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 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.

"Do something every day that scares you."
--Eleanor Roosevelt

If recovery had a quote, this would definitely be it.  Recovery is about pushing yourself and challenging yourself every single day.  An eating disorder traps you in a world of fear and anxiety.  Yet to break free, you need to experience even more fear and anxiety, and learn how to live in tandem with that fear and anxiety.  I've been an anxious person all my life--I was before AN, and I am after.  I worry and get fearful rather frequently, usually about pretty minor things.  Much of the AN helped me avoid these fears and anxieties.  I didn't have to worry about social rejection because I never went to parties because there would be food.  I didn't have to worry about not doing well in school because all that mattered was sticking to my eating/exercise routine.

Recovering meant not just embracing food anxieties (it wasn't easy, but it was relatively straightforward) and learning how to live with the more existential anxieties.  Things like: who am I? What do I want to do with my life? What do I want to do with my free time? What do I want to wear?

Recovery means that I am risking being wrong.

That scares the snot out of me.

The safe protected life that my anxieties would like me to live (the one where I eat the same thing, wash my hands in Clorox, and check and re-check everything) isn't always the life that I want to live.  It's not the life that I know would be fulfilling and make me truly happy.  That means I have to push myself.  Every day, I have to do something that scares me.

Sometimes those scary things can seem silly.  Things like just relaxing.  Or saying hi to someone.  It can mean leaving the house when I feel disgusting.   Answering the phone when I want to isolate.  Or not answering the phone when I don't feel like talking right then.

Life is fraught with uncertainties.  I can say that and say that, and it still doesn't get any easier.  Nor do I like it any more.  But there's also that radical acceptance that uncertainties are the price I have to pay for a life well-lived.

So I keep pushing.  And being scared.  And pushing again and again.  These things don't get less scary, but the thought of pushing myself does.  Part of the mental "game" of the eating disorder was seeing how long I could go without eating, how much I could exercise, how little I could weigh.  So I try to remind myself that meeting challenges is something I thrive on, and it's something I do well.

Lest I drift into the category of unbelievably sappy, I'm going to stop here. :)

One of my favorite blogs is F*ck Feelings, and last week, they addressed fear and anxiety. Although not fear per se, but rather our fear of fear and anxiety. Oh dear--I'm making this quite a bit complicated. I'll let "Dr. Lastname" from the blog introduce the subject for me:

Fear isn’t all bad (e.g., fearing snakes goes a long way towards keeping you from poison venom). On the other hand, fear itself is stressful and painful, so our first instinct is to avoid it, no matter what…which is, of course, when things start getting really frightening. No matter how much we want to protect ourselves or those we love, it’s not gonna happen, so we have to accept the unavoidable scariness of life (and anacondas). It won’t necessarily calm you down, but it will give you the strength to do what matters, fear or no.

Anxiety sucks. There's no getting around that. Anxiety is also pretty normal. It's when we organize our lives around avoiding or neutralizing that anxiety that it becomes really problematic. Of course, it's easier to say that when you're not anxious all the freaking time, but that's a bit of a different story.

I'm good at avoidance. Like really, really good. When I get really stressed, I turn ostrich-like and try to avoid whatever is freaking me out. If I'm anxious about making a phone call, I put it off. And off and off and then even further off. If I'm anxious about what I'm going to eat, I used to avoid eating, or eat only a few specific foods that provoked the least amount of anxiety. If I'm anxious about what might happen if I don't exercise, I just make sure I exercise. The more I avoid these things, the more fearful I become. It becomes more and more certain that something bad really will happen if I make that call, eat that food, or skip that workout.

From the time I was 13 or 14, my life has been dictated by anxiety, be it OCD-driven (mainly germ and contamination fears), about school/work, the eating disorder, or something else entirely. Through recovery from my eating disorder, my anxieties about food haven't gone away. They're still there. What I've learned in my recovery is how not to let my anxieties about food dictate my life. And the more I disregard the dictates of my eating disorder, the less important those dictates really seem.

True, the eating disordered fears still occupy way too much room in my skull. I still do a lot of things to avoid fears about eating more than what my meal plan ways, or exercise less than the maximum I'm allowed, or eat something that isn't the lowest-calorie version. Some of the reason I haven't challenged these is that they really haven't gotten in the way of most of the things I want to do. The other reason is that, well, I'm scared. I know the anxiety won't actually hurt me, but I don't relish the idea of provoking the anxiety demon. Best to let it sleep, right?

Except that I can't recover if I allow these pretty major fears to dictate my actions. All I can do is confront these fears and stop letting them tell me what to do.

