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.

Wednesday, September 9, 2009

Long weekend update

so the long weekend pretty much dragged here, but i guess that was to be expected. i didn't have anything on saturday as far as passes so that day was by far, the most boring. but on sunday there was an outing to johnny rockets for the girls on caf group and then i had an afternoon snack pass that day too.

i was not looking forward to the outing because johnny rockets pretty much sucks and i had just gone there on pass. and honestly, why would you take a bunch of girls with an eating disorder to a burger place? i looked at the menu before and decided to get the tuna salad sandwich, which is something i can get here at the hospital so that's another reason i was mad we went to johnny rockets. however, there was a huge challenge which was getting something that appropriate in place of the chips i usually get at lunch. my options were pretty much french fries or onion rings, neither of which i was enthused about at all--also needed some more vegetable because the one piece of lettuce on the sandwich was not cutting it for the vegetable exchange. i talked to the staff to see if either of those would be acceptable and after talking to one of the girls i decided onion rings were less scary for some reason. it also helped that i wasn't the only one eating them because another girl who gets chips at lunch split the order with me. i also had to get a caloric beverage, so i got orange soda. i didn't know i only had to drink 8oz though so i ended up drinking 16 probably before i noticed that no one else was drinking more. for dessert we all went to mrs.fields and i got a sugar cookie with sprinkles. i was feeling pretty awful about the onion rings, so i knew pass was going to be extremely hard because of that and because of the fact that the outing and my pass were on the same day. the outing was supposed to be on saturday so i planned my pass for sunday so they WOULDNT be on the same day, but when the outing got moved, that kind of put a wrench in my plans. also, the person i was going with i knew would make my pass difficult and the bad body image intensified by wearing a risk shirt wasn't helping.

as soon as i got back to the hospital my ride was here to leave for pass so i left right away. we went to harvard square, walked around a bit, he got lunch and i contemplated whether i wanted to eat or not. i knew i should though because last time i went with him i didn't at all. my team would be mad, and i was already in the shitter with them and then id have to report back to one of my really supportive friends that i didn't eat and i just couldn't do that. since it was afternoon snack i settled on a smoothie...definitely still restricted since it was 14oz and fat free and my usual snack here is one cheese stick, 4oz of juice and 8oz of ensure. but at least i ate something this time! baby steps, right?

monday was ok. i had another pass planned with my parents for lunch. i was once again having bad body image again but i forced myself to wear a risk shirt again. i was in a crappy mood from the body image so i wasn't the most pleasant on pass. we went to this place called "fresh city" and i got vegetable and tofu stir fry over brown rice with teriyaki sauce. of course i restricted again--i didn't get my caloric beverage, my dessert and im not sure if i ate enough rice. i was feeling reallly full for some reason from breakfast so lunch was really hard even with all that restricting. snack was hard too that day and dinner was incredibly hard also. im not sure why my body was being so difficult.

i was feeling really awful that night and i was seriously contemplating stopping eating. so i went up to the nurse and asked her what would happen if i said i wasn't going to eat anymore. she said they would probably evaluate me for safety and then probably discharge me if i really was going to refuse to eat. i REALLY wanted to do this, but then i decided once again that i couldn't face that friend i have here if i did that AND if insurance didn't approve me for more time here i'd be going home anyway so i could wait another day. also, that friend was going to be leaving on wednesday so i could wait till then too if insurance did approve me.

yesterday was alright. i was anxious all day for my insurance review. turns out they were able to get me another week in residential and they made it quite clear that they want me to go on partial too, but i guess the insurance company said they would review again next tuesday. im not sure if they'll ask for more time in residential or just for partial. it depends if im in my range or not. so i guess that was good, well its probably for the best anyway.

i had family therapy yesterday as well as individual therapy. both went ok i guess. i also met with the psychologist that does body image work with the girls here. it was semi-helpful but body image isn't exactly something that changes to easily, i so still really doubt.

today was pretty good as far as mood goes. for some reason i wasn't thinking too negatively, which is always good. i had another therapy session which i say was ok, but my therapist says was good, so i guess it was good. i just felt like i talked about something completely different from the normal so that was odd.

