Therapists’ self-disclosure of recovery status (not into coming up with a creative title tonight, haha)

I recently read this article about the pros and cons of therapists’ self-disclosure of their own eating disorder history. I’m not going to say a lot about this now because it’s something that I’m sure will come up more and more the further along I get in this journey, and I expect my opinion to shift some, but I wanted to at least mention it.

I’ve decided that I really do want to work with eating disorders one day– maybe not right away when I start seeing clients, but eventually when I’m ready. Do I disclose that I’ve recovered from my own eating disorder? Do I not mention it but be honest about it if asked? What about this blog? Should I stop writing in it once I’m a practicing therapist? Do I just make sure it stays completely anonymous (which it pretty much is except for the pic in the “About this Blog” section and my gravatar thing)? I know how people love to google their therapists… what if they found this? Would that be absolutely disastrous? Am I getting way ahead of myself in worrying about this so early in my journey? I haven’t even gotten accepted into a program yet, haha… but I like to be prepared. 😉

I’d love to hear your opinions– from the therapist side, the client side, or the average Joe side.

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When the most exciting part of your day is planning that perfect binge

I’ve been sitting on this blog for several weeks, but I decided to finally post it. My instinct is not to talk about bingeing (b/ping in general, but particularly the bingeing aspect), because to me it’s the most shameful part of my eating disorder. I know I’m not alone in this though, and I hope that the more I address it the less ashamed people will feel about confronting this behavior.

The article “Investigating the Reinforcing Value of Binge Anticipation” talks about binge eating in terms of alleviating negative emotions. A person apparently binge eats in the context of these emotions and through negative reinforcement the binge eating behavior alleviates this negative affect. When I first read this, I kind of disagreed. In the worst of my eating disorder, I binged/purged in the context of any emotion. I sought to numb myself completely but I was also physically starving, so I relied on the constant b/ping behavior to distract from the never-ending hunger. I was either severely restricting or bingeing on large quantities of food and then purging until completely empty (or well, as empty as was possible for me). That was in the worst of my disorder though. When I’m not as physically starving, I do notice the urge to binge is related more to negative emotions and anxiety.

I also noticed right away that the article focused no attention on the role of purging, which makes me wonder if their generalizations apply more to individuals who binge eat without purging, rather than those with bulimia or anorexia- b/p type. For me (and I’m sure others), bingeing is always paired with purging, and purging almost always follows true binges, not regular eating. This is why I usually refer to the entire behavior as “binge/purging” or “b/ping,” because those two behaviors are always linked for me.

That said, the article then goes on to talk about the unique role of binge anticipation, which is rarely, if ever, discussed in the literature. Ah, binge planning… so many memories of scrambling to write down all the foods I was craving in the moment and hoping they’d be the same foods I craved hours later when I actually got the chance to binge. Clearly for most people, bingeing directly following negative emotions is not always possible. You may be at school, at work, or simply unable to obtain the food necessary for the binge until a later time. This is where binge anticipation comes into play. Researchers hypothesized that often this binge anticipation phase may serve the same purpose as the binge itself, in terms of alleviating negative affect. This may explain why so often I’d be in heaven while planning my perfect binge only to be sadly disappointed when the actual binge failed to live up to expectation (or when the streneous purging part ruined it all).

The article talks about a recent pilot study that examined the brain activation of women with bulimia using an MRI scanner. The experimenters used a mood induction technique to place the subjects in a negative mood. They then measured the subjects’ brain activity when they were asked to plan a binge versus when they were asked to pick out furniture for a fictional apartment. They found a large drop in amygdala activation when the women were planning a binge, but almost no change in amygdala activation when picking out furniture. The pattern of amygdala-related change observed when the subjects were planning a binge has been associated with a decrease in negative affect. They also noticed an increase in activation of the caudate, which may indicate positive reinforcement and “appetitive reward.” In other words, this data suggests that the decrease in negative emotion that has been long associated with bingeing happens (also? instead?) during the binge planning stage. Another study they mention involving the anticipation and actual consumption of a milkshake suggest that this reduction in negative affect is solely associated with the planning, and not the eating itself. However, I think there are too many variables not accounted for to make this conclusion, including the role of purging and level of physical hunger before the binge.

