Surfacing After Silence

Life. After.

who is responsible when treatment fails?

holding_hands-1418Reading around the internet today, I came across A Disordered World, and the home page drew me in.  A site about experiencing mental illness and accessing treatment.  I read a lot of passion in this site, and I believe this author’s story is one of the stories that need to be told.  But it’s only one of the stories, and the first article and second article in a series investigating eating disorder treatment centers raised a lot of red flags for me.

Let me be clear:  It is not my intention to nullify this author or to negate her personal experience, but to draw attention to another point of view.  I do think the “investigation” is flawed because it’s an openly biased position with no acknowledgment of any other view.  This worries me, because I am afraid that people would look at this site and use it as justification for not seeking treatment.

I also support anyone who suffers outright abuse at a treatment center and speaks out, but I won’t say that the entire treatment system is flawed and incompetent.

If you have an eating disorder, are suffering, and are scared, please seek appropriate treatment. 

I’ve been in treatment for anorexia multiple times: Inpatient, Partial, IOP, and outpatient group therapy.  I was labelled as “treatment resistant.”  Maybe those are harsh terms that bias providers against potential clients, but using the word “noncompliant” only puts a prettier spin on things; it doesn’t erase the fact that in the beginning of my eating disorder, I resisted treatment.  I played the hospital’s games and got myself discharged and went back to the eating disorder.  I certainly am thankful there were people in my life that “did this” to me.  I would not be alive if people had not intervened and forced me into treatment.  Did I benefit emotionally, or did I come to any understanding about why I suffered from an eating disorder?  No.  But I am alive today because of the NG Tube inserted against my will.  These hospitalizations bought me time. I certainly didn’t enjoy them, but I don’t consider them failed experiences.

Eating disorder treatment centers all have rules, and usually they are pretty strict rules.  A lot of the times, it’s because if those rules weren’t in place, clients would continue to use eating disordered behaviors.  So yes, there are meal requirements.  Early in my treatment, I learned to just play along and clear my plate and I could go home earlier.  When I made my decision that recovery was my only option, I didn’t just “play along.”  I cried at my first dinner and could only manage a few bites.  I believe the first few meals went along the same lines.  And because I wasn’t following protocol–by refusing meals and refusing supplements and, therefore, not gaining any weight–there were repercussions.  At the time, I would have cursed the entire facility and staff and anyone who stepped into my field of vision, and I would have blamed everyone but myself.  But even though I was noncompliant, my psychiatrist and my therapist were supportive and encouraging.  It’s not like I was the first anorexic they saw who didn’t want to eat.  Eventually, I was able to work up to my full meal plan and supplements, but it took a couple of weeks.

I felt like I “should be trying harder” and that I should “just suck it up and deal” and that “it was all my fault anyway.”  One of my proficiencies is accepting guilt for almost anything possible.  But for the first time in treatment, I was being open and honest and showing my true fears surrounding recovery, and I needed that.  Because then, when I chose to eat a couple more bites of food at one meal, it was a personal accomplishment and not just “doing it because I have to.”

I don’t think my experience is unique.  I know many other women and men have experienced similar journeys as mine.  Relapse after treatment is not unusual, but it does not mean treatment failed.  Eating disorders are insidious illnesses; they take over an entire personality.  Recovery is learning who you were to begin with, and who you want to become.  And although it’s cliche, journeys usually involve some stumbles along the way, even as overall progress is being made.

I question writing that offers a blanket statement that inpatient facilities are not the most effective way to treat eating disorders.  (Have we come up with THE effective way to treat EDs yet?)  That doesn’t mean they’re not effective at all.  In an ideal world, people with eating disorders would get help before they required inpatient care and, therefore, immediately benefit from outpatient modes of therapy.  In an ideal world, insurance would pay for these outpatient modes of therapy, but a significant majority of individuals are faced with the either/or decision of inpatient treatment versus once a week sessions with a therapist.  Yes, you can appeal your insurance company, but that takes a great deal of time and energy.  At the time I decided I was going to recover, no matter what, I did not have the time or energy to appeal, and I didn’t have anyone in a position to call the insurance company for me.

I needed the inpatient treatment.  Because I was noncompliant by nature.  I needed the strict rules and consequences to get me through the initial stages of intense fear.  I would not have benefited from a partial program at first.  After six weeks of inpatient care, I did step down to their partial program, but I was ready for it then.  It was still scary and difficult, but I had also developed some faith in myself by that point.

