This follows on from How To Break Unhealthy Eating Habits so I would recommend starting there.
Before we jump into how to stop anorexic thoughts, here’s a quick recap of the Habitual Voice Recognition Technique (HVRT) and how we can apply it specifically to the Anorexic Voice.
What is the Habitual Voice?
Your Habitual Voice (HV) is any thinking, feeling, or urges that encourage habitual behaviours. In relation to anorexia, your HV is any thinking, feeling or urges that encourage anorexic behaviours such as restriction, meal skipping, calorie obsession, and over-exercise. For this article, it makes more sense to refer to the HV more specifically as the Anorexic Voice (AV). It includes:
- Thinking about calories all the time
- Thinking about how much you weigh all the time
- Feeling guilty over how much you ate
- Feeling anxious about your next meal
- Food fears
- Beliefs around forbidden foods
- Having the urge to skip a meal
- Having the urge to over-exercise
I want to highlight, the Anorexic Voice is NOT the behaviour itself. It is the urge to carry out the behaviour or the thoughts and feelings around it.
For example, say you had the thought, “I feel fat so I’m going to skip breakfast”. This thought, and the urge to skip breakfast, is your AV because it is encouraging restriction.
It’s also important to recognise that your Anorexic Voice can sound pretty rational at times. Although the messages it sends out comes from the lower brain (because that’s where all our habits are housed), it is interpreted through the language and logic of the higher brain (the decision making part of the brain) – see Is Your Eating Disorder a Habit for a deeper understanding of the brain.
So, although you know deep down that skipping breakfast is not going to give you the health, happiness, and freedom you want, your Anorexic Voice might justify skipping a meal as healthy because you’ve read in a magazine or on a blog post or on social media that ‘fasting until 12pm is good for you’, or ‘eating breakfast will make you hungrier for the rest of the day,’ or ‘you’ll burn more calories when you skip breakfast’… As rational as these messages might sound (and as many articles as you read that support these ideas), these messages are your AV – automatic, meaningless, powerless, and based on little more than fear.
What is the Anorexic Voice Recognition Technique?
The Anorexic Voice Recognition Technique (AVRT) involves six steps:
- Identify your true self – the real you that has a deep desire for health, happiness and freedom.
- Identify your Anorexic Voice (AV) – you will probably find that your HV sends out similar messages (thoughts, feelings, urges) again and again. It is helpful to write these messages down so you can identify them when they occur.
- Separate your true self from your AV.
- Dismiss your AV – don’t react to it (i.e. engage with it emotionally by judging yourself or giving it your attention) or act on it (carry out any behaviours it is encouraging).
- Take actions that will strengthen your true self and get excited about life – nourish yourself, meditate, spend time in nature, do things that make you happy.
As you read these steps you might be thinking… “It looks like a lot of effort if I have to identify every single anorexic thought and feeling and urge and then dismiss them for the rest of my life – I think it’ll be easier to stick with anorexia”.
Try to remember that the AVRT is a process. It is how you begin your recovery. It is how you break old habits. It is how you create a new normal. Yes, it will take a lot of work to start with. And it might even feel like you’re slipping backwards because you might not have even been aware of your Anorexic Voice until now and, for a while you will be hyper aware of everything your AV is saying to you. But, with practice, the AV will fizzle.
Every time you dismiss your Anorexic Voice and eat your lunch despite your AV telling you to restrict or have carbs despite your AV telling you they’ll make you fat, the pathways in your lower brain that send out these anorexic thoughts will weaken. And as the pathways in your lower brain weaken, so will the anorexic thoughts. Until they fizzle out altogether (this is known as self-directed neuroplasticity).
For some people, this constant dismissal of the Anorexic Voice takes weeks. For other’s it takes months. And even then, at some point, years in the future, the lower brain may send out a random anorexic thought or urge to lose weight or skip a meal. But, because by then you know how to identify your AV and dismiss it, it won’t be an issue. You’ll simply acknowledge its existence and get on with your life.
To help you relate to this a bit more, here is one of my clients’ experience using the AVRT.