The authors go on to suggest more mood induction, ecological momentary assessment (i.e., rating moods in the moment using some kind of mobile device), and longitudinal brain imaging studies of binge anticipation. I would add that studies should be done with a variety of diagnoses that involve bingeing (binge-eating disorder, bulimia, and anorexia- b/p type).

So the answer is simple then? Just do all the fun planning and skip out on the actual binge (and purge). Negative emotions sill reduced! Problem solved! Haha, right. Up next, how to actually apply these brainy findings to real life…

No easy answer: Anorexia and the right to die

A few people have asked about my opinion of this case in New Jersey where a judge ruled that a 29 year-old woman cannot be force-fed against her wishes; instead she will receive palliative care. Honestly, I have no simple opinion on this matter. It’s way too murky for me to say one way or another whether or not this is the best choice. I would love to be the optimist who says, “Anyone is capable of recovery, this woman included,” but do I really believe that? I’ll admit my overall opinion of recovery has shifted over the past several months. I used to think that everyone had a kind of a pre-destined “recovery potential” that dictated the maximum level of recovery they could ever achieve given the best case scenario. I now see things a little less black-and-white. I used to think this was about as good as it would ever get for me, and now I think differently. I believe I’m capable of more, and I hope to get there one day.

Some of my closest friends have severe eating disorders and I can’t imagine myself ever giving the “okay” for them to give in and settle for palliative care at such a young age. Part of this has to do with knowing the profound effect that malnutrition has on the brain. It’s pretty much impossible not to be intensely depressed when you’re starving. However, I’ve watched people I love make dramatic transformations through re-feeding– not just physical transformations but mental and cognitive transformations as well. I’ve also experienced this myself. When you’re drastically underweight and malnourished, simple food will have a much bigger impact on your mood and thinking than any antidepressant will (and actually, most antidepressants probably won’t work at all when your body is that compromised).

On the flip side, anorexia is an illness not unlike many physical diseases that, when determined to be terminal, have led to approved physician-assisted suicide. Have I ever felt defeated enough by my illness to wish death upon myself? Absolutely, more times than I can count throughout the course of  my eating disorder. However, I honestly don’t think any judge would have granted me permission to die (or to give up on treatment) had I asked for it at the time. As sick as I was at times, I had never done such irreversible damage to my body that it would have seemed warranted. Obviously I don’t know the details of this woman’s case, but I’m guessing her body has deteriorated to a degree that they believe she has little chance of ever making a full physical recovery. Re-feeding can be extremely dangerous when a person has gotten to such a grave physical state, so much that many hospitals won’t admit patients who are below a certain BMI. The places that can treat patients with single-digit BMIs or serious medical complications is very limited. For all I know, this woman may have exhausted all her options and is now just looking for any kind of relief– relief that only palliative care may be able to give her (I also can’t help but note that the article states she suffers from binge/purge type anorexia, which, at least in my experience, is like double the horror).

It’s depressing for me to even be writing about this. I’ve watched more than a few people die from this illness. Some of those people had clear wishes to die and others died very unexpectedly. I worry about my current friends and acquaintances with eating disorders every single day. I hate that this illness takes so many lives, whatever the circumstance, and I wish everyone could be as lucky as I’ve been to experience such a life-changing shift in perspective on the prospects of recovery.

Using the past to your advantage: When comparisons may actually be helpful

I was reminded by Facebook that eight years ago today I was sitting at the tiny wooden hallway tables of good old  “4 Center” at New York State Psychiatric Institute writing a sitcom about life on a mixed diagnosis psych unit. Sadly but not surprisingly, that sitcom never got off the ground– I wasn’t exactly known for finishing the things I started back then.

pi-pic

Aside from bringing back both hilarious and horrific memories, it also reminded me just how different my life is now. Eight years ago, despite being 24 years old, I still had not graduated from college; I was too busy being dragged from one treatment center to another in hopes of making any dent at all in my eating disorder.

