My first week of clinic is almost done. I’ve done well, impressing my clinical instructor (CI) within a few minutes and continuing to impress her with each day.
Yesterday my CI asked me to work with a patient who’s an avid runner (since I’m also a runner and she figured we’d be a good match). She had me evaluate the patient’s running form and apply the appropriate corrections to help mitigate some of the compensations she’s instituted since pulling her groin. I did some exercises and neurological re-education with her and then we had her hop back on the treadmill to re-assess. You could instantly see an improvement in her form and my CI said, “Wow, great job! I’m just going to give all of my runners to you from now on! You clearly have a lot of knowledge and good instincts on this!” Then she said she wanted me to do my required in-service presentation on treating runners in physical therapy.
Pretty cool, huh?
At virtually any point before early December, a moment like this would have made me burst with pride and excitement. I absolutely love it when I nail something, especially in my career. And to have made such a good impression on my CI within a mere three days would have had me beaming like the damn sun.
But my internal response was a solid “meh”. My external response was absolutely appropriate for the situation. I expressed a perfect display of humble gratitude. But inside I barely broke neutral.
I relayed this story to my therapist later in the day at our session. She asked what I thought was going on and I explained that the main focus in my life right now is food, weight, calories, BMI, pants size, exercise, numbers numbers numbers.
I know there are other things I should care about; other things I do care about, but they feel so far away. Inaccessible. I can’t be bothered to do much that isn’t feeding my obsession with becoming skinny.
She and I have discussed recovery. My shrink and I have discussed recovery now, too. Wife and I talk about it regularly. The people that care about me the most have expressed concern. I’m far enough into this relapse that I should most definitely be considering how I’m going to get myself the fuck out of this hole.
I want it. But I don’t want it at all.
I told my therapist that I hate living this way, but I also hate the idea of changing it. To me, “recovering” means letting go of the obsession, the control, the single-minded focus on achieving skinny. And to let go of that would most definitely mean staying fat or, worse, getting fatter.
Both of which are absolutely non-options to me.
So then I expressed my frustration over how to proceed in therapy. I want to keep coming and I keep showing up. I want to be connected with her. I want to see her and work with her. But I don’t want to let go of this disorder.
She responded by sharing a bit of her own thoughts. She said, “I think I’m feeling a lot of what you feel, and what I imagine you’ve felt throughout most of your life. I’m the helpless victim, right? I’m not really a victim, but that’s the feeling. This sense that I have no choice but to watch you hurt yourself. And it is painful to watch.”
I started to feel guilty. She talked about how distorted my image of myself has become. She reiterated that she thinks I am already thin and I do not need to lose more weight. I pulled my coat over my body to hide it because my skin started to burn. I hate my body. And I hate when people talk about my body.
I told her that I don’t understand why people lie. Why do they tell me I’m not fat? When I look at myself, all I see is fat! She asked why people that care about me would lie about such a thing.
“I don’t know! I don’t know why they would lie and that’s what scares me the most about it.”
She asked me to imagine someone who cared about me AND shared my belief that I need to lose weight. She said she wanted me to imagine someone else because she does not feel that way and she wanted to make a point to remove herself from that distortion. Fair enough.
I imagined such a person. Then she asked me to imagine how they would feel knowing how much I hurt myself in order to lose that weight.
I said, “No, I know! I don’t expect any of you to endorse my behaviors. I’d be upset if anyone that cared about me thought it was okay for me to suffer and hurt myself.”
So she asked me what I do want.
“I want people to stay. I want YOU to stay. I want to be able to continue with my behaviors because I can’t stand the thought of staying this fat. And I know you think I’m hurting myself, but I just…I can’t be different right now. And maybe not for a while. So what I really want is for you to stay anyway. I want to not have people abandon me when I become difficult or when they feel helpless.”
She nodded. I continued:
“I guess if I’m being completely honest, I want you to watch me get sicker…”
“I do get that sense from you.”
“…but I want you to stay with my anyway. I feel like there’s an hourglass and I’m watching the sand go down as I run out of time.”
“Time with what?”
“How come? Time – as in because the session is ending – or time in general?”
She asked what caused me to feel that way. I wasn’t sure how to articulate it, but we talked about Zooey and the idea that everyone has a line that I tend to cross. I said,
“An important thing I’ve learned is that the only person who REALLY has to put up with me…who has to stay no matter how shitty this gets or how destructive I become is me.”
She spoke about the isolating nature of eating disorders and how much I’ve already isolated myself from the world around me by engaging this obsession so completely since relapsing.
“I know. I know and I see it. But I can’t stop. I don’t know what to do or if I want to do anything at all. And I just see myself running out of time and it terrifies me. Because then I’m just going to be all alone in this…”
She leaned forward in her chair and said,
“Andi, I am here, in this with you. And I have time.”