Maddie* came to me aged 24 after being diagnosed with anorexia at 14. She had been through many traditional treatment programmes, followed countless meal plans, and had been ‘eating clean’ for the last couple of years. Her weight had been low but stable for a couple of years and she hadn’t had a period since before her diagnosis.
Step 1: Identify your true self
I asked Maddie what she wanted deep down, underneath all the fears about gaining weight and desire to eat perfectly.
She said she wanted complete freedom around food. She wanted to have regular periods so she could have kids in the future. She wanted health, love, and happiness.
So her TRUE SELF wanted to health, happiness, freedom and love.
Step 2: Identify your Anorexic Voice (AV)
Using a variety of techniques over the period of a few weeks, I asked Maddie to listen to the messages she had around eating and her body that encouraged anorexic thinking and behaviours – her AV. Sometimes it can take a little while to identify your AV because the messages are so engrained and automatic that it feels like they are part of you.
Maddie identified the messages below as coming from her AV (if you are reading this because someone you know is going through anorexia, then this will give you an idea of how worthless anorexia makes you feel):
- ‘Without the anorexia I won’t have any excuse for being the crappy human being that I am’
- ‘It’s taken me so much work to be skinny, I can’t give it up now’
- ‘People will like me more if I’m skinnier’
- ‘I can’t eat unless I am ravenous and starting to feel faint’
- ‘Eating more will make me fat and unlovable’
- ‘If I eat anything I like the taste of or I will lose control and binge on everything in sight’
- ‘If I gain weight everyone will hate me’
- ‘I’ll get fat if I eat carbs’
- ‘I can’t eat more than 1200 calories a day’
- ‘I need to skip breakfast because I didn’t work out yesterday’
- ‘Gluten makes me bloated so I better avoid all carbs from now on’
- ‘I’ll fill up on vegetables and then I won’t feel hungry’
- ‘I’ll have an americano instead of latte – it’s less calories’
- “Recovery is choosing to be podgy and unhealthy”
- ‘I don’t deserve to enjoy food’
- ‘I deserve to be hungry and weak’
- ‘I’ll never recover’
- Fat and gross
- Exhausted and hungry but not allowing myself to eat
- Lazy for not going on a run
- Broken beyond repair
- Anxiety about going out to lunch in case the café didn’t have any ‘clean’ food
- Anxiety about a stranger joining me and my friend for lunch
- Anxiety about eating a meal without knowing how many calories are in it
- Anxiety about eating oats
- Worthless in comparison to all the bikini competitors on Instagram
- Guilt over eating a handful of ‘unplanned’ grapes
- Guilt about eating a bowl of granola
- I should always be thinner
- Fat and out of control
- Nourishing myself is weakness
- to cut out carbs after hearing my friends talking about their low-carb diets
- to have berries as a snack instead of a banana
- to swap rice for cauliflower rice
- to skip dinner because I ate a bigger lunch than usual
- to fast because my weight was higher than normal
- to cut calories from each meal by reducing portion sizes
- to only have one slice of toast instead of two at breakfast
- to cook without oil
- to feel hungry
- to lose weight
I also asked her in what way the anorexia still served her (because sometimes, as well as being a habit, anorexia serves a purpose in life and we need to figure out healthier ways to fill that purpose).
- To numb the feelings of failure
- Easing pain
- A way to avoid all the feelings about ‘how crap I am’
Step 3: Separate your true self from your AV
Maddie often used to tell me, “I think I’ll get fat if I eat carbs – it feels so overpowering”.
What she didn’t realise by saying this was that she was already acknowledging that these anorexic thoughts were separate from her – they felt like they were “overpowering” her true self. Yes, thinking she would get fat was coming FROM a part of her (her AV) but it wasn’t actually the real Maddie. I asked Maddie these questions:
“If you are finding the thoughts that you will get fat overpowering, then who is it that these thoughts are overpowering? If you are having these anorexic thoughts, and you can observe and identify these anorexic thoughts, then who is it observing your thoughts?”
This helped Maddie to see that she was not her anorexic thoughts. She was simply witnessing them.
