Tuesday, April 14, 2015

Working Girl

Starting next week, I am officially back to work! After 2 months of unemployment, frustration, multiple interviews, and getting slightly off track, I felt really good about this job. I had my first interview on Friday and was scheduled for a second interview on the spot. So on Monday, I went in for my second interview. After about a half hour, they asked me to wait for 10 minutes. At that point, I had a pretty strong feeling that I would be offered something and sure enough! They brought me back into the office and offered me a job on the spot! Now, it’s time to face another transition.

This is a big transition for me. Not only is it returning to work after a shaky 2 months, it’s also returning to my career field, counseling. After discharging from PHP a year ago this month, I looked into counseling jobs. I even interviewed at a variety of organizations, including an eating disorder treatment center; however, after getting an offer from the ED center, I decided I wasn’t ready to go back to giving therapy, especially for eating disorders. So, I ended up working for a boarding school where I could incorporate some of these skills, but it wasn’t the same. Towards the end of my time at that job, I was finally feeling ready to return to counseling, if only because I missed it.

Going into the counseling field was an easy decision. I fell in love with the idea of being a therapist in college, and I’ve never looked back. Even during grad school with my toughest clients and worst days at the clinic, I knew that this is what I was meant to do. With some time off for reflection and learning to work again in recovery, it’s time for my return to doing therapy; however, I am anticipating that it will not be without its challenges.

My biggest challenge will always be balance. As my therapist likes to remind me, I suck at self care and making that separate time to take care of myself. I have always been a perfectionist. I have sacrificed relationships, friendships, family time, and my own health just to ensure that I am the best worker I can be. I have never wanted to disappoint, and I make sure that I do whatever it takes to avoid that. That combination of perfectionism and people pleasing can be my downfall. So, ensuring to incorporate self care will be the most important thing I can do to be successful both in recovery and at work.

Another challenge will be being a therapist again. I knew I couldn’t go back to the field after doing 70 hours of therapy for 12 weeks. After doing so much of my own work, I was emotionally burnt out. I could not have the amount of empathy needed to maintain therapeutic relationships, because I had been forced to use it on myself for the past 3 months. Also, going from being on a locked unit for 3 months and returning to a regular work schedule is a kind of culture shock. But now, I will be working with men who have been recently released from the criminal justice system and are required to attend treatment for drugs and alcohol. This population tends to have higher rates of trauma, and substance abuse recovery has many of the similar constructs as eating disorder recovery. It’s going back into a world that I haven’t been out of for a year, but I’m on the other side of the table this time.

My final challenge is meal plan fulfillment. I am still doing multiple bottles of Ensure a day just to make sure I get everything in. That’s always a tricky question. People who don’t know my struggles almost always ask me why I’m drinking it. Most normal 20-somethings aren’t drinking nutritional drinks. Typically, you see Ensure/Boost in hospitals or nursing homes to help patients who can’t eat for whatever reason. So, I have to brace myself for the questions. I also need to make sure I make the time throughout the day to eat all my snacks and meals, and be honest with my dietician if it’s not working.

As with every other transition, the best thing anyone can do is have a plan. I need to have an idea of how/when/what I will do self care. I have to be mindful of my meal plan and try not to feel ashamed of doing what I have to do. I need to be the best I can be without pushing myself past feasible limits. Without recovery, I won’t have a job. I will be back in treatment.

I will always go back to the title of this blog: You Don’t Want to Go Back to Treatment, Do You?
Nope. I’m good with finally returning to a normal life. It’s pretty nice.

Sunday, April 12, 2015

Fighting to Win or Maintain

So, this week, in one of my many battles with my therapist, we discussed the idea of fighting. In recovery, there are a lot of things we fight, good and bad. The bad things are easy to list: cravings, triggers, urges, etc. But what about the good things? Why is it that we fight so many of the things that are good for us when going through recovery? One answer: to maintain the eating disorder.

I've been incredibly guilty of fighting to maintain lately. After being sick, it's been difficult to get back on track. Even though I wasn't actively restricting, I still was from being sick. That allowed my eating disorder thoughts to come in full force, which when already feeling under the weather, doesn't help. I've also had an increase in my anxiety and PTSD symptoms in the face of upcoming trauma work that have also made my need for control even higher. So, I've been allowing that voice in ever so slightly, but it's enough to make a difference.

