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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Trauma Makes Everything Worse

The depression continues.  It is like I am overwhelmed by emotional pain right now.  I hate it.  And how do I talk about it with the new therapist?  I am trying so hard to push myself to trust her, but she is not Kyla and she is not Meg and she is not the AT.  And she isn’t attuned to me yet.  Yesterday, I tried and tried not to cry, but she wanted to talk about feelings and stuff and my stupid walls collapsed a bit and I cried.  I hate not being in control.

Today, my suicidal ideation started.  No, I am not actively suicidal.  One time Kyla asked me if suicidal ideation is a way of comforting myself.  I had never thought of it that way, but yes, my current suicidal ideation is a way of knowing that there could be relief from the emotional pain.  This is different from some suicidal ideation in the past when I felt like killing myself was the only relief from my pain.  But if I didn’t kill myself then (when I thought it was my only solution) then I won’t kill myself now.  Now, it is more of a litmus test as to how bad I am feeling.

I think a lot of it is the triggered PTSD.  Like, my trauma (as much as I choose to ignore it.  And btw, I couldn’t convince the new therapist that I hadn’t had trauma.) is right in my face right now and I am struggling to manage it.  As a matter of fact, I accidentally re-traumatized myself yesterday.  And I am still reeling from that.  TMI ahead…stop now if you don’t want to read it.

So, yesterday morning, I was putting in a tampon and I somehow managed to pinch the opening of my vagina and it hurt a lot.  It was the last thing I needed with my heightened PTSD; to cause myself vaginal pain (I actually cried because I was so traumatized).  Then the spot where I pinched myself hurt all day.  So, all day, I had this pain triggering me and every tampon I used re-triggered the already triggered me.  It was awful.  (And if you wonder why I kept putting in tampons…I am at that stage of my life where my period is sooo crazy heavy that not using tampons is not an option…And I am lucky if I get two hours out of a ultra tampon before I I bleed through and have to change it.  So..pads?  That just wouldn’t work for being out of the house. Heck, I don’t even like tampons but I have to use them.)

And today? My vagina still hurts.  My PTSD is still triggered.  My passive suicidal ideation is triggered.  I have a therapy assignment to write about shame and I don’t think I have the emotional stability to do it at the moment.  I have a dietition assignment to write about why I want recovery and my body image and recovery, which makes me feel like my dietition thinks I don’t want to recover.  And I am overwhelmed and depressed and starting to feel hopeless.

But, I am blogging to get some of this out of my head, I am meeting a friend at her place to have lunch with her (I am hoping she will let me use some of her Fluff and I can have a Fluffernutter sandwich.)  I have programming today.  I am going to go on a little grocery shopping trip.  I am going to force myself to be “normal” and get out of the house.  Even if I just want to climb back into bed and pretend I don’t exist. Hopefully, this all gets me through until I see my therapist tomorrow morning.

Speaking of my therapist, I have to figure out what to call the new therapist on my blog, because typing out “new therapist” every time isn’t the best way to do it.  Nothing pops immediately to mind.  I’ll have to think about it.

 

 

 

 

Mood Crash

I am depressed.  I hope this is exacerbation is short because I haven’t felt this depressed in a while.  I just want give up on everything and go home.  Trauma? I can just say I don’t have any. Eating disorder? I am sure it is fine (if you ignore this past weekend when I wasn’t feeling well.)  I don’t need the therapy and programming here, I can be fine without it.  I just want to go home where everything is normal.  I can try to keep myself together without relapsing.  I mean, I have to go home at some point? Right?

Last week, I told my therapist that I had high flight urges and she told me she was glad I hadn’t left.  But she doesn’t even know me….Why/how is she glad?

Ugh.  I just want to run away.

Did you know that I have stopped crying?  I just can’t let myself cry anymore.  This concerns me because I feel like I am moving backwards.  I didn’t shed a tear when I left all my friends at PHP.  I didn’t shed a tear when I said good-bye to Kyla or to my self-assigned adjunct therapist, Callie.  Nope. No tears anymore.  I am done with feeling.

I am so tired inside.  I just want to numb it all.

This weekend was hard too because I had a lot of intrusive thoughts and flashbacks.  And something I found very disturbing was that some of my intrusive thoughts were from other people’s stories.  I have heard some pretty awful stories of other people’s trauma here.  I mean, things that you just would never fathom would happen to people.  Can I be traumatized by other people’s stories?  And why now?  Why am I coming unglued now?