Well, I did it. I'm done at the bakery, I've submitted my new insurance information, and I am now officially a full-time freelance writer.


Last night was my last day at the bakery, my last day as a bread slinger, pie wrangler, and muffin maven. I was getting ready to leave and drive home a woman who lives near me, when told her tonight was going to be a fun ride home. Her initial thought was that I was going to be all giggly and buzzing because I was leaving. No, I told her, the ride home was going to be fun because my rearview mirror fell off my windshield and was dangling by its wires. It looked something like this:

I took a deep breath, and I did it. I quit my job at the bakery. I gave my two week notice this afternoon, and I will no longer be an employee of the bakery as of August 5th. My boss took it surprisingly well. She knew the second I pulled her aside and asked "Do you have a minute?" that I was going to leave. Bless her (occasionally flaky) little heart, she gave me a big bear bug and told me she was really happy for me.

So I guess that's it. I guess I really have committed myself to writing full-time.

I think I'm still in shock. It doesn't seem quite real yet. I have never really done the brave, adventurous thing in my life. I've done plenty of things that are interesting and unusual, but I've never sort of leaped off the cliff and figured I'd learn how to fly before I hit the bottom. I'm harm avoidant. I don't like doing things unless I know how they're going to turn out and that I'm going to succeed (keep in mind, this is a perfectionist's definition of success, too!). I was lucky in that I did many things well enough that I could stay safe and be fairly successful. With my writing, I tested the waters while still saying "safe" and ensconced within my very predictable little world. Although I loved writing and--more importantly--being a writer, I felt compelled to remain on terra firma. Where I was safe, but in high school guidance counselor speak, was "not living up to my full potential."

Have I mentioned that I both hate heights and the sensation of freefall? Both make me want to puke. Kind of ironic for someone in recovery that so many metaphors for what I just did are leaping into the unknown.

I always loved this quote by Anais Nin: "And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom." My therapist back in Michigan loved that quote, and we often discussed it in the context of recovery. After all, one of the factors prodding me forward was the realization that staying in the ED was more painful than facing my fears of getting better and all it required.

Now, however, I'm realizing that this quote is even more appropriate for what I'm feeling now. I'm still the same harm-avoidant person I always was. It's just that I'm seeing the harm in not going for it, in not following my dreams, as well as the harm in falling kersplat on my face and looking like an idiot. There's risk in both. But my harm-avoidant self recognizes more harm in not taking the leap than in staying safe and predictable.

It's quite an interesting change for me. One that is probably going to require lots of Dramamine.

I was in the middle of writing another post when I got the ever-appreciated ding that a friend had sent me a message via Facebook chat. I met this friend (let's call her N. to keep her anonymous) in the writing program I was in. We shared a room at a conference and generally got along splendidly because of some similarities in our pasts. Both of us had our share of mental health issues and had spent time in psychiatric units. We discussed our various medications with no small amount of glee. And we both found ourselves struggling after graduation, both of us having difficulty finding our way in the world. We kept in vague touch, although neither knew the full story of what happened with the other person.

So N. asked how I was doing, and I decided to come clean with the story of my relapse and what I was up to now, and I was relieved to hear what kind of support I got. It was so nice to just share what had been going through my mind, and how I felt like our program screw up because of all my issues. And N. said, basically, no, I couldn't be the program screw up because that job was hers. I was just about to assure her that this was one job she was safe resigning from when I had to laugh. It was like those interminable conversations with other people at treatment, as to who was the fattest. And everyone always insisted it was them no matter how often the other girls said that no, they were the fattest ones there. It was a losing argument, and no one ever had an accurate idea of their true shape and size and the end of the discussion, but we always persisted on having them anyways.

Still, it was reassuring to know that someone else was floundering in life and thinking they were a failure and wondering how they were going to be a successful writer when all they could see was this big black wall of FAILURE sitting in front of them.

As I was chatting with N., I was reminded of a visit our program got by someone who had graduated several years previously. She told us of how much of her early career could be described in one word: flailing. All of us in the program laughed nervously, knowing that this experience was waiting for us, too.

And it was. It really, really was.

So I reminded N. about this quote, and I told her: Maybe we're not failing. Maybe we're just flailing.

She agreed and the conversation drifted, as conversations tend to do. We eventually started talking about our current writing projects, me with my freelance projects and her with her novel. Then N. said something rather profound:

Just sitting down to write every day is an act of amazing courage on my part.

I had to agree.

It's hard for me to express to other people just how much courage I have to muster up to get through the day, how much energy it takes to look "normal" sometimes. Sometimes getting out of bed is an amazing act of courage. Eating sure is.

