Wednesday, August 12, 2015

The Elephant in The Room

It's kind of funny how ignorant people can be. I mean, I say "funny" because the reality is, if you don't learn to laugh at what they say to you, then you'd probably cry instead. Luckily, I've gotten to a point where I myself have said, heard, done, and seen just about everything in the book, and rarely fall into the blubbering, teary demeanor... no, I just go straight on the one-way train to 'Pissed-Off City', population one.
Here's a quick update just to set the stage for the little anecdote I'm about to share: I just discharged from inpatient/residential treatment in Denver, Colorado to come home and live with my Dad for about a week before I transition back to my college in Texas. Prior to this, I hadn't seen my Dad since mid to late April (so about 4 months), and I was very much stuck in the eating disorder cycle when last we were together.
I'll preface my story with this: I don't blame my father for any of what transpired. After seeing my enter, leave, and re-enter treatment 11 times, he was understandably frustrated by the goings-on of my anorexia, and had certainly seen me through some pretty hairy phases. This last time, he put his foot down and told me he was absolutely, 100% done with my eating disorder. It was no longer welcome in his house. If I chose to continue on the path I was rapidly tumbling down, he was going to cease having a relationship with me. When I first heard this from him, I was hurt, angry, and depressed. I was so far down in the black hole of my anorexia that I really could see no way out- my brain and body were so compromised that there is no way I could have made my way back to a normal life without intervention. Consequently, I thought my Dad and I would never have a relationship ever again- until I finally sought out help and started to get my head back on my shoulders.
Proud of all the work I'd put in, the distance I had established between myself and my illness, I was really excited to see my Dad again. Yes, I was/am still struggling with things such as body image, restricting urges, exercise compulsions, and OCD-type rituals, but things were 110% better than they had been before I entered treatment. My Dad knew I wasn't going to be perfect- we had discussed this- but he still expected that I was going to do my best.
I expected the warm hug I received when he collected me at the airport. What I did not anticipate, however, was the first words out of his mouth, "You look good. So much better. I'm so happy to see that you've gained weight."
BOOM. The words that many of us with eating disorders absolutely dread... 'you've gained weight'. Even 'you look good' can carry a negative connotation. I mean, what the hell is that even supposed to mean? Was I ugly before? And it's not as if my Dad hasn't been told not to say such things before. We've had enough rounds of family therapy for him to understand that those aren't really the sorts of comments I can receive with pleasure. I forced a half-hearted smile and thank you, but inside I was furious. No one was supposed to talk about my weight. No one. How dare he? How DARE he?

