1. There Is No One Definition of ‘Recovery’
“I think the eating disorder field is pushing for full recovery for everyone, and yet we’re still not defining what that actually means,” Tarpley says.
While writing her book, Tarpley asked more than 700 people with lived experience with an eating disorder whether they identified with her concept of the middle place, and about 85 percent said yes. “I described it as this liminal, gray space between acute sickness and full recovery, where you’re trying to make progress, but you still slip, and your recovery is imperfect,” she says. “I realized how this middle place is so prevalent, and yet we don’t talk about it,” she says.
Just as eating disorders look different for everyone, recovery does, too, says Rachel Goldberg, a licensed marriage and family therapist and an eating disorder and infertility therapist in Los Angeles. “Factors like the type of eating disorder, how long someone has struggled, family dynamics, age, and where they are physically and emotionally all shape the process,” she says.
2. Recovery Is Fluid
The way full recovery was often presented to Tarpley early on made it feel like a finish line to cross. In reality, she’s found it to be more fluid. “It’s about trying to make progress, but knowing it’s imperfect,” she says.
Tarpley says she hopes that defining and talking about this “middle place” of eating disorder recovery helps make healing more doable for others.
Setbacks are absolutely part of the healing process, Goldberg says. If you’re working with a therapist during eating disorder treatment, for example, Goldberg says they can try to help you understand how to respond differently moving forward.
3. Relapse Is Common
Tarpley considers relapses to be different from slips, lapses, or collapses, defining these terms as follows.
- Slip An unplanned, one-time deviation from the treatment plan
- Lapse A more significant engagement in eating disorder thoughts and behaviors over a period of time
- Relapse A repetitive pattern of eating disorder thoughts and behaviors with an inability to get back on track
- Collapse A worsening relapse that requires higher levels of care
Destigmatizing the middle place in recovery could reduce the risk of slips and lapses becoming relapses and collapses, she says.
She titled her book Slip for exactly this reason. “So often we tell people slips shouldn’t happen in an ongoing way, and yet so many people continue to struggle,” she says. Denying that setbacks happen as a natural, common part of recovery perpetuates stigma and shame, she adds, noting that this can make people more self-critical and less likely to ask for help.
One of the best ways to lessen stigma around slips is to stop calling them relapses, Goldberg says. “That word often carries a sense of failure or wrongdoing,” she says. “Periods of struggling with eating, food, or body image happen even to people without eating disorders. Expecting that all unhealthy thoughts or habits will disappear forever is unrealistic.”
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