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.

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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.

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Plateau

Today in session, I was telling my therapist that I feel like I’m at some sort of therapeutic plateau. I have come so far in terms of stability. I am in a good place – my life is overall quite wonderful. Of course there’s a lot I still struggle with, but that is entirely internal at this point. I have eliminated all sources of truly toxic or harmful external stresses. There is no one left in my life who can, or would, hurt me.

So, naturally, I feel a compulsion to continue to hurt myself.

During last night’s session, I nearly had a flashback. I think the only thing that stopped it was that I felt it coming on and mentioned that fact to my therapist. She told me that she knew it would annoy me, but that she was going to do what she needed to do in order to keep me “in the room” with her. For us, that means she asks a lot of grounding questions and makes a lot of grounding statements.

Why is this annoying? Because it feels like an abandonment. Not necessarily from me, but from the parts that are stuck in trauma time. I want to pull away from the memories and sensations, but unfortunately that means that I leave those traumatized parts stranded in their present-day torture.

Which sucks. But I just can’t do it. I can’t go there.

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Scheduling Changes

It’s probably fairly clear from all the time I spend blogging about scheduling issues that my therapist and I often struggle to keep our three weekly sessions. We’ve somehow always managed to figure it out thus far, but it’s tough. We both end up doing a lot of rearranging and making small sacrifices here and there to make it work. Overall, I think it’s worth it, but that doesn’t necessarily make it less challenging.

I’ve been seeing her on Mondays for a very long time. That has probably been the most consistent day in which we’ve had sessions together. Due to my latest clinic schedule, however, she’s had to do a lot of shifting her schedule in order to offer me three “primetime” (i.e. after standard work hours) slots.

Which means no more Mondays. For the next month I will see her on Tuesday, Wednesday, and Friday. Except for a couple of weeks where I either have class or she has a conflict and we have to switch Friday to Thursday. As I mentioned recently, we changed my session to Thursday last week. And then I didn’t have session today because my Mondays were switched to Tuesdays.

I really don’t like that. I’ve gotten into a nice little routine of starting my week with a session after school/clinic. It was bizarre and unsettling to realize that wouldn’t be happening today. One positive is that it opens up my schedule to attend my favorite yoga class again, but I still felt sad and upset about the missing my normal session time.

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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”.

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Not My Favorite

The first thing my therapist and I discussed during Friday’s session was the upcoming schedule changes. As I wrote previously, my school and clinic schedule will be shifting (yet again), causing me to change all three of my weekly sessions.

My therapist had originally discussed the option of having sessions on Mondays and Wednesdays, with the choice to do a double session on Wednesdays or two 90 minute sessions. I respected her efforts to maintain our three hours of session per week, but knew that the length of time from Wednesday to Monday would be very challenging for me.

My plan was to bring this up with her and explain my feelings. I didn’t have solution, but I wanted her to understand how this could potentially impact me.

But in a rare act of initiating the conversation, she asked if she could start out session by talking about scheduling. She said she’d gotten a little mixed up when giving me possible times and wanted to clarify. She said the Monday time would work, but that she couldn’t see me until 7pm on Wednesday (no big deal since that actually would work a little better on the days I have my seminar class). She also said there’s a chance she could see me for a third session. She said, “I could see you on Fridays, maybe, but that’s not my favorite.”

Um, what?

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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

Scheduling Changes (Again)

My schedule is shifting. Again.

My third (and final!) clinical affiliation starts on the 21st and will last for 8 weeks total, Monday to Friday, 9-5pm at a local hospital.

The whole hospital setting is activating and I have plenty of fears and anxiety about that, but I can’t even go there yet. I just need to feel relatively calm for a week or so before I actively tackle those emotions.

But this also means I will have to shift sessions around again. I told my therapist my schedule as soon as I heard from my clinical director. She was okay with it and said she would start moving things around in her schedule to make room for me.

On Monday, she mentioned it and said we should try to talk about it soon. So for Wednesday’s session, I went in with the intent to talk about two things:

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Truth and Transitions

Since I had to go to therapy right after the rather disastrous appointment with my shrink on Monday, I was in a difficult emotional space. I felt intense rejection and a sense that the world was caving in. I think I also felt like I had very little left to lose, since I was now in conflict with both my therapist and psychiatrist, which emboldened me in a much needed way.

So when I got to session, I opened with about as much truth as I could handle. I said,

“I feel like we should just end this: therapy, sessions. Because I feel like you are dangerously close to bailing on me and I can’t tolerate that thought. I can’t be in that space, dealing with all of this fear. I can’t be waiting for that. I can’t be imagining it. I don’t want to think or feel or do anything that has to do with you abandoning me. So I just want to walk away now, before you can really hurt me.”

She first assured me that she has (still) not had any thoughts about bailing on me or ending our treatment, but then she asked if perhaps her comment from last week had left me feeling afraid and concerned that she was at a limit with me?

“Yes, absolutely.”

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Birthday Grief

Last week was my birthday.

I told my therapist in the session leading up to it that I’d need her support. I wasn’t able to articulate exactly how or what she could do to help, but I knew it would be a difficult week. My birthday is always hard for me, for us, as a system. There are difficult memories and emotions that come up in a seemingly unavoidable way each year.

But things have also been very difficult for River lately. She’s been showing up in session more, talking in a really open and honest way that makes me, my wife, and my therapist very happy. It has made it kinda worse in terms of having an eating disorder, but my therapist is convinced this is all part of the recovery process.

So on Wednesday, River went to session. I’m not entirely sure what was discussed, but I know she ended the session by asking my therapist if we could call her the next day to check in. Apparently my therapist hesitated just long enough for River to feel something that was upsetting. My therapist told me she said, “Ugh, never mind” before more or less storming out of the office.

And then she didn’t call our therapist. No one did. Which sucks because I know I could have certainly used the added support.

Anyway.

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