Dealing with an imperfect goodbye

I didn’t say goodbye to my one-on-one MBT therapist properly in our last session, because I knew I’d be seeing her a couple of weeks later at my care plan assessment meeting. I did cry lots and I did get angry over feeling abandoned and I did say thank you for all the help she’s given me. (She said “you’re very welcome”.)

During the care plan assessment meeting that followed, I was so aware that it was the last time I’d ever see her. I was distracted, hung on her every word and kept staring at her though there were several other people in the room. She didn’t say that much at the meeting and I was disappointed.

At the end of the meeting they all left in one go and I didn’t get the chance to say goodbye to her. I don’t know how to deal with that. I wish I had the chance to say goodbye properly. I feel so heartbroken.

Why am I focusing on what the last moment with her was like rather than the entirety of our relationship? Why should that moment have so much importance simply because of it’s chronological place? It was not the most important moment of our therapeutic relationship, surely.

What will I remember of her? Her sense of humour. Her words echo in my mind “but you were just a child” – that’s an invaluable gift she’s given me, her voice saying those words when I blame myself for my past.

Her listing good qualities she sees in me – kind, clever, funny. Her disagreeing when I feel disgusting and saying she doesn’t see that at all. Her belief in me, “you CAN do it”, “I think you’re more capable than you realise”, and “I think you’re very articulate”.

I’m scared of forgetting what it was like, what she was like, what have I learnt? What of the relationship can I carry with me? I can’t put it into words that I can come back and reread. I can’t think of anything. It’s not tangible.

I don’t have the answer. I’m not dealing well with it being a goodbye at all, let alone an imperfect one. I’d love to hear other people’s experiences in the comments or on twitter.

“He’s a psycho” – Professor Adrian Furnham on the importance of cleansing the workplace of undesirables

Sectioned

Harry Enfield as Kevin the Teenager (PA)

Have you seen this? Rachel Hobbs of mental health charity Rethink Mental Illness asked me this afternoon. She was referring to the charity’s response to a piece in the Sunday Times headed “I’m sorry, he’s not a differently gifted worker – he’s a psycho”. I’d just arrived home so hadn’t but, sadly, I had already seen the piece that prompted the rebuttal – and been shocked to the core.

The Sunday Times piece to which Rethink had issued a response advises employers of the necessity of screening job applicants and employees to weed out undesirable ones. The author writes:

“There are three important questions. The first is how you spot these people at selection so you can reject them … The second is, given that they have already been appointed, how to manage them … Sometimes it is a matter of damage…

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Curb your enthusiasm

I feel like I screwed myself over a bit in that group therapy session. I was talking animatedly about all the things I’ve been doing because I have this sudden urge and motivation to get myself things in life.

I’ve applied for a couple of different volunteering jobs, contacted my driving instructor about getting my lessons going again and signed up for a poetry slam (why?!). The trouble when I get like this is that I find it hard to remember when I am in an intense mood that it won’t last forever. That goes for good and bad moods – so I risk signing up for more than I can follow through on and burning out.

I’m hoping this self awareness this time around means I’ll have caught it before I do more than is healthy for me right now. It’s good if i can harness the enthusiasm without overdoing it and I think overall this is a positive sign! It must mean I’m on the mend from the anorexia if I’m looking forward to the next challenge!

When I said I feel like I screwed myself over in group it’s just because I didn’t realise but I talked right up to the end of the session. This meant I had no responses to what I said so I have to live with the uncertainty of not knowing people’s reactions. This is good practice for me as I find it hard to tolerate. I need to reassure myself that I’m happy with what I said and they probably think it sounds like positive steps anyway.

Lonely

There are people around me that want to love me, but I don’t know how to let it in. I need to find a way to let people care about me in a way that also lets me be an independent adult.

Hanging in there

I have been having extremes of feeling and I’m trying to hang in there and keep doing the things I need to do to take care of myself. Sometimes more successfully than others. Things like eating regularly, sleeping regularly and activities I used to enjoy, like crafts and walking. I’m hoping that in time that enjoyment will come back.

What brought me here today is that I just read a really good post on a twitter friend’s blog about how it can be hard to trust your own mind when you have bpd, check it out. It’s so true that huge amounts of time and energy can be used up by second guessing oneself and trying to separate which thoughts and feelings come from a painful reaction to a situation.