Recently I’ve experienced a spike in some super frustrating behaviors. Of course things are nowhere near as bad as they once were, and often I would consider this kind of thinking dangerous (i.e., “Things used to be way worse so things must be fine the way they are now” –> no reason to change or progress further in recovery). However, sometimes I think it truly can be worthwhile to compare the past to the present, even just to ease your mind that not everything is coming crashing down around you.

So, while the actual behavior (e.g., binge/purging) may be the same, the frequency, duration, intensity, and/or circumstances may be completely different. I know for me there are certain aspects of the behavior that have not been a “thing” for me in years– like regularly purging in public restrooms, stealing food, or using the scale and other devices to obsessively (in the moment) monitor my purging “effectiveness.” I no longer wake up and b/p first thing in the morning and continue straight through the day into night. I no longer walk around with scary looking eyes due to all the blood vessels I’d break from purging so excessively. I no longer drive my roommates away by my weird and intrusive habits (it kinda helps that my roommates are now both cats, but still).

So no, things are not perfect now, and I wish they were better, but at least I can look back and remember how far I’ve come. Failed psych ward sitcom writer without a college degree to… accomplished research analyst with a master’s degree (x2, eventually) and an exciting new life plan, with two roommate cats who haven’t kicked me out yet. Yay, total failure this is not!

 

When the “best years of your life” are an awkward disappointment: College and eating disorders

Seeing as it’s “that time of year again,” I wanted to write a blog about college and eating disorders. For a lot of people, college is the first time they ever live away from home. I think it’s pretty well known that major life transitions are common times for mental health issues to develop. However, transitions can be just as difficult for those already dealing with these issues.

I was very excited to go off to college my freshman year. I didn’t have that great of a high school experience, but everyone kept telling me that college would be so much better. “People are more mature in college. You can totally reinvent yourself and you’ll definitely fit in because there are no cliques or ‘popular kids’ in college. You’ll love it!” Well, maybe. I guess it depends on where you go. I went to a fairly small liberal arts school for my first three years of college, and I found it to be eerily similar to high school. My freshman dorm quickly became divided into high school-like cliques. There was drama and gossip and people still had to work hard to fit in. Honestly though, that stuff exists everywhere, even in the adult working world. I think I was just mildly disappointed that it wasn’t the drastic culture shift that so many people tried to to claim it would be.

At the time I was heading off to college, I had already been struggling with my eating disorder for six years. By the end of high school, though, I had at least reached a kind of stasis with my ED that I expected to maintain through college. After all, every one kept telling me college was so much better than high school, so I figured I’d be super happy throughout and have every reason to do well. I said goodbye to my therapist of five years; I figured I’d just go back to her if things started to slip but I really didn’t see that happening. This was definitely a mistake. Things did start to slip, almost right away, but I was too ashamed to admit that I wasn’t thriving in the amazing college scene so I suffered in silence for the first year.

I started having major issues accepting my body. Going in I could at least somewhat accept it– I was significantly bigger than I was at the worst of my anorexia, but I was still technically underweight and could see that most people probably still saw me as ‘thin.’ Within a couple months of starting college, that was no longer enough. I started really missing my old (smaller, sicker) body and my eating disordered behaviors intensified. This is when I first began to struggle with bingeing/purging, a behavior that still to this day remains incredibly shameful for me.

There were also certain factors specific to the college experience that probably didn’t help. For example, my dorm’s Resident Director (who managed all of the RAs) was really into encouraging us to record our calories and participate in these awkward weight loss challenges. She posted signs on the elevators advising us to take the stairs instead, complete with handy pictures of food crossed out with red x’s. Drink all the alcohol and smoke all the pot you want, but whatever you do– SAY NO TO THE COOKIES!!! Yeah, she was weird… I also had two friends who were always trying to get me to join their diet groups, even though they knew about my history with eating disorders. None of these things were solely to blame for my relapse, but they certainly made what I was doing seem more socially acceptable, at least at first.

