This morning's breakfast was cereal. I like it on several levels--for starters, I like cereal, and I like all of the crazy concoctions I can make in my bowl. Also, it's easy and quick to prepare.

I'm a writer. It's my job. For the past few days, I have been tasked with writing up a conference report I was at a week or two ago. The job was painful for several reasons. One, it was not going to qualify as life's most interesting writing project by any stretch of the imagination. For another, I really suck a summarizing things.
My lack of skills in this department weren't obvious to me until very recently. I didn't really think about it, nor did I really think about why the task was so difficult. It wasn't until I was researching an article on cognitive remediation therapy that I grasped the basis for my difficulties.

One of the tasks in CRT is to summarize a short story or a letter in just a sentence or two. The idea is to help people learn to understand the main idea of something rather than focusing on the details. At first, I thought this was a pretty unusual task- I mean, what could summarizing a fairy tale have to do with anything? But then I got to thinking: maybe this had more to do with anorexia than I previously thought.

Reading about this task reminded me of the time when my college roommate was watching me highlight my biochemistry textbook. I dutifully dragged my fluorescent green marker across lines of text, thinking I was marking up the most important sections of the chapter. My roommate looked over and asked why I bothered highlighting if I was just going to turn the whole page green.

"I skipped some words," I pointed out indigantly.

"True," she said. "I think you missed a 'the' up top."

In my biochemistry text, as in so many other areas of my life, I was so overwhelmed by the details of the information that I lost track of the entire point of highlighting. I only needed to highlight the key points, except I couldn't figure out what those key points actually were. I literally couldn't see the forest for the trees.

It was the same with my conference summary. The hardest part for me was deciding which aspects were important because it all felt important to me. Previous summaries I did when I was in school or at other jobs usually turned into long, rambling tomes because of this difficulty. Certainly, this "summary" wasn't short, not by any stretch of the imagination. But knowing what my difficulty was helped me focus my attention. I told myself that the actual writing bit was pretty straightforward, and so I needed to focus instead on identifying one or two key points from each presentation.

This wasn't easy. I worried a lot about missing something, and from picking one aspect over another. It's hard to move away from beating myself up over having trouble with what should be an easy task. But there's no reason summarizing "should" be easy. I finally finished the project this afternoon, and I am so, so glad it's over!

Sometimes recovery means accepting that you do, indeed, have an inner toddler. A whiny, cranky inner toddler who never wants to listen. They are loud and a pain in the ass. They generally have a point. The key is to listen without letting them run the show.

What I've been struggling with the last few days is a nasty case of the "I don't wannas." Mostly, this has to do with food. I don't want to fix a proper breakfast, not because I want to restrict or lose weight or anything ED related. It's just that some days, I feel I can't be arsed. So it's real tempted to just grab a protein bar or whatever and call it "breakfast" because it's a hella lot easier than hauling out bowls and cereal and granola and milk and measuring cups.

I know by now that not feeling like getting breakfast (or lunch or snack) is no excuse not to have lunch or snack. But things like long term planning and sensible behaviors don't pacify my inner toddler. She doesn't want to deal with dishes. Or waking up earlier. Or doing any of those things that grownups generally do.

It's helped me to stop always wanting to behave like I feel a grownup should. A significant proportion of my friends on Facebook are mothers (some of them even have toddlers!), and I can guarantee that their general maturity level isn't always higher than mine. We all have inner toddlers, and we all need to tame them.

Sometimes we feel like being obstinate, just because. Sometimes we lose our marbles for no particular reason--or reasons that are no doubt legit but seem like small potatoes in the grand scheme of things. With time and lots of practice, I've come to realize that this is no big deal. It happens to all of us. I've also learned (mostly) how to let these little fits pass, or simply indulge them in my head. After all, snark doesn't have to be vocalized to make me feel better. ;)

The problem is when these pitched fits start making our decisions and running the show. I can resent having to fix breakfast or, like today, burning the damn toast for lunch.* I can hate having to do dishes and clean the house. I can piss and moan to my heart's content. I also need to suck it up and take care of myself properly no matter how much of a pain it is.

It's something I learned in DBT while in treatment, that two opposite things can be simultaneously true. So I let myself get cranky and hate having to do food prep and so on. AND I can still recognize that it's important and do it.

And on that note, thankfully, I have leftovers for dinner!

*Same setting as I used yesterday, same bread and everything turned out fine. Today? Blackened to a crisp, smoke detectors going bonkers, big scene. Sigh.

Although this article was more geared towards parents, I think it really helped me understand a lot better about what the hell was going on in my head during the worst of the eating disorder.

An excerpt:

An interesting area of research known as “theory of mind” posits that your child’s brain really does change as his or her weight dips below the starvation level. Theory of mind researchers are studying the eating disordered person’s ability to read facial expressions to intuit mental states, sometimes solely by looking at the eyes of the person they are with. They’re finding that this ability falls victim to starvation, just as does the body’s ability to maintain strong bones, keep warm, or grow lustrous, healthy-looking hair. A starving person has difficulty attributing emotions, beliefs, and desires to themselves and to others. Without this ability, it can be hard to function smoothly in the social world.



