Full recovery is so so so much more than gaining weight. There are cascading and wonderful mental state shifts and changes that actually lead to the mental freedom that recovery is all about. And this mental freedom is why the often overlooked neural rewiring aspect to recovery is so important. If you don’t gain mental state shifts in recovery, then you haven’t recovered, you have simply achieved a higher weight — which is a great achievement … and … there is so much more work to do.

Rehabilitate, Rewire, Recover! Is all about how to nutritionally rehabilitate and neurally rewire, so I am not going to get into too much detail on rewiring here. I just want to help some of you who are in recovery now understand the mental state differences that full recovery (neural rewiring as well as the weight gain required to get you out of energy deficit) should bring you. Remember, you can have an eating disorder at any weight, and if you are restricting your dietary intake in order to suppress your natural bodyweight, then you are not fully recovered. Also, if your brain still shows signs of believing that food is scarce (as a result of your restriction) then you still have an active eating disorder.

There are many, many, incredible shifts in mental state that happen with full recovery. One I want to draw attention to in this blog is what I call “mental flexibility.”

What is mental flexibility?

Mental flexibility is the ability to not have a full on internal meltdown if your plans change.

Many of us have a very 24 hour mindset when we have an active eating disorder. We count calories in 24 hour periods. We mentally log our exercise and movement efforts in 24 hour periods. For many of us, we are a living breathing groundhog day because it reduces anxiety for us to stick to doing the same routine every day. We learn what “works” for us in terms of food, movement, routine, and we feel safer if we stick to it. I believe one of the reasons for this is because if you are restricting food and your brain believes you are in a famine or food scarcity environment, it goes all survival instinct — habitual behaviour increases, because your brain likes to stick to what it knows is safe when it perceives it is existing in a hostile environment.

This leads to mental inflexibility. I’ll give you an example:

Phone rings. I answer it. “Hey Tabs, it’s Mum. Dad’s car broke down just outside of Romsey and he’s stuck waiting for the AA to come and tow it to the garage. I’m in London visiting Grandma so I can’t go and pick him up from the garage and take him home. Do you think you can go get him?”

Now, that is a perfectly reasonable request for me to go help my dad. However, that request would put me in a cold sweat and a huge mental meltdown. I would on the one side know that the right thing to do would be to go and help. But, I would also be freaking out because that would mean that my carefully planned out day would be interrupted. Even worse, sitting in the car and driving to Romsey, then back, would be over an hour’s extra sitting that day then I had planned, which would mean I would have to compensate by eating less. Unless I stayed up later that night and did more movement to compensate for sitting. And then there was the money aspect. I would be driving over there and that would mean using fuel, which I hated doing. Spending money was at least as stressful to me as eating more than usual.

To a person without anoreixa none of these problems seem like problems. I just wish I could give you a taste of how these things would feel in my brain. Remember, to a brain that is in anorexia-mode, moving less than usual and/or eating more than usual and/or spending money can make that brain have a full on HPA-axis fear response. And that is exactly what would happen. Then my brain would try and think at a million miles per hour how I could make it okay. How I could go get my Dad, and also do all the movement I needed to do that day, and also make more money to compensate for the gas (this was mental scarcity, I had a lot of savings, just in my brain then any money spent had to be made up for)? Sometimes in situations such as this it would be too much of a mental overload and I would shut down. Then I would simply say I couldn’t do it. Which seems ludicrous. If someone needs help I would always want to help, but often that natural desire in me would be overridden by my fear.

Or, I would work it out. And I would get in my car. I would shake the whole drive out of anxiety and stress. I would run the errand and then make up for it later, staying up until the early hours of the morning if needed completing whatever movement I might have missed earlier that day, plus additional to compensate for the extra time spent sitting in the car.

All this, is mental inflexibility. I could not mentally handle changes to my planned day without incredibly high levels of stress and anxiety. If I were to have to make a change, the stress of doing so would wipe me out mentally for a good couple of days, and I would often become even more reclusive than usual in order to try and recover.

I was never able to explain this to anyone. I imagine most people just thought I didn’t care when I declined sporadic requests like meeting for a coffee. I am sure that many of the friends who knocked on my door unannounced over the years and saw me scurry out of sight and pretend that I wasn’t home wrote me off as a weirdo. I imagine that people simply assessed I was selfish when I said I was too busy to help with something.

The reality was that I didn’t have the mental flexibility to deal with unannounced guests — despite being desperately lonely. The reality was that I didn’t have the mental flexibility to be the person who stops and helps. The reality was I didn’t have the mental flexibility to do anything other than exactly what I did every day.

And recovery — neural rewiring alongside the nutritional rehabilitation — teaches the brain that resources are not scarce anymore. Then the brain, gradually, begins to relax. Then one day, you realize that you just opened the door to someone rather than hiding behind it and holding your breath until they went away. And that is one of the things that means that life is starting again.