Monday, December 14, 2009

Throwing Yourself Down the Stairs

I've been relying on concrete data to "prove" that I'm recovery: X days without bingeing; X days without restricting. Renfrew was good about this--emphasizing hard data when we felt discouraged, but not using it as the sole benchmark of recovery. (I was particularly amused when my nutritionist whipped out a calculator to show that I had a "65% reduction in symptoms since admission" after a particularly bad night.)

That's great and all, but what is feeling like a more remarkable feat is the soft data--the times when I notice that my thoughts have actually changed. I gobbled down a candy bar this evening--not the end of the world, but it wasn't on my meal plan, and since I have a lot of dinners with friends this week at yummy restaurants, I know I'll be having my meal-plan desserts later this week. I ate the candy bar because I was hungry, and lonely, and hadn't followed my meal plan earlier in the day and was short on starch exchanges, so it was somehow "okay" because of that. Essentially, it was a mini version of the exact problem that landed me at Renfrew: restricting and bingeing.

Two months ago, the process would have been: I had a candy bar > that was wrong of me > the whole day is ruined > since the day is ruined I should go all the way and binge > binge > tomorrow I will restrict.

Tonight, it was: I had a candy bar > I haven't had dinner so was probably hungry > I'm going to have a yummy dinner that's on my meal plan > and if I'm hungry later I will have a snack. And that's exactly what I'm doing.

One of the women in my group was prone to my old-think too. She compared it to tripping while walking up the stairs, so standing up and throwing herself down the entire flight, because there was no point in continuing up the stairs anymore. We all laughed when she said that, because it sounds ridiculous in those terms--but that's exactly what so many of us are prone to. So I slipped, and it's fine. It's only a "slip" if I make it as such, anyway--a candy bar is not a binge; it's not anything that needs to be compensated for, even though it's not terribly healthy for me and I didn't plan for it. Having a candy bar sometimes when you didn't plan for it is normal. And again: I'm not a normal eater yet. But today's thought--which, incidentally, I arrived at organically, without having to force myself to think "right"--shows me that I'm getting a little bit closer.

Thursday, December 10, 2009

End of IOP

I write about my personal recovery here and use Velvet Steamroller to write about similar issues in a somewhat more sociological context. But I'll link to myself here: a post about the future of health reporting.

Personal recovery: Tonight was my last night in intensive outpatient treatment at Renfrew. I thought I would be feeling more of a jolt, either a sense of sudden isolation, or freedom, or something. But as my insurance-approved sessions slowly ran out, it sank in more and more that IOP is the beginning of treatment, not treatment in and of itself. I'll still have a nutritionist (monthly) and a therapist (weekly), plus weekly outpatient support group. Those are enormous, but in a way, they're incidental: I will not always have a nutritionist, or a therapist, or a support group. But I will always have my own resources, the tools that I've been given through the more active part of treatment.

I went into treatment not because my symptoms were so out of control (they were bad, but I've had worse and didn't seek treatment then), but because I realized I didn't know what to do to help myself. I thought I knew, but only through proper treatment did I learn that the ways I'd been trying to help myself were actually symptoms of my eating disorder. When I began to realize that, yes, I really had an eating disorder, not a lack of willpower, I looked up treatment plans and tried to do them on my own. I read that ED patients were instructed to eat every four hours, but that didn't work because I didn't know what to eat. I read about intuitive eating, but that didn't work because the barometer of my intuition was calibrated to my eating disorder, not my authentic self. I tried to avoid weight-loss information but instead started looking at the information reallyreallyfast, as though it wouldn't really do any damage that way. In short: I was unequipped to recover on my own. I needed help. And I got it.

I wish I had known earlier that eating disorders were actually treatable. Rather, I wish I'd known earlier that my eating disorder was actually treatable. I thought treatment was something that only really sick people got to have--like, if I'd messed up my heart by purging, or my bones through restricting, then I'd get to have treatment. I didn't know that what I was going through was "enough" to warrant treatment; I thought that, if I needed anything, I just needed some therapy to work on my body image and all would be well. I've read ad nauseam about eating disorders and how complex they are--how they're about control, and family, and expression, and emotion, and anger, and resistance, and, yes, the culture that tells us that our worth is in our shape. But ever since I can remember, my reaction to that has been, For them, sure. But me, I just want to lose a few pounds.

I was wrong.

Wednesday, December 9, 2009

Bikram Yoga Really, Really Sucks

There are certain things or behaviors that automatically scream DISORDERED EATING to me, even if they're not things that are actual symptoms of an ED. Like, whenever I see a woman buying nonfat Greek yogurt along with Amy's frozen meals, I'm all, I'M ONTO YOU. Now, nonfat Greek yogurt and Amy's frozen meals are healthy and enjoyable, and I don't think that the items themselves encourage disordered eating in the least. But they're the kinds of foods that are constantly endorsed by the dietitians quoted in women's magazines, because they taste like they have more calories than they actually do; plus, they're in single servings, making them appear appropriate for a whole meal, even though they're not. (I used to eat Amy's for every single meal--which I thought was healthy and I now see was anything but. I still eat them, but I have sides with them to get all my exchanges.)

Anyway. One of those things, now that I've done it, is bikram yoga. As in hot yoga. As in yoga at 105 degrees, as in sweating through all of your clothes, as in the instructor was in boxer briefs. I'd heard various things about it--mostly from people who had tried it once, found it to be torturous, and never did it again. I do plain ol' room temperature yoga and find it the perfect combination of soothing and invigorating, and saw no need to turn up the heat. When I've done yoga in warm weather, it felt good but not necessarily better.

But on Saturday, I decided to give it a try. I told myself that it was because a new yoga studio opened in my neighborhood and had a price special. I told myself it was because I wanted to try something new. I told myself that I was just sating my curiosity. But I think that I was really just feeding my ED, trying to keep it alive in little ways--pushing the rules but not breaking them.

Just as with the legions of Greek-yogurt-eaters out there, it's not like I think that everyone who does bikram yoga has an ED. At the same time, unlike Greek yogurt, I do think that the practice inherently encourages a disordered mind-set.

