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.

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.