School, Packing, Therapy

We finished classes yesterday, so now I have a full week of nothing but paper-writing and studying. I hate the unstructured time, especially when it feels like I need to be doing something productive relating to schoolwork every second of the day (ahem which is why I am on Blogger). Yesterday was actually kind of sad because I loved my classes this semester and I didn't want them to end. If I weren't so paranoid about privacy, I'd give a big shout-out to my university on here. Coming here was the best decision of my life. I picked it after getting deferred from a fancy-schmancy Ivy League school (no offense to the Ivies - they're obviously fantastic schools), and although I was devastated at the time (DEVASTATED), I can now look back and be glad that things unfolded the way they did. I don't even remember what it was like to sit through classes in high school staring at the clock, willing the hands to move faster so I could get the hell out of there. Now, I wish my classes were twice as long and I hate the fact that most of them only meet twice a week.

Nerdy tangent over. I guess I shouldn't have said that paper-writing and studying are my only obligations, because I'm also moving in a week. It's a long story, but basically I'm subleasing an apartment down the street for the summer, then moving back into this building (but a different unit) in August for the next school year. Have I mentioned I hate moving? Well, I DO. I hate tearing down my room, carting boxes, packing stuff into my car, unpacking, toting everything up multiple flights of stairs, rearranging....argh. Between now and the first week of May, I need to be totally packed up and gone. Plus I will need to have written four papers, taken two exams, and finished several projects for work that I've been neglecting for, um, several weeks. I'm not going to panic. I'm not going to panic. I'm not going to panic.

On to the therapy situation: I saw R yesterday morning and I'm not fired. In fact, we had a better-than-usual session and I'm feeling a little more optimistic. I'm sticking with him for now, and we outlined a plan that I feel really good about.

We talked about major changes to be made, and we both made some concessions:
- He wants me to enter a higher level of care, but accepts that I'm not willing to do that.
- I want to be able to come clean about falling short on the meal plan without having to worry that he will a) pressure me into IP, b) call my parents to recommend IP, or c) kick me out for refusing IP; but I realize that he has a professional and ethical obligation to act as he sees fit.
- He wants me to gain an absolute minimum of XX pounds, but acknowledges that I am not in a medically dangerous place, and that using scare tactics about my bones, heart, eyes, etc. is NOT an effective way to motivate me. Nor are ultimatums involving school, work, hospitalization, etc.
- I don't really want to gain any weight (surprise!) but I understand that it needs to happen, health-wise, and that my reluctance is a symptom of the illness rather than a rational, objective decision.

And here's the part I'm most proud of: I explained how the intense focus on the meal plan, the Boost, the weight gain etc. just freaks me out and makes me feel like a failure for not coming through week after week. I explained that my biggest impediments right now are the terrible body image, the OCD-ish rigidity about meal times, and the automatic, incessant calorie-counting. I'm bad at speaking up for myself, especially about stuff like this that makes me uncomfortable and self-conscious and weird, but I did it, and it seemed like R was really receptive to my suggestions.

So, our new long-term goals:
- Address the compulsive calorie-counting
- Introduce more variety of foods

And, of couse, weight gain. Don't think he's letting me off the hook on that one, although he's definitely backing off in some respects. But, of course, I'm underweight and the gain needs to happen. I KNOW. I'm not happy about it, but I realize that that's kiiiind of a nonnegotiable aspect of eating disorder treatment. Trying to become okay with it.

Oops, this was supposed to be a quick update, considering how much work I have to do. Gotta go, everyone. Happy Saturday!

Variety Over Gain

I saw my dietician this morning for the first time in three or four weeks. Surprisingly, after my tough session with R last week, it was a pretty positive thirty minutes. She and R had spoken briefly since Friday so she was aware of the situation, which made it easier and much less awkward than I'd expected. She promised that she would never tell me I can't come back and see her, although we acknowledged that there has been a serious lack of progress over the past eight months and that changes need to be made.

So, taking into account that the future of my treatment situation is still very much up in the air, J and I talked about some realistic next steps. One possible suggestion was to concentrate solely on increasing variety rather than calories. Obviously weight gain will still need to happen, but I think my brain needs a change of focus. When weight gain is emphasized so heavily all the time, I tend to shut down and tune out all recovery-related recommendations. Right now, my brain can't get past a place of I don't care about anything else, I just don't want to gain weight. I'm becoming more and more willing and ready to diversify my eating habits, however, especially since I'm starting to see/feel the effects of an extremely limited and minimalist diet. But I still get hung up on the idea that more food = weight gain every time. Again, I'm not trying to abandon weight gain altogether, just shift my focus so that gaining isn't front and center in my mind every time I sit down to eat. Selective blindness, if you will. Does that make sense? I'm not feeling articulate today.

