Wednesday, October 27, 2010

"an indicator of relapse is self-isolating"

Relevant, if annoying, Renfrew aphorism. I'm too tired to be with people right now. I can barely manage myself.

I like to compare eating disorders to addictions like alcoholism. It makes sense to me. But I can't imagine an alcoholic feeling like such a failure for maintaining recovery, for pursuing health. I feel like a failure so often, like I lack the adequate discipline to starve or purge or waste away, like I'm no longer strong enough to have a singular obsession.

This post is not coherent.

I'm so tired.

Thursday, October 21, 2010

everyday help

A great post from Carrie Arnold about maintaining recovery when traveling. This is something I need to apply to my everyday life as a college student. I tend to feel guilty about spending too much money on food (a leftover from the hellishly expensive binges of bulimia), and so doing something as simple as carrying around a granola bar or peanut butter sandwich makes my life much less complicated. I don't have to go through the psychological song and dance of debating whether I should buy something to eat, and if so what I should buy to eat and how much, ad infinitum.

Eating disorders are complicated, no doubt, but sometimes even the simplest surface changes (e.g., hey self, you're going to be away from your room all day, you might need to eat something at some point -- here's a granola bar) can make a difference.

Monday, October 11, 2010

Saturday, October 9, 2010

submitted without comment because there's nothing more to say, is there?

This is the very boring part of eating disorders, the aftermath. When you eat and hate that you eat. And yet of course you must eat. You don’t really entertain the notion of going back. You, with some startling new level of clarity, realize that going back would be far worse than simply being as you are. This is obvious to anyone without an eating disorder. This is not always obvious to you.

- Marya Hornbacher

Friday, October 8, 2010

body vigilance

I've started reading Aimee Liu's Gaining: The Truth About Life After Eating Disorders. I'm surprised I hadn't read it before; I guess it somehow slipped under the radar. I'll start by mentioning that her constant emphasis on people's weight (mentioned in specific numbers) is offputting. An Amazon reviewer articulated it perfectly: though in recovery, the author is clearly still caught up in the world of scales and pounds. While I'm empathetic to her continued struggles, I also think she has to accept responsibility for writing a book that could seriously, unnecessarily trigger the very people it's seeking to help. Weight issue aside, I've found it good so far.

When I reached the chapter about the inborn trait of perfectionism, I stopped dead in my tracks at this:

To test for perfectionism, the researchers asked questions like "Did you spend a long time doing and redoing your hair every morning to make sure it was straight without bumps?"


I cannot begin to tell you how many hours of my life I've poured into fixing and adjusting my hair, judging it and always finding it lacking when compared with other girls'. It was always too flat or too messy or too bland. Never, ever good enough. I have cried in frustration in front of a mirror, hairbrush in hand, more times than I'd care to admit. Though therapy, recovery, and Prozac have helped with my body image disturbances, I am still a chronic mirror-checker -- when in between classes or while out to eat or at a club, I generally have to go to a bathroom at one point and make sure I am not, in my own lovely self-dialogue words, "disgusting". It's an embarrassing habit and it causes me undue stress. It always has. No amount of lovely compliments or positive self-talk has been enough to counter it. While my stomach also contends for the dubious prize of "must scrutinized part of the body", the hair obsession has been far more long-lasting, arising well before the advent of my ED.

I still remember, with clarity so absolute that it surprises me even today, one night when I was in the family room with my siblings and mother, testing how my hair looked in different permutations and anxiously asking for evaluation. I was maybe eight or nine. This testing went on for some time until my older sister snipped, "Why do you spend so much time on your hair if it doesn't look good anyway?" I burst into tears, and that phrase has been burned in my mind ever since.

My family thought I was vain -- always checking and rechecking and then rechecking the mirror again because who knows what could have happened to make my hair tangled or static-y or flat or ugly in the past twelve seconds. Their breezy assessment infuriated me, although of course I never articulated it to them. Body image perfectionism was -- and still continues to be -- an incredibly raw subject for me. Describing it would mean articulating layers and layers of disgust and shame.

