Insidious Whispers and Deafening Screams

I mentioned in my last post the the dictator has been whispering in my ear lately, trying to convince me that a relapse into old behaviours wouldn’t be at all a bad thing. I mean, it wouldn’t be a *real* relapse, I’d just restrict and run and life would still run perfectly and I’d have no consequences for my behaviours, I’d just be thin. (Which is totally ridiculous and has never happened to date and, in fact, each relapse is worse than the last, so I’d probably be dead.)

So that has been floating around in my head the past week. Undoubtedly it is related to the stress of the new semester starting, my feelings of utter incompetence when it comes to my chosen field, my highly regimented/probably overbooked schedule, and somewhat overwhelming extracurricular obligations/responsibilities. It has absolutely nothing to do with the food, my body, my weight. Just the stress. (Or so Counselor-Jessica is telling Deranged-Jessica.)

Anyway, that is background for my tale, in which this whisper becomes a wailing siren call on Tuesday. It was the first day of class, so I was already a bit nervous, but our prof for this class is really, really great and very down-to-earth. (She brought brownies! And coffee! And tea! And stress balls!) Early on, she said that she went into counseling because it saved her life. So, ya know, same reason as me.

We were asked to go around and introduce ourselves and tell what drew us to counseling. So I was prepared to just say, “Hey, I’m Jess, I’m a second year CMHC with expressive arts focus and I’m going into this field because counseling definitely saved my life more than once.” For the most part, my cohort (the 15 students I entered the program with last fall) knows about my ED and treatment history and I’m fairly open about it. That said, I don’t generally introduce myself by saying, “Hey, I’m Jess and I’m recovering from an eating disorder.

I was, by virtue of the room layout, the last person to do an introduction. When it came my turn, here is what I said:

“I’m Jess. I’m in the CMHC program with an expressive arts emphasis and I am really going into counseling because it absolutely saved my life on more than one occasion. And I’ve been in and out of a few eating disorder treatment centers and had some really great counselors and some really awful counselors and hope to be one of the good ones.”

So why the mention of the eating disorder treatment?

Competition.

About halfway through the classroom introductions, a young woman explained that she was drawn counseling after her “five year stint with anorexia” (this is actually how she worded it). Alarms started going off in my head. The dictator started screaming.

I needed to defend my ground.

I needed to make sure that everyone knew that I, too, had an eating disorder.

I needed to make sure that everyone knew that it had been so bad I’d had to go to treatment.

I needed to make sure that everyone knew that I’d relapsed and had to go back again and again.

I needed to make sure that everyone knew that I was really sick. (Read: I was thin.)

Because that is just the way the eating disordered brain works. It’s sick and twisted, but my eating disorder still needs to be validated. It still needs that gasp of breath that people do when they hear how much weight I lost in less than a year, that look of pity when I talk about the tube, the almost-jealousy when they hear all the “bad” foods I got to eat freely in treatment to put on weight.

It pisses me off that I feel I so badly “need” this, even after all my time and work in recovery. It pisses me off that some part of me still glamourizes the eating disorder, some part of me still wants it.

I don’t need it and it isn’t glamorous.

It’s hell.

And I need to keep reminding myself of that, but damn if the Dictator isn’t loud these days.

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I Said “Breathe,” Not “Hyperventilate”

So, yeah. All that adorable optimism and chutzpah in my last post pretty much went out the window by Wednesday. I honestly don’t know that I even have the energy to hash the whole thing out, but suffice it to say, my recovery had a VERY close call this week.

Between Wednesday at about noon until I woke up on Friday morning, I was a hot.mess. I’m not entirely sure how I survived Thursday, honestly, as I was extremely dehydrated and undernourished and in a post-SH induced haze. Add a cup or two of shame and a dose of fear and you’ll understand why I was utterly shocked to hear my professor suggest that I go on to a doctoral program.