And I feel so much pressure from the IOP program right now.  We are supposed to find a job, get a volunteer position or take some sort of class within three weeks of starting IOP.  I have applied to three jobs and not heard back.  The volunteering that I would most like to do is human services (like hospice) but those programs require background checks and training and by the time I got through all that, I would be pretty much done here.  Classes?  I was told they could be as simple as classes at Michael’s….but they all cost money and require supplies that cost more money.  The best I have done is found some programming at some local libraries, like Knit Night kind of things…But that doesn’t help occupy my time during the days….And I feel this incredible pressure because now I have two weeks left and no leads.

And I can’t handle any of it anymore.  None.

This is not a good Monday.

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.

 

 

 

Homework and Callie

Homework

I am supposed to be working on homework right now.  I have an assignment to write about, “Identify the cycle of needing to be perfect that blocks me from receiving the care I need and deserve.”

Ugh.

I can kind of deal with the first part of the assignment…but the whole “need and deserve” thing….It just doesn’t work for me.  I want to reject care.  I don’t want people to care, I don’t want to be vulnerable and I don’t want to need people.  I want to keep everyone (except dh) an arm’s distance away, safely on the other side of my walls.  I don’t need care.

And deserve? Are you kidding me?  I don’t even think I deserve to spend money on food that I will eat because I think it is a waste of money (and food).  I don’t think I deserve nice clothes.  I don’t think I deserve peoples’ kindness and attention.  So…deserving care?  I don’t think so.

I know this is harsh, even I can see that…but it is sooo entrenched in me that I don’t know how to get around it.  I mean, I am supposed to challenge it and ultimately, retrain my brain.  But sometimes, I am so stuck in my core beliefs that I just don’t know how to break out of them.

Callie

So, I am going to ignore the homework and write about Callie instead.

Callie is one of the Direct Care staff here.  We have a rotation of 5ish regular direct care staff and they are all very good.  It seems as though Hilltop is quite particular about who they hire and the level of education the people have.  Some of the direct care staff people are even therapists.  I think all of them have Master’s degrees and if not, are working on their Master’s (though I haven’t actually asked everybody so I don’t know for sure.)  Anyway, there are a few that I am really attracted to, that seem like good fits for me, though honestly, they are all approachable.

Callie has turned out to be the person that I reach out to the most.  I really like her, she is very “real” and honest and caring.  I like the way she thinks, I like her insights and I actually feel like I have made a connection with her, which is huge for me.  I have let her into my little world.  Again, huge.  I really feel like I can talk with her and that she hears me.

I don’t know all the details, but aside from working here, Callie has been going to school and this fall, she is doing an internship, supervised by Kyla, in addition to her work hours.  And so, as I have connected with Callie, she mentioned something about sitting in on a session with me and Kyla.  And so, if everything works out today, she will.  I am good with this as it will help Callie know me better and further our relationship.

Also, I am supposed to read my trauma narrative to Callie this morning in prep for reading it this afternoon for Sexual Healing.  Since I am so ashamed of some of the stuff in my narrative and since it is soooo revealing, I am afraid that I will skip parts of it.  Well…I desperately want to skip parts of it, which would not be very productive.  So, if Callie knows what is in it, she can help me be accountable.  (She will be in the group taking notes, which is one of the parts of the Direct Care job.)

And thus, I have officially  integrated Callie into Hilltop Team Heidi.

Just saying Hilltop Team Heidi makes me miss my home Team Heidi.  But I think the Hilltop Team is as strong as as the home team, so I am very lucky.

 

 

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.

 

Emotional Development

This morning, instead of having time to blog, I am finishing up two agendas because I might be up on group to read them today.  Here they are:

  1. How Am I Responding To My Feelings The Way They Were Responded To?
  2. What beliefs do I have that prevent my feelings from being expressed?

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1.

I respond to emotions with:

  • Restricting (both emotional expression and food)
  • Historically, emotional eating
  • Invalidating my feelings
  • Distraction
  • Ignoring source of feelings
  • Completely deny having feelings
  • Isolating when I am crying

The main way I re-enact how my feelings were responded to as a child, is by ignoring their existence.  My parents didn’t acknowledge my feelings.  It was like I was in an emotional vacuum.  The times that my mother did respond to my feelings, it was totally mis-attuned and she would tell me that I was either tired or hungry.  And so she would tell me to eat something.

