Going Back

Life threw me a curveball, and I reacted the best way I knew how: I quit eating. It's a lot nicer to be hungry than in pain. I played it cool at first... explaining away my behavior, minimizing my weight loss, insisting everything was fine. Everything was not fine.

Finally, last Friday, the bottom dropped out. I was called into a meeting with my entire treatment team (roughly fifteen people), my therapist at the helm. I was told that my weight is now below what it was during my initial inpatient admission back in March. I was told that I am considered "cognitively compromised." I was told, quite simply, that I'm in trouble. They gave me a week to figure out how to get myself back in-patient.

So I'm going back. It's only for two weeks; I already laid the entire foundation for my recovery the last time I was there. Rather, these two weeks will be very targeted. I will no longer be able to distract myself with hunger. I will eat, and I will feel. Both in large quantities, I'm sure. I will cry. I will face the things I have been suppressing. I will gain weight. (That last one is a real fucking sticking point for me, by the way.)

I'll be back just in time for New Year's, which is apropos. New beginnings and all that. I am hopeful. I am incredibly grateful for this opportunity to get back on track. And I am so, so thankful that there are so many people - my treatment team, yes, but also family and friends - who believe in me and my ability to get well.

I've said it before and I'll say it again: Eating disorders are horrible, and I regret the day I ever started down this path.

You Can't Have It Both Ways.

I've been told numerous times since my eating disorder was formally diagnosed eleven years ago, "You can't be sick and happy at the same time." I argue that sentiment to this day, but if I'm honest, I accept that it's true. No one with an addictive behavior - eating disorder, alcohol, drugs, gambling, shopping, sex, whatever - can really call themselves "happy." Numb? Disconnected? Aloof? Yes, absolutely. And those feelings are certainly an improvement over the hurt that underlies the behaviors. But happy? No, definitely not.

Last night in group therapy, we had a lecture on Pia Mellody's Developmental Model. It's basically a tree, with the leaves being addictive behaviors, the trunk being codependency, and the roots being trauma. In order to stop the addictive behaviors, we were told, we have to resolve the trauma. Kill the roots and the tree will die. Makes sense. Just a few breaths later, though, things started getting complicated. "You simply cannot do the trauma work while you're engaging in your behaviors," the therapist told us. "The behaviors keep you disconnected from your emotions, which makes healing the trauma impossible."

Okay, so let me see if I understand this. You can't overcome the addiction without healing the trauma, but you can't attempt to heal the trauma if you're using your addiction. Hm. Am I the only one noticing the problem here? Am I the only one really, really frustrated? It's like an unsolvable math equation, where no matter how many ways you rearrange the numbers, it just never adds up.

Maybe my frustration is a result of the sheer duration and entrenchment of my illness and the magnitude of trauma I haven't yet begun to untangle. Maybe I'm just tired of fighting what sometimes seems an unwinnable war. I am discouraged. I am confused. I am desperate. And yes, I am sick and unhappy. I WANT to be well. I WANT to be healthy. I WANT to be at peace. I wish the path was clearer. I wish I could figure out that damn equation. I never was good at math.

Ambivalence

Webster's defines ambivalence as "simultaneous and contradictory attitudes or feelings (such as attraction and repulsion) toward an object, person, or action."

"Ambivalent" is perhaps the most accurate description of my feelings toward the recovery process. On the one hand, I am deeply committed to doing all I can to overcome my disease. I recognize its threat, I acknowledge its destructive power in my life, and I want to be rid of it for good. On the other hand, it makes me feel better. It is comfortable and safe and secure, and I don't want to live without it. Simultaneous and contradictory attitudes indeed.

This has weighed heavily on my mind in the past few days, as I have been given a hefty ultimatum by my treatment team. To sum up, it's pretty much "shape up or ship out." My weight has not been stable, and unless I take drastic and immediate action to rectify the situation, I will be discharged from outpatient treatment with a recommendation for higher-level care. I can't go back in-patient; I have neither the money nor the time. So I have to get my act together and do everything I'm told, regardless of how miserable it makes me. "I'll tell you right now, I'm going to be a raging bitch for the next couple weeks," I told my therapist. "That's okay," she replied, "I can treat a bitch, but I can't treat a ghost." Touche.

And so I must put my nose to the grindstone and slog through the inevitable grief that comes with recovery. I must take it day by day, meal by meal, doing the next right thing every time I can. I am not happy about it. I am not even "okay" with it. But it is necessary, in that painful, unpleasant way a root canal is necessary. I will do it. But I will need help.

Famous Last Words

"I just wanted to prove to myself that I could still do it."

So that crooked manipulator in my head has been trying all kinds of tactics to horn his way back into my life. I had been doing pretty well coming up with bulletproof rebuttals. He'd say, "Look at your kids' friends' moms, they're thinner than you," and I'd respond with, "My kids need a mom who's present, attentive, and affectionate, not a mom who's skinny." He'd say, "You're giving up the only thing that makes you special," and I'd respond with, "Millions of people have eating disorders. I'm the only person with my unique personality and gifts." He'd say, "You'll be in danger if you give me up," and I'd respond with, "I have a great support system, I don't need you anymore." He's a persistent little bastard, though, and finally he got to me with the one thing for which I had no dispute: "I think you just can't do it anymore. Anyone can eat 'normally,' anyone can eat and throw up, but you used to be able to live on air, and you don't have it in you anymore." Damn.

So I thought, I just want to show myself I CAN still do it. That I haven't lost the knack. That I can still do what most people can't. I'll just cut a few things out, lose a little weight, and then I'll get back on track. It's just an expiriment, really. Just a test. No big deal.

"What's going on?" People started asking me. "Nothing," I'd claim, "You're just over-sensitive. I'm FINE." A little lie here, a little one there, after nearly eight months of brutal, unnatural honesty. Heading full speed in the wrong direction.

But then something funny happened. In the midst of the cacophony of weights and calorie counts and paranoia in my head, a little voice piped up. "What the hell do you think you're doing?" It said. "You're only hurting yourself. Do you really want to throw it all away? You made your point, you showed yourself that you can go back any time you want. Now cut it the fuck OUT, before you've passed the point of no return. You're smarter than this, you're stronger than this, and - most importantly - you deserve BETTER than this." And miracle of miracles, I agreed.

So I started copping to my misbehavior. I started admitting my mistakes. I started taking responsibility for my actions and my life, in an attempt to show that sneaky devil in my mind that the biggest challenge of all - kicking his ass - is more important to me than a number on a scale ever will be. I need accountability, friends. I need to be reminded again and again to keep my eye on the prize: a long, happy, healthy life.

Vacation, E.D. style

Think about your last vacation. Think about the food. Chances are good you ate all your meals out, ordered whatever sounded good, ate more than you normally do, and indulged in some special desserts and maybe a few cocktails. That's part of the vacation experience, right?

Now think about the kind of mind-strangling anxiety that deviation from normal might cause someone with an eating disorder. Let me give you a little insight into the stream of consciousness that takes place: "How am I supposed to know how many calories are in that? Is that cooked in butter or oil? How much is a serving size? Am I supposed to eat that? Does that fit into my meal plan? Oh my God, I just know I'm going to come home ten pounds heavier. This is disgusting. I'm disgusting. Why did I even come on this stupid trip? I am miserable. I have no control. I want to go home." Sounds like a fun vacation, eh?

We just took our annual family trip to Disneyland. Prior to going my weight had been doing a provocative little downward dance, and I had been warned that I was entering "the danger zone." I really had no room to mess around. The trip could go two ways, as I saw it: I could either use it as a really convenient excuse to stop eating ("I don't know what happened, I swear! I guess I just walked around a lot more than usual.") or I could use it as a chance to prove to myself that I can eat like a normal human being. I chose the latter, as I have neither the time nor the money to drive myself back into in-patient treatment.

So we went, and I ate. Not especially extravagantly, mind you, but certainly more and differently than I do at home. I had dessert. I had fried stuff and chocolate and *gasp* non-diet soda. "Look at me," I thought, "I'm doing just fine." But that's not entirely true. I spent a good percentage of our family vacation compulsively pinching my arms, legs, and stomach, trying to see if I was gaining weight as rapidly as I thought. I compared myself to every single woman I saw between the ages of 18 and 30, thinking, "Am I thinner or fatter than she is? If I'm the same size, is that okay? Why can't I have legs that little? She's got kids too, what the hell is my excuse?" It was exhausting.

So yes, I had some food victories, and I'm proud of myself for those. But it's clear that I have a very long way to go on the road to body acceptance. When I'm in my own home, immersed in my own routine, it's not too hard to feel secure in my body. I may not love it, but I deal with it. When I'm out in the Big Wide World, though, it's a different story. It's scary and threatening and full of uncertainty, so I run back to the only thing that keeps me safe - focusing on my body. To my own detriment.

