Slip: Life in the Middle of the Eating Disorder Recovery by Mallary Tenore Tarpley is an important book. As far as I know it’s the first book that highlights the complex and ambiguous nature of the term ‘full recovery’ within eating disorder treatment and proposes the possibility of a middle ground. 

Each chapter combines memoir with journalistic work. Tarpley tells the story of her struggles of anorexia from when it was triggered by grief at losing her mother when she was eleven years old through sickness, hospitalisation and perceived recovery to a further relapse at college and a lapse following pregnancy. 

Each section of memories is followed by reflections on an aspect of the eating disorder from her present-day perspective combined with interviews and research. Subjects covered include: the relationship between eating disorders and grief, the problems of lack of eating disorder awareness in the medical professions and misdiagnosis particularly for BIPOC and those in larger bodies, and how the egosyntonic nature of restrictive eating disorders is supported by thin ideals and fat phobia in contemporary society.

At its core lies Tarpley’s concept of ‘the middle place’. She defines this in the introduction to the book as ‘the liminal space that many of us inhabit as we work our way toward wellness.’ She notes that the term ‘full recovery’ is complicated and inadequately defined. ‘The middle place provides a framework that is more inclusive of people who don’t see themselves as fully recovered… (who)… meet all the BMI and body-weight criteria’ but ‘still have distorted thoughts that dictate their choices regarding food and exercise.’

In ‘Chapter Six: The Possibility of Recovery’ she dives deeper. She speaks of how she felt eating disorder recovery was unavailable to her because some of her ‘treatment providers described it as the absence of the eating disorder and all the distorted thoughts that came with it… if I didn’t have anorexia would I still be me?’

In contrast to this approach she says, ‘It’s less about the eradication of the disorder but the elucidation of it’. Getting to know the ‘eating disorder self’, what triggers it, what messages it brings, so it can then be accepted and integrated with the ‘healthy self’ and the latter can be strengthened. She also speaks of onboarding the strengths associated with the eating disorder.

This was incredibly illuminating and reassuring for me. I’ve had an eating disorder since I was six years old. This began with binge eating then developed predominantly into restricting and over-exercising combined with binge drinking. Only recently, aged 44, whilst at a lowish normal weight but still struggling psychologically, have I had a clinical diagnosis. Having read Jenni Schaefer’s books, Life Without Ed and Goodbye Ed, Hello Me, and come across other anecdotes of full recovery that involve ditching weighing and calculating in favour of intuitive eating and leaving behind all weight-related and distorted thoughts, it felt impossible.

I’m autistic and my eating disorder is so bound up with my restrictive and repetitive behaviours that I don’t know where it ends and I begin. The best I’ve been able to do is harness my need for routine and fascination with science and need for calculation to create a healthier diet and exercise regime. Being able to weigh and measure is the only thing that stops me restricting or over-exercising out of panic that I might be in a surplus and gain weight. Thus, the eating disorder and I are currently at a point of uneasy allegiance.

When Tarpley was in the full hold of her eating disorder, she described it as: ’an invisible sea monster that had slowly wrapped itself around my body without my even realizing it’ tightening its grip to the point she ‘couldn’t break free.’ I’ve also seen my eating disorder as a serpent wrapped around me and a Siamese twin and felt that if we completely separated it would kill me.

This has helped me to accept where I’m at now better, whilst maintaining hope of improvement. Importantly, Tarpley states: ‘Living in the middle place isn’t about giving up on full recovery, it’s about viewing recovery as an ongoing process rather than a final destination.’

This book has been helpful for me both as a person with lived experience of an eating disorder and as a shamanic practitioner. I’m hoping that the insights within will help me to be more compassionate towards myself at the place I’m at in eating disorder recovery and to have a better understanding of clients who present with food and body image related issues.