Making Peace with Your Plate: Eating Disorder Recovery

By Robyn Cruze and Espra Andrus

Robyn Cruze, a mental health advocate who found recovery from an eating disorder; has teamed up with therapist and friend Espra Andrus to provide expert guidance for those seeking eating disorder recovery, their loved ones, and treatment professionals.

This revised edition offers new insights and stories, updated approaches to nutrition, and answers to such pressing questions within the eating disorder community as: Does the word "recovered" have a place in the recovery process? What about notions of "good," "bad," "healthy," and "unhealthy" foods? How does soothing the self rather than fighting the eating disorder fit into recovery?

Making Peace with Your Plate helps unshackle us from our fears, anxiety, and the need to control by providing proven strategies for recovery and taking back our power from the illness.

• Language: English
• Publisher: Central Recovery Press
• Release date: Feb 7, 2020
• ISBN: 9781949481273

Book preview

Introduction

Robyn

Having an eating disorder felt much like treading in deep water with only my nostrils above the waterline. I was drowning along with my dreams and purpose. The food, the diets, the purging, and the harsh voice I labeled the eating disorder with that kept me in my place—all of it filled my mind endlessly. Toward the end of the disorder, there was room for nothing else.

One night, I think as a kid, I heard on the news or read in a book somewhere, about some form of Japanese torture practice in which individuals being interrogated were confined in a chamber and unable to move as one drop of water at a time dripped constantly on their temple. Although I do not dare to suggest that I know what one goes through under such inhumane circumstances, over the years in the eating disorder, when I felt I could escape neither from it nor myself, I felt a deep sense of torture. Yet I also believed I needed the behavior, or rather, the control found in the eating disorder behavior to protect me from life, from others, and from myself. Eating disorders are powerful illnesses that need to be addressed far beyond our relationship with food and body.

Toward the later part of my illness, I knew it was only a matter of time before it either killed me or I took my own life. The truth is, 30 to 80 percent of those who have an eating disorder also struggle with a mood and/or anxiety disorder.² This must be addressed on our journey to recovery as well.

Eating disorders have the highest mortality rate of any mental illness.³ This is true. What also is true is that you can take back all the power you gave to the disorder—at any time. I promise you can do it. You can begin to find comfort in saying no to the voice of the eating disorder and gain a new sense of power. By the end of this book, it is my sincere hope that you will have discovered how truly powerful you are! Oh, and heads up, your power is far greater than the power you may think the eating disorder holds over you.

Today, I live a life driven by purpose and full of feeling. My life continues to feel like it has been upgraded from a black-and-white TV to a colorful, high-definition system with surround sound. Yet it did not always feel like that during the early stages of recovery. Recovering from an eating disorder is like shaking out a rug under which you have stored all your dust and dirt for years; the dust and dirt are blinding. They are gritty, and particles fly everywhere.

To realize myself in recovery fully, the recovery process needed to be adapted to my safety requirements and self-discovery along the way. This will be true for you too. I needed a recovery plan that changed along with me. I also knew this process was of no real use unless I worked with professionals specializing in eating disorder, depression and anxiety, trauma, and substance use. Even after I had been free from the eating disorder behaviors for seven years, I still needed to address my anxiety and depression and my periodic use of alcohol to self-medicate. Many of us discover that we have a propensity for substance use. We are not alone. Up to 50 percent of those who struggle with an eating disorder also will be susceptible to substance use disorder.⁴ Treatment for substance use varies, as does the level in which we struggle with substance use, or the type of substance. If you think this may be you, get curious with your recovery; there are many different recovery paths. Find the one that works for you. Find power in your recovery, not punishment.

I remember one cold Colorado morning after I had given myself alcohol poisoning. Having lost my mum one month before giving birth to my first child, I lay in the fetal position, unable to get up. I lay full of remorse and hopelessness in a bout of relentless depression and anxiety. I had resorted to using alcohol rather than eating disorder behaviors to cope with my grief. I had hit yet another valley in my recovery, but it had nothing to do with eating and food. My husband, Tim, who happens to be an interventionist and family recovery coach (I know! You can’t make this shit up.) identified the issue immediately and checked me into substance use rehab.

