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.

 

Living authentically feels so good

I’ll officially be submitting my applications to the four MFT programs I’m applying to within the coming weeks. Aside from the one program that does rolling admissions, I likely won’t hear anything until late January/early February. I’m hoping to get interviews at each school so I can carefully assess which program would be the best fit for me. Overall the process has been so much more pleasant and less terrifying than applying to PhD programs back in 2013. This is something I truly want to be doing and I feel none of the same pressure and dread I felt back then. Don’t get me wrong– I still feel pressure (from myself) and anxiety, but it’s a completely different and better kind.

I’ll admit I’ve found it slightly harder to concentrate on my current life since making this decision, but only because I’m so excited–for once– for my future. Not all that long ago I still dreaded and feared my future, if I could imagine it at all. Lack of focus was always a byproduct of depression or eating disorder, never excitement— what even is that?

I’m trying harder than ever to live authentically and not worry about what people may think of my choices, changes in my behavior or appearance, or anything else. I’m currently at the highest weight I’ve been at since leaving treatment in 2012. I’m letting myself eat more freely in social situations and not beating myself up (as much) for eating a more normal amount of calories each day. My body image is pretty shitty but dare I say not quite as bad as I imagined it would be at this point? I sometimes can even recognize that I’m still thin. I did yoga in front of a mirror for the first time ever over the weekend (my home studio doesn’t have mirrors, which I like). I was completely surprised that I wasn’t doubling over in disgust at how gross and fat my body looked. It actually looked way more acceptable than I imagined it would look at this weight. Were those trick mirrors? “Skinny mirrors?” Perhaps, especially considering I was doubling over in disgust just hours later when in front of my mirror at home. However, just that fact that I was able to see myself– even for just 75 minutes– a little closer to how others see me was pretty significant.

I had a good talk with someone the other day about how it’s not necessary to completely LOVE your body in recovery, or even as a recovered therapist. You merely have to accept it and be willing to let it take up less mental space in your life. Maintaining an unrealistic weight of under XX lbs used to be at the top of my priority list. My self-worth was determined almost entirely by how far below that weight I could be, because I thought it actually meant something. In reality, it meant very little. I never made a positive impact on the world or even just one person because of how thin I could be. Do I like my body now? Hell no, but I’m slowly becoming more okay with just accepting it as a very insignificant part of who I am.

 

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.

Therapy for the therapist (and everyone else too)

Tonight I saw a new therapist for the first time– someone who miraculously takes my insurance. I pay just a small co-pay for each visit; it’s kind of amazing. Of course I’ve only seen her once, but I think I’m really going to like her. Our first session together was different from most if not all other “first sessions” I’ve had with therapists before. We didn’t do a long detailed assessment where I felt pressure to spit out my entire life story in a span of 50 minutes. We didn’t launch right into “How are we going to fix your eating disorder/depression/anxiety?” She just let me talk about what brought me back to therapy.

It’s been over two years since I’ve been in regular one-on-one therapy. My decision to go back was largely motivated by my recent plan to apply to MFT programs and finally pursue my own dream of becoming a therapist myself. Most programs require that you be in some kind of personal therapy for at least a portion of your time in the program. Even if they didn’t require it, most agree that it’s the smart thing to do. I guess I wanted to get a head start seeing as I’m already experiencing such a wide array of feelings since making the decision to go back to school.

Nearly 12 years ago during one of my inpatient stays for my eating disorder, a fellow patient’s father came up to me during one of the weekly “Multi-family” groups and started making conversation. When he asked me what I wanted to do with my life, I said I ultimately hoped to become a therapist. When I said this he (no joke) started cracking up laughing. “A THERAPIST?!? But you’re… here. In a mental ward. How IRONIC!” um, no not really? It was weird to me that this was apparently the first time he had heard of someone with “mental issues” bad enough to be on a “mental ward” going into the helping profession. Hello nearly every person I know who has pursued this path?

This man had a strange way of saying things, but it was far from the last time I heard someone allude to the assumed distinction between “the therapist” and “the patient” as if they could never be one and the same. It makes me sad that therapy in general is still stigmatized at all. Going to therapy does not make you crazy, mentally ill, or broken. A couple weeks ago I was out with some people from work and we somehow ended up on the topic of therapy. The resulting conversation uncovered that most of us have been or are currently in “therapy.” And guess what? We’re all accomplished, intelligent, hardworking individuals. Kind of amazing.

Data Collection and Analysis: Version Real Life

For the past month, I’ve been consumed by an idea that others might find crazy (and that I found crazy at first as well). Ok, brace yourselves for this… This crazy idea would involve me going back to school to become a licensed mental health professional, most likely via an MFT or MSW program. This idea was/is crazy because:

– As I’ve mentioned many times before (even in this very blog), the clinical route was never for me. Or so I thought.

