The anorexic identity can be an enormous factor in the development and maintenance of the disease, and the reconstructive task of recovery.
Even before the onset of the anorexic disease process and the behaviors, there is often doubt and confusion about one’s identity. Several factors often add to the confusion of this matter, especially for women. Parental teaching and expectations, sometimes pertaining to gender roles in society, or religious teachings can cause conflict with regard to individual beliefs and life goals. Society’s influence and focus on outward beauty and physical perfection can trigger guilt and a decrease in self-esteem. In an over-controlled environment, the attempt to gain control becomes central. If one is taught how they ‘should’ be, what they ‘should’ believe, what goals they ‘should’ have for their life, and what is and isn’t acceptable, they can begin to look at all things in their life as ‘good’ or ‘bad’.
Interpretations of good and bad may vary, but being ‘good’ usually means people-pleasing, conflict avoidance, and emotional and physical self-control. Emotional self-control usually denies feelings and emotions, “protecting” one from pain. Physical self-control focuses on body perfection, which is displayed in society as the ultimate goal and success. With anorexia, in time, the need for control and the search for perfection evolves into restricting food, losing weight, exercising, and other forms of bodily control. The lack of clear identity and the obsessive nature of the disease, together presents a forum for isolation and protection from scrutiny or judgment.
When weight loss becomes obvious, the positive reactions from others strengthens the resolve and fuels the belief that this is good and acceptable, i.e. more “perfect”. Others may see this as self-control and strength, and an achievement beyond others’ ability. For the anorexic, there is pride in this, and she endeavors to continue to prove her worth and her strength by denying herself. When she is acceptable and successful in others’ eyes, she is “good”. To an anorexic, “bad” is synonymous with weakness, and can be applied to eating, weight gain, uncleanliness (germs), impulsivity, lack of self-control, displaying emotions, and allowing one’s self joy and pleasure. Sleep even becomes “bad”, because inactivity isn’t acceptable. For some, they believe that if their life isn’t difficult and painful, they aren’t working hard enough. In time, this identity strengthens as individuality diminishes, and they are unable to have a rational view of themselves. It becomes important to them in time that others notice the weight loss, even the decline physically, to uphold the identity.
There are numerous psychological factors involved in the maintenance of anorexia, and they may each take on their own personal identity. It’s terrifying for an anorexic to imagine letting go of that identity. Emptiness is perceived without it, along with loss and loneliness. There is desperation in thinking, “who am I without it?”, “how do I find out who I am?”, “will I like who I am?”, “will others like who I am?” etc. This is a process of discovery, and it can not be forced. But it can be encouraged by being willing to take risks in exploring one’s self, reaching out for support, and by challenging past beliefs. In my experience, after many years of maintaining the disease, and after not being successful in numerous attempts at recovery, I felt no pride or accomplishment in that identity. For years, that anorexic identity had been seen by everyone around me, but I felt shame and guilt for continuing to be sick. I hid my body, and pretended that I was fine. I wanted out of the prison I had built, and I wanted to adopt a new identity, yet fear had me immobilized, and I knew no way out.
As I began to recover, giving up that identity wasn’t so hard. As I said, it had become a source of shame for me. I desperately wanted something better for my life. Also, I didn’t return to the environment I had come from, so I didn’t have the same issues that others might have of people noticing and commenting on the physical changes they saw in me. I did however, feel great fear about what my identity would be without anorexia. I knew myself no other way. I can’t fully explain what the process has been like for me. I know that the first and most important issue that had to be addressed was weight restoration and maintenance. Normal brain function had to be restored. Weight stability, over time, has been the key to allowing myself to discover my true identity, and that continues. I feared at first that I would have to develop or create an identity, which seemed overwhelming, until I realized that I had an identity before anorexia, and that I still have it. It just took a lot of hard work to recover it and understand it.
Recovery, to me, is a process which requires repeated times of letting go and allowing yourself to become you. Actually, developing and maintaining an identity is a life-ling process, as we grow, change, live and learn. Life’s experiences, and how we deal with them, also influence who we are. At this point in recovery, I have learned a lot about who I am, and I am able to accept myself, flaws and all. I have become comfortable with my body size, and when I feel discomfort, I am aware that it is not about my body, but that something emotional is going on, and I’m not dealing with it adequately. Now that I know what maintaining a healthy weight has given me, I’m not willing to sacrifice that. Besides, my weight is no longer who I am.