Monday, December 7, 2009

Some passages for thought

quotes from the book "Tales from the Scale"

and the more years that pass by, the more adverse i am to buying in to the notion that food is bad. that food, in face, is something to fear. global warming is something to fear. losing you job is something to fear. having your leg shorn off by an errant buzz saw is something to fear. I've yet to see any conclusive evidence to prove to me that a hamburger or two is going to do as much damage as any of these things could. i suppose it is my distaste for treating food like it is an instrument of the devil, and subsequently the culture perpetuating this idea, that accounts for my weight problems as an adult.
you mean i am really less of a person because im eating this slice of cake? explain to me how if i decide to eat a bowl of potato chips, this behavior means i possess little to no self-esteem. how is it that i am doomed to an eternity filled with no one to love me and a sadness the likes of which humankind has never known if i order the crab rangoon from my favorite Chinese carryout joint?

according to the diet lore, "indulging" or "giving in to temptation" is a "sin." strangling a few people is a sin. invading east timor is a sin. ethnic cleansing is a sin. testing nuclear weapons in the pacific is a sin. im sorry, but eating doesnt quite make the grade." --Kaz Cooke, Real Gorgeous

i dont think i'll ever conquer my inner fat girl; i just have to learn to manage her presence. shes like an irritating old friend that you never really liked. somehow shes got hold of your number and she insists on calling you now and then, just to remind you shes still alive.
you can listen to her ramble for a while--as long as you know when to say, shut up, and slam down the phone.

im starting to come to the conclusion that my fat girl may just be around for good.
but im also beginning to have some peace with her. though, now she is only a part of me. instead of dictating my every move, holding me hostage, my fat girl is much like the family member who never lets you forget where you came from no matter how successful you become.

i dont know if its possible, after shes (fat girl) lived in my head more than 25 years, to ever completely get rid of her. i can always feel her hovering nearby, waiting to judge me and what i eat ("ugh, salad? no fun!"). radiating disapproval when i decide to do forty minute on the elliptical trainer instead of thirty, or putting on a shirt that comes close to fitting instead of being three sizes too big.
one would think that with weight loss would come a quieting of her voice, but it seems that she doesnt care what i actually weigh. ive lost 125 pounds? she doesnt care. she doesnt care about the reality, just what she decided years ago is the truth, and she wants to yell her truth from the mountaintop.

we are so focused on numbers. in the weight-loss world, we cannot escape them. we measure our body fat. we feel judged by our clothing size. there are the inches around our waists and necks and calves to be tallied. and there is the number on the scale, the supreme number that rules all.
these numbers in and of themselves dont mean a whole lot. after all, they are just that: numbers. they are arbitrary digests that fluctuate and change and differ from person to person...
...yet what does all this tell you about me, really? does this give you a picture of who i really am? does this tell you that im a democrat or a republican? do these numbers indicate whether or not i have children? can you tell if i volunteer or donate to charity? do you know what car i drive?

anyone who has an ED will surely see the correlation between the struggles with being over weight and the struggles with an ED, especially when it comes to the "fat girl" voice which is just as malicious as the ED voice.

as I was on the second to last chapter, i came across a sentence that one of the contributers to the book wrote which i found quite bothersome. it read:"I always wished for bulimia or anorexia--one of those weight problems that results in fashionably thin malnutrition. at least it doesnt show on the outside, at least not in the way overeating does." now anyone who says the wish for an ED is not only mental, but completely insensitive and ignorant especially when they wish to have an ED so they can be thin. when i read this i immediately had the urge to write to the contributer and tell her off, but then i realized how immature that would be. i was just wondering if this bothers anyone else the way it does me and if anyone thinks i should go ahead and write the contributer--but in a kind, mature way. leave me some comments and let me know what you all think.

Saturday, December 5, 2009

Tales from the Scale

don't worry, this post doesn't sound as bad as it's title...that's just the name of a book i've been reading. i know the name sounds pretty much like an ED book and the book really isn't meant to be that way, but of course that's the way i'm reading it. however, it is actually about obese people and their struggles to loose weight. ya, i probably shouldn't be reading it. but anyway, i'm about halfway through and i've found some pretty interesting quotes that i think are important to think about when us people with EDs judge our self worth and live our lives according to a number on the scale or the foods we eat and their contents. and, come to find out, there are a lot of struggles that people who are overweight go through that are similar to the ones people with EDs struggle with. i just wanted to bring this book up because as i continue to read i keep folding over pages, marking the places i want to go back to so that i can find the passages i think are valuable to all who struggle with body image=self worth. so sometime in the near future i'll have a post with all these passages in it.

