• Dina Cohen

I've Put My Behaviors Behind Me. Now What?

by Rachelle Heinemann, LMHC

This post is brought to you courtesy of my friend and colleague Rachelle Heinemann, LMHC. Thank you, Rachelle, for sharing your insights!


When we think about eating disorder recovery, usually what comes to mind is meeting with a therapist, a dietitian, maybe some other team members, meal plans, behavior chain analyses, and fear hierarchies. Perhaps it means a higher level of care for you. Whatever your associations are, all the pieces are incredibly important to work toward healing your relationship with food.

But what happens after weight restoration, or eliminating restriction, or when you stop acting on your urge to purge? What happens when on the surface you are all “better”? Are you?

Well, maybe. There is definitely a huge part of recovery that entails symptoms reduction and decreasing your fears around food. But what most people have a hard time understanding is that that’s when most of the work begins. And that, very often, is when you feel the worst. Your body image has tanked and you’re no longer using symptoms to manage your anxiety. Inside, you’re screaming in pain. Inside, there is so much confusion and frustration. Inside, you feel misunderstood.

Because on the outside your family and friends are praising you for job well done. You are recovered.

But you’re not.

So why does this happen?

Eating disorders were brilliantly designed for your protection. They were developed to keep intolerable emotional experiences out of your consciousness. And guess what? They’re incredibly effective. Think about the ways you have to feel now that you aren’t using symptoms. Think about how the urges are so intensely strong. Think about your fantasies to engage in a behavior and how it would relieve your anxiety.

What your eating disorder has been doing for you all of these years is expressing for you what could not be expressed with words. It’s like a part of your brain was sectioned off and channelled through your body and released via your symptoms.

The question is, how can we decode what’s going on so that you can learn to express yourself with words instead of your eating disorder?

The very first step to expressing anything would be to identify what it is that you’re experiencing. I mean, how can you say what you need if you don’t even know?

I’d venture to guess that being in your body isn’t quite that comfortable right now. I’d venture to guess that for the most part, you aren’t even aware of what’s going on in your body most of the time. That’s by design. But in order to bridge the gap, in order to create a cohesive mind-body experience, we need to bring more awareness to your body.

Start with doing a head-to-toe scan. Begin to notice different sensations in your body. Is that tension in your jaw? Restlessness in your legs? Bloating in your stomach? The point here is just to identify these sensations. Just name them. That’s it. Slowly, over time, you will begin to notice your body more.

I’m also assuming you’re not that into tapping into your emotional experience. Maybe your therapist tries to get you to talk about your feelings but you find yourself rolling your eyes at her. Ugh, feelings. In efforts not to go too much on a tangent here, let’s just say there is something incredibly protective about this. You don’t want to touch your emotions with a 10 foot pole. So let’s start slow. If all you can identify now is bad or good, try to narrow it down ever so slightly. Perhaps you want to use an emotion wheel to help you. It’s always easier to identify what’s going on based on multiple choice rather than coming up with the names on your own. Once you get the hang of it, you can narrow it down further. Is the annoyance or frustration always that? Or can it be anger, resentment, fear, or guilt?

Identifying what your body is experiencing and the names of your emotional experiences will be key to expressing them.

What’s important here is that it doesn’t have to be perfect. Expressing yourself can look like saying “I don’t know what I’m feeling now but it feels really uncomfortable” instead of using a behavior to show you feel uncomfortable or in pain. Or it can look like “I am having the urge to INSERT BEHAVIOR and I would like some support” instead of doing the behavior to elicit support.

Think about in what ways your restriction, bingeing, purging, or exercise has served as a means of communication. What did you want people to see, to know, when you engaged in behaviors. How can you tell them that now, with words?

Rachelle Heinemann is a licensed mental health counselor based in New York. She specializes in the treatment of eating disorders, disordered eating, and body image struggles. She also works extensively with those challenged by depression, anxiety, relationship difficulties and career stress. In addition to her practice, Rachelle has taught courses in eating disorders and body image at undergraduate programs and high schools. She is the host of the podcast Understanding Disordered Eating. Rachelle is part of leadership at IAEDP NY (International Association of Eating Disorder Professionals.) You can learn more about Rachelle at www.rachelleheinemann.com.

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