there were a couple of jarring incidences on the unit today. well, yesterday i was in one of the bathrooms and i smelt vomit and i saw in the sink that what looked like reminisce of vomit was there and also on the rim of the toilet. i alerted one of the nurses just so she could be aware. this morning at the end of treatment planning that same nurse made an announcement that the cleaning lady found vomit in one of the trashcan on the unit. she passed around papers so that we could write our name down on the paper and if we were guilty or not. if no one confessed then we would all be on bathroom/shower supervision again--not a big deal to me since i am back on it again. then later on, i was sitting in a chair in front of the nurses station and i smelt something like vomit. so i looked around the chair and then finally behind it, and sure enough there was vomit behind the chair! i told the nurse and she had it cleaned up by the cleaning lady--tough job. the girl who was purging came forward. it was actually one of my roommates too. how ironic that we both got caught for purging?

sadly, one of the girls who i got really close to, especially in the last few days over the long weekend, left today--about 45 mins ago. im very sad to see her go, but im really hopeful for her. she is the smartest 15 year old i have ever met. she has already achieved so much and i know she will only continue to do great things. she often feels like a disappointment for coming back to treatment for a second time because her parents expected her to be cured after the first time. but unfortunately, this illness does not work like that at all. she is just such an amazing person and she has been a enormous source of support for me. it was really sad to see her go, but i am so happy for her, for all that she will achieve. but i cant deny the fact that it will be hard to cope here without her and without her support and encouragement. she would never let me get down on myself, push me to challenge myself, and help me think more positively.

in the past week about 10 girls have left the unit and a few new girls have come in and we are supposed to be getting one tomorrow. there has been a huge shift in the community. there is only one girl here now who has been here longer than me so it feels odd to still be here. people that came here after me and have been with me for most of this journey are now gone. i don't want to be here anymore and to have all those who were here to experience so much with me makes it that much harder to still have to be here. and to think that i have at least another week in residential and 2-3 weeks on partial only serves to sadden me more. these are certainly hard times.

i don't feel like i am close to anyone here anymore or that i will get close to anyone in the time i have left. everyday is still incredibly hard and life after treatment still isn't looking up.

"You don't have to act crazy anymore. We all know you were good at that. Now retire my dear from all that hard work you do. Of bringing pain to your sweet eyes and heart." --Hafiz

Friday, September 4, 2009

IMPORTANT updates

A LOT has happened in the past few days. it all started the other day when my therapist switched the time she was meeting with me at from 4pm to 11am. she said we needed to talk about some decisions we are going to have to make. when she took me in she talked to me about how im using treatment here and such and that on tuesday, there is a review for insurance. basically, insurance doesn't want to pay for me to be here in residential anymore so we needed to set up a plan as to what we were going to do. should my team appeal to keep me here for a couple more weeks--since im not in my range--or should they just step me down to partial here or at butler, or do i not want to do partial. this was quite a shocker and not a decision i thought i would have to make yet, since im not even in my range yet and you usually don't even think about partial until you are in your range and on a maintenance meal plan.

my therapist sort of made it seem like i was being kicked out though because she talked about my passes and how i don't really use them to help my treatment so it seemed like she was saying, if you aren't going to use the time you have in treatment right, then is it even worth it to appeal for you to get more time here? honestly i just want to go home, well not home, but leave here. i know im going back to my ED and i hate having to gain weight and eat ALL day. i have the highest meal plan of all the girls here, yet i am the biggest one and they're trying to get me to the biggest weight ive ever been in my entire life. that just doesn't make sense to do to some one with an ED. that's not very conducive to recovery.

but anyway,yesterday my therapist came up to me with my family therapist and the nurse on staff and told me she wanted to check-in. i knew this couldn't be anything good if it involved ALL of them. so we went in her office, quite cramped for four people, and she started off by saying, "so basically we wanted to talk to you because since last thursday your weight has plateaued and we want to know if there is anything we should do to help you with behaviors or whatever you might be struggling with with this." i pretty much knew what this could be attributed to...not getting all the food i need on pass, exercising, and the couple of purging episodes i had. i once again told them about the exercise and then i told them about the purging. i told them i did it on pass--but really i did it here when i got back from pass--and they asked if that was the only time. here i paused because i knew i was already in trouble with one time but if i admitted to doing it twice, then i knew what the "punishment" would be. but, i ended up telling them. so then the hard part came. decision time. "what can we do to help you with these struggles?" i love that. help. its not help. i don't want help. its just an annoyance.