I state on my blog that I do not recommend what type of treatment to seek.  We are all individuals, and have our own unique sets of needs and desires and tendencies and fears.  So I ask you not to write off a form of treatment because it wasn’t successful for some.  If we based decisions on that belief, every single treatment option would be scratched from the books.  I know people who have recovered fully using residential programs, inpatient centers, partial programs, IOPs, and outpatient therapy.  I also know people who have died after seeking each type of treatment.  But I know a whole lot of other individuals who died before seeking treatment at all.

If it hadn’t been for the “ineffective” treatments I received in the beginning of my journey, I would not be alive to say that I have been fully recovered for eight years now.  I may bear scars from some of those experiences, but I have to admit that I’m thankful for them.  I may have chosen recovery a little later than others had wanted, but in the end, I did choose it, and I thank everyone who helped me get here today.

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August 1, 2015 Posted by | Eating Disorders, progress, recovery, treatment | , , , , , , , , , , , , , | 3 Comments

I want to get better but this treatment place sucks . . .

I’ve noticed a trend on Facebook lately.  Maybe it’s not a new trend, but I’ve only noticed it in the previous few days.

“I want to get better.  I am so sick of this eating disorder.” followed by “Off to the Fat Farm.” or “This treatment place sucks.” or “There’s no way I’m following all these stupid rules.” or “They must think I’m crazy if they want me to eat this.”  or “I hate it here.” or “This is pointless.”

No treatment place is *fun.*  Sure, I met a lot of great people there and I even have some good memories from a couple places.  But here’s the big shocker: Treatment isn’t supposed to be fun.  Excuse my frankness, but you don’t check yourself in for a bunch of shits and giggles.  You check yourself in because you have a serious problem and need help.

I realize not everyone goes to treatment willingly.  I didn’t the first couple of times.  And I expect to hear “This place sucks” out of them.  But if you chose to seek help and packed your bags willingly, I am tired of the whining about how unfair the program is or how “everything sucks” or how “these people (the staff) have no idea what they’re doing.” These comments do wonders for those contemplating recovery and contemplating seeking help (heavy sarcasm in this sentence).

Really?  They have no idea what they’re doing?  I guess all those success stories must be made up myths to attract more customers.  I guess all the people who claim to have gotten help there are paid to lie.

And if the staff doesn’t know what they’re doing, I’m assuming you know what you’re doing.  Because what you’re doing has worked so well for you so far.

Here’s the thing:  there comes a time when you have to stop blaming the facility.  Or facilities.  There comes a time when you actually have to accept the help that they are offering.  There comes a time when, if you really do want to get better, you have to start listening to other people and consider what they’re saying.  There comes a time when you’re going to have to surrender.  You may not “like” it there.  Who honestly does?  But you do have admit that what you’ve done up to this point just hasn’t been working and accept the alternative, which means accepting the help that’s offered.

There are a couple of alternatives:

A) You die.

B) You just move from one treatment place to another one, comparing notes but not really getting any better.

This may sound harsh. It may sound like I have no right to say these things.  But I’ve been there.  And the first four times in treatment I claimed the desire for recovery while stubbornly fighting the program any way I could.  Was it the specific program’s fault?  No.  They were trying to do one thing: keep me alive.  The fault was mine.  I thought I knew better than they did.  I thought I knew what was best.  And yet I kept relapsing.  I kept ending up back at their doors, or at the doors of another facility.

The shift occurred when I realized I had no idea what the hell I was doing and I had no idea how the hell to change and that it was finally time to listen to those dreaded experts and actually give what they were saying a shot in hell.

If you truly want to be free from the eating disorder, then you are going to have to let go and trust the people who are so desperately trying to help you.

July 13, 2011 Posted by | Eating Disorders, recovery, therapy | , , , , , , , , , , , , , , , , | 5 Comments

cicadas and recovery

 

the shell

I was outside drinking my morning cup of coffee and noticed about thirty cicada shells and newly molted adult cicadas, stretching their wings and crawling on the ground, not yet strong enough to fly.  This may sound weird, but I thought of recovery from an eating disorder when I saw all of these insects (which are not related to locusts, by the way and a harmless to humans, although their noise can be annoying, and they do look kind of creepy).

Cicadas actually amaze me–how do they crawl out of their shell and leave the shell completely intact, as you can see in the first picture?  (Cicada shells are used in traditional medicines in China.) One cicada was in the process of crawling out of its shell, and I wanted to watch the process, but I quickly lost patience.  Apparently, it takes some time.  And this is when the eating disorder recovery metaphor hit me.  I know, it’s a strange metaphor.  Blame on the early morning hours.

