On All Accounts

There is something to be said for going out to eat by yourself. It is one of the hardest things I’ve had to do yet. Its the test of accountability taken to the height of the eating disorder. Sure, on our passes we write down meal plans, where exactly we will go and what dish we will be consuming, but that doesn’t mean that the staff will know if we actually did it or not. To go out on a pass meal with someone is to work with that person and keep each other in check with the agenda. Without that it is almost unbelievably easy to find yourself with your butt in the dirt and the wagon rolling away without you.

On the unit my eating disorder knows full well that it can find no balance. I checked it at the door when I entered this treatment center only two short months ago. Unfortunately, each time I go out though, its still right there waiting and wanting to know where we are off to today. So I go, trying to ignore it, trying to leave it behind, hoping that it will realize that its really just not wanted and I have had success with that many times now. Most of those times though have been when out with other people.

So far I have done two meals out completely by myself. The first of them wasn’t a total disaster per se, I just came out of it relatively disheartened. The main point was that I should have followed the plan I had written. Instead I got out there and got overwhelmed, second-guessing the original choices I had made, and just had a lot of trouble coming to a decision. It was a frustrating venture but a learning experience at the same time. My mini-shmorgashboard included an egg salad sandwich with tomato on wheat, a bag of sea-salt multi-grain chips, a banana, and a triple berry yogurt muffin with a water and a soda.

I wound up eating about half of each item and calling it lunch. Its hard because we are supposed to get about 900 calories per meal but its gets really difficult to estimate the amounts for items without labels. I know its not supposed to be a strict science but in the beginning nerves get wracked because we haven’t yet learned the flexibility, intuitive eating, and general friendliness of food that should be the end result of all this.

Today was dinner. It was a  dark, rain-soaked, two-block walk to Reme’s up the street. This was the first time I had been there and the little restaurant with the red awning was the exact opposite of its foretold crowdedness. It could have been the dreary weather or the early meal time but, whatever the reason, I had my pick of tables and chose a booth in the corner. The pass meal was written for a Hawaiian ham steak with sides but the price on the menu was a good $3 over what the unit menu said so the plan changed. I wound up getting a hot open brisket sandwich with fries and a dish of green beans. Not so keen on the sandwich bread I ate all the meat and beans. I gave the fries a fair shot too but they were very much lacking in the flavor department, even with catsup, so I gave up.

Out int the rain again I rounded the corner to University Deli for a dessert. It had to be enough to make up for the uneaten fries. I stood in the little carry-out eatery deliberating over the sweets until I was uncomfortable with my own actions. In frustration I made a grab for whatever and wandered back to the atrium with my goodies. I have to say that, although delayed, my final decision was a pleasing one. I munched down a good-sized chocolate chip cookie and half a peanut butter Twix which turned out to be just as amazing as I had dreamed each time I ogled it at the store.

All in all the practice of a second time wasn’t perfect but it was just the tiniest bit easier. I’m learning to be accountable to myself. It does help to have someone there with me but, in life, thats not going to be the case all the time. I realize that the harder something is the more I need to do it. Its taking on the challenge thats key and thats the whole reason I’m here.

To Keep Going

I was reminded of surrender today. Its what I’m doing here and I’m glad I was reminded of it. I needed to be. Lately I have been more frequently going back and forth from my normal positivity of the situation to questioning it periodically, and thats not something I want to get caught up in. Not now. Not yet. Its too early to anything except go with the flow. Heather was neither talking to me or about me when the subject of surrender in regards to the program arose. I just happened to overhear a few words and somehow something clicked for me. I have to reconfirm the trust that I handed over to the team when I showed up those two months ago. It was never a question for me to trust my health to them. It was just something I knew that, with stepping through those doors, I would be doing.

There isn’t just surrender within these walls though. The other option that some take is compliance and there is a huge difference between that and the act of surrendering. To surrender is to claim that things just are the way they are. It involves a faith in the system; whatever that system may be to any one person. Compliance is begrudging. It implies a following of rules in action but not so much within the mind. To only just comply with the program doesn’t make for a very positive chance at continued recovery once you leave. To comply is to retain a sense of rebellion and not too many people get through something like this while trying to fight the system thats structured to save them.

There is a well-written research essay by a man named Harry Tiebout called “Surrender Versus Compliance in Therapy“. In it he states that: “In compliance, and individual accepts reality consciously but not unconsciously. He accepts as a practical fact that he can not at that moment conquer reality, but lurking in his unconscious is the feeling, ‘there’ll come a day’, which implies no real acceptance and demonstrates conclusively that the struggle is still going on. On the other hand, the ability to accept reality functions on the unconscious level, and relaxation ensues with freedom from strain and conflict.” The level of acceptance that leads to surrender in situations like this, I believe, is truly within the human capacity. Its just a matter of finding the building blocks that lead to it.