first question: are we locking your room to help you with the exercise. no. ok, we are going to keep it locked now.
second question: honestly, what do we do about bathroom supervision? honestly, if my room is locked what i use to purge would be in there so i cant purge. what do you use? a toothbrush because i finger doesn't work. right, but you can go out on pass and buy a toothbrush and put it in your pocket so we wouldn't find it when we check your purse. ok, so why bother asking me then if you aren't going to listen to what i have to say. it's not that we aren't listening, alyssa, we just want to help you; were putting you back on bathroom supervision at least through the long weekend then we'll reevaluate tuesday.
third question: so what do you want to do about the pass. i don't care--staring at the floor now, not even giving a shit as to what will happen. do you want us to make a decision? i don't care, whatever. ok well why don't we keep the pass for now.

great. awesome. i cried, of course. i was angry, of course. but not so much that they took the privileges away, that i really don't care that much about. its the whole idea that i don't want to be helped because i think its pointless and the fact that they STILL keep pushing and caring really pisses me off. this is how i always work when people start to care. i don't want any of it. there is a lot more to it. but that is the basic premise. my team knows how i feel so they get that this is the same dynamic that plays out with my parents, which they find to be very "interesting" since it is now happening with them.

so that made yesterday kinda of suck, EXCEPT for my pass. i was pretty pissed and was just wanting to do anything to piss my team off, so i decided that i was going to walk to the bus stop instead of taking the shuttle. when christie got here we dilly dallied for a bit before we left, took a couple of shots of vodka--OOPS! AGAINST THE RULES--and then began our 20 min walk. i had a bad feeling that one of the CRCs would be on break and would see me, but i didn't give a shit. i knew what i was doing and i was doing it for a reason. to get in trouble in hopes that my team would really get through my actions, that I DONT GIVE A SHIT ANYMORE.

so of course, as i was walking out of the hospital entrance, i see a car and look in side and it was one of the CRCs on duty. i just laughed and continued on. christie and i stopped at a park and swung on the swings for a bit and talked. then we decided to continue back on to the bus stop to where the dukin donuts and basking robins is. i checked my phone and there was a missed call from a restricted number and a voice mail...wonder who that could be?

so i listened to it and my suspicions were confirmed. the message: "hi alyssa, its the CRC from klarman. i was on break and, oops! i saw two girls walking to waverly place. do yourself a favor and do us a favor and take the shuttle when you come back." i tried calling them but couldn't get through so i continued on with the rest of my plan to get my snack.

it took me about 20 mins to decide what i wanted...this attracted the attention of some asian dude who said, "is it really that hard to pick ice cream?" to which i replied under my breath, "actually, when you have an eating disorder it IS that hard to pick ice cream." im not even going to go through the struggle i had over that but let me just summarize by saying there were many voices and things being yelled at me in my head, to which i compromised with in the end. i didn't eat all of my snack but that was because they switched our evening and afternoon snack yesterday, so i was paranoid about not eating the right things and the right amount.

christie and i just chilled for a bit then we went back to the shuttle stop and threw some rocks at the passing trains and waited for the shuttle to come get us. when i got back to the hospital i had to face the music. i came up with a good lie. that i thought it was ok to walk since it only took 20 mins and im on walk group and that is a 20 min walk so i thought it was fine. the CRC said "well that is walk GROUP, you are supervised." to which i replied, "well i went on a walk with my parents yesterday when they came to visit," and she said i shouldn't have but the nurse that said i could do that was right behind her and she said that she said i could. so the CRC said, "ok so you really thought it was ok to walk?" and i said ya, and she said, "well you are suppose to take the shuttle so take it next time" and i told her next time i would. settled.

SO, today. i had four meetings which is a lot. i met with my psychiatrist first, then my family therapist whom i did not talk to at all about my family, but just more about where i am with everything and my anger toward my team, then my therapist, which was a strange meeting, but she told my family therapist that it went well, so i guess it went well? and then i met again with my family therapist, but this time the meeting was triggered by a phone call put into her from my mom.

basically my mom called for a few things but the foremost thing was how she has noticed "marks" on my wrist. i knew this was bound to happen some time. so my family therapist wanted to know what i was ok with her telling my mom. i really don't want to talk to my parents about this. this, over all things, is NOT something they would ever understand. not many people can understand this behavior unless you use it. basically, we decided that she would call back and say that my team is aware of this and that it is something i have worked on a little in therapy but that its not something i am comfortable with discussing right now. as if i didn't have enough on my plate already. there is just A LOT going on and A LOT going through my head. this only added to it.

these days are incredibly stressful. im still finding way to get some exercise in, though the means are a bit more inconvenient now. but im fighting against this process as much as i can. the only thing i still value is the therapy, but if i want the therapy i HAVE to do the other part; there are some strings attached. hopefully insurance will kick me out tuesday so that i wont have to make much of a decision.

oh, just wanted to share something funny that happened in therapy. my therapist said, "alyssa, you truly are a fascinating person," to which i replied, "ya, to a psychologist." there was really no reply to that.

