Going through my sent mail today, and I found a letter I must have freewritten and sent to my (wonderful/amazing/beautiful) therapist. I definitely remember feeling this way (I still do), but I hardly remember sending it. To my knowledge, she’s only responded to the one I sent before it. I don’t know what to do about it. I feel really guilty right now.

I’m posting this for two reasons — for help in dealing with some of these feeling and (most importantly) empathy!  I want to know that I’m not the only one who has/does feel this way…

From: Ashe
Sent: Tuesday, March 08, 2011 8:04 AM
To: EP LCP
Subject: Debating…

I told my DBT group that I’d send this along, but neither my group leader nor my individual therapist were there to know that. I’m not sure if I’m asking for help. Probably not, because I feel pretty empty today.

I’ve been struggling with defiance and apathy around the eating disorder, and I feel like my head made up its mind to keep it around a long time ago, and I’ve just been pathetically going through the motions. I’m not following my meal plan, and I’m not going to waste time going into a dietitian’s office to tell them the same “I know what I’m not doing, and I know what I have to do” mantra just to turn around and do it again; I guess I’d rather work. I have all of my old rules and rituals spinning in my head and worst of all, I feel at home in those voices and their secrecy. I don’t know how to reduce symptoms if I’m not sure that the better part of me is large enough to fight against them. The feelings that I haven’t talked about (because I know they’re distorted) are very loud and convincing now, like how I feel like I am trapped in this insufficient outer shell and when I nestle back into a mindful place in it and try to nurture it, I—that sense of Self—disappear at the core… Distorted, but convincing. I guess I don’t know if that split between “me” and “eating disorder” has been made clearly yet, and it’s really hard for me to keep wishing the distinction there day-after-day with no real evidence.

I don’t even really know what I’m saying. I’ve had moments in the last few days where I’ve resolved to just throw in the towel and work strictly on personality disorder stuff. I’ve had healthy protective measures (like EDA) jump up; I liken these to self-imposed pressures from made-up expectations in recovery. Whenever I’m struggling, I feel like I need to make an appearance of working recovery even harder—and maybe that’s desperate hope, or just playing the “which mask do I wear?” game.

Maybe I’m just warning you? I don’t know. I just told them I’d tell you what came out yesterday – which was a lot of denial/defiant crud. I’m not sure what a good process is here. You’ll have to help me with that. I’m not sure if it’s in EP’s nature to “deal” with rather defiant adults…

Post-guided mindful check-in:

I am feeling a lot calmer about this now, but I’d still like advice and validation. :)

Yes, I know that *I* struggle between apathy or rebellion with my ED…I go through phases where things are awesome then awful…but the journey to recovery is a LABYRINTH!!!  I think it’s normal to go through cycles of growth and regression in recovery/treatment…you’re NOT the only one who feels that way! ...but, there is something to learn from all sides (ups AND downs)...

I have a question…more of a statement I guess…or both…

Do you feel like you’re paired up with the RIGHT dietician?  Cause there’s a balance of your commitment AND their ability to help you find new ways of resolving the FOOD side of your ED (which is really not about ED at all…because ED is really not about food at ALL, food/restricting/purging/obsessive food thoughts/calorie counting/compulsive exercise/etc. just happens to be what we use to deal with things—our coping mechanism—because we don’t know how to do anything else).  I wouldn’t WANT to go to appointments like what you’re describing…it just sounds like a tool for ED (to punish yourself by making yourself go and prove how “bad” you did and how you couldn’t do the “right” thing).

Honestly, I don’t know that I could go into session after session with someone where I basically was like, “no I didn’t do the meal plan,” and to have to do the “I know what I’m not doing, and I know what I have to do” mantra just to turn around and do it again” like you said.  Really, if you did know what to do and COULD do what you need to do, why aren’t you doing it then?  It FEELS like your dietician isn’t paired with you well (no matter how much you like them, and maybe it’s ED that likes them).  That or ED is bs-ing you and trying to talk you out of treatment…again…what is your commitment level to recovery?

There’s a fine line between being rebellious and just simply not being able to cope and knowing no other way…and there is victory in knowing the difference and acknowledging it.

My dietician will ask me to follow the chain of why/how/what I could have done different for success.  I had a good few months were the FOOD side of me ED were not an issue (I was able to follow the mealplan without much trouble for a few months—not the case now, but that’s another issue)...and my life was SO much easier.  I wasn’t obsessing about my next meal, what I was or wasn’t going to eat, how much to eat, when to eat, what eating would do to me, I just DID it because once I did…about a three weeks in, I was able to identify the WHYs to WHY my ED has such a grip on me.  My dietician asks me what I was really hungry for, what specific foods represent (emotionally), among a slew of other important, challenging questions.

It’s *MY* job to take her expertise and apply it to my life. I feel like, if I had been paired with the wrong person—I’d allow ED to be more rebellious on the food side of my ED and just not give a flip about the diet part.  Have you considered that because you’re working so hard on the “emotional” and “behavioral” side of things (working on your personality disorder) that maybe ED is just “stronger” right now in controlling the food and such (possibly, because that’s the side you’re refusing to address and you’re ignoring)?

