Unplanned Hiatus

Oops, I didn't mean to go for a week without blogging. The break was only PARTLY my fault, since my laptop has been in the Computer Hospital since Friday.

Even before the laptop fiasco though, I was being lazy about updating. I guess I'm a little worried about always rehashing the same things - therapy, food, restaurant stress, body image blahs, etc. All of the above are definitely still very relevant to my life, but I shouldn't assume that everyone always wants to hear me bitch and moan about them. Any ideas for more interesting posts?

Anyway, a quick recap of the last week: therapy was...interesting. And stressful. My dietician J showed me a graph of my weight since I started seeing her and R. Basically, it was a straight line. Meaning, obviously, my weight has not changed in the past eight or so weeks. While this wasn't surprising (I weigh myself at home), I did have mixed feelings about seeing it mapped out in black and white. The eating disordered part of me always wants to lose weight. Always. The ED part only cares about the graph - why isn't the line going down?

At the same time, though, there is so much more going on than what showed up on J's graph. I am way more happy, social, and sane than I was eight weeks ago. While I admittedly have not thrown myself wholeheartedly into weight gain, I have no plans to starve and lose any. I don't feel fat; I just don't feel thin. So, staying at the same weight doesn't necessarily feel wrong, even though I KNOW that I am underweight and should, from a medical standpoint, gain at least X pounds to get back to where I last got my period.

J and R, however, are quite concerned that I haven't put on any weight since starting treatment with them. Both tossed around the idea of IP a couple of times - more as a scare tactic than as an actual threat, I think - but they are still going to work with me as long as I am "willing." It bothers me that they see me as UNwilling, since I feel like I'm trying so hard every day just to break even and it never seems like enough.

I told R that I knew he was probably frustrated with me for making zero progress over the past couple months. It's not his fault - I've been pretty impenetrable on the food/exercise issues. I realize it sucks, as a doctor, to prescribe medicine for a patient who won't take it but still shows up every week with the same complaints. Well, no shit you're still sick!

R was nicer than that. He said: "I'm not frustrated, Kaylee. I know you're trying. But if I let things go on this way much longer, then I'm just enabling your anorexia."

Happier news: I feel myself loosening way up in some food-related areas. I've been to three restaurants this week, went out for drinks at a bar after a full day's worth of food (yes, I'm legal!) on Thursday night, and ate a few gourmet chocolates with NO warning (a present from the boy, awwwww). No, I wasn't happy about the last-minute decision to go out for dinner last night; but yes, I ended up having an awesome Girls Night Out. Progress? I think so!

The semester is flying by. Why is it that a semester at school goes by in a heartbeat, while my semester at home seemed to last for an eternity?

I'll be better about blogging this week, I promise!

Honesty Homework

One of the goals R set for me this week was to tell my roommate that I'm struggling with my eating disorder and ask her to eat more regularly with me. This wouldn't be that big of a deal - my eating disorder isn't a secret and we've talked about it before - except that I feel like it would draw SO MUCH unwanted attention. Seriously, there's no better way to kill my appetite than to scrutinize my eating habits. It makes me want to take my plate into the next room and scrape off all the food into the garbage can.

R is convinced that if I make my friends aware I'm struggling to eat enough, it will keep me accountable and reduce my anxiety about the increased intake and weight gain.

I'm convinced that if my eating is suddenly under the microscope, I'll freak out, have a nervous breakdown, and lose my mind. And somehow, inexplicably, get fat in the process.

Either way, R is probably right that I should try to eat with others more often - but easier said than done. I still have major anxiety about eating around other people because I worry about: a) looking weird, b) eating too much and getting fat, c) not eating enough and getting hungry again five minutes later. So yes, eating my own food in my own kitchen is much simpler.

I did manage to shake things up this weekend though - in fact, I ate in restaurants twice (yeah, TWICE). People, this is big. I hate restaurants. Or at least my eating disordered-self does. This actually is a good gauge of healthy-Kaylee versus ED-Kaylee because I used to love going out to eat. Not just for the food, although I liked that too, but for the whole festiveness of the occasion. Now? Not so much. Break in routine, unpredictability, unknown calories, etc. - all the usual suspects. So this weekend was an exercise in both social eating AND quitting the counting habit.