But then, almost as suddenly as my irritation sprang up, it was replaced by something else. An epiphany of a sort, or if not that, then at least an acceptance and understanding. Granted, my father should not have said those things after being explicitly told not to, and no, they were not comfortable to hear. But they made me realize something important, something that I think we sweep under the rug far too often because we deem it "too triggering", "too much to handle", or even, by some, "unimportant."
Yes, I said it. The dreaded 'W' word. I know we hear all the time that eating disorders are not about food and body, and that's true-to an extent. When I was 11 and developed anorexia, I was doing it because it made me feel safe and secure and less anxious and depressed, not because I wanted to get skinny. But as the years went on, I found myself getting sucked into the body image/weight issues more and more, and although at its core my eating disorder was still not really an issue about food, the manifestations of it were.
For a long time, I couldn't really reconcile this. I knew I really didn't actually care what I weighed, despite what I might have protested. It wasn't the sole, perhaps even the main, reason why I engaged in the behaviors I did. But at the same time, I felt obsessed with it. I felt like I did care- and I cared a lot. So how can this be?
My answer, courtesy of Psych 101 last semester: cognitive dissonance. The practice by which when our actions don't line up with our values/thoughts/desires, we have to change something in order to alter the discomfort that results. The logical thing to do would be to shift our actions in line with what we really value, but somehow, this is rarely what happens. Instead, we shift our values and thoughts so that they are in line with our actions. Basically, I didn't care about my weight and body, but because I was restricting and over exercising and doing things that made me lose weight etc., I automatically changed my thinking so that I didn't feel purposeless. I could continue acting the way I had been without feeling as uncomfortable about it.
Now, I'm not saying that this realization means that I turned around and threw out all my previous worries to the wind. Actually, it changed very little, because it turns out it's a heck of a lot harder to convince yourself that you don't care about something that you've just spent 8 years of your life focused on. My mind still gets hooked easily on thoughts about calories, food, sizes, and appearance. I still judge myself based on these things. But at least now I realize that I have to deal with them rather than just sweeping them under the rug, if ever I am to get free of those thoughts.
You see, I think by giving things power as 'triggers', we validate our belief that they matter to us, that we are not strong enough to handle them. But we are. It's kind of like with eating- it sounds absolutely impossible to do until we just jump in and commit. We CAN eat, we just convince ourselves otherwise.
So what I'm about to do and say next may make you very uncomfortable. I'm giving you a heads up if that's not something you are ready for. Stop reading. It's your choice. What I'm about to talk about is probably "triggering" to many people. Beware, I am going to actually use real numbers and specifics. Why? Because I'm putting it out there. I'm letting it go. I'm forcing it to become just numbers again, rather than something with a lot of meaning to me. I'm distancing myself from the power of weights, from my almost possessive nature over these 'secrets'. Because honestly, weight doesn't fucking matter. What matters is that you were/are sick, and that made you miserable, and you stopped really living. You started putting weight up on a pedestal instead, but now you don't address it, and as a consequence it still has power over you.
Reality check/ time for my admittedly overly blunt way of talking about things. If you entered treatment for anorexia nervosa, often times for bulimia as well, then in order to get better, you're going to gain weight. It may be a lot, it may be a little. But it's inevitable. Sorry. That's just the way it works. You're going to look different. I know that's uncomfortable to hear, but it's also true. Accept it. Reality is, before all this, you looked like a fucking zombie. Your skin was ashy and dull, your hair had no shine, your eyes were haunted, your limbs stuck out like awkward toothpicks. You WERE, actually, in the nicest way possible, ugly. In a way, that's a good thing- if you stayed gorgeous when all your body systems were shutting down, well, then, you'd probably have a lot less energy dedicated to keeping you alive- you'd probably be dead.
I didn't want to believe this when I came into treatment this time. Despite being at a lower weight than I have EVER been (okay, excluding my youth when I was a hell of a lot shorter, so it wasn't abnormal), I was averse to anyone saying anything negative about my appearance. I thought it was unfair- I was mentally ill, I couldn't help it. Conversely, I didn't want to hear anything positive about how I looked either. I felt like a zombie, so in a way, I wanted to look like one. I wanted to look like I was dying- it confirmed that I was sick. I clung to the number on the scale like a life line- I had no other real concrete way of defining my illness. I was desperate to feel "sick enough" so that I could start on the path to recovery. I thought that if I didn't prove myself as being genuinely, truly ill, then I didn't deserve to get better. I needed to be the best anorexic. I needed to be so sick that no one could ever doubt my illness.
Not to put words in your mouth, but you probably felt similarly. It drove/drives you crazy when you see someone else who you perceive as being more sick than you, whether that means they weight less, have worse vital signs, have been ill for a longer length of time, eat less, exercise more... the list goes on and on. You will hang on to whatever you see for a reason to NOT get better. It's easy to make excuses. So I'm going to attempt to force you to come to terms with it- apologies for how hard it will be. I'm hoping it has a benefit. I wouldn't say it if I didn't think it did.
I entered treatment this past time at a weight of 70 pounds. There are people who came in at higher weights than me. And, much to my chagrin, there are people who came in at lower weights than me too. I thought that meant I wasn't sick enough. I didn't deserve to be there. Bullshit. We have to get over it. We have to start realizing that THE WEIGHT DOESN'T MATTER. It's a number- it's been like a life preserver out there in the world of the unknown, but guess what? You can swim. You may not want to, but you can. Let it go.
You weighed what you weighed. You ate what you ate. Stop getting so wrapped up in those things that you can't take the next step forward. You perpetuate the cognitive dissonance by holding those numbers close, making yourself feel like they matter to you. They only matter because you're making them matter, if that makes sense. I don't know what I weigh now. A part of me, the "curiosity killed the cat" part, wants to know. But the main thing is, I'm going to end up at the weight I'm supposed to be no matter where I started off. If you stay in recovery, so will you. And it doesn't make any difference where you started.
So you got down to 60 pounds? Congratulations. I don't care anymore. You have to let go of the competitiveness in your eating disorder at some point, or it will continue to matter and you're going to slip back into it again. Accept that wherever you started out is as low as you're ever going to get anymore if you want to recover. You were there, now you can't be anymore. If someone else got "worse" than you, too bad. It sucks to hear it, but you can't go back now just to beat them at something you don't even want to win at anymore. Just think about it.
So, yes. My Dad told me I'd gained weight. That I don't look like a walking corpse anymore. And my first reaction was negative. I'll admit it. I still am not totally gung-ho about what I look like, I still hate the idea that the number on the scale is higher than when I went in to treatment. But I can't just lie to myself about it. I'm moving on.
And, in case you are wondering, I fully believe that you need to restore ALL THE WEIGHT if you want to recover. All of it. Every ounce. Kicking and screaming and fighting is just a way that the ED maintains its power- making the weight something that matters to you. Let the professionals worry about it. You have better things to do. I know it's difficult when you first start restoring and you feel so much better that you convince yourself it's okay to stop- after just 3 days into my stay this last treatment, though I knew logically there was no way I was at my goal weight yet, I asked my dietician if we could stop. I had energy again. I mean, it's freaking amazing what your body can actually do if you start to nourish it. Like, "Wow. I can walk up the stairs without passing out now." Or, "I don't need to wear 4 layers of clothes to stop shivering." Or, "My heart doesn't feel like it's about to stop and my chest isn't in splitting pain."
But that's not good enough. You need your LIFE back, not just simple, everyday bodily functions (and those won't really stay working if you don't get to your goal weight, FYI). It's totally up to you what to do with the weight piece now. For me, I think knowing my goal weight helped me to desensitize and start seeing it as just a number. For others that may not be the case. But whatever you do, do it to stop this obsession.
Sick enough? Gained weight? Ugly/pretty/thin/fat/toned/flabby? Doesn't matter. What does is your life.

