Back to Scale: Taking My Power Back From The Number

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I’ve always been pretty weird about the number. In fact, I would prefer to reveal my number of sexual partners, number of dollars in the bank, number of speeding tickets, number of times I’ve held my head in shame and sobbed- yup just about any other number than that number with you. I’m talking about the number on the scale.

My relationship with this number has been horribly distorted for as long as I can remember recognizing what a scale was. The development of my eating disorder in high school went unnoticed for years, hence for years I was able to live and breathe for the number. I was able to check that number multiple times throughout the day. That number dictated my happiness. It went down? Success! It went up? Complete disgust with myself.

They say it always gets worse before it gets better. This is sure how it was with my relationship with that number. My eating disorder became increasingly worse during my time in college, and then one day, at the beckoning of my mother, I found myself in the office of a therapist, attempting to explain my worship for the deity that we call the scale (read: that number). I spent the next few years in and out of treatment. The battle then shifted to letting go of the number. And it was not a battle that I took on easily. In fact, I resisted picking up my sword and fighting for a good long while. I protected my number with everything I had. I refused to get on the scale at the dietician’s office. I found tricky ways to deceive the doctors when they did get me on the scale. That number proved pretty tricky to let go of after all.

And to an extent, the number was everything—ultimately determining whether or not I could come back to college at some points, at other points determining if my parents were speaking to me. Other times, it seemed to dictate how many friends I had, with a direct correlation to “friends lost.” More importantly, it dictated my ability to think straight, my energy level, and the very life in my eyes. Some days, the number was 99.9% of my thoughts. Some days it felt like a demonic force, like something that was constantly hunched over me, a darkness that I would never shake, that number.

After years of the abovementioned struggle, years of the back and forth, years of holding on tooth and nail to that number, I took a leap of faith out of what I can only look back on as sheer desperation mixed with complete ambivilance. I chose recovery. I chose it day by day. Minute by minute at first. And what was one of the most significant pieces of this choice? You guessed it! Letting go of that number. It started with the suggestion that so many doctors, dieticians, and therapists had been pushing- I agreed to be weighed “back to scale” (This means exactly what it sounds like- you simply stand with your back to the scale, thereby giving up your choice to see that number). It was terrifying. It also made me strangely angry at first. What right does this nurse have to know that number if I cant? But over time I began to experience a sigh of relief. A loosening of the claw grip of that number. It didn’t happen overnight. It didn’t happen over a few months. But slowly and surely, I began to realize that when I didn’t actually know what I weighed, I could breath. I had freedom from that number. I started asking doctors to refrain from telling me my weight, even when I went for a check-up. I started trusting the fit of my clothing, and (gasp) the mirror a little more. And you know what? It worked. Choosing to forgo knowledge about that number allowed me the breathing room to actually begin to focus on my own recovery, and all the things that I was avoiding by constantly obsessing about my weight and body. It allowed me to see that my eating disorder wasn’t actually about numbers at all. Acknowledging, understanding, and accepting this was ultimately one of the most important pieces of my recovery process.

Don’t get me wrong. This has been something that I have had to work really hard on. I have had to hold myself responsible when I am in other people’s bathrooms or around random scales. I have had to make a promise to myself not to step on those scales because here’s the thing: That number? It means nothing. Absolutely nothing. But for whatever reason, my brain uses it wrong. It uses it against me. So I choose not to know it. I have had people tell me that I am giving the number power by avoiding it. Maybe some day I will move towards taking back that power altogether, to seeing the number and not caring at all. But for now, I am working on simply protecting myself. This means continuing to weigh back to scale when I have to, and not weighing myself when I don’t have to! Works for me. As long as I am actively rejecting my obsession with that number, as long as I am working towards being happy and healthy, then I am moving in the right direction. And any direction where that number is null, and my happiness comes first is a direction that I want to be headed in.

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Not That Size Anymore

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I recently came up upon a journal entry from several years past, which I wrote when I was going through some of the earliest phases of my recovery from my eating disorder. For one reason or another, I decided to read it. At first, it felt like this may have been a mistake. The feelings, so dormant, came flooding back in a surprisingly (and alarmingly) intense way. But instead of running from them (hello, old patterns of behavior in anorexia) I decided to sit with them and learn from this entry.

 

I’m glad I did. You see, this particular entry was written when I was going through the weight restoration phase of my recovery process. One of the darkest, most difficult times for me, hence I don’t care to reflect on it often. My body and mind felt out of control, and I felt desperate for the world to slow down and stop changing so quickly, to just hold on and give me one second to catch up, to get myself together already.

 

“I went jean shopping today. That was fun. No wonder I’ve been avoiding it for so long. Everything. Looked. Disgusting. What is happening to me? I must have taken 10 pairs into that dressing room. Five pairs of my old size. Five pairs of what I guessed my new size would be. None of them fit. Major breakdown. I literally sat there and cried for 20 minutes. I knew I shouldn’t have gone alone. But who would I even want there for that? Too embarrassing. I’m supposed to be “getting better.” I guess it’s time to suck it up and face reality. I’m not that size anymore. I’m not even in that bracket or whatever. God this is hard.”

