I just started reading Richard Dawkins' The Selfish Gene tonight.  It's considered a science writing classic, yet I still hadn't read the book.  It was either checked out of the library, or I forgot to look for it, or I could only find the super-duper deluxe anniversary edition at the bookstore.  But I stumbled across it at the library a week or two ago, and so I eagerly checked it out.

The idea of the book (if I can boil it down to a sentence or two after reading the first three chapters) is that plants and animals and microbes are really just genes' way of making more genes.  I haven't read enough of the book to know whether or not I totally believe it, but the book's thesis isn't really the point.  One of Dawkins' comments was that

A body is the genes' way of preserving genes unaltered.

Or, in non-Oxford University PhD speak, a body is the genes' way of making more genes.

As part of my eating disorder treatment, I learned a lot about how people viewed women's bodies over time.  They were objects or trophies.  Something to be subdued.  Something to be ignored.  Something to be feared.  And we discussed how we viewed our own bodies.  In my case, it was something to be conquered and tamed. Literally mind over matter.  I wanted to not need sleep or food or water or any of that.

It is one view of the body.  A skewed and not all that healthy one, granted, but it's a view.  Many of my therapists in treatment told me that I should think about what my body does rather than how it looks.  That my body should be my temple.  That I should love my body.

Mostly, I'm ambivalent about my body.  It does most of what it needs to.  It is what it is and I generally don't think about it too much.  No, I don't like how I look but whatever.

This quote struck me because it was such a different way of looking at a body.  Not wondering whether it was larger or smaller than me.  Or exercised more.  Or whatever.  Just that a body was what our genes used to make more genes.

The simple practicality of that statement--whether you agree with it or not, and as I said, I haven't finished the book, so I'm not going to say--was really eye-opening for me.  A body is functional.  Maybe the key to body acceptance is to stop making it so damn complicated.

I saw an update on Twitter this morning, linking to an article about how the German magazine Brigitte is going to cease using models in favor of "real women." (those two words are used in the deck headline in the Telegraph news article).

This got me thinking: what is a real woman, anyway? Are models, however starved and Photoshopped they might be, not real? Does that mean that models are fake women?

When I read that, I think of this past election when "real Virginia" didn't include any of the DC suburbs where I lived. I may have been a fairly new Virginian, but the state sure took my taxes! Northern Virginia might be more urban and liberal, on average, than the rest of the state, and it might not be what people traditionally thought of as "Virginia" (government stiffs instead of slackjaw yokels, if you really want to dig into stereotypes), but last time I checked, I was a Virginia resident. I was real. My vote counted as much as anyone else's.

So what makes a woman real? Is it like the Skin Horse in the Velveteen Rabbit? Is it the presence of breasts? A uterus? A monthly craving for chocolate? That seems awfully limited. A mastectomy or hysterectomy doesn't dissolve your womanhood- you're still real and you still count. A transgendered person (male-to-female) is a real person, in my eyes. They're not "fake."

What, then, is different about professional models? Their size? I worked with many TB patients who were almost as skinny as I was in the worst of the AN, but for them, it was a microorganism stripping the flesh from their bones rather than a brain disease. They were still women, despite their jutting bones and androgynous figures shrouded by sheets and paper hospital gowns.

Neither my TB patients nor many professional models look like the "average" American woman. And I think it's cool that the magazine is transitioning away from using professional models and using women you're much more likely to encounter on a 3am emergency trip to CVS to buy Midol, Tampax, and a pint of Chubby Hubby. (Not that I have any experience with this...) But even if I didn't encounter some svelte six-foot supermodel at CVS--though luck would have it that I likely would--that doesn't mean she's fake. Just rare.

Our idolization of her shape and size is our problem, not hers. We criticize these models, yet still buy the products they're advertising. It's probably impossible to avoid buying anything advertised by too thin men and women, but we can cut down. And who's to say that Brigitte will use women who look like "average" German women? They probably won't be the ones with zits and excessive facial hair.

I don't know that I have an answer to the question who is a "real" woman. I don't know that there is a single answer (one of the many reasons I avoided philosophy), but I do think that these semantics matter. Professional models aren't a foreign species, and all might not have arrived by their current figures through nature alone. That might make their bodies fake, but it hardly makes them fake.

My brain feels like mush. The cognitive affects of my ED are some of the most annoying for me to face. The physical stuff, I can usually manage. But not being able to think straight, or to read and feel the text somehow evaporate in the short distance between my eyes and my brain--this drives me nuts. Even the simplest of tasks, whether it's brushing my teeth or crocheting, leaves me feeling like this little guy here:



So what do you think a complete geek like me does when she gets frustrated and exhausted? That's right- she turns to PubMed.

I found this study on the reversal of cognitive markers of anorexia with weight restoration rather fascinating for both my current state of mind and current state of body. Granted, the authors studied adolescents on their first presentation for AN treatment, neither of which are true for me anymore. That being said, I'm not entirely sure that these reversals would have been different for longer-term patients, although they may have taken longer.