A) It uses artificial means to create a response that's above and beyond what a "normal" response to a healthy situation would be (that is, it uses heat to increase the post-yoga "high").
B) It makes you sweat an enormous amount, leading to a (very) temporary weight loss.
C) Most importantly: All that sweating makes you feel lighter and somehow like you've gotten rid of something. It feels like you are purging. It feels like you are purifying. And that is the whole point of bikram yoga.

"Purity" is one of those words that can mask an ED, because it seems virtuous and healthy--few people would ever comment on the amount of food I was eating when I was restricting, but I would frequently be praised for my food choices. "Eating clean," "being pure"--I hear these just as much from my fellow patients as I do eating less, and those thoughts, when vocalized, are much less likely to garner concern/frustration/disdain than visibly restricting portions across the board.

I love yoga, and its benefits have been widely documented--including its benefits for eating disorder patients. But yoga-as-practice differs from yoga-as-lifestyle, and, as in anything that is embraced as a lifestyle for its, well, style instead of for its intrinsic qualities, it becomes something that can be ranked. Yoga class trumps yoga DVD; yoga studio trumps gym-class yoga; bikram yoga trumps hatha yoga. So suddenly, simply practicing yoga isn't enough. It has to be pushed to another extreme. And that extreme, in order to have any meaning, has to be a symbol of greater health, greater purity, greater cleansing--forgetting, of course, that yoga is about balance, loss of ego, breath, and unity of the mind, body, and spirit. It becomes a competition instead of a cooperation. In becoming a lifestyle, it loses its essence and retains only ever-increasing hallmarks--more sweat, more discipline. Which is pretty much what one end of my eating disorder was all about: Instead of focusing on actual health, I focused on what signaled "health" to my ED.

So hot yoga is bad for me because I'm recovering from an eating disorder, but so are lots of things that might be perfectly healthy for others (tracking calories, taking body measurements). But I also think it's bad for the body. Not only was I extraordinarily sore the next day, but two days later I got a painful charley horse in my right thigh. I know the difference between normal postworkout soreness, or even the kind of soreness that comes after trying something new, and this kind of soreness. This was beyond what it should be--this was harmful.

So my legs ache, and only now, on Wednesday, are my shoulders feeling normal again. That's the physical damage. I'm pleased that my mental damage was minimal--in fact, if anything it may have made me more aware of the ways in which I try to trick myself, how I try to "get away" with things. Again: If I am going to recover fully, I need to not trick myself. It's easy enough to recognize my ED when it's telling me to binge or restrict; it's harder to identify it when it's leading me to hot yoga or crazy 1970s books on macrobiotics. But I recognized this as a trick, which is a start. A couple of months ago, I wouldn't have.

Sunday, December 6, 2009

Grocery Shopping, Levity, Recovery

I've always liked grocery shopping. I like going at off-hours--the piped-in music that's carefully calibrated to create a sense of well-being does exactly that to me, and when the store isn't heavily populated I can dance my way through the aisles. And I do: I shuffle off to Buffalo in frozen foods, I heel-toe my way through whole grains, I shake it in condiments. For all my food hang-ups, shopping for groceries has always brought me a sense of joy. (I once went on a date where the guy suggested we go grocery shopping together, and I was in heaven. But he smelled weird, so.)

So on my first official grocery trip of recovery, I was none too pleased to find myself panicked. The rules had changed. My assumptions about what I "could" and "couldn't" eat were in flux, so what had been a pleasant, simple routine was literally making me dizzy. What cheese should I get if it's not for a party, just for me? I "can" drink juice now--what kinds do I like? My god, the cereal aisle! I stood in front of the nuts section for a solid four minutes trying to decide if I could let go of the raw-foods dictate that only raw almonds were acceptable.

I knew that my reaction was understandable, but it was also disappointing: Was this paralysis what the future held for me? What new rules would I come up with for myself? The whole point of recovery is to make my life fuller, and because of the rules I'd come up with for myself in my normal grocery shopping, it was something I could relax into. I liked reading the backs of packages, I liked the constant back-and-forth of putting things back. It was a direct channel to expel my food anxieties; it contained them in a public manner--I'm not at home bingeing, there's nothing to be ashamed of--so it felt safe. I could relate to the world and food in a controlled environment without having to make the choice of what I was actually eating in any given moment. That's where the fear came in; that's when it wasn't enjoyable. Grocery shopping may be panic-filled for other ED sufferers; for me it was a joy.

Today was another grocery shopping expedition, the second one I've done with my newly developed list of staples.* I came to the yogurt aisle. Last week, I picked yogurt just on what sounded good, and found a new brand that had passionfruit and mango, two of my favorite fruits. I bought it without looking at the nutritional information, and only upon eating it and finding myself saying THIS IS SO GOOD out loud, alone, in my apartment, did I look--it was full-fat yogurt. I don't think I've ever had full-fat yogurt before, except as a part of a dessert (the one place I've never skimped--full-fat, real-sugar everything--which is probably why that, and nothing else, is what I would binge on). So today, I picked up that flavor again, and three other flavors of the same brand, all full-fat. And as I put them in my basket, I got this feeling in my solar plexus--light but full, a sort of content elation. It wasn't giddiness, exactly--it felt too deep to be that. It felt like a release.

The last time I felt something similar was the weekend after I broke up with an ex-boyfriend three years ago. It was a troubled relationship with a troubled person, and I'd been steeling myself for the unimaginable waves of pain that would hit once I left him. They never came. Instead: I woke up on Saturday morning at 8 a.m. without an alarm, jumped out of bed, and without putting too much though into it, started doing things that I had put off for years. I dyed my duvet cover. I scrubbed my cabinets. I took a dance class. I cooked myself a good meal. It was April, the time when New York begins to percolate with a certain kind of vibration, and for the first time in the six years since I'd been with him, I was a part of that energy. I walked through the city fully alive, fully awake. I remember it now in candy colors: the pink of spring coats in Soho, the green of the first batch of spring produce at the farmer's market. And, as in this weekend, it wasn't giddiness: It was seeing the world in the way that I'd be able to from that point on.

That feeling wore off, of course. And when it did, I was confused: Breaking up with him was the hardest thing I'd ever done in my life, and I'd thought that the floaty feeling would be my reward--it was supposed to stick, to make sure I knew every day that I was finally happy, dammit.

