TREATMENT & RECOVERY FEARS
Updated version published by Elite Daily
I can remember the panic all too well and my mind racing at the speed of sound with questions and fears in regards to facing going into treatment and the idea surrounding recovery. I know you are all at different stages in your journey. Some of you may have already had lots of treatment in various forms and levels, while some of you may just be worried about the possibility. I am going to address some of the biggest fears that I personally have faced over the past years struggling with my eating disorder and will address them knowing what I know now. ~Britt
Fear #1: “I’m going to be the biggest one there!”
Yes, this fear and thought is definitely number one on my list. Let me give you some personal insight into this one. This was a huge fear of mine every time I entered treatment no matter what level of care it was and I can tell you now looking back that it is completely irrelevant even though it doesn’t appear that way in the moment. For reference, I will use three personal examples. When I was faced with having to go to treatment in early 2009, I was oblivious to the severity of my condition and appearance. I was in such bad shape that I was literally dying and my funeral was being planned; yet in my mind, I was pondering how ridiculous it was that I was not being discharged and allowed back into college. After going through a stabilization program I was transferred to an eating disorder inpatient program. I actually was the “thinnest” patient and you know what? It meant nothing! In fact, if anything my “prize” was that I was never left out of sight by the staff, never trusted and I still believed I was average, bordering fat. There were plenty of staff and kind patients who wanted to support and help me, but I put up a wall that would challenge the one in China. I didn’t benefit from treatment because I got in my own way.
Just one year later, I was faced with going back to treatment again. To put things into perspective, I was over 130 pounds heavier than my 2009 admission. And you know what? My fear about being “the biggest one there” was still just as strong. I agreed to go regardless though because I was desperate and in need of help. So I arrived, met all the other patients and staff, and you know what? I was the biggest one there! And guess what? Nobody cared! I was not treated differently except in my own mind. I felt just as uncomfortable in my body as I did the year before. I will admit that it was hard to see some patients who looked anorexic when just a year prior I looked that way too. There was a sense of competition… a sense that my identity had been stolen, but that was my own personal issue I had to address. The bottom line is that I went to a well-known residential treatment center and truly was, “the biggest one there” and the only thing that prevented me from fully benefiting from the program was once again, me.
The third scenario I will present occurred in 2011. Of course I once again feared being the biggest patient there. (Why do we even convince ourselves that this possibility makes us less worthy or undeserving of help?) Anyway, I arrived and I soon found that I was not the biggest patient there, although I certainly was not the thinnest either. I was average… in the middle of the bunch. And once again, I’m going to tell you that it meant nothing. I was not treated any bit differently from the larger patients or the thinner patients.
So, If you are contemplating going to treatment, whether it be an outpatient treatment center, a residential treatment center or an inpatient treatment center, remember that everyone there most likely shares your same fears and most likely everyone there will accept you and support you no matter what. In fact, you might meet some of the most understanding and compassionate peers of your life. The same holds true for the staff, therapists and doctors. They are there because they are educated about eating disorders and understand that a person’s suffering is not a result of their outward appearance. Please, please do not let this fear of “standing out from the crowd” prevent you from seeking help.
Fear #2:“I’m not sick enough to be in treatment compared to others.”
This is a tough one and also a fear and lie most everyone with an eating disorder constantly replays in their minds. Again, I am going to tell you until I’m blue in the face that you are always sick enough. If you do enter treatment, I will be blunt and honest with you and tell you that it is likely you will encounter one or a few other patients who seem to be what I’ll call “frequent flyers” or “experienced residents.” Because these select few individuals have struggled for a long time or have been to treatment many times, they may come off as confident, more relaxed and sometimes even arrogant. This does not mean they are sicker than you. Perhaps they have struggled longer, so what? Perhaps they have been forced into treatment more frequently, so what? Perhaps they have a higher and quicker relapse rate, so what? Again, this does not make them any more superior, better or worthy of treatment. It just is what it is.
When you enter treatment, you have to remember that you are there for you and your own unique struggle and quest for a happier, healthier life completely independent of whomever else may be present. And one word of caution: There are sometimes the unfortunate situations where you will encounter other patients who do not want and are not ready for recovery and will flaunt their disease and behaviors, or worse try to convince you to act out in a similar fashion. What do you do? Stay as far away as you possibly can! When confined in treatment you may not be able to distance yourself physically, but mentally I want you to focus on blocking their words and behaviors out. It is a sad situation that those individuals are in. It’s not your job to try and save them or convince them of recovery, either. Try not to let them trigger you. When in treatment your one job is you and you only. Once you leave the treatment “bubble” and are back in reality you will realize how distorted and scarce those certain “sick” individuals are. The only prize for being the sickest is a 6-foot deep grave.
