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.

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.

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).

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.

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.

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.

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.

New Beginnings

When I first entered treatment, I was wondering what my life would like like afterwards. I had 2 options: Return to Milwaukee and try to resume the life I was living without using behaviors OR I could stay in St Louis for a while and try to figure things out here. I’m really glad I chose option 2.

Although things haven’t been perfect or easy, I have a pretty peaceful life now. Milwaukee was chaotic and fueled with memories and bad choices. There, if I began struggling with behaviors, I could easily get away with them. I wouldn’t have as much accountability there and would also probably return to my hard partying ways to cope with all the changes I had just undergone. I would have been back to square 1 and probably on another train back to St Louis.

I think new beginnings are important after going through such huge personal growth and change. If we go back to the familiar but remove the eating disorder, it will always feel like something is missing. It makes the mourning period for the loss of that identity longer and harder. Also, the strength of that progress seems diminished. You’ve busted you ass in 12 weeks of treatment to go back and maybe have that work go to the wayside as the day to day routine comes back into play. New things lead to new routines.

Had I returned to Milwaukee, I would have returned to my case management position. This required me to visit clients, deliver medications, and work on paperwork. The vast majority of my work day was in my car, which made it so easy to restrict. If I had a scheduled time to meet with a client, I would make sure I didn’t have time to stop. If I just kept going, I wouldn’t be able to feel how tired or weak I was. It’s not that I didn’t love the position, because I did, but it would have been difficult to balance the requirements of my meal plan with the job specifics. However, this also happened in St Louis.

After being promoted at my last job, I relapsed. Even though my apartment was literally down the hall from my office, I found excuses to skip meals and stayed in my office to avoid eating. I got back into IOP pretty quickly, but still. New beginnings are not without their challenges.

Now, I have accepted an internship program at a private practice in order to finally begin working on my licensure hours again. I’m finally moving forward in my career, and I feel ready to do that. After leaving PHP, I knew I wasn’t ready. I needed time before being able to give therapy again, but it’s time.

While I know that this will come with its own struggles, including learning how to incorporate my meal plan into this schedule, it’s the next step in the new beginning I’ve been waiting for.

All good things come to those who wait. Be patient.

After working incredibly hard the last year on myself, I’m happy to say that those good things are coming in all the time, and I am very lucky.

Does It Ever End?

I had an interesting discussion with some of my favorite ladies tonight. These ladies have been there with me through every step of treatment and my subsequent journey in recovery. They know that part of me better than anyone. So, when we get together, we talk about our lives and how we are doing in our recovery journeys. Tonight, an interesting topic came up. What is full recovery?

There are 2 main ideas behind “full recovery.” Some people believe that those with eating disorders will eventually get to the point where they no longer experience ED thoughts, so they won’t have to use behaviors. Others believe that full recovery can be defined by the presence of thoughts but abstaining on behaviors long term.

I happen to fall into the second group of people. For me, I will consider myself fully recovered when I get to the point where I no longer turn to restricting and other ED-related behaviors as my first choice of coping skills. I believe while the thoughts will always remain, the frequency will decrease, but they will never be completely gone. I have a few different reasons for this:

1) I have spent 10+ of my last (almost) 24 years on this earth experiencing ED thoughts. Even in the time periods where I wasn’t using behaviors, the thoughts have always been there. There are times when I have them a couple times a day and others when they are constant; however, they are still there.

2) Recovery is a conscious choice. With my mental illness, I accept that I will always more susceptible to relapses due to my triggers and previous experiences. I have to make the choice everyday when I am triggered to use behaviors or do something else. While I am working on those things in therapy, my trauma will never go away. It will become less painful, but in some way, that trigger will remain. It might not set off the bomb in my head it previously did, but it will spark a thought or a memory.

3) Eating disorders impact our brains similarly to addictions. I am not saying that eating disorders are addictions; however, using ED behaviors and using substances are both coping skills that produce an instant gratification effect. So, they are similar but still very different. In discussing with people and clients who have previously struggled with addiction, most (not all) have said that the desire to use will pop up, even after 20 years of clean time. I think this can apply for ED too.

These are just some of the bigger reasons that I have for my stance on full recovery. I also am of the mindset that being prepared for the worst is the best approach. If I maintain the belief that maybe one day these thoughts will be gone forever, I feel like I would be waiting for that day and losing hope if it never came.

So, does this ever end? I will never know the answer to this until the end of my life. The most important thing to keep in mind is that, regardless of what your definition of full recovery is, eating disorders will come in when we least expect them. It wants us to choose behaviors at every twist and turn, but in the end, full recovery, in any way, will not be possible if we continue to rely on ED.

Forgiveness

Do we forgive those who have hurt us?
The people who walk out when we need them the most.
Those who forget us when we are struggling.
Ones that look the other way when we reach out.

What about the times that they have tried to make amends?
The moments when you think that maybe things could change.
Times when it feels like the relationship can be fixed.
When both parties are willing to admit that they were at fault and move on.

Then, they are met only with a stonewall that neither party is willing to climb.
Where a compromise can never be met.
Blame is placed and responsibility is denied.
He claims no wrong doing.
She knows differently and places that blame inward.

When years go by and no words are exchanged.
The relationship continues to fall apart.
Each moves on with their lives without consideration of the other.
A thought is triggered and someone reaches out.
Contact is restablished.

Another discussion is had.
More walls are built.
Communication breaks down.
More years go by.
Memories and nightmares remain.

Then, an unexpected message asking for forgiveness.
He acknowledges that maybe help is needed.
She is left asking why now?
Why not a year ago?
What's the point?

Will it help alleviate the pain that's been caused?
Are answers finally going to be given?
Would it change anything?
Does it really matter?

Words have already been said.
Feelings have been hurt.
The damage has been done.
One has been left a broken person,
Because she has placed all the blame on herself.

So, should she forgive him?
She spends days debating the answer.
Ruminating on thoughts and feelings.
Then, she gets an answer:

The person that she should forgive is herself.

Wordless

Some days, I’m just not really sure what to say. Today is one of those days. As NEDA Week 2015 comes to a close, the reality sets in that, while we have 1 week a year to help truly bring awareness to eating disorders, these 7 days don’t come close to expressing how difficult it is to live with an eating disorder.

