Please enjoy her revised chapter which will soon be in the Revised Second Edition of my book, Just Tell Her To Stop: Family Stories of Eating Disorders.
Carolyn Costin’s Story
Being Recovered Is Possible
Interviewing Carolyn and writing her story gave me so much hope for all who are in recovery, and for their families. I found a great deal of encouragement in her story, and wish that you, too, can know that—for many people, complete recovery is indeed truly possible. Everyone has his or her own definition of complete recovery.
Carolyn embodies the kind of hope that all who are affected by eating disorders can look to for hope and inspiration. She recovered from her own disorder over 40 years ago, and had a successful private practice as an eating disorder therapist.
Carolyn is a firm believer that being completely recovered is possible, and it is a message she believes everyone needs to hear: “You can be ‘recovered’ where the eating disorder is truly gone, a thing of the past that you are not dealing with one day at a time. When recovered, you not only have the absence of symptoms, but you have gained healthy ways to resolve problems or meet needs that you once used eating disorder behaviors to cope with or express.”
Carolyn Costin, MFT, who recovered from anorexia, has specialized in the treatment of eating disorders and exercise addiction since 1977.
In the early 1980s, Carolyn established The Eating Disorder Center of California, which provided outpatient services in several locations throughout Southern California. Carolyn also served as clinical director for three inpatient eating-disorder hospital units. In 1996, Carolyn’s dream of opening the first residential treatment center in California came true when she founded Monte Nido, which grew into a group of world-renown treatment centers nationwide.
Carolyn pioneered the idea that people with eating disorders can be fully recovered, and she openly hired and trained other recovered staff members, which both she and her patients attribute as a huge part of Monte Nido’s success.
After selling Monte Nido in 2015, Carolyn founded The Carolyn Costin Institute (CCI) where she continues to provide both live and on-line education and training for professionals on the treatment of eating disorders. Her lectures and workshops range from presentations at national and international conferences, to local community organizations, schools, and week-long retreats for professionals.
Through CCI, Carolyn also trains and certifies Eating Disorder Coaches to work with clients in a variety of settings as an adjunct to traditional treatment. Although Carolyn trained and used coaches throughout her career, eating disorder coaching has not become mainstream in the treatment community. Carolyn believes this is partly due to the lack of rigorous training and certification programs available for coaches to get the proper skills necessary for the job. Carolyn created a 12-module sophisticated training program which includes a supervised internship. Many of the coaching students who apply have a personal history of an eating disorder, but must be two years fully recovered to be accepted into the program, where there is a special track to help them specifically know how to best use their own recovery and avoid common pitfalls. Carolyn believes coaching will become a normal part of conventional treatment.
Carolyn has written six books and a short manuscript on nutritional approaches that are popular with both professionals and the lay public:
- 8 Keys to Recovery From an Eating Disorder, (with Gwen Grabb co author 2011)
- 8 Keys to Recovery Workbook (with Gwen Grabb co author 2017)
- Yoga and Eating Disorders: Ancient Healing for a Modern Illness (with Joe Kelly 2016)
- Your Dieting Daughter; 2nd edition (2006)
- The Eating Disorder SourceBook, 3rd edition; (2006)
- 100 Questions and Answers about Eating Disorders (2007); and
- Anorexia and Bulimia, A Nutritional Approach (with co-author Alexander Schauss 1997)
Driving up to Beverly Hills from Simi Valley in the early 1960s with my mom and two siblings was always a bit surreal. We were heading toward my dad and stepmother’s mansion in Beverly Hills for our weekend visit, a huge change from the home my mother’s teacher’s salary afforded.
We were originally from Texas, and our dad was always dressed in a cowboy hat and boots that elevated his already 6’5” frame about seven inches taller. He was quite a commanding figure, and we looked up to him. Living in the California foothills, my brother, sister and I spent time running around outside, riding horses, and playing tag. We were innocent and unaffected by all that was changing in the world. Fashion and body image were unknown concepts to us.
Our lives were normal until my dad left for London to produce a western play. While there he fell in love with a fashion model. When he and the model returned to the U.S., he divorced my mother—and our lives were changed forever.
The message I received was pretty clear. My dad dumped my mom for this young stick-figure woman, who was a friend of “Twiggy,” the infamous model who set the weight bar for women in the late ’60s.
My experience epitomizes what females in America were beginning to go through. We left the innocence and “norm” of the ’50s for this new way of thinking: women needed to look like shadows of their former selves to be accepted as sexy and worthwhile. Not only was Twiggy popular with all my friends and me, I saw firsthand my dad choose a fashion model over my mom, and that sent an absolutely clear message of what was important and valued in terms of being a woman.
Our lives began changing as fast as our growing bodies—all of this happening during the time when the world was being impacted by the hippie movement. Moving from Texas to the wild and free craziness of Southern California in the early ’60s was a cultural change for all of us. There were so many changes all at once, including going from being a 12-year-old living with both of my parents to living part-time with my mom in Simi Valley and spending time with my dad and my now model stepmother in their rented Beverly Hills home.