During my stay, a counselor requested I get an eating disorder evaluation because I had a history of the disorder and a fierce hatred of being weighed. They wanted to be certain that any eating disorder behavior would not become an obstacle to my recovery from substance use. It was during that evaluation I met Espra. Although it was a short meeting, I left her office thinking, here’s a woman who has taught me more about eating disorders in two hours than I knew already. Let’s face it; many of us who have struggled with eating disorders have studied so much about our disorder that we believe we could have PhDs in nutrition and eating disorder psychology. After all, we are perfect researchers, perfect students, and perfect eating disorder conformists. But Espra brought with her years of knowledge and experience in eating disorder treatment, Dialectical Behavior Therapy (DBT), and a glorious sense of humor that could pierce through the most resistant character. I had recovered from the eating disorder long before, but she understood that a residue of negative self-talk had remained with me long after the eating disorder behavior had ended. Although the negative thoughts no longer dictated my actions, they still needed to be challenged and ultimately put to rest. During that meeting, Espra was able to guide me in removing the negative self-talk and shutting down any remnant of eating disorder thinking by showing me that I truly had the power to do it myself. To be clear, without Espra, this book would not be possible. I am honored and profoundly grateful for her work and her friendship. Thank you, dear Espra.

Since the writing of the first edition of this book, I have learned so much about the labels of fully recovered and full recovery. I have seen many individuals work tirelessly in their eating disorder recovery only to get tripped up by comparing themselves to those who have claimed such titles. Please know there is no textbook or research study that will definitively tell you what full recovery means. But I’m not sure it matters. In fact, I worry that it becomes too much of a focus for many who are contending with this disorder and interferes with the process of recovery itself.

When I was in recovery, there were no such labels. So, a word of caution here: Do not, I repeat, do not, trip yourself up by imagining there is some recovery success club or police. Please don’t do it to yourself. Don’t find one more thing with which to compare or judge yourself. Your recovery is sacred and is unique to you, just like your body, and trying to be like others is not a far distance from the painful comparing in eating disorders that destroys lives. Comparing ourselves to others is a painful trait for most humans. You define your own recovery.

You define your own recovery.

My personal definition of recovery is this: I do not binge, purge, or starve, and my body or food intake no longer dictates my daily activities. In today’s society, women, men, and children of all shapes, races, and economic statuses, are susceptible to the media and their peers’ judgments. However, in my recovery, regardless of the body-image-ideal-of-the-moment our culture deems worthy, that destructive ideal no longer defines me. To me, recovery means that my true self, not the words of the eating disorder, prevails, and for the love of God, I define what it means to feel beautiful and look good.

I’ll end by saying this: No one told me that to be in recovery does not mean accepting yourself from the very beginning. In fact, that is impossible. However, it is possible to own your story. No one told me that recovery is a combination lock that, if I have the courage to open it, will take me back to my true self and all my dreams and life purpose. Grab onto this book and the words of hope within it and breathe it in whenever you are in doubt or fear about this recovery process. You are worthy of recovery, whatever that looks like to you. If you fall, you have not failed. You simply need to get back up, brush yourself off, and be willing to take the next best step in your recovery—without shame. Toward your dreams. Toward your truth.

I’m with you!

Espra

For years, the universe nudged me toward adding the treatment of individuals suffering with eating disorders to the focus of my work as a therapist. I resisted. Then life, with the tapestry it weaves from beauty and tragedy, outright catapulted me toward eating disorder work. As a believer that we all have choices, I felt that I had two choices: 1) work with eating disorders or 2) work with eating disorders.

Two decades ago, I sat in the boardroom with the founders of one of the top eating disorder treatment programs in the nation. I admired them, both as amazing therapists and people, and they had more than eighty years of collective clinical experience among them. As I confessed my inadequacies in treating eating disorders, one of them clarified, If you weren’t a good therapist, we wouldn’t be having this conversation. We’ll teach you what you need to know about eating disorders. And teach me they did; their wisdom and interventions often flowed out of them as casually as if they were telling me how to water a plant. Wishing my brain were a sponge, I watched my mentors as they worked, and I scribbled down their words. They watched over me, taught me, and tirelessly passed on their knowledge, mostly to quell my episodes of panic.

I excessively worry that I will not be able to contribute the very best treatment options that are available to a client or family seeking my help with their recovery journey. This fear keeps me spending crazy amounts of time, money, and energy working to learn and deliver the latest tools that are researched to be effective for treating eating disorders and the phenomena that drive and result from them. My seeking has led me to become intensively trained in delivering therapies like Dialectical Behavioral Therapy (DBT), mindfulness training, Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), shame resilience, and interventions to help heal the brain and release it from the shackles of constant self-punishment.