Another issue -- and god, this is a weird one to explain -- is angles. Yes, angles. This is a private journal entry I wrote about six days before I went into treatment, after spending a weekend trying to hold my shit together enough to attend my sister's graduation in Massachussetts:

I am so gross. I look hideous, by the way. Horrible. Every single time I looked in the mirror this weekend, I was upset at what I saw. Fat, ugly, round, red, messy. Always. (Strange travel-induced memory this weekend: me at twelve, staying at a hotel in Boston and seeing my face at a new angle in the weird mirrors there, absolutely appalled and ashamed at my profile and my stomach, horrified that this was how I looked to the outside world. Crying over it in the shower.)


That memory of being in Boston and looking in the mirror is also seared into my brain. I don't think I'll ever be able to articulate the intensity of the shame I felt after looking in the mirror. It was just so. . . visceral. I think I had gotten used to looking at myself dead on in the mirror and had accepted that that was how I looked from straight-on (even if I didn't like it.) But knowing that other people were looking at me in ways I couldn't control and didn't have access to (from behind, from my far periphery) decimated me. I just remember that feeling of helplessness. I felt like I had utterly failed in my efforts of vigiliance: it was one thing to look terrible, but it was entirely another to look terrible and not even realize it.

I recognized that this kind of obsession was perhaps more intense than others', but not pathological. Just as I spent years starving, calculating calories, bingeing, and purging while vaguely thinking, you know, everyone probably has a phase like this, I'm no so bad, I didn't think this sort of perfectionism was that uncommon. The results of a screening between high-achieving, psychologically healthy adult women and patients with eating disorders would suggest otherwise:

Except for a handful who had overvalued rules and order as kids, the women who had never had eating disorders registered zero childhood perfectionism, zero inflexibility, and zero doubt and cautiousness. By contrast, 60 of the eating disordered had been perfectionistic, rigid, and rule bound as children.


Another indication that there is something qualitatively and intrinsically different about people who go on to develop eating disorders, hinting again that the role of genetics/biology (this time, in the form of inborn traits) influences ED pathology more than culture.

Tuesday, October 5, 2010

meh

Am suddenly, inexplicably depressed as all hell. Not conducive to eating.

So I'm eating what I can. You do what you can do until it's enough.

Wednesday, September 22, 2010

small victories

I just realized that I no longer tally my daily calories in my head regularly. Considering I've been doing this reflexively for about 5 years, this is a big deal. (I will say that my arithmetic skills are off the chain thanks to this habit, but the depletion of my already tenuous sanity definitely tipped the scales -- haha -- toward an ultimately negative behavior.)

When I'm having days where I'm panicking about the amount I've eaten, I sometimes calculate to reassure myself that I've eaten a normal amount as opposed to OMG THE ENTIRE WORLD, but still. Pretttttty big deal.

Saturday, August 28, 2010

fatigue

I always thought I was good with change. I like newness. I like changes of scenery. I can adapt.

People with eating disorders are supposed to fear change. They're supposed to live by rules and habits and plans. I thought I had busted that cliche. After my first day back at college, I only now just realized that I'm only externally good at it, that on the inside my reflexive response to change is to cling to my eating disorder. Out of nowhere, sitting at a friend's house, the thought now I can really restrict and lose weight hit me, and then these thoughts of scales and skipped meals cascaded from nowhere, and it was simultaneously so depressing and so alluring. The thought of all the things I can't stand to lose from getting sick (relationships, trust, hope, stability, happiness) made me cry, and yet the thought of going back to it is almost intoxicating.

I've had a good day full of friends and old faces. I'm not some complete sadsack at the moment. It's just -- oh my god, does this ever get tiring. I wouldn't wish an eating disorder on a single soul.

Tuesday, August 17, 2010

safely walk to school without a sound

For the first time in a couple of semesters, I feel eager and confident about starting classes. I'm taking Principles and Methods of Psychology (okay, not so excited about that one), Psychology of Crime and Violence, Clinical Psychology (!!!), and History of Modern France. Game time: which one of these things is not like the others because it's a requirement for graduation? I'm still looking forward to that one too.

