I am River

I am River.

I’m a fat fucking loser. I hate myself, every minute of every day. It feels like I’m constantly being crushed by myself.

I have an eating disorder. It’s my fault that I have it. I chose to starve myself because I wanted to make my parents angry. I wanted to make everyone angry. I wanted to make everyone as afraid as I am. But now it’s not a choice. It doesn’t feel like a choice.

I don’t get to make any decisions. The eating disorder makes all of my decisions. I know I want to be a child. I want to be small and skinny. Light. Invisible. Weightless. My eating disorder is so loud. I don’t think it started that way. At first, it was just a whisper. It was sweet and it promised me all the things I wanted. I wanted to be safe. I wanted to be a kid. A real kid. I didn’t want to think about scary, adult things. I didn’t want to have to make hard decisions and I didn’t want to be responsible for my choices.

The disorder promised me all of those things, as long as I followed its rules. Then there were more rules. At some point,  I think I didn’t want it anymore, but it’s stronger than me. It’s louder than me. And I needed it to drown out everything else, everything that scared me. And it worked, so I guess I became superstitious. Now I’m a slave to it.

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A Formidable Opponent 

At the tail end of Monday’s session, I found the courage to bring up my eating disorder. This is not something we generally talk about in session because I avoid it at all costs.

But I told her it had been getting worse and I’m becoming increasingly afraid of the potential repercussions, physiologically and otherwise.

I graduate next month.

Right now I have almost nothing to do with my infinite free time except descend further into my illness.

I don’t want to do that.

Yet I do.

I suppose I see this as an opportunity to drop my intake as low as possible and drop as much weight as possible. I want to push the limits of the disorder and see where it will take me. I no longer have professors, clinical instructors, or patients to answer to, so what is to stop me from starving??

Well, I also want to prepare to exit school and enter a profession I have worked so hard to join. I want to continue to run and do yoga and Pilates and leisure read my list of books by feminist writers and continue aprendiendo Español and reading the latest research in my field. I want to see my friends and family and reach out to my network. I want to lounge on my amazing sofa and watch endless amounts of Hulu, Netflix, and HBO.

But I can’t.

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Finding New Language

Part of what has been so challenging in therapy lately is that I have not been able to find words to really describe what I’m experiencing. It all feels so emotionally familiar, but also foreign and new at the same time.

My therapist always says that sometimes when we’re experiencing something new, it is hard to put words to it because we’ve never spoken about it before. This is particularly true when you are trying to speak the unspeakable.

In response to a recent blog post, a reader left a comment suggesting the book “Trauma and the Avoidant Client: Attachment-Based Strategies for Healing” by Robert T. Muller. I did a quick Google search and came upon the book, as well as an article titled “Trauma and Dismissing (Avoidant) Attachment: Intervention Strategies in Individual Psychotherapy” by the same author.

I had to read it a few times before my brain could settle down enough to make sense of everything I was reading. I have often been told I have an anxious-preoccupied attachment style or, more recently, a disorganized attachment style. I’ve done a lot of reading about those two styles to try and understand both myself and the work I should be doing.

So I was very surprised by how much I could relate to this article about individuals with a dismissive attachment style. It turns out this is fairly common in patients with intrafamilial trauma. Since these clients are by definition avoidant, it is a challenge to do research and develop treatment strategies for them. But Muller was able to tackle this important issue and what he came up with resonated with me in a very powerful way.

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I just got out of session and I think I somehow feel worse than I did going into the hour.


I don’t even know how to understand what is going on right now, let alone attempt to explain it. I don’t think I made the best decisions about how to discuss the intense trigger I felt on Monday (and still feel). 

It was a mess for the first half of the session. At one point she said,

It feels like you were late and that is somehow my fault and now you’re angry with me for it.”

Which made me just lose it, prompting a heated battle. And then she stopped us and asked me what I needed from her. 

Just listen to me.”

So she asked me to start over, to begin again and to try and disregard all that had been discussed about this issue in the previous 30 minutes. 

I thought about it for a minute and then more or less went through everything I had written in my previous two blog posts. I gave a narrative timeline of how I experienced the last session and the time until today’s session. 

I talked about feeling like I am ultimately disposable to her. Replaceable. Irrelevant. Unimportant. Worthless. 

