I logged into my Pandora account today, and while I was waiting for my songs to load, I happened to remember that today was September 1. Yesterday (being August 31), I checked my account and had something like 27 of my 40 free monthly hours remaining. I listened to a few songs as I sent some emails, but I was attacked by this momentous sense of guilt. I immediately logged off so that I wouldn't "use up" all of my free hours at the beginning of the month.

I had to laugh at the irony. I am so worried that I'll run out of something that I never use it at all.

I realized I do this with lots of things other than my Pandora account. I have a Coldstone Creamery gift card from several years ago still in my wallet. I didn't not use it just because of the ED. No, I held onto it because I never felt it was the "right time" to use it. Maybe in a week or two I would have a craving for ice cream but wouldn't have the extra cast. So I better pay for my ice cream this time, just in case.

I bought chocolates on my way home from my Europe trip to use up my few remaining Euros. I've eaten a little bit, but they're still sitting in my cupboard. Yes, some of that is ED-related, but I also haven't found the "perfect time" to eat it. This happened when I was much younger, too. I ended up throwing out a lot of my Halloween candy at Easter because I hadn't found the right moment to eat it.

When I had a lot of homework to do, I generally did the icky stuff first (assuming I could prioritize in that manner) so that I would have the easier assignments to look forward to. At dinner, I eat what's on my plate in a particular order: salad first (it's always been a "thing" of mine, eating the salad first), and then in order of least-liked to most-liked foods.

It's all the same mentality: forgo pleasure now so that you can have it later. If later always came, then perhaps that would be okay. But I always keep pushing "later" further and further back. It seems the anticipation of pleasure is actually more pleasurable than the pleasure itself. Since I've delayed for this long, I think, then I need the experience to be perfect.

(I think I would make a great Puritan.)

It's not hard to see how this would play into the AN mentality. Fantasizing about what you'll let yourself eat when you finally don't feel like a barge is more rewarding than actually eating it. And since you can always lose more weight, you can also always look forward to that meal. I'm killing myself on the treadmill now so that I won't feel so anxious later. It makes you essentially live in the future, where everything is going to be okay, perhaps even perfect. Then when the future does arrive, you find it sucks as much as the present did back then. So you redouble your efforts for that perfect future, and the cycle repeats itself, over and over and over.

I'm not going to blow through all my free hours on Pandora in the next few days just because, but it's interesting to see the patterns. To see how a way of thinking infiltrates so many different areas of my life.

I struggle with hunger cues. The major struggle is that they exist outside of the prescribed mealtimes of my meal plan. If I could only get hungry when it was convenient, that would be nice. I think I'd prefer not get hungry at all, but alas, that's not going to happen.

Last Friday, it was late and I had already eaten my evening snack. All is well until I start getting hungry again. Like really hungry. And what sounds really good to me at that time were some baked beans. I debated for quite some time about whether to eat those damn beans. I had already eaten "enough" for the day. The beans had lots of salt which means water retention (said in singsong voice). Blah blah blah. Those reasons were my anxiety talking. I was anxious about eating extra, about eating something significantly extra (I've gotten to the point where I can have an extra piece of candy and not freak the hell out), about, mostly, doing something different. Breaking the routine, doing something "risky."

Yes, I define risk as eating something new or different or extra. Anyone still wonder why/if I have an eating disorder? Didn't think so...

I ate the damn beans. I used the CBT skillz (all the work I've done on learning them totally gives them the extra "z") I had been working on with TNT and told myself the following:

• I was hungry. There was no doubt here.
• I had been unusually active on Friday (worked a half shift at the bakery).
• I don't have a history of emotional eating, so the hunger was almost certainly physical.
• The real risk was negligible- I knew that one serving of baked beans wouldn't hurt in the long run, even if my emotions weren't exactly on board.

I was hungry. I ate. Then I wasn't hungry.

Somehow, this shouldn't result in so freaking much drama. But there you go.

Tonight, something similar happened. I had already had my evening snack (the same thing, come to think of it, that I had on Friday) and I was still freakishly hungry. I wanted, more than anything, to not be hungry because I didn't want to eat again, and I didn't want to have to find something to eat again.