In discussing this with my therapist, a few things were highlighted. My anxiety about facing my trauma has always been bad, but now that we are getting closer to it, it's even worse. I have always been fairly uncomfortable with deep or strong feelings, especially when they're negative; however, connecting that emotion to my trauma is a bigger hurdle. It's one that I rarely have faced throughout my life. This is primarily because I've spent more than half my life using eating disorder behaviors to cope. So, by letting that voice back in, it's the start of a return to a past, very dangerous cycle of relapse for me. Here's the wise quote from my therapist this-

"You fight so hard to keep that trauma and those negative feelings away that it's exhausting, and your eating disorder is there to help maintain that disconnect. If you fought even half as hard on processing them, the eating disorder might actually go away."

Well damn. She's right. I have spent countless days and weeks using eating disorder behaviors instead of just sucking it up and dealing with my trauma. Granted, I have to be in the right place to do my trauma work, and those have been far and few between throughout my life; however, I've been there for a while now. There is just this overwhelming, crippling fear that prevents me from ever truly going to those dark places; the ones that no one, not even myself, knows what's really there. That's where the fight begins.

I know that I will never have complete recovery if I do not do my trauma work. I will not stop using behaviors unless I go to that dark place, feel the pain from those events, and learn to accept and move on. I will not stop hearing those disordered thoughts unless I stop shutting down. So, baby steps are the most important part of this. There are multiple traumas that I have to face. The first step is determining what will be "easiest" and hardest and make a list of what order to face them in. By building my tolerance to emotions in the "easier" levels, I'll be better equipped to handle the hardest. From there, I stop living and fear and choose to begin to feel how angry, upset, hurt, and scared I truly am instead of numbing out.

I make that choice to fight to win.

Monday, April 6, 2015

Sick, Sick, and More Sick

    I thought my biggest obstacles in recovery would be things like: trauma work, depression, anxiety, unemployment, etc. Nope. The worst of all is being physically sick. I’ve been battling a really wicked stomach flu bug since late Thursday night/early Friday morning. Tonight is the first time I am starting to feel real improvement. It’s been completely and totally ridiculous.
    So, I’ve thought of some steps to take when battling a temporary physical illness that may throw off your recovery.

    1) Tell Your Team!
    This has been one of the most important things for me. I use the Recovery Record app on my phone, which is connected to my dietician. This way, she can track all of my logs and make sure I’m following my meal plan without avoiding fear foods, lacking variety, and consuming appropriate amounts. She checks this at least 2x a week, if not more. So, she was the first person I needed to talk to about being sick. We set a game plan for when I started feeling better to help me get back on track and make up some of the missed components of my meal plan. This leads to my next step:

    2) Have a plan for when you feel better!
    This has been really helpful for me. I know it would be difficult to transition back into my fairly high calorie meal plan afterwards. Also, after being sick, many of the foods on my meal plan sounded really unappetizing. So, I worked with my dietician to plan out options for meals and snacks that I could try once I started feeling better. This has helped me better transition into what will, hopefully, be a full day back on my meal plan tomorrow.

    3) Self care- Do it!
    I am pretty notorious for avoiding self care. I’ve been working with my current therapist for the last 6 months, and she always calls me out on this being one of the pieces I continue to struggle with. In being sick, there wasn’t a lot I could do. I basically had 2 choices: distract or self care. So, while I did do my fair share of distracting, especially when anxious, I did take the time for self care. This included: journaling, listening to music, sitting with my dog, and doing my body image work book. All of these things helped keep me occupied but also helped reduce the ED thoughts I was experiencing. Self care is a great thing that most of us, me included, fail to make time for.

    4) Challenge those Eating Disorder thoughts.
    One of the worst things has been the rapid increase and strong presence of ED based thoughts this weekend. Being sick caused my body to be restricted of food, even though not by choice. This made my ED incredibly happy. When I started to feel better, that nagging voice has been there saying “You can just keep doing this. It’s not doing you any harm. You’ll be fine. Keep this up.” This is all kinds of bad and incredibly easy to follow. The best thing I have been reminding myself is that I am not using ED behaviors intentionally and that those thoughts are trying to take advantage of things beyond my control. That’s way easier to say than to actually follow through on, but it has given me some piece of mind as I begin meals and snacks again.

    5) Be proud of yourself for making the choice to stay in recovery.
     Recovery is an incredibly hard journey, especially when we get those unexpected and unavoidable roadblocks. It’s good to remember that things will happen beyond our control, but that doesn’t mean recovery has to be one of them. Getting derailed is difficult, but by choosing to take care of ourselves and get back on track, recovery continues to be possible and make us even stronger.