How many of us have, at various points, decided to get better and went to treatment, had the support offered there, and came home expecting to continue on our merry ways of recovery only to find it wasn’t that easy?  And with a whole of “Is this possible?” questions?

And maybe in the process of recovery, you have asked, “I’ve had my eating disorder for so long, there’s nothing left but the eating disorder?”

And here is where we can learn something from these creepy looking but fascinating insects.  They spend most of their lives in hibernation of sorts  (The eating disorder), waiting to crawl out of their shells (recovery).  When they emerge from their shells, they need a little time to adjust to their new selves, stretching their wings, crawling before flying.  But there they are, adult cicadas, ready to face the world.

Recovering from an eating disorder is much like this.  We spend so much time with the eating disorder, that we lose sight of who we really are inside.  A great many of us doubt that there is something inside at all.  We crawl out of our shells, only to discover the world is a scary place, and we think maybe we aren’t ready for the world, or maybe the world is just too much for us.

We need time to stretch our wings, and we need to walk before we fly.  A lot of us get frustrated at this point; we lose patience–like I did while watching the cicada crawl from its shell this morning.  We lose faith that flying is possible.  But even after 17 years in it’s shell, the cicada keeps stretching its wings and walking and remembers it was born to fly and sing that annoying song of theirs.

Recovery takes time.  It doesn’t happen in the one or two months we spend in a treatment center.  Those months are the preparation.  They help get us stronger so we can emerge from our shells.  And then we rejoin the real world.  Yes, it is scary.  Yes, it is tempting to retreat back into our shells.  But if you retreat back into the shell, you will never stretch your wings and fly.  You will never feel the breeze on your skin, the pure joy of soaring through the sky.
If you don’t emerge from your shell, you will never know who you were meant to be.  And I promise you that there is someone waiting to emerge from that shell.  It may take time, and as you grow, you will continue to learn more and more about yourself and who you were meant to be.  You will find your place in this world.

Don’t give up.  Give yourself the same patience you would give others.  And leave that shell behind you and fly.

The adult cicada

May 25, 2011 Posted by | Eating Disorders, faith, identity, recovery | , , , , , , , , , , , , , , , , , | 2 Comments

How I Did It

I was asked a rather thought provoking question on Facebook today in the middle of a discussion of how once you are in recovery, the issues seem to multiply, not go away.  And let’s be honest, who out there didn’t think life would automatically be better once we kicked the eating disorder to the curb?  I know that’s what I expected.  The eating disorder was making my life hell, so obviously the only way to go was up, right? (sarcasm fully present)  And life did get better without the eating disorder, but it wasn’t great, and I for one was surprised at all the issues that suddenly reared their ugly heads.

So someone asked me how I did it.  How I became aware of the issues and faced them without falling back into the eating disorder behaviors.

First off, let me just say that I wasn’t immune to the temptation of relapse, and it wasn’t a smooth ride.  I had my moments of relying on the old behaviors; I was not perfect.  No one is.  And that’s okay.  Don’t beat yourself up for an off day; acknowledge it for what it was and know that tomorrow you have a chance to make it a different kind of day.

Secondly, remember that this is how I did it.  This is not the one and only way to work through recovery, but this is what worked for me. Do not feel that this is how you have to go about things.  This is just one option, one path among many.

So.  How did I do it?   Because there were a couple of times when I left treatment on kind of solid ground only to be slammed by these issues that seemingly came out of nowhere and then I relapsed and went through the whole cycle again.  And again.  The important thing to note about those times in treatment is that I was never fully committed to recovery.  I wanted the hell to end, but I wasn’t yet ready to let go of the eating disorder because I couldn’t imagine life without it.  The very first thing that happened when I began recovery was I had to realize that I wasn’t living.  I was existing.  No more, no less.  I was in graduate school and everyone else around me was living full, fulfilling lives.  I was showing up to class and trying to stay awake and trying to convince people I was fine.  The day I realized the extent of my lack of life, I confided in a teacher and because I was afraid to do it on my own, called a treatment center from her office.  I hung up the phone and was shaking and she told me that choosing life was the most terrifying thing you could do.  And I started crying for the first time in months.  Then I packed my bags and went to treatment.  Except this time, I was determined to make it work.  I still went through all the normal struggles and I did my fair share of resisting, but the underlying motivation was different.

The second thing that happened was that I discovered a reason for living free of the eating disorder.  That happened when my nephew came to visit me on Christmas day, all 18 months of his little cuteness.  And I realized I didn’t want him to grow up visiting me in hospitals, and I hoped–and still hope–that he doesn’t remember that day.  And I didn’t want him to grow up thinking of me as “the sick aunt.”  So in the beginning, I ate for him.  I stopped exercising for him.  I stopped using pills for him.  Eventually, I was able to do these things for me.