Fear #3: “I don’t want or I’m not ready for recovery!”
This third fear ties in nicely to fear #2. In my personal opinion there is a big difference between not wanting to recover or not feeling ready and being obviously “proud” of having an eating disorder. This brings up the concern of whom we call “pro anorexics,” or others who are glorifying eating disorders, but that is for a later topic. Anyway, if you are not ready for recovery or are at a point in your life where you believe you don’t want recovery, I’m here to tell you that this is okay. For the majority of my eating disorder, over a decade to give perspective, I did not want recovery. I’m smart, I will admit that, and I knew that my eating disorder was destroying my life, my future and me. The problem was that it was still serving a purpose, albeit a negative one. Basically, I was still getting some sort of benefit from it. It was my identity, it was my way to self-medicate and numb the more painful and deeper feelings, it was my excuse for failure, it was my way to avoid social situations that provoked anxiety, it was my role in the family, it was something I could depend on that was predictable, it was an abusive friend that I knew wouldn’t reject me, it was a way to punish myself for the false negative beliefs I held about myself, it was something I was good at, it made life simpler and it satisfied my OCD. In short, my eating disorder was hell… but… look at this partial list of “beneficial gains” it provided me. Can you relate?
So, you don’t want recovery. I get that. Who is to say there is something better waiting for you if you do recover? I mean, it’s so much work! You have to feel again, you have to rewire your brain, you have to challenge and change your thinking, you have to admit your sense of worthlessness is wrong, you have to participate in life, you have to show up without hiding behind the excuse and safety of being “sick,” you have to take responsibility for your actions, you have to grow up, you have to think about and make tough real life decisions, you have to form relationships which all come with ups and downs, and you have to look at all that pain hiding beneath your Band-Aid. Damn! Who wants to do any of that? I’ll tell you why and I can only tell you why because I went through it. I didn’t have a role model and I didn’t have someone else I followed who inspired me. Only doctors, nurses and my parents told me recovery would be worth it and it was my belief that they just wanted me to get fat. But like I said, I managed to find a path to recovery and the ways my life changed are almost indescribable.
We always hear it’s worth it, but until you go through the process yourself you won’t understand. It takes a lot of courage and a leap of faith. I can promise you it will save your life. I can promise you it will be the hardest thing you will ever do. I can promise you that you can go through the motions of “recovery” without wanting or believing in it. I haven’t met too many people actually who enter treatment saying they want to recover; the few who do are those who have struggled for so long and are finally ready to make changes or they are simply lying. You do not have to hit rock bottom in order to want, need or deserve recovery. I highly recommend against hitting rock bottom. You don’t have to want recovery, but you do need recovery and not a minute later. As cliché as it is, I am going to tell you to fake it till you make it. Go through the motions of recovery. Do what you are supposed to do even though your eating disorder is telling you otherwise. Heck, go through the motions for a few years if you need to, but I promise that when you look back, you too will realize that your worst days in recovery are so much better than your best days deep in your eating disorder.
Fear #4: “My health isn’t that bad. Can’t I live a normal life and keep my eating disorder?”
No! But of course you knew I would say that. But in my mind, this is important to address. I often convinced myself and spent countless hours obsessing over how to convince my treatment team and parents that I could be healthy and keep my eating disorder. I thought I could have the best of both worlds; maintain a minimally low weight and be a great tennis player/student/horseback rider/friend/ (insert your own). The truth is once again that your eating disorder is manipulating and lying to you. This is still a form of denial. When it comes to recovery it truly is all or nothing. There really is no half way.
On your way towards recovery there will often be bumps in the road often times, but those are not roadblocks, just speed bumps. They slow you down, but you have to keep climbing over them. I could write more on this topic, but I will leave it at this. From my personal experience and desperate attempts to maintain life and an eating disorder, if you were to ask, “Can I be healthy and keep parts of my eating disorder?” I will answer: “No. Are you crazy? Ha-ha! Absolutely not! Is that a joke? We need to talk about this. Oh dear! This must be sarcasm at its finest! Not by any means! Never! Nope! Oh and did I mention, no!”
Fear #5: “What am I supposed to tell my friends if I go away to treatment for months?”