...One test the researchers used showed both people with anorexia and recovered patients film clips of social interactions between people. Test subjects had to scrutinize facial expressions, body language, conversation and context to read complicated emotions such as desire, embarrassment and hostility. When a teen with anorexia looks into her worried, and frustrated parents’ eyes, can she recognize the emotions written on their faces, and compare it to feelings she has experienced herself? Researchers noted clear deficits in this area among anorexics. The test was able to distinguish those currently suffering from anorexia and those who had recovered. So the good news is that this weakness in processing emotion seems to get better with recovery.


Ulrike Schmidt and colleagues are now readying a paper for the International Journal of Eating Disorders that looks at theory of mind in relation to bulimia. In her tests, Schmidt and her colleagues examine study subjects and the ability to attribute mental states to others and ourselves, which they call “mentalizing.” Interestingly, when a group of patients with bulimia were given this test, they were better able to recognize negative emotion than the control group. Schmidt and colleagues have detected enough of a “distinct socio-cognitive profile” among bulimic patients (translation: they do read and process emotions differently) to merit further research.

The fact that patients with anorexia who have recovered seem to regain their ability to recognize and attribute emotions to others, Banker notes, indicates that this phenomenon could well be a temporary lapse into autism-like cognitive behavior. “When someone’s in a state of starvation that kind of empathic, or higher-relational function shuts down,” she notes, news she hopes will “reduce the personal hurt” that comes with the territory of helping a loved one battle anorexia.

Basically, when I am in the grips of the eating disorder, my "self" shuts down.  It's like my own self is too difficult, too expensive for my starving brain to maintain. And so it goes to ground. Hibernates.

When it does come back, it's like your hand or foot waking up after falling asleep--pain and pins and needles. That this phase is likely necessary doesn't make it any easier. What also doesn't make it easier is when you realize just how long you've been absent. When it suddenly hits you that all your similarly-aged friends are married and having babies and you're still not quite figuring out this whole thing the world likes to call "dating."*

It makes me want to get a t-shirt that says "Excuse me, but my brain was on a prolonged leave of absence."

The irony is that my life looked pretty normal. Graduate degrees, jobs, things like that. It didn't look like I was missing out on a whole lot. But I realize that I never really went through the process of making friends and meeting people for almost a decade. Add in the fact that my natural skills at these tops out at "total suckitude," and it's not hard to see how you find yourself at 30, rather adrift in the world.

Even more ironic is that the eating disorder can start to seem like a good solution. If I shrink my world back down, I'll go back to being oblivious about what I'm missing. Not a bad solution, at least in the short term. Until you realize that going back will mean that even more time has passed and you are further and further behind where you want to be in life.

I think this is the "mourning" the therapists tell you about. You don't just mourn the loss of the eating disorder, you mostly mourn the loss of everything that went along with it. The illness keeps you charmingly oblivious to, well, everything, and only as you come out do you realize what you've been missing.

*Honestly, what keeps my sanity is looking at mating rituals in the animal kingdom. I can put them into context that way. Clearly, I'm a nerd...

Alongside the truism that knowledge is power lives the fact that ignorance is bliss. Especially when it comes to knowing the truth about ourselves.

I ran across a blog post that discussed why people avoid the truth about themselves. A recent study in the Review of General Psychology identified three main reasons (as distilled by the PsyBlog folks):

1. It may demand a change in beliefs. Loads of evidence suggests people tend to seek information that confirms their beliefs rather than disproves them.
2. It may require us to take undesired actions. Telling the doctor about those weird symptoms means you might have to undergo painful testing. Sometimes it seems like it's better not to know.
3. It may cause unpleasant emotions.

I think this phenomenon really captures why it's so hard to begin recovery. You have to face the truth that you're sick, that you don't control your eating disorder, and that you're going to have to begin the very unpleasant process of actually stopping behaviors. It's a monumental task.

Recovery means accepting some very unpleasant truths, and it's not something I always feel up to. The problem is that ignoring the truth doesn't make it any less true.

Humans have a particular blind spot for identifying their own foibles. Remember, though, that it's our own cars that have blind spots, and not anyone else's.  We can avoid the truth by creating our own alternate universe. Most of the time, the differences are really subtle. We're not that late, at least, not very much, or at least not when it's really important.  Doesn't everyone have odd eating habits?  There are plenty of people who weigh less than me that are doing just fine.  But as the ED progresses, the alternate universe begins to look more and more like the Twilight Zone. Everyone else can eat this food without gaining weight, but I can't. Chap Stick might have calories, so I can't use it.  I can't stop exercising or I'll gain 20 pounds.

