The Role of Resilience in Recovery
Resilience is the ability to adapt well in the face of adversity, trauma, or stress. While psychological resilience has been well studied in the field of disasters, it is also applicable to the process of recovering from an eating disorder (ED), which requires many life changes and shifts in order to regain healthy functioning. Just as with a devastating hurricane or traumatic accident, an ED can affect the physical, emotional, cognitive, biological, and spiritual well-being of not only the individual, but also his or her friends and family. Feelings of being distressed, numbed out, irritable, confused, helpless, and overwhelmed are not uncommon. Finding positive ways to cope is critical for handling any personal difficulty, and building critical skills of resiliency can be part of a tool kit for healing from an ED, as well.
In exploring how the concepts of resiliency might be applied to recovery from an ED, it occurred to me that asking clients for their feedback might yield important and valuable information. This led to the development of a brief, informal survey, which I gave to a number of clients in the middle to end stages of recovery. Each survey contained a copy of a tip sheet entitled, “10 Ways to Build Resilience” from American Psychological Association’s Road to Resilience booklet. I included this as a way of orienting them to the concepts of resiliency and possible application to improving eating and body image issues.
More and more psychological research supports the notion that humans have inherent abilities to be resilient, but there are certain behaviors, thoughts, and actions individuals can incorporate, which build skills of resilience including: accepting the adversity, choosing to have hope, changing thinking, making connections, embracing actions and learning from the adversity. For those who chose to participate in my survey, the following thought-provoking and helpful points were revealed.
1. Accepting an ED as an Adversity to Overcome
Certain events and conditions in our lives can sometimes interfere temporarily with smooth functioning—and having an ED is no exception. As anyone working through recovery knows, accepting that a certain adverse situation indeed exists and needs to be overcome is a vital first step towards change. We can’t alter the reality of our situation, but we can choose to see it as something with which we can deal. I wanted to see if clients viewed their ED as a type of trauma or adversity and indeed this seemed to be the case:
“Yes, definitely. At its worst, it felt overwhelming and insurmountable!”
“I would consider my ED to be a trauma. At my worst, I was barely functioning mentally or physically…The effects that it had on my relationships, on my schoolwork, and on my body were life-changing and it was an extremely difficult fight to take on.”
Accepting the current situation is critical, because it then allows us to move on to the next stage of accepting that the current problem is not insurmountable.
2. Choosing to Have Hope
Having hope is an integral part of resilience. ED recovery is difficult work, and staying energized and motivated to carry on despite doubts, uncertainties, panic, and various other uncomfortable emotions is important. Maintaining an optimistic outlook and visualizing forward progress, rather than staying stuck in fears or “what-ifs,” is fuel for positive change. Hope may not, however, be automatic; often we must create ways in which to choose to have hope. Trusting that recovery is possible can be invaluable.
One woman aptly described how she initially found her hope in others, before she was able to develop her own:
“Reading memoirs/stories of others—I craved positive, successful, role models of others’ resilient journeys back.”
The fact that other people—family members, friends or treatment team members—have hope and optimism about our recovery is also critical. This concept was reflected in the following response about one person’s turning point:
“There was one day when I realized that my therapist was completely certain that I had the ability to recover. That really had an effect on me because her confidence made me believe that I was capable of recovering—something I had questioned up to that point.”
Choosing to trust and believe in our ability to bounce back from adversity can be tenuous at first, but ultimately can flourish into a momentous orientation change.
3. Changing Our Thinking
Reframing our thinking and stepping back for a larger perspective is a helpful tool in most any stressful circumstance, but especially in recovery from an ED, where there is such a myopic focus on body and eating myths. Taking in the broader context and considering possibilities from various angles is a whole new way of perceiving, which can be accomplished through psycho-education as well as practice.
Most individuals in recovery eventually come to accept that they can’t “believe” everything they “think” and prove to themselves that there indeed might be different truths in existence. This flexibility and objectivity eventually lead to a different relationship with food and the body. Several individuals who completed the survey eloquently identified one of the key steps to their recovery success as being related to a change in their thinking:
“Because of these mere months that I’ve spent trying to re-work the wiring in my brain—to sort out the distortion and the negative voices from the positive, rewarding ones—my life has been enriched and I’ve engaged myself in thoughts and actions and experiences unlike I’ve ever had in the past.”
“Mind over matter! [ED Therapy] taught me the power of the mind, which led to concepts and practices used toward my recovery. The ability to not believe all thoughts allows me to better regulate my response to stressful situations.”
“[The work] helped me with cognitive distortions and helped me with not seeing crises as insurmountable problems by reframing situations.”