We all have things--courageous things--that we do every single day. Just because they're ordinary doesn't make them any less courageous.

What's your "amazing act of courage"?

I recently read a blog post by Harriet Lerner about anxiety-driven mantras. In the post, Lerner talks about how certain thoughts run through our brains over and over again, usually having to do with being mistreated. These thoughts suck up tremendous time and energy and get us absolutely nowhere.

But Lerner's definition of an "anxiety-driven mantra" was different than what I expected. I immediately thought of an anxiety-driven mantra as the fear that's at the root of all of my angst-ridden ruminations. For me, that fear is pretty simple. My anxiety-driven mantra is this: I'm a failure.

It's what I fear most.

I realize that fear of failure is fairly common, and, to some extent, at least a little bit understandable. My problem is how I define "failure." My definition can be summarized as "anything less than perfect." And since nothing is really perfect, I'm pretty well f*cked in that respect. Even as I am praised by friends and family for writing a book/tweaking a recipe/tying my shoes, I feel like a failure inside because inevitably, it wasn't perfect. The anxiety leaps in here, because I fear that it's just a matter of time until my innate failure becomes obvious.

Hence the never-ending feelings that I'm a fake and a fraud, and the all-consuming fear that one mistake will mean everyone will find out they've been fooled.

The more I think about it, the more I realize that this mantra is also linked to my eating disorder. Gaining weight would make me a "failure." I would have "failed" not only at anorexia, but it would mark me as someone who was weak-willed, and that would make me a failure. Our culture's idea that losing weight is always superior to gaining certainly played a role, but rarely did I fear that others would think I was a failure for gaining weight. I knew pretty much everyone would think that gaining weight would improve my appearance. But it was my own personal standards against which I would judge myself a failure.

And here, too, the AN was a way of telling myself that even if the rest of my life goes to pot, at least I can do one thing right. My not eating made me feel better both in terms of anxiety and depression, and it provided a reassurance (however flimsy) that as long as I was undereating and overexercising, then things would be okay. I would not be a Total Failure^TM.

This is irrational. I'm aware of that. But it's how I've always thought. This is how my standards have always been, despite reassurances from friends and family that a B really was okay and not the end of the world. But it was, I insisted. Where will a B end?

So that's my anxiety-driven mantra: a fear of failure and a desperate need to avoid it. What's yours?

"A soteria is the positive analogue of a phobia. A phobia is an irrational fear of some object, whereas a soteria is an irrational attraction to some other object. In popular US culture, the most famous soteria is Linus's blanket, but I bet that most of us have our own examples, even if we don't have a label for them."

So writes psychologist Christopher Peterson in his blog The Good Life. I've written before about how many aspects of an eating disorder seem like a phobia, but there are also many aspects of an eating disorder that seem like a soteria--albeit a sick, twisted, messed-up one.

Let me explain a bit. I've often thought of my eating disorder as my metaphorical security blanket. No matter how bad the world got, I could always cuddle up with my blankie and make everything okay. Instead of swaddling myself in fleece, I swaddled myself in starvation, exercise, bones, and three layers of hoodies. In a sense, the AN protected me from having to deal with life because the starvation and obsession blunted the sadness and anxiety I so often felt. As long as I was losing weight, or eating a prescribed food plan, or exercising, then nothing else mattered. This happened biochemically, of course, but it also happened in a more nebulous, existential sense. I organized my life around the rules of anorexia.

In a sense, I suppose my OCD rituals and compulsions were also like a soteria. They made the world seem okay. They provided me with a sense, however fragile and fleeting, that I could handle things.

That being said, neither the eating disorder nor the OCD were really a soteria because they weren't a positive analogue to anything. I've never really had lucky socks or a very special token. Outside of the brain disease induced superstitions, I am much more on the dully rational side. And yet I crave the comfort and security of something, of...well, I don't know what. I have a few possessions with an unusual level of attachment (my crochet hooks, my journal, several stuffed animals) that I suppose form sort of what a soteria is. But I can't think of anything concrete, nothing that would counteract the hold of the eating disorder.

I don't know- maybe I don't need something specifically concrete. I would almost prefer something to do, a drive or passion that would overpower the continuing allure of ED thoughts and behaviors, rather than an inanimate object. I'd like to have something, although I'm not sure deliberately looking for a so-called "security blanket" will be the same as just becoming attached to some tatty blanket.

Do you have a soteria? How did you find it?

