Three Essential Steps to My Recovery
By Ilene Fishman, LCSW
As I contemplate writing this article, I notice how challenging it is to separate my own personal recovery odyssey from my professional experience. I have been helping people navigate their own path to getting well from eating disorders for the past 34 years. My understanding of what it takes to achieve recovery certainly started with me and has no doubt morphed over time. I am as passionate now as I have ever been about how good treatment can lead to full recovery and clearer than ever about how to get there.
I developed Anorexia Nervosa at 12 years old in the early 1970s. No one knew what to do with me, let alone how to diagnose or treat me. It was harrowing for me as well as for my parents. I spent a lot of time in hospitals to address my medical condition and about a year in and out of psychiatric hospitals enduring incorrect diagnoses, even schizophrenia! I was completely misunderstood. After solely restricting and being severely underweight, I began purging which then progressed into binge-purge cycling while simultaneously restricting. It was awful.
My eating disorder continued for 11 years until I was 23 years old. What was notable about me is that I was extremely unhealthy and I knew it. I was also extremely driven to get well. I did not deny my pathology. Instead, I desperately wanted help. Most of the professional help we could find was misguided and disappointing, but there were a few outstanding positive, healing, and helpful experiences along the way.
Here are the top three things that helped me achieve recovery:
- Honoring and respecting my need for my eating disorder
- Understanding and addressing my unique self-hatred and self-criticism
- A feminist perspective regarding society, myself, and eating disorders
- I responded very well when my need for my eating disorder behaviors was understood and not threatened. Of course, I wanted it to stop and so did any professional who was treating me. But first and foremost was the reality that I needed my anorexia and my bulimia and could not live without those behaviors. Trying to merely change my behavior or thinking was not helpful. Understanding myself led me naturally to wanting and then being able to change my self-destructive behavior.
- I coined the term “internal tyrant” many years ago referring to a uniquely critical relationship with self. I believe without hesitation that identifying the way an internal tyrant lives in someone with an eating disorder as a self-protective defense mechanism is absolutely critical for recovery. No one gets fully better, not just with the eating disorder symptoms, but also with the problematic personality traits that underlie all eating disorders until this is successfully identified and healed in treatment.
- I stumbled upon an article in 1983 about something called “Bulimarexia”. I was shocked to find a description of my eating disorder and my struggle for the first time. I reached out to the professional named in the article and traveled to attend one of her very first week-long therapy groups. It changed my life. This experience not only addressed my eating disorder, it also introduced me to the concept of feminism and personal empowerment. I came to understand eating disorders and crushingly low self-esteem as a heartbreaking misuse of personal power. It became increasingly unacceptable to me to minimize myself in response to societal pressures. This understanding helped me to use the energy that fueled my eating disorder to heal my unhealthy and painful relationship with myself.
My best advice is to find good therapy – the right therapy and therapist for you. Do not settle for less than full recovery and don’t stop until you get there because nothing is more important.
About the author:
Ilene V. Fishman, LCSW
445 W. 23rd Street #1E
New York, NY 10011
Ilene V. Fishman, LCSW, ACSW, FAED, has maintained a general psychotherapy practice with a specialization in the treatment of eating disorders for 34 years. After graduating from the NYU School of Social Work, Ilene trained and was on staff at the Center for the Study of Anorexia and Bulimia (CSAB) and is currently a supervisor there. While serving on the national board of the American Anorexia Bulimia Association (AABA), Ilene helped found NEDA, the National Eating Disorders Association, which is widely recognized as the nation’s foremost authority and resource for both families and professionals. Ilene currently serves on its Executive Board of Directors and has remained active in NEDA since its formation. Ilene is a clinical advisor of the NEDA Navigator Program, Loss Support Network and National Eating Disorders HelpLine. Ilene taught the first Masters level eating disorder elective class in New York City at the Wurzweiler School of Social Work, Yeshiva University as an Adjunct Professor. Ilene is in private practice in New York City and Montclair, NJ, and speaks widely as an expert on the subject of eating disorders across numerous multimedia platforms. Look for her upcoming book THE GOOD THERAPY ADVOCATE: HOW TO EMPOWER YOUR PSYCHOTHERAPY.