It was also in college that my anxiety related to eating with others became pretty extreme. Eating with people was never an easy thing for me, but I could at least make myself do it when absolutely necessary and I went into college hopeful that I’d be able to eat with my friends from time to time. While I started the year off going to the dining hall with the few friends I made, this quickly became an almost impossible task for me, perhaps largely due to my increasing b/p behaviors which I kept strictly secret.

During the first few weeks of going to the dining hall, I noticed a girl who I knew had an eating disorder. She was quite thin, but even aside from that, it was clear to me. She had all the physical signs of chronic purging, and she always sat alone and ate the same exact foods in the same order. She would finish each meal with a huge bowl of ice cream and then would disappear. I’ll admit at first I was almost envious that she at least had the ability to eat out in the open like that, because my bingeing (and actually at that point, eating anything at all) always had to be completely secretive which made it harder to maintain this behavior that I hated and was so ashamed of but unfortunately couldn’t stop. I also just felt really bad for her though, and often wanted to run up and hug her (but yes, that would have been super creepy so I restrained myself).

I later learned from a mutual friend that this girl did indeed have an eating disorder, and that her original roommates had voted her out of the suite they were living in because they couldn’t deal with her b/ping. Little did I know at the time, this very same scenario would play out for me my junior year.

Now, I want to say something about college counseling centers. Some really suck. I’m sure there are good college counseling centers out there, but the two experiences I had (at two different schools), were really shitty. If you have access to a qualified therapist outside of the school, you’re probably best off sticking them them. I find a lot of therapists staffed at college counseling centers will claim to have experience with eating disorders when they really do not. I was dragged to my first college’s counseling center by my roommates and it could not have been more of a disaster. I was made to feel even more ashamed and at fault than I already felt, and I spent the rest of my time at that school going out of my way to avoid running into these crazy “experts.”

At the end of my junior year I got stuck in a cycle of revolving door inpatient admissions that eventually led to me taking an extra four years to finally graduate. Today, at the old age of 32, I can recognize that while this seemed like the end of the world at the time, it actually wasn’t. I did eventually graduate and even went on to get a master’s degree. That said, if I could magically go back in time I would absolutely do things differently. Sometimes it really is necessary to leave school and get more treatment. I don’t regret ever doing this, I just regret doing it as many times as I did. I wish I would have put more effort and time into making the first few rounds really worthwhile, so that the subsequent times wouldn’t have been necessary. There were also times when I wish my treatment team would have given me more of a chance to turn things around on my own, instead of throwing me back in treatment as soon as I struggled. Hindsight is 20/20 though, right?

I used to get really sad when I’d hear people talk about the great college experiences they had. Mine were filled with lots of shame, secrecy, tears, and hospitals. Can I go back and do it all over again? Like, the whole freshman dorm experience? It could be a reality show– 32 year old ‘cat lady’ poses as a college freshman and infiltrates most popular dorm. Will she finally be cool??

I no longer let myself get sad. I had lots of experiences, and not all of them were good, and some were really, really bad. However, I eventually managed to move on and had it not been for those crazy eight years, I probably never would have ended up here, in Los Angeles, with a graduate degree and a life I finally like.

Sleep: A Strange (or Not-So-Strange) Enemy

I’ve gone through large portions of my life being chronically sleep-deprived for one reason or another. In the early years of my eating disorder, I didn’t like sleeping because it felt like a waste of time that could be spent doing anything else that burned more calories. I would pace around my room for hours every night forcing myself to stay awake until the last possible moment, when I could no longer keep my eyes open. Once I started binge/purging, I was often kept up by that. I would be so tired but also so hungry that the urges were impossible to ignore. Nine times out of ten, I would choose b/ping over sleep. Some nights I would get less than an hour of sleep before having to leave for class or work the next morning. I struggled to stay awake during these daytime activities and sometimes crashed as soon as I got home, which then just led to an even later start to my nighttime b/ping. It was a vicious cycle.

