Wednesday, May 19, 2010


Sad little voices write to me, or talk to me:


“I have relapsed again.”

“I am now 38 years old and suffering a relapse, after one of the girls I was helping died directly from Anorexia.”

“I feel that hospitals mainly place an emphasis on re-feeding the patient to fatten them up and do not focus so much on deeply attacking the underlying issues of the disorder itself. I think this is why the relapse rate is so high for eating disorders.”

“I just got out of the hospital after a two-month stay, for my sixth time. Unfortunately, I've spiraled into another relapse and am not doing so well and looking at a possible readmission.”

“I don't want people with any diagnosis to be stuck to a lifetime of outpatient therapy. Yet, it seems to me, the way they are taught in this field--plus the restrictions of providing services in this country equates to minimal efficacy and chronic relapse of any symptom.”

“I have struggled, and am still struggling, immensely. I was ashamed to say this. OCD makes some days a living hell. Treatment after treatment, I have come out and relapsed.”

“My daughter was first diagnosed in 2004 and has relapsed during the past 12 months.”


What I sense over and over again is the shame of the sufferer; the embarrassment of the sufferer; the guilt of the sufferer for having ‘failed’ again.

How wrong is this!!!?

How hopeless is this!!!?

In Latin, “relapse” is defined as ‘a gradual slide back to a former state.’

In the most common language offered to sufferers of the symptomatology of ‘Confirmed Negativity Condition’, relapse suggests wellness existed before the slide back into illness.

Every intuitive sense in my body, every logical conclusion based on evidence that I have seen, tells me the opposite. In my experience, to do with these conditions, there is no such thing as ‘relapse’. Wellness can only be attainted if the condition (and its symptoms) is properly addressed—and then only if it is properly understood. Wellness—meaning positivity, objectivity in emotional maturity—can only exist if there is total and complete reversal of negative thinking about oneself. We can use the metaphor of the course of antibiotics stopped before its completion—or expecting a proper birth of a child after only two months in the womb—or the incorrect setting of a broken bone by taking the cast of prematurely.

Should we not be looking at treatment that extends itself to when the patient is well, or strong enough to continue with the loving support of a kind circumstance, rather than when insurance runs out—when the program is completed?

Perhaps, then, the onus will not rest on the shoulders of those emotionally incapable of serving themselves, but rather, will be shared by encouraging, visionary therapists who, themselves, are sometimes frustrated with their administrative limitations.

Thank you for your time.

Peace and Love.


Jennifer said...

Peggy,its Jennifer, the 38 year old quoted in this post. I absolutely agree with what you have said - looking back to the few years during which i believed i was "recovered", shows me that i had never attained wellness or recovery in my mindset, it was just that the physical manifestation had ceased to be as severe,temporarily.
I am,in a sense,grateful for this relapse,grateful that it came now and not in another few years,as i am in a place to truly seek help at this time,help for my insides, not just the outer physical self.
Thankyou Peggy, for using the insight and compassion which you have been blessed with. Much love and admiration and gratitude toyou,
Jennifer xxoo

Siobhan said...

You're certainly right when you note that the medical community focuses entirely too much on re-feeding the patient and not addressing the real substantive issues that created the eating disorder. Fear of food is ONLY a symptom of the disorder. CNC is the real culprit! If medical doctors and treatment teams were carefully listening to their patients, they would see that and hopefully take a different course of action to stabilize and effectively treat their struggling (and in many cases dying) patients.

As an ED sufferer who has spent the last year moving in and out of residential and IP places for treatment, I can honestly say that re-feeding was the main focus of my treatment teams. While such treatment was needed, by the time I was physically able to really start to handle and deal with the issues that have contributed to my eating disorder and CNC, my time in IP was up, as insurance would no longer cover the cost OR my treatment team incorrectly reasoned that I was stable enough to face the "real" world again. As you can probably predict, these decisions eventually led to relapse immediately following my release from IP and significantly contributed to the lack of hope I now have in beating this disorder. The longest I have experienced any "sense of normalcy" after treatment only lasted two months, with the shortest period being 2 two days post release. Never have I left treatment really feeling as though I was in a good place; never have I left feeling healed, normal, and hopeful that life would become the great thing it once was.

