Every person with an eating disorder I have ever met had low self-worth, and recovery from an eating disorder does not happen unless self-worth is restored. We place a lot of emphasis on changing attitudes about food, gaining nutrition information, challenging the thin ideal, “saying NO to ED” but I am convinced that all these good recovery habits don’t take root until the person can grant herself permission to take care of herself.
When someone has high self-worth, that person feels worthy of self-care, and both are essential to recovery from an eating disorder. It is typically a gradual process. We believe everything we do, so every time that we accept or solicit nurturing from others, every time we spend an hour on our own well-being or allow someone to understand and respond to our pain, we are building self-worth, which then builds self-care.
Low self-worth is expressed in a myriad of ways, including:
- The tendency to protect other people at the expense of protecting the self (she said something really rude to me but I just laughed it off because I didn’t want to embarrass her).
- Putting the preferences of others above the needs of the self (Dad mentions the need to conserve water so now the son only showers once per week).
- Not asking for help when help is needed (when a husband asks his wife what is wrong and she says “nothing” because she doesn’t want to burden him with her problems).
- Not being willing to change the CD in her car or wear her favorite clothes because she feels self-indulgent when she does.
A person with self-worth problems often resents her or himself for having needs at all, and sees the denial of these needs as a sign of strength, as a protection of other values, or as a necessary assurance that the needs of others will be met. Unfortunately, the better a person becomes at neglecting the needs of the self, the lower self-worth becomes, the lower self-care becomes and the worse symptoms get.
Help your child build self-worth in the following ways:
- Support your child in attuning to and nurturing his or her needs. This is harder than it sounds since once an eating disorder sets in, the symptoms become the voice that drowns out all others, but work together to find enjoyable things to do.
- Avoid comments that generate guilt, because guilt can create a feeling of not being worthy to meet one’s needs.
- Encourage the use of internal boundaries to prevent overwhelming and impossible social role obligations.
- Encourage the person with an eating disorder to “take space” in the world, which means allowing others to see her needs, being vulnerable to asking for accommodation from others, extending self-forgiveness for perceived transgressions and remembering to value the experiential needs in life as much as we value the achievement needs in life.
Remembering to value the needs of the self as much as we value the needs of others is essential. One thing I frequently say to my clients when I implore them to take space is from Desiderata: “…be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here.” We recover when we meaningfully embrace that truth within ourselves.