More about therapy

I have seen people after their upsetting therapy sessions curled in fetal position with their heads buried, completely unresponsive.  I suppose this is called “time out”?  What happens to these curled-up people?  Does the janitor sweep them up at the end of the day?

I have seen people leave therapy sessions saying that the topic of discussion was very upsetting and they can’t stand it anymore and it turns into a huge crisis situation and you can guess where they get shipped off.

Let us not forget all the therapists whose egos are tripled when they discover, upon return from vacation, that half their patients couldn’t cope on their own and hospitalized themselves.  Think how great it must feel for the therapist to be so needed and wanted and loved.

I have had therapists who have enjoyed this power.  When I suggested to these therapists that perhaps having power and control over me, and making claim that they and they alone had the amazing ability to cure me (but if it didn’t work, it was my fault and mine alone) was feeding into their already inflated egos, they invariably flew into a rage.

Those days are over.  I am outta here.

This madness

Although this madness is rather interesting, it is a  perfect waste of time.  I do wish to share it, to tell the world what it is like.  I wish I knew what it was.  It is like I am tripping on LSD, but I don’t know what LSD was like.  That is, I never took LSD.  Yes, I am 54 years old and was born in 1958 so was of that generation that took LSD, but I never took it.  So no, I am not having a “flashback.”  If such a thing exists.  They said people would have these flashbacks and re-live their trips.

But I am experiencing this madness.  This is the third time.  This Other.  I am not sure what it is.  I slept quite well last night, better than usual but was physically ill yesterday.  My stomach seems fine today, no diarrhea or nausea at all today.

There seems to be  no danger in it.  Except a bit ago, as I was returning home, it occurred to me that perhaps I may never, ever snap out of it.

How lonely.  This madness.   To never connect.  There seems no need.

Stark raving mad.  My thoughts are completely messed up.  I am in my own little world and I don’t need to connect with anyone, ever.

I went to see the minister.  Spoke with him briefly, tried to explain.

I really need to shower.  But I did brush my teeth and that feels good.  Real good.  Anyway, after I saw the minister I went and bought some plastic bags to pick up Puzzle’s poops.  I hope I bought the right kind.  It was really, really hard in the CVS, trying to shop and make sense of the products in the aisles, trying to pick out what I needed, the right kind of baggies, the sandwich baggies with the flip-tops.

Okay, now I feel a little better cuz I wrote some stuff I think was clear and cohesive.  I was in the CVS looking confused like a madwoman in a place where people are supposed to be organized.  You can imagine just how tough it was for me to use one of those self-checkouts.  Yeah.  I did it.

Came home and here I am.  Still haven’t showered.  I don’t know how long it’s been.

Trying to figure out what this is.

Stark raving mad.  Your guess is as good as mine.

Anyway.  Decided last night, right before I went to sleep, that therapy is doing me no good.  Figured I’d take a year off.  I’d just spend the time writing and working my way through all my madness.  I’d keep writing and writing.  I have no idea who is reading all this stuff.

My mind is just so precious.  It works so perfectly.  You can tell.  Absolutely perfectly.

Monday night

I see my therapist Thursday.  I kind of dread it.  She is not stupid.  She will ask me right away.  Whether she has heard about my ridiculous ER adventure or not she will ask about those dreaded topics of eating and weight.

I don’t know how many pounds I’m going to drop tonight, tomorrow, Wednesday night.  On Thursday I don’t know what I’ll weigh.  You just can’t predict these things.  She’s been away on vacation and I haven’t seen her since the 19th, a week ago.  I am four pounds less than I was then.

It feels so glorious.

Recently, I dropped four pounds overnight.  Then two more the next night.  I just didn’t want to be fat.

This is scary and I am losing my mind.

 

Winter Solstice Morning 2011

It is morning and I am awake and alive.  In my dream, I was in a cloud, floating.  I felt no pain.  I was lying on my back.  When I awoke, I sprung up.  I had strength, enough to know that I am okay.

I recall now that I prepared for bed very early.  I was tired.  I remembered to take my meds as usual.  Puzzle was confused that my schedule was altered.

I awoke at 12:30, peed, and went back to bed.  I recall saying to myself that I felt back to normal.  Or at least on my way to back to normal.  It felt like it does on many nights when I awake in the night to pee.

I fell asleep immediately.