So I tweeted about my feelings, and reminded myself that I need not hate myself for needing to eat more. And that as much as I would like my car to get better gas mileage, I don't begrudge it the fuel when it needs it. I ate an apple and peanut butter.

I feel disgusting right now.
I feel disgusting and I know I did the right thing.

Maybe that last bit is the saving grace.

This is your weekly smorgasbord, where I trawl the web for ED-related (and not always so related) links, news, research, and more so you don't have to. Enjoy!

As always, send suggestions to carrie [at] edbites [dot] com.





Perfectionism Runs on Mindlessness

What are electrolytes and how are they important?

New insights into the neurological basis of eating disorders

The issue of dating and relationships keeps coming up in therapy for me, and to be honest it's rather relevant. I still don't have any friends down here, outside of the people I work with. And although many of my coworkers are nice and fun while at work, they're not exactly the kind of people I see myself being good friends with (ie, I don't do the beer and marijuana thing for entertainment).

So the fact that I've been living here for about 9 months and still haven't met anyone--romantic or otherwise--spurred TNT into pushing me into trying a variety of options, like signing up for a bellydance class through community ed and, yes, thinking about dating.

Seeing as my dilemma is that I don't even have the foggiest clue of where to meet someone because I don't know anyone and I do NOT do the bar scene, the logical next step (according to TNT) was doing a dating website. Thankfully, my older brother has taken the first step in that regards as he met his wife online, though it wasn't a dating website. I did it once before and the experience wasn't the best, although I was aware enough at the time that it had nothing to do with the guys and everything to do with the fact that I was deep in the ED. And pretty much unilaterally refusing to do anything with food made me a pretty awful date.*

My assignment this week was to sign up for a dating site.** I'm not going to say which one (if you're really curious, you can email me!) for privacy reasons, nor is my profile up yet. I started filling it out, and one of the categories is what you're looking for and why you're here. I said because I was new to the area, etc, and I also figured that writing "My therapist is making me" wouldn't exactly be an encouragement to people. Or at least, the people I potentially want to attract.

This brings up a whole host of issues, the biggest of which is the fact that I don't understand why anyone would date me anyway. It's this core self-belief that, basically, I suck. I know I'm not stupid, I know I'm not totally inept at writing, but the only thing I ever felt confidence in was my ability to be anorexic. Now that my anorexia is in the past tense and I consider my illness (mostly) in remission, I'm back to the old "I suck" mantras.

TNT wanted me to start dating to basically tell the "I suck" mantras to go, well, suck it. That I'm never going to believe that I'm a datable person until I start dating.

So here goes.

*This didn't, however, stop me from going even deeper into the ED because the problem was (obviously!) I needed to weigh less for someone to be attracted to me.

**Actually, it was my assignment last week, but I put it off because of a freelance editing job from hell. Facebook friends, you know what I'm talking about.

I love the blog F*ck Feelings. It always provides a great perspective and very useful advice for dealing with what the authors call "the shit sandwiches of life" (their advice: ask for ketchup). They've never really addressed eating disorders, and I was always curious to see how they handled the subject. One of the most recent blog posts gave me my answer.

A woman had written in about being very dissatisfied with her weight, and asking why she was having these problems if she was already on the thin side.

Dr. Lastname ("because doctors always go by their last names") had this to say:

Most people aren’t happy with the way they look or how much they weigh, and all people spend at least a little time each day being unhappy, but many still manage to live normal, albeit slight chubby/grumpy lives.

As to the source of your insecurities, your guess is as good as mine and the many other scientists, clinicians, and desperate-for-a-topic writers who explain this phenomenon. It could be your ex, or it could reading too much Cosmo.

These experts assume, for the most part, that you wouldn’t be so self-critical if you didn’t listen to magazines, celebrities, or your critical-yet-well-meaning grandmother, and just believed in your self. They tell you that self-esteem will conquer all. Of course, they’re wrong.
There’s lots of evidence that self-hating body thoughts can happen to people with perfectly good self-esteem, nice families, and normal bodies. Instead of obsessing about why you feel this way the same way you obsess over calorie counts, stop and ask yourself, first, whether these thoughts are doing you much harm.

