continued changes and transitions

I’m just kind of in this weird transitional funk where life feels like it is slipping through my fingers and the changes are overwhelming and I’m drowning in a sea of uncertainty.

Feeling all the feels, and I don’t typically like feelings. I like numbing feelings instead. But experiencing them is an entirely different experience, one that I’m still learning how to master. 

I’m going to be leaving the agency I started working at a year ago in about six weeks. I already told two clients– I have three more difficult ones (meaning long-term clients who I have very strong rapport with) to break the news to. I hate this. I knew it would be difficult, but I’m struggling to shake off the sinking thought that I am letting people down, that I am just another disappointment in a string of rejection and abandonment. This sadness is different given that the therapeutic relationship is probably the only relationship both client and therapist enter knowing that it will end. It still hurts. Goodbyes are very hard, even on the other side of the couch.

I don’t know where I’m going to be living in the next few months. I have no idea what this new job actually entails (except that it involves at-risk adolescents and involves briefer, more solution-focused as opposed to my more traditional, insight-oriented therapy). I’m stressed about money. I’m stressed that I’m not doing enough. My inadequacies and insecurities keep cropping up, and everyday feels like an emotional swing.

The rock and anchor of all this, of course, is my loving boyfriend, but even that has had its own set of challenges, as we both try and maneuver and develop our own professional paths while simultaneously designing our relationship path. Thankfully, we are on the same page, and we keep each other sane and happy.  He’s doing a lot of great work, and the competitive and controlling side of me that gets jealous (since we are in the same line of work). It makes me question whether I am capable, whether I am doing enough, whether I will succeed or not.

I want to do a million things. I want to write. I want to go into private practice. I want to research. I want to see adolescents. I want to see adults. I want to pioneer new types of therapy. I want to become an expert on certain models. I want to get increased training. I want to work with eating disorder clients. I want to brand myself as a label. I want to make money. I want to get my name out there. I want to help people- above all and through it all, that’s the main one. 

Without the cushion of school to catch me, I now feel immersed in this strange land called adulthood, and even though I’ve been existing in this realm for several years, it has only felt like pseudo reality. There is always the, “I’m a student” excuse to make up for lack of money, full-time work, professional success, etc.

And I’m being impatient with myself. And hard on myself. I recognize this. I’m doing more than anyone I know my age, and I’m one of the only students in my cohort to have landed a job (even though it is part-time and very low-paying) BEFORE even completing my program all the way. I want to be more grateful for all that is GOING WELL, rather than focusing on what I cannot control and what is making me stressed.

It’s easier said than done.

I do feel overwhelmed, and this usually motivates me to go out and fight, but right now, this is making me feel somewhat frozen. I’m not sure what my next step is. Boyfriend keeps telling me to practice acceptance; he is right in saying that things will get better, that I am competent and will kick ass in this work, but acceptance of the journey is key.

I know this. I do know this in my flesh and bones, but it’s still hard. It’s really painful to doubt yourself and worry that the rest of the world is speaking some language you don’t know, that you are on the outside looking in, that you won’t get your chance to shine when you’ve been working so hard for it.

Self-doubt runs deep.

The good news is that I haven’t engaged in my eating disorder. The good news is that I’m talking and expressing and seeking support. Feelings are intense, but they pass. They pass, they pass, they pass. 

 

being THAT person

Dear Bee,

I am now that person.

The one who people frantically call, on a rainy Saturday morning, while I’m still in sweats and typing a literature review, in their perceptions of a crisis.

The one who people cry to and confide in. 

The one who people look to for answers, for fixing, for the solving of problems.

It is hard, being on this pedestal. It is even harder, because I want to be there. I’m that person for a reason. I’m that person because I am good at what I do, because I’m compassionate, because I believe everyone deserves a safe space and a chance to heal. Pain, to some degree, is nonnegotiable and part of the contract of life. We cannot avoid it, although some of us will get more of it than others. I work with people who have faced all levels of pain, whether it has been internal or external. I do not discriminate. It does not matter who is the sickest nor does it matter who has the worst sob story. Pain hurts us all. It is not a competition. 