Anyway, back to R's assignment: I sort of indirectly brought it up with my roommate last night, just mentioning that things have been a little stressful because I am "supposed" to be eating much more than I am physically or mentally comfortable with. No mention of specific foods or meal plan requirements or the case of Boost stashed under my bed.

So...I guess I partly completed the exercise? For some reason, I don't think R will be totally satisfied with my half-hearted attempt. I didn't exactly mobilize the Food Police the way he seems to want. I just hate making my eating disorder an issue with others. Mostly, I hate the prospect of being forced out of my comfort zone. Call me stubborn.

On the plus side, I actually DID buy the Boost.

Monster Mood Swings

Sometimes my mood is so unstable it scares me. I can be fine in the morning, too busy to notice by afternoon, and ready to cry by dinner.

Like yesterday, for example: wake up, coffee, gym, shower, breakfast. All good. Class, lunch, and coffee/killing time with friends, which put me in a fantastic mood.

But then I walked home in a cold rain, my head hurt, my backpack was too heavy, and by the time I got to my apartment, I was practically in tears. No reason whatsoever, other than the fact that I was tired and everything seemed like too much.

Dinner became a nightmare because I was starving but didn't actually want anything. Option A wouldn't fill me up, Option B didn't sound good, and Option C just wasn't right. I just wanted to get it over with because I had a ton of reading to do, but decision-making was not happening. So I was hungry, exhausted, and basically falling apart at the seams.

Then my roommate came home, and a five-minute, completely mundane conversation with her brought me back to earth.

I know that part of it has got to be hormonal because it's back - right on schedule. My appetite is insane right now, leaving me empty and achy and worn out all the damn time. Combine that with cramps and bloating and a constant dull headache, and you haven't exactly got the makings of a happy camper.

Part of it is stress - I'm busy and worn out, but don't feel like I have a right to it because my class schedule right now is lighter than any other semester thus far. So I vacillate between anxiety over schoolwork, guilt about not doing "enough," and frustration at still feeling overwhelmed by a relatively underwhelming course load.

Part of it is also loneliness, because my apartment is not convenient to campus and I don't really live near a lot of friends I saw regularly last year. Usually I need my alone time, but lately I've just been too stuck in my own head. Sometimes I can't focus on anything because the whirl of worry is too strong for me to pull myself out of without external distractions.

My concentration is abysmal, my self-esteem is non-existent, and my anxiety levels are through the roof. I spend half my time running around in a manic half-hypoglycemic haze, and the other half collapsed in total body-numbing exhaustion. I lose track of my moods because they seem to change hourly. Just one day - one hour - of brain silence would be priceless.

I know this is the kind of thing I need to talk about with R, but it's hard to articulate. His priority is getting me to gain weight, but I quite honestly have zero desire to devote any more time and energy to food.

Boosted

Double treatment session this week, so I saw my dietician J first, then had therapy with R. I think they had pow-wowed about me since last week because J went right to work upping my meal plan.

She prescribed that yummy liquid goop - BOOST. Which I despise. It's expensive. It tastes bad. It makes me feel sick. It's humiliating to buy. I don't want to leave it sitting in the fridge for my roommates to see. So I haven't bought any yet, but may do so this weekend. Haven't decided.

One thing J focused on was me creating a treatment setting for myself. Like, having meal support, meeting people for dinner, showing my roommate my meal plan, etc. The point, I guess, is to keep me more accountable by telling other people what I need to be eating - but that is just SO not my style. I barely talk about my eating disorder at all with anyone. So it would be weird and uncomfortable to suddenly ask friends to babysit me during meals.

J was also big on separating "Kaylee" from the "eating disorder" this week. When I said that restaurants are stressful for me, she jumped in with, "Restaurants are stressful for your eating disorder." Well, okay. But it's not exactly as if I can excise the eating disorder from my "real" self at the moment. It's too intertwined. So for now, we're stuck with each other.

Then R. He was twenty minutes late coming out to get me from the waiting room, and I was super irritated until I realized that he had been meeting with J (who I had just seen) about me.

