Motivation in Eating Disorder Recovery
**Disclaimer: I think I started this post about 6 months ago after being inspired by a group psychotherapy session. Ironic how a post about motivation took me this long to complete, but there were things that needed to happen and I am glad with the process of how this unfolds.
The idea of motivation within Eating Disorder (ED) recovery (as with many other forms of recovery) is something that fluctuates with a natural ebb and flow. I visualize an image of an upward moving squiggle line that I have drawn and re-drawn hundreds of times to describe the process of recovery to those that I work with. Recovery is not simply moving forward. There are peaks and valleys along the way and each is just as important as the other to the overall process. While many people entering recovery have an idea of what their goals look like, it is imperative to view recovery as an ongoing process…and a process it truly is.
“Humans are inherently motivated to grow and achieve and will fully commit to and engage in even uninteresting tasks when their meaning and value is understood (Stone et al., 2008)."
In exploring this, we are able to use the concept of motivation to direct focus and attention to the areas that we deem important. The following are some ED Recovery Truths that I have compiled in my work through the years. Please keep in mind that recovery in a general sense is very person-specific and there is no “formula” for “perfect” recovery. In fact, the concept of recovery challenges the notion of perfection and promotes the acceptance of our individual attributes and variations.
Truth #1: Recovery is HARD.
This is an understatement. Recovery is probably one of the most difficult processes to endure. A client once mentioned to me “I have been through hell, but nothing is as hard as recovery from my ED.”
One of the reasons that ED recovery is so difficult is because it goes against the grain of our society and what we are taught. As Generation X, Y and Millennials, we are conditioned through our fast-paced society to live instantly (receive feedback instantly, respond instantly etc…). Additionally, most of what we do has parameters that are tangible and understood. If you would like a bachelor’s degree, attend college for about four years or the equivalence of approximately 120 credits and you have a degree. Most work positions have movement defined by time frames and assessments that are quantifiable. Recovery asks you to throw out your confines, parameters and assessments. It tells you that the one absolute is that your process will be person-centered with an undetermined timeline. It cannot tell you how long you will be in therapy or treatment, what levels of care you will reach and at what point. One of the most potent issues with accepting this is that you are essentially submitting to the unknown… and that is extremely scary.
I usually ask my group therapy clients, when the topic of fear surfaces, “Who here enjoys being scared and gravitates towards the unknown?” The response 99% of the time is a resounding “not me!” (cue the cricket chirping). Fear is just that…it’s scary. The good news is that enduring the difficulty of this enables long lasting progress. The type of progress that isn’t just goal oriented...but sustainable. This is usually followed by one of my favorite questions to ask; “What would your life look like without fear?” The purpose of this question is two-fold, to imagine the fears that prevent you from engaging in a life worth living, and then imagining a life without the shackles of fear holding you back.
Truth #2: The only way out is through.
Motivation can sometimes appear to be wavering at various stages of the recovery process. Theories that investigate motivation are incredibly interesting, especially when examining intrinsic vs. extrinsic motivation. “The most basic distinction is between intrinsic motivation, which refers to doing something because it is inherently interesting or enjoyable, and extrinsic motivation, which refers to doing something because it leads to a separable outcome (Deci & Ryan, 2000).” Sometimes individuals may feel cornered in recovery. They get to a point in which they believe “enough is enough.” I usually ask clients at this stage to distinguish between ED’s boundaries/limits and their own personal boundaries/limits. More often than not, ED’s comfort zone or threshold is much lower than what we are willing to endure. I have often heard similar ideas from clients, “Why can’t I just fast forward to a point beyond this discomfort?” There are times where the discomfort feels beyond what can be handled. Knowing that this is part of the skill building process and working through this, is effective for their recovery. It is critical to examine this and test our comfort zone limits by trying new things, exposing ourselves to the unknown.
One factor to consider while in the trenches (I use the metaphor of “going to war” with understanding what recovery feels like, to describe how much of a battle it can be at times) is that if it was working before, then there would not be a reason to seek change.
Truth #3: Consistency and Continuity Helps the Journey
These two concepts are a tried and true method to effectively navigate the recovery process. Consistency speaks to various ideas, starting with simply showing up and attending appointments, whether with your therapist, group, medical doctor, etc… It also speaks to consistency with following a meal plan, adhering to treatment goals, trying something more than once before making a decision. Sometimes when we move out of our comfort zone with challenging ED thoughts it becomes difficult to maintain momentum. For many, it may seem like “I’ve tried it once, and that was enough.”
Consistency speaks to this in regards to how we effectively keep that forward movement so that we can overcome the next hurdle. Continuity works hand in hand with consistency. To be able to endure the vacillation of recovery, continuously coming back to your goals is essential. Having thought-provoking questions at the forefront is crucial: Why you are doing this? What inspires you? What would life look like without ED? These are questions that will potentially arise throughout the journey and parallel reminders such as journals, mantras, affirmations, keepsakes, artwork can truly make all the difference. One such helpful mantra that I hold onto: “Struggle brings about strength.” Whatever the route, know that there is help available.
Note: Eating Disorders are life threatening conditions. ED recovery is something that should be primarily monitored and evaluated by a specialized clinical team which typically consists of a medical doctor, psychiatrist, therapist and nutritionist based on medical necessity. At times, a higher level of care recommendation may be made to enhance the level of support that one would require such as an IOP (Intensive Outpatient Program), Day Program/PHP (Partial Hospitalization Program), Residential Treatment, Inpatient, Acute Inpatient Hospitalization. Ensure that you are being seen by someone who specializes in the type of treatment you are looking for. A helpful tool to go about finding a specialist is through the following resource for ED specialists and treatment: http://www.edreferral.com