I know they’re causing you pain, but ask yourself whether they’re affecting your health or relationships. Right or wrong, you can think you need to lose a few without hiding major parts of your personalities and or being a bad friend or parent.

If you think your body-hate isn’t doing too much harm, try ignoring it. Certain kinds of psychotherapy may help, but watch out if you find yourself becoming more self-obsessed and blaming yourself for not getting better. The mark of good psychotherapy, like good coaching, is that it gives you ideas and motivation for managing a problem without increasing your expectations of control.

If body-hate is hurting your health or relationships—if you purge, have become anemic, or acquired any number of the dire symptoms that come with an eating disorder—assemble a treatment team, including a primary care physician, a psychiatrist and dietitian, and don’t hesitate to put yourself into an around-the-clock “eat-your-food” camp if it’s necessary. It can save your life.

In any case, don’t pin your hopes and self-esteem on self-control, or self-hating thoughts will just get worse. If you make it your job to keep trying and regard the illness as you would the weather, it can’t touch your sense of who you are.

You need never see yourself as a food nut or anorectic; you’re simply a person with eating issues, which puts you in the same camp as 90% of the population. You might feel like shit, but you are truly not alone.

Aside from their perspective on intensive treatment (an around-the-clock "eat your food camp" is an apropos enough descriptor), their benchmarks for determining the difference between disordered eating and eating disorder is pretty darn accurate. Because so many people are obsessed with food and weight, it's often hard to determine where this cultural obsession leaves off and where an eating disorder begins. If your obsessing about food, weight, exercise, etc, are causing any health problems (purging, anemia, marked/unhealthy weight loss) OR if these obsessions are hindering other areas of your life, then you've got a serious psychological problem. Not that you can't or shouldn't address disordered eating, but feeling like crap after reading Cosmo is not, in and of itself, an eating disorder.

It should, however, be a really big sign to stop reading magazines that make you feel like crap.

What do you think of "Dr. Lastname's" assessment of eating disorders in general and this woman in particular? Share away in the comments!

The shoe thing over the past few days has been something very different for me- buying something not 100% practical, buying something period, listening to my "wants" as well as my "needs," things like that. This is not something I'm used to doing. I've never been a "oh-what-the-hell" kind of person. I don't throw caution to the wind, and I don't like taking risks.

Recovery has asked me to live life very differently than what I am used to, not just during the AN but also to how I was before my illness. I'm not becoming a totally different person, no. But I am trying to approach life a little differently than I have in the past.

Before, I was all work, no play. Not that I wasn't known to try and read at least a few minutes before bedtime, but I didn't relax unless all of my work (studying, chores, etc) was done. It was never done. I still struggle with just relaxing, although I am getting better at it. I took the day off today. I had writing that I probably should have been doing, but I put in an extra-long day yesterday to get enough of my stuff done that I could finish up by tomorrow's deadline. My parents and I spent the day at a local theme park, something we've talked about doing since we moved down here but we never quite found the right time with the right weather. Today seemed to present all of those opportunities, so we went.

Like Brie, I've found the weight gain process to be the simplest part of recovery (not the easiest, but the most straightforward. My RD told me what I needed to eat, and I got enough support in order to eat and gain weight). It was hellish and unpleasant and phenomenally anxiety-provoking, but it was relatively straightforward.

It's the part of recovery where I have to relearn how to relate to the world that I find so difficult. I've slogged through the worst of the really emotional stuff, but what I really want is someone telling me exactly what I need to do in order to live my life in a non-disordered way. Am I avoiding people or do I really just value lots of alone time? Is my rigidity helping or harming? Am I gravitating towards salads because I'm craving greens and roughage or is that the ED "helping" me with my decision making?