If we really stopped to ask ourselves about how normal our routines really were and what would happen if they suddenly changed, we would have to face the truth that our eating disorder was far more problematic than we would like to believe.  Add in a healthy dose of anosognosia (a literal inability to understand that we're ill), and our brains can spin a web of lies and half-truths for years.

Recovery means admitting that we've been living a lie. It means facing those fears of food and dissolving those routines and rituals that have kept our sanity intact.  It means entering a world of the unknown.

It's much easier to just avoid the truth, put our heads in the sand like ostriches and just ignore everything.

The truth catches up to us, eventually.  It dogs our steps.  It scares us senseless.

Here's the thing that truth doesn't tell you: facing it head-on and chin up isn't as scary as we think it will be.  It's unpleasant, but stripping the lies from our lives (the lies we tell others, yes, but also those lies we tell ourselves) gives us a chance to face life on its own terms. It shows us that we are much stronger than we think we are.

When I was in college, I remember sitting in church and listening to a sermon where we were exhorted to take Sunday (or any other day of the week) and not do any schoolwork, nothing, and instead devode the day to prayer and worship.  I almost burst out laughing--not so much because I couldn't imagine spending an entire day focused on religious activities (and I was much more religious then than I am now), but because I couldn't imagine a 24-hour period in which I didn't do any studying or homework.

I've always sucked at taking time off.  When I was in 8th grade, I skipped most of my brother's high school graduation party to study.  In fact, I brought books to the graduation itself.  In high school, I studied for exams on Christmas (the exams were about a month later).  I rarely went out on the weekends in college because, again, studies came first.  Clearly, I have issues.

But the past few weeks, I've been basically banging my head against the wall at work. I've been sending out story ideas, only to be rejected over and over and over.  I know it's not personal, but it is rather discouraging and frustrating as hell. Since I was sleeping more, it seemed that all I did was eat, work, and sleep.  I think much of my fatigue was old-fashioned burnout.  Don't get me wrong- I still love what I do.  On Friday, though, I had simply had it. {{I did get two smaller stories on Friday afternoon, so all is well on that front.}}

No, my weekend wasn't quite that serene.

So I took the weekend off.  Okay, I did a little work.  But just a few hours, probably half on my Psychology Today blog (a new post will appear tomorrow morning or whenever I hear back from the author of a study) and half on the FEAST Conference Planning.  Other than that, I hung out with J, watched TV, crocheted, and read (At Home by Bill Bryson, if you're curious).  It was unusual.  It was also nice.  I was far more apprehensive of how my little prefrontal cortex would handle the change than I was about actually taking time off.

Yeah, I paid for it a bit today.  But I also had a vacation, and I really needed that.  I'm trying to remind myself that the break has made me much more productive than I might otherwise have been today, and that extra boost of productivity will extend through the week.  It's a total shift from my usual MO.  Before, when I've taken time off, it's been because I was either too sick or too depressed to give a crap about not getting anything else done.  Although I've had at least one "vacation" this year, it was to AED last month, and there wasn't much down time.

I know I need to be more vigilant about separating my work life from everything else.  It's too easy to let work bleed into other times.  Sometimes it's simply necessary (when I have a deadline or need to do an evening interview because of time zone differences), but it's still an area where I need to get better at.

In Jenni Schaefer's book Life Without Ed, she writes about the two main tactics for combatting ED thoughts:

• Disagree: counter the ED thought that a slice of cake will make you fat with thoughts like Eating cake is normal, one slice of cake won't change my weight, I trust my treatment team and the food plan they gave me.
• Disobey: the ED thought tells you not to eat that cake and you eat that cake, dammit.

All of which are well and good.  My dad always told me I should have been a lawyer since I can argue anyone into the ground.  Arguing against myself is harder because both sides of my brain are equally skilled in coming up with convoluted statements, odd facts, and seemingly incontrovertible bits of logic.

Even when I do win against the ED thoughts, the previous hours-long pissing match between Healthy Carrie and ED Carrie has left me exhausted and more than a little demoralized. It shouldn't be this hard!

Indeed it shouldn't. File under: Pyrrhic victory, definition of.

So I came up with another "D" strategy to deal with the ED thoughts: Disengage.

So when I start bickering with the voice in my head that tells me I shouldn't eat, that I'm going to get fat, that eating means I'm a pathetic failure, I don't argue back.  I just say "Mmmmm..."  When you're trying to make a decision, it's not like your brain instantly comes up with a unanimous agreement.  Different parts of your brain provide different input, and that input isn't all equally important or relevant.  It's sort of like the vaguely rabid people preaching the End Times on the street corner: I know these people are irrational, so I just kind of ignore it.

ED thoughts are similar; it's not worth my time to argue.  Arguments seem to give the thoughts credibility, that they're work an argument.  The problem is that they're not.  So I've been trying to mentally walk away from the ED craziness in my head.  We'll see whether it works, but hopefully it will leave mw with more energy and sanity.

Every night, the same thing happens. I mean to blog, I really do, but then I sit down at my computer and I'm just too stinking tired to write very much.  All I want to do is go to bed, preferably for a very long time. Plan B is to see if I can chug some Animagus juice and become my cat.  It's pretty much the same, I'd say.