Like Ancel Keys found in the Minnesota Starvation Study, adolescents in the acute phase of AN showed slower sensorimotor responses to stimuli and were more affected by others' interference. Working memory, however, was not impaired. After weight restoration, the adolescents' performance on the first two tasks were significantly improved, and "relative to controls, they were significantly faster on attention and executive function tasks, exhibited superior verbal fluency, working memory, and a significantly superior ability to inhibit well-learnt responses."

So although eating right now is making me want to bash my head in (metaphorically speaking- my head is pretty darn hard and I would fear more for the wall than my skull), one of the advantages to eating is the reassurance that my brain will work better. If only I could get an off switch for the silly thing...

What helps you along in recovery? It doesn't need to be existential or even particularly significant, just what you cling to when the going gets tough.

You know how you're supposed to add the words "...IN BED" to the end of your fortune cookie reading? So now your fortune reads something like "The best is yet to come...in bed." And so on. Basically, you get to change a quasi-serious saying into something a little funny and risque.

Many different factors affect memory, whether it's neurochemicals, sleep, or trauma. And new research out of Tufts University shows that we can add carbohydrates to that list.

This research, in an upcoming edition of the journal Appetite, found that women who were on a low carb diet had poorer memory function than those on a low calorie diet. Both groups of women lost the same amount of weight over the study period. (A link to the study is here)

Pound for pound, your brain consumes more energy than any other organ in the body. And your brain lives on glucose- a simple sugar. Yes, your body can make glucose via a process called gluconeogenesis, but it's not enough for your brain, which requires at least one fifth of your daily caloric intake to function properly.

As it turns out, a low carb diet doesn't provide enough carbs for your brain's liking, and memory begins to decline within one week.

Says the press release:

Low-carb dieters showed a gradual decrease on the memory-related tasks compared with the low-calorie dieters. Reaction time for those on the low-carb diet was slower and their visuospatial memory was not as good as those on the low-calorie diet. However, low-carb dieters actually responded better than low-calorie dieters during the attention vigilance task. Researchers note that past studies have shown that diets high in protein or fat can improve a person's attention in the short-term, which is consistent with the results in this study.

Obviously, people with eating disorders (specifically the restrictive types, though people with more bulimic patterns usually have pretty restrictive diets outside any binges) tend to have diets that are low in carbs AND fats AND protein, which makes it really easy to understand why the cognitive effects are so severe. Your brain is affected by malnutrition much more quickly than other organs. Though they soon follow.

And if a run of the mill diet can do this to your brain, imagine what's happening to the brains of those with eating disorders, those on fad diets, those young, growing brains. These memory and cognitive effects happened within one week. Imagine one month...one year...one decade. What then?

How much brain power are we losing every day?

About half of the articles I see on eating disorders are titled "Dying to be Thin." This always irked me, and I started thinking about exactly why.

From the outside, it does seem like sufferers are dying to be thin."I'm not thin enough yet," they say. Or, "I'm not that thin." And perhaps that is what our minds make of the eating disordered experience. Dieting and thinness and virtue are all ideals in Western culture. And we all need to narrate our own experiences. Make it cohere somehow.

As someone who is about a religious as a gnat, framing my eating disorder in spiritual terms is not something that I would ever do. God is not punishing me. He is not trying to make me choose between him and Satan. Praying will not cure me. And I am not starving to get closer to god. I'm just not. I wouldn't say it if I had cancer, and I'm not saying it because I have anorexia.

Yet in the Middle Ages, the "fasting saints" did indeed starve as a means to get closer to god. It was seen as an act of purity and devotion.

Come to think of it, dieting and anorexia are seen like that now. If we stick to our diets, we are being "good." If we eating something we "shouldn't," we have been "bad." And just look at some of the pro-anorexia jargon out there. Purity is a HUGE theme. They have "Prayers to Ana*." Yet fasting is much less a part of organized religion (specifically Christianity) today than it was 500 years ago. The purity is still in a moral and cultural sense, but not as much a religious one.

So thinness is very much about our making sense of the illness. But is it really about the illness?

The more I look at it, the more I'm not so sure. I don't think the "drive for thinness" associated with anorexia is so much an actual drive for thinness. I think it's an intense fear of fatness. If you're scared of being fat, then the obvious solution is to try and be really thin. It's not entirely rational, of course, but there is a kind of screwed-up logic about it. And the terror is intense. I couldn't explain why. I didn't even really get all upset about other people's weights. I judged myself. Period.

Then there's my personal pet peeve about eating disorders being about "control." And like thinness, it sure does seem like it from the outside. Also like thinness, it is more about fear than control. In a way, it's a basic fear of food. If you think food is going to make you fat, and you are deathly scared of fatness, then it makes sense to be scared of food. Many run of the mill dieters are also afraid of being fat (hell, our whole culture is), but people with eating disorders often have a deep underlying anxiety about pretty much everything. I think the fears are stronger, more intense in people with eating disorders. But it's just a theory.

You aren't "dying to be thin." You're afraid of fatness, of your own weight. You aren't "controlling" your food. You're desperately searching for that control, and trying to control your fear of food. You aren't refusing to maintain a normal weight, you are unable to maintain a normal weight.