I talked about how this is supposed to be a relationship between two people. A therapeutic relationship, yes, but one that still involves two of us. I talked about feeling as if I am the one solely accountable for the hour of session and what happens to us, to the work, to me. 

I said that her failure to be concerned or to reach out and check in despite me being very late for session for the first time in 168 sessions sent the message that I do not matter, that she is not interested, that she doesn’t care, that it’s not important to her, and that I am not worthy of her concern or curiosity. 

I told her that I understand and respect her policies and methods, but it’s not enough for me. I said,

I need you to fight for me! I need to know that we’re in this together and that you care. I need you to show me that I am worthy when I cannot believe I am worth it. I need to know you won’t just discard me if I am not able to be fully invested in the work or the relationship. Because therapeutic or not, I am only half of this relationship and if you won’t fight for me, or for us, then I feel completely alone and scared and worthless. And that is just not good enough!

She sat quietly for a moment and then asked if I wanted to hear a response. I said no so we talked around it for a while but then she asked if she could say two things:

1. She was absolutely concerned and curious about where I was and why I wasn’t in session at 5pm.

2. She would have called if I had not shown up at all. 

Then she reflected on her statement about the therapy session being my hour to do with as I please. 

That was just not an appropriate response because it doesn’t even address what you were bringing up by mentioning that I hadn’t called to check in.”

Then she spoke about how she uses something like lateness to explore underlying themes with clients. So she doesn’t like to interfere with attendance because she wants to allow the dynamic to play out as it needs to in order to bring it into the analysis. 

But I can see how it can come across as uncaring or coarse and I will think about that more for how it works or doesn’t work with you.”

She said all the right things and seemed genuinely interested and I could tell that she desperately wanted to connect with that deep trigger I was feeling. And maybe we did get to it a bit but I can’t really tell. 

I don’t even know what I feel. Unfulfilled, I think. I needed something from her. I still need something from her. Not only am I unclear as to what that need is, I don’t believe I could get it met even if I did know. 

It feels like this is all for nothing. These triggers, these huge emotional explosions that destabilize me and make my life feel chaotic and scary and lonely, are not okay. 

I can’t keep doing this. I can’t keep feeling this way – a way I cannot even seem to name or articulate. 

It’s like dying of thirst when you don’t know what thirst is, let alone how to get water. 

Fight For Me

I have been thinking some more about what happened yesterday. 

I know that being unintentionally late for my session was intensely triggering. But I also think that the way my therapist responded to my lateness added fuel to the shame fire. 

I suppose I was sort of stunned that she seemed so unfazed and unconcerned by my lateness. Her response that the hour is mine to use however I want to use it is fundamentally true, but it wasn’t good enough. 

What does that really mean? If I just never showed up again, would she even care? Am I so disposable that she can simply wash her hands of me if I stopped coming to sessions? Do I mean so little that she could simply walk away from me if I put up resistance?

Probably. And probably for good reason. But that is not cool. 

I don’t necessarily think I wanted her to be in a state of panic about me being late. I have never been more than slightly late and I’ve never missed a session (even when I wanted to) because I am very cognizant of not being manipulative or doing too much communicating through “acting out” behaviors.  There are moments when I want to behave in a way that would be provocative, but I work hard to avoid that because it never truly pays off. 

However, her (apparent) utter indifference was startling. And this is something that I quite often feel from her. I am sure that if I spoke with her about it, she would deny indifference and give some eloquent explanation for why she responds the way she does. 

But the truth is that I wanted her to fight for me. 

And she didn’t. Which really hurts. 

Her presence in my life is powerful. I have given her the privilege of getting to know me and our work together has allowed her to become part of my support system – a system that is vital to my ability to remain functional. 

If it means so little to her, what does that mean for me?

I feel so alone. 

Why won’t she fight for me?

Why am I not worth it?

Why do I not matter enough?


My therapy schedule has been changing like crazy lately because of myriad factors, mainly my changing internship schedule. 

I thought I was supposed to have session at 5:30pm today. I left clinic early at roughly 3:45pm and took the train to my  therapist’s office. I was super early so I went to a nearby Starbucks and worked on my inservice presentation. 

