Tag Archive: Choose to Recover


spaghettiJust eat! It’s really that simple”

The well meaning eyes of family and friends cast along the frame of an ED sufferer; pupils travelling the ridges of the clavicle, the skeletal hands and down the birdlike legs.

Just say, I CAN do this

Just make up your mind that you’re GOING TO do it and then DO IT

Lots of ‘justs’. Lots of good suggestions. Lots of spilled frustrations.

So why isn’t it ‘that simple’?

Surely it’s not rocket science…

Well…. in actual fact, although it’s NOT about rockets, there is quite a lot of science involved; physiology to be precise.

When someone is well below a healthy weight, the list of psychological blocks to recovery may be a mile long. However, unbeknown to many, there are also many physiological reasons. Chemical and hormonal shifts in the brain that induce behaviours which can make it incredibly difficult to behave in a ‘normal’ way around food. Experts in the ED field will tell you that a full recovery isn’t possible until weight has been restored to the point where a patient’s BMI is between 20 and 25. In fact, many argue that it is ONLY when a patient reaches a safe, healthy weight (and so, BMI) that recovery can begin.

I agree.

One of the strongest pieces of supporting evidence we have for this idea comes from a ground breaking, wartime,  experiment into the effects of starvation, performed by Dr Ancel Keys.

In 1944, as war raged throughout the world, Keys recruited 36 young men (mostly conscientious objectors) all deemed to be at a peak of physical fitness and mentally / psychologically healthy.  Over a period of a year, he studied the behaviours and mind set of the men as he systematically cut their calorie intake and increased their levels of exercise . By the end of the ‘starvation phase’, the men had lost around a quarter of their body weight and their physical appearance was skeletal.

Photographs of the subjects reveal bodies not dissimilar to those who had suffered in concentration camps. Certainly, the men appeared to have been subject to a lifestyle which denied them of their most primal need; much like the self inflicted discipline exercised by those with Bulimia or Anorexia Nervosa.

For someone attempting to recover from an eating disorder, the most pertinent revelations of ‘The Minnesota Experiment’ lie in the fascinating changes in behaviour displayed by Keys’ subjects. Behaviours and attitudes practised in secret, cloaked in a horrible sense of shame, perhaps feared by the sufferer to be so ‘odd’, so far from ‘normal’ that nobody should ever find out… Behaviour that actually, The Minnesota Experiment, proved to be a direct result of the human body being starved and therefore, some way beyond the sufferer’s control.

Keys documents that the more the men starved, the more overwhelming was their obsession with food. Food became an absolute priority while the rest of the world, family, politics, opinions, religion etc, all faded into obscurity.  The men were restless, their minds unconsciously forcing their bodies to forage for food, allowing little sleep as the need for nutrition overrode all other basic needs.

Interestingly, all the men developed ‘abnormal’ eating patterns, becoming ritualistic, taking up to two hours to eat a meal, cutting food into tiny pieces,  mixing food with liquid to make more of it and hoarding food so they could take it back to their bunks and graze on it. Moreover, the thinner the men became, the less able they were to judge their size as being thin or underweight. A few of them even went so far as to express thoughts that others were too fat. Spot the quandary of an Anorexic.

There were many, many physical effects, most of which an Anorexic will experience as par for the course, but in order to explain why it’s so damn hard to ‘just eat’, I wanted to draw from the physiological findings of Keys’ experiment. The state of semi starvation, of extreme self denial, is in itself, a trap. Being below a healthy BMI produces its own set of barriers to eating, making the initial ‘pre recovery / weight restoration’ phase about as difficult as it could be.

It’s really not as simple as it might seem.

Certainly, during the period of re-feeding, the men ate happily (obviously not suffering from an ED) but my point is that whilst starving, the men underwent such changes to the chemical balances in the brain, that food became an absolute obsession and habits previously unheard of, became commonplace.

When an Anorexic tries to recover, they not only battle the mental blocks that the illness creates, they also have strange, unseen physiological blocks.

(Another terrible hidden suspicion of The Anorexic, that their appetites will become insatiable once they begin to refeed, is also borne out in Keys’ evidence, producing yet another barrier).