Kind of ironic that the thing which makes me feel most safe is actually my greatest threat of all.

The Body Conflict

Fact: I can never have the body I want - the body I've always wanted, the one I've come so close to before - if I want to heal the wounds in my heart.

Fact: If I choose to dominate and manipulate my body, to whittle it into the image I have in my head, I will sacrifice my mental-well being and - almost assuredly at this point - sacrifice my life.

Fact: I do not want that body - that angular, clean, pristine thing - any less than I ever have.

Fact: I am furious by this. Spitting mad, in fact. So angry that I am precariously close to unleashing a torrent of four-letter words at my dietitian, whose insistence that my body stay where it is now is fueling my inner conflict.

I can articulate my emotions until the cows come home. If you've read my blog for awhile, you've seen evidence of that. I can wax on about the trials of recovery, the pitfalls of struggle, the beautiful victories of choosing life. Right now, I'm too mad for eloquence.

You see, here's a REAL fact: I have an eating disorder. Rather, IT has ME. Even after all I've learned, after all I've seen, after all I've been through, that little bastard has me in his scaly clutches. Sure, most of the time I follow my meal plan to the letter, keep all my appointments, show up to Group regularly. I walk the walk, in other words. But that sure as hell doesn't mean it's not a daily fight to do the right thing.

I've tried to figure out why this Body I dream of is so important to me. "It's just a shell," I try to tell myself. "It's not who you ARE." Ay, there's the rub. In my head, it IS who I am. In my head, excess flesh is tantamount to complete, shameful failure. I am told, week in and week out, that my body is "healthy." It is "where it wants to be." It is "how it was designed to look." These statements are maddening to me. They suggest that my body is simply beyond my control, and I have to accept it without conditions. That's not an easy task for someone like me.

I know I could go back. It wouldn't take me long to get that Body I fantasize about. I know how to do it; I've done it before. That knowledge is a comfort to me. But I also know that if I ever hope to put my past to rest, if I ever hope to live out the future I want for myself, I have to surrender the Body Conflict. I cannot be well and sick at the same time.

That understanding doesn't keep me from being angry, though. And it certainly doesn't stop that demon from whispering in my ear, "Just a few more pounds won't hurt you." This disease is a killer, friends, and it fights dirty.

Memory

Every day I carry a thousand tiny heartbreaks
in my pocket.
They sting my fingers when I'm reaching for my keys.
They jangle when I'm running for the bus.
Their razor-sharp edges cut me when I'm not careful,
which is most of the time.
Every once in awhile I try to clean them out.
They shift and splinter and multiply like ground glass
and they tatter my lungs when I inhale.
So mostly I let them sit quietly in my pocket,
piercing me with their reminiscence when I move
to walk away.

The time has come to tell the truth, to expose the demons of my youth

I am about to embark on the most difficult leg of my recovery journey yet. EMDR therapy. For those of you unfamiliar with the process, let me give you a layman's overview: EMDR stands for Eye Movement Desensitization and Reprocessing. It's a form of therapy designed for use in Post-Traumatic Stress Disorder (though now it's use is extending to include many other purposes.) The main gist is that, while intently focusing on details of a trauma, your brain is bilaterally stimulated - with lights, tones, hand taps, or other stimuli. When the trauma initially happened, the brain was not able to store the memories in a functional way. (Understandable, since it was kind of busy helping you stay alive.) As a result of improperly-stored memories, PTSD symptoms like nightmares, flashbacks, intrusive thoughts, and hypervigilance occur. The bilateral stimulation used in EMDR is thought to bring those traumatic memories to the forefront of the brain, then store them appropriately, thereby eliminating or greatly reducing the distressing symptoms.

There's your psychology lesson for the day; now I'll get back to how this is affecting my life right now. For seven months (or, since I first began seeing my therapist and she suggested it) I have been absolutely terrified of doing EMDR. I don't think it's possible to overstate my reluctance. The element that is so frightening to me is that I will literally have to bring the most horrific details of my trauma front and center in my mind. Let me put this in perspective for you: I have spent nearly 14 years starving, binging, purging, and cutting in an effort to AVOID those memories. Now I'm being asked to sit down and have tea with them. It's turning my world upside down.

I haven't spoken much about my PTSD diagnosis on this blog. I'm comfortable discussing my eating disorder, I'm becoming less inhibited about my self-injury. But the trauma? The very root of everything else? That's a lot harder for me to face. Especially in a public forum. I'll do the best I can.

I have a pretty extensive sexual abuse history, beginning with molestation at age 5 and culminating with a violent rape at 13. I kept my mouth shut for a long time, only admitting what little I have when a well-meaning counselor pushed me (too hard) to do so when I was 14. By then I was already entrenched in my behaviors and there was no going back.

I will be 27 years old next week. There is a lot of distance, time-wise, between the traumas and me. My brain doesn't know that, though. And with the cessation of my E.D. and self-harm, I no longer have any defenses against the onslaught of vivid, awful memories. I don't sleep much, because exhaustion is preferable to the nightmares. I have a ridiculously exaggerated startle reflex (something that "friends" used to rib me about in high school). The littlest things in my surroundings trigger intrusive memories that are all but impossible to get out of my head. I won't even start on the impact this has had on my marriage.

I'm scared. Like, really, really scared. I already have one foot out the door and on the way back to Madness because, while it's deadly, it's a hell of a lot less frightening. But seven months ago I made a commitment to myself, my husband, my children, and God that I would do whatever it took to free myself from my disease. I think I finally - FINALLY - understand that there will be no freedom without a long, hard look at the past. If you have ever found yourself at a point like this, please share your experience with me. If you suspect that you may find yourself at this point some time in the future, please reach out for support. We don't have to go this alone. We've already spent enough time in isolation, alienating ourselves from the world. It's time to grab hands and walk this road together.

Please excuse me, I'm late for my next mistake.

I'm going to admit something to you that I really, really loathe: I'm not perfect. Not only is my character imperfect, I am also inclined to make some really bad decisions on occasion. The kind of choices that, were my life a horror movie (not so far a stretch sometimes), you would be yelling at the screen, "No, don't do it! Stop! Go back!" Just as the poor misguided blond meets her untimely demise, I put myself into bad situations and cause myself unnecessary distress.

It doesn't happen all the time, thank goodness. I AM capable of making good decisions, particularly when the outcome involves other people. I suppose the stakes are higher to me when someone else could get hurt. Why, then, do I not recognize myself as equally important as everybody else? That's probably one of those questions that requires 250 hours of therapy to unravel.

Self-sabotage comes to mind. I'm pretty damn good at it. Things are going along fine, the water is calm, and I don't like it. I throw a stone into the still water because the ripples soothe me. I'm used to chaos. I'm accustomed to suffering. It sucks, but it's comfortable. Comfort is a really powerful motivator. We humans are biologically driven to stay close to our baselines: physical, mental, emotional. When your emotional baseline is one of distress, like mine, the world just seems wrong when everything is okay. It may not make a lot of sense (why would anyone WANT to live in constant turmoil?) but at the same time I think it's pretty accurate.

I think, for me, it comes down to fear of the unknown. I simply don't know what it would be like for my life to be simple and calm. I don't know what I would do with myself. How would I function? It's a scary thought. Recovery, though, is about facing your fears. It's about acknowledging all of that awful stuff from the past that you've been running from for so long. It's about recognizing the uncertainty of the future and having faith that maybe, just maybe, you'll be all right.

It's Always Darkest Before the Dawn

"Why did this happen to me?" "Why does it hurt so bad?" "How will I ever get through this?" "Will I ever get a break?" Sometimes in life, the blows just keep coming. One suckerpunch right after another, with no time to catch your breath. It's easy, in those times of chaos, to become bogged down in despair, desperation, and hopelessness. I know. I've been there.

A wise person once told me (translation: my therapist told me last week) that wisdom is not gained from the good times. Wisdom is gained from going through hell and coming out on the other side. So what do you do when you're IN hell, and the other side seems so far away? Do you curl up in a ball and try to wait it out? Do you revert to those behaviors that have been there for you in the past - starving, purging, cutting, drinking, using? Do you just throw up your hands, say "fuck it," and give up?

All of those options are there, will always be there. But choosing one of those paths prohibits growth and impedes the development of wisdom. Having gone through the things that I have, lived the life that I've lived, I simply HAVE to believe that there's some greater purpose in my suffering. None of it is in vain, if we make the choice to use our pain to propel ourselves forward. And it IS a choice. I could have thrown in the towel long ago (in fact, ten years ago I tried to do just that, and it was only by some cosmic miracle that I came out of it okay). I have a suitcase full of reasons why it's all just Too Much. But I also have desire. Passion. Motivation. Dreams. So I've chosen to fight this never ending war. I've chosen to suit up and show up, day after day, despite the fact that there's no uphill battle quite like Life. I've chosen to use my experiences - the good, the bad, and the ugly - to grow as a person, and maybe, hopefully, to help someone else get through similar trials.

