If you look at how recovery is described in clinical and mainstream media settings, you might imagine it to be a series of befores and afters – a clearly delineated line. A division. A checklist of achievements and choices. Sure, there is an acknowledgment of the “messy” nature of recovery, and an awareness that it does not always occur in a stepwise manner. But this entanglement continues to centre around a forward progression to an end destination.
Black rocks by the ocean with a figure made of rocks
This might be helpful for some people – for a lot of folks, goals are helpful. Holding onto hope might feel impossible in the absence of a future vision. I would never want to say that this isn’t something you might find resonant or helpful. Many people I’ve spoken with over the years have recovered in ways that they link to goals; these are not necessarily are anchored in food, weight, or levels of movement. Broader life goals (finishing education, getting a job, finding a partner, etc.) can and often do scaffold recoveries. But what of the recoveries that occur alongside, adjacent to, abstracted from, or in tenuous relationship to “goals”? And what kinds of goals are deemed acceptable goals to set? Which goals, and whose recoveries in the service of meeting those goals, are legitimized?
It might surprise some people to know that I have never been much one for goal setting; given that particularly on the outside my life looks pretty bog-standard “successful,” one might imagine I’d been set on achieving milestones. To tell the truth, I’ve always found goals (especially when written down) to be constraining – the threat of not reaching that goal feels impossibly terrifying.
I entered eating disorder treatment eleven years ago to the day (as I write this). One of the first things I was asked to do was set goals; subsequently, for the next eight months, I had to set goals every single week. And I hated it. I set the goals, like I was asked, and I ticked them off one by one – paint my nails, bake Christmas cookies, wear jewelry… and so on. Making goals in a group felt particularly heinous, as I worried about what others would think of my goals.
I honestly don’t know what would have happened if I just decided not to set goals; I can only assume I would have been framed as not committed to treatment. Or perhaps my privilege would have shielded me, as it so often does.
I sometimes wonder what it would have been like to take a step back and unpack why goal setting felt so scratchy to me. How for me, doing so brought me further into collusion with the productivity-and-achievement oriented discourses that tied me up in knots. What might this kind of exploration have unveiled about the vision of myself I was recovering?
This is a very small, and probably inconsequential, example of how treatment systems are designed in ways that limit capacity for improvisation, favouring process and procedures.
I want to make two things clear, at this point in my rambly exposition. The first is that I recognize the systemic constraints that govern eating disorders care. Care providers are working within sets of expectations for what will be delivered and how, and in what amount of time. Rebecca Lester’s 2019 book Famished comes to mind here; her clear and compelling articulation of the systemic constraints (funding, models of efficiency, etc.) reminds me of how it is not a lack of goodwill on the part of practitioners, but the very systems within they work that limit capacities for improvisational, contextualized recoveries.
The second is that I see a time and a place for manualized care for eating disorders—even for structure and rigidity. I am not the first to remark on the potential irony (or even iatrogenesis) associated with treating eating disorders, often marked by rigidity, in rigid ways (see Helen Gremillion’s work, for instance). Still, and perhaps because eating disorders are often tied to rigidity, there is sometimes a need to put in place new rigidities, at least for a period of time, that will allow for different ways of being in relation to food and body.
One of the hallmarks of improvisational practice is that there is a container for creativity – some kind of boundaries that scaffold more creativity. In relation to the doing of social science research, for instance, Berbary and Boles (2014) write about how “creativity and fluidity can exist even when connected to “rigorous” scaffolding” (p. 405). So, engaging with improvisational or creative recoveries is not about doing away with any kind of structure or container, but rather allowing for more time and energy to be spent on exploring the affective, relational, temporal, and flexible aspects of making a life than simply aligning with a pull toward “normalization.”
Where does relationality fit?
Undoubtedly, “recovery model” orientations, which foreground looking at what recovery might be like in the context of the person (see Anthony, 1993), have been helpful for thinking about recovery beyond a clinical lens that hinges mostly on symptom remission, with the “rest” following on. However, others outside of the eating disorder space (e.g. Price-Robertson, Manderson & Duff, 2017) have noted how recoveries are done collectively – it isn’t all about rugged individualism and personal resilience. Further, the people involved in making recoveries might not be the prototypical nuclear family, but rather a network of chosen kin.
Recovery is also done in social context—again, this is not news to anyone who has thought about what it actually means to recover from eating distress in a world that is profoundly fatphobic (as well as racist, ableist, transphobic, and so on). This context doesn’t just exist in the ether but actually presses up against the materiality of our existence.
To say that recovery is relational is not only to foreground the important role that supporters play in its enactment, though that is a part of it. Rather, it is about thinking through what kinds of roles different people might play in helping to establish the boundaries of the container that holds the improvisation or exploration of recovery. And, rather than thinking about supporters and those in the relational network or orbit of people exploring recoveries as “resources,” we might consider how these people, too, are navigating their own practices of being in the world.
Why does it matter?
I will leave off with an interrogation of whether recovery is truly the choice (or series of choices) it is made out to be. Might it be more productive for us to move beyond a before and after framing and toward a perspective on how recovery exists within a relational network, in space and time, and through series of improvisational practices that branch off into different endpoints? Who are we recovering, anyway?
Eleven years into my recovery, recovery feels more improvisational every day. Some days the notes clash, others they sing. And undoubtedly, the container for my improvisation is crystallized in the relationships I have and the privileges I hold. Gradually unravelling the tethering of my recovery to harmful structures of productivity culture and individualized neoliberal dictates feels like the work of my life.
References
Anthony, W.A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 12-23.
Berbary, L.A. & Boles, J.C. (2014). Eight points for reflection: Revisiting scaffolding for improvisational humanist qualitative inquiry. Leisure Sciences, 36, 401-419.
Gremillion, H. (2003) Feeding anorexia: Gender and power at a treatment centre. North Carolina: Duke University Press.
Lester, R. J. (2019). Famished: Eating disorders and failed care in America. University of California Press.
Price-Robertson, R., Manderson, L., & Duff, C. (2017). Mental ill health, recovery and the family assemblage. Cultural Medicine and Psychiatry, 41(3), 407–430.