Me, the girl who had just met with her dietitian because she couldn’t fathom the idea of a meal. Me, the girl that went to health services for an SH wound and was not allowed to leave in the hour that passed between my arrival and the first available appointment. Me, the girl who had gone to bed at seven the night before because she could not deal with life any more. Me, the girl who had seriously considered ending her life for the first time in almost a year.

It started with a therapy session on Wednesday, though to understand the whole story, you need to know that these things were playing in the background:

  • I was at the state counseling conference and listened to a presentation about the new DSM-V eating disorder diagnostic criteria and discovered that they now rate the severity of EDs as from “mild” to “severe”
  • At the same conference, I made the mistake of sitting in on a session about working with traumatized women in the Democratic Republic of the Congo, where “trauma” = “sexual violence” and I spent an hour outside trying not to jump out of my skin

And I totally thought I had done a good job recognizing and processing it and told my counselor about it first thing during our [phone] session. What I did not anticipate was her pushing and pushing on the physical reaction I had during the trauma session.

Why was I so hypervigilant? I needed to keep an eye on everything. Why? So I don’t get hurt. Where did I learn that? …in college. When? …at the bar. When? …I can’t go there today. That’s as close as we’re going to get today, April. 

Everything in me was screaming under the weight of shame.

In a lot of ways, I have made a LOT of progress since I have come back from treatment. Unfortunately, after God-only-knows how many hours and thousands of dollars on therapy, I still believe that I came out of the womb a priori fucked up. My life has been idyllic, nobody has done anything to me, and there is basically no reason that I should struggle because my life has been PERFECT. It’s ME that’s fucked up.

On Wednesday, when I said for the millionth time that I’m just fucked up, my therapist refused to play along. She said that we are at the point in counseling where I need to either dig deep and challenge that (by acknowledging how people hurt me, failed me, missed me) or there’s nowhere to go. And if we don’t go there, what are we going to do in therapy? Keep me from going crazy; maintain the status quo, I said.

She won’t. Either we dive into my story or we need to consider terminating the counseling relationship. If I want a therapist who will help me to maintain my behaviours where they are, I need to find a new one. And while her motives are so pure (she wants true freedom and healing for me, but that means I’ve got to push ahead), I was (and am) upset nonetheless.

April has been my counselor for YEARS. She calls me on my shit. She knows more of my story than anyone else. She has cursed at me, challenged me, eaten with me, laughed with me, comforted me. The idea of losing her as a counselor is terrifying.

Equally terrifying is the prospect of acknowledging how and when people have hurt me and coming face-to-face with the brokenness in me. I insisted time and again in Wednesday’s session that I’m just not ready for that kind of work, and she repeatedly told me that she thinks I am. I cried as our session wound down and she told me that I needed to seriously think about if I’m going to continue therapy.

Above all, she said – it’s an issue of trust. Do I trust my friends, family, and community to hold me up when I’m so weak I can barely stand? Do I trust April to be a wise guide and to walk me through this? Most of all, do I believe that my God and my Saviour is waiting to bind up the broken places in me and heal them?

Yes. And no.

The fear is positively crippling. I feel like I am just barely keeping my head above water this semester. And if I messed up so much and so badly over the course of 36 hours just talking about the possibility of doing this sort of storywork…

How much worse is it going to be when I actually do it?

 

 

Countdown

I have an assessment with Center for Change next week.  I’d been avoiding the treatment talk as long as possible, always blowing off the possibility when my dietitian mentioned it.  But my therapist brought it up on Monday and challenged me to talk to my parents about it.  I talked to my dad on Tuesday and he said he’d been wondering for a month whether or not to push me to go back.

So I have an assessment on Thursday with my old therapist there.  And honestly, I don’t quite know how I feel about it.  While a lot of my eating disorder is wrapped up in my desire to avoid “real life” and escape the pressures that come with it, I’m not all that thrilled at the prospect of putting my life on hold again and going back to treatment.   There will certainly be some comfort in returning to a place that I know so well (it was my home for a third of last year, after all), but it’s not as if I’m all, “Yay! Another break from life! More treatment! More friends!”