I also have an interview to work in a research lab on campus, on a study researching mothers' psychological adjustment and father involvement. I have my fingers crossed. One of my least favorite things about interviews is that I'm sometimes asked about the lull in my grades and in my experience -- a lull that, super coincidentally!, happens to coincide with uncontrolled bulimia.

My rock bottom occurred during the spring semester of sophomore year. It was a hellish time period where bulimia finally, after three years of admirable effort, succeeded in taking over my life. I was occupied by the sickness. It was as though I was simply an eating disorder embodied: no longer Kelly the Friend or Kelly the Comedienne or Kelly the Writer, but simply Kelly the Walking Eating Disorder. Of particular importance during that semester was loss of "Kelly the Student".

Obvious physiological fact of the day: your body and your brain need food to function. And that's just the bottom line. When you throw in unmedicated depression that renders you inert and half-dead, and, perhaps most cuttingly, a sense that you no longer even have a future so why bother, reading and writing and caring about things becomes very difficult. I think my body and my brain were too focused on surviving, and so my ability to read for more than five minutes at a time went right out the window. Oh god, was that a terrible day, when I realized I couldn't read anymore. Horrifying. Obviously this all had an impact on my grades as well.

To this day I sometimes feel guilty that I wasn't able to stick it out, to really dig in my heels and power through. I get angry, sometimes, when I think about my History and Systems of Psychology class. I entered finals with a 98% average. . . and then came the final paper, worth 20% of the total grade. And I couldn't do it. I remember crying in my room at home (I had gotten an extension from the professor and left campus before completing it) because I could not think, could not for the life of me make thoughts cohere. My brain was decimated from exhaustion and malnutrition and the looming reality of inpatient treatment. So I emailed like three sentences to the professor and said I simply couldn't do it. That lowered my grade from a very high A+ to a B in one fell swoop. I sometimes think of girls from treatment who managed to pull out great semesters and get into grad programs before entering residential, and the crazy bullshit eating disorder competitiveness sets in. And I have to laugh at that: beating myself up for not being a good enough perfectionist, for succumbing to a silly thing like a life-threatening eating disorder. And then I tell myself that my GPA is still a 3.6 and I think, good Lord, I'm insufferable.

But on most days, I can accept that it's over and done. I still have two semesters, and I'm really excited for both of them. It's been a year since I've exited treatment and I finally feel like my brain is settling back into my body, back to its old self. I can sleep, and I can eat relatively well most of the time. I'm ready to go back to my old nerdy self and it feels fantastic.

Saturday, August 14, 2010

"sitting with my feelings"

In Renfrew-land, "sitting with one's feelings" means experiencing discomfort, frustration, anger, and sadness without using the eating disorder as a crutch or distraction or dissociation. So, for instance, when I feel like I'm crawling out of my skin because I'm too full, which I am tonight, I am supposed to live through the absurd discomfort without purging or restricting. I should also coexist with my irrational belief that I've suddenly gained a lot of weight, that I'm totally fat now. UGH SHUT UP BRAIN.

It's noble and reasonable and worthwhile to "sit with my feelings", but in the moment it's really fucking annoying. Whenever a nurse or counsellor or therapist at Renfrew said this, at least one person would kind of freak out, either in the moment or afterwards. It's like UGH SHUT UP, YOU DON'T KNOW WHAT THIS FEELS LIKE, STOP BEING SO PATRONIZING. I suppose this is similar to what alcoholics feel. It must be like, yes, yes, for fuck's sake, I know I can't drink, I know I'm a better person in recovery, I know I have an addiction -- but all I want to do at the end of this shitty day is have a glass of wine, is that too much to ask?

The truly absurd thing is that I'm mostly full from too many fluids. I felt dizzy at work today so I had two big glasses of OJ and about 40 ounces of water in a short time period. When you factor in the three coffees I also had at work, then the diet Coke. . . you can see how my stomach feels pretty distended. I feel gross I feel gross I feel gross, but tomorrow's another day, eh?

I almost don't want to end on an optimistic note because I need people to know that this SUCKS, that it is a terrible terrible pervasive feeling. Rawrrrrr, stupid eating disorders.