I'm better prepared this time around. Happiness wasn't my reward for leaving my ex; leaving him was reward enough. I still had all the troubles I'd had, including the ones that led me to get into such a crappy relationship in the first place, but I didn't have to deal with him anymore. And it's the same with the levity I had in the grocery store today. I'm glad I had it--I'm thankful for all the bursts of revelation, all the jumbled emotions I've had since beginning recovery. But that is now what I'm doing it for. I am in recovery not to have the feeling of breaking free, but to be free. I don't think I'll ever take recovery for granted, but I see that the goal is to take the actual liberation for granted.

So: I'm going to enjoy those moments. I'm going to eat the full-fat yogurt and be thankful. I'm going to waltz through the grocery store when it's called for, but I will not cling to that as proof of my recovery. Recovery will come when I have the yogurt just because it tastes good, not because of what it signifies. It hurts to type that, because food has been a signifier for my whole life, and it's hard to give that up. But what I get in exchange is worth more.

*I sat down and made a list of foods I wanted to make sure I always had around so that I'd always be able to make an appropriate meal or have a good snack without having to go to the grocery store at the last minute. I look at it on Sunday, see what I do and don't have, and then go shopping. This is probably what most people in the entire world do, but I've never managed to do it until now.

Monday, November 30, 2009

"Now It's All Ruined": Perfectionism

Art therapy has been a mild letdown until today. I have artistic impulses but little artistic skill, so I was looking forward to having a roomful of chalks and pieces of felt and watercolors and told to "run with it," with little import placed upon the final product. But more often than not, I'm left feeling confused by what I've created, or I intellectualize it.

But today, I was in a sort of haze all day--which, before I started treatment, was my default state. But in the past month, I've only rarely felt foggy or out-of-it; part of that is eating correctly, part is awareness, part is unmasked anxiety vigorously surfacing through the shroud of depression. So when we were told to create the "here and now," I wanted something muted, foggy, hazy--gray felt and olive mesh over periwinkle paper, with strips of black funneling through.

When I was explaining my piece, I used those words: muted, foggy, hazy. But the therapist noticed that letters were peeking out underneath pasted-on bits of felt, and asked me to share the words if I felt comfortable. I did: "Don't Pass Me By" (the Beatles song came to mind); "There's Luck Around Every Corner" (a tune that only came to me in-session--I'm not normally a songwriter, so it's Words and Lyrics By ED-NOS, I suppose); "just say it." I'm not sure what that means--but the obscured phrase that made my face go hot was: "Now it's all ruined."

I was referring to the piece of white paper that was covering the words. I'd intended to lightly chalk it with yellow and wound up getting it dirty--ruining it. But my reaction made me see that I meant more: the days I felt were ruined by bingeing, the "diets" I felt were ruined by me sating my hunger; the afternoons with my father that would be ruined by him exploding. One of the most hurtful things anybody has ever said to me was that I ruined his birthday. (He was a jerk and said it to be hurtful, which it was.) I am petrified of things being ruined. It's why I'm so eager to sweep personal tensions under the rug--tension might ruin the day. It's why I quit my first job and why I never gave editing a bigger chance. It's why I don't wear my prettiest dresses. It's why I follow my meal plan practically to the letter and yet still play games with myself about what I can "get away" with while doing so.

It's why I restrict or binge, and find it so difficult to do neither. A day is good or a day is ruined. I haven't considered myself a perfectionist since dropping AP history in high school--perfectionists, after all, are perfect, and I wasn't. But my non-perfect academic record and long (long!) bouts of slackerdom don't mean that I don't have perfectionistic tendencies. If anything, the slackerdom indicates the opposite: I don't want to write unless what I'm writing is good. Which makes me never want to write. This blog is freeing for that reason--I'm structuring my thoughts here, yes, but I'm not trying to let loose perfect pearls of recovery wisdom that will make the reader weep with perfectly worded recognition. I'm just sharing. It's good for me.

Friday, November 27, 2009


My stated recovery goal is to eliminate my disordered eating behaviors and develop better coping mechanisms for anxiety and depression. My ultimate recovery goal, however, goes farther and will take longer: to turn off my mental treadmill of disordered thoughts and poor body image.*

Since starting recovery, I've found that I'm hyperaware of my eating.
(Obviously, hyperawareness of my food intake is nothing new to me. And this is a far cry from the disordered hyperawareness I've engaged in before...mostly.) Even when I'm not resisting impulses to restrict my intake, everything I eat takes on a new level of meaning. I'm having a salad for lunch, so I don't have to find an extra vegetable at dinner; I had a glass of juice midday, does that count as another fruit serving or just as a snack? There's no such thing as grazing from the potato chips bowl or having a bonbon anymore. I give myself those things as allotted exchanges or scheduled snacks, so it's not like I'm falling into good-food-bad-food thinking--but neither am I eating normally.

The whole idea of going on the meal plan was to regulate my eating behavior, which is working. But the thing is, as much as I restricted before in order to compensate for my bingeing, 70% of the time I wouldn't have been in a space where I wouldn't let myself graze from the potato chips bowl. That 70% of the time, I'd munch from the bowl at parties; would have a beer; might have an afternoon cookie. That 70% of the time, I'd at least appear normal to an observer, regardless of what I was doing for meals or at night. But now--now that I'm in treatment and feel as though everything that goes into my mouth means something, whether it means that I'm getting my protein exchanges or having carbohydrates where they still feel odd or am having one of my thrice-weekly desserts--now that observer would see me refrain in most instances. Now I don't appear normal.

I'm nervous about treating my meal plan as a diet--as another plan for me to get freaky about. My body will respond much better to a wholesome meal plan than it would to, say, my raw-foods phase (I felt great while doing raw foods, but "great" in that "I'm restricting every day and feeling TOTALLY AWESOME because of it" ersatz narcotic way, not in a truly healthful way). So at least my body is taken care of, but what about my mind?

