Jane's brilliance: Life as a Recovered Person, This stage of recovery, meal support , etc.

(This is a very long post. If you're only going to read one part of it, read part 3 because I feel like people could benefit from it and maybe relate)

I had an insightful session with Jane today. I think she thinks I’m doing really poorly and so she didn’t waste any time. Normally I walk in, we exchange “how are you’s” before the session really begins, but today, I walked into her office and, literally before my butt hit the couch, she said, “So, you are having a really tough time with food, huh? This has been lasting too long for comfort now. I’d say it was gradually getting worse for about 4 or 5 months, but especially so within the last month.” I had nothing to say except “Yup.”

I really love Jane because she understands me so well. She understands that there is part of me that really wants to be the person who can eat normally. Then there is part of me who is, in her words, trying to sabotage the treatment plan (literally her words). Then there is part of me that is no longer in denial so much and, as a result, is just so in shock and filled with embarrassment that I have a real eating disorder.

In the appointment, we mainly spoke about:

1) This stage of recovery

2) the need for increased meal support and how to achieve that

3) the factors that are “blocking” my ability/desire to “get better.” (AKA “underlying issues)

4) Q and A with Jane.

This Stage of Recovery: The Critical Stage

Jane summarized my, sorry for the cheesy word, journey as follows: Gain weight and eat a lot for friends, can’t handle it and revert back, realize I want to get better and try on my own with only moderate success, start seeing Tracy and let her completely call the shots, I eat whatever she tells me to eat, I am a nutritional masterpiece for a while, eventually discomfort gets too high AND I want to assert my indepdnence, so I drop the meal plan, only, I can’t “swim” by myself yet, so I go back and forth back and forth, as I deal with trying to eat intuitively. At this point, I’m on a “Back” not a “Forth.”

In terms of denial, I began seeing her with complete denial. “I do not have an ED, I’m just here because I like Tracy and she made me come, but there is no point to this. I’m sure you’re really nice but I have no reason to be here.” Then I went in and out and in and out of denial. Right now, I’m the most “out” of denial as I've ever been, and it takes a toll on self-image when you realize you suck at feeding yourself.

When Jane first saw me, I never socialized. Now, I socialize. I’ve been dating. I’ve been initiating plans. When Jane first saw me, I didn’t care about my own mental health. Stressed to the max? I should be able to handle more. Hate life? Oh well. Hate myself? I deserve it. Now, though, I take better care of myself. I changed jobs. I try to take time to recharge. I do care about the quality of my life, and I believe I deserve a high quality one.

So, Jane says that I’ve made tons of progress, and, sometimes, in this stage, when denial gets stripped away, when the patient is close to recovering but scared to take the final leap (because something is holding them back - getting to that part later), the eating disorder comes back in full bloom. And that, she says, is exactly what’s happening with me. Not everyone experiences a “full bloom” resurgence of the ED, but plenty of peolple do. She says my symptoms are here in full force and that I’ll get through it, but that doesn’t mean I can wait for symptoms to decrease naturally.

Jane very seriously told me that this is a very critical stage of recovery and one that requires so, so much support because, when you break through this stage, you have made leaps and bounds of progress. She said this is the stage when people run from treatment or drop out or wind up in major regressions or just make REALLY, REALLY, PAINFULLY SLOW progress. And she said, we want to make sure I get through this stage safely and, that’s why, she wants to make sure I have tons of support. She told me I absolutely will get through this stage but, in her experience and that of her former patients, it is one of the hardest stages and also the stage when the patient is the most vulnerable.

The need for increased meal support and how to achieve that

Jane was pretty straight up with me here. She basically told me that I can’t lose weight, that I’m not being safe, and symptoms need to be stopped as soon as possible. (Jane has not spoken to me about weight in a long time so that was a shock).

She said that while we need to tackle issues blocking me from eating, we also need to really increase the meal support so that I am getting better nutrition. She said that I want to eat but I can’t. She held out her left and said, “You’re here and,” she lifted her right hand, “The food is here.” And you need to cross the bidge, you want to, but you can’t. I interrupted, “Why can't I? Why is it hard to do something so simple?” She said we’d get there in a second. (Oh. Okay. Yes, Master).

She gave me a drop down list of the ways people cross the bridge to eating. She told me “I’m not talking about which options you’d like, I’m not saying which options I’m saying you have to do, I’m just giving you the options.” Options included:

1. Eating with Jane 1x a week (but she doesn’t think that’s enough)
2. Eating with Jane 2 or 3x a week (but she doesn’t think that’s enough)
3. Going home (which I refuse to do) and/or letting her call my parents and bringing them up here (which I probably should do, but I’m hesitant)
4. Utilizing my friends and eating, every day, at every meal, with friends (I’m lucky to have that as an option).
5. Going to an Intensive Out Patient program (which Jane has told me she looked into two of the programs she liked and they are currently accepting people) where I’d go for half a day, 2 meals, and lotsa therapy + using friend support + continuing to see Jane. (While Jane knows this would be helpful, and I do too, it would not be fun, and I'd have to do so much explaining to so many people.)
6. Going Impatient (which Jane would never suggest I do… I don’t think lol)

She then asked me which of those options appeal to me. She knows me well; she knows I can’t be “Forced” into an option. I can’t feel like my control and power is stripped away from me. So she knows I have to be part of the decision.