I awoke at 4.  And now, it is past 6.  I have done a few things, not a lot.  It felt okay to have a cup of coffee today.  I savored it.

I am thinking about my body, each part.  God gave me so much strength.

My last therapy session…for a little while

My T is going on a vacation.  Never mind where she is going but I will tell you that she is looking forward to it.  I could tell.  She is leaving tomorrow and I think today’s Boston weather had her convinced that she needed a vacation.  This morning was even colder than yesterday morning.

I am cold.  I just finished a hot cup of Celestial Seasonings Bengal Spice herbal tea.  I have never had Bengal Spice before.  It’s rather good, and it helped warm me up.  I am wearing my Winter Classic 5k hat that I got exactly a year ago when I ran the race in Cambridge, MA.  This year, the race was held December 11th.

When I told my T that the race was exactly a year ago, that is, December 19th, that started her on this whole, “What have you accomplished in this past year?” rampage.  Which was fine with me because I didn’t want to talk about certain other things.

So a lot of bullshit got discussed.  She seems to think I have accomplished so many things.  I let her think this because it’s a nice way for her to start off her vacation.  Honestly, it’s been one fucked-up year.  It’s been the worst year of my life.  I kind of said this and shrugged off the “accomplishment” part.

I did tell her this:

I AM OKAY JUST THE WAY I AM.

That was all I said about that.

I told her I felt pretty good, that I was glad to be over that yucky virus I had.  I spoke a bit about the virus and the impact it had on me.

Change of subject: I told a lie last night and it is weighing heavily on my mind.  It is the lie I tell more than any other lie.  This is the lie:

“Julie, you’ve had something to eat, haven’t you?”

“Oh yes, I’ve had something.”

Of course, I hadn’t had anything.  I felt especially bad lying to this person last night.  It is really bothering me now, just getting on my conscience.  I made excuse after excuse not to have the pizza, saying that I had just gotten over a bug.  But there was other food there, too.  I made an excuse to have just water.  I saw water in a pitcher, and knowing it was just water, I asked if there was any alcohol in it.  I wanted to appear to be making sure that it was alcohol-free.  That way, it would look more “okay” to have just water.  Just more anorexic bullshit paranoia.

I smiled and had a good time and put the food and the lie out of my mind.

I smiled and had a good time in therapy, too.

I hope my T smiles and has a good time on her vacation.

I am having a vacation….

Cleaning up the complete mess I’ve made of my life over the past couple of weeks

Last night I finally, finally, finally got a decent night’s sleep.  Wow!  I have no explanation.

Frank reminded me last night, firmly, that I’ve got to stop this risk-taking nonsense.  What I’m doing is dangerous at any age and it’s doubly dangerous at my age.

I wanted to tell him that I’m not going to make it to 55 anyway.

Well, does that matter?  Why am I making myself completely miserable?  Isn’t it stupid to torture myself like this?

Frank is now 60 and is blessed to have come to his senses.  He says I will, too.  When he said this to me only a couple of days ago, I said to myself, believing every word in my head, that what he was telling me was untrue.  Not that he was lying.  He was mistaken, I told myself.  I can’t do it.  I am not strong.

I saw my T yesterday.  I told her I didn’t want her to have hope.  Again, she told me she had hope, and I was pissed.  She sees that I have a tiny sense of purpose in my life and will to live.  I don’t want to have a will to live.  I want to eradicate this will.  She totally gets this.  She is so smart.

She also thinks that I’m much, much better off than I was last summer, when there was so little of me that wanted life.  I guess she notices a much bigger part of me now that wants life.  Church.  My trip.  These are biggies.  The fact that I’m incredibly motivated to follow through with both is amazing.

All three Sundays that I’ve gone to church….Well, let me explain.  My life has been in shambles.  Night and day, day/night sleep/not sleep sun-up/sun-down binge/starve nothing in-between all the same and it’s an ordeal and very internal and tearing me apart and ripping my insides raw.  I’m not depressed but it’s torture to go on like this.  My body can’t take it and I can’t imagine what all this is doing to my organs.  I don’t know how much my heart can take the food/no food thing and my kidneys with the electrolyte/water, skipping meds/anticonvulsant spiking.  This comes to a head Sunday morning after torture all night long Saturday night and little or no sleep.  BUT….What happens amazes me.  9:50 and I’m out the door.  Showered.  Dressed.  I go straight to church.  I do this and right before, I am asking myself if I can really leave the house, but I do it.  I do it and I am blessed with the most awesome experience you can imagine.

