Thursday, September 13, 2012

It's Just a Thought

Periodically, the agency I work for invites a former patient who wrote a book about her recovery to come speak to current patients. She talks about what it was like for her to have an Eating Disorder, and how she recovered. 

For various reasons, the presentation tends to get mixed reviews. The main concern it raises for me is that the speaker presents recovery in rather black-and-white terms: she claims that, since she is recovered, she never has a single thought or impulse to engage in eating-disordered behavior. Never. Not even when she was going through a divorce.

That sounds great, right? I imagine she might think it is a way of holding out hope for patients that they can truly recover. However, I worry that it could have the opposite effect: they may come to believe that "true recovery" means never having a thought or impulse. And because most (if not all) people in recovery may have a passing "disordered" thought or impulse from time to time, this belief is neither realistic nor helpful.

The truth is that these kinds of thoughts may happen - but having the thought does not mean one is no longer "in recovery." It's normal - to be expected after years of habitually having such thoughts. Recovery does not depend on whether or not you have certain thoughts, but rather what you do with them. Learning that thought does not have to become action is crucial in early recovery, and learning that thought need not lead to action is crucial for relapse prevention. It would be much more helpful for patients to hear that someone can have these thoughts and not be fazed by them - recognize them as "just thoughts" and not allow them to become a basis for action.

My worry is that patients, once they are in recovery, may have an "Eating Disorder thought," conclude that they are relapsing...and, consequently, actually engage in "Eating Disorder behavior" leading to relapse. A self-fulfilling prophecy of sorts. 

Instead, I'd like to reassure them: relapse is best gauged by action, not thought. Everyone has distorted thoughts of one kind or another. What matters is what you DO with your thoughts - how you choose to act. Keep doing what you need to do to be healthy (follow your meal plan, use your supports, avoid purging, limit exercise, etc), and let your thoughts take care of themselves. They may come, but they will also go. Keep the faith, and keep up the fight.

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