Yes, in the middle of the darkness it's awfully tough to believe it will ever be light again. It is my sincere hope that you will choose, as I have, to carry the faith that it really is darkest before the dawn. Daybreak will come, my friends. It always has, and it always will.

A Note on Shame

"Shame is a little whip we always carry with us. We can shame ourselves easily; the little whip stings. We often use it to punish our feelings, because they evoke the helpless children we were. So we learn to suppress our feelings of fear, or rage, or desire. We would rather not feel at all than feel the sting of shame.

Why should we punish our feelings? Everyone feels much the same things. Why should our humanity shame us? Perhaps somewhere we acquired the notion that it's wrong to be human; that an inhuman perfection is the only proper public image.

Love can heal the pain of shame. Self-love and self-acceptance can make us strong enough to discard the little whip. We're much more lovable when we acknowledge our humanity and let go of our shame. We're also better able to love others. Shame shuts us up; love opens us to joy."

-from "The Promise of a New Day" by Karen Casey & Martha Vanceburg

The Importance of Support

I don't think it's possible to overstate the importance of support in recovery. I want to discuss two fields of support that I believe are equally vital: clinical, and family/friends.

First, clinical support. I can say with 100% certainty that I would not be where I am today were it not for the guidance of my treatment team. Those people include my therapist, my dietitian, and the other therapy/dietary staff at my outpatient program. I have been so blessed to find a therapist who is absolutely committed to her work, passionate about her calling, and unfailingly ethical. She also never hesitates to call me out on my bullshit. I trust her completely, and for me, that's a big deal. She's firm and tough when she needs to be, but she's also beautifully compassionate and mercifully gentle. My dietitian knows her stuff through and through, and unflinchingly combats the eating-disordered thoughts that threaten to take me back to where I used to be. She understands the reality of this disease, its power, and - thankfully - the ways to beat it. The other members of my team are there for me on a daily basis, encouraging me when I succeed, and supporting me when I struggle. I am grateful for all of them.

Family and friend support is different, but just as important. Many of my friends and family members don't understand first-hand how this battle works, but that doesn't diminish their impact on my recovery. To have people to go to when I just need a hug is pretty powerful all by itself. Then there are my peers in recovery, who intimately understand the nuances of the disease. Their empathy and solidarity are beacons in the night.

It is impossible to go through this journey alone. I know; I tried. It is a very long road, littered with blind turns and potholes and flash floods. It can be awfully discouraging. But - as with any endeavor - it's a road best travelled with company.

When Will It End?

After years of procrastination, fear of failure, and general too-sick-to-do-anything-useful-ness, I have finally jumped headlong into the job hunt. I was so excited about it at first. I'm finally going to make something of myself! Prove I'm worth something! Show everyone what I can do! Not too pathological, eh? Anyway, I spent hours scouring the job openings in my field of healthcare, comparing pay differentials and weighing the costs and benefits of various positions. I discovered that psychiatric clinical support positions were not only plentiful, but more financially rewarding than some of the other options. So I began applying. I shared my enthusiasm with Larry, who didn't seem as jubilant as I was. He suggested I run the idea of working in a psych facility past my therapist. I rolled my eyes, but made the call to appease him.

Well, wouldn't you know it, my dear therapist seems to think it's a terrible idea. She explained that seeing the patients, hearing their stories, would bring up my own issues. She said that when she worked in similar settings, she found it traumatic even without having a "trauma history." She said that the typical recommendation is for clients to avoid working in the mental health field for at least two years after recovery from their trauma - and as she not-so-delicately pointed out, I'm not even IN recovery from my trauma yet.

So I got mad. Furious. Incensed, even. I started pinging back and forth between playing the victim ("I never asked for any of that stuff to happen, it's just not fair that I'm still having to pay for it") and blatantly perpetrating myself ("You stupid, cowardly baby, grow a pair and move on for God's sake. You're a waste of space.") I'm trying to hang out in the middle... accept that, while this isn't the ideal situation and I don't have to like it, it is what it is and I have to change tactics.

It's difficult, though. I am incredibly tired of avoiding my problems by hurting myself, and equally as tired of "taking care of myself" to the point of never taking any risks. I JUST WANT TO GET ON WITH MY LIFE.

Ever feel that way?

Reality Check

The National Center for Victims of Crime reports that 1 in 3 girls and 1 in 6 boys will experience some form of sexual assault. Other startling statistics include:


· 1 in 6 women and 1 in 33 men will be a victim of sexual assault in their lifetime
· 20 – 25% of college women are raped during their college career
· 80% of women and 40 – 60% of men with disabilities will be sexually assaulted before the age of 25

There's a reality check, eh? I have to mention that the NCVC includes the following in its definition of "sexual assault": rape, incest, child molestation, groping, fondling, inappropriate sexual conduct with a minor, and sexual exhibitionism.

Think of all the women you know and love. Then try to grasp that one in six of them have already or will someday become a victim. Makes you angry, doesn't it?

Some day I will post my story of sexual abuse and rape on this blog. I'm not quite ready for that yet, though. However, I view it as my personal responsibility to educate as many people as I possibly can on the very real and very destructive reality of sexual violence.

If you would like more information on statistics or resources, I suggest checking out the following organizations:

RAINN (The Rape, Abuse, and Incest National Network) http://www.rainn.org/

Stop It Now (Together We Can Prevent the Sexual Abuse of Children) http://www.stopitnow.org/

Child Help (Prevention and Treatment of Child Abuse: http://www.childhelp.org/

Pandora's Project (Support and resources for survivors of rape and sexual abuse) http://www.pandys.org/

ASCA (Adult Survivors of Child Abuse) http://www.ascasupport.org/

Misconceptions and Delusions

I was online this morning looking for E.D. statistics for something I'm writing. My search of "incidence of anorexia and bulimia nervosa in pre-teens" yielded some shocking results. In addition to the factual information I was looking for, I was led to some "Pro-Ana/Pro-Mia" websites. They are stomping grounds for aspiring anorexics and bulimics encouraging each other on their paths to destruction. I remember looking at sites like that when I was in my teens, cruising for tips and tricks. However, with the public backlash against these sites several years ago, I assumed they had all but disappeared. Boy was I wrong.

I read with horror posts by girls (some as young as 11) about their desire to be sick. The "glory," the "success," the "uniqueness" that could be achieved - in their distorted minds - only by being painfully, dangerously thin. It made me very sad, and then it made me very angry.

This glorification of eating disorders is simply preposterous. Let me tell you what my disease drove me to do. I threw up in gas station bathrooms, in alleys, in bushes, on the sidewalk next to my house, in the school cafeteria, on dates, in fancy restaurants, and in one very, very regrettable situation, at church while everyone else was taking communion.

I once licked a piece of rotten mean hoping it would give me food poisoning. I researched tapeworms on the internet to see how to go about contracting them. I ate boxes of chocolate laxatives at a time, and spent the next several days writhing in pain on the toilet. I took Ipecac by the vial, getting so sick I would vomit on myself because I simply couldn't muster the strength to get to the bathroom.

I worked out constantly, agonizingly, pushing through cramps and sprains and lightheadedness, to the point of being told by gym staff that I was upsetting the other patrons.

I ended up in the hospital over and over and over. Dehydration, electrolyte imbalance, arrhythmia. I yanked IV's out of my arms because I was so terrified the saline would somehow make me fat.

I spent years of my life that way. Did I achieve any kind of glory? Quite the opposite. Instead, I was a miserable, deathly-ill shell of a person. I put the people around me, the people who love me, through absolute hell. And I never got where I wanted to be... because that's the truth: No matter how thin you get, no matter how much weight you lose, no matter how hard you work, it will NEVER be enough. You will try and try and then you will die, and that's a fact.

If you know a young person who makes statements about her/his body that are disparaging, please don't take it lightly. Every journey begins with the first step, and every eating disorder begins with the first skipped meal. These diseases are deadly. Please join me in doing all you can to protect our children!

You say you understand, but you don't understand...

I have a lot going on in my head right now. What I'm about to say may be irrational. In fact, it probably IS irrational. But it's where I am right now, and I will not invalidate it with "shoulds" or "shouldn'ts."

In the last two weeks, I have had the same sentiment repeated to me by different people in different ways. Their opinions are as follows: "Look at the great life you have right now. You never would have gotten it if you hadn't been through what you have. You should be grateful." "Someday you will look back on your past and be thankful that those things happened, because they helped shape who you are now." "What happened happened, you can only go forward from here."

