Social Connectedness and Eating Disorders by Ashley Solomon, PsyD, CEDS
A patient I treated several years ago remarked that her eating disorder had become her closest friend, her most trusted confidante. To consider letting go of the behaviors that comprised her disorder meant, to her, severing the one connection that she saw as sustaining her. To let go meant allowing the feeling of being alone – and that was terrifying. At their very core, eating disorders are illnesses of disconnection. These disorders sever the individual’s connection between one’s own mind, body, and spirit, separating one’s physiological needs from one’s behavioral responses. They also sever connections between an individual and the people around them. Deep inside the throes of an eating disorder, there is little room for relationships with others. Individuals in recovery will reflect that during the course of the disorder they hid away from everyone and anyone that might have threatened the disorder. Or they were too busy engaging in eating disorder symptoms to socialize. Or they just didn’t have the emotional or physical energy to see friends or family. The relationships that do continue during the course of the disorder are often fraught with tension due to depression or irritability, or remain shallow and lacking meaning. People often describe feeling lonely in a crowd of people. Even while feeling that everyone might be evaluating their body negatively, they describe feeling virtually invisible. So it makes sense then that the idea of recovering from an eating disorder – even with the promise of better and truer relationships – can feel terrifying. If the eating disorder has provided the illusion of comfort and solace in a lonely world, what might it mean to live a life without it? Recovery, full recovery, to me involves developing social connectedness. We know that social connection is one of the most crucial components of both our physical and emotional health. Lack of social connection has been established as a significant risk factor for many chronic diseases, like hypertension, diabetes, and cancer. It’s also associated with stress, depression, and poor health habits, like smoking. It also prevents people from getting healthcare and support when they need it. It makes sense that individuals may be more at risk for eating disorders, or for relapse into eating disorders, when they lack social connection. So, what does it meant to develop social connectedness? Enhancing social connectedness involves a willingness to develop new skills and strategies to create and sustain relationships. Treatment for eating disorders should involve opportunities to learn and try out new ways of relating to others. For example, we know that individuals who are at risk for eating disorders, particularly anorexia nervosa, tend to have traits associated with more inhibited emotional expression and may have a hard time communicating their feelings in ways that bring people closer. Teaching individuals ways of expressing themselves more fully and effectively can lead the development of more intimate and satisfying relationships. I once read that “relationships replace eating disorders.” While eating disorder recovery is complex and multi-faceted, the development and enhancement of relationships is a key component. We hope that a life of recovery is so full of satisfying relationships that there is no room for the eating disorder’s false companionship.