I got something of a bombshell dropped on me today. I showed up for my regularly scheduled therapy appointment, and when I went into my therapist's office, the clinical director of my IOP program was also in the room. I immediately went on high alert. Imagine showing up for a chat with your teacher and seeing the principal sitting there.
The two of them told me that, effective this Thursday, I am discharged from the program and no longer eligible to see my therapist. The reason given was that they consider me to be "spinning my wheels" in treatment; not really making any progress, lacking motivation, and, from a practical standpoint, wasting my own money. They said that this situation is somewhat common in people who have been in treatment for a long period of time. They told me I need a break from focusing on the eating disorder. They recommended I immediately begin group therapy for sexual trauma survivors, and shift my full attention to those issues. The eating disorder, they speculated, may ease up once the underlying causes are more intensely addressed. The only remaining tie I will have to this program that has been my lifeline for the last 11 months is my weekly dietary session, which is considered necessary from a medical standpoint. My therapist insisted that I try this new arrangement for the next three months, and after that period of time, should I find myself appropriately motivated, I can return to her care.
Needless to say, I left the appointment feeling confused, angry, and very, very sad. I understand their reasoning, and accept the part I played in the decision. That doesn't make it easy, though. I went right from that session to lunch (how appropriate), then into my dietary session. When I asked my dietitian for her opinion on the matter, she was frank: "I just don't think you care enough right now, and that scares all of us. You need to reassess your reasons for coming here a year ago. You need to find your purpose again." She gave me an assignment: write about the legacy I would leave to my children if I died today, and what I would leave them if I were given more time on this earth. I got home, sat down with my pen and paper (considerably shaken by the idea that I won't have my therapist to discuss this with), and got to work. Here's what I came up with.
PURPOSE
1. If I died today: If I died today, the legacy I would leave to my children would be one of desperate want. I have made it clear to my kids from day one that they deserve to be loved, to be happy, to be cared about, and to be whoever and whatever they want to be. Even at their young ages they seem to understand that I want those things for them. But they also see me refuse to accept those things for myself. If I were gone, they would be left to reconcile that disparity on their own. I know from my own childhood that what kids observe is infinitely more powerful than what they are told. So far, what my kids have seen from me is pretty grim.
2. If I had more time: If I had more time to be an example to my children, there are a number of goals toward which I would work. Most importantly, I would hope to teach them that they are worth fighting for. That no matter what might happen in their lives, they have the strength and the inherent value to keep going. I want the chance to show them that no situation will ever be bad enough, no damage ever deep enough, to make giving up an option. I also want to help them see that, even with all of its challenges, life is precious and beautiful. Every day contains miracles if we're quiet, still, and willing to look for them. I never want the wondering, joyful light to go out of my children's eyes. I don't want it to go out of mine, either.
Tuesday, January 31, 2012
Monday, January 2, 2012
The Second Time Around
Two weeks pass in the blink of an eye when you're in treatment. I checked in on December 18th, checked out on December 31st, and worked my ass off in between.
Truth be told, the first week and a half were pretty stagnant. I followed my restoration meal plan (translation: weight-gain meal plan), yes, but did very little emotional work. I blamed that fact on the staff, because there were many vacations and sick days taken and clinical treatment was pretty inconsistent. The truth is, though, I didn't want to do the work. I used the situation as an excuse. "I don't feel safe or supported enough to talk about what I need to," I cried. Bullshit. "I don't want to do it," would have been more accurate. Then this past Tuesday, a therapist I worked with during my last stay returned from her vacation, and my pity party was over. "You're being deceitful," she said. I balked. "You're pointing the finger at everyone and everything but yourself," she said, "because you're scared. You have two choices: run back to your eating disorder and play the victim, or do the work and get your life back." Whoa.
So I started talking. And I started crying. And I kept on eating. Those last four days were excruciating, but I learned something very important: it is the things I refuse to name and talk about that pose the greatest threat to me. Nothing will ever be fixed by pretending it doesn't exist. To quote a fun little treatment-ism, "Feelings won't kill you, but ignoring them will."
In all honesty, two weeks was not a sufficient amount of time to bounce back from this relapse. I still have a deep, passionate hatred of my body. It remains number one on my hit list. But I got started, I am following my restoration meal plan (even though it's huge and difficult to sustain on my own), and I am committed to doing what I need to do. I can say that I truly used the opportunity I was given, and I will continue to do so. This isn't easy by any stretch of the imagination, but I have to keep reminding myself that it's worth it.
Truth be told, the first week and a half were pretty stagnant. I followed my restoration meal plan (translation: weight-gain meal plan), yes, but did very little emotional work. I blamed that fact on the staff, because there were many vacations and sick days taken and clinical treatment was pretty inconsistent. The truth is, though, I didn't want to do the work. I used the situation as an excuse. "I don't feel safe or supported enough to talk about what I need to," I cried. Bullshit. "I don't want to do it," would have been more accurate. Then this past Tuesday, a therapist I worked with during my last stay returned from her vacation, and my pity party was over. "You're being deceitful," she said. I balked. "You're pointing the finger at everyone and everything but yourself," she said, "because you're scared. You have two choices: run back to your eating disorder and play the victim, or do the work and get your life back." Whoa.
So I started talking. And I started crying. And I kept on eating. Those last four days were excruciating, but I learned something very important: it is the things I refuse to name and talk about that pose the greatest threat to me. Nothing will ever be fixed by pretending it doesn't exist. To quote a fun little treatment-ism, "Feelings won't kill you, but ignoring them will."
In all honesty, two weeks was not a sufficient amount of time to bounce back from this relapse. I still have a deep, passionate hatred of my body. It remains number one on my hit list. But I got started, I am following my restoration meal plan (even though it's huge and difficult to sustain on my own), and I am committed to doing what I need to do. I can say that I truly used the opportunity I was given, and I will continue to do so. This isn't easy by any stretch of the imagination, but I have to keep reminding myself that it's worth it.
Wednesday, December 14, 2011
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.
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.
Friday, December 2, 2011
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.
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.
Friday, November 25, 2011
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.
"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.
Monday, November 21, 2011
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.
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.
Saturday, November 12, 2011
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.
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.
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