tides of December.

It’s been a month since I wrote last, and as usual, much has happened in the past month.

I have another part-time job. This makes three. My boyfriend got the dream full-time job. We have this thing called stability, and that’s weird, because I’m still transitioning from the academic world to the working grind.

I see a lot of clients everyday. It feels like an assembly line of therapy at times, and I’m too new in this field to think that way. But it scares me. Being unable to divvy my full attention to each individual simply because I have so many. Of course, I am still underpaid and overworked. And, of course, mental health is completely underfunded and underrepresented in nearly all sectors of healthcare.

But, I digress.

I know what I do is important, and I know what I do is meaningful. In addition to my children and adolescents, I’m now working with some really difficult clientele right now. The majority of them suffer from chronic pain or traumatic injury. The depression and anxiety is skyrocketed for nearly everyone I see.

I think hopelessness is the hardest symptom of all, and I think that only because I know what it’s like to experience that feeling myself. I know what it’s like to hate hearing anyone else tell you it can be any other way. Because, in your mind, it can only be hopeless. Because, to accept anything other than hopelessness means risking accepting a change you may not like. Hopelessness, in a paradoxical way, feels safer. It is a cushion of certainty, a guarantee that prevents us from the fear of crashing of burning.

The holiday season always arises mixed emotions for me. I am closer to my parents now that I have moved out of their home. Time with them is cherished and appreciated, rather than met with annoyance and angst. Yet, I tend to struggle with body image around this time of year, only because holidays center on food and food and more food.

And, I can use all the positive affirmations and visualizations and deep breathing I want, but there is still the five-hundred pound gorilla in the room that is masquerading as sprinkled cupcakes, and when my attention is on that, it’s hard to focus on anything else.

As I’ve said so many times before, it’s safer to focus on the craziness of the eating disorder rather than the craziness of the unpredictable day-to-day existence we live in. The eating disorder makes sense and it’s in my control. Nothing else is. Nothing else is. Nothing else is.

Nothing is in my control.
Nothing is in your control, either.
And, depending on perspective, that can be petrifying or liberating.

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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.

The “SYSTEM.”

I have issues with most of the standard “theories” relative to eating disorder treatment.

CBT is a decorative bandaid, DBT is hard to find and difficult to buy into, psychoanalysis is too expensive, and group therapy leaves little room for in-depth personal exploration. Family therapy has high efficacy, but typically, it’s geared towards adolescents, and typically, it’s for wealthier and more motivated families.

Oh, that and most non-profit agencies and college campuses REFUSE to treat eating disorders. Which leaves everyone with: private practice.

Which is no small fee.

What’s happening with me is that I’m developing my own.

I’ve been researching. I’ve been writing. I’ve been thinking and talking outside the box. Using my own experience and my own therapy modality to guide me.

Maybe it’ll go somewhere someday. Actually, no. IT WILL GO SOMEWHERE SOMEDAY.

I’m tired of eating disorders being that “lifelong” illness. I’m tired of high relapse rates. I’m tired of the stigmatization, the broken medical model, the in-and-out recovery, the refusal to work eating disordered patients because they are too “high risk,” the utter lack of funding we have for individuals in lower to middle-class income brackets, and, of course, the fallacy that a disorder as complex as these can be solved with a thought record or a positive coping strategy. I’m tired of anorexia being the most fatal illness and the third highest leading cause of death for adolescents. I’m tired of people neglecting bulimia and binge eating as “crisis issues” because it may not be as physically apparent.

We need more. We need so much more.

There is research. Lots and lots of articles and brilliant professors in laboratories researching neurobiology and possible eating disorder treatments. Great. There are clinicians. Lots and lots of clinicians in residential facilities and private practices.

But there is a gap. There is not enough. The theories are weak. The treatment is difficult. The prognoses are poor.

Inspiration struck last week. My diploma arrived yesterday.

Who knows what will happen from here?

But if someone needs to do it, why not me?

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. 

 

the days after the hard days

Dear Bee,

You are one of my oldest friends. You have outlived every job, every romantic relationship, every school. You and I go way back, all the way to around age 11 or 12 or maybe it was 13–the line between “dieting” and “disorder” becomes blurry–but we have quite an evolution together.

So many times, I have tried to let you go. I have spent so much money and time giving into your pleas, and I have spent so much money and time trying to avoid those same pleas. I am lucky in the sense that I do not believe I have lost life; in many ways, I am absolutely in a mental and physical place that is better than I ever could have anticipated. But, I have compromised much of myself and sacrificed much of myself in order to maintain your existence.

My sanity. My flexibility. My intuition. My sense of self. And, most importantly, my self-love.

When I am with you, I lose these.

It’s not abut you versus me. It’s not even about recovery versus disorder. It’s about keeping my priorities in check; it’s about understanding the costs and risks of engaging with you; it’s about making the best decisions I can when I can. It certainly isn’t about perfection. If it was, I would have been out of the running long ago. 

If you weren’t my weakness, something else would be. That is how humanity works. We all have something. We all falter and fall down sometimes. We all feel lost and hopeless. Emotions are a universal flavor. Pain is a jacket everybody has worn. 

That is the price of this invaluable gift called life. You take some pain and suffering and reap some tremendous rewards and benefits. That is the take and give. And it may not be fair and it may not feel good, but there’s not a whole lot I can do about it. I could complain and bitch and moan everyday and never move.

Perpetual “stuckness” was the phrase I used with a client today. What’s that stuckness serving you? Because you wouldn’t be there if it wasn’t helping you somehow? 