in my last post i talked about an interview i was going to do with my psychiatrist from treatment at harvard med school. i was suprisingly not as nervous as i thought i would be. i listened to her lecture about EDs, which i basically knew all the information in since i do have an ED and then at the end of that it was my turn. i was in a ampitheater, so the semi circle, of steep, staggard seats filled with brilliant medical students was a bit intimidating to say the least. AND to top it all off, i had to wear one of those little clip on microphones just to ensure (ha, i will never say or write that word without thinking about the "nutritional suppliment") that all could hear me. i just kept reassuring myself that the students genuinely wanted to hear me speak and learn from me and that they were in no way going to judge me for anything. dr.d sat right next to me and i basically looked at her for most of the interview so it eventually felt like we were meeting in her office just discussing the normal things we do. i became comfortable quickly and the experience became enjoyable.

after a while the floor was then opened up to the students to ask me some questions. i didn't exactly know that that was part of what i signed up for but i figured i could handle it at that point. i wasn't so comfortable with having command of who could ask me the next question and pointing them out, but i managed. after this was over my job was done. dr.d and some other guy who was running the whol shindig said i did a great job, which felt good to hear. i was getting ready to leave and a couple students asked if i would mind them asking me some more questions. i agreed so i spend about another 20 minutes doing that. AND to top it all off, the students got me a thank you card AND a starbucks gift card. how did they know people with EDs LOVE coffee?

overall it was a great experience, one that i didn't think i would enjoy so much. i really do feel like if i'm going to have such a shitty illness then why not at least help educate those who could potentially treat people with EDs and help them understand the complexitites and the actual thinking of people with EDs. and as a sidenote, my friend who is back in treatment :( was talking to dr. d in her meeting and as dr. d likes to do, she was asking who she was close with in treatment last time and she said my name and she said how i told her i was doing an interview with her that week to which dr. d responded that i was less nervous than her and that i performed brilliantly. i feel like i'm boasting but it just feels really nice to get such praise and complements and to know that maybe i actually did help the students understand more about this illness. of course the cynic in me is still struggling with trying to accept this feedback, but i'm trying to ignore that voice and take the feedback for what it is.

but, on the ED front. i'm really not doing well at all. i can feel it getting really strong, like heading in the direction of how it was in the summer. when i got out of treatment last time exercise was fairly easy to cut down on. this time, i've been out for 10 days and have exercised 7 of those days and recently 4 days in a row. i know that once i start this spiral it really can't be stopped. missing one day now would cause me to not be able to think about anything else for the whole day. exercise has once again become a way for me to justify while i still eat (barely). the only good thing is that i'm still doing considerablly less exercise than i was doing in the summer as far as time goes, but even this i know won't last long as today i increased by five minutes and i know the increases will just keep compounding. this is bad and i know it won't lead to anything good. i have also gone to the grocery store (sometimes two different ones in one day) everyday for the past 4 days, not to mention the other days i did it since i've been home. i go down the isles, with no intention of buying anything, and look at the nutrition facts of various foods. some to see what i might consider eating and others just to confirm why i don't eat those foods. it's bad.

i have quite the dilemma at hand because yesterday at my dr's appt, i asked at what weight he would force me to go back in to tx and it was not a weight that i expected. however, if my vitals start to get shitty, then that'll get me back in sooner. i've been blacking out when i stand up so i know things are not good. yesterday my heart rate jumped up 10 points and my bp when down when i stood up. still, that doesn't reach the criteria for being orthostatic, but i know it's coming. anyway, the dilemma. i want to go to school in janurary, but, with how i'm doing, and judging by the direction i'm heading in, things are not looking so good. my doc said he was fine with me going to school and that he would do everything in his power to keep me in school once there, but i'm worried that i might not even make it to school. my next appt is the 21st and i will most likely be at that weight that he'll want me back in treatment. so you say, then just eat more and stop going to the gym, but if it were that simple, then i'd be recovered and clearly i'm not. i can't just go over my daily calorie intact that i have established and feel ok about it. even one calorie over and i feel disgusted with myself and feel compelled to restrict the next day and exercise more to make up for it. so there in lies the dilemma, oh, not to mention i might have a job in the next few days and that'll only mean i'll be more active which means quicker weight loss making my goal of going to school seem even more impossilbe.

there are ways to sort of work the system, as far as weight goes, which i do employ, so that'll by me more time. but as i loose more weight more drastic measures will be needed and that deception can only get me so far because believe it or not, weight loss becomes noticable and when the number on the scale doesn't compute with appearance, a doctor is generally smart enough to know that something fishy (ha, the name of a site about EDs) is going on. but even more telling are my vitals and bloodwork which are the things most affected by malnutrition, so even if my doctor gives me the benefit of the doubt when it comes to the number on the scale, there will be no denying what my vitals and blood work say. of course there are ways to manipulate this too, but i'm not so sure it'll work out so well.

