Wednesday, February 24, 2010

crushing

All that, and then I get a call from the program saying the insurance won't cover it because I left the useless program at Arbour "against medical advice."

I don't know what I'm supposed to do now. I'm being punished for leaving a program that wasn't helpful. Some asshole who knows nothing about me has decided I shouldn't be allowed to get help.

I'm back to where I started, minus any kind of hope or resources. This is what I left school for?

small steps

So my intake at Cambridge ED Center was at 8:30am this morning. It was easy to get to, but pouring rain, so I was soaking wet and cold by the time I got there. It was the usual. A half hour's worth of paperwork. Then one of the case managers from the program took my history robotically. She was nice enough, though, and it wasn't all rushed like at Arbour. Afterward, she took me upstairs where the partial program meets. It's so funny how all ED programs look and even smell the same. There was the group room, the same affirmations on the wall, the eating area. She weighed me backward, so I still don't know what I weigh, and took my blood pressure, which she said was low.

The program is pretty typical. 9am-3:30pm, 2 snacks and lunch. Wednesdays you bring your own lunch. If you don't eat 100% you get Ensure, and if you refuse that you get sent home for the day. I love that, that the punishment for not eating is to go home and not eat . There are about 9 people in the group at the moment, mostly around my age, though the youngest is 13 (I hate when there are really young girls in treatment with me; so triggering). There are also 2 males. I'm more nervous about the people even than the food. I don't want to be the fat one. I am terrified of having to really eat, though. Even though I can skip breakfast and dinner if I want at home, it's been a long time since I've eaten even one normal meal. I'm so scared of not being able to handle it physically and mentally. I'm worried they won't take that into account, how low my intake has been for so long, since my weight isn't emaciated.

Anyway, I start tomorrow. I'm trying not to think too much about it. I still have to call Sue to tell her I'm going so she won't send the cops to my house, and that I'm not going to therapy tomorrow or probably ever. I didn't sign the release form, so she can't talk to CEDC. I love how I'm apparently such a high risk and a danger to myself that I need to be sectioned, yet when I didn't call her on monday to check in like I was supposed to, she never called me.

Tuesday, February 23, 2010

I went to therapy yesterday morning, which was hard enough getting out of bed for. But I needed support about applying for MassHealth insurance and coming up with a concrete plan for things. I just needed encouragement and someone to understand.

My therapist, Sue was annoyed because she had let a message for me on thursday about getting an intake at Cambridge ED Center, but I never got it because, like I told her, my phone was shut off. But she acted like that was beside the point; like oh i did everything i was supposed to do and you dropped the ball. I tried talking about friday's meeting at school, and my frustration and loss about not being able to return for a whole year. But Sue just pushed my feelings aside and lectured me about basically how I need to get my act together and "do the work this time," whatever that means. When she starts talking like that I feel even more alone, and like a bad child, who isn't trying hard enough. She said i need to do this program. I said I know, but the reason I haven't made calls isn't just me being resistent. I'm really depressed, and everything seems overwhelming. But no one wants to treat my depression, they just blame my eating disorder. So then she started talking about sectioning me! I said, "i don't meet the criteria for being sectioned. I'm not a danger to anyone, I'm medically stable, and my weight isn't critically low." But she argued that she could do it, that my weight is low (she doesn't even know what my weight is) and I'm a danger to myself by not eating.

I started freaking, because I've been sectioned before and had so many bad experiences. At the slightest hint of that kind of loss of power, I lose it. I told her I wanted to get treatment, but with her threatening me and trying to force things on me, it makes me want to run in the other direction. But she didn't take any time to acknowledge my feelings and fears. It was all about her frustration and not knowing how to help me. I don't fucking need to be sectioned; she just doesn't know what else to do with me. Then she picked up the phone and called Dale down, so I grabbed my bag and was all ready to run. i said, "no way, that means ou're trying to section me, and I'm leaving." She told me I'm not leaving in "this state of mind." you fucking put me in this state of mind! Dale came down, and I just zoned out, shut down. Basically they said if I don't call for an intake in the next couple days they are going to section me.