Most importantly, everyone’s pain is valid. There is no such thing as “fake” pain, because even the pain that we perceive as fake or attention-seeking indicates a PAINFUL problem in it of itself. 

Anyways, being a therapist is a challenging job. Yes, it is entirely rewarding. And no, I can’t picture myself being as fulfilled doing anything else. But, it’s definitely difficult. And it definitely makes me question humanity and how we approach life. It makes me question why we do the things we do and why we make the choices we make. It makes me question fairness and equality, especially when some of the sweetest people seem to face the worst circumstances. It makes me feel grateful, that is, without a doubt, that I can function in this world relatively well and give to others what they cannot give to themselves. In a single session, I can feel so many emotions, ranging from happy to sad to angry to afraid to bored to curious to impressed to worried to insecure. I can be just as emotional as my clients. The difference is, I have to contain it differently. Because, otherwise, I wouldn’t be doing anyone any favors. And therapy isn’t about me. It’s about them. My job is only to facilitate that.

In conclusion, I really care about my clients. Every last one of them. I want them all to prosper. 

We need to talk about how much I trip, spill, and break.

Dear Bee,

Clumsiness is one of my greatest assets. Seriously, one of these days, I need to put it down on my resume. But ever since school started, two weeks ago, my awkward encounters have been worse than usual. To summarize, I’ve gotten a UTI, torn a skirt, spilled stuff all over a shirt, did an applause-worthy trip, chipped a tooth (on a fork. I kid you not), spent two hours messing up an entire software program, burnt myself, and literally forgotten something essential every single one of those days.

I’d like to chalk it up to bad luck, but let’s face it. My multitasking is back in full swing, and although I used to pride myself on the ability to pump out a 5-page essay in one hour while simultaneously listening to music, stalking Facebook, and texting, I know that this type of fanatic energy only increases the anxiety I am trying to deplete. 

I. Need. To. Slow. Down.

Mindfulness, staying present, focusing on one task at a time. Sounds great in theory. Sounds like the advice I’d tell anyone to follow. But in actuality, it’s hard. We run on a 24-hour, round-the-clock treadmill where doing is synonymous with success. Therefore, one must do MORE, MORE, MORE to win. 

And if I need to keep going? Just drink some coffee. 

We’re constantly wired. Buzzes, vibrations, tones…we can distract ourselves with a million different things at any given moment. This isn’t healthy. Not for the mind, body, or soul. And that’s what this recovery journey is all about. Healing the mind, body, and soul. Because they work in tandem. 

We didn’t evolve to engage in simultaneous activity at the same time. In fact, studies show that we decrease our cognition and increase our risks when we do this (texting and driving, anyone? Mindless eating & TV?)

I think a part of my overall recovery needs to focus on just being okay with doing one thing at a time and being comfortable with that. Staying in the task, even if I want to stray away and scroll through my phone or check something online or so on.

Anyways, with that said and done, I’m exhausted. Not much on the eating disorder front. It’s 10pm, and I had two bowls of some generic cereal for dinner. I was too tired to make anything else. Whatever. 

I’m ready to pass out. My schedule is absolutely erratic. I have clients tomorrow and Thursday, and I’m crossing my fingers they all show up. Looks like I have some pornography addiction, Borderline Personality Disorder, couples counseling, and adolescent trauma up ahead. Stoked.

Peace out friends. 

Guess who had her first client today!?! :)

So anyone who reads this (and really, anyone who’s anyone should be reading my alternating sagas of eating disorder recovery, anxiety, graduate school, therapy, nudity, and contemplations on the meaning of life) knows that I’m studying to be a therapist. The past year was foundation work. All classes, consultations, demonstrations, and role-play interventions. A thousand textbook readings and papers. Almost fifty personal psychotherapy sessions. 

WELL…drumroll please…

I had my first client EVER today. Real session. Fifty minutes. One-on-one.

It went so well. OMG. We totally connected, and it was magical and beautiful, and I already have a million ideas spinning in my head for how I want to address her issues, work through them, and develop some strategies for healing. Ah yes. I’m flying. My supervisor and peers were extremely impressed with my compassion and ability to sit with her feelings and provide empathy. Even the obligatory constructive criticism was scarce.

STOKED. Fresh-faced novelty at its finest. 