It's semantics, but it matters.

*I hate hate HATE the word "ana" for anorexia and "mia" for bulimia. It's trivializing. Use the full name or abbreviations like AN or BN. Ana is not a person. It's a brain disease.

When I started treatment for my eating disorder, I was always given the line, "It's not about the food, it's about the feelings."

As I've moved along in my recovery, I've learned that an eating disorder IS about the food as long as you are starving yourself, bingeing, purging and/or underweight. Your brain isn't functioning right.

However, I'm learning that feelings are involved, though not in the way I think the therapists meant.

I don't know that my eating disorder was ever a "coping mechanism." And if it was, it certainly never was intentional. I didn't stop eating to "cope" with feelings of inadequacy, emerging sexuality, or enmeshment with my family. That just wasn't how it worked. I thought that losing weight would make me happy and healthy. And then...I don't know what. It blurs together, stops making sense.

Anorexia and bulimia both are self-perpetuating illnesses. In a person predisposed to anorexia, a small amount of starvation feels...good...somehow. And the person keeps going. The same with bingeing and purging. They perpetuate themselves. Once you pass a certain point, you literally can't pull yourself out. You just can't. The disease takes on a life of its own, and you're simply along for the ride.

But the feelings.

Ah, the feelings.

Starvation and over-exercise are very numbing. They do neutralize those feelings of inadequacy and anxiety. They neutralize all feelings because the brain can't afford to produce those neurotransmitters involved in emotions. They're unnecessary.

Research has shown that people with anorexia* have inborn difficulties with processing emotions, with anxiety, with appreciating pleasurable things. If you're starving, you have no emotions to process. Losing weight is the ritual that helps decrease your anxiety. So the system works, in a sense.

Then you regain the weight and all of the same stuff is there, only you don't have that starvation neutralization effect going on. This is the part of ED treatment that really gets me: why therapists and hospitals and everyone seems so willing to back off once a sufferer gets to a healthy weight and stops behaviors. The worst is over, they think. They've done it. It will get better now.

Only the sufferer is more miserable than ever because there's no buffer from the eating disorder, and they still don't know how to deal with all of these crappy feelings.

This is where I spent years searching for answers. I was told that if I could understand where all of these feelings and behaviors came from, I could overcome them. "Why are you starving yourself?" I was asked. "Hell if I know," I said. So we would search and search for answers.

Insight wasn't my problem. I knew from the start that I was anxious, depressed, a perfectionist. I knew I was brutally hard on myself, but I thought I had to be. Learning that- shocker of shockers- I needed to be gentle with myself got me precisely nowhere. Except another visit to the psych unit.

What I needed was skills.

Do I understand why I developed anorexia? I had a genetic predisposition. That I know. The OCD and mood disorder didn't help things, either. Neither did perfectionism. But why I thought that losing weight would make me happy? I don't know. And I don't need to know. Maybe there is no answer, no good reason why. Maybe I just got dealt a shitty hand of cards, and I have to play the hand I was dealt.

Could eating disorders be women and men trying to be perfect? To live up to society's expectations? To look like models? I doubt it. That's part of it. It's the cultural context of the illness. In the Middle Ages, women (most of the recorded cases were in females) who starved themselves were considered saints. They fasted to get closer to God. Some, like Catherine of Siena, got hooked. It felt good. Her explanation was of faith. Ask a sufferer today, and a lot of it seems to be 'healthy eating' and images of supermodels and the idea that you can Have It All. It's no more a reason than faith. But it is a context. It does explain the triggers, the psychological environment from which an eating disorder develops.

One of my OCD fears was that I was going to catch AIDS from someone, or that I already had AIDS and was going to give it to someone else. Regardless, it was OCD. But if I was about 15 years older (the OCD AIDS stuff started in about 1993-1994, when I was 13-14), AIDS wouldn't have been on the radar. It might have been another disease. It might have been something else entirely. A person with schizophrenia would not have feared the CIA listening in on phone calls 100 years ago. First off, they probably wouldn't have had a phone, nor would there have been wire taps, and lastly- there was no CIA. Diseases have a context. But that doesn't mean that AIDS fear mongering caused my OCD, nor that the CIA causes schizophrenia.

My recovery had to begin with weight gain. That is still the foundation. Think Maslow's hierarchy here. If you're not eating right and taking care of your basic needs, learning how to handle setbacks isn't the most useful of things.

Will I ever be less anxious? Less depressed? Well, with medication. But that is my personality. I don't think I have it in me to be a total slacker. Can I learn to be more tolerant of my mistakes? I hope so.

*Unfortunately, research on bulimia lags far behind that on anorexia, though I'm assuming my assumptions will hold true for all people with EDs.

I have this nagging sense of dread. Doom shall follow. I know it. I can feel it in my bones, deep down inside, my heart tapping nervously in my chest.

Things are, of course, going well.

I am certain this can't and won't last.

I know- things are going to suck at some point in the future. That is the nature of life.

Yet. And yet.