Separating your true self from the anorexic thoughts of your AV is something that takes practice. It all comes from an understanding of the two minds. This is an Eastern concept that is being used more and more in Western psychological approaches because of emerging neuroscientific research (see Is Your Eating Disorder a Habit? for more explanation on a neurological approach to the two brains) where you have:
- The Thinking Mind: the lower brain, your AV
- The Observing Mind: the higher brain, your true self
Thoughts think themselves and we have very little control over the Thinking Mind (our AV) – it sends out thoughts and emotions and urges all the time. And these things are out of our control, they will continuously pop up into your awareness and you cannot stop them. You cannot stop thinking. And you cannot stop feeling.
What we do have control over is the Observing Mind (our true self). So, for example, when Maddie had the thought “I deserve to be hungry and weak” (arising from her Thinking Mind), it is not the thought itself that was causing her suffering, it is the way she was getting sucked into it, giving it meaning and seeing it as part of her.
Before Maddie was able understood the difference between her two minds, she would get dragged along by all the anorexic thoughts and emotions arising from her Thinking Mind (her AV). But when she began to use her Observing Mind she acknowledged, even though the anorexic thoughts may still pop up, she didn’t have to believe them or act on them.
Maddie began to understand that it wasn’t about trying to stop the anorexic thoughts. It was about simply watching them without giving them any meaning. It was about accepting that these thoughts and feelings and urges would pop up and consciously choosing to act in a way that would bring her closer to her goals of health and happiness and freedom regardless of how rational, logical, or overpowering the anorexic thoughts felt. It was about no longer letting her Thinking Mind and the messages of her Anorexic Voice control her. It was about realising that although she had no control over the anorexic thoughts, she did have a choice over how to respond to them.
Below are three techniques that can help you separate your Anorexic Voice (Thinking Mind) from your true self (Observing Mind).
1. Rephrase your Anorexic Voice
Language is powerful. A simple way of finding separation between the Anorexic Voice and true self is rephrasing the messages your AV send out.
So, for Maddie, she could rephrase the message from her AV which tells her “I deserve to be hungry and weak” as “I have the THOUGHT that I deserve to be hungry and weak” – by doing this Maddie began to recognise that although she HAD thoughts about deserving to be hungry and weak, she didn’t actually deserve to be.
Let’s try another example…
By Maddie acknowledging that she was “FEELING fat and out of control”, instead of being “fat and out of control” she was able to see that just because she FELT “fat and out of control” didn’t mean she actually was.
Likewise with her urges…
When Maddie put her urge to skip to dinner into the words, “I feel the urge to skip dinner”, she realised that just because she FELT the URGE to skip dinner didn’t mean she HAD to actually skip dinner.
By rephrasing her anorexic thoughts, feelings and urges, Maddie was able separate them from her behaviour. She was no longer a slave to her Anorexic Voice and slowly began to live less out of habit and more from intention.
2. Meditate on it
Meditation was a total game-changer for me. It gave me the space, stillness and practice I needed to learn how to separate my AV from my true self. I mainly used these meditation techniques:
(Just click the names of the meditations above and there’s a how-to guide for each one).
To begin with I found it tough. I found it difficult to identify my AV and I often got sucked into my anorexic thoughts, feelings and urges. If I had the thought, “I can’t recover because I’ve had anorexia for too long”, I would accept it at face value and carry on with my anorexic behaviours. But with practice, instead of believing these thoughts, I was able to acknowledge them:
“I feel scared that I can’t recover because I’ve had anorexia for too long”
“I have the thought that I can’t recover because I’ve had anorexia for too long”
And, once I was able to acknowledge them, I could separate myself from them and then dismiss them and get on with my life.
Maddie had a similar experience. By visualising the messages from her AV as passing clouds and herself as the sky (using the Just a Passing Cloud Meditation), she discovered that the thoughts would always pass without her having to do anything at all. And underneath the anorexic thoughts, she realised that, just like the sky, she was limitless.
For more a deeper understanding see, Meditation and Eating Disorder Recovery.