Something I felt better about this week was that it seemed like they both listened to me when I said things like I don't think I can do that. I told J that I honestly wasn't sure if I could drink as many supplements as she wanted, so she told me to at least get them at the store so that I would have the option, and then just do what I could. Then I told R that I didn't think I could gain as much weight as he wants - that I wouldn't ever be able to fully commit to it because it just feels too unnecessarily high. So he agreed to let me aim for a range - the lower limit is where I last got my period and the upper limit is the ultimate weight he and J originally wanted.

For the first time, I felt like they were being realistic about what I would and would not do. I didn't want to feel bullied into agreeing to something just to make them happy, knowing that I wouldn't follow through. I hope it doesn't sound like they're letting me off easy - the meal plan was substantially increased and weight gain is still absolutely nonnegotiable. But now, I no longer feel like the weekly goals are so far out of reach that I don't even want to try.

Failing at Therapy

R wants me to gain weight so that we can move forward and talk about things other than food.

I want R to fix my brain first so that I feel okay with gaining weight.

Obviously, he's right and I'm sick. But the bottom line is: I don't feel capable of adding calories and gaining to the weight he wants. I just don't. At this point, my mind won't let me. I'd hate myself too much.

To clarify: my weight is NOT in a danger zone. It is lower than optimal, but not deathly (I swear!). So yes, I should gain the weight that R wants - or at least regain the weight I've lost since May - but it isn't a matter of life of death at the moment.

So it's hard for me to agree with R when he goes all alarmist on me about it. It's not that I'm not taking it seriously, it just doesn't seem like something that needs to be fixed right this second or else you won't make it through the semester. 

Right now, I just feel stuck. I'm not trying to intentionally antagonize R by being a stubborn little snot, but my brain is caught in a rut and the idea of changing up my meal plan with the goal of actually gaining weight is absolutely unfathomable. It's not that I don't think gaining weight is necessary - I do think it's necessary, to a certain extent. I want my period back. I don't want to be ruled by food rituals. I want to be able to eat in restaurants without freaking out before, during, and after. I want all of these things, but I just cannot see myself actually giving up what I have now. Which is, essentially, a pathological obsession with meaningless numbers.  Yay.

There was a moment in my appointment this morning when I actually thought R was going to fire me. He didn't, but did start pushing "more intense treatment." The options he laid out: 1) stick with what I'm doing by seeing R and J each once a week but actually follow the meal plan, 2) see R and J each twice a week, and have my mom come out for "support," 3) start going to group therapy in addition to seeing R and J, 4) start attending IOP in the center where R and J work, or 5) go home.

Obviously, I picked the first option. I basically told him IOP was NOT an option. Not interested. Not necessary, in my opinion, and not exactly feasible with my schedule. I know that health is the priority over school, but still.

So. I guess that's where things stand. I'm really going to try following the meal plan.  But if it were that easy, I would have done it already.

Settling In

I, for one, am glad that September is over. It's a month of too many changes. And while most of them were good this year (starting my junior year of college after taking a semester off, moving into a new apartment, being back on my own after living with my parents for eight months), the instability of the transitional period left me constantly anxious and on edge.

Now, I'm feeling much more settled. I'm used to my apartment, my roommates, my walking routes, and my classes. I have my daily routines. My anxiety levels have been toned down by orders of magnitude from where they were a couple of weeks ago. Now, my biggest anxieties are school-related, which oddly, I am much better equipped to handle than the little things like running out of yogurt or losing my umbrella on a rainy day or forgetting to do laundry on my one free afternoon. That stuff practically sends me into hysterics.

I am also getting used to R, my new therapist. At first, I was hesitant to see him because he is, you know, a dude, But I'm way more comfortable with him now after only three or four sessions. I really like R's personality and approach. We are still at a bit of a stalemate over the Weight Issue, but I'll get there. I think.

Lately I've been spending a ton of time with my roommate K (same one I visited back in June), and realizing how much better life is with such a good friend. Even though I am incredibly independent and need my alone time to function, I had forgotten how much easier life is with friends. I have been sloooowly opening up to K about the ED, which is big for me. For the longest time, I only ever discussed the anorexia with professionals - e.g. therapist, dietician, doctor. In some ways, that's easier because they are already familiar with the symptoms and don't need to be educated. Real people don't always get it. But when I talk to K about it, she seems genuinely interested in trying to understand my mindset and learn what is helpful/not helpful for me.

