To expound upon earlier thoughts...verbosely.

Ex post facto, as is so often the case, I'm thinking yesterday's post may have been made a bit rashly. By which of course I mean that yesterday I was basically freaking the f-k out and somehow had the misfortune of getting my fingers onto a keyboard, thereby spilling a noxious pile of disjointed, jumbled, frenetic words. Contrary to popular belief the best writing is made with a level head, not one stressed and emotionally charged.

My initial shock at the Drs' assessment of my case is still pretty much the same as ever. I still fail to understand how I need inpatient care; to some extent, I'm still questioning whether or not my level of health or illness requires something so extreme as intensive outpatient. Okay, that's a bit of a lie: I know I could do with some outpatient treatment. But inpatient still does seem over the top.

However, since yesterday's phone call with Drs Roberts and ...a woman whose name I forgot... the general consensus among friends and relations seems to be that inpatient care might not be such a bad thing for me.

I'm still trying to wrap my head around this.

For the reasons I listed yesterday, I still believe myself to be in a fairly healthy place. Particularly when I compare myself today to myself two years ago (or even one year ago), today's self looks a world healthier than I was previously. Water and hundred calorie fasts are no longer a routine thing for me. For that matter, I haven't intentionally fasted in quite some time. My periods are regular, my fatigue has lessened; although labs haven't been run for me in well over a year my body feels like everything is working well. When I eat, I don't do well making sure my meals are healthy and ballanced and supplying all necessary nutrition, but neither are they comprised solely of high fiber vegetables and...more vegetables.

My question about what health should look like that proves I'm so far from it still stands. I'm beginning to ask myself if the main reason I think I'm healthy is that I'm comparing myself to a prior, sicker version of myself - not to a normal, healthy standard of existence. Granted, I'm much healthier than I used to be. My life is not in immediate danger from any starvation consequences. But does that mean that I'm to the standard of health that is the goal of recovery? If not, how far away am I really?

Following are my principal objections to the partial hospitalization program:

-FINANCES. Call me a jew if you will, but worries about finances are still the number one concern about this program.
-->Aside from the fact that the program itself will likely cost far more than EIOP, it will be an eleven hour a day, seven day a week commitment. This, simply and unavoidably, will not allow for me to work. Even if I were able to get my work to allow me to come in at 8 each night to help close, that would leave me with a potential for six hours sleep per night. Therapy is hard work in and of itself, even a one or two hour session once a week. Realistically, there is no way I'd be able to go from eleven hours of therapy to four hours of work to six hours of sleep to start over again.
-->Crystal and I work hard to meet the bills each month as it is. She's going to have a much tougher course load this semester, meaning she'll have to work less. If I'm completely out of work (or even on a greatly diminished schedule) there is no way we'd be able to make ends meet. (Although, as Crystal pointed out, our food budget will go down since the center'd be feeding me five times a day. Somehow this seems ironic.)

-Triggers. This may seem silly at first glance, but think about it this way... It's been a long time since I was fully immersed in my disorder, seeking out thin pics, thinking about eating and not eating constantly, obsessing about the possibility of breathing in calories or the calories contained in chapstick.
-->Visually, I'm afraid that being in an inpatient facility would present me with a whole lot of girls who are seriously ill. I'm not to a place yet where this seems unattractive to me - contrarily, it'd definitely make me extremely jealous.
-->Verbally, I know that many girls get some of their best tricks from staying inpatient for a while. I know that this does depend some on 'you get out what you put in', but that doesn't mean there won't be tons of conversation about how to tongue pills or wipe butter off on your slacks or slip food into sleeves/purse/shoes. Even if I'm seriously trying not to pay attention to this, it is probably going to be triggering to be surrounded by it.
-->PHP feels to me like I'd be re-devoting my life to my eating disorder. Crystal says this is stupid and she's probably right, but... Like I said, it's been a long time since I was thinking ED thoughts every second of the day and to jump into such a rigid, complete schedule of treatment feels like I'd be backsliding. Crystal pointed out that it'd be devoting twenty-four hours of my day to recovery thoughts, not anorexic ones, but in my head it doesn't feel that way.