I completely understand that surrender is not an easy step to take and I definitely had both my years of complete rebellion and of mere compliance before I got there. Sure I was agreeing, going along with the program, but in no way did I have any sort of enthusiastic or whole-hearted approval. I still wanted very much to do it myself. I did want recovery but only on my own terms. I can see too, with some of the other girls here, that there is a willingness to go along for the time being but their inner reservations make that willingness thin and fragile. It won’t be until that compliance crumbles, until they have hit some sort of a bottom, so to speak, that the room for surrender even becomes available to them. As long as any part of compliance is in action there is no space for surrender.

This recovery program is varies greatly from the one I was in 2 years ago but, despite the multitude of differences in structure, one of the main differences is within me. My attitude and openness of accepting all that they are trying to do for me has brought about the surrender that is getting me through the tough times like these. I know it all sounds very spiritual and I’m not a spiritual person, but I have to put my life into the hands of someone else because trying to work things out myself is what got me to Columbia in the first place.

I need to be right here right now.

Gaining

Every body is different. Thats something that I have to remember. We all gain and lose in different places and the skin we wear is suited to fit each of us perfectly. I say the now as a reassurance because lately I have caught myself thinking more and more about how this recovery looks on me. I have to call it that – Its not weight, its health that I’m regaining. I know, too, that when I look in the mirror, what I see may be the common view but I interpret it differently than others would.

When I look in the mirror I try to point out the good things about where recovery is working its wonders. My waist, for instance. In my eyes it is all settling around my waist there is scads of logic and miles of reasoning to rebuke that. Its a fact that in the refeeding process the initial weight does seem to amass in the abdomen. This is because of a few things such as your stomach, not used to food, is digesting slower. It makes sense. Your body, not knowing when it is going to be deprived of food again, tries to hang on to what it does get for a longer period of time than normal.

Its also a fact that, when a person starving themselves of the nutrients that supply energy, the body takes that energy that it needs from internal things in a certain order. Fat goes first. When it has used that up the energy stored in muscle is the new target. Those get used and limbs start looking gaunt and thin, and so it goes down the line. Eventually the energy needed starts getting taken from some organs to keep other, more vital, ones working. Organ mass is lost and shutdown of different ones can occur as your body does its best to keep the two most crucial, your heart and brain, going as long as it can. Thus, when your body is gaining everything back, it regains first what it last took from and things in your torso get replenished before arms and legs do.

All of this comforts me when my mind starts to wander into the questioning black hole realm and I know that what I see around my middle will disperse through the rest of my body in time. I also know that I am going to gain differently than some of the other girls here by comparison for one very BIG and important (and cute as can be) reason. Reese. I have had a child and most of them have not. My amazing, now 8-year-old, son is the driving force behind so much of my work here and there will never come a day when I would choose a flat stomach over him.

We are all different, in all unique shapes and sizes, and if defined by no other label, I am ME.

Volumes of Issues

Walking alone, half a lap ahead of my peers, I watch the quiet surroundings of the fresh air park rotate in their slow carousel around me. I’m in a more contemplative mood although part of what I’m to work out in my head is whether or not I should be talking to my friends instead of thinking about things that have the potential to bring my mood down. Its just that between last night and so far today there has been enough drama around here to suffocate any amount of good intentions. I’m trying to not let it get to me. I’m trying to stay positive but its hard.

People that have been here longer than me are starting to have problems stemming from the prospect of going home. Some are having extreme family issues that peak into screaming matches both over the phone and in person when people come to visit. Some of the newer people are just having problems with the meals in general and there have been a lot of tears shed at the table recently. Some are also having food issues due to being scared of going above the goal weight that they have already met while here. Reaching “maintainance weight” and still trying to restrict your eating, still accepting that you can more or less eat whatever you want is harder than can be represented in words. I can admit, too, that seeing my peers, my friends, have their own questions and doubts does scare me. I have to admit it because, if denied, it has the potential to sneak up and just floor me.

I care about these people because I see at least some aspect of myself in each and every one of them. Its difficult to just stand by and know that I can’t really help them with their issues. I want to. Badly. Its in my nature. If I choose to do that though I know it would jeopardize my own recovery. I just can’t go back there in any part of my head right now without the potential of losing what I have worked so hard for. Some encouraging words and just letting them know that I understand is about as far as I can safely go. I have been both stunned by my positivity and in love with it in such a way that I’m terrified of losing it.

