Forgotten

I have session three times per week. Right now, my appointment times are the same on Mondays and Fridays and slightly earlier on Wednesdays. I have to haul ass to get there on time after clinic. This past Wednesday I took a little longer to finish up with a patient and thus I got to the office one minute late.

I know my therapist’s clock is a little slower than my watch, so I wasn’t too worried. I really had to pee though, so after sitting in the waiting room for a minute or so, I just said “screw it” and ran to the restroom, assuming her door would be open by the time I got back.

It wasn’t.

I watched as the minutes passed and I became increasingly more anxious. Other patients came in and then went to their respective therapist’s offices for session. I still just sat there. Eventually, after probably 8 minutes or so I grabbed the book I was almost done reading and tried to occupy my mind with something other than my growing panic.

Fifteen minutes after my session was supposed to start, my therapist opened her door. She looked her normal self and didn’t offer any explanation for the delay. I was scared to say something, but I knew I needed to.

“Don’t we start a little earlier on Wednesdays?”

I watched as she processed what was happening and then a slight look of horror crossed her face. “Oh my god. Yes, you’re right. I’m so sorry – I got confused about the days and times.”

I felt both my heart and lungs stop functioning. I froze in place.

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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.

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Excited

Tomorrow I start my second clinical affiliation. I was super nervous about how I’d manage full-time clinic with therapy three times a week. Turns out the physical therapy office I was assigned to is literally three blocks from my therapist.

Huh. Interesting how that worked out, eh?

finally got my schedule from my clinical instructor. I was originally assigned a week of mid-shifts, but I asked to switch with my fellow student so now I have a schedule that allows me to go to therapy right after my internship on Monday, Wednesday, and Friday.

I am very looking forward to getting back into a regular routine. Therapy has felt sporadic and far away lately. We’ve been mostly puzzling our schedules together, trying to make the pieces fit as best we can. I was totally checked out emotionally during finals week, so I kinda feel like I haven’t really been in therapy since late November. We did have one phone session while I was away, but I was so distant and walled up that it didn’t really feel like much of anything.

But she came in to see clients on the 28th and that session was fruitful. I felt very relaxed and spoke openly about how much I’ve been struggling with my eating disorder. I think she was relieved that we were finally really talking about this in a way that allowed for more options. Since I was going to see my psychiatrist later that week, she asked if I would be willing to share about this with the doctor as well.

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Pickles

When I was 11, my parents hosted Thanksgiving. In my family, we generally ate breakfast and then fasted until gorging ourselves on the impending feast in the early afternoon. There were no appetizers or snacking pre-turkey. Partly because I grew up poor and partly because my family is punitive around food. 

So that’s about six or seven hours without food. Which, when you’re 11, is a long time. 

On this particular holiday, my mother put a dish of pickles out on the table just before dinner. They were sweet pickles, the “bread and butter” type, sliced into pieces. 

Our dining room table was pulled apart with the extra leaves stuck in to make room for more guests. It barely fit into the dining room. I was carefully navigating my way between the wall and a line of chairs when I spotted the pickles. The porcelain dish sat next to a tiny pickle fork used only for this occasion. 

I impulsively reached for the pickles. I was hungry and I love sweet pickles. 

My uncle, however, was watching me. He was standing on the threshold between the dining room and family room, arms crossed, apparently surveying his environment. 

Just as I put the first pickle slice in my mouth, my uncle pointing at the remaining 2-3 slices in my hand and said,

“See, Andi, that’s why you’re fat.”

I can’t remember what I said. Probably nothing. I think I was stunned and embarrassed, so I just shrugged. I was also mid-chew, so I finished eating. And since I’d already touched the other slices, I ate those too. 

Later on when dinner was served, it was the first time I restricted what I ate for the sake of not wanting to be held responsible for “being fat”.  I also felt acutely aware that people may be watching me eat, thinking the very same thoughts my uncle did as he watched me eat the pickle slices. 

He violated me. He humiliated me. I was a hungry little girl who was innocently eating a few slices of sweet pickle. He intruded on my moment of pleasure to shame and guilt me for a very natural thing: eating because I was hungry and the food in front of me looked good. 

I don’t think I have ever been able to do that since. 

