Anorexia Treatment and Understanding Your Core Beliefs
Want to learn more about this anorexia treatment plan?
Let me preface by saying, this is not a typical anorexia treatment plan. My new client has had anorexia for four years. I’m not very far into the inventory of her beliefs yet, but already there have been some interesting discoveries. As I suspected with issues like anorexia, it’s not about the food.
Her eating behavior have to do with emotions and beliefs.
Jill (not her real name) has been doing some of the exercises in the Self Mastery Program and it’s given her an initial understanding of what’s going on in her mind.
An important step in the process is that she wants to be free of the condition. Jill is mature enough to realize that the current condition of her body prevents her from living a life she wants. Jill spent some time writing out what she wants her life to be like. She wants to go to University and get a degree. She also wants to travel, hike, socialize and freely go out with her friends. She doesn’t eat enough on her own to do those things. Her parents are with her several times a day to get her to eat some food for a minimum number of calories. If left to her own behavior, she wouldn’t eat enough, and her body would collapse.
For achieving her larger life goals, Jill wants to put on weight and gain strength. However, when there is food in front of her, another part of her mind activates and wants her to push the food away. She has come to call this part of her mind, “the Eating Disorder.” It is made up of a number of false beliefs.
Belief Inventory of Anorexia and Anorexia Treatment
The process began with a “character map”. (You can see it below)
In this process we take a mindfulness approach and watch closely the thoughts and emotions. As the observer we then attribute patterns of thoughts and emotions to what we call sub-personalities or characters. Mapping out the different parts of your personality help you understand your motivations, inner conflicts, thoughts, emotions, behaviors, and resistance to change. Jill has one part of her that wants to travel, and this requires being physically stronger. She has another part that wants her to be skinnier. These are two of the several characters that make up her belief system.
We have some aspects of our personality (characters) that will conflict, some will be adventurous, some rebellious, some agreeable, and some will seek safety. Some are angry, some fearless, some afraid, and some, flexible, and some stubborn.
Step 2 of the Anorexia Treatment Plan is Understanding “The Judge or Inner Critic”
Jill saw her characters as occupying the kingdom in her mind. At first, she placed the “Judge” character as the king. It was the loudest and bullied all the other thoughts. It told her what to do and berated her if she didn’t do it. If she ate or put on a pound, then it screamed at her that she would get fat and be disgusting.
As Jill wrote about different characters like the “wise woman” “the compassionate one”, “the adventurer”, “scholar”, or “comedian” (as she has a wicked sense of humor) she realized that the “Judge” was not a king. The Judge didn’t control her sense of adventure, her compassion or her desire to travel. Nor did she want it too.
The judge wasn’t wise the way a King should be wise. It was more of a petty tyrant caught up in small issues. The judge was one dimensional. It criticized and bullied, that’s all that it did. It was loud, and it would shout her down. In some ways, it acted out like a child having a temper tantrum. It tried to get Jill to be perfectly in control, but the Judge couldn’t control itself. It acted like it was all knowing, but when she looked behind its justifications they weren’t that well thought out.
Even if the judge was the loudest voice in her head, Jill saw that it wasn’t completely in charge. If she continued to follow its direction, she would end up in the hospital again and probably dead. Jill saw that the judge was really behaving more like an executioner in the way that it didn’t mind if she ended up dead.
At the same time Jill had a part of her that was afraid of the Judge. It was afraid of breaking any of the strict rules the Judge had imposed on her. This fearful part that received the judge’s criticism and believed every word of it. It was a self-image that portrayed Jill as a loser and failure. She called it the Victim. Initially it appeared as if all the stuff wrong with her was true. When the Judge yelled at her, Jill felt victimized and her identity merged into the Victim. But in the process of the mind mapping of characters Jill had to attribute this aspect to a character. This isn’t who Jill is all the time, it is only a role that she gets pushed into emotionally by the Judge, and then is out of it later. It is not her permanent identity, and therefore, more of an emotional point of view she adopts for moments and then leaves.
The Victim projects Victimization to Everyone
In previous years Jill thought that her parents didn’t respect her and tried to control her. They told her what to eat, when, and that she couldn’t exercise. They limited her social schedule at times if her weight dropped below the approved level. Not having power over these things is what she attributed to feeling powerless and dismissed. She felt controlled and victimized by them. In this frame the victimization seemed true, and Jill’s parents appeared to be the perpetrators.
However, when she looked at how the Judge treated her compared to the way her parents treated her, her parents looked pretty good. The judge overreacted and criticized her for the smallest things when her parents didn’t. She also noticed that she could just be sitting there doing nothing, and the judge would go on a tirade about something in the past, and do it over and over again, punishing her for the same thing dozens of times. The Judge didn’t know how to let it go. Her parents might punish her, but only once, not dozens of times for the same thing. Jill began to see that this Judge was far harsher. The Judge did more to create the feelings of victimization than her parents ever did.
