730 Days

Today marks two years since I was discharged from my last IOP admission. I don’t miss the vitals/weight checks, or weekend planning every Thursday, or hospital food. However, I do miss feeling understood by others like me, the care given by the providers, and having somewhere to go every day. Before my third (and last) admission, it was easy for me to go straight back into the program. It was familiar and I knew what to expect. I wasn’t getting what I needed from my therapist at the time and I was stuck.

Quite frankly, it didn’t bother me that I repeatedly came back. It felt like an accomplishment at the time. Others like me, the “frequent flyers” often laughed about our situations. It was an attitude of not caring and being a bit obnoxious about it all. But I was stuck in the revolving door and couldn’t escape. Then, one day, it all clicked for me and I got it. It wasn’t funny to have to come back time and time again. It wasn’t an accomplishment to have the lab techs know me by name because I went for bloodwork so often.

I spent most of 2008 and half of 2009 driving back and forth to the hospital, spending hour after hour, day after day in the program. When you’re so used to that routine, it’s very hard to do anything else and move away from it. Luckily, by the time I was discharged for the last time, I found a therapist who really understood and supported me. I finally felt like there was a chance that I wouldn’t need to go back. And I didn’t.

It wasn’t easy, either. There were a few times when I was warned that’d I’d be headed back to IOP if I didn’t step it up. It was scary. I was anxious. My treatment team pushed me and I wasn’t always happy about it. But it’s what needed to happen to make any progress. Goals were set and I needed to stick to them in order to keep moving forward. I thought I could get away with some tricks…but my team wasn’t stupid and they called me out. Tough love doesn’t only work in family situations.

There are still times now when I want to give up and go back to IOP and be taken care of while I ignore the difficulties for a while. In session the other day, I told my therapist that living with the eating disorder was easier than it is now. She laughed a bit because she knew that if I really thought about it, that’s not true at all. Living with an eating disorder is not fun. You’re tired. Cranky. Zoned out. Emotionally unavailable. Constantly worried about food. Not living life. It’s an alternate reality that seems like fun, but when you’re there, it’s miserable.

What “Nutritionists” Really Eat

As soon as I began my recovery process, I wondered if my treatment providers followed their own advice, and especially, if they followed the same meal plan I was given. Until I was admitted to IOP, I thought I was the only one who wondered. Then I learned that we were all curious to know if they ate what we were supposed to eat. During dinner time at IOP, we ate in the hospital cafeteria, and sometimes a couple of our treatment providers would come in for a snack. We all watched to see what they’d buy while trying not to be too obvious, and we all whispered about their choices. We talked about it amongst ourselves and kept quiet until some one had the guts to ask the question we all wanted to ask. “Do you really do what you tell us to do?” Without hesitation, we got an answer: “I wouldn’t tell you to do anything I wouldn’t do myself.” While we had no reason to believe she’d lie, it was hard to picture any one following our meal plans. To us, it was a lot of food. We didn’t know what was normal.

I’ve also wondered how many providers treating those with eating disorders had (or have) an eating disorder themselves. To us, any one who was thin must’ve had an eating disorder. “Pretty people” were supposed to only eat healthy food, and our treatment team was made up of some very attractive women. That myth was proven false when, during rounds one day, some one noticed an empty bag of potato chips in the office trashcan. She asked the doctor if she actually ate the chips. They were a “bad food” and she ate them! It was another piece of evidence that what they taught us, they followed themselves.

While my experiences with treatment providers have been positive, not every one in the business should be trusted. I recently came across an article posted by another recovery blog. The article is from Marie Claire – which may be triggering – and it seems as though Marie Claire is not the best source for healthy articles for those in recovery. “Food experts,” who are apparently very popular with some famous clients, let the world in on their own eating habits. I figured that since they give advice to others, they’d know exactly what is healthy, appropriate, and “normal” intake for a day.

I was wrong.