The answers aren't clear cut, and they don't stay the same. Sometimes I do really feel like a nice big salad, and other times I just order it because it feels "safe." So I can't just check a question off my list and move on. I have to go back and re-evaluate. And often, in order to evaluate my feelings, I have to do something different, see how that feels, and check back in with myself. It's laborious and not all that fun. In fact, it's rather exhausting.

But this something different is enabling me to live life again and, heaven help me, have a little fun along the way.

I bought the shoes. I got them for $54 on Amazon- the very last pair in my size.

I was going to have a more substantial post, but I was really busy all day and I am fading fast.

Thanks for the encouragement, ya'll. I will definitely post pics when my little lovelies arrive in the mail.

I've never been much of a shoe person (I usually prefer barefoot indoors, flip flops outdoors). I think the most I've ever spent on a pair of shoes is $45 for a nice pair of hiking boots on clearance*.

But that was before I saw these lovlies:
There are lots of good reasons I shouldn't buy them, not the least of which is that I'll need a new car sooner rather than later, I'm trying to save up for a down payment on my own place, and also that they're twice as expensive as any other shoes I've ever owned.

Logic tells me no.

But my heart? My heart tells me yes.

What do you think? Vote in the poll below!

*It's one of the advantages of having freakishly small feet.

It's your Sunday Smorgasbord, where I trawl the web in search of ED-related (and not-always-so-related) news, research, links and more so you don't have to.

Have an idea for a smorgasbord link? Send it my way at carrie [at] edbites [dot] com.


The Psychology of "The Neuroscience of..." and the lure of brain explanations

Don't eat on a full brain. I find it hard to make food choices in my best interest when stressed as well.

10 Things Science Says Will Make You Happy

Maslow's pyramid gets a much needed renovation. It's interesting, though I'm not sure I agree with it.

Fixing a World That Fosters Fat

Treat the causes of EDs, not the symptoms, says James Lock of Stanford University

Effects of gustatory stimulation on brain activity during hunger and satiety in females with restricting-type anorexia nervosa

Attack on anorexia: Maudsley treatment puts parents in charge. Featuring the always-lovely Dr. Sarah Ravin and some parents from FEAST.

Girl’s School Tell Her She’s Overweight and Now She Won’t Eat

How your diet defines you in trillions of ways: a tour through three new studies on the gut microbiome

Associations between specific components of compulsive exercise and eating-disordered cognitions and behaviors among young women

Perfectionism and its relation to overevaluation of weight and shape and depression in an eating disorder sample

Development of emotion acceptance behavior therapy for anorexia nervosa

An eating disorder has often been described as a metaphorical "crutch." For me, anorexia helped me self-regulate (or self-medicate) my often crippling depression and anxiety. Some of this was the peculiar biological response to starvation unique to eating disorders--not eating altered my brain chemistry and made me feel better. Some of the response was psychological and more related to the meaning I ascribed to my anorexia: that it made me special and unique, that I could tell myself it didn't matter if I screwed up at X because at least I could be good at losing weight, restricting, and exercising. Looking at it through the lens of OCD, self-starvation was a compulsion I used to alleviate the anxiety of, well, pretty much anything.

Some psychologists posit that you are using a "crutch" because you are "hurt" somehow. Although I won't deny that co-morbid conditions are the rule rather than the exception in eating disorders, I don't know that I buy the blanket statement that EDs are some metaphorical way of trying to heal a past hurt. I may have been a little barmy before AN came around, but that doesn't hold a candle to how whacked out my brain and life are now. Yes, the ED made me feel better in profound ways, but I've known people who were very well-adjusted before they got sick.

I guess the best analogy is this: being predisposed to an eating disorder is like being prone to joint and bone problems. There's a greater likelihood that something is going to throw you "off course," either in terms of stress or mood or whatever, and so you're much more likely to find yourself using a crutch, just as someone prone to joint injuries is probably more likely to wind up using crutches at some point.

