Saturday, 31 October 2015

Dispelling illusions

A spooky thing has happened. I was in therapy the other day, immersed in conversation, and I accidentally referred to the eating disorder as 'she'. I'd never done that before. It had always felt like a vaguely masculine presence - sort of alien-like and distant. Then I looked over at the empty chair opposite me and saw her slouched there. And she was me. She wore the same clothes as I was that day; her hair in the same messy bun. It stopped me in my tracks.

Rationally, I've always known that the eating disorder was my own construction. There's been no zombie takeover or demonic possession of my brain. The voice of anorexia was clearly coming from within, but I didn't feel like it belonged to me. I thought of it as a malevolent force I had to fight and defeat. But when I saw her(me). sitting there, looking vulnerable (and more than a little sheepish) I understood that it was me - or at least, part of me. In that moment, for the first time, I owned the disorder.

When I made the recognition, my first instinct was to punch her(me). I felt shocked and betrayed. It's me? It's me?! How could you do this, you evil cow?! But the feeling was fleeting, and sadness took its place. I felt sorry for her(me) (OK I'll just say her or she from now, even though it's me... it's getting confusing). She - the eating disorder - is the embodiment of the things I had learned in my life that were wrong. She's defective, and has done an awful lot of damage. But she exists for a very good reason. In fact, she has done excellent work, helping me cope through a turbulent time.

If I were to list her attributes, it would make for a good job application: Her work is of a high standard, she's persistent, hardworking, means well and always tries her best. She is ingenious and adaptable. But then I'd rubber stamp it with this: DANGER! KEEP CLEAR!!. On no account do you want to employ this girl... she's wired to self destruct, and she'll take anyone who's close by down with her.

If I accept the eating disorder is truly part of me, it means I have to accept all the thought distortions - the hateful judgements and dysmorphic illusions, are in fact mine. Though the external environment has to be 'right' for an eating disorder to flourish, it is me that gives it life. I am responsible for it, yet it isn't my fault. My sub-conscious is the driving force behind it. There is no rationality involved - no choice. To make a choice, there has to be at least one viable alternative. When I took this path, I'd exhausted all my internal resources. The eating disorder was my only option according to my mental capacities at the time. I'm trying very hard to make a different choice now, but I'm struggling to knock down what I have constructed.

It's difficult to take ownership of this stuff. The warped thoughts fly in direct opposition to everything I want to believe (and do believe when I am healthy). My 'crazy' has got, well, really crazy.




I am going to try and set myself straight. What follows is a list of some of the distortions. They come right from the heart of the disorder, but they are (unfortunately) part of my belief system.

Distortion
I look much better with bones protruding. Healthy flesh looks disgusting on me.

Reality
I am unable to judge what looks good and what doesn't. My perception is all off. I know that I used to feel fine with more coverage. I also know that I look a lot older without my skin filled like it ought to be. It doesn't feel good to have exposed bones when my children prod them and question me. I would hate to see any of them with ribs or hip bones sticking out. Good health looks beautiful on everyone else, so why not me?
*
Distortion
Sign of 'womanliness' are starting to return. The curves look revolting and I want to rip them off.

Reality
The truth is, the absence of  womanliness was a key motivating factor in halting my weight loss. I used to have - for want of a better expression - a decent rack. And it felt good. Boobs are cool. There's nothing cool about having the body of a child with the face of a 42 year woman. I felt ashamed.

*
Distortion
Being thin was everything it is supposed to be: fabulous! fun!, easy! I miss it (now that I'm ginormous)

Reality
The 'slim persons' wonderland' does not exist. Even if I had something fun to do, like a trip to the beach with the kids, I couldn't enjoy it. My mind was wrapped up in the disorder. I was anxious, cold and had no energy whatsoever. There is no room for anything in life other than the illness. It is agonising and scary. I would really like to have fun again one day, without being shackled to my eating disorder.

*
Disortion
You can wear anything when you are thin. Clothes look better.

