What You Really Need in Eating Disorder Recovery

Needs are funny. 

We say we need a lot of things. 

My nine year old thinks she needs to go to Disney World at in the immediately foreseeable future. 

My toddler thinks he needs to sleep with his entire transformer rescue bot collection every night. He needs all of them. Including that one that rolled under the couch and hasn’t been seen since the early hours of the day. 

I think I need to buy another book from Amazon even though my collection is growing to an uncontainable level. Even though my “to-read” stack is currently taking up the entire length of my desk. Even though my husband gives me that face that says, “how many books do you really need?” Even though he knows the answer, all the books. All of them. That is how many I need. 

I think, if I am being honest, we are overusing this word need and it gets us all sorts of mixed up. It’s messy because I think we begin to confuse all of the wants of this world with needs and then when we really are in need the word has been diminished by its overuse. 

I am going to kick it way back to grad school and take a peek at one of the many diagrams I had hoped I could learn about and forget because it couldn’t possibly ever be therapeutically useful. 

I am going to kick it way back to grad school and take a peek at one of the many diagrams I had hoped I could learn about and forget because it couldn’t possibly ever be therapeutically useful.

Maslow’s Hierarchy of needs.

The diagram basically says it all. If our basic physiological needs aren’t satisfied we can’t move up the hierarchy toward higher-level needs.

In my work, as an eating disorder specialist, I often share this with families in recovery early on. Many of them are wondering, “Why can’t my loved one get to a place of self-love and knowledge that we love them?” 

My answer is usually that this client isn’t adequately nourished. If these basic level needs aren’t taken care of, it’s difficult to move to the higher level needs of safety, love and belonging, esteem, or self-actualization. 

It makes the therapeutic work necessary for recovery truly difficult. This is often so validating to clients, it gives words to their experience. They often feel so exhausted. It’s also why I think a treatment team approach is essential. For me to do the work of therapy, the eating piece has to be addressed. So many of my clients want desperately to avoid that.

The body is pretty amazing. We watch a lot of Sci-Fi- or I should say I sit next to my husband while he watches a lot of Sci-Fi. It’s weird how many shows we have watched where the crew of some starship has to go to life support power and this diminishes the ship’s capability. The ship enters survival mode. Only the systems completely necessary for survival will function. Our bodies are pretty wise when they don’t have what they need to function, power is diverted to the most crucial systems. 

Another analogy I like to use with families is how I parent when I have the flu and my husband is out of town. Imagine. Years ago, I had the flu and my husband was traveling for work. I remember just laying on the couch hoping my children would not need anything. Typically we do crafts, we do chores, we might go play in the park. When I am sick with the flu, we survive. That’s all. Power is diverted to the bare minimum needed to just get by. 

Often when I share this a parent, spouse, or loved one sits back and relief washes over them. It all makes sense.

This is such a pivotal point for people. 

This is also why, as a therapist, I have to be asking these questions- and I encourage people to ask these types of questions of everyone in their life. 

Are you eating? 

How many meals/snacks do you eat on a typical weekday and weekend? 

What do you eat at a typical meal/snack?

If we don’t know the answers to these questions then we don’t know the most basic and important information about the people in our lives. 

I think, we feel like these questions can be so awkward but these are the things we truly need. 

We aren’t ashamed to talk about our need for a Target run, bubble baths, and Pumpkin-Spiced things. So why are we so afraid to talk about the things we actually need? What makes us afraid to check in with the people around us and make sure that they are getting these needs met? 

It almost feels more vulnerable and intimate. But if we can’t talk about these things then it will be very difficult to speak up when higher level needs are lacking. When we feel unsafe. Unloved. Unfulfilled. 

I think we need to be trained to have these conversations and it starts small. When children are expressing physiological needs we need to encourage our children to have the language to describe their experiences. 

So many of my clients will report telling an adult they were hungry or tired and being told: “you aren’t hungry…you’re just bored.” This teaches children to not listen to their bodies and divorce themselves from their body’s natural cues. Instead, we need to be taught to honor and trust our physiological cues and experiences. 

We have to understand that if those most basic needs aren’t met due to dieting, eating disorder behavior, or scarcity we are asking the nearly un-askable to have people do the deep work of pulling themselves out of a pit. 

Because if I don’t have the space to say, “I’m hungry” I will never find the space to say the harder things.