I called CEDC twice, and they finally called back today. I have an intake scheduled tomorrow at 8:30am for their partial program. I'm supposed to call Sue and let her know what's going on, but I feel sick just thinking about it. I'm not returning to therapy. I'm so tired of treatment being a punishment. I really do believe Sue has gone about things all wrong, even harmfully. I have been starving myself for a long time, with 2 years since I've been in ED treatment. Now all of a sudden it's an emergency? Why wasn't it before? Sue doesn't know my weight, my labs are normal, and it's been months since we've specifically discussed my food intake. So how can she gauge whether I should be sectioned? I get that she's frustrated and doesn't know what to do with me. But you can't just section someone because they have an eating disorder and aren't doing what you want them to do.

Everyone is ignoring the fact that everything truly fell apart when I got off all my meds. While I agree that my eating disorder is a big problem and needs attention, the main reason I dropped out of school and am not functioning is that my depression is crippling. This is how it was 6 years ago, before I was medicated, before my ED even started full-force. This is how bad it gets without a medication. But no one wants to treat that because it must be my eating disorder. So they start me on a low dose of Wellbutrin, which does shit, and don't plan to up it until my prescription runs out next month. Before they were all about meds, now it's all "nothing's going to help until you address your eating disorder." The truth is that no one knows what they're doing.
So I guess it's up to me.

Saturday, February 20, 2010

time

I just want to thank everyone who has commented, and even just read my entries. I like blogging because it's open, anyone could be reading. I'm always afraid of people feeling obligated to respond, but here I am just putting things out there, so it feels like if someone responds it's not because they feel they have to. just being heard helps, along with getting out my thoughts.


Yesterday was hard. I think it was the first time I truly felt a sense of loss from what my eating disorder has taken from my life. I'm used to thinking of failure in terms of not being sick enough. But yesterday I saw it from a more "normal" perspective, of how I'm wasting so much time.

I went to school to meet with this woman Mary to fill out paperwork for a leave of absence. My academic advisor, Debby, wanted to be there too for support. I had her as a professor my first year at Wheelock, when I was at my low weight, and then again a couple years ago, so I feel like she knows me pretty well as a student. Anyway, we all met together, and I had to briefly explain the situation. Debby said she wanted me to know that no one thinks less of me; that going on leave shows my strength as a social worker, to recognize what I need and to take time for that. She said a lot of people in the field have their own struggles, and it can make them better at what they do. She also said I'm one of the best writers they've had in the program.

They both couldn't have been more kind. They listened and were helpful and didn't make me feel judged at all. The situation sucks, though. If I signed the paperwork that day for a medical leave, I would lose my insurance right away, which would mean no treatment. But If I don't fill it out and wait to withdraw, I would be responsible for paying a full semester's worth of tuition. I can't afford either. I filled out a form to apply for MassHealth, but I need to get it figured out ASAP. either way, though, I will be losing money. It's too much to even think about.

But what really hit me was when they said I wouldn't be able to come back until next spring, A YEAR FROM NOW, because the only classes I need to take meet just in the spring. And Wheelock classes are very specific; I can't take them anywhere else and get credit. At that point I broke down a little. A whole year. More lost time. That will make 2 1/2 years of medical leave from school. Even my younger sister has graduated before me. All because I'm too screwed up; it's my own fault. Why couldn't I just stick it out and finish the semester? It's such a mess.

They were kind and tried to comfort me. Said maybe there's a way that I can start my internship in the fall. in order to do that though, I'd have to be enrolled as a student and taking classes (that I don't need to take), and I can't afford it. I almost wasn't able to go back this semester. Luckily my uncle cosigned for my loans (my mom couldn't because she had to file for bankrupcy), but now I'm probably screwing him over too by losing money this semester. ugh. it's all so confusing.


All because of my eating disorder, all because despite all the years of treatment I still can't get my act together. I called Nate in tears, and he tried to help me reframe it. He said maybe it's a good thing. I can really dedicate myself to treatment, then I can just work and save money, make time to do things I enjoy. That it will be exciting, and I'll be in a better place when I go back to school. That there's no shame in not graduating "on time." he himself never finished school, and he can still always go back; there's no time limit.

I hung up feeling better, but now I'm back to feeling lost. It sounds good in theory; take time off and recover, return and be able to do my best. But what will be different this time? I still don't want to gain weight, I'm still not committed to doing better. Part of me is already thinking I'll go to treatment for a bit, then go back to losing weight, only this time I won't have to worry about screwing up school because I'll just be working a shitty job that takes zero brain power.

