Black & White Thinking in Autism and Anorexia

Black and white thinking: a topic that is all too common among neurodivergent individuals in ED recovery! Although I’ve worked on my mindset so much over the past couple years that I’ve really improved when it comes to thinking in extremes, it wasn’t all too long ago that this polarized thinking held me back from living a full life. In fact, I believe black & white thinking is one of the main reasons it is so hard to recover from an eating disorder, and that’s what I’ll be sharing in this post!

I’ll also be sharing why autistic individuals are more prone to black & white thinking, which is yet another way in which autism and eating disorders are linked. Of course, I’ll also be sharing strategies you can implement to not live life in the gray - because gray is boring and dull - but to live life in full COLOR! And speaking of living life in full color, that may just be the subtitle of my upcoming book, hint hint, cough cough! ;) If you're excited to learn more, keep on reading!

Thinking in extremes

You want to recover from your eating disorder, but going “all-in” feels like too big a leap. You want to eat some cookies, but are afraid you’ll end up bingeing if you as much as open the box. You want to have a healthy relationship with exercise, yet can’t help but feel that movement only “counts” unless you’re panting and sweating profusely. Does this sound familiar? Black and white thinking is really easy to fall into, especially in our world of diet culture that thrives off of labels from “good” and “bad” to “success” and “failure.”

So why are autistic people, especially those who go on to develop disordered eating behaviors, prone to these rigid thinking styles? To answer that, I want to take a step back and reflect on my own experience with black and white thinking. Growing up, I was as perfectionistic as the meaning of the word perfectionism goes. I approached everything with an all-or-nothing mindset, only committing to sports or games if I knew I could win, and believing I was only a good student if I got straight As. If I made as much as one mistake on a test I had studied the material for inside and out, I’d immediately deem myself a failure, completely overlooking all the answers I did get right. I was a huge people pleaser, never wanting to rock the boat out of fear that one disagreement or argument would lead the other person to “hate me”. 

If you’re nodding your head thinking omg, this is me, you seriously NEED to get on the waitlist for my book! It’s a memoir written in the style of a novel, in which I truly hold NOTHING back. I share my story in a way that is more raw, vulnerable, and unfiltered than I’ve ever shared before, uncovering parts of my life that have always been my own secret. I talk about what it was like growing up as an undiagnosed autistic girl, how my eating disorder developed because of that, how I manipulated the treatment system for years, what was necessary for me to recover, and really, just every step of the journey that’s gotten me to where I am today.

What is the purpose of black & white thinking?

I’ve spoken before on the importance of purpose, and more specifically, becoming aware of why we do things…because only once we become aware of a certain behavior and only once we become aware of what purpose it’s solving, can we decide whether we want to continue engaging in that behavior, or tread an alternative path. I mean think about it: you can’t fix a leaking sink if you don’t know it’s leaking in the first place!

When it comes to the purpose of black and white thinking, the purpose is that it provides a (false) sense of certainty and “control,” aka what autistic people are constantly trying to find, so we can better navigate a world that wasn’t built for us. It’s often believed that autistic people are super rigid and inflexible, but I actually believe it’s the opposite. Autistic people tend to be very open to new opportunities, but because we become so easily overwhelmed by the abundance of options and then fall into analysis paralysis because we can’t choose one, it’s so much easier to just have one single routine in place! This gives us something to rely on, which is what we need most in a world that’s just so dang unreliable.

How does black & white thinking contribute to eating disorders in autistic individuals?

I also believe this is a main contributing factor for autistic people in developing eating disorders. Following the rules of an eating disorder, which pretty much comes down to black and white thinking, simplifies life into deceptively neat little boxes where things either become “all good” or “all bad.” As long as you follow the “all good” rules, you feel safe from whatever it is you feel threatened by, whether that’s “bad” health, being shamed for your appearance and/or health status, “failing” to meet certain standards in school or in the workplace…the list goes on. The problem is, society’s rules – which are heavily influenced by diet culture – for what’s “good,” “healthy,” “attractive,” “impressive,” etc. keep changing. Which circles back to a core autistic trait, being difficulty with change!