This is an entirely new phenomenon in my life. Events just don't go smoothly. I've had a breakdown upon starting school since I was 11 and starting middle school. Every damn time. So here I am, in my nice little apartment, looking around at the pigeons divebombing the building and waiting like Chicken Little for the sky to start falling.

I feel like I'm missing something. Something big. Really big.

Could I be relapsing and not know it?

If things start going too well, am I going to get too relaxed and get fat?

Erm. Nice to know that little fear of mine. I don't want to get un-paranoid about food and weight because then I will gain like no tomorrow and wham! wind up fat.

I know this isn't realistic. I know that I wouldn't care if it happened to one of my friends. They'd still be my friend. Then again, I still don't quite know that I'm my own friend, so would it really matter?

So here I sit. Waiting.

I don't get this. I can't enjoy the good times because I'm too busy looking over my shoulder for one of the bad times to come flying at me again. This won't last. Breakdowns in my program are somewhat legendary. Granted, my breakdowns are somewhat more intense than the average person's. I want to tell myself: enjoy this while it lasts. Because it won't.

I think I'm missing something. That I should be worried and terrified about something and I'm not and that means something hugely bad is going to happen.

I'm walking down this dark alley, and it opens into a dimly lit street corner. I can hear the dripdripdrip of the rainwater splashing off the gutter. The screech of far-away tires followed by a wailing siren. My footsteps echo, the loudest thing in earshot. I whip my head around back and forth, eyes darting over each shoulder. The bad guy is there. Somewhere. I grip my car keys tighter and my heart begins to race.

Is the boogieman there? I don't know. It certainly seems that way. Every horror film has a scene like this, where the protagonist should be afraid (very afraid) only they can't see the danger lurking. And just when you think they're safe, the bad guy leaps out and strangles them.

That feeling. The watching and waiting knowing the main character is in danger but you don't know when and where it will strike.

That's how I'm feeling.

Wariness is good. I know Ed rarely gives a whole lot of warning before he begins to worm his way back into my life. I do need to watch out. He's gotten me that way before. I'm not stupid enough to think he's gone entirely. But the constant watching and waiting is getting to me.

And pissing me off.

This anxiety over things, even things that don't exist, has been my downfall in the past. Rationally, I should save my worry for something real. Oprah would say that she's done the excessive worry thing and then she learned that life is short, etc. She has all the answers. I don't get answers like that. My income is also several orders of magnitude less than hers, so there's that.

I'm worried that I'm worried too much about nothing, and simultaneously worried that I'm not worried enough. That I'm missing something.

I wish my mind would just pick. Either I should be worried or I shouldn't. If nothing is going wrong, then why freak out?

Because this is when Ed usually strikes. Only now I'm afraid I will have worn myself out so much that if he does, I might not have the strength and mental fortitude to keep him at bay.

Sometimes I hate my brain.

I'm starting to feel...I don't know...almost normal.

Not that I have ever been, or ever aspire to be normal, but there's a distinct lessening of ed-nosity (thanks Lulu for the term) in my life. My eating is still a little chaotic, and I still need support and guidance from my parents, but it's really lessening.

I'm meeting a friend for lunch tomorrow. Just me and him. (a him friend! ::twitter twitter::) I haven't done that in over a year. I had a challenge lunch with my therapist, I went out with my mom a number of times with no advance notice to help decrease my anxiety and rigidity around food choices. But not with a friend. For that matter, I haven't had friends nearby with whom to even have lunch.

And it feels...nice. Like something any almost-27-year-old should do. Can do. Would do.

I'm not used to that. Having a normal life not eclipsed by anorexia or depression or OCD. It's like when you have a buzzing in your ears and all of a sudden, the volume drops. I'm all "Huh? What was that?"

are we the fools for being surprised
that a silence should end with no sound?
--dar williams

Don't get me wrong here. I still think I look like a beluga whale more often than not, and almost instinctively order the low fat option when available. But it's not inhibiting me from living my life anymore.

I had a chat with the dietitian today, and we both came to the conclusion that I am at my setpoint weight. This is where my body functions optimally. It's nice for me to engage in activities that are fun and enjoyable (walking, swimming, biking when I can get a nice used one) rather than that damn StairMaster. Wrecked my knees on that damn thing. No more. No more. Tentatively, I am realizing that the benefits of being at a healthy weight FOR ME far outweighs any benefit I might get from having an anorexic body.

It's hard for me to accept that I'm not naturally willowy and graceful. I know self-defence. I can kick your ass if I need to- and I look it. I come from hardy Eastern European stock- my genes don't have "tall" anywhere in them. I am working on that lovely grey area between "thin" and "fat" into which most people fall...myself among them. Health is the key. Not the weight.

I need help taking my own freaking advice, true.

I also have difficulties breaking the status quo. I have a hard time NOT behaving as an anorexic because that was just how things were. I didn't make effort to contact friends because I was friendless. Just how things were. I couldn't get beyond that. It's still a monumental effort.

I'm trying. That's the best I can do, and the best anyone can do.

And that's normal.

Okay, for the first part of the blog, we're going to assume that childhood obesity can and should be prevented. So bear with me.

