Program Day 66

Sarah: Yes, I did learn a lot from my trip. Thank you for the well-wishes. I am feeling up and down about myself right now. I was feeling better, but the staff told me today they want me to go back up to PHP, which makes me question myself...

David: Yeah it was really neat to hear that comment from my friend because 1) it reminded me that we don't hide it all that well and 2) it was a compliment that recognized that I have made progress. As for moving out... weird thing is that it wasn't sad at all. It was like I had no attachment to the apartment. I hardly remember living there - strange but that's how I experienced it.

Battleinmind: Thank you for the comment. Yes, I did learn from the weekend for sure.

Molly: Yeah I can't believe how much food our body requires, can you?! I mean to think that my body is maintaining weight on this amount of food with a relatively sedentary life style... I can't imagine what my body truly needs while I'm up and about on my feet. This is something for you to keep in mind too, missy, as the school year starts :) And, yes, recognizing the difference between being in my mind and body has been so helpful for me too. The first step is even just taking note of which one (mind or body) is calling the shots - b/c lots of times we're not even aware, you know?!

Anon: Thank you so much for your comment. IT truly means a lot to me.

Heather: I love you! Thank you for leading the way for me. You've always believed in me and sent me such inspiring energy through your words. Thank you!

• Well, wow, program staff is holding me to a high standard - the standard of "must not be any ED behaviors happening." Today, they told me they want me to go back to PHP. My reaction: confused but willing to think.
• Program RD told me I am a "Master Rationalizer" and she there must be less behaviors and less rationalizing. (Admittedly, I was rationalizing when this conversation came about. Specifically, I said, "yeah, but if you start the week at Thursday, then I only got off track for one day ... one and a half days b/c skimping is like half a day off track." And she was like, throwing her hands in the air, cracking up, saying, "Did you just hear yourself?! You just said 'If we start the week at Thursday.' ) So, we agreed on the following: I will follow Meal Plan 100% and Exercise plan 100% and, if I think I have a good rationalization for not doing something, I will not act on it but I will tell her my rationalization instead.
• Here are the facts: Tues I ran 7 miles and didn't mention that anywhere or to anyone until today; Wed I walked for about 3 hours; Thursday I walked for 2 hrs. Sun I walked 1 hr to bfast when others drove. Wed one meal was very restrictive. Sun my meals were skimpy which led to unwanted grazing in the evening. Today I skipped Breakfast and Lunch.
• Here's the way I frame my last week: I improved in self awareness, self talk. I came to understand I have to put ED recovery as my priority right now. My food was totally 100% except for wed lunch, fri bfast, sun, and mon. But the other days, I ate 100% of my meal plan. I also didn't calorie count for 4 days in a row... that is huge! And I ate unlabeled, new, challenging foods frequently! Yes, the exercise was out of control in the first part of the week. But that was before Thursday. On Thursday, I got back on track after I had a super helpful Tracy session. Then Sun I got a wee bit off track, but it was b/c every meal was out, I was moving and busy, I was out of town... and I learned from it so I don' think it's a big deal. And today... yeah, well, yeah, today was off. But I just... like, I know the first part of the week was off - but I dealt with that with Tracy. For sure. Then I was totally on track! The part that got off next was due to being busy out of town, but I learned from that! I don't feel like I'm about to continue to be off track. I don't feel like Im' struggling. I feel like I'm learning and I'm willing to get back on track.
• Program staff told me today: "Everything stops. Life goes on hold until you get back to 100%. Your only goal for this week is to put ED recovery as a priority."
• Program sees it this way: holy crap her exercise was out of control at the beginning and that one time she walked on Sun was eating disordered (they don't take into account that I then figured my stuff out on Thurs and got back on track). Holy crap she skimped big time on WED and moderately on Sunday (I still see Sun as a good day). Holy crap she skipped 2 meals today (ok, yeah, problem).
• If insurance will pay, they want me to do PHP for 1 week and then go back to IOP to get more support.
• I'm kind of delaying thinking about this until I even know if insurance would cover it or not. I'll find out tomorrow or Wed.
• Staff today gave me a sit down chat about how I have poor insight into how "nasty" my ED is and blah blah blah.
• Staff said: "just let us see if insurance will pay for PHP again. We're not saying to do that for 3 months. We're just saying to go back for a refresher course to help you get back in the swing of things - probably for just a week. (I started to say "But....") Why are you fighting us on this?" I thought that was a good question. Why was I fighting them? 1) Because I am not sure I'm actually struggling or not. I don't super feel like I'm struggling..... 2) Because I'm not sure going back to PHP is what's best for me. Isn't the point to learn how to get back on the horse even when you're not in PHP? (They had a good response to that. They said, "yeah, trust us, you'll fall off the horse in IOP again later, and you can get back on the horse w/o PHP then. You'll have plenty of opportunities to practice getting back on the horse on your own. And, you never had our blessing to got to IOP in the first place; that was insurance.) 3) Because I feel embarrassed to be recommended to go back up and, if I did, I wouldn't want to tell my friends/parents. But I think the main reason I was fighting them was reason # 1.
• Anwyay, discussing php was what I spent most of my individual session doing.
• RD session was me feeling like I'm in a confessional or something and listening to her tell me that I need to "do" and not just "think about doing." And me telling her "I am doing. I did struggle last Tues - Thurs, but then I had an epiphany and I've been fine ever since (except today)"
• Group therapy - geez what was it even about? what was my take away? Idk....
• Then we did a skills group where we had to hold an ice cube in our hands for 10 min and then talk about the experience. I used the 10 min to play around and experiment with how I'd experience the ice cube in my hands based on waht I did with my thoughts. First, I focused on it and how it kind of hurt. Weirdly, my reaction was to make it hurt more by squeezing the ice more. Second, I wanted to lick my other hand so as to make my hands feel even - both of them wet. Third, I noticed how if I put my attention on something else (like how my butt felt in the chair; or how my elbow felt on the arm of the chair), that I didn't even notice the ice cube in my hands. Then, I pretended I was a polar bear who loved ice - and then I liked the sensation the ice gave me. Anyway, so it proved that even though there was a constant (the ice in my hand), the power our brains have over how we experience that is huge.