    So, stomach bugs suck, but it’s just a part of life. Now, I just keep rolling along (and sleeping).

Saturday, March 28, 2015

Landslide

What do you do when things start going out of control faster than you could have ever anticipated? That’s one of the trickiest things about eating disorders. When you start to feel things getting slippery, all of a sudden, you’re halfway down the slope.

One shouldn’t play with fire, but sometimes the temptation to do so is just too strong. Running back to behaviors is a safe place. It’s that little hole that you just want to crawl into and hide in to feel better. So, when things start to get too chaotic, that hole seems more and more appealing. It also gives that sense of “stability” that I crave when things feel uneasy. That’s the biggest reason I have been using behaviors lately.

Recovery is an exhausting process. Sometimes, it’s just too overwhelming to even think about the meal plan and challenges that come with each new day. I am ready to be at the point where I don’t have to think about these things and just do them, but I know I’m not there yet. So, I catch myself sometimes taking a break from recovery to use behaviors to just feel at ease. That’s pretty backwards logic. In order to stay in recovery, I can’t use behaviors, but behaviors make me feel safe. It’s a horrible catch-22.

How do we break the chain? The first thing is to stop the landslide before you reach the bottom. I have been very lucky to have the gift of self-awareness to my behaviors and irrationality. I once had a supervisor tell me that I could rationalize myself out of anything. That’s exactly what I’m doing now, but it’s also coming from a disordered place. The next step is to reach out for help and support. I’ve done my best to be honest with my team, my family, and my boyfriend, because they’re the ones who confront me when I’m being disordered and support me when I need it. Finally, I need to make changes. This week, I did some self-care and was forced into some, which ended up helping. I reached out for support and was honest about when I was struggling.

What matters most is the effort. I know if I give up, I will only end up back where I was last year. I don’t want to lose my freedom and the trust of others again. I also need to get my shit together and stop running back to behaviors to feel better. That doesn’t break the cycle. Only making small daily changes can lead to major overall ones. That’s what it means to have a life in total recovery.

Thursday, March 19, 2015

Habits

Old habits die hard: a situation I am finding myself in quite frequently lately. It’s weird how your eating disorder can still creep into your life during recovery, even if you feel like you’re doing well. Overall, I am. I have been completing almost all of my meal plan every day and am trying to stay less stressed about my lack of job situation. I had 3 interviews this week, so I can’t be that bad a candidate. It’s just frustrating. But when I met with my dietician this week, she told me to be cautious.

There seems to be this cloud in the recovery process. Sometimes, people can sit on it and think, “Look at this, I’m 100% in recovery. Nothing can go wrong. I’m great where I’m at and I’m never coming down.” Then, they fall from the sky and hit the ground hard.

I don’t consider myself fully up on this cloud. While I feel like I am doing better than I have been in previous months, I know I’m far from recovered, as pointed out by my dietician. One of my biggest behaviors was counting and measuring. I had a set point that I would reach every day and not allow myself to go over. If I went over, I would be filled with this self-loathing and overwhelming guilt. This pattern seems to have transitioned with me into recovery.

When I first entered recovery, I didn’t want to know my counts for my meal plan, because I felt it would be too triggering, especially when I was still on a weight restoration plan. But when we got to an idea of what might be maintenance, I was having difficulty reaching my full portions for some meals. So, I asked to know so I would have that goal. While this has helped me actually reach my restored weight and maintain it, which is still strange and slightly uncomfortable to say, it has also become a modified behavior. I now know the counts of most of the meals I eat in a month and always strive for the lower end of the calorie range. If I go outside the range for that snack/meal, I will apply to excess to the next eating period. While I am getting my appropriate meal plan in, this is a dangerous behavior.

I am able to see that this is not the healthiest way to keep track of my meal plan; however, it is nice to have that numerical validation that yes, I did actually do a full day like I was supposed to. That’s exactly the problem though: numerical validation.

When I was sick, that numerical validation is what kept me there. There was a number that defined every day. Whether it be caloric intake, weight, size, whatever, my life was ruled by them. Now, while I might not be looking at unhealthy numbers, it’s still that control. I am still controlling my intake. I still get uncomfortable by that number on the scale or the size of my jeans. Numbers continue to be my world, even though it is for a better life.

Now, I find myself this place of being stuck between a rock and a hard place. While counting ensures that I get my full meal plan in, it always makes me use some form of behaviors, which will ultimately affect my recovery. So, what do I do?