3. Practice the Pause
I explore this in more detail in my book, Fear-Free Food, but, in summary, practicing the pause is exactly as it sounds. When you feel anxious or guilty or have the urge to skip a meal or think recovery is impossible, simply PAUSE. Stop. Take a few deep breaths. And remember who YOU are. When you are in a rush or feeling stressed, it’s easy to slip back into your habitual way of thinking and become slave to your Anorexic Voice. Pausing at times like this helps you remember that YOU are not your thoughts, you are not your emotions, you are not your habits, and you have a choice about how you respond to your AV. You have a choice about how to live your life.
Step 4: Dismiss your Anorexic Voice (AV)
Dismissing your AV involves two things:
- Not reacting to your Anorexic Voice by giving it any meaning or getting caught up in the emotions.
For example, when Maddie started feeling anxious about eating a ‘fear food’ she would see the anxiety as nothing more than a fleeting feeling that would pass instead of allowing the anxiety to intensify.
- Not acting on it by doing what your AV is telling you to do.
For example, when Maddie’s AV told her to skip breakfast, she would eat breakfast anyway.
There are two main ways to help you dismiss your AV:
- Stop and meditate.
Take a break from whatever you are doing, sit down and make space to consciously separate your true self from your AV using one of the meditation techniques above.
- Carry on with whatever you are doing.
Acknowledge your AV and consciously choose to continue with your life. This way you don’t allow any anorexic thoughts, feelings or urges to get in the way of living a meaningful life.
An alternative to dismissing your AV is to distract yourself from it. I wouldn’t recommend doing this all the time as you need to be able to sit with the anorexic thoughts and feelings without acting on them in order for them to fizzle out BUT dismissing your AV all the time is pretty exhausting (you are literally rewiring your brain). So, sometimes you need to make life easier by distracting yourself from your AV. If this is the case, then distract yourself with something that nourishes you and makes you happy (see Step 5).
Step 5: Strengthen your true self and get EXCITED!!
Stopping anorexic thoughts is a lot easier when you are taking care of yourself. There are four parts to this step:
Once you make the promise to look after yourself for the rest of your life, something amazing happens: you start looking after yourself. And, because your Anorexic Voice is at odds with your promise, it’s easier to dismiss. And because you dismiss it more, your AV begins to fade until it is just a whisper. Just a memory. Part of your past. Part of your story.
You will notice that your anorexic thoughts are stronger and your AV is harder to dismiss if you are feeling stressed or anxious or in a rush. This is because stress hormones cause your brain to shift back into habit mode. So, by reducing the stress in your life and calming your mind, you will find that you have more mental space to separate from your AV (step 3) and dismiss it (step 4).
For example, Maddie found that when she was stressed at work she would become even more obsessive about calories than normal and wouldn’t eat anything if she didn’t know how many calories were in it. By asking her colleagues for help to reduce her workload, she decreased her stress levels and had the head space to identify her urge to count calories, and instead of reacting to it by totting up her day’s calorie intake in her head or acting on it by skipping lunch, she could dismiss it.
One reason anorexic thoughts can feel overpowering is because you are exhausted. When you are deprived of sleep, rest and nourishment, your brain shifts to survival mode of the lower brain where you Anorexic Voice lives (your Thinking Mind) making it harder to dismiss.
Self-care and stress reduction techniques include:
- Reading a book
- Meeting a friend for a chat
- Having a bath
- Cooking yourself a nourishing meal
- Spending time in nature
- Getting a massage
- Going to a gentle yoga class
- Getting an early night
- Spending time with people you love
- Asking for help at work and with chores
- Day dreaming (my favourite!)
You want your approach to nutrition to be pretty neutral. For example, eating a slice of cheesecake should have no more emotional meaning attached to it than eating an avocado. BUT eating is an emotional experience. Nourishing yourself feels incredible. Food is something you can get excited about. That’s why Fear-Free Recipes are so important to Fear-Free Eating. Because food is fun. And cooking is a great way of exploring flavours, experimenting with ingredients, figuring out what you do and don’t like and giving yourself the opportunity to create fun, enjoyable experiences around food instead of seeing it as a source of anxiety, guilt and shame.
Fear-Free Recipes are all about falling back in love with food, falling back in love with nourishing yourself, and falling back in love with life.
These are some of my favourites: