Decreasing Support

I am doing well….Really, I am in a good place right now but I am aware of the fact that I have only been home for 11 days.  With therapy and couples therapy (more on that later) things are getting hard.  Now, I am weathering it okay so far and hope to keep doing so….But I am kind of nervous about it.

Monday, I saw my doctor and she took one look at how well I was doing and suggested that we no longer need to meet weekly, but could schedule every other week.  I said I thought we should at least keep my next week’s appointment and then look at it from there.

Yesterday, I talked to my Blue Cross case manager and she was very happy to hear how well I am doing.  She suggested after our next check-in phone call in two weeks that we could “close” my case because I’ll have met all my goals.  She did say we could see how I was doing and then go from there.

How am I feeling about all of this?  Well….really scared.  Support has been part of what has kept me on track. Without all the support I got in the spring, I surely would have been much sicker.  I am hesitant to decrease support now, especially since I just barely go home.  I feel a little bit abandoned.  I will say that it might make sense to finish with my case manager as if I have met my goals in terms of my work with her, then I won’t need the support.  I do get that.  But my doctor?  I don’t know.  Is taking away support a step in the right direction? Or a set up for failure?  Luckily, I have until next Monday to think about it and then I can talk to her about how I am feeling.

Now, as to couple’s therapy….Dh and I have been doing couple’s therapy since February and it has been incredibly helpful.  But one of the things I need to work on is sex issues because I struggle because of my trauma history.  Although I have talked a little bit with our therapist about this, it had not come up in a session yet.  Until yesterday.  Week two of being home and seeing him and he dove right in to “intimacy.”  It was really hard for me and I am still kind of reeling from it.  When one of the first questions was about if dh and I are having intercourse, well….I knew the discussion was going to push me past my tolerance level.  And it did, so we talked about some aspects of intimacy, but not about sex.  After the session, I felt like I needed therapy with the AT to process it all.  Alas, I don’t see the AT until tomorrow morning, so my job is to hold myself together and not use eating disorder behaviors to deal with my feelings.

There is going to be a running theme in my blog, which will be how to manage life without relying on the eating disorder to manage my feelings.  This is my job now: learning and using healthy coping strategies.

And on a side note…I had a really strong compulsion to paint with watercolors yesterday, but didn’t allow myself time to do it.  What’s up with that?

Yesterday Sucked

When I woke up this morning, I had to check to see if I was in one piece.  Yesterday was a brutal day emotionally and I wasn’t sure if I had actually survived.  Honestly, the best part of yesterday was going to bed so that the intense emotions would turn off.  And yup, I still feel a bit sensitive/fragile, but I am indeed in one piece today.

Basically, I had one of those days where I just ended up crying. A lot.  It started with texting my PNP in the morning and she said something that I got both angry and hurt about.  I put my phone down and just cried.

A while after that, I had an intake assessment phone call with the residential facility that I am hoping to go to.  Now, these phone interviews are long, at least an hour long, and pretty intense.  They go over every detail of your eating disorder and of your co-occurring mental illness(es).  It is like being stripped naked emotionally and made to stand in front of a crowd…Just exposing every detail of what I struggle with the most and to a total stranger. Awful.  Plus it totally highlights exactly how fucked-up I am.

But that wasn’t the worst part.  The worst part was the trauma history part.  The facility wanted to know details…Physical abuse? Emotional abuse? Sexual abuse?  And details…If you were physically abused, how often? By whom? With what?  Emotional abuse: In what way? By who? For how long?  Sexual abuse had the same questions and, Did you tell anyone about it/report it?

After the phone call was over, I hung up and burst into tears.  The phone call was sooo triggering!  Of course, the timing of the call was such that I had to immediately make and eat lunch (ha!) and then run out to triple-decker appointments.  So, I forced food into my body and launched into the afternoon, even though I was emotionally raw, PTSD triggered and feeling fucked-up beyond repair.  Basically, I was holding out for my AT appointment. I just needed to keep myself together until Art Therapy and then it would be okay to fall apart.

I actually did keep myself corralled until therapy.  And that occurred even though I had an embarrassing/shame part of my doctor’s appointment.  The shame didn’t help my emotional misery, but I didn’t cry…So I consider that a win.