So here comes my refrain: It took me 25 years to get to recovery; recovery will not be complete in my six weeks at Renfrew, or six weeks beyond that, or six weeks beyond that. I am hoping it won't take a lifetime--I'm hoping that I will get to a point where I'm able to eat intuitively and stop the whirring of mental calculations. But it will take time. I know that my body feels miles better, and my mind scads sharper, now that I'm nourishing myself properly. That is a victory. I think that the meal plan will eventually settle in and my vigilance will wane, if I pay as much attention to the rest of recovery as I have the meal plan. I'm ready for my thoughts to go elsewhere.

*Here's another place where finding "normal" feels impossible. It's hard to find the mythical "normal" eater, but doubly so to find an American woman with a wholly intact body image. I don't want to set a goal for myself that's unachievable; is it possible for anyone to feel only thanks for her body, no forgiveness, exceptions, or qualifiers needed?

Sunday, November 22, 2009

Why Kate Moss Doesn't Matter

One of the most remarkable surprises I've had in recovery is how little I'm thinking about my shape or weight.* My body size has preoccupied me for even longer than my eating disorder; I remember being eight years old and trying to decide between letting my stomach go au naturel (pooched out but with a slight indent at the waistline) and sucking in my stomach (flatter stomach but with no waistline). There have been periods of my life where I have thought about my body fat every single waking minute of the day.

Logically, I'm not surprised. I know that eating disorders are about control, not about losing weight or even about food. So in recovery, my thoughts are certainly food-oriented--but instead of thinking about food I want to eat and will deny myself, or about food I'm going to binge on, I'm thinking about food combinations, satiety, getting my proper exchanges. I still daydream about food, but overall it's been non-disordered.

More important, though, when it is disordered I'm able to look at it and examine it. Sometimes I merely tell myself to stop; more often, though, I ask myself, Why this? Why now? Why is that image popping up now; why are those words affecting me now? In short, I'm finally able to look at the cause, not the symptom.

And that's what I like about Laura Collins's take on the Kate Moss "nothing tastes as good as skinny feels" bit. A month ago, prior to entering treatment, I would have pshawed the thought that the skinny-model phenomenon wasn't a primary cause of eating disorders. But--hello!--I have an eating disorder: I have a myopic focus on the body. Whatever anger I managed to take outward instead of inward, I targeted toward what I perceived as the problem: I wasn't skinny enough, and the reason I thought I wasn't skinny enough was because of the images I was absorbing. That anger, plus the righteous anger that comes with awareness of the double standard surrounding women's appearance, creates a laserlike focus on those images.

But those images weren't the problem, or at least weren't the locus of the problem. My desire to be thin was a symptom of my eating disorder, and my focus on those images a secondary symptom of that desire. If my true problem were merely a sheer desire to look like a model, I'd be abusing my face and hair the same way I have my body--plastic surgery, expensive hair treatments. But while I've certainly looked in the mirror and wished my teeth were more even, my pores less visible, my hair more naturally picture-perfect, it pretty much stops there. A bit of makeup, a deep conditioning, and I'm through. I treat my face much the way I imagine a non-disordered woman treats her body--wishing it were more to her liking and taking certain means to ensure that it's closer to her desires, and then directing her energies elsewhere.

This isn't to say that we shouldn't continue to object to the iron maiden of beauty presented to us. What woman in the western world hasn't looked at a cover-girl model and felt inadequate? What woman hasn't cursed her body for being too fleshy, or too flat-chested, or too short, or too wide-hipped--the standard being the image of a model who is paid to look the way she does, and that image manipulated to inhuman proportions? Every day, women feel robbed of our own brand of beauty because of these images, and I'd love to see our culture's definition of beauty expand thousandfold. As a feminist--as a woman--I'll continue to seek out those images, applaud outlets that dare to use a wider definition of beauty, do my best to avoid those who take the narrow path.

This also isn't to say that those images don't play any role in eating disorders. Besides being fantastic fodder for using symptoms, they normalize body dissatisfaction and "fat talk," making it easier for those with EDs to engage in disordered behavior without others noticing. And, of course, the desire to be model-skinny has kick-started many a diet, which creates hungry people, which leads to disordered eating, if not eating disorders. But I'm happily signing on to Ms. Collins's rant nonetheless. The woman and feminist in me cares. The eating disorder patient in me doesn't.

*This may seem contradictory to last week's Rice Meltdown, which was, on its surface, provoked by appearing to have gained weight. But given that at its core I've always been more preoccupied by calories and food than by my body weight, and that an inconsistent up-down of less than two pounds has never bothered me because I know full well that it likely has nothing to do with my actual body fat, I can now see that it was about trust, not weight. Again: Weight was a symptom, not the root problem.

Wednesday, November 18, 2009

Sitting With It

We have weekly weigh-ins at Renfrew. I'm guessing that the idea is that the staff can monitor by our weight whether we've been following the meal plan. Some women are weighed blind; I'm not one of them. Today I wish I were.

I have followed the meal plan very closely. I'm not always 100% perfect with it--but my slip-ups have been negligible. (I didn't eat enough for lunch on Saturday to pre-compensate for a big meal that night, which turned out to be not that big; I went over on exchanges a couple of times, but in the course of a normal meal, not bingeing--two starches over because I had two slices of pizza to get enough protein exchanges, for example.) And I have accepted on blind faith that my nutritionist is right: I will not gain weight with this plan, and in fact will probably lose some weight.

But this week I was up 1.5 pounds from last week. Now, I know full well that that means exactly nothing. Nothing! The clothes I was wearing, my water retention--1.5 pounds is utterly meaningless. But it still sunk me: I had been doing everything right, and I felt like my body was repaying me in fat.

I think I acted out at dinner as a result--I was supposed to eat a cup of rice and it felt like punishment. Punishment for having been fat in the first place, even though I'm not overweight by BMI standards. Punishment for every minute slip-up I've had; punishment for years of fucked-up eating that may have damaged my metabolism. Punishment for wanting to eat, punishment for being soothed by foot; punishment for having gotten to this place, even though "this place" is far, far away from where some of my fellow patients are. (I'm certainly on the healthier end of the spectrum there.) I didn't finish my meal, and the more the therapist intervened, the more upset I became. She gave me a supplement--which I think a part of me wanted (I wanted to get it, not to drink it), as a weird sort of badge of defiance. I think there was a part of me that was curious to know what would happen if I wasn't the model patient for once; if I said "fuck this" and didn't eat what I was supposed to. And doing so at Renfrew was a safe place to do that. There was support around me afterward; there was a therapist reminding me via the supplement that, yes, I really do need a cup of grains; nobody was going to either boot me out or treat me somehow "special" because I didn't eat my meal.

