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?

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:

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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.

 

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.

 

 

What She Said To Me…

Yesterday, my therapist made a very direct statement to me that I have the fight and persistence I need to maintain recovery.  She said I might lapse and lapse again, but that I have the stubbornness to keep on going.  It was very powerful and I asked her to write it down. She said she would and she gave it to me today.

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“Heidi,

You are a fighter and you are both persistent and stubborn.  This is something I have seen from the get-go and if you use that to your advantage there is no doubt in my mind that you can have recovery and maintain it even when there are lapses.  Hold onto that persistence and fight that you have and use it to your advantage.  That isn’t something that someone can give you or take away, it is something that you have.”

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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.

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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.

A Wordy Post!

By whatever method I am being measured, I suppose yesterday counted as an awesome day.  Just as long as no-one looks too closely.

Yes…I made it to yoga.  I literally almost didn’t.  I didn’t do my timing right and still was eating breakfast and in my pajamas when I needed to leave for yoga.  Luckily, at least I was showered!  I was sooo angry at myself for not even giving myself the choice to go (because it was too late) that I cried.  Lots of judgmental thoughts went through my mind.  And then, I looked at the clock and thought, “I still have time. I might be a few minutes late, but I can try to make it.”  So, I got the dogs settled, ran downstairs and changed my clothes, grabbed what I needed and ran to the car.  I made it to my 8:00 yoga class at 7:59. So yes, I got to do yoga, which I really enjoyed. I am going to look at the yoga schedule today and commit to getting to yoga more than once this week.

Next was grocery shopping.  Other than feeling guilty for spending so much money (I have discussed my beliefs about not being worth buying food for.) it was an uneventful trip.

In the early afternoon, was the lunch with my peers and the peer who is leaving for a higher level of care.  I didn’t want to go.  I went more for social graces interests than because I wanted to be there.  Something about the whole luncheon really bothered me.  As I was driving there, I realized that celebrating the departure of my friend (who had to leave the program because she was starving herself) just seemed wrong.  It felt like we were celebrating the fact that her ED had won this round.  The same issues came up around Sarah’s wake in June….I didn’t blog about it, but spent a long time talking to the AT about it.  So, I got to the lunch and luckily, I was seated far away from that peer.  I decided to pretend that I was just having lunch with the peers sitting by me (there were 11 of us, so it wasn’t awkward to just focus on the folks near me) and ignore the “celebration” aspect of it.

Do you know that I hate getting together like this with my peers?  Seriously, I am so fucking tired of talking about eating disorders, our mental illnesses and watching people sneak in behaviors at meals.  Or…of knowing that the person is eating the meal, but is going to go right home and purge.  There’s a new person in IOP and she has been and is still actively purging and binging and purging.  She’s been doing it for weeks.  As a matter of fact, she and the girl who we had the lunch for, were living together and I am guessing some of what was going on with her was that they were in a situation in which they ended up competing with each other.  Who could be sickest?

But I got off topic.  I am so sick of my peers.  I don’t know why I am encouraged to spend time with them outside of treatment.  They are solely focused on ED talk…not even recovery talk, but ED talk.  I am sooo much more than my eating disorder…I just don’t want to talk about it every time I am with them.  I want to have real conversations about real things and that doesn’t happen.  This is a huge part of the reason that I connected with my Janis, my pastoral care person, because she and I can talk about other stuff, which is a refreshing break.  It’s also why I like hanging out with Linda.  We have normal conversation.

I was so frustrated about my peers yesterday that I was ready to just wash my hands of IOP.  Like, just screw it.  What is the point anyway?

And if that wasn’t enough stress yesterday, I got a text from a peer/fried (who has been out of the program since September) asking if I wanted to go to her house and see a movie.  I jumped at the chance. She and I have done stuff together before and it is really close to “normal” i.e. not focused on our EDs.  When we were firming up plans, she seemed a little bit irritated in her texts.  I let it slide and went to her house.  When I got there, she seemed really put out and was cold and distant.  I thought she was mad at me, and was relieved that we were going to watch a movie so we didn’t have to interact much.  Then I noticed her gait was different, she had sort of a limp.  That’s when I realized that I was not watching the movie with my friend, but rather with one of her alters.  It explained her behavior…but still was pretty awkward as she seemed irritated the whole time I was there.

Aside from yoga, the only other positive about the day was that my friend who came over Friday night came over again last night.  We sat by the fire and chatted, yes about ED stuff, but in a recovery way, we drank coffee, we had a snack, it was relaxed and pleasant.  A good way to end a tumultuous day.

Today, other than church, I have nothing planned.  It does mean that my depression may be more active…only time will tell.  I have 3 agendas to work on, which will take up most of my afternoon.  And I am going to video chat with dh.  After yesterday, I am looking forward to a quiet day at home!!

Oh…and the whole realization that the luncheon yesterday felt like an ED celebration made me really miss the AT.  He is the one with whom I processed Sarah’s wake.  And thinking about that just made me pine for his compassion and caring.  I trust him, I feel safe with him and I miss him.  I am tired of being emotionally disrupted here with the revolving door of therapists.  All I wanted and needed was some continuity of support which is not really an option here.  At least I will be able to get that at home.