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.