I understand the motivation behind these statements. I get that people are trying to be encouraging, inspirational, that kind of thing. But you know what? IT PISSES ME OFF. When you've been molested repeatedly, when you've been held down and raped, then you can tell me how I should or shouldn't feel. When you've had your innocence ripped from you, you can tell me I should be grateful. Until then, I DON'T WANT TO FUCKING HEAR IT.

The fact is, I'm NOT grateful. The fact is, I am desperately hurt and wildly confused and frighteningly angry. I love my husband, I love my children, I love my happy little life in the suburbs. I wouldn't change it for anything. But that sure as hell doesn't mean I'm okay with everything that came before it.

If you're a well-meaning friend or family member, let me give you a piece of advice: Instead of telling your loved one how they should feel, or, worse yet, imply they lack gratitude, try this. Simply say, "I'm sorry you had to go through that. I love you, I'm here to listen if you need to talk, and whatever you're feeling right now is okay."

A Crack in the Armor Shows the Silver Lining

If you read last week's post, you may have gathered that I got called out pretty harshly. Part of my issue had been my reluctance to share more openly in groups. I was fond of saying, "I'm not comfortable discussing ______ here," or "I don't want to talk about ______ right now." Apparently that sort of refusal to disclose shows two things to the treatment team: 1) I simply don't want to participate, and 2) I believe I am "terminally unique" (a bit of psychology jargon meaning that I don't believe the rules apply to me as they do to everybody else). I was mad as hell upon hearing that, but after a bit of pouting and stomping of feet, I took the feedback in.

The fact is, the team was right on both accounts. I didn't want to participate in certain conversations because to do so would mean facing thoughts and feelings at which I had no desire to look. Also, I really did play the terminally unique card. Often. I was stellar at giving constructive feedback that I would never apply to my own life. I must have been a very obnoxious client.

So I took what I heard, and I used it. For the last week, I have completely thrown myself into groups and therapy. I have forced myself to be totally open to all of the activities and conversations, many of which made me profoundly uncomfortable. Case in point: last night in group, we had what is called a "Shame Circle." All the clients sit in a circle with a stack of paper. We go around the circle and admit something aloud that we are ashamed of, then we crumple the paper and symbolically throw the shame away. Let me tell you... there is nothing quite as terrifying to me as sharing my shame with others. That's the nature of shame; it makes you want to hide, to lie, to cover up. This kind of activity flies in the face of all the work I've done to block my shame for years.

I cried. Good God, did I cry. Each time my turn came around, I dug deep and gave a voice to things that have plagued me for years. "I am ashamed of being a financial burden on my family." "I am ashamed of being a bad influence on my children." "I am ashamed that I have never been as dedicated to anything as I have been to hurting myself." Ouch. And it wasn't just me; every person in that room was eviscerating their innermost secrets. The emotion was palpable. Even our steadfast therapy staff were having a hard time keeping it together.

After the group was over, a funny thing happened. I was okay. I hurt, and very deeply... but I was okay just the same. I allowed myself to feel whatever came over me, and didn't fight it with my usual defensive fervor. To put it plainly, I did what I have been taught to do. I went home, I spent time with my family, I went to bed. I got up this morning in a cheerful mood.

Listen, friends. This therapy shit WORKS. I've spent a decade in and out of treatment, in and out of therapy, repeatedly refusing to be open to the possibility that things could ever improve. Guess what? Once I finally laid my weapons down and listened, and spoke honestly, things actually began to get better. Imagine that.

Stuck

Have you ever had somebody call bullshit on you?
Had somebody hold up a mirror to you
and you don't know whether to scream or run or sit and take it like a man
or stand and fight, let the punches fall where they land
So maybe I'm dramatic
or a fucking fanatic
or maybe I'm just good at it
and I gotta be good at something

This is my life, not some TV movie
the shit that happened molded and moved me
So maybe I'm not a well-adjusted girl
Maybe I don't live in a well-adjusted world
I think I deserve to be a little bit mad
at God for all the shit that I never had
And I think I deserve to throw some punches around
Hope they connect with the throats of those who held me down

So yeah, this is me and I don't know what I want
Don't know who I am or what life that I want
I just know I'm sick and tired of all of this lying
Mad as hell that I can't seem to stop crying
Maybe I needed to be called out to reality
Maybe I had to see that it all comes back to me
It's a choice and I fucking hate making choices
I'd rather be a real crazy out chasing voices
that aren't there, but I'm there, and life isn't fair
Sometimes I just wanna close my eyes
and pretend it's not real
But it is, it always has been, and right now I feel
stuck.

A Letter to My Old Friend

To My Dear Old Friend:

I think this is finally good-bye. You have been my constant companion for half my life, and leaving you behind is anything but easy. I lost another best friend once; he turned on me just as you have. It aches in my bones now as it did then.

Remember when we first teamed up, you and I? You were the answer to a thousand lonely, desperate prayers. You were my escape from a hellish misery with which I was unequipped to deal. I convinced my child-self that you were my only path to redemption.

Oh, how you came through for awhile. At first, people validated my hard work. Then, later on when you had dissolved my body like acid, they sat up and took notice of my suffering. No one had ever done that before. My body was crying out in the pain my voice had kept silent for so many years.

As in any good tragedy, the relationship began to sour. You grabbed the reins, and took the control you promised would be mine. I became your battered spouse: in danger if I stayed, but too terrified to leave, still convinced things could go back to the way they were at the beginning.

I know better now. I see you for the parasite you really are, and I will be your host no longer. My voice, which got so hopelessly lost, is finally finding its way back. I can make it without you. I will miss you, and I am grateful that I had you at a time when I had nothing else to see me through. But I am stronger now, and getting better every day. My power no longer comes from you; it comes from within me.

Good bye,
Cassie

Radical Acceptance

One of the skills being taught at my outpatient program is called "Radical Acceptance." The idea is that the refusal to accept reality is what leads to suffering (and while pain is inevitable, suffering is a choice). In order to overcome your own suffering, you must accept your reality: be it your disease, your family dysfunction, your trauma, whatever. A distinction that has been made (to me in particular) is that acceptance is NOT the same as approval. You can strongly disapprove of a situation, but still accept that it is reality.

I can't do it. Yet, anyway. Or maybe I WON'T do it. There are some "realities" in my life that I simply will not accept. I demand to know why these things have happened, and without a crystal clear explanation (from whom? from God? I don't know...) I won't concede anything.

Kind of a problem. I have my behaviors under control. I'm doing everything that's asked of me, miserable as it makes me feel sometimes. I am trusting the recovery process. But I just can't do the radical acceptance thing.

Shit. Guess I'm stuck for awhile.

Soliloquy

O how it stings when the knife twists.
My hot tears carve a path down
the soft curve of my cheek.
It seems that the pain may never end.
Shakespeare had it right:
"To die, to sleep -- to sleep,
perchance to dream..."
For in my sleep of death the dreams that
come bring no relief.
My pillow bears the weight of
a thousand violations.
Who says nightmares can't hurt me?
My memories are vengeful warriors
and sleep their battleground.
My only hope for victory is to awaken;
ay, there's the rub: for in that
blissful consciousness lies the promise
of another bloody night of war.

God's Presence

My spiritual journey has taken place side-by-side with my disease. I have had periods of feeling utterly abandoned by God, and times of feeling overwhelmingly blessed and forgiven. Even now, when my faith is more established than it has ever been, I still falter sometimes. Below are two poems, one of which highlights my frustration and disconnection, and the other my reprieve.

SILENCE

Hey you. I'm talking to you.
Seven billion people and you're supposed
to listen to me?
They told me to pray.
Said you died for my sins.
Really? Seems a little drastic.
Where have you been, anyway?
I could have used your help a couple of times.
I turned the other cheek like you said.
It just got me slapped twice.
I tried to believe in you, you know.
Didn't really work out for me.
"Who's your daddy?" he said. And I
thought of you.
Then the knife broke the skin.
Mustard seeds and loaves and fishes and
prodigal sons never meant much to me.
What I remember is "Who's your daddy?"
and how you weren't there.

MY PROOF

In the stillness
I feel Your grace.
When I chase after it,
when I yearn for it,
my hands are empty.
But when all is quiet,
when I am broken and
have given up,
Your finger is upon me.
It is in those moments
of heartache and contrition
that I am redeemed.
Your mercy, like rain,
has washed me clean.

The Power of Suggestion?

Tonight in our Body Image group we had a rather enlightening assignment. We were to come up with a body affirmation - something positive about our bodies that we do not currently believe but want to believe in the future. Then we had to fill out a worksheet answering questions about that affirmation. It seems like a rather straightforward exercise, but it threw me for a loop. It exposed the core belief that has driven my eating disorder and other self-destructive behaviors for years. It also shed light on why my progress is going so slowly and painfully. Here is my affirmation, and the ensuing Q&A.

