Lessons from Two Eating Disorder Classics

This content is educational and reflective in nature and is not meant to replace clinical advice.

As therapists, we learn so much from books. I wanted to write about a couple I’ve read recently and how I might bring their ideas into sessions. These are just ideas, but it’s fun to think about how classic therapeutic approaches can help people explore these themes in their own lives. I’ll include an example along the way to bring them to life.

Book 1: Eating in the Light of the Moon by Anita Johnston, PhD (1996) is a classic in the eating disorder field, especially for women and girls struggling with binge eating, bulimia, chronic dieting, and emotional eating. Through myths, folktales, and personal stories, Johnston helps readers see their relationship with food as a metaphor for unmet emotional needs, rather than something to simply control.

Book 2: 8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb (2012) is a practical, hope-focused guide. Both authors are therapists who have recovered from eating disorders themselves, and Costin is the founder of Monte Nido treatment centers. The book blends clinical expertise with lived experience, and includes client stories, journaling prompts, and exercises readers can work through on their own or with a therapist.

The Log in the River

The image from Eating in the Light of the Moon that has stayed with me most is the log in the river.

Picture yourself caught in a rushing, cold river. The current is pulling at your body, you knock into hard rocks at every turn, and you’re struggling just to keep your head above water. Then, all of a sudden, you see a log, heavy and strong, bobbing above the water. Without thinking, you throw your arms around it and hold on with all your might. For the first time in what feels like forever, you can breathe and rest.

On the riverbank, people are gathering. They can see the log, and they’re worried. “Let go of that thing!” they shout. “It’s dragging you down! Swim to shore!” They mean well. From where they stand, the log looks like the problem.

But what they don’t understand is that you don’t know how to swim. You know that if you let go now, you will drown. The log isn’t drowning you. It’s the only thing keeping you alive.

What This Means in Therapy

For many people, an eating disorder is that log. Bingeing, restricting, excessive exercise, dieting, obsessive thoughts about food and weight: these behaviors often began as a way to survive something overwhelming. Maybe it was loneliness, pressure, criticism, or never having a safe place to just be 🫶 you 🫶. The behavior can numb the pain, create a sense of control, or offer a short-term moment of comfort in a world that feels harsh.

So when someone comes to therapy, my goal isn’t to pry their fingers off the log. Ripping away a coping strategy before anything else is in place can leave a person feeling even more frightened and alone, and it often leads to the behavior coming back stronger.

Instead, the work is learning how to swim. Together, we slowly build new ways to stay afloat until you feel ready to swim on your own. Here’s what that can look like in therapy:

1. Learning to notice and name emotions

Many people with eating disorders feel either flooded by emotions or numb to them. Either way, it’s hard to work with something you can’t name. So we start by slowing down and getting curious.

What we do: In session, I like to use present-moment awareness to notice emotions as they show up. That might come through a story you’re telling or something happening right there in the room. We might tune into the body: Where do you feel this? What does it feel like? Sometimes we discover several emotions happening at once.

Once we’ve named an emotion, we explore it together:

• What does this feeling make you believe about yourself?

• Is it familiar? Where and when does it usually show up?

• What does it make you want to do?

  
  

If I notice someone uses the same one or two feeling words for lots of different experiences, we might brainstorm or “try on” new ones to expand your emotional vocabulary. We also look underneath the surface. When someone feels angry but doesn’t know why, there’s often loneliness or sadness underneath. Getting to that deeper layer is usually where we find compassion for ourselves and figure out what we actually need.

Why it helps: When we understand why an emotion is there, we can make room for it instead of letting it take control. With practice, you learn to ground yourself and return to the calm, steady, compassionate part of you that is always there. In Internal Family Systems (IFS), this is called the Self. It’s similar to what Costin and Grabb call the Healthy Self, which we’ll explore next. From that place, you’re strong enough to welcome any emotion.

2. Tolerating distress without being swept under

This one can be tricky, but it’s also really empowering, because it builds self-trust. The goal isn’t to push emotions away or ignore them. It’s to feel them without letting them run your day or stop you from moving toward what matters.

The ED voice and the Healthy Self: When we’re in distress, it often feels like two voices are competing for our attention. One framework I love for understanding this comes from 8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb (2012). They describe recovery as strengthening the “healthy self” so it can heal the “eating disorder self.”

The ED voice is usually the loudest. It can sound harsh, urgent, or rigid. But here’s something important: the ED voice isn’t simply the enemy. Like the log in the river, it showed up to help you with something. It might be trying to help you feel safe, in control, worthy, or less overwhelmed. Its methods just come at a big cost, and they don’t last.