No amount of blogging, sharing, or talking can give the true picture of what it’s like to be trapped in an eating disorder mindset every day. It’s being completely stuck in your own mind and using these behaviors that you might hate, but just can’t stop doing.

No amount of facts describes what it’s like to be laying in bed unable to sleep, because your mind is racing with things you’ve fucked up that day, how much you hate yourself, and thinking of all the ways to punish yourself for the things you’ve done.

No before and after transformation picture will describe the hell you went through to get from picture 1 to 2. The amount of physical and emotional pain that you undergo in treatment in order to enter recovery. The strength it takes to overcome all of those awful thoughts in order to eat even one bite of your meal plan for the day. The work you had to put in to get there.

No wearing purple or mismatched socks will make people understand the battle that goes on with even trying to put on clothes for the day. The criticism you hear your head no matter what item you pick up. How fat you feel, regardless of what others say or what the mirror may show. The dread that sets in when you realize you have to leave your house and have other people see you.

That being said:

No awareness means that others won’t recognize when they may have an eating disorder, because symptoms have never been previously discussed.

No awareness means that those who recognize that they are struggling may not reach out because of fear that others won’t understand.

No awareness means that no steps will be taken to improve the research and treatment of eating disorders.

No awareness means that the journey to recovery becomes that much harder.

Thank you to all who participated in NEDA week. Raising awareness will help the discussion of eating disorders become more prevalent, which in turn will help more people receive services and reach the recovery that they deserve.

Shut Up and Be Happy

For the first time, potentially ever, I have found myself in a surprisingly calm period of my life, and I am freaking out about it.

It's not like everything is perfect. I'm having a huge increase in eating disorder thoughts, which makes me want to use behaviors. I haven't really done so, and if I have, I always make it up later or the day after. I still don't have a job and haven't really heard back from any type of employer, except rejection emails, which is incredibly frustrating. Besides these things, everything is else is great and, dare I say, stable.

Stable is a weird word for me. It only ever seems to exist in the short term in my life. I have gotten used to relying on change to give me stability. No change makes my life feel uncomfortable, which it's not true in any way, shape, or form. It's actually a really good thing. So, what do I do in these situations? Create the instability.

One of my crowning achievements is that I am fantastically great at self-sabotage. I get scared that for the first time, things will be okay. My eating disorder hates that, hence the number of thoughts I've been having lately. It wants me to remain in chaos, so that it can come in and help control everything. Typically, I succumb and enter a new relapse.

Today, I can feel myself teetering. There's such a huge part of me that is determined to continue in recovery, but another that is honestly just tired. This journey is exhausting, and I've been listening to more ED thoughts lately. I just don't have the energy to keep pushing them out and challenging them. The worst part is that I make this worse by adding more value onto events than is really necessary. For example, my therapist called me out last week on being frustrated by lack of contact from jobs. She pointed out that I really haven't been unemployed for that long. It's only been 2-3 weeks. So, I am the one making myself feel badly about this. Self-sabotage at its finest. But how do I make it stop?

When working with clients with anxiety, I used to challenge them by making them give real, actual examples of how those irrational thoughts were in any way valid. Typically, there isn't any or, if there is, it's a pretty big stretch. I used to have clients very similar to me. Some had grown up in a very different world, but it was still chaotic none the less; however, when things were good, their anxiety would get worse. With one of my favorite clients, this went on for weeks until I finally told her to tell those thoughts in her head to shut up and just try to be happy in the moment. For once, things weren't chaotic. They were good. In some lives, that never happens for long. She was taken aback, but she agreed to "Shut up and be happy."

This is a phrase I need to take to heart more. I have spent so much time living in my eating disorder that I remember more moments related to that than actually positive ones. That's just sad. No one should live like that. If I continue to stay in this mindset, I will never actually be able to be content with where I'm at right now, and my life right now is wonderful.

So, self, shut up and be happy.

I Had No Idea

The theme of this year's NEDA week is "I Had No Idea." Sometimes, we have these cookie cutter ideas of what eating disorders are and how they can impact a person, but there's so much more to them than just a label.

I Had No Idea:

• The level of distortion I had when looking in the mirror.
• I was so cold all the time, because of ED.
• How much hair I would lose.
• I would end up with a chronic heart condition.
• Eating a meal would continue to cause stomach pain and issues, even in recovery.
• There are no good/bad foods.
• How hard it is to begin eating again- physically, mentally, and emotionally. 
• My thoughts were covering up so much more underneath.
• Using behaviors would give the high that cocaine once did.
• Wanting to be thinner wouldn't make me any happier.
• How quickly dieting turned into disorder.
• Seeing the size on my clothes get lower would cause me to push harder.
• Not everyone constantly beats themselves up mentally everyday.
• How much my self-worth would become dependent on size, shape, and numbers.
• A bad body image day would impact my ability to do anything.
• Skipping work would happen so frequently from being sick from behaviors.
• That I punished myself with restricting.
• I would use self-injury.
• Other mental health issues contributed to my ED behaviors.
• Anorexia would be closer to me than many friends and family when I'm sick. 
• The impact of my behaviors on my ability to perform well at work.
• Lying would become a part of my daily routine.
• I wasn't very good at hiding behaviors, even though ED told me I was.
• EDs have a major influence on how your brain works and performs.
• I had no clue who I was without my eating disorder.
• Anorexia would become my identity.
• The negativity of my core beliefs.
• How strongly my trauma affected me without restricting.
• Talking about my issues would be and continues to be the hardest thing I have to do.
• The amount of support I needed and continue to need to stay in recovery.
• Comparing myself to others would cause me to lose self-confidence.
• How amazing the community of people fighting EDs is. 
• As a therapist, I wouldn't know all the answers to help fix myself.
• I wouldn't be able to bring myself to dance again.
• People don't spend 2 hours in the grocery store to get a basket's worth of food.
• I have the ability to take care of myself and other people. 
• Suicide would be an option I would ever seriously consider.
• My behaviors could have killed me.
• Hunger cues would go away, and Fullness cues take time to adjust.
• That I would continue to fight anorexia 10 years later. 
• Just how sick I actually was.
• I would have to give up my job, relationships, friendships, life in order to go to treatment.
• I would lose everything to my eating disorder.
• You have to hit rock bottom before you can build yourself back up again.
• Even skipping one meal in recovery would put me off track. 
• Insurance coverage is solely based on numbers, not on actual mental stability.
• Letting go of behaviors would be this difficult.
• How hard it is to stay in recovery.
• I could feel so good without using behaviors, being a certain size, or a number on the scale.
• Treatment would be the hardest thing I would face, but it was absolutely worth it.

