Insomnia Means Means More Time to Blog, Right?

Howling coyotes (if you can call the sound they make howling) woke us up at 3.  They must have been very, very nearby as they were so loud.  As suddenly as the howling started, it stopped.  But I was awake.  I thought for a few minutes about the wild rabbit we have seen the past couple of mornings, or as we like to call him, the Yard Rabbit.  But 3 is early for crepuscular animals such as yard rabbits, so I am hoping he is safe.

I tried to fall back asleep, but the room was too quiet and too dark. And dh was snoring.  And I just didn’t feel sleepy anymore. Then I started thinking about chores and laundry….I know I will  be miserable later because I started my day at 3 (well…technically 4:06 cuz that’s when I got out of bed.)  We are due for some nasty weather later today, so being home and napping in the afternoon is a definite possibility.

The question I am being asked is, “How are you doing?”

I am overwhelmed.  And I am surviving.  I have had a lot of anxiety over doing this all perfectly…Yes, I know.  The last thing I need is perfectionism right now, so I am really trying to cut myself a LOT of slack.  Basically, re-integrating the first couple of days, I just felt kind of stunned and numb.  Yesterday was much better. <phew>

I am eating.  That’s the first and most important thing, right?  And despite a lot of anxiety about it, I am pretty sure I am eating my meal plan correctly.  I won’t know that for myself, I need to wait to be weighed and then someone will tell me how I am doing, but they only will if there is an issue.  So…I will keep doing what I think is right and see where it leads me.

I saw the AT yesterday.  I was soooo glad to see him.  Despite me feeling pretty anxious and worrying about reconnecting with him, it went well.  We actually had a bridging phone call last week when I was still in the program. My program therapist, the AT and I talked for an hour.  I think it was key to re-building my trust with him.  And I wrote a self-assigned piece about what he needs to know about me now.  So, yesterday I felt a little awkward at the start, but slid easily into safe comfort with him.

I have reconnected/connected with half my team now.  (I mean of the clinical team…Dh is always part of the team, even if I don’t mention him outright every time.)  I met the new dietitian Saturday.  She seems okay…I have a couple hesitations but I am going with it for the moment.  I saw the new Couples’ Counselor (CC) with dh yesterday.  He seems really nice and I think seeing him is going to be really helpful.  As I just mentioned, I saw the AT.  I also had a phone “interview” with an OCD therapist.  At the end of the interview, he accepted me as a client and I will be starting with him next week.  So, that’s contact with 2/3 of my clinical team in my first 3 days home.

Today, I see my primary physician.  Tomorrow, I see my Psych NP and the AT (again).  Then the rest of the week, I get to relax and recover and catch my breath.

Between all of Team Heidi, I will have 7 appointments a week to start.  The AT commented yesterday that it is like I will be having a job and that it is exactly what I need to be doing right now.  I felt relieved when he said that because I worry that all of my appointments are selfish, or like I am taking too much from all of my clinicians.  Or that I should be getting a real job and diving right back into the world of employment (which would be a bad idea at the moment.)  I like it when my therapists say things that actually make me feel better.

Tomorrow, I will write about my/our (dh is on board and helping with this) project of changing the physical environment of our home to help me not fall back into old habits and patterns of behavior.

And I will write about my plates.

 

Grounding

Pretty much all of the work I do here is really stressful and I often feel very overwhelmed by emotions and get totally flooded.  Frequently, I end up dissociating, which does no good for working through issues in therapy.  Because of this, it is important for to me to have grounding techniques and tools. Basically, grounding brings me back into the present and changes my focus so that I can stop feeling flooded.  The goal is to calm myself enough to continue the work.  Examples of grounding techniques I use are 5,4,3,2,1 , ice pack/cool cloth, breathing, sensory input, hand fidget toys, reading book titles, counting things, etc.  Some of these I can do on my own, some end up being facilitated by my therapist if I am dissociated.

I do well with sensory input, like my stuffed rabbit, or the ice/cool washcloth, or things with texture or that fit in my hand.  I will automatically start rubbing the hem of my shirt, or fiddle with my socks.  I have some toys, putty, a baby teether with spinning beads, etc that give me something to do with my hands and give me sensory feedback.

 

 

However, I recently found the most amazing grounding tool for me!  I snagged it a local Goodwill.  It is a Crayola product, they call it Mess-Free Touch Lights.  It is basically finger painting, but without the mess.  Technically, the toy is supposed to have a stylus, but being at Goodwill, mine doesn’t.  But that’s okay. I much prefer the tactile input of just using my fingers to draw on it.  And the  best part is it is a light board, so the drawing is backlit and just looks really cool.  I use the board before bed if I am anxious and/or having a PTSD hard time.  I also use it at programming.  Actually, I was lucky enough to find a second one at Goodwill, so now I don’t have to tote my board back and forth.

