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I had another good talk with J yesterday, though I kept breaking off into tangents.
It’s always good to be honest, and honesty doesn’t usually go hand in hand with an eating disorder. However, we both told eachother we had mixed emotions about living together. As our dietician has told me time and again, it could end up being a great thing, or it could be a sh*t storm.
My weekend was not great. I felt out of control and completely in my eating disorder. I didn’t know how to get out of it. Once the work week started, I went back into “recovery mode,” as structure is good for me.
My therapist called me yesterday afternoon to check in, and I told her I felt better about recovery, but still apprehensive about living with J. This whole situation sucks: her body composition triggers the heck out of me, yet we have so much in common it’s inevitable we will become friends. So except for the whole ED thing (which of course is a big deal), it’s the ideal roommate situation.
Ugh.
So I sent J an email, suggesting maybe we check in once a week with how we’re doing, and what support we might need from each other. She agreed, as long as we have the usual parameters of abstaining from talk about calories, weights, workouts, and foods (well, the food part is hard since we cook together sometimes, but you know what I mean.) So it’s a start. Time will tell, I guess.
Last night, I cut up some old collages I had made in treatment, and fit them into frames. I read a couple of homework assignments that were stuck in my drawing pad. Wow, I have come a long way (baby). I can’t believe it has been a full year since returning to work and leaving intensive treatment.
Treatment was the best thing to happen to me. I was in a desperate place back then, and the only solution was to shell out a good amount of money and go to residential, partial hospital, and intensive outpatient therapy. I am a blessed, blessed, blessed individual to have that kind of money at my disposal (thanks partially to my shellshocked parents) and to have an employer who allowed up to four months of medical leave at full pay.
Residential treatment attacked the purging and (lack of) eating. Though insurance only allowed me to stay ten days, I needed that exact amount of time to prove to myself that I could effectively live a life eating an adequate amount of food without purging. I had never gone that long before. It was hell, but an amazing time of growth.
PHP (Partial Hospital Program) continued to attack the food and purging, while attempting to get at the root of why I had an eating disorder. My relationship with my parents was addressed time and again. I routinely was threatened with being put back in residential because I could not last but a few days without purging. Finally, I got through a weekend without eliminating my food prematurely, and THAT gave me the confidence. It was my breakthrough. I suddenly felt that I could actually recover.
I left my residential and PHP program after a total of two months, and returned home. I attended an Intensive Outpatient Program (IOP) nearby for 4 hours every weekday and some Saturdays. The rest of the time was devoted to being acclimated with living without an eating disorder. I cooked. I ate. I exercised much less than I wanted to. This rhythm helped me prepare for the impending “real world” which would include work. When I was in program, we worked on my self esteem, prior traumas, and what work would look like. How would I eat? Where would I eat? What would I say if coworkers noticed my weight gain?
Each stage of my treatment was necessary… for me. Some people I know only did one of these types of treatment. Others did only two. Still others found recovery with weekly dietician and therapy appointments.
The key is to be open and honest with oneself. If I’ve learned anything in the recent weeks, it’s that personal recovery is absolutely essential. Living with any speck of an eating disorder is no way to live. Improved energy, physical health, clarity, self esteem, and meaningful relationships are only some of the fruits of recovery, and recovery is only possible with at least some level of treatment.
I’m on track to eat 100% today. Actually, more than that, as I ate double for my snack just now. In Jess’ words, “I’m hungreeeeee!”
Mixed reviews have come in regarding the living situation. Therapist still thinks it will work, but will only give me till Halloween to be fully back on track. If I’m still struggling, I need to move out or as J to leave.
The girls in my support group think it’s a horrible idea to live with her (though in my defense, I had NO IDEA she had an ED when A and I asked her to move in. If I’d known, I’d never have wanted her as a roommate), and they think I should move out immediately.
My thoughts? I think it will work. Granted, yesterday sucked in the eating department, but today is a new day. Yes, I think it will be harder with her around, but not impossible. We get along so well already, and I think the prospect of moving out of an otherwise great environment will help motivate me to get back into gear.
What do you think? What safeguards should I have? Or should I call it a wash and move on? Why?
Last week was hell.
Besides being constantly hungry and sick from a plethora of caffeine and next to no food, my mind was playing insane tricks on me.
Living with an anorexic is hard, when one is trying to resist anorexia.
I had emergency sessions with my therapist and dietician. I tried to eat but couldn’t get above 40% of my meal plan. I was going downhill.