 I could go on and on, but eating disorders are so much more than a DSM diagnosis. That's why weeks like NEDA Awareness are so important. Without educating, many people may not understand or receive the help that they need. Spread the word!

Social Media

Hi All,

I just wanted to share that I am expanding this blog to more social media to help spread the word about eating disorders and my story. You can also find me here:

Twitter/Instagram- mellamoheidi
Tumblr- http://backtotreatment.tumblr.com/

I'll also continue to post here. Please follow me on these sites and spread the word!

Thanks,
Heidi

Identity

One of my biggest struggles in recovery has been identity. For the last 10 years, my eating disorder has taken up a significant portion of that. When I'm in the disorder, I become my anorexia. My behaviors take over every second of every day. My world revolves around staying safe in my bubble of restricting, self-hatred, and the familiarity. So, when that's all gone, what do I have left? I found a quotation today that has described this struggle:

"She wants it to be over, but she’s afraid of it being over, because then she’ll have to figure out what comes next." 

This describes my everyday battle. I have no desire to continue using my eating disorder behaviors. They are nothing but destructive, and they have ruined so many opportunities in my life. But at the same time, without these behaviors, I have no idea how to truly cope with the real world. 

My entire life has been nothing but change. Growing up a military brat, you have no control over where, when, or how much time you'll have before moving to a new place. At 23 years old, I have lived in over 23 houses/apartments. Change is a constant, which is what makes those few pieces of stability that much more important. I would cling to these things, because it helped me feel kind of normal on some level. In childhood, these things were my gymnastics and dance. They helped me feel safe. When I was there, I didn't have to worry about anything else. That was fine and dandy until my eating disorder became a part of that world. 

My eating disorder first started when I was 9th grade. I had dabbled in behaviors before then, but this is when I began using them consistently. I had been dancing more due to my involvement in musicals, which became my support group and my escape. Then, the first thoughts of "You're not good enough" began creeping in. I was never good enough to get the good dancing parts. I can't really sing, so I never got those parts. I was just always kind of there: a dancer who could pull it off, but not really. While these thoughts served as a good motivator, it also became my downfall as I started listening to them. I began comparing myself to those around me. The other girls were always prettier, thinner, and/or better than me. By being at the bottom of the totem pole, I had the choice: don't change anything and stay here or work really hard to move up. I went with option 2. 

I was able to work really hard and moved my way on up. I became "the dancer" in a variety of situations. It felt like I had an idea of who I was. The way I got there? Restricting and being as involved with as many dance classes and performances as possible. It felt like my eating disorder helped me achieve that. I was finally skinny and pretty. Even after I moved to Maryland, I was able to establish myself as a dancer very quickly in my new high school. This connected me with a new group of friends, which avoided my need to form a new identity. I could use this one. My identity as a "dancer" lasted all through high school. Then, when I hit college, I added to it.

Once I began college, I went through a lot of changes. My identity as a dancer remained, but I soon found myself in the role of caretaker and emotional support as my family went through a pretty heinous situation. I buried my feelings and took care of business. After that, I became the girlfriend, and very soon after, I was the fiance. Over the next 5 years, I graduated college and graduate school. I went from the fiance to the single girl. I became the 19 year old college graduate and the 22 year old with a Master's. I became the alcoholic, the hard worker, and the compartmentalizer. Through all of the changes I was undergoing, I kept onto one primary identity as my constant, the anorexic. 

The anorexic served a great purpose for a long time. Now, we all have our different definitions of great; however, I am positive that I would not have made it through graduate school without it. Anorexia helped numb the pain from so many events that would derail many people. From the time I began high school to the time I graduated graduate school 8.5 years later, I lost 8 friends in a variety of horrible ways. My father chose to leave our family as my grandmother battled a brain tumor. After 8 weeks, my grandmother went from diagnosis to death. My relationship with my father was a roller coaster. I had a variety of health issues. I began having flashbacks and nightmares. I had more traumas in addition to this list that I do not want to discuss. My life plays out like a bad soap opera where they are always adding in a new twist. My eating disorder made it possible for me to feel safe in all of this. It protected me from having a complete breakdown and allowed me to continue functioning in all that I needed to do. Anorexia was my partner.

Treating my eating disorder is honestly another loss in my life. What do you do when how you have lived your life for 10 years finally catches up with you? How do you change that? Do you even know how to change it? I had no clue, which is why I went to treatment. While I have been able to reduce my behaviors, I still cling violently to them, because I'm not sure I am ready to completely give up the familiar and the comfort I get from them. It's the ultimate "What's next?" 

If I have a major issue happen, I'm not sure that I am capable of dealing with it without restricting. I am terrified that I will finally be a person who has to breakdown and feels emotions. Yes, I recognize that that's a normal person, but I have never been like that. It's the ultimate push out of my comfort zone, because it ultimately causes me to look at myself as a person and not as my eating disorder.

I have very little idea of who I am. I'm not really convinced anyone knows the answer to this question, but I think I'm on the path to figuring it out. I am NOT my anorexia. That's for sure. I am capable of living a life without behaviors, but I need to get over my fear and just commit 100%. It won't be until then that I can answer the "Who am I?" question. I know what traits I value and what issues are important to me. I think that building off of that might finally lead to an ED free world and a new me.

Why is Eating Disorder Awareness Important?

February 22 through 28 is National Eating Disorder Awareness Week. This is the week where schools, organizations, and more can bring more education and attention to eating disorders and the accompanying issues. But why is it so important? Here are my top 7 reasons why we need eating disorder awareness:

1) Eating Disorders affect over 30 million people in the United States
Looking at my life, I have been able to identify many people who have struggled with eating disorder behaviors. Even though these behaviors don't aways lead to eating disorder diagnoses, they are still common in our society. We often hear about the newest diet fads and pressure to be thin. I can remember as young as elementary school recognizing the importance that people place on shape, size, appearance, and more. The value I took from this and placed on myself is how my eating disorder started. I felt the need to be thin and was willing to go to any length to make that happen. Regardless of how eating disorders begin, you can't always tell who has one. Eating disorders affect all genders, races, and ages. Bringing awareness to how common eating disorders truly are can help us facilitate the conversation about the symptoms, signs, and options more openly in order for everyone to get the help they deserve.

