A Little More Hopeful than Hopeless
Ah yes, so as we most recently learned, I relapsed (which I feel weird saying as my time spent "in recovery" was fairly limited) in late spring/early summer of this year. I had to go back to treatment at my favorite fucking place in the world (slightly sarcastic, slightly not), and I spent yet another consecutive summer going through the motions of PHP into IOP. I say that because I think a significant difference between past stints in treatment and this one was that for the majority of the time I was there most recently, I was merely going through the motions of it all. This is one of the contributing factors to why I ended up where I am today.
Something that has been a huge motivator, and the sole-motivator frequently, was (is?) going back to school. Having so much idle time has been the bane of my existence and, therefore, my recovery. A year ago, this time on my own outside of treatment led to an increase in behaviors and eventually a depressive episode which I somehow managed to actively blog about in the midst of? Thus, the idea of having responsibilities and commitments once again sounded heavenly, or at least hopeful. I have spoke previously on the challenges that it also presents, but the hope it brought me seemed to outweigh those things. Basically, I wasn't going to completely abort the recovery train before I got a chance to try it out when I started school. I got a few weeks, three to be exact, of IOP treatment before school to test out the waters of increased freedom (read less support) and more time participating in real life (read a world of less accountability). I was fortunate enough to be able to go to school and continue to be in IOP treatment by the grace of the scheduling Gods, but because of the rocky waters that those few weeks prior to school were for my recovery, there were lines drawn for me that would determine whether or not I would be able to remain in school. Basically I had to maintain my health well enough so that they wouldn't have to consider moving me into a (in unison) higher level of care.
There seems to be a trend that I am alluding to. I want to try to name it more explicitly, if possible.
1) Go to treatment at PHP level of care- whether it be after coming back from residential, stepping up from IOP or starting again after discharging.
2) Doing well during program hours of PHP, but struggling when on my own. However, because the PHP program is most of the day, doing well enough to move down to IOP sooner than later likely according to insurance (even though that was less of a factor most recently).
3) The struggles I had when outside of program on a smaller scale while in PHP amplified when I moved to IOP, but the concern this resulted in felt more safe than the alternative, reinforcing my desire to feel "sick".
4) Ultimately I end up being confronted with having to go to a higher level of care and cycle through treatment again. This sucks but again, it feels safer.
I think I went through these particular steps four times and several more if we consider making slight modifications but keep the general trend. My idea of support and connection got entangled with treatment and being sick. I quickly became unable to separate the two and got stuck with a new quantifiable measure (based on old beliefs about love and connection) of how much people would care about me: with how "sick" I was which I ultimately determined by the level of care I was in. And yes, it was this trend that played out once more over the summer. I think there were other factors that should be noted as well that prevented any interruption of it.
It was late April when I started intentionally using behaviors more consistently, and in this season of my eating disorder, these behaviors looked like restriction. Initially, the motive was not to change my body, because honestly, I felt I was too "far gone" from the eating disorder's idea of "acceptable" to even strive to get back there. In fact, after numerous months of, more often than not, allowing myself to have the foods I had for years labeled as "bad" and "unhealthy", the pleasure I was accustomed to getting when I gave in and ate them was no longer as intense. The change was so drastic that it felt like I wasn't enjoying these foods at all! And if I wasn't enjoying these foods, the ex-fear/binge foods, I could promise you that you couldn't pay me to eat a damn vegetable. When food stopped becoming so gratifying and rewarding, I struggled to justify eating it. My logical mind knew what this really was though. My eating disorder was trying out a new strategy in an effort to get my attention and divert me from recovery. It worked. Why did it work so well? Because this was the part of my eating disorder I liked, the part that didn't make me feel shame because it aligned with our society's fat-phobic ideals. It aligned with the internalized fat-phobia in me. Soon enough, these behaviors had reawakened the body-hatred/dissatisfaction I had worked so hard to move away from. At this point, eating food wasn't enjoyable rather it felt like chore, and now I was unhappy with the body I was in and wanted to change it. I could see where this train was headed and explained sooner rather than later to my outpatient therapist that I thought it was best to seek out IOP/PHP treatment while I would still qualify (opposed to waiting to see if things would turn around in outpatient and just declining to the point where I would need to go to res).