But the only way to learn how to walk without your crutches isn't really to sit around and ask what is hurting and why and acknowledge that part of you. The only way to walk without crutches is to...walk without crutches. That's not to say that you won't need a lot of support and training to learn how to do this, but the analogy of a psychological hurt to a broken ankle isn't 100% perfect. You do need to stay off of a broken ankle to let the bone heal. In that case, the crutches are serving a good purpose. They're benefiting you. An eating disorder probably has plenty of adaptive functions, but, on the whole, it's hardly benefiting you.

I've broken my ankle, and I found literally learning how to walk without crutches to be bizarre and painful. And perhaps this is where the analogy is the most true. I didn't really need my crutches as my doctor had cleared me to walk. But I still felt like I needed them as much as I never wanted to see the damn crutches again. Similarly, I often felt like I needed the anorexia when, in fact, that was just another ED lie. Recovery is a lot like rehab, in that it involves the repetition of a lot of seemingly basic tasks until my "recovery muscles" are strengthened.

You can't get there, though, unless you ditch the crutches. Understanding why you're using them isn't much use unless you actually stop depending on your crutches. Using actual crutches to let your ankle heal is a legitimate purpose and helps your body heal. Using an eating disorder as an "emotional crutch" might make you feel better, but it's not helping your mind heal. The eating disorder essentially broke your ankle and than gave you crutches to "help" you out- how kind.

Yes, ask for help. Yes, ask for support and a walking buddy and painkillers and all of that. But let go of the crutches.

I'll admit I moped a bit this morning (well, early afternoon. I didn't wake up until 11am). Then I mailed out a contract, talked to a researcher in Portugal, cringed at the thought of my phone bill with all of these international calls (three others last week), and sat down with a cup of coffee to watch a little TV mid-afternoon. I didn't have anything real pressing, and I was curious to see what was on.

I had just put my feet up when I get a text message from my boss at the bakery- she wants me to come in ASAP and help close. Since I didn't have anything better planned, I said okay. I could use the money and it seemed like a better idea than just trying to find something better to do. I put on my old baseball hat and name badge, and I go into work.

I don't miss the bakery, not really, and I still don't. But I think there is something therapeutic in mild physical labor, in having heaps to do and just bulling your way (mostly) through it. There was the connections with my coworkers as well, or even just being in someone else's company. Perhaps just as importantly, it got me out of my head. All of that.

I'm done with my shift and feeling much better. I do better when I have a lot to get done. I really enjoy feeling productive and checking things off my to do list. And it felt good to be really busy (though not the sweating buckets bit...that wasn't pleasant in the slightest) and now to be tired in the way that signifies you've really worked hard.

I know I work hard at my writing, but this is a different kind of hard work. It's given me a bit of insight into why I found exercise so addicting: it was this pseudo-productivity, the good tired of having exerted myself, along with the endorphins and semi-dissociation from what was bothering me, and the OCD ritual of it all. My brain sort of shut off when I was exercising, just as my brain powered down a bit during work. The moment became about the doing rather than the thinking.

Don't get me wrong. My back hurts and my feet hurt and I really stink at the moment. But about 6 hours at the bakery just flinging bread and packaging croissants and getting disgustingly sweaty really improved my mood and my outlook.

The title of the post pretty much summarizes it: I've just been in a funk all day today. There's no rational explanation for this, nothing that set it off or anything. Mostly, I feel weighed down by this odd sadness and lethargy.

My eating is mostly meal plan compliant, but the urges are still very strong. I don't understand that because it's not like I want to get sick again or lose weight again. The body dysmorphia is pretty much where it usually is, which means I hate looking at myself in the mirror but I'm also not trying to make my own liposuction machine out of a straw and the Dustbuster. I wrote before that I had too much to lose, and I still believe that. I'm doing lots of writing, and I'm mostly enjoying it (those of you who are Facebook friends will know the particular project I'm talking about!).

So what gives? Why am I having such a hard time getting myself to eat properly?

Before, these lapses into ED thinking never really bothered me. Maybe I hadn't really been free of disordered thinking so I didn't notice it. And a return to symptoms always seemed like a good idea, a way to neutralize the anxiety that I was feeling about anything and everything. Now, I know that AN will only make me miserable, that I would really like to have a life, and that the relief provided by restricting is temporary at best.