Having such a mismatch between my drive to get things done and the energy needed to carry them out is really frustrating.  Usually when I'm extremely fatigued, I'm either so driven by anxiety and OCD that I don't even ask if I have the energy, or I'm so depressed that I don't care if I get anything done.  I'm fundamentally a very driven person, and I usually can summon the energy to do what I need to do on a pretty consistent basis.

But over the past few weeks, I've just been utterly drained.  I rarely make it through the day without a nap.  I feel like all I do is eat, sleep, and work.  I've done some crochet, yes, and I do try to watch at least one TV show a day, even if I am catching up on email while watching.  And it figures my book club picked A Tale of Two Cities for this Saturday's meeting. This isn't a piece of literature that can be described as a "page turner." 

I easily slip into mopey, woe-is-me moods.  I feel like I have no confidence, not because I'm actually lacking in confidence or drive, but because I don't have the energy to summon confidence.  Screw life goals, I just want a nap.  I want my email to stop pinging me with new messages, I want my editors to stop requesting another set of changes.  I want to wander around Target and not worry about how much work I need to be doing.

I wish I could just accept the fact that doing the extra eating and recovery work means that I might not be able to function as well at work and that's okay.  But that doesn't come easily to me.  In fact, it doesn't really come at all.  I don't look at my grades in grad school in the depths of my ED and think "Imagine how well I could have done if I wasn't sick!"  No, I think that I should have done better and worked harder and maybe tried to get more studying done while spending hours on the elliptical machine.

I can tell myself that I'm doing the best I can, and even though I get that it's true, I also feel that this still isn't good enough.  And then I realize that I don't have the energy to try harder even if I could, so it doesn't really matter.  The spoon analogy does help here. I'm using extra spoons at mealtimes and on recovery stuff, so it makes sense that I have fewer to "use" with work and other things.

I guess the moral of the story is that I'm tired of always equating fatigue and proper rest with laziness.  And when you're constantly fatigued, it's a pretty crappy situation to find yourself in.

First of all, thank you SO MUCH for the wonderful support.  I have the best readers, bar none, and I will seriously kick anyone's ass who says you aren't.

I've gotten emails and texts from quite a few people who have shared their own struggles. One comment I was particularly struck by was via Twitter (it was a private message, so no need to waste time looking!):

I lost a bit of weight recently and it's started up this annoying talk in my head. I hate how freaking pleased it makes part of me.

It's the last line in particular that really resonated.  It would be so much easier to fight off urges and behaviors if we found them seriously distressing.  The problem is that distressing is not always the word that comes to mind when ED behaviors return.  This summer, I did experience distress at the return of ED stuff, both while I was in Europe and then when my parents were away for a week or so.  Serious distress and only a little weight loss.  I remember being simultaneously puzzled and relieved at the distress--puzzled because it was something totally new, yet relieved that the distress meant I was extra motivated to address these issues.

Eventually, the ED stuff does get distressing.  Things like blue lips, anemia, and utter exhaustion ultimately take their toll.  For me, the notion that I wouldn't be able to keep working up to my usual capacity was a major motivator for me to take action.  For better or worse, my identity is very tied up with my career, and I take any threats to that very seriously.  I realize that I am more than just a writer, but that's also primarily how I think of myself. I don't have the security of disability or sick leave as a freelancer, and so if I can't work, I don't get paid.

Addressing a slip is generally much more stressful for me than the slip itself.  And therein lies the problem.  It's hard to change when you're not feeling any internal pressure to.  Of course, external pressure quickly stepped in and helped me move along, but still.  When I notice my depression increasing, I'm generally pretty motivated to do something about it (assuming I feel there's something that can be helped, but that's another story).  Same for the anxiety.  It's unpleasant.  The ED isn't always the same.  Staying in recovery would be so much easier if falling out of recovery was harder to deal with.

Usually, a mild relapse initially makes me feel better.  Hence the problem.

I think I need to start accepting that minor relapses aren't going to cause me any sort of distress and that I need to stop expecting distress to happen and relying on it to take action.  It's totally counter intuitive, but not much about EDs makes logical sense.  Why wouldn't a recurrence of a potentially deadly illness not stress me out?  I dunno.  Here's what I need to get through my thick skull: just because I'm not freaked out doesn't mean that it's not a big deal.


If that came naturally, my life would be so much easier, I think.

I'll be honest: the past few weeks have been rough, ED-wise.  Nothing catastrophic has happened (as in, people are talking in nervous whispers about "hospitalizations" and such), but my weight is down some and I've noticed an uptick in ED thoughts and behaviors.  I've been remanded to daily doses of Ensure Plus, which isn't my idea of a good time, as well as upping the food intake.

As a consequence, I've been unusually tired and wiped out, which probably explains the decrease in blog posts over the past few weeks.  Either I didn't know what to say, or I didn't have the energy with which to say it.