Reality
Actually, I avoid clothes shops altogether, because I feel self conscious and confused. No matter what I put on, I felt only disgust. The eating disorder would never let me feel good about my appearance. I'd always be too much of something - too: fat, round, scraggy, womanly, manly, wretched, old, robust, healthy, scrawny, soft, bony, too much of an All Black (I know, it's weird). I can't win. One minute I'm trying to hide chicken legs, the next minute, fat legs. I don't know how it is that I can be too fat and too thin in the same moment, but that's what this disorder would have me believe.

*
Disortion
Everything about me is big and heavy. My organs, ribs, hands, feet and toes. I weigh more than everyone. Big is bad and ugly and being this way makes me a failure.

Reality
The importance of weight and size is massively exaggerated in anorexia. Obviously, I've magnified the significance of it all. I can't trust my judgement right now, or rather, I can trust that my judgement is skewed. The size of a person is irrelevant, and says nothing about their value as a human. Anyone who says otherwise (like the media; the beauty and fashion industry) are wrong. It's bullshit.
*
Disortion
I'm destined to be enormously fat, and I won't ever be able to control myself around food.

Reality
This is an imagined catastrophe - a cognitive distortion, not a fact. I can't predict the future. All-or-nothing thinking is common in someone with an eating disorder, and that's what is happening here. Based on my history and current situation, it's unlikely that my prediction will come true.

*
It is hard to believe I have taken on board so much toxic crap. At least now I recognise the distortions for what they are. Earlier in the year, I don't think I would have acknowledged I had this sort thing going on in my head. Now it's all out in the open, there's nowhere for it to hide. So that's progress.


xx

Sunday, 25 October 2015

The 'B' word, the 'O' word, or just 'HELP'?

I look and feel like a train wreck. I have a swollen salivary gland from purging. It looks like a golf ball is embedded in my cheek. My throat is red, raw and sore, and yet the urge to binge again is intense. One thing is clear: I can't fight this alone. It's too hard.

So I put the call out to my therapist. I said: I need more help more structure more support more tools more skills more knowledge I can't do it by myself I need help I need help I need help. I spend so much time alone. There is nothing to hold me back from doing my worst. It is me battling me, and I'm a nightmare of an adversary.

And so... the ball is rolling. There is one other treatment centre available under the public system where I live (and so free). My therapist is organising a referral for me. It is a small clinic that offers both a residential and a day programme. Whenever this treatment option had been mentioned to me in the past, I thought it sounded perfectly hideous. They have structured, supervised meal times - and no way was I prepared to sign up for that. While it still isn't exactly appealing, I have officially given up restriction (I've had fifteen days free of it!) and I think I could manage it now. Honestly, I'm so desperate to escape from the pool of vomit I am swimming in, that I'd do almost anything.

With the help of my meal plan, I have now clocked up a total of SIX DISORDER FREE DAYS. After more than eighteen months of disordered eating, this is HUGE. I have felt stronger than I have in a very long time. But anorexia was Chief Stress Reliever (and creator) in my life, and now I am now scrambling around lost. Bulimic behaviour has taken it's place.

I'm not happy about it. Bulimia is not 'my disease'. It's shameful, depressing and deeply unattractive. Despite that, I have weird compulsion to talk about it to anyone who's willing to listen. I'd like to get a bloody great loudspeaker and shout from the rooftops 'Do you how much I can eat?! You would not believe it! Buckets of caramel and chocolate and ice cream. Yes folks, and then I vomit! I vomit and vomit and until my throat hurts and my eyes water and I am exhausted and it is nasty!' It's as if 'outing' the behaviour puts it at a distance, and I want it as far away from me as possible. Still, I wont be putting in on my resume.

The way I see it, the labels used for eating disorders are contrived. There is so much cross over from one disorder to the next, that I wonder if there is any point trying to pin a classification to a person. My disorder has been morphing so rapidly lately, I don't know where I fit. In a lot of ways it doesn't matter what label you are given - certainly nobody is chasing after me trying to slap me with a new tag every few weeks. But it is useful when explaining my situation to someone, and helps to organise things in my mind.

