be, do, think and feel. The media, your friends, your family, the practitioners and doctors and so on. This approach reinforces the disharmony in you of not determining and discovering yourself. You hand over the power and the answer. But who knows who you are and want to be? If the eating disorder is a messenger of the disharmony in you due to not being yourself, then it only dissolves when you are yourself. Feel, experience and live your own passion. The way of remembering is the way in. Investigating, questioning, feeling and connecting with yourself until the memory is back. You know it. Focus on remembering the experiences when you felt joy, enthusiasm, cheerfulness and harmony. Sometimes it's hard to get to that memory. Everything has grown over it. It's like you've lost your inner compass. But it's in you and you can remember it. When it is deeply hidden, sometimes you need a powerful tool to bring it out - such as hypnosis, meditation and trance. Those are safe states from where you can access your deeper intuitive knowing and intelligence. That way you can also get in touch with your feeling, your own compass - to determine your own direction again.
The experience of being yourself When you remember who you are and want to be, what you desire and make you happy, what your passions are, and you can feel it again, the next step is to actually be. To be, think, feel and do what you want your way. Is that allowed? Can you? The challenge is that following your own path has not been safe for you and can therefore still feel unsafe today. Being yourself follows the experience of what it is like to be yourself. Your environment can react to it. Do you dare to be yourself regardless of the reactions you get? Can you stay on track? Learning to be yourself can go through trial and error. Continuing to discover your potential and desires, and how to make those experiences a reality, is something everyone is learning. Also your father, your mother, brother, sister, partner, child, friends and practitioners. Everyone is experiencing what it is to be yourself in the world. Rediscovering the faith, confidence and strength within yourself is exactly where you need support. Instead of being told that you are not doing it right, that you should do it differently, you need to experience that you can do it, that you know and that you are allowed to do it. Growing that confidence again, believing in it again, believing in yourself, feeling and experiencing what makes you happy again - that makes your confidence grow. That's what good support does for you. Someone who believes in you, accepts you as you are, without judgment and expectation. Curious about who you really are. Having the space to go within to feel what feels right to you again. How it feels to be yourself. Only you know what's inside you. There are also tools for this step that can help you grow and give you confidence - such as learning to be an observer in your experience, redirecting your attention, using the I-am anchor and making 'pit stops'. The interpretation of this is personal for everyone - a skilled counselor will work with you to find the right instruments for you - tailored to your unique being and needs.
Supporting
Hoe kun je iemand daarin ondersteunen? Hoe kun je als ouder, broer, zus, partner, oom, tante, vriend of vriendin iemand daarin helpen? De vraag daarin is of je de ander onvoorwaardelijk accepteert en lief hebt, zoals je zelf ook onvoorwaardelijk geaccepteerd wilt zijn door anderen en door jezelf. Ben je nieuwsgierig naar wie de ander is? Wat die ander echt gelukkig maakt? Ook als het anders is dan wat jij wilt? Ken je je eigen kind of partner wel echt? Hoeveel ruimte is er voor diegene om zichzelf te zijn en te ontdekken? Kun je je eigen oordelen, waarheden, verwachting en percepties loslaten, ruimte maken voor de ander? Kun je je eigen behoefte om het te weten en anderen te sturen en overtuigen overstijgen? En wellicht is uiteindelijk de weg dat als ook jij jezelf mag zijn en liefhebben, de ander dat ook mag en kan.
The makeability of life All this is based on the more basic question: how malleable is life? How do you make your experiences? Who makes your experiences? And what do you learn from it? Is it your environment, genes, thinking, others or God? Or do you create your experiences? The answer to that question is very personal in my opinion. It is based on your own experience how malleable your life is for you. It is therefore up to everyone, and also up to you, to investigate the malleability of the eating disorder experience and being yourself. In summary, in my experience, the eating disorder is about the disharmony between who you want to be, who you are, and what you experience. When those three perspectives are in harmony, the eating disorder completely dissolves. It is no longer necessary. The message has arrived and you have done something with it. That opens the door to experiencing who you really want to be.