When I called to make the assessment I told them I was interested in their “inpatient short-term stabilization program.”  Basically, just three or four weeks to get you back on track so you can go back home to your program or outpatient team.  My outpatient team here is fabulous, y’all.  In six months with my therapist, we’ve nailed down three of the major underpinnings of my eating disorder.  My mood is stable for the first time in YEARS.  My dietitian pushes me as hard as she can and sometimes, I even comply.

I would love to kickstart the process and then come back home, back to work, back to friends, back to my team and finish the work here.  I’m just beginning to wonder how realistic that is.

While my mood is VASTLY improved over this time last year (as we come up on the one-year anniversary of my week long stay on a locked psych ward), the eating disorder stuff is…worse? Different? More entrenched?  I’m not really sure.  I like to imagine that I’ll be able to go back to CFC, immediately comply with my meal plan and eat everything and not have any self-harm urges and be ready to go home in less than a month.

I just don’t know how realistic that is.  I’m thinking specifically in terms of the weight I need to gain to get back to where I was when I discharged last August.  Am I really going to go, get put on a weight gain meal plan posthaste, gain for a few weeks, then come home and be totally okay with it and ready to keep working on weight gain at home?  It’s a nice idea, but…what are the chances that I come home x pounds heavier and head straight to the gym and start restricting again?

From the way my mother worded it, my parents are expecting me to go back for an extended period of time.  I was assured that they would cover the cost [again] if I agreed to “stay through to the end of the program.”  At the end of the day, I’ll agree to whatever the CFC team thinks is the best option for me.  I have no intention of going in trying to control the process or fight like hell like I did last year.

Which is, in itself, progress.  My therapist noted this as one of the reasons that this trip could be even more beneficial than last year.  I’ll go in wanting to recover and knowing some of the areas that we need to hit HARD in therapy (as opposed to spending 2 months trying to figure out how to keep me off Caution Status). Potentially, I could stay a shorter period of time (not 4 months, anyway) and derive a lot more benefit.

I get pissed at the idea of going back to treatment again. I get pissed at the thought of spending another birthday in treatment. I get pissed at the long, winding, road to recovery, when I wish God would just HEAL ME ALREADY, DAMMIT!

And part of me fears that I won’t go back to treatment at all.  I fear that I’ll have my assessment on Thursday and the team out there will think that I am not “sick enough” to need inpatient or residential. I mean, my weight’s not THAT low, my restricting isn’t THAT bad, my exercise is far better than it was, and I’m not really a safety risk to myself.  I fear that I’ll be told that I should be able to do this outpatient and that I just need to pull myself up by my bootstraps.

Three totally different scenarios: being told I’m not sick enough, being told I could just stay for a few weeks, being told I need to stay long-term again.  They’re all terrifying, honestly.  And while my eating disorder would love for one of the first two to come to fruition, the part of me that wants so desperately to recover knows that my best shot is another long-term stay. A long enough stay to completely weight restore and then settle into that body while dealing with the shit in my past.

It is scary for me to admit that I want to go back to CFC for an extended period of time.  I’m not sure if it makes me feel “weak,” or “attention-seeking,” or “avoidant,” or what.  But I DO want it.  I want this disease out of my life for good.

Assessment is on Thursday.

I could be back in treatment in a month.

Every Winter After

“It does not hit you until later. The fact that you were essentially dead does not register until you begin to come alive. Frostbite does not hurt until it starts to thaw. First it is numb. Then a shock of pain rips through the body. And then, every winter after, it aches.” — Marya Hornbacher, Wasted

 
Wasted is one of those books that hurts to read.  I love it and I find it one of the most powerful books on the subject of eating disorders because it is so raw.  Marya holds back nothing.  It also makes it a tremendously triggering book for those who are suffering.  I have yet to be able to read the book all the way through from a standpoint of recovery.  I have read a chapter or two, sure, but then things become too intense and my own eating disorder begins to flare up and compete.  
 