The clinical criteria for anorexia and bulimia are specific and very narrow. Aside from these well known disorders, there plenty of delightful variations, including: anorexia binge/purge sub-type, purging disorder, binge eating disorder and OSFED (Other Specified Feeding or Eating Disorder (previously EDNOS)). Orthorexia (an obsession with healthy 'righteous' eating) keeps popping up in the media, but isn't yet officially recognised.

Sometimes your head fits in one category, and your body in another. Eating disorders are classified as a mental illness, so I don't understand why physical markers are relied on so heavily in diagnosis. There were months early on when I was mentally and behaviourally 'anorexic' (I jumped straight into it because of my past history), but my body was a healthy weight. Then I had some time when I was anorexic weight and continued with purely restrictive behaviour. Then I added in some of the binge/purge cycles. Next, I had a period when I was binge eating and not getting rid of the food. And then back to alternating between restriction and binge/purge. Giddying isn't it? Some time around then I would have come up out of the anorexic weight category, but was still underweight. Now, I binge and purge, no restriction, with windows of normal behaviour. Does that make me bulimic? Or anorexic in recovery? (in the same way an alcoholic might always refer to themselves as an alcoholic, even if they have gone twenty years without a drink). I have seen bulimics referred to as 'food addicts', and I don't relate, because I've been addicted to hunger, not food. The urge to binge comes after eighteen months of physical and emotional deprivation, and I think I'm unconsciously driven to restore the imbalance. It could be thought of as part of my recovery, rather than a pathology in its own right.

So where does that leave me, technically speaking? OSFED? Well, no thank you, that label is crap. I'm inventing my own:

"FUCKED UP BUT FIGHTING."

There.

I'll ask the people at the new clinic to treat me for that.







xx




Wednesday, 21 October 2015

I think I can't

I've had two messy, disordered days in a row, and today very nearly became a third.

Thank goodness, I managed to put the brakes on. I did what I often do when I'm desperate - I pulled out my paint and brushes. This is the result:


 

While voices in my head cried I can't, I painted and pondered. I stared at what I had done so long that eventually the words settled inside me and I believed that I could.

Another thing happened that helped me through. A good friend called out of the blue. On her own initiative, she'd dug around and uncovered some resources for people with eating disorders. She had found local support I could access, made phone calls and found new websites that might help me. Her call came right in a moment of despair. It's so hard to pull myself out of the deep when I'm sunk, and her thoughtfulness made me feel so much better. Having someone that cares makes the world of difference.

xx

Friday, 16 October 2015

Trials & triumphs: Week 1 on a meal plan

This week, I have made radical changes. Following a meal plan has made an enormous difference to my behaviour and thinking. Things have been far from perfect (as you'll soon find out) - but still - much, much better. I've recorded each day.

It all began spectacularly well. For all of day one and most of day two, I was on fire. ZERO disordered behaviours. I was positive, clear-headed and full of hope. I wrote a bit about it here. However... after I posted that entry, near the end of day 2, bad things happened. Afterwards, I trudged back to the computer and wrote this:

Day 2 (evening)

What a shame. I've defiled my meal plan. I was feeling all glowy and positive, then boom. Binge. Vomit.

I am not going to catastrophise. Today was still 90% good. Mentally, for almost the whole day, I won the battle, and I'm not going to let that success go. This is bound to be rocky. I'm reporting my digression to keep myself honest. Tomorrow is a new day, and I will show up. I will show up and fight every day until I beat this STUPID eating disorder into submission.

Day 3

Feeling a bit sad about the vomiting last night. Fears crept in overnight: What if it doesn't work? What if I'm still hungry, even with the right amount of food, and I keep binging and purging? That sort of thing. But I'm here. I've had the breakfast I planned, and ticked the boxes I needed to tick.

I have another challenge today. My therapist just texted and told me I had an appointment with my doctor at the clinic. That means one thing - I have to be weighed. Usually, I don't eat or drink anything in the morning before the appointment. Every detail of what I wear is planned in minute detail (my clothes have to be 'light'). This morning I've already had my breakfast and a coffee - it's too late for all that. In a way, I'm glad, because I don't have to choose between my usual disordered behaviours, and my brand spanking new 'good' behaviour. I'm going to weigh more - I know that much, so this time, I've decided I'm not going to look. It won't help me to know, and I don't want to let the eating disorder win by refusing to be weighed.