The issues that reared their ugly heads?  Yeah, they came up.  But my therapist and I put them on the back burner while I concentrated on controlling my behaviors and getting through normal day-to-day stressors (and there are a lot of them in graduate school!) without relying on any eating disorder behaviors.  I practiced using healthy coping skills.  Once I had confidence in my ability to handle normal stress in a healthy way, using these healthy coping skills, my therapist and I began looking at the underlying issues, the ones I had kept buried through the eating disorder.  We started with the smaller issues first, working our way up to the deeper, more painful ones.  If things started getting too overwhelming and I was having a difficult time not relying on eating disorder behaviors, we backed off and focused on strengthening my healthy coping skills.

Right now, I am working with a Dialectical Behavioral Therapy therapist, and one of the main goals of DBT is to “create a life worth living.”  For me, that has been crucial in maintaining my recovery.  It’s been a slow process, and there has been some give and take at certain points, and I’m not finished.  My life has changed a lot due to medical reasons in the previous two years, and that has meant rearranging the things that make my life worth living.  At one point, I kept a list in my journal to help remind me of why I was fighting to stay in recovery on the days when things were particularly difficult.  I’ve had to reevaluate things recently due to some medical news, and that list has made another appearance.  I’m learning that this is life.  Sometimes–a lot of the time–we can’t control what gets thrown our way.  We adjust the best we can.  And sometimes the road will be bumpy.

So I guess my overall advice, based on what worked for me, is to first get to a point where you are physically strong enough to handle intense emotions and stress and then to make sure that you have a good amount of healthy coping skills that you can rely on.  The best time to practice these skills is when you aren’t overwhelmed, and then they will eventually become second nature and a natural resource during times of stress.

Above all, I recommend working with your treatment team and being honest with them.  Part of recovery involves trusting other people and learning to let other people help you.

May 23, 2011 Posted by | coping, depression, Eating Disorders, recovery | , , , , , , , , , , , , , , , , , , , , , , | 71 Comments

Missing the Illness, Part Two

who are you?

Who do you see when you look in the mirror?  I think this question is another of the reasons why we may find ourselves missing being sick.  Not the body image problems of looking in the mirror, but the deeper meaning of the question, “Who are you?”  Just imagine the caterpillar from Alice In Wonderland and the drawn out “Whooooooooooo”.

Seriously.  How many of us lost everything to the eating disorder, so that all that remained was the eating disorder?  So that we became our eating disorder and how we identified ourselves?  One of the things that makes that initial step into recovery so difficult and so terrifying is the fact that you are stepping into the Unknown.  You’re letting go of the eating disorder and reaching out for . . . . what?  What is going to be there to take the eating disorder’s place?   That initial step into recovery is a huge leap of faith.

I was “lucky.”  When I made the decision to recover I was in the middle of my Master’s program and “all” I had to do was throw myself into the classes and workload.  I was also lucky in that while I was there, the group of students in the program and the professors were a very tight-knit group and were extremely supportive and encouraging.

So now, when the identity of student is no longer mine, and I’m caught in between that student identity and the next phase of my life, it’s only natural that I find myself longing for a familiar identity to cling to.  I think this is something a lot of individuals face when they leave an intensive residential treatment facility. After a couple to a few months of living and breathing the illness and recovery and spending your days talking about it with other people who “get it,” you are thrown back into the real world.  The same world you inhabited before treatment except this time you’re missing the eating disorder.  And how you relate to everything and everyone has to change.  It’s terrifying and oh so easy to slip back into your old identity.  The familiar is always more comfortable than the unknown, even when you know the familiar is killing you.

With the uncertainties all around me, it’s been tempting me–my old “friend” the eating disorder.  I haven’t given in, but the thoughts are there.  And I finally understand why.  And last night, in my journal, I took these black alphabet stickers I have for scrapbooking, and wrote the word “lose” in the middle of my entry.  And then reminded myself of all I stood to lose if I relapsed.  I look around my apartment and see everything that I have gained, the life I now call my own.  It would all disappear and I would be left back at the beginning, having to start over from scratch.  Again.  I am not willing to give up all I have become, no matter how terrifying this unknown that I am facing is.

So I challenge you again–what do you stand to lose if you relapse?  And to look at it from a positive angle–What have you gained in your recovery?  And–What do you stand to gain by continuing down the path of recovery?

