205 Days

205 days ago, at the crack of dawn, I left dh and ds for what I thought was going to be 6 weeks of treatment for atypical anorexia. 205 days later, I am being discharged from the program, a healthier, happier and completely changed person. Although difficult in many ways, this extended treatment was the best thing that I could have ever done for myself. I want to thank all my supporters, near and far for helping me on my journey. I also want to thank my therapists, dietitians and other staff at Hilltop for their expert care and guidance that has helped give my my life back. Today will be a day of mixed emotions as I leave the program that saved my life and also look forward to flying home tomorrow to start a new chapter of my life.

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Victory 3 (This is a big one!)

My therapist said something to me Wednesday about how my feelings spiral and I get to a place of self-hate.  I listened, agreeing in my head and then I was kind of looking for that self-hate part.

Gone.

I don’t think I hate myself anymore.  I am shocked.  I know I do fall into patterns of self-hate, but self-hate is not my baseline. This is sooo different. Like, I almost feel lost without it, and there is a sort of hollow space there.

Then she asked if I was neutral about myself of if perhaps I had some compassion for myself. I kind of laughed at the idea of me holding compassion for myself.  But….maybe some day?  At this point, I’m at neutral.

So, of the core beliefs I have challenged and changed, what do I believe now?

  1. The sexual abuse when I was 4 was not my fault.
  2. The sexual abuse when I was 14 may not have been my fault.
  3. I can tolerate my body (for the most part).
  4. I can tolerate myself (neutral feelings).
  5. My eating disorder is a serious problem.
  6. I do have an eating disorder.
  7. I did have trauma.
  8. I was treated unfairly as a child.
  9. I have needs.
  10. I didn’t deserve any of my traumas.
  11. I can heal.
  12. I am lovable to some people.
  13. I can trust some people.

Okay…that’s kind of a mind-blowing list.  And while I have these new beliefs, they are very fragile and get shaken very easily and there are still lots of contradicting feelings about them.  And they are in no way cemented in my brain and I will and I do lapse on them.  But to even accept these things as true (even if tomorrow I will try to deny some of them) is more than I ever had hoped for.

I am telling you, Hilltop has changed me in ways that are going to change my whole being. I am going to walk out of Hilltop a totally different person than when I went in.  It is kind of terrifying, I don’t know how to be a different me, but I am really trying to learn.

 

 

Moving to IOP

It’s like every time I get on board with blogging…I get interrupted in the flow.  But as of this week, I think I can be much more consistent with my blogging because I am going to have more free time.

Tomorrow, I start my first day of the intensive outpatient program (IOP).  IOP is significantly less demanding in terms of program time.  Instead of being in programming for 10-12 hours a day 7 days a week (although the past few weeks I have been having weekends off so was only there 5 days/week) I will be in programming 4ish hours a day 5 days a week. The meal system changes too.  At PHP, as you go through the levels, you become more responsible for your meals.  At IOP, you are responsible for all of your meals and only have one supervised meal a day.  And that meal is something you bring in yourself.

So, I am going to have more free time, more meal responsibility and less programming. This part of the program is going to be the most challenging and the most work out of all the levels I have been in so far.  I am a little scared.

Of course, the change of programming means a change of treatment team (again!).  I am truly fortunate, in that my psychiatric NP from home is picking me up for psych stuff while I am in IOP.  Since I adore and trust her, I really couldn’t be happier about it.  However, I will have a new therapist and dietician.  I have met them both and I really like the therapist and Kyla highly recommends her.  I actually ran into Meg a few days ago and she also thinks the new therapist will be a good fit. <phew> The new dietician though….I have met her and….Let’s just say, I am highly skeptical.  And I am really frustrated because I felt like she was questioning my integrity and also wanting to over-support me.

My PHP dietician at Hilltop has been very hands-off with me for the past couple of weeks.  I got thrown into my first solo-weekend day with no support from my dietician, but I made do.  After that, I expressed concerns about portioning and food-anxiety, etc. and my dietician kept telling me that I was doing fine and that it wasn’t a problem.  She didn’t review a menu with me, didn’t ask me what I was eating…She just reassured me that I knew what I was doing and to keep doing it. Okay…So, I did.  Honestly, she was totally missing me on my need for support, but I muddled through, kept asking for support and not getting it and then just saying, “Fuck it” and doing it on my own.

