The key to recovery: empowerment

In my opinion, one of the key ingredients for a successful and robust recovery from an eating disorder is empowerment - feeling like you have agency and the ability to control your own destiny. So much of traditional treatment relies on the patient / clinician dynamic whereby the patient is passive and simply “receives” the treatment from the clinician. This is a wholly disempowering position for the patient. ED recovery cannot be passive - it must be active.

Empowerment, by definition, means to give authority to someone to do something. It is crucial, for rewiring purposes, that the person recovering feels empowered to give themselves permission (and to act upon this permission) to eat in the ways that the ED disapproves of. If this permission is only granted by external sources (clinicians, family, online content, etc) then it is unlikely full recovery will be reached. Rather, the conditions around eating habits have changed - “it’s okay to eat this pizza if my partner is, but not on my own”. Unless the permission comes from true empowerment it is likely that there will be tendrils of the ED that remain. After all, while there are many similarities between ED presentations, each individual's experience will be unique. There is not a single person on the outside who knows exactly where someone’s ED rules, behaviours and thoughts lie. The most expert person on that is the person with the ED. They are therefore best placed to combat each and everyone of those rules, behaviours and thoughts but this process will require a lot of self awareness and honesty. 

This is not to say that the road to recovery must be travelled alone! Quite the opposite - the journey to empowerment is not something that happens overnight and often benefits from a lot of support along the way. In my experience, education is rarely the limiting factor in recovery. Most people who want to recover from an ED could write a book on the subject. Chances are they have scoured the bookshelves and the internet for all possible content on recovery. This is often done to seek permission and to confirm that it will be okay, but often still results in a lack of action. So then it is often the case that people in recovery know what they need to do, but lack the confidence and belief that they can in fact make the changes that they understand to be necessary. It is the role of the support team to encourage and empower this person to back themselves - to actually do the things that they know will be most supportive. In doing so, this will not only help the individual to fully recover, but will teach life-long skills of self confidence, self trust and self worth. It is this self trust that is established through empowerment that predicts a full recovery - to be able to stand in the belief that you trust you will be able to self support through the ups and downs of life renders an eating disorder futile as a coping mechanism. I strongly believe that putting the person recovering firmly in the driving seat dramatically improves the likelihood of robust recovery and fundamentally changes the dynamic of treatment. Empower the individual and watch what they are capable of.