I was watching the news this afternoon, and an interview came on with a local Weight Watchers guru (who I think has lost MORE weight through multiple facelifts) and a young woman who had lost 55 pounds on Weight Watchers.

I roll my eyes. Yet another weight loss story.

This woman (a nurse at a prestigious hospital), said that she had always been "heavy," even as a child, and had always thought of herself as the fat girl. This I can relate to. My body type isn't dainty or waif-like. Never was. I understand this all too well.

The ludiocrity of this interview was just starting. The nurse said, now that she's thin, she can actually feel good about herself.

Honey, I hate to break it to ya, but that's temporary. If you gain even a little weight back (quite likely), you're gonna feel like utter crap. And then you diet again so you feel better. It's not an eating disorder per se, but it can be an unhealthy obsession with food and weight.

The sad thing is, it's quite normal in our society. If a friend asks if a pair of pants makes her butt look fat, it's like entering a mine field. You can't say yes, because the said friend will freak the hell out. And if you say no, she won't believe you. It's this odd female dialogue that goes on.

Female 1: I am so fat. I can't wait to start losing some of this weight.
Female 2: You think you're fat? No, I'm fat. You're a toothpick compared to me.
F1: Seriously, look at my butt! It's huge!
F2: Not compared to mine. Besides, you have a great figure.
F1: It's only a great figure if you're posing as Venus of Willendorf.
F2: But you're well-proportioned. My hips are way too big for my body.

And on and on it goes. Sometimes, I think asking if I look fat in something is a subtle way of fishing for a compliment. That I might actually look okay or even- gasp!- good. Another thing that question does for me is to help combat my continuing anxieties about fat. In a sense, I know I'm probably not going to get a safe answer. On the other hand, I need that answer, that reassurance. I am terrified of being fat. I'm not terrified of fat people, or of fatness in general, just of me, Carrie, being fat. We need those lies, sometimes.

This "fat talk" has been called a mandatory part of female life these days. A way of bonding. Men have beer. Women discuss pant sizes and BMIs.

Women who have been fat and have dieted their way (I initially typed in "weigh." Go figure.) to eternal happiness and bliss have also expressed concern over their own children's fates.

The nurse who was being interviewed by the over face-lifted WW guru said that she wanted to keep her kids from going through what she went through (the teasing and low self-esteem). A good, noble idea. But she was going to do it by telling them how awful it was to be a fat kid.

Brilliant. If a kid is genetically predisposed to be larger, and you're telling them fat kids are called names, teased, hated by society and the only way to prevent this is to be thin, then you're only further lowering your child's self worth. Shame never results in lasting behavior change.

Emphasizing eating a wide variety of foods, of eating when you're hungry, stopping when you're full, along with moving your body for fun, that's how you can help your child feel better about themselves. Not by telling them how awful it is to be fat. I doubt a single American child out there doesn't think of fat people as some sort of lesser species.

I think a mother's ability to relate to their child's problems (what it's like to be teased or singled out) is great, and can be quite helpful. But saying, "You wouldn't get teased as much if you weren't fat," is so horribly wrong.

That's the one thing in the world I wish I could put an end to. Self-hatred. Yes, poverty, world hunger, and a cure for AIDS are right up there, but self-hatred kills, too. Not always literally, but it can leave you mentally and spiritually dead.

In it's place, I would like self-acceptance. It's the only way.

This is something I struggle with as I try to separate from Ed and identify myself as a different person:

Ed's voice is internal. Sometimes, he even sounds like me.

I mean, it seems like I'm the one saying restrict, barf, run, take pills, etc. Yet, I know it's my illness.

I think I know.

Maybe.

Then again, I don't know that I think I know.

See, here's the thing: is my eating disorder a choice or an illness? I am firmly of the belief that it's an illness, as are my OCD and mood disorder*. So it's an illness. Those thoughts aren't me. They're not representative of who I am. It would be the same with schizophrenia- a person who hears voices or has paranoid thoughts might not be able to understand that it's a psychiatric phenomenon and the CIA really isn't after them. Time and perspective (and meds) help, though.

I think part of the other difference is that the eating disorder thoughts are so freaking common in the general culture. If I say, "God, I'm fat today," most women will take a look at their own butts and say "No, you're not. I'm fat today." And so on. It totally reinforces the fact that what I'm thinking isn't all that out of the ordinary.

However, even I knew I had begun to crack when I had the Sweet N Low folks on the phone and were screaming at them for false advertising because those little pink packets did, indeed, have a fraction of calories. I still feel bad for that lady.

My understanding of the ED voice was improved a day or two ago as I worked on the first of my books from my reading list. The said book was An Anthropologist on Mars by Oliver Sacks. One of the essays was about a surgeon- named Bennett- with Tourette's Syndrome and his views about living with the illness.

"I don't think of it as a disease but as just me. I say the word 'disease,' but it doesn't seem to be the appropriate word."