Now the new dietician wants me to track every meal and send her daily “Honesty Logs.” This is when I got mad.  First of all, I have never had to do an Honesty Log.  Those logs are reserved for people who lie, deceive, and try to cut corners without telling their team.  I am totally insulted that I have been asked to do Honesty Logs.  I have a lot of integrity and am always honest with my team.  I don’t lie or try to deceive my team.

And….If I was given so much autonomy by PHP dietician, who repeatedly assured me that I know what I am doing and was totally hands-off with my independent meals and meal planning, then why do I have to be micro-managed now?  Argh!  I am so annoyed.  The new dietician tried to explain it was to better use our appointment time so that we weren’t talking about food and what I had and how it went, but so we could do more important stuff.  ?????  Hello???  Does this make any sense?  I am in ED treatment.  Talking about food and how meal planning and eating is going seems kind of important to me.

Sooo….I am skeptical.  Of course, the most annoying thing is that I was pissed at our transition meeting and she knew it.  I told her that I would consider whether or not I would do “Honesty Logs” and if I decided I would, then we would not be calling them “Honesty” logs.  I am not sure she knew what to make of that.   Ummm…and I don’t know exactly how I did at making a good first impression.  😦

Oh…and one last thing about IOP.  It is in an ugly place.  I mean that literally.  Both the residential program and PHP program have been tucked in woods, peaceful, serene….Deliciously soothing to mind and body.

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IOP? It’s in a totally more urban area and it overlooks a parking lot, McDonald’s, Krispy Creme and gas station.  And the view just past all that is the highway.

I don’t like change.

 

 

 

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.

 

 

 

I Ran Away

Sometimes, I think if I actually survive all the therapy and work at Hilltop, it will be a miracle.  Yesterday….Well, it was one of those days.

First of all, I felt like crap most of yesterday. It started after lunch on Sunday, I kind of had a stomach ache and was super tired.  When I woke up yesterday morning, my stomach ache was full-on nausea and I felt like shit.  I was achy and my head hurt…I must have picked up a virus somewhere (yet another reason to not go out in public…too many germs!).  When you are in ED treatment, not eating is not an option and I was not looking forward to the day.  They are big on giving you meds if you are nauseous but I don’t have a prescription for that med…So, I just muddled through and was miserable.

As a matter of fact, I felt so sick that after breakfast I told the direct care person, “I just have to say for the record, that I do not purge, so if I throw up, it really is  because I am sick.”  Of course, they all know I don’t purge, but I thought it was worth saying since people do swap around ED behaviors.  The DC told me just to let her know if I felt that bad.

I did slowly feel better all day, until right before bed…I think being tired made everything worse.  This morning….my stomach is a little bit wobbly but hopefully better.

Okay, but enough of that.

Therapy yesterday sucked.  Worse than usual.  I was stuck in defensiveness behind my walls, frustrated that I can’t immediately snap out of my defensive habits and angry at my therapist for that stupid trauma narrative.  The appointment was frustrating and pointless and was just like spinning my wheels on ice…I got nowhere. I had that old familiar suicidal mantra echoing through my mind. (Probably I should have mentioned that to my therapist?  But I didn’t want her to think I was being dramatic….Not that I engage in much drama here.) I left the appointment furious.  I went upstairs, put my laptop on the table and walked out the door and kept walking.  I ran away.  I just couldn’t take one more minute of PHP or Kyla or anything.

Of course, there is no place to run away to here.  And I purposefully did not grab my keys when I headed out the door (because I would truly have left the grounds), so I walked down to the parking lot, and sat on the ground between my car and the car next to it and I just sat there.  The sun was shining, the wind was blowing, the sky was blue.  I could hear the hawks and the rustling leaves and the squirrels in the woods.  I decompressed a little bit, I was no longer furious, but my self-harm urges spiked to that level where I would have willingly self-harmed to feel better.

