So, it’s raining outside, and life sucks.
How many times have you heard that?
It’s something I could never understand, because, shock of shocks, I love the rain. I am the happiest person ever when it is raining. Like this morning, I was lying in bed I had the most amazingly restful sleep. I didn’t wake up until 5:30, so I was dead to the world, and when I did wake up to roll over, the first sound that greeted my ears was the sound of gentle rainfall. And the biggest smile came over my face.
Then I took a big breath in, and I could smell it. That fresh, clean, spring-type smell that comes along with the rain… gosh I love it! I rolled over, and before going back to sleep for a couple hours, I hoped to myself that it would still be raining when I got up.
AND IT WAS!
Cue my happy dance as I prepped my oatmeal in the kitchen this morning, clad in my favourite sweatshirt (seriously, buy it and you will never be more comfortable in your whole life!), and pyjama shorts, spoon of peanut butter in hand. Then sitting there with this delicious monstrosity:
And a cup of tea, right by the window, listening to it pour down = bliss.
But this bliss was quickly replaced by the most nagging, annoying anger and frustration that I’ve experienced in quite some time. I was finishing the last couple bites of oatmeal, and thinking about what I wanted to do next, and all I could think of was how much I wanted to be outside, soaking up all that glorious rain in a walk to the coffee shop to do some writing. I mean how satisfying would that be:
A day off, that had been preceded by a restful sleep that results in waking up full of energy. Then commenced with a delicious breakfast involving blueberries (the best berry), followed by a walk in spring rain (the second best rain to summer rain- which is so refreshing because it’s so hot!- because it’s not too cold to walk in), breathing in all those smells! Then, THEN, a nice, warm latte in a cozy cafe while I get down to creative expressionism.
Can you beat that?! I think not.
Except… ugh, I have an eating disorder. But not just an eating disorder: an eating disorder with an exercise obsession. And my dietitian set goals in our session yesterday for me to do different types of movement this week instead of walking, so that I break rigidity and don’t get repetitive and obsessive. In theory, all practical, and solid plans… except then it had to go and rain!
Part of this is a me problem. I never learned to ride a bike when I was little. Plus, now I have my license (finally… stop smirking boyfriend), but I don’t yet know how to drive, and even if I did, I would have to drive WITH someone. And the dietitian would totally support me going to the cafe to write, but then I’d have to get a ride… not that easy when the other person in your house sleeps till noon. I don’t want to go at noon. I want to go now. I like to write in the morning.
Plus it’s raining, and my favourite time to to walk is when it’s raining! Now, don’t get me wrong, I’m not in denial here. For once, this is not an eating disordered behavior! I don’t enjoy walking in the rain if it’s pouring so hard it’s bouncing off the streets, or if it’s raining in the middle of fall or winter and the water is actually freezing cold. And I hate being wet… so if it’s going to involve me coming out on the other side looking like a drowned rodent, I’m out. HOWEVER, if it’s above 14ºC, not bouncing off the pavement, smells like fresh heaven, and I have access to flip-flops and an umbrella, GET ME OUTSIDE AND ON THE SIDEWALK! AKA: if it’s like this morning.
So you have the healthy version of me, throwing a hissy fit, because for once, FOR ONCE, it’s me wanting to be on that pavement, not ED, and I’m not feeling motivated by ED in the slightest (something that hasn’t happened in YEARS), and I CAN’T GO! I can’t go, because I’m supposed to be trying out different forms of activity. I can’t go because, once again, my eating disorder is in my way of me being my healthy self.
Cue the Googles:
Note the search term: Ways to get around NOT walking
And what does it come up with? Helping my baby learn to walk, how to walk around the world, and a science article that promotes walking to work.
The Googles be mocking me…
Cue more frustration. I’m in a small town, there’s no bus, no train, ridiculously priced taxis that you’re insane to take, I’m stranded, and the cafe is a measly 20 minutes away. My creative expressions are pushing at the inside of my brain to find an outlet, which is just more annoying, and the longer I sit here, the closer the rain is to ending because I live in a desert and it only ever lasts so long and then I might not see it again for months.
Cue my brilliant idea to do lunges to the cafe. It’s not walking!
