Point of no return

There’s something I want you to know: It is not too late. You are not too broken. There is no point of no return.

I did some pretty “bad” things when I was sick. Gross things. Embarrassing things. Dangerous things. Things that hurt other people. Things that went against my values. Things that I had sworn I would never ever do. And I remember feeling every time my behaviors escalated, that it was one more nail in my coffin, one more strike against me, and that eventually I was going to have done so many “bad” things that I would be a lost cause, that I would have gone too far and there would be no returning to the land of the living. I was sure that there was no way to pick up all the pieces I had shattered into and reassemble them into anything that resembled a real person.

I want you to know that I was wrong. I am here. I am living a real, full, happy life. I was not too broken, too bad, too fucked up. I was not un-fixable. And neither are you. I was pretty far gone and I came back. And you can too. As long as you are alive, recovery is possible.

Likewise, if you are in the beginning of your recovery journey, I want you to know that no matter how hard it is, I promise you, it does not mean that you are not on the right path. Recovery will at times be harder than you can imagine. And you will think that this is not what recovery is supposed to look like. Your illness will tell you that this amount of struggle is not normal, that it means you will fail at recovery and that you might as well just give up now. That is a lie. No amount of struggle is indicative of the fact that you cannot recover.

This is a message for family members and care givers too: your loved one is not beyond help. No matter how many interventions have “failed” in the past. No matter how long they’ve been sick and no matter what their behaviors are, they are not too sick to get better. Your confidence in this fact is a perhaps the most important thing you can give them. Show your loved one that you absolutely believe that they will get better. Lie if you need to. Tell them you have a plan b, c, and d in case plan a doesn’t work. Even if you don’t. Tell them you will never give up. Even if sometimes you want to. Tell them that other people in their situation have recovered. Even if you’re not sure. Please know that you’re loved one needs to believe that you believe this. Even when you don’t. And do not give up on yourself. Nothing that has happened in the past means that you cannot become an active part of your loved one’s recovery. No matter how many times you feel you have failed them, it is not too late to get it right. Be honest. Tell them that you know you got it wrong in the past, that you didn’t understand their illness, that you got bad advice from professionals. Tell them that you know more now and that things are going to be different. Tell them that you are not giving up, that you will never give up.

There is no point of no return.

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Some Wedding Photos

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2013 Year in Review and 2014 Goals

2013 was a hard year guys. It had some great moments and some pretty shitty ones and all in all I’m not sad to see it go. My dog had cancer (super shitty although he is ok now), we got married (awesome but super stressful), I struggled through three more quarters of school (really rough but at least I am closer to being done), my husband decided to make a major career change and apply to graduate school in a new field (we feel good about this but it is stressful and means we don’t know where we will be next year), and I dealt with several episodes of depression and severe anxiety and some lapses into restriction (super shitty although I am doing well now).

2014 is going to be a big year too. I (knock on wood) will graduate college and we will most likely be leaving Seattle. Other than finishing school, my only real goals for 2014 are to keep moving forward with recovery by dealing with some lingering issues in therapy and being more honest with my husband when I am struggling. It would be great if I started blogging again, got more exercise, and went back to volunteering at the animal shelter but I’m not putting too much pressure on myself about those things.

Happy new year everyone!

 

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The Double-Edged Sword of Stigma-Reduction

I am taking an abnormal psychology class this quarter and its pretty terrible which makes me angry and frustrated and sad (and we haven’t even gotten to eating disorders yet!). A large portion of the curriculum seems to be dedicated to reducing stigma around mental illness. Which is great (although not really what I think an abnormal psych class should focus on). Its the way the professor is going about it that is getting me all stabby. Like many other mental illness awareness/stigma-reduction campaigns the focal point seems to be the idea that mental illness is not that different from normal emotional experiences  and therefore that people who suffer from mental illness are just like everyone else and that everyone can understand what having a mental illness is like.

JUST NO.

Mental illness is not just an extreme version of normal emotion and behavior. Yes, sometimes the outwardly visible symptoms of a mental illness can appear as exaggerated versions of normal behaviors but the emotional experience of the sufferer cannot be understood in those terms. Eating disorders may look like extreme dieting behavior but let me assure you having an eating disorder IS NOT in any way like the experience of dieting. You cannot take the experience of a non-eating disordered person who diets and has “normal” body image issues and multiply it by any order of magnitude and get the experience of an eating disorder. Depression is not just feeling extra sad. Anxiety disorders are not just feeling extra worried. I believe this holds true for all mental illnesses.

