My Eating Disorder: Progress and Hope, Part III of III

Continued from yesterday, Part III of III

However, I have made some good progress during the past couple of weeks. I am talking about my eating disorder with my therapist, psychiatrist and husband including the lying. I’m blogging about it. Thinking about the further health problems that this will add. I’m also feeling quite anxious and angry at myself for talking. (ambivalence sneaking in) I am also feeling happy and relieved that I said something. It is really self-destructive and takes a lot of energy to not talk about my eating disorder.

Now, I don’t feel like my eating disorder isn’t just mine which brings up a whole lot more feelings and again ambivalence rears its ugly head because I don’t feel in control taking about it when, in fact, I am in more control. My eating disorder doesn’t continue take over my life.

To add to those feelings, at the suggestion of my therapist, I now have to manage the feelings that I have about boxing up for donations all of my smallest sizes. The smallest sizes include for pants, skirts and jeans are 24-25 and double zero to zero; tops are xxs-xs; bras are 32A, undies are xs or 4. To give you some perspective I am 5’ 4” and was 97-110 pounds. I’m angry that I'm donating my clothes, I feel like I’m letting go, am out of control, am sad, am disappointed and probably others that I can’t identify yet.

There is also much ambivalence. I am donating a ton of clothing (300+ pieces) that are all in good shape and not out of date. Seeing the amount of clothing also made me realize that up until last year with my health problems that I wasn’t doing very well. I have spent on and off over twenty years with this consuming me as the smaller sizes have usually fit me during those years. I’ll write further about this in a later post.

I am really angry because my therapist told me that he was sure that they would never fit me again because he would hospitalize me first. More ambivalence and control issues here. I know that he is right, but I still think that I can get down to those sizes and be healthy.

I also fool myself and become angry at my therapist when he tells me that I am anorexic. I tell him that I don’t meet the DSM criteria. He says that my thinking, feelings and behavior are the same. And, sometimes I want to fight him about even having an eating disorder. I think that he is wrong and that I am okay. Again, denial and that I don’t want to accept this or let anyone in…again, I am only fooling myself.

Bottom line is that I am anorexic and am in trouble. Also, that I am being more honest and want help. I am also willing to change some behavior, but it certainly doesn’t mean I like it. And, ambivalence says, “now I want to push everyone away.” But, I really don’t want them to go…I do want help and encouragement to work this through and am afraid that I’ll be fat. I am anorexic and don’t have control…my eating disorder has control over me.

To be continued when progress and setbacks occur...

My Eating Disorder: The Ugly Details, Part II of III

Continued from yesterday, Part II of III

Now, I’ve never wanted to give details of what I’ve exactly done to try and hide it on this blog thinking that it will give others ideas. But, when it comes right down to it I didn’t want to look at the truth because if someone has an eating disorder they already know the bag of tricks and more. I just want to deny that it is a problem, that it never was, I can handle it, I’m in control…sounds like addict thinking to me…it is fucking bullshit. I’ve never been in control. It has always had control over me. Sometimes, denial is good until you can deal with the issue or it become life threatening.

There are many ways that I’ve tried to hide my eating disorder, mostly from myself. Like not talking about it and wearing clothing that hides how much I weight. When I had evening sessions it made it really easy to lie to my husband and say I’ve already ate. I would if I had time change from my more form fitting work clothing to loose clothing before session. Avoiding my husband touching or seeing me. I am not doing these things now. But, I was very vigilant when I was in real trouble.

Currently, I am in trouble now in which I will explain what I am doing. The worst part is I am lying to my husband about eating when I haven’t. I especially liked it when he was working late because we did not have any meals together. I tell him that I wasn’t hungry, or ate very little, but lying to him really means I am in trouble because I am not one to out right lie to anyone especially to my husband. I heat or cook something or dirty dishes with food and put the food down the garbage disposal. I always taste a bit, so I can tell him that “I had a little of this to eat.” (I know this is a lie…splitting hairs)

Some days consists of coffee in the morning and water the rest of the day. Sometimes, a piece of bread or something sweet. I sleep through meal times and then say that I’m not hungry or don’t feel good. I am and have always have cut my food up, so people can’t really tell how much I’ve eaten.

I started to lie to my therapist by omission or giving vague answers…I think that I was getting away with something, but, if I thought about it, I would realize that I was only fooling myself. I become extremely anxious when mealtimes come and I really become focused on everything I eat or drink. Along with it, I become preoccupied with my body by weighing myself almost every day or several times a day.

I constantly look in the mirror and see myself as grossly overweight. I am literally not sure what I really look like and haven’t in years. I’ve need my husband to point out women that look like me or if they seem to look heavier or thinner (usually it is heavier). Estimating calories for the day is a way of life. Food is categorized into good and bad food. Along with that is this thing of if I have a bad food I can’t have two meals or snacks or something.

