The hardest thing she’s ever done in her life, says Beth Mayer, social worker and executive director of Massachusetts-based MEDA (Multi-Services Eating Disorders Association), was to recover from her own eating disorder. She didn’t tell a soul about her struggle until she had graduated from college and started group therapy, though she had been locked in an exhausting battle with it since high school.Her body image problems began when she was even younger, though she couldn’t have defined them at the time.
“I developed very early and became heavier [than other girls] earlier,” says Mayer. “My mother had a weight issue, and was very fearful” about shape and size, Mayer says. “The body, how people appeared physically, became very, very important in my family,” she notes. In a family where “it was very clear that you got praise for being adorable,” gaining weight set off panic alarms for Mayer. While one of her three sisters responded to the situation by gaining weight and not losing it, Mayer figured out how to survive by becoming bulimic and staying severely underweight.
Back in the late ’70s and early ’80s there were few resources for a teenager or young adult fighting an eating disorder. One doctor Mayer saw—when she was at a weight that today would be cause for hospitalization—prescribed potassium and sent her on her way. She gradually recovered by keeping a daily log of her eating-disordered behaviors and working hard at not freaking out when she began to gain weight. By the time she finished graduate school, she considered herself recovered.
Today Mayer declares that not only is full recovery possible for eating disorder sufferers, passing on this belief to her clients (she maintains a part-time private practice in West Roxbury, Mass.) is a key factor in putting them on the path to recovery. Although it’s common to hear truisms in this field such as “you’re never fully recovered,” or “I’ll always be ‘in recovery,’” Mayer is refreshing in her generous take on recovery. “Just because you have [some residual] symptoms doesn’t mean you’re not fully recovered,” she believes.
In her life, it seems, every five or ten years after pronouncing herself newly “recovered,” she reaches yet another level of recovery. The first stage came after graduate school. The second came after having children, and the next stage, she says, came with growing older. “Allowing myself to be gentle with an aging body and continuing to appreciate its strength has been wonderful,” she explains. “I am 56 years old and I just did my first mud run!”
Three years ago, when I first heard Mayer speak, it was unusual, especially for an East Coast eating disorder professional, to publicly declare her or his own past history with the disorder. Although in her part of the country most treatment centers don’t allow staff to disclose if they’ve had an eating disorder, she has been doing so since she entered the field in 1983, and explains that while it’s critical to understand the pros and cons of disclosure, “I have always felt that I have the skill to disclose and that it has been helpful to my clients.”
“The beauty of having recovered is that you understand how stuck you can be, and how scary it can be to recover,” she says; the disorder is hard to shake because it keeps unwanted and overwhelming feelings in the deep-freeze. To her, the most important thing is to believe in full recovery, “that people can really live a life without their eating disorders,” no matter what the trigger, or “how damaged their childhood was,” she says. The other important thing for patients to hear, she adds, is, “I never met a person who has recovered say, ‘I wish I had never recovered.’”
On the topic of relapse, Mayer is equally forgiving. She learned to respond to relapses with a “so what?” attitude. “The idea is not to beat yourself up, but be gentle with yourself. People are so angry at themselves and toward their illness; they beat themselves up continually,” she notes. She came to see that “if I could be gentle with my recovery then I could go on after relapse,” and keep going on to full recovery. Mayer often wondered: “if something horrible” happened in her life, would it send her high-tailing it back into the arms of the eating disorder? The answer, she learned, was that although “many horrible things did happen, I did not relapse.”
Of course we know that all this recovery talk is fine for someone who has actually summoned the courage to engage in the daunting battle to recover one’s health. In a recent article Mayer wrote for The Renfrew Center’s journal Perspectives, she wrote about being able to sense when a patient is ready to take the first step toward recovery. Thirty years of clinical experience has taught her to sense when a client is “sick of being so sick,” and thinks, “What can be worse than this?”
Mayer’s approach is to say to the patient, “It feels like you’re ready to give up a parts” of the disorder, making it clear that the recovery process doesn’t have to be an all-or-nothing deal. She guides her patients in baby steps: “Did you have any symptoms today? How are you doing tonight? Every time you get through another day or night you have that new memory implanted; you’re building new and vibrant memories of recovery…could you read that book for one minute without thinking of your eating disorder? Two minutes?”
In this way, Mayer explains, “recovery is a minute-by-minute process.” The anxiety surrounding giving up the disorder, she adds, is of course immense. “It’s like you’re ripping away [the client’s] security blanket… I say, ‘I’m just putting it over here. You can walk over and get it and hold on to it as long as you want, but then let’s try to give it back.’”
By this stage, the client trusts Mayer and her professional team enough to take these first steps toward recovery. Writing in Perspectives, Mayer sums up her point of view this way: “Clearly, full recovery is possible, and, as therapists, we need to ensure that every client believes in recovery, embraces recovery and takes the journey with us.”