A Blogger's Take on "Ed" and "Ana"

Aja, blogger at Writing and Recovering, found an old post she had written addressing her perception of gender in the personification of her eating disorder. It goes right to the heart of why I've started this project, so I wanted to share it with you. I encourage you to read her thoughts here: http://writingandrecovering.wordpress.com/2010/12/21/my-thoughts-on-ed/

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!

Gender-Bending

My conceptualization of gender and personification of the ED was blown wide open this week. I was leading a group, and trying to help the women separate themselves from their EDs. We got to talking about the names they would each give their ED, and whether it seemed to have gender.

I have to admit that I initially jumped to conclusions on the gender front - after all, one was called Patricia, and another Ed. However, when the topic of gender came up, I discovered that the woman who's ED was named Patricia perceived Patricia as male, while the woman who's ED was named Ed perceived Ed as female. The second woman said she just called it "Ed" because she'd heard that name used so much; after thinking about it, she decided to call it Edie instead.

However, Patricia presents quite the quandary. The woman couldn't remember how she arrived at either the name or sense of gender - both had been a "felt sense" for a long time. That raises a question that fascinates me: how DO people come to their personifications? To what extent does it come from their imagination, past exposure/experience with the world, etc, and to what extent does it seem to arise from the nature of the ED itself? Are there varieties of "ED voice" that have nothing to do with the "diagnosis" (e.g., anorexia or bulimia), but more with its style - whether it is more "mean girl," critical authority figure, abusive ex, etc? What do you think?

Company for Ed

It's not that I don't see the logic and benefit in descriptions of the ED as "Ed." Often portrayed as a jealous, abusive partner, Ed offers an apt metaphor for the verbal (and physical) abuse eating disorders inflict on those they inhabit. I get why people relate to the image of "Ed."

I just think that too many survivors talk about "Ed" because they've read others' descriptions of him, and/or heard about him in treatment - not because they really resonate with all the connotations. I suspect that, if everyone began without a preconceived notion of how to personify their ED, we'd see a much broader range of images and metaphors. That's what I've found when I've worked with people with different types of problems, and I think a similar process would unfold with EDs.

Unfortunately, I also think that the range of images and metaphors people think are "acceptible" in recovery has been limited by the pro-ED "movements" that have usurped feminine personifications of EDs for a destructive purpose. I'm on a one-woman mission to make feminine personifications part of the recovery dialogue - to take back what pro-ED groups stole from us. It's not that I want these personifications to replace Ed; I just want to give him some company!