It can be really hard to leave to focus on treatment when it also means leaving your friends, possibly school and life, as you know it. It’s not easy, but in this case again you have to be selfish. There are several ways to go about this. One way is to simply say nothing and just go. You really owe no one an explanation for seeking help to save your life and getting well. Another option is to tell your close friends, if they don’t already know. Explain to them, whether they understand eating disorders or not, that you need to go get some extra support in order to live a better life.
Sometimes, depending on the treatment center, you will be able to have some forms of communication available to you such as limited phone and computer access where you can periodically check in with your friends. I think you would be surprised at how much support you’ll often receive when you are honest with people about your struggles. Also know that sometimes people just don’t have the capacity to understand what you are going through due to limited knowledge, other built in stereotypes, or the culture they were brought up in. This is okay too. I lost many friends going in and out of treatment, but what I can tell you is that once you come back and people can see you are better (both physically, mentally and just the way you carry yourself) they will flock to you like magnets. You never lose friends; you only find out who your real ones are, and if you can put yourself first, then I promise you will have many more true friends in the future than if you struggle in silence and aren’t honest with the people around you.
And again, this can depend on what level of treatment you are going to. If you are entering outpatient treatment or an intensive outpatient (IOP) treatment center, then maybe you don’t have to say anything to your friends yet if you aren’t ready. If you are going to a residential or inpatient treatment center, then often your access to communication via phone and computer is limited or not allowed. As hard as that can be to accept, in my experience the loss of communication is absolutely vital and I think you will learn to really enjoy the break from the social media chaos. So, in summary, it’s up to you how you handle your friends and leaving your life at home temporarily. What you do need to know though is that you should not think twice about your decision to get help or what others might think. If you are your best self then you in turn help others become their best selves; period.
Fear #6: “What if the weight gain is too fast?” OR “ What if the weight loss is too slow?”
Of course you fear this! And honestly if you are happy with how fast you are gaining weight (if that is needed) and if you are happy with how fast your are losing weight (if that is needed) then you are probably either at a poorly run treatment center or manipulating the system. The weight gain will always seem too fast. The weight loss will always seem too slow. The rules will always seem unnecessary. Good, it means it’s working. Recovery is about change and let me tell you that all great change is incredibly uncomfortable and difficult. But the greater the discomfort, the greater the reward. When it comes to recovery one of the hardest components is your sense and lack of control. This is vital. You have to surrender your control. It may seem like you are losing control and out of control when you don’t have a means to act out with your normal coping skills, but in reality your are slowly coming back in to control. None of this will make sense in the moment and often it won’t make sense until much later, but in order to get better you have to be willing to offer up some faith and compliance to an educated professional such as your therapist, doctor, psychiatrist and/or dietician.
You believe you are the expert and on one hand you are the expert of yourself, but when it comes to recovery I hate to break it to you, but you are one uncoordinated beginner. Accept this! Embrace the challenge! Don’t view recovery as starting over, but rather a blank slate at creating your best life. Remember, eating disorders rarely are about weight, food or appearance… rarely. So, when you freak out because you think you are changing shape and gaining weight too quickly and when you freak out because you don’t see much change and think you aren’t losing weight fast enough… remember that this is all part of the normal recovery process and it is in your best interest to feel the uncomfortable feelings and sit with them without acting. Nothing that comes easy is usually sustainable or worthwhile and things that are difficult and take patience usually last.
Fear #7: “I can’t go to treatment I’m in school/ have a job. I’m going to be so behind!”
When it comes to this dilemma it is all about priorities. For me personally, I’ve always been a perfectionist and always wanted to be the best in all of my classes and the best at every job I ever had, and the thought of possibly “losing” my lead or becoming average was non-negotiable. Boy did my life have other things in store for me. As a lot of you know I started college at UC Davis with honors and scholarships, only to get asked to leave because my eating disorder was killing me. I never thought I’d attend school again, yet here I am back at college, Cal Poly now, loving it and moving through my classes. In fact, I think because I spent the time getting well, I am now in certain ways at an advantage compared to my peers. I may be a few years older than my classmates, but I know exactly what I want to do with my life. I’m incredibly passionate about my work and I know myself really well. School will always be there. The right job will always be there. Your health and life will not always be there if you don’t address it and take care of it. Here is a thought I’ll leave you with that applies to me personally and you can alter it to fit your situation:
Scenario 1: I graduate college on time, but my health and mind are suffering. I highly doubt that I would have really enjoyed any part of school, made any meaningful relationships or learned much about myself and passions because I was so preoccupied with my eating disorder.