Here’s what it looks like:

0109170852

And here’s what it looks like with some doodles and then with a hand print and some of the color options.

Anyway, I just adore this toy and it totally works for me.  Oh…and if I leave it by my chair at programming, sometimes I am lucky enough to come back to it and find messages from my peers; smiley faces, “I love you” and one time one of my group leaders was talking to me and reminding me to cut myself some slack and she wrote “Kind” on my board.

I have to say, if you like hands-on grounding things, I highly recommend this.

 

She Slips But Does Not Fall.

I weighed myself. 

12-19

I weighed myself.  This pains me in ways that I didn’t expect.

Everyone always asks, “What is the function of engaging in such-and-such ED behavior?”  And for this, I don’t have a great answer.  I have wanted to know my weight forever…at least it feels like forever.  The compulsion to know has waxed and waned and I try to roll with it.  The day I weighed myself, I started in the morning asking my dietitian about my weight.  I wanted to know if I was “healthy.”  I didn’t quite phrase it like that to her, not that I was trying to be deceptive, but more because I felt kind of awkward for asking.  We discussed it briefly and then moved on to the next topic, but my dietitian told me that we would go back to the weight discussion at the end and that I should remind her to do so.  I did remember, but I felt really embarrassed about it, so I didn’t ask.

Later, I still had my weight on my mind, but not in an obsessive way.  I was reading my old blogs and looked at where I was a year ago.  I was blown away by the changes I have made in the past 12 months.  Seeing how far I have come and how different I am gave me the impression that I could know my weight and handle it.

I went to the closet and pulled out the scale.  Honestly, it felt surreal, like I wasn’t connected to what I was doing and I wasn’t quite in my body.  I tapped the scale with my foot to see if it would turn on.  If the batteries were dead, I would have just let the whole thing go.  But they weren’t.  I gingerly put one foot on the scale and watched the numbers change.  I shifted my weight more and watched the numbers.  Then I just put my second foot on the scale.  And that was it.  The numbers scrolled by and then stopped.  The number was not at all what I expected.  I felt like throwing up.  The disconnected feeling got worse and I felt hollow in my stomach.

And then it hit me.  Fuck! What did I just do? All the time and work that I have put into not knowing my weight…I just fucked it all up.  By standing on that scale and looking at my weight, I just did something that I could not undo.  My eating disorder perseverated briefly on the number.  But the overwhelming feeling I had was a profound disappointment in myself.  And fear…fear that I let down myself, dh and my team here, fear that I couldn’t fix it, the number was in my head.  I couldn’t un-see it

It was pretty much time to leave for programming and this was the only chance I would have to talk to my therapist about it until after Christmas.  As I drove to IOP, my thoughts went from, “The number can’t be right. The scale must be broken.  Yes…that’s it, the scale is broken,” to “I have to exercise, I need to exercise,” to “It’s just a number.  My worth is not defined by a number.”  The thoughts were scrambled and competing.  And I just kept telling myself that all the scale did was give me a number.  It’s not who I am, it’s just a number.  Even if I didn’t like the number, I have been happier in general the past few months and becoming more tolerant of my body.  My body hasn’t changed just because I weighed myself.  Number or no number, next time I look in a mirror, my body won’t have changed.

At the end of the day, I wasn’t thinking about the number.  I am thinking about how much I disappointed in myself.   I am disappointed that I caved and made a choice was not at all a recovery based choice.

At dinner that night, I felt like a fraud.  We were peer posting and I didn’t have high ED urges but I felt like not saying something about my huge slip up was not being honest with my peers.  We stepped to the art room and I told them what I had done.  They were amazing and supportive.  We went back to the table and I said that I needed more support so we actually went to the group room and talked some more.  I explained how I felt like I had disappointed people and myself.  My peers reminded me that I don’t have to be perfect, that some of them had weighed themselves too, that some of them secretly own scales, that weighing myself doesn’t have to derail my recovery, that I am okay.

And you know what, I felt better.  It is nice to feel understood.

I did not tell my dietitian, I am too embarrassed to tell her about it.

So…that’s the story.  But what does it mean?

That day, I ate my dinner, I ate an evening snack.  I went to bed and didn’t perseverate over my “failure.”