2) Eating Disorders have the highest mortality rate of any mental illness.
Eating disorders wreck not only the mental health of people struggling but also the physical. Each classification of eating disorders can come with their own set of physical problems. Most commonly, people with eating disorders have heart, stomach, electrolyte, neurological, and other issues.

3) Eating Disorders have long lasting effects, even in recovery.
ED has all kinds of physical and mental aftershocks. Physically, I have a heart condition and stomach issues over a year after treatment. These are problems that are irreversible and only become more severe in a relapse. These physical problems can make recovery that much harder. I have a very difficult time facing the fact that I have done this to my body. It triggers my guilt and shame, which feed my eating disorder. It's a vicious cycle. I truly believe that I will live the rest of my life with my eating disorder. I don't think that voice in my head will ever completely go away. With work, it can get quieter, as it has over the last year, but silence seems like a dream. Everyone's journey is different, but eating disorders make a major impact on one's life.

4) Eating Disorders often co-occur with other mental health problems.
Most eating disorders do not come alone. Many people, myself included, struggle with other disorders at the same time, including: depression, anxiety, PTSD, OCD, and more. These disorders can also impact each other. For example, if someone is experiencing more severe depression or anxiety symptoms, he or she might turn to eating disorder behaviors to help cope. This adds more layers to treatment. Not only do you have to treat the behaviors, but you have to teach new coping skills for the other disorders as well. This multifaceted process takes time and patience.

5) Awareness helps reduce stigma.
By increasing the conversation, we can help reduce the negative connotation associated not only eating disorders, but all mental health issues. While we are improving on mental health care and awareness in our country, it is still seem as shameful to admit to having a problem. This makes admitting that you are struggling that much harder, because you are afraid of the fallout. It is even worse when some people say things like, "She looks so anorexic" or "He needs to go work off that food." You can never tell who is impacted by eating disorders. Comments like these only perpetuate the stereotypes and increase the stigma. By becoming educated, it can help open up the conversation and process to entering some type of treatment.

6) Insurance companies are difficult when it comes to treatment.
Let's be real- insurance companies suck when it comes to the treatment of eating disorders. To them, it's all a numbers game. Someone can be struggling really badly, but if he/she is in the goal weight range, insurance can say, "Sorry. Not gonna cover anymore." Residential treatment typically costs over $1000 a day. Unless you are extraordinarily wealthy, that's almost impossible to pay out of pocket for the amount of time it takes for appropriate care. For me, my insurance company dropped me from partial hospitalization the same day I was released from the hospital. I had been inpatient for a week after being actively suicidal. I returned to treatment and was told that I was no longer covered. I went from 42 hours of treatment per week to 15. The reason? I didn't lose that much weight in the hospital, so clearly, I didn't need PHP anymore. Bringing awareness gets the conversation started about how we can organize to help institute change to better serve all people.

7) Recovery is a much easier journey with support.
One of the biggest components of my treatment has been raising awareness among my own friends and family. Discussing my needs in order to be more successful in recovery would not have been as easy had they not taken the time to learn about my disorder and how to help. Awareness helps people get a feel for how difficult living with an eating disorder truly is. I admit that I am a very difficult person to deal with on days I'm struggling. I recognize that, but I am also still working to change that. It doesn't happen overnight. They also have learned what behaviors I display at the beginning of a lapse. That patience and knowledge, because they have taken the time, is a huge part of the reason why I am still in recovery today.

This is not an easy process and one week out of the year is not a lot to truly recognize all the facets to eating disorders; however, one week is better than nothing. NEDA week means that people can truly learn what the impacts of these disorders are. It's not just starving yourself to be thin or eating large amounts of food to make yourself feel better. These disorders are nasty.

Your hair falls out. You get dark circles. Your teeth rot. You are cold all the time. You don't have enough energy to make it through a day without taking naps. You are constantly miserable. You are fighting a war against yourself every minute of everyday. You are irritable towards others. You isolate in order to do behaviors. Your heart skips beats. You pass out. You can't eat a normal meal without ending up in the fetal position after. You hate your life. You think about ending it. You lose everything. Worst of all? You lose yourself.


So, please take the time to discuss eating disorders this week! It can be with family, friends, coworkers, children, strangers, anyone. The more conversations that happen, the more awareness is raised. More awareness helps build a community of support and ultimately, earlier interventions to help those struggling.

Professional to Patient- How I Went From Therapist to Client.

One of the hardest things for me to tackle during my treatment and recovery process has been having to switch roles from being a therapist to being a patient. This role reversal has lead to some road blocks in my process, because it is difficult to go from working with clients on certain topics and then having to face them myself. So, how do I deal with being a therapist while in treatment?

My journey to becoming a therapist started when I was in college. Upon entering college, I was pretty set that I would double major in Psychology and Spanish in undergrad and move onto a PhD program in Clinical Psychology. This was my plan for 2 of my 3 years. Then, I took a Counseling Ethics and Methods class with my college advisor, and I was hooked. During this class, we learned about the skills required to be a counselor and what kinds of techniques worked effectively for different disorders. I remember looking forward to that class every week, because it was always new and exciting information for me. I began to question my choice of Clinical Psychology. Did I really want to do research all the time? Did I eventually want to teach in higher education? As that semester went on, my answer to both of those questions started to lean more towards a no. Also, the idea of spending 7 more years in school sounded dreadful. Then, I took a group therapy class, which I still owe my graduation to. I honestly do not think I would have graduated college if that class had not happened. My own personal growth in that class made me want to help others that way. So, I began to research graduate programs in Counseling Psychology.

My final semester of college had a lot of changes in my personal life. The relationship I was in was about to face some major changes as he chose to enter the military. I accepted that, in order to make it all still work, I would need to do graduate school close to home and then relocate to be with him after he had finished his training. So, I looked into the program at UW-Milwaukee, an hour from where I was living. For being so close to home, the program had a fantastic reputation as a great school for counseling. I looked into the work that professors were doing there and decided that this would be the program for me. So, I applied and was accepted shortly after. I was excited to start this new chapter after receiving a great foundation in undergrad. Even after my relationship ended as I was beginning grad school, counseling felt like the fresh start and new journey that I was ready to take.