OK, well I feel guilty for writing a post that makes it sound like I'm struggling. I'm not even sure I am strugling or not. I think I WAS struggling, but I think I'm doing better now...... I know today wasn't good with 2 skipped meals, and I know I have to eat tomorrow - and I don't really doubt that I will. I do want to.

Here is my reflection chart on last week:

GOAL	SUMMARY OF WEEK
No restriction	Skimped: definitely wed lunch in a big way; Fri bfast (because I skipped bfast, but I had the a.m. snack like always in the program and I consider this snack to be my bfast); It is hard to tell if I skimped on Sun’s meals or not… probably a little bit – it’s hard to tell bcause I bet the staff would tell me to eat more (I know they would have), but my dad ate the same as me and didn’t eat the snacks that I ate…. Skipped: Sat evening snack (but I’m really not sure I needed the evening snack. I had eaten 2 afternoon snacks and, I ate a larger dinner than would have been required by the MP I think, and I was satisfied through the rest of the evening) 100% meal/snack: without counting Sunday’s food: 90% eaten Anything additional added: I had 2 afternoon snacks on Saturday I ate a.m. snack on Sun + I ate quite a bit extra in the evening on Sun (all out of hunger. I wrote something additional about this at the end) Effective strategies this week: -staying in the present and telling myself that I don’t have to think about the next meal/snack for a few hours. -“I have the power to know how I want to spend my time and energy” (what do I want to think about instead of food? Ok, go think about that) -“nothing is out of control yet.” -pleasing Jacque, Abby, Jane, Tracy -wanting to prove to myself that I can have a better week than last week. -Seeing food as energy. “I will need this energy in order to …. ” -Thinking like a non-ED person (forcing the thoughts) -Pulling focus out of mind and into taste buds and body -Remembering the sad memories of the past and not wanting to go backwards.
Eat without calorie counting	I did not calorie count 4 days in a row, and LOVED the feeling that came with not doing that. I think I might continue that J Things are going well here in this category.
Eat without measuring	I did not do the underemeasuring that was happening last week. Didn’t measure one of the evening snacks or anything that came from a restaurant. Things are fine in this department.
Exercise according to plan	I stopped myself from exercising a couple of times. Tues I ran 7 miles (which I didn’t tell anyone about). WED I walked briskly for 1 hr and then, later in the day for 2 hrs. Then I had an appt with Tracy on Thurs and got a grip. Sun I walked an hour to bfast with my friend while my bro/dad drove and met me there. I’m not sure if this is allowed or not. Ok, fine, I know it’s not. Plus, I only walked because I had eaten a “new” and “big deal” food for dinner on Sat . So, it was a form of compensating even though I did enjoy the walk. The times I wanted to run out of hyperness, happiness… I stopped myself.
No compensation	The walking on Sun morning was compensating for Sat’s dinner. (This is the first time I’m admitting that exercise is a form of compensation for me). Other than that, no compensation
No chewing and spitting	No chewing and spitting
Honor hunger	I was hungry for Wed lunch, but skimped (not honoring hunger). Sat I was hungry for a.m. snack, but did not eat it. (Not honoring hunger). Later on Saturday, I did honor my hunger: I ate 2 afternoon snacks and I ate more than required by the MP for dinner. Sunday there were SEVERAL times when I was hungry but did not eat or did not eat enough (not honoring). But, Sunday, I did honor it in the morning when I ate an a.m. snack (but did I only let myself do this because I knew I had eaten ½ of what the MP requires for breakfast?)
Respect fullness	Yes. I was never too full this week. Oh, but, right, respecting fullness doesn’t just mean “don’t eat too much” it also means “eat enough.” Instead of saying, “did I ever get too full?” (answer is no) I could also say “did I get full enough?” Hm… I’d have to think about that side of this. Most of the time, I think so. I didn’t get full enough ever on Sunday (which caused the extra eating in the evening). I also didn’t get full enough after Sat’s lunch (which is what caused 2 snacks in the afternoon). I did not get full enough after Wed’s lunch, but, at the time, I was so disordered and anxious and stunned that I thought I was plenty full. All the other itmes I think I got full enough. And I never got too full.