AFFIRMATION: "My body is not the cause of my past suffering."

"If I feel this way, then I will have to..." stop punishing and blaming my body for all the hurt in my life.

"Then what might happen?" I will have nothing or no one to blame.

"If I feel this way, then I will no longer be able to..." excuse all of my self-destructive behaviors.

"Than what might happen?" I would have to stop acting out against myself.

"If I feel this way, then I will run the risk of..." losing my entire identity.

"Then what might happen?" I won't know who I am or why my life has been the way it has.

"If I feel this way, what aspects of my identity might I have to let go of?" My identity as a bad, dirty, unfixable person.

"Then what might happen?" I don't know, and that scares me.

It is with trepidation that I proceed...

I have been writing poetry like a crazy person. It just comes pouring out. Make no mistake, I'm not painting literary pictures of spring rains or blossoming tulips. My work is dark, sometimes explicit, and always very personal. I have gone back and forth for weeks deciding if sharing it on this blog would be wise. In the end, I remain uncertain. But I do know this: as important as understanding the complications and resolutions of eating disorders is, understanding their origins is just as vital. No two people arrive at an E.D. in exactly the same way. Some come by way of chaotic families, others by controlling parents, others from seemingly idyllic pasts, and some - like myself - get here with suitcases full of unresolved trauma.

No matter what form a person's eating disorder takes, no matter how long or short a time the person has suffered, recovery is simply NOT possible without digging into the root causes. That's why my recovery has taken so long to even begin. I have been unwilling (unable?) to do the very difficult work necessary to overcome my past. I am here now, just starting out, dipping my big toe into the pool of therapy. Part of my work is writing. It's something I can do. Simple as that. Some people paint, some sing, some reach out and talk with friends... I write.

If you are easily triggered, squeamish, generally uncomfortable with bad language or disturbing imagery, I discourage you from reading the following poem. If you are looking for a glimpse at the damage that precedes an eating disorder, read on.

REVENGE

I'm naked as a jaybird.
You stink of fear and sex.
My mouth is on your
cock-a-doodle-doo, it's time to wake up.
Another nightmare down.
One of these times I'm gonna get it right.
One of these times I'm gonna put up a fight.
I'm gonna make you sorry for fucking little girls.
For getting turned on by their ribbons and curls.
You just wait.
You just watch.
I'll visit you one night
and my specter will give you one hell of a fright.
You may be up now and I may be down
but soon in my dreams I'll turn it around.
I'll get you, my pretty,
and your little sin too.
You'll be the one begging and crying and
pleading.
You'll be the one damaged, broken, and
bleeding.
Mark my words, Michael, I'm coming to
get you.
Mark my words, Michael, 'cuz I'll never
forget you.

Rx

I don't know how to heal
but I can write.
Nouns, verbs, adjectives, like sutures
knit my ragged flesh back into
something human.
Language, like a medicine,
taken in the right dosage at the appropriate
time.
My pen is a scalpel,
operating on that gangrenous abomination
that is rotting out my soul.
I put on my latex gloves and deputrify
my mind.
Words, like peroxide, burn me clean.

Words of Wisdom

"Don't let the fear of the time it will take to accomplish something stand in the way of your doing it. The time will pass anyway; we might just as well put that passing time to the best possible use." - Earl Nightingale

Whack-A-Mole

Anyone who has been in treatment for any kind of addictive or compulsive behavior will be familiar with the concept of "whack-a-mole." Once one set of behaviors is under control, another set tries to pop up somewhere to compensate for the stress and emotion released by the treatment process. A recovering alcoholic turns to pills. A recovering drug addict turns to sex. A recovering anorexic/bulimic turns to self-harm. It's known as "addiction switching," and not only is it very common, it's also very dangerous.

I was admitted to treatment with a primary diagnosis of bulimia and secondary diagnoses of anxiety disorder and post-traumatic stress disorder. That was quite enough, I thought. But part of my treatment included mandatory daily Alcoholics Anonymous meetings. I resisted the notion at first. I'm not an alcoholic, why should I have to spend an hour a day with those people? God knows I have enough problems of my own. But a funny thing happened when my ED behaviors got squashed down. I started getting really thirsty. Getting buzzed starting sounding real good. Just a couple of drinks, just to take the edge off, no big deal. Oh. Now I see why I have to go to AA.

As an outpatient, I've been working very hard to maintain my meal plan and avoid alcohol. I have had a few drinks, but I have held myself accountable to my treatment team and gotten back "on the wagon." As I wade deeper into my therapeutic work, though, that old foe Self-Harm has popped his ugly head out of his hiding place.

I have only mentioned my self-injury history in passing on this blog. It's been the elephant in the room of my life for some time; many of my scars are visible, but people seem too uncomfortable, too embarrassed, or too shy to ask about them. I have at least been able to say with certainty, "That stage of my life is over." Maybe not.

Many of my self-destructive behaviors are used for different purposes. Restricting is used to control the chaos in my life. Binging, purging, and exercising are used as a method of stress relief. Alcohol is used to numb out. Self-harm, for me, was always a response to intense anger towards myself. It is an act of rage, of violence. Getting into my trauma history has brought that old self-anger right to the surface. Those old urges are back, and as strong as ever.

And so I play Whack-A-Mole, along with all the other addicts out there. At least I know that there's a small army on my side this time: therapist, dietitian, recovery peers, meetings, friends, family. If I hand everyone a club, maybe I can win this game once and for all.

Behold the World's Worst Accident

Some days I am full of motivation, full of hope. Some days I understand the concept of "one day at a time" and I act accordingly. Some days I review the myriad constructive tools I have learned to cope with my struggles, and choose one that fits the situation. Some days are good.

Today isn't one of those days.

There's a quirky little trait about people with unresolved trauma. Little things, insignificant to most, can propel us damaged folks right back to a place we desperately want to avoid. The memories come pouring in. Awful images seep into every crevice of our brains, crowding out everything else. It's suffocating. It's crazy-making.

In those moments, when reality is replaced by nightmare, it's awfully hard to maintain the recovery momentum. Sick just seems so much easier, promises so much relief. Being sick froze my emotions solid. Now recovery is thawing them out, and I feel like I'm drowning in the run-off.

My only solace is the knowledge that the worst is over. Memories, terrifying as they may be, can never be as bad as the original event. This pain, raw as it is, will not last forever.

Slow and Steady

I had this picture in my head of what treatment would be like this time. Since it was the first time I actually wanted to get better, I assumed the experience would go something like this: I would show up, understanding all the rules and accepting them without question. I would impress all the staff with my knowledge and insight, and gain their praise for my willingness and dedication. I would eat the prescribed amount, never questioning it, knowing that it was what my body needed. I would sail on through, getting out after four weeks, never to struggle again.

Boy was I delusional. Here's a more accurate picture of what transpired. I arrived, shell-shocked and clinging to my husband like a spider monkey. I tried to convince him, as he was getting in the car to leave, that this was all a big misunderstanding and he should just take me home with him. I looked at my first meal with great scrutiny, analyzing the calorie count and mentally murdering the dietitian who prescribed it. I walked into my first therapy session absolutely terrified, declaring that I was unable to cry and therefore could not partake in whatever "healing" was deemed necessary for me. I got mad. I yelled and fumed and swore. I crossed my arms and flatly refused some of the food. When my meal plan was increased (as it would be many times), I wrote scathing notes to my dietitian. Despite my previous admonition, I did cry. A lot. Sobbed. Heaved, even. I talked about things I haven't thought about in years. Those four easy weeks turned into ten agonizing ones. When I finally did get "out," I had to recognize that my healing had only just begun.

Recovery isn't neat and tidy. Rather, it's messy, excruciating, and painfully slow. I have been home for two and a half weeks now, attending my outpatient program five days a week, and to be honest I am more mentally exhausted than I ever have been. As I told my therapist a few days ago, "I am afraid of going backward, afraid of going forward, and miserable where I am." True, my eating disordered behaviors are under control; tomorrow will mark three months (!) since I have acted out by binging and purging, restricting, or over-exercising. While I recognize that as a true victory, I also know that the real work is only just starting. Now I am digging into the reasons I have abused myself for so many years, and frankly, it sucks. I don't enjoy that kind of brutally honest self-analysis. It hurts.

When I get discouraged by the slowness of my progress (which is, ummm, daily), I have to remind myself that it took me a lifetime to get as sick as I was. Healing is not going to take place overnight. It truly is one day at a time. And, for the first time, I see that I don't have to do it alone. For that I am very grateful.

Treatment: Redux

A funny thing happened on the way to insanity.