I got up the next morning and was looking in the mirror as I hooked my bra. I turned left and right, looking at my body.  It looked the same as the day before.  Probably it was the same.  I had an urge to weight myself to see what the number was in the morning before I had eaten.  I mean, why would it matter? I already blew it by weighing myself. But I knew that I can’t start the habit of daily weighing.  That is a slippery slope that I don’t want to slide down.

And yes, I can’t un-see the number on the scale, but I can “fix” it by doing exactly what I did the next morning, which was to acknowledge my urge, counter it, and then just let it go.  I know that this will not be the last big mistake I make with my eating disorder.  Rather than obsess about it, hate myself and descend into a shame spiral, I am going to see it for what it can be…which is a “learning point”.  Just because I make a mistake doesn’t mean everything is ruined.  And no matter how disappointed I feel in myself, I am not a bad person.

I did not fuck up by weighing myself.  I did not ruin everything.  And how I am dealing with my choice is evidence to me that I have strength of self that I didn’t have 4 month ago, because I am accepting my mistake, not letting it derail me and moving on and doing the next right things. I think I kind of like this person who does not let a mistake drag her down into hatred and self-loathing.

12-27  About the Second weighing

Why did I do it again?

So, a week after the first weighing, I did it again.

This time, when I did weekend check-in  at programming, I admitted to the group that I had weighed myself again and that I had weighed myself last week.  Again, I got questions about what function the second weighing served.  I don’t really know.  I feel like partly, I weighed myself because I could.  And I also know it was totally ED related.  But ultimately, I don’t even know if I cared about the number.

I don’t know if weighing myself was about control over what has been happening while I have been in treatment or about managing the feelings when dh left (I didn’t let myself cry after I left him at the airport) or about my obsession with knowing my weight. I am just kind of at a loss as to what function weighing myself a second time served.

I am not happy about my choice to weigh myself again.  This not a path I want to go down.

I plan on moving the scale to where I can’t access it easily and I plan on utilizing peer support, journaling and containment to get through the next urges to weigh myself.  When I get home, there won’t be a scale in our house.  Of all the ED things I am giving up, the scale is actually the hardest thing.  I need to put more thought into why.

12-28

Moving the scale to where I can’t see it is not a viable option because I would still know where it is.  I can’t get rid of the scale, because it is not my scale, it belongs to the woman I live with.  It is not her primary scale as she has one in her bathroom.  I can respect her space and not weigh myself on hers. So, what to do with the scale outside my bathroom?

I took the batteries out and threw them away.

In order to use that scale again, I would have to make a very deliberate effort to get new batteries and put them in the scale.  That extra step is enough to slow down the impulsiveness of the urge and give me a chance to catch my breath and deal with why I am having the urge vs. just giving in to the urge. I think it is a good solution.

And yes, the two weighings have spiked my urge to weigh myself.  I am getting lots of opportunity to explore what is behind the urges.

Today, I see my dietitian.  I still have not told her face-to-face about the weighings, but I sent her the first two parts above. Plus, I am sure my therapist told her. I will not get judged by my dietitian. However, I am still really embarrassed and will be judging myself. It will be an awkward appointment for me.

Recovery is a messy process.

OCD Exposures

Not sure what to write about today…So, here’s this:

As a method of reducing my OCD behaviors, my anxiety therapist has started me on germs and contamination exposures. I made a hierarchy of what things bother me from least to most.

Germs and Contamination

  1. Using a communal blanket
  2. Wearing clothing after someone else has worn it (i.e. like if I lent a sweatshirt to someone)
  3. Dirty tables in restaurants
  4. Touching things that I consider yucky (a used sponge, mine and other people’s dirty laundry, things that have landed on the bathroom floor, raw meat, etc.)
  5. Reaching into a trashcan for something
  6. Not washing my hands after using the toilet
  7. Not washing my hands (if I feel like they are dirty) before I eat
  8. Using food that has a broken seal (like fresh from the store, but the seal is torn or cracked or coming off, like on a yogurt)
  9. Touching the inside of the garbage can lid or having to push the flap in on a garbage can to throw things away
  10. Eating something that has fallen in the sink
  11. Drinking out of someone else’s glass
  12. Bumping my hands in public bathroom sinks or knobs or paper towel dispensers after I have washed my hands (I will have to re-wash my hands)
  13. Touching my face if I feel like my hands are contaminated (especially with sick people germs)
  14. Getting in close physical proximity to sick people
  15. Eating near sick people
  16. Breathing when sick people have coughed/sneezed/sniffled close to me
  17. Turning faucets on/off with bare hands esp. in public places
  18. Touching doorknobs (especially public bathroom or doctor’s office)

The most distressing things revolve around public sinks, doorknobs, sick people and trash cans.  These are the things that I use behaviors to avoid every single day, and multiple times a day.