The fight for recovery is exhausting, and I just want the fight to end.  I want food to be food and not filled with doubts and terrors.  I want my own mind to cease being a minefield and my own worst enemy.  I want anxiety to stop snowballing into something bigger and more sinister.

It's frustrating mostly because I thought I was past the point where I thought something this serious could happen.  I knew that small slips and things were likely just because life is life.  But to have to go back to Ensure Plus?  Seriously?!?

Ouch.  It's a bit of an ego blow, I'll confess.

The good news is that I've learned from previous experience and I'm not in any medical danger, I'm still working to my usual capacity, and I'm not a suicidal basketcase.  I've gotten a handle (or at least started to address things) before they spiraled totally out of control and I lost my ability to fight the anorexia as an outpatient.  Because as bad of an ego blow as this is, it's not as bad as having to quit my job and/or move home and/or go back into treatment.

So.  That's where I'm at.  Down but not out.  I'm pulling myself together and getting back on the recovery bandwagon.

I was thinking about my snack this afternoon, and several options floated through my head.  As I was contemplating what to have, I remembered my after school snacks from almost 20 years ago now.

The fluffer nutter was one of my favorites. 

For those of you that aren't in the know, a fluffer nutter is a peanut butter and marshmallow fluff sandwich.  Except my mom didn't make fluffer nutters with bread. She made them with graham crackers.  Actually, I didn't know that my mom's confection had a formal name until I was in high school or college.  Nonetheless, I loved my peanut butter and marshmallow fluff on graham crackers.

Of course, an eating disorder changed that innocence where all I thought of was "sweet-salty-crunchy-yumminess." 

Now I think about things like carbs and whole grains and high fructose corn syrup.  I wonder whether I'm eating too much added sugars. I worry what others might think of a 30-year-old eating a fluffer nutter for a snack.  I worry what others might think of a 30-year-old having an afternoon snack, period.

The truth is this: I don't remember what it feels like not to worry about every crumb I eat.  I remember that there was a time when I didn't, but I don't actually remember that feeling.  Some of that loss may be the inexorable process of growing up.  After all, I think about lots of things in a much more nuanced way than I did as a 10-year-old.  But there's a difference between being aware of the fact that straight up sugar might not keep you satiated for long, and fretting over what the sugar might do to your butt.

I don't know that this innocence is ever coming back.  And that's sad.  I'm tired of worrying so much.  I want to switch this off, just for a bit.  Yet the fact of the matter remains that it likely won't every go away, not really.  Not completely. 

I'm not saying that this worry will never stop consuming much of my waking hours.  After all, I'm not dropping substantial cash on therapy for nothing.  I am working to relax about food and, you know, pretty much everything.  But I feel like I know too much and have let too much of my life be taken up by these obsessions to ever go back to the carefree person that existed before the anorexia struck over ten years ago now.

At the same time, I think it's important to remember that this person did exist in the first place.  That I could manage my food and weight without interfering in every little detail, without worry and fear and gnawing anxiety.  That I didn't need to follow a food plan to the letter and yet I was okay and the world was okay.  It's a very different mindset to how I currently manage things.

I suppose sitting here and being all mournful about these changes is neither uplifting nor enlightening.  I don't want to just piss and moan over what used to be.  I don't do nostalgia.  I can't change the fact that I got sick and have been sick and have changed.  It is what it is.  Time passes and the person I was has become the person I am now.

I'm not missing a sandwich, I'm missing a mindset.  But that doesn't mean I can't still enjoy a fluffer nutter or two.

When I moved into my new place last month, I splurged on cable.  I tried to justify it for any number of reasons (my other entertainment budget is nil, etc), but ultimately, I thought it would be kind of fun.  It didn't hurt that TV reception is pretty minimal without cable where I live.  So cable it is.

I used to be one of those "Oh, but I don't watch TV" people.  It started as a legitimate I-have-no-real-inclination-to-watch things.  When I was younger, I preferred reading.  Now that I'm older (and I spend all day reading and writing), I need to relax with less eye strain.  And I've gotten over my need to appear as a cool Intelligentista who is way the hell too cool to sit in front of the boob tube every night.

I thought eschewing TV made me hip and edgy.  It made me different from the stereotypical "fat, lazy American" that you read about in the papers.  It made me feel sort of better than.  I'm not the kind of person who would spend heaps of cash every month on something that just rots your brain!  There were plenty of times when, financially, forking out any extra money wasn't going to happen.  Not that my current budget has me rolling in the dough, but I can be careful and comfortable.

Here's the confession: I really like cable.  Every Saturday night is House reruns on Bravo (which is, as far as I can tell, the sole redeeming feature of that network).  I watched Bones reruns tonight on TNT.  I tuned in to a true crime marathon the other day, which was way too much fun. We all need a bit of smut, right?  I don't have DVR or Tivo--generally speaking, I'm around when a show airs, and if I like the program enough, I'll make an effort to watch it.  If it's not worth the effort, that I guess I'm not all that attached to the show.  If two shows ever aired at the same time, I would be in trouble, though.

