Recently, my friend and I were discussing the pros/cons of her stepping up the level of care in her treatment. Interestingly, “eating in program” was on both the pro and con list. She thinks it’s easier to eat while in program (as opposed to on your own), but that some of the food sucks and you have to eat things you don’t like (or are not comfortable with).
I can definitely relate to this. When you first start a higher level of care (like IOP, PHP, IP – anything involving a meal), the amount of food you have to eat (and keep down) is a little overwhelming. At the same time, there’s a little bit of relief that comes with eating at program. You don’t have to make the decision of what to eat yourself. You really don’t even have to take any responsiblity for eating. The meal is structured, dietitian-approved, and you could spend the next couple of hours processing the horror of the meal if necessary (although hopefully not).
While thinking about this, I decided that there are four stages of eating in treatment (in this sense):
- Eating at program is really hard. It’s more food than you would eat on your own (or not purge). You’re struggling with acting on symptoms at home, and meals at program are much more “normal” and overwhelming than you’re used to.
- Eating at program is still hard — but for a different reason. You are actually starting to eat more normally at home, and it really feels like too much when combined with all the food at program. You feel guilty for not compensating (or not purging).
- Eating at program is easier. This is because
a) you’re used to the meals by now
b) you’re taking food risks at home (eating fear foods, going out to eat with friends, challenging food rituals, etc.)
The food at program feels reliable and safe in comparison.
- Eating at program is boring — and even annoying. You’ve eaten a veggie burger every week for two months and feel that you could go the rest of the year without eating yet another yogurt. You would rather be eating at home — not because you want to restrict, binge, or purge, but because you want to eat something better (that you actually like) or be eating with other people.
I could probably come up with more stages, but these four are the most obvious to me. I’d love to hear your thoughts…