Rain: Thought On Cause (part one)

Bear with me, dear reader, while I lay out a long metaphor (people who know me would tell you that there’s nothing I love more than a long and meandering metaphor).

It is raining. There is a crowd of people who are all soaking wet. They all give different reasons as to why they were outside in the rain and how they got wet.

One says, “I like to play in the rain but I didn’t realize how hard it was raining.”

Somebody else, “My friends were out playing and it looked fun.”

Someone chimes in, “My sister was making fun of me for being afraid of the rain.”

One says, “I didn’t know it was raining.”

“Me neither,” says someone else.

One says, “I was already outside when it started raining.”

Another, “I had an umbrella but someone grabbed it from me.”

“Yeah, that happened to me too.”

And another, “I knew it was going to rain but I forgot to bring my umbrella.”

“I brought my umbrella but it broke,” says another person.

Somebody else says, “Someone pushed me out the door and into the rain.”

“This jacket said it was waterproof but it wasn’t.”

“It wasn’t safe to stay inside where I was.”

“I was trying to help someone else who was in the rain.”

“My car broke down and I had to get out and walk.”

“I missed my bus and had to walk.”

And so on.

Now, their narratives about getting wet are valid and deserve to be listened to and acknowledged. The factors that led them to be in the rain deserve addressing. For the person who likes rain but didn’t realize the intensity of the rain, how can they prevent themselves from making that mistake again? For the person who forgot their umbrella, what things can they put in place to ensure that they remember to take their umbrella when the forecast calls for rain? The person who had to go out in the rain because where they were wasn’t safe, needs help finding a safe place to be and support in resolving that trauma.

But here’s the thing: they are wet because it is raining. They all have different circumstances that led them to being in the rain or being unprotected from the rain but none of those things would have, or in fact, could have, made them get wet if it had not been raining. AND it is neither helpful nor necessary to address any of the other issues even (perhaps especially) the most serious while the person is still outside in the rain or even inside but still sopping wet. Get them inside and give them a damn towel.

So what does this have to do with the cause(s) of eating disorders? If you talk to lots of sufferers, you will hear lots of narratives about why they developed an eating disorder: societal pressure to be thin, bullying due to not being thin, needing to feel in control of something in their life, wanting their emotionally distant parents to pay attention to them, pushing their bodies to excel in sports, gender dysphoria, wanting to have or wanting to avoid sexual attention, wanting to keep their body looking prepubescent because they were overwhelmed by adult responsibilities, and so on. These narratives are valid. They are true to the person which is all that is necessary to be valid. And everyone deserves support with feeling overwhelmed and out of control, with meeting their (completely normal and healthy) need for attention, with navigating and unlearning diet culture, with healing from bullying and other traumas, and with living in a body that is congruent with their gender identity. And, it is also simultaneously, one hundred percent true, that none of these things did or could cause an eating disorder.

People develop eating disorders because they are neurobiologically and genetically predisposed to them. Just as the people who are wet are wet because it is raining. Some of the issues are absolutely reasons the eating disorder sufferers may have fallen into undernourishment and “triggered their biology” (for lack of a better word). Some of the issues are common comorbidities with eating disorders, existing alongside without being causal. Some are just things that happened at the same time. Some are narratives that sufferers put together to understand their experience of an eating disorder [this is not judgmental - it is human nature to create narratives to make sense of things we don’t understand]. Biology being the cause means eating disorder treatment MUST start with nutritional rehabilitation before any of the other issues can be addressed in appropriate ways. Otherwise, you are, at best, throwing towels out to people who are still in the rain; at worst, you are throwing buckets of water at them.