It was something my eating disordered brain fought tooth and nail.  A chance to laze about!  Sit and do nothing! Become a couch potato!  Heavens, no!  Cable was banal and indulgent.

Well, maybe it is.  But it's also fun.  That's something I'm really starting to enjoy.

Recovery is tiring.  Exhausting, really.  Between ED stuff, and my job, and trying to juggle everything else, I'm really just drained.

I'm trying hard not to resent my recovery--and the time and energy and money it consumes--but I'm not always successful.  It's hard, in the day-to-day slog of meal-snack-meal-snack-meal-snack, to take pride in my accomplishments (I ate! On my own! With no one watching!).  I resent that I have to eat.  I resent that it takes so damn much effort.  I resent grocery shopping and dishes.  I resent people who get to buy smaller-sized clothes and brag about it.

Yep.  That positive around here.

It's frustrating.  I want to be "over it," like a cold or the flu.  I want to put my illness behind me.  I want to look at a menu without first identifying the lowest-calorie, lowest-fat items.  I want--heaven help me!--to have a stinking clue what size I actually am.

I know the solution isn't "give up," but rather "keep going."  A nap helps provide perspective. So do kittens and friends.  For that matter, blogging about it helps.  Letting these feelings fester isn't good.  I know my support team doesn't like hearing that sometimes I want to pull a three-year-old-style temper tantrum and just say "Screw recovery!!!!"  But pretending that everything is all happy and shiny and unicorns pooping rainbows doesn't help, either.

I have been working hard to stay on the right path. Have I always been successful?  Well, no.  Not always.  Despite having many moments when I'm bloody well sick of anything related to recovery, I have to take a deep breath and ask myself: what are your other options?

I think about this.  Mostly, I don't like the other options and I know it.  In the quiet of the night, as I let the slow thud of my heartbeat lull me to sleep, I forgive myself for such heretical thoughts.  I think: tomorrow is another day.  Tomorrow I will get up and fight the good fight all over again.

And then I do.

When I don't want to deal with something--ED or otherwise--I tend to avoid it.  I must confess that it is, occasionally, effective.  Sometimes people need to let their tempers cool off, and sometimes rebooting the computer really does fix everything.

Most of the time, it doesn't end up like this.

Usually, the scenario goes something like this:

Make a small mistake.  Feel embarrassed.  Avoid dealing with small mistake.  Small mistake festers into a big mistake.  Avoid dealing with that, too.  And so it goes until I spiral into a masterly cycle of self-hatred and despair.  In the midst of this self-hatred and despair, I never really deal with the actual problem: my avoidance.  Instead, I tell myself that the real problem is that I'm lazy, stupid, and a bad person.

Aside from the verbal self-flagellation, the litany of reasons I suck gives me an out.  Bad people do bad things.  Ergo, I have no real reason to push myself to stop.

It happens with the ED stuff (embarrassment at a small slip -> don't tell treatment team -> I'm a failure -> small slip becomes a big slip), and it happens in real life.  I never really listened to criticism and helpful feedback because in my mind, anything less than perfect was just an example of how crap a person I am.  I didn't listen because there really wasn't much point.

So I avoided even more.  Pulled away, hid from view--even when admitting my difficulties would have made the situation so much simpler.

An example: I was late on a deadline this past weekend.  Part of it was the chaos of moving, yes, but once I realized I was overdue, I resisted buckling down and attacking my job.  Plainly, I was mortified at my mistake.  I can be a space cadet at times, but generally I can keep things put together.  By going back to my work, I would have to admit to myself that I wasn't perfect, that I had royally screwed up.  So I put it off.  It was the weekend, and it wouldn't have mattered much anyway.

There was an element of truth to that.  But if I was being honest with myself--
If I cut the bullshit and really admitted to myself what was going on--
I was avoiding dealing with the problem.

A simple email to my editor saying "Oops, totally forgot in the moving chaos, I'll get something to you by Monday morning," would have essentially fixed everything.  Sending that email would mean I had to admit something was wrong.

I didn't want that.

I wanted to pretend it was all okay.

That wasn't okay.

The ED was a way for me to avoid so much of the crap that was going on in my life.  I didn't actually have to deal with it because I was focused instead on exercise, food, and weight.  When I was into the anorexia, I mentally checked out of life.  I didn't intend for that to happen, not really, but it fit my profile of dealing with things.

Avoid.
Ignore.
Smile through the tears.

Neither my reluctance to send an email nor the anorexia-driven avoidance really ever solved any problems.  I could pretend for a while.  Pretend that everything was fine, that it was no big deal, that I could manage everything.

This weekend reminded me that I couldn't.  My editor asked me to kindly send her an email when I was going to be late.  To be honest, I earned that. 

But this screw up allowed me to see another of anorexia's accidental functions.  I could connect the dots and see the patterns.  Avoidance.  I started to see the consequences, for once.