We talk a lot about "sitting with" a feeling. As in: You're anxious; can you just sit with that? "Sitting with" a feeling is a positive coping mechanism in and of itself, up there with reaching out for support, or going for a walk, or distracting yourself with a movie. It's not something I'm very good at. But the only way to get better at sitting with a feeling is to just do it.

So: I feel fat. Part of that is literal; I run my hands over my stomach, feel my flesh, feel my roundness, am upset. But "fat" is not a feeling--so what exactly is it I'm supposed to sit with? I feel disappointed in myself for not having exercised enough. I feel ashamed at having acted out at dinner; I feel sad and weak that a number on a scale can mean so much to me. I feel sad that I will never be as thin as I once was; I feel sad about no longer leading the life that symbolized (I was confused, but I was also having a lot of fun--everything felt new to me). I feel angry that I care about my weight; I feel angry that I'll never look a way I'll never look. I feel angry that I feel angry. I feel sad that I feel sad.

Tuesday, November 10, 2009

Light Like a Feather

Joy at What I Weigh Today has a timely (for me) post about what actually happens to your mind and body when you eat three square meals:

It has taken me eons to realize that I’d rather weigh 150 pounds and have my full energy, intellect, creativity, and concentration at my disposal than be a 125 pound version of myself so clouded by chronic imperceptible hunger that I don’t even notice how dull my mind has become.

I'm beginning those eons now. I mean, I've been trying to "come to peace" with my body all my life, no matter if I was overweight or not. But I've always framed it in solely in terms of body image, of approval and acceptance of what I look like. Trying to hold onto those brief moments when I'd catch a glimpse of myself in a mirror and like what I'd see; trying to dispel the distaste and shame that fills me when I cross my arms over my belly. At best, I'd frame my body in terms of its function: I can run several miles without stopping; I'm muscular; as a result I have an athletic heart rate and overall good health.

It has never occurred to me to think of bodily acceptance in terms of what I can gain by not being thin. It has always, always been a question of being at peace with what I thought I would lose by not being so.

I've been thin once in my adult life. I wasn't underweight, but I had the kind of body that salespeople felt free to comment on, for being "able to wear anything." (It was a very weird awakening, to find that people felt more free to comment on the body of a thin person than of an average or slightly above-average one.) I'd look in the mirror and see these little hips, these hips that weren't mine; I was constantly touching my hipbone because I'd never felt it so sharp before. I got attention from a certain kind of man I hadn't before. I liked being "able to wear anything"; I spent a lot of money on cute little dresses.

And. I was hungry. I smoked a lot and drank a lot of coffee. I went to bed hungry. I spent meals, say, ripping away any bread that wasn't necessary to hold together the sandwich. I knew I wasn't anywhere near fat, but the number of "fat days" I had decreased by maybe 10%. The "certain kind of man" I was meeting at that time was more often than not also sort of a jerk, so I was a faintheaded wreck, anxious over my love life and too hungry to have both feet on the ground. I was feeling great about running, but would come back after 3.5 miles so exhausted that I'd nearly pass out in the shower (what was I doing to my muscles?).

Okay, enough life-while-thin horror stories. The point is: It came with perks, but not one of those perks is worth its cost. I was hungry all the time. I was more motivated to "do something" with myself during that time than I'd ever been, before or since. I took writing classes; I joined writing groups. And it was impossible to concentrate during those: the anxiety, the lightheadedness, the hunger robbed that precious motivation of its rightful place in my life. It robbed me.

Fuck that shit. I'm going to have 1.5 ounces of hard cheese. NOW.

What do you do when you're hungry?

The good news is that my meal plan no longer seems like it's enormous quantities of food. My body has adjusted; I can eat a bowl of cereal with milk and a cup of berries and a piece of toast for breakfast, and then have a big salad with a half-cup of quinoa and tortilla strips and 2/3 cup beans and so on and so on.

The bad news? I'm now hungry. I think. I don't know. All of last week I was feeling stuffed--I don't think I genuinely felt hungry until Friday (I started the plan on Monday). I was so focused on the stuffed feeling that it took me a few days to realize what I wasn't feeling: irritable, lightheaded. I wasn't ever feeling that floaty high I'd feel when I was eating what I thought was right and not bingeing--I do miss that feeling, I admit--but I wasn't feeling the negative side of hunger either.

So this week I'm feeling cranky and a little lightheaded and spotty, and I don't feel that way immediately after eating. I think it is hunger--but if over- and under-eating has been masking my emotions for so long, what if I'm just actually feeling like a big ol' grouch?

"Eat something and find out which it is, hunger or true irritability," says my sensible mind.

"You should relish this meal plan until you're bumped up to a higher-calorie one," says my eating-disordered mind.

They flip a fictional coin. Last night sensible won; today the other half wins. I am following my meal plan, after all; I'm doing what I'm supposed to be doing. On Monday I will be honest with my nutritionist, and I suspect she will move me to the next meal plan--right now I'm on a "transitional" plan, which is used for people who restrict, or for people who are very short. That is: It's not supposed to be quite enough. Not yet. So: not yet.

I don't know what to do when I'm hungry--are you "supposed" to eat when you just had something that "should" have filled you up? Or are you supposed to wait? Are you supposed to eat fruit, or string cheese, or graham crackers? Are you supposed to have whatever you want? What if you don't know what you want? What if you feed yourself and you can't stop?

Sunday, November 8, 2009

Heading into week 2

Eating "so much fucking food" has gotten easier over the past week. I was incredulous--as in, I literally did not believe it--when my nutritionist said that she thought my binges were provoked in part by hunger. But already I am seeing that she was right. Certainly hunger is not the entirety of it, but it's a much larger chunk than I was able to see, in part because I WAS HUNGRY AND WASN'T THINKING CLEARLY.

