A Half-Baked Cake?

This is too good to not share:
I rec’d this from someone from the ED coalition:

Apr30
When I was at the Congressional Briefing following the EDC Lobby Day this past
Tuesday, I heard the clinical director of the Renfrew Center in Bethesda, MD speak. Mainly she spoke about how managed care has dramatically changed the treatment of eating disorders–and not for the better. One of her comments really hit home with me, when she said (approximately) the following:

Normally, you look in a cookbook for how long to bake a cake, and the recipe says to bake at 350 degrees for an hour. Managed care operates under the premises that you can make the cake at 500 degrees for 20 minutes and still have a finished cake. The irony is that often the cake looks done on the outside, but the inside is still completely raw. And if you let the cake sit for any length of time, the uncooked interior causes the whole cake to collapse.

The parallels to eating disorders are obvious: as soon as you start to “look” or outwardly seem better (i.e., the outside of the cake looks baked), the heat is turned off, the support is removed, and the whole thing collapses because it can’t yet support itself. The analogy transcends issues related to managed care and really has to do with how we view eating disorders.

We need to start seeing the initial phase of weight restoration and normalization of eating behaviors similar to detox from addictions–it’s a necessary first step but far far from the last. Furthermore, intensive, ongoing support is still needed after detox and weight restoration so that brain healing can take place and the person can learn how to overcome their tendency towards substance abuse or eating disorders.

Although the Renfrew director and I differ on why care needs to be continued after initial weight restoration (for her, it’s the need to address the root cause of the eating disorder, which I think is mostly bollocks; for me, it’s the need to allow ongoing brain healing and begin to learn and use better skills to deal with life), I do agree with her on the priority of weight restoration and the need for intensive support long after you start to look “better.”

Maintaining a healthy weight is still hard for me. I have made huge strides, yes, and the higher weight has really helped to start to cement some of my recovery in my brain. But I still need a LOT of therapy to help me learn to turn off that knee-jerk response of lose weight-restrict-control-
control-control that my brain seems to have when faced with basically any kind of stress. My perfectionism is alive and well–perhaps because I can’t bury it exactly six feet under.

My cake isn’t fully baked yet, no matter how good the outside looks. I don’t blame people for getting impatient- heck, I’m getting impatient. But the cake needs to stay in the oven and my therapy and support need to remain in place until the cake is baked.

And then I’ll probably have to frost the damn thing
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Don’t you wish that ALL supposedly ED ‘professionals’ understood this, as well as the people around you who just don’t ‘get it’? I hope this will help all of YOU to keep in perspective what an important and complex process recovery is, and to NEVER GIVE UP!!