Life After Recovery

SHIFTING GEARS

2011-07-25T10:19:27-07:00

Last week, as I listened to commencement ceremonies at Goddard College, where I teach creative writing, I was reminded that a healthy, fulfilling life is full of difficult transitions. One of my favorite graduates turned to his classmates and faculty and said, "I don't know whether I'll ever see any of you again, but know that I love you all."

I bring this up because, for some time now, I've been putting off a difficult transition of my own, one that will involve saying goodbye to many people I love. And now the time has come. I need to step away from my work in the eating disorders field and concentrate on my creative work again. This will be my last post for this blog.

As difficult a decision as this has been, I believe that it reflects a necessary stage for those in recovery. In Restoring Our Bodies, Reclaiming Our Lives, we call that stage Discovery. On the surface, the preoccupations of this stage have nothing to do with eating disorders. With restored health, individuals in Discovery pursue passions for rock climbing, improvisational acting, graphic art, photography, teaching. They achieve the dreams that were beyond their reach when they were tethered to anorexia, bulimia, binge eating and when their focus was on "recovery."

With full recovery comes a fully integrated self. This means that you have the power and the freedom to shift gears when you need to. You choose to direct your focus to positive passions and pursuits. You embrace change that opens up your horizons. You "know thyself" well enough to balance your life and prioritize your goals. Acting to organize your time and energy, rather than constantly reacting to the demands and expectations of others, you choose to devote a greater proportion of your attention to fulfilling your own highest needs and loves, while controlling the amount of energy you give out of a sense of obligation or guilt.

Over the past eight years, my research, speaking, and writing on the topic of eating disorders has dominated my working life, and I am proud of both Gaining and Restoring Our Bodies, Reclaiming Our Lives. I am profoundly honored to have helped many, many people struggling with eating disorders. But I'm not a therapist or a researcher, or even a science writer, by trade. I am a novelist and a teacher, and literature is my true home, where my mind and spirit are most fully nourished. I need to regain the balance that lets me spend more time in this home.

There are so many voices in the world of recovery that need to be raised and heard. I hope I have encouraged a few of them, and I now yield this blog spot to make room for them. Elsewhere, you may find me occasionally speaking up at www.redroom.com or at www.msmagazine.com/blog, and you can reach me through my sites at www.gainingthetruth.com and the FaceBook page for Restoring Our Bodies. I hope to hear from you as you make your journeys through recovery, out into the world and to the home that most deeply nourishes you.

Thank you so much for all that you do and for all that you are. And always, be well.

To think I could have been dead...

2011-07-02T15:56:35-07:00

I just received a fantastic update from one of the contributors to Restoring Our Bodies, Reclaiming Our Lives. Liana was born in Estonia and received treatment for her eating disorder in Germany. She writes:

After 6 years of severe anorexia , I ve been stable ever since my decision to recover, with not even a thought of relapse. I completely rebuilt my life from scratch, earned an MBA in one of the top schools in Europe and now work in mid management. To think that doctors were right and I could have been dead within months before I decided to recover, makes me sad, as I know how many girls out there are scared, lonely and have no one to talk to.

I wish we could prosecute eating disorders, as we do criminals, for robbing so many smart, sensitive, and deeply beautiful human beings of their lives and livelihoods. Liana's phrase "decided to recover" may make it sound a bit too easy, as if all that's involved is a simple decision, but as anyone who's been through it knows, there is nothing simple or easy about making that essential decision. It's like "deciding" to fight off an armed assailant. But oh the feeling when you fight and win!

From Fruit Flies To Anorexia

2011-06-07T17:41:07-07:00

You never know what you'll get to be grateful for.

That's a refrain I hear all the time from my best friend, who's lived for more than twenty years with non-Hodgkins-lymphoma, and the other day she sent me news to feel grateful for that truly knocked me sideways. Several years ago she gave a copy of my book Gaining to her next door neighbor, who in turn shared it with her brother, Eric Aamodt, a molecular biologist at Louisiana State University. Reading the book, Eric was intrigued by the description of anorexia nervosa as a condition with genetic and biological roots. He shared the book with his colleague, Donard Dwyer, and they got to talking about the possible role of insulin-signaling pathways in the development of anorexia.

What if, they wondered, there were people who became anorexic in response to starvation, just as there are people whose diabetes is triggered by obesity? What if anorexia were a metabolic deviation and not, primarily, a psychological condition?

Aamodt and Dwyer spearheaded a review of existing research examining starvation responses ranging from yeast and fruit flies to humans. The resulting theoretical paper was published in the journal Molecular Psychiatry [ Download Molecular Psychiatry ], and has been getting quite a bit of press!

In a nutshell, their findings suggest that anorexia nervosa "is primarily a metabolic disorder caused by defective regulation of the starvation response, which leads to ambivalence towards food, decreased food consumption and characteristic psychopathology…initial bouts of caloric restriction may alter the production of neurotransmitters that regulate appetite and food-seeking behavior and thus, set in motion a vicious cycle."

