Happy almost 1-yr anniversary to this blog

Today is the start of yet another National Eating Disorders Awareness Week. Last year, I hesitantly posted this story and shortly after that, I started this blog. I had what I thought was a great topic to post about this year, but after thinking about it I started having doubts that it would be well received. Yikes; such an anxiety-provoking awareness week!

In the past, most of my qualms with this week have centered on misconceptions that I think those “on the outside” sometimes unintentionally spread in the name of awareness. For example, often I felt that certain factors were overemphasized and others not at all mentioned when talking about what “causes” eating disorders. I hated the thought of people being fed an over-simplified idea of what all eating disorders were or were not, when I knew just how diverse and complicated they were.

This year, however, I realize that many of my reservations are now related to misconceptions that I think are perpetuated by some of my fellow sufferers. I know I have to be careful when talking about this, because the last thing I want to do is invalidate anyone’s personal struggle.

As I’m sure some of you have noticed, these days NEDA week is often “celebrated” by a current or former sufferer posting a dramatic “before and after” collage on instagram (or Facebook, or Tumblr, or whatever their platform of choice is). These collages often feature photos from their very bone-jutting sickest next to pictures of their smiling twinkle-eyed face today. When I see these posts, I’ll admit, I kind of want to scream. A post like that tells me absolutely nothing. All it tells me is that you used to be really skinny and (apparently) quite sad, and now you’re healthy (maybe) and (apparently) quite happy. Yay! Good for you, really. However, I’d much rather see a candid non-photoshopped picture of you doing something you love, or read about all the things you can do now in recovery that you couldn’t do in your eating disorder. That would be way more interesting and inspiring to me, but of course it’s the dramatic before/after collages that get all the “likes” and re-blogs.

One more word about the pictures, and then I’ll move on. It’s perfectly fine and even admirable to be so proud of how far you’ve come. And while weight is not a factor in every eating disorder, it is in many, and I realize firsthand what a big accomplishment it is to finally begin to accept yourself at a more normal weight. I have my own pictures, and I sometimes look back on them to reflect how far I’ve come. Please, however, think before plastering these kinds of pictures all over social media. This is a very competitive illness, and people can be negatively affected by such things at all stages of illness and recovery. If you feel the need to hold onto all of your sick pictures, fine. Keep them in a box and pull them out whenever you need a reminder of how far you’ve come. If you feel the need to share them, share them with close friends or family members who you know won’t be triggered, or with your therapist or your cat. Don’t post them on your public instagram tagged #soinspirational. I can almost guarantee you, you are not inspiring people in the way you hope.

Another troubling mindset that I notice is rampant in the eating disorder community is that idea that “more treatment is always better.” Whenever anyone currently struggling with an eating disorder even hints that they’ve recently been struggling more than before, the first thing their so-called supportive friends (all of whom also have eating disorders) often say to them is, “Go back to treatment!” Surely, $1,000+/day residential treatment is the answer to everything, right? Because a good couple months of equine therapy and challenge snacks is all anyone needs to break a lifetime habit of self-destructive behavior! That must be why anyone who goes to those places never needs to go back, because the treatment is just that awesome. Oh wait… that pretty much never happens. 😦 What does happen (more often than not) is that person gets sucked into the toxic treatment center vortex. They do well in treatment because everything is neatly packaged and decided for them, and all the triggers of everyday life are removed. When they’re finally forced to leave (often due to insurance “kicking them out”), everyone seems surprised that they can’t keep up what they were able to keep up in the treatment center bubble. As soon as they struggle, they’re sent right back to treatment to repeat the whole cycle all over again. To many of us on the outside looking in (many of whom have been caught in our own treatment center vortex at some point), it seems so obvious. “Treatment” isn’t working. You’re never going to learn how to live a healthy life by being trapped in a completely unrealistic bubble for months at a time. I’m glad that I finally realized this myself, before I wasted even more time in the treatment center vortex.

Before I go any further, I should clarify something– I am not saying that all treatment is toxic or unhelpful. I am certainly grateful for much of the treatment I was fortunate enough to receive over the years. In many cases, it kept me alive and/or helped me get to a place where I was able to make more rational and life-focused decisions for myself. I am not against treatment when it is truly needed from a physical or psychological standpoint.