Continues Tomorrow: "Progress and Hope"

My Eating Disorder (Part I of III): The Beginning

I want to write this post and I don’t…boy is that ambivalent. I guess that is a good way to start. One of the most difficult issues with having a Borderline Personality Disorder (BPD) is ambivalence. Webster’s defines ambivalence as “simultaneous and contradictory attitudes or feelings (as attraction and repulsion) toward an object, person, or action” and or “continual fluctuation (as between one thing and its opposite).”

It is difficult to tolerate feeling both seemingly opposite feelings at the same time which leads to the “all or nothing” and “good or bad” splits. There are no gray areas. (By the way, everyone does this to some degree.) The book entitled, “I Hate You-Don’t Leave Me: Understanding the Borderline Personality by Jerold J. Kreisman,” is a good introductory book to read to gain a better understanding of this issue and the Borderline Personality Disorder.

Two weeks ago, I wrote quite personally about my eating disorder which I want to elaborate on further which is also why I explained ambivalence. For me, it is all or nothing. I either want to die slowly or I want to nurture and take care of myself. I either have complete control of my eating and weight or I am absolutely out of control. I want to live and I want to die. I want help and I want to push everyone away. I want to be taken care of or I want to be independent and need no one. I’m good or bad. I am all feeling or don’t allow myself to feel at all.

Oh, and the list could go on and applies to many other types of mental health issues and addictions. My thought process and behavior become consumed by my eating disorder. It is self-destructive, self-harming, suicidal and an expression of self-hatred like other addictions as well. It is also a defense mechanism which I use to prevent myself with dealing with what is currently going on or avoiding a topic or issue. Like all addictions there is a of addiction, which I referred to in previous posts and always hides the “real issues and problems.” I’m reading what I already wrote and if anyone has guessed it…I use my cognitive skills to avoid real issues. However, what I have written is important.

Since, I wrote my eating disorders series, I decided to talk about what is currently going on and to be more honest in therapy. You’d think that going on nineteen years with the same therapist, I’d have covered this…well, no I haven’t because part of an eating disorder is about control. And, damn it I was going to have control by omitting details of my eating disorder including allowing my therapist to think my psychiatrist was addressing it and vice versa. It was just last week that I said something and asked for help and am open to receiving it and initiating changes. (Like, my therapist didn’t know…duh)

Continued tomorrow..."The Ugly Details"

Eating Disorders Awareness Week ~ Overview

Your mother, father, daughter, brother, neighbor, friend or colleague all could have an eating disorder. You might never know it and be unaware of the turmoil that follows every day throughout the day. On the outside, he/she may be normal weight or slightly overweight, seem successful, happy and have an enviable life. But, looks can be deceiving. Watch this video for some basic statistics. (Please, if you have an eating disorder there are images that may be triggering, so make sure that you are safe!

Somewhere within a month’s period it is a National Eating Disorder’s Week wherever you live. Today (2/24/08) is the beginning of the U.S.'s National Eating Disorder’s Awareness Week which is a collective effort of primarily volunteers, eating disorder professionals, health care providers, educators, social workers, and individuals committed to raising awareness of the dangers surrounding eating disorders and the need for early intervention and treatment.

Eating disorders are mental illnesses. They are generally defined as a broad range of disorder where preoccupation with food and/or weight takes primary focus in ones life that they can hardly focus on anything else. They become obsessed about food, weight and body shape.

The three primary types are anorexia nervosa, bulimia nervosa and binge eating. There are also a range of sub-categories that you may have heard like anorexia athletica, compulsive exercise, orthorexia, body dysmorphic and compulsive over-eating. There are specific diagnostic criteria for the three eating disorders as defined by the DSM-IV-TR. Please visit the sites below for more information.

Anorexia Nervosa is basically starving yourself, keeping yourself below 15% of your normal weight and they may exercise excessively. Body weight is of thin appearance. Emotional and behavioral symptoms include refusal to eat, denial of hunger, lack of emotion, difficulty concentrating, skipping meals, having “safe” foods, food rituals (cutting into tiny pieces), elaborate cooking for others, repeated weighting, distorted body image, hoarding food, wearing baggy or layered clothing, complaining about being fat and depression or anxiety.

Bulimia Nervosa is eating large quantities of high calorie foods sometimes for hours and then getting rid of it afterwards through laxatives, vomiting or exercise. Body weight can be normal to slightly over weight. Emotional and behavioral symptoms include constant dieting, feeling that you cant control your eating behavior, eating to the point of pain, unhealthy focus on body shape or weight, distorted body image, going to the restroom after or during eating or meals, hoarding food and depression or anxiety.

For both anorexia and bulimia, medical symptoms may include abnormal bowel function, bloating, dehydration, fatigue, dizziness, irregular heart beats or rhythms, dry skin and irregular or loss of menstruation in women and girls. There are many more. Please, see references below for more details.

