When I came back to College City about three weeks ago, R suggested we write up a contract to make therapy more productive. Basically, the contract states that I must gain each week or the meal plan will get boosted; and that if I ever fall below XXX lbs, I will get admitted to an IP program. Seems harsh, maybe, but I've honestly been willing to cooperate anyway. What I like about the contract is that it lays out clearly defined goals - in addition to those two major overarching stipulations, we also set weekly goals in each appointment, like "add X to lunch" or "drink Y supplements on Z days" or stuff like that.
So far, I've met every goal - including gainage. Today, though, R pointed out that despite me following the meal plan and drinking Boost, I gained a whopping total of a tenth of a pound since my last appointment. And apparently that doesn't exactly cut it. Although I satisfied the official goal of "gain each week," that doesn't necessarily mean I'm a robust picture of health. And while I genuinely want recovery and don't want to be sick anymore, that's a lot easier to say when I'm not actually gaining any real weight. Part of me is incredibly relieved, thinking: I want recovery just as long as I can stay underweight.
The next step, according to R, will be to set more concrete, substantial weight-gain goals. We didn't talk specific numbers yet, but he was pretty clear on the fact that gaining a tenth of a pound a week is not okay anymore. Probably starting next week, we will include a minimum weekly rate of gain. I'm not exactly sure what a reasonable rate is...maybe around a pound a week - does that sound right? I think that's approximately how fast I gained last year, although it seemed to happen in fits and starts rather than in a linear pattern. I'm a little hesitant to commit to that again, but I know it needs to happen. At the rate I'm going, I won't reach a minimum healthy BMI for, like, three years. So that needs to change. And for now, I'm okay with that. Ask me again in a few months when I'm feeling fat and horrendous...but for now, that seems reasonable.
The idea of a contract scared me at first. I didn't want to commit to something I might not do. I didn't want consequences - that made it feel too much like I was getting in trouble. But now, well, I've undergone such a mental shift that I think I would be eating to gain regardless, but I really like having it laid out in black and white. It's also making me realize that I don't want to just scrape by. Yes, I am doing what is required of me by gaining 0.1 lb a week, but I'm not getting healthier. I'm not conquering the hard, yucky stuff that keeps me mired in the eating disorder. I'm not breaking down any walls. And if I'm not doing any of that, then what's the point?