After all these years though, I do think I can honestly say that I am almost always against long-term inpatient or residential treatment when similar treatment can be provided in a less-restrictive environment. I’ve just seen too many people I know and care about become overly reliant and harmed (yes, harmed) by this kind of treatment. It is not healthy to keep a person in residential treatment for years at a time, or to lead that person to believe they are utterly helpless without that kind of 24/7 support. (Click here to read more about my thoughts on residential eating disorder treatment).

For many years as an adolescent and young adult, I was blessed to have really amazing insurance. This meant I was “lucky enough” to have several long-term treatment stays completely covered by insurance. If ever I was set up to make a perfect recovery, it was then. But what actually happened? I left each treatment center more hopeless and frustrated at my inability to get better. Any progress I seemed to make while in treatment was completely erased once I got home. When I lost this amazing insurance back in 2008 (this is back when they cut you off from your parents at age 24, not 26), I thought I was doomed. And yeah, the first few years really sucked, but I eventually learned to be more resourceful and I think it was during that time that I finally started to think differently about myself and what I was capable of. When I truly needed it, I was forced to spend time in a few very unpleasant state hospitals, and the only actual “treatment” I could access involved me agreeing to be a guinea pig for a bunch of eating disorder studies being conducted at the time. What I realized though, is that however much I thought that treatment “sucked,” it wasn’t really any worse than the treatment I received at the expensive residential centers. It was just different. At the end of the day, it didn’t really matter where the treatment was or what exactly it consisted of, what mattered was what I decided to do once that treatment was over.

I know several people who I’d say are quite seriously “addicted” to treatment. They don’t know how to live without that continuous 24/7 support. These are adults who have not been able to experience anything remotely “real” in years because they’ve been kept in this overly protective bubble. Sometimes I don’t even know who I’m angry at for this or if it’s even anger at all. Half the time I don’t think these people even realize why it’s so bad for them. I didn’t really know this myself, until I got out. Do I get mad at the people who are telling them to stay there, when they should know better, after all these years of seeing the cycle repeat itself? I don’t know.

Of course “getting out” of the vortex is only the very first step. It’s not like I just stopped going off to treatment and suddenly figured out how to handle my illness on my own. Not at all. For many years I was kind of just “white knuckling” it, as they say. I knew I couldn’t do it completely on my own but I also wasn’t about to throw all my progress away and get sucked back into the treatment vortex. I started trying out support groups and therapists. I encountered a lot of really unhelpful therapists (some downright harmful), and groups that sent me into high anxiety and panic. For a while it seemed like I really was completely on my own.

Eventually though, I stumbled upon a system of support that works for me. I am now lucky enough to have amazing insurance again, although this time I’m not using it to run off to treatment whenever things get hard. I’m using it to get valuable outpatient therapy to work on the things I never had time to work on before, when I was too busy dealing with the latest crisis of the hour and planning my next treatment stay.

Everyone’s journey is different, and I try to respect that. I just really doubt that a glitterized before/after collage is ever going to be the key to anyone’s recovery, nor is that 17th stay at that famous center in Denver.

 

“I wouldn’t want you to throw this all away.” Don’t worry, I won’t.

 

I feel like the tone of this blog has been shifting towards more personal posts lately which has been unintentional but perhaps meant to be? A couple weeks ago I was really concerned with “what to do” about this blog once I become a legit therapist who sees clients as if that were scheduled to happen like, tomorrow. I’ve since calmed down a little and realized I still have time to figure all that out.

As scared as I often am of being so open here, I hope I’m at least doing my part to “shatter the stigma”– the stigma of being a person still struggling with mental illness while out living life in this big scary world.

Yesterday I spent Christmas with my family and it was pretty wonderful. My little sister and her fiance are in town from the east coast and it was great being able to see them along with the rest of my immediate family. We did our yearly tradition of eating dinner at this restaurant on the beach near where my parents live.

During dinner the topic of me applying to “get my second master’s” came up and my dad expressed doubt that this was the best idea. “You’re doing so well where you are now, I’d hate for you to give that up.” This wasn’t the first time I’ve heard this concern; hell, I’ve had this very concern myself. Outwardly, I am doing pretty well right now. I have a stable job at a great company and most days I even enjoy what I’m doing. Why would I want to give that all up to take a risk at something that has no guarantees at providing me that same stability? Well, for one, I don’t plan on “giving this all up.” My plan is to stay at my current job for as long as I can while in school, even if that means dropping down to part-time eventually. I don’t plan on leaving the world of research entirely, I just hope to supplement it with something I’ve always dreamed of doing but haven’t been in a place to pursue until now. I know to the casual observer though, this sounds suspect.