Scenario 2: I graduate college a few years later than my peers, but my health and mind are beaming with passion, knowledge and purpose. I soaked up all the things I learned in my classes, made life long friends, got involved with campus events and have a solid direction as to where I want to take my life.
Scenario 3: I am a licensed psychologist with my own private practice, but mentally I’m struggling and it’s hard to keep my focus on my clients with my thoughts constantly drifting off about food, calories, weight and eating disorder related things. Physically I also look poor. What kind of example does that set? In fact, it doesn’t matter how brilliant I am or how many credentials I have. If I look like I’m struggling then I lose all credibility.
Scenario 4: I am a licensed psychologist with my own private practice and it took me quite a few extra years to make my dream a reality, but mentally I have an enormous range of expertise both personally and educationally. Physically I am glowing and as an added bonus I now have the unique opportunity to be proof to my clients that recovery is possible, not just because I studied eating disorders, but because I achieved it myself.
Fear #8: “I’m a vegetarian!” “I don’t want to eat dessert or fear foods!” “I won’t survive without exercise!” “Once I start eating a trigger food I can’t stop!”
Part of recovery involves a give and take. You are going to have to give up certain things in your mind that may seem impossible, but in exchange you are going to see, sometimes only in hindsight, how much more freedom you truly gain. If you are a vegetarian for purposes clearly documented as separate from your eating disorder, then many programs will offer food options that meet your needed nutritional requirements without having to eat meat. I do challenge you to really rethink your motives though, and this goes for people who are also following vegan and gluten-free diets, etc. Are you doing it for sheer medical reasons or personal beliefs? Or has your eating disorder convinced you this lifestyle was necessary?
Anytime you avoid something for long enough and mentally label it as “bad” there is going to be anxiety around having to face this avoided thing, which in this case could be dessert or a fear food. I can assure you that you will survive, the fear will decrease each time you face it, you won’t have to overcome this fear alone and you may even learn to be proud of yourself and enjoy all the new wonderful foods that you are always allowed to eat.
For those who struggle with a component of exercise addiction, going to treatment where activity is severely limited can seem like prison, but you are going to have to reframe how you look at the situation. It is your “sick” mind that tells you that you have to exercise; it is your OCD and anxiety that builds up so high that you feel exercise is the only way to lessen the overwhelming feelings. This is the point of getting better though. Stripping yourself of your harmful coping behaviors in a safe environment, so that over time you can learn to replace your harmful behaviors with something more positive. Take a deep breath; this is a good thing and I promise you who are athletes out there that you will not get flabby or out of shape.
The nice thing about going to treatment is that there is a high sense of accountability and supportive staff and peers surrounding you when you do challenge yourself to eat a food that normally would cause you to binge. Treatment is for challenging yourself and trying new things. It’s for being uncomfortable, afraid and a beginner in many aspects. I think you will be surprised that with the structure and support, you will not have as strong an urge as you believe to eat uncontrollably. You could call it peer pressure, but it works and with patience and practice you will gain confidence and re-teach yourself that you can enjoy foods in moderation.
Fear #9: “I’m at a normal weight. I’m afraid my insurance will kick me out or that I won’t be able to find any treatment center my insurance will cover.”
Sadly treatment is very expensive and hard for many people to get due to lack of insurance or limitations on their particular insurance. The good news is that when you call treatment centers as a prospective patient, they have a whole team working on your personal behalf to fight and obtain your maximum benefits. Once you are in treatment, try your hardest not to think about the possibility of getting kicked out due to your insurance being cut off. Your job is to make the most of each day in treatment regardless, and it is the staff’s job to advocate on your behalf that you need treatment.
If you are unable to go to a residential or inpatient treatment center due to insurance or if you do get kicked out for whatever reason much too early, then I want to make you aware of some alternatives. There are quite a few treatment programs that are licensed as partial hospitalization programs (PHP) and intensive out patient (IOP) treatment centers. However, they run closely parallel to that of a residential treatment center. This means they offer a 24/7 program with housing, a house manager supervising the clients at all times along with all the usual offered groups, individual therapy and dietitian sessions. There are of course some differences and often these programs are a little more lenient with the rules and do offer more freedom than a licensed residential program, but sometimes this option is actually a better fit for some people anyways. The good news though is that because they are licensed as PHP/IOP programs it means insurance companies are much more willing to cover your treatment. I was able to benefit a lot from this scenario and my insurance paid up to 4 months of my stay.