I could go on and on about this great study in starvation, but it’s all for another post. What I want to convey is that, despite all appearances, recovery is never as straightforward as ‘just eating’. Refeeding, within itself, is fraught with unconscious physiological blocks and hurdles.

For me, personally, despite this knowledge, and armed as I am, I still stand on the wire, looking at that vast expanse that is ‘no man’s land’, weighing up the risk, trying to see where the mines are set, where the searchlight falls.

It’s been ten years raging, this war.

gripping barbed wireI still want to fight…

…but the real enemy

lies in the woodland

on the horizon

I still need to make it to.

THAT’s the pathology of an eating disorder.

THAT’S the physiology of starvation.

 

Dear ___________,
agony1

It’s hard to  know where to be
gin because I cant remember where or when the beginning was.  What I DO know is that you’ve no idea how hard I’ve had to work just to keep things balanced.

I want you to stop and shut up and LISTEN.  I’m going to try to tell you about what you’ve done and what you’re STILL doing. It’s a hard thing. Bear with me.

Despite your attempts to poison me and to harm me, I fought to stay healthy. I cleaned your blood, carried it round, battled illnesses, healed up your wounds.

You crossed what had become a very blurry line around ten years ago.  Then the real brutality began. You fought me with systematic, dogged determination; tried to change me, control me, reshape me with the tools of death you fast learned to use.

The irony of the fact it began with a health kick hasn’t escaped me. When you cut out the cigarettes, I was overjoyed! Clean breathing at long last. I’d been clogging up with thick tar, and in some ways, I think I’d resigned myself to the blackness, and to the knowledge that it would continue to seep and creep, until it covered all my tender healthiness.

But you cracked it! And I began to work at cleaning it up, helped greatly by your exercise and your healthier lifestyle. It was so good for a while.

Up until you stopped feeding me.

At first I wasn’t worried. I don’t even know when I first noticed. Those workouts of yours grew progressively harder to sustain. When I began to flag, instead of the little rest I was used to, you pushed me all the harder. After sprinting half a mile, you’d ramp up the speed. For a while, I thought it was normal; y’know, a good technique for burning my fat and making muscle. I trusted that you knew your stuff. I figured you’d stop when I reached my optimum, and I worked so hard for you, did what YOU wanted. Stretched to the limit, I kept going, convinced you’d be satisfied with my performance.  It’s hard to acknowledge just how far you fell from my expectations and it’s quite impossible for me to understand.

Over time, you and I underwent a transformation that nobody, NOBODY could believe. I think it’s fair to say that it simply wasn’t a you that I recognised.

You were brutal.

Whispers of encouragement became barked orders as coach turned to tyrant. I began to dread you.

Your lack of mercy started to take its toll as I struggled to balance your system.

I tried to tell you. I couldn’t help but let you feel the impact of your cruelty. You can’t flog someone half to death and expect the scars not to show. I stopped biting my lip and started to shout, but you lashed me harder, your determination a steel whip, your mission a desperate urge to keep control.

And all this talk of exercise is perhaps an avoidance of the most painful point: that of starvation.

I struggle here.

The louder I cry, the harder you starve. The more I plead, the more you withhold. If I let myself think of food, you give me less, and yet, I’m so hungry, I can’t think of anything BUT.

You’re killing me.

It’s not rocket science. If you don’t take care of something, it’s going to fall apart.  I’m SO tired of having to hold you up. You demand so much of me but give so little; a cruel rider lashing at his horse, numb to the pain of its seared flank; numb to the deep ache streaming down it’s legs, for all that matters is the win and the blinkers of victory blot out the damage.

If I was a separate being, you’d be done for abuse. The cruelty is almost intolerable. You tease me with the broken edges of foods that I crave. You tell me I can have it, then, just as fast, tell me I can’t. I’m starving and you lead me to the fridge fskeleton appleull of food that I’m not allowed to eat. Like an object of worship, you kneel in front of the full shelves, and as I cry that it’s nourishment you only see numbers.  For food has become a mass of calculations that stream through this brain, tangled wit
h the inevitable bargaining script of ifs and buts and onlys… And all the while, my mouth drools.