(Oh damn I have just started to weep as I write these words.)

Well, I was considering stopping writing this entry and taking a break due to overwhelming outpouring of emotion, maybe letting it settle and doing some cleaning around here, but I think I’ll say something that just popped into my head:

Why spend my last days…however long I have…in misery?  What’s the point in torturing myself?  I should be–really–treating myself well.  Super well.  Keeping my body clean and making sure my apartment doesn’t get back into the filthy, disorganized state it’s gotten into at the moment.  And not letting myself get into the filthy, disorganized state I got myself into, either.

Okay, sudden extreme fatigue.  Ten-minute nap and I’ll be back.

Back.  Eight minutes of heavy, heavy sleep.  Dreams.  I don’t remember them.  We’re leaving for Puzzle’s day at Pooch Palace soon.  We’ve got a coupon for free day care along with her groom.

So.  For today.  Clean the house.  I’ve showered and all the clothes I’m wearing are clean.  Be patient with my body.  My stomach is doing okay.  Sticking out real bad, full of the food I stuffed myself with over the past three days, and I’m not going to let that embarrass me.  I’m just wearing clothes that hide it.  But no edema in my ankles or legs.  That chapter of my life…over?  Just a little puffiness in my face.  Kind of upsetting but it’ll go away in time and I’ll be patient.  The quantity of stuff that accumulated in my stomach is slowly, slowly emptying into my intestines.  There’s a lot still in my stomach but I’m surprised at how much has already emptied.  I guess it was the decent night’s sleep I had.  My intestines are another story altogether.  How they can hold this much is beyond me.  The temptation to take something to speed along the process is overwhelming.  I won’t do it.  I’ll be patient.  It’ll take a long, long time for my body to fully recover from this.   The money I spent on binge food….My budget, sadly, will never recover.  I spent money I don’t even have.

Except for the money part, I grossed you out I’ll bet.

I’m going off to Pooch Palace.  Oh, one more thing before I leave:

I’m calling Dr. P today.  I’m telling her…I’m telling her that I want to clear up what went on when I went to see her last week.  Last week when I walked into her office I wanted to tell her that I had no will to live.  And I want to tell her that as of today I’m going to clean up the mess and move on.  I’ll be honest with her.  I’ll tell her what my gut feeling is, that I won’t make it to 55, which is simply no big deal…it simply isn’t…and whether it’s true or not…who knows…I might not be right, after all…I probably am and it really makes no difference…no impact on the Here And Now…I’m doing what I’m doing…I have exciting plans that my T feels will give me a sense of purpose and be a real boost for me….

It’s Tuesday.  Wednesday Thursday Friday Saturday Sunday.  Today and then four more days and then the next day I get to go to church again.

How do you like that!

I have anorexia nervosa.  I go to therapy with the best therapist on the planet.  I deal with it.  Well, dang.

An open letter to my T, my blog, and the world

I need to make this writing a priority this morning over a number of other activities because I need to get this off my chest.  It does not take priority over certain things that are vastly more important.  I have walked Puzzle.  I need to make sure she can get groomed tomorrow.  So I need to stop writing at some point and remember to call Pooch Palace to get her scheduled.  Hygiene–hers and mine: essential…but today I haven’t showered yet and writing takes precedence.  I’ll make time to brush my teeth again.  My hair…yeah, I gotta do something with this mop before I go to therapy.

I need to say some things.  I need to be straight with my T about certain things.  About a week ago I realized that I don’t have much time left on this planet.  I thought about things realistically and figured that my 54th birthday is in January and I’ll probably make it to that, but the chances of making it to 55 are next to nil.  My body won’t hold out.  I see the statistics and it’s amazing that I’m still alive.  The statistics are different depending on the source, but by far the majority of patients who end up with anorexia nervosa don’t make a full recovery.  A small portion do.  Many do, and deal with it for the rest of their lives.  A portion die.  A portion suffer a great deal for the rest of their lives.  A portion commit suicide by other means.  And so on.  The younger you get it, the worse your chances are.  The longer you’ve had it, the worse your chances are.  And so on.  You can interpret the data a number of ways but it’s a fatal illness no matter how you look at it and no matter how you look at it, it’s clear that this illness is the most lethal mental illness.