As I’m typing these words, I’m yet again reminded of how flabbergasted I am about the lack of recognition and understanding when it comes to the link between autism and eating disorders. Now that I’ve made it my life’s mission to bridge this gap, break the stigmas, and ultimately help autistic individuals live the free and fulfilled lives they deserve, it’s truly insane how you start to see the connection between autism and eating disorders EVERYWHERE. So much so, that I’m like, how is basically every single health “professional” missing this? Anyways, this is yet another one of those times that I think: “Livia, you can only control what you can control, and must accept what you cannot,” and what I CAN control is providing you with my best value. So speaking of value, let’s talk about how you can break out of black and white thinking and why it may feel particularly difficult for autistic individuals.

Why are autistic individuals more prone to black & white thinking?

Psychologists use the term “coherence” to describe a more holistic type of cognition, which is the opposite of black-and-white thinking. Coherence is the tendency to integrate information in context. So, for example, you don’t do great on a science test, but instead of telling yourself you’re a failure who doesn’t know anything, you can see the event as part of a larger whole: you didn’t get enough sleep the night before, you were distracted by other commitments, or maybe science just isn’t your thing, which says nothing about your ability to excel in other areas. This has applications to diet culture as well. Integrating information in context can feel like an impossible task when confronted with all of diet culture’s dizzying and contradictory mandates – from lifestyle diet labels such as vegan to paleo and carnivore, but also product and food labels from low-carb-high-fat, low-fat-high-carb, no-carb-high-protein, no-carb-no-sugar-no-XYZ….the wheel keeps turning!

If you are autistic, difficulty with coherence will most likely resonate more deeply, and there’s a reason for that. Studies have linked autism with “weak central coherence,” or the inability to experience wholes without paying full attention to individual parts. This could be reframed as a proclivity for detail, which is one amazing autistic trait! Yet it can also be our Achilles’ heel, because hyper-sensitivity to detail can make us especially vulnerable to black and white thinking. There is, of course, a lot of heterogeneity and nuance here - not every autistic individual will necessarily struggle with this. But if you do, there is a lot of interesting research to explain why.

One major difference that’s been found between autistic and neurotypical people is the extent to which perception of the “global order” interferes with perception of the “local order.” Now before you put your hands in the air in confusion, stick with me here! Local order is the very concept you may have already observed in yourself: the details feel so important, so all-consuming, that it’s hard to see past them to the larger whole, or global order. My teacher didn’t call on me in class today, so she must secretly hate me. Or, my friend skipped lunch today, that must mean they secretly have an eating disorder too! The context of the situation – that your teacher was distracted, or that your friend may have been busy and made up for lunch later in the day – gets lost.

So how did researchers figure out that autistic people perceive details differently? There have been a lot of studies investigating this phenomenon, but one example is face perception. When we look at someone’s face, two things are happening at once: we’re perceiving the person’s individual features (their eyes, nose, and mouth) but we’re also perceiving the face as a single, integrated whole. In one particular experiment, participants were asked to identify faces right-side-up and upside-down. For neurotypical participants, recognition accuracy dropped significantly when the faces were upside-down. Why? Because “normally,” global order (the way the face as a whole looks different when it’s flipped) interferes with local order (the distinct look of each facial feature.) In the autistic participants, however, accuracy did not drop. This means that they were paying more attention to local features. For them, the fact that the “gestalt” (the organized whole) looked different upside down did not actually slow their processing time, because they weren’t thinking in terms of gestalt. They were thinking in terms of the details.

If you’re wondering why this is a problem – it isn’t! Like I said, attention to detail is an incredible autistic trait and in the case of this study, attention to detail worked in the participants’ favor! To label any thinking style as universally problematic would just be another kind of black and white thinking, and you know I’m all about living label free :) The more important question is, when does fixation on detail and/or neglecting the larger whole create unnecessary pain? In the case of eating disorders, a good example might be the tendency to obsess over the ingredients or “health” attributes of a particular food, instead of evaluating it in the context of your desires, your tastes and how the food makes you feel. 

Neurally rewiring black & white thinking in eating disorder recovery

When it comes to recovery, people often choose to stay stuck in the misery of life with an eating disorder because the idea of changing all your food rituals and routines feels too overwhelming. But this is where I want to remind you – and this is at the very core of the work I do with my clients during 1:1 Coaching – being fully recovered isn’t the result of one day waking up and declaring yourself recovered. It’s the result of taking small, consistent action steps over time. Being fully recovered is the result of both physical health restoration and creating new neural networks in your brain…and the only way to create new neural networks in your brain is to consistently give your brain a reason to create those new neural networks! Just as your eating disorder behaviors didn’t engrain themselves in one day, recovery-oriented habits cannot engrain themselves in one day. You’ve gotta keep showing up, keep doing the work, and over time, positive change is a natural byproduct!