so breifly, i've got some shit to work out. yes i want to go to school, but badly enough to eat more? at this point i'm pretty sure that the answer to that is a no. do i want to go back to treatment yet again? no. do i want to stay out of treatment buy doing the one thing that will up my odds of staying out (eating)? the answer to that question is not a definite no, but almost.

i hope no one else in the world gets and ED. it really does ruin lives and makes everything that used to be important, unimportant. school used to be the most important thing to me, and now my ED is so important that i might just not go back to school so i can be very activly engaged in my ED. recovery does not seem an option at all right now, and by acknowledging that, i also need to acknowledge that that closes a lot of doors for me. i still have the distorted thought that all things are possible with a severe ED. i do doubt it more than i used to but i still think i'm fairly capable of doing many of the things that were once important to me and still have my ED, at least holding a job and going to school. other things may suffer, such as my social life, but i'm not so sure how much that actually matters to me now too. my life has changed dramatically and so have i.

EDIT: i just remembered some thing funny i had to say. so when i was at my therapist's office on friday she said to me "you look like you're having trouble eating." i replied with "ya" but what i really wanted to say was "of course i'm having trouble eating; i'm anorexic!"

Tuesday, December 1, 2009

Trying to start up again

so much for posting while i was in treatment.

this post might be triggering for some...these a lot of ED thinking in the end...

i came home from treatment on wednesday...lucky me, just in time for thanksgiving. needless to say i was quite anxious for thanksgiving and for the extended family that was coming to my house for the holiday, but really, i had no one to blame because i'm the one who wanted to leave treatment and i'm the one who chose to leave on wednesday rather than friday.

thanksgiving is probably one of the worst holidays for a person with an ED. yes, most holidays include some sort of feast, but at least the feast is only a component of the holiday and not the sole focus of the holiday. the dietitian at treatment ran a group and talked to us about thanksgiving and said that it is a day where everyone as an ED. the accepted practice on thanksgiving is to starve yourself all day so that you can over-stuff yourself at one meal. but for those of us that have EDs and have been to treatment, it is just another day where we eat all our meals and follow our meal plan, we just have a bit more choice when it comes to our dinner because of the plethora of food offered at the thanksgiving feast. for me though, it was not just another day where i follow my MP. it was my first full day out of treatment--which did not help me one bit this time--which means it was my opportunity to once again engage in my ED. My plan was not to eat with my family but to just basically hide all day, which i succeeded at until my mom came down and asked if i was going to come sit with everyone. i told her i really didn't want to because i knew i'd have like nothing on my plate and everyone would look at me. she said that no one was going to say anything which lead me to believe she already alerted everyone to how hard this day was going to be for me. so i ended up going up stairs and putting some stuff on my plate and ate with my family. that's all i had to get through, because not eating dessert was a given.

since thanksgiving i've been busy redoing my room. lots of painting, moving furniture and cleaning.

i've gone shopping a few times--of course on black friday--and have spotted some places that are hiring for the season, one of which is Michael's. I filled out their application last night.

i had my first OP appt yesterday and don't have anymore until friday. i'm not sure if i'm going to stick with doing OP this time.

while i was in treatment my psychiatrist asked me if i wanted to do and interview with her. i sceptically agreed and then she told me it was in front of 200 med students at Harvard Med school. i got crazy anxiety just thinking about it. i asked who else she was going to ask and she said no one and then i asked why do you want me to do it and she told me because she thinks i do a good job with the interview process. i don't really believe her. i feel like she had no other choice but to ask me, but maybe that is just me being cynical. needless today, that day has come. the interview is at 4pm today but she is giving a lecture at 3pm which i want to go to. i guess this will be a good opportunity; to help educate prospective doctors about EDs. i guess if i'm going to have an ED i might as well do something useful with it.

a quick update of how i'm doing with food...BAD. basically the same as i was doing when i got out of treatment last time. something that is good is that when i went shopping with my mom, i got a tad bit more variety than last time but everything i got did have to follow a strict set of rules to qualify for me to eat them. i'm a bit overwhelmed right now though because i feel like i have too much food in the house that is for me and i feel like i need to eat it all right away which obviously isn't going to happen. i have this fear that it's all going to go bad and i hate wasting food. but i also know that this is a distortion because all the food i bought are non-perishables and the ones that aren't don't expire for a few weeks and those are the things i'm eating first. but still, i have this anxiety around that and it just won't leave until all the food is gone. but, once all the food is gone then i start to freak out that i have no food or that i'm low on food. it's just a loose-loose situation. oh, and i bought some jelly belly jelly beans...why??? i have no idea. in case i wanted to indulge? even though if i had one serving size of them i basically wouldn't be able to eat anything more for the day according to my rules. that means i'll probably have to eat like one a day just for a little taste. ahhhhhhh!

Saturday, October 24, 2009

It's been a while

I know, I know. it has been a very long time since I last posted. There was just way too much stuff going on in the last few weeks of treatment that I couldn't even begin to think of where on earth to start with everything.