Years later, after recovering from the eating disorder that inhabited me for seven years, I remembered a significant incident from that time. It occurred after my dad and stepmother married. My siblings and I were at their Beverly Hills mansion for our regular visit. I walked into the large white master bedroom and saw a closet with big, mirrored sliding doors, filled with my stepmother’s many clothes and interesting full-length coats, including mink and cheetah.
I saw the most beautiful pink mini-dress ever, and couldn’t resist trying it on. This was the height of the ’60s, mini-dresses were all the rage, and I was just becoming interested in fashion.
When I tried it on I couldn’t believe that it did not fit my now 13-year-old body. I was so embarrassed looking in the mirror, I made a vow right then that someday I would fit into that dress. For years I had forgotten this incident; remembering it was an eye opener into a part of my past, a piece of the jigsaw puzzle that contributed to my developing an eating disorder.
Two years passed after I tried on the mini-dress before I developed an eating disorder. Neither the pink mini-dress nor my model stepmother caused my eating disorder. As an eating disorder expert, I now know that my genetic predisposition, anxious temperament, perfectionist personality, dieting with all my friends, cultural pressure to be thin, and underlying psychological issues all contributed to my eating disorder.
As the teen body is growing and changing, it is challenging to maintain a sense of self-esteem. The unintentional damaging messages from the media seep into our delicate psyches, and plant seeds that can bloom into life-destroying disorders. I received the clear message: Thinness is beauty. If you are not thin, you are not special.
By the time I was 15, I had lost 45 pounds. The details of how I suffered with anorexia nervosa aren’t what is important here; what is important is what helped me to completely recover.
I remember feeling like there were two parts of me: the real, healthy self, and this other part that had taken over, the eating-disorder self. Eventually, I realized it’s not about telling the eating-disorder self that it’s bad and has to go, it’s about permanently strengthening the healthy part of the self so the eating-disorder self is no longer needed. It is a person’s healthy self that heals the eating-disorder self. This is not a quick fix but a slow process, just like developing an eating disorder is a slow process.
You don’t wake up one day with an eating disorder, and you don’t get rid of it that way either.
When I am asked how I recovered or what is the most important thing for recovery, the answer is a difficult one in some ways. The real answer to this question is found in my book, 8 Keys to Recovery From an Eating Disorder, because in it I discuss what I believe are the most important key elements to becoming recovered. Personally though, there are a few things in my situation that I think really helped me get better. One thing was that I never battled with my parents. They truly tried hard to understand what was going on in my mind, and I think this helped us not get into fights about my illness and behaviors. Having understanding parents who listened and talked helped me feel like they weren’t trying to take control. This helped me to be honest about what was going on with me.
Control is a word that always comes up with people who have eating disorders. There are many aspects to this, but one thing to note is that collaboration is important in the treatment, not just externally focused or forced change. Behavior change that is forced by outside control will only be maintained while the controlling force is maintained. Unless there is an internal shift, the person will go back to the behaviors because the eating-disorder self will just regain control.
Another interesting thing that helped was that my mom did a visualization technique with me about having an imaginary doctor inside of me. She would tell me to imagine that this real healing essence was breathing inside of me, and could heal me. We did this a few times during a period when I was pretty ill. She was the first person who actually taught me the concept of the inner healer—and how powerful we humans genuinely are.
As it was, I did not actually get much professional help. I was ill in the late ’60s and early ’70s, and not much was known about eating disorders yet. When my mother took me to our medical doctor, he took blood tests and had to admit that everything was fine. I took that as a green light to keep going. My mother then took me to a different doctor who told her I might be pregnant and trying to hide it. Undeterred, Mom took me to a psychologist, who tried to get me to drink a soda in front of him to see what I would do. I never went back.
I went to the college counseling center but the therapist there had never heard of eating disorders, and could not fathom such a thing as my being so thin, yet seeing myself as fat. I tried to explain that I felt guilty when I ate, and she suggested that if I felt guilty when I ate in front of others, perhaps I should eat by myself. The problem was that the guilt was my own. I felt bad eating, whether in front of others or alone. In fact, eating alone made things worse.
These experiences were so bad that I never tried to get further help. No one suggested family therapy or told my mother to try to be firmer about my eating. Most people did not even know what to call what I had.
I had the eating disorder for seven years, and feel that if the professionals back then (or my parents and I) had known what we all know now, I might have recovered much sooner.
During college, I started reading books on spirituality. The authors helped me begin thinking about being in a world where I wanted to pay attention to my soul, not just my body. This made a big difference in my life, and started to help me get better. Many books explained the difference between the ego and soul; many were various translations or western explanations of Buddhism. They all opened me to look at the world, myself and my soul in a new way. They helped me separate myself from my thoughts and feelings, helped me become aware of my own consciousness and beingness. They helped me place value and importance on things of the heart and soul rather than the scale and my fat gram intake.
