Program day 22

• Everyone: Thank you. Thank you for reading and commenting. Thank you for all of those who encouraged me to talk about feeling the restriction/exercise urge so that I'm not struggling alone. My program therapist has been out of town all week due to family emergency reasons, but she called today to check in to see how I'm doing, and I told her about the massive urge to "pull in the reigns" and "Get control back" (i.e., restrict and run) - and I confessed to things (like for walking non-stop for 2 hrs in between Tracy's appointment and the start of the program because I was fearful of the upcoming food). I told my therapist that I'm doing my job in terms of dealing with this urge to restrict/run. I'm journaling like a journaling addict. I'm eating my meals. Repeat: I am eating my meals. It is true that my evening snacks are slipping and my exercise is slipping, but it's because I have less buy-in to eating snacks and following my exercise plan. Anyway, despite the fact that I am "dealing with this on my own," I did talk about it today - and that made a big difference. I don't think talking about it in group gave me any good "insight," but it's just good to know that other people know what is going on with you. Because I talked about it, the dietitian checked in with me both before and after dinner for a good amount of time. Because I talked about it, some staff members checked in with me randomly throughout the day. Because I talked about it, I feel safe because I know that people know - and I don't feel alone. It's a nice relief.

• Here are some conclusions I've drawn about talking about your stuff (not just responding to other peoples' stuff) in group therapy:

1. You do not have to have a specific question to talk. But if you do have a specific question, that's fine too.
2. You do not need to be looking for feedback to talk. But if you do want feedback about a certain situation, it is a good forum for getting it.
3. You don't have to have any idea what you want out of sharing it in order to share.
4. Sharing just so that what people know what is going on with you is a good enough reason.

• I feel so supported today - by staff, by other clients, by Tracy. Today, in Tracy's appointment, we ate breakfast (breakfast wrap with egg, cheese, spinach and a class of orange juice), and we talked about my fears. 1. I'm afraid of decreasing weighing myself because i'm afraid that if I stop weighing myself entirely, I'll become so afraid of the scale again that I'll never weigh again. 2. I'm afraid that, when I leave the program, I'll forget the importance of eating my food. I'm afraid I won't remember the importance of eating my food and I'll slip. I'm afraid I'll lose all the progress I've made. 3. I'm afraid that my body will stop being able to handle the food it's eating. What if the only reason my body didn't blow up from eating all this food for the first month was because, prior to coming into the program, I was so underfed. What if now my body doesn't need all of that anymore? Anyway - I told Tracy all of these anxieties - and she said "WE'LL have to work through all of this." And, after she said that - said "WE" - I felt a huge sigh of relief. Like, oh, okay.... okay.... I have people around me to help.

• With Tracy, I made a list of "food goals." She and Jane have been trying to get me to make this list for forever but I never would - why try food just for the sake of trying it? Why try to eat chips if I don't care for chips? The argument is that you want to decline food because you don't like it... not because you CAN'T eat it without a lot of mental reprecussions. So, now I'm on board. Tracy was talking about how we have to systematically go through and eliminate all eating disordered behaviors/fears. So, together, we started to make a list of foods to eat to "prove the eating disorder wrong." The foods - SO FAR (list is still incomplete - we made in in like 5 min) - are:
• pizza
• pasta,
• tacos,
• burritos,
• mexican food WITH chips and guacamole,
• potato with butter/sour cream,
• cheeseburger,
• fries,
• lasagna,
• chinese/thai/indian food at lunch or at dinner without eliminating lunch/bfast,
• brownie
• ice cream
• a bigger cookie (or a fresh baked cookie - not with a label where i can count cals)
• curry (without restricting the rest of the day to "make room" for it)
• mac 'n cheese
• broccoli/cheddar soup
• things with coconut milk
• french toast
• homemade waffles
• restaurant salads that aren't just veggies and chickens (maybe ones that have cheese/nuts/dried fruit)
• stuffing
• pancakes
• scrambled eggs from a restaurant (where they may or may not have used butter to cook them and I can't know exactly how many eggs there are)

This list could go on....