Time for reinforcements in the forms of my best friend and boyfriend.
I came up with a goal. If I was not FULLY back on track by Thanksgiving, I would move out. I have no idea where I’d move, but the goal was to provide motivation, and not actually have to relocate.
The prospect of moving has propelled me to eat. 60-ish% on Saturday. 75% yesterday. And I’m aiming for 100% today.
Let’s get this straight. I don’t want to eat. I want to starve. I want to “be thin” (whatever that means). I want to look like her.
But I can’t always get what I want.
When I first told my parents about my eating disorder, they were most shocked about two things: first, that I actually had an eating disorder (“but you’re not even boney!“) and second, that I was seeing a dietician.
Unless one has an eating disorder or is familiar with the field, a dietician might seem odd. Eating disorders are thought of as behavioral health problems. See a therapist, start eating, and presto! You’re better!
But an eating disorder is physiological as well. The brain is starving and shrinking at a rapid rate, and a therapist is not equipped to address a lot of the physical needs, such as a meal plan.
In my recovery, a dietician was incredibly necessary. She guided me into a meal plan, first just getting me to eat one starch every meal. Of course, residential and outpatient treatment did the rest and set me up with a structured plan, but even when I got out of those facilities, I still met with my dietician. For the first few months after treatment, I met with her every week and was challenged to eat desserts and other foods that I still felt were “scary.”
I see her ever few weeks now, and in a few months will finally be discharged from her care (!!). She is helping me with Intuitive Eating as well as challenging me to cook more. She keeps an eye on my weight, which has not changed and thus has freed me of caring what my weight is at all. As long as my pants fit, I’m good to go!
Remember — it’s an eating disorder. It is a brain and emotional disorder, to be sure. And it usually involves depression, anxiety, or another co-existing condition. But food — like it or not — is a huge factor. A dietician is a huge part of the treatment puzzle.
(For help with finding a dietician specializing in eating disorders, click here)
What are your thoughts about dietitians in the recovery process? Do you have one? Do you think you need one? Leave a comment!
I haven’t relapsed.
And I’m not going to.
Okay, now that we’ve gotten that out of the way.
This has been a tough few weeks. The trigger doesn’t matter (and is a bit too personal to blog about, as I’m still working through it myself), but I will say that it started with a seemingly “normal” therapy session that ended up delving into some incredibly difficult material. I held it together, or so I thought, for a day or two. Then, I cracked.
Binge.
Purge.
Binge.
Purge.
Restrict.
Run.
Purge.
Repeat.
I felt like I was on autopilot, as though there was no way in hell to stop me from performing those actions. And I was fighting, hard, to stop.
That was the difference between the past few weeks of behaviors, and my previous relapse. I could not give a shit before. Now, I want to curb the behaviors and get back on the path of recovery like no other.
I called my therapist. I called my dietician. I made extra appointments with each. I asked for prayer. I prayed. I wrote. I went back on my meal plan.
I slipped. More than I would have liked.
But then I got back up.
I’m still on my meal plan, except when I go out to eat. But this past weekend, which provided many instances in which a meal plan just wasn’t going to happen, gave me the confidence that I could begin to (slowly) eat intuitively again. Without restricting, or feeling the need to binge or purge. I’m back on track, with some reservations.
Perseverance is difficult, but worth it
I’m doing well.
Let me type that again, because I’m still a bit shocked by this fact.
I’m doing very well.
And not just in recovery (though I’m doing better than ever in that regard.) My social life is still in existence despite the departure of my two closest friends. Work continues to go well. Life is… good.
That is why I haven’t been posting. I’m used to writing in this blog when the going gets tough, and I require an outlet to flesh out my emotions. But I want to continue writing when things are good, both to offer support to people (like you?), and to have an outlet when my therapist is not there. Because we are already talking about meeting only every other week, which I never really thought about.
So for the last 17 days, I’ve thought about the previous 365. The past year has been insane. I’ll use that word because “mindfuck” is a bit derogatory. Oops, I wrote that word anyway.
Even so, it helps to look back and even celebrate the craziness. Because my life is so incredibly different.
January
Spent the first day of 2010 vomiting due to alcohol poisoning, unable to keep even water down. I finally admitted to a friend that I kinda sorta had issues with food.
February
Boss referred me to my HR representative. Was put on probation.