He’s a shit person who has no influence on my life now whatsoever. But that moment, and his choices in that moment, had a profound impact on me.

And from that experience, I learned that I could control uncomfortable emotions by altering the amount, type, and quality of food I eat. I also learned that “fat” is highly undesirable and I should do everything in my power to avoid it. 

A lesson that has tormented me ever since and come into full relapse for just over a year now. 

Can I just sleep until Friday??

Fuck Thanksgiving. 

A Life In Numbers

Content Warning: Disordered Eating

After my therapist and I finished the conversation about scary movies, I changed the topic to food. November 4th marked one year since I relapsed into my eating disorder and I had a calorie tracking chart to show for it. I said,

“So I brought a document with me today.”

“A document? Well, that sounds…formal.”

I laughed and pulled out my folder. I explained that the 4th marked this specific anniversary and outlined the chart for her. The numbers are in different colors: green for “good”, yellow for “caution”, red for “bad”, and blue for “best”. Each day lists the exact number of calories I ate and the font corresponds with the appropriate color. The bottom of each column gives a monthly average and the bottom left corner has an overall average.

It is green.

After I explained all of this to her, I handed it over. She said, “Wow, okay, so this really is a ‘document’?”

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Dysmorphia

Today’s session was a hot mess.

It didn’t start out that way. I had my first shift of clinical affiliation today, so I went to session right afterwards in my scrubs. The therapist opened the hour by saying, “Nice scrubs!” and I told her I had a funny story about that:

When I found out I needed scrubs for clinic, I asked my classmate where to get them. She said to just order online, so I found a company I liked and ordered them from Amazon. My wife suggested a certain size, but once she left the room, I decided to get the larger size instead.

When the scrubs arrived the next day, I pulled them out of the box and held them up to myself. Wife said, “Do you think those will fit you?” and I said, “Yeah, probably.”

“Okay. Try them on.”

I did. They were admittedly way too big on me. My wife asked me if I’d genuinely believed those scrubs would have fit me and I said that yes, I really did believe that.

At this point she took a photo of me in said scrubs and we jokingly posted it on Instagram.

I relayed this story to my therapist and showed her the picture. I explained that in the photo I am wearing size large scrubs and the scrubs I was currently wearing were a size small. I also added that Wife and I felt that taking a photo of me in these huge clothes would be a good way to demonstrate the severity of my body dysmorphia.

She agreed.

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The Year of Sadness

Yesterday’s post actually started out as “The Year of Sadness”. I wanted to preface it by explaining how last year had been The Year of Anger, but then I had so much to say about anger that I quickly realized I’d written a whole post already! But I do want to talk about the sadness…

Friday’s session went something like this: I suddenly “came to” and realized I was sitting on the hardwood floor of the therapist’s office in a black dress I didn’t remember putting on. In fact, when I fumbled through my memory to recall that last time I distinctly remembered being “me”, I had to go all the way to Tuesday evening. I know I’ve been out on and off since then, but at that moment – nothing was registering.

The therapist immediately noted my confusion. She said, “Hi. I have been talking to Anna for this session, but I asked for you. We only have a few minutes left. I wanted to check in with you…I’m worried.”

I tried to speak and stumbled over my words like some kind of drunk toddler. I was struggling to orient myself to time and place and everything felt weird. I wasn’t sure why Anna had been out – that seemed odd and unsettling to me. The therapist reassured me everything was okay, but I wasn’t so sure.

Regardless, I had to leave so I did, but she said she could call me later that evening. When she did call, Wife wasn’t home yet and I was still an incoherent mess. It’s hard to remember what I said or what she said, but I know it was somehow a productive (albeit frustrating) conversation, wrought with helplessness for both of us.

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Finding Peace in Eating

Every once in a while I come across something that resonates so powerfully that it’s truly startling. Usually it’s song lyrics or book excerpts, but I recently stumbled across this incredible Ted Talk by Dr. Laura Hill entitled “Eating Disorders from the Inside Out”. It’s just under 20 minutes long, but if you have the time – it’s a wonderful representation of what it feels like to have an eating disorder:

She specifically talks about Anorexia and Bulimia, however I believe this version of self-talk and brain response is representative of many forms of disordered eating.