So. I went back to treatment. It was supposed to be 4-6 weeks. It ended up being 10. 10 weeks of residential treatment, followed by an indefinite number of weeks in Intensive Outpatient Treatment. How'd this happen, you ask? Hell if I know.

See, here's the thing. I lie exceptionally well. I have always had an uncanny ability to make people believe whatever I want them to believe (and, often, what they themselves want to believe). I had everyone convinced that my recovery was strong and reliable. That, though I still struggled with unhealthy thoughts, my behaviors had been under control for some time. That, my friends, was a collossal untruth.

The reality is, I've been in the midst of relapse for over two years. I have vacillated between periods of restricting (at times meeting full diagnostic criteria for anorexia) and binging and purging (nearly always meeting DSM-IV criteria for bulimia). My behaviors were easy to hide, my weight fluctuations easy to explain away. I even kept up this blog, extolling the virtues of healthy living. Oops.

The turning point came when my health began to really suffer and I could no longer deny the danger I was in. My heart, my stomach, my esophogus. All were ailing and teetering on the edge of disaster. I began to imagine dying on my bathroom floor (esophogus finally having ruptured or heart finally giving out), my husband or children finding my cold body covered in vomit. Terrifying, isn't it? Scared me shitless.

So I made the call to a treatment center. I only want a therapist and a dietician, I said. I'm not sick enough to need higher level care, I said. I met with said therapist and dietician, and was told in no uncertain terms that if I did not head immediately to residential treatment (do not pass Go, do not collect two hundred dollars) I was risking my life. I looked at my family, considered their love and need for me. I threw in the towel.

Making the choice to return to treatment - this was my fourth go 'round - was perhaps the most difficult thing I have ever done. I have held tight to my eating disorder for half my life, believing at my very core that it was the only thing that could save me from the horrors in my mind. Living without it was impossible to envision. Giving it up was like giving up the very essence of who I am. I was scared to death. But I was also scared OF death. I knew I was on borrowed time and the end was imminent if I didn't change something drastically.

I will post more in the coming weeks on my experience in treatment, what I learned, what I gained (in knowledge, thank you very much), and how my appreciation for life has grown. Thank you for sticking with me. Please accept my sincere apology for misrepresenting my recovery as I have up until this point. Those of you familiar with eating disorders will understand that lying is part of the disease. To quote one of the many treatment-isms I have picked up, "Secrets keep us sick." No more secrets, my friends.

A Letter to My Disease

Dear Liar,

So many, many broken promises. So many nights lying awake, hungry, head pounding, pinching fat and feeling bones. So many dollars flushed down the toilet. So many people deceived. So much hurt.

You walked in with a James Dean swagger, all bravado and empty promises. You told me I'd be free. You told me I'd be strong. You told me I'd be happy. You knew all along.

I hate you for robbing me of myself. I hate you for convincing me, time and again and year after year, that I'm not worth anything. I hate you for what you've done to my body. I hate you for making me manipulate the people I love. I hate you for everything.

Now go. Leave me alone. Let me pick up the shattered pieces of my soul and attempt to reconstruct them into something meaningful. Don't come back again. You are unwelcome. You are a liar and a cheater and a thief. I can get by without you. I WILL get by without you.

Ungratefully Yours,
Cassie

Asking For Help

A lot of people have trouble asking for help. I'd venture to guess that most people have a hard time with it. Humans are a proud bunch (probably some evolutionary adaptation). In addition to pride, shame and guilt play a big role. I can't count the number of times I've begun a request with, "I'm so sorry to ask this, but..." or, "Please don't hate me, but could you..." We are supposed to be able to fix our own problems. We are supposed to be independent. We are supposed to be self-sufficient. Above all, we are supposed to be strong.

Ha. When you find that perfect, needless person, call her a liar right to her face. There IS no such person. We ALL need help sometimes. The ability to ask for it is absolutely necessary to survival (physical AND emotional). I go to school with a nice but very insecure girl. We get out of class late at night, and she has no car. She walks home, in a sketchy neighborhood, by herself. She will not ask for help. Think of the dangers: she could fall and injure herself. She could become the victim of a crime. She could be struck by a vehicle. This girl knows there are plenty of us from whom she could get a ride, but is afraid to ask for help. (Luckily there are enough of us who recognize her risk to talk her into one of our cars most nights.)

Let's take that example, and apply it to an eating disorder. We'll call our subject Leah. Leah is sick, has been for some time. She restricts, binges and purges, exercises too much. She's worked very hard to hide her behaviors from the people around her. Now, though, Leah is starting to have health complications. Her hair is falling out, she's frequently dizzy, she's cold all the time. Leah knows she needs help before it gets worse, but she's afraid to ask. Let's explore the danger Leah could be in: she could pass out while driving. She could have a heart attack. She could choke while binging. She could have a gastric or esophageal rupture while purging. She could develop osteoporosis and fracture a bone while exercising. She could fall into a deep depression and be at risk for self-injury or suicide.

Does Leah need help? Absolutely. Is Leah scared? Extremely. Is Leah ashamed, embarrassed, guilt-ridden? Without a doubt. Is it more important that Leah keeps her secret, or that she reaches out for help? We all know the answer to that.

Every person in this world needs help at one time or another, and we usually need to ask for it in order to get it. If you need help right now, please put your health and safety first and ASK for it. If someone needs help from you, please extend your arms in gratitude, for it is a great gift to be needed.

There is no "try?"

I was out for drinks with a dear friend last night. For most of the evening we laughed so hard we nearly fell off our chairs, but occasionally the conversation turned to more serious issues. She asked about my recovery. My response was that I continue to "try to be well." She quoted Yoda (told you she was awesome) and said, "Do or do not. There is no 'try.'"

Now, had anyone else said that to me, I would likely have slapped them. But since this gal is who she is, I tried to take the comment as constructive criticism. Do we - people who have struggled with eating disorders for years - have the power to simply CHOOSE to be well? Does it boil down to deciding to be healthy or sick? Is it that easy?

A few years ago much was made about the book "The Secret." For those who aren't familiar with it, the premise is that you can accomplish anything simply by thinking positively. While I agree with this idea in certain situations - careers, personal relationships, financial goals - I don't believe it can be applied to disease. A person with cancer can have the most positive outlook in the world and still die.

Maybe the real issue is whether mental illness is viewed as an actual disease or just an excuse for bad behavior. There has been extensive controversy on this topic. Knowing what I do about neuropsychology, I count myself among the group that believes in genetic, biochemical, and physiological causes of genuine organic illness. There are a fair bunch of folks out there, though, who believe mood, anxiety, and personality disorders, eating disorders, chemical dependencies, etc. are simply manifestations of weakness, laziness, defiance, confusion, and lack of will.

If mental illness falls into the latter category, then it stands to reason that people should quite easily be able to choose between sickness and health. If, however, the causes of psychological disorders are much more complex and largely neurobiological, "The Secret" method doesn't hold water.

So let's turn this into a discussion. Do you believe mental illnesses - eating disorders in particular - can be "willed" away? Do you have any thoughts you'd like to share on the origins of psychological disorders?

How Many Lies?

"I ate a late lunch." "I'm not feeling very well." "I had a friend over, and she ate all the ice cream." "I don't know why the bathroom smells funny; maybe the plumbing isn't working right."

How many lies have you told in the name of your eating disorder? I lost count of mine about 10 years ago. I have lied to so many people about so many things for so many years. I have to add, I'm a terrible liar. I have an overactive conscience. Even "little white lies" make me queasy. But I would tell anybody anything to protect my disease. Even as the words sting like bile when they come out of my mouth.

There's that saying, "The truth hurts." Maybe we need to acknowledge that for once. Lies protect our disease because our disease masks our feelings. The truth exposes our feelings, in all their raw, painful, ugly glory. It's no surprise that we'd do anything to make those feelings go away. But we have to realize that we're not helping ourselves at all. For every lie we tell, for every meal we skip, for every binge and every purge, we lose a little of ourselves.

Hold my hand, and we will tell the truth together. The truth is, life hurts sometimes. But if we're honest about it, we can help each other through it.

The Selfishness Conundrum

There's a rather vicious dichotomy to eating disorders. They are at once both a hatred of self, and a complete obsession with self. Where the narcissist obsesses about her own value, prestige, and vanity, the eating disordered person obsesses about her own inadequacy, failure, and imperfection. As different as their perceptions of themselves may be, both people are completely preoccupied with themselves.

I have a very hard time with this notion. I have always been motivated to help others; to reach out, volunteer, donate to causes I support, be active in service. Self-centered people irritate me to no end. I think to myself, "Does this person not realize how many billions of people there are in this world who need help, love, outreach? Maybe if she was a little less focused on herself, she could actually do some good for humanity." I find it exceptionally difficult to count my self-deprecation as its own form of self-centeredness. It is, though. As much time as the narcissist spends puffing herself up, I spend beating myself down. Neither of us are able to contribute much to the universe at large.