Alas, June 13th arrived, and I returned. Same place, same people, same old shit. So I did PHP, as mentioned in the previous post, for six weeks, stepped down to IOP by the first week of August, and then started school at UH August 19, 2019. Was I grateful to be able to go back to treatment and be given more time than I was used to? Absolutely. 100%. I was grateful AND I wasn't improving. I was wavering around a point of stability while I had the accountability of being in PHP and then starting declining again once in IOP prior to school starting. So right before school started and this downward trend was impossible to ignore, I received a contract to sign from my team that I would have to follow in order to stay in school. The line was drawn. Essentially, I had to maintain my vitals and eat close to 100% of my meal plan (they weren't expecting perfection). If you are a OG reader, you know that the concept of a "contract" is not a foreign one to me. Actually I am more than familiar with it. I have signed several with varying purposes. I don't know if it was the normalcy of such a document or the sheer manipulation of the ED inside my head, but for some reason, I felt as if I was immune to the consequences of not abiding by it. This didn't mean I wasn't aware of the actions or inactions of mine that broke the contract, and knowing that they did definitely made me uneasy. Still, the anxiety never drove me to change. I was mostly just anxious about upsetting people by not following it, not that they would enforce the outcomes they claimed that they would in the contract.
I shouldn't have been so surprised. It shouldn't have caught me so off guard. I realized afterward that it was a session with both my therapist and my dietitian, around the time of the end of my contract period, and I hadn't not upheld the my end of it. So even after this was brought up at the beginning of the session, when my therapist stated that they were recommending residential and especially when she said she has already talked to the place they wanted to send me, for the the first time that I can recall in treatment, I went into "fight" mode instead of "freeze". No, I didn't physically try to fight my therapist- though I did yell, and yeah, I think in that moment it was at her, as opposed to kind of just yelling to yell. Of course, I apologized immediately, not wanting anyone to be angry with me (for being angry with them?), but truth is: I was angry. And I was hurt. I believe part of the reason I put myself in the position I did was to avoid getting hurt or the feeling that I was being abandoned because I was no longer "sick enough" to need support. Yet, here I was feeling both of those things anyway.
How did this rendezvous conclude? It did so by deciding we would discuss the matter further with my parents the following Monday (it was Friday), and what was decided in that rager-of-the-year was that it was gonna be my choice how things proceeded. I could either leave school (which to me also meant losing a scholarship and other emotional repercussions) and go back to residential in Oklahoma, or leave treatment altogether and hope I could find an outpatient team who would see me despite my status in recovery. I could see that for the first time since going to the counseling center at UT a year and half ago, my recovery was fully in my hands. Sure, I mean, technically, it has been the whole time. I could have always left treatment or given up. But now, given my overall low motivation, I really felt like I was capable of making that choice even if it meant going against other's wishes for me. This scared me shitless. I knew all along what choice I was going to make. I knew before there was a choice to make. I had been having some form of invasive thoughts about quitting treatment and hoping for the best (likely planted by the friend in my head), so it felt like the plans my eating disorder had for me were simply coming to fruition, through my doing. I think that's why I didn't want the choice to be mine. I wanted to scream, "THIS ISN"T ME! You can't let me make this choice because its not ME making it!" I wasn't entirely able to articulate the sense of powerlessness I felt over myself.
It wasn't until the day before, "decision day" as I deemed it, where I experienced a small, but significant, moment of clarity regarding this. It was like, for half a second when talking to someone in my support system, the lenses of the ED where taken off and the blurry fog that I had been trudging through became clear. I realized if I made this choice to stay in Houston and leave IOP, I would have to make changes or I was simply delaying an intervention that would happen inevitably. I didn't ignore this realization. I tried to hone in on it as much as I could before it was lost in the blur when the lenses returned. I studied this thought so that I wouldn't need to see it in order to remember what it looked like and how it felt to think it. It felt scary, but also, a little more hopeful than hopeless, which was plenty for me. When the next day came and I made the decision official, I did so not with the intention of dragging on the game I was playing, but maybe looking for loopholes in the rulebook, or maybe just a new angle. Stupid analogy aside: I chose to step out of treatment at CFD amidst my relapse at least aware of what I was getting myself into. With the knowledge that I had to do something, anything, differently than how I was doing it now. This insight allowed me to feel more comfortable and at peace, for I felt I understood, to the best of my ability, the sort of shit I would be diving into head first.