Dear T: The truth is that I want you to just go along with this.  Quit trying to stop me and quit trying to change me and quit your assumption that I am trying in any way to get better and change and grow.  It is useless.  I gave up on myself.  Just let me die and keep me company.  A week ago I decided to self-starve because I have no will to live.  I am not trying to make myself die I am just trying to lose weight.  If I die I don’t care.

Okay, I’m tired now and I’ll take a t0-minute nap and come back.

I’ve been permanently sleepy for a couple of days now.  Back.

As you know, I get these breakthrough binges (you I’m sure are bored of hearing about this) and I have binged a few times but get right back to starving and continuing to lose weight.  I don’t think I lost anything over the weekend and I haven’t been able to get anything like an accurate reading with a belly full of food.

I have had a couple of instances of drinking high amounts of zero-calorie liquid (water or zero-calorie sports drink, occasionally diet soda) very quickly and then peeing it all out.  I can’t seem to stop myself when I do this.  I’m not trying to hurt myself.  It is automatic.  Maybe I am just thirsty.  I drink to the point of physical discomfort.  I looked up on the Internet how much you have to drink to get a serious problem and I’m reasonably sure I’m not in the danger zone.  When this happens, my pee is bubbly afterward.

I believe the last couple of times that I binged, my food wouldn’t go down my throat.  It got caught there.  I got some water and pushed it down with the water.  I found that I was able to stuff food down faster than ever.  At 53? weird.  Maybe I’m just remembering wrong.   I have some junk food in the apartment right now that I should probably get rid of.

For a while, when I binged, it “showed.”  Oh, no, when I binge it shows anyway.  Duh.  Stomach and intestine overload.  I have heard that your stomach or intestines can burst from this.  A doctor once told me that this was the truth but I looked it up and there have been cases. Of course you don’t survive that at my age.  When I say that it showed, I meant that my ankles and legs and entire body swelled up.  As of sometime yesterday, this stopped happening.  They’re fine.  My torso is huge and full of food but the rest of me looks normal.  I have to wait until I poop it all out.

Okay, back to life.  But the body changes again.  I am making all kinds of spelling errors and am falling asleep…again.   Something’s horribly wrong that I have to sleep all the time.  Another ten-minute nap and I’ll be back.

I woke up two minutes before the alarm.

I sleep…I don’t sleep…well, duh…I play with food and it messes real bad with sleep.  Real bad.  Serves me right.

I don’t know why I do all the stuff I do but I can’t make it stop.  Losing weight…it is just ridiculous.

My DMH person seems to think everything’s hunky-dory with me.  Whatever.  It’s her job to make sure people shower and get to their appointments and fill their prescriptions.  I don’t think they have people with anorexia in their program much.   I dress with my shirt right-side out and she looks at me and figures I’m fine.  ADL’s.  That’s “Activities of Daily Living,” meaning, again, showering, taking meds, brushing teeth, getting to your job, cleaning the house, laundry, paying your bills, taking public transportation…I do everything but one: eat.  A big one.  I guess that one’s a given for most of her people.  And sleep.

I don’t even sleep responsibly anymore.  Night blends into day which blends into night.  All a blur.

There are things going on that are very good right now and I thought I’d mention them.  My relationship with Frank.  My relationship with L.  Puzzle.  Puzzle’s walks.   Puzzle’s walks have been a little crazy and driven because I think about death while I’m walking her.  I enjoy myself anyway.  I keep my appointments and that’s a good thing.  Church is just a fabulous addition to my life.  Absolutely a fantastic thing I’m doing.  I’m going to print out what I wrote yesterday and bring it into today’s session.

Okay, here’s another thing I haven’t made public but I will.  I ran it by my T Friday and she feels it’s a very positive step I’m doing to help myself.  I’m taking a trip to London to attend a seminar my publisher is putting on for its writers.  The trip will be in a month.  I can’t believe I’m doing this.  It will give me a sense of purpose and I don’t want a sense of purpose but it’s weird because at the same time I really want to meet my publisher and get to work with him, and I assume get to meet the other folks at the publishing house as well.   I won’t be gone long.  I made the plane reservations and hotel and am all signed up.

