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Recovery, remission, and verb tenses

Posted Apr 07 2010 7:25pm
I was about to post a comment on Laura Collins' recent blog " Another word bites the dust " when I realized that the comment was long enough to be its own post. So here goes.

Laura's post was about the use of recovery/remission when talking about eating disorders. I know that in my (lengthy) treatment experience, I am much more familiar with the word "recovery," and have more or less adopted that into my lexicon. The problem is that there is no solid definition of recovery from an ED- most research studies measure "recovery" as no longer meeting the diagnostic criteria for anorexia or bulimia. Which, as anyone with an ED can tell you, is ludicrous almost to the point of hilarious. Because we all know anorexia is "over" once you hit 86% of ideal body weight, and you no longer have any problem with bulimia as long as you binge and purge less than twice a week. Riiiiiiight.

The idea of eating disorder recovery is from the addiction field, and there certainly are no shortage of parallels between eating disorders and addictions. Is an eating disorder the same as an addiction? I'm not prepared to make that statement, but nonetheless there are many similarities. Laura writes on the "recovery model"
This use of the word means re-framing the goals for the treatment process. The recovery model asks the patient what they want, what the illness means to them, and sets goals based on those goals and values. Since this idea comes out of the addictions and schizophrenia world I understand the shift away from pathologizing and insisting on "cure" in that context but absolutely reject it with eating disorders.
Not surprisingly, I agree with Laura. To some extent, the recovery model has a point: there is no cure for eating disorders. For that matter, we can't cure the common cold or the flu, either, let alone cancer, AIDS, and even athlete's foot. But we can treat these illnesses, even without a "cure". The difference is that with most illnesses, the sufferer wants treatment and seeks it out; with eating disorders, that's not always the case. Cancer is no longer a death sentence or necessarily a lifelong condition. We treat it and then we watch and wait and monitor. A person can life a fulfilling life that is totally and utterly cancer-free, and yet they still need regular monitoring.

Eating disorders are similar. I'm not saying that "monitoring" needs to be regular therapy or doctor's visits or monitored meals. But ongoing recovery can't be neglected. Jenni Schaefer says she is "recover-ED" and I have no reason to doubt her. Yet as much as she has put her eating disorder behind her, she also doesn't tempt fate by dieting, being unmindful of her eating, or otherwise not taking care of herself.

In a nutshell, my views on recovery/remission from an eating disorder is this: the goal is to put your eating disorder in the past tense, but always keep your recovery in the present tense.

One day, I want to say "I had an eating disorder," or "I used to be so obsessed with food." It happened, my illness was treated, and now my life is continuing, unencumbered by anorexia. But my recovery must stay in the present tense. I can't get lazy about not waking up early enough to eat a proper breakfast. I can't neglect my sleep. I can't think about losing a few pounds and believing it will end well. I can't forget that I once had an eating disorder. This doesn't mean that I will be haunted by my disorder and spend every waking moment fighting my way through the ED bullshit.

So I don't think of Life Without ED as recovery or remission, really. I think about it as verb tenses. The illness: past tense. My life: present tense.
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