I did cry during therapy.  Honestly, I didn’t really do much during therapy, I was too triggered to do anything.  After a little bit, I asked if I could draw and I sat at the art table and drew purple spirals over and over on a piece of paper.  It made me feel better and I was able to self-regulate enough to talk to the AT a little bit. But then the appointment ended.  I really didn’t want to have to leave.  I feel safe with the AT…I didn’t want to have to leave that feeling .

I don’t actually remember much about the rest of the afternoon or about dinner.  But after dinner, I snuggled with dh on the couch and felt warm and safe.  And finally, I decided to just go to bed and make the day end.  Sometimes, the easiest thing is to just throw in the towel and start over again the next day.

And today will be better. I have a fun play date with SS, Pixie and Blossom that I have been looking forward to for a looong time.

I also will hear back from the treatment place today to and will find out what level of care they accept me at.  And then the ball will really be rolling and I will soon be off for round two of treatment.

 

 

Contract? Fail.

I am not going to lie.  I am restricting.  Sure, it’s just little bits of restriction….Or big bits, depending on how you look at it.  But I am restricting and that is all there is to it.

What I might have forgotten to mention is that I think technically, I am supposed to be eating a different (higher) meal plan. And I am supposed to be having afternoon snacks to make up for the over-exercising I’ve been doing.  And I am skipping my Gatorades. And I am supposed to be eating a dessert every day (this might be instead of the snack not as well as, sometimes my Nutritionist confuses me.)  Ummm….I think that is pretty much it.

In the past couple of days, while making an attempt at doing the “right” thing, I have realized how strong my ED urges are right now and how much I need to fulfill those urges.  It is like I am powerless in terms of fighting the urges.

And of course, my mind already goes to….If I am a little bit non-adherent with my meal plan, then it won’t really matter if I am a lot non-adherent, right?  What’s the difference? Restricting a little, restricting a lot…It’s all still restricting.

Here I am, with a written safety contract, presented to me by someone who really cares about me and my mental health, and when it comes down to brass tacks, I am not honoring that contract.  The AT is going to hate me.  Which is fine, I hate me…Why shouldn’t I alienate everyone around me and make them hate me too?

I have no fucking idea what to do anymore.

Since I am airing my dirty laundry, I should also probably admit that I have not been completely adherent with the self-harming part of the safety contract.  I am not up to my usual self-harming, but Friday morning, I was in a fuck-it-all state of mind, so I deliberately did not take my psych meds.  Actually, I didn’t take any of my meds.  (Since then, I have been taking my meds correctly.)

What I am learning is my brain can find 101 ways to restrict and 101 ways to self-harm.  Come to think, my doctor said something about this a couple of weeks ago.  It’s not that I necessarily set out with an intention of restricting or self-harming, but basically, I have a compulsion to do it.  And when I find a way to manage whatever symptom is most active at the moment, a new one sneaks up on me and takes over.  I don’t even notice it when it is happening and then all of sudden, there I am with a new symptom to have to overcome.

Is it a wonder that I feel hopeless and discouraged?  How can I have all this amazing support and still be constantly fucking up?

Okay…one more admission.  Tomorrow, I was supposed to see my Nutritionist, but I schedule something else over my appointment time, so I cancelled my nutrition appointment.  I am so sick of going to see the Nutritionist, I just decided to do something that I actually want to do tomorrow vs. something I am supposed to do.  Maybe that’s okay, to give myself a break once in a while?  I don’t know.  For what it’s worth, I am keeping my AT appointment tomorrow…Not that he’s going to want to see me after this contract debacle. Ugh…I hate going to see him and feeling ashamed.  I guess it is my own fault though.  If only I had worked harder to keep the contract, then I wouldn’t have to be ashamed.

I wish I knew how to help myself, because I feel like I am not doing a very good job right now.

And I wish every blog post was not negative drivel.

Quadruple

You know about those triple-decker appointment days?  Today was a quadruple-decker appointment day.  I started at 12:30 and by 4:00 I has seen everybody on Team Heidi.  <phew>  I am tired!

Highlights?

