The Rule of Thirds
Around one third of patients [with anorexia] recovery fully; another third improve significantly and the last third do not recover.
I had a therapist explain this statistic to me once…
Group 1: Full recovery – The individual either recovers on her own or with treatment. The duration of the illness doesn’t really matter… what’s important is that the she goes on to live a relatively symptom-free life.
Group 2: Significant improvement - This could mean two things: Either the individual improves to a point where she can have a life with manageable symptoms or she “rides the ED roller-coaster,” so-to-say, with up and down periods of recovery and relapse. While the eating disorder still may affect her life, she’s a functional, productive member of society.
Group 3: Chronic illness — The individual is severely ill for most of her life (since diagnosis). Periods of recovery are brief (if existent at all) and all of her time is spent either consumed by the eating disorder or in treatment for it.
So, given these definitions, I decided that I was probably in group 2 (okay, go ahead and tell me that that’s the wrong mindset and that I could be in group 1 if I wanted to, etc. I am being realistic here). Kind of kiddingly I asked, “So, if you’re not in group 1, are you in therapy for life?” And her response: “Maybe–sometimes.”
WHAT! I only asked this question because I thought it was a pretty absurd question. She went on to explain that for the 2/3rds that don’t recovery completely, the goal is minimizing symptoms. Maybe you can go 6 months without treatment… and then after a year of going back to therapy and getting back on track, you can make it a full year without needing to see someone. The goal is always to get better… but if that means intermittent–or even consistent–treatment throughout your life, then that’s okay.
… thoughts?
I think this is a pretty familiar theory with professionals–that with eating disorders, though some do completely recover, for many it is about minimizing symptoms, keeping the patient out of the hospital, keeping them “functional.” Maybe this is part of the problem. I mean if we don’t have clinicians who even believe we can really recover, then how are we to completely? Of course, this only follows the notion you believe in fully recovery.
I know for me, I don’t want to be in therapy forever, but at the same time, it’s a very safe place for me. So then it makes me wonder whether I’ll turn into a therapy junkie, never really being able to resolve all my issues which includes anything pertaining to eating disorders. It’s kind of scary when I think about it that way.
I’ve tried a few different therapy styles, and never managed to get to anything which resembles recovered, although my classification did change a few times. I’ve found it hard to establish whether I am worse in treatment, when I’m trying to eat “normally” and throwing up much of the time, but utterly dependant on a therapist, when I’m left to my own unmedicated devices and binging like it’s an olympic sport, or when I’m medicated and unsupported and trying to starve myself to death. None resemble recovered.
i try to maintain a positive attitude, but realistically i think i’ve always been a 2 up until this spell of restriction, and in the past 6 months, what with severe depression and time off work, i can see me forging a place in group 3.
well, darn. Wouldn’t I love to fall to either extreme of the spectrum but here I am loitering in group 2. The yucky middle (in my ED’ed mind). I’ve spoken in my posts of the desire to be both perfectly well and perfectly sick (sometimes at the same time) but what I’ve got instead is a case of long-term muddling through. I recently likened my battle to a chronic illness like Multiple Sclerosis. Not the most optimistic of views but perhaps reality is more important than optimism at this stage.
I’m sure on different days, depending on whether it was my “recovery brain” or “ED brain” thinking, I’d designate myself in different categories and/or desire to change to different categories. Bottomline – I don’t really trust myself to be a good judge of my long-term progrnosis.