So I stepped out of that self-hate spiral and told myself: the only way to solve this problem is to get to work.  Not punish yourself with more exercise or less food or some other misadventure. I didn't need punishing, I needed to sit down and finish what I had started.

And so I did.

I've read a number of studies that show people with eating disorders have difficulty reading emotions in other people.  A new one came out this week. The general theme for people with anorexia is that they tend to be hypersensitive to anger--that is, they see people as angry, even when they're not.  No one really seems to know why this is, but it seems to be one of those general traits of people with EDs.

It's something I know a lot about.

I don't like social situations for any number of reasons (anxiety, etc), but I also tend to dislike them because I always feel that everyone hates me.  Saying that they hate me is probably an overstatement, but I am usually very uncertain about how people feel about me.  My brain tends to hone in on even the slightest hint of anger or ambivalence.  I can never quite seem to tell what people think of me.  On the one hand, my brain sees lots of anger.  On the other hand, I often don't see much angry behavior directed towards me.  Or at least not a huge amount of it.

So yeah, social situations are very confusing and difficult for me. 

It's not just random social situations, either.  I've often thought my mom was angry at me or yelling at me when she wasn't.  She might be stressed, even if it's unrelated to me or the ED, but I interpret it as anger.  And when someone is mad at me, I feel that they must hate me. 

What this really means is that I feel I live in a hostile world.  It's scary, and it doesn't help with my stress level.  It helps to explain some of the reason I have lots of anxiety, and why I tend to isolate myself.  Meeting new people means wading through even more uncertainty and feelings that someone is angry with me.  Anorexia played into this by almost buffering me from these feelings.

I find reading these studies helpful because it helps me reframe social situations.  Instead of leaping to conclusions that, in fact, people really do hate me, I can remind myself to wait for something more concrete than random worries.  I can try to assess the situation before letting my emotions take over.  I still don't like social situations, but I'm getting better at dealing with them.

If two's company and three's a crowd, and if the third wheel is usually something that feels unnecessary, then I usually feel like the third wheel when I go out with people.  It's not that I feel less welcome than, say, the second wheel, but I do feel like an add-on.

It's not what others are doing, it's what I associate it with. When I was younger and in elementary and middle school, I was usually the last person picked for group activities, for teams in gym class, for pretty much anything besides academic projects, in which everyone could mooch off of me.  You know how there would be an odd number of people, and you'd have 10 groups of two and one group of three?

I was almost always in that damn group of three.  Not because two people wanted to be with me, but because the teacher or whoever stuck me with someone.

So yeah, I really dislike that feeling of being a third wheel.

And because I haven't really established my own group of people where I live now, and because this stupid dating thing is slow as hell, I usually end up tagging along with my parents.  Like I said, I don't feel unwelcome, but I do feel unwieldy.  It reminds me of being back in the third grade and waiting for someone to take pity on me.

It's that feeling that if I left, everyone would still have somebody else.  Feeling extraneous.  Not unwanted or unwelcome, but unnecessary.

I hate this feeling.

I know I'm not in third grade anymore, that no one's making my friends and family include me in their activities.  I know they genuinely want me there with them.  That's what makes this different from third grade. 

The other thing that grates is that I'm how old and the only people I have to hang out with are my parents?  It's...disheartening? Embarrassing?  Pathetic?

Despite knowing that my friends and family really do want me to spend time with them, I still often feel that I need to fend for myself.  That if I'm not careful, I will once again be left alone.  That no one will pick me out and say "I want to be her partner!"  I've never really experienced that.

I try not to let these feelings get me mopey, but, the fact is, they often do.  And these feelings stir up that nasty pot of loneliness, which sucks.  I feel like I am working hard, I am doing all the right things to meet people, and I still spend my Saturday nights with my parents.

The only question I can ask myself is: what the hell is wrong with me?

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.

Last week, I was freaking out about the start of group therapy led by TNT.  Tonight was the second episode of Group Therapy, TNT-style, and it was much less intimidating than last week.  I wasn't quite looking forward to going--therapy is a positive experience, but it's not fun--but I wasn't freaking out, either.

Facing your fears sucks, and usually facing them results in this gradual ebbing of fear.  It usually happens so slowly, or over such long periods of time that you don't get to notice.

I noticed this week.

I still struggle with getting out of my head each week and really participating in the group.  I usually have comparison-itis, much of which is related to my own body image issues, and the rest of which has to do with how others are dressed, how they talk (ie, thinking I sound dumb when I open my mouth), if they work harder than me or have a cleaner house.  Things like that.  And it's all an excuse for me to find a big metaphorical stick with which to hit myself.

I'm guessing this isn't the point of the group.  Especially because I can compare and despair without driving for an hour and paying for group and individual therapy.  I know this has nothing to do with what everyone else has done, and much more to do with my own deep-seated feelings of inadequacy.  I'm starting to realize that I'm wasting much of my life beating myself up for things I have no control over, when there are really much more productive ways to use my time.  Like for the pointless navel-gazing I like to call blogging.