At an initial glance, a new study from the Journal of Consumer Research appears to have absolutely nothing to do with eating disorders. It wasn't about magazines or models or the purchase of diet products. The title of the paper had the rather bland-sounding titled of "Counteractive Construal in Consumer Goal Pursuit." That sounds as exciting as organizing my sock drawer. Rather, what caught my eye was the title of a news brief about the research titled "Resisting temptation is easier for those who exaggerate the threat."

And I thought, "Huh. That sounds a lot like what happens in eating disorders."

It sure does.

The authors of the research did four different studies, which they looked at to draw their conclusions. Two of those studies had to do with dieting and weight loss.

From a press release:

“Four experiments show that when consumers encounter temptations that conflict with their long-term goals, one self-control mechanism is to exaggerate the negativity of the temptation as a way to resist, a process we call counteractive construal,” the researchers write.

For example, in one study, female participants were asked to estimate the calories in a cookie. Half the participants were told that they have the option of receiving the cookie as a complimentary gift for participation and half were not. The results showed that consumers with a strong dieting goal construed the cookie as having more calories and being more damaging to the attainment of their long-term goal of losing weight.

{snip}

In [another] study, female participants entered a room that either had posters depicting fit models or nature scenery. “Participants who were exposed to posters depicting fit models (goal-priming stimuli) were more likely to exaggerate the calories in a tempting drink that they expected to consume later on, and consequently consumed less when offered the drink,” the authors write.

The relevance to eating disorders is obvious, even when you ignore all of the stuff about weight loss. That's not what I find the most interesting. The key words that leaped off the page at me were "resisting temptation" and "exaggerate the threat." For many people, temptation is temptation. Someone who is predisposed to an eating disorder, however, may be much more likely to view temptation as a threat. You can add me to that category. People with AN in particular are prone to asceticism, which Wikipedia defines as "a lifestyle characterized by abstinence from various sorts of worldly pleasures (especially sexual activity and consumption of alcohol) often with the aim of pursuing religious and spiritual goals."

Want something even more ascetic that renouncing sex and booze? Renounce food. If these things weren't considered somehow "tempting"--read any nutrition advice about the holidays and you'll see what I mean--then they wouldn't need to be renounced. Many people with AN struggle with including pleasurable things in their lives. I'm not talking about pleasure from a night with your latest order from Good Vibes and a pair of AA batteries. I'm talking about the pleasure of relaxing in front of a fire, leaving the dishes until morning, going to a party even though you have a paper due the next day. Little things. I don't find them alluring as much as I find them anxiety-provoking, perhaps because they are so alluring to me. The thought of holding up a bank doesn't cause me anxiety because I have no desire to do so.

So there we have the part about "resisting temptation." Now we get to the part about "exaggerating the threat." The all work, no play work ethic of mine gets its oomph largely from my fears of what will happen if I play. How can I relax when there are stories that need researching and writing? How can I leave the dishes until morning when there might be a bug problem? How can I skip working on my paper, which could mean that I do horribly, fail the paper, fail the class, fail out of college, and wind up living in a cardboard box?

Like I said, "exaggerating the threat."

I'm a veteran calorie counter. When I'm wrong about the calories in something (which I occasionally am, although after 10 years, there's not a whole lot that I haven't already looked up), it's because I grossly over-estimated the number of calories in something, not an underestimate. An extra bite becomes 1000 extra calories in my mind. And when you consider that food is anxiety-provoking to people with eating disorders, there's already that tendency to exaggerate how awful, fattening, and massively portioned a food was.

Besides my food issues, I am also terrified of spiders. I've whacked off several roaches, millipedes, centipedes, and other bugs I didn't take that good of a look at. I don't like these bugs, but I can at least get rid of them with some shred of self-respect. Spiders are another matter entirely. Even a daddy long-legs seems huge to me. I see one and I scream like a girl. The other girls in my dorm always asked me to be on spider patrol because I was a "biology person." All I could think was that I use a microscope, not a fly swatter. Spiders seem massive to me- a literal interpretation of exaggerating the threat.

So when food seems far more threatening than it is tempting, it's easy to see how avoiding food would become almost instinctual.

This fantastic little tidbit titled "Scare yourself skinny" is almost inconceivably wrong. The blog is about pretty much what it sounds like: how anti-obesity campaigners can use fear to scare people thin. The idea comes from the use of warning labels on cigarette packets. Before the labels, cigarettes were cool and hip. Now, they're cancer sticks. The labels and warnings may very well have prevented me from starting smoking, but I'm not sure they would have been enough to get me to quit. It didn't work that way with my eating disorder, and I don't think it would work that way for smoking or weight.

