The negative mind. Ed. The demon in your head. The eating disorder voice. There are lots of ways of describing the negative thoughts that individuals with eating concerns experience, but they are all essentially describing the same phenomenon which are the thoughts and urges that compel us to make choices that we know rationally are not in keeping with our well-being.
Sometimes the thoughts are subtle: “you don’t really need to finish that sandwich.” Sometimes the thoughts are blunt: “how can she help you? Have you seen her thighs?” But regardless of whether these cognitions are blatant or subtle, they all work to create confusion, doubt, guilt, and shame.
If you’ve asked for help, how many times have you made a commitment for change, only to break it in the moment of action? It happens all the time, whether the commitment is to eat three snacks per day or stay away from the scale at the gym.
These broken commitments can be demoralizing as you may feel embarrassed, guilty, or ashamed that you don’t seem to be a person of your word. This experience often leads to avoidance, isolation, and withdrawing from making other commitments because the underlying belief is “I can’t keep commitments, so why try?”
In the early stages of an eating disorder, you might not have much awareness about the negative thoughts. You might assume that the thoughts in your head are your thoughts, that the thoughts are automatic. Of course, that’s not a far stretch to think the thoughts in your head are your thoughts, but I’d like you to consider what may be influencing your thoughts.
When struggling with an eating disorder, your thoughts can be harmful. They are unbalanced. They can be deadly. For example, one of the elements of an eating disorder is an over-focus on body image. This unbalanced focus on the importance of body image leads to negative thoughts about your body, unrealistic expectations about body image, and a loss of self-esteem if unrealistic beliefs are not realized.
This unbalanced focus on body image leads to all sorts of cognitive chatter that compels you to make choices that are not in keeping with your health, and that can lead to dangerous behaviors. The more you focus on these unbalanced thoughts, the more harmful the thoughts can become and before you know it you are engaging in behaviors and having thoughts that are a far cry from your values, your beliefs, and what you recognize to be healthy.
As you develop more awareness of your eating concerns, you will likely develop more awareness about this eating disorder voice. You will start to distinguish the eating disorder voice from you, your beliefs, your values, and what you know logically.
For instance, while you might feel compelled to exercise hours on end based on the thoughts in your head (“you need to lose weight;” “the only way to get rid of that belly fat is to stay on the elliptical longer than everyone else”), with time and awareness you can start to recognize that even while you feel compelled to exercise for long periods of time, you know that there are risks to this behavior and that it’s not reasonable to exercise hours on end.
Once you start to recognize that there are two voices in your head—the eating disorder voice and your true voice—prepare yourself because this is when the battle begins to rage.
I’ve had clients tell me that they want to hit their head against the wall to quiet the voices in their head; that they just want the voices to go away. Of course, this is a really distressing experience and it’s absolutely understandable that you want the battle to go away, but let me tell you why the battle is a good thing.
Why the Battle is a Good Thing
When I hear clients tell me that they are experiencing a battle in their head between what the eating disorder wants for them and what they recognize is in their best interest, I do a little happy dance. Don’t get me wrong, I’m not happy to hear about the distressing battle individuals are struggling with, but I am thrilled that my clients are starting to recognize that there are two separate and distinct voices in their heads.
As good girls, we’ve always been taught to avoid battles. To play nice, walk away, be polite, to not make a scene. But when it comes to eating recovery, you can and must be willing to take on the battle in your head. There is no other way to find full and sustained recovery. Period.
Note that in the description above I described what the eating disorder wants vs. what you recognize is in your best interest. It’s really important to keep in mind that making the decision between the eating disorder and recovery is not a simple choice between what we want vs. what we don’t want. If it were that easy, getting over an eating disorder would be so much easier than it is. And it’s not. It’s among the most difficult mental health concerns to overcome.
Why is that? Because you often have to make a choice between something you want (the eating disorder) and something you don’t want (recovery). It’s not that you don’t want recovery, you just don’t want all the things you have come to fear about recovery, even though a lot of these fears fall away as you really start to face them.
But even so, it’s important to acknowledge that this battle is real and it’s not a simple battle between right and wrong. It’s so much more complex than that. It’s a battle between our fears and our hopes. It’s a battle between who we think we are and who we really are. So, yeah, the battle is a tough one, but this is why the battle is a good one.
Awareness of the battle means you have more awareness of your cognitive experience.
Once you recognize that there are two opposing views in your head, you are empowered in ways you were not before you had this awareness. You recognize that the thoughts are not simply automatic, they are not necessarily true, and you don’t necessarily have to believe them and follow them.
Awareness of the battle can spur you to action.
Once you have awareness of the battle in your head, you also recognize that you have more options than just to obey. You can challenge the negative mind. You can be disobedient. You don’t have to be a nice girl.
The recognition of options can be a powerful motivator for action. You can see that you are not passive when it coms to the thoughts in your head, you are not a victim to the eating disorder voice, and you can talk back to the negative mind.
Awareness of the battle can help you enlist soldiers for the fight.
Any good battle commander knows that his effectiveness in battle depends on a few core strategies.
- A commander’s job is to have awareness of the battle, but if he doesn’t communicate this to his soldiers, the battle will be lost. As commander of your recovery, you must be willing to:
- Communicate your needs
- What you understand of your battle, the ways you get tripped up, the ways you need to be strengthened.
- Don’t expect loved ones to read your mind or know the specific ways you need support. It is your job as commander to identify your needs and ask for the help that will indeed be helpful. If you’re not sure what your needs are, ask for help determining your needs.
- A commander must have the supplies necessary to effectively fight.
- Ensure you have competent psychological, dietary, and medical care.
- Utilize appropriate structure. Are you following the structure your team is providing? This includes structuring meal time, hitting dietary targets, pacing meal and snack time, following appropriate exercise guidelines, limiting body checking, etc.
- Set goals, make commitments, ask for accountability, and follow through.
- Call in reinforcements as needed. Perhaps a temporary increase in session frequency, adding group therapy, including family and social support in treatment.
- Every good commander must have a strategy for fighting the battle.
- Ask for help when you are especially vulnerable.
- Anticipate the times you are most vulnerable to the eating disorder thoughts and prepare for those times. For instance, you might feel especially vulnerable if you are home alone on Friday nights. Have a strategy! Call a friend on Wednesday and make plans for Friday night. Ask your mom to support you with meal selection when faced with an overwhelming buffet. Exercise with a supportive friend who can remind you to stay away from the scale at the gym.
- Develop a mantra that you can use to “talk back” to the eating disorder voice, even something as simple as “I’m not listening to you anymore” can be effective. Ask your loved ones to talk back when you feel you can’t.
- R & R. Any battle requires a lot of energy and resources. You need rest and recovery in order to sustain your efforts.
- Make sure you are getting adequate sleep.
- Do your best to eat appropriately so you have energy.
- Build in time for relaxation and fun.
- Utilize coping skills that can quiet the chatter in your head. Deep breathing, meditation, and soothing music are just a few quick examples that can provide powerful relief.
- Talk about what you are experiencing, cry, have someone validate the difficulty of the battle you are facing. These tools of empathy can be powerful, and yet are often underestimated.
When it comes to eating recovery, things often get harder before they get easier. While this can be frustrating, don’t conclude that you must be doing something wrong, or that you just can’t recover, or that you are the exception. Carry on, and know that the battle in your head may indeed be a sign that you have greater awareness of your experience, and can help you maneuver yourself into a position of strength to indeed fight and win the battle.