I have worked with people with eating disorders for a long time now and I am currently on sabbatical.  However, I have written extensively about what I have learned from my clients and have a rather controversial understanding of anorexia.  In the coming days I will be writing a number of hubs about what I have found to be true.  No clients will be identified in any way and my writings are my own views, I am not claiming to be 'right'.  I just know what worked for me in practice. 

One of the questions asked most frequently by the families of individuals with anorexia is: “Does anyone ever get completely better?”  I asked one mother what she meant.  She asked whether people with anorexia ever get cured or free.  The GP had advised her that there was no cure and that her daughter would always battle with anorexia nervosa.  Free from what I asked?  Did she mean freedom from the possibility of relapse, from starving, from distorted body image, from obsessions with food, from ritualistic eating, from social phobia, from perfectionism, from the inability to relax or from self-loathing?  She was obviously not referring to her daughter’s weight or menses, both of these were now ‘normal’.  

And it was interesting that she used the word ‘cure’ and not ‘recover’.  According to the medics, she had recovered.  Her weight could be measured in kilograms and menses were present.  However, according to her mother, she was not cured.    This raised many questions for me about the nature  of recovery and how this differs from a healing process.  It also made me wonder how this could be measured or evaluated.  So I looked at the research available that covered these issues.  Extensive searches revealed very little information especially from the perspective of people who had been through the anorexic process.  There was plenty of information about how people got ill, and various approaches to therapy, but very little about how they got better from their own point of view.  

So I conducted a small research project (my MSc thesis), and asked individuals who had made a good recovery, how they did it.    I examined the process and journey of each individual, and then looked for the themes contained within the journeys.  When I had completed this with each individual, I collated the information to determine whether there were themes common to all participants.  I was amazed at the shared process that emerged.  It reminded me of some indigenous shamanic practices where individuals face their worst fears in order to conquer that which holds them back in life.  In these practises, the elders do not interfere, unless absolutely necessary.  These findings have made me examine how I practise and the prevalent understanding of anorexia nervosa and thinness in our society.  

In my experience, individuals who do anorexia are generally bright and talented but struggle with assertiveness, confidence, self-esteem and decision making. Typically, they feel disempowered in life and search for control and esteem through controlling food and weight, simultaneously denying hunger.  As they deny their hunger for food and for life, the anorexia renders them even more powerless, and that which they seek becomes even further out of reach.  But these are clever individuals and anorexia is a clever illness.  If this bold statement seems more than a little controversial, it is.  

I needed to write about this because I realised that my unorthodox thinking about anorexia and ways of practising work.  Clients who have travelled with me have not only re-covered what was lost, but have engaged in a healing process that has resulted in dis-covering new life skills and greater self-esteem.   And I have also noticed that it is not just the individual who benefits from this ‘healing’ process, but the whole family who are all affected by living with someone with anorexia.  So the metaphor that I have created from the research has messages for all involved in the journey with anorexia. 

 I have composed a metaphor, likening anorexia to a journey made by Native American Shamans, known as a vision quest.  I will be posting that tomorrow.  Until then, 

Kay