I don’t think bpd instincts are always wrong, but it’s helpful to have all the facts when deciding how to act and I think part of that is knowing which of our responses come from a difficult history. Then we can decide for ourselves if they are useful for the here and now.

Starving for attention

Content note: eating disorder, bmi, scars

I’m in recovery from anorexia. I’ve gained weight, warmth and am gradually getting my personality back. I’m slowly connecting with people in new ways. Choosing starvation gives me nothing, while choosing life leaves all kinds of possibilities open. The chance of something good is better than certain death.

I’m struggling with having my feelings back. I’ve got my depression and anxiety back. I’ve got my fear of abandonment or rejection back. I’ve got my self hatred.

I’m 8 stone and my bmi is 18. I’ve been struggling with bingeing and I’ve had serious health problems as a consequence of refeeding following more than three months of starvation.

I’ve been given 6-8 sessions with a dietician on the NHS on top of the therapy I’m having at the CMHRS. I saw her on Monday and we talked about how I can tackle trying to stick to my meal plan. It’s not easy but this week I am doing much better with it.

Today in individual therapy we talked about the possible reasons why I did something so extreme as starving myself to the point I did – my bmi went down to 16 at my lowest weight and my periods have yet to return.

I used food as an analogy for how I am in relationships. I talked about how eating cakes is a shortcut to a feeling the way self harming is a shortcut to getting care from someone. But a more nutritious diet and a different kind of genuine, ongoing connection with people will do me better in the long run.

Starving myself sent a message to the world that described how much emotional pain I am in. It made the outside match the inside the same way my scars do.

I need to learn to live without the intense hit of a binge or a dramatic show of pain if I want the more nutritious and sustaining things I can get from life. Or I guess: stop living from binge to binge or dramatic pain to dramatic pain – still have a cake or an honest outpouring of emotion, but don’t make them my main source of sustenance because that’s not healthy!

I’m working towards being more spontaneous and real with people because then I get more genuine responses back that I can trust. I need to trust myself that my real self is OK and not the horrible monster I fear is inside. This will be my route to better relationships with others.

Feeling desperate and urgent

Today my therapist and I talked positively about steps I’ve taken recently to let people (especially my partners) in. She says I’ve been a lot more real with here and a lot more emotionally honest, a noticeable change in the last couple of weeks.

Now that I’m eating again I’m not feeling so numb and distant but this has meant having to engage with and feel my emotions. The first main feeling that came in was sadness. I think I’m sad because my family have let me down. They didn’t give me the start in life I needed, they abused me and told me I was bad and worthless – something I ultimately believe to this day and something that has limited what I’ve been able to get out of my life so far.

My eating and my spending habits are out of control. I’ve been bingeing every day. I push myself to keep eating when I’m hungry, until I am in agony. I punish myself with food. I’m grabby with food, desperate to eat all the things, as though starvation again is just around the corner. It’s hard for me to trust that there’s no rush, that there will be food provided and it will be ample and I will still be satisfied (in fact, more satisfied) if I don’t scoff everything immediately. I’m letting myself enjoy food and eat what I like – but I just want to be able to stop eating when I get full and wait a while before I eat anything else.

I’m gaining weight quickly because of this, something that brings a lot of anxiety. I know I’m underweight and my body wants to reach a natural weight for me, I know I need to gain weight for health benefits and my periods need to start again. It’s not like I’m bingeing whilst being overweight. I’m trying to believe that my appetite will reach an equilibrium when I am eating enough calories regularly and when my weight reaches the ‘normal’ range for me.

My eating disorders unit assessment is on Monday. My social worker says it is good that I have tried to change things myself and that I am eating even though it feels out of control, because that is all more information for them to work with and it will give them a fuller picture of my issues with food. I really want them to help me to develop a totally new, healthy relationship with food – something I feel that I’ve never had.

The WANTING feeling that I’m feeling all the time is what is driving my eating problems and my spending problems. I’ve left my debit card at home today! The wanting feeling is grabby. I have judgemental thoughts that I am greedy. The wanting feeling is agitated and impatient. Part of it might be appeased with craft projects and keeping myself busy in ways that are productive, that give me something at the end of it. I have been baking a lot and trying to give away most of the results so as not to exacerbate the bingeing situation.

