going through the motions

I went to see my therapist on wednesday, and it went better than it usually does when things are this bad; meaning, I didn't get taken away in an ambulance. Sue asked what I would like to happen, and that she thought I should go get evaluated. I said, "That sounds like sitting all night at the ER and then getting sent to Bournewood." that's always what happens. So we talked about that, and then Sue suggested Walden (the eating disorder hospital), and I adamently refused that. No way. I said that the women's trauma program I went to a few years ago was helpful, and a safe place.

Sue called the crisis team that's part of the clinic, to see if they could evaluate me, but they were too far away for me to get to without a car. So she got in touch with Advocates, a local place that evaluates patients and helps, well, advocate for them, and get them into programs. She explained the situation to the counselor there, and said that Bournewood, the psych ward i always get sent to, is out of the question, that I've even filed a complaint against them. She wanted me to go that night, but I convinced her that I was okay enough to wait til the next morning and have Nate go with me.

So I went to Advocates yesterday, and I still can't believe how easy they made things. I met with the social worker, Jen, and she was awesome. She didn't seem that much older than me, but she was friendly and kind and talked to me like a normal person. I instantly felt comfortable talking with her, when usually those types of assessments with total strangers are awkward and uncomfortable, and less than comforting. Especially at the ER, they don't really care what you have to say. they just want to know if you're going to off yourself.

So we went through all the questions and I explained what was going on. She suggested the eating disorder partial program because she was worried about my intake, but I wouldn't consider it. I told her about the women's trauma program that was helpful in the past, so she left the room to make some calls. In less than 30 minutes she got me an intake with the program, got insurance to cover it, AND gave me names of doctors, including one who the ED hospital usually refers patients to. Nothing in my experience with the mental health system has been that simple or gone so smoothly.

My intake at the Arbour women's program is wednesday. it feels far away, but I'm glad to know that there's at least something in place. I just have to hold on.

As I was waiting for the bus after my Advocates assessment, my friend Michele called me. Michele is always honest with me, and I trust her opinion. She can be really irrational when it comes to herself, but she knows me well and is usually spot on. She said she was really proud of me for doing this, but strongly suggested that now that I have time off from school to go back to the Walden eating disorder program. She said that it's good that I have the women's program, it's better than nothing at all, but that I'm running from the main issue. I won't be able to get as much out of it if I'm so malnourished. She said that I want the best of both worlds; I want to get better but not eat, to still have my eating disorder. So even though it looks like I'm getting help with the women's program, it can only do so much if I'm not eating.

And I know deep down that she's right. I'm pretending that I'm doing something to get better. But this really feels like all I can do right now; I'm just trying to not kill myself. I cannot even consider going back to IP at Walden until I've lost enough weight (i.e., back to my lw or lower). Last time Michele was there, as torturous as it was for her to eat, she was at a healthy weight and wasn't required to gain. So even when she ate all of her meal plan she didn't gain weight. Even though I'm not emaciated, I would have to gain, and I can't do that. right now the weight I've lost since my zyprexa-induced fatness is the one thing I hold onto.

breaking point

Deep down I've always been convinced that as much as anorexia consumes me, I would always be able to function with it, I'd always be able to do everything that's expected of me and more, in work, school, and anywhere else. For awhile it was true. I spent years fueled on starvation, getting perfect grades and never missing a day of work or class, even when twig legs could barely get me to the bus stop. But now I'm exhausted. Yet I can't give myself a rest because I did so much more at lower weights; there is no excuse to be this weak. I can't look like this and be dying.

I'm at the point where I have to choose functioning over my eating disorder, and I just can't do it. I'd rather have no life then let go, because life is even more unbearable when I'm bigger. I can't do it all anymore. Even when I'm not crippled by despair, physically my body can barely carry me around, and my brain cannot hang onto text book readings or have room to care about anything. I have no more passion or future plans beyond losing weight.

It's my last semester of school, and I don't think I'm going to make it. I made it through one day of classes and one day of placement. I want to be there, I like it, but I'm falling apart. This morning I woke up paralyzed. I knew I couldn't miss classes, but I couldn't move as much as I willed myself. I break down in tears just trying to figure out what to wear. I stare at one sentence in a book and I can't absorb it. I think about the day in front of me and feel like I am drowning.