Have you ever written down your feelings/thoughts that want you to quit?  Have you ever “talked back” to them?

I’m glad you’re feeling calmer…

katie111 - 09 March 2011 02:45 PM

Do you feel like you’re paired up with the RIGHT dietician?  Cause there’s a balance of your commitment AND their ability to help you find new ways of resolving the FOOD side of your ED (which is really not about ED at all…because ED is really not about food at ALL, food/restricting/purging/obsessive food thoughts/calorie counting/compulsive exercise/etc. just happens to be what we use to deal with things—our coping mechanism—because we don’t know how to do anything else). 

I don’t know. I didn’t have a dietitian before I enrolled in IDP in November, and I was just assigned to the dietitian of the program, then I was switched to the one in the IOP program when I transitioned, and now my dietitian is leaving the location and I was to be assigned back to the one from IDP. Who knows…? I feel like having a dietitian isn’t for me; once I have an understanding of a healthy meal plan, it’s up to me to follow it, and, more often than not, when I don’t I understand the root of the symptom use and, like you said, it’s not a food/dietitian issue. I have a very analytical mind that finds the root causes and over-analyzes everything before I go to an appointment; I NEVER go unprepared. So, inevitably, I have all of the answers, and the things she said I’ve already told myself in my head, and then I write it off as well, if it doesn’t work when I say it, how can it when someone else does?

katie111 - 09 March 2011 02:45 PM

That or ED is bs-ing you and trying to talk you out of treatment…again…what is your commitment level to recovery?

Yep. And I don’t know. For the first time since I’ve started the recovery track a year ago, I feel like I could go either way—I’m not at all convinced I’m committed anymore. I was at one time, though.

katie111 - 09 March 2011 02:45 PM

There’s a fine line between being rebellious and just simply not being able to cope and knowing no other way…and there is victory in knowing the difference and acknowledging it.

Probably this. I can’t cope with the emptiness my ED would leave behind. Seriously.

katie111 - 09 March 2011 02:45 PM

Have you considered that because you’re working so hard on the “emotional” and “behavioral” side of things (working on your personality disorder) that maybe ED is just “stronger” right now in controlling the food and such (possibly, because that’s the side you’re refusing to address and you’re ignoring)?

Yep. I’ve considered it thoroughly. It’s whack-a-mole. It doesn’t help that when I was hospitalized (for personality issues), the head doctor said “occasional to frequent symptom use is permissible” and my IOP team said that it might be more appropriate for me to deal with the personality stuff first. It’s been tricking me very convincingly that not only is it not important to fight, it may not even be worth it.

I think a part of this flare up is more than just “I need to focus on the personality piece” and more to do with that dying need to prove that my ED is legitimate. I feel like I have SO MUCH EVIDENCE that supports that it’s not serious, or it’s okay, or that people are so tolerant that it’s difficult for me to reason my way into “sobriety,” so to speak.

katie111 - 09 March 2011 02:45 PM

Have you ever written down your feelings/thoughts that want you to quit?  Have you ever “talked back” to them?

I’ve done Daily Records for Dysfunctional Thoughts where I challenge the automatic thoughts (typically ED-related) with balanced ones. That’s about all I’ve done in written terms.

Ashe - 09 March 2011 03:21 PM

I don’t know. I didn’t have a dietitian before I enrolled in IDP in November, and I was just assigned to the dietitian of the program, then I was switched to the one in the IOP program when I transitioned, and now my dietitian is leaving the location and I was to be assigned back to the one from IDP. Who knows…? I feel like having a dietitian isn’t for me; once I have an understanding of a healthy meal plan, it’s up to me to follow it, and, more often than not, when I don’t I understand the root of the symptom use and, like you said, it’s not a food/dietitian issue. I have a very analytical mind that finds the root causes and over-analyzes everything before I go to an appointment; I NEVER go unprepared. So, inevitably, I have all of the answers, and the things she said I’ve already told myself in my head, and then I write it off as well, if it doesn’t work when I say it, how can it when someone else does?

 

Yes, the dietitians are there for the food/science aspect of it, but I think it’s real important to have someone that matches well to you personally because then it becomes less about the actual food and more of a situation like what Katie is describing. (adding in the thought thing of why/how/what she could have done different for success).

I agree with Katie. Not saying that your dietitian (either the newer one or the IDP one) are bad dietitians—they just may not be the best fit for you. I went through a few at ep before finding one that worked for me—and she is awesome. When I go in there, even if it’s been a rough week, I feel like I can let my guard down and we can cut directly to the issues surrounding my food rules/fears and I leave a stronger person. Her style works for me and I’m glad I have found that!

I am also an analytical person and for me that is part of my ed. It’s nice having someone who gets that and can challenge that little brain of mine!

