A query came up a few weeks ago on The Food and Feelings message board (http://groups.yahoo.com/group/foodandfeelings) about how to use feelings to prevent food abuse rather than going unconscious and being barraged by an onslaught of negative emotions after the abuse. This issue arose often during my years working at a clinic with polysubstance abusers who often felt little or no fear about dealing drugs— ignoring the real possibility of arrest—but were terrified about going to jail after being caught. These clients appeared fearless, but were not: they buried their fear until they were forced to face consequences. My work was to help them experience their full-blown, post-behavior fear before they behaved badly in order to prevent it.

The same process applies to eating or not eating. If your medical tests warn that you’re at high risk for major trouble in the near or distant future because of the way you eat (not eating enough, eating too much, or eating too many unhealthy foods), you should be fearful. That fear is meant to move you toward behaving in ways that are healthy. But if you don’t experience fear, as you are meant to, before diving into food or refusing to eat, then your fear response is not working properly. If you read my chapter on Anxiety in The Food and Feelings Workbook, you’ll see that fear is meant to guide self-enhancing behavior and deter self-harm. When you inhibit this response in relation to food—or anything else—you lose the ability to take care of yourself effectively.

Believe me, fear of disease and dying is your friend, not your enemy. Yes, it’s painful to contemplate the ruination of your body, ill health, and mortality, but it’s often the missing piece of the puzzle that you need to make healthful eating decisions. In order to experience appropriate fear about the consequences of dysregulated eating, you must remain conscious and connected to your feelings. Awareness is crucial to considering and predicting consequences and fear is key to making positive eating choices. The minute you go unconscious and forget about your cholesterol, electrolytes, and blood pressure, you shut down the possibility of using fear to avoid disordered eating.

Write down the reasons you have to be very afraid of what your eating disorder is doing to your body. Practice experiencing your fear and even intensifying it so that you know you can tolerate feeling the discomfort it brings. Read over your list before making food decisions and let the fear sink in—deeply. Stop making belief and refuse to let yourself go unconscious. Look to your fear every time you make food decisions and trust that it will guide you toward eating in a way that is healthy for your body.