I have been writing this blog in my head for the last six months. Ever since I started working for Eating Disorder Solutions, one of the most difficult realizations I had to come to was, I will not be able to help everyone. So, this blog is not about me, but I do want to explain why I am so passionate about this topic. As I begin my journey with this company in Admissions, I learn so much every day about the sheer courage it takes someone to make that first phone call and reach out for help. Especially with everything going on during this public health crisis, to be able to reach out for help when there are so many unknowns is a huge act of bravery. I feel lucky to be the one that answers the phone to help others, whether it be just to listen, to give resource assistance, to advise, or to discuss treatment options. It is right after this stage though, once someone accepts they may have an eating disorder, that they begin justifying their thoughts and behaviors.
This is where most of the struggle has come for me, as I know this person needs help, but they are just unable to see it. I wrote the previous blog to this one about the anxiety during this stage as it is totally real! You may tell yourselves that in order to be sick enough for treatment, you need to look a certain way, weigh a certain weight, or be doing badly in school. What this blog will dissect then is the justifications we make because of our perceptions of health. I have asked almost all of my clients this, as it seems to be at the root of all of our misconceptions, what does it mean to be healthy? Let’s look at this a little further.
Definitions of health:
The World Health Organization defines health as “a state of complete physical, mental and social well-being.”
Merriam Webster’s dictionary defines health as “the condition of being sound in body, mind, or spirit.”
My little sister defines health as “a positive mental and physical state.”
My definition of health, after much research and reflection, is ” The optimum level of mental, physical, spiritual, and relational wellness.”
All of these definitions seem pretty similar. What this says to me is most everyone agrees that there are more than just physical components to health. So why do we as a society base our perception of health only on the physical? I get the question all the time, “if I am still healthy, why do I need treatment?” When I inquire more about what they mean by healthy, they typically say they have no physical symptoms or medical conditions to necessitate getting treatment at this time. Therefore, the question here is, if someone is at an ideal body weight but they are isolating, having panic attacks, and unable to keep food down, are they healthy? If our definition of health includes the mental, spiritual, and relational aspects, as well as the physical, how can we define ourselves as healthy if only the physical is currently surviving?
Another explanation for why individuals with eating disorders may see themselves as healthy, when they are not, is explained best by Dr. Jennifer Gaudiani, the founder and Medical Director of the Gaudiani Clinic, and one of the founding members of ACUTE Center for Eating Disorders at Denver Health. Dr. Guadani wrote about the “house on fire” metaphor in her book “Sick Enough” and I believe that this metaphor, if used correctly, can help explain why eating disorders can fake healthy. In her book, Dr. Guidani explains how clients would say all the time “I’m fine,” when in reality they were physically, mentally, and/or socially deteriorating. So to explain this phenomenon, the “house on fire” story goes like this:
Visualize that someone is standing outside of a burning house. The fire department roars up and says, “We’re here to put out your fire!”
The person says, “Oh, I don’t have a fire.”
The firefighter says, “But, I see the smoke, I feel the heat, I see the flames. What do you mean?”
The person says, “Well, if I had a fire, it would be so hot that the sidewalk would be bubbling, and because my sidewalk isn’t bubbling, clearly I don’t have a fire.”
At this point, the firefighter understands the person to be mentally ill and proceeds to put out the fire. This story is meant to show how even the most obvious of circumstances can seem unreal when we are overcome by mental illness, like eating disorders. Reflecting back on how this metaphor looks with our definition of health then, if the house represents our health and even when it is fully engulfed in flames, it isn’t until we see physical symptoms, or the bubbling sidewalks, that we finally believe it to be real?
In all, it just goes to show that eating disorders are complex, and so is this world we live in. Health is a multipronged concept that needs to be treated by a multidisciplinary team. I hope we can keep helping you find your way back to healthy!
Health. (n.d.). Retrieved August 27, 2020, from https://www.merriam-webster.com/dictionary/health
Guadiani, J. (2016, September 14). Combating “Fine”. Retrieved August 27, 2020, from http://www.gaudianiclinic.com/gaudiani-clinic-blog/2016/9/14/combating-fine
Sartorius, N. (2006, August). The meanings of health and its promotion. Retrieved August 27, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/