I was discharged from treatment on October 5th. I was not at all ready to go which I think I made quite clear to my team and staff--after I was readmitted into residential after a week on partial because I fell out of my range, was loosing weight, and went on a bit of a hunger strike. I hadn't even gotten down to a real maintenance MP before I left. I had family therapy the day I left and I openly admitted that I didn't even know if I was going to eat dinner that night, which I did not. Basically since I've been out I have been restricting more than I ever have before, only eating "dinner." One good thing is that I have cut down on the gym a LOT but I guess maybe that's not so good because I have been compensating by restricting more. With my intake the way it is, I lost weight. Quite a bit in three weeks time. My PCP visits all showed that--even though I did manipulate the scale by wearing ankle weights so even my doc doesn't know how much weight I've really lost--and the labs that I had done also confirmed malnutrition and my declining health. Also, in the last week I developed a rash and when my doc looked at it this week he confirmed it as shingles. Just another sign that I have a crap immune system because of what I'm doing to my body.

My doc told me on Tuesday that he called treatment to see if they would take me back and they agreed so long as I don't treat the place as just a place were they feed me. They also requested that I make a list of how treatment would be different for me this time which I expected because my therapist told me they would ask me for this if I ever needed to come back. My doc really wanted me to go on Thursday but I convinced him to let me stay this weekend and go on Monday so that I could work on the list with my therapist and because I didn't want to go on the weekend when there are no clinicians AND I might as well add that I was trying to avoid one of the resident's birthdays which is tomorow so that I wouldn't have to eat cake at snack. Let's just hope they don't postpone the cake until Monday.

The list (worked on by my therapist and myself):
1. I want to work a LOT more on my traumas--affects social functioning
2. I want to be able to have a longer time on a maintenance MP so I can get used to what normal eating is before I leave and have to do it for myself.
3. I need to have more defined plans for passes--food and activities I will eat/do.
4. I want to challenge myself more at caf--not eat so many safe foods and actually try getting what I want instead of what my ED tells me--INCREDIBLY HARD!
5. Examine relationships--ones that are safe/unsafe and figure out how to handle them.
6. Explore whether there are any other way to work on social aspect--ways to expand social network--ways to engage in regular social situations.
7. Plan ahead for volunteer work/job/classes after discharge.
8. Much more specific planning by me for discharge to provide more structure when out of treatment.
And just a note from my therapist: Alyssa feels she's going back to K in a different place--ED isn't working in the way it used to.

That's probably the most notable thing I think. My ED is definitely not doing the same thing for me that it used to. Before it came so naturally and i got a thrill and a high out of it. Now it's more of a constant struggle to maintain it everyday. It's not so enjoyable anymore. Don't get me wrong, I still do get something out of it and every time I see that number on the scale go down I become more addicted to wanting to lose more, but it's just not the same. One girl at treatment told me that for her, going back to her ED just wasn't the same. She says it's like a drug attic, always chasing the first high. After you've been in treatment it's just not that way. I remembered that and I have come to see that that is very true.

My ED has also been changed by treatment. There were certain foods that I lived on before I went into treatment and I was even able to still eat some meals that my mom made. But now, those foods that were once safe I cannot eat, which is rather bothersome since that was mostly fruits and vegetables. I have only eaten one crab apple sized apple since I've been home and even that was a huge struggle and guilt trip afterwards. I have only been eating greek yogurt, dannon light and fit, and cottage cheese since I've been home. I've also gotten waaaay slower at eating and I take incredibly small bites now. I never had a huge problem with those things before I went to treatment--I mean I was always a slow eater, but not as slow as I am not--but now it's just ridiculous. I'm not sure how I'm going to handle that when I go back seeing as it takes me about 30 mins to eat a yogurt or a cup of cottage cheese and at treatment you have a half hour to eat a whole meal.

I must say my relationship between my parents and I has gotten a lot better and I think it's important that I was able to see that with my time home. I wasn't sure how it was going to feel or if I would like it, but I have to say it hasn't been all that bad. I don't think I mind it.

It was also important that I got to see that my ED is not doing the same thing as it used to. This has put me in a different place. I feel that this time in treatment, with my definite list of things I want to work on, that I am more willing to work. I think this time I might actually give recovery a try or at least hold on to the thought of it.

"We must be willing to let go of the life we had planned so as to have the life that is waiting for us." --E.M. Forester

Friday, September 18, 2009

Overload

this honestly makes no sense. why the hell am i being made to stay here longer when nothing is helping me. i have already made my choice as to what im going to do regarding my ED when i leave here and i am very invested in keeping my life the same in all the other ways as far as my thinking goes. a lot has happened in the past few days and im seriously coming to my wits end. let me list the things:

1.) wednesday my therapist told me that basically insurance gave them an ultimatum and that i had the choice to go on partial either that night or thursday night. i knew that if i waited until thursday all that was doing is postponing the inevitable and would only cause me to suffer another day of anxiety.