So, now I am practicing “easier” exposures.  So I was sent home with my first exposure tasks and a form to rate my distress.

bans

She told me to use the SUD scale to rate my distress.

Subjective Units of Distress Scale

0   No distress at all. Feeling okay and calm.
1   Feeling little if any stress. Not quite fully calm.
2   Faint tension or mild stress.
3   Feeling slightly unpleasant or uncomfortable.
4   Growing distress or discomfort. Mildly agitated.
5   Verging on becoming very uncomfortable and distressed.
6   Very uncomfortable affecting my attention.
7   Emotionally painful becoming severe.
8   The emotional pain is taking over my attention.
9   The emotional discomfort is almost unbearable.
10 The emotional pain is overwhelming me–the worst possible

And so…It has been a long few days.

Struggling So Much

I feel like a failure.

I am not going to make it to  yoga this morning.  Saturday morning yoga is my favorite part of my weekly routine and the class has my favorite instructor.  And I am not going to make it because I spent 45 minutes trying to will myself out of bed to shower, get dressed, eat breakfast and be ready to go….And I couldn’t do it.  And now, it is too late to get my shit together and go to yoga.

What is wrong with me?  Why can’t I shake this depression?  It is not helping me at all right now…Although I don’t think depression ever actually helps.  But really, it is impeding my recovery process.  I suppose it is a good sign that I still care, because when it gets to a point that I stop caring about recovery, then I will know the depression is out of control.

I didn’t struggle with the PTSD episodes last night.  Last evening, I went grocery shopping with a peer.  I didn’t have a good time.  Last time I went out with this peer, I didn’t have a good time.  I think I will stop doing things like that with her.  She just is always distracted, texting, doing her own thing.  I mean, that’s all fine, but if you are going to do something with someone, it would be nice to actually spend time together, iykwim.

We were out through dinner time, a tactical error for me.  She didn’t care because she isn’t eating right now. I cared.  By the time I got home, it was over two hours after I usually eat.  I was fascinated by the fact that I wasn’t actually hungry.  (When you mess up your body with an eating disorder, you mess up  your body’s ability to cue you about hunger.)  I did eat.  I made myself some quick mac n cheese and had tomatoes dipped in salad dressing.  I am guessing my friend went home and ate nothing.

After that, I video chatted with dh for a while.

I don’t know if it was the being with people, or chatting with dh, or change of routine, but the Friday night PTSD torture did not happen and I am sooo relieved.

But now, here I am, in the depression hole. I have self-harm urges, passive suicidal ideation, emotional pain and no energy for initiation of anything.  I haven’t even gotten out of bed to pee.  And…now, I am going to miss yoga.  F.A.I.L.U.R.E.

I have spent some time this morning, as I have been trying to will myself out of bed, asking myself why I feel so depressed, why I feel like self-harming, why I feel suicidal ideation.  What purpose is this serving me right now?  I can’t come up with much.  The last two days of programming this week were kind of tough.  Yesterday, I did that me-in-the-group check in.  I also checked in about the use of eating disorder behaviors I have had this week.  That was hard…and didn’t really make me feel better.  We had a really hard discussion in our sexuality group on Thurs about trauma effects on sex and masturbation.  I shared something I had written about it on my trauma timeline, which was really hard to do.  (And despite my shame about what I had written…I had several peers thank me both during and after group for my candor and putting words to a hard topic and opening it up for people to talk about it.  Because as ashamed and embarrassed as I felt, I was in a roomful of people who had the same experiences and felt the same way.)  Sharing that probably pushed me farther into trauma stuff than I should have gone.

I don’t know…I feel scrambled as I am blogging…and there is so much more that I want to say, but I feel like I am not making much sense and this post is going to get too long if I say it all.  Wait…this is a time for bullet points.

  • I am still reeling from my therapist saying I probably need to be here another 8ish weeks.
  • I am concerned about our finances and how we will afford to keep me here that long.
  • My anxiety therapist did the Y BOCS II with me yesterday (an OCD assessment) and I scored really high…I am still trying to process what that means for me.
  • I think my PNP is worried about my depression.
  • I am supposed to go meet with peers at Starbucks this morning and I don’t want to go
  • I have started to lose my boundaries with the peer that I wanted to keep distance from because our relationship is unhealthy.
  • I am furious at my friend who is not eating.  I am trying really hard to be compassionate, but why does she get to not eat?  And why does she smirk and look pleased every time someone asks her about it/confronts her about it/or clinicians talk about it?  And is she just trying to kill herself? Is it attention getting behavior?  And when she restricts at our group meals, why aren’t they following their protocol about it?  WTF.  Everything about it makes me mad. Which probably means I need to just ignore it so it doesn’t interfere with my process.
  • My PNP really wants me to do something “sweet,” as in finding something I enjoy for self-care and lifting my mood some.  I don’t feel like I enjoy anything.  How can I find something “sweet”?

