When Someone Loses Hope

I was sitting with a woman recently who told me that she felt so hopeless. She was caught up in a binge and purge cycle of her eating disorder to the point that she was having a lot of difficulty stopping. We sat and spoke about various strategies she could use to disengage her behaviors, but I could feel the fear and anxiety in her that she wouldn’t be able to control herself when the urgency to purge began to rise.

The question of what to do when the person we are working with loses hope is something that we are all likely to face at some point. It is a difficult question to answer.

In reality, it is possible the person we are working with who is struggling with an eating disorder may die from the disorder. About 10,200 people die as a direct result of an eating disorder each year (Website, n.d.). Over 25% of people with an eating disorder will attempt suicide (Arcelus et al., 2011). Suffice to say, the work we do helping people overcome their eating disorder is serious business.

So the expectation we must have for ourselves is to sometimes hold hope for the hopeless without becoming overwhelmed. I have found that it is necessary to radically accept that I cannot make someone recover. I can only do my best to create an atmosphere where the individual I’m working with begins to feel empowered to recover.

I have to monitor and manage my own emotions. It is unhelpful for me or for the person I’m working with when I express frustration or anxiety when suggestions of interventions are met with doubt and skepticism, or when this person repeatedly tries and fails to control those behaviors.

For me, the key has been to be patient in consistently offering support, focused on the issue by not getting distracted from behavior change, and constant in the message that this person holds value. I also have to recognize that my sadness or frustration or fear are real and valid and need to be accepted and valued by myself. These emotions are not things I should avoid, but which I need to sit with and move through, just like I encourage the people with whom I work, to do.

With this woman who felt so hopeless, her longing and desire has been that someone would give her a pill, or design a custom treatment, or identify a specific trick that would make her stop her behaviors instantly. She wanted magic. Sadly, there is no magic to recovery. For her, it must begin with eating a snack or meal, feeling the urge to purge and then not purging, no matter how urgent the feeling becomes, then repeating that over and over again until the thoughts and urges and emotions no longer have power over her behaviors. The hopelessness she feels is due to the fear of sitting with that discomfort and her intense desire to avoid it at any cost.

So, I continue to hold hope for this person even though she has none. I continue to offer whatever support I can and try to find different support when what I’m doing is inadequate. I continue to allow myself to feel and work at balancing my own life with the challenges I face in every area of life.

Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724–731.

Website. (n.d.). Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.

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*The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders and not intended as endorsement by iaedp™ Foundation, Inc. or its Board of Directors.*

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