May 1, 2011 Posted by | Eating Disorders, identity, recovery | , , , , , , , , , , , , , , , , , , , , | 1 Comment

Missing the Illness, Part One

One of the topic suggestions was how to deal with missing being sick or deathly thin.  At first I didn’t think that I could write on this topic, because I had no idea what the person was talking about.  But the more I thought about it, the more I realized I did know what the person was talking about and just didn’t want to admit it.

I don’t miss being sick, and I honestly don’t miss being deathly thin.  But I do miss the results of me being sick and deathly thin.  I don’t miss the tiredness, the constant cold, the feeling like crap, the inability to attend all my classes or do all my work, and I certainly don’t miss the fact that when I was sick the papers I wrote made absolutely no sense (even though I thought they were brilliant at the time).  I like being a competent adult.

Here’s what I miss that I was ashamed to admit: I miss being sick because when I was sick, other people took care of me and checked in on me more often.  People called me to see how I was doing.  People offered their support on a regular basis.  Friends offered to eat with me or cook for me or sit with me or talk to me.  When I was in treatment, I had a whole treatment team taking care of things and I could finally let go, give up some of the control, and let someone else call the shots.  I “just” had to sit back and accept the help offered.

I was ashamed to admit this because I’m thirty-some years old and an adult and shouldn’t need other people to take care of me, right?  But life has been rather stressful lately, and I’ve found myself wanting to throw up my hands and let someone else step in and be the adult.  I don’t want this responsibility, and I find myself wanting to retreat.

But here’s the thing–There’s no magic age we reach when we stop needing other people.  No magic number when we stop needing someone else’s care.  No turning point where we’re supposed to be able to do everything on our own.  This has been an exceptionally difficult lesson for me to learn: that it is okay to need someone else.  I may not need them in the same way I did before, but you know that quote “No man is an island”?–it’s true.  I am not this self-sufficient island, capable to taking care of every small little thing, one-hundred percent of the time.  I need other people in my life.  I still need other people to call me and say, “how are you doing?”  I still need a shoulder to cry on.

There’s a significant difference between when I was deathly thin and now, however: Now, I use my voice to meet those needs rather than my body.  And that, as most of us know, can be terrifying.  A lot of us developed our eating disorders in part because we didn’t know how to use our voices.  But I do know one thing: my friends appreciate me using my voice and find me easier to relate to now than when I used my body to speak for me.  And I’ve found that they are more able to meet my needs now that I use my voice and not my body.  But yes, this way is, initially, harder and scarier.  As you keep using your voice, however, it gets easier.  It may take a long time for it to feel natural, but it will get easier.  And you will find the people around you more open and honest.  And they will be more willing and able to be close to you.

So I challenge you–if you are missing being sick, what, exactly, are you missing?  And what have you gained that you would lose if you become sick again?  Do you really miss all the physical complications of an eating disorder?  Are you willing to give up the freedom you have gained?  And once you identify what you are really missing, can you write down ways to meet those needs?

Remember that you deserve to have those needs met in healthy ways.  You do not deserve what the eating disorder does to your body and your life.

Use your voice, not your body.  Your body will thank you.

April 30, 2011 Posted by | Communication, Eating Disorders, identity, recovery, relationships | , , , , , , , , , , , , , , , , , , | 3 Comments

Perfection Calls . . .

Perfection

I haven’t done any official studies or surveys.  I’ve read a lot of books and I’ve done a lot of writing.  And I’m going to guess that a lot of people reading this blog regularly have issues with perfection.  And in our eating disorders, we’ve found something that, finally, we’re “good enough” at.  The perfect meal plan, the perfect number.  In DBT language this is, of course, emotion mind speaking.  Wise mind knows there is no such thing as perfection.  But we cling to perfection in our eating disorders.  A lot of us cling to perfection in our recoveries as well.

I honestly thought I had conquered my issues with perfection in my recovery.  Then three things happened this past February that rocked my boat and made me reach for anything that would make me feel “good enough.”  A) I decided, for a multitude of reasons to leave my PhD program, even though school had always been my “thing.”  B) I was hit by another depressive episode that landed me in the hospital (I’m bipolar, type 1).  C) While I was in the hospital, my cousin died.  He was the only cousin of mine on that side of my family whom I could say I really knew.  And my emotion mind said, “If you hadn’t been in the hospital, you would have been able to help your cousin.”  Definitely not my wise mind speaking there.  Not one ounce of rational thought in that sentence at all. And because I was in the hospital, I could not attend the funeral.  Another sign of failure.

