What does "Using Symptoms" mean?

One of my editors for my book for families: Just Tell Her To Stop; Stories of Families Moving From Fear and Panic to Peace and Hope (working title), questioned my use of the phrase "Using Symptoms" yesterday. I have become so accustomed to the phrase that I didn't realize that not all readers might know what it means.

It is important for family members of people with eating disorders and also health care providers who treat people with eating disorders to understand how their language may impact the use of symptoms.

My understanding of using symptoms is an unhealthy way of coping with stress for people in eating disorder recovery. What this means very simply is: when a person with the eating disorder is feeling stressed, overwhelmed, lame, worthless, guilty, basically feeling badly about themselves or something they did or didn't do; they may fall into their pattern of utilizing ineffective behaviors to cope.

What can this look like? I don't want to get into too much detail here because some people who are still struggling may see these things I say as a "trigger" (which is another term to learn about another day), so I don't want to be the cause of more destructive behavior, therefore will keep this simple, general and brief. If you want to know more we can talk about it but I don't want to put triggering information out here in this cache to be here forever. For those supporting people in recovery, it will be helpful to know that "using symptoms" for the person in recovery can mean that they will skip eating, purge, eat or do whatever it is that they do to utilize their destructive behaviors to calm themselves.

An example of how language of a care provider or family or friend might trigger the "use of symptoms" could be saying simply: "You look so healthy, it looks like you are getting better." It sounds so positive and encouraging doesn't it? Well, to a person in recovery this is what they might hear when you say that: "You are so big." "You are fat." "You need to cut back on calories so you can get back to being thinner." "You've failed at even your eating disorder and now you are too big." Sounds irrational. Well, that's one irrational way that eating disorders impact people. Staying away from comments about appearance and food are essential. AND, I know that it is extremely hard to do. And, there is not much you can do as a family when loved ones come over who haven't seen your person in recovery for a long time and they burst forth with what they think is a compliment: "Oh, you look so great!" AAAarrrrggg, you think, all that therapy, undone in one fell swoop. Hopefully not, but if you can educate your doctors, nurses, social workers, teachers, family, friends...send them to this article so that they can understand the gravity and impact of their words. This is a concept that can be challenging for people to grasp and they might think that they are having to tiptoe around the person in recovery. Well, it might feel like tiptoeing but, it's better than attending a funeral. Once people understand how great the negative impact can be, then they will be more likely to heed your advice.

For health care providers this can be a huge challenge as weighing is such a major part of our typical medical checkups. There are ways to weigh people without informing them of their weight, this is essential for people who are in recovery and often it would be useful for teens and pre-teens who are very sensitive about their size.