  • Nutrition:  We discussed Invisible Restricting (as described in that blog a few days ago.) Plus over-exercising.  Evidently, hour long walks on hilly terrain is too much exercise for my calorie intake  Then when you add 1 1/2 hours of heavy yard work after the walk…Well…then that is way too much.  Of course, I am good with it…But the Nutritionist? Not so much.  Her solution?  Either limit my exercise to 45 mins a day. Or increase my meal plan.  Ummm…..No, increasing the meal plan is not gonna happen. I think that falls under, “Ways to give Heidi a nervous breakdown.”  And limiting exercise?  Welllll……Let’s just say, we’ll see about that.  I like negating my calories by exercising.  Why would I want to change it?
  • Primary Physician:  Was pleased to see me in better spirits this week.  Of course, I am pretty pleased to see me in better spirits too!  Also, Thursdays are my weigh-in day.  And you know what I figured out?  If I want to know my weight, all I would have to do is watch the nurse type it in.  This thought dawned on me as she sat down to enter it into the computer. And I quickly looked away.  Somehow, as desperately as I want to know how much I weigh, I am also really afraid because I might have gained weight.  And I know this is potentially an irrational fear….But, it is what my ED tries to tell me, that I have gained weight and therefore need to restrict it away.  Of course, knowing that I have lost weight is a trap too because my ED will be sooo excited and want more.  I guess not knowing is the safest thing for me right now, even if it does lead to obsessive fits of wanting to know my weight.  Overall, the appointment was good.  My doctor was thoughtful and empathetic and and we talked about the blog (she had mentioned it a couple of times recently) and I asked if she wanted to look at it and she does.  So, now enters another member of Team Heidi into the crazy, complicated and uncensored version of what is in my brain.  In for a penny, in for a pound…..
  • PNP:  For some reason my PNP concurs with the Nutritionist about the over-exercising.  Go figure!  And she spent a lot of time trying to appeal to my logical side. And I spent a lot of time trying to say that I am good with the calorie imbalance I have created.  And she tried to point out the long-term implications of restricting and I ….Well, I don’t really know.  Thus is the ED conundrum.  Restrict and control and feel good at the expense of my health.  Or don’t restrict, be out of control and maintain my health.  See…when I type it, it seems a bit simpler, health is good.  But then…Restricting is so appealing too. And around and around it goes in my head.
  • Art Therapy:  Have I ever mentioned that I hate feeling things? And really, feelings themselves kind of suck! (And come to think of it, feelings came up with my doctor today too…It’s like feelings are important or something!)  The feelings part of the  AT appointment, I will save for tomorrow’s blog.  Aside from feelings we looked at some art I had done since my last appointment. And then we looked a bit more at some of my art from Art Therapy at Renfrew.  Of course, it was one of those pieces of art that gave me a little emotional melt-down. <sigh>  Everything is so hard.  I wonder what it would be like to have an uncomplicated life…Well, it’s probably not worth thinking about, I am pretty sure I drew a short straw when it came to having a “normal” life.  Pining for one will only lead to disappointment.

 

The Same

I am not really sure what to post that will be new and different….I am definitely in a rut right now.

Today is a triple-decker-appointment day.  I start with my physician (and that means a weigh-in), then the Nutritionist and then the AT.

The AT is going on vacation tomorrow and won’t be back until after Memorial Day.  I am going to be really lost without the routine and support of the AT.  I am barely holding myself together now, I don’t know how I will manage the next ten days.  Honestly, I am afraid, really afraid of how I will manage myself while he is gone.

And speaking of therapy, after Tuesday’s awkward session (where I inadvertently over-shared), and the shame I felt/feel, I am feeling kind of anxious about today’s session.  I don’t know if I can even look at the AT.  I just kind of feel sick about it.

I suppose if I have three appointments today, I will actually have to make myself presentable by showering and changing out of pajamas.  I’ve kind of been slacking lately…It’s just hard when I just don’t care.  But, I know that clinicians look at appearance, so I need to pull myself together and at least look like I am functioning.

 

 

FML

That shift I was talking about on Friday?  All gone.  No more shifting.  I am just tired and frustrated and sad.  I feel like I can’t get enough sleep. And I hate eating.  And I am sick of talking to people about my food intake.  At this point, I just want to say what will make people happy vs. what is going on in my mind.  To that end, I dumped the rest of my last Gatorade out.  No more of that for me! (This is kind of flying in the face of an agreement I made with my Nutritionist that if I don’t meet all of my meal plan requirements in a day, I will supplement with a Gatorade…This is how I knew she was counting the calories and how I knew that I needed to stop drinking it. Plus she asked me if I was drinking the diet or regular Gatorade which wouldn’t matter unless the calories matter.)

