Posts Tagged ‘therapy’

I feel like I just posted yesterday, but it’s been over 3 weeks. In those 3 weeks I have watched my brother run in the state track meet, drove to Denver and back, spent time at my parents, went to graduation parties for my brother, cousin, and a few others, worked, and even managed to fit in a few alone days at home. I also have gone back to see E—.

I have now seen her 3 times. The first time I went I was terrified. Maybe terrified isn’t the right word. Ashamed is probably more accurate. Really I am ashamed every time I see her. Probably 90% of the emotions I experience are some form on shame. I am ashamed of what I eat. I am ashamed of what I weigh. I am ashamed of when I eat. I am ashamed of not exercising enough. I am ashamed of being fat. I am ashamed of having a huge stomach. I am ashamed of my fat fingers and thighs and arms.

But the difference this time is that even with all this shame I am fighting. I’m not always moving forward, but I’m fighting to not move backward. I would say that although I’m not jumping in to the work of recovery, I am dipping my toe in.

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Breaking Out

I’m taking another break from my therapist. This time it was mostly my decision. Last time I did this (January) it was E’s idea, I was pissed, and took it out on myself. The break led to a downward spiral where I lost weight, returned to purging, and began lying more. Last week, E suggested that I was not prepared to change and if that was the case then there wasn’t much reason for us to continue.

That night I cried and cried. I was and still am torn about what I want to do. Part of me wants to continue with E and continue to fight, but as a lifelong people pleaser I don’t know if it’s because I really want it or I just want to please E. Another part wants to go out on my own, leave the hassle of doctor and therapy appointments behind, along with my “identity” of an eating disorder. And I would be lying if I didn’t say that a small part of me wants this as a way to run all the way back to the disorder and lose even more weight.

But there are so many things that I don’t want to lose in my life right now. I am so close to my mater’s I can almost taste it. I have a great job at student health. I have a medical school application on the line. And I have my boyfriend, M.

Time will tell how this experiment turns out.

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Yep. My therapist “strongly suggested” we take a month hiatus.

And not because I’m doing so well.

It’s because I’ve made absolutely no progress in the last 1 1/2 years.

So now I have a month alone. And I’m not sure how to deal with it.

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I can’t do it

I’m so split.

Simply put, this life is hell. But it seems some part of my psyche is determined to continue it.

My therapist and I came up with a plan-a checklist of sorts-with what I need to do every day to get myself out of it. I tell her I will do it. Come up with some goal for myself. (this week she came up with the goal…x lbs).

And the whole time I’m plotting how to get away without doing it.

Hmm….she only specifically said I couldn’t run. The plan says a 15 min walk with the dog 4 days/week. Our short loop is 25 min. Close enough. And If we only run part of it it’s not really a run. And biking to work isn’t really exercise because biking’s not hard….and it’s getting me to work so it has a different ulterior motive. And my jump rope? Well, like biking, it was never specifically banned.

And a rice cake counts as a carbohydrate, a complex one at that because it’s a whole grain! And it never really says how much yogurt; I’ll continue with the 2 oz I’ve been putting on cereal.

As she finishes her spiel with “having this weight goal doesn’t give you permission to water load, wear heavy clothing, wear different shoes, or hide your weight any other way.”

And inside I’m saying “just because you don’t give me permission doesn’t mean I won’t do it” (how’s that for a load of negatives?)

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My new therapist really knows how to hit a point home. We were talking about my motivation to recover. I’m not sure where it is most of the time; I do hate a lot of things about how I feel now but at the same time I am completely and utterly terrified of gaining weight. She pointed out a chair across the room and designated at the ED-free life zone.

“Are you willing to get out of the chair you’re in now and take a step toward that chair?”


“It can be something small. In fact it doesn’t have to even be a step at all; it could be scooting yourself forward to prepare to stand up.”

I might be able to do that.

“The catch is, you can’t go back to that chair when something happens or when you feel uncomfortable. Well, actually you can, but that doesn’t help. You need to keep moving forward. Let uncomfortability be your guide.”