You’re breaking me. My bones are dry and brittle. Osteoporosis casts shadows on my hips and my spine is wearing thin. I can’t remember how many years since I bore the ache of fertility. This womb dry and cold, no longer fit to feel the moisture of tiny breath.

Every step is painful as bone grinds on stone. Every step is my protest. And yet, you carry on, rising above the screaming soles, too frightened to stop. You run away from me, barely look at me, only glancing to check that your clothes cover your skin.

I am weary, made tired by your disdain. I am weary of being underfed, ignored, tempted, denied.

I am weary of being brought to the brink of health, and then being starved to the brink of death.

I am weary of daring to trust that I no longer have to hunt to survive, then being shot at when I rest.

I am weary of empty promises, of bearing the weight of your illness.

If you continue, we will both die in this civil war and nobody will ever know who won or who lost.

All of me will rot; but, you if you remain, will rise above the webs of half rotted reasons, above the dry dust of me

And it will all

seem

so

completely

senseless.

******************

I didn’t want to seem rude when my very lovely clinician suggested writing a letter to myself. I almost squinted with the effort of holding back on the eye roll, resisted the sideways pull of my lips.

Been there. Done that. Got T-shirts to clothe an army.

But. This was a bit different. Not a ‘ years from now thing. Not a letter to myself, but a letter FROM myself. More specifically, from my body.

I put it here to remind myself why I need to keep eating. I also put it here hoping that it might be helpful in some way, to someone else.

 

 

 

.

 

 

 

In my last post I think I may have explained that I was accepting a third round of inpatient treatment, which I hope will go some way towards explaining my temporary absence from the blogsphere.

It’s been four weeks.

Four weeks of a graded increase in food.

Four weeks of setting up my small bedroom and equipping it with things that will make it look less like a hospital and more like student digs.

Four weeks of adjusting my routine; of getting used to eating six times a day,  of sitting still in a crowded communal lounge for a total of four and a half hours each day, often subjected to death by American ‘comedy’ interspersed by the even more torturous Jeremy Kyle show and Hollyoaks.

Four weeks of sussing out the eight other patients; logging their individual idiosyncrasies… getting to know who experiences distress at the mention of the weekly menus,who cant touch anything after eating for extreme fear that there exists a phenomenon whereby calories can be transferred onto any object she touches.

Four weeks learning to tread carefully around topics others find ‘triggering’, learning who responds to a hug and who shrinks from it, leaving and receiving little notes of encouragement and kindness.

Four weeks of interacting with different staff nurses and health care assistants.

Four weeks of twice weekly ‘weigh ins’; the unavoidable moment of fear, where figures flutter round, and then pierce, the early morning brain fog.

Four weeks and I feel hopeless and despairing because the pain of weight gain, albeit gradual, feels increasingly frightening and I just don’t know if my courage can hold out for the long haul.

record-player2

… And we’ll all sing along like before…

Goes the song.

Irritating when your internal MP3 is stuck on the same track and no matter how hard you shake it, it won’t stop. Trying to get away from it is just about as effective as trying to go on holiday without your head. And don’t we all wish we could do that at certain times in our life. Take enough hallucinogens and maybe it’s possible, but they’re not exactly cost effective and the insurance you’d need to take out is ridiculous.

No.
No way around it but to play enough music to flush this one out of the system.
This particular musical ghosting is a song by Del Amitri (who for some unknown reason, I always confuse with Dire Straits). An especially depressing number, aptly named, ‘Nothing Ever Happens’.

I guess it’s the theme of repetition that lends the song to my worn out inner ears; and for good reason.
On Wednesday, I retrace my tracks to the very same unit I was in over Christmas.

Yep.
That’s right.
Wednesday will see me standing outside what is going to feel like Hell’s doors.
And to be clear, it’s not that nothing will have changed, because I have. My illness has. My thinking has. I’m not on exactly the same rung of the ladder as I was in December.
What is hard, is that it’s the same old hole. The same darkness. And, pretty much the same distance to the light. (So maybe I AM on the same rung…)

Hence, ‘we all sing along like before’.

Last time I came out  ran away because I couldn’t stand the increases in my diet. I left with a BMI of 15. Clearly not recovered in any sense really… Although it felt like it.

