Breaking the Cycle: Why is Stopping Destructive Behaviours in Eating Disorders so Difficult?

In the last two weeks a few of my clients described their difficulties with feeling trapped in the cycle of destructive behaviours their eating disorders create. They voice intense frustration towards these behaviours: Even though they know better, they still can’t seem to break free from them.

The question arises in therapy all too often: “Why can’t I just stop doing the things I do that hurt me and keep me in this eating disorder?“.

Let’s dive into four more common reasons behind destructive behaviours within eating disorders, and provide the broad remedy process for each.

Reason 1: The Comfort of Avoidance

Eating disordered behaviours often serve as a way to numb or avoid difficult emotions. In the short term, they might provide relief, but in the long run, they prevent the development of healthy methods to cope with life’s difficulties.

The co-occurrence of eating disorders and anxiety disorders frequently arise, and with it, Fear models and the identification of Fear as a possible treatment target becomes a plausable venture for eating disorders treatment. Within eating disorders, Fears can typically be focussed on fears of food, eating, unpleasant physical sensations, body shape, and weight. Fear of loss of control, fear of failure, as well as fear of negative social evaluation from others represent more complex emotional fears.

Some research has hinted the role of avoidance in the development of anorexia nervosa, positing avoidance as an important mechanism in its maintenance. In short, the more fears the eating disorder client presents with, the worse their potential prognosis as the mounting fears create more problems that need be resolved (or learned to be coped with). As a mechanism to avoid these fears, eating disorder behaviours can be used in ways that help the client avoid facing their fears. In this manner, eating disordered behaviours often start as a way to manage these fears, but they quickly become problems in themselves. This paradox is at the heart of why letting go feels so daunting – your eating disorder (and the behaviours) becomes your stable anchor you rely on, but also keeps you from breaking free and learning to face your fears.

The Remedy Process

Even though this would never be a simple answer, I would advise that you start working towards ceasing avoidance. This would involve three broad steps.

1. Cease destructive behaviours (easier said than done for someone who relies on this to help manage feelings).
2. Start embracing life’s difficulties by ceasing to avoid problems or things that cause discomfort. This includes being willing to move into the discomfort of facing problems.
3. Develop healthier and better ways to cope with discomfort, replacing destructive behaviours with healthier alternatives.

Reason 2: The Neural Pathways of Habit

Our brains are remarkably adaptable, being able to change structurally and functionally in response to internal and external stimuli. For survival purposes, your brain’s job is to develop a suitable and accurate model of the world around you. Much of this adaptation is done during key developmental periods like childhood and adolescence.

But this plasticity can work against us when it comes to eating disordered behaviours. The longer you engage in certain behaviours, the more entrenched they become as part of your neural pathways and behavioural repertoire. Even though the brain can change and adapt, it would not easily do so because of the strength of these neural pathways established. In fact, the brain would be quite reluctant and resistant to do so. For example, brains quickly learn anxiety-avoidance strategies (because anxiety is threatening and developing methods to cope with that would be high priority), and become reluctant to let them go – especially if these strategies effectively helped you survive a difficult experience or period of your life previously. Once these strategies are entrenched, your brain will likely resist to change them.

And so later, when your life circumstances change, and new updated models of coping with the world need to be developed, the brain inherently resists to do so. Even though it is possible, this would require repetition. A rudimental example would be if you want your brain to learn how to hit the perfect serve in tennis. You would need to repeatedly engage in hitting tennis balls with perfect form for a substantial period of time for the brain to adapt. Similarly, if you want your brain to produce less anxiety during exams, you must frequently and repeatedly expose it to test situations and practise strategies to sit within that anxiety and uncomfortability. The process is the same during recovery, and the same principles apply. Repetition is key.

The Remedy Process

The behavioural fix would be to replace the destructive behaviours with better, more appropriate behaviours that serve you better in dealing with what problem or feeling you’re facing. This can be very difficult, as your brain and automatic reactions will default back to behaviours/methods you’ve previously used to deal with these issues. But every time you can divert from these, and use new and different ways of coping, you inherently condition your brain to forming new neural connections, that bolster and strengthen with repetition.

Reason 3: The Chamber of Self-Defeating Thoughts

Many of my eating disorder clients report difficulties with negative and self-defeating inner talk. They present with strong and rigid inner critics that take any opportunity to highlight their shortcomings, and minimise their successes. This inner critic may punish them harshly if they perceive they’ve failed to uphold certain standards they deem as important. Mistakes have the potential to derail their mood, re-enforce negative self-talk, and ultimately perpetuate using self-destructive behaviours. Research has shown that up to 72% of clients with eating disorders also engage in non-suicidal self-injurious behaviours like skin-cutting, self-hitting, self-burning and scratching; These types of behaviours further exacerbate the negative inner self-talk.

The Remedy Process

These internal narratives align perfectly with destructive behaviours and create self-fulfilling prophecies (that motivate further destructive behaviours). Breaking free from this self-critical attitude and self-defeating inner talk can be truly difficult, but it must be done in order to allow for self-respect and self-care to happen. Even though some general recommendations exist: Positive affirmations; learning self-forgiveness; encouraging self-respect; challenging the inner critic – these are complex and time consuming steps that require the buy-in and willingness from the client. I would have clients begin with a hard think about the relationship they want to develop with themselves, become aware of the self-talk they use on a granular level, and try to then be intentional in how they alter their self-talk. Self-talk will always be happen, but we can be mindful about the words we use, and the tone in which we talk to ourselves. Self-respect is not a feeling, but rather a choice that I must make consciously and intentionally.

Reason 4: The Illusion of Control

In a world that often feels unpredictable, eating disordered behaviours can provide a false sense of control. This is particularly relevant in society today with rapid change and pressures of modern life. Stress and its management are very relevant to most peoples’ lives, including those living with eating disorders.

An eating disorder may offer temporary distraction from chaos and a false sense of control, alleviating stress and worry. By engaging in eating disordered behaviours, clients often describe a sense of invincibility or immense strength. However, when these behaviours become part of your life for long enough, they inevitably block you from dealing with what’s causing you stress in the first place.

In reality, restricting and controlling the way you eat doesn’t actually help you with any of the problems and stressors of life you face. For example, you aren’t going to change how someone treats you at work because you work on losing weight, or learn how to install healthy boundaries with a co-worker unless you face the issues at hand.

The Remedy Process

Real freedom comes from realizing that you cannot control much in life. Simply put, things will happen that you cannot predict, that you cannot change after the fact, and that you will have to face up to (in the end). All these issues are part of the human experience, and accepting that they are out of your control can actually help you in starting to face them. You can control how you respond to those events in a way that is positive for your mental and physical health, and you can regain power over those situations by adapting and finding new and alternate coping strategies. Perhaps not easy, but it is possible.

Breaking Free: The Path to Recovery

Breaking free from destructive eating disordered behaviours is challenging, but understanding the reasons behind their persistence is the first step towards recovery. No matter whether your struggle with one or two mild behaviours, or whether they rule your life to a high degree – climbing out of destructive eating disorders behaviours is part of recovery, and will require your full and focusses attention.

Seeking help is a sign of strength, not weakness. If you’re struggling with a eating disordered behaviours, reach out to a family member or a healthcare professional, and get the help and support you need. Take the first step towards a healthier, more fulfilling life today.

Visit www.reverencerecovery.com.au to explore more resources and learn about personalized treatment options that can help you reclaim control over your life and well-being.