 

Reading this may not be hard for you, but it literally took my breath away. Once you have some solid distance from your eating disorder, it is easy to forget what it is like to reside in this particular acre of hell. This girl, the girl writing the jeans entry- she seems so angry. So broken. So alone. So-confused. Confused being the most important point, I think. I was not able to think straight at that time. My body and my mind were fighting a battle, and were working hard to heal much damage that had occurred. I remember feeling hopeless and downtrodden, as if the fact that I didn’t fit into those jeans meant that I was no longer special, or that on some level, people wouldn’t love me as much anymore.

 

There is one sentence in this entry that truly catches my ear: “I’m not that size anymore.” This, to me, speaks volumes about my confusion and headspace at the time. Because now, years later, with a well-nourished body, and a mind that has been working towards emotional growth and healing for so long, I am able to see- I was not that size because I was not a size. I am not a size. Let me repeat that because it is just that important- I am not a size. I am not my jean size, I am not my shirt size, I am not my weight, I am not my height. I am not a number. Clothing fits me, not the other way around. If the size of the jeans that I wear happens to change, so be it. And this is a long-term lesson that will apply for the duration of my life (not just during the weight-restoration phase of an eating disorder). My body is dynamic and ever changing. The number will morph throughout the years. If I become pregnant, my body will change, and the number on the clothing will change with it. When the shape of my body changes as I mature into middle age and older adulthood, I am assuming the number will ebb and flow right there along with it. This is more than ok. This is natural. The important part is that I am able to see that I am me, regardless of the number/s.

 

As you can see from my journal entry, this is easier said than done when you are in the earlier phases of recovery. If your own recovery involves weight change, the best advice that I can give is this:

 

  1. Be gentle with yourself. Remind yourself that your body is changing because you are choosing to beat this eating disorder. Give yourself permission to dislike these changes, but never stop reminding yourself that you are working towards eventual body acceptance and love.
  2. Wear clothing that makes you feel comfortable. Before weight is distributed, it tends to settle in our core, because this is where it is most essential for survival. If this is making you feel self-conscious, go out and buy a few flowy tops. These won’t take away the discomfort, but they will not continuously draw your attention to this zone throughout the day like a tight top will.
  3. Try not to buy new pants and shirts until you are finished the process of weight restoration. Wear stretchy comfortable clothing in the interim.
  4. Throw out/ donate the clothes that you wore when you were in your eating disorder. Trust me on this one.
  5. Recognize the distortion. Understand that while you may notice every bit of weight gain, the reality is others around you do not see what you see. Remind yourself of this daily.

 

 

One of my favorite quotes of all time is, “Never run back to what broke you.” I think this applies so well to this part of recovery. It will be hard. It will feel impossible at times. Keep going. Turning back wont speed up the process. Above all else, be kind to yourself. As I said before, give yourself permission to mourn your old body. But only for a moment. Then turn around, toss those old jeans into the trash, throw on your new pair, and tell yourself, “These are size LLA (living life again).”

-C

 

 

 

*Please note: This entry pertains to one subset of the population of individuals in recovery from an eating disorder (i.e. those who require weight restoration). This is not meant to invalidate the seriousness of all other subsets of the eating disordered population. Medical complications and chronacity of illnesses are shown to be positively correlated with all eating disorder diagnoses, hence there is no one type of eating disorder that is “more serious” than another.

The Myth of Partial Recovery

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Recovery. Full recovery. Partial recovery. Recovered. Recovering. There is a plethora of phrases that individuals use to describe their experiences of recovering from an eating disorder. There is no definite consensus about what “recovery” versus “recovered” means, even in the medical community (and yes I work in an inpatient treatment setting, so I have the inside scoop folks). Eating disorders are fundamentally different from other behavioral disorders in which people invoke the term recovery towards (such as addiction). Recovery is not black or white. Not even a little bit. It’s every shade of grey that exists on the color spectrum, which means it can be tricky to place yourself on the “recovery continuum” throughout your own journey. While I do not believe it is particularly helpful to get too caught up in the minutia of “Am I in recovery?” versus “Am I recovered yet?” there is one particular phenomenon that I do want to advocate with all my power against- the idea of partial recovery, and more specifically settling for partial recovery. It’s not uncommon for people aiming to recover from an eating disorder to reach a point in their process in which they decide, “This is as good as it is going to get.” I myself have experienced this thought during my recovery journey, and I hear the same thought voiced over and over from the warriors that I now work with. It gets me to thinking- in some sense, when we get comfortable with this thought, we are seeking the “best of both worlds.” That is, we may have challenged and successfully blocked some our most problematic behaviors and progressed from a dangerous place where life is compromised, but still be attempting to control our weight, or still have food rules. In this place, this half-world, we can hold down a job, sustain relationships, and even put up the façade of having a halfway decent relationship with food. And hey, in a diet-obsessed, thin-idealized culture, isn’t this good enough?