The truth is, the past several weeks have not been easy. I’ve been wrestling with this decision and trying to convince myself it will all be worth it in the end. I’ll admit though that I keep coming up against imagined road blocks, many related to my ability to do what I really want to do given my own demons. When I first had this idea, I was so excited that I got this burst of motivation to make a lot of serious changes in my life. For example, I increased my calories quite a bit and told myself I was going to finally let myself get to a healthier weight and stay there because that’s part of what I thought being a successful eating disorder therapist required. I was almost surprised at how “easy” it was at first. My body image concerns became mostly background noise and I was able to ignore them and remain focused on my new life’s ambition, for the first time ever. It was pretty amazing but seemed almost too good to be true.

Sure enough, a few months into this new way of life things started to get a whole lot harder. I’ve become really uncomfortable with my bigger body and I’ve started to question why it’s even necessary. Even if I do plan on working with eating disorders, it will still be quite a while before I’ll be doing that in any direct capacity. What’s the hurry? I might as well take advantage of this time and you know– “get all the eating disorder out of my system”– have one final hurrah. This is the same thing I used to think every time anyone mentioned a higher level of treatment. “Ok, I’ll go into treatment, but not before I lose as much weight as possible and have as much ‘fun’ with behaviors as possible because once I’m in treatment, that will all be taken away from me, and once I’m out, I’ll be in recovery and none of that will be acceptable anymore.” Of course, given my history of many failed treatments, this method was never that effective. Every single time, my “one final hurrah” just sent me into a deeper state of despair and made it that much harder to succeed in treatment.

What’s scary is, I can totally see myself going in for my “one final hurrah” now and never coming out. I’ve seen firsthand from friends who have been fighting this as long as I have, that things really start to shift  around this age. Not only is the body increasingly less resilient to the abuse, but the level of hopelessness that accompanies the deeper stages of this disorder becomes even more ingrained and hard to overcome.

I’m actually glad my dad made that comment at dinner last night, because it caused me to really reconsider the idea of the “one final hurrah.” Whether he meant it or not, I took his comment to mean that he doubted I could succeed at something other than what I’m currently doing. He’s seen how long it’s taken me to get to where I am today, how much I’ve had to struggle and fight. I’m sure it would be very hard for him to see me “throw that all away.”

Well, I don’t plan on throwing it all away, and over these past 24 hours I’ve regained some of my steam. My dad hasn’t (to my knowledge) been reading this blog, nor have we really discussed my reasoning for choosing to go down this new path. Perhaps if he knew these things, he’d feel differently, although in the end it shouldn’t really matter what he thinks. For Christmas I asked for a bunch of therapy-related books, some of the “must reads” for every new therapist. I’m already well into the first book and it’s become even clearer to me that this is what I want to be doing. Has it all become “easy” again, like those first couple months? No, not at all, but I have a renewed sense of hope that somehow, I can and will succeed at this.

 

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. 😉

 

When yoga gets complicated: How to appreciate the mental aspects of yoga

A little over a year ago, I was on the phone with my best friend. I remember telling her, “Ok, so don’t hate me, but I think I want to start doing yoga. Like, real yoga. For real.” She had a good laugh and then was like, “Wait. You’re serious?”

What’s so funny or unbelievable about wanting to do yoga? Well, for most people, absolutely nothing. It was funny to us though because up until that point we both had a strong mutual dislike for yoga. I’ve found this to be true of many people who’ve been through a great deal of eating disorder-related treatment, as yoga is often incorporated. I’m not just talking about the fancy residential centers; I’ve been to inpatient EDUs and even general psych wards that incorporate “yoga.” NYPSI, 2008– a unit comprised of patients with eating disorders, depression, and pill addiction are led in weekly sessions of “yoga” which consist of a bunch of dirty makeshift mats spread out on the tiled dining room floor (yes, we yoga-ed where we ate). Because ED patients were usually on restricted exercise there was very little movement involved, so it usually ended up being 90% meditation with maybe a tree pose and one downward dog thrown in to spice things up. It was often led by some random psych-tech and very rarely by an actual licensed yoga instructor. Is it any wonder why people exposed to this kind of “yoga” would develop an aversion to it?

