Amidst the recovery journey from an Eating Disorder (ED), there are certain words which can sting and shock like angry curse words. The ED voice using certain words over and over again in a context of disapproval and disgust can have an indelible negative impact – for both the client and the clinician. Although the initial reaction for any ED-specialized clinician may be to abolish the use of certain words, a reframing and embracing of the words might ultimately be more beneficial. Choosing to deconstruct and reconstruct such words for our clients — and even perhaps for ourselves — can assist all of us in being more aware and generally more prepared to challenge the cascade of destructive thoughts which usually follow the ED expletives.
The “f word”
Fat has unfortunately come to be a negatively tinged word in our current culture and our current century. Unlike so many other countries and other historical time periods, dietary and body fat have become concepts to be avoided and used in shaming ways rather than celebrated and incorporated. The biological importance of body fat and the valuable nutritional properties of fat in our diet are no longer talked about in schools or headlined in magazines. Furthermore, this “f word” is so often used as a cover over the opportunity to discuss true feelings, with fat regularly substituting for expressing feelings of fear, disappointment, anger, anxiety, and myriads of other, generally negative sentiments. Rather than being a descriptive word, like green or striped, it has come to be one of the highly rejected, disgraceful, and over-used words. Just as any other over-used word, it then becomes more meaningless and convoluted yet still manages to pierce the inner confidence of those who regularly use it in a deleterious, self-degrading context.
Rather than maintaining a striving for the non-fat emphasis or a fat-to-be-feared focus, we can aim to assist our clients to take on a gentler, kinder acceptance of nutritional fat and body fat. We can continue on with the psychoeducational components of the value and the need for fat, but perhaps more open use of the word with pride and honor will help our clients to shift their focus. Over time, we might be able to eventually disconnect the social judgment and let fat just be fat, an adjective and a noun.
The “c word”
Calorie has become such a loaded, values-driven word in our society that its mention can cause some to shudder. It’s actual definition is a unit of energy and represents something that humans need multiple times every day to survive, yet calories have become known as something terrible to be avoided and reduced whenever possible. Our clients are often so well versed in the process of automatic calorie counting and engage in such mental math torture throughout the day that the shift to intuitive, spontaneous and flexible eating feels quite overwhelming at the start.
Incorporating varied, sufficient calories is naturally part of any recovery process, and so perhaps we can simultaneously help the term calorie get back to its root as a “unit of energy.” Although we may not be in a position to influence such a change on the actual American nutritional labels (though it is interesting to note that several European countries still list “units of energy” rather than calories on their food labels), we can help our clients to learn to translate this word to a more neutral and descriptive terminology. Rather than using the nutritional labels as a method of judgment, competition, or humiliation, can we return to the original aim of labels that were for informational purposes? The US Food and Drug Administration (FDA) has a long and interesting history of determining how best to provide full disclosure to citizens, and it was the Nutrition Labeling and Education Act of 1990 which required the basic per-serving nutritional information to be listed on foods. This new law seems to have culminated from a series of detrimental incidents that resulted in new regulations, such as Saccharin Study and Labeling Act of 1977 (which requires a label warning that saccharin has been found to cause cancer in laboratory animals) or the Sherley Amendment of 1912 which prohibits labeling of medicines with false therapeutic claims (following the death of infants who were given a soothing syrup for colic which was also laced with morphine). The FDA likely had no idea that food labeling would open up a whole new branch of ED obsessions. Shifting focus back to the calorie count as information about quantity of energy ingested is challenging, especially amidst our culture of a preoccupation with aiming for fewer, but it might allow some to actually engage in a bit of a double-take when considering how much energy one might need to make it through that busy day.
The “b word”
Bad is another word which clearly has been overused and has become a catch-all word for anything falling into a category considered potentially unhealthy, unclean, uncontrolled, or unfamiliar. There seems to be an alarming ease with which some individuals can slip into black and white thinking, despite the fact that we actually live in a more rainbow colored world of complex, layered concepts. The “b word” creates an immediate culture of judgment and self-doubt. The finality and decisiveness of the word creates the sense of a dead end wall rather than allowing for the more realistic gradation of nuanced notions.
Instead of “I am bad” or “That’s bad,” perhaps we can help our clients to consider a broader use of the word. The use of the “b word” might actually often reflect times of “I feel bad” or “I worry about if I am unworthy” or “I am scared I might be doing wrong.” Through a broader exploration of various internal sensations, negative memories and potential external triggers, we can go beyond the shutting off that occurs with the use of “bad” and instead aim to uncover more meaningful understanding of the difficulties of the moment.
The “h word”
Healthy is one of those multifaceted words which can mean so many different things to different people. At first glance, it appears to be a word which should be embraced and reinforced; however, any ED specializing clinician knows too well the way in which many individuals with EDs have become hostage to the word and can use it to rationalize many of the behaviors in which they are engaging in service of the ED. “I am just being healthy” can easily serve as a cover for food avoidance or exercise obsession, and support systems can be easily confused and befuddled by the slippery use of this word.
We will likely not have success in erasing all of the rigid meanings of this word in our culture, but we can help our clients to have better understanding of the word in terms of the broader and more authentic use of the word. Good mental and physical health generally includes sound, rational reasoning and balanced approaches to life activities. Helping clients to not use the word as a cover or a distractor for activities but instead to consider true needs of the self and to trust the inner wisdom that each of our bodies possess. Health is not simply defined as just the absence of disease; true healthy living involves taking responsibility for body, mind and spirit in a comprehensive, harmonious way.
The “s word”
The social media explosion in our current culture has clearly impacted many domains of current living, including ED development and recovery. We know how moods, thinking and behaviors can be negatively impacted by a mere click on a page or a post of a stranger. The visual flash of a photo-shopped image or the triggering quip of a struggling individual can go viral in moments, and this can result in literally thousands being impacted. Most know that the images aren’t real, but pictorial imagery is powerful and result in instant comparisons – and, as Theodore Roosevelt is quoted as saying, “Comparison is the thief of joy.” The permanency of the image also results in obsessive comparisons continuing long into the night, increasing negative thinking, body shaming and self-objectification.
We know that virtual connectivity is here is stay, and so we need to keep working on ways to make positive use of social media for connection, for advocacy, and for support. Clients need ways to know how and when to step back, distract or ignore; clinicians can also assist clients to step forward to find recovery-enhancing sites and recovery-supporting virtual friends. Helping to give clients permission to unfriend someone or methods of unfollowing ED-promoting sites is crucial. More and more excellent on-line communities, websites and apps are being developed every month, and we can join, support and advertise those. We may not be able to change the currently large portions of time spent in a typical social media diet, but we can influence the way in which it is used.
With a bit of creativity and ingenuity, those “ED curse words” can be shifted from expletive to explanatory, from profane to profound, and from indecent to indispensable.