-Perhaps most stupid of all my concerns, I'm terrified to go into the PHP program because I feel like I'd have absolutely no control over...anything. Myself, my time, my recovery. (When I told this to Crystal she shrieked, "EXACTLY!!!" But.. Meh.) I suppose some part of me feels like recovery is a way to teach me self control in a healthy way, and therefore I want to retain control over the recovery process. I feel like I'd be okay with three days a week because then most of my time would still be my own, like I'd have certain time devoted to therapy and the rest of the time devoted to whatever else I felt needed to be done.

Even the times I have been inpatient before, I never relinquished control. Granted, I was in a really worthless facility, but while inpatient I found ways to skip meals, self-injure, avoid any participation in group activities; hell, when I was finally fed up with inpatient I found a way to lie so completely and extensively that I got them to release me long before they should have.

I feel as though, historically speaking, every time I've let go and done as I was told by people who cared about me, it only made things worse. Why should I give up my life to total strangers?

Sigh.

So there's where things stand. I suppose nothing will really be known for certain until I talk to them again and then set up the actual intake exam. I'll be sure to keep you all posted.

All I want for Christmas

The title of course is misleading: the following subject is not the only thing I want for Christmas. In fact, there are quite a few things that I'd love to get for Christmas (not the least of which is financial stability, but that's a whole different kettle of fish). However, this next item is something which I've been thinking about increasingly over the last month or two and am now trying earnestly to obtain.

If you're reading this entry chances are you've read some of those preceeding it as well. This being the assumed case, you've probably caught on to the fact that my eating has not been nearly as good as it could be lately. A big thing I've been noticing is that even though I'm eating at least a meal a day and am trying to at least eat something when I'm hungry, I may be doing the actions but mentally I'm deteriorating again. Distorted body image has been again growing more distorted, obsessive thoughts more obsessive, calorie counting once again almost an unconscious act.

And all that makes it sound like it had ever totally gone away in the first place.

I've never once willingly addressed my eating issues in therapy. This may sound surprising, considering I've been in and out of therapy since I was seventeen, but if you think about all the other issues I've got to deal with (depression, DID, etc) and then take into account that I haven't wanted to talk about my eating... Well, it's been easy enough to steer conversation into other areas that I'd rather deal with. Perhaps that's one fault with the therapy styles so far used with me: it's been way too easy to just change the subject when I don't want to talk about or address something. But now I'm really sick of it.

The therapist I've seen recently (Chris) has next to no experience treating eating disorders. Aside from that, she only sees clients once every other week. Out of all the therapy I've done, the only time that was really intensely helpful was when I saw someone twice a week. Once a week was pretty much just enough to keep me from getting worse, but I didn't see a whole lot of improvement.

All these considerations in mind, I've decided (and have talked this over with my psychiatrist, who agrees) that intensive outpatient would probably be a really good idea for me at this point. After looking into it some, I've found a treatment center in Denver which appears to have a really good program, great treatment team, and should hopefully be able to work with my insurance. It's through the Eating Disorder Center of Denver. (Fitting name?)

The program I'm most interested in is their Extended Intensive Outpatient Program. It's twelve weeks, three nights a week, four hours a night. You work with a nutritionist, psychiatrist, therapists, etc... Dinner is eaten together with group therapy immediately following. There are a lot of the things you'd pretty much expect with an outpatient program... Group, one-on-ones, body image workshops, art therapy, etc. But, from what I've read on the site, it sounds like they've got a really solid program set up.

The center offers three different levels of care: inpatient, EIOP, and a weekly group follow-up thing. I'm sure that I don't need inpatient care (for one, I'm not in a serious enough place medically) and the last sounds like it really wouldn't offer enough. Sooo I've sent an e-mail asking for more information about the program and admissions procedure. Mostly I need to know about the cost and how much my insurance would cover...