Thursday, August 6, 2015

You Need More Than Magic

When I first embarked on this long process toward recovery, I was an innocent, naive, mind-numbingly positive 11 year old who swallowed up the messages in such books as "Life Without Ed" by Jenni Schaefer and "Making Peace with Your Plate" by Robyn Cruze as if they were the antidotes to all my self-critical thoughts and even outright self-hatred. I practiced talking back to an empty chair sitting across the room from me, pretending that I could be magically cured by chocking up all my problems to an imaginary person named "Ed" and simply telling 'him' that I would much prefer to eat a slice of pizza over half a cucumber. I truly believed in these moments that I was 'deciding' to recover; that the miserable months I had spent painstakingly counting out each individual Cheerio in my breakfast bowl to ensure exactness or getting up in the middle of the night to pour out the Boost my parents had stashed in the cupboard and fill the empty containers with water were simply a time where I just hadn't known any better or hadn't had the strength to "fight the voices plaguing me".


I'm not angry at my younger self for buying into these fantastical views of recovery- she didn't know any better. Her fierce hope that she could shed her disordered existence as easily as she had slipped into it made her vulnerable to the messages that all she needed to do was make a simple choice to NOT have an eating disorder, to tell some imaginary enemy that she was done with him, and just muscle her way through to the other side. When you're 11 years old, this sort of thing sounds fairly reasonable. You get a cold, you DECIDE to take medicine, and you get better. You get a scraped knee, you DECIDE to put on a bandaid, and the wound heals.

There are several major flaws in this sort of logic. The first, and probably most glaringly obvious, is that deciding that something ought to be does not always make it so. I cannot make the world become flat simply because I decide that it should be. Or, in a less comical example, people with cancer cannot just "decide" to get better- they need chemotherapy, and sometimes even then they don't recover. Yes, I suppose you could argue that they have to make the choice to undergo treatment in the first place, but that brings me to the second fallacy in this thinking. It's not the DECISION to get treatment (in the case of cancer, chemotherapy, or in the previous examples, taking medicine or applying a bandage) that causes healing, it's the treatment itself. Therefore, making a choice to recover does not actually do anything- as round-about as it may sound, it's the actual recovering that makes you recover. Third, eating disorders are mental illnesses which are not nearly as simple to fix as a runny nose or a cut. Just as we (hopefully) have progressed beyond telling those with schizophrenia to "stop imagining things" or those with PTSD to "decide to stop acting irrationally", so should we cease telling those with eating disorders to make a choice to recover.