I mean, I was just as likely to binge after a full meal as I was after a skimpy one. I don't think I'm triggered to binge by hunger or by a big meal; it's more complex than that. Days of not eating enough cloud one's judgment, making one more prone to not-great choices where the primary focus on one's mind--food--is concerned. (Note that the people in the oft-quoted study that re-created dietary conditions of concentration camp victims--the one that showed that they all became seriously preoccupied with thoughts of food--were given food. They just weren't given enough.) So when I'd finally get proper nourishment, instead of feeling sated, I felt somehow wronged for what I hadn't been eating--like I wanted to go on a roll, but not with healthy food. When full portions are denied, they become the forbidden. I'd heard plenty that denying yourself one food was the surest way to make sure you'd eat in in the future. And I've only rarely denied myself any particular food; I'd just deny myself enough food in general. So food in general would become my preoccupation.

At some point I hope to be more focused in this blog. For now, I'm just sort of putting my thoughts out there.

I didn't follow my meal plan this weekend as closely as I'd planned to. I decided to make pancakes on Saturday, which required a trip to the store, and then it took a long time to actually make them. More than two hours passed between waking and eating; that's too long. I was ravenous and exhausted by the time I ate (I did eat an apple, but it wasn't enough). Not eating until noon threw me off for the whole day. I got in all my portions, but questioned myself more on Saturday and Sunday than I had the rest of the week. My weektime meals tend to be pretty structured--I welcome the variety that a meal plan steers me toward, but a structure is just easier to follow. So instead of "follow meal plan," I think my goal for this week should be to "plan meals." I was telling myself I shouldn't over-plan because that's not "normal." But the fact is, I'm not a normal eater yet, and won't be for a while. Years from now, I hope to not have to plan out every meal. But for now, I need to.

That's actually a recurring theme--two, really--normality, and patience.

1) Normality: NOBODY IS FUCKING NORMAL ABOUT FOOD. I hung out with a friend on Friday night, someone I consider "normal" about food. At one point she said that a coworker brought in a bag of candy corn specifically for my friend, because the coworker knew that my friend loves candy corn. Which she does. But it was Halloween last week, so my friend had had her fill of Halloween candy and didn't want any more. In order to not hurt her coworker's feelings, she put the candy corn in a bowl between their desks, and my friend makes a show of grabbing some whenever she walks by. She then throws it away.

Now, this is "normal" in the sense that she recognizes the emotional connection to food (her coworker doing something nice for her), and "normal" in the sense that she's not eating more sweets than she would like to consume (she had had enough candy for the week and didn't want to have more). So this behavior is normal, because she's a normal eater. But it's also weird! It's just weird! Weird in general that anyone would have to put a show into taking candy corn. I get why she did it, and obviously it's not disordered eating. But for me, it would be. My boyfriend will throw a fit if there's mayo on his sandwich. That's not normal. He's totally normal about food, but not in that way. Nobody is fucking normal.

2) Patience. I don't consider myself a patient person. I'm not necessarily impatient, but during my time in therapy I would repeatedly get frustrated by how much time it took for something to sink in. Like, I'd intellectually recognize that X was a problem for me as a kid, which makes me do Y now. I'd get that. But I'd still keep doing Y. I couldn't understand why an intellectual understanding of it wouldn't just make it poof go bye-bye.

I'm glad I met with a nutritionist before jumping into the program. Because that showed me that I really don't even have an intellectual understanding of eating disorders, or at least of mine. I had no idea I was restricting to the extent that I was. I was utterly blind to that. I saw quickly and dramatically how I had to just sort of close my eyes and put myself into the hands of this program--that is, I have to do the work. And I have to put my own individual effort into it, and it has to be real effort. It will work. I don't know exactly in what ways it will work; I have no idea, realistically, how I will be in five years. But it will work in the sense that I trust that my life will be more livable because of this program. I have to do the faith fall. That means following all the rules and listening to myself while doing so. That means not brushing off my reactions as overblown or inauthentic; that means not creating food issues for myself where there are none. That means not looking at raw food diets; that means not entering my intake into calorie calculators. That means using my food diary. That means planning for meals, and planning for weekends, and not spacing out in group. That means effort, and I will do it.

Tuesday, November 3, 2009

Day One, or: The Wheat Germ Meltdown

I entered Renfrew because my binge eating felt out of my control. So I pictured my treatment plan as focusing on stress-relief techniques other than bingeing ("take a walk!" "call a friend!") and, I don't know, drawing some sort of picture of my body that would then give me a Big Happy Magic Moment when I realize that my body is just fine. The nutrition part I figured would be a snap--my meals are complete and healthy; the problem comes after 10 p.m. on nights when I'm alone.

What I didn't expect was that not only would I be put on a meal plan, but that it would be SO MUCH FUCKING FOOD. When my nutritionist began asking me about my meals, I interrupted her: "I know you haven't seen my chart [my nutritionist was switched at the last minute] so you don't know this, but mealtime isn't my problem; it's bingeing." She asked me to articulate my meals anyway, which I did, expecting gold stars for my daytime eating: six ounces nonfat yogurt with berries and two tablespoons muesli for breakfast; spinach salad with bell pepper and chicken or beans for lunch; five prunes and eleven almonds for a snack; dinner, depends. (Yes, I know that eating the same thing pretty much every day is also a sign of disordered eating. What can I say--that works for me.)

"How many calories do you think you're taking in on a given day?" she asked.

"Probably 1,600 to 2,200, depending on my dinner."

"You're not taking in anywhere near that amount." I felt--proud, tight in my solar plexus, scared. Then she began saying what I should be eating, how I can make my meals more complete: Add half a cup of muesli instead of two tablespoons. Have bread with lunch. Have a cup of rice with dinner instead of "a bit." These are all things I've purposely cut down on in order to either lose or maintain weight. The thought of having bread with lunch--not because I'm at a restaurant and the bread basket is good, not because it's homemade, not because I'm choosing a sandwich over a salad, but because bread is a part of a normal meal--fills me with panic. I thought panic would be reserved for the mythical anorexic 12-year-old I had in my mind; I'm a big girl (heh heh), I can have a goddamned piece of bread without freaking out. This is a part of my recovery; I'm signing up for this.

But I had underestimated how strong the power of restriction had become for me--how easily I'd made it a part of what I considered "normal" eating. I didn't think I'd done any restricting for years--but then, my definition of "restricting" was "not eating," not "not eating enough." I had been so focused on the enormous volume of food I had been consuming that I hadn't looked at what I hadn't been consuming.