This isn’t to say that all of the therapeutic yoga I experienced was horrible. For example, the place I was at in 2012 actually had a really awesome (licensed!) instructor teach legitimate yoga to patients once we were medically stable. It was experiences like this that led me to wonder if maybe I really could/would enjoy “real” non-treatment yoga one day.

So, in May of 2015, I took a leap of faith and signed up for my local yoga studio’s newcomer special that allowed you to take three weeks of unlimited classes for just $30. By my second or third class, I was hooked and I signed up for a membership as soon as my 3-week trial was up. I loved almost everything about it. I was pleasantly surprised to see that I maintained a lot of my gymnastics days flexibility. I loved that it was 60, 75, or 90 minutes at a time where I could temporarily escape from my everyday worries and stressors. I loved that the body image aspect I was so worried about (more on this later) wasn’t nearly as bad as I feared. People really seemed to be focused on their own practice. And finally, I really loved the social aspect. Even though it was several months before I got comfortable enough to casually talk to the people I regularly saw there, just the experience of being in a space with 10-20 other people was surprisingly really… nice. I sometimes think I’m an extrovert stuck in an introvert’s mind/body; I do love people and can feel energized by them when I allow myself. In time I started being more friendly and open with people. I quickly became “good enough” to attend the advanced classes. Yoga life was good.

I’ll admit, my major motivation initially was physical. I suck at most regular exercise, so I thought yoga could be my thing. I made myself go to at least one class a day, often more. I gravitated to the most physically intense and advanced classes. More often than not my thoughts during savasana were along the lines of “I wonder how many calories I just burned?” Super deep and spiritual, I know. When yoga was a purely physical thing for me, I was convinced I had to be super compulsive about it. If yoga wasn’t going to help me achieve/keep the body I wanted, there was no point. Yoga twice a day everyday or not at all.

Gradually, however, I started noticing the more mental and emotional benefits. I noticed I just felt generally better after yoga, in every way. I went to sleep in a good mood and woke up excited for the day ahead, which was not typical for me. I started being easier on myself if I had to skip a class due to a scheduling conflict because after all, beating myself up for only going to yoga 5x/week instead of 7 was kind of silly. When my one-year yoga anniversary (yoga-versary?) came up in May, I was feeling pretty good about my yoga journey over the past year. I had managed to embrace the more spiritual side of yoga without becoming a hippie pot-smoking flower child (no offense to hippie pot-smoking flower children; that just isn’t me).

Then, a couple weeks ago something happened that kind of threw me for a loop. After class one night I was chatting with a fellow yogi. I mentioned that it was recently my one-year anniversary of being at the studio, and how crazy but cool it was that I had come to be such a fan of yoga. And then, out of nowhere, she started telling me how she had noticed a remarkable transformation in my body (yes, my body) over the past year. This came completely unprovoked; I didn’t give this woman any indication that I wanted her to give me a detailed analysis of the changes she noticed in my body (my body!) over the past year. It was so completely bizarre and uncomfortable. I just stood there with a blank stare on my face until she finally stopped talking long enough for me to kind of awkwardly laugh and tell her I had to be getting home.

I remember driving home that night thinking, “What seriously just happened??” As for the specific comments, it took me a long enough time to figure out what she was even trying to say. I think she was trying to pay me a compliment, but not unsurprisingly nothing about it felt good to me. I had recently worked hard to convince myself that even though I may be X lbs higher than I was at this time last year (thank you daily weight records), it’s not the end of the world, and it’s even okay because I’m generally happier and in a better place. I should also note that this wasn’t the first time this woman had made comments about my body, although this time was definitely the strangest, as she actually made reference to changes she’s noticed in specific body parts. What…the… actual… f*ck?

This woman is not aware of my history with EDs. That said, I truly think comments like this would make anyone uncomfortable, even people with no ED history whatsoever. I was telling this story to a close friend today, and she passionately validated for me that this woman’s comments were completely inappropriate.

