In the endeavour to recover, Hope, Intention & Action do well together. They support and need each other. They do not do very well apart. In the daily grind of recovery, small everyday intentions anchor hope to action. Intention and action can bring clarity to the wispyness of hope.

The standardizing of clothes that focuses on sales and marketing implicitly suggests that bodies need to adjust to the clothes rather than clothes adjusting to bodies. It absolutely took attention away from the subjective nature of the bodies we live in and the changes they adjust to, in life. Puberty, maturation, pregnancy, surgeries, deaths, losses and old age. We tailor the body instead of tailoring the clothes.

In a typical couple relationship, both partners have expectations of each other. This is a conditional relationship. An adult relationship requires both partners to “show up” with presence to grow themselves and the relationship itself. A partner who is truly present to the relationship will find the one with the ED trying, but absent or secretive.

The idea that a “Yes” is more desirable than a “No” starts very early. Children know when they are not allowed to disagree. When a No is unpracticed, an adult will tend to continue saying Yes where they might want to say No and become what we know as a “people-pleaser”, sometimes at great cost to themselves.

There is no consensus in the eating disorder world about the possibility of recovery. Clinicians and clients alike differ on what they think. And therefore believe. Whether one thinks that a full recovery is possible or not, decides the direction of one’s efforts and conversation from the very first meeting. The stage for the rest of the play is set very early.

The world of eating disorders has its own rules. Words and ideas are borrowed from the outside world and used wherever convenient. “Exercise is good for my health” or “I am trying to be healthy”. On the face of it, one cannot really argue with such a statement. Till one understands the desperation beneath the word “healthy”. Once exercise becomes part of the ED picture, it plays an important calorie-reduction role and cannot be taken away.

One of the pitfalls of comparing eating disorders to addictions ( i.e. substance abuse and dependency) is that treatment modalities, terminologies and philosophies are transferred over from the established addiction treatment world.

Enter the manual into the world of therapy. A book of instructions and “strategies” that the client can do when they are dysregulated, to regulate themselves. A concrete solution that both the therapist and the client can touch and hold onto, in their moments of anxiety. A tangible solution to that pesky intangible thing - anxiety. Anxiety LOVES paper………

The claim that CBT is the “gold standard” - implying that it is THE fix to ALL problems - is a heavy claim that , in my experience , is repeated with far too much lightness. The problem is with the dark underbelly of this statement - what then of the other ways of practising? Does this statement leave any room in the tool box or is CBT the only tool we need? What is the effect of this statement on a young, new aspiring clinician?

One of the biggest challenges is communication with a child who seems distressed all the time. Parents start questioning their capacity to parent and everything that they did before this point in time. The initial attempts to “conquer” the ED often backfires and timelines as we have known them, don’t seem to help. Not knowing the landscape of an ED renders all attempts at communication a struggle.

How many calories are there REALLY in an egg - I think the real answer would be “ it depends”. And that would be the answer to how long it takes to recover - it really depends.

The conversation of “recovery” starts almost as soon as an Eating Disorder has been identified and diagnosed. Almost always the person also is surprised to find themselves in a diagnosis and unaware of how to reverse the situation. The whole family now has to become acquainted with certain facts and ways of thinking to understand the situation and find the way out. Here , I will try to address some of the common terms and questions that arise in treatment.

In the pursuit of doing the right thing, self-care is often talked about mechanically - a list of things “to do” which becomes a series of boxes to be checked off. Sometimes people are surprised that doing the list of things does not achieve what they are supposed to do, i.e. make one feel better.

The therapist and the client have to take care to “stay interested” in the process of recovery. Staying interested or maintaining focus for a very long time, sometimes years, is an exhausting task.

I came to Canada 22 years ago. While living in a “first world country” or the “West” was not my lived experience, it was certainly familiar to me in the alternate world of my imagination.

In the world of mental health, understanding symptoms or emotional presentations, requires the exploration of the emotional landscape, both of the ‘identified patient’ and the family system they belong to.

It is helpful to question the term we are trying to deconstruct - Body Image. The term , as is, suggests that body image issues have to do with the “image” of the body. The real issue might not be that simple.

The Meal Plan is the unavoidable and most avoided part of Eating Disorder recovery. In my opinion, a an eating disorder therapist would do well to be 1/3 dietitian and 2/3 therapist and the dietitian , 2/3 dietitian and 1/3 therapist to cover the overlap between food and feelings.

In the eating disordered world, if anxiety is the problem, control is the solution. It is important to find a definition for “recovery” that makes sense because it is important to offer the individual a sense of the end goal ; the lighthouse that identifies we are on the right track as we navigate through the treacherous waters of daily challenges and terrifying long-term overall change. It is also important to be clear about what we are trying to change, to attain recovery that is sustainable.

Therapy can be a wonderful exploration of myself and my landscape, both inner and outer. The landscapes of my life, my relationships and my emotions that often lie unexplored and unknown. One does not need a crisis or a ‘diagnosis’ to be called to this exploration.