"Life Without Ed..."

The Issue: Eating disorders affect seven million females in the US. This shouldn't come as a shock, since we all know someone who has a disordered relationship with food or their body image. But, unfortunately, many who suffer don't get help or know how to get better.

The Fix: Life Without Ed: How One Woman Declared Independence from Her Eating Disorder and How You Can Too, by Jenni Schaefer and her therapist, Thom Rutledge. Our expert, San Francisco marriage and family therapist Lisa Bograd, provides a detailed review of the book below:

This book chronicles Schaefer's courageous, agonizing, and ultimately successful journey to overcome her eating disorder. A singer/songwriter who now lives in Austin, Texas and has been appointed an Ambassador of the National Eating Disorders Association (NEDA), Schaefer writes with unflinching honesty about her "abusive" relationship with her eating disorder, whom she personifies and refers to as "Ed," and her subsequent liberation from this relationship.

Unlike other eating disorder autobiographies, Schaefer's inspiring personal story is interspersed with helpful exercises designed by Rutledge and targeted to the reader so that they too can do the work of learning to liberate themselves from their eating disorder, or from their disordered relationship to food and to their bodies. Readers are given the opportunity to take their own journeys, by participating in a host of exercises, including writing about their relationships with food, defining their own recovery and developing a relapse prevention plan.

As Schaefer explains, "When you are trying to begin your separation from Ed...you must be able to distinguish between standards that Ed holds for you and healthy boundaries that you set for yourself." The tyrannical voice of Schaefer's eating disorder would tell her things like, "You must always be the thinnest person in any given place on any given time," and, "You must always eat less than the people you are dining with on any occasion." Women who have been guided by such commandments will find hope in Schaefer's ability to see them as sick and destructive rather than healthy, and perhaps it will give them courage to cultivate a healthier voice within themselves.

Schaefer's therapist, Thom Rutledge, a Licensed Clinical Social Worker (LCSW), seems to utilize a therapeutic approach that allows Schaefer to see her eating disorder as something separate from her, instead of embedded within her. He employs a combination of therapeutic techniques, including cognitive behavioral, voice dialogue and drama therapy to get Schaefer to actively challenge the distorted beliefs that are embodied in the voice of Ed.

I myself tend to use a more traditional approach with my eating disorder patients, focusing on their family history and their psychological and sexual development, and seeing their eating disorder as a part of themselves that is speaking a language we need to understand before we can alter. As such, I was both riveted by and at the same time a little skeptical of some of the techniques Rutledge uses, like getting Schaefer to put all of her anorexic jeans in a pile on his office floor and to say goodbye to them. However, it is clear to me that this kind of work gets results with this particular patient, and that is what matters most. Whatever works to give eating disorder sufferers a shot at developing a more loving and life-affirming relationship with themselves is something I applaud.

In order to get better, it's critical for someone with an eating disorder to understand what it means to love and properly care for themselves. In one very poignant exchange, Schaefer is clinging to her eating disorder voice, which is telling her she is fat with a vengeance. Rutledge asks Schaefer pointedly, "Do you trust (Ed) to baby-sit the little girl inside you? Do you trust him to be with her at all, knowing what you know about him?" And through a voice dialogue series, Schaefer is able to understand how negligent and damaging it is for her to allow herself and her inner child to be abused by this malignant internal voice. As she says, "Caring for my invisible child teaches me about self-compassion. It helps me not to beat up on myself when I have setbacks with Ed. After all, I would never beat up on a little child--real or invisible."

My hope, like Schaefer's, is that somewhere along the way, readers will feel empowered to take up this important work and to apply it in their own lives. Schaefer, just like me, is on a mission to get women to challenge the distorted cultural messages we get and that we tell ourselves about how we can achieve happiness, feel good about ourselves and find meaning in our lives.

Related Ask Rxperts:
A friend of mine has a great body, but she's constantly dieting and picking at her "imperfections." How can I help her have a healthier body image?