Practice self-care, my friends; this post may be triggering to some.
When I wrote the above journal entry I had been in recovery for two years. It would be another two years and 8 months before I binged and purged for the last time. The road was long, grueling, messy, and confusing, but I made it, and today I celebrate five years recovered from an eating disorder that took 12 years of my life.
This old journal entry really captured my attention, because it sums up what was most challenging about my recovery process: sitting with the discomfort. Of course, at times, “discomfort” couldn’t begin to describe what I was feeling, the skin-crawling, nail-biting, heart-wrenching, head-pounding agony of living in my own skin after eating. I used to imagine digging my fingernails into the couch cushions, into the walls, into anything that would anchor me down and keep me out of the bathroom. There were times when I wanted to die, because it all seemed too painful to bear.
Looking back, it’s no surprise that I had trouble sitting with discomfort, with distress. Studies show that low levels of distress tolerance paired with high levels of urgency can predict bulimia nervosa (Anestis et al., 2007). The paradox of this life-threatening disease is that immediately following a binge/purge episode, bulimics experience a rapid drop in stress and other negative emotions along with a corresponding increase in positive emotions (Smyth et al., 2007). In other words, purging is an effective coping mechanism that makes sense… in the short-term. These reinforcing factors are part of what makes it so hard to beat.
And yet, it’s possible. I’m living proof.
This is not to say that my day-to-day is without struggle. A better marker than years for recovery would be the number of times I’ve felt physical discomfort or emotional pain and chosen to do something other than binge, purge, or restrict my food intake. What a number that would be! That’s how ‘five years recovered’ happens: sitting with one uncomfortable urge at a time.
Dr. G. Alan Marlatt, who was the director of the Addictive Behaviors Research Center at the University of Washington, called this practice “urge surfing,” and he used it with patients suffering from all kinds of addiction, from drugs, to sex, to food (Taitz, 2012). But you don’t need an addiction to use urge surfing; everyone can benefit from mindfully observing the rise and fall of a craving. We all struggle with urges that satisfy us in the short-term but might not be in line with our long-term goals. That makes us human.
Luckily, the intensity of my struggle has diminished with time and practice. I’ve gained a great deal of insight studying Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), mindfulness, and yoga. Each in their own way has helped me cultivate self-empathy and nonjudgmental awareness. I find when I’m able to slow down, notice what’s happening in the present moment, and accept the moment for what it is, I am free to create more beneficial patterns of thinking and behaving. And that is what recovery is all about.
So how do I plan on spending my big day? Well, I’ll start with my favorite yoga class, and I’ll probably end with a meal at my favorite New York City restaurant, Pure Food and Wine. A massage might be in order. More importantly, I’m dedicating this day to embracing each emotion as it comes, the good, the bad, and the not-conventionally-beautiful. Because if I can embrace those emotional waves and ride them with loving kindness, there’s nothing that can stop me.
- Anestis, M. D., Selby, E. A., Fink, E. L. and Joiner, T. E. (2007), The multifaceted role of distress tolerance in dysregulated eating behaviors. Int. J. Eat. Disord., 40: 718–726. doi: 10.1002/eat.20471
- Smyth, J., Wonderlich, S., Heron, K., Sliwinski, M., Crosby, R., Mitchell, J., & Engel, S. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75 (4), 629-638 DOI: 10.1037/0022-006X.75.4.629
- Taitz, J. L. (2012). End emotional eating: Using Dialectical Behavior Therapy skills to cope with difficult emotions and develop a healthy relationship to food. Oakland: New Harbinger Publications, Inc.