Of course, my doctor was telling me that if I don’t meet my meal plan requirements then I should take the Seroquel daily to decrease my restricting urges. I told her that it was a great motivation to eat (so I won’t have to take daily Seroquel) but….I just don’t know.

I feel really pressured by everyone to do everything right.  I don’t want to drink Gatorade. I don’t want to take Seroquel every day.  I don’t want to fill out my stupid food log.  I don’t want to eat all that food.  I don’t want any of it.

Oh and I am having one of those I-am-going-to-gain-weight obsessive spells. I ate in a restaurant with a friend yesterday and I forgot my food journal, which really threw me.  And I didn’t have my list of exchanges, which really threw me. And I think I fucked up the exchanges (ate too much) though I have no data to support that.  And all I want to do is restrict to make up for it.  And since I can’t/am not supposed to restrict, I am now obsessing about my weight.

Hmm…And maybe the online bathing suit shopping isn’t helping any either.

Ugh…and I have a splitting headache.

FML

Yesterday

Yesterday was one of those shifting kinds of day. I would feel my perspective shifting a bit more towards the positive.  Of course, I was excited that I would wake up this morning and be “all better” so I was kind disappointed when I woke up this morning feeling depressed.  But I will roll with it and give time for the shifting to happen.

A lot happened yesterday (amazing what can transpire in one day) and rather than write it all out, I am going to bullet-point it.

  • I saw the AT, my Physician and the Nutritionist and texted my PNP
  • I was honest with all of them about restricting (a few minor bobbles over the past week)
  • I told my doctor about the self-harming (AT and PNP already knew)
  • I showed my doctor my self-harm wounds….I was so ashamed.
  • My doctor is really supporting me and I am really comforted by her genuine concern. She hugs me at the end of every appointment now.  And they are “real” hugs, not just cursory hugs.
  • My doctor got to see (and call me out on) some of my distorted/illogical thinking
  • Seroquel. Prescribed by my PNP and my doctor had strong opinions about how I should/could be taking it.
  • My doctor doesn’t trust me to take as-needed medications when I need them.
  • I realized that my Nutritionist is always asking me about my Gatorade consumption because she is counting the calories. Therefore, I am going to stop drinking Gatorade because I had thought the calories didn’t really count.  If she is counting them, then they must count as “real” calories.  Since I don’t need the Gatorade (or its calories) I am going to stop drinking it. (Is this restricting behavior? Yeah…probably.)
  • My Nutritionist is too damn optimistic. Seriously.
  • The AT was weird yesterday. Something was off with his affect and it really threw me.  I wanted to leave.
  • The AT had me do an interesting project yesterday (I may have felt uncomfortable with him yesterday, but I still did my work.) and it was a good representation of a negative thinking pattern I learned about at Renfrew called the Downward Arrow. Basically, it is when your thoughts get more and more negative, kind of whirlpooling you down into a miserable pit.  I didn’t make the connection until just now about the Downward Arrow.  I will have to tell the AT about it on Monday.
  • The AT told me that I am healing.
  • I told the AT something that had been really bothering me…I only glanced across the topic, though the AT was able to fill in lots of the gaps. I am sure it will be the source of much more discussion.
  • Dh saw my self-harm wounds for the first time.
  • Dh and I have spent the past several days putting up a new clothesline for me (I haven’t had one in a couple of years.) Yesterday, the cement had set and I got to hang laundry. I LOVE hanging laundry.  Seriously, it is totally a Zen kind thing for me.
  • I was asked to go camping with a friend and her family and extended family Memorial Day weekend. I said yes despite my immediate panic of social anxiety, food anxiety, recovery anxiety and body shame.  (What the fuck was I thinking?!)
  • I made a plan to have a good weekend instead of the crash-and-burn weekends I have had for the past couple of weeks.
  • I realized that I need to buy a bathing suit for the aforementioned camping trip. This is a topic that I will have to blog more about another day.  Suffice it to say, body shame and bathing suit shopping?  Sounds like the makings of nightmares!

laundry

violets