Compulsive over-eating/Binge eating is impulsive gorging or continuous eating. It is the number one eating disorder. While there is no purging, there may be sporadic fasts or repetitive diets. Body weight may vary from normal to mild, moderate, or severe obesity. Emotional and behavioral symptoms may be eating to the point of discomfort or pain, eating much more food during a binge episode than a normal meal or snack, eating faster during binging, feeling eating behavior is out of control, frequent eating alone, frequent dieting without weight loss, hoarding food, hiding empty food containers, and depression and/or anxiety.

What causes eating disorders? It is three-pronged. There is a biological component. Studies are finding genetic links and chemical commonalities. Second is the sociocultural component. The media and peer pressure has given the message that thin is successful, popular, perfect, loved, strong, sage and beautiful. As a result self-worth becomes linked to size and weight. Third is the emotional and psychological component. They tend to be perfectionists both physically and academically, have low self-esteem, have high body dissatisfaction, and have periods of depression. Being sexually abused as a child is often a contributing factor to the development of an eating disorder.

Eating disorder are common in individuals in sports or professions where there is a high value on being thin. Athletes, actors and television personalities, dancers, and models are at higher risk of eating disorders. Eating disorders are particularly common among ballerinas, gymnasts, runners and wrestlers. Eating disorders are more common in industrialised societies where there is an abundance of food and where there is a cultural ideal for women to be thin there is an increased risk if a parent or sibling has had an eating disorder, mood disorder or alcohol or drug problem

The earlier treatment is sought the better the chances at full recovery. :-) Please go to the links below for more on treatment and prevention.

What I haven’t covered and why I know so much is that I’ve had an eating disorder for 30 years with varying degrees of recovery. I am diagnosed with Eating Disorder, Not Otherwise Specified, which means I don’t meet the criteria for one of the categories, but my internal life with food and eating and my weight effects impacts my physical and mental health significantly. So, I know a bit more from the insiders point of view that what has already been written. :-) Secrecy often keeps an eating disorder going.

However during my recent psychiatric hospitalization my diagnosis became, once again, a point of contention. Although I tend toward anorexia, I am not diagnosable as such, but my therapist really pushed the point. He basically said that he didn't care what the DSM said, but that I have anorexia. I made a feeble attempt at saying that my weight was normal and maybe a little overweight. Then, I just had to laugh because I know that has nothing to do with it because my thought patterns and behavior are the same. Also, if it weren't for the medications, I would be underweight.

Eating disorders are highly addictive mental illnesses. They are an expression of deep self-hatred, lack of self worth, and unknowingly a lack of control. I know that I feel in control when I lose weight, but in reality it has control over me. I know that once I reach my goal, it will be lowered, I’ll reach it and it will lower. There is no end to it until I require hospitalization.

Somewhere, I read, that “it is a desperate attempt at making sense of the world.” Well, in the world of chaos and abuse I grew up in, I really was set up for an eating disorder. It is also my way of handling my anger of not being able to self-nurture or feeling in control of events and intense feels that occur. It is the first thing that I run to when I am under emotional stress. I hate the feeling of being full and love the feeling of being hungry and overcoming it.

It makes me feel in control, but control really is an illusion. It is secretive and mine. No one else can stop me, so I am in control. Recently, I just barely began to speak about my eating disorder rather talk around it which is, in part, why I decided to write this post.

However, it has been painful to write and especially painful to find a video because it triggers me. In looking at the pictures and videos, I feel fat, hate how I look and want to lose weight even more. My sense of reality becomes distorted. What I think I look like is not reality. The scale is my best friend and worst enemy. If the numbers are lower then I feel good for a brief moment and then I wish it were lower. At one point I was weighing myself 4-5 times per day. My self-esteem goes up and down with the numbers on the scale. But, no number would be lower enough.

I absolutely hate people talking behind my back instead of to me or comments that like “I wish I had an eating disorder, so I could be as thin as you.” It is painful and makes me realize how hard it is to give it up. It isn’t a glamorous thing. It is an illness.

It isn’t about self-control, it is about lack of it. It is a tough thing to overcome, but I know that there is hope and healing. But it is tough, painful work. It also requires giving up one of my best friends, “control.” My distorted thinking still thinks that I am in control as does my deep denial. It was quite therapeutic writing this post, so thank you!! :-) This was a good experience. I hope this post helps you or someone that you love.

Eating disorders are extremely complicated and there is much more information available. For more details and for help for yourself or someone else, please visit the following sites:

National Eating Disorders Association
National Institute on Mental Health
National Library of Medicine at the National Institutes of Health
Mayo Clinic.com
The Eating Disorder Foundation

In your comments, I do ask that you do not mention numbers, in terms of weight, as that is a trigger for those who have eating disorders that can set off an episode.