Food is more of the same. I really do want to do better because I've been noticing that my energy is definitely down. At times, I find myself slipping into that slightly manic must-eat-now state that only happens when I'm restricting. If I am consistently eating enough to sustain myself, I can hold out for longer and not dissolve into a shaky hypoglycemic panic if lunch gets delayed by an hour. Even though I haven't really lost any weight in the last couple of weeks, I think the recent loss combined with the lower intake (not scary low, just lower than R would like) is starting to take its toll. So I am motivated to turn things around NOW while my brain and heart and metabolism still have a fighting chance.

Okay, gotta get moving. I've got a 14-page paper and two 10-pagers due this week, plus a presentation and a big project for work. Peace!

The Rundown

So sorry for the lack of updates. There's not much going on beyond what I've already talked about. I'm hanging in there with eating, trying to stay on track as much as possible. I think my weight is pretty stable but I haven't really been keeping close tabs on it. You would think this is a good sign - that I'm less obsessive about weighing myself at EXACTLY the same time every morning like I usually do - but I historically get less rigid about the weighing ritual as my eating deteriorates. When the anorexia was at its worst last year, I barely ever weighed myself, even though we had a scale sitting right there in the bathroom. I was vaguely aware of my weight, as in I would hop on the scale every once in a while and register the number with a brief huh, that's lower than last time, and go on with my day. It's sort of similar now, except that my eating is way better than it was then and I'm still as nervous as ever for my weekly weigh-in with R. So, I'm not sure what to make of that observation.

In other news, I'm having a really good time with my friends and getting wrapped up in classes and schoolwork again. For the sake of my sanity, I HAVE to stay fairly busy, but it's a fine line between healthy-productive-busy and stressful-panic-self-destructing-busy. Lately I've been toeing that line, trying to figure out exactly where it lies. Schoolwork is starting to pick up, as are various club/research/work activities, and I'm trying to resist the urge to take on a million projects and throw myself into everything headfirst without first consulting my responsible, moderate, reasonable side.

I really hope my last post didn't come across as all doom and gloom, because I really am happy to be here and trying so hard to make it work. I don't think I was ever under any illusions that this would be easy, but the reality of it has still taken some getting used to.

Things I'm happy about:
1) My wonderful, compassionate, brilliant, endlessly supportive and understanding roommate.
2) My mom. We've been talking on the phone almost every day. I know she's super worried about me, and she is doing an amazing job of being available without prying.
3) Therapy. I really like R a lot, and I'm almost looking forward to seeing him this week. I feel like he is very purposeful during our sessions and sets a clear agenda and goal, whereas my old therapist W just sort of asked questions and listened to me ramble before moving on. So I'm thinking R is definitely an improvement and I could make some real progress with him. If only I didn't have to get weighed.
4) The delicious sushi I just ate for dinner. I was feeling fat and gross and really wasn't up to facing a restaurant, but my friends wanted to go and we ended up having a great time. Why don't I learn from these experiences?

Things I'm worried/stressed about
1) Schoolwork, exams, too much reading, blah blah blah.
2) The paper-thin walls of my apartment. Seriously, I can hear my neighbor snoring from the next unit.
3) Therapy. Like I said, I really like R a lot, but I HATE getting weighed. Last time he gave me to option of having blind weights, which I'm still undecided on. I have my own scale so I could theoretically check my weight anytime I wanted, but maybe having the blind weights with R will reduce some anxiety about my appointments so I can focus on the therapy part and not the weighing part.
4) Not having time to get to a grocery store. My food supply is majorly depleted. There are places on campus where I could eat, but not everything is Kaylee-friendly.

I think that's all for now!

New Therapist

Today I had my first appointment with the new therapist.  I didn't realize I was so anxious about it until yesterday/this morning when my stomach started doing these nervous rumblings and I couldn't sit still for more than two minutes at a time.  Homework did not get done.

I think I was just uneasy about jumping back into treatment after being able to sort of pretend to forget about it for a couple of weeks.  Like I got a little honeymoon period without all the therapy and weigh-ins and meal plans, which made recovery - and the ED - seem less real.