2.) in that same session i told my therapist about a thought that has been in my head a lot more often and she had my sign a safety contract which basically said i would ask for help when unsafe, and that i wouldn't do certain other behaviors.

3.) also in that session my team "strongly recommended" that i have another meeting with my parents to discuss these harmful behaviors i take part in because i have said many times i cant always be responsible for myself so they felt my parents need to know about these things so that they can look out for when im struggling.

4.) went on partial that night...didn't eat snack, but family things went better than expected.

5.) thursday my family therapist met with me at about 9:30 and decided to tell me at that point that my family was coming in for a family meeting at 10. thanks for the notice. the meeting went ok, though it was incredibly difficult to talk to my parents about some things that i never ever intended to tell them. my family therapist did help me out a lot in the meeting. thank god.

6.) partial again...no snack. AND i showed my parents the contract that my therapist made up for me. it went well but my mom asked at one point if i would discuss some of the "tips for self care" that my therapist tailor made for me. i responded by essentially saying no because those are things that i discuss in therapy and don't really want to share in any more detail than what they already had read.

7.) the dietitian told me my meal plan might go down on sunday, but then the nurse told her that i don't eat my evening snack so then that pretty much squashed that idea. she told me that if i fall out of my range they wont let me leave and all that crap, so i told her id drink and ensure that night. i even shook on it...i didn't drink it.

8.) early therapy session yesterday. this one went ok.

9.) 11 o'clock meeting with psychiatrist in which she began with a rapid fire of questions. one of them i answered "yes" to which caused there to be further questions. after revealing what i had to her, the rest of the session was difficult and i was once again totally in my head. not too much got through to me in that session.

10.) during the one o'clock group, after we had just started, my therapist walked into the group room and gave me the finger...she wanted to meet with me. so i went into her room and she told me she wanted to see if i could take a day off this weekend. i REALLY did not want to but she told me i sort of have to for insurance reasons and that also i needed to get an appointment with my prospective outpatient therapist for before wednesday. the pressure was certainly being put on me. as far as the day off, if i had to take one i decided to take sunday off because that is the day of the outing to bertucci's and if i could get out of that then i certainly was going to, even though my therapist said i should take saturday off so i could go to the outing, but i really didn't care what she had to say because she was making me take the day off in the first place so i was going to do what i wanted.

11.) before the 2 o'clock group, my family therapist asked if i could talk to her. i replied with quite a reluctant "i guess." she said, "i know seems like you cant get a break today, huh?" that's for sure. she said it was only going to take two minutes but when she told me what she wanted to talk to me about, the conversation ended up being about 40 minutes and mostly consisted of me refusing to look at her and say much of anything. she told me that she had to tell my parents about some information i told my therapist and psychiatrist. i know it is a legal obligation that she tell them, but still, this did not make my situation any easier. i was not looking forward to going home that night.

12.) at 4:40 my outpatient therapist called me and i was able to make an appt for this tuesday with her. i went to my therapist to let her know that i was able to get an appt and she then asked me if i wanted to check in with her since she was planning on checking in with me before she left. i agreed and she said we would talk until about 5, but as usual, the season went longer until 5:20. this session was a pretty pivotal one. my therapist needed to know with a "yes" or "no" answer if i was going to be able to keep myself safe this weekend. for most of the session i only replied with an "i don't know" and didn't say much of anything to her. when she kept pressing for a more definite answer she said, "look it's friday afternoon and i need to know if you can keep yourself safe. if you can't or if you can only tell me i don't know, then i might need to consider sending you to the CEC for an evaluation for a longer inpatient stay. do i need to do that?" i knew exactly what that meant and i did not want that, so i said she didn't need to do that. then she went on to tell me a lot of really important things that really resonated with me. she told me that the reason she wrote me the contract was so that i could have something to take with me and read to create a safe place for myself and that the contract represents a relationship--the one between her and i--and if i valued anything about the relationship at all, then i would follow the contract. she also told me, as she has before, that she will be thinking of me over the weekend and though she will not physically be with me that her thoughts are with me and if i choose to, i can allow her words to be with me over the weekend to help guide me. she also told me that the choice i am tempted to make is NOT a solution to any problems and it is not something that can be undone. it is a way of quitting on life, and she does not picture me as a quitter. but the most powerful thing she said to me was "alyssa, i know how much pain you are in and how much you are suffering. i know. you don't need to show it anymore by harming yourself and making it a reality for you. tears a real too. they are reality."

13.) i journaled after this to help me process that session. though the things sounded great in the moment and though i did assure her that i would stay safe this weekend, i was still unable to really believe any of the things she said to me.

14.) partial again...no snack and went on a 30 minute or so walk.