I wanted to get a Frappuccino because it’s “Frappuccino Happy Hour” week, but then I couldn’t justify ingesting unnecessary (and unplanned) calories, so I panicked at the last minute and ordered an iced coffee instead. 

But the barista misheard me so I was given an iced latte. That has far more calories than a simple iced coffee, so I asked for the correct beverage. Then I realized I had paid about twice as much as I should have for an iced coffee.  

I was flustered but I sat down and started to work. My iPad was open on its keyboard stand and my shaking hands then promptly dropped my cup and I spilled iced coffee all over the keyboard, the table, the floor, and myself. 

I stayed surprisingly calm while I diligently soaked up all the spilled coffee with a endless amount of napkins. 

Then I sat down and went back to work. 

I don’t remember much until 5:28pm, when a friend of mine texted me. This prompted me to look at the time and realize I had two minutes to get to session. 

Before every session, I open up iCal in the elevator and double-check my session time. 

It said 5pm. 


I went into my therapist’s office and asked if I was supposed to be there at 5 instead of 5:30. 

I was. 

I started panicking internally. But I knew I only had 25 minutes left in the session and it seemed like I probably shouldn’t waste any more time. I think I was trying to force myself to be okay with what happened. But I wasn’t okay. 

I’m not okay. 

I have never done this before. In roughly 170 sessions, I have never once made this error. 

Why now? Why today?

My therapist suggested there is a deeply rooted issue coming into play here. I can’t say I disagree since we just had an extensive conversation about this last week involving her sending an email “out of bounds” with the parameters she had set. 

I told her the email made her seem unreliable and that it is very important that her words match her actions. She fought me on it at first and we spent an entire session arguing, but then she thought about it more and decided I had a good point and she realizes she needs to make sure our work stays protected. 

It was a standard rupture and repair – something we have done many times at this point. So I struggle to see how this would have such an impact as to cause me to lose time and subsequently show up for session 32 minutes late. 

I was also surprised that she didn’t reach out to me after she’d realized I was so late. She mentioned in the beginning of this session that she thought perhaps I had mixed up the times since things have been so chaotic lately.  

So why didn’t she call me and check in?

I asked her as much at the end of session and she said, “I wouldn’t do that because it is your session and you can do with it as you please…but maybe we can talk more about that next time.”

I understand her point, intellectually, but what I am feeling right now is as if she said “because I don’t give a fuck whether or not you show up or why you would be late”. 

Which really does not feel good. 

There’s so much going on for me right now emotionally. It feels like something snapped or exploded inside of me somewhere. My session ended 30 minutes ago and I am literally squatting against the wall in the lobby right now so I can write this post. I felt like I had to stop and somehow discharge some of my thoughts and emotions somewhere or else I might combust. 

Also, I need to finish my presentation tonight so I need to somehow be able to return back to baseline enough to function and focus on schoolwork. 

This fucking sucks and now I feel like this post has been about nothing. But I needed to just say what happened. I don’t know why something so simple would be this destabilizing, but it is. 

I am completely unraveling and I can’t figure out how to make it stop.

Mother’s Day Metaphor

Last night I was alerted by Facebook that one of my estranged siblings, my brother, had used an old family photograph I posted to Facebook five years ago following my uncle’s wedding. My brother cropped me out of the original photo to create a Mother’s Day photo for his profile picture.

So what remains is a cropped photo of my entire family, sans me. 

For the first minute after I’d read the notification and realized what he had done, I was speechless. The heartbreak, betrayal, and sense of grief was overwhelming. 

Then, after I’d had a chance to breathe and think about it a bit, I just started laughing because, really, it is an absolutely perfect representation of what has transpired over the last several years. 

Those five individuals – my former family members – have remained exactly the same, preserved in a state of chaos and dysfunction. My life has changed dramatically, for the better, and has continued to improve with each passing day since I severed ties with them. 

But the only thing about their life that has changed is that I am no longer in it. I literally cropped myself out of the picture. 

It’s hard to remain upset when the universe handed me such a beautiful metaphor on a day when I really needed to be reminded of why I became estranged from these people in the first place. 

They will never change. 

I will never stop growing. 

Happy Mother’s Day to myself: the best mother I have ever had.