No soap box here

It struck me recently how pervasively the sensitivity to the fears of an eating disorder patient can lead us to try to avoid those stressors. The easiest examples would be avoiding fats, 'trigger foods,' 'junk food.' And even when we draw the line and say 'you need fat, you need full nutrition, you need to face your food fears' we can still built a cocoon of safety on other things.

Things like the (stupid, sexist, devaluing, offensive) media.

Like thinner people. Or fatter people. Like even benign comments about appearance.

Like stress and eating out and change and - LIFE.

I've grown sensitive on a lot of these issues as well, and I'm starting to wonder if I've gone off the rails.

We don't ban soap commercials for the benefit of people with compulsive hand-washing. We don't close down the Space Program because it validates the irrational fears of schizophrenics who believe they've been abducted by aliens. But in the ED world we do avoid "triggers" and try to change the environment around the person.

Perhaps that is a seductive approach because things like size 0 models and sexism and stress really ARE things to hate.

I don't have an answer... I'm just thinking.


  1. My thoughts:
    I don't think the analogy holds with your OCD and (the preferred term these days) schizo-affective disorder examples. We allow lots of things despite their potential to harm even substantial numbers of people - alcohol, tobacco, and firearms all rush to mind. BUT it is common to sheild sufferers from outside stressors when we are trying to treat them. Hence the term "asylum".

    Addiction recovery models usually include removing stressors and triggers while the physical and psychological effects of the addiction get treated. Early in the process this is often done in a controled setting where no drugs/EtOH/etc is allowed, and no contact with F&F who may be part of the social setting of the addiction.

    What we do when trying to help someone combat and recover from ED is analagous. Except of course, the needed amount of food has to happen at every meal, and meals have to happen 3-6x/day - which is kinda the opposite of your typical addiction. EDs have to ingest their "abused substance" in order to recover, while addicts need to NOT be in contact with the substance.

    Reducing the outside stressors lets everyone focus on that one (sometimes seemingly overwhelming) challenge - eat healthily for this meal. Rehab settings provide the same thing for someone combatting substance abuse. And in both cases, at some point the recovery becomes the process of the person learning to function in a world where stressors and triggers exist.

  2. I think it is the sufferer's responsibility, once fully recovered, to avoid these 'triggers.' Just as a recovered alcoholic must avoid bars, a recovered anorexic should avoid things that focus on weight and appearance. As they become more and more comfortable with themselves, they might venture into the appearance-obsessed culture if they so desire, just as the alcoholic might walk into the bar and order 1 drink. This can serve as a test if they are strong enough to handle these pressures and temptations. But I don't think those with ED should require any special 'accomodations.' I don't think they should be tortured with the temptations of dieting, though, by exposing them on purpose to negative media sources.

    Just my 2 cents.

  3. I'm glad to hear your questions, Laura.

    I have been thinking a lot about how so many of the messages that I heard from clinicians during recovery were almost anti-food, such as "Don't focus on the food," "It's not about the food," etc. While there was a necessary degree of un-learning that had to take place in order for me to be able to separate food from (uncomfortable) emotions, now that I am recovered the struggle is to develop a more positive, pleasurable relationship with food and my body. Food can be fun, but the ED community so often emphasizes the downsides of food obsessions to the detriment of any enjoyment from food. What if it IS about the food -- about food and nourishment and holding it in and letting go and learning to live with all of the good and the bad? We can't purge (pun intended) our media and our surroundings of triggers and negative images; we can't ever achieve a "perfect" environment to protect us from our obsessions. But we can learn to live in the gray areas, where hope abides and change is possible.

  4. Amen, amen, amen...

  5. Good points. I don't think ED sufferers should get special treatment because we're not the only people in the world who are suffering from something whether it's alcoholism, OCD, etc. We're not special. You never know if you're doing something that could "trigger" someone. Maybe my choice to drink a glass of wine at a restaurant will trigger an alcoholic sitting nearby. That doesn't mean the rest of us should be forbidden from enjoying a glass of wine.


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