It is difficult for Bennett, and is often difficult for Touretters, to see their Tourette's as something external to themselves, because many of its tics and urges may be felt as intentional, as an integral part of the self, the personality, the will. It is quite different, by contrast, with something like Parkinson's or chorea: these have no quality of selfness or intentionality and are always felt as disease, as outside the self. Compulsions and tics occupy an intermediate position, seeming sometimes to be an expression of one's personal will, sometimes a coercion of it by another, alien will. These ambiguities are often expressed in the terms people use. Thus the separateness of "it" and "I" is sometimes expressed by jocular personifications of the Tourette's: one Touretter I know calls his Tourette's "Toby," another, "Mr. T." By contrast, a Tourettic possession of the self was vividly expressed by one young man in Utah, who wrote to me that he had a "Tourettized soul."

It was long complicated paragraph, but when I got done reading it, all I could think of was, "Holy crap! This is me! This is just the way I feel about my eating disorder!" It makes sense. It completely makes sense. I was always under the impression that I could control my eating disordered behaviors. And there was a yes and no to that. Physically, I could eat. Mentally, not so much. In treatment and at home, I still had to make the choice to eat, to pick up the freaking fork and put it in my mouth. But the choice was easier: eat, or sit at the table until you finish.

Ed still goes yakity-yak a lot. Just yesterday I was sitting in the car, finishing up my snack, when my mom went back to grab something she had forgotten in the house. So there I am, just me and my string cheese and a garbage can about 10 feet away. And it was then, in that split second, that I heard Ed: "You don't have to eat that, you know."

I said: You know what, Ed? You're exactly right. I don't have to eat this. But I'm going to.

*They can't quite seem to decide whether I have some form of bipolar disorder, or just major depression and really moody. ::shrugs:: It's basically the same, really.

Sometimes, recovery sucks.

It sucks much less than anorexia does, but it still sucks.

I've found the only way to get through these tough times is to accept that this will suck. And that it's okay. The suckiness will eventually pass.


Giving myself permission to utterly hate this part has actually been somewhat liberating. It's what, in Dialectical Behavioral Therapy, is known as radical acceptance. It's very Buddhist and Zen- that there are things we will have to accept in our lives that we may not want to. But we can save ourselves a lot of suffering by doing so. I have radically accepted that recovery can suck and that's okay. I am not obligated to like it.


This is the drudgery, the facing meal after meal, snack after snack, fear food after fear food, in an unrelenting chain. Kind of like a cafeteria conveyor belt. Except none of the items look appetizing, but I can't get out of line until you make a choice. So I wait and wait and all that passes by is mystery meat with nasty congealed gravy.

The only option, in the end, is to suck it up, pick a plate, and start eating. Because there's life out there.


I don't have to like the entrees. I do have to eat it.


My good friend from college calls this the growing-flowers-from-shit phenomenon. This actually encapsulates the concept quite well, when you get right down to it.


The only difference is that I have to eat the shit. I don't think she realized this part.




I get discouraged a lot. Wondering, pondering the question: will this ever get any easier? When? Will my sanity hold out until then?


I think, though, my turning point was when I was at the day patient program this past December and January. Insurance had kicked me out, told me that I was no longer in need of health services. It was this horrific feeling, that I had been living in this bizarre limbo between deathly ill and truly healthy for years, and no one was going to pull me out. Ultimately, it was up to me. I would receive treatment for just long enough to pull me back from death's door, and then be turned loose. I would do okay for a while, slide back down, and the whole process would begin again. And I realized there was no end in sight.


So I made a U-Turn. Said whatever happens can't be worse than this half-life.


Recovery hasn't been, really. It's been hard in a different way. The general public associates anorexia with willpower and strength. For me, anorexia wasn't willpower. Recovery- that was willpower. Willpower is facing down your greatest fears day after day after day, with the knowledge that tomorrow wouldn't be any different.


I cling to the idea that one day, it will get easier. There are moments when I think it might have started, and compared to the beginning of this mess, it has.


I want it to be better NOW. This makes sense. Who wouldn't it want to be better now? I could do another Zen thing and say there's something to be learned in the meantime. Again, that's probably true. I'm just not like that.


At the end of the day, I am where I am, and I'm moving forward. I can't ask any more of myself.

I was at the mall yesterday, just browsing while my parents picked out new appliances. I wandered around, looked in the store windows. And I kept thinking, "I would look so much better in that dress/t-shirt/pair of jeans/pair of socks if I were thinner."

Then I stopped myself. Realized this is not necessarily true. And even if it was, there's not a whole lot I can do about it. I'd look better in orange if I didn't have auburn-ish hair. I roll up the cuffs on all of my sweatshirts because the sleeves are too long. I have midget feet. And so on. But that is not to be. It's okay. I'm okay.

I saw these two store clerks standing outside Hollister, looking sexy as part of their job. Like saying "Look at hotties like us who dress in Hollister. Come join us."

Frankly, I'd rather give myself a lobotomy.

With a fork.

A plastic fork.

First of all, I like shorts that cover my ass. Secondly, I'm a little old to be shopping there. Ditto Abercrombie (don't even get me started on them) and Victoria's Secret Pink. I find it disturbing that 50 year old women have sweatpants with "pink" stitched across their behinds. I guess it's not the actual sweatpants that disturb me- it's that they're wearing clothes to feel younger, and to make themselves look younger. Specifically for that purpose. It's okay to be 50 or 60. Seriously.

