by Randy K. Hardman, Ph.D. and Michael E. Berrett, Ph.D.
People who suffer from eating disorders battle intense emotions and inner conflicts that negatively impact their recovery. For many of these people, deep spiritual struggles are a major impediment to their ability to recover from an eating disorder.
The purpose of this article is to acknowledge the importance of including a spiritual perspective in treatment and recovery from eating disorders. We recognize that this spiritual perspective can be an important part of recovery for many women and some men who have suffered many years from the effects of a damaging eating disorder. We recognize that an eating disorder has led many of these spiritually oriented people away from personal and spiritual connections, religious communities, and loving relationships that are so vital in their ability to recover from the disorder. We believe that as people suffering with eating disorders express and clarify their spiritual beliefs and then begin to activate those beliefs in a more congruent fashion, they will receive benefit in their healing process. We simply want to encourage these women and men to take advantage of this spiritual source of healing and empowerment that can help them in their journey of recovery.
From our clinical experience working with women with eating disorders, we have observed women suffering from long-term eating disorders feel terribly alone, inadequate, unworthy, undeserving, and hopeless. Many sufferers, at previous times in their lives, have felt a connection to God and a degree of personal spirituality. Some have participated in religious observations, but through the course of their eating disorder have, almost universally, lost those connections. They feel unworthy of love and acceptance from others, and in an act of self-rejection they believe that they are undeserving of God's love and acceptance as well.
The eating disorder consumed every aspect of my life. My life was centered entirely around food and weight. I felt unworthy and undeserving of having a relationship with God. I hated myself and did not think it was possible for anybody, including God, to love me. I did not feel that I was good enough to merit a relationship with God. (20-year-old woman.)
When incorporating a spiritual perspective into recovery from eating disorders there is no need to be disrespectful of anyone's spiritual or religious beliefs and behaviors. Be respectful of each person's perspective and simply encourage them, within the context of what they believe, to once again open the door to spiritual influence in their recovery.
Significant Spiritual Issues
Some of the significant spiritual issues that women with eating disorders may encounter are: 1) negative image of God, 2) feelings of spiritual unworthiness and shame, 3) fear of abandonment by God, 4) intense difficulty surrendering and having faith, and 5) dishonesty and deception.
Negative Image of God
When discussing their negative images of God, eating-disorder patients tend to describe God much as they describe their parents. If they perceive their parents as distant or unavailable, they often feel that distance is true of God as well. If they perceive their parents as rejecting, critical, controlling, angry, devaluing, shaming, etc., they also often project these characteristics onto God. As the eating disorder progresses, this negative image of God plays a significant role in their disconnection from spiritually based relationships.
Around the time my eating disorder started, I began to lose a connection with God, and as I got sicker, I became totally disconnected from God, even doubting his existence. My eating disorder made me want to pull away from and go against my family and parents' belief, causing me to pull away from God even more than I would have because my parents were so strong in their spirituality. There were some days I would have gone to church but had binged the night before and was too fat to go. (18-year-old woman.)
Feelings of Unworthiness and Shame
A second spiritual issue that impacts eating disorder recovery is a deep feeling of spiritual unworthiness and shame. Many of these women believe that God and everyone else views them as unworthy, unacceptable, and flawed. They often try to compensate for these feelings of spiritual unworthiness through perfectionism and a relentless pursuit of impossibly high standards. Their failure to meet these perfect expectations only confirms their belief that they are unworthy of spiritual connections or spiritual experiences. They decide that they have disappointed God and are unworthy of his kindness and love. They may feel undeserving of forgiveness or acceptance from anyone, including God.
Throughout my eating disorder, my spirituality decreased dramatically because of actions and behaviors I did to support my eating disorder. The more wrong my choices and inappropriate my behaviors got, the more I felt undeserving and unworthy of God's love. (23-year-old woman.)