...Well, I think that's actually about all I meant to discuss. At least, I can't really think of anything else... I'll keep you informed as I find out more and if/when there's anything else major to report about this. Cross your fingers!

Incurable cases?

It Gets Better - Jenni Schaeffer

This is my personal inspiration for today, which I thought I'd share with all of you. After actively fighting this disorder for almost a year and a half (as opposed to passively, which constitutes the latter half of my life) I often feel like I should be well now. I should be eating regularly, enjoying it, maintaining or gaining weight --- especially not losing and not caring, or finding vicious celebrity gossip 'thinspiring'.

I do miss being under a hundred. I miss being dizzy all day. I miss the bruises all along every ill-padded bone. I miss regular self-injury. My eating disorder has been nothing but abusive, spiteful, manipulative, selfish, ruinous, and yet perhaps I will always miss it.

Lately, you've been watching me relapse to some extent. Perhaps it's not been much of an active relapse, but I've still not been doing a whole lot to fight it too hard. The past few weeks have been the sort wherein eating somehow feels like an exhaustive, distasteful chore whose purpose is obscure and value inconclusive.

Today I'm trying to reinforce the understanding that it is okay to relapse. Probably this is not the statement most professionals would want me to be saying, but be realistic here. Relapse will happen. I'm not saying it is okay to embrace it. I'm saying it's okay for it to happen. It is okay to accept bad days along with good.

What's not okay is to welcome it, engage with it, actively pursue it and see how bad it can get. Today I'm trying to look at my life and say, all right. I've been having some bad times lately. My eating has not been what it should be and my attempts to thwart it haven't been up to par. Now that I understand this, I can accept it as something which happens from time to time instead of beating myself up about it for being the worst recoverer ever. I can acknowledge the bad and try to pick myself up again instead of saying, crap, I failed again, I must just not be cut out for this health thing. I can let the relapse be what it is and then let it go.

One thing Jenni wrote in her article in particular stood out to me: her realization that the belief she held about being too ill to recover was false. I remember many, many journal entries along those lines and can now realize that even in the midst of a bad spell I'm still able to see how far I've come toward health and that I'm still moving toward it even despite a two steps forward one back progression.

I still often feel that this disorder may always be with me. But I know now that it does not and will not always control me. I AM NOT TOO SICK TO GET BETTER!!! I was not the sickest, I was not the least sick, but I AM getting better in spite of everything!

Be encouraged!!! You probably feel like a hopeless case. Like no matter how many people say they understand, they really, truly don't. They can't see inside you and realize what a horrible, twisted, incurable creature you are. Like I'm full of sh-t for saying that I know what you're feeling. I won't claim to be all-knowing or all-answer-ful. But I will say that I have felt that before. Sometimes I've felt that my core evil was so warped and disgusting and pervasive as to be a tangible force. I've felt that it defined every part of my being so inextricably that all I would ever be able to be was worthless.

So not true.

Please, please don't listen to the lies this disorder tells you. It tells you you are worthless because it makes you easier to control. Would a person who highly valued and loved herself be as easily inclined to destroy herself as one who thought she were worthless? It's all a power scheme. A vicious and effective one, but only a scheme.

It is possible to break from this disorder and grasp the health that seems so impossible.

Confrontational feeding

It's always hard to tell where you draw the line between wanting sensitivity and understanding from others and trying to recognize where you yourself are perhaps being too touchy. All through childhood my dad was quite insistent that I took myself 'way too seriously' and needed to learn to laugh at myself... Personally, I often felt that was a bit of a harsh judgment, but that's neither here nor there.

In any case, on this particular occasion, I've got little to no doubt that the comment in question was out of line.