When I first started writing this blog, I remembered my sleep issues all occurring in the presence of my eating disorder. Then I recalled a funny conversation I had with some family members several months ago that made me realize I was actually weird about sleep even before my ED officially began. My mom and my aunt were talking about taking long family car trips and my mom said, “My kids usually slept most of the way, except Rebecca- I don’t think I ever saw her asleep in the car. I guess she just never got tired!” This sparked memories of those long 10+ hour car rides we used to take to visit family out of state and I replied, “It wasn’t that I never got tired, it was that I always forced myself to stay awake in the car. I was miserable!” I saw sleeping as a sign of weakness. At 5, 6, 7 years old. What a weirdo. No one ever told me sleeping was bad or anything; I came to that conclusion all on my own.

When I first got into therapy, a lot of professionals tried to insinuate that my parents held me to unattainable standards or even that they put strict limitations on what I could eat, do, say, etc. That couldn’t have been further from the truth. My parents held me to very reasonable standards and were not at all restrictive about how I lived my life, what food I could eat, etc. No one ever told me I was only allowed to sleep X hours a night or that I couldn’t eat X type of food. All those rules came entirely from my own strange brain. And not only that, but once I imposed those rules and had people take notice of my weird behavior, I thought it was absolutely essential to uphold that version of myself. Once I became known as the kid who didn’t sleep in the car, I had to be extra careful about never to allowing myself to fall asleep in the car. Once people knew me as the kid who never ate in front of people, I couldn’t let that version of myself die either. It made no rational sense but it was the way I lived most of my life.

One of the first things I noticed about inpatient facilities for eating disorders was how obsessed they were with sleep. Upon my first admission, I was immediately put on medication to help me sleep, before I was even asked if I had trouble sleeping. If a nurse noticed me still awake during one of their routine checks during the night (usually every 10-15 minutes), they would ask what was wrong and if I needed more meds to sleep. Apparently anyone who took longer than 15-20 minutes to fall asleep at night had severe insomnia!

I never liked taking meds for sleep because they always left me extremely sleepy in the mornings. I would struggle to stay awake in groups and sometimes even meals. As if meals weren’t hard enough, I had to continuously pinch myself to stay awake. When I would ask to be taken off the meds or when I refused to take them, it would go down in my chart and I’d be labeled a “difficult patient,” all because I didn’t want to fall asleep in my cereal.

This was a theme throughout most of the inpatient and residential facilities I passed through over the years. Many places had doctors prescribe patients powerful antipsychotics as sleep aids. I remember the first time I was handed Seroquel; I was so confused. I knew my meds, and I knew that Seroquel was an antipsychotic. Why was I being given an antipsychotic when I displayed no psychotic symptoms? I quickly learned this was becoming the new trend in the mental health world– prescribing antipsychotics for their “off-label” uses, many of which included drowsiness. Seroquel, Risperdal, Geodon, Zyprexa– I’ve been on them all that some point, mostly for the sole purpose of helping me sleep, even when I never asked for help in the first place. Speaking of Zyprexa, it is also commonly prescribed to anorexics to “help them gain weight,” as weight gain is a common side effect of the drug. Because, you know, that is totally the answer– give someone who is already terrified of gaining weight a drug with a known side effect of weight gain. That will totally work! They won’t suspect a thing! That one is wrong and ineffective on so many levels, but doctors still use it.

