Why Personify an Eating Disorder?

The image of the eating disorder as its own person has an intuitive appeal for many people with eating disorders, perhaps because it fits the stream of thoughts that are such a big part of the experience of having an ED, because these thoughts can be described as the ED "talking." Similarly, many therapists find this image use because it provides a language for distinguishing ED "talk" from the survivor's own "voice."
However, some people - survivors, therapists, and allies alike - have concerns/reservations about the practice of personifying the ED. These concerns typically involve at least one of two points: (1) objectifying or personifying it belies the fact that it is an "illness," and therefore, personifying it may be a form of denial, or a reason not to receive needed treatment; and/or (2) attributing the ED to something external may be seen as a means of absolving responsibility for the consequences of the problem, or for change.
The practice of personifying or objectifying a problem comes from Narrative Therapy, where it is called "externalizing the problem." Narrative Therapy is based on a postmodern philosophy called social constructivism. Basically, the idea is that all of our perceptions of "Truth" are no more or less than ideas that we've collectively agreed upon - they are socially constructed (i.e., built). The concepts of "illness" and "treatment" are just that - constructions of our particular social location. In other parts of the world, and in other eras, the same constellation of symptoms we call eating disorders have been understood quite differently (the book Fasting Girls provides an interesting summary of how anorexia has been understood over time).
When it comes to selecting among available constructions, what really matters is what leads to better outcomes in people's lives (however they define that for themselves!). However, for many people with eating disorders, seeing the ED as an illness is just another way of seeing themselves as flawed, inadequate, defective, and therefore worthless. Another good book states:

" If women think of anorexia as a part of themselves, even if they decide to fight it, what choice do they have but to indict themselves at the same time they indict anorexia? An anorexic trap is laid such that when they begin to think in opposition to anorexia...they step into a view of themselves as "sick" or 'disordered.' And from there it is a relatively easy matter for anorexia to co-opt their fledgling rebellion and tighten its grip by reminding them of their worhtlessness and inadequacy" (p. 82).

All too often, the result is that survivors think they don't "deserve" treatment or recovery, or are incapable of recovery because they're inherantly, inevitably "mentally ill."

What of the fear that personifying the ED would help people avoid taking responsibility for the consequences of the ED, and/or working for change? From my own experience working with a wide range of mental health problems, and as an ED therapist, I am here to tell you that the opposite is true. Instead of feeling like they are at the mercy of an external force, survivors begin to believe that they have choices in how they respond to the ED. For many, this is the first time they've seen any alternative to following the ED's dictates. Personifying the ED as something separate creates space for the person to maneuver - to see possibilities for change by redefining their relationship with it, and adjusting their responses to it. In fact, they might recognize small ways they have already attempted to do so. Since one of the most insidious methods EDs employ is convincing people that the ED is their identity, separating the ED is a revolutionary step. It allows people to reembody their own identities.

Finally (for tonight), personifying the ED offers a tool for resolving the ambivalence that is such a normal part of the recovery process. It offers a way to sort out the thoughts and impulses that are "pro-recovery" from those that are "the ED," to guide choices toward recovery and away from the ED. At the same time, it normalizes the presence of "ED thoughts and impulses," so that they aren't as likely to perceive these experiences as "failures in recovery." That, in and of itself, has prevented countless relapses.

I'd love to hear other people's opinions - both doubts/concerns and perceived benefits of personifying the ED, so please leave your comments!