4. Making Connections
Caring and supportive relationships are significant in recovery from any hardship or adversity. Friends and family members give us the opportunity to experience love and encouragement during a difficult time, while simultaneously allowing for the important practice of skills, such as communication, problem-solving, and alternative perspective-taking. It can be hard to connect with and trust others again, as so much of the ED relies on secretiveness, but being heard, accepted and understood by the significant people in our lives has magical healing power. This concept is exemplified beautifully in several survey responses:
“Most important for me was getting involved with people again, letting people in and letting them know me for the first time, and, in turn, getting to know myself more deeply…being true to what I wanted and was passionate about.”
“I am much better at telling people when I have bad body-image days so they can know where I’m coming from and how to help me.”
For those of us who have a hard time asking for help, it’s helpful to remember that healthy relationships usually provide opportunities for both parties to benefit. Assisting others in need is often tremendously beneficial for the helper as well as for the helped.
5. Embracing the Action
Developing realistic goals is important, but steadily working towards them is just as critical. Baby steps allow us to try out unfamiliar behaviors, whether with a new food, new boundary, or new way of looking in the mirror—without feeling immediately overwhelmed. Although it is easy to fantasize that our problem would just go away or resolve itself overnight, the foundation for a healthy life is built by taking the necessary steps through recovery. Taking action was readily identified by several of the survey respondents as an important part of their journey:
“Yoga…allows me to focus on my body in a different way than I did when I was still in the grips of my ED. Rather than just seeing myself getting bigger, I feel myself getting stronger. I’m growing into myself.”
“I always try to start out my day looking in the mirror and finding at least three things I like about myself.”
“For me, it was songwriting.”
“[I got] a ‘ME’ book that had questions about one’s likes, feeling, etc. —it was a major step towards thinking about myself and connecting with my own beliefs and interests.”
Each person prioritizes different actions, and this reflects the exciting and complex nature of each unique individual.
6. Learning from Adversity
People generally don’t seek out trauma, adversity, or illness, but these situations do occur. Fortunately, and maybe somewhat ironically, there are often some surprising benefits that emerge as a result. A relatively new concept of “posttraumatic growth” has prompted psychological scientists to explore and validate some of these positive outcomes. Some of the potential benefits include enhanced social resources, improved self-understanding, better relationships with support systems, assertiveness, empathy, maturity, and improved coping skills. This idea was reflected in the following unique and potent ways:
“I have become a much more empowered and stable woman. I have a perspective on weight bias and objectification of women in our society that I may never have understood had I not sought therapy for my ED.”
“I believe I have more empathy for people in all stages and walks of life.”
“The most important good that came from my ED is an awareness that change is possible, and that there are many different kinds of strength.”
“There is a certain kind of bravery that comes with beating an ED. Sometimes just knowing that you didn’t just survive, you conquered the ED makes you feel like you can handle anything thrown your way, because you literally fought for your life and won. Who wouldn’t get something positive out of that?”
Like the ED recovery journey, the resiliency journey is a personal one: each individual must choose what works best for him or her.
Some factors affecting resilience aren’t in our control, such as heredity or early life experiences; however, others can be intentionally and purposefully developed. Harnessing our natural powers to rebound as well as developing newfound skills—and becoming stronger in the process—can and will maximize the progress in ED recovery.
As I had hoped, the feedback from survey participants was thoughtful, inspiring, and indicative of resilience in action.
APA tip sheet, “10 Ways to Build Resilience” see: www.apa.org
Flach, Frederich. Resilience: The Power to Bounce Back When the Going Gets Tough. New York, NY:Hatherleigh Press, 1997.
Siebert, A. The Resiliency Advantage: Master Change, Thrive Under Pressure, and Bounce Back from Setbacks. San Francisco, CA: Berrett-Koehler Publishers, 2005.
Seligman, Martin. Learned Optimism: How to Change Your Mind and Your Life. New York, NY: Simon Schuster, 2006.
Tedeschi, Rich, Park, Crystal, & Calhoun, Lawrence. Posttraumatic Growth: Positive Changes in the Aftermath of Crisis. Hillsdale, NJ: Lawrence Erlbaum, 1998.
Wicks, Robert J. Bounce: Living the Resilient Life. New York, NY: Oxford University Press, 2009.
by Sandra Wartski, Psy.D.
Silber Psychological Services, Raleigh, North Carolina
reprinted with permission ©2012 Gürze Books
About the Author:
Sandra Wartski, Psy.D. is a licensed clinical psychologist who works with Silber Psychological Services in Raleigh, NC. Dr. Wartski specializes in the treatment of eating disorders, affective disorders, crisis work, and family issues. One of her favorite volunteer positions is engaging in outreach through NEDA, the National Eating Disorder Association.
Dr. Gnap website editor eatingdisordersrecoverytoday.com. Dr. Gnap is a family practice physician and behavioral medicine specialist in suburban Chicago. Dr. Gnap developed the Inner Control™ Program in 1970 and has worked with thousands of people to improve and correct medical, emotional, behavioral and learning problems including performance.