Dis-ease

A couple weeks ago I ordered the book Feeding Anorexia: Gender and Power at a Treatment Center by Helen Gremillion.

Feeding Anorexia challenges prevailing assumptions regarding the notorious difficulty of curing anorexia nervosa. Through a vivid chronicle of treatments at a state-of-the-art hospital program, Helen Gremillion reveals how the therapies participate unwittingly in culturally dominant ideals of gender, individualism, physical fitness, and family life that have contributed to the dramatic increase in the incidence of anorexia in the United States since the 1970s. She describes how strategies including the meticulous measurement of patients' progress in terms of body weight and calories consumed ultimately feed the problem, not only reinforcing ideas about the regulation of women's bodies, but also fostering in many girls and women greater expertise in the formidable constellation of skills anorexia requires. At the same time, Gremillion shows how contradictions and struggles in treatment can help open up spaces for change.

The book came today, so I haven't started reading it yet. The topic interests me though; over and over again, through my own experiences and those of so many other women I know, I have seen how treatment has been ineffectual and sometimes harmful. There has to be a better way. I remember reading about in Hunger Strike by Susie Orbach the ways in which the treatment of anorexia is very similar to that of the "hystercial" women of Freud's time. Of course no one wants to hear from someone so visibly starved that force-feeding is not helpful. "Our discomfort may be such that we will wish to fight the anorectic, to stop her making us feel so uneasy by taking away from her the control she has fought so hard to exercise over her food intake. In forcing her to surrender, professionals relieve themselves of the burden of having to examine her pain and the discomfort her starvation induces in them."

I have never strived for recovery on my own. Hospitalizations were forced on me, and maybe they were necessary; it's hard for me to judge. What I do know is that none of them made a difference in anything except my weight. It made everyone else feel better to look at me, but anyone I know who has recovered did not do so with the help of a hospital. The hospital for me is just a competition of who is the sickest, who can get away with the most, or get the most attention. All it ever did was reinforce that I need to be ill to be cared for, make me feel like an incompetent and powerless child, and use my body and behaviors to be heard because no one listened to my words. It taught me new behaviors and created a safe place where I could continue to use anorexia as my identity.

I can't imagine myself ever going back voluntarily. ED treatments centers and psych wards are all too comfortable for me, but I can't choose to go, I don't care enough about myself and things are never "bad" enough. Sometimes hospitals are all I really want out of life, when I need to know that I matter, at moments when I believe I can't be good at anything other than being sick.

hunger

I'm so tired of being pissed at everyone just because I won't allow myself to eat.

It's taken me a year to be able to admit to my boyfriend when I am hungry. Anorexics aren't supposed to get hungry. It was easier pretending I wasn't; now I can say all I want that I'm hungry and what I'd like to eat, my boyfriend will offer things, but I still can't eat. It makes me frustrated and angry.

It's also weird when your eating disorder becomes the norm, accepted almost. When people stop offering you food or acknowledging that you haven't eaten. Like last night I made dinner for my boyfriend. He always shares it with me, meaning I take a couple bites of what vegetables I make, maybe 2 bites of meat. Maybe. Afterward, there was a commercial for Subway or some crap food, which always looks good when your starving and haven't eaten anything like that in years. I commented on it, which I would only do with him, and he said, "You're still hungry?" What? "We shared dinner like always." Yeah, five bites. I must be stuffed. It's like people see you survive on so little, they start to think that's all you need. So even my non-ED side starts to think they're right; why should I have more than that? That would be Too Much.

I feel like I've reached a dead end. I could either turn back and keep doing what got me here in the first place, or I could make my own way, alone, in a new direction. The problem is that I don't think I care enough about myself to fight my way through. I'm not a Strong Person and I cling to things that kill me because it feels safer.

After going through several incompetent and sometimes harmful therapists when I was 18, I found my current one. I've been with her for I think about 5 years now. You wouldn't know it to see me in that room. It's still so hard to talk, and it's recently gotten to the point where I'm going backward, losing language and the ability to say even the most basic things about myself or feelings.