I was worried about the therapist being male, and that it would just be too weird to talk to him.  Was I supposed to bring up my period?  Would he bring it up?  Ew.  I was worried about getting weighed - I wasn't sure it would happed, but figured it was a distinct possibility.  So I worried that my weight would be too low and the therapist would think I was restricting.  And I worried that my weight would be too high and he would think I didn't need treatment.  I also worried about having to explain my ED history - how the hell do you condense something like that?  And how do you phrase it without sounding stupid and dramatic? Worryworryworry.

Long story short, I survived and the therapist - let's call him R - was super nice.  I was uncomfortable at the beginning, but I really think it had more to do with me being uncomfortable about therapy in general than it did with R being male.  He was really easy to talk to, even though he made a me squirm a couple of times.  But the squirming was because he was challenging me and trying to make me articulate my recovery goals and some disordered patterns I still have.  So I think it was good for me.

Basically I felt like he understood me without too much trouble, and was able to recognize pretty quickly where I am in recovery.  I signed a release for him to talk to W, my therapist from home, which will hopefully save us some rehashing of stuff I've already gone over in therapy before.

He did weigh me.  At first he wanted to do it backwards, which caught me off-guard because B never did blind weights.  After hearing that I'd known my weight all along, R left it up to me.  So I said that I would rather see my weight, and that I probably already knew what it would be anyway.  Then he asked what I thought my weight was, and my guess was correct within a pound (i.e. I weighed one pound less on his scale than I had predicted).

I was pretty (irrationally) self-conscious about my weight, and nervous that R would say I was too fat for therapy and he wouldn't want to waste his time on me.  Obviously this did not happen.  He started off by saying, "I don't think you need to lose weight."  Okay, well, duh.  I guess I didn't really expect him to tell the anorexic to lose weight.  But then he said he would like me to regain some of the weight I'd lost over the summer, and asked whether I would be willing to do that.  This was one of the points at which I squirmed.  But never fear - I did agree to gain the weight.  Still squirming though.

As for seeing a dietician - R said it probably wouldn't be completely necessary every single week, which is fine with me.  Been there, done that.  And I'm already kind of an expert on calories.  However, R and I both agreed it would be helpful to at least check in with the RD there at least every few weeks.  I tend to lose perspective on what "normal" eating and "normal" calorie amounts are, so hopefully an RD will be able to keep me on track.

So I think this was a positive development.  I'm not thrilled about being back in therapy and I wish it weren't necessary, but I'm open to it.  And at least the guy's nice.

The First Good-Bye

I had my last session with W today, which was kind of sad but not tragic.  I really do like her and I think we were just starting to make some progress (considering it took me about six months to fully warm up to her).  It's frustrating to have to start all over with someone new in College City, but I really prefer the idea of seeing someone in person rather than staying with W via phone sessions.  Actually, W was the one who said that was probably a better plan, since she thinks I "give away more with body language" than I do with words.  Huh.  Not sure how to take that.  Maybe she just needed an excuse to get rid of me.

I wish I could report having an earth-shattering therapeutic breakthrough in honor of our last session, but no such luck - just some rehashing and wrapping up old stuff.  W asked me what some of my longterm recovery goals are, and I came up with: A) less rigidity with food/exercise/timing and B) less obsessing about my weight, e.g. not letting an upward fluctuation derail my entire day or a downward dip put me on cloud nine.

Then W added C) be more open with people about my feelings because according to her, I don't like looking vulnerable.  To which I say, who does?  But okay, she has a Ph.D. so, I'll try.

Looking forward, I am sort of interested to see how a new therapist operates, and to compare her approach with W's (oh, and also to recover from anorexia).  But honestly, I'm feeling a bit ambivalent about therapy in general.  It has been over eight months and I'm starting to wonder what, if anything, has changed.  My weight went up, then went back down a bit.  I started taking a drug, then stopped.  I've been seeing W every week and opening up even when it's hard and uncomfortable - but not many of my thought processes have changed at all and this does not make sense to me.  Shouldn't I be cured me by now?  Why do I still count calories obsessively and work out X minutes a day, every day?