This is what I’m meant to do GUYYYYYS. I have been on this euphoric high all evening.

It feels so great to be following my passion and, in turn, help others with my knowledge, intuition, and support. I have thousands of clinical hours to complete, another year of graduate school to finish, endless hours of supervision, research, treatment plans, and presentations to create…but MOMENTS like this, SESSIONS like those, and INTERACTION like that make it all worth it. This is my DREAM. This is where I SHINE!

I have a couple more clients that I am meeting for the first time this week, and, as you can probably tell, I’m overjoyed. 

AHHHHHHH ❤

I love me some mother fucking therapy. 

 

annnnnnnd now i’m a therapist

Dear Bee,

I have clients. I have a caseload. Real people with real names and real issues and real diagnoses and real personalities. I already called them all, left messages, and am waiting to schedule our first sessions together. I’ve read their case histories and bios. I know them on paper, but words on paper tell us so little about someone. I need to know those people, see and interact with them, listen to their struggles, grow with them. These people are not just names or diagnoses or presented problems. They are people living lives and have things they want or need to change. 

It’s surreal. People are going to be coming to me, ME, for guidance and facilitation- for remedy and relief. People are going to be coming to me for answers that I may not be able to give and problems I may not be able to fix. 

I’ve done so much work and training and self-discovery for this moment. This is my dream, and it’s coming true. It’s going to be hard, yes. I was able to select some of my clients, and I know a few of them will be challenging and push me beyond my comfort zone, but that is okay. I am a sponge, ready to absorb, learn, and grow. 

I am a little nervous and very excited. I know I cannot change people more than they can change themselves, but I do know I can sit, guide, facilitate, and aid people in their own processes towards self-healing and overall life improvement. I may be young, but I am intuitive, and I am motivated and driven. I love therapy for what it has given me, and I hope to provide others with the same rewarding effects. If I don’t, I can’t take it personally. I can’t save everyone. I’m not perfect. 

My greatest gift in recovery was learning how to be my own best friend and take care of myself. My second greatest gift was learning how to trust the universe and take in the present moment. My third greatest gift will be learning how to teach those skills to others. 

 

Have a stunning Wednesday, and for today, be your own BFF. YOU deserve it! ❤

First day of school and my rushing to the hospital.

Dear Bee,

I was just in Urgent Care for the first time in my life. Deliberating bladder pain. I was screaming, crying, and literally immovable for about two hours. I have a severe urinary tract infection. The pain runs on a spectrum, and although I tend to err on the side of modesty, I imagine mine embodied an outlier of torture. I probably got it from traveling in Europe. I wasn’t able to drink as much water as I normally do and bathrooms weren’t as accessible as they are out here. 

So, I was lying in the hospital bed, as they kept giving me water bottles and trying to get me to pee in a catheter (which is incredibly awkward if you’ve never had one), and I’m just sobbing from the pain and slipping into slight hypochondria (could this be appendicitis, kidney stones, cancer?!?)

Today was my first day of school. I was in my practicum class and the content overwhelmed me. I have mounds of paperwork. I have clients soon. This morning, before class, I went out to breakfast with my mom. We went to the same restaurant, where about a year and a half ago, I sat across from her and admitted that I thought I had an eating disorder. Today, we talked about how much I’ve grown since that emotional morning. I am proud of myself. I am proud of who I was, who I am, and who I will be. I never discredit myself for all the work I’ve done in this journey.

This pain was the worst pain I’ve ever experienced. I’m not naturally a crier. I don’t readily accept help, but today, I did just that. I let people take care of me. I was miserable, yes, but grateful. Grateful, why? Grateful because this could have been much worse. Easily so. It could have been anything. Urinary tract infections are usually characterized by a burning sensation during peeing. My entire body felt paralyzed.

When the doctor came in and said she had my lab results ready, my entire body shook. For a moment, I had no idea what the test answers would reveal. And that petrified me. I’m also grateful because the past few hours reminded me of the importance of being grateful. 

Most of what we stress about never actually materializes, and when it does, we can choose how to handle it. Here’s what matters to me: love and happiness. That’s it. I no longer feel nervous about school or the fact that I’m seeing clients in just a few days or all the laundry and cleaning I still have to do or the upcoming homework that will surely be piling on or my toenails that desperately need to be painted.