 

The problem is, this whole half-world is just that- a half world. It is an illusion. A smokescreen. It’s actually the worst of both worlds. Maybe your body is physically restored to your lowest safe weight. Or maybe the behaviors that invoked the loudest concern from family and friends are no longer occurring. But the fact is, your mind is still very much under siege. The eating disorder is still there, it is still taking up residence in the very depths up your soul. But it’s even more dangerous now. Why? Because it has become an even trickier, wilier bastard. It’s not screaming at you at all hours of the day and night, but it is there, whispering. It is not all consuming, but simply lurking. It tells you it is gone, leaving, on the way out, but its bags are not packed yet. Problematically, the chances are that you will be receiving less support during this time than when you were at your most severely ill.

So is partial recovery good enough?

No way José. Not if you want to get your life back. As Marya Hornbacher (author of Wasted, one of the first memoirs about eating disorders) put it, “That’s the common denominator among people I know who have recovered. They chose recovery, and they worked like hell for it, and they didn’t give up.” If your life is still ruled by diets, if your mind is still consumed with constant anxiety around food, you’re not recovered. Even if such and such BMI is reached. Because all of these are indications that your mind is still malnourished, and needs more time and effort in order to fully heal.

As I previously stated, eating disorders are wily. They will hang around and dawdle and drag their feet, and ultimately will sneak back in if the door is left ajar. And that is, in essence, what partial recovery is. It is never giving yourself the chance to be fully free. It is trying to swim to the river bank without letting go of the log that your are drifting on in the middle of the river. It is stopping short, just before the finish line. Just imagine, for a second, what lies beyond. It is hard, but not impossible. Keep pushing forward, don’t stop, and strive to live the life that you deserve!

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-C

Recovery Puppies: The Healing Power of Dogs

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I open the door after a long day of work and peer into my apartment. It is dark and quiet. One might even call it gloomy to come home to after a tiresome day. I sigh and throw my keys onto the table. What a lonely feeling. Except- I flick on the lights and-wait for it- there is the faintest sound of jingling from the next room. Then he appears. Or more aptly, he all out sprints towards me, a ball of warm fluff and legs and happiness. He barrels into me and just about knocks me over, and begins the daily ritual of attempting to lick me from head to toe. No, I am not talking about a boyfriend or a husband (are you relieved?) I am talking about my dog Ollie.

 

Dogs are good for the soul. I maintain that they can be one of the most healing pieces of recovery. In essence, they are better than human beings for a few key reasons. For one thing, they don’t care about appearance. Weight, bed head, zits- whatever you are feeling insecure about, you can rest easy that your dog truly, truly doesn’t care about any of it. They will love you the same whether you roll out of bed and spend the day in old sweats or dress up in your highest stilettos and get a professional blowout. It doesn’t matter to them. Additionally- they don’t care about your standards of perfection. In fact they will probably challenge them daily, without tying to or realizing this. For example, when I got Ollie, I had to, shall we say, let go, of my obsessional need for a pristine white bedspread that you could bounce a dime off of in the morning. Ollie didn’t care about my compulsion to keep my bed wrinkle/stain-free. He proved this very well when he would take running leaps onto the bed, complete with hysterical digging/thrashing around, seconds after I finished making it each day. Thirdly, dogs are one of the greatest examples of vulnerability that human begins can take on. They will likely pass away before us, yet we willingly jump into relationships with them and make them our family members anyway. Most of us dog owners are fiercely devoted to our buddies, and develop an intense love and protectiveness for them that rivals that for our children/spouses. The same can be said of how our dogs feel about us. They love us. And I mean love us, love us. Love in the most unbridled sense of the word. They gaze at us adoringly, follow us from room to room, cuddle up in our laps long after they are far too big to do so, all because they just think we are the greatest thing since sliced bread. They are also great at showing us what unconditional positive regard really means. They don’t hold grudges. Ever stepped on your dog’s tail? Ollie will let out a little yelp and then turn around and start voraciously licking me as I start to apologize as if to say, “I get it, you didn’t mean to!” Finally, they teach us about what it means to have an open heart. I often watch Ollie with other dogs and even with other humans. He approaches everyone in exactly the same way- extreme friendliness, enthusiasm, and the assumption that you are all-around absolutely awesome. I have thought about what the world would be like if we all approached each other with the same open mindset and extreme levels of gregariousness (*Sees person on other side of the street. Runs over to them smiling widely. Extends hand to offer hand shake then immediately pulls person in for a hug* “Hi! So nice to meet you! You look like you would be so much fun to hang out with, lets be bff’s!”)