15.) saturday was nothing too special. my day was going ok until the 3 o'clock therapy group. at one point, the topic of discussion turned toward me. at the end of the discussion around my issues, i was left totally in my head and in not the best place to have to be going home that night. after this group was yoga. this helped a bit but then i journaled after and got to thinking again.

16.) partial. no snack. went on a 30 min walk/run. my mom came in my room later that night and asked if she could lay on my bed with me while i journaled. i said she could. this situation was awkward but at the same time, comforting. i felt like the parent and her the child, a complete role reversal. i know that this was her way of just trying to be with me without being too forceful, which is why she asked if it was ok, so i understood the intention and i appreciate that she asked because that is not something i am too comfortable with, but at the same time, the fact that my mom knew she had to ask to be with me was jarring. it sort of allowed me to see what ive done to her, as far as making her feel on-edge around her own daughter. i do feel bad, but at the same time, it's how i am about all that and i didn't just wake up being that way.

that's basically the run-down. not really as brief as most run downs go. but quickly. i had a day off today. i was quite anxious for it. meals were hard. i definitely restricted and will probably be on warning tomorrow. as far as how the day went...i went to church with my parents and my anxiety was pretty much through the roof the whole time because i was worried about seeing people and all i could think about was how different i was last time i was in church over 2 months ago. my parents and i went to my lakehouse and went for a 2 hour LEISURELY walk around the lake and went for a nice boat ride. the whole day i felt very odd, like i had no idea who i was or what was going on. i felt like 12 year old, but im 19. i guess that's what my therapist meant when she asked me how old i feel. it's really jarring to think that i am no way near 19 mentally and emotionally though my biological age says i am.

sorry, no quote today.

Tuesday, September 15, 2009

The good mood ran out

So. As expected. the good mood thing ended after five days in a row of good moodness. sunday night i started to get really down and then it all went downhill from there.

yesterday was pretty tough because my psychiatrist met with me as soon as all the clinicians got out of rounds, and since my psychiatrist NEVER meets with me on a monday like that, i had a bad feeling. i was right. i sort of, but not really, got in trouble for this habit that i have that my team just found out about. i say "sort of" because you don't really ever get "in trouble" per say in treatment. you just get talked to and advised about things and the actions that you team do from there are to "help" you, never to "punish." but anyway, that happened. also, the issue of insurance was brought up again and my psychiatrist said that insurance may very well say they are done paying, even for partial. so ill make it clear that i do not want to be here in treatment, however, nor do i want to be home. it doesn't really matter where i go, i'll still have my ED, but at home is where EVERYTHING is just so much more intense. i hate home for SO many reasons and when i left the appointment all i could think about was home and the idea of possibly having to go straight home, no partial as a transition to make it a little more bearable. after that appointment i sat i front of the nursing station silently crying and thinking A LOT.

then my family therapist came up to me and told me how her and my therapist were going to do a joint meeting with me at 1, but that she was going to come in around 1:15 because she had something to do first. i pretty much knew this couldn't mean anything good either. at this point i was having a lot of anxiety and was seriously considering not going to caf and staying back and not eating lunch and refusing to replace. however, i knew that if i was already in some crap with my team that that would not help, nor would it help my mood at all or get me out of my head. so i went to caf, but was incredibly anxious the whole time not only from my meeting with my psychiatrist, but because of the upcoming meeting and the fact that i was eating.

after lunch and after we all filled out our mood monitors we got our pass requests back from rounds. mine said: "see therapist. could you consider going home for a dinner pass to eat with your family and brother in preparation for PHP." as soon as i read that i reacted quite strongly and went into the day room, lied out on the couch, and started crying. i was not ready for that at all. even the thought of having to spend an hour or two at home was something i couldn't handle, how in god's name would i handle going back altogether??? when i realized the time, pulled myself together in preparation for the joint meeting.

i headed to my therapist's office and we began and of course the "how are you doing question" was asked and i responded "not that good," which i thought was quite obvious from my red puffy eyes but apparently she couldn't tell. so i told her why and as soon as i talked about the pass request form and what they had written i began crying again. not even 2 minutes into the session and i was crying. amazing. THEN as if things couldn't get better, there was a knock on the door and it was my family therapist. "looks like i came in at a difficult time," she says. i'd say. "we just started," said my therapist. "yea we just started and i'm already crying," said i. it was comical to me for some reason, but sucked all the same. basically the whole session was spent on talking about going home and how incredibly difficult it will be for me and what it will mean. then my therapist asked if she could switch gears just a little bit, and of course i was completely agreeable with that. and then they talked to me about the same thing my psychiatrist talked to me about which was really what they intended to talk to me about from the start, but i did a wonderful job of delaying that issue. but it was talked about and not too much came of it.

i gave into a urge after this. i probably should have told my therapist today about it, but oh well.