One of my major hesitations to joining a yoga studio was the fact that it would mean major “exposure” for my body. In general I really hate the thought of anyone looking at or even noticing my body. This used to be so bad that I would avoid leaving the house entirely on bad body image days. As such, willingly choosing to put myself out there via group yoga was a pretty huge deal for me. Whenever I started to feel weird and anxious about my body being “on display” I’d tell myself that no one was looking at or examining my body; everyone was too focused on their own practice. Listening to this woman give such a detailed assessment of my body negated this completely.

I think this woman is a perfect example of someone who does yoga purely for physical reasons. This is absolutely fine; I respect that everyone does yoga for their own reasons. That said, I’ll admit that being around people like her make it harder for me to embrace the other more mental/spiritual aspects of yoga, as it brings the entire focus back to the physical.

I don’t intend to let this woman spoil my love for yoga, although it’s definitely been a mindf*ck of a couple weeks as I try to make sense of and put to rest these comments. I’m grateful for the very candid conversation I was able to have with a friend today who was able to offer much needed perspective and insight into this and related body concerns. Thank you, friend, your input today meant more than you know.

“Body image is the last to come.” What does that even mean?

Throughout all of my eating disorder-specific treatment I’ve always been told that “body image is the last to come.” In other words, you can recover physically and stop all/most behaviors, but the body image distortions may persist for many years. I was talking to a therapist about this about a year ago and she said to me, “Well, even though you’re not fully recovered yet, you must notice some improvement in the body image stuff.” I was in a particularly bad mood that day so I quickly responded with, “Actually no, there’s been no improvement whatsoever. I still despise my body just as much as I did at 12 years old, even more probably.” Haha.

I probably really did hate my body on that particular day, because my feelings about my body are often heavily influenced by my mood in general. However, part of the reason I was so quick to respond like that likely had something to do with my weird need to never let go of that part of my eating disorder. This is hard to explain to most people. Basically, I fear that if I ever stop hating my body (or even admit to hating it less), that I’ll start loosening up my “control” by way of allowing myself to eat more. This, I fear, will lead to me becoming less and less rigid about food which will then lead to me getting bigger and bigger, perhaps so gradually that I fail to notice until it’s “too late.” I’m speaking in present tense because as pathetic as it sounds, I do still have this fear at times, although I can usually see how irrational it is far faster and easier than I could before.

I’ve said before that loving or even liking your body should not be a prerequisite for recovery. I may not “hate” my body as much as I once did, but I still don’t like it and I would feel pretty discouraged if I thought I needed to in order to make any further progress. I realize now though that the body image aspect of eating disorders and recovery encompasses a lot more than liking or not liking your body.

Before I go on I should note that while body image issues affect most people with eating disorders, they don’t affect everyone to the same degree or some people even at all. The latest edition of the DSM tweaked the criteria for anorexia because it is now accepted that some people who exhibit all of the other criteria do not experience body image distortions or a drive to lose weight and become thinner. For a lot of these people, their eating disordered behaviors may be purely OCD-driven.

That said, the majority of people with EDs do experience at least some body image-related symptoms which may include body distortions (sometimes even warranting a co-occurring diagnosis of Body Dysmorphia), or frequent “body checking” or measuring behaviors. I experienced all of these at some point. While my distortions were never as severe as some people’s (i.e., I never thought I looked legitimately overweight when I was at my lowest weights), I still had trouble seeing that I was ever as thin as other people said I was, and I always saw myself as “chubby” at weights that were considered normal/healthy. Rarely was my eating disorder about fearing that I’d actually become overweight; it was more about always feeling the need to be thinner and never being satisfied no matter how low I got. I also believed that others were somehow judging my level of self-control, success, or worthiness based on my weight. Because I was always comparing myself to my lowest (and/or anyone who I thought happened to weigh less than me at the time), I assumed everyone else was as well. Like, shit… surely that person I ran into the other day noticed I was a good 6 lbs. higher than I was the last time she saw me, so she must be thinking I’ve become super lazy and relaxed in my eating and is judging me for that.

In terms of body checking and measuring, I’m kind of a professional. I was “body checking” long before I even knew what it was, even before my eating disorder fully took over. I was involved in competitive gymnastics for most of my childhood up until the age of 13, so I was naturally more aware of my body than a lot of kids my age. I would stand in front of a mirror for hours in a leotard observing the space between my thighs, the degree to which my stomach stuck out past my hip bones, the circumference of my upper arms, etc. This soon progressed to performing very specific “body checks” throughout the day at school, on the bus or in the car, at home, or in bed. My most common checks included wrapping my left hand around specific points on my right arm, wrapping both hands around each of my upper thighs, and feeling the bones on the tops of my shoulders and my chest to make sure they were still as prominent as the last time I checked (likely earlier that day). I also went through long stretches of time when I would keep daily records of various body part measurements (e.g., the circumferences of various points on my arms/legs, my waist, hips, chest, neck, etc.).