It is for all of these reasons and more that I believe in the power of recovery dogs/puppies. Taking care of, say a puppy, can become an excellent model of how to take care of yourself. For example, your puppy will need to eat three times a day, every day. No exceptions. This mirrors how you should be treating yourself! She will also need lots of patience from you during the housebreaking and training period. You will learn patience for her, which will in turn, show you how to be patient with yourself. There will be ups and downs during her training, much like there will be ups and downs during recovery. She may make you feel hopeless some days, when she has four accidents in a row, then other days she will have little breakthroughs that show you the sun may just be peeking through the clouds. All in all, the whole experience can be extremely healing, and an excellent metaphor for recovery.

In conclusion, consider the idea of a recovery dog. We can learn a thing or two from these animals- Patience and self-love being two of the most important lessons!

 

-C

Hello 2016, Goodbye ED!

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When the ball drops on New Year’s Eve, talk of resolutions for the New Year typically abounds. And it’s no secret that weight or fitness resolutions tend to top most people’s list of resolutions, for one reason or another. I am here to advocate against these types of resolutions. Why, you might ask? Well first and foremost, these resolutions are clearly detrimental to recovery. Resolving to stick to some diet or hit up the gym daily may actually be resolving to listen to ED’s siren call. Also, appearance-related resolutions are boring and uninspired. Why resolve to do the same thing that everyone else is doing when you could march to the beat of your own drum? Additionally, these types of resolutions are personally degrading and are a set-up for failure. Don’t make your main goal for the next year of your life to alter your appearance! Resolve to pour your time and energy into something more personally fulfilling, such as a new hobby. Finally, statistically speaking, only 8% of people successfully keep New Year’s resolutions, and that number decreases when only taking into account those who make weight and fitness-related resolutions.

 

So instead of resolving to join some lame gym, try undertaking one of these goals come 12:01, 2016. Make this the year of bringing healthy habits in, and kicking ED’s butt out!

 

  1. Accept your body: That’s right. The opposite of what most people resolve. Spend some serious time trying to provide your body with exactly the type of treatment that you know it deserves. Body love too lofty of a goal? That’s fine! Simply working on being ok with the body that you were born with. Work on appreciating the functional aspects of your most precious gift, your physical being. Body love will come.
  2. Do one thing that scares you for every year that you have been alive: Are you twenty years old? Then make a resolution for 2016 that you will do twenty things that scare you before the year is up. Scared to take some time off school or work for that much-needed vacation? Do it. Shaking in your boots when you think about cutting off your hair into that pixie cut that you have always secretly adored? Go for it. 2016 will be the year of conquering those pesky fears.
  3. Find a new hobby: Studies show that one of the most protective factors for self-esteem is having a hobby that one can lose themselves in from time to time. Explore the activities or crafts that you have always wanted to try, but never have. Take up knitting, buy a coloring book, take a jazz class, ask your Dad to show you how to change the oil or fix the alternator (too much?) Find new outlets to funnel your creative energy into.
  4. Volunteer somewhere: Make 2016 the year of giving back. Apply to walk dogs at your local animal shelter. Help out at the soup kitchen down the road. See if there is a hospice program in your area that accepts volunteers. When we spend time and energy giving back to those in need, we inevitably end up receiving much, much more than we give.
  5. Less things, more gratitude: Make a rule that you will buy less material items in 2016. Why? So that you can focus on appreciating what you do have. We live in a consumerist economy, and while I am just as up for a self-care mall trip as the next girl, acquiring things rarely leads to long-term mood changes. Instead it leads us to appreciate what we have less and want more of what we don’t have. Set a goal of not buying clothes for the next three months, vow to limit your shoe shopping sprees, or promise yourself that you will not buy anymore throw pillows for the next year. Then be sure to begin noticing all the wonderful things that you already have in your life by journaling about one thing that you are grateful for each day.
  6. Challenge your appearance rules: Take one day a week off from wearing make-up. Go to the grocery store in sweats. Wear something that you love but told yourself “is for other body types.” Challenge at least ten random appearance-based rules that you have made for yourself at some point throughout the New Year.
  7. Take on five major tasks that you have been putting off: Paint that room, apply for that new job, start searching for that new apartment. Make a list of your top five tasks that you have been putting off, but that you know must be done eventually and DO THEM. Thing about how good it will feel to check each one off of the list.
  8. Reach out to more people: Do you, like most of us, constantly find yourself wishing that you reached out to old friends or family more often? Make it a goal to actually do so in 2016. Life gets busy quickly, so it’s easy to put off phone calls or tell yourself that you will write that letter later. But there is no substitute for lasting connections with those who truly touch your heart, so pencil in weekly time for reaching out. You will feel better, I promise.
  9. Take a class: Sign up for that sign language course. Take the American literature class that you have been dying to do. Pick the course that you have always wanted to take on, and sign up. Don’t think, just do. You can thank yourself come 2017 when you are a wiz in sign language (or Spanish, or English literature, or whatever).
  10. Limit your social media usage: We are a phone-obsessed culture. Instagram, facebook and twitter take up far more time than most of us would like to admit. Set a daily or weekly limit for yourself for social media usage (i.e. “I will only check social media once a day”) and then stick to it! Then find something fun to do with all of your extra time!