What is the jittery, impatient feeling that makes me want so much so constantly? Impatience. I want to create. I want things for myself. Agitation. Anxiety of what happens next. Impatience to get onto the next step. I think planning my time and activities could help. Keeping busy with activities that are fulfilling. Giving myself things including things that aren’t food or shopping. But trying to accept and enjoy one thing at a time and take my days one bit at a time. Lots of deep breaths and reassuring myself i have everything I need right now. I have everything I need right now in this moment. It’s OK.

Impatience and a relapse

Content warning: Food, calories

I tried to do too much too soon in terms of eating. I wanted to dive in and tried to “eat normally” straight away and it was wildly unrealistic of me. This was a combination of my impatience and a lack of recognition that I genuinely have anorexia. Underneath it all I was convinced I could stop any time I wanted and that I was just attention seeking. When in fact I have serious issues with food, I know that now, and actually attention seeking is a valid reaction to my invalidating life experiences.

Yesterday I felt a huge emotional backlash to my attempts to eat normally on Thursday and Wednesday evening. I panicked all Thursday night, couldn’t sleep, and went online to join the gym.

The next day I planned to eat nothing and exercise all day to try to undo what I perceived as a huge mistake. I spent Friday morning at the gym and then headed to my occupational therapy appointment.

Thankfully I was able to be honest with her about what was going on for me. She suggested I not push myself so hard so early on. It had led to me feelng out of control and like I was binge eating. I let myself get too hungry between meals, and that and my body crying out for calories due to being starved for so long revealed a huge appetite. I felt this confirmed all my worst fears – that if I ate what I wanted to eat I wouldn’t be able to stop once I started and I would get enormous. In fact it’s likely that once I’m eating a normal amount regularly and I reach a healthy weight for my height, my appetite would reach a normal level too. I’ve never been overweight in my life, so why would that happen once I am consciously trying to have a healthy relationship with food?

My OT suggested as a plan to decide on a number of calories I could increase to initially, that was a bit higher but not so high I’d freak out and feel the need to restrict or exercise after in response. She also said to eat very frequently so that I don’t get too hungry before I eat so that I can eat without feeling the urge to binge. I don’t know if feeling too full is a problem or if it is literally just that I let myself get too hungry beforehand so that the full feeling is now associated with the urge to binge for that reason.

I’ve been on 600 calories a day for three months so I have planned to increase this initially to 800 a day building to 1000 in the near future and to eat little and often rather than pushing myself to eat things that look like meals/eating a larger amount in one go in the evening for ‘dinner’. I’m finding this hard because 800 simultaneously feels like too much and too little/too limiting. It feels like a lot because it is 200 more than I’ve been on and I’m very aware of the increase. It feels too limiting because it is still objectively a very low amount of calories a day, I am still hungry all the time and I don’t want to feel like this any more – restricted all the time, watching the clock for when I am allowed to eat, etc. It’s my 30th birthday weekend and I want to be able to have some cake, damnit, but I’m acutely aware of the risks now of trying to run before I can walk. If I eat cake today, will it jeopardise my recovery? Possibly. I have a higher chance of success if I take baby steps and accept the limitations for now. It won’t be the perfect birthday weekend but if I play it this way, I’m more likely to be eating that cake sooner than later and without the repercussions of relapsing and self loathing.

Nourishment

Today, my therapist said she is proud of me. I feel it’s important for me to record this here because I’m holding it at arm’s length and not letting it sink in yet.

I told her about the things I wrote about in my last post that have shifted my feelings about starving myself. I realise that I am heading towards death. As I said to her, I feel I’ve turned around. I am facing away from death and towards life. I know which way I want to go.

She’s proud because of this, but also the way I have been talking about my feelings about my family. That I have been having little conversations with my family that ask a little more of them, even if I don’t expect to get it. It’s okay for them to have to deal with my expectations.

I want nourishment and care from my family. I have to face up to the devastating possibility that they may be incapable of giving me this, and that it is their failure to provide this that has made me unable to accept and receive care and love as an adult.

I can still want this from them, how could I not. Denying that it’s something I’ll always want and wish I had doesn’t help anyone. But to keep seeking it at some point becomes self destructive. How much of me starving myself has been down to me trying to show them how hurt I am, as if to stand emaciated before them and say “look at what you’ve done to me”. That is what I have done – and the reaction is NOTHING as ever. I get nothing back. They feel helpless. They cannot give what I am looking for. It is tragic.

