Ambivalence in Eating Disorder Recovery
Ambivalence refers to the state of experiencing two opposing feelings toward a particular course of action. Despite the dangerous health consequences that are associated with eating disorder behaviors, those who are ambivalent toward recovery may experience anxiety, uncertainty, or fear surrounding the need for treatment.
By: Chella Po
Eating disorders are incredibly complex illnesses that are woven into many aspects of a person’s life. As a result, recovery is not always straightforward and many people will encounter ambivalence toward their treatment. Ambivalence is a state of having simultaneous conflicting reactions, beliefs, or feelings towards something. Often, people will feel both positively and negatively toward their eating disorder, and this internal conflict can make people feel stuck, standing in the way of recovery.
There are a number of reasons why someone might not be fully convinced of their need for treatment. For individuals with an eating disorder, it may seem as though their illness serves many positive purposes in their life. Many feel a sense of identity, and even a feeling of self-confidence, achievement, and happiness from their behaviors. Eating disorders often develop as a coping mechanism in dealing with difficult events, emotions, or past traumas, and allow a way to communicate and release emotions. Some describe their eating disorder as a ‘friend’ who has been there in their difficult times. Importantly, they provide a sense of control. These “benefits” can make it feel worth it to continue living with their illness, however destructive, and one might not be willing to give this up.
Despite the supposed positives, individuals can understand simultaneously that they need to get better. For many, feeling a loss of control over their behaviors prompts them to seek treatment. The eating disorder, which began as a source of comfort, instead causes deep pain, isolation, and disruption to many aspects of their lives. Many are aware of the serious negative effects that their eating disorder has on their physical and psychological health, as well as the social impact on themselves and others around them. Nonetheless, it can be incredibly confusing for these consequences to coexist with the so-called “benefits” they gain from their disordered behaviors.
Fear also plays a large part in ambivalence, and feeling the urge to hold on to just some parts of the eating disorder is common. Change is scary, and confronting the illness typically requires changes to one’s whole life, and possibly even facing their past traumas. Thus, recovery happens in stages — it is not linear. Treatment is essential for helping individuals overcome the cycle of ambivalence. Clinicians should seek to understand an individual’s ambivalence, build their trust, and help them develop skills and feel empowered to face these changes. Eating disorders are serious illnesses that cause harm, like many other illnesses. Full recovery involves not only the restoration of one’s physical health, but behavioral , and psychological health as well.
If you are struggling with an eating disorder, here are some ways to work through your ambivalence:
Acknowledge and accept: ambivalence is a normal part of the recovery process and could actually be a sign of progress. Accept your thoughts and feelings, and be kind to yourself.
Explore and understand your ambivalence: naming and listing the positives and negatives of pursuing recovery can help you uncover your motivation. It can be helpful to understand how you got to where you are to be able to see where to go next.
Develop new ways of coping and practice them: you might need to learn new skills to face your challenges. Practice using these skills and they will become easier over time.
Accept change: making a change is stressful but necessary to improve your quality of life and overall wellbeing.
Keep moving forward, even when you slip: relapses are inevitably a part of recovery but do not indicate that you have failed or that recovery is impossible. Remember what you are working towards, and why you are doing this.
Get support: an eating disorder is an illness, not a choice. Don’t be afraid to lean on supportive loved ones or ask for help from professionals.
At Balance Eating Disorder Treatment Center, we understand that seeking help and pursuing recovery for an eating disorder can feel overwhelming and frightening. No matter where you are in your journey, we are here to help. We are dedicated to treating the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, orthorexia, and other disordered behaviors and body image issues. Through our array of services, we offer treatment for women, men, LGBTQAI+, and adolescents and provide all levels of outpatient care.
We are proud to offer an array of free and low-cost virtual webinars to help those struggling with eating disorders, disordered eating and body image concerns. In our Tackling Eating Disorder Recovery Ambivalence webinar, BALANCE Admissions Director Danielle Levitine MS BC-DMT LCAT CED-CAT will help you sort out how your thoughts and behaviors are affecting your quality of life and mental health. Our admissions team would be happy to answer any questions you may have about our webinars, programs, and services. Book a free consultation call with our admissions team below or read more about our philosophy here.
This post was written by BALANCE Dietetic Intern, Chella Po.
Chella is a graduate student pursuing her Master’s Degree in Clinical Nutrition at New York University. She received her Bachelor’s Degree from Boston College with a double major in Sociology and International Studies. Previously, Chella worked in philanthropy at a global non-profit organization focused on solving world issues by building trust and partnership. While living in busy New York City, Chella developed a passion for helping people live healthy lives through food and beyond. Originally from the Philippines, she hopes to make good nutrition and wellness more accessible in her home country.
Resources
Darcy AM, Katz S, Fitzpatrick KK, Forsberg S, Utzinger L, Lock J. All better? How former anorexia nervosa patients define recovery and engaged in treatment. Eur Eat Disord Rev. 2010;18(4):260-270. doi:10.1002/erv.1020
I Want It, No I Don’t: Working Through Ambivalence. Center for Change Website. https://centerforchange.com/i-want-it-no-i-dont-working-through-ambivalence/.
Levitine, Danielle. Tackling Eating Disorder Recovery Ambivalence. Lecture presented at: Balance Eating Disorder Treatment Center; April 28, 2020; Zoom.
Recovery and Relapse. NEDA Website. https://www.nationaleatingdisorders.org/learn/general-information/recovery. Accessed October 3, 2020.
Stages of Recovery. NEDA Website. https://www.nationaleatingdisorders.org/stages-recovery.
Williams S, Reid M. Understanding the experience of ambivalence in anorexia nervosa: the maintainer's perspective. Psychol Health. 2010;25(5):551-567. doi:10.1080/08870440802617629