Friday, January 13, 2012

On Compliance

I've been back in College City for almost two weeks now, going to therapy and dietary every other day. Since I get weighed and show my food records to R at every appointment, this keeps me super accountable. At the same time, I'm staying alone in my apartment, so there's zero accountability in that regard. No one to make me eat, or to watch what I do/don't eat. I'm fully aware that it would be easy peasy to fill my fridge with baby carrots and lettuce and buy stock in Diet Coke, then guzzle a gallon of said Diet Coke before zipping over to R's office and hopping on the scale. It would be easy to keep fake food records with Boosts and butter and meat and eggs and cheesecake written all over them. I KNOW THIS. I'm not stupid. In some ways, these two weeks would have been the perfect chance to lose a few pounds that I oh so desperately need to lose.

But honestly, that just would've been a huge waste because R and J are expensive and I'm here to get well, not to keep myself sick. It's only two weeks - it's not even like I could lose any significant amount of weight in two weeks, plus the fact that I have anorexia and I do not need to lose any weight and I am actually supposed to gain XX pounds overall.

No, I have not been perfect. I have not hit the full meal plan once since being back here, but I come damn close most days. I've never in my life falsified food records or intentionally gamed the scale. I'm being honest in therapy, drinking my Boosts, and not exercising. I gained a lil weight this week, of which I am trying to be proud. It sucks when doing the right thing feels so crappy and wrong. Although, it is amazing to me how much more progress we make in therapy when I've actually done what I'm supposed to. If I've wimped out on the meal plan all week and/or lost weight, R spends a good portion of our session harping on food issues, which is probably necessary and reasonable if not enjoyable. But if I've followed the plan (or come close), we can actually talk about other stuff. On those days, I leave R's office feeling one hundred percent different and better.

One thing that has befuddled me in the past is how to be compliant but also to struggle. I've always had this implicit sense that if I am a good girl and eat all my food and gain weight, R will think I'm cured and donezo and I best get my well-fed butt out of his office to make room for the real sick people. If I'm not starving and pale and emaciated, then he might think this is easy for me and that I want this, and how the hell will he ever know how terrible I'm feeling? What if I actually have to - gulp - talk about it?

But I am, I'm talking, even though it feels icky and uncomfortable and I've probably cried every single day for the past month (and I am NOT a crier). I think today's session with R was the first one ever that did not involve a ten-minute lecture on Why Kaylee Should Strongly Consider a Higher Level of Care as She is Clearly Not Making it Outpatient. (I guess now I'm fishing?)

Anyway, that's the status of things. Happy Friday everyone!

1 comment:

  1. Really glad that you're staying on the food bandwagon even when your external accountability is at a minimum. I never saw the point in lying to treatment teams either. It's about you, so tricking them doesn't really do much either way and it is your money/time that is being spent--and if you're not making progress, they will figure it out in the long run. Sounds like you know that of course and are handling it well.

    REALLY happy to hear that R. sessions have been more fulfilling! It is amazing how much easier things can be when part of a session isn't spent analyzing why you haven't been cooperative (I say "you" in the general collective sense). And I know I make comments to this effect often, but...R. has a ton of training, and he will know that just because you're compliant and restoring some health, it doesn't mean that everything is going perfectly in your mind, and he won't think your problems or concerns are any less valid. I think most ED therapists feel like they have to get a patient at physically restored just so they can start tackling the deeper issues, and don't treat compliance or weight as a signpost that their job is done. I think at one point ED treatment did go like that (or still does if you ask insurance companies), unfortunately.

    Hang in there, hope you've had a great weekend and are staying warm!