Ashe, I don’t have much to add, but I am struck by the depth and heaviness of your worries. I feel like, and I could be entirely off base, but if you can, try to be gentle with yourself while you’re trying to figure this out. It is evident through your posts that you are working so hard at your recovery. I hope you give yourself credit for the work you’re doing. I truly believe your answers will come, perhaps when you’ve created a little space for the answer to grow into. Err, I hope that makes sense.  (((hugs)))

chickadee - 09 March 2011 08:44 PM

When I go in there, even if it’s been a rough week, I feel like I can let my guard down and we can cut directly to the issues surrounding my food rules/fears and I leave a stronger person. Her style works for me and I’m glad I have found that!

I am also an analytical person and for me that is part of my ed. It’s nice having someone who gets that and can challenge that little brain of mine!

Alright, alright, alright… I’ll try someone new. I’ll talk to my therapist about it when I see her today. It would be nice to have someone who would, oh, I don’t know, challenge me a little. :)

tweedy - 09 March 2011 09:47 PM

...I could be entirely off base, but if you can, try to be gentle with yourself while you’re trying to figure this out. It is evident through your posts that you are working so hard at your recovery. I hope you give yourself credit for the work you’re doing.

I’m working on this. I haven’t had the greatest track record about self-forgiveness or being gentle with me.

Ashe - 10 March 2011 08:16 AM

chickadee - 09 March 2011 08:44 PM

When I go in there, even if it’s been a rough week, I feel like I can let my guard down and we can cut directly to the issues surrounding my food rules/fears and I leave a stronger person. Her style works for me and I’m glad I have found that!

I am also an analytical person and for me that is part of my ed. It’s nice having someone who gets that and can challenge that little brain of mine!

Alright, alright, alright… I’ll try someone new. I’ll talk to my therapist about it when I see her today. It would be nice to have someone who would, oh, I don’t know, challenge me a little. :)

So… what’s the verdict on trying a new dietitian?

chickadee - 10 March 2011 10:47 PM

So… what’s the verdict on trying a new dietitian?

Ultimately holding off. I’m working with my individual therapist to try to figure out what I’m looking for. I still have an appropriate meal plan, so for now, the direction is there.

Follow-up to this:

I met with my individual therapist yesterday, and of course, a number of these issues came up. Basically, we got really deep in there. It’s messing with my mind what we talked about. I think I found a couple of roots in my apathy and my symptom use—and this root forks so that part is buried in the ED and the other part is buried in my bipolar II/borderline personality disorders. So, if nothing else, we have enough direction where I actually feel better about continuing to try to recover.

That said, defiance and apathy are really hard to deal with. I mean, it’s hard to convince yourself in your own voice that the notion of “not caring” about something isn’t real. It’d be like saying to yourself, “I don’t care—No… Yes, I do! No, I don’t. Yes, I do. NO. I. Don’t. Yes. I. Do.” Which one is loudest? Which one is more “natural”? It feels like neither are answers fully because I seem so polarized all the time. (Bad joke: Bipolar girl is polarized.)

Anyway, thank you for sticking it out and supporting a dietitian. My apprehension on that seems to be coming more strongly from the defiance-side rather than the ED-side. And that…is something I can work with a bit. Maybe. We’ll see.

Ashe - 11 March 2011 07:33 AM

Follow-up to this:

I met with my individual therapist yesterday, and of course, a number of these issues came up. Basically, we got really deep in there. It’s messing with my mind what we talked about. I think I found a couple of roots in my apathy and my symptom use—and this root forks so that part is buried in the ED and the other part is buried in my bipolar II/borderline personality disorders. So, if nothing else, we have enough direction where I actually feel better about continuing to try to recover.

That said, defiance and apathy are really hard to deal with. I mean, it’s hard to convince yourself in your own voice that the notion of “not caring” about something isn’t real. It’d be like saying to yourself, “I don’t care—No… Yes, I do! No, I don’t. Yes, I do. NO. I. Don’t. Yes. I. Do.” Which one is loudest? Which one is more “natural”? It feels like neither are answers fully because I seem so polarized all the time. (Bad joke: Bipolar girl is polarized.)

Anyway, thank you for sticking it out and supporting a dietitian. My apprehension on that seems to be coming more strongly from the defiance-side rather than the ED-side. And that…is something I can work with a bit. Maybe. We’ll see.

I’m glad you and your therapist talked it through and decided what was best for you right now!

good post, thanks for post

AchenbrennerLinda - 26 March 2011 08:03 PM

good post, thanks for post

Shut up.

Ashe - 27 March 2011 10:42 AM

AchenbrennerLinda - 26 March 2011 08:03 PM

good post, thanks for post

Shut up.

lol…awesome!  you tell that spam-idiot.

katie111 - 27 March 2011 06:48 PM

Ashe - 27 March 2011 10:42 AM

AchenbrennerLinda - 26 March 2011 08:03 PM

good post, thanks for post

Shut up.

lol…awesome!  you tell that spam-idiot.

spidiot?