the future of eating disorders

Today was long.

First day seeing clients at a new job. Without revealing too much information, the population is vastly different from the one I’m used to at my other agency. It’s also time-limited, brief therapy, which isn’t exactly my favorite. But it’s kids and adolescents, which I enjoy, especially the junior high kiddos.

I wonder what my life would have been like if I went to therapy when I was younger. My parents don’t really believe in it. They’re more along the lines of “getting over it” and just “thinking about the positive,” which, as a mental health professional, terrifies me. No parent should ever be ashamed of their child needing psychotherapy. It’s like being ashamed of needing to go to the dentist or doctor.

The stigma may be lessening over time, but it’s still there, and it’s still devastating.

Recovery stuff has been good, however I’ve been having trouble sleeping the past few days, which throws me off track. This is the ebb and flow though, and it’s okay.

I’ve been seriously researching this eating disorder recovery work, and I truly think I can make a difference in the systemic approach we have. I have several ideas and am writing extensive literature reviews on the research that already exists.

Most of it frustrates the hell out of me.

For one, I’m tired of overpriced services. For two, I’m tired of high relapse rates. For three, I’m tired of the overall unwillingness to work with a population that DESPERATELY needs help.

I have a vision, and I am set on following it. Maybe it won’t manifest today or this month or this year, but it WILL happen because I know I have the drive, motivation, and creativity to achieve it. I also know how important it is in this society.

It’s something I wish I had when I was deep in the disorder. I want to revolutionize the private practice vs. treatment center recovery plan (which are both extremely expensive), and I want to be able to help re-define a realistic recovery for people who are suffering. I want to be able to reach to those who may NOT be upper-class or even insured. I want to be able to reach to those who cannot afford to do inpatient or residential work. I want to RAISE AWARENESS to this epidemic that is happening in our schools, to our children, in the bathroom stalls, on the plates of people everywhere.

Some would say it’s dangerous because I’m in recovery myself. And I would agree. But you know, it’s worth the risk. Because life isn’t just about helping myself. It’s about using WHAT I’ve learned to help myself to help the greater good. So maybe it’s dangerous, but nothing worthwhile ever happened while staying in a comfort zone. I want to bridge this gap between clinical jargon and actual application. I want to reach out to the bleak and hopeless, the ones who feel they have failed over and over again. I want to change the way we perceive these diagnoses.

And that’s exactly what I intend to do.

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How progress happens

Dear Bee,

Cleaning out my room and car today led to the findings of many wrappers. Evidence of an eating disorder. Evidence of secretive, shameful episodes of bingeing or overeating or private consumption. It saddens and worries me. Am I actually making progress or is it all just a mind-fucking game of two steps forward and three steps back?

Of course I’m making progress. That is undeniable. 

But progress in mental illness is so different than progress in, say, some kind of skill or quantifiable subject. Progress in mental illness is multi-layered and complex. It all depends, I suppose, on conceptualization. Post-modern theories, like those of cognitive-behavioral sciences, use numerical figures to determine success (i.e: engaging in one less behavior each week qualifies as an achievement). Older theories, like psychodynamic and humanistic schools of thought, tend to believe awareness and insight create the pathway to change. Which is better? The concrete approaches that focus on numbers, solutions, and behavioral outcomes? Or the abstract approaches that focus on childhood, family-of-origin, and even current state of being? Of course neither are better and neither are worse. But, the bottom line is, progress is not clear-cut. 

Progress in eating disorder recovery moves forwards, backwards, upside-down, and inside-out. When you think you have it figured out, life throws you a curveball, you’re resorting to behaviors you swore to never do again, and suddenly, you feel back at square one. Maybe at square zero. I thought this was unique to just eating disorders, but I have found that this is characteristic of nearly every “mental illness,” ranging from anxiety to depression to even personality disorders. Similar to the ebb and flow of life, there is an ebb and flow to our mental states and our recoveries and our feelings. A million variables affect this: what’s happening in our current lives, the triggers that range from friends to families to school to our moods…We are vulnerable creatures and resilience is not just the act of being able to be “perfect” at any given moment. You aren’t back at square zero. Everyday, in fact, you’re standing in a new square.

We must honor the process of progress, as non-linear and unconventional as it may be. Every new turn presents us with a new opportunity and with a new chance for healing and recognition of our past lessons and future endeavors. 

There is this old saying that progress moves slowly. I think perhaps we are missing the point. Progress doesn’t move all that slowly; it’s just moving in directions we may not be expecting. 

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! ❤

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. 

 

Striving for normal in an abnormal world

Dear Bee,

I guess it’s already a twice-a-day type of afternoon. Writing you is tough, but it’s necessary, and I know that. I find strength in addressing and confronting you directly, rather than trying to run and hide from you. Because no matter how fast I sprint or how sneaky I think I can be, you always catch up to me. By now, I know that simply “wishing you away” does not work. 

Times like these can be incredibly frustrating. Times like these I want to complain and slink into the dangerous why me? syndrome. And yes, times like these I wonder if it will ever get easier, if I will ever feel “normal” concerning food, eating, exercise, my body.

But normal is overrated, and to be honest, nobody I have ever met has felt “normal.” We all have our quirks and irregularities: these are the characteristics that distinguish us from one another, the traits that create boundaries, personalities, impulses, and attraction. Eating disorder behavior is clinically considered “abnormal,” but I firmly believe it is human nature to carry abnormalities, whether it manifests via our thoughts, feelings, actions, or a combination of the three. 

How boring would it be if we were all perfectly rational and stable all the time?

Humans are the only creatures that have cognitive capabilities to experience and think beyond the primal moment of survival. It is no wonder we have developed mental disorders; once our evolutionary needs are met, we naturally encounter different, higher-level problems.

There is a huge misconception that eating disorders ONLY stem from depression and low self-esteem. While they are undoubtedly correlated, not everyone with eating disorders has these symptoms. During the six months I essentially starved myself, my body did not look  emaciated; likewise, during the height of my frantic binges, my body did not appear outwardly large or grotesque. Not once did I feel “depressed.” Sad, yes. Upset, yes. Utterly hopeless? No. Uncomfortable with my body, yes. Wishing I could change my body, yes. Absolutely hating my body, nope.

My relationship with you was rebellious. Even though, at one point, I met every single criteria for binge eating disorder (which has not yet been classified in the DSM, although it will likely be included in the upcoming DSM-V release), nobody had a single idea. The same occurred when I fell into the throes of anorexia and bulimia, non-purging type. 

You were smart. You kept our relationship secretive.  You kept my weight and body looking “normal.” You made sure I ate “normally” when around others. Not wanting people to raise their eyebrows or ask intrusive questions, you kept me all to yourself. You figured if people knew you were in my life, they would do everything in their power to eliminate you. Your reasoning was correct. Because, yes, once I finally started revealing you to the people I trusted, they banded against you. They convinced me I did not need you, convinced me that I deserved BETTER, and most of all, they convinced me that I was not “abnormal” or “weird” or “broken,” feelings that you had engrained onto my soul for so long.

Nobody really knows how much you influenced my life; I often sugarcoat our relationship, categorizing your power in safe ways I think people will understand and approve. When talking about binges, I cannot be honest in admitting my exact intake, because even I sometimes struggled to believe it myself.

Yes, I still fight with the shame and embarrassment surrounding our relationship and our past history. But, slowly, it is getting easier to talk about. Slowly, I am realizing that I AM NOT ALONE and that there are so many other people, struggling and understanding, growing and learning…and we all need support.

 Asking for that support is the strongest thing we can possibly do.

And, on that note, it is the ONLY thing that has worked in getting over you.