This food-response to feelings certainly was part of what created my emotional eating habits.  If I was upset, then food would make it better.  I was basically trained on that.  Right now, I do not emotionally eat.  Just the same way I emotionally restrict, I also restrict-food.  Only, restricting food is better because not only do I get to shut down emotions, but I get to lose weight too.  It is a win-win situation.

My mother’s response to feelings also served to completely invalidate what I was feeling and never actually look at why I was having intense feelings.  This left me at a loss to manage those feelings on my own.  Eventually, I learned that my feelings are not valid and that it didn’t matter what I felt or how badly I was hurting, feelings were not important.  The source of my pain was inconsequential.  It didn’t matter why I was hurting, it just mattered that my feelings needed to be stopped.

I continue this pattern even now.  I will avoid and distract from feelings and refuse to look at what is causing them.  It just seems easier than dealing with the pain.  And if I don’t want the feelings then why bother to figure out why I am feeling them.  If I am really pushed and really upset, I will regress to, “I don’t have feelings.”  I just shut down completely.  I don’t do it too often anymore, but it is a fall-back response when I am emotionally flooded and/or in too much emotional pain (I mean severe, intense emotional pain.)

I also deal with emotions by withdrawing physically (especially to cry).  When I was young, my parents would lock me in my bedroom when I was having intense emotions.  I used to rage and rage while in my room and then just melt into a crying mess of defeat and worthlessness.  As an adult, I repeat the pattern of the physical isolation when I need to cry.  As a matter of fact, I retreat to my bedroom, close the door and shut down.  As an adult, I don’t rage.  But I certainly crash into feelings of worthlessness, hopelessness.

2.

I also have come to have the belief that my emotions are too much for people, too big for people to deal with.  If my parents weren’t able to support me emotionally and had to lock me in my room when I was emotional, then my emotions were so big that they needed to be contained.  I could barely make sense of what I was feeling and how to manage the feelings (I was only a preschooler and didn’t have good modeling from my parents) so the fact that I had to be shut away when I felt emotions taught me that emotions must be shut away.

When I did approach my parents with intense emotions, my dad was unresponsive.  He was always emotionally unresponsive and unavailable and when he did demonstrate emotions, it was to rage.  He would rage against us kids, he would rage against nothing in particular.  He never would rage at my mother.  With my mother, my father just expressed a cold seething, but with me and my sister it was a terrifying rage and being hit with his belt.

My mother was too self-absorbed to pay attention to my emotions.  Anything else was more important than me and what I was feeling, be it her job, the soap operas she was addicted to or my sister.  If she did notice my feelings she always invalidated and dismissed them.  I never remember her letting me crawl on her lap to cry or to talk about what I was feeling. And if I ever did try to talk to her, there was correction and shaming on her part that was I was feeling wasn’t right.  But really, I was left to my own devices and as a self-sufficient kind of child, there was no real “need” for my parents to be involved in my emotional affairs.

Really, the messages I got were that emotions are bad, especially Sad and Angry.  Emotions would get me punished.  Emotions were too much for anyone, including myself, to handle and that what I was feeling wasn’t really what I was feeling.  As a young child, there was no way to make sense of any of this and thus began the development of some of my core beliefs.

As an adult, I still am emotionally withdrawn.  I feel very vulnerable and expect rejection when I try to share emotions with people, so I don’t.  And if people ask how to support me with my feelings, I often have no idea what to say.  I am afraid to feel sad and I am afraid to feel angry and I am sure if I express those emotions at/with people, it will push them away and I will be all alone again to try to manage what I am feeling with no idea of how to do it.

Struggling/Depressed

I’m not gonna lie.  I am super depressed.  It hits me most in the mornings and evening when I have no distractions.  I am weary and dead-inside.  I struggle to get out of bed and function.  I can’t make simple decisions, like what to wear.  I am overwhelmed.  The evenings are barely better.  I feel hollow and empty and try to convince myself that brushing my teeth is a good idea.  I put on my pajamas and crawl into bed…My mind slowly drifts across the day (not in an obsessive/anxiety sort of way) and I wish I was dead and intrusive thoughts break into my quietness and then I fall asleep.