Being “stuck” in quasi-recovery? Being “stuck” on the teeter-totter between wellness and sickness? It serves me comfort, familiarity, predictable pain, a cheap and guaranteed outlet for stress, anger, and any other emotion that feels too “overbearing.” But what does it cost?

My sanity. My flexibility. My intuition. My sense of self. And, most importantly, my self-love.

And sometimes, I’m going to choose old behaviors. Because I’m not perfect. Because recovery is fucking hard. Because this eating disorder is cunning, powerful, and baffling, and no matter how hard I try to work at it, there will be days that are harder than others. Because LIFE can be hard.

But being stuck is never random nor useless. Being stuck has a purpose. Being stuck tells you something. 

Find out what that is. 

cha cha changes.

Life, I’m always reminded, is defined by mere moments. By spurts of opportunity and rare offerings that suddenly change the entire course of action.

Things are happening. And they seem to be happening quickly and intensely.

In a few hours, I have a job interview for a counseling position I haphazardly applied to, without thinking much of anything. And they seem to really like me. I’m feeling really confident about it.

On Friday, my old therapist-YES THAT ONE- contacted me. Asking if I would potentially be interested in working for an eating disorder residential facility running groups and providing individual psychotherapy, and could I send her my resume- she’d like to pass it to the CEO? 

That’s obviously a different story, and all the weird transference and feelings about her and this opportunity will be addressed later. 

On Friday, my boyfriend met with a psychologist in private practice who is looking for interns. She loved him (no surprise) and now he is thinking of taking that opportunity. The kicker is that it’s about one and a half hours away. We’d be moving from my cushiony Southern California hometown into the jungle maze that is Los Angeles.

I’ve never moved.

My job opportunities are down here. My internship is down here. My current job that I’m working at (which is just to supply some income) is down here. I’d leave everything I know and start over fresh. This is terrifying; it is also exciting. 

We have the world on our shoulders, and yet, I wasn’t prepared for any of this. 

I love my boyfriend. I love him more than I thought I could possibly love another person, and I always use the phrase that relational health remains strong when the we comes before the me. This is a prime example of this. Figuring out budgeting, figuring out living accommodations, figuring out how to be a grown-up in a professional world I don’t necessarily feel equipped to deal with…

None of this is a rehearsal. None of this is a trial or a practice run. This is real life- this is it. Right here, right now, in this moment…

I have everything I ever wanted- the career I envisioned, a supportive and loving boyfriend, opportunity…

And yet, there is reluctance. And fear. And skepticism and doubt and the activation of those core beliefs, I’m not good enough and I’m not going to make it. 

There is the desire for movement and change and risk with the apprehension that the novelly will somehow destroy what I am preciously holding onto now.

I am a therapist. My job is to push people from their comfort zones, to expand their horizons, and to encourage them to take risks they may have not wanted to take before. That is where the magic and growth lies.

All of this– it’s overwhelming. But I’m going to make it. Because this is where I’m supposed to be and this is what I’m supposed to do.  

Another update.

I never saw my therapist.

After confirming date/time and everything, I get a text a few hours later…
Her: how much can you afford for the session?
Me: Is ___ (rate I ALWAYS paid) still okay?
Her: Really need 70. Rent has gone up quite a bit (as if I care?)
Me: I understand. I just can’t honestly afford anything more. I just need a session. If this is possible for you, I’d appreciate it, but if not, I understand.
Her: Wish I could, but I have to pay $20 for the office hour (TMI. I DON’T CARE)…I’d really love to meet with you. I’m already lowering my fee from _____ an hour. (quotes an insanely high price that she’s NEVER charged anyone as far as I’m concerned)
Me: Okay. Can’t do it. Never mind then.
Her: Sorry 😦

Why did she fucking ask how much I can afford for the session? Why didn’t she just tell me, straight-up, that she had a change in fees, and this was what I needed to pay? Who does this? Unethical therapists who can’t keep boundaries, that’s who does this.

I felt so betrayed. So livid. This all happened on Thursday. Couldn’t even think straight. Take a risk, want to reconcile some unsaid things in therapy, want to process our journey, but no. This happens. And it’s not the money. It’s the PRINCIPLE. I faithfully saw this woman for a year and a half- I was a consistent client and one who she said could always come back. I’m not trying to act like I’m entitled. I recognize that people change rates; I recognize that this is common in my field.

But, I would never do that to a client. Thursday, as a matter of fact, I had a client text me out of the blue…he needed a session. It had been six months since termination. He wanted to talk; I saw him the next day.

She never instilled boundaries before. And people warned me. It’s not normal for therapists to routinely text/call their clients, to self-disclose so much about their lives, to complain about office rates and coworkers, to offer me a job after graduation…none of this is ethical. Now she decides to tighten up? Whatever. I’ll process this–if I ever really do process it–with another professional.

Eating has been off-and-on this week. Job training everyday. Lots of candy and sugary snacks and free lunch and junk food provided. Sitting all day. Boredom eating. Or refraining as hard as I can…only to overeat later. I’ve had mini episodes of overeating three times this week. None escalated into a full binge, but I’m on the black-and-white pathway of “good” eating and “bad” eating. In fact, I want to just “binge it out” right now…like get it out of my system.

That sounds so distorted. It’s fucked up. It’s the reality I’m experiencing.

I don’t know. It’s just been emotionally difficult. And I don’t want to do recovery. I want to turn it off for a bit…and go back later. But I can’t even do that.