Still, it's a popular tactic, as evidenced by the recent New York City Health Department campaign in favor of calorie counts on menus and subway posters titled "Pouring on the Pounds." (h/t VoiceinRecovery for pointing out the posters to me several weeks ago). You can even adopt a five pound piece of pet fat to help remind you of that icky icky fat you just don't want to have (all for only $149.95 plus shipping!). I personal prefer the little fuzzy adipose cell at Giant Microbes, and have adopted one myself to remind myself that fat isn't all bad.

There is the minor detail that fat molecules line all of our cells, and help conduct nerve impulses. It makes our hair and nails shiny and healthy. It provides padding against injury and daily wear and tear. It helps keep us warm. It's not all that bad.*

The author of the blog post cited several studies that showed how fear tactics can work to change behavior. And if you were just considering the short-term, I would tend to agree. But even I, Anxiety Freak Extraordinaire, become inured to risk and fear. Serious ED symptoms rapidly stopped frightening me. It was just the way things were. Fear tends not to change things long-term.

There's the small fact that people aren't fat just because they're not scared enough of it. Our culture is awash in this fear. I can't believe that people aren't aware of it. Then there's the fact that some people aren't fat because they drink too much Coke and too little "water, seltzer, or low-fat milk." Some people are just fat, and no amount of fear is going to make them lose weight.

Weight has an environmental element, true. So does height. Where, then, are the articles titled "Scare yourself tall"? Shouldn't you be scared of your decreased salary? Shouldn't you?

(EDITED TO ADD: I just found a great piece in Slate tackling the politics of the "soda tax" called The Growing Ambitions of the Food Police.)

*Yes, I'm trying to convince myself of this, too.

At this year's NEDA conference, I attended a session titled "Dangers and Phobias," which was a three-fer session: the first part was on the dangers of eating disorders, the second part was a whirlwind tour of neurobiology that even I could barely follow, and the third part was about phobias and eating disorders. Now, an eating disorder isn't just a simple phobia of food, but a food phobia is a major part of an eating disorder. This phobia takes on different forms in different eating disorders (it might be a phobia of eating carbs*, or a phobia of not throwing up, etc), but this phobic response is almost always present.

Maybe it's because I also have a hella lotta anxiety issues outside of the anorexia, but this presentation on the relationship between eating disorders and phobias really hit home for me. I became anxious around food, so I started avoiding it. This decreased my anxiety to a point, but then the anxiety came back. So I avoided it more. And so the cycle continued. Each time I avoided food, it cemented that fear. If I eat, I thought, something really bad is going to happen. That "something bad" could be a magical mysterious weight gain of 100 pounds, it could be I would feel like crap, it could be that I "ruined" the day. When nothing bad happened (as it usually did), I linked that to not eating. That tiny shred of self-esteem from watching the scale go down? That was because of my not-eating. The stylish new jeans I let myself wear? Not-eating. The (seeming) decrease in fear around food? Not-eating.

Eating would somehow erase all of that. Eating and gaining weight would remove the whole foundation on which I had built my life. That's a pretty big fear.

I discussed this fear in therapy a lot, which was much more enjoyable than facing the fear. I learned where it might have come from and what purpose it might be serving. All of this discussion did precious little to alleviate these fears. In fact, the longer I went on not-eating, or purging, or over-exercising, the more these fears cemented themselves in my brain. Many aspects of these phobias turned into habits.

I've been facing these fears head-on in the past few months. Not dissecting them, not just introducing myself by with stickers saying "Hello My Name Is" and then moving on, but having the kind of staring contest with them that even my cat would envy. Did I gain weight when I started eating again after this relapse? Yes. I also needed to rather badly, but still, weight gain was an element. Did my world fall apart? Yes, but it fell apart because of the fears, not from facing them.

Do I have my moments? Um, yeah. I'm not happy-go-lucky about food, nor do I think that would be a reasonable goal for me. For that matter, I don't want to be totally nonchalant about food. When I get sloppy, I start skipping meals and then minimizing the negative effects of said skipped meals. Paying attention isn't a bad thing.

I don't know sometimes if I'll ever be totally "over" this fear. I hope and believe in a time when it won't rule my life, but my years with anorexia have profoundly changed me. There's no going back, but there is the moving forward.

*Blogger spell check doesn't recognize the word "carbs." Can I tell you how excited that makes me?

In the news lately, I've read a lot about buyer's remorse and the role overspending may have played in the current economic crisis. But in today's New York Times, a story looks at the dangers of oversaving. Psychologists have dubbed this phenomenon "hyperopia," the medical term for farsightedness, as "it’s the result of people looking too far ahead. They’re so obsessed with preparing for the future that they can’t enjoy the present, and they end up looking back sadly on all their lost opportunities for fun."