What is it going to take? How much do I have to lose before enough is enough?

Thursday, February 18, 2010

"When I try to move my arms sometimes, they weigh too much to lift"







I had therapy this morning. My therapist and I talked about treatment options, and I tried really hard to stay rational. I'm trying to have more control over my treatment and not have everyone else make the decisions like in the past. My therapist talked to Mclean Hospital, and they won't allow me in their behavioral programs because of my eating disorder. They do have an eating disorder program, Klarman, but besides hearing bad things about it from friends (one of whom had escaped through the window), they don't take anyone over 23. I know that my ED should be the main focus, but I guess I didn't expect it to keep me from being able to get any other kind of treatment, and that scares me.

Now there is no other option except an ED program. My treatment team is pushing for residential, but I don't want to or feel like I can. At Walden they usually make you do at least a few days in IP, and I cannot take that again. IP is the most triggering, and I can't go back at this weight. Residential is much better and supportive, but I don't think I can handle being stuck someplace without freaking out. So Partial seems like the best option right now. Which I know I've been going on about for awhile. I think I'm going to have to try, because my life is completely at a stand-still.

That's really hard for me to accept. While my therapist talks about how I need to take care of myself before I can do social work, I start thinking maybe I shouldn't do social work, maybe I should do something that makes it look like I'm functioning/having a life while still being able to hold onto my eating disorder. That's how I think; I don't allow anything to motivate me toward a better life. It's like I'm terrified of betraying my anorexia. Like choosing life or anything good is a cop-out.

Wednesday, February 17, 2010

My phone has been shut off since sunday, so I haven't made any phone calls for treatment. Not sure I would have anyway. I hate each day spent stuck at home alone, but I feel paralyzed.

I keep losing the feeling in some of my fingers. They get ice-cold and numb, and turn bright yellowish white. It happened once a couple weeks ago, then a couple days ago, then twice yesterday. I was scared at first, but now it's just an annoyance.

Monday, February 15, 2010

Ordinary Human Bodies

I feel myself expand and diminish from day to day, sometimes from hour to hour.
If I tell someone my weight, I change in their eyes: I become bigger or smaller, better or worse, depending on what that number, my weight, means to them.
I know many women, young and old, gay and straight, who look fine, whom I love to see and whose faces and forms I cherish, who despise themselves for their weight.
For their ordinary human bodies.
They and I are simply bigger than we think we should be.
We always talk about weight in terms of gains and losses, and don’t wonder at the strangeness of the words.
We’ve lost hope of simply being seen for ourselves.
The number of the scale became my totem, more important than my experience - it was layered, metaphorical, metaphysical, and it had bewitching power.
I thought if I could change that number, I could change my life.
Weight is now a symbol not of the personality but of the soul - the cluttered, neurotic, immature soul.
When I say to someone, “I weigh too much,” I hear, “Oh, no! You don’t. You’re just —” What? Plump? Big-boned? Rubenesque? I’m just not thin. That’s crime enough.
Because it is my fleshy curves I want to be rid of after all. I dream of having a boy’s body, smooth, hipless, lean. A body rapt with possibility, a receptive body suspended before the storms of maturity.
I want to be a bud and not a flower.
Sometimes I look in the mirror and see a woman with flesh, curves, muscles, a few stretch marks, the beginnings of wrinkles, with strength and softness in equal measure. But to like my body would be shameless, to be wanton in the pleasure of being inside a body.
If only I could catch a glimpse of myself by accident and think only: That’s me. My face, my hips, my belly, my hands. Myself.
Other times, I look in the mirror and think: Who am I am kidding? I’ve got to do something about myself. Only then will this vague discontent disappear.
Then I’ll be loved.


~ From A Weight that Women Carry by Sallie Tisdale

Sunday, February 14, 2010

living in blue

I'm supposed to call the Cambridge Eating Disorder Center for an intake at their partial program. I did an intake there a few years ago. I had just gotten out of IP, and they didn't want to accept me because my weight was still too low. I was desperate to not go back to IP, so I was trying to get into the CEDC evening program after school. I ended up never showing up because I just didn't have the strength to get myself there. It seems like an okay program, and I think it's better than going back to the ED hospital I've been to so many times. This place is near where I live, and it's not actually a hospital.