This is why I hang back. They walk and I hang back just absorbing my surroundings, absorbing my thoughts. There will be a right way to do this. This is just one in a line of speed bumps that will unfailingly be along my road to recovery. I hate to get so cliché with the terminology but is just what best describes it in this case. It is a road we are each traveling, a journey we are each individually on. And, in the end, it is each of us who decides just how big the obstacles along the way will be.

When the head aches…

For two days now I have been plagued by a sinus headache that just wont seem to let go no matter how much Sudafed or Tylenol I take. My head throbs every time I turn my neck or move too fast. Periodically there is some relief as it unclenches its grip on my brain, but it never seems to fully go away, as I find more and more tired and less able to concentrate. I never used to have sinus problems but they started off mildly about 4 or 5 years ago and progressively get worse with the onset of each year’s spring and the subsequent fall. If they continue to escalate in the way I will have to find some other battle tactic or weaponry to fight them with. I don’t mean to sound like I’m griping, they just make it so hard to focus beyond the pressure.

Ok, thats enough of that. As far as other things go we finally have a new person on the unit. If I really want to get technical about it we have got 2 new people…except one isn’t really ours. I’ll start with Molly. Molly is the actual eating disorder patient. Her thick shoulder-length red hair frames her narrow face that ends with an angular chin. Arriving here already at her 75% she isn’t given the gradual caloric additions but instead is right away started at the 3,000 calorie level. I don’t know very much about her yet because, with her arrival yesterday, she has not been so much untalkative but shes quiet in a friendly sort of way. Its as though shes poised to answer a question about herself happily but doesn’t readily provide info without that prodding. I know that shes 20, grew up just outside Boston, and now lives in Ney York, but thats really it at the moment though. I have the hunch though that she’ll be a pretty ok addition to our little bunch of bananas.

The other new entity is Jose. He is Benji’s new roommate. Jose walks around more or less like the ghost of Bigfoot. He lumbers awkwardly through the halls, during the rare times he is not sleeping, buried in sweatpants and a large hoodie. His long black hair hides his face most of the time and everyone’s first guess to his heritage is American Indian but we later learn, in his somewhat broken english, that he is from Mexico. The staff won’t tell us what he is here for although its made clear that his issue has got nothing to do with eating disorders. I suspect its detox of a sort but I don’t know from what substance or for sure thats even what it is. He seems friendly enough and my money is on the bet that if we asked him to clarify he would. However this would require him to be awake long enough to ask. Basically, the reason for all of this is that Jose belongs on a different unit within the hospital and is just here until one of their beds opens up. He doesn’t have the same protocol as us and therefore doesn’t attend our groups or eat meals with us but his strong patchouli scent lingers through our halls long after he has retreated back to his room.

My sinuses now have a fog of medication to wallow in as the Tylenol takes the pain down from the top shelf into a manageable arena. Its still there, just dulled, and, just like anything else, I’ll have to wait and see what the rest of the evening brings.

At the table

For some reason we have been processing after meals a lot more recently. Its a basic exercise that really just involves the group of us sitting around the large dining room tables for a chat. After loading our more or less empty trays back into the trolley to be taken downstairs we kill the radio that livens up our mealtimes and settle back into our seats.

With this being an eating disorder treatment center it goes without saying that there will inevitably be some issues surrounding meals. In processing generally someone starts the group off, lately this job has fallen to Elle, and from there we go around the circle and discuss anything from the dining experience that might have been difficult for us. Usually any staff with us at that point remains pretty quiet and we do our best to offer each other support for our various issues.

Just because I have been tacking each meal with an ease and acceptance thats surprising even to me doesn’t mean that everyone else has such a relaxed time with it. Different meals have different components that create different amounts of anxiety in different people. For some of us its been so long since we have eaten in a natural social setting that we aren’t even sure what a “normal” way to eat certain things might be. Questions, like weather or not you would use a fork to eat a brownie and how many pieces one would usually cut a hamburger into before picking each one up and biting in, do come up. These quarries may seem silly to someone looking on but, to my peers, they are legitimate and the search for the answers is real. We just want to get back to a societal normality because our versions of table manner are so bizarrely skewed.

Elle, for instance, has problems touching her things. The idea of something being a finger food is not a concept that is easy for her to accept. Once she touches a food she gets the feeling that its crumbs, oil, or other remnants are all over her face and hands. In the beginning she wouldn’t pick up any of her meal with her hands. Now, after some time and a lot of encouragement, she still cuts things up a bit more than other people but she will pick up the pieces to eat. She has also been doing a great job fighting the urge to wash her hands of the imaginary debris the food has left after each bite.