J also talked about turning points - like what would need to happen that would convince me to change. And honestly? I don't know. I've been fighting this thing on and off since I was in middle school. Over the past seven or eight years, I've been at low weights, I've blacked out on the treadmill, I've been hospitalized, I've been pulled out of school, I've lost an internship that I wanted, I've made both my parents cry too many times, I've wasted thousands and thousands of their dollars on treatment, I've had myriad ED-related health complications, I've lost touch with countless friends and family members, the list really goes on and on. I don't know how you define "rock-bottom," but I've definitely had moments that felt pretty damn low. So my point is, I'm not sure that anything would become a transformative lightbulb moment for me, and change my mindset for good. I've had periods of wanting recovery, but it never lasts. The only solution, really, is to grasp at what I can and do my best to hang in there. Right now I'm feeling like I can work on variety, so that's what I'm going to do.

If this is all sounding super negative and defeatist, I don't mean for it to. I'm actually feeling pretty positive and motivated - definitely more so than I was after leaving R's office on Friday. I hate having everything so unsettled, and hopefully my appointment with him this week will help me put a more concrete plan in place.

Good Timing, Times

Wow, do the New York Times gods read my blog and respond accordingly?

I really like what the author says here:

Many patients need an aggressive therapist who prods them to face what they find uncomfortable: change. They need a therapist’s opinion, advice and structured action plans. They don’t need to talk endlessly about how they feel or about childhood memories. A recent study by the National Institute for Health and Welfare in Finland found that “active, engaging and extroverted therapists” helped patients more quickly in the short term than “cautious, nonintrusive therapists.”

I think R probably falls somewhere in the middle, as he definitely sets goals and is very behavior-oriented, but I've also somehow been able to get away without making a whole lot of progress food/weight-wise.

Thoughts? How long have people been in therapy, and how did you know when it was time to call it quits? I suppose eating disorders would qualify as "severe psychological disorders," as the author says, that require years to manage. Maybe I'm just being impatient.

I swear I do other things besides read the New York Times.

An End, Maybe

I hesitate to write about this because I'm still processing it and don't really have an articulate summary thought out yet. Sorry if this isn't coherent, but it's weighing on my mind and I had to say something. In a nutshell, I think I'm getting fired from therapy. My appointment with R yesterday was...rough, to say the least. It was a weird, awkward mixture of him asking whether I found therapy helpful, and me trying to answer honestly without offending him, while also not exactly being sure what my answer even was. We talked about how my eating habits, my thinking regarding food and weight, and my rigidity remain almost entirely unchanged. That makes it seem like therapy has had zero effect on me whatsoever. Except that maybe I'd be a lot worse off without it, who knows?

Staying in treatment was a condition of my parents letting me come back to school this year, so it was never really my choice to begin with. But now that it's pretty clear I'm not improving, I'm mad and frustrated with myself for failing.

A major issue, according to R, is that we fundamentally disagree on the weight thing. Not about gain in general - I know that I should gain weight. But his goal is significantly higher than anything I deem remotely reasonable. He also flat-out doesn't think I can get there outpatient. History is on his side, considering I haven't put on any significant weight in eight months, but I flat-out refuse to go IP. There might be people who disagree with my position on that one, but it's nonnegotiable. I'm not giving up my life again, no matter how stubborn and dumb that may sound. I've been in semi-decline since getting sick over vacation, but I'm not in dire straits medically, and I don't think it's fair for him to force me into a higher level of care.

And okay, deep breath, this is the part I'm still working out: the shame. Just being in therapy gives me this deep-seated sense of inadequacy that I carry around constantly. Outside my immediate family, I think only two or three of my friends actually even know that I see a therapist, but it still feels like I have a neon sign over my head announcing to the world that I'm a wreck who can't keep her shit together without professional help. (I don't think this about other people in therapy. It's a purely self-conscious issue.) I walk around every day with this profound sense of failure, like I'm flawed and diseased, like something is fundamentally wrong with me. And I hate that. Sometimes it feels like therapy has destroyed my self-esteem. I worry that I can't function without it because I've been told over and over again that I need it.

I'm stuck somewhere between not believing there's any valid reason for me to be in treatment (because I'm not skinny, I'm not sick, and I'm perfectly functional in everyday life) and not believing that I'll be okay without a professional support system, simply because I've become convinced that I won't make it on my own.