Just as the immediate rush of a purchase doesn't last forever (hence buyer's remorse), neither does the guilt over the purchase. Researchers found that students who spent more of their spring break studying/working, as opposed to relaxing/partying, had more regrets over the way they spent their time when they were surveyed one year later. Dr. Ran Kivetz of Columbia University, and someone who researches consumer behavior said, "what builds up is this wistful feeling of missing out on life’s pleasures.”

This...this I understand. In fact, this pretty much summarizes my life. I'm not unsympathetic to those who have trouble with managing their money, nor am I particularly proud of this. But I also know that the regret is very true and very real. I don't remember much of college. I remember the chair in which I studied so often. I remember being so exhausted that I was constantly on the brink of tears, and then became even too exhausted to cry. I hate the scent of Juniper Breeze lotion from Bath and Body Works because I used it during the worst of my days and the scent always takes me back to that awful place.

Obviously, mental illness contributed to this hell. I won't deny it. Yet I don't know for sure whether I would have been able to loosen up even if I wasn't clinically anxious and depressed.

Kivetz has this to say:

“Don’t be too hard on yourself,” he said. “Obviously you need to be responsible and conserve your savings. But it’s been a depressing winter, and there’s nothing wrong with indulging yourself a little. This is a chance to reassess the quality and the balance of your life and to think how you’ll feel in the future. As long as you can afford it, it’s not a bad thing to be enjoying yourself.”

Enjoyment is the key word, as the hyperopia I experience extends far beyond money, and I'm guessing that's the case with others as well. It's about the price of enjoyment, or even (might I suggest) the fear of enjoyment. I will occasionally "enjoy" things, but only if I've earned them. And I put a high price on fun and relaxation. I'm not talking about making sure the cat has food before you go out for dinner. I'm talking about making sure the carpet is vacuumed, the laundry is folded and put away, the papers are organized, and the bills are paid.

This is some of the hardest thinking to break, because I've always been this way, and my parents definitely tend towards this way and I don't know any other way to exist. My threshold for fun and enjoyment are probably way lower than others' and I'm okay with that. But this article just really summarizes the dilemma in which I find myself so often, and the worldview that really contributes to the anorexic thinking.

Thoughts?

On my last post about my upcoming series on the biology of EDs, Susie asked this:

i'd certainly be interested in medical complications. you never know, i may read something that shocks/scares me into gaining weight.

To be honest (and bluntness is a character fault of mine, so I do apologize if I sound harsh), there are two answers to your question. The short answer and the long answer.

The short answer? Nothing will scare you into gaining weight.

The long answer? Unfortunately, the more you read, the more convinced you become that you can escape the consequences. Or, for me, the longer I was sick, the more I began to experience these medical consequences. And so where I was originally faced with a list of problems A through F that could arise from my ED behaviors, I found that A, B, and C had happened and I had lived to tell the tale. Ergo, I wasn't that sick. So D, E, and F really couldn't be that big of a deal. Then D, E, and F happened and I was still sick and unable to see that I was sick and then I learned about G and H.

You get the drift.

The fact that you have an eating disorder prevents you from understanding the full extent of your illness. It's called anosognosia- a lack of insight into illness. It's not a character flaw, it's just the way starvation monkeys with the brain.

Furthermore, fear doesn't change behavior. It just doesn't. Lasting behavior change really needs positive reinforcement, not negative. Because if fear worked, there would be a lot fewer smokers in the world. And the obesity hysteria certainly has people all worked up over the possible dangers of fat- yet most people tend to weigh about the same. Heroin addicts shoot up despite risks of HIV and Hepatitis C. People gamble knowing they could lose their house.

There are many positive reasons to get into recovery. But your brain needs to heal from malnutrition first, before you can really focus on that. Right now, when you're underweight, you're like a heroin addict, high as a freaking kite. You need to detox (ie, gain back to a healthy weight), and then you can try to find positive ways to stay healthy.

Find someone to help coach you back to a healthy weight. Reading about the medical complications that can happen if you don't probably won't help, though.

Fear and anxiety are a large part of eating disorders. Fear of food and gaining weight, or not being able to purge or exercise, etc, are the key hallmarks of the disease. A lot of recovery means unlearning those fears.

And it ain't easy.