Maybe these things seem harmless from the outside, but these slight semantic changes have enormous impacts. It is because of them that most of our regrettably ill-informed society still think of eating disorders as manifestations of vanity, and death from them as a result of "losing" some metaphorical battle. This is because if we attribute the ability to recover to choice, then we simultaneously assign the act of NOT recovering/staying sick/dying to choice as well, albeit the opposite choice. And that's neither fair, true, or perhaps ever more importantly, helpful for anyone suffering with an eating disorder.

Am I just a cynic who has spent too long in the throes of anorexia to be able to see the glorious light that lies beyond my illness? Maybe. But I'm also a realist. And maybe what Jenni Schaefer and Robyn Cruze and Carolyn Costin and a hundred other recovery speakers rings true for them, that they woke up one day and thought, "Huh. My life is shit because I don't eat like a normal person. Maybe I should eat. I think I will," and voila- RECOVERY! happened (exclamation mark not optional). I'll give them the benefit of the doubt. But for the vast majority of all the rest of us slogging day in, day out with our disorders, that is so far from the truth that it's almost laughable. Here's a more realistic version of the truth: I wake up one day and go, "Huh. My life is shit. (This was pretty much every day for me) I know that I don't eat like a normal person, and that my not eating is driving away friends and family, is the reason I have absolutely no energy, my hair is falling out, my vitals are whacky, and my bones are like an 80 year old's. I would very, very much like to just eat like a normal person and have a non-shitty life." And yet, when push comes to shove, I can't. And it's not some character flaw that stops me. It's the fact that I have a legitimate mental illness, a block in my brain that positive thinking is not going to fix.

So where does this leave us? Some reading this post may feel a sense of despair- if making a choice to get well is not going to effectively cure them of the eating disorder, then what hope is there? I think this is perhaps part of the reason why so many, my former self included, buy into what I am now going to define as the "choice" model of recovery- it gives us a sense of empowerment. We hold the reins. We are in control. That seems a whole lot safer than surrendering to the fact that we're sick.

But here's my take: surrendering to being sick is NOT the same as being powerless. It is NOT the same as giving up. It is NOT the same as saying that you will never recover or that recovery is impossible. It is not even the same as saying that you have no choice in the matter. You do. Every day when you wake up or sit at the table, you have the choice to eat.

"WAIT WAIT WAIT!" You're saying. You just spent a whole article ranting about how people don't have a choice in whether or not they have an eating disorder or whether or not they recover. You're right. I did. And I also didn't actually contradict any of that in my last statement, so I'm going to repeat it.

You have the choice to eat. This is akin to the putting on of the bandaid on the aforementioned scraped knee, the drinking of the cold medicine for the sore throat and runny nose. Choosing to eat is choosing to TAKE AN ACTION that will lead you towards recovery. It in itself is not recovery. It is the absolutely necessary step that leads one to it, but it isn't the same thing. Eating is an action; recovery is a noun. I can choose to do an action, but I cannot choose to do a noun. So yes, I am maybe moving closer to recovery by eating, but it's a small step. I didn't leap there in one epiphany. I will have to continue to choose to eat every single day for the rest of my life. That is my way of choosing something that moves me towards the recovery I want. But I'm still not CHOOSING recovery.

I don't know if how I'm wording this makes any sense at all, but if it does, I hope it helps. I think the reason so many of us stay stuck is that we think we CAN choose recovery. We struggle for years and years thinking we've finally chosen it only to find ourselves in the same old patterns and behaviors. We must have not wanted it badly enough. False. We have to choose the action that leads to the outcome, not the outcome.

To summarize: if you want the end result of recovery, you will have to make some choices. Choosing to recover isn't one of them. Choosing to eat, choosing to not purge or overexercise or take laxatives or engage in any other behavior you can think of.... those are.