Another option is even a little less structured, but still a good option for some. Some programs offer a basic day outpatient program, but do offer housing to clients who don’t live nearby. Often this means there is much more freedom and personal responsibility on your part in regards to making meals and reducing behaviors, but sometimes the extra support during the day and change of environment can be a great jumpstart to your recovery. Again, some people might even prefer and do better in this situation, as some programs will allow you to volunteer, work part time or attend classes during part of the day. These types of scenarios are very similar to sober living homes for alcohol and drug addicts.
Lastly, sometimes scholarships are available through certain treatment centers and foundations that you can look into.
Fear #10: “I’m a guy with an eating disorder and am afraid I’ll be the only male there.” “I’m an older adult and am embarrassed I will be the oldest one there.”
Relax guys! We girls love when there are guys in the mix! And it is nothing to be ashamed of whatsoever as it is now finally being brought to the attention of the media that men struggle with various forms of eating disorders, and at a much higher rate than previously thought. You guys are just better at not speaking up! But please in all seriousness don’t let this be a barrier to you. Some of the most memorable and favorite people I met in treatment were males.
And to those of you who are struggling with an eating disorder and believe you are “too old” to enter treatment or are embarrassed or worried you will be the oldest… once again I’m going to tell you to relax! It is also being discovered that a very high rate of eating disorders occur in adults and you deserve help just as much as the next person. I have been in treatment with people as old as 60. In fact, once again some of my favorite and most memorable people I met at treatment were much older than me. I urge you to seek help as soon as you can, but again, never allow you own mind of doubt convince you against something beneficial to you. You are never too old and it is never too late to get help.
Fear #11: “I don’t look sick, so I must be fine and no one will take me seriously.”
I touched on this subject briefly before, but I want to nail it on the head. In many ways I was just as sick and at certain times even sicker when I was at a normal weight. And what you really should be fearful of is the fact that you aren’t actively seeking help due to your appearance alone. Sadly, I will tell you that I have lost many friends and people I’ve known to eating disorders. And you know something else? Most of them died when they were not at their lowest weight and often their family and friends weren’t aware they were struggling. With eating disorders, such as bulimia just as one example, all it can take is one purge to mess up your electrolytes enough to cause cardiac arrest. I don’t like talking on this darker note, but this is the ugly, ugly truth. Eating disorders kill and they kill at all ages, length of years of struggle, weights and genders. If anything, your weight should be the last indicator of your health in my opinion.
Fear #12: “What if I spend all this time in treatment only to come home and relapse?”
So what if you do? At least give it a chance. I know many people are too afraid to even take the first step because they have convinced themselves so strongly that it won’t work anyway. So many times I entered treatment purposely planning to relapse when I got home, but you would be surprised at how much can change in a short time. Don’t focus on this made up guilt you have for spending all this time and money at treatment only to come home and not be “all better,” because that’s not realistic anyway. That is your perfectionistic, all or nothing thinking taking over. Nobody expects you to come home from treatment completely cured and if they do, then know that they are not being realistic.
Unfortunately many people with less knowledge of eating disorders believe one stint at treatment will make everything better. This is not often the case. Treatment can help tremendously, but it is only a part of the puzzle towards full recovery. Often once you are at treatment, there are opportunities to do conference calls with your family and with your therapist, and some programs even offer a family week where certain myths and expectations can hopefully be clarified. However, don’t let your own fears, or fears about others’ expectations paralyze you from even taking the first step. Even if you leave treatment with only one new positive change, experience or thought… it was worth it.
Fear #13: “ I’ve been to treatment many times before and it’s never worked, so why try again?”
It can be so frustrating and easy to feel hopeless and like there is no point to seek out help for the umpteenth time when all other attempts have seemingly led you right back to the same spot. For me I could tell you “story of my life.” But the truth is you are always a little different each time. You may think you are struggling so badly or that you relapsed so badly that the last treatment center did nothing, but I think you’d be surprised. I felt this way and I got really mentally tired of going in and out of treatment only to come back home and struggle. But you never know when you are going to meet that certain therapist, that certain inspirational person or enter a treatment center that provides you with that “ah-ha” moment.
People are interesting creatures and I know for me, many of my greatest changes took place when I least expected it and I even surprised myself. I’ll tell you over and over and over: try again! Keep going until it clicks. For some it clicks the first time; great! For others it clicks the 20th time; great! Now put your fighting face back on and give it your best shot!