Then I remembered the whole point is to find different activities to do that I ACTUALLY enjoy. I hate lunges. I hate lunges more than I hate potatoes, which is saying something. My hatred for lunges and the pain they bring to my crappy genetically-weak knees, is second only to my hatred for burpees and the elliptical, which also hate my knees. It is possible that I hate my knees more than I hate lunges, but I have to live with my crappy knees. I don’t have to live with crappy lunges.
Scratch that idea.
Idea number 2: Skipping to the cafe.
This one was more so amusing than practical. It actually came from my conversation with the dietitian yesterday, who suggested skipping around my yard instead of walking, followed by a weights session. But the impracticality arose from how on earth I was going to manage to skip with a laptop. Cue the idea that someone should invent some sort of laptop transport system that literally straps it to you so it can’t bounce up and down… does this system exist? I’m envisioning something similar to a baby carrier… although I think that if we created that we’d have some ridiculous activist group claiming that it was a comment on how screwed up our society is that we value our computers as much as we value our babies. Kind of like the whole Starbucks red cup epidemic, or the suing of Starbucks over ice in their drinks relative to the price…
Man, Starbucks has had a rough year…
Either way, it would have been interesting. I think people might have thought I was insane skipping up the sidewalk… the things you can get away with when you’re a kid that you definitely cannot when you’re an adult. But then again, I really loved skipping as a kid, so maybe in the future I should just say, screw what everyone else thinks about my skipping and do it anyways. But I have to find this laptop carrier first…
Frustration, anger, and annoyance all reaching a climactic level by this point, now coupled with a sense of urgency. It was after nine, usually the point by which I have already gone, and I was feeling nervous and anxious because I didn’t want to miss the rain and I knew it was only a matter of time. It never rains all day. MAKE A DECISION.
My decision can be summed up in precisely two words:
This is five words… but I was literally referring to the first two. It was those two that I literally said to myself in that instant as I pushed myself off the chair by the window, slammed by laptop closed, and grabbed my book bag.
Now, of course, while I was walking I had a plethora of time to think. Being the perfectionist, and non-rule-breaking-type that I am, this can backfire on me, resulting in over analysis, guilt, and anxiety. It’s the same sort of thing that happens when I’m at work and I don’t wipe down the cupboard doors (a relatively minor thing) because I don’t have time to do them. It’s on the closing checklist, so if I don’t do it a cornucopia of negative self talk comes up: lazy, not trying hard enough, don’t work hard enough, slacker, etc etc. Followed by the catastrophizing (what are they going to think of me? Will they think I take my job for granted? Will they think I don’t care? Will they fire me? Will they cut my hours?)… Needless to say the emphasis of this scenario is exactly this: I don’t have time. So realistically, there are many other things that it is MORE IMPORTANT to get done for closing, such as stocking, cleaning windows, etc etc, and if wiping cupboard doors doesn’t get done one day it IS NOT the end of the world, and honestly, if it’s not smattered with stuff it would probably go unnoticed. But it’s me; chances are, I’m more likely to stay late on my own time to wipe the cupboards than to miss it for one night.
Same thing goes on here: the rule and assignment was to find alternative ways of movement so that I’m not rigid and ruled with walking and thus redeveloping old obsessive habits. Here I am, walking to the cafe, when I’m not supposed to, even though it is me NOT ED that is wanting to do it. This key emphasis is important, but like the cupboards it is considered irrelevant in my mind. The negative self talk begins as early as the point when I step outside the door: irresponsible, cheating, guilty, unimaginative, stubborn to a fault…
Followed by the catastrophizing: What is the dietitian going to think? Is she going to be mad (or worse, disappointed) in me for disobeying the rules? Is she going to take some activity away (again!-this is an on and off thing, as I push limits too far or let the ED take over)? AND MORE IMPORTANTLY: Am I just fooling myself? Do I only think that it’s me that wants this, but in reality it’s all ED? Am I jeopardizing my own recovery process by doing this? I’m walking a fine line, and is it possible I’m letting it go too much? Is this the beginning of the end again? I just started to let go of some of the exercise obsession, did I just ruin all I’ve achieved and put myself 10 steps back?
