Many people with DID or some sort of dissociative disorder also have other concurrent struggles. Disordered eating is a common one. I say ‘disordered eating’ rather than ‘eating disorders’ because the behavior – like dissociative issues – may not be full-blown enough to qualify for a diagnosis…but it may be incredibly harmful and/or distressing nonetheless.
I had an eating disorder for about 16-17 years. It started out as anorexia, but once people caught on, the pressure to recover was so intense that it developed into bulimia for several years. Then in college, it morphed back into anorexia – the purging subtype. (I didn’t even know this was a thing until much later.)
When people ask me about it, I’m always reminded that it’s very, very surprising (and unusual) for someone who’s had an eating disorder for as long as I did to actually recover at all. Usually if you have it for that long, people just assume that it’s chronic, un-treatable, and that it’s going to kill you. Even after I was mostly recovered, I still had some unhealthy habits for several years. This is where the term ‘disordered eating’ comes in, although I wouldn’t have qualified as having a full-blown eating disorder. I still had some unhealthy perspectives for quite awhile – and as an American woman who is not blind or deaf to our culture, that’s no great surprise. And to be sure, I did some long-term damage to my health that may or may not be correctable (e.g. gave myself a heart condition from abusing dangerous diet pills). But I’m alive. And in terms of the eating disorder, I’m recovered. Mentally and emotionally speaking, I’m okay with myself now. Are there things I’d change if I could? Yeah. Of course. I think most people would say that. But do I feel the need to compulsively try to disappear? Not anymore.
So…how did I recover? –is the big question. Understanding that no two people – or systems, as with DID – are the same, I can only offer what helped me. I doubt that there is one universal way.
In my opinion, one of the most important things to do is address the underlying self-hatred that is intrinsic with all eating disorders.
But Jade, how do you know I hate myself just because I want to be thin(ner)? I can hear you asking it already, even though we all know by now that denial is not a river in Egypt.
Even if you’re not in touch with that self-hatred, if you have disordered eating habits linked to a desire to be thin (a desire that is never satisfied no matter how thin you actually are), I can guarantee you have some self-hatred on some level. For a person to believe that starvation, or bingeing and purging, or exercising until they literally injure themselves or physically run themselves into the ground –to believe that these things are a reasonable way to lose weight denotes a significant amount of self-hatred. Whether you can admit it or not, or whether you can feel it not…it’s there. You do what you do because deep down, you think you deserve it.
People who do not hate themselves, who would simply like to shed unhealthy pounds that are negatively influencing their health, go on a ‘normal’ diet. They eat less unhealthy food and make more healthful choices, and exercise a reasonable amount, and lose the weight gradually, and are satisfied – and stop losing – when they’ve reached their goal. People with disordered eating are not like that.
In all honesty, my T did not address my eating issues at all. To be frank, sometimes this was frustrating to me. Sometimes I felt like at least a small amount of conversation about it would have been helpful. But aside from that, what she did do was – in a roundabout way – help address a lot of the motive that drove the behaviors. Ultimately this was more valuable than having a lot of talk that focused on the external stuff, because about 3 years later…I was free. Without addressing the behaviors at all. I guess it’s a bit like a car: siphon the gas out of the engine and it stops going. Learning that I was valuable outside what I looked like or how much I weigh (which is honestly news to some of us) took a lot of wind out of the sails of the disordered eating habits. It did not happen all at once, but slowly over time. Eventually the new ideas took root and gradually crowded out the old ones.
To reiterate: eating disorders are an external manifestation of an internal struggle. It’s not that much different than self-harm with a razor blade; it’s just carried out differently. I won’t go into all biological effects of eating disorders that make them become self-perpetuating, because you can read all about that on plenty of other websites. They are addictions. They are bitches, to try to overcome. But it can be done. Specific behaviors can become ingrained coping mechanisms, and healthier coping mechanisms need to be learned…but, no one will be motivated to learn some other way of coping if you don’t deal with the self-hatred first. This is why treatment programs fail.
Addressing self-hatred is pretty vital to this process. And that task is not to be underestimated. For me, being loved unconditionally by my T for several years gave me a model to grasp onto, as to what that looked like. Internalizing love from someone else – even if on a finite basis – helped me start understanding how to do that for myself. You can’t take the stance of “I’ll only love myself as long as someone else does” – at least, not forever. You may be able to start there, but people are just people. And no person has perfect love for another.
Even if you have no one in your life to model how to love yourself up close and personally, imagine what kind of love and attention you wish you had – and give it to yourself. The healing power of creativity and imagination cannot be understated.
People with DID who have parts with disordered eating habits may find this frustrating from more than one angle. If one of their alters has anorexia, but that alter is not in control of the body on a regular basis, that alter may feel increasing frustration with others who eat normally. Or vice versa. It’s important to understand that there are no parts of you that are your “enemy.” They all need love. They may not know how to ask for it, or receive it, but they still need it nonetheless. They need to understand that they are valuable and worthwhile regardless of what the body looks like, and that their appearance doesn’t define their worth. A multi-level approach may be needed when DID and disordered eating become intertwined. If there are parts who hate the body or the system and parts who don’t, the healthier parts may be re-traumatized (especially if they are young) if and when the ones with the unhealthy habits take control and deny the body food, purge, or over-exercise. It’s important to find the ones who want to do those things, and work with them.
People may say “You can’t be serious, you can’t be saying that ‘healing’ from an eating disorder is as simple as just learning not to hate yourself. There are specialists dedicated to trying to understand the complexity of eating disorders and even they can’t figure it out. So it can’t possibly be that easy.” Well. Yeah it is. The process isn’t easy or simple. But the idea is. The process has a million and one ways it could play out, but the idea is not difficult. There are a lot of other issues linked into the eating disorder, but in my unprofessional opinion, self-hatred is the foundation of all of it. Remove the foundation, and the building will eventually collapse.
The behaviors themselves are a choice, and people who do them – including me, for years – don’t like to hear this. We like to believe we are powerless because it absolves us of taking any responsibility for it. I’m not saying this from a place of detached insensitivity. I get it. I was there. I did and felt and thought all the things, and if you’re pissed off at me for this paragraph that’s okay. I probably would be too, before I was ready to hear it. But listen: despite me saying the behaviors are a choice, I also understand that you have really good reasons for making that choice. I’m not arguing with that. I had good reasons, too. I’m not even concerned with the behaviors; I’m concerned with what drives them. And that’s what we need to focus on getting to the root of.
Now. There IS one caveat to all this “don’t focus on behavior” stuff. The caveat is this: if your body is so malnourished (note: malnourishment is not always measured by weight) that you are in a medically unstable position, you need to be working with someone who can monitor that. I’m sure there’s at least someone out there reading this who has that little eating-disorder voice in their head saying Sweet, I’d love unmonitored freedom to just keep doing what I’m doing without anyone bothering me about it. Yeah, but if you’re so unhealthy at this point – from a medical perspective – then it’s necessary to do what must be done to keep you alive. You can’t recover if you’re dead.
That’s actually all I’m going to say about this for the moment. Healing the self-hatred is one of the hardest but most important parts of this process. (Also note: once I got past the self-hatred, the self-harm spontaneously stopped as well. But that’s another story for another time.)