It's a tricky balance, though. To consider my anorexic/bulimic behaviors as self-obsessed is to feed into the notion that I am "bad." "Good people" don't spend so much time thinking about themselves. Since I'm already "bad," I may as well go on punishing myself. Nasty cycle, isn't it?

I have found that the most constructive solution to this problem is to simply spend as much time in service to others as possible. If I surround myself with positive people and fill my schedule with worthwhile activities, I squeeze out any time or energy for self-destruction. In addition, there's such a beautiful gratification that comes with reaching out to another person. Knowing that you've done good can be more powerful - and more healing - than years of therapy and dozens of medications. And when you see that you CAN do good, it makes you want to do MORE good. It's wonderful self-perpetuation.

Don't fret about who you are or who you're not. Go and do good. It will come back to you in spades.

The Good List

Sometimes recovery is hard. If you've followed my blog at all, you'll recognize that I've made this point several times before. Life can throw all manner of stresses at you, and it can be tough to fend them off in a healthy way. When I feel shaky, I like to make a list of all the joys my recovery has provided me. It's an excellent affirmation exercise. Below is today's list:

An incredible, smart, funny, sweet husband who not only accepts my many quirks, but loves me even more for them.

A six-year old son who tells me - unprompted and on a regular basis - that he loves me.

A four-year old son who insists that when he grows up he's going to marry me, because I am "the best lady there is."

A two-year old daughter who twirls and sings and giggles and smiles the day away, simply happy to be alive.

Friends who make me laugh until I pee a little.

A strong, wonderful relationship with my mother and sister.

Education in a field that will allow me to help people every single day.

A church filled with inspiring, supportive, amazing people who reaffirm my faith in God and humanity.

Wine.

Greek food, Italian food, Mexican food, Chinese food, French food, bar food... you get the idea.

A sense of deep respect for my body. Not only did it survive the years of abuse I put it through, it also grew and nourished three miraculous little people.

There's today's list. Tomorrow's will be different, and may include the sharply blue sky, the crisp Spring air, the excitement of my dog when I walk in the door, even if I was just outside for a moment to get the newspaper. There are so many, many things in life to appreciate when you're seeing through the lens of recovery.

Live to love, love to live!

It's Okay.

It's okay to feel scared.

It's okay to get angry.

It's okay to cry.

It's okay to admit that you're struggling.

It's okay to say, "I need help."

It's okay. And if it's not okay right now, it will be soon.

Temptation

I wish I could break all the mirrors in the world. Throw away all of the scales. Get rid of all the clothes in my closet that are too small, but I keep "just in case." Abolish skinny chicks from TV and magazines. Escape the diet food aisle in the grocery store. Live in a world free of temptation.

Unfortunately, I can't do any of those things. So I fight. Every day. Rail against the voice in my head, try to convince myself that who I am and how I look is okay.

I fight. Every day.

Truer Words Were Never Spoken

"I want to be superwoman, and the fact that I'm not makes me hate myself and constantly wonder why I'm such a waste." -Marya Hornbacher, from "Madness"

How many of us have felt that way? Many people are overachievers. Many people routinely take on more than they can handle. But there are some of us whose pattern of taking on the world then being crushed under its weight is pathological. It's what we DO. It's who we ARE.

This is one of the things with which I still struggle daily. I have an innate need to prove to myself how smart! talented! wonderful! irreplaceable! PERFECT! I am. The fact that nobody is perfect is not lost on me. But somehow I can't shake the feeling that it's my respobsibility to break the mold. Like, if I can't be perfect, then why bother at all?

It's important for me to share this for two reasons. First, because I want to show that I am not infallible. My recovery is not without flaws, weak points. Second, I need to remind myself that perfection is not a reasonable goal. I can only try to be the best person, the best wife and mother and daughter and sister and friend and human being, that I can be. And I have to trust that that's enough.

Devastation

About four years ago I watched the HBO documentary "Thin." It followed four women as they struggled with their eating disorders at Renfrew, a very well-known treatment center in Florida. The film is extremely well done, capturing the reality of life with ED's as few other movies have. A warning: the movie can be extremely triggering. I strongly discourage anyone who may be shaky in her recovery to avoid watching. There is a lot of ED imagery, and the raw emotion shown by the women is very disturbing. That being said, for anyone interested in seeing what the beginning of the recovery process is really like, I recommend "Thin."

One of the things that bonded me to the film so much was the recognition of myself in the women featured. Their fear, their anxiety, their sense of chaos/control, their manipulation of others, their reluctance to let go. The population at large has a tendency to think anorexia and bulimia are either "phases" girls go through, or that they're just manifestations of neurosis, or - worst of all - they're simply attention-getting ploys. Make no mistake; eating disorders are DISEASES, as real as any cancer, and potentially as devastating. Those of us who have been trapped in that hell know how isolating, how frustrating, how anguishing it is. Wanting desperately to be understood, to be helped, but at the same time being terrified of letting people in, relinquishing control.

I found out today that Polly, one of the women whose lives were shown in "Thin," died from an intentional drug overdose a couple years after the movie was released. Here are a couple statistics for you: Eating disorders have the highest mortality rate of any mental illness. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anorexics die within 10 years after contracting the disease; 18-20% of anorexics will be dead after 20 years and only 30 – 40% ever fully recover. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old. 20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems. About 80% of the girls/women who have accessed care for their eating disorders do not get the intensity of treatment they need to stay in recovery – they are often sent home weeks earlier than the recommended stay. Horrible, isn't it?

I personally know three women who have died from anorexia/bulimia. Jenn, an anorexic woman whom I met in my first stint in treatment. She was in her early 30's, beautiful, tall, with gorgeous blonde curly hair. Her husband was a doll. She was released from treatment in May of 2002. She organized a "homecoming party," to be held at her house, for all of us who had been in treatment together. She died of a heart attack the day before the party.

Bonnie, another woman I met in my first treatment center. She was in her 40's, bulimic and an ipecac-abuser. She was a licensed social worker, one of the kindest women I've ever met. As a child she had suffered horrible, unspeakable abuse at the hands of her parents. During the time I knew her, she was still living with her mother, caring for the woman who had tormented her for her entire life. Bonnie died of a heart attack at age 44, the year after I had met her.

Val, a former principal dancer for the New York City Ballet. I met her during my third in-patient treatment. She was in her early 40's, but looked like she was in her 60's. She spoke of the culture of anorexia that was present in the professional ballet. She said she hadn't eaten normally since she was a child. She had to retire from dancing prematurely because she was diagnosed with osteoporosis at 28 years old. Val died of heart failure shortly after I was released from treatment, in February of 2003.

I HATE THIS DISEASE. It is a life-stealer. It robs people of their emotional lives, their relationships, their spirituality, and too often their physical lives. The relapse rate is appallingly high. The recovery rate is dismally low. The access to treatment is shameful. Our society is much to passive in its reaction. SOMETHING MUST BE DONE! But what?

That's A Good Question

Last week I gave six speeches about my life to sophomores at a nearby high school. The process had begun about six months earlier, when a dear old friend (who knew me at my worst) connected me with a wonderful gal interested in sharing my story. She worked with me to develop my life into a narrative form, then whittle it into something striking, attention-grabbing, reality-checking. The process was long and at times difficult. When you've come as far as I have, it can be difficult to wade through the pain of the past. However, by the time I was ready to speak, I had owned my story. I was proud of my progress and so humbled to be able to share my journey with others.

The experience of speaking was a unique one for me. I have no formal education in public speaking, nor any familiarity whatsoever. I am actually quite shy, although I deal with my shyness by projecting myself out on the world. A very useful skill, I must say. There was something absolutely transforming about standing before a room of 90 16-year olds and commanding their full attention. I had only to speak for a moment before I captured their interest, and I held it for the duration. These kids wanted to hear my story. They became invested in it. They saw themselves in it. Sexual abuse, family drama, eating disorders, insecurity, fear... there was something in my life to which every single kid could relate. I saw that on their faces. It was such a gift to me.

Following my story was a Q&A. These kids didn't hold back! They asked me loads of questions, many I answered and some (what was your lowest weight? how did you try to kill yourself?) I did not. But the question that came up most often, and was most impressive and thought-provoking to me, was this: "Why an eating disorder? Why not drugs or alcohol?" (And, as one young lad phrased it, "Why didn't you just smoke weed?")