Wednesday, August 11, 2010

focusing on not focusing on my stomach (and face, and arms, and thighs, and argghhhhh).

Having a bad body image day is analogous to crawling out of my skin. It's this acute awareness of my flesh that creeps in slowly in the most mundane moment -- when I'm driving or reading or talking to a friend -- and then infiltrates my entire stupid brain, growing more urgent as it remains. I feel like I am sheer flesh at the moment -- just fat without discernible shape or muscle. It is deeply uncomfortable.

It doesn't matter that my weight is pretty stable at a moderately thin weight, nor does it matter that I've received a lot of nice compliments from strangers and friends, the latter of whom are pretty much universally supportive all the time. And it doesn't matter that I intellectually know that I am not, in fact, grotesque -- because, honestly, if my eating disorder were an intellectual affair, I'd've thought my way out of the whole shebang in five minutes.

Rawr. Obnoxious Pollyanna-esque silver lining: this feeling always goes away with a bit of time. In the meantime, I have to focus on not restricting/purging/being eating disordered and try to get in some yoga. It makes me feel much more connected and cohesive and sane. And, more pressingly, I should get some sleep.

Tuesday, August 3, 2010

subconscious

I was watching Intervention* with my mother. It was this heartbreaking story about a woman addicted to painkillers and how her family had to deal with it. Very very sad. Then one about crack addiction came on, and I jokingly said to my mom, "If you ever get the urge to take up crack, please resist". Then she jokingly said, "Let's hope we never have to do an intervention on you." Uh -- awkward.

There actually was a mini-intervention done on me in high school. I literally just remembered this -- maybe repression, maybe because that seems like so long ago. Long story short: I got a note in homeroom from the guidance counselor to go see her, and I was like, whatever, I'm a senior, she probably wants to talk about colleges. Turns out she wanted to talk about self-starvation and sadness. Friends had sought her out. They were awkwardly sitting there and we talked for a bit, and then agreed that I'd see the counselor every so often. I was horrified and embarrassed and angry at my friends, but in truth part of me was relieved.

I was a straight-up restricter at the time and had lost a bit of weight, but not enough for the counselor to adequately give a shit. Which -- it's not like she was a bad person or anything. It wasn't apathy, I guess. I'm going to sound like a jerk, but I was a very self-aware semi-adult with an exceptional knowledge of eating disorders**, and I felt like I was smarter than her in that respect. I also had a stubborn refusal to deal with life, and she didn't specialize in EDs. So that was that. The whole affair left me feeling like a silly girl who wasn't even sick enough to warrant serious attention and obviously she must have thought that I was too fat to really have an eating disorder. It was. . . counterproductive.

When I passed out later in the semester due to hunger/faintness, I got pushed to my parents' car in a wheelchair in the middle of the hallway and I saw her and she just stared and it was this terrible, terrible moment of awkwardness and silent blame and guilt.

ANYWAY. It was an uncharacteristically weird comment from my mother, who is in all other respects educated and very empathetic in all things eating disordered. I wound up saying, "Well, that hits a little close to home, huh?" and she said, "Why?"

Why? Because I was in treatment for ten weeks. My mother (and father, and sisters, and brother) visited me at a place where girls/women were pacing around and crying and freaking out about pasta, and she cried when I told her about my suitemate at Renfrew who was dying -- not immediately, not right away, but in a wasting kind of way, in a slow-burn, slow-fade kind of way. I was -- and am -- one of those girls.

This is not a coherent post. It was just a profoundly weird interaction. Maybe she just didn't want to think of her daughter as having something in common with a 52-year-old crack addict.

*I'm feeling morally conflicted about this but I don't have the energy to write about it at 1:25AM. But I know I will soon enough.
**People with eating disorders tend to have an obnoxious knowledge of them, at least in my experience of knowing people with EDs.

Sunday, August 1, 2010

on hunger

I have a really low appetite, and I don't know if that's due to the eating disorder fucking up my metabolism/hunger cues or if it's just what I'm naturally like. And it's sad - I actually have no idea what I'm "naturally like" in regards to hunger because I can't remember the last time when I wasn't weird about it all.