Another one of the girls, Carrina, has issues with peanut butter. It’s a fear food of hers and she doesn’t want to be around it because it used to be the main thing she would binge on when she was back home. The other day she explained to some of us that, before she came to Columbia, she cleaned her room and dug up about a month’s accumulation of jar from its depth. She admitted that there were 26 cleaned out peanut butter jars that had been stashed in various spots. Here though she still has to face her fear. She doesn’t have to tackle the peanut butter issue everyday but she’s not allowed to avoid it either.

Other issues surrounding our meal table include things like cutting food into miniscule bites, putting salt on literally everything, the compulsion to eat things only in a certain order, or chew each bite a certain number of times. We are all trying though. Its hard but we are doing our best to overcome these things which can be so baffling to the average public.

Processing after meals helps all this and, although I don’t always have a whole lot to add myself and sometimes people say the same issues over and over, its good to help. As far as providing support goes we are a good little family. I’d be more than happy to have any of these girls on my side when and if I ever need that extra help.

United diversity

The conversation with Benji and Cora had gotten me thinking. There is so much about this illness that so many people don’t understand, and the stigmas surrounding it don’t help in the least. Even I, before all of this, upon hearing the word anorexia would automatically jump to the image of popular highschool cheerleader just trying to get the guy. I have since learned that that ingrained mental picture is terribly wrong, but still the education of the public on the true nature of eating disorders remains at a minimum. There is so much more to it than the flimsy stereotypes and it took actually realizing that I was anorexic myself to actually understand that. Laura, who has been living with this for more than 10 years, frequently states that she wouldn’t wish and eating disorder on her worst enemy.

Diane is a good example of the diversity surrounding this. She is the new patient. Since her arrival yesterday she has done little more than sit with her head resting in her thin arms and her small frame bundled in multiple sweatshirts. Exhausted doesn’t even begin to describe how tired she looks, but it’s not a sleepy sort of tired. Diane is the perfect picture of being stretched too thin, taking on way too much in life. She looks so delicate – as though poking her with even just the tip of a finger would cause her bones to just separate and fall to the ground with a breath of dust that radiated relief.

At the age of 47 Diane is officially the oldest among us. We learn that she has 6 children ranging in age from 21 down to 8 and, looking at the differences between us, I almost can’t believe we have sons the same age. Topping off raising 6 kids she has spent her life going to school for nursing and working full-time as well as avid volunteer work in various areas. She is slightly shorter than my own 5’4″ stature and her husband’s shadow completely engulfed her when he accompanied her at check-in. With her gaze trained to the tiled floor her short blond highlighted hair falls forward hiding her face. Beneath her sweats and slippers she nervously fingers a string of pearls that hangs from her swan-like neck.

Tonight was the fifth meal since her arrival that she has joined us at the table for but she does little more than just that. The previous meals she at least ate a little, although it was a visible struggle for her, she would get about half down each time. Tonight though dinner was apparently out of the question. With her frail hand at her forehead to shade her eyes she didn’t raise her gaze or eat a single bite.

I had thought that having someone near my size come in and not eat would hinder my own progress because thats what happened at Remuda. Others not eating was a huge trigger for my own eating disorder tendencies to jump in. This time, though, it was different. The only thing that Diane not eating made me feel was a boost of determination. The conscious refrain of “I don’t want to end up like that” silently urged me on as I finished one of the biggest meals I have been faced to here to date.

Part of me was mad at her for not taking advantage of her situation here but maybe shes just still adjusting. Everyone comes in here with a different attitude towards recovery and there is plenty of potential for things to get better for her. We’ll just have to see how she does. Its all about time.

Fiends and fears

It was coffee time and Benji and I watched the clock tick away our allotted minutes until someone came to deem us ready to leave for the small upstairs cafe.

“I’m going to give them until 8:47 to get their act together before I start pestering them about leaving.” Benji was speaking of whichever one of the 3 staff members would be escorting us upstairs as his knee jumped in antsy anticipation. “We are running out of time!”

“I know, I know,” I said as I shuffled cards around in my computer solitaire game, “I don’t know why they put groups back to back with fresh air time when we are always running late in the mornings.”

“And its only the mornings!” Benji exclaimed, as he peered around the corner at the front desk for the umpteenth time. “All i ask for is my coffee in the mornings. Is that too much? It would be good to have more than 10 minutes to drink it in too. This standing around chatting like they are doing right now – this is crap!”