I did not realize until I did some journaling homework for therapy this previous week how much I wanted that “good enough” feeling back.  How easily that feeling translates into “restrict” and get to XXX number.  I feel lucky in that my therapist is willing–and rather adamant that we do so–to address this now rather than wait until I’m at a dangerous weight or my medical stability is in jeopardy.  Rather than wait until there is a glaring problem, we’re going to stop it from becoming a glaring problem.  Yes, my therapist is willing and this makes a huge difference, but I have also been honest with him, and that has, perhaps, been a bigger contribution.  Years ago, I never would have been this honest this early.

How my therapist and I are tackling this issue is different than how I’ve tackled it with other therapists in the past.  There’s this little part of me that’s going, “He’s not doing it right.”  As if there is one perfect way to recover or make progress.  But even without doing studies or surveys, I know that there is no one perfect way to recover.  We forget that we all got to the illness in different ways for different reasons.  We forget this because when we wind up on an eating disorder unit together we’re either at rock bottom or close to it, and that looks the same.  The initial stabilization is similar for a lot of people, but then we need to remember that we each need to approach recovery on a unique path.  We must confront the different issues that led to the eating disorder, the different anxieties we have about recovery, and we must use our individual strengths as much as we can.

I guess what I’m trying to explain is that you can’t recover “wrong.” I’ve heard people say that they aren’t doing it (recovery) “right” or “good enough” or “perfect.”  There are many paths to recovery.  Many different approaches.  Some will work for some people; some will work for others.  There is no magical formula for recovery.  Do not judge your own  recovery by comparing yourself to someone else.  The two of you are two different people and have different needs and will require a different amount of time. Are you headed in the same general direction?   Are you working towards the same thing?

Your recovery is all your own.  People use “Ed” to name their eating disorders.  Give your recovery a name, a name that has personal significance and meaning.  Write down your reasons you want to leave Ed in the dust.  Write down what you stand to gain by working towards recovery?  Give yourself permission to go at your pace; give yourself permission to stumble along the way.

Write “perfection” on a piece of paper and then tear it into tiny pieces.

April 28, 2011 Posted by | bipolar disorder, coping, death, depression, Eating Disorders, recovery, therapy | , , , , , , , , , , , , , , , , , , , , , | 1 Comment

The Pull of Friendship

One of the topics that several people suggested I address is eating disorders and friendships.  That is, maintaining friendships with people you either met in treatment or met through an eating disorder forum or support group.  I briefly tackled that topic here, but I think it’s a worthy topic to look at in more detail.

The question isn’t whether or not you should maintain friendships with people you met in treatment if you are both doing well.  Congrats to both of you, and I hope you continue to support one another in recovery.

But what about two different scenarios–the first being if you aren’t doing well and have basically stated you don’t intend to and the second being that you are trying as hard as you can to work toward recovery but you have certain friends who are doing everything they can to cling to the eating disorder.

In the first post I mentioned, I address how when I was sick, I was super-eating-disorder-activist.  I lobbied, I spoke at colleges and universities and conferences.  And the vast majority of my friends also had ties to the eating disorder world.  Looking back, I do not think this was helpful.  What I needed to be doing was “normal” stuff that would teach me I could have and enjoy a “normal” life, such as school, work, friends and family and social engagements that had nothing to do with eating disorders.  I needed to purge myself of the eating disorder identity (every pun intended).

I am not sure I could have recovered if I had kept up close ties with everyone from treatment.  The people I maintained contact with were people I would have been friends with if we had met in a class or on the subway or at a coffee shop.  The eating disorder just happened to be this unfortunate coincidence that we shared.  AND all of these friends also wanted recovery, so we were able to support and encourage each other in a positive direction.  If we bitched about a bad day, the response was more along the lines of “What can you do to turn it around?” than “Ugh, me, too.”  We called each other out on things we saw that weren’t recovery focused.  I still have a couple of friends do the same for me.  Recently I wanted to take a break from therapy, and one friend questioned my motivation for that and asked if it would, in all honesty, be a good idea.  And after journaling on the topic, I realized she was on to something.

Does it sound cruel to do what I’m suggesting?  Keeping friends who are actively pursuing recovery and not maintaining friendships with those who aren’t?  I repeat something I’ve said before: Protect your own recovery at all costs.

After a year of self-enforced exile, I returned to the online eating disorder community.  And I still maintain online friendships with people who are at all stages of recovery, even those who say they don’t want recovery.  I know what it’s like to have people give up on me and walk away, and to say it hurts is an understatement.  Now that I am strong enough, I will not be that person who walks away.  Neither will I be the false, cheery voice that only says, “You can do it, hun, hang in there.”  I am not afraid to ask questions and to push someone in the direction of recovery.