My dietician is forcing me to pick things that I don’t know the counts for at least once a day, which is proving to be more difficult than it sounds. I know counts for almost every food I eat on a somewhat regular basis. It’s also just overwhelming to think about not knowing how much is going into my body, which is just a sign of how much further I have to go in this recovery process.

The body moves faster than the mind, but it’s a matter of keeping the body healthy while the mind heals that will ultimately impact how well I can stay in recovery. If I allow my mind to stay in this unhealthy state, it will lead to my body becoming unhealthy again. So, by keeping my body in as best a place as I can and with time, patience, and hard work, I know my mind will catch up.

Friday, March 13, 2015

Pitfalls

It's been an incredibly challenging week. That's the tricky thing about recovery: when things seem to be going well and you are beginning to feel comfortable with where you're at, all of a sudden pitfalls begin to appear to try and set you back. This week has been full of them.

First of all, a very unwelcome person decided to try and re-enter my life via LinkedIn. This person has not been a part of my life in quite some time because of the choices he made, ones that hurt me very badly. So, I made the decision to stop contacting him but I have never been ready to truly say I feel in order to officially end things. He has been blocked on all other types of social media; however, when I joined LinkedIn approximately 2 weeks ago in order to help support my job search, I did not think to automatically go block this person there. So, when I got a message from him asking me to add him, it was all total bullshit.

This was very triggering for me. My phone number and e-mail address have not changed in 10 years, but he could not make the choice to contact me there? And LinkedIn of all places? What the fuck? It just brought up a lot of the anger I have tried to shut out for the last few years. I had had it. Finally, I found myself with the courage to finally send the "Go Fuck Yourself" e-mail that I have never been able to do. I was always worried that, because it would be the final nail in the coffin of our relationship, it would ultimately backfire,and I would become a more damaged person from it. As I have learned in recovery though, this is not the case.

Because I kept holding onto that relationship, I was staying a damaged person. I was not able to truly process and grieve the loss like I needed to, which resulted in my constant state of being shut down. This set off my eating disorder behaviors and the vicious cycle continued. Every time I would become upset about the issue, I felt that damage more strongly than I had before. Each time I pushed it down, it simmered and grew. All the time I spent "protecting" myself was wasted on unhappiness and pain; however, I wasn't ready to do it yet. It took me a long time to get to this point, but I finally reached it. So, I hit send.

There's nothing more validating than finally telling the person who hurt you to fuck off. Those small words mean so much, because it means I'm no longer allowing him the occupancy in my heart or mind. I will no longer allow him to continue causing me pain, especially when he is no longer a part of my life. I will not allow my eating disorder to creep in and say that I need to use behaviors to cope with this loss. I am my own person who is deserving a life with only people who love and support me, not those who use me to make themselves feel better. I am taking back my life from my abuser, something that I have never been able to say until now.

One of the most important steps for me after sending that e-mail was to write a goodbye letter for myself. I waited until the next day and put myself in the position where I could do it. I used a picture of him and my journal to sit and write all of the things that I never could say. These will be things that I never will say to him, because he doesn't deserve to hear them. I did this for me and surprisingly, I didn't shut down. By giving myself the space to write the letter and using the picture, I cried for the first time in 7 years about the pain he's caused me. I cried for 45 minutes, which is something I haven't done in years, and it felt good. I even made my therapist cry when discussing it, so that's pretty damn good. The next (and most dreaded) step will be processing the letter in therapy though, which is going to be the most difficult thing I will ever have to do. Pitfalls at their finest.

The other major issue this week has been with my license. I found out last night that my counseling license is actually NOT valid in the state of Missouri, which is overwhelmingly frustrating. I have thought that I would be fine, which I clearly looked at the wrong information. So, I quit my job to return to a field that I love but cannot currently practice in until I take another graduate class. With it being the middle of the semester, I am going to have to wait until at least summer and maybe fall in order to do so. So, the internship I just started has no benefit for me and I just feel very stuck. With my stuckness came the possibility to shut down; however, for the first time in our relationship, I actually sat down with my boyfriend and cried... a lot. I've teared up and cried a little, but nothing like this. It was a really great moment, because it shows that I don't need to shut down and I am safe being vulnerable. Rationally, I know that, but it's still very uncomfortable for me to experience emotions. I am the luckiest lady to have such an incredibly patient partner.