But if you can read it from a perspective of recovery, it is surprising the new passages that jump out at you, that have new meaning, that can actually aid you on your journey to recovery.  This quotation, which showed up on my Tumblr dashboard this morning, is one of those.  For me, it helps remind me that those times when the eating disorder aches, when you feel the pain of it all over again, when you want it back so badly it hurts — are actually part of the healing process.  It hurts not because you need the eating disorder again, but because it was there at one time and killed parts of you that are now hurting as they come back to life, and hurt more when they are brushed once again with the cold that nearly killed them.
 
Almost everyone I have talked to on my journey into and out of the eating disorder hell has said that they have periods each year which are more difficult than others.  Anniversaries, if you will.  A lot of people, myself included, struggle a lot during the holidays.  (I also have another “anniversary” near my birthday, when I was first officially diagnosed with anorexia.)  Highly charged emotions about families and holidays meet highly charged emotions about food and it creates something of the perfect storm.  
 
As a result, I can tell you exactly what I’ve eaten, how many pills I took, what I weighed, and how much I exercised (and how and where) for every Thanksgiving for the past four years.  I long for the days that my Thanksgiving memories include trips to see family and friends and games played and jokes told.  This is (both literally and figuratively), the winter after that near-death, when the limbs that have been damaged ache with the knowledge of what was.  
 
This doesn’t mean I’m relapsing, this pain and ache where the eating disorder once was.  It doesn’t mean you are either.  We certainly have the choice to do so, of course, as we always do.  
 
But if we can begin to befriend this ache, we can see it for what it is:  a sign that we are healing.

Moody

This is the worst my depression has been since my first month in treatment.  It’s getting harder to deal with and I’m not sure how to bring it up in therapy.

I’m not sure how to discuss it at all, really.

I’m so disappointed in myself.

For being this depressed all over again.

For relapsing into my eating disorder all over again.

For just being me.

It feels hopeless and I wonder why I keep trying at all.

 

If I Had a Million Dollars…

I posted this as my Facebook status earlier today, and it was actually really interesting to see the responses from my friends (the few who commented).  In all honesty, it was a thought I had as I was struggling through the afternoon, playing out the past few days and weeks and months in my head.  What would I do if money were no issue?  

What would I do if I could take months off work?

What would I do if I didn’t have to worry about paying my bills?

What would I do if I just didn’t have to worry about anything else in my life?

The answer, for me anyway, was simple.  I would go back to treatment.  In a heartbeat.  Tomorrow morning.

I wish I could do it.  I wish I could find a treatment center, and just go until the process is over.  I am failing miserably at doing it here.  I can’t focus on anything and I’m constantly acting on behaviours at one end of the spectrum or the other.  I spend more time than I’d like to admit in morbid fantasies in my head.  And I feel like it is never, ever, ever going to get better.

I feel hopeless.  Unfixable.  Worthless.  Wasting time and space that another human would be so much more worthy to occupy.  

So maybe, if I had a million dollars, I’d try treatment one more time.  Give myself the benefit of the doubt that all this is just part of being sick.  Believe for just a moment that this, too, shall pass.  

But I don’t have a million dollars.  

And I’m running low on hope.

Varying Interpretations

What my therapist actually said:  “If you want to restrict and exercise, just restrict and exercise.”

What my therapist meant:  “If you are weighing yourself because you think it’s going to give you some sort of new information and influence your decisions, don’t bother.  Whether the scale is up, down, or the same, you’re always going to think you’re fat and want to restrict and exercise.  So just cut out the step of getting on the scale.”

What my ED heard:  “RESTRICT!  EXERCISE!  IT’S OKAY!!!!!!!!!

 

I mean, obviously, that’s not what she meant, right?  And maybe 25-30% of me believes that.  The other 70-75% believes she just gave me permission to act on my favourite eating disordered behaviours and that I ought to do everything in my power to make sure my weight is down at the next weigh-in.

