What is true recovery? When do I KNOW I’m done with all of this? I cannot tell you how many times I’ve had to answer this question. From everyone, including parents, patients, concerned friends, you get the picture. The only people who have not asked me this questions are my Stage 9 fully recovered patients. It’s going to be a horrible way to answer this question, so I will definitely elaborate with some of the different stages of recovery I have seen in my 15 years of treating eating disorders. The ugly truth is this:
If you’re asking, it hasn’t happened yet.
God I feel awful saying this, because it makes people feel so disheartened, however, I can promise it’s the truth. The reason people are asking is because there is a discomfort with the process. Either the length of the process, the intensity, or the way it’s affecting their lives, relationships or environment. So the first step is honestly to just admit you’re having a case of the “F&$! Its” Let me explain: the process of getting to and through recovery is impossible. There I said it. People normally don’t make it. Alone, that is. If people are not treated, getting less treatment than is needed, or are, for a lack of a better term, giving their providers the “runaround,” the eating disorder lasts until there is a medical complication, or death. You know what I mean by the runaround… Leading an eating disorder provider to believe you are consistently too scared to (insert recovery fear step here). But rest assured, being ANYWHERE in the recovery process, even if you feel stuck in the case of the “F*&! Its,” is going to be intolerable. Prep for the worst, and you’ll expect ALL that it has to offer. So the following are MY stages you can jump to, as I’m finding people either believe they are entrenched in the thick of an eating disorder, or fully recovered, and there are at least 7 steps between these.
Stage 1: I’m Entrenched.
It’s pretty self explanatory. This stage involves not being able see the forest for the trees. Everything is the eating disorder. 99% of every thought has something to do with how to take the next step in disorder, either the next weight loss step, body checking, restricting, or planning the next eating disorder behavior, planning on how to get out of that next talk about going to or seeking treatment from friends or family. Obsession with the scale or how you can get your next behavior planned is front of mind.
Stage 2: I’m Recovery Curious.
This is the stage where you still feel in control and still maintain all of your behaviors and thoughts, except one has been replaced with the idea of recovery curiosity. Not QUITE ready to take that step, but doing your research online about what life COULD be like without the monkey thoughts that infiltrate your psyche on the daily. NOT that you’re ready, but you do want to know if there’s some truth to the rumors you’ve heard about the magic people who have recovered, and what their lives must be like. You’re not looking at treatment options at this point, however, you are wanting more info.
Stage 3: I’m Willing to Be Willing to Consider treatment.
Yep. This is a stage, I promise. You’ve either heard so much about how concerned everyone is for your health and wellbeing, that you’re ahead of the curve, doing mad research about treatment options, what the least is that they expect for you to be there, how sick you must be to be acknowledged as a “sick enough” patient, and the easiest treatment facilities to appease your loved ones. This involves furious research, joining online groups that review treatment facilities, and finding out the worst possibilities you can endure.
Stage 4: I’ll Do the Bare Minimum.
So this is where it BEGINS to get scary. You’re not in full inpatient treatment, but you have “enough” treatment providers to make it seem like you are taking steps toward recovery. You go to these appointments, pull the wool over their eyes, and stay right where you need to be. You might be listening, and you might even care, but you know you are running the show, not telling the truth and getting away with it.
Stage 5: I’m Stuck.
Ok, now you’re invested. You’ve been seeing your providers enough to know they genuinely care about you, you’ve gained enough weight to make everyone feel as though you’re not needing inpatient treatment, but they keep telling you it’s not enough. You still have eating disorder thoughts, and you’d rather do ANYTHING than what it actually takes to gain recovery weight. You’ll go to dinner with friends, get a pet, eat fear foods (as long as they fit into the exchanges that keep you at the weight you’re at), keep busy with work, etc. Your providers have no option but to be proud of you, because it is something you’ve not done before, and it seems like the direction is recovery. You want to recover, and feel like the path forward is too scary, but when you’re honest with yourself, you’re scared, or just as uncomfortable where you’re at in each moment because the voices of the eating disorder are the loudest they’ll honestly ever be. This is the point where it’s absolutely the hardest. You are upset and not happy where you’re at, and there’s no way you could tolerate a higher weight, as you’d do absolutely anything to avoid it. You can’t lose any weight, as your providers would give up on you. You’re scared to lose providers that have given you all the slack you’ve needed to stay stuck for as long as you’ve needed to. Any other provider would NEVER allow you to get away with what you know is a recovery crime. but you cannot take that next step without the push you KNOW she’ll never give you. Your pain is the worst here. You are in the worst pain of your life, and recovery feels like it would be unbearable. This stage SUCKS!
Stage 6: It’s Too Painful to Stay Stuck.
This is only less painful than the most painful stage by a very thin hair. This is the tipping point. this is where it all gets real, where you’d do ANYTHING to not feel this way, even gain weight. Yep, that’s right. Willing. To. Gain. Weight. It’s AWFUL. The pain has now become that intolerable. This is where recovery desperation sets in. You’re willing to surrender to the idea that nothing you’ve done has worked, that the monkeys of anxiety have only gotten louder regardless of your attempt to lose the weight for with which they’ve asked. The only relief you’ve received is the 5 minutes when your weight is where the monkeys want it, before they get louder than they were before, demanding a lower weight to quiet again. This is where real change begins. This is where the pain of staying stuck becomes too much not to break free. I discuss this as how baby chicks are born. The egg they hang in is so warm and comfy, but in order to live they must bust out of what’s comfortable. It’s the ugliest part of the process, you can trust me. The pain of being in the egg, as comfortable as it’s been, becomes too much, and the only way out is destroying the egg. It’s slimy and nasty, as that little chicken’s foot busts through that shell into the coldest, scariest place that chicken has ever been. I now I say this a lot, but it’s the worst. That sweet chicken CANNOT go back to the safety of his egg. It’s over. He must hatch, there’s no looking back. The interesting fact is that if someone cracks open a chicken egg before they create the strength to hatch themselves, they actually die. Survival TAKES the strength of the chick to bust through their shell with their own strength. The strength only comes from being in so much pain from feeling stuck. Don’t worry, you’ll get there, and I’m sorry too, but also so proud of the slimy and ugly little chick that will slither out of your eating disorder egg shell.
