Elijah: Creating My Own Recovery
Anxiety, Rigidity & ARFID
I became fascinated by psychology at age ten, around the same age that I began listening to the nagging thought in my mind: If you eat, you’ll get sick. I grew up a skinny, androgynous child, buried in thick books and too-large clothing. I had sensory issues, could not tolerate changes in temperature or clothing that “felt wrong,” or any aspect of the environment that I deemed “too loud,” “too bright,” “too crowded,” or “too overwhelming” in any other capacity. I was described as “difficult,” by my parents, “weird,” by my peers, and “interesting” by other adults. Social clues eluded me, and my mind struggled to make sense of the world around me; the expectations and unwritten rules of how to interact. I didn’t have interest in making friends; people were too dynamic and changing, and I preferred rules and routine within which I could exercise control. It is perhaps fitting, then, that I developed a phobia of vomiting, what I perceived to be the ultimate loss of control. I began struggling with anxiety and panic attacks when I was seven years old, all focused around getting sick.
Eventually, the fear of vomiting manifested in chronic stomach aches and nausea (in hindsight, likely a combination of anxiety and lack of nutrition) and I became convinced that almost any food would make me ill. I had no body image issues, but what we now understand to be the symptoms of ARFID [avoidant-restrictive food intake disorder] — fear of food making me ill, lack of body image issues, sensory difficulties, weight loss in the absence of an underlying medical condition, fear of foods other than those considered “safe”– was diagnosed as anorexia nervosa. was sent to an inpatient eating disorder treatment center in sixth grade, surrounded by older teens and adults where, in a barely supervised cesspool of self-starvation, I learned to hate my body.
I was later diagnosed with ARFID at age nineteen, the same age at which I first heard the label “severe and enduring” applied to my diagnosis of anorexia.
"I didn't want to die."
The years went by, with brief stints in outpatient programs and one helpful stay in a residential program, but I always slid backward and ended up losing the small amount of weight I’d managed to gain, and my rituals, now including exercise, became more entrenched. My world consisted of counting, panicking, and academics, the latter of which I clung to like a lifeline. My recovery came not from a place of self-love, but rather a last-ditch attempt to save my own life. I was tired of hearing that I was a lost cause, I was tired of reaching out for help and being told that I was “too severe.” “Too complicated.” “Too medically unstable.” I was tired of every initial consultation that ended in defeat or yet another referral to someone who might be able to help me but would ultimately decide I was “too much.”
I have always been hyper-independent, reluctant to rely on anyone. If I was going to recover, I knew it had to be sustainable, a method that wasn’t dependent on the variable nature of others. I loved structure, I loved routine and rules. People are not static. They are complex and changing and confusing to figure out. Psychology helped me make sense of my interactions with others and gave me a context within which to socialize. I craved not to be taken care of, but to take care of others. I wanted to be the help that I wish I had been able to access for years.
In October of 2022, my body began to shut down. I collapsed while out for yet another walk and was brought to the emergency room, where I was hooked up to an IV and heart monitor that sounded an alarm every time my pulse dropped below a certain level. The toll that all of these years of malnourishment had taken on my body was too great. “I’m not going to die,” I said. “I don’t want to die.” It didn’t occur to me at the time that I may not have a choice anymore. I couldn’t think myself out of organ failure.
Finding a reason for recovery
So, I began the long, arduous process of calling treatment centers yet again, desperate for help. I could not find a program willing to accept me due to my cardiac complications and low body weight, and limited insurance. But as weeks passed, my options began to dwindle. I didn’t want to die, but I didn’t have anything left to give to the world besides the fact that I wanted to live.
I set myself a weight goal and decided that once I reached it, I would submit my applications to work as a counselor at a psychiatric hospital. I knew that if I got an interview, if I got the job, I had to push myself the rest of the way. Employment wouldn’t make me recovered, but it would give me a reason to recover and stay recovered. Working for this particular employer and failing to keep my job due to my eating disorder was the most soul-crushing thing I could imagine. But if I got it, I had something to keep fighting for, and I could fulfill my purpose that I had imagined all those years ago.