 

Happy New Year Warriors!

-C

Hello From the Other Side: How I Took the Leap of Faith Into Recovery (And How You Can Too)

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I am pacing back and forth in my living room. My family members sit quietly before me and sadly look on as I rant. I rant on and on and get louder as each second ticks by, becoming more vitriolic and more combative each moment. “What don’t you get?” I scream to no one in particular. “Why are you doing this to me? You are all over reacting. Stop projecting your own shit on to me!” I glance, wild-eyed from from my sister, to my brother, and then to my parents, all of whom are still silent. I pause, then continue on in my nonsensical solilique. “Why are you doing this to me!? Who do you think you are anyway?! There’s no way I’m going. I’m just stressed that’s all. I’m just overworked. I’ve just been so busy ok? Just stop over reacting and I will take care of it ON MY OWN!”

 

They were not, of course, over reacting. (As evidenced by the fact that I was the one shrieking like a damn hyeina, whilst they all sat sadly but calmly around me repeating what the counselors had instructed them to repeat. “We love you. We are scared. We don’t want to lose you. We want you to get help.”) It was 2008, and my eating disorder had hit an all-time peak in terms of intensity. They had a right to be scared. Not only was I in terrible physical condition, but my entire personality had changed. I had lost friendships, my grades had slipped, my emotions were muted. I was a shell of their former daughter and sister. They were, as they very well should have been, terrified. All logic would suggest that I would have been terrified too right? I mean I was, in essence struggling with an illness that was literally eating me alive. I wasn’t though. I was furious. You see, my eating disorder was my very best friend at this point. It was my coping tool, it was my reassurance, and though I knew deep down that it was driving me insane, I felt much more strongly on another level that it was keeping me sane.

 

And herein lies the conundrum that eating disorder sufferors face. A push-pull tug of war, mental volleyball game in your own head that spans throughout each day. You know in your soul that you are sick. So sick. Something deep inside you might even be scared. But you are also more scared of letting it go. Letting go of the eating disorder, of the smooth and silent easy calm that counting calories and pouring all of your energy into the number on the scale gives you- letting go of this would mean-what? Chaos? Complete lack of control? Unstoppable weight gain? Outrageous personality changes? Nu uh. Too scary. (Scarier than death? Yes scarier than death).

 

So you decide (Read: I was forced) to listen to your family and friends, and get yourself some much needed help. You are submerged into therapy. Psychologists are encouraging you to kick ED out. Dieticians are telling you that food is fuel. Suddenly you begin to feel guilty when you eat and when you don’t eat! What the hell? When it was just you and the ED at least the guilt only happened when you ate! Now it feels like a lose-lose. And here, is where the giant leap of faith comes in my friends. When you are uncomfortable, sad, angry, terrified, physically in pain, guilty if you eat, guilty if you don’t, and yet you still make an active choice to continue on. A choice to listen to the professionals, and those who have recovered before you, who are telling you that this will all be worth it. A choice to keep going even though every fiber in your being says go back. A choice to believe that there is life on the other side, a choice to believe that you can make it to that life, and finally, a choice to believe that you are worth that life.

 

There is nothing in my life that I am more proud of than the fact that I made that choice. I wasn’t ready. I didn’t even know if I wanted recovery. But I had hit rock bottom so many times, both physically and mentally, and something clicked in me that my next rock bottom could be death. So I stopped clinging to the eating disorder, and became somewhat ambivilant. “I could try it?” I thought to myself. “I know the eating disorder is here if I don’t like it.” Turns out this shift was all that was required for this leap (well that and a hell of a lot of hard work and courage down the line). I took the ambivilance and trudged forward. I started out crawling. Then slowing I began walking. Cautiously, then all at once I found myself running, running towards freedom, running towards happiness, finally running with recovery, not from it.

 

So now I can finally say, I understand what the others were trying to explain when they said that recovery will be beautiful. The joy on the other side is indescribable. I know it’s hard to believe. I know you’re thinking that it can happen for others but not for you. I thought the same and I took the leap anyway. Now it’s your turn.

-C

Hold the Appearance Comments Please

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When I was a little girl, I liked to watch my mother do her makeup. I absolutely adored observing the process of when she would take one wand after the other, lengthening her eyelashes and making her cheeks rosy. I would hop onto one foot, then the other shouting, “When will it be my turn!?” I was (not so patiently) awaiting the time when I would be allowed to apply, blend, and transform my entire face with these beautiful pastes and paints. To me, wearing make-up was akin to being pretty. And being pretty was my absolute highest aspiration.

