Game Plan?

This is hard to articulate and put out there but here goes...

I've been doing a lot of reflecting about where I am right now in all of this.  I quit therapy due to finances and not feeling like I was getting my money's worth.  I think I've figured out why.  Maybe if I get it all out on here and process then I can explain it all to Dr. M when I see her next.  It's coming up and I'm not looking forward to it because she is not going to be happy to hear that I quit the rest of the team.

I was going to get a new psychiatrist too (for a fresh start), but in the end she's just so intelligent.  I don't mean to be snobby about this factor, but I am.  I meet too many dumb people and it's hard to handle them ever, but especially when you're suppose to be in their care.  Sure, we disagree (a lot) and she frustrates me almost every time I see her.  But in the end its all because she challenges me and can hold her own against my ability to make things sound logical (even if they aren't).  So she stays, but I'm going to have to set a few things straight next time I see her.

Issue one:  I'm not bulimic and she'll have to switch her focus away from gauging how I'm doing based on those behaviors.

Issue two:  I'm not anorexic.  I am not below a healthy weight nor will I be when I lose the last 5 pounds.  95 sounds ridiculous to a lot of people but most people aren't 5 foot.  I'm tiny no matter what and tiny things tend to weigh less.  I'm medically overweight at 125.  Yes my goal puts me at the lowest point of the healthy range, but its in the healthy range.  If I weighed 90 I'd be underweight but nowhere near critically underweight (or anorexic) and would only be giving myself the same health risks that slightly overweight people do.  But that's not even my goal.  My goal weight is healthy.  And being at that weight is a nonnegotiable.

Issue three:  I'm not nor have I ever been an alcoholic.  She asks me about alcohol intake every time and makes me feel like I have a problem if I drink at all.  I started lying and just saying I hadn't drank at all.  I get that when I first started seeing her I binge drank a lot.  I was also not on meds for my depression and mildly crazy.  I was also 24 and just living a normal life for a girl with a social life.  I rarely drink anymore and when I do, yes, I get drunk.  Seriously, I'm 5 foot and weight 100 pounds, I'm legally drunk after two.  But I don't get wasted often and not on purpose like I did when I was younger.  So those questions have got to go.

Issue four:  I will not see a dietician again.  Ever.  It's a complete waste of money and time.  I took nutrition in school, I can read, I can research, I am capable of creating a meal plan for myself that has the suggested amount of calories and food groups.  I choose not to.  I tried and I can't do it right now.  So it's paying someone almost 200 bucks a month just to tell them I failed.

Issue five:  I need a new psychologist with a new focus.  I need them to be female, incredibly smart, and a specialist in anxiety not ED.

This is what I've realized as I've looked back over the past year when I honest to goodness tried very hard to do all the things everyone wanted me to do.  My team tried to do too much with me too soon and focused on too many things at once.  I felt way too much pressure to just get better, be better right away.

I know I'm not good right now.  I'm a driven person.  When I want something, I get it.  When I set a goal, I reach it.  I don't allow myself not too and I never have.  Oh those perfectionistic qualities that rule my life... And the things and goals never end because to me I will never be good enough because I expect perfection and it doesn't exist.  But, when I am reaching a goal I'm not one to take the slow and steady path to get there.  I set a goal of staying under 100 and a target of 95 when I weighed 114.  I could eat slightly less, exercise more, be patient, and give it time like I should but that's not me.  I want 95 as soon as I can get it and I have no problem starving to do it.  This isn't about being at the bottom of an addiction, it's about me being a workaholic with unrealistically high standards for herself and believing the ends justify the means.

I know this is an issue that eventually needs to be dealt with, but not now.  Every time I've quit therapy, no matter what reasons I came up with (all valid though) there is one common factor.  I started having a very hard time handling my life when therapy started getting real or 'working'.  It's not that therapy got too hard, it's that when therapy got easier life got harder.  Anxiety, which I'm finding completely controls my life, started seriously negatively effecting my daily life when therapy started going well.  Specifically my career which is probably the absolute most important thing to me.