Just then Cora walked into the tiny day room. Cora was a larger woman, one of the nursing staff, who had a fluctuating attitude that she didn’t attempt to hide.  “What was going on with Elle at breakfast? What was the problem there?” She eyeballed the unkempt stack of magazines on the coffee table for a moment before looking from Benji to me and back again.

“Oh, she was just having some problems with the peanut butter. Its one of her fear foods.” Benji glanced past Cora at the front desk once more.

“She did a good job though. She ate it all in the end. It had just been causing some anxiety.” I added.

“I don’t understand. i just don’t get how someone could be scared of something like peanut butter.” Cora said with a gesture of her hands that displayed her giving up of comprehension. “In my house peanut butter is normal. The kids all eat it, everyone eats it no problem. Why would someone be scared of it…its just peanuts and sugar!”

Benji and I tripped over each others words as we both jumped in at once to try and explain the thought process behind “fear foods”. By the time we had sorted out who was going to say what though Cora had already turned and walked away. Benji looked at me.

“Well shes not known for her niceties.”

“I know,” I said, “but what I don’t understand is how someone who works on an eating disorder unit hasn’t had training in basic ED habits. Not only that but her walking away like she did just shows that shes not even going to try…”

“Coffee!” The call echoed around the room cutting our conversation short, that one word trumping all else.

REM

Oh the tricks our minds can play on us in dreamland…They do seem so real sometimes. Last night my subconscious played a haunting game over my field of sleepy vision as I snoozed beneath the white linen sheets. In the dream I was here, at Columbia, in New York as I am now. It started with me arriving and working out last-minute details of my stay as I got settled in. It played by the reality that I now feel in my waking hours and tried to pass itself off as a generally good dream. Quickly though it turned on me as my fears about this situation became apparent.

In the dream, after only a few weeks stay, I had to leave Columbia and go back home. I was terrified. There was no reason why I had to cut treatment short, I was just told that I had to go. Thats when it turned into a nightmare. Knowing I hadn’t been there long enough and terrified of just falling back into my old habits I headed home.

I’m not going to go into detail, because its evident what happened as a result of me leaving treatment early in the dream, but what does it mean? I can only assume that it’s a good thing that even my subconscious is scared to leave treatment. I hope that means my chances of continuing in recovery are that much better when I return home. It’s a tricky road to maneuver with lots of potholes. Here I am in an all new environment – new people, new schedule, new meal plan, everything. It causes how I eat and view food to stubbornly fall in with the agenda. It makes it easier to accept.

I’m not saying that once I am back in the environment that I know and love, the place I enjoy calling “home”, all my old habits will assuredly come back. I just know that there is, in fact, a very real possibility and recognizing that I am scared of it will allow me to figure out a defense. If I am better armed against the potential enemy rather than allowing my new-found joy of life leave me open for a sneak attack then that’s all the better. I will be prepared.

Take this girl

Up at 5 am and, looking in the bathroom mirror as I yawn and stretch my arms from sleep, I can’t help but smile. It may just be in my head because, being weighed on a daily basis, I know I haven’t put on a whole lot, but I think my face looks ever so slightly different. For once the drawn out hollow-cheeked thing I have dubbed “the horse face” isn’t staring back at me. The difference is subtle and it may be that I am the only one who notices it, but it feels good. It reminds me that the girl I thought I lost, the one that was replaced by this person that I don’t ever want to think of as me, is still in here somewhere.

The reflection in the mirror that has been gazing back at me with its hollow, purple-rimmed, sleep deprived eyes has been a constant presence for about 4 years now. Whether this sickly zombie version of me has been fully emerged or lurking just below the surface she has made her presence known for a long time. I talk about her as separate from me in hopes that its true. She isn’t the me that I know, the me that has the potential to be happy, the me that actually knows how to smile. Yet she has been there, in and out of vision, slowly inserting her bony cheeks and wan pallor into my life.

She may never be totally gone because, if nothing else, she will exist in memory. That type of presence I can deal with though. I know that I won’t ever be able to forget her once she is completely out of the reflective eyes that stare back at me but at least she will be where she needs to stay…and I will be where I need to stay.

Would now be a good time to sing the praises of zucchini bread? The slice that graced my breakfast plate this morning practically came with its own glowing aura. Somehow, though, I didn’t feel bad about eating it, in all it’s glory, at all. The only thing I can say is that it was calling to me and I took full advantage of its sweet song. Heck no, I don’t feel guilty!