I want this to work… which means that I will have to work. Very hard.

It will be bearable, though it won’t feel it.
It won’t kill me, Ironically, it could save my life. But it won’t feel that way because the process of weight restoration will involve the slow death of a part of this illness, so it will feel like it.
In all the darkness, I must somehow manage to fix my eyes on a light I will not always see.

In order for recovery to take place, you have to believe that, just as there is always a sun and a moon, there is a new life beyond, and there is a different person behind, the illness / addiction.
The courage it takes to make this leap of faith is immense and for me personally, I don’t know if I can sustain it.

… sometimes takes more courage than to continue a fight.

Image may be subject to copyright

Image may be subject to copyright

Sometimes it makes more sense to submit than to lose everything by fighting a battle you’re not equipped enough to survive.

That won’t please the shiny miracle brigade. Those who remarkably manage to cling to a hope that pays off once in a very blue moon. I’m not saying anything is impossible, just that suggesting that holding out hope can sometimes be a little like burying your head in the sand.

Believe me, this isn’t an easy thing to write on a blog referencing hope in the title; a blog whose very essence was supposed to be hope. A place which might offer encouragement to others, and help deepen understanding about the struggle of recovery, insight into the world of mental health and eating disorders.

However, it would be dishonest to spout rubbish about a recovery that I haven’t yet made. This is where I find myself; admitting defeat. I’ve had to have an honest look at No Man’s Land and an inventory of my fire power tells me that I need to regroup in order to stay alive.

I am being admitted to an ED inpatient unit on Monday. The admission is for a month, at least, so that they can prevent organ failure and minimise the risk of death that is posed by my current BMI. (Body Mass Index, for those who may not know, is a calculation of relative body mass and height, which gives an indication of where an individual is in terms of the healthy weight range of 20 – 25).

I’m lying in the trench, a little wounded and very weary. It has taken guts to submit. I’m losing the battle in the hope that I might still win the war. If I carry on fighting, there’s absolutely no chance.

Tipped out and raked through, the innards of handbag look like an Emin – style installation.

I could write more about this, but this isn’t really the place for theorising about what does and doesn’t constitute a work of art.

I’m focused on one particular thing (though I may list or photograph the contents of my bag for those whose curiosity has been inexplicably peaked).

Amidst the clutter, the handbag holds the main thrust of my last weekly appointment at the Eating Disorders Unit. A folded piece of crumpled paper. A list, scrawled by my clinician in desperation: “Reasons to Increase Weight”.

Turns out that the essence of this list can’t permeate the tan leather of my bag. It isn’t going in.

Which brings me here. Perhaps the skin on my fingertips is more permeable? (I jest)2014-12-08 16.55.06

SO:

I want to increase my weight:

  • To prevent my organs from packing up
  • So I’m not hungry all the time
  • To have more energy
  • To be able to write
  • To be able to get a life?
  • To be able to eat out again.

They’re pretty broad… but it’s hard to think about the possibility of ever being well, especially when the illness has eaten so much of your brain; Worse, your hope.

I’m getting nearer that piece of land between two warring factions. The Anorexia versus Team ED. I should be in there somewhere… perhaps a third party divided between the camps. But I’m not.

Truth is, I’m lost at this point in time. The daylight is fast fading, the guiding lights are all extinguished and I’m stumbling through no man’s land clinging onto a crumpled list of reasons.

For whatever reason, I feel the need to preface this post with a declaration that I do not buy the Daily Mail. Finding it, all too often, a thinly veiled excuse to propound nationalistic views, I frequently have to remind readers that the world is not really that bad a place unless they believe all they read in this trussed up tabloid.

I was, however, drawn to the full page article about a long suffering mother, who, five years after her daughter’s tragic death, has made the decision to release the girl’s diaries. Diaries that record the tortured journey of Loredana Verta, a bright, talented sixteen year old, who was dead within three years. Heart attack.

Rightly or wrongly, some of  this young sufferer’s innermost thoughts and feelings are laid bare in newsprint for all to see.