"Part of the problem with the word disabilities is that it immediately suggests an inability to see or hear or walked or do other things that many of us take for granted. But what of people who can't feel? Or talk about their feelings? Or manage their feelings in constructive ways? What of people who aren't able to form close and strong relationships? And people who cannot find fulfillment in their lives, or those who have lost hope, who live in disappointment and bitterness and find in life no joy, no love? These, it seems to me, are the real disabilities." --Mr. Rogers

Tuesday, September 1, 2009

An unfortunate event

the past couple of days have shown no change as far as my motivation and body image.

family therapy went better yesterday, but i still am reluctant towards the whole thing. bottom line is that im not ready to give up my anger. i feel like if i let it go then i'll forget, and so will everyone else, that i was so unhappy. i feel by letting the anger go that i am invalidating that feeling for myself. im so used to living with anger, i don't really know how to function any other way and at this point im not sure that id want to since it is comfortable and it is what i know. good emotions such as happiness just scare me to death. i don't know how to handle those emotions nor can i imagine a life where those emotions are part of my life. anger has been my comfort, besides me ED, the one thing i can fall back on to be there. in some ways it serves as an excuse for some of my actions and reactions, but most of all it serves as a reason to have my ED. if i let my anger go, then i feel like i'll be expected to let go of my ED too and im just not ready for that yet.

i put in a pass request for a dinner/snack pass with my parents and brother yesterday. i was really hoping they would deny me since i did so poorly on friday, but part of me knew they would give it to me since i was going to be with my parents and i did well with them before. i even wrote, "id be fine if you just give me dinner or snack if you think dinner/snack would be too hard. i know either way it's going to be difficult so...and if my family meeting goes poorly, i'm not going." so i tried to give them a reason not to approve me; i was almost begging them. but alas, they approved me for dinner/snack, and of course, my family meeting had to go ok. so there was no backing down.

we went to the rain forest cafe. i primarily went there because i heard it was a cool place and had never been, but also because it is a very distracting place which i thought might make things easier for me as far as getting out of my head was concerned. i already pretty much knew i was going to restrict, but not too badly. i only ended up not getting my third starch and a caloric beverage, i probably didn't have enough vegetables, but that's not a big deal.

i was very anxious about having to eat in front of my mom, dad, AND brother. i was totally beginning to zone out during the end of our family session because i was in my head thinking about having to eat and how awful i was going to feel. this feeling didn't go away during the car ride, once we got to the restaurant, while looking at the menus, while ordering, or while waiting for our food. surprisingly, ordering wasn't too difficult. i wasn't too worried about taste because i knew i wouldn't taste the meal anyway.

when the food came and everyone had their plate in front of them, only then did i feel semi-ok, but that was only because i was beginning to disconnect. the mechanical part of me took over and allowed me to eat. i ate slowly though of course and with some ED behaviors. i had a wrap, which is always particularly difficult for me to not eat without ED behaviors present. the way i eat a wrap is just incredibly EDed. my third starch actually conveniently came with my meal--potato chips--but i wouldn't eat them. there were a few reasons for this 1.) because i decided before i got there that i wasn't going to eat my third starch 2.) i cant remember the last time i ate chips in front of my mom and i would have felt like a fat pig for eating them, even if i only ate them for the sake of following my meal plan 3.) if i ate them, then that would mean i ate my entire meal and the only other person who didn't leave anything on their plate was my dad. to do the same thing would have meant i was like my dad, and my dad is rather large...i would not have been able to handle all that. but mostly, the whole eating them in front of my mom was the major issue for me that really was the deciding factor to not eat them, and the fact that she left basically half her meal uneaten.

after dinner we walked around the mall and shopped for a while. i got a shirt and some bermuda shorts. both fit me and i am comfortable in both. i was very reluctant to try on pants because im not sure if my size will stay the same and no sense in wasting money. i only tried on shirts that would hide my "refeeding belly." it was ok, but a rather depressing and anxiety provoking experience.