I think group will be good for me.  It's good to spend time with people who relate to what you're going through and can provide instant feedback.  I guess TNT knew what she was doing when she said that group would be good for me.

TNT is starting a therapy group, and she wants me to go.  The group is CBT-based, and it's sort of an "Advanced Recovery Skills" group.  In order to attend, you need to be asymptomatic in your ED and at least decently into recovery.  I fit the bill, and TNT wants me to come.  She says "it will be good for you."

I think all therapists say this when they know you're going to object to their advice.  It's in the Therapist's Handbook that provides scripts like "Tell me about your mother," and "How does that make you feel?"  Okay, I'm being somewhat sarcastic, but still.  I definitely have mixed feelings about group therapy.

I agreed to go, and I had to commit for the first month.  So four Mondays, 1.5 hours each week, 6 hours total.

But still I worry.

I worry I will have nothing to say or contribute.  I worry I will be either too utterly mental or too normal.  I worry the group will turn into a competition-fest.  I worry that no one else will think I should be there.  I worry I will waste everyone's time.

And yes, sad to say, I worry a lot that I will be the fattest one there.  I've already gained over my target weight--significantly over my target weight.  Whether that means the initial target was wrong or that my body wants to hang onto some extra weight because of the years of starvation, I'm not sure.  So yes, I am very uncomfortable with my weight right now.  It's worse because I have no idea of my actual size (I know, I can look at the tags on my jeans, but unless I know everyone else's pant size, I have no real way to compare), and so all I can do is obsess about how large I really am.

I know EDs can come in any shape and size.  I know that.  This comparison is much more of an internal thing.  It's competition combined with body dysmorphia combined with the fact that I have no real idea how big my ass is.  When I see pictures of myself from New York two weeks ago, all I can see is how huge I am.  It blots everything else out.  I get panicky and start to feel ill. I'm HUGE compared to everyone else.  And I'm so disgusted I kind of want to throw up.

This is the part that TNT thinks would be really good for me to deal with in group.  That would be a fantastic group icebreaker: "I feel like the fattest one here. Let's discuss." 

So, yeah, group therapy.  This should be really interesting...

Those three words have been the curse of my life. If I had to identify one thought that has plagued me for as long as I can remember, that has to be it. The feeling has always been with me. No matter what I do or how hard I try or how much I achieve, I never feel that I have accomplished enough.

I used to think that if I could just get one more good grade or lose one more pound or get one more pat on the back, then I would finally fill up my "enough" deficit. I've had enough therapy to realize that there is no amount of achievement that will ever make me feel good enough. I was lucky in that no one made me feel this way. My parents never criticized my report card or told me to try harder. They never pressured me to achieve academically--in fact, I think they would have loved for me to bring home a "B" just so I would see that it's not the end of the world.

I look at my resume, and all I see are people who have done more. It's what psychologists call "upward comparison," when a person compares him/herself to those who are somehow "better off." The wide world of the internet, the fact that I have freakishly successful friends, and my own abysmal self-esteem means that I perceive many people as being more successful than I am.

There are a lot of really amazing, cool, brilliant, successful people out there. In many ways, it's inspiring and I feel honored just to be allowed to listen in on some of these people's conversations. These conversations also make me feel tremendously insecure, because my Inner Critic voice is blathering away in the back of my skull that "I suck, I suck. I don't have get paid to blog about science. I haven't won any awards. I haven't gotten any feature-length stories. Therefore, I suck."

I am aware that I'm measuring myself against Pulitzer Prize-winning veterans of science writing. And I still feel that as a newbie to the field, that I'm never going to measure up.

This "upward comparison" helps explain why I get so distressed sometimes at seeing images of freakishly thin women. It's not so much the thinness, but the achievement of thinness that gets me. The thinness itself is irrelevant. But the fact that someone has "achieved" something I haven't really tortures what little there is of my self-esteem. When I get depressed, these "I suck" mantras only get louder and more constant. My initial attempt at losing weight was a way to make these mantras shut the hell up. I just wanted to feel better.

And, like so many other things in my life, I never felt like I had lost enough weight. There was always someone thinner or sicker than me.

It's a shitty way to go through life, in this frenetic quest to achieve something, anything, just so you can feel good about yourself. And the achievements, when they come, do give a momentary rush. Just as quickly, the rush is gone. Only now, the bar has been raised, the achievement itself has been discounted and brushed off, and nothing less than the past achievement will be tolerated. The demands go up and up and up.

This is one of the mindsets that still leaves me paralyzed and unable to really move forward. I can't imagine ever feeling like a success. I can't imagine looking over my resume and feeling satisfied. I get frustrated because I know I have accomplished what looks like a lot of things to outsiders. It just doesn't feel that way. Nothing is ever good enough. I want it to be. I want to feel successful and satisfied, I just can't figure out how.