Day 3 evening

Success! Today I did everything I was supposed to do and nothing I wasn't. At the clinic, I was weighed with my back to the scales, and it felt fine. I need to let go of those numbers if I'm going to recover.

I cannot wrap my head around all the eating - food just keeps on coming. And my stomach feels so bizarre. There are things in it. Weird.

Day 4

Despite eating everything on my plan, I was ravenous all day. If I could just eat one piece of chocolatey caramel goodness (like someone without an eating disorder), that would be okay. But I can't. If I had one, I'd have five, then panic, then vomit, then restrict... and on it would go. For hours I battled urges and won, spurred on the thought: I value my recovery. It's too important to throw away. It gave me strength. But at the end of the day, I was tired and still ridiculously hungry, and I broke. I binged - big time. I broke into a cold sweat and collapsed on the floor with intense stomach pains... then up came all the food.

It's very glamorous, having an eating disorder.

Day 5

Before the day started, I knew things were going to go awry. Hunger and ebbing hope drove me to binge on buckets of chocolate. Before it happened, as I circled around the confectionary isle at the supermarket, I wished there was someone I could call to help me out of the situation. An alcoholic might have an AA sponsor to contact in vulnerable moments, and that's exactly the type of support I needed.

I feel like I am at a pivotal point - I think I'm done with restriction. It's a blinking MIRACLE. I want to recover, but I need to get on top of the binge/purge behaviour before it becomes a deeply embedded habit. I don't know how or where to get the right sort of help.

One good thing: afterwards, I got straight back on the meal plan. I'd usually write off the entire day and I'd be an unholy mess right up until bedtime. Although I felt like I'd let myself down today, it was an achievement to get back on track after my stuff up.

Day 6

I'm so proud of myself! All day, I fought urges and won. I took it the day gently, made few demands of myself and focused. Each time the call to disorder rose its ugly head (every five minutes) I talked myself through, repeating "Make today a good day. Take care of yourself today" over and over again. My hope and positivity have been restored.

I feel GREAT!

Day 7

8am: I'm gunning for two good days in a row. My plan is to keep things really simple again, stay calm, focused and cheer myself on. My kids have gone for the day, and I have written this on my fridge:

20 minute binge
= 45 minutes vomiting
= loss of hope, feeling of failure 
= continued eating disorder

It links the disordered behaviour directly to the consequences. Binging gives me a brief high, or a sort of release, but it is absolutely not worth it.

8pm: Did not make it. Rubbish afternoon. I feel like I would really benefit from being locked up right now, or maybe handcuffed to a post.

The conclusion...

This week there have been ups, downs, and everything in between. Some miracles, a few abysmal failures, and a lot of weirdness.

The tally for the week:
3 x excellent days
2 x good days but bad nights
1 x shit day
1 x really shit day

The most important thing from now on is perseverance.






xx

Monday, 12 October 2015

Words for wobbly moments

The temptation to revert to disordered eating is strong. It's a constant mental battle - at every meal time I fight it, and the hours in between. I needed a quick stop list of reminders to refer to, when I feel the urge to chuck it in. So here are 6 excellent reasons to stick to my meal plan.

  • I value my health.
  • If I binge and vomit or restrict, I will lose hope and feel sad. New disordered habits will form around the plan, and I don't want that to happen.
  • I am taking care of myself, and that's what I want to do.
  • I need to relearn healthy eating behaviours, and to give my body a chance to heal. It's going to take time. Later on, I will be able to eat freely and intuitively, but for now this plan is my stepping stone to recovery.