Yet experiments have shown that in patients with OCD, a form of cognitive behavioral therapy called exposure and response prevention can physically change the brain (Adobe Acrobat required to view the link). The fears of OCD, though biologically driven, are also learned in some sense. They aren't innate, and the rituals and habits of the illness often ingrains them in the brain- literally. The brains of people with OCD look different than the brains of people who don't have the illness.

So if these fears are learned, then, they should be able to be unlearned. Which is not only true, but also leads to changes in the brain.

A study from the October 9 issue of Neuron found that "learned safety" can alter the size of the dentate gyrus, which plays a role in both memory and stress and depression.

From a press release:

The behavioral changes observed in the mice squelched anxiety as effectively as antidepressant drugs such as Prozac, said [lead investigator] Eric Kandel, who is at Columbia University. 'It's a little bit like psychotherapy,' he noted. 'This shows that behavioral intervention works.'

The new study is noteworthy because it reveals in elegant detail how behavioral conditioning can affect the brain. According to Kandel, knowing how behavioral intervention works at the molecular and cellular levels may prove to be an interesting route to identifying novel drugs to treat depression and anxiety disorders.

Intriguingly, genetic analyses revealed that in the amygdala, the brain's fear center, learned safety tunes the expression of key components of the dopamine neurotransmitter system and the neuropeptide system. Both systems are thought to influence learning, mood, and cognition.

The point of the study is not about drug discovery, at least not to me. Rather, I think it shows how powerful and important it is to learn how to eat without fear. Moving through those fears is so powerful that it can literally change your brain.

I was watching the evening news last night as I finished up one of my beading projects, and I heard a little promo for a story after the next commercials. It was something along the lines of "Scientists have found a new way to control our weight and make us look slimmer and younger." All of those phrases were in there, though I can't guarantee in what order.


The first thing that pissed me off: the headless pictures of 'obese' people lumbering around and eating french fries. They're people. They're not button-down shirts straining at the belly. They're not jiggling asses. People. You don't show thin people in this way. Thin people eat fries. Shirts can get too small on thin people (just let me do your wash and you'll see what I mean). Just another stereotype.


The second thing that pissed me off: the hype. As if we should be so excited that we can now conquer obesity like a platoon of armored knights charging the castle of obesity. Let 'em have it, boys! But dude- it's an empty castle. Conquering it will just cost money with no net gain at the end of the day. Is it just me, or does that sound like the war in Iraq? But I digress...


The third thing that pissed me off: since when is weight something that we should control? Wow, let's control our breathing. The amount of urine we pass each day. How many times we blink. Or swallow.


That's the assumption above all assumptions that gets to me: not only is weight something that can be controlled, but that should be controlled.


I hate to break it to you, but your weight is controlled by your DNA.


The gist of the story was this: back in the 1970s, before the advent of antibiotic treatment for ulcers and the development of effective acid-blocking drugs, doctors performed a vagotomy, in which they snipped the vagus nerve connection to the stomach to stop acid production. One of the side effects was weight loss. Now, with gastric bypass surgeries at over 175,000 per year, doctors are on the lookout for 'safer' means to help people lose weight. Enter the vagotomy. Again.


"Obese" volunteers for this surgery were not hard to come by- the fears of fatness and health effects of obesity in the medical community and the media, overblown when not outright false, has people lining up to lose weight and "get healthy." And so went the first round of surgeries. People did lose weight. Not as much as with gastric bypass, but they lost weight. Success!


I'm hearing that ca-ching sound right now.


One of the doctors of the pilot study said:

"But I think this will be a rational alternative for a cadre of patients that are sort of in the middle there. With as much obesity as we have in this country, that's a big middle."

You don't say. Or is it a large group of people who are being told to be afraid- very afraid- for weighing more than a little chart says they should and they're all going to wallow in their own fat and die. Only it's not true. But people believe it is and are willing to let someone snip away a nerve for false security and the hopes to prevent any range of health effects that "overweight" will bring.


I think the word predator comes to mind.

I've seen this headline quite a bit when journalists talk about eating disorders. Being a journalist myself (somewhat), I know the lure of a snappy title. Like the article I managed to write about the new choir director with an eye patch after he was in a motorcycle accident...and I spoke of his "new vision." Yeah. Good going there, Carrie. (Jane...this should make you feel better...AND making it into two blogs this week!) A headline is big, folks. It will make people read your story- or run fleeing.

I'm not saying that all articles titled, "Dying to be Thin" are bad or negative or any of that because I haven't read them all, nor do I think a bad title indicates a bad article. No more than a good title indicates a good article.