In my many years of obsession with reading, researching, and learning about psychology I've never really given much attention or care to anxiety as a disorder.  You think I would have too since my mother has severe general anxiety disorder and has been on medication for it since I was 13.  I don't think I've ever taken it that seriously though, much like how most people don't take depression seriously if they have never experienced it.

It took me a while to take depression seriously and come to terms with mine.  My depression has been debilitating for most of my life (though I like to deny this fact).  I hid it well but I've spent the majority of my life in a deep self hatred, not understanding why I was put here just to live in such a state of misery, and obsessed with the idea of my own death.  When I was younger I would fantasize about ways I could die prematurely while most people hope to die old, happy, and asleep in their bed.  Not me.  Every time I drove on a tall bridge or highway loop I'd imagine driving off it.  I'd obsessively come up with ideas on how to kill myself.  I also created various scenarios in which a tragic event would send me from this world so that I wouldn't have to cause the pain suicide causes the ones you leave behind.  I was a pretty messed up kid and teen, so it's kind of comforting to know its a chemical imbalance now.  I never wanted anyone to see it, but I came to terms with the fact that I had a psychological disorder by senior year in high school.  I could have gone on drugs then, but my pride made me think that I'd made it to 18 without them so I could continue without them too.

Ten years later and I have now realized that I could go on living without antidepressants but I prefer life with them.  I don't feel like I did my whole life pre 24.  I feel good and happy and can just be.  Might sound boring and common to some people but before I started my meds I had never genuinely felt like that.

When you're suicidal that's really all anyone focuses on, even you.  And who cares about an eating disorder if you're not dying from it but you are wishing and considering killing yourself.  It's so distracting in fact that  I and everyone who worked with me (before psychologist S) totally missed the other just as serious disorder which is my general anxiety disorder that I can probably thank my mother for.  Why wasn't it obvious?  Because I found an incredibly effective way to medicate it long before any professional started working with me.  My eating habits.  As soon as I started restricting I became a significantly less anxious child.  Makes sense because I felt in control of something.  Textbook case really.  I avoided feeling, therefore anxiety, by starving and restricting and losing weight.  Weight goes down, anxiety goes down.  The more anxiety I experience, the more weight I lose.  Sometimes correlation does equal causation.

I think this is the most complicated part of treatment for my eating issues.  They are more than just an addiction and issues with self image, while they are both of those things.  Mostly they have let me live a relatively anxiety free life for the past 16 years.  I'm high strung for sure, especially in certain aspects of my life, but as I found over the last year, nothing compared to how it could be.  I have my mini panic attacks over a million different things all the time, but I get past them quickly by restricting and purging.  It's like the two medications I had for migraines.  I had one for acute attacks and one as a preventative.  Purging is my acute reaction to sudden intense anxiety and restricting is my preventative of that anxiety in the first place.  So just as taking away those meds causes an immediate return of numerous migraine headaches, taking away my purging and restriction causes an immediate return of intense anxiety.

When I really did start working in therapy this last go around and even went as far as seeing dietician CA and making plans to start going to a support group I had no idea what I was in for.  I always assumed the anxiety treatment brought was over fear of gaining weight or losing control and I'm sure part of it is... at first.  But what happened this time was a feeling that I was losing it completely.  I can't put into words what my daily life was like there for a while.  I was on edge and felt like I could explode or breakdown at any moment.  I was constantly walking on a tightrope with no net below trying desperately not to fall.  It took nothing to make me cry.  The smallest most insignificant things could send me into a state of intense panic that I've never experienced before.  I was afraid everyone was mad at me or disappointed all the time.  One misinterpreted comment or look and I would be sure I'd ruined a relationship with someone.  I didn't want to talk to anyone or go anywhere because it stressed me out too much.  I basically stopped talking to people on the phone completely.  I couldn't go to sleep because my mind was racing and once I did fall asleep I woke up constantly to stressmares.  I felt like I couldn't and wasn't doing my job, that I was failing my kids.