Glo
Something that has been a huge motivator, and the sole-motivator frequently, was (is?) going back to school. Having so much idle time has been the bane of my existence and, therefore, my recovery. A year ago, this time on my own outside of treatment led to an increase in behaviors and eventually a depressive episode which I somehow managed to actively blog about in the midst of? Thus, the idea of having responsibilities and commitments once again sounded heavenly, or at least hopeful. I have spoke previously on the challenges that it also presents, but the hope it brought me seemed to outweigh those things. Basically, I wasn't going to completely abort the recovery train before I got a chance to try it out when I started school. I got a few weeks, three to be exact, of IOP treatment before school to test out the waters of increased freedom (read less support) and more time participating in real life (read a world of less accountability). I was fortunate enough to be able to go to school and continue to be in IOP treatment by the grace of the scheduling Gods, but because of the rocky waters that those few weeks prior to school were for my recovery, there were lines drawn for me that would determine whether or not I would be able to remain in school. Basically I had to maintain my health well enough so that they wouldn't have to consider moving me into a (in unison) higher level of care.
There seems to be a trend that I am alluding to. I want to try to name it more explicitly, if possible.
1) Go to treatment at PHP level of care- whether it be after coming back from residential, stepping up from IOP or starting again after discharging.
2) Doing well during program hours of PHP, but struggling when on my own. However, because the PHP program is most of the day, doing well enough to move down to IOP sooner than later likely according to insurance (even though that was less of a factor most recently).
3) The struggles I had when outside of program on a smaller scale while in PHP amplified when I moved to IOP, but the concern this resulted in felt more safe than the alternative, reinforcing my desire to feel "sick".
4) Ultimately I end up being confronted with having to go to a higher level of care and cycle through treatment again. This sucks but again, it feels safer.
I think I went through these particular steps four times and several more if we consider making slight modifications but keep the general trend. My idea of support and connection got entangled with treatment and being sick. I quickly became unable to separate the two and got stuck with a new quantifiable measure (based on old beliefs about love and connection) of how much people would care about me: with how "sick" I was which I ultimately determined by the level of care I was in. And yes, it was this trend that played out once more over the summer. I think there were other factors that should be noted as well that prevented any interruption of it.
It was late April when I started intentionally using behaviors more consistently, and in this season of my eating disorder, these behaviors looked like restriction. Initially, the motive was not to change my body, because honestly, I felt I was too "far gone" from the eating disorder's idea of "acceptable" to even strive to get back there. In fact, after numerous months of, more often than not, allowing myself to have the foods I had for years labeled as "bad" and "unhealthy", the pleasure I was accustomed to getting when I gave in and ate them was no longer as intense. The change was so drastic that it felt like I wasn't enjoying these foods at all! And if I wasn't enjoying these foods, the ex-fear/binge foods, I could promise you that you couldn't pay me to eat a damn vegetable. When food stopped becoming so gratifying and rewarding, I struggled to justify eating it. My logical mind knew what this really was though. My eating disorder was trying out a new strategy in an effort to get my attention and divert me from recovery. It worked. Why did it work so well? Because this was the part of my eating disorder I liked, the part that didn't make me feel shame because it aligned with our society's fat-phobic ideals. It aligned with the internalized fat-phobia in me. Soon enough, these behaviors had reawakened the body-hatred/dissatisfaction I had worked so hard to move away from. At this point, eating food wasn't enjoyable rather it felt like chore, and now I was unhappy with the body I was in and wanted to change it. I could see where this train was headed and explained sooner rather than later to my outpatient therapist that I thought it was best to seek out IOP/PHP treatment while I would still qualify (opposed to waiting to see if things would turn around in outpatient and just declining to the point where I would need to go to res).