Fear of Abandonment by God
A third issue that arises among women with eating disorders is a fear of abandonment by God. The desire to receive approval from other people is a significant emotional issue and they fear that if they displease or disappoint, then loved ones will abandon them. That fear and belief is also projected onto their beliefs about God. A number of these women have been sexually abused as children and they believe that God abandoned them during the abuse. In such cases it becomes difficult for them to trust again and believe that God will support and help them in their times of need. These feelings of abandonment that originate in childhood can become their reason for avoiding spiritual relationships completely and can be deterrent to re-establishing spiritual connections that can aid them in their recovery.
My eating disorder destroyed my relationship with God. It blocked me from him and I lost all faith and trust in God. I became very angry with Him because I felt like He had abandoned me. Eventually, I just stopped thinking about Him. My eating disorder became my God and my body became the Devil. Now, I feel a lot of guilt and shame in denying Him. (25-year-old woman.)
Intense Difficulty in Surrendering and Having Faith
A fourth spiritual issue that impacts eating disorder recovery is the difficulty in surrendering, trusting, and acting in faith. Many eating-disorder patients become experts at controlling or numbing their emotions, and consequently are often unable to experience sensitive spiritual feelings. They attempt to avoid experiencing emotions and the associated primary emotional pain that contributed to their eating disorder. Thus, to "let go" and begin to exercise faith and trust in God becomes a frightening challenge to these women. They may feel so afraid of losing control, or whatever sense of control their eating disorder brings them, that they struggle with giving up control to a "higher power."
Becoming so obsessed with my body decreased my faith in everything I believed. I wanted and knew that I could only go through this pain with the help of God, but my life revolved around me. There wasn't enough room in my heart for both my eating disorder and Heavenly Father. I had to choose. I chose wrong and ended up in an eating disorder clinic. (19-year-old woman.)
Dishonesty and Deception
A fifth spiritual issue that impacts recovery is dishonesty and deception. Common coping strategies among eating-disorder patients include: "covering up," secrecy, and blatant deception and lying. Many feel a great deal of shame and remorse about their deception and lying, compounded by feelings of guilt from too many failed promises to give up their eating disorder. Many have lied over and over again to people who love them, in order to protect their eating disorder. All of this leads to the incorporation of "false pursuits" within the eating disorder that become substitutes for the spiritual connections in their personal lives.
Ten Common False Pursuits of Eating Disorders
This section of the article will address ten false pursuits of an eating disorder, their spiritual consequences, and some pathways that can help women with eating disorders begin to change course and once again reopen a more healing and helpful spiritual perspective in their lives and in their recovery. These ten falsehoods are what those with eating disorders pursue in place of, and often at the expense of, emotional and spiritual nourishment in their lives.
Click the (+) next to each topic to learn more.
There are numerous spiritual interventions that can be used to help in someone's recovery from an eating disorder. A few mentioned here are:
- Teaching spiritual concepts
- Encouraging the reading of religious and spiritual articles and literature
- Encouraging prayer
- Encouraging spiritual imagery and meditation
- Encouraging forgiveness
- Encouraging people to seek spiritual direction from their own religious leaders
- Encouraging self-correction and self-kindness in recovery
- Encouraging people to be involved in their own religious community, etc.
(For more detailed explanation, see P. Scott Richards, et al, "Spiritual Issues and Interventions in the Treatment of Patients with Eating Disorders"--Journal of Treatment and Prevention, Volume 5, Number 4, Winter, 1997.)
Certainly, what interventions are encouraged and emphasized are dependent upon the individual and what they are willing to do within a spiritual framework. The client always leads in her own spiritual journey and recovery. She does most of the work outside of therapy with occasional conversations within the therapy setting to encourage and support this component of recovery.
One of the things that we encourage in the beginning stages of recovery is to start praying again, and in those prayers to be honest, direct, and to tell the truth about their feelings, whether positive or negative, distorted or accurate, and to begin to reopen the communication with other people, with themselves, and with God.