I've been through more than a couple managerial transitions in my time spent working the restaurant industry. I've had maybeee....two? general managers that I've liked. Yes, two, that's the right number. I like this particular, current general manager least of all so far. He's very heavy with the sarcasm when displeased, and not afraid to bitch people out publicly either. He's a good six foot something, all football player looking, a bit snaggle-toothed and overall quite intimidating. Quite the asshole.

On Sunday mornings he gets extremely stressed out. He always locks himself in as the expediter to make sure ticket times aren't running too long and the foods all get out correctly and whatnot, since Sunday brunch has a slightly different menu and can be stressful for the kitchen. Because of this, Sunday mornings he institutes a unique rule which I have the most impossible time remembering: employees may not make any modifications to their meals.

As I, granted, frequently do, I forgot about this rule yesterday when ringing in my food before going on break. I remembered almost immediately after sending in the order....but unfortunately, once done is done.

When I went to get my food from the line and take it to the back for my break, the GM was up in his usual spot and decided to make a scene, or maybe just an example, of it. As mentioned before he's a big man and has a big voice to go with it, so when he raises his voice at all it's definitely audible.

"Tina. Hey, Tina? Next time would you do me a favor and just not eat?"

...

That very morning over coffee with Crystal I talked about the fact that I've been really struggling with body image the last couple weeks. (Wow, I forgot to write this anecdote... When I went to the doctor last Saturday I realized quickly the part I'd forgotten to put in my medical istory: anorexia. The reason I realized this was that when they took me into the back the first thing they did was to put me on a scale. Fully clothed and facing forward. At this point, I realized that, fully clothed, wearing shoes, and having just eaten, I was a good ten pounds less than I was when last weighed, without all those other factors. Unfortunately, to the eating disordered mind there is nothing like finding you weigh less than you thought to trigger the desire to lose more.)

The whole affair triggered a panic attack and rid me of any desire to eat. I guess it was evidence of how far I've come, though, that I still did eat my lunch.

Haircuts and Mannequins

I get the feeling that all my entries are merely old rants rehashed. Anyone? Anyone? Yeah.

In other news, I got my hair done! This is not a big deal for normal people, but I'm crazy... And aside from that, I haven't cut my hair in like three years. Because people totally suck and wouldn't shut up about my eating habits I was feeling really ugly and disgusting by the end of the day.

Why does everyone who sees a morsel of food enter my mouth feel the need to comment on it?!? I got a mini pizza and a salad for lunch and was so hungry I charged through the salad in like ten minutes... Immediately all coworkers in the vicinity, even my manager, started jibing about how much I was eating, how either I was going to balloon or else must be purging what I eat. I HATE EVERYONE. Actually, after I'd had half the pizza and couldn't stand any more of it I lost it. Said something to the effect of, "Look, you have no right commenting about my eating habits. You have no idea about my history, you don't know if maybe I do have food issues, if maybe I was hospitalized three times last year. So back the f- off."

I wouldn't recommend that as the most polite, poised way of handling situations like that, but it did work.

When I got off early from work I wandered around the mall for a while, talked on the phone to Crystal some, saw all the mannequins in the windows and cried like a lameass, and wandered more. I've been thinking about getting my hair cut for a while now and got the idea to use my extra time to go to the salon. It was actually a really good decision.

I'm of the opinion that few things feel so good as getting your hair done. I mean seriously, isn't it just awesome to have someone play with your hair? And then the shampoo-y thingy and the little shower head thingy all sheurhohgshhhh, it's just awesome.

Watching her go snip, snip, snip as six inches of my hair fell to the floor was extremely unnerving, though.

...Mmkay, I was going to conclude with a picture but can't seem to find my bluetooth device (so that I can get said picture from my phone to the comp) sooo... Yeah.

In conclusion, yay haircuts. It was an awesome way to feel better physically, get some innocent compliments (is saying nice things about your client's hair part of the job description?), and feel better about myself without doing something crazy or triggery. I think everyone should go get their hairstyled just for the hell of it. Yep.