my family therapy session went ok. basically we talked about going home and how scary that is for me and all that. i cried some more. then i had a pass with my family and brother. it was better than expected, as far as my mood. i restricted as usual. got a couple of pants which im not too sure about yet, it was a pretty difficult thing to do and im not sure if ill regret the decision later on down the road. it was the last time i saw my brother before he leaves for germany tomorrow.

so the rest of the day and basically all of today i was really anxious, awaiting the insurance company's decision. everyone made the reality of the situation very clear to me so i had an idea of what could happen.

i had a session with my therapist again today at 2 and this one was going ok, but then towards the end somehow we got on the topic of the power that i have and how i use it as an abusive power and how that could hurt other people and myself. i was in my head most of the session and at one point she asked me for some feed back and i told her i was in my head and she said, "i know that's why im asking you to come out of it." i don't know what i was thinking with the answer i gave her. obviously she could tell i was in my head and she wanted me to tell her what was going on up there. so i basically told her that i am afraid. and she asked of what. so i told her of what i would do with my power. and she said to who. and i told her...myself.

then the rest is some pretty heavy stuff, but then snack was called. saved by the bell! but of course, since i opened up a can of worms that couldn't just be let go, so my therapist asked me to come back after snack so we could follow up. so i went, ate snack and went back. long story short, i ended up staying in there for about another 45 minutes. i guess what happened in that extra time was necessary, but it still doesn't make anything easier for me. but she told me she is concerned for me and that maybe i need her to be concerned about me. i forgot what i said to that but im pretty sure she replied with something like "well you cant control that," basically the usual response.

then we had group. and guess what? the girl that usually runs group wasn't here today so my therapist filled in. a whole 3 hours with my therapist today. good thing i like her.

dinner was immensely hard today and this was one of those times where once again i seriously considered not eating snack or anything after dinner from now on. of course the fact that one of the girls didn't finish her dinner and then sat with her ensure and didn't replace, didn't help anything. i had a strong urge to purger since last time i had this meal and felt the same way after i did, but i didnt this time. but at least i did accomplish my treatment goal for today of writing my aunt a little letter about how her letter was pretty unhelpful. i had one of the CRCs read it and she agreed that i went about it in a very respectable manner and that i said just enough to make my point when i could have said sooo much more.

so, insurance never got back to my team today, so im here for at least tonight. i guess i'll have to sit with this anxiety for a bit longer before i can find out what is going to happen with my life. all i know is im scared shitless.

"It is possible to move a mountain by carrying away small stones." --Chinese Proverb

Saturday, September 12, 2009

A good mood?

so this is the fourth day in a row that ive been in a fairly good mood which is a very odd and uncomfortable thing for me. i keep reaching for something negative to get mad at so i can be in a crappy mood. its whats familiar to me and to not feel that way is very confusing and feels wrong. i know people are probably thinking, "why would you want to purposely make yourself feel bad?" but the fact is i strive on stress and negativity. i know how convoluted my thinking is, but its how i think. don't judge.

there hasnt really been anything bad that has happened lately, except the fact that my aunt sent me a rather very unhelpful letter. ive thought about the letter a lot and i even spent time in therapy discussing it and practicing how i would talk to her about it--which i will probably never do--and basically what i came up with was this, "i know that you care about me and that you are trying to support me and thats why you wrote the letter. however, i felt that my eating disorder was only understood as being completely about vanity and not feeling as though im 'thin' enough and so i 'starve myself to death' so i can be thin and be the envy of those around me. though wanting to be thin is a part of it, my eating disorder is much more than that. it is about years and years of supressed feelings and issues that i have not dealt with which have now manifested themselves as an eating disorder. i really do appreciate you trying to help me, i felt like i was being preached to, when what i really need is just to know that people are there for me if i need them." so the general idea of the letter was basicallly about vanity and i just felt like i was being called vain, which is really not the case as i just said. i think its important though to quote one line that was EXTREMELY unhelpful: "so my recommendation for you, from me, from Dr.Judy--let it be known that she is not actually a doctor, this is just sarcasm--is that you should maintain a weight of about 112-115 lbs. anything other than that i will find unacceptable. for anyone who ever talks to anyone that they know has an eating disorder, PLEASE, PLEASE, PLEASE, do not tell them how much they should weigh.