These and other interventions have been found to be effective in treating Bulimia Nervosa and Binge Eating Disorder. While it has been even more complicated to identify therapeutic approaches that show effectiveness in treating Anorexia Nervosa, I find that many clients appreciate knowing how to use DBT skills to regulate emotion and tolerate distress as they take back their power from the eating disorders. Radically Open DBT skills help individuals who struggle with high levels of overcontrol, as is found in Anorexia Nervosa.

Many of the interventions I use in treating eating disorders come from traditional therapeutic modalities, while others were discovered or developed in the trenches alongside clients, families, and colleagues on the eating disorder battlefield. Many of the techniques I use I have learned from the most informed eating disorder experts of all—my clients. Some of these experts have taught me in subtle and almost imperceptible ways, and others have taught me with passionate critiques. If held with an open mind, an open heart, and a desire to be a part of healing, all of these can be useful.

Despite more than twenty years of training and practice, I don’t feel like an expert in treating eating disorders. If anyone touts themself as such, you should run away from them. A true expert, who had conquered her eating disorder after eighteen years of battling it, once entered my office merely for a one-time consult as a matter of protocol for the program where she was seeking other help. We spoke of her recovery journey, one that led her to a fulfilled life that had been free of eating disorder behavior for seven years. We spoke of how lingering thoughts about her worth and value depending on her body size and shape—thoughts she knew to be untrue—niggled in the back of her mind, even though her life was not influenced at all by eating disorder behaviors or urges. I tossed only a couple of ideas, which I’d seen as beneficial to others with similar struggles, her way, and we experimented with those in my office before Robyn went on her way.

It was two years after that brief encounter when Robyn called me to see if I would be interested in writing a book with her. It turns out that writing a book was on my bucket list, and I had been impressed with Robyn’s recovery work and mindset. So when she told me of her idea to write a book to help others recover from eating disorders, I thought the universe was urging me to pay attention.

Robyn wanted another voice to speak about recovery from the other side of the therapy room, and wondered if I would consider being that voice. While this was my dream, it gave me permission to be imperfect, because Robyn’s recovery story fills in any holes that my work alone might leave. I knew I needed to accept the call.

Robyn and I share a passion: getting the message that it is possible to break free and heal from eating disorder behaviors into as many hands as possible. One way to do that is to expose the illusion and lies that eating disorders have sold to more than one out of every ten people, of all ages, in the United States.

I cannot begin to count how often I have clenched my teeth and snarled, like Robyn, #@*! you, eating disorder, you’re not going to win! I hate eating disorders! They convince amazing, intelligent, and talented people that they are worthless and unworthy of love and connection. Eating disorders convince individuals who fear they are inadequate that getting their food or body to be a certain way will make up for their imperfect selves to protect them from being banned from the love and acceptance that are the right and need of every human being.

So often I have thought, there’s got to be something, something that I can do better or more intensely to shake the hearts of these beautiful souls. What can I do to help them see that eating disorders thrive on half-truths, lies, illusions, and discouragement? What can I do to help others step back and see a bigger picture that exposes the devastation (to ourselves, our loved ones, our children, and our society) that eating disorders leave in their wake? What can I do to help those who suffer with eating disorders see that both recovery and a better life exist, and that recovery has rewards that reach far beyond a mere existence of using sheer willpower to hold eating disorder behaviors at bay?

Recovery is more attainable to those who keep trying.

As Robyn said, there is no formal definition of the exact point called eating disorder recovery, so both partial and full recovery are still defined based on an individual’s experience of eating disorder symptoms or the absence of symptoms. Not everyone escapes eating disorder behaviors and thoughts 100 percent, but chances increase dramatically for those who enter the race, begin it, and stay in it. Recovery is more attainable to those who keep trying. Decrease eating disorder behaviors, no matter how long it takes. Set goals to increase self-kindness and self-respect along the way. Neither Robyn nor I want to activate your shame and guilt and hopelessness by pretending there are only two extremes in eating disorder recovery, full and complete recovery or failure. There are unlimited places in between that truly result in a better life.

There are also many different models to recovery. DBT is just one of them. We have found that a combination of tools is required. Take what you want and leave the rest. In recovery your goal is to eat when you are physically hungry and stop eating when you are physically full, most of the time. You want to allow yourself to eat a wide range of foods rather than depriving yourself to a narrow range. When you eat more than your body needs, the next step is to work toward compassion rather than compensating by ingesting more calories, spending calories, or restricting them later. You work to remember that it will sort itself out. Recovery means that you might be upset when you do not like the way your body looks or the way your clothing fits, but those thoughts and feelings do not consume you or dictate how you spend your day. You engage in regular physical activity with the goal of enjoyment and life balance instead of spending calories. You are able to focus on your values, relationships, and priorities beyond the size or shape of your body, regardless of your eating or how you feel about your body.