My Master's degree is in Educational Psychology with a focus in Community Counseling. During my time at UWM, I took the necessary classes but also additional classes in Trauma Therapy, AODA issues, and multiculturalism. I knew that my dream population would be working with veterans, after being a military brat. Trauma Therapy has always called to me; maybe because of my own experiences, but during those classes, I knew I was in the right field. The most important component of my program was my practicum experience, which I completed at a local Mental Health/AODA outpatient clinic. Working in that clinic, while incredibly overwhelming at times, was one of my most life changing experiences.

During my practicum, I was working with about 20 clients and co-facilitating 2 groups: Seeking Safety and Suboxone Recovery Psychoeducation. I also completed intake assessments as a part-time job on the side. The first few months were difficult, as I encountered business politics. But as time went on, I began to see more clients. My clients ended up being primarily women who were using substances to cope with their significant trauma histories. These women were some of the strongest people I have ever had the privilege to work with. Many of them stayed my clients for over a year. Upon graduation, I transitioned into full-time work to begin my hours towards full licensure. At that point in time, I was given 85 clients and continued to run 1-2 groups per week. I struggled with finding the balance between work and home. I often would struggle with leaving some of the experiences from my clients at the office. This also became one of my biggest triggers.

My eating disorder throughout this 5 year period had always been present. I had had some lapses, but no major relapses. I was functioning, but I was spending a lot of time compartmentalizing my own issues that were being brought up both at school and work; however, after I graduated with my Master's, things began to get worse, and it didn't go unnoticed.

My biggest ally at my job was one of my supervisors, Jane. My first day at my practicum site was a disaster. I was caught in the middle of politics, and I ended the day on the verge of tears in her office. We had a strong bond from the start, and I always felt comfortable going to her with both professional and personal issues. As I was nearing graduation, she confronted me about the possibility of having an eating disorder as she noticed I was counting calories and rarely eating. I admitted that I had been struggling, but I wasn't ready for treatment. I credit the entire start to my recovery journey to Jane. Had she not suggested that I maybe needed treatment, I never would have gone. Granted, I didn't go in the time frame she suggested, but that idea stuck with me.

So, in the summer of 2013, I went for an intake assessment at an eating disorder clinic where they recommended I go inpatient or PHP, which I refused. Their compromise was IOP, but I never went back. I was in pretty hefty denial at that point in time, so I was convinced that I didn't really need it. As time went on, Jane continually pushed for my need to have a therapist, but I continued to avoid it. Even after I left that clinic and took a new job, I was getting texts asking if I had gotten treatment yet. It helped, because I got one of those texts right before I accepted that she was right and I needed to go.

Eventually, the intense therapy I was doing with clients began to cause some burn out. I would work 10 hours a day and go home exhausted, unable to shake the stories of my clients from the day. I used some negative behaviors to cope, including restricting and binge drinking. Couple this with the negative relationship I found myself in, and it was a recipe for disaster. After that relationship ended, I cracked, drank for 3 days, and made the call for treatment.

There is nothing stranger than going from being the person asking the questions to having to answer them. My first intake session felt like some alternate universe. I was waiting for her to stop asking questions, so I could begin asking her the same ones. It felt like the practice exercises I had done in graduate school where we were fake clients for one another. This wasn't anything like that though. I had to be a real client, because I was one. I was on the receiving end for the first time and on the verge of making a commitment to being there for the foreseeable future. It was a contract I wasn't sure I was ready to sign, which I didn't on my first intake.

As a therapist, I knew what questions to anticipate during my intake. I had spent a year and a half asking others those questions; however, I knew that if I were going to start this process, I needed to take a step back and just listen. That got horribly derailed though when the first intake woman said to me, "Well, you're a therapist. What would you say your 5 axis diagnosis is?" I was taken aback and had to say to myself, "Did that really just happen? Yes, yes it did." Needless to say, I chose not to have that woman be my therapist and sought out a different clinic for my care.

My next intake was much better, but harder as well. I walked into the waiting room, and there was my brother. So, I was already very overwhelmed entering the intake. As I spoke about my history, it became clearer that my idea of doing IOP for a few weeks and going back to Milwaukee wouldn't happen. She was pushing for 10 hour PHP, an idea I was pretty staunchly against. After all, my eating disorder wasn't that bad in my mind. We compromised at 6 hour PHP. 6 hours of treatment every day? That's what I was used to working, not doing.

The first day of treatment sucks for everyone. I think if I were to go back and poll everyone I went to treatment with, most would say that the first day is the hardest. I had to submit myself to numerous appointments where I would have to tell my story multiple times and admit that maybe I had a problem. I had a new found respect for my clients who used to have multiple appointments a day at the clinic. I shared the same thing 4 times to 4 new faces and was exhausted by the end of it. The second day was the beginning of my new scheduled programming. 2 snacks, lunch, and 3 groups in the 6 hours a day I would be there. Thus began my new life as a patient.

I was very resistant to this role reversal at first. I don't think my first two weeks at McCallum really did anything, because I was so set on the idea that I would be returning to Milwaukee by the end of the 30 day leave I was granted. I couldn't just leave my work. I had clients and responsibilities to them. I had my apartment. I had friends. I had my life in Milwaukee. So, I stayed in my little bubble of denial, which solidified even more when I was upped to 10 hours a day. I couldn't be too comfortable in the patient role, because I had to go back to being the therapist in just a few short weeks. I couldn't get out of practice. Eventually, I came to the harsh realization that I couldn't go back to Milwaukee. I needed to stay and do treatment the right way, not just run away from my problems like I had before. That's the moment when I accepted that I needed to be the patient, not the professional... for now.

One of the hardest parts of this transition for me were some of the groups. The groups were a variety of process, psychoeducation, and experiential. Process groups are the type where you discuss your feelings and provide feedback and support to one another. Psychoeducation groups are where you discuss different types of coping skills, educate about disorders, etc. Experiential groups are where you use activities for expression, including: art therapy, dance, yoga, music, etc. The vast majority of these groups were psychoeducation with a particular focus on Dialetical Behavioral Therapy skills.

