Understanding Ego-Syntonicity
Because ego-syntonicity is so central to many (if not most) peoples’ experience with anorexia, I find it to be a massive oversight when dietitians only provide education on the harms of engaging in anorexic behaviors and tools for nutrition rehabilitation.
Ego-syntonicity is one of the reasons why recovering from anorexia nervosa is such an arduous and lengthy process, as well as why recovery rates hover around only 46-62.8%.* Ego-syntonicity describes thoughts, feelings, and behaviors that feel natural and align with self-concept. Not only do these thoughts, feelings, and behaviors not cause distress, but they feel natural and right! On the other hand, ego-dystonicity creates internal conflict, discomfort, and distress. Symptoms of most illnesses feel unwelcome and we recognize them as such. We want them to go away and will typically feel highly motivated to take actions that decrease them and return us to our “normal” state.
What Does Ego-Syntonicity Feel Like?
Imagine that you spent years in school studying French and have become quite proficient. You take pride in your linguistic skills. You have traveled to many francophone countries, picked up local dialects, led conversation groups, and made lasting social connections. Being multilingual is a major achievement for you, and you have spent years working toward it. You even become known for it! You dream of learning other languages and pursuing a PhD to inspire others.
All of a sudden, everyone around you starts telling you that you don’t, in fact, speak French. They tell you that when you think you’re “speaking French”, you are actually speaking in gibberish. And you can’t just go and ignore them; you have to receive mental health treatment! Multiply the feelings of outright confusion and intense defensiveness you might experience by 100 and you can begin to imagine what it feels like to be told that restricting food and aiming for weight loss at any cost is unacceptable. You’d be absolutely convinced everyone around you was out to get you.
Obviously this is a less than stellar analogy. The piece that is critical to understand, whether you have AN yourself, love someone with AN, or simply want to wrap your head around it, is that anorexia will manipulate the crap out of you. It tells you that everyone else is wrong and actively trying to harm your “progress.” Those who are trying to convince you that you need to be “fixed” clearly can’t see that you are doing better than you’ve ever done. You’re great at what you do, and if you didn’t do it, who would you even be?
How Can You Challenge Ego-Syntonicity?
In short, by building awareness. Awareness of ego-syntonicity creates space to question anorexia’s instructions, building psychological flexibility.
Awareness can look like:
Learning how ego-syntonicity plays a role in maintaining anorexia
Understanding the way anorexia may have helped you cope/manage/protect yourself at some time
Exploring pros/cons of commitment to your eating disorder (acknowledging both what you may lose and gain if you let go of your eating disorder)
Identifying ego-dystonic elements created by your eating disorder: the fatigue of food obsession, the low energy, the numbness, the loss of friends…
Building a practice of self-compassion (No, everyone else doesn’t have an easier time in recovery. You aren’t failing — don’t let it convince you otherwise.)
Using language to externalize the eating disorder. It might feel cumbersome but there is a reason your therapist or dietitian redirects you from making “I” statements to “my eating disorder” statements.
Reconnecting with parts of your pre-anorexic life (people, hobbies, interests) that feel like they expand your world, or seeking out new ones
*Eddy, Kamryn T et al. “Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up.” The Journal of clinical psychiatry vol. 78,2 (2017): 184-189. doi:10.4088/JCP.15m10393