I couldn't and can't live my life like that.  My heart is racing just thinking about that period of time.  I was recently incredibly disappointed in my end of year testing scores.  There are many factors that contributed to my failure this year, but I know that treatment and my instability this year was the number one reason I didn't perform well.  And now I feel incredibly guilty and selfish for doing it at all because my problem became my students' problem.  I won't let that happen again.

This next time around I'm going a different route.  I know I need to get into consistent treatment because I do realize that there is a chance that I may not want to stop losing at 95 and I have a lot of baggage to deal with before I can live a 'healthy/normal' life (though I don't want too normal).  But I can't try again until I already have a bag full of tools to handle my anxiety.  I can't let go of my ED while also learning how to deal with feelings, issues, and anxiety.  Someday I hope I will be able to really work at recovery but I won't jeopardize everything else for it.  I'm okay with my habits if they are what keep me sane and happy.

And there's another problem, I'm happier now than I have been in a long time.  I'm not even taking the work thing as badly as I would have a year or two ago.  Part of it is because I do feel that I know why, I won't let it happen again, and I'm keeping the same kids next year so I get to fix it.  The other reason is that I just plain feel good.  I don't hate the image I see in the mirror nearly as much as I normally do.  I feel great.  I'm not stressed and on edge.  And if a non life threatening version of an eating disorder is the reason, then I'm okay with that until there's another option.  My last round of therapy wasn't able to give me anything that worked in it's place.  I'm not willing to go back to how I felt and functioned then and I'll just have to hope to find a psychologist who can accept and work with that.  

Poem number 2

I Could Be Just Fine If You'd Let Me

(Style of Tanka)

Judging eyes pierce me.

Unspoken words stifle me.

It's my choice not yours!

Shrinking brings pain that rivals not

The grief your doubt in me breeds.

I'm Okay

I really am okay.  I know I have my moments of venting and to most people my logic sounds false and that I lie to myself to justify living the way I want to live.  I get that.  But I am fine.  I'm not hurting myself.  You, my doctor, my psychologist, psychiatrist, nutritionist, and neurologist could not tell me that anything was physically wrong with me.  I have self destructive behaviors that can lead to health issues and complications later, but I'll work on those.  But right now I'm fine.

I don't even fit into the diagnostic criteria for having an ED.  I restrict more than many and have a bit of an unrealistic view of myself and goal for weight.  All of which falls in a completely healthy range even though the lower part.  I'm fine.  I eat, enough.  I avoid situations in which I will purge.  I've cut down those instances a lot.

Just please don't worry about me.  Several people have made comments about me getting really thin and the fact is that I'm not that thin.  I'm 107 thanks to the trip to I and it is mainly all on my hips and butt.  I hide those so you don't see them, but trust me I have the ten pounds to lose there.

And I will lose them by any means necessary.  End of story.  Ten more pounds and then I'll be good (relatively speaking of course.)  Ten more pounds and I can focus on something other than work and weight for a while.  Have a social life even.  :)

Point is, I'm okay!  

My first peom in the style Terza rima :)

Returning Hollow Back

She sits numb with head turned and lips sealed tightly,

Lamenting eyes guilt the fork to do its work, 

Bites untasted and swallowed with agony.  

Explosion of feelings as the void is gone,

Intense emotions send sanity to her knees

Fiercely all is purged returning hollow back.

All is well again... until the day it"s not...

MM 5/10/11

The world revolves around food...

Showers, happy hours, birthday parties, regular parties, work celebrations (rewards/treats), holidays, get togethers, reunions... what do they all have in common?  Food is always the focus.  Why is it that when people get together they always need to eat?  And it's rarely ever anything that isn't horrible for you.  Or if the food's okay, you still have the dessert to deal with (normally several that you 'have just got try').  

It's like putting an alcoholic in a bar.  Nothing will ever be a bigger trigger for purging.  The best option is to eat on my own and not eat at functions but it's like a major taboo to not eat when food is provided and everyone else is eating.  