The workiarticle-2713000-202CA0CA00000578-585_634x910ngs of this girl’s mind are utterly consumed by the illness. Her writing is littered with scribbled self loathing, capitalised screams of  “I HATE ME… I HATE MY BODY”.   Most teenagers feels like this at some point. Hormones, skin, peer pressure, perfection culture, fashion… It’s all there to taunt the aspiring, spot laden, hormone raging teen.

Except Loredana’s thoughts are all centred on weight loss and weight gain and wrongly perceived fat.

To my mind, what is more haunting than the poisonous self hatred, the desperation, the pleas to God and the cries for help, are the words of a grieving mother, who says,

“Lorry thought she could live with the condition – that as long as she was thin, she would be OK. She didn’t realise that anorexia is a deadly disease. It is a killer”.*

For long term sufferers, ‘old hands’, Anorexia can be so ingrained, so deeply habitual, that we forget that it is something UNnatural… an invasion. It becomes like Stockholm Syndrome… It’s is our natural fall back position.

It KILLS.

Let’s get real.

It is deadly.

We think it won’t ever happen to us, and yet, why wouldn’t it? It killed Loredana in just THREE years.

Of all psychiatric disorders, Anorexia is the biggest killer. TWENTY PERCENT of sufferers die prematurely.^

I hear my wake up call.

Can you hear yours?

 

* Emphasis is mine

^ Statistics according to B-EAT

I can stand for ages in the ‘greeting cards’ section of supermarkets or gimmicky gift shops reading the captions under funny cartoon pictures of penguins, small pen sketched characters, or black and white photos of men and women from a bygone era. More often than not, there will be something that makes me laugh loudly enough that I have to throw a couple of sidelong glances to check that nobody within the immediate vicinity is looking at me as though I am obviously mad.

A lot of the cards will adapt a formulaic linguistic structure; “X knew that she / he was _________ when he / she ___________” .  For example, ” You know you’re getting older when…” followed by the punchline, …” ‘happy hour’ is a nap”.

Amused?

Have a few more…

You know you’re getting old when…

  •  the candles cost more than the cake

  • you and your teeth don’t sleep together

  • you have to scroll to your date of birth

  • your friends start having kids on purpose

  • an ‘all nighter’ means not having to get up to pee

You get the picture?

Right.

I was trying to tell a friend a little bit about the treatment I receive at the unit I attend daily in order to restore my weight and, hopefully, recover a little bit of my mind… (I hardly dare type those last seven words). My friend couldn’t really grasp the fact that I wasn’t feeling proud of myself for managing to stick it out for the last nine weeks. She felt that I should be happy to be gaining weight and ‘getting my life back’.

Careful not to sigh, I resigned myself to the fact that there are many people who will never comprehend the fact that recovery from an eating disorder is a long and rough-road-ahead-signtorturous process. It is one of the few illnesses where, the ‘better’ you are doing, the worse it feels. I can only liken the dichotomy between wanting to be well again and wanting to starve as having my left and right limbs tied to two opposing poles which are subsequently pulled in opposite directions. It is torture.

Just like the greetings cards, I had a flash of this image with the caption, ‘You know you are in recovery when…”

And there are so many ways I could finish this sentence that I could be here all night… But I guess the truth of it is, you know your’re in recovery when:

  • your actions are a direct contradiction to the voices in your head.
  • you want to use a wood plane to shave the flesh from your bones
  • the treasured silence of your starvation turns to desperate, strangled sobs
  • just being in your body feels so horrific, you writhe and twist and rail
  • you meet ‘weigh days’ with a dread that simply cannot be put into words, and then a weary resignation.

You’re gonna have to forgive the starkness of the description. I don’t think there’s a way I can ‘soften’ the truth about what recovery from an eating disorder must entail in order for it to be real. Recovery can be
half-hearted. You know you’re not doing it right when, for example,  you are compensating at home for the food you eat when you’re there. Or, you’re getting out and sticking your fingers down your throat. Or you’re going running or over exercising.

You know when you’re doing recovery right when you’re living in hell.

Politician Frank Field says of Christmas;

“It is my favourite festival because it reminds us that we can always begin again”…

…A sentiment I like because it’s rooted in hope. Now, perhaps you are one of those enviable types whose boundless optimism shines forth, making you a beacon for desperate souls like me (who experiences hope in a short rush

Sand-Hand-1309326

which passes the mind through like sand from a loosely clasped fist).

