Last night, I had a fat attack.  My old therapist back in Michigan would have preferred that I reframe it as a "bad body image attack."  Well, maybe.  But this feeling was very different than looking in the mirror and saying "Ewwww..."  Which I've also been known to do, but not last night.

For starters, I was laying in bed and not looking in the mirror.

For seconds, it wasn't a visual issue.  It was a more physical, visceral issue. 

I wanted to claw my way out of my own skin.  I felt huge, uncomfortable.  I couldn't stop thinking about my body.  I wanted to do something, anything to get rid of this feeling.

Somewhere through the anxiety, I started thinking, "You know what this reminds me of?"

OCD.

I had the stereotypical germ OCD when I was in high school.  Mostly, I obsessed and worried over every little thing.  Either I was harboring some nasty germ that was going to kill everyone I knew or saw or had contact with, or everyone I knew, saw, or had contact with had a germ that was going to kill me.  I would wash my hands or reply scenes in my mind to make sure I hadn't touched something "bad" or coughed wrong or whatever.  I would inspect every inch of my skin to make sure I didn't have any cuts that could get or receive germs.

Therapists call these contamination fears.

I felt like my skin was crawling with germs.  I washed my cracked, pathetic hands in bleach to try and make this feeling go away.  No, I couldn't see the germs. I wasn't always 100% positive they were there, but I was sure that I could feel them.  All I wanted to do was make that feeling go away.  If it meant screaming in pain from bleach, so be it.  I was so distressed and terrified that nothing else mattered but making this feeling go away.

Which brings me back to the fat attack.

I didn't feel that my skin was crawling with germs, but it did feel like it was crawling with fat cells.  And in moments like that, it suddenly doesn't seem so foreign/stupid/pointless to do something like purge or overexercise.  I didn't, but nonetheless.  Thinking of these fat attacks as another manifestation of my OCD has made a lot of sense to me.  Yes, I have significant body dysmorphia above and beyond the fat attacks. 

Yet any time off exercise or eating something "unsafe" or "forbidden" would bring about a fat attack--just as touching something dirty would set off a contamination attack.

I don't think this totally explains my eating disorder.  Not at all.  But it does explain parts of it.  It helps explain why I would do such crazy things.  To escape the distress.  To keep the calm.  Vanity and sticking to my "diet" wouldn't--couldn't--explain this.  If you're scared enough, you will do some crazy things.

I never was able to recover on my own as an outpatient because the fears and the feelings were just too strong.  It meant living in a non-stop fat attack for months with no sense of relief.  Considering the crazy stunts I pulled to avoid the feeling just for a few hours or days, is it really any wonder that I tried to avoid refeeding and recovery?

Seeing fat attacks as OCD helps me calm down in the moment.  It's just the OCD talking.  The OCD was wrong about me spreading or receiving the plague, so it's certainly wrong about this.  What's more, I know the awful feelings do pass.  Eventually.