So, now what? This is a question I don't really know the answer to at this point in time. For now, I'm just going to try and figure out a plan B. The one thing I have to keep in mind is that pitfalls will pop up everywhere. Whether it's a bad body image day or a major life changing event, life isn't perfect. Neither am I. The best I can do is rely on things outside of my eating disorder in order to keep moving forward. Even if I do use behaviors, it's better to take one step back and get up swinging than to fall back to a full blown relapse. All I can do is one day at a time.

Sunday, March 8, 2015

Shutting Down

My number 1 coping skill, even above ED behaviors, has always been shutting down. Any time I feel any strong negative emotion (angry, sad, hurt, shame, guilt, etc), I have the automatic reaction to cut those off and turn them into anxiety. While anxiety is also a negative emotion, it's one that I'm pretty used to and am somewhat comfortable sitting with. It makes things easier to deal with, but it also has some wicked consequences.

Shutting down prevents me from being 100% vulnerable with the people I care most about. I always have that last protective layer from the really ugly parts of myself. Rationally, I know that they aren't truly ugly, but it's how I feel about the emotions related to my trauma.

I have become comfortable discussing my trauma through treatment and having to retell it to various doctors, counselors, and dieticians, but it's putting the emotion behind it that I continue to struggle with. I tell my life story like it happened to someone else. It's like giving someone the details of a movie plot. I'm detached. I'm emotionless. A robot. This is what happens probably 95% of the time.

The one major time I have been able to push past my automatic shut down mechanism was in a psychodrama group during treatment. Psychodrama is basically a group where someone will use other people or props to discuss something. I chose to go the 3 chair approach. The first chair represented me without ED. The second was my eating disorder. The third represented grief/loss. I have experienced a tremendous amount of loss in my life. From my sophomore year of high school to my last year of grad school (7 years), I lost 11 friends in a variety of ways and all but one of them were unexpected. This coupled with the loss of relationships and other things have crushed me in the grief/loss department.

So, in this type of psychodrama, you have to move yourself between the 3 chairs and talk about what you experience in each of them. I started in the self chair and talked about what my life might look like without using eating disorder behaviors. In the next chair, I talked about my eating disorder and how it kept me safe. Then, I had to move back to my self chair to talk about how I used that middle chair to protect me from my grief.

It’s incredibly hard to sit there and talk about what the real reasons you use your eating disorder are. One of the biggest misconceptions about eating disorders is the idea that they are solely about weight, size, shape, numbers, etc. when, in reality, that’s barely scratching the surface. For me, my eating disorder has primarily served as my wall between myself and those strong emotions that I am extremely uncomfortable with. ED keeps me safe from truly having to feel those things. While that wall keeps the anger and sadness out, it also prevents others from getting in.

So, after those 2 chairs, the worst part comes: having to sit in the chair of grief and loss. Sitting in that chair, I finally had to let myself feel everything about that suicide 8 years earlier, which set the stage for how I dealt with every subsequent loss. As I was talking and (finally) crying about the tremendous guilt I felt for this suicide and how angry I was, I said something about the other losses.

So, the therapist asked me how many other losses I had experienced. She added 2 more chairs: one for my father and another for my first relationship. So now, I had 3 chairs for grief. As I kept talking, she kept adding more chairs for every other loss until I was surrounded. The sheer visual impact of the amount of loss in 10 years was overwhelming and I felt it as I sat there. Then, I had to move back to the first chair.

As I sat in my self chair, I had to look at the number of chairs beyond my eating disorder. Again, just a huge number of chairs, none of which I have ever really dealt with. All of that grief carries a huge amount of weight for me that I work really hard using my eating disorder to keep it out. Without my eating disorder or shutting down, I have to feel all of that, which is too much for me to bear most of the time. So, I stayed numbed out, with or without using behaviors.

One of the most difficult things about my journey in recovery has been allowing myself to have myself and my emotions become one thing instead of these separate entities. Recovery is feeling and experiencing all of the bad that comes with the good, and honestly, I really suck at that. I’m very good at shutting down though.

While it hasn’t been an easy process, I am genuinely trying to reverse this automatic system, because it’s not fair for other people in my life and I don’t want to be this robot forever. It doesn’t go away overnight though. I can’t all of a sudden feel all of these things I’ve been blocking for years. It’s too overwhelming that way. But by taking the steps to try and sit with feelings or to come back from shutting down to discuss what’s going on, I feel like I am taking teeny tiny baby steps towards feelings, as terrifying as that truly is.