Step 3 of the Anorexia Treatment Plan is Common Sense is to Check on Your Beliefs and Values
I asked if Jill talked to anyone the way the judge talked to her, she replied with a resounding, “NO, that would be rude”. I asked Jill if anyone else talks to her the way the judge speaks to her. Jill said No. I asked her if she would hang out with anyone that talked to her that way. Jill said, “No way”. One more question. “Would the victim hang out with the judge even though it treated her that way. Jill replied, “Yes.” It turned out that the victim part of her mind would accept all the abuse and harsh criticism. No other part of Jill would tolerate being treated that way.
For Jill it was like waking up and realizing that the victim part of her mind was hypnotized to take abuse and didn’t consider stopping it. This conflicted with Jill’s sense of values, and common sense. Jill didn’t want to be abused and didn’t want anyone to be abused. For Jill this is a core value. Finding these aspects of the belief system that conflict with her conscious values builds skepticism and is an important step towards changing beliefs. Changing her beliefs is a critical step towards changing her eating disorder.
Past Jill – False Belief Character
In the map of characters, the judge often criticizes Jill for something that happened a week or month ago. Jill realized on the map that it was criticizing a past version of Jill. The memory image of Jill the Judge was criticizing had one failure aspect and the Judge focused on it as if that were the only quality of “Jill.” It wasn’t the real “whole” complete Jill with all her parts. Jill could see that the present moment Victim was being punished repeatedly for what past Jill had done once. By making this inventory Jill could separate herself from these false self-images of her identity and could begin to see that she wasn’t the person that the Judge described. This allowed Jill to begin to feel better about herself.
You can’t see the water in the pool when you are swimming in it.
This shift in point of view also helped Jill be more skeptical of what the Judge was saying. In order to change beliefs, it’s not enough to be aware of them. You also need to remove yourself in a mindfulness way to a neutral observer perspective.
From inside her head the world looked one way. It looked the way the characters saw it through their foggy lenses of misinterpretations. When listening to the judge in her head, it all seemed true, and that she was worthless and disgusting. With the character map Jill stood outside the foggy lenses that distorted things and it looked a lot different. She could see the foggy lenses each of them was looking through. When Jill could ascribe the feelings of unworthiness and disgust to the victim aspect, she could see that she had other aspects of herself that were worthy at the same time. Jill was beginning to get some perspective and she could discern that the voices in her head weren’t all from her, and furthermore, they weren’t telling her the truth.
In the process of changing beliefs, it is not enough to simply know what your belief are. You have to scrutinize them and evaluate them for elements of truth, and falsehoods. You can only do this from a new and neutral perspective.
Characters or Sub-Personalities are part of our Belief System
Making an Inventory of the Characters that make up your Belief System doesn’t change is a start to changing the beliefs. It moves you out of the pool so you can see what is going on in the water. A look into some of Jill’s core beliefs revealed the following about her anorexic behavior. This isn’t a complete list, but just one part of her belief system affecting her behavior. This part of Jill’s belief system consisted of a number of associations that would produce certain emotions.
- Eating means “I” will gain weight. (even though you can eat and just maintain weight)
- Gaining weight will lead to being fat.
- Gaining weight will make her body disgusting. (even just one ounce) Jill already finds her body disgusting so to gain one ounce means more disgust. For Jill’s belief system, a healthy person of healthy weight is disgustingly fat.
- Feelings of intense disgust can be avoided by not eating.
- Having a fat body will also lead to people judging her and that will result in feelings of rejection.
- Rejection is equivalent to not being loved and generates a feeling of unworthiness and emotional pain.
- Unworthiness and emotional pain can be avoided by not eating.
Jill’s belief system has developed a shortcut for all this. It now does all these associations like a Pavlov’s dog response. If Jill thinks about eating food, her belief system generates feelings of intense disgust and emotional pain from rejection. Jill feels these emotions of disgust and rejection whenever food is put in front of her. These emotional pattern responses are produced by her unconscious belief system.
Her conscious mind is left to pursue strategies in avoiding horrific rejection and feelings of disgust. Her conscious mind is thinking of ways to negotiate with mom on each bite, arguing with her therapist, negating what her doctor says, and how to fight against any calorie intake.
Add One More Fear from the Belief System
Over time, Jill has developed a fear of feeling disgust, and emotional pain from rejection. What is important to notice at this stage is that Jill doesn’t have to eat any food in order to feel these emotions. Jill only has to imagine that she ate some food, or will eat some food tomorrow, and the full pattern of beliefs and emotions is triggered. She feels the fear of eating, the fear of feeling disgust and emotional rejection, and the disgust and emotional rejection without taking a bite. Jill is creating in herself the very emotions she is trying to avoid.
In her unaware state, Jill was certain that the emotions of disgust, rejection, and fear were because of the food. She is now becoming aware that her belief system is creating these emotions as an automated response to the idea of food.
Imagination is a powerful source of emotions. When false beliefs run the imagination, it is a powerful source of painful emotions.