Okay…now I know I am rambling. I am going to drag myself out of bed and take a shower, take my meds, get dressed, eat breakfast and try not to crawl back into bed.

Actually, I think I can hear water running which means the woman I live with is showering.  It gives me an excuse to just stay in bed for a while longer.

 

 

Panic and Hope

And then sometimes, the panic about food just hits me.  Like, it is a visceral response where I feel the breath sucked out of me and my anxiety rockets through the roof and I feel almost woozy and as if I am imploding.  The panic is because I have been eating food.  I used to panic like this really frequently about food.  Now, it is less frequent, but it will just hit me randomly and I feel like, “What am I doing?!  I have been eating food! I have to make this food go away.  I have to do something…I can’t eat like this anymore.”  Of course, “eating like this” means following  a normal meal plan.  But to me, it seems like an excessive amount of food and the repercussions of eating so much food for so long….Well, I just about can’t take it.  And so the panic hits me…And the room whirls around me and I need to catch my breath and collect myself and talk myself down from the fear.

It’s moments like this when I know I have an eating disorder.  Not that spending almost 4 months in eating disorder treatment doesn’t remind me of that every day..

Now, instead of escalating the panic, I can talk myself down from it.  I don’t have to engage in behaviors to make it better, and lately, more days than not, I feel like I have actually made a ton of progress.  Progress does not mean perfection or anything close to it.  But progress means that I am less attached to the eating disorder compulsions.

My dietitian got all excited on Monday because I expressed a slightly tolerant thought about my body.  She pointed out that that tiny bit of tolerance is a huge step forward.  She also said I will sort of bounce back and forth between body hatred and tolerance before I settle in mostly at tolerance (and then do the same thing towards liking and maybe even loving my body.)

I dunno…I think things are changing.  I think I am changing. It is terrifying and exciting.  This treatment experience really has the potential to be life-changing for me, because it is not just the ED being addressed, but the underlying stuff too.

Hold on…You know what I just realized?  I actually feel some hope. Hope! When was the last time I actually felt some hope for my outcome?

Hope? Is it possible?

 

 

Callie’s Oops and the Trauma Narrative

Callie’s Oops

Yesterday morning did not go as planned. Callie had a different obligation and did not make it in to Hilltop until after lunch.   My whole plan of reading her my narrative, talking about my fears about presenting it, etc. was totally blown to pieces.  And of course, there was no sitting in on my session with Kyla.  I struggled with this turn of events.  Of course, my core beliefs were triggered, that I am worthless and not important, that I am can’t trust anybody or count on anybody, that’s what I get for being vulnerable and reaching out to someone. And I kind of sorted through the core beliefs and eventually worked my way to my feelings.  I felt hurt that she had another obligation.  I felt disappointed that she wasn’t going to be there.  And I felt scared that my plan of working with her to manage my anxiety didn’t go the way I wanted.

And of course, I didn’t actually talk about any of this during my appointment with Kyla.  Nor did I talk about any of it with Callie.

Ultimately, just before group, I got a very mini-version of what I planned on with Callie and it was helpful.

The Trauma Narrative

So, presenting the trauma narrative was horrific.  I made it through and I did not die of shame, even though I was sure I would.  I did get supportive feedback which reduced my shame and I did leave feeling better than when I went in.

Now, I have a peer who says things she shouldn’t, so she sat with me this morning and listed all the people who had had a difficult time with my narrative (as in were struggling after the session.)  I didn’t really need to hear that.  But…whatever.  This peer actually says lots of things that are upsetting or triggering to me (and it actually takes a lot to trigger me, but she always seems to hit my sensitive spots) and seems to have no awareness.  So, that was kind of hard.

But anyway…the trauma narrative from when I was 4 is done.  I am sure I will get to process it lots more in therapy, but presenting it in the group is done.

And Callie?  Callie was there in the group, and I totally was comforted by her presence. And her being there and having read parts of the narrative right before group (I had her read the parts that would be hardest for me to not skip, so that she could call me out on it if I needed it) really did help me stay accountable.  And I also knew that she had read the parts and not hated me, so hopefully no one else would hate me either.

And this morning, I feel super depressed and sad and raw.  It’s just a typical day at PHP.