So, which options do appeal to me? Basically what I said was, “I have tons of support around me, local support. I just need to get over my pride and use it.” Her response: an enthusiastic EXACTLY.

So we went into more detail about how to use my support, but then Jane said, “There’s an elephant in the room here. You’re being sneaky. I can feel you agreeing but I don’t really feel a commitment coming from you. I can just sense that you’re like half way here.” I said, “It’s just because I’m so shocking myself lately that I don’t know if I can trust myself.” Jane said, “I don’t trust you either.” And then we both burst out laughing. Jane proceeded to clarify that she trusts me in lots of ways but not, right now, in the eating department.

So, basically, Jane has decided she wants to have dinner with me 2x this week (for free. Very nice of her). We talked a/b who I’m eating what with when. Breakfast is on my own. But lunch is with Crissy (boss/friend) every day. Tonight I was supposed to eat with my friend Will (but I didn’t actually call him, so that never happened). Tomorrow I’m eating with Nicole. Wednesday and Thursday I’m eating a LATE (like 9pm) dinner with Jane. Friday I’m eating dinner with either Jenny or Nicole (or both). Saturday I’m totally on my own except for dinner. Dinner I’m supposed to ask a friend to eat with me. Jane wants me to ask Nicole. Sunday I’m going to Crissy’s family’s house for Easter. And Monday I have Jane again – and Tracy comes back.

Jane told me it is not okay to just....., woops, forgot to ask someone to eat with me, oh well :) She basically told me I need to follow through and be vigilant.... which I did not do tonight....

Jane was just totally blunt. She said she doesn’t know if I can cross the bridge at this point with this level of support. She doesn’t know if I’ll actually end up reaching out to friends. But, she made clear, she really wants me to, but, if I fail, to not feel bad about myself.

Jane kept reiterating that I shouldn’t feel bad because I’m working so hard. AT the end of today’s appointment, she said, “Wow. You did some majorly hard work today! Good job!”

I brought a PB sandwich to eat with Jane today. When she told me to eat it, I didn’t want to, but I didn’t hesitate to unwrap it. I told her that I think there’s 1000 calories in it. She said, “No, I heard PB sandwiches have 4 billion calories. And I also heard they make you fat on the spot.” Then we both burst out laughing. I ate half of it, but not the second half. She told me I need to, which resulted in a conversation of “This isn’t fair! If I didn’t have an ED you wouldn’t make me eat both halves!” Her response: “True. But if you didn’t have an ED, you would have had a lot more calories yesterday, this morning, this week, this month. Plus, you do have an ED. A very strong ED at the moment.” Hang head.

I never ended up eating the second half. I don’t know what’s wrong with me. I felt stupid. Jane’s face got this sad look and her tone became sympathetic. She said, “It’s really hard to eat it. I know. I’m so sorry you’re going through this phase. It’s so hard.”

She told me to keep eating it, and I picked at the crust of the 2nd half, but that's all. I think she actually thinks I ate it. I really do think I fooled her... not proud of this, just sayin'.

So, the plan is to try to use my local support to eat with people. And the goal is to not “sabotage the plan" as I did tonight.

The factors that are “blocking” my ability/desire to “get better.” (AKA “underlying issues)

I will list them, and then elaborate on one of them. Things “blocking” me and making me “Resistant” to getting better.

1. The strength of the eating disorder in the current moment, Jane said, is making me want to sabotage efforts to help myself. She added that the brain’s reaction to malnutrition makes it harder to restore nutrition in “anorexic patients” (does she have to call me that? I don’t meet the crieteria.)

2. Afraid I’ll gain weight if I resume normal eating (though I do remember that my weight was technically normal and fine just a few months ago, when normal eating was, more or less, the norm. And, as nicole said, it's impossible to eat normally and get fat. No one who eats in tune with their hunger and fullness is fat.

3) What I imagine my life to be like as a recovered person (incorrect, black-and-white image I have of myself as a recovered person)

# 3 was basically the big discovery of the session. The eating disorder does many things for me, but one of the the main things it does is it protects me from feelings of failures. Hear me out: If I keep an ED, I have an excuse to not reach my potential. I believe I have a high potential actually, which means I also have a high risk of failure. It's easier to just not try to reach that potnential. In other words, I have an excuse to fail at reaching my potential. I have an excuse (the ED) to not be perfect. As I go on to discover in the session, my idea of my potential is totally unrealistic.

As a recovered person, I imagine I will be able to do anything. There’s no reason to not be the CEO of some socially-good organization that I thought of. There’s no reason to not have start my own organization. There’s no reason to not date, be in a relationship, have a family. There’s nothing holding me back from being Miss Spontaneous, becoming the Social Queen, Ms. Facebook Extraordinaire. Without an ED, I’ll have no reason to not be 100% independent, impress people with my accomplishments, have a robust social life, AND keep a clean house, etc.. Without and eating disorder, I’ll have to be perfect. There'll be nothing wrong with me, and so I'll need to be perfect - sociable, professionally successful, presentable, well-balanced... a Wonder Woman.