I’ve been slowly unraveling distortions and emotions around food on this blog (and in therapy itself) as I attempt to better understand and connect with River. The closer we get, the more access I gain to her daily experiences.

Dr. Hill talks about the noise that occurs around eating for people with eating disorders. She delves into brain anatomy (in a user-friendly way) to help explain the differences between brain reactions in individuals with versus without eating disorders. Something in particular that struck me was how she describes the absolute terror associated with even making a decision around food.

I relate to this so much.

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Trauma Memories and Body Image

I have been attempting to share more about this whole disordered eating mess with the therapist. I was talking about River and myself seemingly become less and less dissociated from each other, thus causing me to feel some of the intense emotions around food and body image that she regularly experiences.

But then I admitted that the body image issues aren’t entirely River’s fault. Yes, I do experience some of the very thoughts I know she sorta “sends” to me, but my relationship with this body has been complex since the beginning. Sharing a body with other Parts is in itself a strange and complicated way to live. But, also, as I’ve received more and more information about our collective history, it makes it very hard to feel comfortable or safe in this body.

I’ve always known that “I” was abused and raped by more than one person at various points throughout this life. I understood that on a factual level since the moment I came into existence around 2009 as the shiny new host of a System I didn’t even understand existed yet. What I didn’t initially have, however, was any emotional attachment to that fact. 

But throughout the last several years that has changed. As the internal walls start to come down, I feel more and more integrated with the memories and emotional experiences that are shared with me. There are moments where I feel completely overwhelmed – as if I’m drowning in the reality of that truth. 

I get these memories…these images and sensations and feelings that come to me, either in dreams or flashbacks or thoughts. As I piece them together, I get a clearer idea of what, exactly, was done to me. Most of the time I try to keep it far away from me. I create distance by reinforcing that this happened to another Part. 

Not me. Not Andi.

But I am them and they are me and we are all this body.

So in reality, those things did  happen to me. I AM that little girl. I AM that teenager. I AM the person who was hurt so many times. We all are.

And that information – the awareness of what was done to me and to this body is what makes it sometimes unbearable to exist inside it. It makes me hate it, hate myself, hate to look in the mirror, hate to exist at all. It makes me want to scream and cry and rip off all my skin. It makes me feel insane.

And, admittedly, it makes me want to starve until I disappear into nothingness. 

A nothing that no one can hurt ever again.

Relentlessly Destructive

*Mild Trigger Warning for topic (Eating Disorder Behaviors)

Last week was a little rough. Beyond pulling my hamstring, which has still not fully healed, we had an incident involving stimulant laxatives. Apparently River was displeased with our stalling weight loss. So she fronted long enough to both procure and take three times the recommended dose of laxatives. I did not know this until I went to class the next morning and suddenly felt very ill.

At first I thought it was just some strange tummy ailment caused by all the meds I was on. I’ve never taken muscle relaxants before, so I figured it was causing some unpleasant reactions. Then my nausea got worse and worse. I thought I was going to be sick, but then I had to go to the bathroom very urgentlyI excused myself from class and after three trips to the public ladies’ restroom, my professor asked if I needed to lay down. My classmates reflected back to me that I looked “a little green in the gills” and everyone told me I should go home. I asked my professor if I could leave and he said that would be fine and to feel better soon.

It was a rocky commute. I just kept begging my stomach to stay calm and wait to get home to completely freak out. Luckily, I made it home without incident. I took some stomach medicine and laid down, willing my intestines to relax.

Once I felt somewhat settled, I pulled out my iPad and stylus. I opened up the System journal I created (using the GoodNotes app). I very nicely asked if anyone had any information or input on why our stomach was so upset. I got a quick reply from another Part (admittedly “tattling”), letting me know what was going on. Eventually River admitted to it, but she didn’t say much beyond that.

I brought this up to the therapist in session later that evening. She asked me if I had any input on why River was “upping her game” in terms of disordered eating behaviors. I honestly don’t know. I thought things were going fairly well, but obviously they’re not. I expressed extreme frustration and distress about this whole situation. I feel so helpless. I hate it when Parts front and push me out of the way, especially when they use that time to do unsavory things.

The therapist said, “You talk about your Parts with a certain quality…as if they are relentlessly destructive.”

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