Understanding Resistance to Eating Disorder Recovery

For many people with eating disorders, it can be common to have mixed feelings about their recovery journey. Some may be hesitant about beginning recovery because an eating disorder often serves as a coping mechanism for managing difficult feelings or scenarios.

But research highlights this ambivalence can result in treatment abandonment, refusal of help, and recurring symptoms.

The concept of mixed feelings, or ambivalence, describes having conflicting thoughts or emotions about a particular situation. In eating disorder recovery, this often manifests as an internal struggle between the desire for change and the pull toward familiar patterns.

This back-and-forth between recovery motivation and maintaining disordered behaviours creates confusion not only for the person affected but also for those supporting them. Ambivalence is particularly prevalent in eating disorder recovery because these disorders typically develop as maladaptive coping mechanisms for managing emotional challenges. Consequently, individuals often feel simultaneously drawn to both recovery and their established patterns of behaviour.

While you might clearly understand the physical and psychological risks of continuing with disordered eating patterns, the prospect of change can feel overwhelming. The isolation, anxiety, and pain associated with eating disorders can become exhausting, yet these very behaviours often begin as attempts to gain control, ironically leading to a loss of autonomy as the disorder progresses.

Meanwhile, the uncertainty and anxiety surrounding treatment can create significant resistance to recovery. The recovery process demands confronting deep-seated fears and potentially restructuring core aspects of your identity, including attitudes, behaviours, and values. Complex emotions like shame, grief, anger, and exhaustion commonly emerge during this process.

It’s crucial to understand that these emotional responses represent a normal part of the recovery journey.

The initial step toward recovery often proves most challenging, but remember that recovery follows a gradual progression. No one expects immediate transformation.

For those experiencing ambivalence about eating disorder recovery, consider these strategies:

• Document your emotional landscape: Take time to write down your thoughts and feelings about why you might be feeling hesitant to recover. Creating a comprehensive list of recovery’s advantages and challenges can provide clarity while strengthening motivation. Consider sharing these reflections with someone you trust, such as a family member or healthcare provider. This transparency helps your support system better understand and assist with your struggles.
• Embrace the non-linear nature of recovery: Setbacks and relapses are normal parts of the healing journey and shouldn’t been seen as failures. These moments, while challenging, often reveal important insights about triggers and coping mechanisms that can inform future recovery strategies. Explore NEDC’s “Stages of Change” resource for deeper understanding of recovery progression.
• Anticipate initial challenges: Creating meaningful change requires facing uncomfortable emotions and letting go of eating disorder behaviours. Remember that the initial discomfort with change typically diminishes over time as you develop stronger anxiety management skills and healthier relationships with food and body image. Your resilience will grow through this process.
• Seek inspiration from recovery stories: Reading about others’ recovery experiences can provide valuable perspective. These individuals have navigated similar challenges and emerged stronger. Butterfly’s Share Your Story platform offers diverse accounts of eating disorder recovery journeys and triumphs.
• Practice self-compassion: Frustration with negative thoughts and recovery’s pace is common. Support systems can help you understand these feelings and develop strategies for maintaining patience and kindness toward yourself throughout recovery.

Supporting Someone Struggling with Recovery Ambivalence

Watching someone battle an eating disorder while hesitating to embrace recovery can be upsetting and frustrating. Rather than expressing frustration or anger, maintain a supportive presence through active listening and compassionate understanding.

Additional support strategies include:

• Highlight life beyond the eating disorder by discussing their interests, aspirations, and opportunities currently limited by the eating disorder. Remember to separate your loved one from the illness, and that inside a ‘healthy self’ remains. Build their confidence and self-worth to reinforce their capacity for change.
• Practice active listening by reflecting their statements back to them. For example: ‘I hear you saying that part of you feels like you want to change, while another part of you feels scared of changing…’
• Express appreciation for their vulnerability in sharing their feelings and affirm your commitment to supporting their recovery journey.
• Provide realistic expectations about the recovery process. Reduce uncertainty by involving them in treatment decisions, fostering empowerment and respect – person-centred care is most effective in treating eating disorders. Emphasise progress rather than end goals, which might feel overwhelming or unattainable.

If you are looking for confidential and free support now, the Butterfly National Helpline is open 7 days a week, 8am-midnight (AEST/AEDT). Call 1800 ED HOPE (1800 33 4673) or chat online or email.