The Role of Self-Expression in Recovery

Louise Glück, a Pulitzer prize-winning poet who was anorexic in her youth, says in her essay, "Education of the Poet," The tragedy of anorexia seems to me that its intent is not self-destructive, though its outcome so often is. Its intent is to construct, in the only way possible when means are so limited, a plausible self.

It"s easy, growing up, for girls to get confused about who they really are. By middle school, they have been exposed to thousands of messages about the necessity of being nice, sharing, and being polite, but not a lot about how to be authentic and assertive. Although teachers, parents, and other influential adults can often be healthy role models, the media bombards them with images of women who are smart, athletic, hyper-thin, and cosmetically beautiful. Impossibly perfect. Most are affected to some degree; some develop eating disorders. The effort to measure up to impossible standards can overpower the development and expression of a girl"s true self. Her most unique thoughts, ideas, impulses get pushed offstage, locked out of the action, and eventually, forgotten. She ends up uncomfortable in her own skin without understanding why or what would help.

Mary Pipher, in her book, Reviving Ophelia, calls this "the problem with no name." The problem with no name, experienced as internal emptiness and loss of direction, provides ripe ground for an eating disorder.

Yet it deserves repeating: The initial intent of an eating disorder is self-preservation.

The eating disorder, the substitute "plausible self," based on deprivation, refusal and a rigid system of controls, offers a false sense of purpose, and a sense of safety at first, even exhilaration. The various rituals and weight loss compensate for perceived deficits and shut down inconvenient emotions. But then, inevitably, the eating disorder overfills the emptiness it"s meant to address, saps energy, distorts reality, and drowns out the inner cues that should be providing guidance.

Recovering from an eating disorder, then, involves not only learning normal eating and dealing with eating disordered thoughts, but also with restoring access to those inner guides.

Client example—Ann

One of my clients—let"s call her Ann— told me that when she was little she loved to dance on the lawn in front of her house. By the end of sixth grade, however, she grew uncomfortable with dancing in public. Her mother told her repeatedly not to show-off, emphasizing that Ann"s dancing talent might make other girls jealous and sad. Ann cared about other people"s feelings. If dancing outside could cause someone pain, then, she had to stop doing it. Ann continued her ballet classes but her dancing changed. She remembers it like a light being switched off, the loss of spontaneity and ease. This loss, on top of other complications in her life (her inherited tendency towards depression, her father"s alcoholism, for instance), affected Ann"s self-esteem. By the time she was 13, she was convinced she was ugly and stupid. Losing weight, she thought, would at least cure the ugliness. She began dieting and didn"t stop until, at 15, she entered treatment for anorexia.

An important part of Ann"s eventual recovery was rediscovering what gave her pleasure and reclaiming the free-spirited child who"d danced on the lawn. As Ann worked with her team to learn to eat in a healthy way, she also began to reclaim her body. She started with simple self-awareness exercises, then some writing assignments (examples follow). Soon she was dancing, free-style, to her favorite music. She regained strength and stamina, and found she enjoyed movement again. By the time she graduated high school, she had restored both her weight and her love of dancing.

What Ann did, and what I"m suggesting here, is a three-step self-reconstruction.

Step One: Re-establish Baseline Health

The first step involves physical health, changes in eating, and being kinder, overall, to yourself. Self-discovery has to start from a strong base: adequate nourishment—for both body and spirit—so that you have the energy to do the rest of the work. When you"re underfed, overstressed and sleep-deprived, the sensations that indicate emotions, needs, and impulses get muted. Your internal navigational system—designed to keep you balanced and pointed in the right direction—gets toned down, like a hushed voice in a dark room. In order to know yourself, you have to turn up the volume.

Step Two: Get to Know Yourself

The second step involves learning to pay attention to that internal navigational system so you"ll get clearer about what"s true for you, what you like and don"t like, what makes you happy or sad, what goals excite you. The signals will be subtle at first. In fact, you"ll need to train yourself to notice them, by listening to your body, your emotions, and your inner voice. If you practice self-awareness (using the following exercise or another you prefer) for a few minutes every day, you"ll create a habit of checking-in with yourself. You"ll become an expert on you and therefore less subject to other people"s expectations about who you should or shouldn"t be. You"ll become your own person.

Here is one way to tune in: Sit in a chair with closed eyes. For a few minutes, notice the physical sensations of breathing. Notice how it feels to sit as you are right now. Where do you feel the pressure of the chair? Where do you feel your clothing against your skin? What thoughts run through your mind? (Don"t latch on to them; notice them as they go by) Where is your body tight? Where is it more comfortable? What images do you see in your mind? (Notice, don"t judge.) Remind yourself again and again that you are okay, whatever your sensations, thoughts, feelings. Do this for 2-3 minutes at first, longer as you get the hang of it.

Step Three: Express Yourself

Step three involves expressing yourself in some way, shape, or form. This can mean, for example, speaking up when you"re angry, expressing appreciation or affection, or asking for what you want. You can even express yourself through any kind of art. Working with materials like clay, paint, or pencils, can engage you, wake you up, calm you down, and connect you with feelings. So can writing, music, or movement, if those forms of expression are more comfortable for you.

Whatever art form you choose, though, remember that there"s a difference between art as therapy and art as product. Therapeutic art, whether it is through images, words, or the like, is exploration. It"s about letting your brush, pen, or keyboard take you where you need to go. No plan, no map. Just a starting point. The result needn"t be—usually won"t be—pretty. Think mud pie rather than masterpiece. More nursery school than art institute. Process not product.

This kind of free process is useful in several ways. It can help you discover what it is you're thinking or feeling in that moment. It can also provide a way to externalize the background chatter that fills your head, to get it outside of you so you can find out what else is on your mind. And, even when no great revelations accompany your expression, you may find it relieving, calming, and a whole lot of fun to do.

Here is an example of a writing practice technique: Set a timer for 15 minutes and write without stopping. Any topic. Keep it simple: a time you lost something, a description of your childhood bedroom, the color blue. Anything. Don"t fix punctuation or spelling. Go wherever your pen wants to go. Don"t stop until the timer goes off. Again, the point is to allow the process to unfold without judging the product.

By now my message should be clear: art and writing aren"t essential to recovery, but self-expression is. Every one of us has a need—and a right—to be our own imperfect, quirky, self.

It may be that your self-expression involves creating a business, planting a garden, or being a good friend. It might be how you combine styles, fabrics and colors in the clothes you wear. Or it might simply be the way you lead a life of integrity and truthfulness, every day. No matter what you choose, when you live your life as an ongoing expression of self, when you tell your truth, do what you enjoy doing, and match your actions to the beliefs that are dear to you, there"s not much space left over for an eating disorder.