Stage 7: I’ve Got This.
This is the stage where you start understanding that you’d rather do the painful work of gaining weight, feel your damned feelings, hate the world, but would RATHER have this pain than the pain of feeling stuck. You just F*cking DO IT. You eat every part of your damn meal plan, don’t manipulate and let your providers know when you’ve had enough and want to flipping quit. You discuss the cases of the “F*ck its” instead of dealing with them on your own. You snap back at providers, telling them when they don’t get it, and what you need for support. You went shopping for the most fab sweat/yoga pants, as you know you’re in this refeeding bloating process for a minute (at least a year). You’re finally taking on the role of the head of your treatment plan, as ugly as it might look.
Stage 8: I’m Writing My Own Recovery Story.
This is where you start to think beyond ALL the crap you have to do to recover. You start thinking about your own dreams and desires in this world. You start to develop your own taste regarding food, informing your team that you ACTUALLY love this food, you may have hated in your eating disorder egg, and you HATE this food, you used to binge on. Your little feet start to stand on their own, and a wobbly as your little chicken legs might be. Your peep is a little damn louder. You start demanding food challenges without your dietitian coming up with them, because you KNOW where your challenges really are. You went shopping for really cute clothes that you can go into the world and look halfway adorbs without having anything tight around your sweet belly, because we have just gotten used to the food show; and for the monkeys to calm the F down, you’re fine dealing with it, plus it’s not as bad as it was a month ago, because you know you’re being consistent with the food you KNOW you need to eat. You lead your own sessions with your providers and let them know the challenges they don’t and are pretty up front about them, as you’re not scared of them the way you were before. You set your own goals based on what’s JUST beyond safe, and feel confident in yourself to accomplish them. You got it, but now you get it.
Stage 9: I’m Bored.
This is the point where “Recovered” starts. I hear it all the damned time. Scarlett, I’m so done with treatment. I know what I need to do, and I’m not even thinking about my eating disorder anymore. I (insert dream here). I’m not thinking about my eating disorder anymore! It’s boring! Why do I even have to come to these appointments?! You know I’ll do anything you want me to do, and I don’t even have a problem with it anymore. I just want to live my life. Uggghhhhhhhh!!!!!!! This, my friends is where I get CRAZY excited. This is the natural flip into recovery that happens over 8 stages of recovery….. it’s where I jump on my couch like Tom Cruise, and say, “You’ve MADE it to boredom!” I can’t tell you how hard it is to remind people that they struggled for so long before all this, because, honestly, they forget!!!!! It makes me crazy! I’ve worked with them through 8 stages of the worst pain, and now they’re bored and don’t remember? Ugghhhhh! Just kidding, it’s my favorite, because this is the natural turning point in real and permanent recovery. Bored = Recovery? Yep. Until you get there, I cannot explain it ANY other way.
Stage 9: See You When I See You!
This is the stage where I actually call you recovered. Donezo. Kaputz. Fenito. This is when I feel like I will miss you, as I know your life has so much meaning, that it will demand you be 1,000% IN. The world has always needed EVERYTHING you’re passionate about, and now that the eating disorder shell is out of the way, you can fully participate in life, which means you have little time for your treatment providers (AKA: me). It’s definitely a waterworks moment, as you should never be in “Treatment” longer than you should, but it doesn’t stop me from codependently missing you. This is where you’ll always be in my heart, and you’ll always know I’m a call away to celebrate your victories, cry with your losses, and be there without you ever needing to be in touch with me. You’re mine, in the world, wild, doing what you were born to do each and every day, knowing that that may change every single day, and that I support it all, because I am, and have been your biggest fan since we met. Not because you recovered, but because you let me join your journey toward the most YOU there has ever been.
These stages are all 100% beautiful in their own right, and I appreciate them all equally. I feel proud at each stage, as I know it took all you are to make it to the stage you’re at. I also know that the stage you are at now used to be impossible. but you’re here, just the way I know you’ll make it to the next stage when it naturally happens for you. The goal is to make it to the NEXT Stage, not the last. Find the one that explains you the most, and the next one is the one we need to strive for. That’s all. You’ve got this, and I’m here for you 1,000%. That there’s no pressure, because this is your journey that I am non-religiously blessed to be on with you. I will never be frustrated with where you are, or however long you need to stay in any one stage, as I know permanent recovery means you do these steps yourself. It doesn’t mean I don’t have feelings as you go through each stage. When you feel pain, I want to fix it, but know I can’t. When you don’t need treatment anymore, I cry tears of happiness and missing you. When you’re in precontemplation, I want to strangle you. That’s who I am. I tend to truly fall in love with all my patients, and understand the world needs them. But mostly my feeling throughout any recovery cycle is that of gratitude. The gratitude of being fortunate to be included in the darkest part of your life, that creates the spark that is the dynomite of your existence. Few get to be in that darkness, get to know the worst part of the journey, but I do. And it’s the only reason I want to wake up in the morning. I already KNOW your recovery, let’s do this.
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Scarlett Ramey, MS, RDN, CD
P.S. Hope to see you in the comments. Let’s rally together during this time and stay connected in supporting YOUR Recovery journey. The world deserves the BEST of you.♥️