I'm feeling so stuck about what to do. the rational part of my brain says it's worth a shot, i can use it as a period to regain some brain function and physical strength. it's not like I have to commit to recovery and giving up my eating disorder. Just the thought of starting to eat again terrifies me. I haven't been in an ED program in 2 years. and digesting? if i eat a bowl of vegetables i can barely move for hours, it's like a rock just sitting there.

the ED side of my brain says I'm crazy to "choose" treatment. yes, everyone has been pushing for me to do it. but there isn't that desperation there was all those other times, of people begging and crying and then forcing me into treatment. Now it's me being the "weak" one, who can't handle it anymore. I can't help feeling like I'm weak for letting anything come before anorexia, including my life, school, Nate, sanity. Like if I were actually sick I would stop at nothing.

but now i am nothing. i can barely do anything. so maybe it's worth a try?



My mom works at an elementary school, and one of the kids gave her a heart cookie she made for valentine's day. it was in a plastic baggie, and my mom took it out and begged me to eat it. She told me the girl who made it reminds her so much of me when I was little. She's a tomboy, with long knotted hair, and her best friend is a boy with mental health issues (i was always friends with the special needs kids). she's already starting to be rejected by other girls. so anyway, my mom was telling me I deserve to eat this cookie, to give something good to myself, and to think of how I wouldn't want that girl Samantha to get older and deny herself things. I rolled my eyes and stuffed it in my bag, but it stuck with me. I can never have sympathy for myself as a little kid, but thinking of that little girl ending up sad and hurting herself played in my mind.
so I ate half of the heart-shaped sugar cookie, which was small anyway, and later on I ate the other half. because sometimes eating doesn't feel as bad as being a hypocrite.

Thursday, February 11, 2010

wasting

I'm so sick of wasting every day.

There is nothing I enjoy doing anymore. I spend all day hiding inside where it's safe, where I don't have to act when I'm barely holding it together. But I'm so alone, and I'm just existing.

Two hours this morning were spent getting dressed. Two hours. putting on layers and tearing them off, over and over, seeing only a disgusting blob in the mirror that won't go away.

Therapy in an hour, then work, just keep going through the motions. everyone is so far away.

Wednesday, February 10, 2010

trEATment

I'm not going back to the day program.

I'm just fed up with it. I gave it a chance, but besides getting nothing good out of it, it often makes me feel worse. It's so triggering for me to be ignored in a room full of people. It's just further proof that I'm insignificant, that I need to be blatantly ill to get my needs met.

The groups are huge, as I mentioned, 20 people. They are also mind-numbingly boring. Just about every group consists of being given a hand-out, then going around and reading it allowed. Like, I could read that on my own. They don't expand on it, they talk about it in the most basic, dumbed-down way imaginable.

Last week a man came in for "music therapy." He must've said 5 times that he's a "board certified music therapist", but I wonder how much school that takes because he looked younger than me. he seemed preppy and sheltered, and I instantly didn't feel comfortable with him. but 5 seconds after introducing himself he's stuck a drum in my face telling me to say my name and "play what I'm feeling." I just shook my head, and he pushed the drum closer, with this snarky smile on his face. "I'm Caitlin, and I'm good without the drum." there was awkward silence and a stifled laugh. everyone else after me went along with it. But seriously, I hate that stuff, especially if I don't feel safe or comfortable to begin with. I don't want to act stupid on top of it. Ive got enough problems as it is. I need to at least appear cool while I'm falling apart.

I don't fell close to, or even really know, any of the women in the group, so i don't feel safe enough to share. the staff members have not taken time to talk to me at all, so when they ask me something in group I feel really judged. I feel horrible after the program ends. completely drained and mush-brained from sitting in a 100 degree room all day saying nothing.


My case manager, Brigitte, looks like a brunette, French version of Marcia Brady, but is cold with very little personality. She can't even fake empathy. She wanted me to join the eating disorder track of the program, the aptly named Courage and Connection, but I refused. I wanted to do the groups, but I would have to eat snack with them and bring in my own lunch in compliance with their meal plan. I don't know how I'm supposed to go from barely eating, to going grocery shopping for real food and putting it together in the way they want. That is completely overwhelming. She just said, "Well, you can just eat the cafeteria food." Right, like that's any better, eating their greasy french fries and macaroni and cheese. I think not.

