Next month my therapist is taking a two week vacation. She’s never taken more than one week, especially in August. December is trickier depending on when the holidays fall, but her summer break has always been just one week.
This sucks and clearly the younger parts have some feelings about this:
*sigh*
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.
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
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.
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?
I 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.
New Year’s Eve is always a weirdly emotional time for me. Similar to my birthday, it’s a time when I feel a lot of panic and anxiety about whether or not I’ve done anything worth celebrating. It’s also a time, culturally, when we’re encouraged to reflect and make promises to ourselves about all the changes we’ll make to be better in the new year.
Fuck that noise.
It’s just a damn day. Sure, the year changes and I guess that could mean something, but is it really that much different than the day before or the day after? No.
Last year I resolved nothing. My only goal was to survive. Anything above that was to be a bonus. And in that sense, I’d say this was a year of bonuses:
I completed all of my clinical coursework, including my first internship, maintaining a 4.0 GPA and scoring a perfect 100 on my comprehensive final practical exam.
I weathered a shit ton of relational and other challenges with a new therapist who is now someone I trust and value tremendously. I saw her once a week. Then twice. And now solidly three times a week.
I finally found a psychiatrist that I don’t hate. In fact, I love my shrink. She is my favorite doctor that I’ve ever had, ever.
School is back in session.
The first day was long and terrifying. The second day was long and exhausting because I had to go to session in between classes. I had exactly enough time to commute there, have a one hour session, and commute back. I made it to class with one minute to spare after running from the train in pouring rain.
Not super fun.
Yesterday was long, but better. The first-day scare tactics my professors love to employ wore off a little and they were more chill and seemed genuinely enthusiastic about the material. I’m already beginning to feel less anxious and more excited about my classes this semester.
And I finally found out my first clinical assignment. It’s about a 25 minute commute via subway train and I’ll be going on Fridays, which means I only have to reschedule one therapy session per week. My clinical director paired some of us up and my partner is a classmate I really enjoy being around. We’re both meeting with the clinic director on Monday to talk logistics and find out the hours we’ll be working.
Very exciting, very scary.
A few weeks ago, the woman I call “Mom” called me and left a voicemail. She wanted to ask me a favor and requested that I call her back. I returned her call as soon as I got home.
She repeated that she wanted a favor and asked me what I was doing that Thursday and Friday (as in two days from this call). I told her nothing (since I was out of school and work by that time, which she knew), so she explained how her good friend was in town for a job interview. She was scheduled to fly home on Thursday, but had an overnight layover in my city. Her connecting flight wouldn’t leave until Friday afternoon, so she asked if this friend could stay with Wife and I on Thursday night.
Then she referenced how her son had stayed with us for a month last summer while he looked for work. He slept on our couch through all of August and it was (mostly) fine, so she suggested her friend could also sleep on our couch.
My knee-jerk reaction was to say yes, so I did. But I only said yes because I felt very put on the spot. I’d just told her that I was free, and she knew that my schedule was open. Plus we did in fact let her son crash on our couch for an entire month, so what excuse could I come up with at that point?
As soon as I agreed to the favor, I heard her tell her friend, “She said yes! Just like I said she would! She’s the best!” and I realized (with a bit of horror) that her friend had been sitting next to her as she asked me for this favor.
I suppose this seemed like a no-brainer to her, but it’s not so simple for me.
As I’ve mentioned recently, my schedule is about to become a total clusterfuck.
I actually only have two classes with two labs this session, but since we also have our first clinical affiliation coming up, we can only hold those classes on two days of the week. Thus, we have to fit twelve lecture and lab hours into two days. Wednesdays are reserved for affiliation seminar (whatever that means), studio hour (whatever that is), and Physical Therapy Club (of which I am the President).
Therefore, the yet to be assigned clinic hours will happen on the remaining weekdays. As I understand it, we will have clinic on Monday and/or Fridays and it could be all day or half the day – which could be either morning, afternoon, or evenings. And we don’t yet know where these clinics are, so my commute could be twenty minutes or two fucking hours. We have no idea.
I also have to go to physical therapy 2-3/week for the next six weeks to treat my own janky hip/leg/back/everything. And, of course, I have psychotherapy 3x/week. Plus yoga class and regular gym time. And there should probably be time to sleep, eat (meh), study and occasionally talk to my spouse and friends (social life? haha). Also, although I attempted to respectfully resign from my job in the Anatomy Study Hall, I was told that was “unacceptable” and that I need to give hours. Oh sure! No fucking problem.
Anyway. I explained all of this to the therapist last week because she’s trying to figure out her Fall schedule. I was really overwhelmed by the task of fitting my schedule with hers so I just kinda blew it off in session. She gently reminded me that she can absolutely be flexible and make three sessions work around my schedule, but she does need some advance notice.
So I’ve basically made it. In less than 24 hours I have therapy again. Pretty sure I can make it to 4pm tomorrow without any major event. Phew.
I feel good about how this break has gone. It’s been surprising, actually. I didn’t predict that I would fall apart, but I didn’t predict that I would spend this time feeling mostly stable and okay about being separated from the therapist, either. This is new. I’ve never experienced anything like this before in any relationship, let alone with a clinician.
But I do miss her now. The therapist, that is. I am reaching a point where I find myself thinking about her more often. I have so much I want to tell her. And we left off on a very important note that deserves a lot of attention. I’ll probably re-read the posts I wrote that week just to jog my memory and bring all of that stuff back to the forefront.
I know it will be tricky to dive back into the material. It probably won’t be easy and we likely won’t just jump back in where we left off. But I think we’re in a very good place right now and the time away will hopefully only make our relationship stronger.
I didn’t want this time off from treatment, but I think I needed it. This week has been a true week off for me. No work, no school, no therapy. I was able to just be with myself – read, write, watch tv, exercise, meditate, etc. I could simply flow with whatever made sense and felt good in the moment. It was relaxing and I desperately needed to relax.
Things I Learned In Therapy 