I told my (former) therapist that I felt “stuck” in my eating disorder. She told me to buy new clothes because my current attire didn’t look good on me, and then I’d feel better about myself. Gee, okay!
Finally told my best friend about my eating disorder. She was shocked, but the day after told me she was prepared to be my support system and would do anything to help me.
March
I moved a city away, into an apartment with two other girls. I shared a bathroom, whereas I had my own in my old place. I was convinced this would cure me of purging. Um, not so much.
My (former) therapist referred me to my current therapist, who specializes in eating disorders. Not that I had one, of course. I just had a weird issue with food. After our first session, this therapist told me I had a serious case of bulimia. I really struggled with that diagnosis.
My eating disorder to a massive turn for the worse in late February-early March, and never let up until I entered treatment.
April
I had my first and what I hoped would be my last session with a dietician. It was the hardest thing I had done thus far in my pursuit of recovery. Food had always been so secretive to me, and now I had to open up about the most intimate thing in my life to some stranger?
I kept going, and she set me on a “meal plan,” begging me to eat just one carb a meal. I couldn’t do it. We both knew it was a matter of “when” and not if I would enter a more intensive treatment program.
May
I ran my first half marathon with my dad, against my treatment team’s advice. I had a blast. They were pissed.
The day before the half, my HR rep told me I would be fired in the next week. My therapist and I hatched a plan to go on a medical leave in order to save my job (if I’m not there, I legally can’t lose my job) and go into outpatient treatment and seek recovery.
My dietician had different ideas. Within an hour, the plan changed and I was going to live an hour away at a residential facility.
I told my parents that night. My mom noted that I wasn’t “bony enough” to have an eating disorder. They just didn’t understand.
I left for the facility the next week and was in residential for 10 days. I then switched to outpatient because of insurance difficulties.
June
I spent my birthday in treatment. But my best friend came out two days later to take me out.
My parents visited me twice while I was in treatment, and they were both extremely awkward. They were trying to come to grips with this “new daughter” – a daughter who hated herself and had no sense of self worth. A daughter who chose to punish herself by violently vomiting and refusing food. They chose to believe that I had high self esteem and was “doing fine.” The truth hurts, and they were experiencing that fact first hand. I was, too.
June was the hardest month for recovery. I had to re-learn basic skills, like grocery shopping, and eating “normal” meals and snacks. I still had many slips, but was trying as hard as I could to stop my behaviors.
July
I left my facility for a less intensive center that was closer to home. The first day was brutal. I loved my former treatment center, and bonded deeply with the girls there. I cried during my groups at my new center.
Oh yeah. Something else also happened in July. That month sucked.
More later!
Dealing with intake coordinators can be stressful. There were so many questions I wish I’d asked. Now that I have been through the process, here are some questions to consider asking, if you are considering residential treatment.
1. Do you deal with trama? Many centers tend to hold back on dealing with trauma and leave it to the outpatient therapist. This was fine with me, but I know other patients who were annoyed by this.
2. Do you deal with dual diagnoses? If you have bipolar, self-injury or suicidal ideations, depression, etc, how will the facility incorporate them?
3. What are the current age ranges of the patients?
4. What is your philosophy on food? Do you follow intuitive eating, or another philosophy?
5. What type of meal plan do you follow? Exchanges? Calories? My outpatient center did not follow exchanges, which is what my residential center followed and what I preferred. It wasn’t a deal breaker, but I think it is a good question to ask, especially if you are currently on a certain meal plan.
6. What electronics are okay to bring? I mentioned in my previous post that the answer you receive is not always true, and I stand by that. But this is a good guideline.
7. Is there detergent on site, or do I bring my own?
8. Can I bring my car? Will it be safe? I was local, and it was imperative that I drive myself to the center. So this was an important question for me.
9. What is the visitation policy?
10. What is the address for care packages? What can be sent?
11. Do I pack towels and sheets, or do you provide those?
12. How long is the waiting list?
13. Do you provide scholarships, or a sliding scale?
14. If it turns out that my insurance does not approve me on the first day, when am I notified, and do I have to pay for that first day? Remember this key fact — most insurance companies require the patient to be admitted to the facility before they consider admitting her. That makes ever admit case a gamble. For example, I was denied on my first day, but the director of the facility pulled some strings so I would be able to stay and not have to pay any extra. Not everyone is that lucky. It is important to get this kind of financial information before arrive.