Dunno about that one. It’s pretty easy to fall back on ED.

“In five years you could still be sitting in that ED chair. It would be no problem at all. But is that chair getting you what you want? How about medical school in that chair? I assume that medical school will be a challenge enough as it is and adding the challenge of an eating disorder could sabotage it all. Do you want to have to take a semester, or a year, off for treatment and fall behind your class? How about having to tell your staff doctor that you need to take a medical leave of absence from your favorite rotation because your weight is dangerously low?”

Damn you. I know medical school is impossible in this state. Taking time off? Why would I ever do that? But hearing it said aloud scares me to death.

I ferociously guard my history of an ED at work because I’m afraid that people will want to limit my options if they knew about it. If the behavioral health people knew I was struggling with an eating disorder would they worry about me working on the psych unit and getting pulled to work on the unit with the eating disorder program? I am very good at separating work and personal life; despite my extensive history with this hospital (my mother’s extensive hospitalizations there, my brother’s severe accident and subsequent time in the ICU, my own time in ED treatment) when I get to work my mind thinks only about work and what the patients need. My own issues never cross my mind. But people don’t know that. Talking to someone who knew about my treatment I was advised that I should tell my supervisor about my history so she could “be aware of the effect of the patients’ issues on my own recovery.” Ridiculous. I know myself better than she. I know what makes me worse and it is definitely not work.

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With a move across the state comes another move. A move to a new therapist. It’s not just a new person; it’s a new office, new staff, a different day, a different time, different chairs, different lighting, different vents, different parking, different styles, different (to an extent) goals. Have I mentioned before how much I struggle with the small changes?

I think it will be good for me. I view therapists in much the way I view music teachers: every teacher has his/her own strengths and abilities and although continuity is desirable, there comes a time when you need to move on to another teacher and learn from their strengths.

If I wasn’t moving I wouldn’t have switched therapists. However, I plan to take advantage and make the best of this move and the new knowledge to help me.

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I know the typical treatment program’s view on triggering language, behavior etc. I also understand why many of them have those rules.

My most recent treatment program had none of that. We were able (in some cases encouraged) to talk about specific behaviors we had engaged in and in fact some of the therapists would purposely used triggering language during groups. Why? Because that’s how the real world works. Outside the walls of treatment people talk all the time about food and fat and calories. The entire population doesn’t walk around thinking “I wonder if she has an eating disorder? Perhaps I should say this in a different manner or avoid it altogether.”

And you know what? I liked it. A lot.

I have had my times when things have “triggered” me–sitting in a psych lecture where we spent an hour talking about obesity and how to avoid it and then some time spent talking about eating disorders with triggering pictures and whatnot. It was an incredible difficult lecture, in a class of 1000 people, so I’m sure I wasn’t the only one who struggled with it. But would it have been okay for me to talk to the lecturer and tell her that? I don’t really know. She was just doing her typical teaching thing, 99% of the students probably didn’t have a problem with it, and how often in life am I going to get into similar situations where I don’t have the right to bring such subject matter up?

No matter how careful a person is and how much she tries to avoid triggers, they will happen. And if I am restructuring my life to avoid ED triggers, then I am not enjoying full freedom from the eating disorder.

If there is a time and place to learn to face and deal with triggering language, therapy is it. Surrounded by supportive people, with a chance to express and deal with emotions, one doesn’t have to just stuff it down. They are in a unique position to face the underlying issues about why that language triggers them. There are other ED sufferers that understand the difficulty in hearing it and there are professionals trained to help them work through it. I think that a treatment center that is willing to face the realities of this is very intelligent.

And now that I’m out of intensive treatment, I find that having to censor my thoughts is very difficult. It’s cumbersome and it distracts me from what I am thinking and feeling about the real issues I have. There’s always that voice in my head going “Can I say this? Should I say this? How much of this should/can I say?” and if that inner dialogue goes on long enough it becomes “Well, I don’t really know where the safe zone starts or stops, so I guess I won’t say anything.” And that is where a ban on triggering language moves from being a safeguard to being a liability.

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