What I have issue with is the whole dying to be thin concept in general. When I was severely anorexic, I was dying all right. Not to be thin. Not to be anything. Just...dying. Of starvation. A very slow, miserable way to die. I was not doing this so that I could be thin. That's bullshit. It was a thing to latch onto, a way to explain the inexplicable. Why else would I starve myself? It wouldn't be as mundane as something as a phobia of food.

Or would it?

That's what it was, though. When someone who is scared of flying avoids planes, even a Medevac flight, we don't say that they're "Dying to stay on the ground." No. They're scared of heights/flying/whatever. When I had bad OCD in high school and was terrified of germs and AIDS, I wasn't dying to be clean- even though I almost attempted suicide because I didn't know what was happening and was so miserable.

I never wanted to be thin, really. I liked the idea, and it's intoxicating because most women in our society wants to be thin. I thought if I ate healthy and got rid of my tummy, then I would be happy, then things would be okay. I wanted to have the "perfect" diet and exercise routine. I wanted to feel comfortable.

Lo and behold...it worked. The first five pounds, anyway.

That's the thing with obsessions and compulsions. Your brain gets used to it, like an addict develops tolerance for a drug. Then it takes even more (compulsions, hooch, crack, heroin, you name it) to quell that horrific anxiety. And then, no matter how much you do or how little you eat, it isn't enough. Which is when it happens- the only conceivable thing you can identify as what's happening is that you're dying to be thin.

No!

I was dying to avoid food, to avoid my horrific fears. Of course they didn't make sense. Who in their right mind would be afraid of food? Would call Sweet N Low because they heard there were actually calories in those alluring pink packets and bitch them out for false advertising. Starvation drives you completely, utterly insane.

I might add that while I was at my lowest weight, I also had the top grade in the most advanced chemistry class on campus: physical chemistry (aka p-chem).

So don't tell me I was dying to be thin, because I wasn't. My anorexia wasn't about looks, or fashion or really about anything. Except fear.

The battle of the Supers! The Clash of the Titans! I am Spartacus!

I am Spartacus! I am Spartacus! I am Spartacus!

Sorry. This post has nothing to do with Spartacus.

What it does have to do with is our strange, messed up society that has Mickey D's commercials immediately preceding those for Weight Watchers or Jenny Craig. We have Super-size and Supermodels. Super everything. Supersized fries are evil, supermodels are evil.

We are, it seems, a culture of extremes. The larger our portion sizes get, the smaller we're supposed to look. And, in a way that only Americans can, we're beginning to tackle the issue.

Health class. I remember my first health class. Fifth grade, the filmstrip "You're Becoming a Woman Now," where a pimply faced girl with one of those side ponytails (this was 1990, keep in mind) slides a Kotex into her backpack. End of story. Both the ponytail and the whole notion of a "filmstrip" date me horribly, but still.

Now we try to terrorize children into the dangers of the world around us. Yes, the world can be a dangerous place. You can get raped, mugged, kidnapped, beaten, the clap, AIDS, fat. The whole nine yards. So we show SuperSize Me and have 11-year-olds read "Fast Food Nation." I'm not saying go Biggie size your fries every single day. But if you have a hankering for fries, then go for it.

The supreme irony is that this lecture is, no doubt, followed by the one on eating disorders. It doesn't take a rocket scientist to connect the dots.

There is a book out called Fat is a Feminist Issue. Since I haven't read it, I won't comment upon it. What is interesting is how the whole notion of "Fat" as a social concept has changed. Fat is no longer (just) a feminist issue. Fat is a fear issue. One should be afraid of fat and obesity, of the millions of Americans just lumbering along down the street, arms swaying in the breeze, gleefully munching away on hot dogs. I remember watching ads for Sweatin' to the Oldies, and watching Richard Simmons cart the extremely obese out of their homes on a forklift. A couple of tapes and some spangly shorts later- fit and fabulous!!!

Again, I suppose this dates me horribly. But anyway.

People do not typically change their behavior because of a fear somewhere down the line. So we start telling kids "You're getting fat! Just look at that adipose multiply! You can see it before your very eyes! Don't touch that french fry!!!" So you take a kid prone to anxiety and make them fear fat. So they cut fat out of their diet. Except in a small percentage of the population, they keep going. And going and going and going, a veritable Energizer Bunny of dieting.

To be sure, health classes usually have a lecture on eating disorders, which tends to be quite "tippy" if you ask me. Thin is good, fat is bad, so anorexia must be, like, awesome. Sorry, but that's the message out there.

I'm not one of those people who idealizes the past and thinks that everything was better back then. Maybe it was, maybe it wasn't. But let me tell you this: if I want a Snickers bar, then I'm damn well going to have one.

That's so super.