That’s the other thing:  collaborative weighing.  Meaning, once a week, my therapist and I weigh me and plot it on a graph.  Fabulous.  Because nothing makes me feel like a cow more than my adorably petite therapist weighing me and having to see just how fat I am, week after week.  Right now, my weight falls “within normal limits” on the BMI chart (yaaaaaay?) and the idea, say-eth the therapist, is to keep it “within normal limits.”  Ideally, throughout this process, my weight won’t drop below the red line or rise above it.  

Well, that, again, is what say-eth the therapist.  Ideally, say-eth the ED, my weight drops out of normal limits within the first two or three weeks we’re working together and my weight inches ever closer to that 
miracle weight where everything is wonderful!  Where life is good!  Where I wake up with energy and love myself and my body!

Except…I’ve been that weight.  I wasn’t happy, I didn’t love my body.  I was miserable.  I was sick all the time.  I struggled to get out of bed in the morning.  I fantasized about killing myself all the time.  

So what’s the appeal?  Why work so mother-flipping hard to get back there?

That, friends, is an entirely separate blog post, which may or may not ever be published.  (Yes, I know what drives my eating disorder, particularly the restriction.  But I’m afraid to say it out loud.  Mainly because I don’t fancy getting committed to a psychiatric hospital.  Again.)

work in progress

Aside

My friend Brandy is doing a daily blog project throughout December and today’s assignment was to create a piece of art.  And while I love art, I’m no artist.  My art pieces tend to be childish at best, and totally lame at worst.  I’ll leave it up to you as to where on that continuum this piece falls.

I have for a while wanted to do a series of art pieces on what I believe recovery to be:  physically, emotionally, and spiritually.  This is not one of those pieces, incidentally.  This is more of a…..er, process piece.  It’s a piece where I’m working through my totally mixed feelings on recovery and trying to decide if the loooooooooooong road ahead of me through some awful emotions is really worth it for the things I stand to gain.

In other news, I may be off to inpatient treatment before the year is over.  I found a program that takes my insurance, I’m just waiting for the final word as to what other information they need from me and how long they expect I’ll be staying.  The great thing about this program is that I can do the entire process from start to finish (inpatient, residential, PHP, outpatient) at this one facility and maintain continuity of care (same team!) for the duration of my treatment.  I feel like this is a vast improvement over switching therapists and dietitians every six weeks when I change levels of care, which is essentially what I’ve been doing this year.

I’m still ambivalent about the whole thing and positively terrified of gaining weight.  I mean, I realize this is a part of the disease, seeing as it is one of the major diagnostic criteria, but I just can’t imagine a day when I’ll be OKAY at this weight, much less at my set point (which is a significant number of pounds higher).  I’m deeply saddened to have to leave my job, but strangely comforted by the idea that I don’t have to deal with anything but supplements, meals, and therapy groups for the next three months.  I am driven to obsession with the idea of getting as low as possible before admission, but worried about what that will mean for a chest that already hurts on a daily basis.

I am going to miss my friends and family terribly while I’m gone.

But how much am I missing already by living this half-life?

Objective Look

One of my best friends called me after she read my last post.  I wish I could remember more of the conversation, more specifics, as she is always so good at speaking Truth to me, but I do remember hearing her kids in the background.

I love those babies of yours, I say.

I know, buddy, she says with a hint of sadness in her voice.  And I want them to know that for themselves.  I don’t want to have to tell them about how much their Aunt Jess loved them because you’re not around anymore.

The tears started to well up in my eyes.  Those are the kids whose photos were posted in my bedroom during residential treatment.  Those are the kids I choked down pancakes and BLTs and ice cream for, the kids I wanted desperately to see the second I came home.  Those are the kids that are crawling around on the floor when I do my safe place visualization.  I couldn’t love them more if I had been the one to birth those 11 pound babies on her bedroom floor.  (Seriously, my friend is amazing.  In more ways than one.)