Alas, June 13th arrived, and I returned. Same place, same people, same old shit. So I did PHP, as mentioned in the previous post, for six weeks, stepped down to IOP by the first week of August, and then started school at UH August 19, 2019. Was I grateful to be able to go back to treatment and be given more time than I was used to? Absolutely. 100%. I was grateful AND I wasn't improving. I was wavering around a point of stability while I had the accountability of being in PHP and then starting declining again once in IOP prior to school starting. So right before school started and this downward trend was impossible to ignore, I received a contract to sign from my team that I would have to follow in order to stay in school. The line was drawn. Essentially, I had to maintain my vitals and eat close to 100% of my meal plan (they weren't expecting perfection). If you are a OG reader, you know that the concept of a "contract" is not a foreign one to me. Actually I am more than familiar with it. I have signed several with varying purposes. I don't know if it was the normalcy of such a document or the sheer manipulation of the ED inside my head, but for some reason, I felt as if I was immune to the consequences of not abiding by it. This didn't mean I wasn't aware of the actions or inactions of mine that broke the contract, and knowing that they did definitely made me uneasy. Still, the anxiety never drove me to change. I was mostly just anxious about upsetting people by not following it, not that they would enforce the outcomes they claimed that they would in the contract.
I shouldn't have been so surprised. It shouldn't have caught me so off guard. I realized afterward that it was a session with both my therapist and my dietitian, around the time of the end of my contract period, and I hadn't not upheld the my end of it. So even after this was brought up at the beginning of the session, when my therapist stated that they were recommending residential and especially when she said she has already talked to the place they wanted to send me, for the the first time that I can recall in treatment, I went into "fight" mode instead of "freeze". No, I didn't physically try to fight my therapist- though I did yell, and yeah, I think in that moment it was at her, as opposed to kind of just yelling to yell. Of course, I apologized immediately, not wanting anyone to be angry with me (for being angry with them?), but truth is: I was angry. And I was hurt. I believe part of the reason I put myself in the position I did was to avoid getting hurt or the feeling that I was being abandoned because I was no longer "sick enough" to need support. Yet, here I was feeling both of those things anyway.
How did this rendezvous conclude? It did so by deciding we would discuss the matter further with my parents the following Monday (it was Friday), and what was decided in that rager-of-the-year was that it was gonna be my choice how things proceeded. I could either leave school (which to me also meant losing a scholarship and other emotional repercussions) and go back to residential in Oklahoma, or leave treatment altogether and hope I could find an outpatient team who would see me despite my status in recovery. I could see that for the first time since going to the counseling center at UT a year and half ago, my recovery was fully in my hands. Sure, I mean, technically, it has been the whole time. I could have always left treatment or given up. But now, given my overall low motivation, I really felt like I was capable of making that choice even if it meant going against other's wishes for me. This scared me shitless. I knew all along what choice I was going to make. I knew before there was a choice to make. I had been having some form of invasive thoughts about quitting treatment and hoping for the best (likely planted by the friend in my head), so it felt like the plans my eating disorder had for me were simply coming to fruition, through my doing. I think that's why I didn't want the choice to be mine. I wanted to scream, "THIS ISN"T ME! You can't let me make this choice because its not ME making it!" I wasn't entirely able to articulate the sense of powerlessness I felt over myself.
It wasn't until the day before, "decision day" as I deemed it, where I experienced a small, but significant, moment of clarity regarding this. It was like, for half a second when talking to someone in my support system, the lenses of the ED where taken off and the blurry fog that I had been trudging through became clear. I realized if I made this choice to stay in Houston and leave IOP, I would have to make changes or I was simply delaying an intervention that would happen inevitably. I didn't ignore this realization. I tried to hone in on it as much as I could before it was lost in the blur when the lenses returned. I studied this thought so that I wouldn't need to see it in order to remember what it looked like and how it felt to think it. It felt scary, but also, a little more hopeful than hopeless, which was plenty for me. When the next day came and I made the decision official, I did so not with the intention of dragging on the game I was playing, but maybe looking for loopholes in the rulebook, or maybe just a new angle. Stupid analogy aside: I chose to step out of treatment at CFD amidst my relapse at least aware of what I was getting myself into. With the knowledge that I had to do something, anything, differently than how I was doing it now. This insight allowed me to feel more comfortable and at peace, for I felt I understood, to the best of my ability, the sort of shit I would be diving into head first.
Glo
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