Today, I begin trying to nourish myself. Take those tentative first steps towards the life I want to live. It is not recovery, I am not recovering anything I have ever had. It is life building. It is a journey into, towards, and through life – one choice, thought and action at a time. I plan to nourish myself with food and hopefully by thinking more compassionately towards myself. I will also try to let care in from my partners, especially the one that I live with. We may be going together to an ED support group this evening.

My first steps in anorexia recovery

A couple of things happened this week that have really shifted my mindset.

I am losing my hair. It has been falling out more than it used to for a while now, but I was sort of in denial about it. I sat up in the bath and there was a row of hair where my head had been resting against the end of the bath. It was alarming. This is as a direct consequence of anorexia and malnutrition.

The other thing is something someone said in group last week and they touched on it again this week after I’d had the chance to mull it over for a while. Having the gap between it being stated and reiterated made me more receptive to it.

They said that when they were referred for eating disorder treatment, they started eating proactively by themselves, as a way of maintaining control but in a positive way. These words have been echoing round in my head.

I have been feeling so desperate for someone to help me and I think it’s really disempowering. I know I do need outside help with it but maybe I can channel my fears of treatment and my fears of control being taken away from me into gaining control over my eating again and being proactive in taking a few first steps to eating and recovery.

I know my mindset has shifted because i used to look around and see thin people everywhere. Now I look around and see people who are my old size (uk 12-14) and I think they look happy and healthy with the energy to live their lives and I crave that. I think they look fine, they look good because they are healthy.

I’m still scared I will start eating and not be able to stop and I’ll become obese. Since I’m currently a UK size 6 this danger is a way off yet.

It is the fear of being out of control though. When I eat after being hungry/I eat a meal (normal size to me, probably small by regular standards) I feel full. When I feel full I feel panicky and overwhelmed and I want to react to the panicky overwhelmed feeling by eating more, I guess to numb the anxious feelings.

Why does feeling full make me feel panicky? I’m scared I will keep eating and not be able to stop, but that is because the feeling full leads to anxiety which leads to wanting to numb the anxiety with food. What is the original source of post eating/fullness anxiety? Is it guilt? Do I feel guilty and like I don’t deserve to eat? Do I feel like eating any amount of food is a failure and a sign of weakness in me? Because it’s not. Did I just so rarely feel full as a child that the full feeling is still unfamiliar and overwhelming to me? Is it just the association now with past episodes of bingeing after meals especially in the evenings and the fear that will happen again?

I need to learn to ride out these feelings and recognise the feeling of fullness as satisfaction (no further action required) and to wait because sometimes craving further food is residual hunger from before when I ate and it takes a while for your body to process the calories and stop telling you you are hungry.

I started attempting to eat last night. I feel like it was a binge but actually it was not excessive, just an understandable amount given that I have been starving myself for so long.

Today I am going to try to eat more normally, in a meal pattern with healthy snacks. When I feel full I need a plan:

1. It is okay to feel full. It means you have given your body what it needs and you will be happier and healthier as a result and more able to achieve the things you want in life.

2. After eating, know that the panicky feeling starts to subside after 60-90 minutes, so
Reassure self as above
Don’t reach for something else to eat, use distraction if necessary
Could have a cup of coffee or herbal tea as a post meal ritual? Would this soothe some of the anxious feelings
Try not to focus on when the next meal or snack is. I want to stop agonising and over planning food as it has taken over all of my thoughts and is exhausting.

3. Notice feelings of fullness and try to coach myself that these are feelings of satisfaction/not needing anything further and that it is OK to have eaten. Try to notice feelings of hunger and to distinguish between being ‘mouth hungry’ which is usually an emotional/bored craving for food and ‘body hungry’ which is a genuine hunger and a signal from my body to eat. Maybe okay to stick to a more rigid food plan/routine until I am better at recognising the differences/tolerating full feelings, to avoid binges and subsequent guilt ridden relapses into starvation. If I’m mouth hungry for a particular food maybe have a vague plan to eat it another time, remind myself it’s not off the menu forever, but I have the whole rest of my life of meals to eat, I’m not going to be starving myself any more, so I don’t need to eat like a starving person!