Best Self-Exam

Posted by fxckfeelings on March 28, 2013

Addiction is easier to understand if you picture it as a mental squatter, the way advertising for nasal decongestants depicts mucus as a working class family that happens to be gooey, green, and getting by in your sinuses. Even when people are strongly motivated to stop compulsive or addictive behavior, their addiction is often one step ahead of them, distorting their thinking to undermine their efforts and stay put. In some cases, they are so obsessed with the self-perceived ugliness of their bad habit that they can’t consider more important reasons for stopping, while in other cases, they are so obsessed with finding their addiction’s ultimate cause that they wind up blaming people who care the most and could offer the most help in their recovery/to send the addiction packing. If you’re ready to quit, avoid stoking up feelings of self-disgust or blame; instead, prepare to tolerate pain without blame while looking for positive reasons to manage lingering inner demons and keep them from setting up house.
–Dr. Lastname

I think I meet the clinical definition of having an eating disorder (at least, according to the all-knowing and all-powerful Wikipedia). For the past four years I have been binge eating and semi-purging through excessive laxative use. Before that, for about two years, I was probably somewhat anorexic, although I say this in retrospect as I don’t think I either realized or would have admitted it at the time. (5’2” and less than 90 lbs. is pretty thin, though). My goal is to stop binge eating, and I don’t know how. My eating and obsession with food have basically taken over my life, and though I fight it and things have gotten better than they were a year or two ago, I’m constantly afraid of when I will binge next. I don’t trust myself at all. It affects my professional life, and I need to stop letting that happen. I miss the self-control and feelings of power and self-worth that my thinness used to give me. I realize that going back to that is not exactly a healthy goal, though. I’d frankly be pretty pleased if I could just stop binging and get on with my life.

It’s hard to underestimate how all-consuming an eating disorder can be; as you obsess about the ways to keep food out of your body, it becomes the main occupant of your mind. Every moment spent avoiding the act of eating requires twice as many moments of mental torment on the subject.

Then there are endless concerns about your appearance, feelings of worthlessness, compulsive behaviors, and the intense ties between them. Eating disorders foster a kind of self-obsession, a dependence on your own thoughts and secret behaviors that devalues other goals and relationships.

It’s not surprising then that managing an eating disorder requires, not more self-control, but an acceptance that you’ve lost control and a willingness to admit other people, like family and therapists, into your private, obsessive relationship with food. It’s not unlike the so-called First Step of managing an addiction—admitting your helplessness and recognizing the importance of values other than your needs and shame.

As such, reading Wikipedia to discover whether you fit a diagnostic category isn’t necessary, because that’s just another way of comparing your appearance to what’s normal in the eyes of others. You need to ask yourself whether your eating disorder is preventing you from achieving other goals you find as or more important, like being good to your family, pursuing your passions, or moving up in your career (which you’ve acknowledged it has).

Instead of trying to stop because the internet says so, consider whether you need to stop because you say so, according to your values. Then do research on the short and long-term health risks of binging and purging and then ask your primary care physician for a physical exam and lab tests that will tell you if it’s done medical damage or put you at risk. The more you ground your efforts in actual health problems (if any) and a willingness to open up about your concerns, the more you’ll break into the self-contained and self-sealed thinking of an eating disorder.

You’ve already accomplished a great deal by overcoming anorexia and developing a professional life. The one upside to anorexia is that sometimes the perfectionism that fuels it can push you to unusual proficiency and great achievements. Perhaps it’s your growing awareness of other goals that now allows you to write about your eating disorder and seek ways of changing it.

Remember, in the same way someone with a drinking problem still identifies as an alcoholic, even when sober, you may always have an eating disorder that either involves persistently abnormal behavior or a risk of relapse. Your goal, however, is not to control what you can’t, but to manage your eating behavior as well as possible and, hopefully, prevent medical harm. As usual, accepting your lack of control will give you strength to manage your problem and the self-confidence that comes from knowing you’ve done your best.

So disown the self-loathing that goes with binging and purging, open yourself to more humane values, and share them with others. The more you accept both food and your tendency to obsess over it, the easier it will be to free up your mind and body to do other things, like eat, work, and even have fun.

STATEMENT:
“I can’t stand binging and purging and the way it can’t help me feel thin, but I have other values, including managing my health and being able to be honest with friends. I will challenge my eating disorder by becoming a stronger person, rather than simply a better controlled eater, and thus achieve a pride that won’t depend on the activity of the top end of my GI tract.”

I’ve always worried about my son’s drinking, and I’m glad he decided to get help, even if he only did it because his wife threatened him with divorce. Unfortunately, as part of his recovery, he’s discovered that I’ve been a bad influence on his addiction because I drink wine with dinner every night, and I’ve always bent over backwards to help him out when his drinking got him into trouble, which makes me a co-dependent enabler. He says that, until I realize my role in his addiction, I’ll be part of the problem and that he needs to stay away from me. I’m glad he’s sober and I feel terrible for anything I’ve done to contribute to his addiction, so my goal is to figure out what he means so I can get our relationship back on track.

As noted above, people struggling with compulsive behaviors are naturally self-centered because compulsion focuses their attention, desires, and concerns internally, and trying to stop that behavior often makes them turn inward even further. Your son’s decision to stop drinking is, of course, an exciting step forward, but it’s not surprising that he distributes blame according to how you make him feel, without regard to the good you’ve done, his own responsibility for his behavior, or anything outside of himself.

So don’t make his mistake and assume that, since he feels you interfered with his recovery, his feelings have value, because they don’t; they’re what got him into this mess in the first place. Use your own judgment to decide whether you did him more harm than good and, if you did harm, what you can do to correct it.

In terms of your own drinking, I assume you would have stopped it in his presence if he had asked, and I bet, if you had, it would not have pushed him into sobriety. Odds are then that you shouldn’t accept responsibility for that one (or stop drinking wine, unless you think it’s adversely affecting your own life).

If you’d been less helpful in rescuing him from his drunk-induced fuck-ups, he might have sobered up sooner and he might not; contrary to what many people believe, there is no exact place on the mental map called “bottom” that, once hit, prompts people to wise up and sign on for sobriety. That means, once again, the major responsibility is his, not yours.

Now that you’ve got your balls back, don’t apologize for mistakes you never made. You’re delighted with his sobriety, and as such, have no trouble supporting and respecting his decisions to avoid alcohol and his commitment to take responsibility for whatever mess he gets himself into. You suspect, however, that, no matter how what part he feels you played in his addiction, your relationship is much more positive than negative and you can help him sustain sobriety in the long run.

You hope he won’t throw the baby out with the bathwater then because his feelings have singled you out as a bad influence. Putting long-term benefit ahead of immediate needs is what sobriety is all about, and you are all about his sobriety, whether he’s ready to ignore what his feelings tell him or not.

STATEMENT:
“I feel terrible to hear my son tell me I prevented his recovery, but I know there’s something irrational in his thinking that reeks of alcohol and tells me he has a long way to go. I’ll offer him an unapologetic, positive view of our relationship that will encourage better decision-making and, regardless of his response, take pride in my efforts to show him how to be sober.”