I also see someone in the same clinic for medication. I've tried dozens of meds in the past 6 years, sometimes being put on 4 at a time. Not because I wanted to, but because that's the first thing people run to when they don't know what else to do with you. I don't feel like anything has ever really made a difference. 2 years ago, before my last forced hospitalization, I got fed up and threw them away-Lithium, zyprexa, seroquel. Seroquel made me a zombie who fell asleep on buses and in class, zyprexa made me gain 20lbs even while starving myself, and lithium made my face constantly broken out.

But there was one I couldn't get off of; Effexor. An SSRI antidepressant, which had never helped me, but has such a short half-life that even being late taking my dose made me extremely sick. About a month ago, however, I decided I wasn't going to continue putting something in my body that had that effect. So I bit the bullet and started coming off of it on my own, from 150mg to 75, to 37.5, to nothing. It's been absolute torture, to the point where I could barely function. Constant nausea, headache, dizzyness, and alternating between being drenched in sweat and shivering. My body has been so sore from the constant shaking.

After over a week of this hell, I called my psych out of desperation. I went all the way to the clinic in the freezing cold, barely able to stand. I got there, and told him all my symptoms, which he writes down, but then suddenly he's asking me to step on the scale, which I refused. I don't need that humilation, the measuring of sickness in pounds. He said I need to find a medical doctor, which I know, and have been trying to do. But it's actually not so easy to find a doctor who specializes in eating disorders if you aren't an adolescent. Then he had me get out my insurance card, and started dialing the number for me to call. Um, what? This isn't why I came today. I told him I didn't come all this way because I needed to be babysat while making a phone call I can make on my own at home. I came because I thought he might be able to help me, with the med he put me on.

But no, he kept trying to tell me that the reason I'm so sick is because of my eating disorder; that I need medical care and should go to the E.R. for fluids. I felt like I was in the twilight zone. I know anorexia doesn't make me the picture of health, but that's not the issue here. Has he even fucking typed the word "effexor" into google? Every account of withdrawal I read about was exactly the same horrible experience as mine, or worse. But no matter how I tried to explain that, he told me I'm not everyone else, I have an eating disorder.

I wanted to scream. IF I'M SO SICK AND EATING DISORDERED THEN WHY DID YOU PUT ME ON IT IN THE FIRST PLACE!! We kept going back and forth, taking everything in me to stay calm, shaking in my chair from sickness. He ended up saying he and my therapist cant just watch me continue to harm myself, and he can't see me anymore until I find a doctor. This man I've known and trusted with my care and secrets for 5 years. How fucking convenient for him, to put his foot down on my treatment, refusing to see me, when I'm sick from stopping the medication HE put me on. It's so fucking wrong. I came to him sick and desperate and he turned me away because he didn't want to be responsible.

I'm not anti-medication. But I'm so sick of doctors handing out prescriptions, pratically throwing them at patients. Nothing so awful to warrent medication can be cured by a medication. But that is the first and sometimes only option given. The medications I've been on have been more harmful than helpful. But what do I know, right? I'm just the crazy patient, it's just my eating disorder talking, me being difficult or manipulative or resistant. I'm so tired of not being heard.

Usually he and my therapist do things as a team, so maybe she'll decide to get rid of me too. I have no problem with getting a doctor. But I don't do ultimatums, and if there's someone monitoring me, I don't feel like my weight should be advertisted to everyone as a measure of how "bad" things are. When I was starving myself and zyprexa kept me at a normal weight, no one gave a shit. Was I less sick than I am now just because my weight is lower?

sometimes i feel like no one knows what they're doing. this is the field I'm going in to, and it's hard to not be disillusioned and bitter when you've been fucked over so many times by people who are supposed to help.

my voice is many voices. an echo

New Year's has never held much meaning for me, but I guess there is always a small part of me holding out some hope that something will get better.


I barely slept all night. I'm so tired of battling my head and drowning in emotions that turn into pysical pain, spreading out from the center of my body to my hands and fingertips. It hurts so badly, and I can tolerate less and less. So many years, and I'm so tired. And now a another year staring me in the face. It never ends, no matter what good things happen, or how old I get. It lives inside me and just keeps growing and eating me alive.