Jane noted that this is completely false. She said that, without the eating disorder, you have free will, which means you can choose to say NO. You don’t have to become a bar hopping, spontaneous, Stepford Wife. You don’t have to become a bar hopper. You can be a game-nighter. You don’t have to be a serial dater. You can be a one-time-a-week (or month, whatever) dater. You don’t have to create an organization and then become CEO of it. You can if you want, but there’s no timeline for this. If that happens, great. If not, great.

Also, this idea of having to be a perfect person is a complete lie. I don’t have to be a perfect person. No one could possibly, in their right mind, expect me to. Jane said the only people like this are perhaps Disney characters.

WHAT I AM EXPECTING OF MYSELF AS A RECOVERED PERSON IS COMPLETELY IMPOSSIBLE, UNREALISTIC, AND UNATAINABLE.

Jane said, Recovered people are not all that amazing. Recovery is great, but it’s not like you land in some paradise where you’re a superhuman and fully capable. Recovered people are just REGULAR. She told me that, when you’re recovered, you’re still you, but without the eating disorder. Before, you had an eating disorder and you hated spontaneity. Afterwards, you don’t have an eating disorder…. And you still hate spontaneity. (For the record, I like some types of spontaneity). Before, you have an eating disorder and you get anxious. Afterwards, you don’t have an eating disorder and you still get anxious.

When you’re recovered, you still have your same preferences. If someone asks you to do something, you don’t need an EXCUSE (the ED) to say no, you can say no simply because you want to. Jane said I can say no to anything – except eating.

When I’m recovered, if I want to hang out, I can say yes. If I don’t want to, I can say no.

When I’m recovered, if I want to do something dangerous like sky diving, I can say yes. If I don’t want to, I can say no.

When I’m recovered, I don’t have to do anything more than eat, sleep, drink, go to the bathroom, be social enough to be happy, and make enough money to survive. Anything on top of that is just icing on the cake. There are no expectations.

When I’m recovered, I will not be suddenly expected to be some world famous person who saves the education system.

When I’m recovered, I wll not be suddenly expected to decorate my house really cute.

When I’m recovered, I will not suddenly be expected to be happy all the time.

When I’m recovered….. do you see how this could go on and on?

I breathed a sigh of relief and said, “Yeah, I just get to be myself when I’m recovered. I don’t have to do anything.” Jane said, “Yes, but you do have to eat. You don’t get to be your eating disordered self. You don’t get to just decide you prefer the eating disorder. Just to clarify”

Jane made an observation: Having an ED helps me say “no.” It holds me back so that I can say “no.” No to situations I’d rather not be a part of. No to goals I don’t want to achieve. No to goals I fear I’ll fail at.

Sometimes I say “no,” when I should push myself to say “yes,” but, in general, I’m not going to recover and become an out of control “yes-sayer, living a life I don’t want to live.” Jane said that it seems like I fear that, without the eating disorder, I fear I’ll lose my ability to say “no.” I think there is some truth to that.

This is why Jane says assertion is such a big part of this phase of recovery. In order for me to be able to live true to myself, I need to tune up my assertion skills – so that I can say yes when I want to say yes, no when I want to say no, and wait when I need more time. I need to know that it’s okay to not know. I need to know that there is no time line to living.

I'd say then a big underlying issues are assertion, imagined expectations, people-pleasing, staying true to my own preferences and knowing that it's okay to have preferences.

Question: Jane, how would you Describe Me to another psychologist in terms of where I stand in recovery?

Her answer was something like: "She is a highly functioning woman who has an eating disorder. She's made great progress in her relationships and her social network. She's made tons of grown in her ability to not think in black and white and her ability to think with a less punishing inner-voice. We're working on correcting a perfectionistic expectation of herself. She tries hard and spends a lot of time processing what goes on in the sessions, so you have the opportunity to go far in every session. The most difficult thing for her by far is eating and right now a lot of focus needs to be on refeeding and achieving nutritional stability.

Question to Jane: In comparison to your other patients, how is my ED? How do you see me? Am I normal? Am I a lost cause? What...?

Answer: You have a very entrenched eating disorder and you've had one for a long time. Even before you had full-blown symptoms, you flirted with it and had a belief system and mindset primed for getting an eating disorder. This would be much easier if I had gotten to work with you quickly after you developed it. So, it takes time, but recovery is fully possible.

Homework from Jane

Re-read the book Brain Lock

Do a helluvalotta Mindfullness

Eat food.

Call a lot.

And, because I’m including it just for transparency sake, here's today… but please don’t make your comments just about how my food sucks. Trust me, I know.

B – none

L – small side of normal

S –very small

D - small (at first post of this entry, it said none. Then I remembered talking to R earlier and her telling me her meal schedule was going to be weird today but she was going to get her meals in. So I realized, it's 10pm. I'm hungry. I can eat now.)