There is nothing inherently wrong with using medication to treat (actual) insomnia. The problem I had with these facilities’ obsession with sleep was that they did what this article referred to as “medicalizing sleep.” Sure, there are countless physiological processes that occur during sleep, many of which have been studied in depth. However, the overall concept of sleep itself is impossible to measure. We’re also constantly being fed mixed messages about sleep. We’re repeatedly being told how important a good night’s sleep is, how adults require a solid X hours of sleep per night while children and the elderly need X (it’s always changing). Entire clinics are devoted to helping people learn to “sleep smarter” and doctors are handing out medication for sleep like it’s candy, including powerful antipsychotics. On the flip side, we set multiple alarms to make sure we wake up at the same ungodly hour each morning, and some professions have people working 60 and 70 hours a week. How do we reconcile these two mindsets? We’re being told that the quantity and quality of our sleep has critical implications, and yet we’re being expected to endorse lifestyles that make getting sufficient sleep impossible.

The idea of sleep being a sign of weakness was probably not completely invented by my own strange brain. My parents did not instill this into me, but modern society might have. When we run into people we haven’t seen in a while and they ask how we are, chances are both sides will say something like “I’ve been so busy!” It’s good to be seen as busy. It makes us feel productive and useful and sometimes it can even be a source of competition. We’ve all probably been a part of many “who’s the busiest?” conversations, either at work or amongst family or friends. “I am so busy this week. I have to do x, y, and z, all while managing Project A.” Then someone chimes in, “Is that all? That’s nothing compared to my week. I have to do a, b, c, and d on top of managing Project x, y, and z.” And so goes the game of one-upping; everyone wants to be seen as the busiest. Bonus points for mentioning how much sleep you’ve sacrificed.

There are countless parallels that can be drawn between sleep and eating. I know I’m not the only person with an eating disorder to have these warped ideas about sleep. I like to think that the distorted thoughts and behaviors I have (or had) around sleep developed much like my distorted thoughts and behaviors around food did. No one single person drilled these ideas into me, nor did society force them upon me. It was likely a combination of my innate personality traits interacting with the messages I received and interpreted (in my own way) from society. I’m lucky to have, over time, cultivated a progressively less black-and-white view of these things. Sleep is not all bad or a sign of weakness, and neither is food. I can admit to liking both now, which seems like such a silly thing to even point out. Sleep and eating are both basic human needs, and yet for so long I could not allow myself to admit to liking either one. Well shit, the secret’s out. I do love sleep. And food. Never believe an anorexic who says she/he dislikes food. Everyone likes food, and I’d even venture to say that most people who develop anorexia (or any eating disorder) probably “like food” even more than the average person. Otherwise, there would really be no disorder… but that’s a topic for another blog. 😉

Moving, planning, and changing: What is realistic and what is self-sabotage?

I’ve moved a lot in recent years– four times since moving out of my parents’ house in 2010, five if you count my couple month stint in St. Louis a few years earlier (which I usually prefer to forget about because WTF was I thinking?!? haha). Last weekend I moved into my latest place, and so far things are going pretty well, minus the currently non-functioning WIFI (grrr… this seems to be an issue whenever I move).

I know it’s common to see moves as “new starts” and I’ll admit I’ve bought into this cliché pretty much every time I’ve moved as an adult. Not once has the experience lived up to my grand expectations. I’ve made some really significant changes over the past few years, just none of them have perfectly coincided with any of my moves. Not a big deal, but knowing this did cause me to second-guess myself when I once again started coming up with big changes I was going to make to go along with this move. Had I not learned my lesson by now? Things don’t magically change for the better when you move to a new place, whether that place is 3,000 miles away or 3 miles away. No, things don’t magically change for the better when you move; you have to plan and work for them just like changes you expect to make at any point in your life. The truth is though, I’ve been meaning to make some pretty big changes for a while now, and the recent move just gave me more of a push to finally get serious about them.