The Healthy Self is the calmer, wiser voice underneath. It wants to help you meet that same need, but in ways that are kinder, more grounded, and sustainable. The Healthy Self is always there, even when it feels quiet or hard to hear.

Part of our work together is learning to recognize both voices. In my work, I like to add a step inspired by Acceptance and Commitment Therapy (ACT) and IFS. Rather than fighting the ED voice, we acknowledge it, and even thank it for trying to protect you. Then we strengthen your Healthy Self so it becomes easier to reach each time you feel caught in the middle.

What we do: ACT is one of my favorite approaches. We practice noticing difficult feelings, naming them, and letting them come along with us while we still choose actions that fit our values.

Let’s try it out: Say you struggle with excessive exercise. You planned to go for a run after work, but when you get home, you’re completely drained from a busy day. You notice that uncomfortable “in-between” feeling. Your Healthy Self is telling you to rest and make dinner. Your ED voice is telling you that you have to work out to “earn” your dinner.

Instead of fighting the feeling or giving in to it, you might:

• Name it: “I’m noticing discomfort.”

• Acknowledge the ED voice: “Thanks for trying to help me feel in control. I know you’re worried about what it might mean for me if I miss a workout.”

• Tune into your Healthy Self: “What do I actually need right now?” Maybe it’s rest, nourishment, or a slower evening.

• Let the discomfort be there, without needing to fix it, and bring it with you as you make dinner.

  
  

The discomfort might stick around for a while, but you don’t have to put your life on hold because of it. Often, the feeling actually gets smaller once you’ve paid attention to it.

Why it helps: Each time you ride out a hard feeling and choose your Healthy Self, you collect evidence that you can handle it. Your Healthy Self gets a little stronger and easier to hear, and that’s how self-trust grows. Over time, when you’re faced with a choice between your ED voice and your Healthy Self, the healthier choice starts to feel more natural and more within reach.

3. Finding words for needs that have been silent

It’s common for people with eating disorders to feel like they aren’t allowed to have needs. Maybe you’re the caretaker in your family and carry the weight on your shoulders. Maybe you learned early on to do what everyone else wanted, because there wasn’t room for your voice.

What we do: Sometimes the most powerful question is a simple one: What do you need right now? We practice asking it, and noticing what comes up when you do. For some people the answer comes quickly; for others, the question itself feels unfamiliar. Both are okay, and each points us somewhere a little different.

When you know what you need, but something gets in the way: You might know you need rest, connection, or space, yet still struggle to let yourself have it. Here, we get curious about the blocks. Is it guilt? Fear of disappointing someone? A belief that your needs are “too much” or that you have to earn them first? We look at whether the eating disorder steps in to cope with that gap. Then we practice small, manageable ways to meet the need more directly.

When you’re not sure what you need: If you’ve spent a long time putting others first or tuning out your own signals, you may never have had the chance to ask yourself this question. That’s where values work comes in. Instead of starting with “What do I need?”, we start with “What matters to me?” We explore what you care about, what brings you energy, and what kind of person you want to be. Your values can act like a compass. They point toward needs you may not have had words for yet, and help you begin building a life that feels more like your own.

Why it helps: When your needs have words, you can start meeting them directly instead of through food, exercise, or control.

4. Building relationships and supports that can actually hold weight

Are you taking care of everyone else, while no one is taking care of you?

What we do: We look at your support system honestly: who feels safe, who drains you, and where you might want more connection. We also work on your relationship with yourself, practicing self-compassion and learning to offer yourself the care you so easily give to others. Sometimes this means practicing how to ask for help, set boundaries, or let someone in.

Why it helps: The log has been carrying a lot of weight alone. When your own needs go unmet, relationships can start to feel depleting rather than nourishing. Real support, from yourself and others, gives you something sturdier to lean on.

Letting Go of the Log

As these skills grow stronger, something shifts. Your grip on the log naturally starts to loosen. It isn’t because anyone forced you, but because the log is no longer your only option. And one day, you realize you can let go and swim toward the shore on your own.

Here’s to learning to swim, one stroke at a time 🌊🪵

Ginger Freeman, LPC-Associate 💙

This post is for educational purposes and is not a substitute for professional treatment. If you’re struggling with an eating disorder, please reach out to a qualified provider or contact the National Alliance for Eating Disorders helpline at 1-866-662-1235.

References

Costin, C., & Grabb, G. S. (2012). 8 keys to recovery from an eating disorder: Effective strategies from therapeutic practice and personal experience. W. W. Norton & Company.

Johnston, A. (1996). Eating in the light of the moon: How women can transform their relationships with food through myths, metaphors, and storytelling. Gürze Books.