I use these concepts in my practice and recommend these kinds of books to my clients when I feel it is appropriate. Some examples of the books I recommend to clients now are: Care of the Soul by Thomas Moore; Seat of the Soul by Garry Zukoff; When Things Fall Apart by Pema Chodren, a Buddhist Monk; and The Power of Now by Eckhart Tolle.
When working with clients, I try to help them reconnect and stay connected to their soul-self, a concept that is not often talked about. I teach clients that rather than being humans who are on a soulful path, they are souls who happen to be on a human path. I call their bodies their “earth suits,” and talk about caring for their bodies that their souls embody here on the planet. It sounds complicated but it is actually simple. I help people get connected to or reacquainted with what is truly sacred and most important in their lives. I help each client develop a stronger core, a healthy soul-self. I believe that once re-connected with what is truly important in life, the need for the eating-disorder symptoms diminishes.
Parents can be an important part in helping us develop a strong, healthy self. In my work I teach parents how to align with their child’s healthy self, and not make enemies with the eating-disorder self, but rather get the healthy self strong enough so it takes care of the eating disorder. As I began to recover, I began to gain back weight…and I would cry. No one understood why it felt so bad to be getting “better.” I always ask my clients to explain to their parents why “getting better feels so bad.” This helps family and friends understand the dynamics that keep fueling the eating disorder.
I believe families are an important part of the solution. I do a lot of work with individual family members, and have used multi-family groups to help family and loved ones understand the eating disorder—and also get help for themselves, and get the tools they need to continue to support their loved one in recovery.
I tell families that the goal of the therapy is to put myself out of business with each client, that is, making it so the client and family no longer need me. This is true (or should be, at least) for all therapists.
My job is to teach families what it is I do that works, so they can do it.
Every person who walks through my door for help has a healthy core person inside of her or him—as well as the eating-disorder self they have developed. When families are included in the recovery process, they can be trained to see the eating disorder is a part of the person, but that they can also find the healthy person in there. This helps significant others work to recognize and strengthen their loved one’s healthy self. Instead of getting in fights with their loved one, they begin to see that they can align with him or her against the eating-disorder self.
Learning to support someone you care about who has an eating disorder is a huge task, and it takes time and guidance. It is so easy to get pulled into the fights and lose sight of how important it is to support and guide your loved one back to health. Most families feel so hopeless and overwhelmed; it is essential to learn to take care of themselves, as well as how to care for the person who is in eating-disorder recovery.
I find it very annoying when I hear that parents are told their loved ones will not fully recover. Although it often takes a long time, people can be fully recovered. Some studies have shown that with family involvement, the recovery can be shorter.
Studies show that people with eating disorders can fully recover. Monte Nido has a very positive and hopeful outcome study that was conducted on patients from 1 to 10 years post-treatment. It shows 80–85 percent of the clients are either fully or partially recovered in an average of 4.5 years. I have been recovered since the early 1970s. I don’t have any desire to restrict food, weigh myself, take laxatives, skip meals, lose weight or use any of my past eating-disorder symptoms. I don’t need to deal with it one day at a time.
I believe that having found a deeper purpose and meaning to life was essential for me in order to gain a foothold on recovery. I decided I wanted to be a teacher, and becoming one helped me to have something else to care about. Going through college, I studied psychology and became a high school teacher for kids who got kicked out of regular school. I went on to become a school counselor, then after further study, I interned as a marriage and family therapist. I wanted to work with troubled teens.
As I began my psychology practice, I received a few referrals for people with eating disorders, and I successfully treated them. Soon people were referring clients to me from all over, and my practice grew. Eventually I was hired to run a hospital unit for eating disorders, then another. Over time, I knew I needed to open my own center. It gives me great joy to help others find their own purpose and meaning—and begin the process of shedding the eating-disorder self that prevents them from fulfilling their own life purpose.
Carolyn Shares Some of Her Philosophy:
1. I believe that the ability to be one’s true self and enjoy life is robbed by an eating or exercise disorder.
- Focusing on eradicating the symptoms is not enough, I work to help clients discover what they are recovering to, rather than get too stuck on what they are recovering from.
- Developing meaning and purpose is assisted by providing teaching in spirituality, lessons in understanding the difference between ego and soul and helping clients learn and practice the concept of “Tending The Soul.”
- Once clients are reconnected to the spiritual, sacred and soulful aspects of life, the need to use the eating disorder behaviors diminishes.
- The efforts, love, and support of family and friends has been shown to positively affect recovery.
- People who have recovered from eating disorders often cite being loved, believed in, and not “given up on” as crucial factors in their getting help and getting well.
- Clients need to get rid of the eating disorder behaviors, but the eating disorder self becomes integrated into the core self so there is only one whole person. The old eating-disorder self becomes the alarm signal or messenger serving to let the client know when there is something that needs to be attend to.
- Ambivalence is part of the problem, and is to be expected
- Lack of motivation is not a problem with the client, but it’s an important challenge for the therapist
- It is my job to help clients work with their motivation and ambivalence.
- I can’t make anyone stop their eating disorder behaviors, I hope I can make them want to stop.