I have always had a strong interest in aesthetics. My mood can be highly dependent on how pleasing my environment is to the eye. I adore beauty in a multitude of forms, from the simplicity and calming effect of an organized room, to vibrant sunsets, to freshly painted nails, to the grandeur of Monet piece, to gorgeous outfits, and yes, to watching my mother (and years later myself) transform her face with makeup. Caring about the appearance of my surroundings and myself has always felt like a natural tendency, albeit one that I have sometimes taken too far.

I absolutely ached to change my appearance during those years when I watched my mother put on makeup. I felt plain and subpar on the looks front as a kid. As I hit puberty, I remember feeling as if I had too much hair, too much excess skin, too much oil- I was altogether too much and not enough at the same time. At the same point this was going on, I was developing a strong need for attention (coupled with a painfully introverted personality, and low self-esteem. You can already smell the problems that were about to arise can’t ya). I wanted attention. I NEEDED it. I felt as if there was no good way to get it, until high school hit. TA-DA! Just like that, I was allowed to wear make-up. I was allowed to shave. I was allowed to pluck. Suddenly a great deal of time and effort was being funneled into the appearance category for me. And because I NEEDED the aforementioned attention, this all quickly escalated. Skirts got shorter, make-up got more pronounced, bras became less functional and more, ehem, deceptive. And guess what? All of this effort paid off. Sort of. Most of the attention I got became focused on my looks. Whether it was my mom or my sister complimenting my outfit of the day, a friend at school asking if I had lost weight, or a boy I was interested in telling me my new V-neck made me look “sexy as hell,” appearance became the cheap and easy way to get my attention needs filled and self-esteem boosted (momentarily of course). I LIVED for the moment a friend would say, “You look so cute!” I got high off of a stranger asking, “How do you stay so thin?” And every time a boy told me I was beautiful, I silently gave myself permission to feel proud for a moment, a respite from the constant barrage of negative self-talk and self-hate that I was participating in on a daily basis.

The problem is, I am not unique. What is the first comment most people make when they meet a friend’s little girl? “Oh she’s beautiful!” Think about when you were a little girl. Did most of the compliments that you received have to do with your intellect, your ability to follow directions, your assertiveness or your leadership skills? More likely than not, this was not the case. Instead, most little girls receive a message from very early on that “pretty” and “beautiful” are very important roles, and a party that we are not all inherently invited to. Telling girls that they are beautiful from an early age, while complimenting boys on other, more static personality attributes, leads little girls to over-identify with their appearance quickly. They begin to think that their looks are what make them special. Here is where it gets really problematic- once you begin to put all of your eggs into the appearance basket, it is all-too easy to lose sight of the shore, to hold on to “pretty,” enhance, it, and ultimately begin to strive for perfection in this attention-grabbing arena. Another issue here? Pretty fades. Even if you do happen to hit the genetic lottery, appearance changes. Beauty fades. Aging continues on despite our best efforts. So the dilemma is, the basket that all of these little girls at putting their eggs into is a shaky one, and one that will ultimately dwindle away over time. Appearance is not a core part of our souls, so basing the majority of self-esteem on this variable leaves us vulnerable to long-term self-doubt and insecurity.

It is highly important that we begin praising girls for their other accomplishments and values. Mothers, fathers, teachers, family members, and friends should stay away from comments about physical appearance in general. If you do feel the need to compliment a physical attribute on another female, especially a little girl, make sure to couple it with another compliment on something that actually lasts (i.e. intelligence, motivation, dependability, humor. The list is really endless, so endless, in fact, that it highlights how ridiculous it is that the main compliment that little girls receive, by far, is about their looks).

So here is my main message to girls, young and old alike: Don’t allow others to assign your value to your appearance, weight or body type. Make sure you are cultivating and nurturing the “other baskets” that you have, and rally against the cultural stereotype that females are primarily meant to be prized for their aesthetic value. In fact, the next time someone tells you that you are pretty, make sure to respond with “And damn am I smart/clever/witty/etc. too!”

-C

An Open Letter To Insurance Companies

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Dear Insurance Companies,

 

It has become increasingly apparent that there are some significant injustices when it comes to treatment coverage for individuals suffering from eating disorders. Though eating disorders have the highest mortality rate of any mental illness, a mortality rate that actually rivals that of some cancers, many of you, the insurance companies, have policies that specifically exclude reimbursement for eating disorders. As someone who has had to obtain treatment for my own eating disorder, and now years later, is working as a professional in an inpatient eating disorders treatment facility, I feel that I can offer a unique and multifaceted view on this managed care issue. Here are some of the main problems that I have noticed with the way that you deal with eating disorder coverage:

  1. All too often, you provide very low caps, particularly on inpatient days. In fact, the number of inpatient days provided is often so shockingly low that it leaves me wondering if you have been educated as to what the purpose of an inpatient facility even is? What do you expect us, the psychologists, psychiatrists, and dieticians, to accomplish in five days? Perhaps it would be helpful for you to read through the DSM-5 and other accompanying literature, so that you may better comprehend the chronicity and stubborn nature of this illness.