Daytime is better.  We are so busy here and there is really no way to be disengaged.  I do the work I need to do, I smile at my peers and the support staff, I deflect my sadness with humor.  I am not faking it too well though.  When I am distracted from the busy-ness, my affect changes.  I know this, because I have had a few people approach me in such moments and ask if I am okay.  Mostly, I say that I am just tired.  To some, I have said I am depressed.  Feeling depressed is run-of-the-mill here, so it is an honest answer, but sort of meaningless.  I have not told anyone how depressed I am.  Or that I am struggling to maintain function and to not cry all the time.  (Although, crying is run-of-the-mill as well…so it wouldn’t look any different than any other day.)

I even can tell you why I am depressed.  Last week, Kyla had my write a trauma narrative from when I was 4.  It has stirred up lots of stuff.  She had me read her the narrative and I omitted stuff from it when I read it, which I told her.  She gave me the assignment of highlighting the omitted stuff before the next session.  And I didn’t do it.  She reassigned it.  I didn’t do it. She reassigned it on Monday.  And I did it. And I added to the narrative and I hunted down something I had written and given to the AT in May.  And I hate all of it.  So, the depression has settled around me, like a tarry blanket.  I feel broken and sad and like I am being swallowed into a dark hole.  It’s no wonder that I am tired all the time, I am working hard to maintain my day affect.

So, here I am.  Depressed.

The depression makes me not want to eat.  Supposedly, I am going to be moved to Level 2 today, giving me more autonomy with my meals. I have been waiting for this “promotion,” but right now, I feel like the timing is poor and I will struggle to do what I need to do with my meals.  I have already thought of 101 ways to get around eating what I am supposed to when I am moved to Level 2.  I am frustrated that I think this way, frustrated that I might use the autonomy to work the system.  Disappointed that I can’t shake the ED thinking.

I just don’t know.  I have therapy at 11 this morning.  I am supposed to read the damn narrative again.  But I won’t.  I feel stubborn about it.  Or scared…I guess really, I feel scared and so I want to put up every wall  I can to not have to read it.  However, I may get around it because there are a few things that I actually do need to discuss with Kyla that are not the narrative, but that are becoming pressing issues.  Mind you, she can spot distraction behavior a mile away, so I don’t know what I will be able to get away with, but I do have some other things to talk about that are totally legit.

 

 

 

 

Lorazepam Makes It All Better

Yesterday was pretty close to the most miserable, awful day I have had since I got here.  I spent the morning having an anxiety attack and crying.  (This started within minutes or me waking) and basically having an anxiety attack with ranging severity for about 6 hours.  It was. not. fun.  I will spare you the details because it is sort of a long saga and too complex to explain. Plus, I don’t want to re-trigger myself into more anxiety.

The end result of my day of angst was that by bedtime last night I felt completely unsafe and just wanted to go stay in a hotel.  I just wanted to have a night of no worries, of safety and of actual sleep.  Since going to a hotel was not an option, I used better-living-through-chemistry to manage the night.

I have not taken any of my as-needed lorazepam (anti anxiety med) since I got here.  And usually when I have taken it at home, I take 1/2 to 1 whole tablet.  Last night, I asked for whatever the max dose was.  It turns out my max dose is two tablets.  I have never, ever needed to take two!  But I figured the only way to get through my anxiety about the night was to numb my nerves and be oblivious to the world.  So, I gulped down my two pills, while wishing that I could have taken a handful.  Then I got into my pajamas, turned the volume on my soothing-noise/white noise app up all the way to drown out anything that i might hear, and I turned so that I was facing away from the door-side of my room.  And I burrowed under my blankets.

I still didn’t feel safe, but pretty quickly I could feel the smoothing calm of the lorazepam wash over me and with the roaring of the white noise app, I was able to cocoon myself to sleep.  I don’t know what, if anything, happened during the night…But I had rendered myself oblivious.  As a result, I slept pretty much straight through the night, only waking up maybe once and again when my alarm went off.  I felt a little groggy from the meds, but that wore off pretty quickly once I started moving.

So, the night in which I was feeling the most unsafe turned into one of my better nights of sleep thanks to lots of anti-anxiety meds and nearly deafening white noise.  I can only imagine how much better my night would have gone if I could have taken more of the lorazepam and just completely deadened myself to the world.

Today is another day.  Most of my angst about yesterday is gone, though I still have a reminder on my arm where I self-harmed.  That will take a while to heal.  Maybe it is a good representation because even though I say my angst from yesterday is gone, it will take me a while to feel safe here again at night and a while for me to heal from the emotional trauma of the day.