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Eating Disorders Treatment

When I spent three months in residential treatment back in 2010, the clinicians would frequently encourage the other patients and me to communicate and honor our needs. This practice was meant to teach us how to separate our own inner voices from the control and influence of an eating disorder. As well-intentioned as these clinicians were, however, I remember asking myself: "How can I learn to express my needs if I'm not sure what they are?"
Hello, my name is Obsessed with Metrics. I say this with snark, but I also genuinely mean it. A few months ago, when I wrote about my exercise addiction, I briefly touched on how metrics fuel this behavior. I count the number of steps I take. I count the number of miles I run. I count the number of stairs I climb. I count the number of minutes I exercise. I count the number of calories I burn. At times, I feel like a human calculator—ironic, since math has never been my strong suit.
When I think about an anorexic mindset, two primary features stand out to me: deprivation and control. Within the eating disorder framework, these attributes often manifest in behaviors such as caloric restriction, compulsive exercise, food rituals, or body image obsession. However, an anorexic mindset can impact many areas of life outside the parameters of an eating disorder as well.
I’ve chosen to avoid pregnancy conversations over the years. I hesitate even to broach this subject in therapy sessions, and the reason is simple: I'm ambivalent about motherhood. The irony is I love children. I am a huge fan of my friends' little ones. I find my nieces and nephew irresistible. But I don't feel strong maternal instincts, and I lack the desire to parent children of my own.
I believe trauma is often a repercussion of eating disorder treatment. Of course, clinical interventions are helpful, beneficial, and even crucial parts of healing, but they can still be traumatic nonetheless. This might sound like an oxymoron, so let me explain the possible trauma of treatment.
Each year, as the calendar flips to November, I'm hit with a reminder of how complex the holiday season feels in eating disorder recovery. Of course, that's not unique to those with a history of eating disorders. This time of year can be overwhelming for anyone. In 2021, three out of five surveyed Americans felt their mental health worsen over the holidays, with 60 percent noticing a rise in anxiety and 52 percent noticing a rise in depression. Now couple all that with eating disorder stressors or behaviors, and this hectic season can become even more fraught. So with the 2022 festivities just around the corner, let's acknowledge it: The holidays are complex in eating disorder recovery—and that is alright. 
Terminal uniqueness is a concept I first learned about in eating disorder residential treatment. At the time, my restless, irritable teenage brain had no interest in the phrase. But over the years since, I've come to realize that terminal uniqueness is a common barrier to eating disorder recovery. In fact, it's not a unique or rare phenomenon at all—ironically enough. So what does terminal uniqueness mean, and how can it affect recovery? Let's unpack this further.
As someone who has been a professional writer for almost 10 years (and a writing enthusiast for my whole life), I am a firm believer in journaling. Granted, I have not maintained a consistent journaling rhythm in the season where I find myself now. But when I commit to this self-care practice on a regular basis, I feel connected to my goals, priorities, and intentions for healing. Moreover, I am compelled to take meaningful, decisive actions that align with those priorities. So if you, like me, have fallen into a journaling rut over the past weeks or months, here are some journaling topics to refuel your motivation in eating disorder recovery.
If you have experience with trauma-informed mental health care, it's quite possible that you're also familiar with eye movement desensitization and reprocessing (EMDR) therapy. This therapy is an intervention used to help the brain resolve unprocessed traumatic memories, as well as the thoughts, emotions, beliefs, and physical reactions or sensations connected to those memories. But, is EMDR therapy useful for eating disorder treatment? That's a nuanced question without a one-size-fits-all answer. However, as someone who is currently in the thick of EMDR sessions myself, I want to examine its potential benefits for eating disorder recovery.
I will never forget one specific breakfast during my time in residential treatment. An on-staff clinician supervising the meal told me to throw out my pancakes and grab a new batch. When I asked her why, the answer was confusing, but as with most rules at this inpatient facility, it left no room for further questions. "You spread peanut butter on your pancakes—that's a food ritual," she replied.