• My meeting with Tracy today made me realize that, it's so true, in order to fully get over an eating disorder you can't leave a single behavior unchallenged. I must eliminate all eating disordered behaviors. I want to:
• eat any food
• have days of no movement AND enough eating (not restricting to make up for lack of movement)
• Have days of eating more than normal followed by a TOTALLY normal eating day the next day (no exercising the next day and no restricting the next day)
• no marching in place while doing things like hand washing, teeth brushing, standing in elevators, filling up my car with gas, etc.
• I'm sure there are more....

• Week 1 of program: VERY HARD: I was only eating food in the program, wasn't eating outside of program, was so anxious around the food I was gonna die.
• Week 2 of program: HARD but I'm able to work through it: I was eating program food + bfast on half the days and a PM snack on half the days. Was anxious, but was dealing with it well.
• Week 3 of program: FUN AND... dare I say.... ALMOST EASY? I was enjoying tastes. I was not counting calories as much. I didn't feel at all anxious around the food! I ate breakfast every day but 1 and evening snack every day but 1 + the program food.
• Week 4 (this week) of program: Back to feeling anxious around the food sometimes - but not as much as week 1... strong urges to restrict... but still eating nearly as much as I was eating in Week 3..... urges to exercise and giving in sometimes but nothing too - too crazy

• The difference, though, between Week 4 and 1 is that, in week 1, I wasn't sure that "all this food" was really normal. In week 4 - I'm sure it is.

• As I was describing my urge to restrict and run today, the group leader (dietitian) said, "But have you felt these urges before?" Here's the answer: Yes! Of course! Tons of times! But this is the FIRST TIME (seriously) where this urge really, really, really scares me, unnerves me..... because I AM NOT WILLING to give in or go back. Before, when I felt urges... I thought "I can give in to them a little bit." I now realize that I CANNOT give into them. I'm SO AFRAID of giving into them too much and going backwards. I understand the stakes. The stakes are "life without and eating disorder" or "hovering at functionally eating disordered." And I DO NOT want the second one of those options. So that's why this urge wave of restriction/running scares me more than any other urge wave has scared me - I understand how important it is to stay on track, even when it's uncomfortable.

• We had a great Cognitive Behavioral Group today where we really learned the interplay of thoughts, feelings, behaviors, and physical sensations. And, when you understand how these different "parts" inter-relate, you are then so empowered to calm yourself down, to manage your behaviors, etc. We also talked about realizing that evaluating your actions is not dependent on if someone else is pleased with your actions. So we talked about realizing not everyone will be pleased with your choices in every situation, but that doesn't mean they're wrong choices. We also talked about how to speak your mind and voice your opinion.

• Now that I've "come out of hiding" and told everyone that this week has been hard for me and I feel unpresent and distracted and out-of-my-body because I have such a strong urge to restrict my food and move, move, move.... I suddenly feel alive again and I felt like I was useful to others again today. I felt like I was a helpful presence in Group Therapy.

• I feel a lot better now that I know the staff knows I'm having this urge and Tracy knows and clients know. I feel a lot better.

• This is the hunger/fullness scale we use here. I have to eat 100% no matter what b/c they tell me they're serving me an appropriate amount and they tell me I don't know my hunger/fullness cues well enough. But, the idea is to start eating at a 3, finish at a 7, and, depending what you prefer, once a day or a few times a week, finish at an 8. At first when you start this process, though, you may legitimately feel at a 9 sometimes.... but, after you "even your system out," you should be able to accurately sense the hunger/fullness scale.

10: Binge Full. sick feeling with stomach and/or back pain.

9: "Thanksgiving Fullness." You need to unzip your pants in order to be comfortable.

8: Uncomfortable fullness that comes along with eating more than usual.

7: Fullness that allows you to leave the table without looking back. You may be bored of all of your food including the sweet taste. You are still not physically uncomfortable, but you may not feel totally comfortable - you feel like you just ate. You feel the food in you.

6: Comfortable fullness that results in a satisfied feeling within 1/2 an hour. Stop here and you will be satisfied for a couple of hours.

5: Satisfied feeling that allows for more to be eaten.

4: Your senses indicate that you are hungry. Food looks good and tastes good. You may not know that you are hungry until you taste the food.

3: Stomach is empty and may or may not growl. Need to eat soon.

2: Headache, irritable, tired, weak, light-headed, preoccupation with food. You may want to order everything and have a difficult time choosing what to order.

1: Starving point where you are ravenous for food. "Eating Disordered Hunger."

0: Fasting numbness that is felt when food is no longer craved.

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