Many recovery stories talk about choosing to recover.
I agree that in some ways this is a really significant part of the process. Unless in the minority of people legally required to have treatment via the Mental Health Act or similar measures, reaching out to services is a decision that we make because we want things to be different in some way.
However, this is where the ‘choice’ element starts to become more complicated. Yes, asking to be referred into services is one matter. Being able to to access them following that is another. Many, many eating disorder services are stretched to their absolute limits, meaning there are huge swathes of people who will end up on very long waiting lists, or won’t be eligible for treatment at all.
For those of us who do meet the right criteria, treatment itself comes with a cost. This is especially true if weight restoring. Refeeding meal plans can be incredibly expensive purely just on the volume of food required. Travelling to and from the clinic comes at a price too. And that’s not even considering the cost of prescriptions and ‘extra challenges’ like going out for meals. Finally, taking time away from work to focus on recovery can be costly – many people either only receive statutory sick pay or may not be entitled to any through work at all if they are on zero hour contracts for example. Being able to access adequate treatment is a privilege.
So what if you can’t access treatment? Although incredibly challenging, there are people who manage to recover without it. But the likelihood is, a robust support network is going to be a key part of being able to do this. Not everybody is fortunate enough to have this.
So yes, it is true that some parts of recovery come down to ‘choice’ (even when they don’t feel like they are). Something my therapist always used to say to me is that in recovery, nobody is holding a gun to my head. Whilst anorexia can scream and shout at me and tell me not to eat something, it is me who ultimately makes the decision to put the fork to my mouth. For me, this was empowering and helped me to remember that I am in charge of my eating disorder and not the other way around. However, I was in a place where I was receiving intensive treatment from a team who knew me well and saw me quickly. For people who don’t have this experience, much of that ‘choice’ is not available.
In some ways, it really is as simple as just picking up the spoon and eating. In other ways, it is far, far more complex than that, and snappy mantras and toxic positivity can lead us to think that all people need to recover is willpower and that simply isn’t true. I personally needed huge amounts of willpower. I also needed six months of daily intensive treatment and a year of therapy, in addition to support from my family and friends, a stable job with generous sick pay and supportive colleagues. Without that cocktail behind me, I have no doubts that I would not be where I am in recovery today.
So yes, it is partially true that some parts of recovery are a choice and I do believe you need to have the motivation to get you through. However, motivation alone is rarely sufficient without adequate support and suitable circumstances. Those of us in recovery have a responsibility to address the privileges we have had or we risk leading people to feel like failures if they don’t feel able to make the same decisions that we have, despite us maybe having very different situations.
Parts of recovery may be about choice, but treatment is a privilege.