General social situations are okay.  I'm getting pretty good at just knowing my limits and not letting people who have no idea the war in my head guilt me into eating things that I know I can't handle.  Family though... that's a whole other issue entirely.  

American culture fixates on food, but my family is over the top.  Food has always been the center of family time (extended especially).  Christmas is almost a solid week of constant food being made and kept out on the table.  If we're hanging out, then we're eating.  We go out to dinner, our tab is ridiculous. I have a tendency to stick out up north with all those guys.  I'm significantly thinner than the rest of my family and I can't eat the way they do and keep my head out of the toilet.  

I love LOVE spending time with my extended fam on my dad's side.  I'm going up this weekend and am really excited.  But unfortunately that happiness and excitement will always be paired with intense anxiety over the food battles and never ending war.  

Sometimes I wonder if my parents had stayed up north after college and I had grown up there, would I be 'normal' about food?  How much did growing up in the south and in two big cities (known for pretty blondes and cheerleaders) effect who I am?  Always comes down to nature vs nurture.  One of my favorite authors made an interesting point about why she became ED and said that no doubt it was about self destruction, but she had many different options and means and for some reason she chose ED.  Obviously she didn't have the answer to why, no one does.  I find it very interesting though.  How different would things have turned out if there had been slightly different circumstances.  And think about how worse it could have been!  Starving is numbing and in large doses induces varying degrees of mania.  Purging offers releif from anxiety and crisis mode.  I could get all this from a variety of uppers and downers (legal and not).  I could have been strung out on a plethora of dangerous substances by my teens.  Still could.  I've never not had access to these things.  So looking at it that way I'm glad I have some eating issues over substance ones.  

Why did I stop eating? Part 2

Having a lot of trouble sleeping lately so time to write.  Let's see, last I left off I was 13 and in Houston...

Half way through 7th grade my mom decided that she wanted for sure to move us up to Dallas.  I can't even begin to explain the anxiety, depression, and hatred towards my mother that developed with this decision.  In my head at the time, she had always sucked as a mom and my dad had never actually had to be a dad.  And now she was moving me away from all the adults who took care of me and the friends that were like siblings that I'd had all my life.  Plus I'm not by nature any good at change, especially forced change.

The end of 7th grade and she had for sure taken a job and we moved into a rich suburban town that was the absolute opposite of the neighborhood I came from.  Well opposite might be misleading.  I was from a neighborhood that had been build the year I was born.  My parents along with tons of other parents with kids my age moved in that same year.  It was affordable starter homes for young parents.  It was very 'real' and not snobby and laid back.  My new home... full of 6 figure millionaires.  Tons of snobs and people who spent a lot of time and money on appearing well off whether they were or not.

I went from acceptance for who you were to a middle school that defined you by what you wore, where you lived, what your parents drove, and of course what you looked like.  Well surprise surprise that depression, anxiety, hatred of parents, shallow and judgemental environment, and no control over ones life would feed into ED.  In truth I don't remember much of the year 13.  I was so deeply sad all the time that what I remember is hazy.  I remember getting my period for the first time, La Femme Nikita, discovering AOL chat, and trying very hard not to make friends because I already had wonderful friends that didn't need to be replaced.  I remember being very miserable and making it a mission to make my mother just as miserable.  World War III had erupted.

I often feel guilt for my sister because she also doesn't remember this time well but I think more out of the fact that it traumatized her.  Life under our roof was not fun or healthy for anybody.  I don't remember eating much at all and since I can recall exact instances of eating foods since about age 5 that says to me that I just plain wasn't eating much.  I don't even think it was conscious.  I was just simply too depressed to do anything but sleep, watch Nikita, listen to music, and wish I was dead.