Now the issues of whether people with mental illnesses are just like everyone else and can lead completely normal and successful lives is a little more nuanced. I absolutely believe that with good treatment most people can go into remission from their mental illness. I like to think that I am living proof of that. My life looks – and for the most part is – very normal. And yet for many years I was completely unable to function in any way that resembled normality – unable to hold down a job, stay in school, have relationships, feed myself properly, at times unable to even get out of bed and get dressed. And for some people with mental illness, their lives may never get back to normal. When we harp on and on about the idea that people with mental illness can be totally “normal”, what are we implying about the mentally ill people who can’t? That if they just tried harder they could overcome their illness! and be normal!? To me it just reeks of victim-blaming. Because, honestly, the difference between me and the homeless, schizophrenic man on the street corner is not that big. My parents were willing and able to pay for airplane tickets home from South America and pay rent on apartments when I couldn’t. They did a lot of things wrong but they never told me I couldn’t come home. That’s all. That is the difference. There are moments I think back on when, without that financial support, without a home to come back to when I had nowhere else to go, I would have ended up on the streets, on drugs, psychotically depressed, doing god knows what. The people for whom that becomes the reality do not deserve to be thrown under the bus in the name of making the general public feel more comfortable with mental illness. These people do not deserve to have the burden of the stigma thrown entirely on their shoulders for the benefit of those of us lucky enough to come out the other side and be able to pass as “normal”.

So, no, I do not believe that people who have not experienced mental illness can truly understand what it is like. For some reason that is not entirely clear to me, this seems to be a belief that offends a lot of people. I am not saying they have never experienced anything painful or hard. I am not saying that they cannot learn about mental illness and effectively support people who do suffer. I am not saying that they cannot become wonderful, compassionate clinicians. I am not saying that loving someone with a mental illness is not a challenging and painful experience in and of itself. What I am saying is that YOU DO NOT KNOW WHAT IT IS LIKE. And that’s ok.

We do not talk about other illnesses in this way. People do not claim to understand what it is like to have cancer because something bad happened to them once. We do not conceptualize cancer as a really really exaggerated version of the flu. We do not think that our ability to treat people with physical illnesses with compassion is tied to our ability to relate to their experience. Treating physical illness or supporting someone who is ill does not require us to KNOW exactly what they are going through. We need to stop doing this with mental illness. We need to encourage an educated and compassionate view of mental illness that is not relient upon this idea that its “not that different”.

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Language and Responsibility

The immense power of language and how it affects how we think about eating disorders (and mental illness in general) is something I spend a lot of time thinking about. Dr. Insel, head of the National Institute for Mental Health and one of my very favorite people ever, wrote about this in this blog post. This is deeply personal subject for me because the first time I heard EDs referred to as biological brain disorders I very nearly wept with relief. It was breath of fresh air, a ray of light, and any other cliched term you care to use. In that instant my understanding of what had been happening to me for the past seven years began to shift. No, it didn’t cure me. I didn’t even start getting better for several more years. But I began to stop blaming myself and my parents and started to believe that just maybe there was hope for recovery. It led me to the information I needed to eventually find recovery. Those words changed my life.

Language is that powerful.

But is it good enough to just use the right words? Does our responsibility end with word choice? Is our job done once we have spoken/written the words? I would say no. I would say that choosing our words carefully is only the tip of the iceberg. Because, really, what we actually say matters very little in comparison to how people interpret our words. We can use the most scientifically accurate, most politically correct, best-in-every-possible-way, language and if our audience doesn’t understand what we mean it doesn’t do anyone any good.

When practitioners make comments about eating disorders without thinking about how they are going to be heard, they run the risk of doing real harm. When they say that bulimia is not as serious as anorexia because the mortality rate is thought to be lower, they need to think about whether a parents hearing that might back off on getting their child help. When they say that, unlike anorexia, bulimia is thought to be culture-bound without clarifying that that “does not mean that genes do not influence BN or that they influence BN less than AN“, they perpetuate harmful mythsWhen they say that ED patients are non-compliant or manipulative or untruthful, perhaps they don’t mean to imply that these are personal failing of the patient, but you can be sure that that is how patients will hear it. When they cite research that anorexic patients report more displays of negative emotion from their parents during childhood without clarifying that they mean it as an illustration of the patients’ tendency to misinterpret other’s emotions, they sure as hell sound like they are blaming parents. 

Often I hear people arguing that we should avoid language that is easily misinterpreted even if it is actually the correct language to use. This comes up frequently in regards to the term “biologically based brain disorder” because it has been shown that, amongst the general public, this language actually increases stigma around mental illnesses. I am NOT saying that we should not use accurate language because of the risk of it being misunderstood. I am saying that we must be aware of this risk. We much always speak with the least educated or most vulnerable audience member in mind, especially when we put our words on the internet, where we have very little control over who the audience will be. [If you are writing a blog for clinicians or parents, please please please be aware that sufferers will read it too.]