Relationship bucket	I did have people in my life this week. I didn’t feel too alone. I felt a good balance of alone time and people time. I also didn’t felt like, in general, my relationships had a better balance of give and take. I was in contact with non-local people to a degree that is satisfying to me. There are some people I need to and want to call back, and I will do that. Local people: I didn’t do much with peers – more just with my family and neighbors. This week, it might be good to do some more things with local people. The challenge will be to stay true to my wants/needs with local people (because all the local peers I know are program friends). The challenge will be to pick and choose who I hang out with. There are some program friends that I know I’d have fun with and it wouldn’t feel like a burden to hang out with them. I will seek that out. There is another rprogram friend who wants me to go visit her at IP. I care about her. Even though I don’t particularly want to drive up to her IP, I do care about her, so I will choose to visit her. I’m okay with that.
Life-enriching activities bucket (fun bucket?)	I didn’t do 5 life enriching activities of my choice like my contract said to do. I did see a movie and state which movie I wanted to see. That was fun. Friday I went and drank (a very large glass of) wine and ate appetizers with my parents while sitting outside. I was completely present, totally myself, and laughing SO much. This was a very fun life-enriching activity. Also, when my parents were deciding “should we go here or there, should we go here or there.” I said “let’s just go to place B.” I picked place B not for the food but because I thought the outside seating was better. I had an easy time articulating this preferene because a) it was my parents and b) I really didn’t think my parents had a preference of their own (I did say something besides “I don’t care.”) On Wed the time I had to do a life-enriching activities was used entirely by walking/exercise. I was walking out of anxiety/stress/worries/etc., but I could have just as easily calmed down with a life enriching activities (Take note of that, self) Thurs, the time I had to do life enriching activities was used by me doing something for someone else (which I would have preferred to not do, but wasn’t bitter while doing it. Sat and Sun I did have fun (going out to eat, walking around a shopping strip), but it was more of a “go, go, go, go to a wedding, move out of an apartment” type of weekend. That’s okay because it’s a 1 time sort of weekend.
Career bucket	Had networking conversation (and felt stupid and weird afterwards) Got 1 contact that I want to follow up on. That’s all. This area of my life could have used some more attention than I gave it. I have 2 jobs I want to apply for. This week, I’ll apply for those. I’ve released myself of a time line to get back up to the bay area, but I’d still like to make sure I am applying to jobs and following up at a reasonable pace. Reasonable maybe means 2 jobs a week? Some weeks more?
Eat with Variety / Try new things	After Tracy’s appointment, I felt a lot more able to challenge myself again. I followed my index cards everytime I ate outside of a restaurant except for Wed lunch and except for when I was purposely challenging myself. New/challening things I ate/tried: -croissant and latte for bfast (not new but impt to me to keep doing bfast like this sometimes b/c it’s still not natural) -tacquitos + NF refried beans for lunch -unlabeled casserole of quinoa, cheese, veggies -FR restaurant outing sandwich -ice cream cone as afternoon snack on fri -hard to keep track of dinner on fri with my parents (sweet potato fries, mozzarella tomato salad, fruit and bread) -blue cheese burger and fries for dinner (I am not going to turn vegetarian now, but, seriously, everytime I eat meat, 70% of me is weirded out… I liked the taste but I kept thinking about how I was eating a cow) -unlabeled farmer’s market cookie on Sunday -bagel and cream cheese from restaurant without asking for the cream cheese on the side -slider made of veggie patty: garbanzo beans, sunflower seeds, potato -unlabeled farmer’s market granola bar (goji berries, coconut, pepitas, chia seeds)