yesterday i had a rather good therapy session where i was able to talk more about how convoluted, distorted and twisted my thinking is. this doesnt just go for how i view myself and others physcially, but just my thinking in general. at the end of the session my therapist and i somehow ended up having a heart to heart. she said once again that i am a truly great person to get to know, and that she isnt just saying that because she is a therapist (i thought that comment i made to her last time was never going to be alluded to. i was wrong). i didnt really say too much here because i really didnt know what to say. i just kept looking down then at her every now and again. she then asked if that was difficult to hear and i told her it was and that i still dont really believe it and that its hard to not look at her out of the role of a therapist. and she then said that the truth is that she likes being with me. then she covered her mouth and laughed and said i shouldnt have said that. i cant really describe what i felt in that moment. obviously it felt good to hear, especially because i do feel a connection with her and really do like talking to her because she is the one person i can tell anything to without being judged and that is a truly amazing thing to experience. then she continued on saying, "well it is true. and it doesnt happen with everyone." once again it was really hard to believe this so i told her that and then said its just really hard to not look at all this just being said because she is a therapist and thats the only reason she finds me interesting. to this she said, "well i am a person too with feelings and you dont have much control over how i experience our time together." then we just talked a little and the session ended with her saying that she hopes that pending insurance stuff, that we have at least a week or two more together. i became really somber and genuinely sad at this point. i sort of felt a rush of emotion come over me and tears almost came to my eyes, but i didnt want her to know how much i really dont want to end therapy with her. i began thinking about the new prospective therapist i have lined up and how therapy wont be the same and how much i appreciate my therapist now. i dont know that i can ever express that appreciation and sentiment fully. im pretty sure she sense my emotions--shes good at that since it is her job--and she asked if i was alright. i said yea, and then the session ended because she had to run the next group.

before i went in that group i saw one of the girls making a sign for a new person coming in. it was 2 o'clock so it was odd that a sign was being made then since new admits always come in at 10 in the morning and rarely on a friday. i saw the name and then recongnized it immediately and the CRC said that i knew her. i knew who it was and it was a girl who had just left here about a month and a half ago. that pretty much bummed me out. it sucks so much to hear about people who arent doing well and then especially to have someone come back that was here with me before. it struck me later when i was thinking how i always hope so much for other people and want them to do well, yet i dont give a shit about me, at all. and im fine with that. i WANT everyone else to do well and recover, and i want to suffer. i have no real desire to end my suffering with my ED, at least not the way everyone else wants me to.

i applied for a pass yesterday before rounds and also for 18+ walks. after lunch i got the request back and my team wrote: "you are approved for dinner/snack pass tonight but we cannot approve you for anymore priviledges until you demonstrate 100% MP compliance on passes and until you completely stop exercising." so basically that means i wont be getting anymore privileges while here. my therapist asked me about what they wrote and i told her exactly that. she sort of chuckled and said alright then and that they decided that they werent just going to give me privileges but actually make me work for them. perhaps if i cared enough about the privileges then i would do what they say i need to do to get them, but i dont, so thats that.

so i went on pass last night with my best friend and we went to dinner and then the mall and had snack there. as always i restricted. we went to chili's. no need to know what i restricted, not really much different than normal, except that i think this time i got my third starch, so that was an improvement at least. BUT snack sort of ruined it all because i got a small mint chocolate chip ice cream, which was definitely not near the caloric value of my evening snack. i went to CVS to see if they had any yummy ensure i could add on, but they didnt have any different flavors than they have here so i decided to not to that. but its the thought that counts!

i had a lot of fun on my pass last night. i made out with some shirts and a couple other things ;) i laughed a lot. talked a lot. got lost on the way back here on some scary ass road. but i had a great time. i think ive honestly had some of the most fun times ever on these passes with my dear, dear friends. i havent been able to do that in a long time since my ED took over and being with friends, and then enjoying myself with them was essentially impossible. but still, this, dear i say it, happiness, is something that is very unfamiliar and uncomfortable to me. looking back at it now i feel guilty for having a good time and am and mad that i wasnt unhappy. im addicted to unhappiness and negativity. once again, anything other than those emotions just feels wrong to me.

today was nothing special. we had an outing to TGIF which was rather stressful for me. picking out my item wasnt too bad, but once again i had to get something that would be somewhat equivalent to chips, so i got fries, but at least this time i was able to get sweet potato fries, so it wasnt AS bad. the drink i ordered was not at all what i expected and the dessert was a whole different issue. i kept asking the CRC how much i should drink of my drink, how much i should eat of my fries and how much of the two scoops of ice cream that i ended up getting, that i should eat. i told her how i was really paranoid and freaking out about this and she said that its fine but she much rather have me deciding how much i should be eating, on my own. though i probably only needed to eat one scoop of ice cream to be equivalent to a normal dessert at lunch, i decided to eat both because everyone else got way higher calorie desserts so i felt like i would get in trouble for restricting if i didnt eat it all. it sucked, a lot. and i felt really guilty and wasnt really able to enjoy any of the food, as usual. but i did ask the nurse how long till i get in my range and she told me probably 4-5 days, SOOO at least it will only get me there faster and then my meal plan can start going down! thank the lord!

instead of a quote, i have a link that i think you should check out. its from a book im reading that my grandmother got me. it talks about the pain-body, something that i feel i truly have and helps explain a possible theory as to why i, and other people, thrive on negativity.