Then there's the store Forever 21. I don't want to be 21 forever. That year contained more abject misery than the rest of my life up to that point. I spent my 21st birthday in the psych ward. No shots of tequila for this young filly. Nope. I did a shot of Ensure.

Yum. ::rolls eyes::

Then, while I was waiting in line at Starbucks for my iced mocha, I saw these two young girls (around 5 years perhaps) in not-very-fashionable clothing. A HUGE no-no for these parts. They're all Gap Kids when they pop out of the womb. Designer clothing to puke on. And so on. Secondly, these girls had short hair. Thirdly, they weren't thin.

That struck a chord in me.

I had short hair when all of my girlfriends had long. I wasn't exactly the fashion queen. Lots of fluorescent sweatsuits, though I can attribute part of that to the fact that this was the 1980s. They just reminded me of me at that age. Awkward. Unsure of themselves. That kind of inner knowledge that they would never be popular.

They reminded me of, well, me.

And I felt sorry for them. Some mean kid on the playground was going to call her "fatty." Another would tell her she dressed ugly. If she was smart, she would be the nerd, the geek. She would be the last one picked in gym class and develop an undying fear of team sports. She would then retreat inside herself, find solace in books, in writing, in being smart.

I wish that all the self-esteem building in the world could be instilled in young girls. My parents did as well as they could, but when you know you're different from all of the other kids around you, it's hard. Especially when the other kids take great pains to remind you of it every day.

I'm not saying this teasing caused my eating disorder. But the isolation...

One of the lies Ed loves to tell me is that it was good I didn't have a lot of friends. That meant I would have more time to go to the gym, fewer opportunities to have to eat. In public. With food I hadn't personally prepared.

In the end, I've realized that I'm quite different from almost every person I meet, and that's okay. It doesn't say anything bad about me or them or whoever.

It's just one of those lessons I wished I had learned sooner.

See, here's the strange thing. I always thought my eating disorder was more cult-like than the recovery aspect.

I'm not so sure anymore that this is the case.

Jim Jones or David Koresh don't have anything on Ed. They really, truly don't. He does work in the same way. He isolates you. He convinces you of really wacky things. He starves you.* He demeans you, convinces you that you are nothing without him. He demands you serve only him. He threatens you with all sorts of terrible things if you leave.

Very cult-like.

And here's where the parallels get even stronger. It's the pro-ana phenomenon. I have avoided- quite deliberately- bringing this subject up. I would bet that anyone reading my blog knows what pro-ana is, and if you don't, it's better that way. Trust me.

But so many eating disorder sites are almost...evangelical in nature. Especially pro-ana and the message boards. The confirm what Ed is already saying. And they are a way for him to find more converts. After a while, you pretty much know all the tips and tricks out there. I didn't need a pro-ana site to teach me them, or even to "motivate" me to keep restricting. That was internal, a function of my disease and the malnutrition it caused. What I do see those sites doing is convincing new people to "join" and also to keep those who might be on the verge of leaving to stay. They're not called "ana buddies" for nothing. They are who you associate with, who you can relate to.

Writer Linda Moran has a really good article about the similarities of diets and cults that is well-worth reading (as is the rest of her site).

It makes sense. People in cults tend to form very tight communities, and though you might be able to join, it's much more difficult to leave.

So. The metaphor of my leaving a cult (even though I have never regularly visited pro-ana sites) certainly seems pretty sound.

Right?

Right.

But then I read the health and wellness articles online, I see the ads for weight loss programs. Hell, I worked in an environment that was a continuous Weight Watchers meeting. Which makes me wonder: is recovery a cult as well?

Think about it: how many people do you know that you can say are honestly intuitive eaters? Seriously. Most people in my family are. Okay, my parents, and I think my brother, but I'm not sure seeing as I don't talk to him. My treatment team. And maybe throw in two others for good measure. But that's it, as far as I know. Some people restrict what kinds or how much food they eat. Others restrict during the day and binge at night. Others eat mindlessly. Etc.

Recovery and having a healthy relationship with food and your body is actually quite uncommon. I wouldn't say that we proselytize or anything, or that we keep people from leaving, but the need for a community is very real.

I have to re-brainwash myself. I have to convince myself that eating is okay, that taking a day (or week or month) off from exercising is okay. That chocolate won't kill me. That coffee is not a food group.

The really ironic part is that getting yourself out of a cult is much harder than getting yourself in, even though the process (brainwashing) is the same. I'm leaving the familiar, the unknown. That sucks. It's hard. It doesn't hold the same promises and certainty that the eating disorder did.

I'm trying to learn how to live with that. Thus far, I'm doing okay.

*Starvation is a common tactic in people who are being brainwashed

I was a biochemistry major in college. I sat through many tortuous 8am lectures, and even one Saturday morning lab. Much of it was erased through the haze of starvation and sleep deprivation, but some of it (I hope) stayed with me.