As a therapist, I spent 5 semesters and a lot of money on getting the education to be able to provide psychoeducation to my own clients. As a client, I was on the receiving end of information that I had already learned. This made many groups torturous. It was even more frustrating when I could explain some concepts better than therapists or was asked to do so, if they were struggling. We would be given worksheets in groups that I had previously given clients in my Recovery group. Substance Abuse and Eating Disorder Recovery share a lot of similar concepts and techniques; however, substance abuse often encourages abstinence in recovery. Using abstinence in Eating Disorder Recovery is what keeps you in treatment. So, every day, there would be multiple groups that I would have to sit in and listen to concepts I already knew. My worst day was when I had to step in for a therapist, because she was literally doing nothing while someone in group shared something incredibly difficult and triggering. All the therapist could do was stare at the floor and say, "That must have been really hard." I stepped in and provided the support from a therapist perspective to give insight and support. This created this internal conflict of therapist vs patient even stronger. I felt that I couldn't just be a client.

I would talk to my individual therapist about these struggles, particularly because I was so livid at the therapist that day. My therapist would often validate that it is difficult to step out of that role, because I spent years training for and doing it. No one really stays in this field unless they're good at their jobs. It gets to be too draining if you're not and frustrating since your clients don't make a lot of progress; however, my therapist called me out. My personal favorite response was, "Well, since you know everything from school, why are you here? Why aren't you out in the real world using it?" Touche. There's that whole idea of "Practice What You Preach;" however, the vast majority of us suck at it. She encouraged me to take things as they were: I was a patient. I was here to be receptive to treatment and the information being given to me. My identity still had a therapist component, but I needed to make space for a patient component, especially if I had any real hopes of staying in recovery long term. She encouraged me to look at myself as my own patient. "If you had a client in your shoes, what would you say to him/her?" Followed by: "If you can say that to them, why can't you say that to yourself?" She had a pretty solid point, but I still found myself judging the techniques she was using in my sessions.

It's not like I could forget all the training I had. There's no way to just shut off that information that you learned in school and make it sound brand new in treatment. Wouldn't that be nice? But there is a way to make a compromise. I did and continue to remind myself that, while I know these concepts and skills, there's always something to learn. One of my favorite things about the counseling field is the amount of collaboration between colleagues. Whenever I would find myself at a roadblock with a client, I could turn to my coworkers and supervisors who always had some alternative ideas. There's never just one pathway to a solution. There can also be multiple solutions. That's what treatment is too.

Becoming the client not only made me admit and discuss my problems and trauma, it grounded me in that, even though I am a professional, I am not the expert. No one is. Every client is different, and I'm not excluded from that. That outside perspective that I used to get from coworkers, I now get from my therapist. I have insight on both a professional and personal level on my own experiences, which has been extremely helpful in sessions, but I can't do it alone. Also, using my professional knowledge, I have some insight on what type of therapist is best for me. I struggle with therapists that I can predict what technique they will use next. I need a therapist who isn't afraid to call me on my bullshit and does not just sit back and wait for me to come to the conclusions. Silence is not a technique that works with me, because I too have been trained how to sit comfortably in it until a client is ready to talk. I have had many a mandated client who would eventually start talking, because they hate the silence. Things like this help me become a better client and, in turn, a better therapist.

Going from the therapist to the client has given me more insight than any job or classroom experience ever could. I have a new level of empathy and respect for anyone who will sit in front of me as a client, because it truly takes an incredible amount of strength to get to that chair, let alone be willing to talk when you get there. I have had to experience things I put my clients through: talking about my trauma, fear of taking and dislike of psychiatric medications, being sent to the psych ward after admitting suicidal ideations, reading and signing treatment plans that I didn't 100% agree with, and, most importantly, facing my mental health issues head on. It also gave me the insight that I was not ready to go back into practicing immediately after leaving treatment. I needed to take a break from giving therapy after completing so much of my own. This break has continued, but I believe it is one of the main factors that has kept my focus on recovery.

Jane used to tell me that she believed it should be mandated that all therapists have their own therapist. It goes back to that idea of practicing what you preach. If you aren't willing to see your own therapist, is it hypocritical to expect your clients to be completely open to your services? I don't have an answer to that question, but I know that I will never practice again without having my own therapist. Too many things are triggered for me in doing trauma therapy for me to be the best therapist I can be without one.

While my transition from therapist to client was not an easy task, it was necessary. Since I have not returned back to the counseling field yet, I cannot say for sure how my role reversal back to professional will be, but I do know that my identity as a client will maintain and continue to make me the best therapist I can be.

Stalemate

If you don't change, nothing will. Random messages from my therapist will pop up in my head at seemingly opportune moments when I am struggling. This is a message that's been replaying a lot lately.

Since I started seeing my therapist during IOP at the end of September, I really honestly haven't made too much progress. It's not that I expect to make these huge astounding changes, but I haven't made as much progress as I would have liked at this point.

One of my biggest struggles continues to be meal plan fulfillment. To me, I'm not consciously doing it. The thoughts of "You need to restrict" are no longer incredibly prominent when I am planning a meal. Part of it is honestly just laziness. Following my meal plan is such a daily chore. It involves prepping, (sometimes) cooking, reading labels to check that I am getting all my calories in, actually eating, and then recording my thoughts/feelings/food on my phone to send to my dietician. Rinse and repeat 5 times a day. It's exhausting. Combine that with my stomach issues, and meal plans become dreaded chore. So, I have been skipping some, mostly snacks. It's not every day and it's rarely multiple times in one day; however, it's still not doing what I am supposed to be doing. If you don't change, nothing will.

Then, I look at my therapy sessions. I've been really stalling on the emotional component of my trauma work. As I've talked about before, I have a really difficult time feeling and expressing any type of emotion. It makes me feel very uncomfortable, so I just try to avoid it. My therapist is pushing this aspect more than lately. Part of me is ready to do it, because I actually really hate when I shut down, especially within certain relationships. It causes me to become very detached and isolate, which is not helping my depression right now. The other part of me is flat out terrified to do it. I have a difficult time trusting that my emotions are real. I sometimes worry that, when I go off irrational thoughts,  I will express things that aren't real. They're feelings based off of false knowledge. If it's not irrational, it's foreign. It feels like sharing these emotions will ultimately lead to more pain, because I've opened myself up that much. It's not that I don't trust the people in my life, but I've experienced enough times of my feelings not being validated that I just don't express them. If you don't change, nothing will.