It's just so frustrating to find my head in the exact same place it was six months ago, eight months ago, a year ago.  Thousands of my parents' dollars have been sunk into this treatment thing and I'm still clinging to my same old rituals and anxieties.  Tell me, W, why am I still like this?

Hopefully this lapse in motivation is just end-of-summer introspection gone wrong.  I am not under any illusions that I can or should get by without therapy, and I'm completely committed to starting with someone in College City as soon as I can set it up.  It just would be nice to have something to show for my past eight months, aside from a few extra pounds and frustration through the roof.

A Therapeutic Exchange

Me: "It's hard for me to see this as a problem because I've weighed less than this and lost my period for X months before and no one made a big deal about it."


W: "Whether or not it was acknowledged, it was an issue then and it is an issue now.  As a professional, I cannot let you stay in an unhealthy place."

The Drug Dilemma

Here's the background: I was on a medication earlier this year for insomnia and anxiety and I hated it.  I will be the first to admit that I'm not sure how much was the drug and how much was just general refeeding misery, but I felt sluggish and sleepy and awful the whole time I was taking it.  I came off of it sometime in February, and I haven't taken anything else since.

Starting around that same time, my therapist and ED doctor have both brought up the possibility of trying Prozac or something similar for depression a couple of times.  I was pretty opposed from the beginning, since I felt like any depression I had was a result of the fact that my life was pretty depressing.  Being home alone eight hours a day with nothing - no class, no job, no friends - in the dead of winter is depressing for anyone, I'm pretty sure.  Combine that with serious body image issues, huge anxieties over food six times a day, and the most snowfall recorded in a decade, and you don't exactly have a recipe for bliss.

I have tried outlining a semi-logical argument for my therapist explaining why I am so resistant to taking anti-depressants, but it usually just boils down to: "Because I don't want to."  I don't know if that's a good enough reason, but so far W has been accepting it.

There are a few reasons I'm not huge on the medication idea.  First of all...okay duh, weight gain.  I don't know anything about this other than it seems to be a stereotype about anti-depressants, which is enough to scare me away.

Second, I hate the idea of being tethered to a pill.  At school, my schedule is hugely variable from day-to-day.  Is it a big deal if I miss a dose? Or accidentally double up?  What about alcohol?  I'm sure tons of college kids are on all kinds of medications with no problems, but the idea of living on my own far from my family and my doctor while taking serious medication makes me hugely nervous.  What if I have a bad reaction?  What if my weight suddenly balloons out of control? (Okay, that was a reiteration of reason #1.)  What if the drug stops working and I end up even worse than I was before?  Then what?

I don't want to rely on a pill to be able to function.  (This is NOT  criticism of people who DO need medication to function. I am not anti-drugs; I am 100% pro-drugs for those who need them.  I have a family member with schizophrenia who is completely and utterly unable to lead any semblance of a normal life without a heavy regimen of medication, and I totally respect him for recognizing and honoring that. Same with a friend who has severe anxiety.)  So maybe this is me just being stubborn and refusing to concede that I, too, may actually NEED medication to function, but I also feel like I haven't given myself a chance to learn how to just cope.  At the moment, my (healthy) coping skills are nonexistent.  Feeling fat?  Cut lunch in half.  Nervous about the weekend?  Run an extra X miles.  I have no fucking clue how to feel uncomfortable or anxious or guilty and just weather the storm without self-destructing.

Right now, the ED is my anti-depressant.  So how will I know if I really need drugs unless I can give up the ED long enough to find out?

So, that's the Medication Issue in a nutshell.  Since my weight is down, my therapist has been pushing it a little harder lately, but I'm 90% positive that I'll be sticking to my guns on this one, at least for now.  Mostly, I just have a general aversion to any drugs at all - at least for myself.  I never take anything stronger than Advil, and the thought of having something so powerful in my body all the time just plain freaks me out.  It's not as if I can't get out of bed in the morning, so at this point taking medication is entirely up to me.  And I Just Don't Want To.

In Which I Realize I Am Totally Clueless

Uhhhh......well remember yesterday when I said that I didn't think my therapist and my dietician communicated very much?  Wrong.