I think part of this funk (and the ED thoughts) may be the simple fact that I'm tired of doing so much recovery work. I'm not tired of recovery--there are no, screw this, the ED was better thoughts. But I'm tired of always having it be so much work, of having to think about it so damn much. On the one hand, it has gotten easier. On the other hand, I had hoped it would get a lot easier much more quickly than it has. I am making strides towards a new life, but I feel stuck in this endless limbo. I haven't met anyone in my new town. I love my job but it's not exactly conducive to meeting people. I'm still living with my parents for crying out loud.

All of this frustration and loneliness are just building. I'm tired. I want a break. I want everything to stop being so much effort.

I hate that this post has devolved into a sad, pathetic whinge. My life doesn't suck but I still feel dissatisfied with...something.

A few minutes ago, I got this update from my friend Harriet Brown, author of the upcoming book Brave Girl Eating.

"The Good Morning America appearance was canceled after I refused to allow photos of my daughter at her sickest appear onscreen. Makes me ashamed to be a journalist."

Because there's no other way to talk about eating disorders and treatment and recovery than showing pictures of emaciated children...right?

Save the voyeurism for bad reality TV shows. We don't need it to show how devastating an eating disorder can be.

It's GMA's loss, really. The appearance would have been a great opportunity to educate people and dispel myths about eating disorders. And now, because of a producer's stupidity, that opportunity is lost.

Will people ever learn?

As the economy began it's nausea-inducing nosedive at the end of 2008, many US banks and insurance companies were loaned money by the government because they were "too big to fail."

This week, as I have been on my own and trying to bull my way through piles of writing and work, I have been hearing the siren call of AN. I wasn't looking for the call, I wasn't seeing it out. But with my routine shaken up a bit with my parents out of town and then visiting my friend for the weekend, I got off track. And sleeping through breakfast yesterday meant that I felt pulled to skip breakfast this morning. Surely it won't make a difference, will it? And lunch. Who really needs lunch, anyway. Think of all of the writing I could get done.

I did eat breakfast, and lunch, but not nearly enough. I knew this should have been a big red flag--a red light sign in my relapse prevention plan--but I felt strangely not bothered by this. I wasn't particularly hungry, and eating seemed like such a damned inconvenience.

Apparently, I was bothered by this at least somewhat because I mentioned it to TNT at our session today. Not in the on-my-way-out-the-door, at least I can assuage my guilt about lying sort of way (admit it--you've done it, too!), but in a way where I actually sought out feedback about what was happening. We discussed what I needed to do to get back on track (eat a meal plan compliant dinner and evening snack, both of which I did) and then plan out my meals for tomorrow.

We also discussed where I was in recovery, about my blossoming writing career and all that I want to do professionally. About the fact that I really, really want to get my own place and pick out paint colors. About how I want to travel to the Galapagos and Australia. I have a fighting chance at a real life now.

Like the banks that were too big to fail, I have too much to lose now.

Before, all of these wishes and dreams were so nebulous and ephemeral that I could shrug off their loss. I mean, I'm not going to own a Mercedes, either, and I'm not exactly bothered by that. But now, my dreams and my life are so much closer. They're realer (if that's a word). I'm making them happen, right now. I can't continue to make them happen when I am deep into ED. I won't be researching how bacteria can smell, I will be looking up calories in food and determining how much I need to exercise and staring at recipes all day long.

My last relapse brought me face to face with the stark reality that I couldn't have what I wanted in life and also have my eating disorder. I had to choose.

And I chose life.
I chose life and I didn't look back.
At least, I haven't looked back very often.

TNT told me I had worked my ass off to get where I am in recovery (I turned around, looked down, and said, "No, I didn't. My ass is sadly still there."). There's the reality that I always have another relapse in me, but I don't know if I have another recovery.

So I ate.
And hated myself.
And then forgave myself.

Eating can be an inconvenience, but relapse is a bigger one for me right now. I have stories to write and condos to find and places to go and dreams to fulfill. My ED is not part of this--it never was.