But I know myself right now, and know that I am not triggered by pictures or comments or numbers or people going in and out of treatment.  I could not say that when I first started on the road to recovery, hence my friendships with recovery-minded people who would not trigger me.  Know your triggers, and if something/someone is triggering you and you are having a difficult time staying on-course, there is nothing wrong with taking a step back from that group or from that friend.  When you are more solid in your own recovery, then, if you want, you can return and help others.  If you are still triggered, then that is not the role for you.  Your recovery is your number one priority.  Do not compromise it, do not put it in danger.  If talking to others or posting on forums helps you, then keep that up.

Know yourself.  Know your triggers and take steps to avoid them whenever possible.  Your life is on the line.

April 27, 2011 Posted by | Communication, Eating Disorders, recovery, relationships | , , , , , , , , , , , , , , , , , , , | 1 Comment

Healthy Addictions

my healthy addiction

“Addiction” has a negative connotation.  We think drugs and alcohol when we hear the word “addiction.”  For those of us in the eating disorder world, we’re told our eating disorder is an addiction.  For some of us, self-harm can be an addiction.

Letting go of an addiction is not as easy as just stopping.  If it were, there’d be no need for hospitals and residential treatment facilities.  We’d all just stop and be cured.  Wouldn’t that be nice?  But letting go of the eating disorder or self-harm, or any addiction, leaves a giant gaping hole in our lives.  That hole often drives us back to the very thing we tried to leave.

My suggestion (and it’s not really mine, the experts came up with it long ago): find something to replace the eating disorder and the self-harm.  In DBT-lingo, we call this “distract” with ACCEPTS.  Sounds easy, but there’s a slight problem: generally the thing we’re giving up is much much larger than the one thing we pick up to replace it, still resulting in a gaping hole.  A hole that’s slightly smaller than before, but still a hole.  And holes leave us feeling empty and hollow and quite crappy.

So my real suggestion is to find multiple addictions to replace what you’re giving up.  Here are mine:

knitting, crocheting, writing, reading, writing people letters, drawing, taking pictures

Right now, knitting and crocheting are my main addictions.  I always have multiple projects going because I have Yarn ADD.  Currently I’m working on an afghan (the very first one I’m making for me; I’ve always made them to give away), three different hats (I’m also addicted to hats), washcloths and hats to donate to various places, potholders, and a scarf.  There’s probably a couple other projects buried in the bottom of my basket that I’ve forgotten about, too.

The nice thing about knitting and crocheting, for me, is that it keeps my hands busy.  When I get urges to self-injure, keeping my hands busy is rather important.  And I feel good about myself if I’m working on a project for someone else.  And knitting and crocheting are things I can take pride in. And writing letters to people also keeps my hands busy and I love that I’m going to make someone smile when they open their mailbox.  I know I get this huge smile on my face when I get snail mail.  When I was recovering from the eating disorder, knitting and crocheting and writing letters were things I could do after I ate, when my stomach felt ugly-full and I felt awful.  The knitting and crocheting and writing letters took my mind off of those thoughts and feelings and kept me distracted until my stomach digested the food and settled down.

Taking pictures gets me out of the house, outside where I can breathe fresh air and see fresh things and take wonder in the amazing world around me.  Right now, flowers are starting to poke through the soil and peek out at the sun. Trees are starting to bud.  The air is getting warmer and the squirrels are more active and run in front of my floor length window and drive my cats absolutely crazy.

I would love for people to leave a comment here–not on facebook, because not everyone who reads this goes to facebook–with your healthy addictions.  I know that some of us are recovered and exercise has once again become a healthy form of release, but please keep in mind that for a great number of people reading this, that is not the case.  Try to leave suggestions that anyone at any stage of recovery could engage in.  Maybe, just maybe, someone will see something and think, “That sounds like fun; I could do that.”

And I dare each one of you to try one of these things or something you’ve always meant to try but never got around to.  Just one thing when you’re feeling stressed and anxious.  And if that one thing doesn’t work, try a different one next time.  Keep trying things until you find something that works for you.

Happy addiction hunting, y’all.

March 29, 2011 Posted by | coping, Eating Disorders, recovery, self harm | , , , , , , , , , , , , , , , , , , , , , | 5 Comments

Full Catastrophe Living

Full Catastrophe Living by Jon Kabat-Zinn, Ph.D.