I will be the first to admit that I am not always mindful of this. I don’t always take the time to explain the terminology I use and too often assume a common knowledge base that may not actually be there but I am going to try to be better. Because if the only people who understand what you are saying are the people who already understood the idea, what good are you doing?

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Success!

I would like to announce to the entire world (or, you know, the two people who read this blog) that I successfully bought a swimsuit. Not only did I buy one but I think I will be willing to wear it in public and I actually kinda sorta even think I look cute in it. Guys, I haven’t worn a swimsuit in six years and an attempt to buy one last year ended in an epic meltdown. So this is kind of a big deal. My body dysmorphia still gets the better of me at times (ahem, wedding dress fitting) but I am fighting back and am finally making some progress. I’m kind of awesome. Just sayin’.

Also, stay tuned for a series of blog posts on communicating about eating disorders.

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2012 Year in Review and Goals for 2013

Last year I made an ambitious list of new year’s resolutions. Let’s see how I did shall we?

1. Go to bed earlier. Didn’t do such a great job with that. Definitely something to keep working on.

2. Apply to school (and get in). Success! I applied to University of Washington and started full time this summer. I have completed two quarters. Its been a bit of a bumpy ride but I guess that was to be expected.

3. Drink less beer. I wasn’t drinking a lot to begin with but I do think I’ve cut down a bit. I’m actually not sure why I made this resolution last year?

4. Watch less bad tv. Hmm total fail. I will watch pretty much anything (except reality shows).

5. Read more novels. See more live music. Go to the movies more often. I have been reading a lot more but completely failed on the other two.

6. Cook a wider variety of foods. Nope. Laziness continues to win out on this front.

7. Tell my boyfriend (J) I love him more often. I actually think I’ve gotten a little better at this. I still don’t initiate ‘I love you’s’ very often but I do feel more comfortable saying it.

8. Keep the apartment tidier. Ha! If anything this has gotten worse.

9. Make some friends. I wouldn’t say I’ve made a lot of close friends in the past year but I have widened my network of people I am friendly with. I joined a new soccer team, met people through volunteer work, and even occasionally talk to a classmate.

10. Do a better job of keeping in touch with my friends who are far away. Yeah I suck at this. I saw my Boston friends in September but haven’t really talked to many of them since. I did get to see a friend in NYC who I hadn’t seen in six years and another friend in DC who I hadn’t seen in 13 years.

11. Start volunteering at the Seattle Animal Shelter. Check. Took a couple of false starts (new social situations make me pretty anxious) but I did it and its been really fun and rewarding.

12. Find a way to practice my Spanish before it completely disappears. Nope. I think it has officially disappeared from my brain.

So basically I sucked at following through on last year’s resolutions. Still I would say 2012 was a success over all. Starting school again was really hard and fall semester was a bit of a disaster but I didn’t give up and I didn’t freak out too much over my less than perfect grades. I went to the second annual FEAST conference in DC and had a wonderful time. Oh! And I got engaged this summer and bought a beautiful wedding dress without too much body anxiety and had a mostly good visit with my fiance’s family over Christmas.

The other resolution I made for 2012 was to be more proactive about tackling my body dysmorphia. In general my recovery is very solid. No major lapses into restricting in 2012 although I still hear my ED voice fairly often. Most of the time it is just background noise that I can ignore with any difficulty. Sometimes its a bit louder but not overwhelming. No cutting or purging either although I sometimes still feel those urges too. Judging how I am doing with my body dysmorphia is tough because it changes wildly from day to day. I bought a lot of new more adult looking clothing for school and I think that was helpful for my body image. Wearing tighter jeans and closer fitting tops was really really hard but forced me to look at and deal with my body in a way that I had been avoiding. And sometimes I actually thought I looked ok. And then other times my body dysmorphia still rears its ugly head and makes my life pretty difficult. Just a couple of days ago I saw some photos of myself from the holidays and promptly disolved into a hysterical mess and decided I should never be allowed to leave the house looking so disgusting. Sigh.

So goals for 2013:

1. Keep on pushing through the anxiety related to school. Be better about actually going to class and keeping up with the work but cut myself some slack when the anxiety is overwhelming.

2. Survive wedding planning and get married!

3. Keep working on my body dysmorphia. Resist the urge to return to wearing baggy jeans and my boyfriends t-shirts. Start going to yoga which I find helpful in feeling grounded in my body. Keep playing soccer and jogging and appreciate how good it feels to be strong and healthy. Be patient with myself when I am struggling.

4. Clean the damn house.

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