This was the first time that I planned suicide.  I had thought about dying and killing myself for as long as I can remember.  It's not much more unique to my personality than being dramatic or athletic.  I was sad and wished I wasn't around.  13 though was the year I almost slit my wrists in the bath.  So cliche I know.  Part of the reason I stopped after the first cut.  The others were as follows, I decided my mother wouldn't win (because she might as well have been the anitchrist), I didn't want my 8 year old sister to find me in a tub full of my own blood, and I wasn't crazy about EMS strangers dragging my naked dead body away.  Later I would add the fact that if you try and fail then you're labeled crazy and decrease your chances of getting away with it in the future.

I did make friends despite my wall, however.  Two of them best friends of mine to this day.  By my freshman year (14) I actually had a core group of friends and started adjusting to the fact that no matter how miserable I might make my mother, we were not moving back and 18 was a long ways away.  Freshman year I started restricting again.  Probably the only year you might have been able to classify me as anorexic if you ignored that fact that I never was rid of my period.  In an effort to make peace, my mom started sending me to H town to visit.  Keeping an open connection to my roots made me more inspired to make a life in the big D so that I had updates and an image to share when I got back.  Reenter the fantasy of dropping 30 punds by the next visit to finish the transformation.  I remember almost thinking I was thin enough that year.  That and platform shoes.  Man did I love platform shoes.

Spring Break was awesome that year.  I didn't know then how important that long weekend in Galveston would be to my memories.  I remember every detail.  The clothes I bought for the trip or chose to pack to show off the new me I was suppose to be.  The solo walk in both airports and pulling up to the G's house and surprising CG who didn't know I was coming.  The alone bonding time with F upon arrival since she had an off period.  All the preparations for our quick trip into Galveston to the beach condo.  Driving with the girls and listening to Sublime and hanging out at the pool and beach. And the severe relapse in depression when I got home.

I don't think I must have gotten over it by the end of the year because I don't have many memories outside of that fateful graduation weekend.  It was a weekend with my dad and we had told everyone that we would meet the extended fam in KC for the weekend.  Then we decided not to go but my dad being eternally irresponsible didn't tell anyone.  He didn't want to hear it from his family so he didn't answer their calls and since he didn't ever want to hear from my mom he didn't answer hers either... until call 50ish.

I knew a battle was coming so I retreated into my room the second I heard my mom on the other line screaming at him that everyone had been looking for us and that she had even called highway patrol to search for wreckage.  I remember aside from his initial yelled response about over reacting that he never rose his voice again and yet hadn't hung up on her and that he stayed on the line and didn't come into my room for about twenty minutes.  Then he came in, sat down next to me not meeting my eyes.  I've never felt the level of dread and internal knowledge that something horrible had happened like I did right then (and to this day if my mom calls me several times in a row I assume the worst).

He simply said this, "Well... it's never easy to hear this type of news.  F died this morning in a car accident coming back into Houston from Galveston for P's graduation."  I sat for 30 seconds, stood up, walked into my bathroom, shut/locked the door, turned on the sink, climbed into the tub and sat there for who knows how long.  I'm not sure I even cried.  The only person close to me who had died was my dad's mom and it was sudden and she died young at 58.  I know I felt cheated and abandoned and I know that I shut out the whole thing.  I have no memories of that time and I was almost 9.

The day F died though, I shut off.  I didn't want to talk to anyone and I wasn't interested in being close to anyone emotionally.  We went to the funeral (it was horribly southern babtist) and all about celebrating her life and not mourning her loss and in my head I thought "F you, all of you.  She was 16."  I didn't talk about it to anyone and I never dealt with it.  The first time I cried outside of the funeral (cuz who can't cry at a SB funeral?) was when seventh heaven aired their episode where Lucy finds out her friend's sister has died on her way to pick her up against parent permission.  It took seeing familiar pain for me to express mine and then that was over within an hour.

I guess it's definitely a peice of why food and weight obsession intensified during this time.  I retreated from the world more each day and into the mirror.  I didn't want anyone to bug me about anything (then I'd maybe have to deal) so I became a very good liar and actress in the year that followed.  It was also the building blocks of many other self destructive behaviors I would have love affairs with both short and long term through out the next decade plus.