In 1999, I was a patient at New York Hospital’s Dialectical Behavioral Therapy (DBT) Program.  DBT, developed by Marsha Linehan, Ph.D., for people with Borderline Personality Disorder and problems with self-harm, has four components: Emotion Regulation, Distress Tolerance, Mindfulness, and Interpersonal Effectiveness.  It was a three-month program that, literally, changed my life.  I fully embraced the Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness modules.  I did the homework for the Mindfulness component, but really didn’t believe in it and had absolutely no intention of continuing it after I left the program.  This is  called willfulness.

Jon Kabat-Zinn, Ph.D., is the author of Wherever You Go, There You Are, Full Catastrophe Living, and other books.  Mindfulness is an important part of Buddhist philosophy.  Kabat-Zinn adapted mindfulness in his stress reduction program and Linehan adapted mindfulness for her work with Borderline patients.  Anything that involved sitting still, staying in the moment, being aware of your thoughts and emotions–without trying to change them–all of that rubbed me the wrong way.  It sounded well and good, but it didn’t come naturally for me.  And if it didn’t come naturally for me at the time, I rejected it.

Well, the time is twelve years later.  And, lo and behold, I am working with another DBT therapist.  Except this time, I will grudgingly admit that mindfulness could be quite beneficial for me.  It still doesn’t come easily.  I still fight it.  But if you look at my Kindle, you’ll see Wherever You Go, There You Are as one of my books, there for anytime I feel like taking a few moments and, well, appreciating the moment.  Or learning to appreciate the moment.  And I also own Full Catastrophe Living, a book my therapist recommended to help me manage everything that comes along with this wonderful cardiac diagnosis of mine and all the lifestyle changes I have had to make.

Here are some words from Kabat-Zinn about “catastrophe” (and they might  not be what you expect.  at least they surprised me):  . . . ever since I first heard it, I have felt the phrase “the full catastrophe” captures something positive (?!?!?!?!?!?!) about the human spirit’s ability to come to grips with what is most difficult in life and to find within it the room to grow in strength and wisdom.  For me, facing the full catastrophe means finding and coming to terms with what is most human in ourselves.  /   “Catastrophe” here does not mean disaster. (?!?!?!?!?!?!) Rather it means the poignant enormity of our life experience.  It includes crises and disasters but also all the little things that go wrong and that add up.  The phrase reminds us that life is always in flux, that everything we think is permanent is actually only temporary and constantly changing.

He goes on to explain that “the full catastrophe” includes what we term “positive” and “thrilling.”  Full Catastrophe Living developed from his eight-week long Stress Reduction & Relaxation Program at the University of Massachusetts Medical Center.  They believe that mental and emotional factors have a great deal to do with your physical health and ask their participants to practice mindfulness every day, six days a week for eight weeks.  The testimonials from some of the patients are amazing.

I admit I need this.  I also realize that I am now at a stage where I am willing to welcome this practice into my life.  Hence reading the book.  Hence taking a class called “mindful writing” even though I am withdrawing from the PhD program.  Hence me making a commitment to myself —and not any program or professional–to bring mindfulness practice into my life.  I have no idea what this is going to look like yet.  But I do know that I admire the people I know who do make it a part of their lives.

I’m not saying that I’m going to celebrate having a heart that is, literally, slowing dying.  That would, I believe, qualify me as insane.  But I do want to learn to be aware of what is going on in the moment, and to appreciate what is going on in the moment.  To not try to force things to go differently (that gets quite tiring, by the way).

A reporter once remarked to Kabat-Zinn in trying to understand mindfulness: “Oh, you mean to live for the moment.” His response was, “No, it isn’t that. That has a hedonistic ring to it.  I mean to live in the moment.”

This is quite a challenge.  There are a lot of moments I’d like to do away with.  And I spend a lot of time thinking about future moments, moments that must be better than the current one.  But guess what?  I can’t do away with the current moment.  It’s here.  Whether or not I like it.  Whether or not I like it is totally irrelevant.  And all that time spent thinking about the future?  That gets exhausting.  And, really, I have no idea what the future is going to bring.

So I’m giving this mindfulness program a shot.  I know I will complain.  I know there will be resistance.  I know it will be difficult.  But I’m hoping that when I’m done, I’ll be able to write a testimonial like the ones I read in the introduction and first chapter of this book.  So here’s to a couple of months of doing something I never thought I’d be willing to do.  Without anyone forcing me to do so.  See–miracles can happen.

March 2, 2011 Posted by | bipolar disorder, coping, death, depression, Eating Disorders, mindfulness | , , , , , , , , , , , , , , , , , , | Leave a comment