– I already have a master’s degree (in experimental psych, aka the research/stats side of psychology) that took me long enough to obtain thanks to my crazy maze of a life. I also finally have a job that I enjoy that also took me quite a while to achieve thanks to that same crazy maze of a life. So… why the need to complicate things?

For the past six months I’ve been talking a lot about eating disorders with a former colleague to help her understand them better. It’s been a really great experience– not only have I helped her gain a deeper understanding of what is a very complex disorder, but I’ve also learned some news things about myself. For example, I’ve learned that I’m capable of providing useful knowledge to others based on my own lived experience. This may sound really simple and obvious, but it was a pretty big revelation for me.

About a month ago she brought up the topic of me pursuing a career in therapy (particularly therapy for eating disorders), even though she knew it was something I had in the past rejected. At first I straight out rejected the idea again, saying it was not for me and it would never work, for a million reasons. To be honest, it surprised me that anyone would even suggest this as something for me to seriously consider, because at the time I still saw myself as this crazy f#cked up person and assumed everyone else did as well. And yet, here was this person who I really looked up to and admired telling me that she could totally see me being an amazing therapist. I almost cried tears of joy. Almost.

Just a brief recap of my career aspirations, my original goal back when first choosing psychology as my major as a college freshman a million years ago was to became a practicing therapist. At the time I actually hoped to get my PhD and become a clinical psychologist. However, as the years went by and my eating disorder grew stronger and stronger I realized this was a pretty dead end goal for me. I was never going to be mentally stable enough for that to become a reality, so I switched my focus to research instead. I got my master’s in experimental with the intention of going directly to a PhD program in clinical psych, although my focus was going to be almost purely research/teaching. I mean yeah, I would be getting clinical training whether I liked it or not in a clinical PhD program, but my end goal was to be a researcher; I was only looking to clinical programs because my research interests were clinical. (This all makes 10x more sense if you’re familiar with this field, otherwise you’re probably bored and/or confused to tears right now, haha). Anyway, I ended up frantically withdrawing all of the PhD applications I sent out 3 years ago– for several legit reasons, but also, if I’m honest, because I didn’t think I was stable enough to handle such a grueling career path at the time. I had nightmares of making all of these drastic life changes in pursuit of this path (e.g., cross-country moves, going into more debt) only to have it all come crashing down due to me falling headfirst back into my eating disorder and depression. I mean, let’s face it, that had happened several times before already. So, as the story goes, I put a halt to that plan and found work in the field instead, which is how I ended up where I am today, in a job I genuinely enjoy and feel good about.

Even though I finally feel good about what I’m doing, I’d be lying if I said I never wondered what could have been or even what could still be. Over the past couple years, as I’ve made once unimaginable progress with my eating disorder, I’ve found I’m more and more eager to  share what I’ve learned in hopes of giving other people hope that a better life may very well exist for them as well. I started this blog in March in hopes of reaching others and I’ve been talking a lot recently to fellow sufferers about how I was able to make changes that I never thought I’d be able to make.

Over the past month, I’ve reached out to many people from various parts of my life, past and present. I’ve contacted old therapists, co-workers, bosses, friends, etc. I’ve talked to people currently in the clinical field as well as people who started down that route who ultimately went in a different direction. I’ve asked them to share their own experiences with me, and perhaps a bit selfishly, I’ve asked them what they think about me ever succeeding in such a role. I really wanted to get a diverse and balanced perspective, and that’s exactly what I got. While everyone I talked to was supportive of me choosing to go down such a path if I so ultimately chose, some were more optimistic than others and many offered their real concerns and hesitations. This is exactly what I was looking for– real, honest feedback! The problem is, I’m now left with the difficult job of analyzing it all and deciding what the final conclusion is. And I know it’s not that simple. This is not my work as a research analyst; life choices like this are not a simple matter of some nifty data analysis and reporting.

I’m not looking to start a whole new career. As I’ve said before, I truly do enjoy and find fulfillment from my current line of work. I get to use some of my best skills to make data meaningful to people who can then use that data to inform practice and programs. My goal would not be to replace this but to supplement it with a new clinical skill-set. I guess ideally I would see myself continuing to work in the non-profit research sector while also holding a part-time private practice. The agency where I currently work is rife with people who maintain small private practices outside of their full-time jobs so I know it’s possible, I just wonder if it’s possible/feasible for me?