Once I came to the realization that the only way I was going to recover was through God, a huge weight was lifted off my shoulders. I was humbled in His presence. I pray every time I feel anxious, depressed, or not myself. I ask him to help me to work things out and to listen to what is going on around me. As soon as I put my recovery in God's hands, things started to fall into place. (19-year-old woman.)
We are cautious not to tell people how to pray. We do encourage those who believe in God to address that relationship in the context of prayer and to begin to talk honestly and openly about internal experiences, struggles, and emotional conflicts, and, in time, to begin to ask God for help in sorting out and resolving these struggles. We encourage them to listen for answers to their prayers and to use the understandings or insights that may come to them.
My relationship with God has helped me so much in my recovery. Just knowing there is someone you can always turn to and trust always gave me somewhat of a relief after I prayed--kind of a peaceful feeling. It helped me see there is so much more to life. (20-year-old woman.)
We have seen that women in treatment who are able to use prayer in the stages of recovery begin to recognize an influence beyond themselves and feel evidence that God is helping them as they include Him in their eating disorder recovery.
Being able to feel like someone else is in control can help make me feel better and feel like a weight is lifted off my shoulders when I tell God my concerns. (23-year-old woman.)
A patient who is in the severe stages of an eating disorder feels powerless to change her course or correct it on her own. But when she begins to feel help beyond her own to change her course and to begin to do things she could not do on her own in her recovery, it strengthens her hope and resolve to continue to develop and enjoy that personal relationship with God.
My spirituality and my relationship with God have given me hope and strength. Whenever I'm too weak, out of control, or just lonely, I close my eyes and imagine God and His angels with me. My faith is unstable right now, but even that helps me. >If ye have faith as small as a mustard seed, nothing will be impossible for you. (23-year-old woman.)
This spiritual perspective of help in recovery is not without its challenges. It is important to remember that oftentimes spiritual recovery is an unseen, subtle, and quiet experience. It is also important to remember that the intense worship of the eating disorder is a hard thing to give up because it is so deeply based in fear and self-contempt. The barriers to spiritual reconnection are often the very things that influenced the onset and maintenance of the eating disorder.
I believe that God answered my prayers and my family's prayers for making a way for me to get better. He helped me feel loved and not alone in my most difficult days away from home. He gives me answers and instructions that help me, makes me hopeful in the scriptures, and I know that He is there to support me and help me recover. (18-year-old woman.)
We encourage women with eating disorders to regain spiritual connections by participating in structured assignments and activities where questions are asked and where they reflect and respond in writing. We encourage readings that they can select, including books, scriptures, writings, and affirmations. We encourage personal and private meditation and self-reflections. We encourage prayerful hearts or spiritual pauses in the course of their day. Support can also be given to help them reconnect with their religious communities, activities, and structures that many of these women have given up.
I believe spirituality is a pivotal aspect of recovery. I don't think it is possible to get through this without having faith in God or a higher power. When I am in my eating disorder, I feel alone and tend to isolate myself from the world. I feel lonely and disconnected. It is easy to give up on life if you don't have a belief that there is something greater than yourself to live for. (19-year-old woman.)
In treatment, encouragement is given to reexamine or challenge the beliefs from their earlier lives that had a negative impact on them spiritually and religiously. We encourage them to reexamine old beliefs and decisions and to make new decisions, changes, and develop new direction for themselves within a spiritual and religious context.
It is only through the grace of God that I was able to pull through my eating disorder. Because of His unconditional love and the Atonement, I am able to be whole once again. Never in my life have I felt so much peace and comfort. I rely in Him in all I do. Praying for strength daily, I am able to win this battle. (28-year-old woman.)
A new hope for recovery is kindled when those suffering with eating disorders begin to turn away from the false pursuits of the eating disorder and embrace again their own spirituality.
Courtesy of Center For Change, Orem, Utah