Its not about the wanting

I’ve been observing a conversation between parents online about how to cope with adult sufferers of eating disorders and various co-morbid conditions – about how to keep pushing for recovery when you are the only one fighting and about when to lovingly detach for your own survival.

Let me perfectly clear: I am not judging these parents. I completely understand where they are coming from, why they feel the way they do, and I offer them and their families my most sincere compassion. Moreover I think it is an incredibly important discussion to be having and one that too often gets swept under the rug because it is sad and uncomfortable and scary. No one deserves to have their reality swept under the rug because it is not a story others want to hear. The truth about eating disorders and mental illness in general is that even the very best treatments we have will not work for everyone. We can throw everything we have at these illnesses and some people will stay sick and some people will die and we need to able to talk about this.

What I do find striking (and upsetting if I’m being honest) is the way in which this discussion is being framed around words like “wanting, “willing”, and “non-compliant.” Its not about the wanting. Or the willing. Its about the strength of the illness. No one – and I mean absolutely no one – wants to live in the hell of an eating disorder or other psychiatric illness. Being too scared to change, not believing that change is possible, or┬ábelieving that the process of change will destroy you – none of these things are equal to desiring the status quo. You are not waiting for your loved one to want recovery enough to overcome the illnesses. You are waiting for the illness to loosen its grip just enough for your loved one to access the part of them that already wants recovery. And sometimes refeeding and weight restoration accomplishes that. Sometimes it takes meds and therapy too. And sometimes we don’t have the tools to make that happen for a particular person.

I don’t always love the analogy of ED as an abusive partner but in this instance I think it is a helpful comparison. People stay in abusive relationships for lots of reasons even when they have people offering to help them leave. But no one wants to be abused and I think (hope) that we all recognize that. It hard to keep that in mind with ED and other mental illnesses because the sufferer is the only one who can see and hear their abuser. But that does not make it less real.

So even in discussions of chronicity and hopelessness and frustration and the need to detach from the sufferer I think it would benefit us all to remember that its really really really not about the wanting.