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I rode out the SH urge.  And the leaves fluttered down around me and their crispness caught in the wind and they spun around as they fell.  I felt hungry (stupid body!) and still had high self-harm urges and I still hated PHP, Kyla and this state.  But I knew it was time to go back to the building and be safe and eat a snack and do the next right thing.

Of course, this is the real world, so I got back to the building, ignored that I had snack, started browsing airline tickets (I was still stuck in my ‘flight’ (running away) mode).  And then a peer came and sat with me. And another. And another.  And soon there were a handful of peers listening to me hate therapy and hate the program and missing home. And they were kind and reasonable (to counter my lack of reasoning) and they even encouraged me to get snack.

So….I vented, had snack and then told my favorite Direct Care person, Callie, that I really needed to talk to her.

Talking to Callie helped a lot.  And I need to write more about my relationship with Callie, as it has become important here.  But…I will have to do it later today or for tomorrow’s blog because I am just plain out of time right now.

So, I ran away yesterday, but not very far.  I fantasized about buying a plane ticket home, but did not.  I got support from my peers, even though I didn’t ask for it, and wouldn’t have asked.  I got really, really angry, which is something I don’t often do.  I felt like self-harming, but didn’t.  I felt sick all day, but still met my meal plan.  I connected with Callie and felt reassured.  And really, most of that happened in the space of a couple of hours.

Hopefully, today will be less intense.

 

Treatment is a Bitch

Yesterday, I ended up sharing homework assignments in both our Eating Disorder group and in our main therapy group.  I also had my 1:1 anxiety therapy.

My name was top of the list for sharing in Eating Disorder group.  I like sharing in groups because it is an opportunity for getting feedback, support and thoughtful questions from my peers and the therapists running the group.  Sometimes the questions make me squirm, but it is always productive.

My dietitian and I had discussed what to talk about in ED group and she said I could read an older homework assignment or read something from my blog.  I felt like reading the post about my family of origin and food would be most helpful in terms of getting support and feedback.  I felt embarassed to share it as it kind of highlights how fucked up my family was…but part of sharing in groups is about reducing shame.

You know what I realized when reading it and during the feedback after?  That my orthorexic thinking has much deeper roots than I realized.  Like, it goes way back to when I was in elementary school.  I had no idea!  It gave me a bit of pause about the self-judgment I feel because I have a hard time shaking the orthorexia.  The orthorexia is deeply ingrained in my thought processes and feelings about food.  I am not going to just be able to snap out of it.  It’s not at all that simple.  Now…if I can turn that understanding into some compassion for myself, I will be in a better place.  But, I still am frustrated and angry at myself that I cannot shake the orthorexia faster.  I guess since I really only got diagnosed with it recently, I figured it was a recent development and would be easy to stop.  I sure was wrong about that.

Anxiety therapy was hard yesterday.  Somehow we got to talking about what I feel like I deserve and don’t deserve.  I don’t think I deserve much.  Like really, this is another deeply ingrained belief.  And while we were talking, I was working hard at challenging my therapy blocking behaviors (namely, shutting down when I felt intense emotions.)  It was a hard and draining session.  I left sniffling from crying and feeling totally raw.

I went from that session to the main therapy group…I walked in half-way through it (because of the anxiety appt) and noted that there were four people observing the group.  I don’t like change, people observing make me uncomfortable.  They were clinicians from around the country who had come for an event that Hilltop PHP is having today and tomorrow, but they had come early to observe groups and stuff.

So…I sat down and was trying to decompress a little bit and…My name popped up on the sharing list and I was immediately called upon to share some homework.  Yikes!  So, I shared an assignment about feelings and tried to ignore the visitors and focus on what I was doing.  The glitch was that the assignment briefly addressed the physical abuse I endured as a child.  This is something I pretty much never talk about and had never even really brought up during my whole stay a Hilltop.  (Because I am pretty sure I deserved the abuse because I was bad.)  Of course, it became part of the discussion and I was really uncomfortable.  And I didn’t share that I minimize the abuse because I feel like I deserved it.

