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Anxiety In Recovery Brain Health Emotion Recovery Rewiring

Tolerating Uncertainty In Eating Disorder Recovery

As humans, our brains are hardwired to dislike uncertainty in any aspect of our lives and I find this an interesting topic and particularly relevant here as the ability to tolerate uncertainty is key in eating disorder recovery.

Every human brain loves certainty.

Our basic survival brain perceives uncertainty as a danger and so it will update our world hundreds of times a day, making up stories to keep us feeling secure.

To the brain, uncertainty means that it has less ability to help us avoid danger and when it is in that situation, it will assume the worse, make threats personal and jump to conclusions.  Our basic survival brain is therefore wired to overestimate threats to our safety and underestimate our ability to tolerate them.

Naturally, this basic neural hardwiring that we all have, to a greater or lesser extent, means that an increase in uncertainty in our lives will directly lead to an increase stress response in our brain and body.

Now, let us for a moment, bring this back to eating disorder recovery.

How many of us, when contemplating, starting or even along the road of recovery, hesitate or experience sharply increased anxiety, merely because of the unknown that recovery brings?

The life in the eating disorder might be miserable, but it is our status quo.  We might hate it but at least we have adjusted to the day to day way our lives play out and there is a false sense of safety in what we know.  Recovery on the other hand throws up all kinds of uncertainty.

From the method we use (which is ‘right’ or ‘wrong’), to how much weight we will gain, to what our lives might look like in recovery or will we even tolerate the process….?!?  The entitre prospect of eating disorder recovery is filled with uncertainty.  There is no clear cut, black and white, one size fits all model or method to follow that has a guaranteed outcome.

And, where our survival brains are just doing what they are hard wired to do when uncertainty surfaces in our lives, it will not help the situation by making us think the worse and jump to conclusions that we will believe because our brain wants us to believe them!  So, of course with the uncertainties of recovery, our brains will convince us that we will gain weight indefinitely (and that that would be a bad thing), nobody will love us, we won’t tolerate the recovery process and we will feel lost and overwhelmed if the eating disorder plaguing us is lifted from our lives.

In the current world situation, we can see the way uncertainty plays out in most members of the human race too.  With the Coronavirus pandemic, many people, even with the most stable mental health, are experiencing increased stress, predicting the worse with how Covid-19 will end and finding it hard to cope with the uncertainty about the future.

One fascinating research finding when it comes to studying uncertainty and the stress response to it is that people are less able to tolerate uncertainty about a situation than to tolerate an actual stressful event when it happens.  An example of this might be a person who finds their job security is threatened.  This time of uncertainty about their job and future can be a lot more stressful for them than actually losing their job.

Similar findings come when considering pain.  A person who is told that they will definitely experience a pain response to a situation is usually calmer than a person who is told they might experience pain, with a level of uncertainty about that fact.

So, are there ways we can bring this back to help us in eating disorder recovery?

Very often in treatment for eating disorders, professionals use ‘target’ weights and ‘meal plans’, which I am sure are to remove that element of uncertainty from the process of recovery, with the hope that it will make it more tolerable for us.  I am sure their thinking is that if we are given reassurance that this is the weight we have to reach and this is how much food we have to eat, with set out plans and predicted graphs, it will help recovery feel less uncertain for us, more safe.

Of course, the problem with that is that our bodies are not machines, our bodies are not predictable… our bodies do not know what a professional has decided they are to do for us to recover.  In recovery, our bodies may well need to gain more weight than a ‘target weight’ set and our bodies will probably be crying out for more food to properly repair than any meal plan can provide.  And this means that those well intentioned measures to help us manage recovery uncertainty fail because they do not really let us recover.

Ultimately, the uncertainties of eating disorder recovery do have to remain uncertainties until we move through them, face them and learn to just sit with the unknown, trusting that the pessimistic outlook our brains are providing are not real, are ungrounded and until we just try it and see, we cannot know.

When it comes to pain too in recovery, I often tell people – expect the process to be hard and distressing.  For in recovery, knowing that it won’t be easy, preparing for and making space for the pain, so that it is a more certain part of the process, might ultimately alleviate stress.

Whether it is Coronavirus or eating disorder recovery uncertainties, mindset is also a crucial part to handling it.  Rumination, pessimism or catastrophic thinking will only serve to increase our stress levels and have negative physical effects on the body.  Instead of this, we need to find the opportunities in difficult times, look for positives and learn skills to sit with and manage the uncertainty until it naturally dissipates.

Turn those ‘we are all doomed thoughts’ around!  Particularly in recovery… force yourself to realise that any amount of weight gain is a wonderful thing to celebrate and not fear and understand that life in the illness might be predictable but it’s also a shit way to live and look positively to the possibilities that your life could become!

But what are some other general ways to manage uncertainty?

– Stay present… focus on the here and now, avoid jumping too far to thinking about the future, particularly if you are predicting the worst!

– Sit with anxious feelings that come up, but avoid responding to them.

– Identify that the anxiety you are experiencing is your worrying about what might happen, not what will happen or what has happened – and then come back to staying present!

– Mindfulness techniques or just focusing on the breath can be excellent to use to ground ourselves, keep our body calm and reduce anxiety when fears of the future arise.

– Finally, be aware of behaviours that might arise when you are seeking more certainty… People anxious about the uncertainty from coronavirus at the moment are tending to behaviours such as obsessive news-watching, reading social media, googling coronavirus symptoms and buying toilet paper(!)…  In recovery, when we are trying to find ways to manage our uncertainty, we can over research in a similar way – read blogs, social media, watch YouTube and seek reassurance that what we are doing is right (if it involves food and rest then it is right!).  In recovery, we might also seek more certainty about our situation by behaviours such as weighing ourselves, calorie counting or body checking.  When any of these behaviours are identified, stop, breathe and come back to the present, asking yourself – is this helping me feel better at the moment?  If not, stop!

Overall, uncertainty in our lives, be it recovery, coronavirus, jobs, whether George Clooney is going to call or anything else is uncomfortable and stressful and at times, even might be described as feeling intolerable.

But uncertainty will always be part of life – there is no escaping that and if we can develop some incredible skills at tolerating one of the hardest forms of uncertainty arising from recovery, then we will be pretty set for anything in life!

Unfortunately, eating disorder recovery does not come with a textbook that will give you certain answers to what recovery is going to look like for you – how much you will weigh at the end of it, how much food it will take, how many tears you will shed.  But, like the person who is anxious about losing their job – the anxiety about the prospect of recovery, your ability to tolerate it and what might happen when you do start the process… trust me – when you do jump in, you too will find that the reality is easier to tolerate than you think.

And if the above techniques to deal with the uncertainty of recovery don’t work then just try the fuck it mindset – e.g. thought = ‘you will gain weight forever more’… Respond with, ‘fuck it’!

It works for me!!!

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