Of all psychiatric illnesses, eating disorders have the highest mortality rate. It's estimated that 10 per cent of sufferers will die within 10 years of onset.
Given the prevalence of this problem, and potential for tragic consequences, it's important to bring clarity to the complex – and vastly misunderstood – process of recovery. The greatest challenge: There is no "one way" or "right way" to ensure success.
Writing about recovery is intimidating because it is impossible to pin down. Yet, it's imperative we shed light on some misconceptions. In my 10 years of practice, I've yet to come across two people who have moved through recovery in the same way – myself included. Although many who suffer engage in similar symptomatic behaviours, the reasons behind why they harm themselves, how long they've harmed and the meaning of their harm are uniquely their own. This is the recovery dilemma: People who suffer are suffering both externally and internally, and though it might look the same on the outside, inside it's not. The recovery process must then cater to each person's circumstances.
Here are some of the other common misconceptions about eating disorder recovery.
When someone begins to look better physically, they are better.
They may not be, and often aren't. Why not? Because you can't just eat "normally" and be well. When people enter into treatment, often the initial focus is on food – what they're doing with it (or not) and the implications this has on the body. Sufferers go through this part of recovery robotically – they may move through the motions of eating, but it doesn't mean they feel safe with it, are accepting of their new body or feel at peace about this shift. Often, this level of recovery is not passed until they develop a better understanding of why they're harming themselves in the first place and why their life would be better if they didn't.
After you go to treatment for a couple of months, you'll be fine.
Nope. So rarely is this the case. How long it takes to get well is not about the amount of time spent in treatment so much as what happens in that time – namely a person's acceptance, willingness, desire for wellness, consistency, commitment and the support they have outside of treatment. I've worked with people through their recovery for six months, two years, five years. I've endlessly listened to loved ones often wonder why it's taking so long: "If he's gained the weight, why is he still here?" The answer is simple: Recovery is long. If someone has been suffering for years, the likelihood of them getting better in just months is rare. There is no shame in it taking a long time. That is normal.
I just want to get her back to how she used to be.
No, you don't. How she "used to be" is what got her here in the first place. The most rewarding part about recovery is seeing the transformation that takes place for a person when they establish control over their life. Though it's important to acknowledge what happened in the past and to work through any issues, a person enters recovery thinking and seeing themselves one way, and by the time they are free, it's unlikely they will think of or see themselves in the same way at all. The greatest privilege of my work is knowing someone when they begin their recovery and witnessing who they are when they are well enough to leave.
Someone will get well for their kids, to prevent a breakup, to do well at school or keep a job.
These may be the inroads to recovery – often we need an incentive to face this most challenging process. However, to stay in, to actually get well, means that the person suffering must fight the fight for themselves. The work is too hard, too consuming and too turbulent to make it about external influences. The will to stay in has to come from you.
My team and I recently worked for approximately 16 months with a young woman through her recovery from anorexia. She came in dead in spirit, depressed, lonely, isolated and filled with self-hatred. Her parents were terrified, helpless and desperate.
Over our work together, we watched her shift – slowly, very slowly – through a treatment process filled with pain and crisis, fear and chaos. It was hell to watch. In due time, though, she began to find herself. She appeared calmer, happier, more connected and energized. She worked endlessly through her pain and unresolved history, fought the demons in her head and stayed in the process despite her anxieties and insecurities about her new body. She fought and fought and fought. And in time, she started to like herself, to resolve her pain and feel worthy.
Today, she is well and free and nothing like who she was before. Her story doesn't have to be rare. Over time, she found her way.
Despite the endless misconceptions that surround treatment for eating disorders, one thing is certain: Recovery is possible. I see it every day.
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Kyla Fox is the founder of the Kyla Fox Centre, an eating-disorder recovery centre in Toronto. She has been a clinical therapist in the field of eating disorders for the last decade, and is also a public speaker, writer and advocate for eating disorder awareness and prevention. You can find her at kylafoxcentre.com and follow her on Twitter @Kylafoxcentre.