If you want to work with someone who truly understands what it means to do the work, who truly understands how difficult recovery can feel, and who’s life’s mission is to guide you to full recovery while embracing your neurodiversity, I want to invite you to book a coaching session with me. Yep, that’s right, after several requests for single sessions, I now offer just that! Of course, you can book however many sessions you may need and you always have the option to pair it with my Extreme Hunger Course or 24/7 support, but to get to the point, know that you are NOT alone and I am here for you.

I believe the worst thing about living a life that’s ruled by labels is that it creates a negative feedback loop: you follow the rules and adhere to the labels, you get a short-term reward, and that reward reinforces the belief that you have to keep following the same rules or everything will become chaotic and messy. You might be thinking: "No, actually, I’d be fine with just one success. If I can just meet X goal, I’ll give myself a break!" But studies have actually shown that perfectionists tend to strive for even more difficult goals after a success. This helps explain why when you reach your “goal weight” or “succeed” at eating a minimum number of calories one day, you will set a new goal and push yourself even further the next, often to a point that is truly beyond your limits. It’s the reason anorexia is such a fatal illness, because the “success” that the illness makes you believe you’ll achieve, is never “successful” enough.

Strategies to challenge black & white thinking for autistic individuals in ED recovery

So what if you know you’re prone to black and white thinking and you want to stop, but don’t know how? Psychologists have done extensive research on this, and there are many strategies that have proven effective. Again, it may take several different approaches before you land on something that works for you, but that’s what life is for! Discovering what works for you may take a lifetime, but luckily, a lifetime is exactly how long we’ve all got!

One of my favorite strategies is to identify and challenge the black and white thoughts. As I mentioned earlier, this starts with becoming aware, because we can’t challenge something we’re not aware of! So, for example, your friend seems upset, and you instantly assume it’s your fault.

If you’ve ever taken a psychology class, you might be familiar with the term “cognitive distortions.” Aaron Beck, one of the founders of Cognitive Therapy, found through his practice that there are several types of common “distorted” thoughts that underlie a lot of different mental disorders. The one I described above would be an example of personalization - assuming personal responsibility for every bad thing that happens. Other examples are catastrophizing (expecting the worst), mental filtering (ignoring positive events/focusing exclusively on negative events), and mind reading (presuming that others are thinking critically of you.) All-or-nothing thinking is on the list, as well. If you’re thinking that there seems to be a lot of overlap between these terms, you’re right - they are all inflexible and fatalistic by nature. 

So, this week, I invite you to pay extra close attention to these cognitive distortions and try to catch yourself when your brain is going into all-or-nothing mode. In the case of the friend example, you can practice shifting your mindset from “it’s all my fault” to “I don’t know what’s going on in my friend’s life, so it’s most likely that my friend is upset about something that has nothing to do with me.” Not only will this conscious practice allow you to rewire your brain towards more fluid, nuanced thinking, but it will lift so much weight off your shoulders!

Once I stopped basing my self-worth off what I thought others thought of me, I gained so much SPACE in my life to focus on what really matters…and one of those things is what I’m sitting here doing right now, and that is bridging the gap between autism and eating disorders, and supporting neurodivergent individuals and their loved ones to a life that is truly worth living. If you appreciate my work, it would truly mean the world to me if you would consider becoming a Liv Label Free Patron! Creating free, valuable content is something I love to do, and your support allows me to keep doing it. Any donation amount supports this show as well as the publishing of my book and all my future content. I am so grateful for your generosity!

Sources:

1. Amaral, J. et. al. (2012). (PDF) beyond the black-and-white of autism: How cognitive performance varies with context. ResearchGate

2. Rozental A. Beyond perfect? A case illustration of working with perfectionism using cognitive behavior therapy. J Clin Psychol. 2020 Nov;76(11):2041-2054. doi: 10.1002/jclp.23039. Epub 2020 Aug 12. PMID: 32783218; PMCID: PMC7689738