Now, I’m a very practical and risk-averse person, so to say I’ve carefully examined all the messy logistics and financials of this idea would be an understatement. I’ve kind of been obsessing over it for the past month. 😉 It would be a lot of work, none of it easy. There are programs that would allow me to continue working full-time through the first year or so (before I’d start my supervised clinical hours), but it would definitely take some adjustments. I’d have to take out more student loans, and somehow find the time and financial space to complete all my internship hours to eventually become licensed (i.e., to become licensed as an MFT you need to accumulate 3,000 supervised hours, most of which are usually unpaid while you’re still in school and very low paid once you have your degree). If I applied to programs soon for fall 2017 admittance, I’d realistically be looking at about 3 years of school and another 1-2 years before becoming licensed and able to start building my own practice, so about 5 years in all (and 6 years from now). I’d probably be 38 before I’d even have a chance of starting to live that life I’m so ideally imagining– working full-time in the non-profit research arena while also maintaining a small but thriving private practice. If it all worked that way though, it would totally be worth it to me. Hell, 38 is not that old. I’d still have several decades of working years left (and let’s face it, I’ll probably never be able to afford retirement so I’ll be working until I’m dead 😉 ).

Of course, I’m a pessimist by nature so it’s really hard for me to picture any of this working out even slightly as planned. I’ve come up with pretty much every imaginable reason why it wouldn’t work, and yet somehow, I haven’t been able to fully release the idea from my brain, which I’m starting to take as a sign that I must really want this on some deep level.

Now before I get too carried away with this, I should mention the pretty huge part that I haven’t really touched on yet, which is the question of whether I’m even in a place to be considering this, mental stability wise. This idea originally focused on working specifically with eating disorders, which was perhaps why I initially had such a strong pessimistic reaction to it. Yes, I’m doing a million times better than I have been in the past, but I’m the first to admit I’m not fully recovered, and may never will be. As someone who’s been exposed to quite a few “recovered” ED therapists, I know firsthand how important it is that these people be actually recovered. While people with lived experience have the potential to be great therapists, I’ll admit I’ve come across more people in the eating disorder world who were actually worse therapists because of this. They say or do quite triggering things without even being aware, or they inaccurately assume things about their clients’ eating disorders based on what they think is a universal experience. They fail to recognize the incredibly unique experience of each individual. When confronted with this these things, they often get defensive and even angry. I think a big part of my reluctance to consider this a serious career possibility until now has been a fear of being like these people. Yes, I want to help people and I truly believe my life experiences could be an asset, but I also know there’s a huge risk in assuming that to be true.

I would never, ever want to risk being a negative influence on my clients, so I quickly decided that I’d have to commit to being more in recovery than I currently am if I ever planned to work with clients with eating disorders. Part of this would mean finally getting to an actual healthy weight (not just “better for me” which I currently am and have been for a while, but like, actually a legit non-underweight BMI). Could I do this? I think I could, but who really knows? At first the thought of this actually made me excited… like I finally had a reason or “excuse” to loosen up my control a little bit. I could allow myself to eat more, and even if I gained a little weight, it wouldn’t be the worst thing in the world, because I’d be doing it for a greater purpose. Would it really be that easy though? Is it really wise to get better for the sake of others, especially others who I plan on legitimately helping through this very issue? And what about my own personal philosophy that I’ve been preaching for the past six months, ever since starting this blog, that “full recovery” may not be for everyone and that’s okay? So now I’m saying it actually is necessary, at least if you want to help others? Or is that even what I’m saying? Who’s to say that getting to a healthy weight would mean I was magically 100% recovered anyway? And would that be okay?

These are all complicated questions that probably no one can answer for me. The bottom line is that if I do pursue this path, I would not limit myself to the treatment of eating disorders because I’m not fully convinced I’m capable of being “recovered enough” in that area. It’s a specialty I would ultimately love to pursue, but I’m also not willing to risk the health and safety of others to make it happen. While I truly do think that starting down this path would help me take my own recovery to the next level, I know that’s not the reason to pursue anything. I would be doing this to help others, and if I happened to help myself in the process, great, but at the end of the day my goal would be to help people in the way I best felt I could, whether that be specifically with eating disorders or other issues.

Does this all sound completely out there and unrealistic? If it does, feel free to tell me. I’m still on my quest to gather as much information as I can about the feasibility and soundness of this plan. I don’t do well with indecision and the unknown so I’m hoping to make a decision about whether or not to take the next steps to make this dream a reality within the next week or so. I know the real decision is mine, but I also really enjoy and appreciate hearing so many different perspectives from the people whose opinions I value most. If you don’t feel comfortable replying directly to this blog or on Facebook, feel free to message or email me privately. I love data! The more the better! 🙂

 

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. 😉