I got the interview, and then the job, and losing this job was scarier than gaining weight. I had to set the stakes high for myself, create a rigid structure where none previously existed. Force myself into a recovery that I was still unsure I wanted. So I ate, mechanically, fearfully. I hated every moment of it. Scared of the looming cloud of “refeeding syndrome” that echoed over my head, repeated by those who told me I was too complex, that refeeding myself on my own was too risky. It was a risk I took. Every night I prayed my body would forgive me and carry me through another day.
I had to adapt my environment to reflect a situation in which losing whatever was motivating me at the time was far scarier than gaining weight. Academics, as much as I’d hoped they could, would not suffice in providing the high-stakes reinforcement that I needed. Throughout my middle, high school, and college years, I’d been told “you can’t succeed in school while undernourished, you can’t devote time to your degree while you’re spending hours each day at the gym, calculating and recalculating your calorie allowance for the day, you can’t have the energy to write the substantial amount needed for your papers and projects if you aren’t eating.” But I could, and I did, and this very fact seemed to reinforce the mindset that I could survive off of motivation.
I threw myself into my job, knowing full well that if this door closed, that was it. If I let my eating disorder take this from me, it truly had won. I had not been able to be convinced by doctors, therapists, or treatment centers to “trust the process.” I couldn’t wrap my head around the idea of recovering just for the sake of recovering. Anorexia and ARFID were all I knew; I had few memories before my eating disorder began. There was no “before the eating disorder.” Only an unknown, ambiguous “after, if at all,” which, as someone who thrives on concrete directions, structure, and routine, frightened me more than staying in my inhuman, self-created concrete world. I have never understood ambiguity, nor been receptive to following a path or structure that I didn’t understand or create. I had to manufacture my own “after,” throw myself into it, and hope for the best. It seemed as though I had been in a mental fog, on autopilot, for the past fourteen years, and I was inching my way toward becoming a flesh-and-blood human being again. Slowly, my job became more important than my weight. Slowly, I began to feel the same satisfaction while driving back from work as I did when I hit my step quota or successfully starved another day, but this satisfaction was coupled by an exhaustion that appeared sustainable, rather than draining.
"I have never understood ambiguity, nor been receptive to following a path or structure that I didn’t understand or create. I had to manufacture my own “after,” throw myself into it, and hope for the best."
Recovery is different for everyone
Social cues and interactions are still hard, but I love my job, and interacting with patients each day reminds me why I pushed myself to get better just as hard as I pushed myself to disappear. I know that this is what I was meant to do, I knew that since I was a kid, and though my passion for psychology never wavered, it took battling through an eating disorder for me to develop the empathy and attitude necessary to understand people’s struggles.
I’ve heard, especially in the absence of structured treatment, that one must be ready to recover, to want it for themselves. I disagree with that, at least at the beginning. Had I waited until I was ready to recover from anorexia, I would be dead. I merely reached a bit too close to the end of a timeline that I initially perceived to be indefinite and realized that whether or not I was ready to recover, I needed to force myself through it in order to work. I use employment as an example throughout this story because that was my driving force. It doesn’t have to be work. Yours may be different. I don’t consider myself as having “failed treatment.” But I do realize that formal treatment isn’t accessible, practical, or doable for everyone. That doesn’t make you a failure. And I am sharing my story for this reason: When I was at my worst, I spent hours searching for people like myself, who were considered lost causes but somehow found a way through. I didn’t fit inside a pre-existing structure. I never have. So I created my own.
Elijah R.
(he/him)
Elijah is a 25 year old man living in the northeast and working at an inpatient psychiatric hospital. He studied behavioral health counseling in college and has a long-standing passion for psychology and helping others. He wishes to share his story of recovery to inspire those who have not had access to or found benefit from traditional treatment programs. Elijah strongly believes that no one is a lost cause and would like to spread awareness regarding issues that may complicate eating disorder recovery, such as sensory differences, anxiety disorders, phobias.