Or, as the popular press sums up the theory: "It's not stubbornness or a mental disorder that keeps anorexics from eating, it's their own bodies."

Here are a few more links to info about the review:
http://www.americablog.com/2011/05/is-anorexia-biological-disorder.html

http://jezebel.com/5806626/is-anorexia-a-disorder-of-the-mind-or-metabolism

http://www.msnbc.msn.com/id/43196217/ns/health-mental_health/

Speak Out About Recovery

2011-05-28T22:23:31-07:00

This just in! NORMAL in Schools, a non-profit dedicated to education on eating disorders is seeking volunteers to participate in an online educational campaign about eating disorders. NORMAL has made a valuable educational film called Speaking Out About Eating Disorders which includes interviews with many of the leading researchers and treatment specialists in the field. Now NORMAL is recruiting individuals in ED recovery (or those recovered) to create videos that share their experiences in battling this illness.

To participate, individuals in recovery (and/or those recovered, and/or close family members) will submit a short (40 second or so) video about their struggle with eating disorders (or about their family member's struggle, as applicable). The goal is to distribute the videos through social media as a PSA to educate the public about ED.

NORMAL is asking participants to craft a script (using a simple instruction sheet) that helps them share their truths about battling and/or eventually overcoming this highly-misunderstood disease and what they "wish" society / the world understood about them (versus the myths and judgments that typically pervade our culture). For detailed instructions, please contact Sedef Onder, 212.699.3761.

NORMAL's goals for the educational project include:
-- increasing the awareness of and educate about ED as a serious mental illness
-- raising visibility of its prevalence among young populations of girls and boys
-- encouraging open discussions
-- providing people to whom young people can relate and identify who have struggled with ED and its assorted challenges
-- inciting people to seek help

University of California - UC Newsroom | Does eating give you pleasure or make you anxious?

2011-05-22T22:11:33-07:00

Perhaps the most puzzling symptom of anorexia nervosa -- a disorder that tends to occur in young women -- is the refusal to eat, resulting in extreme weight loss. While most people have a great deal of difficulty in dieting and losing weight, particularly if a diet extends over many months or years, individuals with anorexia nervosa can literally diet themselves to death. In fact, this disorder has a very high death rate from starvation. A new study, now online in the journal International Journal of Eating Disorders, sheds light on why these symptoms occur in anorexia nervosa.

via www.universityofcalifornia.edu

This is an extremely important study led by Walter Kaye at UCSD. People with histories of anorexia do not respond to pleasure as others do. The question that remains is whether this anxious relationship with pleasure is innate, or is it "learned" through the experience of the eating disorder. My guess: it's both innate and intensified by the eating disorder. Which means that it can be un-learned to a degree in recovery, but people with histories of anorexia are not likely to become hedonists.

The Stigma of Eating Disorders

2011-05-22T21:58:40-07:00

Hats off to Margarita Tartakovsky, MS, for her article on PsychCentral:

The Stigma Of Eating Disorders & Setting Stereotypes Straight

I could not agree more with her statement:

"Stigma appears in all different shades, stripes and colors. We see it any time a publication – I say that loosely – blasts headlines about “outing” “anorexic” stars. Or when the media portrays eating disorders as vain or as lifestyle choices. Or any time someone says they wish they had that problem."

Her blog references my recently released benefit book Restoring Our Bodies, Reclaiming Our Lives: Guidance and Reflections on Recovery From Eating Disorders as well as Harriet Brown's Brave Girl Eating: A Family’s Struggle with Anorexia

Many thanks to Margarita!

How we teach our kids

2011-05-11T11:18:52-07:00

I just received a note via the ED Activist Network on Facebook from Matt Wetsel, who's starting a blog about eating disorders. His first post is an absolutely heart-breaking public service announcement produced more than 10 years ago by NEDA and Hydrogen Advertising. The PSA gives a powerful reminder that the messages we give our kids DO contribute to eating disorders, even if they don't entirely cause them.

Please watch this and circulate. It's never too late to remind people why they should be mindful of their messages, especially to children. Eating Disorders PSA.

While you're on Matt's blog, take a look at his history. Bravo to you, Matt!

Read our full FaceBook interview on recovery

2011-05-06T21:29:56-07:00

My live FaceBook interview on Thursday was great fun and thought provoking.

Now EatingDisordersBlogs.com has posted the entire interview with a permanent link:

Live FaceBook Interview with Aimee

We covered LOTS of different aspects of eating disorders and recovery.

Take a look and let me know what you think!

PARTICIPATE IN A STUDY OF RECOVERY!