You can be in recovery and, like most people, still dislike parts of your body, think about dieting, or sometimes use food to cope with emotions. The difference in recovery is that you are committed to recognizing the eating disorder’s traps and doing whatever is necessary to steer clear of them or get out as soon as possible after falling into them. Your energy and behaviors are spent pursuing your values and goals more than making or keeping your body a certain way. You work to remember that you are not an object whose worth can be reduced to numbers. For example, if I find a wallet with a hundred dollars in it my long-term values would lead me to return it, but I am certain the thought would occur to me that I could keep it. Once I observe the gap between my long-term values and my immediate thoughts and urges, I might call a friend and ask her to remind me that following my long-term values and returning the money would leave me feeling better in the long run. I might think I am bad or dishonest for having the thought to keep the money. Being who I want to be, however, is in what I do with those thoughts and the behaviors I choose. My clients generally agree that eating disorder recovery means working to avoid eating disorder behaviors even when thoughts or urges to do otherwise are present. Individuals generally consider themselves fully recovered when the thoughts and urges to engage in eating disorder behaviors are merely a blip on the radar that uses no more energy than a fleeting irritation.

Both Robyn and I are convinced and are committed to spreading the word that there is hope in eating disorder recovery—not only hope of muddling through some miserable existence, but hope that your life can have more peace, fulfillment, and meaning in pulling out of the eating disorder’s clutches. I refuse to fall for the lie that eating disorders will prevail.

Robyn and I speak a lot about fighting in this book. We want you to understand that illnesses, eating disorders included, are technically not treated by fighting them but by understanding what is needed to accept the nature of that which is affecting us and work with our body, mind, and emotions to give ourselves all we can. We must work to identify the best ways to care for the illness and help it be as stable as possible and hopefully even heal completely. For example, fighting cancer does not include being mean to oneself; it means serious self-care in very specific ways and in the face of not knowing what the outcome might be. It means fighting anyway.

Anger gives us energy to push through obstacles that stand in the way of our goals, and my anger, in part, has fueled this work. Both Robyn and I have channeled our anger to help us find courage to act. Courage, as any soldier fighting in a war will tell you, is not an emotion. Courage is taking action even when you are scared to death. There are tools we can use to help us in these challenges. We must be awake (we call this mindfulness) and prepared to act on opportunities to align ourselves with our values and goals. It has taken tremendous courage for Robyn and I to embark on this journey to help others find hope. We invite you to come along with us.

Your world, your life, and your dreams

are right here waiting for you.

Today I will allow myself to try something

different in order to claim my life.

—Robyn

2 Ulfvebrand, S., Birgegard, A., Norring, C., Hogdahl, L., & von Hausswolff-Juhlin, Y. (2015). Psychiatric comorbidity in women and men with eating disorders: Results from a large clinical database. Psychiatry Res, 230(2), 294-299.

3 Arcelus J. et al. Mortality rates in patients with anorexia nervosa and other eating disorders. Archives of General Psychiatry, 68(7):724-731.

4 Brewerton, Timothy D., & Dennis, Amy Baker (Eds.). (2014). Eating disorders, addictions and substance use disorders: research, clinical and treatment perspectives. Berlin: Springer Verlag.

1.

Enough Already

Cory Jones and Hollywood Dreams

By Robyn

It all began outside the school canteen (cafeteria) as I sat bingeing on the five bags of potato chips that I’d purchased for recess. It was the first time I’d consciously decided to forgo my usual order of a sandwich for a larger quantity of food. The act was calculated and numbing. I was eleven years old.

Cory Jones was sitting across from me, trying to impress me by eating a fly. Dare me to eat it? he shot off, cupping his hand over a trapped fly caught between his hand and the concrete.

Yeah, I muttered, in between shoveling in potato chips. I was in a comforting trance that I would later realize was telling of all my binges to come. Just a day or so prior, my mum had told our family that she may be dying. Mum had an autoimmune illness—lupus. Back when I was a child, it was a rare disease and treatment was very limited. Mum was running out of treatment options and her kidneys were beginning to fail. There at the dining table, the night before Cory ate a fly, I commenced a crippling battle with an eating