Biochemistry is the foundation of all health sciences (psychology and psychiatry seem to be unfortunate exceptions). You can learn a lot about health in a biochem lecture, provided your professor's accent isn't so strong and handwriting so messy that you begin to drool on your notes. I can tell you about enzymes Co-Q, the citric acid cycle, the aerobic and anaerobic production of ATP. There were many formulas- you get an average of 31 ATP molecules for every glucose molecule ingested. And so on.

The health industry ("thindustry") pounces on the idea of formulas as a way to measure health. Count your fat grams. No, your carbs. What about the glycemic index? Crap! Then wait, no, it's the total number of calories you consume. On top of that, you have to exercise.

So most of these companies (and the federal government) have created little charts telling you how much to eat and drink and exercise to maintain an "ideal" weight.

Now, I'm not much of a fan of our current government, and a cynic by nature, but why the hell should the government be calculating the ideal size of my butt? It makes no sense.

Digging a little deeper.

These formulas are attractive. My little OCD reptilian brain loves to count calories. It latches onto those numbers, stashes them away in a little cerebral filing cabinet where the information can be retrieved upon Ed's request. The thing is, our bodies do not work on math alone. Magazines tell you that if you eat this many calories, run this many miles, do this many crunches and leg lifts, then you will look like this model/celebrity by Memorial Day. I'm assuming, of course, you purchase the issue at least 24 hours before Memorial Day begins. It makes no sense. First of all, I will NEVER look like the person in the picture because I'm probably too short. Secondly, I'm not that person. I don't want to look like a celebrity, and I certainly don't want to be one. I hide at the mall when I see someone I know because it's usually a hassle to talk and explain what I've been doing in the past 6 months ("Oh the psych unit is great...you really should visit. It's so rejuvenating!").

I could get up on my soapbox at this point and do the bra-burning feminist chant of I am so much more than my body, but I won't. I know it's true. That was never the issue.

But formulas. They don't make sense. Your body doesn't burn calories at an equal rate every single day. The same person of the same height and weight will not burn the same calories at the same workout. Formulas give us the illusion that if we can just get things to add up, then we can have whatever someone else has. The whole grass is greener on the other side of the fence deal. Life is messy. Formulas are nice and neat.

Health isn't nice and neat. Health is a little of this, a little of that, some play time, some sleep, some creativity, some love, some annoyance, and so on. A healthy life for me isn't going to be the same as for someone else. I like to go hiking. My mom doesn't like any activity without a flush toilet within 5 minutes walking distance. My cat doesn't like any activity that involves moving. Yet we're all reasonably healthy. There's no magic number or formula.

Let me start off with this: much of my thinking today has been concerned with my class, how I'm going to structure it, what I'm going to do, running to the bathroom because I'm terrified and might wet myself. I worked myself into quite the lather.

Then I did something totally out of character for me. I turned off my laptop, lay down on my bed, and just let myself think. What are the assignments? What do you want to focus on? Will you have time to focus on it? What are the benefits of leaving this out?

Slowly, one by one, I went down the list. I didn't try to resolve the questions, but rather to put them into context. To slow my ever-spinning brain down. To breathe.

To tell you the truth, my questions aren't a whole lot more answered now than they were before. I still don't know the exact course sequence, which I'm told is understandable. But I can begin to put things into place. I can actually make a wise-minded evaluation, rather than running off half-cocked and freaking out. Which is a horrific combination and has resulted in my making many horrific decisions.

This is compounded, however, by my inability to see all potential sources. I don't have access to Medline, which means I can only see abstracts. Tomorrow will be fun with the printers; however, that's not to say that I can't do anything at the moment.

Because of my anxiety disorder, I tend to rush ahead out of fear. Part of the reason it helps for me to have my parents along when I'm looking for housing is that I get so anxious about not finding anything that I sometimes want to take the first thing I see. Obviously, if it's a roach-infested dump, I don't have a problem leaving it behind. I don't like roommates with two legs (four legs and furry, however, seems to be good), let alone those with 8+ legs. I get so freaked out and stressed out that I begin to say "Screw it!" and just sign the damn lease to have it over with. I'm not rash. I don't make decisions without really thinking, or because I don't care. Rather, I tend to panic and do something out of fear.

Taking time to think.

That being said, I know what I like when I see it. I have also been known to think something to death. I can analyze a Nutrition Facts label to death...calories vs. fat grams vs. sodium vs. fiber vs......versus any damn thing you can think of! I (try) to think now of things like: what do I want? Have I had enough protein today? What sounds good?

Step back.
Think.

It's so contrary to our entire culture at the moment. I think that's why the 'good' and 'bad' labels are so appealing- we don't have to think. French fries? Bad, don't eat them. We don't have to think if we want them, the type of fries we want (steak fries with that powdered ranch dressing mix on top. If you can top this, let me know- I'd love to try it), where we want to get them. Apples? Good, eat the apple.* Obviously, we need to be able to make quick decisions. But there's an advantage to really stepping away and thinking.

*By the way, the whole "Apple a day, keep the doctor away" thing is total bullshit. I ate an apple a day during my eating disorder and that has done the complete opposite.