I looked at the sheet of meal plan guidelines, looking at how I could update my breakfast. A half-cup of muesli is a lot; I could instead have...three tablespoons wheat germ? I pictured three tablespoons, saw the fullness, the richness of wheat germ--a health richness, a nutrient-filled richness, a richness I had forbidden myself more than a tablespoon of, ever, without really thinking about why.

I occasionally make breakfast bars for my boyfriend, who used to be prone to skipping "the most important meal of the day" (there's an irony in there, oui? He's not the one with an eating disorder). I pack them full of wheat germ, thinking that will help him power through the day. I usually give him the whole pan minus two bars, which stay in my freezer until I throw them out. My preteen-sized nonfat yogurt is waiting.

"You're flushing," the nutritionist said. I hadn't noticed; instead, I was noticing my shallow breath, the tears, the world seeming vivid, almost hallucinatory, my nutritionist's face coming into hyperfocus. A panicked reaction I never thought I would have--a reaction, in fact, that I'd read about in my "learn all about eating disorders so I can learn how to do it right" and both wanted and couldn't at all imagine--a reaction to three tablespoons of wheat germ.

"Does that seem like a lot?" she asked. I nodded. "It doesn't seem like a lot to me," she continued. "You have an eating disorder. You've had one for twenty-five years. This will seem hard at first, but this is what will help you know what's normal." We went through the meal plan, me recognizing that my reaction was borne of those twenty-five years--of a whole box of cereal in one sitting, of day after day of starvation, of Amy's Organic Brown Rice Bowls for breakfast, lunch, and dinner, which was during a period I thought I was being sensible.

So I'm sitting here with index cards, putting together meals that I think I can eat, enjoy, finish. I had two of those meals today. It is a lot of food--I went onto a calorie-counter website (which is probably verboten, but hell, the literature said "No diet books" so...) and by the end of the day I'll have consumed almost 2,100 calories--which, as it happens, is about my daily caloric need. It seems like a lot of food, but it is what I need. More than that, doing this--sticking with it, slogging my way through a full serving of yogurt with the goddamned wheat germ and toast--will help me figure out hunger, and need, and satiety. I won't have to have two grains, one fat, one dairy, one fruit every morning for the rest of my life. But until I know what my body needs, and until I have worked my way through my food compulsions, until I know what is actually, truly, really normal for me, this is what I have to do. I am already dreading when I have to step up to the next level of meal planning, which will be even more food. The nutritionist assured me at the beginning that this meal plan wouldn't make me gain weight, and I believed her--until I figured out what my caloric intake would be (which, duh, is probably why they don't want us reading diet literature). I will figure that out, with her aid, when I get there.

I thought the hardest part would be sitting through the nights when I wanted more than anything to black out with food. That might be the hardest part, eventually--I don't know; I haven't had that kind of night yet. But this part--the eating part--is already harder than I'd imagined.

Sunday, November 1, 2009

eve of treatment

The thing about announcing to people, even just a handful of them, that you're beginning an official program to rid yourself of an addiction, is that then they're going to expect you to live up to it. I enter the Renfrew Center's intensive outpatient program tomorrow and am nervous--scared. Nervous that all the ideas of addiction and illness are bullshit and I just lack willpower. Nervous that it's too late. Nervous that I'll walk in and it will be a bunch of anorexic 12-year-olds and me. Nervous that I'll get worse instead of better. Nervous that I'll get off the binge eating cycle and onto the restricting one. Nervous that I'll enjoy restricting if that happens. Nervous that I'm just lazy. Nervous that this will lead me to say "fuck it" and I'll eat whatever I goddamn want and will become fat. Nervous that I don't really have a problem. Nervous that I do. Nervous that my insurance will crap out. Nervous that I will be too ashamed to look anyone in the eye.

Honestly, I am a little bit petrified. But now that I am writing it out, I see that I am indeed terrified and that it's okay. It's a feeling I can handle. It's better than numbness. I hope I can remember that when feelings stronger than "a little bit petrified" begin to kick in.

I want to sit here and vow that I will give this my all. Because I have to; because it's been 25 years; because this is my chance. Because it's time. Because it could be the rest of my life like this if I don't. But I don't know if I can make that promise--I don't want to make a promise I won't be able to keep. I don't even know what "giving this my all" would mean--I've made so many halfhearted promises to myself and broken them in the light of morning. Write every day / No sugar / Spend 20 minutes cleaning my apartment every day / meditate every day / call my brother once a month / write a letter once a week. These are not impossible promises to keep, but I've broken every one. So if I were to say "I promise to give this my all," I would be lying.

What I can say: I will do my best. I will be kind to myself, while noting that "kind" does not equal permission to numb myself with food and television. I will approach this with an open mind. I will trust that this can work, but that I will have to do my part for that to happen.

Tuesday, October 20, 2009

Fat Talk Week

I love the idea behind Fat Talk Free Week (and wrote more about it here). I love how it lays out specific actions for women to take, because so often the supposedly compassionate response to "I'm so fat" is "No you're not." But that response doesn't help, because it A) assumes the position that fat is awful, B) might not be true, and someone who is genuinely fat will only feel pandered to if you tell them that they're not, C) keeps the focus on what may or may not be "wrong" with the person, and D) doesn't make anybody feel any better anyway. (The response that the sponsors suggest is to form a pact with a friend and to call them out on the pact whenever they break it.)

But the thing is, I hardly ever engage in fat talk. Even before it was a conscious feminist effort, I just felt stupid doing it--saying "Oh, I look disgusting" is an invitation for reassurance, which never helps me feel better. (It can help with momentary anxiety over something fleeting--like, being assured that my zit does not overtake my entire aura--but that's not fat talk.) I hate forcing other people to compliment me as much as I hate being forced to compliment others. Nowadays when I hear fat talk from someone, I just say, "Oh, stop that." If I'm in a situation where it makes sense to have a real conversation about body image, I'll invite that--but the people with whom I have that rapport know better than to throw around "Oh, I'm fat" in my presence.