During this experience, I didn’t think about my eating disorder once. I didn’t care to. It didn’t cross my mind. I will never undermine the significance of the mental suffering I experienced through working recovery, but I also realize that I am extremely fortunate to be in such good health. And I want to do my best to maintain it. That means continuing with taking care of myself in the best ways I know how. 

I HAVE MY DSM-V!

I HAVE IT NOW!!!!! My adorable brother bought it for me, and it was waiting on my bed when I came home. I’m such a dork and acted like a kid on Christmas morning. It’s just so shiny and beautiful. 

Even though we won’t be using it in school just yet, I’m totally perusing all the new modifications and changes with ridiculous excitement. 

PS: The DSM stands for Diagnostic and Statistical Manual of Mental Disorders (aka, the therapist’s bible). 

PPS: THERE ARE SO MANY EATING DISORDER CHANGES. 

PPS: I THINK THEY ARE ALL POSITIVE AND MUCH NEEDED, and I will post a more detailed and highly unprofessional opinion on them later.

PPPS: I can’t believe how much I freakishly dig this stuff. It’s insane. If I wasn’t in this field, I don’t know what I’d do with my life. 

 

Diagnosing: helpful or harmful?

Dear Bee, 

The other day, I mentioned that eating disorders almost embody personality disorders, in the sense that they typically manifest themselves in a pervasive, chronic, unstable way of living that affects multiple ways of functioning.

Is it any surprise, then, that the correlation of comorbidity between personality disorder and eating disorder diagnoses is so high? 

I have been doing extensive research on Borderline and Histrionic Personality Disorder interventions and treatments for one of my classes. Personality disorders fascinate me, and maybe that is because they still hold some relative taboo. Few people understand them, and most are quick to judge people who may be suffering. In general, any treatment for personality disorders tends to be scarce and success rates tend to be low. These individuals, historically, tend to be difficult to work with. Therapy with them can be a challenge. 

Both these personality disorders share similar criteria to eating disorders: markedly diminished self-esteem, need for attention, intense emotions, seemingly unquenchable desire for validation for reassurance, inaccurate perception of others, impulsive behavior, fear of abandonment and rejection, the likelihood of experiencing early trauma, etc. In fact, I see so much of the bulimic mindset entrenched in Borderline Personality Disorder that it makes me believe BPD is probably misdiagnosed or under-diagnosed. 

In general, I don’t know if I agree with diagnosing beyond insurance and medication purposes. My own therapist and I discussed this last session, and we talk about it frequently in school. I’m nosy, of course, so I’d want to know what’s going on with me. But, is that a good thing? I mean, how do you tell someone that their personality, that the identity that makes them who they are, is abnormal?

Sometimes, we need a name for distress. Sometimes, we recognize a cluster of symptoms and we want that reassurance that other people have experienced the same thing we are. There is comfort in knowing that we are not alone. But, other times, I think diagnosing can be detrimental. For one, the DSM, no matter how many times it is updated or revised, is still subjective. There is tremendous controversy about its flaws and limitations. Many clinicians in private practice who do not use insurance billing avoid using it altogether. For two, diagnosing can instill a self-fulfilling prophecy. People accept this stereotype and label, as their imminent fate. We see this all the time with depression and anxiety. We see it with eating disorders as well. Oh, of course, I did X and Y. It’s because I have Z and people with Z do that. 

Diagnosing can pigeonhole people. Two individuals may both have the same eating disorder, and yet they may look, act, respond to treatment, and recover at completely different speeds. This is why I struggle with treatment plans. We are all individuals: even if we are bonded by the same symptoms, we all have different ways and reasons for coping with them. 

I’m curious to know anyone else’s opinion with diagnosing mental illness, as this helps me with my own research and studies, so please feel free to share your response 🙂 

We suck at educating people about eating disorders.

Dear Bee, 

In one of my classes this summer, we each have to present an evidence-based treatment on a specific disorder. Last night, the presenters for disorders typically diagnosed in childhood and adolescence (eating disorders, ADHD, conduct disorder, etc.) spoke. 