I wipe my tears and try to allay her fears.  I’m not going to die.  I’m not even at my lowest weight.  And even at my lowest weight, I wasn’t really sick.

I’m not going to validate your eating disorder by discussing what you do or don’t weigh, Jessica.  (Did I mention she’s amazing?)  I don’t care what you weigh, you’re sick.  You may not be as bad off as you were physically, but mentally, you are much sicker than you’ve ever been.

It was difficult to hear that.  It was difficult to listen to her tell me that if I went back to work now, I was basically writing my death sentence.  It is difficult to imagine that this illness could possibly kill me, even when I seem to be in no physical danger now.

I’ve been reading some of my old journal entries, both here and in my personal journals.  I am amazed at the fight I had in me, even in my darkest months (May-June 2010).  I am amazed at the faith and hope that I had, the belief that — even though I couldn’t see it — the story wasn’t over yet and I would pull through.

Even last year at this time, as I struggled hard and tried to decide what to do, I was filled with hope.  I was able to write and tap into those parts of me that I knew to be true.  I was able to lean hard on my Saviour and my God and trust that He had a plan for this thing.

Now, it is 8 days before Christmas and all I can think about is the fact that we have french toast every year for Christmas breakfast and I can’t eat french toast.  I think about our annual family Christmas party next Friday and wonder how I will deal with it when I only eat six foods.  I think about sitting in church on Christmas Day, then going to the movies (as is our family tradition) and can only consider how it will be nearly impossible for me to keep still, keep my leg from bouncing, keep my mind from counting calories on the day I should be celebrating the miracle of the Word made flesh.

So yes, maybe mentally, I’m worse than I have been.  My list of fear foods is infinitely longer than it’s ever been.  My chest seizes in panic at the thought of taking my chewable multivitamin with its 10 calories.  My feet and legs seem possessed by a power outside myself, constantly moving, even into the early hours of the morning, convinced that if I stop for even a moment, all the weight I’ve lost will magically reappear.  I haven’t showered in two days because I haven’t figured out how to do so in the dark and without ever having to touch, see, or deal with my body.

I’m sure there was a point to this post.  I guess it’s just to say, yes — I’m not completely oblivious to how bad things are.  I can, occasionally and for very brief periods, see things as they are.  And in those moments I cry.

I cry for the things I’ve lost and the things I’ve missed.

I cry for the fact that I don’t see an end to this hell, save the grave.

And that small 2% of me that still knows I am a child of God, cries for the fact that this not how it is meant to be.

Use Your Coping Skills

This has been the constant refrain of my treatment team for the last two weeks.  Usually with an added, “The HEALTHY ONES!”

I haven’t felt much like writing.  There’s nothing really to write.  Treatment sucks, I’m barely compliant, and they’ve threatened to discharge me twice already this week.  Today the psychiatrist asked me if they got approval for me to go inpatient if I would do it.  Part of me just wanted to say, “Sure, why the heck not,” knowing that there is no way in heck that insurance is going to cover my fat arse going into hospital.  A much larger part of me thought, “Well, if they did – by some freak act of God – cover it, there is no way I’m going.”

My motivation is steadily falling and I am becoming increasingly depressed.  So depressed, in fact, that a conversation with a friend last night ended with that friend calling the local police who showed up banging on my door at 9:30 pm.  Let me tell you, THAT was a fun conversation to have with my parents (who answered the door).

In all honesty, despite my weight being higher, I’m much closer to where I was this time last year (just before residential) than where  I was when I entered PHP in March.  Of course, my insurance doesn’t cover residential, so even considering a higher level of care is moot.  My family is STILL paying off my last stint in Florida, and I can’t possibly go again.

It seems hopeless, honestly.  It’s not pretty and it’s not uplifting, but it’s real.  That’s just where I am right now.

But hey, on the bright side – I blogged.  And surely that counts as using one of my [practically non-existent] coping skills, right?