This was in fact very difficult to do.  My bank decided that whatever transaction I did was suspicious activity, and shut down my credit card after I made each purchase.  This started with the transaction with my publisher, because it was a UK transaction.  My bank doesn’t take chances.  I appreciate this.

I have been spending the month of October working on my outline for November’s National Novel Writing Month.  National Novel Writing Month probably won’t happen for me because of this trip.  I’ll be gone for four days but it’s going to zap much of my energy for November.  It was a sacrifice I had to make.  I will still create the outline.  Why?  I’m excited about the book.  I think Nano is doing another Nano later in the year.  Nano got so big that they do one in a month other than November now.  So I’ll have another opportunity maybe.  I haven’t talked much about this outline.  I will.

I’ve run out of energy and there’s more I wanted to say.   Later.

This is the letter that I will be handing to my T tomorrow at our session

I skipped Monday’s therapy appointment and e-mailed my T, saying I was “vacationing.”  I will show up tomorrow.  Instead of explaining myself and my “vacation” out loud, I will hand her this letter and ask her to read it.  Here it is:

Written Monday 5/2/11 and also Tuesday 5/3/11

A LETTER TO MY T REGARDING MY BRIEF VACATION…FROM THERAPY…THAT WOULD HAVE BEEN LONGER EXCEPT THAT I STARTED TO FEEL GUILTY ABOUT FIBBING

Dear T,

As of the time I am writing this to you, I am on a vacation from therapy.  That’s where my vacation was.  I didn’t go to Hawaii (which would of course have been my first choice), rather, I stayed at my home and didn’t come to therapy and told you I was “vacationing,” which is the truth.  I am doing this vacation because I needed a break to mull things over and try to figure out exactly how I felt about what was going on with my body and with what you expected of me.  I am also on vacation from my weight check appointments with Dr. K, for the same reason.

Sometime after April 12 and until April 30, I experienced unexplained rapid weight gain.  During the last week of this 18-day period, my weight showed a 5-1/2 pound increase in a single week between weight-checks with Dr. K.  In addition to weight gain, I noticed many other changes.  These included the following:

Ankle, calf, foot, and leg swelling

Abdominal (stomach area) swelling

Slowed digestion

Food staying in my stomach for many hours, even overnight, instead of going into my intestines after a short while

Constipation despite vigorous exercise (running)

Sluggishness, especially in legs

Depressed mood

Difficulty walking due to pain from what were now ill-fitting shoes

Difficulty tying shoes properly due to enlarged feet

Decreased physical stamina

Slowed running, difficulty running, and finally inability to run at all

Extremely lowered energy level

Loss of “bounce in step”

Feeling cold all the time

Loss of motivation

Insomnia every night

Feeling ashamed of my enlarged body

Feeling hopeless about my body

On Thursday, April 28, I finally experienced severe depression due to my hopelessness over my weight.  I knew something was drastically wrong.  I had counted how many calories I was consuming and how many calories I was burning.  I had watched my scale read a half pound a day gain for days.  I cried all day long over my weight and could think of nothing else.  Our session that day was only a quick fix.  I went home and cried some more.

The following day, April 29, I went to see Dr. K and showed her my swollen ankles.  She explained that I had refeeding edema.  I wasn’t familiar with this term, so I looked it up when I got home.

You know, if you Google refeeding edema, refeeding syndrome, which is fatal, comes up on the very same page.  I clicked on both.  I clicked on a lot of things.  I read some scholarly information, as well as some posts on message boards from people who were experiencing refeeding edema.  I learned that swollen ankles is a sign of refeeding syndrome.  Dr. K’s reassurance that the refeeding edema was temporary was also only a quick fix.  Even when she explained that this was the reason for the weight gain, I was not satisfied, because at this point, I was beginning to distrust both of you.

I awoke April 30 to a 2-1/2 pound weight increase.  Water weight, huh?  I went to tie back my hair in the mirror.  I did something at that point that I rarely do.  Normally, I use the mirror to look at my hair only, just to tie it back.  But I felt my face with my hands.  It felt fleshy and less angular than it had been.   I felt round cheeks, like a doll’s.  Slowly, I tilted my head up and looked at my face.

I didn’t even recognize the woman I saw in the mirror.  What I saw was a soft, round, chubby face, like the moon.  It was a sad face.  It had a pasty, white, stretched look, and no life in its darkened eyes.

