We are sincerely thankful to our current and former patients who took the time to answer the survey that we distributed last month. The answers, which I will probably discuss more in the future, were insightful and helped us to better understand what we can do to help people going forward, which was the whole point of the survey.
Some families and former patients emailed me directly with feedback and updates, and I particularly appreciated these messages, some of which came from people I had not seen in well over a decade. Being a dietitian is tricky work in some ways, one of which is that I work with someone for a finite period of time before they go off on their own, and only occasionally do I learn how they fared after our time together ended. But I wish I knew more often, both because I actually care about my patients and hope they are doing well, and also because having some knowledge of their outcomes helps me to evaluate the work we did together so I can potentially do things better in the future.
Given that, these updates – which, when taken together, built a sort of unscientific longitudinal study – feel as valuable as a pile of gold. Some former patients are thriving, which was the best possible news, while others are still struggling to one degree or another. The rest are, well, I guess I am not really sure, which brings me to this . . .
Somewhere in the neighborhood of a decade ago, I attended a continuing education event at the Multi-Service Eating Disorders Association (MEDA). During a break, I was talking with a colleague who specializes in both eating disorders and addictions, and whatever it was that we were discussing inspired them to ask me if I was familiar with the term “dry drunk.” No, I was not, so they explained that the term refers to an individual who has ceased a problematic behavior – such as abusing alcohol – but has not yet dealt with whatever is going on underneath that led to said behavior; thus, the underlying issue shows itself in a new and different way. Their explanation reminded me of the arcade game Whac-A-Mole: hit one mole down and another one pops up.
Some of my former patients seem to possibly fit that picture, and I want to explain why, but I need to be careful. On one hand, I need to be vague enough to protect patient privacy. On the other hand, I have to be specific enough for readers to get the gist of what I am saying. Maybe the best way for me to put it is that some of these individuals have chosen paths that require a heavy focus on their eating and/or appearance in ways that neither scream recovery nor struggles, but rather suggest that perhaps the issues that brought them to me years ago have since bubbled up into something new.
Maybe that means there is still work to be done, that the ongoing existence of underlying issues calls for further treatment. Then again, maybe it means that for some people who have a history of an eating disorder, disordered eating, or body image challenges, channeling – rather than doing away with – what was once a negative into something questionably positive is enough to constitute a degree of recovery.
My gut is telling me that I have some learning to do in this realm, that I could benefit from doing some reading, talking with colleagues, and sitting with my own thoughts. Meanwhile, I am profoundly grateful for the updates that prompted me to reexamine the fundamental question of what it means to recover.