2011-05-02T11:09:57-07:00

First of all, I want to thank everyone, from the contributors of letters and sidebars, all the way through to the magnificent staff of the Academy for Eating Disorders -- and Melanie, Lindsay and Leigh, of Gurze Books -- who helped to make our launch of RESTORING OUR BODIES, RECLAIMING OUR LIVES such a spectacular event last Friday night in Miami. We not only raised more than $20,000 for the AED's Research and Clinician Scholarship Program, but we also brought tears to many eyes with a staged reading of excerpts from the book that challenge the stigmas and myths around eating disorders. Our cast of voices included those of a blind woman, a male athlete, an identical triplet, an African American woman, a girl in the outback of Australia, a young woman from Estonia, a mother of four, and doctors and therapists who have histories of eating disorders, as well as the parents and spouses who have such an essential role to play in recovery. Together we offered compelling evidence that recovery IS not only possible but truly powerful.

Now, as the perfect follow-up to our launch, I would like to invite YOU to play a role in advancing scientific understanding of recovery. I've just received this appeal, from University of Pennsylvania doctoral student Martina Verba, for women (over 18) with long-term recovery from anorexia nervosa or bulimia nervosa to participate in in-depth interviews about the recovery process. Specifically, she is conducting a study exploring the progression from the early stages of recovery, which are typically characterized by a focus on behaviors, to a fully experienced felt sense of recovery [exactly the progression we trace in RESTORING OUR BODIES, RECLAIMING OUR LIVES!] .

In order to conduct the interviews in person, Martina is recruiting participants from the following geographic areas: Philadelphia area, New York City and surrounding counties (as far North as Albany), New Jersey, Connecticut and Massachusetts. Names and other identifying information will be kept strictly confidential. If you are interested in participating, please call Martina at 914-231-7295 or email at mverba@sp2.upenn.edu. If you know someone who might be interested, please pass this notice along.

Other criteria for inclusion in the study:

1) Eating disorder fulfilled DSM-IV criteria for anorexia nervosa or bulimia nervosa for the period of at least one year

For individuals with histories of anorexia nervosa:

1. Maintenance of normal weight and return of normal menstruation (unless lack of menses or irregularities are due to medical conditions unrelated to the eating disorder) for past 2 years

2. “No extremes,” defined as no interference in functioning, in the realm of eating- and weight-related thoughts

3. No bingeing and purging, as defined by self-induced vomiting, ipecac use, laxative use, weight-loss or diet pills, and excessive exercise in past 2 years

For individuals with histories of bulimia nervosa:

1. No bingeing or purging, as defined by self-induced vomiting, ipecac use, laxative use, weight-loss or diet pills, fasting, and excessive exercise in past 2 years

2. “No extremes,” defined as no interference in functioning, in the realm of eating- and weight-related thoughts

Thank you for your help. Please contact Martina if you have any questions.

Food for Recovery Thought in the New York Times

2011-04-25T18:57:07-07:00

Tomorrow is the official publication date of Restoring Our Bodies, Reclaiming Our Lives, and as luck would have it, I'm quoted in an Article in the New York Times today on the topic of recovery from anorexia.

The article is sure to stoke some controversy among ED veterans, professionals, and families. Although it's not clear in the piece, I'm actually a true believer in FULL recovery, both physical and psychological. But as the journalist, Abby Ellin, rightly points out, there is great variety in the definition of recovery. I applaud her for highlighting the cognitive, emotional and other psychological aspects of recovery, in addition to gains of weight and healthy eating behavior.

Abby and I talked at some length about the role of the insurance industry in "restricting" the definition of recovery in order to deny coverage for extended treatment. Space constraints prevented her from examining this critical issue, but I hope the Times will pursue it in another article.

I am a little concerned, though, that readers will view this article as bad news for those in recovery. To brighten the picture, I'd just like to stress a few important points that did not make it into the piece:

The sooner you begin treatment with a professional eating disorder specialist, and the more you yourself genuinely want to recover, the greater your chances will be for full recovery.
No one can agree on a single timeline or pattern for recovery, because every case is different. The time it takes to recover will necessarily depend on age, physical condition, the degree of severity and duration of the illness, the quality and duration of treatment, and the strength and health of relationships and support networks -- among other factors.
This article focuses on anorexia nervosa -- implicitly, restricting anorexia -- which has the highest level of genetic vulnerability of all the EDs, and is the most difficult to treat.That said, restricting anorexia nervosa also represents the smallest piece of the eating disorder "pie." Vastly more people wrestle with binge eating, bulimia, and EDNOS. It's unfortunate that the article did not have a broader focus, since the prognosis for full physical and psychological recovery is much more encouraging for these other eating disorders.

Personally, I absolutely consider myself fully recovered. The key for me lay in recognizing that the half-life of eating disorders -- free of food obsessions and compulsions but still mired in self-criticism and perfectionistic thinking -- is far from a full life of health. As long as I remained stuck in the half-life, I remained vulnerable to relapse. Writing my last book, Gaining, and working with an extremely gifted therapist on my whole life's health helped me reach full recovery at last.

Fortunately, more and more ED therapists now take a much more holistic view of treatment and of health. As a result, many of the contributors to my new book also consider themselves fully recovered. I hope you will find wisdom and inspiration in their words. Recovery really IS within reach.