Now, I know that every mental illness has its own pathology. Nothing is black-and-white. Nothing is as straightforward as a treatment goal or intervention. Therapy was never meant to be simple, and if treatment for such disorders was easy, I would probably be out of job.

 I hate to say it, but we are completely undertrained to work with eating disorders. And by we, I am referring to graduate students studying to become therapists. Obviously, most professionals who specialize in this kind of treatment receive some kind of specific training, but it saddens me to know that if any of my classmates happen to receive an individual with an eating disorder as a client, they may have no idea how to handle the situation. Beyond the basic level, and we all know, that eating disorders are multi-facted, complex shitstorms. I’m not saying I know exactly how to treat eating disorders either, and I’m not saying I’m an over-qualified individual (I would have no idea how to do therapy on someone with, say, schizophrenia or antisocial personality disorder at this point in my training, either). But, still, this annoys me. Why? Because eating disorders are prevalent. And they are on the increase. And they are fatal. 

In our training, we tend to talk about the physical symptoms including weight restoration, reduction of harmful disordered behaviors, and normal pattern of eating, with little to no emphasis on the eating disordered mentality. Okay, sometimes, my professors mention challenging cognitive distortions. These evidence-based treatment plans are effective, sure, but not in the cookie-cutter way they are presented. For example, the presentation on Anorexia Nervosa demonstrated the Maudsley Family-Based Therapy, which is proven to be very beneficial for individuals who still live with their parents. Family-Based Therapy exists on the premise that Anorexia Nervosa is a family problem, meaning the eating disorders is simply a tangible manifestation of the dysfunction within the household. I believe that. There is a TON of research that shows how family interactive patterns correlate with eating disorders, and there are several predictors that indicate a child may develop anorexia. However, retraining a parent to force their kid to eat is simply a bandaid on a broken arm. The real healing takes so much longer than just monitoring a dinner meal. 

And while I fully recognize that eating disorders are medical problems, given that Anorexia Nervosa still embodies the most fatal mental illness, the idea of discharging an individual after he or she achieves weight restoration simply terrifies me. It’s not just about weight restoration. At all. In fact, without proper restructuring of the anorectic mindset, without addressing the underlying issues and core beliefs, without retraining self-worth and creating a healthy definition of control, what will happen once that individual is released into the real world? He or she may actually be worse than before treatment. 

This, ladies and gentleman, is why, despite all the research, literature, and professionals, relapse rates remain so incredibly high for eating disorders. I’ve said it once on here, and I’ll say it again: Eating disorders are diseases of the MIND. Not diseases of the body.

I’ll even take a wild leap and say they are extremely similar to a personality disorder, in the sense that they completely skew how an individual approaches him/herself, the world, and others in a pervasive, all-encompassing way. 

Anyway, I guess it’s my job to change the stigmatization and way professionals approach eating disorders. Because, we need good therapists, and unfortunately, there are a lot of bad or misinformed ones out there. At some point in my life, I imagine I will work with this population. I will never undermine an eating disorder as some black-and-white, simple behavioral problem. Because, recovery or not, it isn’t. Ideally, we just need INFORMATION out there. We need to teach kids from a young age. Just as parents are willing to talk about drugs, alcohol, and sex to their children, we need them to be willing to talk about food, body image, and weight. Eating disorders are the good kid’s drug. They slip under the radar. In middle to upper-class Westernized cultures, they are almost “expected.” Skinny is the norm. Dieting is a bonding experience. Not everyone who is skinny or diets develops an eating disorder, but some do, and unlike the many teenagers who experiment with drugs and alcohol, a teenager cannot just easily experiment or turn on and off an eating disorder. Once it’s there, it’s there. 

In other news, things with THE BOY are going exceedingly well. Like more than I ever could have imagined. I saw him last night; we were going to go out, but we just ended up talking about everything in life and cuddling at his place until three in the morning. 

I’m excited and terrified at the same time, but the body cannot distinguish the two sensations, so I’ll just say I’M EXCITED. He’s literally everything I could want in someone at this point, and that amazes me. 🙂 

self-care, dating, and the paper chain project.

