REALITY OR WHOM AM I HURTING ACTUALLY?
The answer is simple. It's not a choice. It's a "must".
Eating disorders are stress coping mechanisms, a safety belt, and identity.
After experiencing any kind of trauma or voices in their head telling them how unworthy they are they have to take emotional and body control back. Because when they feel miserable rules are there to make them feel better.
How?
By setting an abnormal arsenal of self-punishing rules.
The rules give them control and we all want to be in control. They are addicted to the rules. Break them and they feel as if they have lost their identity. One pound more on a scale and they lose control. On the other hand, when down they turn to one thing that will make them happy: food. They deliberately lose weight so that they can eat more!
Every time when they feel out of control or stressed they made a new set of rules so as to feel safe again.
But the rules that allegedly gave them safety are actually slowly killing them.
They become a hanger for their clothes.
The hardest part is that they are not aware of it- of their ribs showing, the hips protruding, hair falling out.
They think there's nothing wrong with them and often feel very disturbed when involuntarily charged to hospital.
Their "nutrition" plan without any sweets is perfectly normal to them. They weigh themselves at least 10 times a day. After being diagnosed it's much harder for them to follow their rules.
The most common types of eating disorders listed in the diagnostic manual of Psychiatry and Mental health called DSM-IV:
The last (Eating disorder- not otherwise specified) was officially recognized as a mental disorder only recently, namely in 2013. In a very short period of time, a person consumes huge amounts of food without being hungry. They hide while doing it. After overeating, they feel guilty and disgusted with themselves. Since there is no compensatory behaviour the obesity is the following issue. It is more found in men than in women, unlike the first two disorders.
Eating disorders are influenced by myriads of factors, but the exact cause is still unknown.
Biological factors:
Psychological factors:
Environmental factors:
Psychological counselling / Therapy
Nutritional Counselling
Drug Treatment (Anti-depressants)
The treatment and recovery process is not linear. The journey from disorder is rarely linear because of the relapse.
Sometimes it is extremely difficult to relate to the patient. They are angry and annoyed at the very idea of being cured. Getting better from treatment means they are losing their identity. They ask themselves- "If I am to be treated who am I going to become then?"
As a therapist, you are interfering with their rules and that's why they are uncooperative in most of the cases. Sometimes there is no noticeable change at all.
Since psychological and physical (biological) issues are tightly interconnected the treatment never involves only one approach. Moreover, the interconnection is steel not clearly defined which makes the treatment even harder to implement.
CBT most successfully addresses all of the above-mentioned issues since changing their behaviour and thinking patterns makes them fully aware of them. It results in another, crucial change- readiness to change and accept new self without fear of losing their identity. Also, it gives an individual in recovery the opportunity to identify and heal from traumatic life events and develop healthier coping skills and ways of expressing emotions.
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