 

  1. Many of you will only cover expenses that are “medically necessary” but will not rule on medical necessity until well after treatment has been initiated. Then, ridiculously, upon review it is decided that care for an eating disorder is not deemed medically necessary. Once again, this leaves me wondering if you have been provided with the proper education needed to understand the nature of eating disorders. These illnesses often include a medical and psychological component. Both are serious enough to warrant treatment.

 

  1. You tend to use weight as the defining factor in whether or not someone receives coverage. This is particularly problematic. I cannot begin to describe how much heartache this ill-thought-out notion has caused both myself in the past, and now the patients that I work with currently. For one thing, it provokes and provides fuel for the long-standing and stubborn “I am not sick enough to deserve help,” thought that plagues so many individuals with eating disorders. Secondly, it colludes with current societal ignorance that eating disorders must be accompanied by weight loss. Did you know that the vast majority of those suffering from eating disorders are not underweight? Please try to understand- you cannot tell who has an eating disorder by looking at them. Low body weight is a symptom of some (the minority) of those suffering from eating disorders. Can you now begin to see the absurdity of basing coverage on a symptom that most sufferers do not have? This would be like basing coverage for chemotherapy on headaches. Some people suffering from certain types of cancer might have headaches, but to base coverage on this transient symptom simply makes no sense

 

  1. You seem to place a hierarchy of eating disorders that is not based in fact. For example, Anorexia Nervosa is typically considered easier to obtain coverage for than Eating Disorder Not Otherwise Specified. However, a 2009 Longitudinal study by Crow et al determines that there is an increased rate of mortality for Bulimia Nervosa and Eating Disorder Not Otherwise Specified. This new study shows that this diagnosis has an elevated mortality rate similar to that of Anorexia Nervosa. I urge you to read this research, in order to better understand that coverage should not be diagnosis-specific.

 

  1. Some of your policies appear to base coverage entirely on medical necessity, with no regards to emotional or psychological symptoms. Hence even if you do take other factors (aside from weight) such as blood work into account, when these symptoms clear up, you decide to stop covering treatment. Again, this leaves me wondering if you understand the nature of eating disorders. To clear up some of your misunderstandings, I recommend that you read “The Great Starvation Experiment” for a research-based perspective on the long-lasting psychological effects of manipulating food intake and weight. Eating disorders do no “go away” once weight/blood pressure/ electrolytes have been stabilized. Please understand- pulling coverage as soon as medical symptoms have cleared leaves patients confused, and clinicians aggravated.

 

These, insurance companies, are the main problems that I have noticed thus far. Because treatment for eating disorders is so critical and can, quite literally, mean the difference between life and death, I urge you to begin to think more deeply and in a way that makes sense about coverage for these illnesses. Please hear my plea, and the pleas of sufferers, family members, friends, and clinicians all around the world. The request is quite simple. We want eating disorders to be covered by all insurance companies in the very same way that medical illnesses are. We want time and consideration placed into length of stay granted, and we want a deeper understanding about the nature of eating disorders by you, the people who are controlling the very treatment that will save our lives, and the lives of our patients.

Thank you for your time,

C

 

Dear ED

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Dear ED,

I never found any religion to embrace. Sometimes I feel sad that spirituality is not something that I have had the opportunity to incorporate into my life. I often wonder why I have been unable to find any real connection with God and organized religion. But when I really stop to think about this deeply, I realize one very important fact: I have experienced religion in my life. I worshipped at your alter for more years than I would like to admit. I devoted my life to you in ebbs and flows, as I recovered and relapsed. Each recovery felt like I was trying to outrun my own shadow. Each relapse was more severe than the last. This seemingly illogical cycle makes sense when I dissect it. If I think about you as my religion, the difficulty I had in running away is not hard to understand. After all, cutting ties with one’s own religion is no easy task. Our religions seep into our lives in uniquely multifaceted ways. Religion affects lifestyle choices, weekly routine, yes, but it also affects our conscience, inner monologue, and the way we view the world around us. Every relapse occurred with increasing intensity because I was renewing my vows to you every time. I suppose in this sense, you were my husband as well. My violent, controlling, terrifying husband. My mind-numbing, night-stealing religion. Either way you prefer to think about it, one thing is for certain: I bowed down to you and obeyed you without question for a good part of my life.

 

But somehow, I disentagled myself from your black claws. Against the odds, I found a way out of your dark rabbit hole. How did I do this, you ask? By standing up to the cloaked monster that you truly are. I told you I was divorcing you. I said that I would not be attending your services anymore. You won’t catch me kneeling with my head bowed, confessing all of my so-called-sins to you, and begging for repentance. I no longer need you to be my whipping master because I no longer believe that I need to be punished.

