QUESTION: Hey there, I have been suffering with bulimia nervosa for about 8 years now. I am at my worst and don’t know what to do at this point. I have been in & out of inpatient treatment about three times already in the past two years. I haven't given up but I am scared. I for the past year have done nothing but binge and purge all day since my boyfriend left for the navy. I need to stop and I am ready; I see a therapist/nutritionist/ psychiatrist. Nothing seems to help! What should I do?

ANSWER: Well, the very first thing I would share with you is that statistics show that for every year spent with an eating disorder, it will take 1-5 years to heal, depending on the level of care and dedication of the individual. So if you have had bulimia for eight years, and have been in recovery for two years, you can already see that the math isn’t adding up yet.

That is NOT to say that you cannot come very far along in recovery in those two years, but it sounds like for some reason, the alchemy of your recovery journey thus far has left you feeling worse than before you started trying. I understand how that feels – I was on my own during the bulk of my recovery journey, and there were definitely times that I wondered if recovery was even possible for anyone, let alone for someone like me!

If you need to stop and you are ready, then you can, and you will. It is that simple. Whether you are in treatment, or on your own like I was, when your determination to heal matches the determination of the ED to own you, then you have the potential to overcome, and overcome for good.

What should you do next? Excellent question. Not knowing more about your specific situation, here are my thoughts:

  1. Grab your journal or a blank piece of paper and divide it into two sections. On one side, write, ‘Reasons to keep my ED’. On the other side write, ‘Reasons to Recover from my ED.’ When you have the full list on each side, pick out your #1 reason that you go back to your ED, and your #1 reason that you want to recover from your ED, and circle them. These are the two issues you will have to confront on a fundamental level in order to break your cycle of relapse and get on the right track for you to do the healing work you need to do.
  2. For the item you circled as the #1 reason you want to recover, this is what I call your ‘key to life’ – the one thing that matters to you more than your ED; the one thing that without which, life (with or without ED) just doesn’t feel worth living. It’s the one thing that, if you are 80 and dying and haven’t accomplished yet, will cause you to feel regret for time and opportunity wasted in your life. It is the thing that makes your heart sing. If you have more than one ‘key to life’ that is great too, but I only started with one – my music. I realized I couldn’t have both my music and the ED, and that I had to choose. I chose music, and that turned me into a fighter who eventually left her ED in the dust - forever.
  3. Adopt the attitude in recovery of, ‘I don’t know if I can do this, but I’d rather die trying than die never knowing if I could have beaten ED!’ This will give you a lot of courage, freedom and inspiration to try new things, go for it, and give every recovery challenge your very best shot, because you simply refuse to die a coward’s death. When you are already at the bottom, when you have nothing left to lose, then you have nowhere to go but up, and everything to gain - just from trying and seeing what happens!
  4. Talk with your treatment team about your recovery goals. Do they work together, or, if they don’t currently, are they willing to? If so, see if you can call an in-person meeting with all of them, or a phone conference, and ask for their collective help and advice. They know your recovery journey better than I do, obviously, and can be a valuable resource for you in what has worked, what hasn’t, and in giving you insights into why you are still struggling and what they can do to help you.
  5. If you are able to and choose to return to inpatient or intensive outpatient treatment, now might be a good time. It sounds like the trauma of your boyfriend leaving may have triggered some of your recent relapse behaviors. This is common. When a significant relationship is disrupted, or other unavoidable change occurs, often the ED becomes our first refuge. You simply MUST either build new skills to add to your coping toolbox, or become stronger in using the ones that you may already have and have just forgotten about. Often if you will really sit down and look at what you gained during therapy sessions and treatment, you will realize you have many more skills at your disposal than you can bring to your awareness in moments of trauma and crisis. List those skills for yourself, post them on your wall or bathroom mirror, and make a pact with yourself to try everything on the list before you even give ED a chance to reach out to you.
  6. The most important determinant of success in recovery from eating disorders is this: You must learn to turn your own mind from your enemy into your ally. You must learn to recognize – for yourself – what triggers your eating disordered behaviors, and how your ‘early warning system’ works, and then you must literally ‘re-parent’ your own mind, using stern discipline and constant reminders of the choices at hand when the early warning system kicks in (i.e., if I practice my ED today then I can’t….fill in the blanks with your 'key to life'…). Then you must learn to give your mind other options than the ED (‘You can’t practice your bulimia, but you CAN do these 3 other things (all recovery-based options of course) – which one would you like to do?)

If you would like more detail on how this all works, I offer one-on-one recovery coaching through my organization, Key to Life, and would be happy to share information with you about how to set that up (click HERE to get started).

Thank you again for your question, and let us know how we can support you!

Much love,

Shannon

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