Siobhan said...

So much more is needed to support the sufferer in our daily war against self and the Negative Mind. The impulse and often times command to self-destruct is SO strong that longer periods of treatment are needed. While I recognize the necessity to have a patient physically stable enough to undergo emotional work, insurance companies and treatment facility practices only seem committed to helping individuals stay "physically" alive. They often forget that it's the individual's emotional death that predated and established the eating disorder.

Furthermore, some current treatment methodologies appear akin to an ER doctor's failed attempt to heal a wounded soldier. For example, if a soldier comes into the ER after being wounded in battle, would we only put a band-aid over his gun shot wound and wait patiently until it stops bleeding and heals? I think not! Instead, we assess the wound, clean it out from front to back, apply pressure to stop the bleeding, and eventually suture it up. Once all of this has been completed, we then bandage the wound knowing that we've done what we needed to do in order to ensure that the infection does not develop and uncontrolled bleeding lead to death. Approaches to healing individuals from eating disorders should be no different. Treatment teams have to be willing to delve into the wound of the hurting patient and clean the nastiness that's been deeply embedded. Then, and only then, can we begin to suture the wound and prepare for its eventual healing. Any failure to do so will only lead to a continued infection where CNC will become so incredibly systemic that the patient will eventually die with the belief that they weren't "strong" enough or didn't take care of themselves enough in order to live. I question, is this really the message we want to send human beings who are struggling with understanding their worth? Do we really want to beat up the person who beats up his/herself every day, all day? The pain of living with an ED is hard enough. We sufferers don't need our treatment teams and insurance companies insisting that we "pull ourselves up by our bootstraps."

Peggy, thank you so much for understanding this disorder- inside and out. I sincerely wish more people would take to heart your message of hope, healing, and understanding. You are truly an angel!

Much love,

Anonymous said...

i remember when I was 11 years old and the first therapist i was forced to see was explaining my diagnosis and treatment to me. she described it similar to me the whole addiction mentality of recovery and that i'd be managing these symptoms for the rest of my life. interesting that at 11 I clearly wondered how symptoms management of recovery was any different than just
staying sick? I wanted the real deal which was hopefully so much more than 'managing symptoms'.

seems simple to me, right? even though at that point i had no clue the depths of this. no understanding of the power of it. but if you have an infection you treat the source and not just the runny nose.

how confusing that as someone who works in the social service setting it does not seem that complicated what is needed. yet as someone trapped in it it's so complicated i can't see straight.

thank you for persevering peggy.

Biddy Stitch said...

The Negative Mind laid dormant for 13 years. I don't know what I missed.
Thanks for all of your insight angel. You have been a blessing. And as I read through again, I hope to find whatever I missed the first time round.
Peace and Love to you as well;

Anonymous said...

I'm scared. I thought I was healthy, but just because my body may be doesn't mean my mind is. I thought it would all go away....but it hasn't. I was just re-fed. Now what? What happens next? No one will listen to me!

Vilda Bäbin said...

Oh yes, the guilt of relapse. The guilt of having this disease to begin with, since you feel that it is you who have a negative mindset, you who think negative thoughts instead of being positive, that you cause this disease. But that's not true.

Thank you for writing this Peggy. I don't think anyone is guilty of having anorexia, OCD, or any other CNC-related problem. It's like breaking a leg, nobody chooses to keep thinking negative thoughts or to "relapse". The negative mindset was something that came about not something that the person created themselves really...

MollysMama said...

I have read Peggys bok so many times. I really felt that she was the first one who really gets how it is for us. Although i have read it so many times, i don't see how any of that can apply to me. I don't believe i will ever come out of this. There is no talk of my situation here in this house. He just asks how did the appointment go, he doesn't really want to know. I see a counselor but,there is so much i don't think i could ever tell her or anyone for that matter. I am sooo ashamed of who i am,and i think i ever would let any of that out,people would hear it and agree with me how awful i am.There are a few people who i know that have ED's. But i mostly just listen to them.