Out of the five (so-called) nutritionists, the first one grabbed my attention the most. Natalia Rose works out of NYC and charges $850 per personalized program. According to her stats, she is underweight, and she doesn’t eat anything before the sun goes down because the air, sunlight, and clean water gives her enough energy. Her food log consists of nothing but fruit, a bit of greens for a smoothie, and macaroons for dessert. She added a squeeze of lemon to her breakfast tea – and she COUNTED THE CALORIES. The three calories (which says “All calorie counts are approximate.”)  in the juice were written down to be included. I’m not sure where she learned to be a nutritionist, but these few details scream “EATING DISORDER!” Or at the very least, disordered eating.

While I still have my struggles, I am wise enough to know what is an appropriate meal plan. Natalia’s is not one that should be followed, nor one that should be given to her clients – especially to those with eating disorders. It makes me frustrated to know that if some one is struggling and they go to see her, chances are, their eating wouldn’t improve. A “nutritionist” doesn’t necessarily have to be qualified to practice. I know enough about nutrition to educate others, but I wouldn’t be comfortable enough to give that type of professional advice. A dietitian, however, is very much qualified and must pursue degrees, an internship, pass an exam, and obtain licensure to be labeled a “Registered Dietitian.” The two are different and may have very different views and techniques.

If there is no “RD” behind the person’s name, they may have no idea how to handle eating disorders. They may believe in fad diets. They may harm some one. Seek some one else’s advice. The only way to stay stable in both metabolism and weight is to eat a balanced variety of foods, with meals spaced out appropriately at the same time each day. Every thing is okay in moderation. You want that ice cream cone? Go for it. And please eat before the sun goes down.

Love Your Body. Love Yourself.

I’ve been told many times that body image is the last thing to change when it comes to recovery. Body image problems don’t start at the beginning of an eating disorder, so it’s no surprise that it doesn’t end when symptoms are no longer a problem. We develop our body image very early in life and it continues to develop through the years. My earliest memory concerning my body is when I was only three years old. I specifically remember worrying that I was fat, although, I’m not sure how a toddler knows exactly what “fat” means. Family, Continue reading

You Must Speak

The image on the left is from the website, Therapy Tales, a hilarious comic strip blog about therapy. In this particular comic, the therapist is merely repeating what the client says. Fortunately, most of my interactions with various therapists haven’t been like this, but I have had a few. When it has happened, I asked myself, “How is this helpful?” It was frustrating not to receive much feedback. The most frustrating circumstance was with a professional who just nodded and mumbled “Hhmm…” a lot. It wasn’t helpful at all. Yet sometimes those struggling with eating disorders have no idea how to communicate back, either, at least about personal feelings.

During interpersonal therapy group sessions in IOP, the hour always started with a check-in. We had to express how we were doing and what we were feeling. While the question, “How are you feeling?” seems easy to answer, it is not easy for any one who is used to stuffing emotions and not speaking about feelings. The easy answer was, “I’m fine.” It got to the point where so many of us said, “I’m fine.” that a new rule was created: No “I’m Fine”‘s Allowed! Or any variation of it (“I’m okay.” “I’m alright.”). With the rule in place, we were required to say how we were really feeling, whether it was good, bad, or indifferent. Sometimes, it took a while to be able to pinpoint a specific feeling. Continue reading

But That’s Too Much Work!

It’s Easter Sunday, and since I saw my family yesterday, I decided to stay home today. During every holiday, we usually have a set dinner, out of tradition. But since I chose to stay home, that meant that I had to fix a meal for myself. I am quite possibly the most lazy person when it comes to preparing meals, and I’m sure my team can vouch for that. I don’t like taking a lot of time to whip something up when it only takes minutes to see it all gone. It seems like a waste to me, and I’ve used that excuse many times. “It’s too much work!” That excuse has run its course and I can’t use it any more. My dietitian doesn’t buy it and she knows how to challenge me. Toasting Pop-Tarts takes too long, so I eat them straight from the package. Preparing tuna salad seems like a lot because a dish gets dirty, a can has to be opened, and then Continue reading