  • If I fall off the wagon, I don't need to catastrophise. It happens - the important thing is to get back on. I won't wait until the next day - i will get back on the plan at the next meal.
  • I value my recovery. I don't want another year of this shit, so I have to go through this period even though it's uncomfortable. I want to rebel and go back to disorder, but all that would do is drag this process out. It would mean more misery, and I've had enough. It's time to help, rather than punish myself.



    xx

Saturday, 10 October 2015

Tick, tick, tickedy tick

Good news. I am now on the second day of my meal plan. It is a roaring success. That's not to say it's not hard to do - it is. The most difficult thing is resisting the temptation to restrict the food. My head automatically tries to shave off calories, and I have to stop myself from doing that every step of the way. The second hardest thing is resisting the urge to vomit, or binge then vomit. I am eating just enough to keep this particular monster at bay. I do not want to cock it up! All the hope I have of getting rid of my eating disorder is resting on this meal plan (Note to self, just in case: If you have stuffed up, that's OK, people do, just pick it up again the next day.)

I have now drawn up a plan for a full week. That in itself is a major feat - I didn't expect I'd actually do it.

The whole venture is surprising. I surprised at the amount of food I am supposedly allowed to consume. Just when I start to get hungry, I look at the clock, and what do you know? It's time for a snack! And not even a miserable one - it's, like, proper food. It takes the edge off my hunger and keeps my energy up. I'd conveniently forgotten that crucial piece of information: we eat food to fuel our bodies. It keeps us going.

I get it now...!

Something else I hadn't expected - mentally I feel so freaking good. I've got it firmly in my head: I am taking care of myself. It's okay to do that. I can take up more space if I need to (which I do). I'm even ready for the 'You look well' comments. I will say "THANK YOU" and understand it is good, because I am taking care of myself and my efforts are being acknowledged.

WOW. What a turn around.


xx

Thursday, 8 October 2015

An unexpected victory

Guess what I've gone and done?

I've drawn up my own meal plan, and I'm feeling quite pleased with myself. The last few months, I've been wrestling with the idea, but up until yesterday, I really thought it was beyond me. It wasn't a lack of knowledge that prevented me from doing it, but the overwhelming emotion I've attached to food. To do it, I had to detach myself from my anxieties, step out of my eating disorder and leap across a great divide to get at the rational, healthy side of my brain.

It had to be done. On my restriction days, I'm now down to 7 miserable items of food: carrot; apple; piece of frozen bread... The same things, in the same order, at the same time of day. If I'm not doing that, I binge and then spend hours with head stuck down the toilet. It is no way to live.

When I sat down to do the plan, I put on my 'clinician's' hat, and pretended I was doing it for somebody else. That kept the eating disorder beast quiet for a bit (it's actually not as clever as I thought). I could approach it with care, look at what 'the client' needed and make a plan that was safe. I added some challenges and variety, and stuck to the calorie requirements. When I was finished, I had a nutritionally sound eating plan, with none of the wishy-washy, Shrewsberry biscuit nonsense that my dietician had recommended. Better still, it's laid up in a nice tight, colourful grid, with plenty of boxes for me to tick. Exactly what I needed!

How's that for success?

I NEED CHANGE.

Tomorrow, I am doing this plan. That's it.





xx

Friday, 2 October 2015

Meal plan SOS!

I have one word to describe how I feel about the meal plan I received yesterday: DISAPPOINTED. Note the caps, the bold type. Also this: :( 

Still not enough to express my upset.

When I met with the dietician and requested a meal plan, I was as clear as I could be. I said I needed a structured alternative to disordered eating. I didn't want to have to make decisions, so that all I had to do was follow the plan. The most important thing was that it felt safe. We agreed weight maintenance was a good place to start, and spoke about nutritional needs. I hoped the dietician might be able to suggest some things that were a little less bleak than the offerings on my current menu.

To be able to trust the menu plan, I knew I needed specifics. No fist or palm sized servings for me. No, I wanted numbers, grams, cups and inches. Also lines, columns and preferably some arrows if she could find a use for them. The dietician asked me about the sort of things I would be likely to eat. She seemed to get it. It gave me hope.

BIG. LOUD. SIGH.

It didn't happen, and now I'm desperate.