Usually when I move, I make really ambitious statements like “Once I move, I’m never going to purge again!” which is pretty funny considering up until this most recent move, the first thing I checked out in every apartment I looked at was the bathroom to make sure it was “purge-friendly” (sorry if this is TMI for some people, but it’s just reality for many people with chronic EDs). Every time, I would fail at this goal by night one or two and then I’d just laugh it off like, “Well, this is me! It’s just what I do!” It wasn’t until just a few years ago that I was able to make any meaningful dent in this particular behavior. At the risk of possibly revealing too much to people who may have thought I was doing better than I am, it’s still a behavior that exists for me. It is considerably less frequent and not nearly the burden it was for the majority of my life, but it does still exist. All of the same urges are still there, I’m just better at fighting (most) of them, but I still give in at times. It’s still something I have to think about and factor into my every day life (i.e., how to avoid it or how to do it without letting it completely spiral out of control).

I have never lied about my progress and it is 100% the truth that I’m doing better now than I’ve ever done before. Overall, I’m a pretty happy person these days (which I never thought I’d be able to say) and I’m able to live a pretty full and active life. That said, certain things about my eating disorder are still pretty present and bothersome and I’m just now realizing it’s okay to admit that while also maintaining that my life is pretty good right now. It can be both.

I’ve said before that the main thing that has allowed me to make any progress has been accepting that I’ll have this eating disorder forever and that the myth of “full recovery” doesn’t really exist for many people with long-term EDs. I still feel this way. However, I’m now more open to the fact that maybe I still have room to get better from here. I’ve talked a lot about the progress I made in the first couple years after leaving treatment the last time in 2012. Since then, things have been pretty stagnant ED-wise (although lots of awesome stuff has happened since then in other areas of my life). For some reason, I kept thinking this was as good as it was going to get for me. After all, I’m no longer b/ping for 10 straight hours a night, avoiding any and all social food situations, or refusing to leave my room if my weight is even 1/10th of a lb higher than the previous day. As long as things are more than a step up from that, I figured I should just shut up and be grateful!

The truth is though, even considering the very reduced rate at which I’m engaging in that behavior now compared to before, there are still many, many reasons why I wish I wasn’t doing it at all. I wrote all of these reasons down, along with the reasons I continue to do it (because yes, those exist too, I’m not doing this because it’s fun). There have always been points on each side, but the difference now is that the “reasons not to do it” far outweigh the “reasons to do it.” There’s no comparison. In fact, I’d say the “reasons to do it” are actually reasons WHY I still do it and not reasons WHY I WANT to do it, because I don’t want to do it. Not at all. It did used to give me something, but now it doesn’t really give me anything that I can’t get in other ways. I do it almost completely out of habit now, and possibly still to some degree, out of a physical need. My dietitian has been reminding me for years that I’m still not eating enough, and while on some level I know she’s right, it’s also hard to accept considering what my intake is now compared to at all other points in my ED. I usually think, “but I’ve gotten by on so much less food!” which is true. However, “getting by” usually meant resorting to hours of  b/ping each night and only having enough energy to do the bare minimum with my day. There’s no way in hell I’d be able to do all that I’m doing now on that little food (kept down) and that level of b/p intensity.

Over the past several years, I have actually made many attempts to reduce this behavior further. I’ve taken up yoga, started this blog, meditated, read many dumb self-help books, seen several psychiatrists to change up my meds, etc. Some of these things have helped a little, but nothing has been a total game-changer. I’ve even changed up many food-related things, hoping that would help. I’ve played with the times I eat, the setting in which I eat, the ratio of macro-nutrients in what I eat, etc. The one thing I haven’t changed, however, is the amount of food I eat. Well, that isn’t entirely true. I’ve made minor changes, like increased my overall calories by 60, 70, 80 or even when I’m feeling really daring—100 calories. Rarely have these small increases made a difference in my hunger levels or how I feel physically though, and I just end up getting mad at myself for “wasting” the added calories for no noticeable benefit (i.e., feeling less hungry during the day and having fewer urges to b/p). Throughout all of these attempts, my dietitian would encourage me to make bigger increases to notice a difference and I would really want to. I would tell myself that even if I took a major plunge and increased by 4-500 a day, I’d still be eating less than most people. But, what if I gained weight? Let’s face it, I’ve gained on less food thanks to my lovely f#cked metabolism, so it’s quite possible that I would, at least at first. One day I hope to be able to tolerate being a truly “normal” weight, but I’m not there yet and as controversial as it may be to some of the hardcore ~recovery warriors~ out there, remaining within the confines of the “underweight” BMI range while still being otherwise healthy is what’s kept me from completely relapsing since 2012, and I’m grateful to have people in my life who understand/support that.