I haven’t looked at that face in the mirror since.  I just tie back my hair and ignore what’s underneath.  But seeing what I saw then was the breaking point for me.

Was my body really playing this trick on me? Who was tricking whom?  No, T and Dr. K, it is you two that are playing the trick on me and on my body.  Why?  Because you expect me to sit back and watch this happen to myself.  You expect me to accept this rapid weight gain, extremely high fluid level in my body, and subsequent sudden larger weight and size as my fate.  You expect me to live with a myriad of other symptoms as I described above.

No, no no no no no.  I will not let this dangerous, cruel, thing happen to my body.  I am taking back my body.  I own this body–you do not–and I am going to care for my body right here right now.

I went running and did a lot of thinking.  I noticed that I was very, very sluggish on my run.  In fact, my pace was so slow that a walker in good shape could have passed me!  Whereas I normally run three to five miles, my legs were so filled with fluid that I was only able to run for seven laps, less than two miles.  My stamina was very low as well.  I gave up and came home, and did some more thinking.

After lengthy consideration, I decided to do the sensible thing: I cut back on my food to rid myself of the edema, get my digestion back in order, and bring my weight to a number that I can accept as okay for me right now, not some out-of-control and rapidly rising number that I am not ready for.  I knew that I was specifically not following your and Dr. K’s wishes by doing this.  However, I am following what is stated in my contract, that is, to take care of my body lovingly and with respect.  If I saw Puzzle puffed up and swollen, I’d be so alarmed that I would think that she was going to die.  I’m sure the vet would be extremely worried as well, and would respond appropriately and not tell Puzzle to “sit with the fear” and continue to allow Puzzle to remain an ill and bloated dog.

I chose to cut down on my food quite a bit.  After one day of reduced caloric intake, I felt much, much better.  Already, the swelling had gone down considerably.  On the second day, I noticed some body changes happening quickly. Although I am now eating less, I actually have more energy because there is much less bloat in my legs and the rest of my body, and the stomach fullness has almost completely come back to normal, though my digestion was still very slow.  After three days, my sleep quality was better than it had been in over a month!  My depression has been alleviated due to the fact that I no longer see out-of-control weight gain in the future.  I have taken back my body, and intend to keep it.  It is mine.

I have kept a careful log of everything that has been happening to me since I have cut back on food starting Saturday.  It is all good stuff, except for minor pain in one foot to walking in ill-fitting shoes (same shoes, expanded feet).  The foot is on the mend.  I also took photos of my ankles every day to illustrate the progressive lessening of my edema.  I may print out these photos and bring them in to show you.  I have posted these progress photos daily on the Internet, and have intentions of posting a warning to people with anorexia about refeeding.  Boy do I ever hate the term “refeeding.”  I intend to say that you shouldn’t suddenly start eating “normally” because of this horrible thing that can happen to you that happened to me, that plus the chance of developing refeeding syndrome is high if you’ve been starving yourself for a while and then suddenly change your regime, with a note that refeeding syndrome is indeed fatal.  Let it be a warning.  I will not do this again to my body.

I hope you understand.

Julie

Sad

I am depressed now and have little desire to eat.  I don’t feel hungry and didn’t eat breakfast, but forced myself to eat a seitan sandwich and some cantaloupe for lunch.  I walked to the supermarket and bought some more food for myself but haven’t a clue how I’m going to eat it all.  I bought a fair amount of fruit.  It was on sale.  It is going to rain.

Two letters to my T

I wrote two letters to my T that I will present to her when I go back on Thursday.  This will be after I have skipped my Monday appointment.  I skipped it because I was intensely angry at her and needed time away from therapy.  Instead of telling her this, I lied, and said I was “vacationing.”  I think, though, she suspects that I was lying.  She’s no dummy.

The first letter is lengthy.  It states the reasons why I cut back on my food and that I stand by my decision.  The letter states that I want my body back, and that in cutting back on my food I am in fact following my contract.  I am reducing the edema and treating my body lovingly and with respect.

The second letter states that I am afraid that I will die of complications from anorexia nervosa.  In the letter I told my T who to contact if anything happened to me.  I also requested that she refrain from force-feeding me in any way.  I said I was very scared, and left it at that.