Breaking Rules and Needing More Support

At this point it has been six days since I stopped actively restricting or counting calories.

It is hard. Really hard.

I don’t have any intention of stopping anytime soon, but I’m not sure how long I can keep this up. Every moment of every day is a struggle. I feel like I’m standing right on the edge and fighting to keep from sliding right back into the disorder.

Part of what made me want to stop restricting is that my therapist does not want me to have to go into inpatient or residential treatment again. I don’t want that, either. I think it can be tempting to surrender all control over to a treatment team that tells you exactly what to eat – how much should be starch, protein, dairy, vegetables, fruit, etc. They decide when you eat, where you eat, how you eat, what you do before and after you eat; they essentially make every decision around food for you.

Which can be very helpful, especially for someone in the throes of anorexia who is so malnourished and trapped in the disorder that they are in danger of dying if they don’t get calories. It can be simpler to follow the rules someone else is enforcing than to have to break your own rules.

But, in the end, it’s still about rules. And that is what my therapist and I are trying to avoid. Neither of us want me to trade my own rules around food for someone else’s. Part of why I have this disorder is because so much of my life was controlled, particularly regarding food. I was told what foods I liked and disliked. I was put on a diet as a toddler. I was deprived of the foods that I loved and forced to eat foods I hate.

Done

It’s strange how so much can change in so little time.

In my last couple of posts, I’ve addressed the challenging nature of battling an active eating disorder. I felt so completely helpless and out of control. I could feel myself spiraling further into self-destruction and although I also felt a sense of urgency to grab hold of something – anything – to prevent further descent, I could not figure out how to do that.

However, it would appear that a series of well-placed events and interactions have finally opened up the space I needed to slow, if not stop, my free-fall into anorexia.

After my double session last Friday, I felt unsettled. Having an ED is sort of like living inside a very well fortified castle. I think that somehow the workshop at Renfrew, combined with my conversation with my psychiatrist about ED-specific treatment (where she recommended residential treatment), followed by an email, phone call, and two-hour session with my therapist somehow had enough force to breach the castle walls.

I couldn’t quite understand what had happened, and I still don’t really get it, but I just sensed that the eating disorder was struggling to maintain its hold. Restricting suddenly felt difficult, where it normally is effortless. I found myself questioning if starving indefinitely is truly what I want for myself and being curious about other options.

Then I saw my nieces and nephew.

Random

I went to a workshop at Renfrew tonight that really just solidified how badly I need ED treatment. And I want it. I just don’t feel like I deserve it. (Yet?)
I felt so sad for myself and so profoundly envious of the other women who had been through treatment and were seemingly light years ahead of where I could ever even imagine myself being. It seems hopeless. I think I would fail spectacularly at NOT being eating disordered so maybe I am just more content being really good at it? Who knows. 
But it sucks. I want what they have. I want to feel better. I just can’t figure out how to allow myself to do that. And on the opposing side, I also really want to be anorexic, which is gross and fucked up. 

Such a mess. 

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.

Using Anorexia to Disengage

Things have been pretty calm in therapy lately, at least from a relational perspective.

That’s not necessarily why I haven’t been writing about it more on here, but I think it might be part of it. Mostly I’m just too under-nourished and distracted by my obsession with food and other related numbers to find the time or energy for blogging.

I don’t know how others experience eating disorders, but I must admit it is the most energy-consuming and demanding thing I have probably ever encountered. There are moments here and there where I feel like I’ll start to shake it off, but then something activates me and bam! I’m right back to the usual nonsense.

It’s tough. Using ED behaviors as both a pretty effective coping mechanism and a tool of self-destruction has become more of a habit than anything else. There are moments when I think about pulling out of the incessant self-deprecation. For example, I’ll think, “Okay, so I’m disgusting. But maybe that’s okay. Maybe I don’t need to obsess and panic about it every literal 3 seconds.” Which, for me, is progress. But then I feel the ED tug on me and I reassure it that even if I am less self-loathing, I won’t give up the disorder.