Step 4 of the Anorexia Treatment Plan is to Understand the Core Beliefs of the Perfectionist
“I” am Disgusting and not good enough. – Character
I asked Jill what would happen if she ate, not according to the Judge, but in a way that her parents thought was healthy. Her reply was that it would be horrible. It took a few more questions to discover what “horrible” meant. It came down to this. “I’d be afraid that if I wasn’t careful about eating then I would eat everything, get fat, and then feel disgusted with myself. I asked her to tell me about the fear. I asked Jill, “Who is the “I” character that would be afraid and feel disgusted with herself?” Jill described a part of herself that she hated and knew was a disgusting failure.
“I” just want to be loved and accepted. – Character
Jill described that there was a feeling of fear, and it seemed to be saying that she desperately wanted to be loved and accepted. This aspect of her mind (or call it a sub-personality, or character, or just a feeling) didn’t feel love and so it devised a plan to get acceptance, approval, and love. It created the ideal Jill that would be perfect. To be perfect it had to be really thin. It had to get perfect grades, be athletic, funny, get awards, liked by everyone in the school, and get into the best university as well. If it did these things it could avoid all the criticisms of the judge that made it feel bad. It would also get the love and acceptance it so desperately wanted.
“I” will make a plan to be Perfect. – Planner Character
Odd thing about this structure of beliefs. When mom and dad, and the doctors and therapists, wanted Jill to eat more, this character interpreted all these efforts to save her life as a message that she wasn’t okay the way she was. The “not good enough/disgusting” character used all their efforts at change to reinforce its own story of not being accepted. “I’m still not accepted and loved the way I am”, and so it felt emotionally worse about itself. The “not good enough” character dragged Jill along into these emotions.
The solution to those same emotions was the same plan, be even MORE PERFECT! This meant, be thinner and so fight mom and dad more and fight harder not to eat and lose more weight. Then mom and dad, in order to avoid another hospitalization, fought harder to get Jill to eat more. Which Jill’s “failure” character used to interpret as a message of, non-acceptance and not loved. The misinterpretation of the belief system was driving a feedback cycle that made everything worse.
The Planner – Character
The Planner was convinced if she looked perfect enough that feeling of acceptance and love would come. The child inside her that felt unloved had devised the plan that this would work. It had been four years, multiple hospital visits, and yet the feeling of acceptance hadn’t come yet. The characters, lacking any self-awareness, or ability to measure cause and effect, were still convinced that the solution to feeling love was the same, be more “perfect”. The characters weren’t able to evaluate their own plan. They just stuck to it. They were one dimensional in that the solution to the emotional acceptance and love issue was a body type. They convinced Jill in a kind of hypnotizing way because “they”, the characters talked about it so convincingly in her head all the time.
The Perfectionist – Character
People in her school get judged and made fun of for being fat, but no one gets criticized for being too thin. At first glance, Jill’s plan to become “Perfect”, the super thin, does everything perfectly, so everyone likes her will solve her emotional problems. But this is at a glance. It’s a surface level look at the Perfectionist. The “Planner” took all of a moment to formulate the plan for love and acceptance but didn’t think it through in depth. It grabbed it in the moment it flashed as a thought.
I had Jill take a good look at the Perfectionist. Tell me what she is like I asked. At first Jill described how thin and successful she was, and how everyone thought she was great, admired her, and wanted to be her. I then asked her what the “Perfectionist’ thought of overweight people.
“She has a lot of judgments about them,” Jill said.
How does the Perfectionist feel about the part of you that feels disgust?
“She hates that part. She hates the girl that feels disgusting and wishes she would go away,” Jill said.
How does the “Perfectionist feel about other girls in school that aren’t as thin as she is? I asked.
Jill said, “The perfectionist hates them too. Well, maybe hate is too strong of a word. She feels disgust for them. She doesn’t want to talk to them or be seen with them.
I asked Jill what she thought of the “Perfectionist”
“She is really shallow,” Jill said.
Do you respect her or like her?
“No, but she is my ideal,” Jill said as the confusion set in. “That’s really weird. I hadn’t looked at her that way before. I just assumed she was perfect. But when I really look at her, and how she behaves and treats people, she’s not nice. She only cares about superficial things. She doesn’t care about people, she isn’t nice, she isn’t compassionate. She doesn’t care about the other things I care about.”
With this realization, Jill’s belief inventory of the Perfectionist began to show chinks in the shell. The “perfectionist” goal she had been chasing was no longer the end all and be all answer for love and acceptance. She had some human problems also. The “Perfectionist” lacked depth.
The feeling of confusion that Jill felt was appropriate. She had found out that the goal she had been pursuing since she was 14 was a superficial image. The eating disorder didn’t completely break at this point, but we had made progress. Her confusion was a good step. Jill began to be more skeptical about where her unconscious beliefs were taking her. That helped her take the next step in changing the core beliefs contributing to her anorexia and utilizing this anorexia treatment plan to the fullest.