Anyway, it was an intense day.  And everything has been more intense lately because I have been steadily working on my trauma narrative from the first sexual abuse I had when I was four.  That assignment has me in a constant state of emotional rawness and miner overload.

It has been a long week.

K…I don’t have time to proofread…Hopefully, the typos aren’t too bad!!!  I’ll try to get to editing later.

Self-Worth and My Body

(This was a homework assignment written Sunday evening)

How I Define Self-Worth and How This Became Correlated to My Body

I am not even sure how I define my self-worth.  What things make me worth anything?

  • My intelligence
  • My sense of humor
  • My persistence/perseverance
  • My work ethic
  • My creativity
  • My compassion
  • My love of nature
  • My love of my family

What makes me feel like I am not worth anything?

  • That I am not smart enough
  • That I am not skinny enough
  • That I am ugly
  • That I am disgusting
  • That I am never good enough
  • That I am damaged
  • That I am bad
  • That I am stupid
  • That I do stupid/embarrassing things
  • That I am fat

Just looking at these two lists, it is clear that my sense of worth revolves around things that are intellectually/brain based and the things that make me feel worthless are all about my body.

I guess that the reason my body measures my lack of worth is because of messages I got over and over as a child. I was never good enough because I wasn’t lady-like enough. My body betrayed me by attracting sexual abuse.  Puberty came before I was ready.  My peers teased me relentlessly, first about my early puberty, with ogling and snide remarks about my breasts, and then because I got fat and thus my peers bullied and tortured me for the next 6 years over my size.  Basically, I learned at school to hate my body because my body was what made me a social pariah.  And it was my body’s fault.

I also had lots of criticism about my body at home.  It was never spoken directly, my mother never said to me, “Heidi, you are fat. Lose weight.”  But I was told how to dress and what to wear to make me look good/smaller despite my body size.  I also was told what to wear and how to dress to minimize my busty chest.  And then there was the time that my parents made me do Nutrisystem with them.  No…no one at home ever said I was fat, but the message was there loud and clear.

And the constant focus on my size and my feelings of shame and subsequent hatred of my body because of that focus, consumed my thoughts and emotions and became the central point of my self-worth.  Being smart wasn’t good enough, being funny wasn’t good enough, being kind and compassionate wasn’t good enough.  All people saw when they saw me was my body. And then that’s all I saw too.

So…the past few weeks, at HillTop, I have been feeling a bit better about my body.  I had started to accept my body…I mean, in tiny baby steps, but I was starting to like what I was seeing.  Maybe it was just over-confidence, but I was seeing my body as smaller and feeling some acceptance of it.

But then this afternoon, I undid all that.  I went out shopping with Mel and tried on a bunch of shirts because I wanted some new shirts to wear with my new leggings.  I have been wearing the leggings because they are really comfortable and I really want to be comfortable.  I am also really attracted to the prints and patterns on the leggings.  But when shopping, none of the shirts I found fit right.  And I got to actually look at myself in a mirror and I got to look at myself in my leggings…And I hated what I saw.  And I realized that I have been fooling myself and that I still am disgusting and ugly.  And not worth having any self-confidence.  There is nothing about me to like or feel good about or to even tolerate.

When I look at my body now, like even just sitting in this chair, it looks different.  I am huge.  I can see how big and fat and ugly I am.  I feel stupid and embarrassed that I actually thought any differently.  And that I let myself start to feel comfortable.

This means that everyone is wrong.  I can’t eat food the way I have been eating it.  I can’t not-exercise.  And Mac is wrong.  I do need to know how much I weigh so I can keep everything under control.

And what I really need now is to lose weight.  And a lot of it.

So…I guess the only way I can define self-worth is by my body size.  And right now, I am not worth anything.

 

Tuesday update:  After losing my shit and crying most of yesterday because I hate my body and I am so disgusting….I woke up this morning and pulled out my favorite pair of leggings, put them on, put on a tunic top (which is super comfy and shields some of my awkward body spots) and am trying to wear my leggings again.  I am going to try to tone down the hatred and dial up the fact that I enjoy the comfiness of the leggings…Not sure how this will play out…But I am giving it a try.