Yesterday, though, she had me go to the nutrition group. I was on the verge of breaking down. the nutritionist was a really kind woman, who talked to us like normal people, without that fake, condescending voice. We went around the room and she just checked in with how we were doing. Actually being asked that question genuinely by a kind voice made me completely fall apart. It was so embarrassing. The 6ft. girl with the voice of a 5-year-old handed me a tissue, but that was it. the nutritionist asked me who my case manager is. I told her, and she just said she'd talk to her. ok? I had just met with her. a lot of good that did. that was it, the group ended, me still with tears coming down my face, and it was lunch time, so I just went for a walk. no one checked in with me or anything. I seriously considered not coming back. I don't know why I did. but that was the last time.

I don't know what I'm going to do. It took so much to leave school, and now I'm just wasting time.

Thursday, February 4, 2010

from despair to where?






Wednesday I started the day program. I am not the same person as when I walked through those doors 5 years ago, but I'm not sure that's such a good thing. When I entered this program the first time around, I was scared and willing to try anything. It was the first time people were asking me to talk about me, the first time I was worth paying attention to. Five years later, things are worse than when I left. Today I am more angry and bitter and disillusioned. I've met these same women just with different names. I've talked to the same staff who ask the same questions in the same patronizing way. I sign the same forms and make the same empty promises.

I remember Arbour as my safe place. Before being admitted that first time, I had needed and wanted help for so long, but I couldn't ask for it. I was cutting badly, every day, over everything and nothing. I cut to get myself to go to work, to get to sleep, I cut when I was bored, I cut to feel nothing or to feel something, or just because I deserved to be punished. I was completely out of control. My therapist didn't want to talk about it. So I kept cutting, hidden under long pants in the summer heat. No one had any idea.

***SI trigger warning***

One night in late August, my secret came out. I was one week away from starting my second year of college. I was home alone, after work, except for my father who was on the phone in the other room. I can't remember what triggered it. I think it was my second cutting session of the day. But it was a brand new straight-edge razor, and I pressed too hard against my ankle. the skin split apart so fast, so wide, and the blood spilled over in slow motion. but suddenly it was everywhere. I tried to hold the edges together but I couldn't. It was too much, and I remember feeling sudden relief. this was it. it was over. the secrets and the hiding alone. I didn't have to do it by myself, I could let go.

I remember hobbling down the hallway, my leg wrapped in a towel but still blood all over the place. numbly telling my father, "I cut myself." he didn't know what I meant at first and I didn't know how to explain. I don't remember the car ride, but I remember most of all the burning shame of the emergency room waiting room. I could not look at anyone. not my father, especially. not the people who deserved to be there, or the television screen documenting the coming hurricane Katrina, or the doctors who kept asking why. Why? I couldn't think of a single reason why not.

they tried to shame me, tell me I was too old to be doing this, that I just missed a major artery. The psychiatrist came into talk to me, saying "nice artwork" when he spotted the blood splattered on the table around me.

School didn't happen that year. The next day I started Arbour. For the first time in my life, I felt like I belonged. It took a hospital for me to feel like I was ok and maybe likeable, and like maybe it was okay to talk without rushing in the fewest amount of words possible. The women I met there changed me forever, and despite the many hospitalizations I've had since then, I've never forgotten a single one.

But starting the program this wednesday was not the same. My intake was hurried, done by an intern about my age, doing an internship that I should be doing this semester. The group is way too big; 20 women with PTSD and trauma-related issues. That's a room full of fragile emotions and a lot of needs that some will fight for and others will let fall to the wayside. That's me. I can't compete, and there is nothing more triggering to me than being overlooked. Being in a room full of people with problems that are more important than mine. I become invisible, and that just feeds into me not feeling like I exist or matter, that if I can't speak loud enough with my voice, my body will have to suffice.

It didn't help when an emaciated girl came in today. it's not an eating disorder program, but a few of the women struggle with ED. I instantly wanted to run out the door. That feeling that I can't possibly take up anyone's time unless my BMI is back to 14, I couldn't possibly have an eating disorder or need help. I'm so exhausted and miserable, and yet I allow the number to decide when I can get help. I'm holding myself prisoner, and I don't know how to stop.

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