i was hoping i would get off the hook for snack, but alas, once again, my family remembered. we went to hagaan daas and all got some sort of ice cream-ish dessert--except my dad but that was fine, he doesn't really bother me too much with that stuff. it took me a really long time to decide what kind of ice cream i wanted--my ED was yelling at me a lot--or if i should restrict more and go with the sorbet, the smoothies, or even just a yogurt parfait--my ED was yelling at me about this too. somehow i decided to get cookies n' cream ice cream. i think i remembered how my mom used to get that kind for us a lot when we were younger so i decided based on that.

i ate it slowly--though i was the first one to get my snack, i finished it last, and quite a while after everyone else was done; ED. i hated eating this in front of my family too. i felt huge and embarrassed. it had been a long time since i last ate ice cream in front of them, not counting the other time on pass. when sat down in the car, feeling my stomach made me sick. i felt uncomfortably full, and then the idea came in my head to purge. the internal conflict began.

once i got back to the hospital, i talked to the CRC about how it went but all i could think about was purging. i was very anxious and really couldn't focus on the conversation. when it was time for bathrooms to open i got my stuff to clean my face and brush my teeth and went into the bathroom. i purged.

when it was time to fill out my pass return and i got to the question "did you purge?" i really didn't know what to say. i have always been very honest on my pass returns and i already had answered "yes" to "did you restrict?" i stared at the paper for a good five minutes and then decided to be honest. i replied with, "yes--a little." which was not a lie. at this point, i feel like my team knows where im at and doesn't really get affected when i write on my pass returns that i restrict so to add this too it didn't really seem like something that would phase them too much.

consequently though, i had rather bad body image from the moment i woke up and i was thinking about the night before and what i did. breakfast and lunch were ok. i felt full after both, but particularly after lunch this feeling of fullness was accompanied by even worse body image.

the rest of the day was rather uneventful. i had no meetings today, only groups.

dinner was fine as far as me eating goes...it generally is fine since i disconnect. however, the incident that occurred did not make dinner so easy towards the end.

a girl that i really respect made it pretty clear when there were 3 minutes left to dinner that she wasn't going to finish eating since she had half of her meal left. a couple of her friends tried to encourage her but she just kept joking, acting like nothing was wrong. they said to her that she was going to have to replace and she said she wasn't going to drink it--which she could refuse to do since she is not medically compromised. when time was up, she booked it out of there to call her therapist to see if she could leave, avoiding the whole replacing thing altogether.

myself and her two friends were rather upset by this especially after she was on warning today since she hadn't eaten much of anything all weekend during her stay on another unit AND since i saw her replacing for her lunch today. i told one of the girls that im worried about her and she replied that she thinks shes trying to get a head start on her ED. this was not a comforting thought at all.

then in post meal, when it was her turn to talk about her day she said how it went and how dinner when and her reason for not finishing was that this weekend on the other unit, she proved to herself that her body really doesn't need that much food. to hear that was EXTREMELY triggering and upsetting. this is a girl who i greatly respect and really held in high esteem. to see her basically fall apart after this weekend was just a huge blow. i looked up to her as a role model. there had been sooo many times where ive wanted to not eat, not finish meal, or not eat on passes, BUT i always--except on passes--ate or finished because i always worried what this girl would think or say. she has a tendency to give people the third degree for not finishing so for her to not finish and then continue to joke and not worry at all about how she was affecting anyone else was just a huge slap in the face.

mostly though i am just sad and worried for her. im worried because these are not good signs at all. im worried because she is the type of person who lets something get in her head and then she becomes overpowered by it; she cannot fight it. im worried because i really fear that she will go back to her ED once again. but most of all im sad. im sad because she is such a great, beautiful, smart, and compassionate girl who cannot see how much she is valued by others and cannot value her own life. im sad because she seems to have made the choice to go back to her ED

ever since last night the idea of purging has been in my head. after the incident at dinner, i decided once again to purge. once it was time for the bathrooms to be unlocked after dinner, i purged. im not sure yet if i plan on doing this after snack too. i don't think i will tell my therapist. i don't really know what im doing right now.

im still engaging in another ED behavior too. one that most people know about but one that i haven't been able to stop.

all i do know is that im fighting like hell to keep my ED and i am trying to make it clear to everyone that this is not over for me yet by any means.

"You may have to fight a battle more than once to win it."