My recovery How did I recover from an eating disorder? I recovered because I started to live my own life more and more, because I dared to be myself more and more. Because how to be myself, I couldn't have made that journey of discovery in my early life. From unconscious to increasingly conscious. By not giving up and going my own way with trial and error. Often insufficiently realizing what my real motivations were. By undergoing a lot of diversity and variety in my life, by having many different experiences. By investigating who I am, what belongs to me and what makes me happy. It has taken time to explore and experience what suits me, the acceptance of my search and the confidence to find and see myself. I also adapted a lot in my search, because I did not sufficiently understand that not adapting was my key to recovery. I did not understand that, beneath the adjustment, my fear of rejection, of not doing well, of not being compliant, of being left out and abandoned, lay. This often resulted in seeking isolation or doing things that were perceived by others as strange leaps and irresponsibility. I wanted to be loved and I sought that in perhaps the strangest ways and I did not feel my own limits. The core of this story is that I didn't love myself, that I didn't dare to choose myself, that I didn't understand what choosing myself meant. I thought I would, but I didn't. Sometimes it seemed like I was choosing myself, which made it not seem like adapting and I didn't feel that I was adapting anyway. I didn't know the feeling and the way how to choose myself and go my own way. I was focused on the outside world and had no connection to my own compass. I had no connection with my own inner world. I had to turn my compass a lot to finally find the right direction, my direction to getting to know and be allowed to be myself. The direction of my talents and passion.
Food itself was also part of that. It took me a long time to break free from the eating list I had learned to use while in treatment. A treatment that was unsuccessful and traumatic and after which I decided never to go into treatment again. I was quite sure of that. Also in terms of food, I slowly learned what I like to eat and what I don't like, what my body needs and what my body doesn't need. In my opinion this is different for every person and it asks for contact with yourself. You don't think of food that suits you, but you feel it inside. Compensating through exercise was part of my experience of having an eating disorder. Here too I had to learn to feel when my body said now it's enough and yes, now I love to move. Distancing myself from fear and choosing love requires turning inward and feeling and listening to what I need. Attention to what I want to experience in my life and what is good for me remains in life even after I recovered from an eating disorder. A facial paralysis not long ago signaled to me that I had gone off course. For some time I experienced that this was the case, that I no longer followed my own compass, but I didn't dare to listen to this. I was adjusting again. Having the eating disorder experience again did not occur in my life, but the experience of facial paralysis did. I now know that I can never deny myself again, that I can and must love myself unconditionally. I will not deny that sometimes daring and courage is needed, but once applied I feel that it is the way and that my emotions have always shown me the way and will point to being myself.
The next step
The treatment I received 35 years ago was being removed from my home and banned from contacting my parents for a year. Fortunately, much has improved since then, but we are not there yet. The current trend is back to the idea that the "healer" has the diagnosis and the solution - standardized, focused on efficiency and ignoring the unique makeup of each person. Much is approached from the 'head' - evidence based we call that. But the 'evidence' is that a far too low percentage recovers. We are, of course, more than our heads as human beings. For example, we also have a heart. As soon as we consider the total (holostic) picture, we can take bigger steps.
The approach I've seen work focuses on the self-discovery and learning capacity of each person - it's person-oriented customization, focused on discovering who you are and how you can be yourself. Because somewhere in yourself you know exactly what the eating disorder is telling you, what it is to be yourself, and why you don't take the space for that. You also know what you need to be yourself. Because the influence and the many advice from outside can make you doubt, you sometimes need help to reconnect with your own compass and knowing. To feel it again. And once that contact is there again, the path to recovery becomes clear step by step.
The supporter plays a more important role in this than the method that is provided - as research shows. The unconditional love, acceptance and non-judgmental openness (neutrality) of the support creates a safe learning environment in which there is room to be. Ultimately, you are the one who restores the harmony in you, and you just need the love and patience to get there yourself. This is a two-way learning process - it is learning together - in which the support worker and 'student' are equal - in which 'right', 'wrong', 'must' and 'not allowed' have no place. You are no more or less, better or less good than anyone else. Together you learn what it's like to be yourself.
How much support you need in this is personal. Sometimes a few mentoring sessions are enough. Sometimes a study group with others. Sometimes an intensive retreat. Sometimes a dose of love and patience - without pressure - without having to. Or a combination of them. It is tailor-made, because you are unique. Such a mentoring program focuses on becoming aware of what you want, who you are and what you experience - and finding those answers within yourself. This does not have to be heavy and difficult. Discovering yourself is exciting, interesting and even fun, even if it is sometimes challenging. In this way you learn through and from your experiences - and that builds your confidence and strength to be completely you. I hope from the bottom of my heart that you get to experience that.
Hesther van 't Pad Bosch has recovered from an eating disorder herself and has 15 years of experience in supporting many within the mental health care sector. She co-founded The Experience School based on the book The Experience Maker - an approach in which you examine your own role in your experiences in order to gain more control over your life. Thanks to contributions from Joost Wentink, Thijs Plokker, Hanneke Wentink, Carlijn Damen and Tijne Bijpost.