The dietician broke one day into six meals: breakfast, lunch, dinner and three snacks. Under each meal she listed the food group I was supposed to eat, and then one or two examples tacked on at the end. Like this:
 
Breakfast
1 starch + 1 dairy + 1 fruit
Eg. 2 slices of bread with jam, yoghurt and fruit

Afternoon tea
1 snack
Eg. 30 grams nuts

Along with this, there were separate pages with large lists of foods for each food group, that I was supposed to choose from. One of the 'snack' pages had twenty seven options on it. There were eighteen different starches to choose from. And I was meant to go ahead and mix and match.

Yeah, right.

The sheer number of items listed was enough to make my eyes water. I couldn't take it in. Choice is a big problem - that's why I asked for the dieticians help. I needed somebody else to draw up the plan so that I could keep my muddled brain out of the proceedings.

The examples she provided felt like an after thought. I'd expected them to be the basis of the plan, and to have maybe a few days mapped out exactly. She made suggestions on the spot, for instance for a protein, I could have chickpeas. As in, just open a can, and have them plain. I like chickpeas. But, um... isn't there some thought missing? Is this what dieticians usually do?

It was completely unspecific. There was no breakdown of calories or a even a daily total, which is essential for me at the moment. I asked her what it added up to - she didn't know, so did a quick calculation in front of me in less than twenty seconds.

The foods listed were vague as all hell. On the snack page were things like: one average piece of cake; one muesli bar; two cookies. HUH??????? Average? What's that? Which cake? Does it have icing, or chocolate bits? How about I make it my type of average, which is a slither, or none, or the whole cake, and then vomit it up, because I don't know what average is? How does that sound? Which muesli bar? Some brands have 300 calories or more, some a lot less. Which one am I supposed to go for?

As part of dinner, she had listed "2-3 vege", without saying which vegetables. For someone who didn't have a problem with food, this might sound like a reasonable guide, but no way is it adequate for me. A cup of peas has about 125 calories. A cup of tomatoes has about 30 calories. She told me the difference between vegetables didn't really matter. Hello??? I have an eating disorder. IT MATTERS. Why didn't she understand this? Further down the track, I would be trying to let my calorie obsession go. But not now. That's not where I'm at and it wasn't what we'd agreed to. If I couldn't trust the plan, I wouldn't use it. It's as simple as that.

I needed it to be safe, and it wasn't.

Some of the food the dietician recommended confused me. I know the idea with recovery is to restore balance, and I understand that some unhealthy food is fine. To be fair, she couldn't know all my personal preferences, as I'd only met her once before. But there were things on the plan that I wouldn't have expected to be there. There were Shrewsberry biscuits, iced biscuits, flavoured milk and soft drink. It seems strange to me - I'm not a little kid. Commercially made biscuits are rubbish - they have trans fats, food colouring, and flavouring. Potato chips make me feel disgusting when I eat them. I don't understand. I'm looking to fill a nutritional deficit here, not to load my system with empty calories and chemicals.

The other thing is - and this is crucial - I'm trying to convince myself that I deserve nourishment. I'm not going to feel good about putting this shitty food in my body, and never would have. It's not nourishment in my book.

I told the dietician I needed more specifics, so we went through and added some more details - like the type of bread, nuts and fruit. She wrote down the calorie requirement I needed to meet for each meal. The end result was an improvement, but no way was it the air tight plan I needed it to be. I didn't trust her work by that stage. The lack of care put into it made me sad, and I was so disheartened I just wanted to get out of there. I cried all the way home and most the evening.

Healthy me would be able to deal with this situation. I have enough knowledge. I could whip up a concise plan, have it laid out, colour coded and looking pretty in no time. But healthy me is AWOL, and I cannot piece it together. I have so much anxiety attached to food, my brain simply freezes.

I wanted this to work so much, and I feel really let down. The people at my clinic seem to have an aversion to structure, but it's what I need and I tell them over and over again. Eating disorders are their speciality, so why this is hard? My needs surely aren't unusual. I've seen plenty of others in the recovery community (You Tubers) waving their fancy, detailed meal plans about. I want what they have, and I don't know how to get it.



Xx