So fat talk isn't exactly the issue for me. My words reflect someone with an intact bodily self-esteem; my thoughts do not. I'd like to be able to just do this with myself, but that makes me feel like one of Eve's three faces. I'm almost wondering if I should start saying what I say to myself out loud, to other people. Not because I want to get into the oh-you-look-fine game, but because it might help me recognize how ridiculous what I am saying is.

The larger issue is one I've come up against repeatedly: how to reconcile my feminism with my body issues. One of the big reasons I'm so vocal about being feminist is because of the body issues I've had all my life; reading about the sociology surrounding body issues and eating disorders has informed me well, from recognizing the unrealistic standards I'm held to as a woman to getting more deeply into recognizing the link between the tightening of the Iron Maiden and the emancipation of women during the second wave. I'm no longer at the point where I feel like a Bad Feminist for having body and food issues, but the fact remains that what I say ideologically is miles away from where I am with my most private thoughts and actions. I've always known that the personal is political--now I want to invert it and make the political, personal.

But you know what? A lot of bloggers are playing along and saying what they like about their bodies on their blogs. So I will too:

I love my legs--I'm probably even vain about them. They're strong and curvy, hard in the places I want them to be, soft in the places I want them to be. They help me look good in a dress; they show the world that I'm active; they bring me pleasure to look down and see strong, long calves. Even the burn I got on my right calf this spring in Vietnam, I love: I got off on the wrong side of a motorbike on my second day there and got an enormous burn, a perfect circle the size of the bottom of a pint glass. Every time I see it, I am reminded of an extraordinary time in an extraordinary place. I laughed to myself that my father and grandfather both fought in Vietnam and I'm the one who came back wounded--a joke I'd never say out loud, because certainly they were wounded in a much different way, despite the lack of physical marks. But it ties me to one of my main reasons for going there, which was them and their times of service; it's almost like a little nod toward them, and how, a generation later, I needed to have my own marks of that long, skinny, hot little county on me.

Sunday, October 4, 2009

Genes and Eating Disorders

Sunny at Healthy Girl brings up the role of genetics in eating disorders. I tend to have an irrational gut reaction against thinking that my issues could stem from a brain-wiring issue; I prefer to think that my problems stem from some sort of murky thing that happened circa 1979 or so and can be unearthed through therapy alone (which is why I was in therapy for 7 years before I quit). But it's obviously a worthy question.

One sort of offshoot question about genetics and eating disorders, though: What did people with ED genes do before eating disorders were, well, "invented"? I mean, I know that eating disorders go way back--Freud writes of patients with symptoms we now term anorexia, for example. But EDs have become a sort of handy place for people with generalized "issues" to turn. The "hysteria" epidemic of the 19th century wasn't actually an epidemic; rather, it was a way for culturally restricted women to act out in a way that, though it wasn't exactly understood by the establishment, was at least recognized. In the same way, EDs are far from understood in our culture, but we recognize them as requiring care.

It makes sense that there's a good amount of ED sufferers out there who turned to restricting or bingeing or purging not because some synapse organically told them to, but because in a culture that A) has an abundance of food and B) therefore treats food not as nutrition but as a thing of cultural and familial significance, and C) has a strict standard of beauty that requires thinness, food seemed like a pretty good way to deal with personal issues. In much the same way that hysteria became nearly a fad in the 19th century--not because it was to be aspired to, but because it was a recognizable funnel for one's social and personal issues--eating disorders can spread like wildfire in our environment.

What the studies linking genes with eating disorders are actually saying isn't exactly that there's a gene that makes you want to starve. ED sufferers are more prone to irregularities in mood-regulation hormones--the same hormones that play a role in depression and anxiety. And one way to spike a low serotonin level (linked to depression) is to eat lots of sugar (a common binge target); similarly, a way to calm a perpetually high serotonin level (linked to anxiety) is to starve it to death. But plenty of people have messed-up hormone levels--some just deal with it, others go on medication, others self-medicate through addictive substances or behaviors. Not all of those people go on to develop eating disorders.

And that's where images come into play for people who develop not just unhealthy body image, but eating disorders. When your mood regulators aren't regulating themselves and you find something that "works" for you (e.g. bingeing or restricting), you do that thing. And you have reinforcement on every billboard and magazine cover around you.

It's much more complicated than what I'm saying here, and it varies patient by patient. Few people in the ED community would argue that EDs are caused exclusively by genes, brain chemistry, family, or culture. The combustion point of all these factors (and more) is where EDs spring from. I'm just wary of jumping too heavily on the "it's genetic" bandwagon. If the "it's in the genes" theory comes to dominate ED research, it's not too far-fetched to think that ED treatment can be written from a general practitioner's prescription pad instead of from the comprehensive therapy that currently comprises ED treatment. (Which is the case with several other psychiatric and mood disorders.) And if an ED sufferer opts not to swallow a pill, then what are they complaining about? There's a "cure," after all. And then we're still left with the cultural images that tell overweight women that they're not really worthy; images that exclude an enormous proportion of beautiful people. We're left with associations with the words "thin" and "fat" that have nothing to do with being thin or being fat (like pretty, or slovenly, or loved). We're left where we are. A pill might be nice for ED patients, but it'll suck for everyone else.

Tuesday, September 29, 2009

First Post, Which Is Scattered But I've Put Off Starting This Damn Thing for Months

I’ve given myself a lot of eating disorder mythologies over the years. I’m anorexic (except I’ve never been underweight); I’m bulimic (except I only purged a handful of times); I’m orthorexic (for a grand total of the three weeks I spent on a macrobiotic diet); I’m normal (except for the starvation, occasional purging, macrobiotic diets, and ability to down 15,000 calories in a sitting, sure, yes, normal!).

It’s been nearly twenty-five years since I first dabbled in disordered eating. I’m tired of mythology. I have messed-up attitudes toward food and my body, and have binge eating disorder. I decided at the beginning of 2009 that this would be the year I dealt with "all that body stuff." That was a hopeful thought, likely the child of the "do X for a year and blog about it" body of work (say yes to everything! cook Julia Child recipes! go out on a date with everyone who asks!). It’s not something I can lick in a year, even if I’d been as diligent as I planned on January 1. It will be an ongoing project.

And this blog, a chronicle of my experiences and reflections, will be one spoke on the wheel.