Dear Bee,

I love how it’s summer, and I’m drowning in school. I really don’t feel sorry for myself; I knew what I was getting myself into. My life has transformed into this discombobulated chaotic mess of diagnoses (and it’s a lovely thing that the new DSM just came out and I’ll have to learn an ENTIRELY NEW SET of criteria soon. I actually don’t mind in the least. That’s how much I love this ish. No sarcasm.), treatment plans, and the occasional play-doh session. I see my first batch of clients at my traineeship site this September. I have no idea how ready I am, but that’s all part of the experience. For this kind of career, textbooks and role-plays and video demonstrations can only teach you so much…it’s best to just be thrown into the action, make mistakes, observe and shadow, and learn along the way. All I know is, this is what I’m meant to do. No doubt about it. People deserve to be heard. They deserve empathic hearts, giving hands, lending ears, and open minds, and I’M SO READY TO GIVE IT. 

We talk about the importance of regular self-care ALL THE TIME in school. I don’t think I ever recognized how essential it is for ensuring mental stability until this year. And especially until I started recovery. Before that, all those lectures about doing things for myself came in one ear and out the other. Self-care just seemed prissy and selfish. Who has time for that? Isn’t there something productive you could be doing? Now, I realize, I only thought that way because I didn’t think I deserved to indulge myself, and I resented those who could without second thought. 

Self-care is especially necessary in recovery. I am doing what I can to incorporate it into my daily life, be it through sitting outside with a cup of coffee, pouring over the newspaper, taking long baths or hot showers, filling the room with good music, driving around with the windows down, getting cheap massages, walking barefoot in the grass, reading a good book. Self-care doesn’t have to be expensive or time-consuming, but it does have to feel good.

I will have to learn how to separate my professional life from my personal one. I know this will be a challenge in the beginning stages, but I will make a conscious effort to avoid letting the two overlap. That’s how burnout happens, and, unfortunately, it happens frequently. 

In other news, I’m pretty sure I’m ready to date again. Yes, I still have my own shit to sort out, and yes, I need to still keeping working on myself, but it’s summertime and the weather is warming up and all those young hormones are in the air. I just need to have some fun until I fall in love with some European this August on my backpacking adventure. Seriously, I always envisioned that’s how I would find my future husband. Across the world. I keep my dreams convenient. 

But, for right now, I think I just need to find myself a nice dude to chill with. Go hiking. Drink coffee. Get lost in the ocean. Engage in deep, intense, and worldly conversation. I want something in between the let’s get buzzed on cheap vodka, fuck, and then wake up remembering how you came in like three minutes and kept unintentionally biting my lip and the oh, so, when are you looking to settle down, have 2.5 kids, a white picket fence, and drive a soccer-mom van?

 

So, I’m putting myself out there. Keeping my mind open and my legs closed (I mean, until we get to really know each other). Dating feels foreign to me, as I kept myself safe in dysfunctional-but-funcational relationships for several years. Dating also invokes those feelings of skepticism, insecurity, and frustration. But, you know, fear is just an acronym: False Evidence Appearing Real. And that’s exactly what it is.

Besides, I’m a hell of a lady to date. 

Finally, since this is a blog devoted to my eating disorder and I haven’t actually talked about it yet (because obviously, my career plans and dating life are FAR MORE IMPORTANT), I will mention that I stumbled upon this super-cute, awesome, visual representation of recovery. I wish I could give the creator of it credit, but unfortunately, I don’t know who it is (if any of you do know, please notify me!)

PAPER CHAIN PROJECT

– For every day you go without self harming, bingeing, restricting, or purging, add a colourful link to the paper chain
– If you slip, just add a white link to to the chain and carry on the chain without any disruption
– Over time the paper chain will grow in length and you can see your progress, and see that even if you do relapse, the are still days you go without hurting yourself. The colourful links.
– Over time and through your recovery watch the amount of coloured links begin to increase, and the amount of white links begin to decrease.
– If you feel like hurting yourself, look at the paper chain and realise just how far you’ve made it, and realise that if you’ve resisted before you can do it again 🙂

I wish I had started this when I started recovery, but that’s okay. I started it this week. I have six colorful links. Six days back on recovery. Six days I am so very grateful for. 🙂

 

 

Stay lovely<3