Last year’s Thanksgiving was interesting. It was just my parents and I, but my mom was still intent on having a feast with all the trimmings. I, however, was about 5 months deep in my eating disorder, and with the lack of people (distractions) present, I knew I would have to eat.
The actual day turned out fine. I faked a migraine, like I often do in anxiety-ridden situations, so neither parent was alarmed when I didn’t eat very much.
The next day, armed with leftovers, I started binging on the drive back home, purged immediately, and repeated the cycle several times that day.
I recount that story as an illustration of how I used my eating disorder: to relieve anxiety. Family members are a big source of my anxiety, and this year, more of them were present at Thanksgiving.
We had dinner at a restaurant this year, which was good in that I would be receiving a portioned meal and couldn’t really do anything about it, but bad because (without any eating disordered thoughts involved) I absolutely detest the restaurant.
This would be my first Thanksgiving – and holiday – after treatment, and I had full intentions of making this my first day of recovery after relapsing a few weeks ago. But after forgoing breakfast and still running on a trail, I knew I wouldn’t be able to hit my full meal plan.
Dinner was bearable. There was plenty of wine. My food didn’t taste good, but I ate my first decent sized meal in weeks. I came back to my parent’s house trying to fight tears away.
I’m a failure. I’m a failure. I’m a failure.
I felt physically and emotionally uncomfortable. I wanted to purge, and I think my parents knew it. I, in essence, felt like shit for a few hours.
But just for a few hours.
Fast forward to today. I am on day two of eating 100% of my meal plan. After every meal, I feel overly stuffed. “Thanksgiving full,” as they say in treatment. I am incredibly tempted to run to the nearest bathroom to purge. But I know by now that the feeling will pass. I went through re-feeding once before in treatment, and this time isn’t nearly as bad.
I ate a fantastic lunch of sushi and seaweed salad, as a sort of reward for starting to get back on track with recovery. Because I didn’t know the exact amount of exchanges in my meal, my mind started to play tricks with me: there was so much rice, there’s no possible way you need to eat that granola bar at snack.
But 100% of a meal plan means… 100% of a meal plan. Dammit. So I ate my afternoon snack, albeit a little later than usual. I am not happy about eating, or the feelings it is bringing up. But recovery is all or nothing. Perhaps that is black and white thinking, but I either eat the damn snack, or I continue to restrict. Continue in my relapse. Continue to tell my support groups, “I have no idea why I can’t hit 100% of my meal plan. I’m trying so hard” (Nnnnooootttt entirely true.) Continue to have debilitating hunger-induced migraines. Continue to feel like shit.
Or, I eat 100% and keep it down. Because like I learned on Thanksgiving this year, it is possible to fight through the feelings.
I had my second session this week with my dietician today. This time, I had to eat a full sandwich in front of her, since we meet on my lunch break. That wasn’t hard, as I planned the rest of my meals accordingly. But the rest of the session was just… difficult.
We usually talk about food. What food will I be eating over the weekend, what food challenges me still, what foods do I like or dislike and why. Before last Wednesday, I was at the point of recovery that I was starting to enjoy food, and I no longer feared it. Therefore, emotions weren’t as present.
This time, we talked about feelings. And lots of them. And she hit hard on the benefits of recovery and the fact that my long term goals (finishing school, having a family) would probably not happen the way I’d like if I continued down this road.
I didn’t have much to say in defense, except that it’s so damn hard to feel emotion.
I’m awful at it. I’m a 2 year old in a 27-year-old’s body. The last time I allowed myself to sit in my feelings as opposed to using my eating disorder landed me on suicide watch at one of my treatment facilities.
However…
I came back to work, still ravenous. I refused to eat an afternoon snack. And I began to complain to myself the agony of having my hunger cues and restricting. It’s physically painful at times. Then I got up to go to the vending machine. Then I sat down.
I got up. I sat down. Repeat.
That’s when I realized: I want to recover more than I don’t. It’s the battle that is stressing me out.
So there’s a solution: eat. I did. And in a half hour, I will be going to happy hour with a friend, and will eat again.
I’m not saying the switch has been completely flipped. I still want to eat less than my full meal plan. But no amount of stuffing my feelings will compel the boy to text me back, or my best friend to stay in southern California. I’m just hurting myself and feeling like shit, and I’m tired of it.
So I’m going to try to eat. And I’m going to think about sitting in the many emotions I have inside of me right now. And I’m going to give this recovery thing another shot.
Because I’m really tired of fighting with myself.