I've had this voice inside of me that hasn't been able to come out in 15+ years. It's something that has so much to say, but no idea how to express these things. Even more so, it's worried that what it has to say isn't important. Rationally, I know that that isn't true. I know I have people in my life and the support of my treatment team that it would be okay. It's overcoming that huge obstacle of my fear to getting there. That's not an easy task. But it has to be done.

If you don't change, nothing will.

I'm ready for a change.

Sick Equals Love

Sick equals love. An interesting concept. Yesterday, my therapist brought up the idea that maybe, on an unconscious level, I continue to struggle to stay in recovery, because this is ingrained in me. On some level, my needs are fulfilled when I am sick, but not when I am doing well. This is why I stay on this teetering edge between relapse and recovery. Does sick equal love in my world?

To me, my first gut reaction is absolutely not. It feels like she was telling me that I stay sick on purpose in order to get attention from others, which isn't true. I have never used my eating disorder as a cry for help. It has always been a type of self-punishment and sense of control for my unpredictable life. I went 10 years in my disorder before even admitting that I may have a problem with restricting. Now that it's been out in the open for a year, I feel more of a sense of responsibility to do well and stay in recovery, because if I struggle, people are going to notice it much more quickly. I also have those who are holding me accountable for my meal plan and doing well. So, I don't completely agree with this idea of sick equals love.

But what if she's right? What if on some level, I do stay in my eating disorder to receive love from others? That's a horrible thought. While I do receive more outward support from others when I'm struggling, I have so much support in my day to day life that fills me with so much love. How can she be?

When I'm sick, I cannot feel the love of others. I become very selfish and stay in my own self-absorbed eating disorder world. My eating disorder becomes my love. To me, sick equals love means that I feel more comfortable in the love from my eating disorder than from every other source. My eating disorder has never left my side. It's been there when other loves have ended. It's the one constant source of love. When I am sick, I am loved... by my eating disorder. That is a truly dysfunctional love.

My eating disorder is like that past relationship that you would do anything to keep or get back, but rationally, you know it's completely unhealthy and would ruin everything. You just can't help but want it. Sick equal love.

Today, I am trying to push myself more into that unfamiliar territory. I've been in this comfortable long term relationship with ED for entirely too long. I have a new relationship that pushes me to areas where I have never felt secure or comfortable with anyone. It's been causing me to retreat back into that comfortability that is restricting. For the first time in a long time, I am working on opening these places and trusting that it is the best thing.

Recovery is this horrible scary journey. You go into it thinking that you only have to worry about learning how to eat food again. Not even close. You have to be willing to open yourself up to these places that you have shut yourself off from for so long, that have definitely never been shared with others. But if you don't, sick will always equal love. Love equals love and if you're willing to be uncomfortable and learn to adjust, you might just find something extraordinary.

One Year Later: A New Perspective

One year ago today, I made the decision to seek treatment for my eating disorder. 

February 1, 2014. I woke up this morning feeling lower than I had in a very long time with a hangover so bad that I could barely see straight. I hadn't eaten in 4 days, but I had consumed about a bottle and a half of Jack Daniel's in that time. I woke up unsettled and uneasy. I could feel my heart skipping beats, my head spinning, and constant waves of nausea. I had just finished another night of blackout drinking to help alleviate the depression and anxiety I was overwhelmed with. I had been reeling from a break up that I knew was coming but was still having a difficult time accepting. I lay in bed staring the ceiling debating if I would get up or if I would take the bottle of heart pills on my night stand. I could not bear to stand the weight of my eating disorder, my alcoholism, and the bad person I had become. I reflected on how things had gotten so bad.

7 months before, my supervisor was encouraging me to seek treatment. In July, I went to one session with a therapist. I was recommended for intensive outpatient treatment, as I was refusing to leave my job, but I never went back. I had spoken with friends about my eating disorder 7 months before. I was scared about what power it was beginning to have. I knew that I needed help at that point, but I wasn't ready to truly admit it. Shortly after, I entered into a relationship that I was convinced would help distract me from my eating disorder and fulfill this void that I had had for years. In reality, that relationship became my downfall.

From September until January, I put on a brave, happy face to those around me, but no one knew how truly volatile things were in my relationship. My eating disorder behaviors were not only ignored, but they were encouraged. Multiple times a week, I was being told that I needed to go to the gym to tone up. I needed to grow up and move on from my trauma. I just had to deal with these things by working through them, regardless of the flashbacks. My skipped meals went without comment. My drinking escalated quickly as I joined his lifestyle. Soon, I was eating one, maybe two meals per day and drinking enough whiskey that I couldn't remember the hurtful words. I isolated from friends, only seeing them at the bars. I withdrew from my outside world. I went to work and to my relationship. I had no life of my own outside of that. So, when this relationship ended, I had no idea how to live a life outside of my eating disorder or my relationship. I was nothing, and I felt like it.

February 1, 2014. As I stayed in bed, I thought about the people in my life; the ones who tried to reach out and stand by me, even when I was pulling away. I thought about the people I had lost to suicide. I thought about what my loved ones would say if they were the ones who had to stand by and watch me being lowered into the ground, as I has done for so many of my friends before. I decided that I couldn't put my people through that, especially when no one truly knew what was going on. I got out of bed, talked with my roommates, and went out with them to try and have a positive day, but there were so many different thoughts going on that I had no idea what to do. 

I had to think about what my options would be. My biggest was making the choice between continuing to live in this downward spiral or finding some way to get out of it. In all of my previous bouts with anorexia and depression, I always had some type of life transition that allowed me to cope with things better. There was always a light at the end of the tunnel. This time, that light was gone. All I saw was darknesss. If I didn't commit suicide today, I would create a plan that would help alleviate as much of the pain as possible for those around me. I had no doubt in my mind that that would be what happened if I didn't make a change, but there's always that little voice that says "What if?"