 

Walking away was excruciating. I have never had a more difficult experience than when I had to extricate myself from your arms completely and leave you in the dust like a bad memory. “Why can’t it be simple” I thought to myself? “Why can’t I slip out quietly in the night, never to look back?” For so many years, I struggled to leave you, but continued to feel your breath on the nape of my neck. I could still hear your whispers from time to time, and imagine your sneer as I tried my damnest to outrun you. Like I told you, sometimes it felt like trying to outrun my own  shadow.

 

I guess, looking back, the trick really was repeated effort, repeated kicking you back when you kicked me down. Dogged effort to bring you down and expose you for the monster that you truly are. We struggled and fought one other for so many years, and at one point you even tried to call a truce. You said, “Look. You put in the work. Your body is no longer weak. Your family is no longer worried. I promise I won’t infiltrate your entire life again. Just let me hang out with you from time to time. Just visit me at night. Just come to the alter on weekends.” Thank goodness I didn’t listen. Because I knew, I know, that there is no halfway with you. We are an all or nothing deal ED, and though it felt a bit unnerving to finally stand up, un-cup your hands from my ear, walk away from the alter, and close the door on you completely, I know that it absolutely and 100% must be this way. No hang out sessions. Not alter visits on weekends. Nothing. You added nothing to my life. You only stole from it. So from here on out, you are no longer allowed anywhere in it. Hear me. Listen to me. Because I’m the captain now ED, not you.

 

So ED, My ex-husband. My lost religion. My white flag is down. My black flag with skull and bones is up. Don’t even consider coming any closer. We are done. And I win.

 

Love,

 

Your ex-devotee- C

 

Trick or Treat? Surviving and Thriving in Your Recovery During the Holidays

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Holidays and celebrations can pose some significant and specific challenge to those of us in treatment or recovery from an eating disorder. Let’s face it- nearly every holiday has some sort of a core basis around food. Christmas, Hanukah, Thanksgiving, and even the Fourth of July have traditional foods that are as integral to each day as the presents and the ceremonies. Halloween is no exception. In fact, the emphasis is on candy, which can be especially challenging.

 
Awareness and planning is vital to staying strong and focused in your recovery during any holiday. Planning ahead, practicing, and seeking out support can make the difference between an enjoyable day and a potential relapse. Hence it is absolutely vital to develop a very specific, detailed plan for managing any and all stressors that may occur throughout the day. This may involve pre-identifying triggers or triggering situations that may occur. Write them down, and then write down how you will ideally handle the situation in a recovery-focused manner. Also be sure to write down triggering thoughts that you may have- then be sure to write down challenging statements to those thoughts. The more specific you are in this journaling process, the more likely it is that you will be better prepared to defend against these irrational thoughts on the actual day.

 
Make sure to only say “yes’ to gatherings or events that you feel confident in attending. Also, if it helps, RSVP with a time limit. For example, say, “Thank for inviting me. I can make it from 4:00-8:00.” This will take some of the pressure off, because it provides firm boundaries, and an opportunity to leave if the anxiety becomes overwhelming.
Write down your favorite coping skills on a notecard (or in your cell phone) and make sure to keep them close by throughout the day. This way, you will have concrete examples to turn to should you become overwhelmed or upset. Also, write down three things that you used to enjoy about the holiday. You can use these to remind yourself of why you are trying, should you become upset or negative during the event.

 
Talk to your supports. Identify those people in your life that feel safe to turn to with struggles and let them know about your concerns. Brainstorm ways to make sure that the day goes well together. Tell them specific ways that they can support your during the event/gathering. These things are not always obvious to our loved ones, and chances are they are eager for information on how they can help in any way.

 
If you have a meal plan, make sure that you plan out how to attend the gathering/event and still make your meal plan work. Ask ahead of time about what type of food may be available. Make a commitment to yourself to follow through with your specific goals. Avoid getting into any type of “bargaining” with yourself about swapping out food. For example, during Halloween, this detrimental bargaining could manifest as “I will have some of that candy but maybe cut back on my dinner.” Chances are, if you make a commitment to hold yourself accountable ahead of time, you will be more likely to follow through.

 
Lastly, remember that the holidays are meant to be fun. Being in recovery does make them trickier to navigate, but this does not mean that they are unmanageable, or that they should not be attempted. There are many ways to make the holidays easier on yourself, so take advantage of them! And finally, remember that holidays, much like ourselves, are not meant to be perfect. People will spill drinks, burn cookies, and talk too close to your face. Family members will step on the dog’s tail, music will be played too loudly, and friends will show up late and early. Find a way to embrace the mess, in all of its perfect imperfection, and you will find yourself at peace. Because, after all, embracing imperfection is one of the most important pieces in the journey to recovery.