What an excellent question. Why anorexia and bulimia, and not some other tool of self-medication and self-destruction? I could have abused any drug I chose - I surely had access. Alcohol was commonplace and there for the taking. So why not? My go-to answer has always been that I sought to control my life, and drugs and alcohol gave me a distinct feeling of being out of control. I wanted total power over my thoughts, feelings, and actions, and substances would have prevented me from that. The more I thought about it, though, the deeper I realized it went.

Drugs and alcohol. For as far back as I can remember, I saw them as bad, bad things. Maybe all of those "Just Say No" ads really did work. Or maybe I recognized, even at a young age, that I was unwilling to relinquish myself to anything. Control over my life had been taken from me on numerous occasions, and I absolutely would NOT give it up willingly. Why do people turn to drugs and alcohol? To escape. To get away from their problems. Why did I turn to anorexia and bulimia? To escape. To get away from my problems. So yes, it's a good question.

I have long pointed out the similarities between eating disorders and addiction. Not only the high rate of relapse, the lack of positive coping skills, and the tendency for co-dependency in the family, but also for the root causes: abuse, mental illness in the family, lack of stability. At the end of the day, I starved myself for the same reasons a heroin addict shoots up; I binged and purged for the same reasons an alcoholic goes on a bender. I wanted to make the bad stuff go away.

We all go through things we shouldn't, have to deal with things with which we aren't equipped to deal. We all try to make the bad stuff go away. But instead of food, or the lack of food, or drugs, or alcohol, maybe we should seek out each other. Maybe we should lean on each other, talk to each other, listen to each other. As different as we may be, chances are good we're also very much the same.

The Definition of Insanity

As Albert Einstein famously quoted, "The definition of insanity is doing the same thing over and over again and expecting different results." I'm struck by how much this applies to the recovery-relapse-recovery cycle.

Recovery is tough. It's a fight. Frankly, it's easier to be sick. Miserable, self-defeating, and dangerous, but easier. The longer a person is ill before entering recovery, the higher the likelihood of eventual relapse. This is a maddening statistic for those of us set on a future of happiness.

My eating disorder has gone through varying degrees of intensity. I have gone from "functioning anorexic" to "near-dead bulimic" to "symptom-free picture of health." It's a roller coaster. The hardest thing to grapple with is that the eating disorder is ALWAYS our default response to stress. We have learned to cope differently, more constructively, in healthful ways... but the stress will always remain. It's part of the human condition.

The biggest challenge to a recovering anorexic/bulimic person is resisting the temptation to revert to old behaviors in times of stress. There's this pervasive thought: "Just this once. It'll make me feel better. I need it." I imagine it's the same thought a recovering alcoholic or drug addict considers. It's that proverbial devil on your shoulder, whispering promises. It can be incredibly hard to stand firm. The most effective method I have found is to talk right back to that voice. Out loud, if necessary. "No, this will NOT make me feel better. In fact, this will make things a million times worse than they already are. It only takes one slip to fall down flat." It seems a little silly, but it works.

Let's remind ourselves not to do the same things over and over and expect different results. Let's try something new, as difficult as it may be. The payoff is happiness.

By the Numbers

10 years since my initial diagnosis of anorexia nervosa.

9 years since my first descent into bulimia.

8 trips to the emergency room.

3 in-patient hospitalizations for anorexia/bulimia.

2 in-patient hospitalizations for depression/suicidal behavior.

6 therapists.

14 different prescription medications.

177 lbs. gained and lost and gained and lost again.

103 visible scars resulting from self-injury.

Hundreds of diet pills and laxatives taken.

Dozens of vials of Ipecac Syrup swallowed.

Tens of thousands of dollars in medical care.

Innumerable tears, sleepless nights, regrets.

That's my eating disorder, by the numbers. Doesn't seem worth it, does it? I wish every person on the cusp of anorexia or bulimia could glimpse the future quantified cost of their choices. Perhaps they might think twice.

Dichotomy

Bulimia and New York City. Two places, one in the mind, the other on the map, both in my soul.

Bulmia. Binging and purging. Chaos and calm. Full and empty. Companionship and solitude. The act of binging is a frantic one. "I feel lonely. I need company. Nobody loves me. Food loves me. I need food. More food. More more more. NOW. Fill me up. Surround me like a blanket so I don't feel so scared." Colors everywhere, the world is vibrant.

Panic. "What did I just do? How could I lose control? I'm weak! Pathetic! I hate myself!" Purge. Get it all out. "I want to be empty. I want to be free. I want to be alone. I want to be clean, pristine, perfect." Everything is white.

New York City. Two-faced. One side is money, power, privilege. Sharp edges, clean lines, exacting design. "I want to make something of myself. I want everybody to know my name. I want to be seen. Respected. Remembered." Buttoned-up and polished.

The other side, wild. Anything goes. "I want to be sexual. I want to be who I am, and nobody else. I don't care what anybody thinks. I want to live, to create, to die. I want to break the rules, smash in the windows. Fear me, loathe me, misunderstand me." Broken-down and messy.

Bulimia and New York City. Two places, one in the mind, the other on the map, both in my soul.

Discrimination

I am a bigot. My intolerance is not of people of different races, religions, sexual orientations. My bias is against obese people.

I am not proud of this. I try very, very hard to fight against it. I tell myself over and over and over that people are obese for the same reasons I was underweight - they use food to deal with their emotions. Truthfully, I was no different from an overweight person. I was no different at 95 lbs. than a heavy person is at 400.

Still, my feelings persist. I see an obese person and my first thought is, "WEAK." "She has no control over herself." "He's a glutton." "She's just lazy." I hate myself for this. This type of discrimination is something that disgusts me at a core level. I have no patience for people who judge others based on trivial arrtibutes. Why, then, do I vilify heavy people?

Insecurity. Plain and simple. I know that I have issues. I know how skewed my mind is. I know how unnatural it is to analyze my elbows to ensure they're no bigger than they were yesterday. If I can look upon an overweight person and deem her weaker than I, then perhaps I'm not as pathetic as I feel.

Discrimination is an ugly, self-defeating thing.

A brownie by any other name would taste as sweet

Sometimes I have to play a little trick on myself. It’s similar to the kind of trick a mother plays on her toddler; instead of referring to the vegetable as “broccoli,” the clever mom will declare it “little trees,” much to the delight of the previously skeptical 3-year old.

It’s not veggies that I rename, though. It’s dessert. Most people with eating disorders are pretty anti-dessert, and I was no different. Part of my recovery has been to relearn to enjoy the after-dinner sweetness, the reward for a long day. I can eat a brownie now, or a bowl of ice cream, or a piece of pie. That’s a pretty big deal for me. The thing is, in my head, I can’t say “brownie” or “ice cream” or pie. I have to pull a fast one on that mean, skinny bitch that still hangs out in my mind. I have to think of those items as “carbs,” “calcium,” and “fruit.” I have to assign a nutritive name to anything that passes my lips, even if it happens to be a gargantuan Cinnabon with two cups of icing (grains and glucose).

I know it’s silly. It’s weird to rename food, and it’s slightly ridiculous to rename it to yourself. But it works for me. It allows me to relax a little, soothes the anxiety that inevitably arises. “It’s okay, Cass. It’s only some calcium. You didn’t have enough milk today anyway.” If that’s the little white lie I need to tell myself in order to indulge, so be it.

It's hard to dance with the devil on your back

I was recently introduced to the theory that mental illness results from the influence of demons, of Satan. I suppose it's not a new idea, but I had assumed it only existed in horror movies. Not so. There are some out there who would have you believe that with the appropriate amount of faith, any mental issue can be overcome.

Obviously I dismiss nearly the entire concept. There are many, many origins of mental problems: chemical imbalances, brain injuries, early childhood trauma, genetics, chemical dependency, volatile upbringing. But demons? Not so much.

Moreover, to suggest that mentally ill people simply do not have enough faith, or enough moral strength, to overcome their afflictions is just insulting. A schizophrenic person can no more "pray away" his disease than can a person with leukemia. It's not nearly that cut and dry.

The only element of the "spiritual infirmity" theory that I agree with is a purely metaphorical one. No, I don't believe that the sicknesses are caused by devils. However, they can become like demons, ever-present, tormenting, dragging us down to Hell. I often personified my eating disorder, seeing it as a being all its own, at once my best friend and my worst enemy. Similar to a devil it will promise you the world, but in the end it strips you down to nothing. Like Faust, I made a deal with my devil... my soul in exchange for that which I so badly desired.

To quote a hymn we sang in church recently, "I danced on a Friday when the sky turned black; it's hard to dance with the devil on your back. They buried my body and they thought I'd gone; but I'm the dance and I still go on."

Maybe, at the end, it really is through divine mercy that we are delivered from our devils. That mercy may take many forms: religion, medication, therapy, relationships, personal awakening. We are spiritual beings, and despite great, seemingly insurmountable odds, we still go on.

Let go, and dance with me.