But basically, due to a bunch of different circumstances, I didn't get to eat much today. Then my family and I went to my father's friend's private restaurant-opening party. There was a buffet, which I was actually comfortable with. . . until I realized it was not vegetarian-friendly. Long story short: I spent a while at the restaurant weak with hunger. After about 45 minutes, the owner made some vegetarian hoagies. I was really grateful - I felt like my vegetarianism was such an imposition. I was exhausted and cranky and inpatient and all I wanted to do was go home and eat "my own food" and possibly sleep.

And it made me realize that, oh my god, I was always that miserable when I was sick. A lot of my problems were psychological, but there's also the simple physiological fact that humans need food and they feel terrible without it.

It made me really appreciate recovery.

And those vegetarian hoagies were really good.

Wednesday, July 28, 2010

annoying eating disorder terminology pt. 1: "food rituals"

Confession: I am a serial muffin dissector.

This is what we refer to as a "food ritual". If you've even been in residential or inpatient treatment for an eating disorder, you will come to hate this terminology, because any person will come to hate anything that they hear SIX THOUSAND TIMES A DAY. To be fair, it is those counselors' jobs to kindly but firmly say things like, "See, what you're doing is a food ritual. In the real world, people don't tap their fork to their plate three times after they eat pizza."

The gist: almost everyone has a few little eating quirks. These are mostly habits they develop as little kids then grow out of: eating food on their plate in a clockwise fashion or eating foods by color (yellow first, then green, then brown. . . ). I don't know, things like that. But, as with pretty much everything in the world, people with eating disorders take this to an unhealthy extreme. They develop these rituals mostly because the anxiety of eating a "normal" amount of food and digesting it like a Real Person is suffocating when you've spent so much of your life doing the opposite of just that. So food rituals aren't just actions; they're systems, and they generally serve as a way to lessen anxiety by exerting familiar control over eating, to take the edge off of an incredibly uncomfortable situation.

They tend to make little sense, but it is extremely anxiety-provoking for the patient when they're stripped away. In treatment, there was a girl, for instance, who had to eat an apple in 20 bites. No more, no less. This was an intelligent girl. She recognized the absurdity of it, but she also fiercely clung to it on a visceral level. A few other people "had" to cut food into laughably infinitesimal pieces.

For me, there is a positive correlation between the amount of social anxiety or insecurity I'm feeling and the number of muffin pieces that wind up strewn across my plate. Muffins are an easy culprit because you eat them with your hands -- it's like God WANTED you to rip them up into countless pieces, right?

Occasionally it extends elsewhere. Once, on a date, I ordered a Nutella and strawberry crêpe. (When I'd realized that we'd be going to a crêpe place, I spent the rest of the afternoon/evening stressing out because I had just eaten a big meal and wasn't intending on eating anything else and oh my god the world is ending, omg.) I cut it. . . and cut it. . . and cut it. Over and over, until it looked like a crêpe massacre had taken place on my plate. I was aware of how stupid it looked, how childish, but I couldn't help it, and it was embarrassing. And on the outside I could see that it looked like a coy oh-look-at-me-eating-like-a-bird-how-precious-and-feminine scenario, but it wasn't. It was actually more of a you-are-evaluating-me-right-now-and-thinking-I'm-probably-inadequate-and-of-course-fat-so-I-need-an-eating-disorder-way-of-handling-this. This kind of behavior existed long before the advent of my eating disorder, too: I remember being pretty damn young, definitely pre-teenaged, and conflating people-hate-me anxieties with my perceived overeating and high weight. (In reality, I was eating a perfectly normal amount and I was really quite thin. I didn't go on to develop an eating disorder for no reason.)

The crêpe affair actually happened when I was like. . . six months out of treatment. So, suffice it to say, there is still headway to be made in this particular arena. The Ziploc baggie in my pantry full of leftover muffin crumbs from breakfast could tell you as much.