Eat without daily weighing	I skipped 2 days of weighing myself. I also wrote my good-bye letter to the scale (as an assignment) I wrote it 3 times actually. The assignment made me realize that there’s nothing wrong with me having a scale. And no, I didn’t try to write it so that that was the conclusion. I really wish people would listen to the way I see it. I could be wrong, but it seems to me that the staff is just projecting other clients’ experience onto me. (“it’s one of the 3 things that lead to lasting recovery according to Carolyn” is a good reson to evaluate the role the scale has in my life, but it’s not a good reason in and of itself ot make using the scale a bad idea. Every person is different, and, when Carolyn visited, she confirmed that it sounded like I might be someone whose use of the scale is a helpful thing. Also, everyone should take note that I am willing to give it up later – not now. If I make a pros and cons list, the pros of the scale totally outweigh (ha) the cons. And the pros are not just ED reasons like “I can’t eat without the scale” because, even though I sometimes do think that, that’s not actually true. I know I’d eat without the scale. Also, the problem is more that it’d be so easy for me to give up the scale! That’s what make me want to hang onto it. I want to continue to challenge myself – it is a challenge to keep weighing myself – not the other way around. And people say “that’s why we weigh you.” I understand the idea that professionals weigh you and keep track of it. But I’m not going to be having professionals in my life forever. So what happens when I totally no loner have an ED… just no one keeps track of my weight? (yeah, yeah, doctor shmoctor). I’d rather be able to rely on myself. Id rather be empowered enough to be able to check my own weight without freaking out. Ok, whatever, this topic just annoys me b/c I feel not listened to and very misunderstood. In the end, I have the right to make my own decisions. I choose to keep the scale, to keep weighing myself, and if that means other people (staff) think I still am “super eating disordered,” then I will live with that. (I know I sound bitter, angry, etc. Maybe I am?) In an ideal world, I’d keep my scale and the staff would say “We understand; you’re different! Good decision!” But this might be one of those decisions that doesn’t get praise. I can live with that.
No non-committal, weird eating	Mostly, no. Sunday night, however, it would have been better to acknowledge that I was very hungry and eat a sandwich with a side (even though it was 9pm) as opposed to eating like 4 snacks. Non committal eating happens because of hunger 99% of the time.
Identify and correct cognitive distortions	I did a good job at keeping self aware this week. Most common cognitive distortions were about how I was feeling full, when really I wasn’t – I was instead feeling self-critical or anxious during thos times. I recognized that and delt with that and the fullness went away – every time. Or I’d convince myself that “the food from yesterday is still in me.” But I corrected that on accounts of that not being possible. Or I’d tell myself a couple of times that “I’m the fattest person ever.” And I’d remind myself that I’m not fat. Fat is a clinical word and it doesn’t describe me.
Productive, effective, accurate self-talk	Yes, I actually did a very good job at being positive, productive, accurate, and effective in my self talk. I’ve come a long way in this area. I told myself good things about myself when I was feeling self-critical. I grounded myself in truth, in history, in my goals when feeling anxious and disconnected/receded. I reminded myself that I am in control of how I spend my time and my mental energy, and I chose to keep my day enjoyable by keeping my thoughts healthy.
Identifying my wants/needs/likes and asserting/communicating them	I noticed other people easily stating their preferences and took note of it. Hm, people do this more than I do. People do this and no one reacts horribly. People do that and I think nothing of it. People do it and it seems pretty normal and natural. I asked myself “do you have a preference?” a few times before just saying “sure, whatever” or “yeah, I don’t care.” 2 times that I can remember, I did have a preference and I didn’t act on it. A couple of other times, I did voice my preference (these were about simple things – restaurant choice, movie choice).
Journaling	I journaled every day except one day (the day I moved and went to a wedding and had a friend sleep over)
Preventative reaching out	No. I thought about it and, in hindsight, I would have benefited. On Sun night when I was so hungry, I thought about texting alyson, “I am so hungry, but I already ate my evening snack. Should I eat again?” She would have texted back “yes.” And that would have given me a mindset of “you’re allowed to eat,” which might have made Sunday night less grazy. But, I didn’t send this text message.
Transparent to others	I hid the fact that I ran 7 miles on Tuesday (until now). But everything else I have been totally transparent about.
No Overeating	Sun night I got pretty grazy/snacky and it counts as overeating. I can find a way to be grateful for it, though. I learned a lot from it (see below)

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