Surfacing After Silence

Life. After.

recovered/in recovery/recovery/john?

One of the comments on my previous entry is something that has come up both here and in my “real life:

I have always wondered about the terms “in recovery” and “recovered.” Why do you choose “recovered?”

Perhaps it is just a game of word play, but there is a significant difference for me in the associations the two words bring up.

“In recovery” (to me) means that I am, in some way, living with the illness.  It means that I am on guard against behaviors or symptoms or eating disordered thoughts.  It means that I am managing the illness and that I am not free from it.

“Recovered” (to me) means that I have moved on, put the illness behind me, and am living without consciously making sure I am “following the program.”  It’s past tense.  What was is exactly that, what was.

For years, doctors and therapists told me that one never truly recovers from an eating disorder, that one manages symptoms, guards against relapse, and makes sure one is eating appropriately.  Somewhere around 2005, I realized that this wasn’t good enough for me.  Why spend so much hard work in treatment (both inpatient and outpatient) if the only thing to gain was “managing symptoms.”  If I was going to recover, I was going to recovery.  All the way.  This has been one of the few times black and white thinking has worked out for my benefit.  I want no part of the eating disorder.  I don’t want to manage symptoms, be on guard against destructive thought patterns, or monitor my food.  If therapy is working (for me) these are all non-issues.

So again, one would ask how I could possibly call myself recovered right now.  I know the issues behind my eating disorder.  None of them caused the return to restricting, although, as I said, I did learn that if I diet in a healthy effort to lose weight that I have a medical reason to lose, it reminds me of restricting too much and I can’t take that risk.  While I was in the hospital, I didn’t have to work through the underlying issues to get myself to eat; I had to get used to eating again, on a physical level.  A couple of ritualistic behaviors came back while I was IP, simply because I was in that setting.  There’s been no desire to engage in them since.  Have I had destructive thought patterns that would lead to restricting?  Nope.  And I’m not monitoring my food intake.  I’m relying on hunger and satiety cues to let me know when and what and how much to eat.

But this is how I feel about these terms.  In all honesty, they don’t mean much if you are not engaging in behaviors and are living symptom free.  In either case, “in recover” or “recovery” means health.  Call it whatever you want, even give it a name such as “John” if you’d like, but take care of yourself and claim health as your own.

February 28, 2010 Posted by | Eating Disorders, recovery | , , , , , , , | 10 Comments

Still Recovered

wordle.net

So one might think after this recent jaunt back into treatment that I would think I’ve taken some major steps backward and that I no longer am recovered.  I have to admit I was feeling this way my first few days of being inpatient.  The embarrassment and shame at having to admit to using behaviors again and needing help were pretty strong.  But they were gone by the time I left.

Part of it has to do with the length of time (years) I had of solid recovery before the relapse.  Part of it had to do with the length of time (several weeks) of the relapse.  Part of it had to do with the severity of the relapse, which was “minor” until the last couple of weeks.  Part of it had to do with the number of symptoms involved–only a couple as compared to before.

Most of it had to do with my mindset upon leaving and what got me into the relapse in the first place.  I honestly thought I would lose weight in a healthy, controlled manner.  And no, this was not an eating disorder delusion coming from someone who didn’t need to lose weight in the first place.  There were legitimate reasons for me to lose weight.  There still are.  But I learned, too late, that I am not someone who can ever diet in any way shape or form.  As soon as I cut out one thing, I went into full blown restriction mode.  A few days before I left treatment, I realized that for three plus years I had maintained my ideal weight by eating intuitively.  The two main physical causes of the weight gain have been resolved.  So if I go back to eating intuitively, my weight will, eventually, go back to my ideal weight.  It may take longer than I originally wanted, but it will happen.

I didn’t leave with a meal plan.  I didn’t write up a week’s worth of meals before leaving.  I planned on going back to what I was doing all along, because that is what worked.  I’ve only been home a week.  While there have been moments when I’ve been tempted to skip a meal out of emotional exhaustion or because I am running late, I haven’t succumbed to those moments.  I haven’t sat down before a meal and figured out how many exchanged of each food group I’m getting in.  I haven’t obsessively measured my portions.  I decided to eat based on what I feel like eating at that moment.

I am not saying meal plans are bad.  Or the exchange system is bad, or measuring portion sizes.  There was a time I relied on all of these.  But I spent a year working with a nutritionist after I ceased needing these things learning how to eat intuitively.  How long it takes to get to that point is different for every individual.  And if meal plans and measuring keeps you on track then keep doing it.  Do whatever works for you.

I’m doing what works for me.  And what works for me leaves me with one word: Recovered.

February 26, 2010 Posted by | Eating Disorders, health, recovery | , , , , , , , , , , , , , | 4 Comments

complaining about needing treatment when you *want* recovery

So, after seeing several different status updates on Facebook (I do seem to have a vendetta against FB updates), here was my update:

here’s the thing. Don’t complain that no one gets it or that no one is helping you and then bitch about needing treatment. Take the help that is there, as it is offered. It’s a way to start healing. It may not be your ideal way, but if we always knew what was best for us, we wouldn’t need help in the first place.

Seriously.  I’ll see a series of updates from one person about how their treatment team just isn’t doing the right things or they aren’t helping enough or they’re not listening, but the second that treatment team suggests more intensive treatment-either in the form of more therapy sessions or closer monitoring via labwork or a much needed trip to the ER or going inpatient or partial program, I see the same person complain about how unfair it is.  I could maybe understand these contradictory comments from someone who didn’t want to get better, who was very much stuck in his or her eating disorder and had no intention of giving it up, but from someone who says he or she wants recovery?  What’s the deal?