What if I made the choice to live differently? What would that even look like? How would I even get there? Could I actually admit what was going on? What would my family say? What would my friends say? Can I give up everything? Can I accept the help that I had been giving to others for so long? Is this really what I should do? Where would I even go? Could my life really be different? What if I failed? What if I can't ever get better? What if this is what the rest of my life is supposed to look like? What would it take to make that change? What if I actually did it?

February 1, 2014. I made the choice to contact my family to let them know what was going on. I wasn't sure what to say or what would happen, but I had to be honest. I spoke with both my brother and my mom to tell them about my suicidality and my eating disorder. I had to admit how bad things were and to what extent. I had to have support to make this change. I have the best family, because they were willing to help me do that.

My family accepted this information with listening ears and open hearts. Had they not done so, I have no doubt in my mind that I would no longer be here. They worked with me to figure out what my best option was and talked about the things that would need to be taken care of: my job, my apartment, my life in Milwaukee. I coordinated with them about what the first steps needed to be. Ultimately, that decision was that I would look into taking a leave of absence from my job in order to seek medical treatment in St Louis and return to Milwaukee after that. It was the first step to a major life change.

I had to contact my job to let them know what was going on. My supervisor was incredibly understanding, but very taken aback, as she had no clue what was going on. I had only been at this job 2 months, so she didn't know my struggles but was willing to support me in any way. She volunteered to contact the company to determine how much leave I would receive and to direct my coworkers in covering my clients. She agreed that I should leave Milwaukee for care in order to avoid personal/professional conflicts and to be with family. She helped ease my mind that maybe I was making the right decision. I spoke with my roommates saying I would be gone for a little while, but I would be returning. I would leave all of my belongings in Milwaukee and take a bag on a train to St Louis to be with my family for a little while.  

February 1, 2014. My roommates and I returned home where I grabbed a pile of clothes off my floor and shoved them into a bag. I couldn't even think straight, but they helped me get organized enough in order to make it through the day. They took me to the train station in downtown Milwaukee. I said goodbye and walked in knowing that I couldn't look back. I sat in the lobby tearing the corners off my paper train ticket, waiting for them to call boarding for my train to Chicago. Finally, that time came. Boarding that train was the most overwhelming experience, but some part of me knew I needed to do it.

I sat on that train and thought about who I needed to tell. I contacted my best friends via text to let them know what I was doing and why, and received nothing but love and support back from them. I cried and stared out the window at Milwaukee and Wisconsin passing by. I knew that nothing would ever be the same. I made the decision to share my journey with those close to me, because it was important to me to be honest, not only with myself, but others too. I knew I had hurt people in this process, and it was important for me to be honest about it so that I might be able to redeem myself in some way to these people. I said goodbye to the life I had known. I got to Chicago, waited anxiously for my next train, and finally boarded for the last leg of my transition.

On my train to St Louis, I couldn't do anything but sleep. I was so emotionally drained and mentally exhausted that my body could not stay awake anymore. For 6 hours, I slept and dreamed of the life I might be able to have; a life that didn't involve obsessing over calories, weight, size, shape. For once, maybe I could have a life that involved being happy. I arrived in St Louis exhausted, but happy to finally be able to get some rest. I was at the end of the longest day of my life, but it would ultimately be the first day of the rest of my life.

February 1, 2015. Today is a vastly different day from the one a year ago. I woke up without a hangover (although, this cold can go away anytime now). Even though I feel a little under the weather physically, I am in a much better place emotionally. 

I am grateful for the new life I have here in St Louis; a life that never would have happened if I had not made the call to my family. This life does not include: a negative relationship, drinking everyday, restricting myself to 500 calories or less, obsessing over each calorie, hating myself if I go over, body checking every time I see a mirror, suicidal thoughts, melting down if something doesn't go the way I planned, and so many other negative things. My new life is one that I never was really sure I ever deserved, and I'm still not 100% convinced that I do. 

February 1, 2015. Today, I am still struggling with some aspects of my eating disorder. My body image can range from "This is okay" to "How did you ever let yourself get this fat?" It depends on the day or the circumstances, but I do have far more better days than bad ones now. I do sometimes struggle with complete meal plan fulfillment, but I try to be honest with myself and my dietician about it. I still have physical problems as the result of restricting. My stomach might not ever be the same, but I am taking the steps to figure out what I can do. My heart condition will always be there, and I have to accept that. Overall, I have learned how to battle ED when that voice gets too loud, rather than caving in and following through on behaviors.

February 1, 2015. I have more love and support from people than I ever would have imagined when I posted that note on Facebook a year ago. So many people, even some I barely knew, reached out to me when I left for treatment and throughout the process. I cannot thank those people enough for that. My family is amazing, and I never would have followed through with treatment or the requirements of it had they not been so supportive, but one of the best parts about coming to treatment was the people I have met during and after this process. 

The people I met in treatment are some of the most courageous people I know. It takes a lot of guts to admit that you have a problem, let alone commit yourself to daily intensive therapy to confront and work through it. That's what makes those people so wonderful. My friends from treatment are truly the ones who have kept me accountable. We have a certain level of comfortability with each other to reach out and say, "I'm really concerned about you. Are you okay?" These are the ones that supported me the most when I went back to IOP at the end of the summer. I would not have felt as comfortable going back had they not supported me in it.

Also, the people I have met outside of treatment have also been so supportive of my recovery and making sure I stay on track. My coworkers have helped keep me sane in a stressful job that has derailed me a few times. They've also made sure we go get margaritas and food when things are really bad. They bring laughter and joy to my life. I also am especially grateful for the one coworker who led me to the best support a girl could ask for. 

I couldn't ask for a better partner, because he is always there for the support when I need it and has also taken the time to learn about my eating disorder behaviors to help ensure that I stay on track. I couldn't have imagined this relationship in my wildest dreams, so I feel so incredibly lucky that he's in my life now.

February 1, 2015. Today, I look forward to the future. I know that so many of the things I have now are because of my choice one year ago today, and I know that in order to keep these things, I need to keep working at recovery and not give into ED. Today, I have love and happiness, things that definitely were not there previously. I have the last year to look back on and recognize that, even though it doesn't often feel like it, I have made leaps and bounds of progress. For the first time, I have taken control of my life and made the decisions I had to in order to get myself in a much better place, and it feels pretty damn good.