Tuesday, July 27, 2010

how intelligent people come to believe in absurd things

A while back, I was writing a piece for a fiction class about the children of a mother with schizophrenia. At some point in the story, I was working through a way of describing what schizophrenia must be like, inspired in part by a throwaway comment in Ron Howard's A Beautiful Mind: "The nightmare of schizophrenia is not knowing what’s true. Imagine if you had suddenly learned that the people, places, and moments most important to you were not gone, not dead, but worse – had never been. What kind of hell would that be?"

Anyway, in the story I was trying to inject some of this truth -- the hell of not knowing, the gap between objective reality and personally experienced "reality". I wound up cutting the scene because it was sub-par (I am a proudly ruthless self-editor), but in writing it I found what remains my working layperson's definition of mental illness and disease:

Believing in untrue things that make your life hellish.

Simplistic? Oh hells yes. Simplistic enough that I've never mentioned this theory to any psychology major or psychotherapist or anything like that. But to me, it tends to encompass a lot of different mental disorders, eating disorders of course included.

For example, something that came up yesterday: I have a specific weight in my mind that I would like to reach -- a number far below what is medically or personally healthy. After a couple of weeks of zero appetite and lessened caloric intake, I am now closer to that weight than I've been in while. (Well, relatively speaking. I'm talking about a rather sizable loss, here. Because I'm nuts.)

Anyway, even now -- even before I reach that number -- it is already inadequate. It is already not enough. I am acutely aware of the pointlessness of losing weight. I know it will not take me anywhere worth going, and I know that it will never satisfy me. I know that it will cause me incredible anguish and isolation and sadness, because it will involve diving back into ED.

At the same time that I know this fact, I also believe its logical contradiction: I will feel better at this weight and I will look better at this weight; ergo, I must reach this weight. I will be able to reach this weight and maintain it without spiraling into an eating disorder frenzy. Once I reach this weight, it will be enough.

Both of these ideas are constantly yapping around in my brain, shrill and shrieking, jockeying for position, and I tell them to shut up because I don't care any more, don't have the energy or will, but the sheer fucking loudness of it all is enough to drive you crazy.

The only thing I knew how to do was keep on keepin' on like a bird that flew, tangled up in blue. Thanks, Bob. You've got my back.

beginnings

I can't start with a carefully honed history of my eating disorder or a nuanced explanation of the neuropsychological or existential or psychological underpinnings of my eating disorder or any one else's eating disorder. I can't offer a definitive list of What An Eating Disorder Is and What An Eating Disorder Is Not, partially because no such lists exist and partially because I lack the colossal emotional/intellectual energy making such lists would entail.

It's well within the realm of possibility that three people will ever read this, and that's okay. I started this because it's been roughly a year since I've been discharged from residential treatment for bulimia, and though I am doing well, I am also so tired of fighting eating disordered thoughts every single day that I want to scream. So here's an outlet, I suppose. I'm not going for emo ramblings of how ~*hard*~ recovery is. Though it is without a doubt the most difficult thing I've ever attempted, that's besides the point, and it's also boring. I mostly just want to write about this because it dominates my life, because the eating disorder and the ensuing recovery have been the most formative experiences of my life. I write if only because it's impossible not to. Also, I have to say that I find eating disorders sheerly fascinating on an intellectual level, so there's tons of interesting theories waiting to be expounded upon out there in the philosophical ether.

Anyway. The beginning and middle of this poem encapsulates where I'm at right now, and the end is just lovely.

You are tired,
(I think)
Of the always puzzle of living and doing;
And so am I.

Come with me, then,
And we'll leave it far and far away—
(Only you and I, understand!)

You have played,
(I think)
And broke the toys you were fondest of,
And are a little tired now;
Tired of things that break, and—
Just tired.
So am I.


But I come with a dream in my eyes tonight,
And knock with a rose at the hopeless gate of your heart—
Open to me!
For I will show you the places Nobody knows,
And, if you like,
The perfect places of Sleep.

Ah, come with me!
I'll blow you that wonderful bubble, the moon,
That floats forever and a day;
I'll sing you the jacinth song
Of the probable stars;
I will attempt the unstartled steppes of dream,
Until I find the Only Flower,
Which shall keep (I think) your little heart
While the moon comes out of the sea.


-- e.e. cummings