“The brain takes longer to heal than the body does.” If you have been in or around eating disorder treatment for a while, you have probably heard this.
It’s true. Yeah, weight gain usually happens relatively fast (if you eat enough, that is) compared to the brain becoming accepting of that weight gain. Not to mention compared to the brain dropping the eating disorder behaviours and thoughts. But I think it is deceptive to imply that the brain simply takes time to “heal” and that given enough time at an unsuppressed bodyweight it will take care of itself. Because it often doesn’t.
Nutritional rehabilitation + Neural Rewiring = Full Recovery
Healing body + healing brain = healthy happy life
Nutritional rehabilitation alone doesn’t achieve full recovery (unless you have only had an eating disorder a short amount of time and hence neural wiring of the behaviours didn’t really happen. You see this most often in children and for some kids it is true that nutritional rehabilitation alone can get them fully and sustainably recovered. Some children).
The brain can and will “heal” but it doesn’t only take time, it takes work. That work is neural rewiring, and neural rewiring is crucial for most people to achieve full recovery. Neural rewiring is the process of re-training the brain out of entrenched behaviours, thought pattens, emotional reactions, etc etc. Neural rewiring, by the way, is critical to amending negative body image and/or fear and disgust of one’s unsuppressed bodyweight. It doesn’t happen by magic, you have to actually do it to yourself. And no, you can’t do neural rewiring for someone else, nor can you have someone do it to you. That would be like having someone else complete your maths homework and expecting your brain to learn from it. Our brains learn by doing, by thinking, and by making decisions. That’s the toughest part about neural rewiring: you have to step up and do it.
Most people I talk to as a coach, once they understand that, are willing and able to step up and work on rewiring their own brains. Many of them “get it” immediately and understand what they need to do. Many are dismayed that they have spent 5, 10, 20, 30 years in treatment and the concept of neural rewiring has never been put to them. The lack of understanding about neural rewiring and the role it has in recovery from an eating disorder is what leads to the revolving door treatment that so many people in recovery from an eating disorder experience. If you don’t rewire your fear of weight gain, of course you are going to fall back into activities that suppress your bodyweight as soon as you are left to your own devices.
I cannot express how important neural rewiring is for full recovery from an restrictive eating disorder. I don’t believe that anyone with a long-term eating disorder can fully recover without doing this work (and nutritional rehabilitation, of course). Unraveling the belief system that thin is better than fat is a big part of neural rewiring. Without neutralising this belief, you cannot expect someone to be comfortable (happy, even) in their unsuppressed body.
Eating disorder treatment has to recognise that neural rewiring is how the brain “heals” and that this is active work that has to be engaged in. It is more than just “time.” Neural rewiring is a skill to be learnt. Neural rewiring is both classical and operant conditioning and the process of undoing a conditioned response and establishing another response, or a neutral. It’s more than that too. Neural rewiring is the process by which our brains form and establish belief systems.It is a wonderful, empowering, frustrating process.
I explain the neural rewiring fully in my book Rehabilitate, Rewire, Recover!, and even more specifically Neural Rewiring for Eating Disorder Recovery. I mention it in just about every YouTube video (these are free) I have ever put out there. I can’t answer a question on eating disorder recovery without mentioning it. Furthermore, this stuff is easy to understand. It sounds way more complicated than it actually is. It is something that you are going to have to do if you want to fully recover so … let’s get going, eh?