It’s been a fairly recent discovery of mine that many of these body image-related symptoms have actually gotten better. While in the depths of my disorder I was intensely focused on my body and all the hatred I had for it. I would spend entire therapy sessions whining about how disgusting and gross I was. I would be told “fat is not a feeling” and to dig deeper and talk about the real issues and half the time that just made me angrier, because in those moments I couldn’t see past the body stuff. Other times I would be up all night studying years worth of weight and body measurement records, driving myself insane. Why did XX weight correspond to a measurement of X in 2008 but not in 2010? Why were certain measurements getting smaller without my weight going down, or vice-versa? Even 1-2 years ago I remember complaining to my dietician (who is more like a therapist to me) about how distracting my body checking was during the day, so much that someone had even noticed me doing some of these weird things so frequently at work and asked, “uh… what are you doing?” Wow, how awkward. You mean not everyone wraps their hand around their arm about 10 times an hour?

For many years, I corresponded almost daily with my dietitian through email. It started out as checking in each night about how my day had gone with food and behaviors, but it quickly morphed into more casual sharing and venting. I recently looked back on some of the emails from 3-5 years ago and was reminded just how body-focused these emails were for a very long time. I was complaining about how my weight was up two-tenths of a pound that day, or how I couldn’t focus in class because I was so fixated on how swollen my face or legs were. At one point she told me she wasn’t going to reply to any more of my emails where I referred to myself as fat, gross, or disgusting, so I pulled up good old thesaurus.com and expanded my vocabulary. I was now corpulent, rotund and roly-poly.

Over the past year or so, I’ve gradually relied less and less on these body-checks or emails. In fact, I can’t remember the last time I actually sent an email to my dietitian that was even about my “gross” body. I still write about my body troubles but rarely do I refer to my body as gross or disgusting anymore. Does this mean I like my body? Hell no, but I do pretty well at least tolerating it now. Most of my emails and in-person sessions these days are not even about my body. They’re about deeper issues, stuff at work, my future, relationships with friends/family, etc.

For most of my life I’ve been constantly striving for something “better” than what I currently have. In terms of my body, this usually meant setting lower and lower weight loss goals without even stopping to consider that maybe I didn’t need or even want that. I used to say, “If I’m not losing, I’m gaining” which makes NO sense (what happened to maintaining?) but it was my way of ensuring I never became content. I used to have so many rules and rituals that I had to follow exactly. If I didn’t, I’d lose control and become lazy, fat, gross, unsuccessful, etc. I’m finally starting to see that all hell may actually not break lose if I don’t follow all of these rules and rituals to the letter. I let myself have a few drinks last weekend without majorly restricting or compensating before and after, which is pretty much unheard of for me. I also ate a few things that I normally would never allow myself to eat (without proper “compensation”) and guess what? I’m still alive, no fatter than I was last week. It’s like some kind of miracle.

I’m always telling people that in order to make any progress in recovery you must find other things in life to focus on. I cannot stress this enough right now. I’ve only been able to let go of some of my body obsessions and compulsions because I started replacing them with other more meaningful things– dedication to my job/career, writing in this very blog, cultivating new relationships, and letting people in more than ever before. It all sounds so cheesy, I know, but it’s the most useful piece of “advice” I can offer anyone.

Now because I wrote this, I’m sure I’ll have a moment or two next week when I’ll be saying to myself, “WTF Becca? Nothing has changed. This body is not ok and you must do x, y, and z to fix it.” This happens whenever I start to acknowledge my progress because as strange as it sounds, it’s often really scary to get better.

When people used to tell me that “body image is the last to come” I would get really depressed. What was the point of putting any effort into recovery if I was still destined to hate my body for the next undetermined number of years? These days this thought actually gives me hope. I may still not like my body, and even struggle to tolerate it some days, but I also have proof that I can lessen the impact it all has on me by bringing new and better things into my life.