It is stubborn and strong and a LIAR. Yet I love it. It makes me feel safe and powerful and worthy and capable and accomplished. It is what my therapist has not so lovingly started calling my “greatest frenemy”.

Losing Control

Dear Therapist,

I haven’t been restricting as much. I know this is what you want but I hate it. I feel so fat. I feel like such a worthless piece of shit loser. The number is technically still “restricting” but it feels too high. 

It IS too high. It’s not real anorexia. I’m on a diet. A fucking DIET! This is bullshit. I am shit. I hate myself and I hate that it feels like I’m losing control. I cannot give this up yet. I am not skinny enough yet. 

I worry that this treatment is working. I worry I am relaxing too much around food. I’m breaking my own rules and loosening my grip. 

And now I will get fat. I will never get to be skinny. 

I hate you. I hate me. I hate everything. 

-River

Honesty

You told me to be honest. Well, you asked. I don’t know, you said something about honesty.

So I told you the truth. I said I WANT to be anorexic. I WANT to prove I am someone special, someone strong, someone worthy. I am not a “dieter” – nothing so common, so mediocre, so temporary.

You said I already AM anorexic. You brought down the DSM-V from the top shelf and read out the words that I know you don’t even believe in. You said numbers are stupid and categories are dangerous.

Still, you said that my diagnosis is anorexia. That’s what you would call me: anorexic.

But it doesn’t matter.

I am not anorexic ENOUGH. Not yet.

But then you got upset. And, yes, there IS room for both my truth and yours. You pointed out that maybe your truth got a little bigger than mine and I agree. You’re allowed to be angry that I hurt myself, but I’m allowed to feel upset about your emotions.

Because this is what’s real. This is what’s me. And if you cannot sit with that…if you cannot see me in the difficult moments that upset you…

you cannot see me at all.

-River

New Levels of Self-Hatred

My levels of self-hatred are at an impressive and nearly debilitating high right now. I recently wrote about my decision to not weigh myself every damn morning.

That lasted one week. Or six days, really.

Then Saturday came and I’d gained nearly 4lbs. Logically I knew this was likely water weight from having my period, but seeing that number threw me into a tailspin. I was devastated. I weighed myself on Sunday and was already back down 2lbs, but the emotional damage had been done.

I’ve weighed myself every morning since, seeing anything within a 5lb range of Saturday’s number. I either stay the same or gain.

That is unacceptable.

I could tell myself it’s hormones or water weight or even muscle weight since I’ve been doing more strength training and eating more calories to fuel those workouts. I can look at my intake and know, rationally, that it is impossible for me to have gained actual fat. I don’t even eat enough to fuel my body through its basic functions like breathing and pumping blood, so there’s no possibility that I could be eating an excess that would add fat to my body.

Yet still, I see that number go up and I immediately feel fatter. I look in the mirror and just KNOW I am fatter.

(Un)tethered

I have weighed myself every single morning for the last year and a half.

Before that, I weighed myself maybe once or twice a month and it didn’t mean much. I think it was mostly just curiosity. The only scale we had in the house was a cheap dial scale that probably wasn’t even accurate.

But when I relapsed last November, one of the first things I did was order a fancier digital scale from Amazon. And from the moment it arrived at my doorstep, I have been tethered to that bright orange square of doom.

My therapist and I have recently begun tackling my eating disorder in sessions. I should have been doing this a very long time ago, but I refused to even acknowledge it was a thing. It wasn’t until it became concerning (enough) to others that I brought it up with her. I guess their concern somehow gave me “permission” to ask for help or something.

It’s been hard. I don’t make very much progress. Or at least I hadn’t been anyway (or maybe it just didn’t feel like it?). I wrote previously that my psychiatrist prescribed Ritalin to help me gain a more “top-down” way of using my brain, allowing for more executive control and rational thinking. That was about three weeks ago.

And I’ll be damned if that isn’t exactly what is happening.

I Have Time

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?

Sure.

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.