So yeah, I might gain weight, but hopefully not much and hopefully just temporarily. I have proof that it is physically possible for someone with a functioning metabolism to maintain my current BMI while eating quite a bit more than I’m eating now, so I guess I’ll just pray that my metabolism regulates after the initial increase. It has before and I guess it can again.

The thing is, I’ve made so many plans to do exactly what I’m talking about and I always end up backing out or abandoning it after a day or two when it gets too hard. I actually enjoy the planning process. I absolutely love making plans for things I would allow myself to eat (without compensation) if I could. I makes lists of all the foods I’ve dreamed of for so long but haven’t allowed myself to eat (at all or without purging) and I get really excited. If only I just got to eat one of those foods on a regular basis, that would be awesome. I get excited about the possibility of eating a bigger snack at night that I can extend to take X amount of time to eat instead of only X amount of time, which pathetically makes me so happy because omg, food!!! And then I smile when I think about  actually getting to enjoy the food and not have to worry about ~getting rid of it~ immediately after. It is all so exciting and fun to think about.

Reality, however, is far less thrilling than the planning phase. In reality adding new foods or increasing amounts of a food is usually more anxiety-provoking and guilt-laden than it is exciting, so much that it often doesn’t feel worth the effort. This is where I always get stuck. Can’t I just remain in the exciting planning phase forever?

I realize this may all sound crazy to some non-EDed readers. I just think there should be no shame in being a little more honest about some of the things I still deal with, even while appearing so healthy and functional to the outside world. I know when I was deep in my ED and would look at people like the current me, I would assume what they had was so out of reach. I want to show people that it is possible to have really cool shit going on in your life even while you still struggle with many of the same ED things, but it’s also always possible to continue making progress and working towards a better “recovery” than what you currently know.

I promise I will finally get to my point. When I decided to move, I decided it would be the perfect time to finally take the plunge and increase my calories by a real amount, because if there’s any chance it might help further reduce that behavior I so deeply hate but can’t completely stop, it would be worth it. I didn’t want to bring the same problems associated with that behavior to yet another apartment (and there are many– things people wouldn’t even think about until they happen, and they all suck). This time I didn’t make the overly ambitious statement of “I’m never going to purge again!” I also didn’t come in with the expectation that my new ~plan of action~ would begin perfectly on Day 1 of living in my new place (which is good because this week has been riddled with unexpected and shitty events, none of which have been conducive to starting this new plan). What I have done is make very detailed and honest lists of why I’m doing this, the good things that will come out of it, and the bad things that could happen as a result of continuing not to do it. I’ve read these lists over and over to myself and have tried to imagine how good I’ll feel once I’m finally able to make a bigger dent in this behavior that  continues to follow me wherever I go.

Will it finally “work” this time? What does it “working” even look like or entail? Will I last longer than a day or two this time? Well, my friends, 13906825_10100726571122622_5367965971188160289_nI make no promises. I don’t want to be that obnoxious person who proclaims to the world via the internet that she is finally DONE with her eating disorder, like FOR REAL this time because life is now SO AWESOMELY AWESOME that there’s no room or reason for  some dumb eating disorder… only to come back a week or two later to report that sadly, she was wrong.  Life actually still sucks and the eating disorder is her only reliable friend, so like… back to square one. No, I will not be that person. I do feel that this time is “different” for me, but I’m not naïve enough to think it will all go exactly as planned.

As per usual with me though, the plan starts Monday. In the meantime, I will continue badgering Charter to finally fix my WIFI because phone typing long blog entries is not fun. 😉