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Perspective on Eating Disorder Recovery and Relapse

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edited from original:  see for readers' comments

Meaning of "Fully Recovered"

A thirty-three year old man wrote to me saying he had been a binge eater most of his life and now was fully recovered. Food has been a non issue for two years.

Of course, I am glad he is happy with the strides he has made in his life. But his post got me to thinking about what recovery means.


I have been working since 1980 with people who have and who have had eating disorders. I don't know what people mean by "fully recovered."

While it is possible that people can have two years or more of being in a state where food is a "non-issue" that doesn't necessarily mean they are "fully recovered."

By the same token, if they have not binged or purged for some time and then begin again they may be responding to a signal to grow and develop more rather than entering relapse (although, of course relapse is possible too.)

Five Stages to Healing and Recovery

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It takes many steps and blunders before we reach the first step to deep healing and real recovery.

We can be in pain because we’ve lost a person or an object dear to us. We can be frightened or humiliated because our longed-for plans and expectations have crashed around us. We cry, blame others and blame ourselves. We rail at the injustice around us.

But mostly we are bewildered and thrashing blindly. Hopefully we are not reaching for food, drugs, alcohol, dangerous relationships, and risk taking to escape our bewilderment.

Eventually, our bewilderment is so thorough that we feel forced to ask for help. Even then we ask for help to get our world in order, to stop pain and to regain or recreate what we have lost.

Cure for Boredom and Being Stuck

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Through the course of my forty years as a psychotherapist I hear this question from my adult eating disorder patients. Whether they are in their thirties, forties, fifties or sixties, they ask, “Aren’t I too old to resolve this eating disorder? Isn’t it too late for me to change my life?

I’m increasingly grateful for my age. My words of encouragement will not give them a believable response. But my existence as an older woman living a satisfying life does reach them. My presence gives them hope, even in their denial of hope.

But what are the details that bring about healthy change? It’s not diet and exercise. It’s not medication. It’s not a physical makeover or an affair.

What guarantees recovery in psychotherapy?

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My informed consent form that clients sign before working with me states that no guarantees come with psychotherapy. Yet psychotherapists and clients strive together for healing and recovery. Five phases for the work create the strong possibility for success.

Despite the lack of a guarantee, clients have hope and willingness to work as do psychotherapists. The client puts energy and commitment into her work because she wants health, freedom and happiness. The psychotherapist puts energy into the work because she’s seen healing and recovery in others and has a growing framework of what makes that possible.

When the psychotherapist sees the commitment of the client energy the psychotherapist’s commitment and energy for the client’s wellbeing grows.

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