Our conversation yesterday left me feeling really negative and defeated. R was sympathetic, but his position is that unless I agree to IP, or at least IOP, as per his official recommendation, there's not much else we can accomplish together. I should have seen it coming, considering how difficult I've been all year, so I don't really have any right to be upset. But still, it's hard to hear how messed up you are for eight months, and then get turned out on your own. I should make clear: he didn't officially fire me, but definitely addressed the possibility of us not working together anymore. We left things up in the air for now. I'm going to see him next week, the last time before a stretch where we're both out of town a few weeks in a row, and we'll make a decision then.

Body Weight Denial

Obviously the body size misperceptions for people with eating disorders tend to work in reverse from what's described here, but the neuroscience sections of this article are pretty fascinating: Are Most People in Denial About Their Weight?

Grocery Store Mishaps

This is the first year I've done all my own grocery shopping, and I'm now pretty efficient. I can get in and out of the store in under twenty minutes, if all goes well. This week's trip, however, was quite the adventure. Not in a good way. First of all, there was hardly any fresh produce stocked. I don't know why the shelves were so bare this week, considering I went at the same time last week and the selection was fine, but this week? Majorly slim pickins. So, um, what's a recovering anorexic with a serious vegetable-consuming habit and a pathological fear of change to do? My diet literally includes pounds of fresh produce each week, and Grocery Store was not coming through. I ended up buying frozen veggies instead, about which I was less than pleased. Once you've gotten used to the fresh stuff, frozen just won't do. (I'm a recovering anorexic and a food snob, apparently.)

Then I went to the snack food aisle to buy a box of the same brand of crackers that I've been eating for years and years. (Wheat Thins, if you must know.) And what do I discover? No Wheat Thins. None. Not a single box on the shelf. There were a million other brands, all of which I'm sure are comparable, but really? Wheat Thins isn't exactly an obscure brand. Regardless, there were none. So naturally, I was left totally stumped. I paced up and down that damn cracker aisle, picking up a million different boxes and flipping them over, holding two side-by-side to compare serving sizes, calories, sodium, fat, protein, total price, price-per-cracker, price-per-calorie...you get the idea. There was an employee pushing a mop around who made me self-conscious for standing in the stupid cracker aisle for ten minutes, so I finally just grabbed a box and threw it in my cart.

I finally got through the store with all my staples, picked a check-out line, paid, cringed as the cashier stuffed my loaf of bread at the bottom of a bag and slammed my bananas around a little too roughly, and finally made it back out to my car. I drove home, carried all my bags inside, put everything away, and realized that I didn't have any of my frozen vegetables. I had been so preoccupied watching the cashier manhandle my fruit (does that sound dirty?) that I hadn't even put all my bags in the cart. So I grabbed my car keys and ran back outside, heard my front door slam behind me, and instantly realized that I'd left the key to my apartment sitting on the kitchen table. SHIT.

Luckily, I had my phone in my pocket so I called my roommate, who was already on campus. I drove over to get her key, drove back home, got inside and grabbed my key, drove back to drop off my roommate's key, drove back to Grocery Store, found my cashier, learned that my bag was at the customer service counter, ran to customer service, waited ten minutes for someone to dig my veggies out of a freezer somewhere in the back of the store, drove home, threw my veggies in the freezer, rechecked my pocket for my key a million times before leaving the apartment again, and sprinted to class.

I'm STILL flustered after this whole ordeal, twelve hours after the fact. All for some stupid frozen broccoli. I just ate some of it with dinner and you know what? Totally not worth it.

Monday Tidbits

I'll try to keep it short after my monster of a post over the weekend!

- There are officially two weeks left of classes. For now, the final paper/exam/project situation is under control, although I'll be working my butt off between now and May 7. The end is in sight! But actually, I love my classes and I'm sad they're ending.

- A friend asked me to brunch next weekend, about which I am panicking just a little. Dinner in a restaurant seems more manageable, although I suppose dinner always freaks me out too. I'm just not used to eating big brunch-style meals early in the day, and I'm afraid of feeling horrible and fat and guilty for the whole day instead of just the few hours after dinner until I go to bed.

- But I know that one meal will not make me fat, and maybe this would be a good recovery-oriented challenge for me.

- My ex S contacted me last night and we've been politely messaging back and forth since then. He's abroad right now (another reason I ended things when I did), so it's been conveniently inconvenient to get in touch with him this semester. Not that I've tried - I haven't particularly wanted to deal with the messy post-breakup fumbling. Anyway, it's still a lil awkward now but at least we're on relatively good terms.

- Thoughts go out to anyone in the Midwest, those tornadoes were scary.

Happy Monday! Hope everyone's good.