This story is unavailable.

I have been working on similar things recently. One thing that helped was reminding myself that problems of being can’t be solved by doing. For example, “fat attacks” are almost certainly some kind of somatization — something deep inside doesn’t feel OK and it appears on the body as something identifiable that can be put right by restricting and manipulating numbers. I don’t know if you tried this, but a useful thing I learned in therapy was using visual or auditory flashcards to use in difficult situations: audio ones are short voice-memos you put on your phone. You note what might really be going on, remind yourself to breathe and notice any other things that might be clues, remind yourself that the feeling may abate on its own without making any decisions on actions like restriction or counting. Phone messages can be particularly accessible in those moments.

Apart from anorexia, I don’t really have any OCD type issues, but I found it incredibly useful to start seeing some things as “intrusive thoughts”. In therapy — I did schema therapy — I did also look into what the various thoughts/voices were and where they came from — self-punishing ones, perfectionistic ones, critical parent ones etc. But, for me, reading about intrusive thoughts honestly made a huge difference: learning that most people get these thoughts, but some people get more ”captured” by them and start thinking of ways to put them right. I think it’s OK to sometimes identify anorexic cognitions as mere intrusive thoughts and do whatever it takes to accept they are random and not meaningful at that time. That can run in parallel with therapy when we consider the origins and meaning of particular kinds of thoughts. Think of it not as a contradiction but as a two-pronged attack!

Wishing you well. All the insights you wrote about are really valid and promising paths. I agree that giving up the idea of a coherent map is the ideal, but a bit scary.

Show your support

Clapping shows how much you appreciated Pam Shiran Watson’s story.