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.

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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!

The shit hits the fan; diagnosed with anorexia

TW: eating disorders, weight

Had a really cathartic appointment with my individual therapist this morning. I sobbed over my parents not giving any reaction to me, they are always on the other side of this wall they’ve put up, the only feeling that ever broke through was anger.

I’m desperate to feel love and care from them. I feel like I never learnt how to accept love and care and so I can’t get it from other relationships either. I don’t know how to move forward with this right now.

Also it’s never about me. Even when I’m really ill like now, it is always about protecting mum and her feelings. It should be about me and my hurt for once rather than it being that I’m screwed up and causing people stress. I want my feelings to finally be heard. But not this weekend. Not on mother’s day.

The title refers to the hell of a week I’ve had. I weigh 99.8lbs. My bmi is 16. Sunday evening I had a meltdown and couldn’t stop crying. I felt like I can’t go on. The stress of worrying about food stuff and all these hurt feelings and anger is unbearable. My life is unmanageable. I’m too tired and weak to do the things I need to do. Eating is torture and so is not eating. Agonising about food is causing me immense stress.

I reached crisis point and luckily I was able to see my GP the next day (Monday). He weighed me and asked me lots of questions and he diagnosed me with anorexia nervosa. I had to go for blood tests and then an ECG at the hospital yesterday. I’m being referred to the eating disorders team. I don’t know how long it will take and I’m desperate but at the same time I’m afraid. I’m afraid of gaining weight. I’m scared I’ll start eating and won’t be able to stop. I’m scared I won’t be able to eat even if I really try.

At group this week I came clean about what is going on with the eating disorder. I got a couple of supportive reactions and one who made it all about her. Not a bad average I guess. The group leader said it was good I’d gone to my GP and was being referred and that treatment for my ED should take priority for now. He said that some people take a break from MBT at least at first when they are getting treatment for things like anorexia.

My therapist today also said a couple of times that she thinks it’s really good that I made the decision to go the the GP. She said it shows me making a decision and an action to help myself, to look after myself and towards becoming myself, becoming an adult person who will be able to move on from the poisonous thoughts my parents gave me about myself, the thoughts that have been such a core part of me but they don’t have to be a part of me forever.

Holding onto Anger

This week in group I was sort of ambushed about my eating problems. I denied there’s anything going on. Just not ready to talk about that in group yet and I wasn’t prepared for the group leader to hint at it.

Today in my individual session we talked about what could be fuelling the eating disorder. There are feelings brought up by MBT that I just don’t know how to handle. Anger, shame and guilt.

The plan now is to talk through these and maybe learn to manage them in other ways. We talked about my fear of my own anger, how I feel like I’m just like my dad when I’m angry and how that makes me hate myself.

Another big issue I have with anger is getting stuck with it after. If I could express it properly and then move on it wouldn’t be half so unbearable. Perhaps if I could express my anger more effectively/in a way more aligned with my values, it’d be more cathartic/productive and I’d feel more able to move on from it.

My therapist hinted that if I continue to lose weight, the therapy could be deemed as doing more harm than good. She didn’t mean this as a threat but it sort of feels like one. She said “I can’t just watch you getting thinner and thinner and not do anything about it” and gestured to my body. She even asked at one point if I want to be referred to am ED specialist, but I don’t know if she meant it.

Educational Privilege and the Mental Health System

I know this is a slightly different tone of post than my readers might be used to. It’s not a personal update (although it’s certainly personal as well) but more of a political one.

The mental health system is a subset of broader social life, and as such prejudices like classism operate in a similar way but can be made worse by the additional ableism and stigma attached to mental health problems.

There is an assumption that people with mental health problems are less intellectually capable. This is part of the stereotype of the mentally ill person and has no basis in fact.

People who have less formal education will face greater challenges in navigating the mental health system and endure greater discrimination. The system is full of obstacles such as form filling and being expected to advocate for yourself with people using medical language instead of speaking in terms you would use to describe your own day to day experiences.

In a similar way that men experience negative effects from sexism, people with educational privilege experience negative effects from the ableist assumption that a person cannot be both educated and mentally ill. (This in no way negates the fact that it is privilege in action here.)

If you have the fortune to be educated you may be refused the help you need because you don’t conform to stereotypical assumptions about how a mentally ill person appears. I find myself holding back and becoming fearful of advocating for myself because there is no understanding that you can be very capable or experienced in some areas while experiencing severe problems and inability to cope in other parts of your day to day life.

It is vital that work to improve mental health services continues to emphasise the diversity of experience and presentation of people with mental health difficulties and to make the system work for the user, rather than being a series of hurdles to access help.

Thank you for reading. Please share and I’d love to hear your comments below.

The cat is out of the bag

Trigger warnings: ED, weight

So, my eating issues came out in my MBT review last week and they said I should talk to my social worker about it this week, or basically they’d do it for me.

I’d decided by this week that it was terrible that I had said anything at all about it at my review and that I would NOT mention it to my social worker as I feel safer keeping this stuff to myself. My eating disorder has become my whole world at this point and the thought of letting others come blundering into that world is a terrifying one.

Then, at my meeting with my social worker, out of the blue she says “so are we going to talk about the elephant in the room?” and I thought the others had spoken to her but actually she’s noticed my dramatic weight loss herself and it was coincidence that she brought it up herself just after my review. So after I’d consciously decided to keep it to myself as much as possible, I ended up having to have another intrusive conversation about it.

She’s concerned and to be fair to her she’s lovely and desperate not to push me further into my eating disordered behaviour. But that is exactly what is happening. I was on 600 kcals or less a day and since this conversation I feel the need for increased control, to hold onto it with both hands because I feel like them knowing risks taking some control away from me. So now I’m on 500 kcals or less a day and I’ve planned in plenty of exercise over the weekend.

To give you an idea of the extent of it at the moment, I’ve lost over 2.5st (35lbs) in total since MBT began last April and over 1.5st (21lbs) of that is since Christmas. My BMI is 16.5 and my periods have stopped. Basically, I’m anorexic. I couldn’t stop (without help) if I wanted to).

I feel like I’m floating away from the world…