To me, your treatment team is doing exactly what needs to be done in order to help you the most.  Sometimes we need someone to step in and help us know what is best for us.  This is called keeping you alive.  Oh, but that’s so dramatic you might respond.  And I’ll reply that eating disorders have the highest mortality rate of any mental illness.  That’s right, highest mortality rate. Not so dramatic anymore.  At least not to someone who has known over 10 people face-to-face who have died from an eating disorder, and then add that to the numerous FB friends I’ve *known.*

And yes, if we knew what was best for us and knew how to implement that knowledge, we wouldn’t need a treatment team in the first place.  The last time I was *made* to go into treatment, I was unhappy and angry–but not at my treatment team.  I was angry that I had relapsed again.  This most recent time, no one told me to go inpatient.  I knew I needed help, more help than was available outpatient, and I recognized this a lot sooner than I had ever recognized it in the past.  And yes, there were certain aspects of the program I didn’t like, and there were two days I was tempted to just leave and go home.  But I knew I had made the correct decision in going in the first place and was able to see my desire to leave as my fear of changing.

If you really want to recover, take what is offered.  You may not be in the best treatment facility in the world–but I’ve now been to a treatment center whose treatment philosophy is a polar opposite to all places I had been in the past and *gasp* both have been successful–but you are somewhere, and there is always always always something to be learned, no matter where you are.  But that requires opening your mind a little and being willing to listen and being willing to try something that might be a little foreign to you.

Recovery is foreign ground to many of us.  There are many different paths to get there, but you never will get there if you don’t let go of the eating disorder.  And that is a choice that only you can make.

February 22, 2010 Posted by | Eating Disorders, recovery, therapy | , , , , , , , , , , , , , , , , | 9 Comments

“not your year”

i just got home yesterday and have no recent photos so we'll stick with the ballet theme

I am home.  I’ve been home for less than 24 hours and I’ve had one doctor’s appointment and I’ve gone grocery shopping and crashed on the couch watching NCIS,  my latest favorite show, with my cats climbing on and off my lap in a game of King of the Mountain in order to get my attention.

It’s been an . . . interesting three weeks.  I had a lot of ups and downs while I was there.  I was set to leave the very first weekend I was there, but we got hit with a snowstorm that I laughed at since I grew up in upstate NY, but which was a major deal for Oklahomians.  Overall, I am glad I stayed.  I learned a lot, not necessarily about the eating disorder, but about myself.

On my drive home yesterday I listed to “Not Your Year” by The Weepies.  A few particular lines caught my ear:

“Breathe through it, write a list of desires, / Make a wish, Make a toast, Slash some tires, / Paint a heart repeating, beating, “Don’t give up, don’t give up, don’t give up.””

One thing I realized is that this really hasn’t been my year.  Not the year 2010, but the 365 days leading up to my admission.  During my admissions intake, the person asked me if I’d experienced any big loss recently, and I stared at her blankly.  “Like someone dying, a serious illness. . . ” she prompted.  “Does being diagnosed with ARVD and having a defibrillator placed and being told you might be on a heart transplant list someday count?” I asked.  This is when she looked at me as if I were truly crazy for not having immediately thought about that as a loss.

After my diagnosis, I felt some sadness and some fear and maybe a touch of anger, but I tried to shove these emotions aside and raised money for the heart walk and threw myself into learning all I could about the illness.  And then I tried to start school 5 weeks after surgery and got physically exhausted and then I got depressed, either from Seasonal Affective Disorder or my thyroid finally petering out on me or a combination of the two and probably I was a little depressed about my heart diagnosis although I wouldn’t admit it, not fully.  And then due to the depo shots and the thyroid, I gained weight very quickly and very scarily.  And I honestly, truly tried to lose it in a healthy way.  But cutting one thing out of a meal reminded me of restricting, and with my all or nothing thinking, I was in a full blown relapse in no time.

There was a lot I had to breathe through while I was in the hospital.  My body had to learn to accept food again.  I had to deal with the initial weight fluctuations that always happen during refeeding.  I had to breathe through a couple full-blown panic attacks, and I learned to return to my breath when the environment around me was overwhelming, when my feelings were overwhelming.  I learned that a “list of desires” or goals or things that are worth living for is something I lost sight of.  Wishing?  I’d given up on them.  Toasting?  I couldn’t find anything worth toasting.  I will not slash any tires, but I have realized the importance of acknowledging, expressing, and dealing with the anger I have inside of me about everything that has happened.

I learned there that you can experience joy even in sadness from another patient, that there are always things worth toasting.  I learned not to give up, to keep wishing, from another patient.  And while I may be angry about my cardiac diagnosis and scared of my heart, I can still have a dream.  I can still have many dreams.  I do not have to be a “Cardiac Patient” and then a student or writer or teacher.  I can be a student and writer and teacher and friend and aunt who just happens to have a heart condition. Just as four years ago I made the decision not to let the eating disorder define me anymore, I cannot allow ARVD to define me.  I  get to choose what defines me.

I may change on a daily basis.  I know I changed during these three weeks, in ways I wasn’t prepared to going into the program.  That scary word: Change.  But when you control what is changing, sometimes it’s not so scary.

February 18, 2010 Posted by | Eating Disorders, heart, identity, recovery | , , , , , , , , , , , , , , , , | 6 Comments