Today when I walked into my appointment with W, she asked How are you? And I said, Good!  Great!  Fine!  How are you?  And I wasn't totally full of shit either, because I really have been feeling a little better lately - as in, no random crying fits or skipping food or pounding out extra time on the treadmill.  No jumping for joy or anything, but feeling pretty okay at least.  So I was somewhat looking forward to seeing W and having something semi-positive to report instead of the usual I hate my body I hate food I hate home.

But this morning as soon as I got through saying how Great! I was doing, W said, "B and I are very concerned."  I guess B had been really worried about me losing weight again at my appointment last Thursday so she called M (the main doctor who runs the treatment center that W and B work for, and coordinates all the therapists and dieticians and patients) and then M spoke to W, who has been in contact with B ever since.

Things that have been discussed at length for months without my knowledge:
1) my weight
2) my "affect"
3) my menstrual cycle (or lack thereof)
4) my fall class schedule
5) my future apartment's location (off-campus, meaning more walking)
6) my aversion to anti-depressants, even though W and M both think I should be taking something

The last one is the biggie. I have made it clear to both W and M that I do not want to be on anti-depressants (maybe more on that later), which they both seemed to accept.  Today I got the impression that they no longer respected my decision on that and they wanted to get my parents on board to convince/gang up on me to change my mind.

As for the other stuff, well, I guess it shouldn't come as a surprise that my therapist and my dietician have talked about my weight and other relevant things, but it still feels like my privacy has been a little violated.  I have always been 100% honest with W about my weight, my intake, my period, etc. and it bothers me that she felt she had to confirm without telling me.

So, I'm not sure what to think about all this.  I've never really felt like my sessions with W had anything to do with my sessions with B, but they've really been coordinating all along.  Apparently W has asked B to look out for correlations between my weight/intake/exercise with my mood, and the two of them have even met with M for the Anti-D discussion.  Now, I just feel really left out of the loop and not clued into the whole plan that is supposed to be helping me.

This isn't meant to sound bitter at all.  I'm not angry - I know that these are professionals who are doing their jobs and genuinely trying to help me get better.  After having the day to think about it more, I realize that I'm actually grateful B and W been communicating because it means that they both have a much clearer and more complete idea of where I am recovery-wise than I thought they did.  It also means that they are able to pick up on things I can't necessarily admit to them on my own.

So I'm trying to be okay with knowing that all these Kaylee-centered talks are going on behind the scenes.  Giving up some of my autonomy (moving back home, getting weighed, handing over my food records) has been one of the hardest parts of recovery for me to accept.  I am intensely private and fiercely independent, and the thought of having others discuss something as personal as my weight makes my skin crawl.

I know that having my entire treatment team on the same page is a Very Good Thing in the long run and that it will only hurt me to float through treatment without really taking it seriously.  It is also a Very Good Thing that B and W are on top of their games and refuse to let me get away with sliding backwards.  At the same time, though, I'm still feeling a tiny bit pouty about the whole thing.

The Team

I have mentioned some random appointments, but I don't think I've really talked much about my treatment team on here yet. I see a therapist and a dietician every week, am pretty happy with both, I guess, though I don't really have any basis for comparison.

I had mixed feelings about my therapist, W, at first.  I had never been in therapy before this past January, so I didn't really know what to expect.  I discovered early on that the whole therapy thing made me really uncomfortable.  It is definitely NOT in my nature to vent (or talk at all) to strangers, and it sort of eluded me that the whole point of this therapy thing was to be honest and forthcoming so that she could understand my mindset and therefore actually help me.  So I spent the first several sessions being polite and shy and not exactly seeing the point of it all.

It took me a while to realize that the question "How are you?" is different coming from a therapist than it is from someone in the grocery store.  Your therapist doesn't want to hear: "Good! Great! Weather sucks, doesn't it? How are you?" Your therapist is asking how you really are. She is looking for the answer you can't give anyone else because it would be weird and awkward to say to a neighbor in passing that you actually feel shitty because you think might have measured your cereal wrong that morning.