Perhaps you are a glass half full sitting on the sunny side of the table.

If so, great! You can probably look over your shoulder and give a grateful nod to those who brought you up (controversial point, I know).

If like me, you struggle to keep a faint ember glowing, this post is for you!

When I started writing this blog, I wanted it to be about HOPE. I wanted it to be a small ray of hope streaking through the darkness of cyberspace.

Candle-calendar

If ever there was a time where we see the little lights of hope, “Advent” is it.  And I want to say that Christmastide, although an incredibly tough time for people like myself and perhaps, you, is also a time where there is a sense of something new… and not just the ipad or the SatNav in your stocking, but in the way that we can live our lives and make small changes in the ways we react and respond to people or situations.

Hope is intrinsically linked with change: something I’ve never really thought about before, but seems so relevant to those of us who struggle with eating disorders or addictions. It’s so easy to give up. Sometimes it’s easier to say; “I’ll never make it”; “I can’t change”; “my ED is stronger”;”my problems run too deep”.  But the painful truth is, believing these ‘despair-mongerous’ statements (okay, so I made up a word), is putting a jamjar over a flame.

And we’ve all done it. We all give in to the nagging despair. But it doesn’t have to be like that. We can fight for the life we want, or to be the person we want to be. Where there is hope, there is light and life. Christmastime can be full of angst and grief and despair. It can be a time of immense loneliness and suffering. But, as in the real Christmas story, there can be moments where hope is born.

The hope that we can make it… that we haven’t blown it.

I have just completed my third week of refeeding at the day treatment unit and it has been nothing short of agony, which is a tough thing to be honest about because I want this site to be about positive encouragement and support. I want it to be inspiring for those who are thinking about going for treatment, motivational for those who are sitting on the fence, unsure which way to drop.

However, I also want it to be realistic and honest. Just as I’m not a great advocate of polite, ‘home counties, garden party speak’, I’m not great at literary niceties. It is possible (on reflection) that I value honesty above all other virtue. In the words of wannabe surfboard – wielding  teens the world over, I have to ‘keep it real’.

Back to the concept of agony then.

To any ‘normal’ person (for the purposes of this post, let’s just assume that such a thing exists) the idea that sitting around and eating all day should be anything other than a pleasure, sounds ludicrous! If I offered most of my friends the chance to take a few weeks away from work to join me in treatment,  they would literally jump at the chance! I almost wish that I could offer it as a free gift on one of those LoveFilm ‘friends and family’ type cards for Christmas.

For an anorexic however, the relentless pattern of snacking and sitting and eating and talking, resembles the slow medieval torture of The Rack; the steady tearing of bones from sockets, muscles from tissue and flesh resembles the inner sensations of being torn apart. Sounds dramatic? Perhaps, but I fail to find metaphors which can adequately illustrate the pain of beginning recovery.  Admittedly, being severely underweight heightens the trauma of refeeding, physically as well as mentally, but it’s a pretty horrendous process wherever you are on the BMI scale.

What I think is an important point to emphasise at this stage though, is that despite the immense increase in my calorific intake, in three weeks, I have only gained point 5 of a kilo overall. That’s a pound (in old currency).

We are weighed twice a week on a Monday and Thursday  (an event so anxiety provoking I am woken by palpitations in the early hours of a Thursday morning).  The pattern for me has been a predictable gain on the Thursday and loss after a weekend of Anorexia V Relief at ‘Respite’. The harder you work at the eating, the greater the agony as the Anorexia rears its demonic form, screaming and contorted, afraid of losing even an inch of its grip.

agony1

At this point, there is no comfort.

If Anorexia is being frozen to death, treatment is a hot water bottle that burns if you hold it close.

It flogs as it spares; it blinds as it darkens; it kills as it saves.

And just as the illness commands a dying body to keep dragging itself over upturned shards of glass, so recovery demands that the same body be dragged in the other direction.

Agony.

But

if you have to suffer it,

it may as well be suffering towards recovery.

Right?