Once I realized that therapy doesn't exactly work if you aren't honest, my sessions with W became much more productive.  I'm still not totally comfortable baring my soul in therapy, but I'm coming around.  One big issue I still have is that W usually has to bring things up before I will talk about them - meaning that if something is bothering me, I won't mention it explicitly and W has to be a detective and figure it out.  Yes, I realize this is completely inefficient and wastes time and my parents' money. I KNOW.

I am also bad about mentioning anything that was bothering me earlier in the week but no longer seems relevant.  For example, if I spent Monday-Thursday intensely hating life/my body/the world and bursting into tears every ten minutes and skipping snacks because I felt fat, I probably wouldn't mention it at my appointment the following Saturday because now it all seems stupid and I don't want W to think I'm a nutcase.  Yes, I really do worry about this.

I warmed up to my dietician, B, a lot quicker.  Personality-wise, she's a little more easy-going and friendly than W.  I also just found it much easier to talk about food and calories than about feelings. At first, I thought regular appointments with a dietician would be pointless because weight gain is, after all, not exactly rocket science.  I can add up calories like it's my job, so I didn't really get why I had to see B weekly.

Actually, B is awesome and does much much more than hand me a meal plan and send me on my way.  She definitely takes the time to talk through my thought processes about food and exercise, and sets me up with a plan that is both healthy and comfortable for me.  When I freak out about my weight, she is good at talking me down and helping me keep things in perspective a bit.  The downside to seeing B is that she weighs me, and I get extremely anxious for a few of days leading up to it.  Not going to lie, my eating the day before an appointment is always less than optimal.  Not horrendous, but definitely not what it should be.

W and B don't really communicate about me (as far as I know), but they often have overlapping ideas - eating in restaurants, eating more variety, cutting exercise, to name a few.  In general, B offers a lot of practical ideas and assignments whereas W tends to be more vague and cerebral.  I used to think B was much more helpful to me on a day-to-day basis - mostly because I HAD to eat every day but I didn't necessarily have to mull over the inner workings of my brain.  Lately, though, I am finding my sessions with W to be really useful and her advice has been sticking with me all week after I see her.  I don't know if this is a result of my brain being better-nourished and more receptive to therapy or if I am just learning how to be a better therapy patient (probably a combination of the two),

Anyway...I've been thinking about this a lot lately because when I go back to school in about a month (!!!) I will probably have phone sessions with W but not with B.  I'm not sure how I feel about this...I really like W, but she doesn't challenge me in the same concrete ways (e.g. bring a different kind of sandwich for lunch every day or try a new restaurant). And even though I hate it, getting weighed by B  and going over my food/exercise plan in person every week has been really important in terms of keeping me accountable, and I don't entirely trust myself to keep it up on my own.  I will probably still get weighed periodically somewhere, but I really like and trust B and I hate the idea of starting over with someone else.

So, therapy tomorrow. Goals are to tell W about: 1) losing weight a few weeks in a row; 2) not sleeping well; and 3) my worries about school.

Empty?

Today my therapist, A, said: "You think you're empty."

We were talking about my fears/anxieties regarding social eating, body image insecurities, and basically presenting myself - my body, my personality, my hunger - to the world.  I was telling her that this new weight on my body feels so darn uncomfortable all the time that I am embarrassed to go out.

She said that it's about more than my weight.  That I feel like I don't have anything to offer, and I am afraid to engage sometimes because I think I'm "empty."

I'm not exactly sure how I feel about this statement, because I don't think I feel empty.  I feel trapped, obsessed, riddled with fears, endlessly anxious, insecure, angry sometimes, sad sometimes, almost happy sometimes.

My stomach certainly isn't empty.  It's usually a bit too full for my taste, even though my hunger signals are out of whack and I often feel stuffed and hungry at the same time.  But not empty.

My head certainly isn't empty.  In fact, my head is usually so full with swirling numbers, weights, nutrition facts, counting and recounting and recounting again that it feels ready to burst.

I'm not so depressed that I feel like the future is empty, either.  It's more like the future feels so full of things that are scary and unknown and potentially fattening that I want to curl up and hide.

Part of the problem is that I have been so detached from real life and real people these past few months that I am too full of obsessive, self-centered ED things to make much room for real world things.  Maybe my ED self is too full, and my real self is too empty.  But the ED self has been part of me for so long that I'm not sure how to separate it.