Let’s be honest: These are all good questions. Well, actually I take it back… they’re good questions if they’re relevant and possible. They’re not so good if they make you feel unjustifiably guilty and ashamed of yourself, or create more useless anxiety. It’s good, especially in recovery, to think about your reasoning and motives for doing things, and the possible complications that can arise from making a particular decision. In a sense, this is mindfulness in practice: actually being in the moment enough to think about what you’re doing in that moment, rather than mindlessly jumping into something without a second thought. It is this differentiation that can save you from engaging in disordered behaviour without even realizing this is happening. It’s your opportunity to interrupt the cycle of thought-emotion-behaviour, and choose what to do.
It’s a good thing.
Where it becomes mindless, is when you’re overanalyzing it. When you step too far away from the present, and it becomes a cascade of what-if’s resulting in your ultimate destruction and the realization of the worst possible scenario.
So you have me, walking up the street, and then eventually sitting at the cafe, feeling glorious: liberated, fulfilled, satisfied, happy, and completely anger and frustration dissipated… but now shadowed by this nagging guilt and uncertainty of myself and the ramifications of my decisions. Did I make the “right” choice?
How do we know when it’s “okay” to break the rules?
How do we know whether we’ve made the “right” decision?
Is it ever okay to go against the advice of seasoned professionals, especially in an eating disorder recovery sense, and change the plans?
Did you notice the resounding theme in all these questions? Let’s examine again:
Okay. Right. Wrong. Black. White.
Do you see the pattern? In therapy, a universal practice in the management of anxiety, depression, addiction, and the like, is using knowledge of cognitive distortions to recognize and interrupt toxic thinking patterns. I’ve mentioned some of these in previous posts, and a few in this one (catastrophizing and overgeneralization, labelling, as well as filtering [I did one thing, and therefore it ruined everything], plus mind reading [she will think/do x]), and now to all be lumped together resulting in one of the patriarchal distortions: all-or-nothing/black-and-white thinking.
Once again, even in the pursuit of recovery, we become wrapped up in the idea of good vs bad, right vs wrong, success vs failure. We try so hard to achieve a “perfect” recovery, or if not “perfect” at least striving to always be in pursuit of recovery, that we don’t even realize that we’re putting the same limitations and boundaries on ourselves that got ourselves into this mess in the first place.
It’s something I, as well as many others, come up against on a daily basis. We become hyper-vigilant, and we transfer our food related anxieties to other aspects, just as when the other aspects of our life became too difficult to handle we transferred the anxiety to food. I remember when I was in the hospital, the doctor had me hooked up to a heart monitor constantly because they were so terrified that my heart that was going down to 20 something beats per minute in my sleep, and 30-40 something when I was awake, was just going to give up. One day I had a scare.
I woke up early in the morning, and went to the bathroom to pee before my weigh in. I had just sat down on the toilet when suddenly a frantic beating on the door was heard. It was the head nurse, her voice in a panic, calling my name.
“Tiffany! What are you doing?”
“I’m… peeing?” I answered, uncomfortable and bewildered.
“Peeing? That’s it?”
“Yes… would you like me to unlock the door so you can see?”
I guess the calmness of my voice, as well as my bewilderment was enough to convince her, and she told me to just finish and get back to bed. I finished, opened the door, and she watched me walk back and climb in, at which point she grabbed my wrist checking my pulse. Worry was evident on her face, but after hanging on for some time, she seemed to calm, and reminded me to stay in bed before she left again.
It was only days after the fact that I found out my heart rate upon standing had skyrocketed to 180 beats per minute, AKA danger zone, and TOTALLY NOT NORMAL for someone just standing up at a toilet. The minute I laid back down in bed it climbed down to a low 50-ish.
Later that afternoon, I was playing a dice game with a friend that came to visit when suddenly a nurse popped her head in the room and told my friend in a worried voice she had to leave. The panic in her voice was enough to get me scared. What was happening? Why was she making her leave? What was going on?
Not even two minutes later, people were rushing in with a portable ECG machine, and I was suddenly surrounded by people stripping off my clothes and poking me with electrodes. They were quick moving, serious, and answered none of my questions when I asked what was going on. They just told me to lay still, relax, and keep quiet. “Breathe, they said, “Slowly, calmly, in and out. Relax.”
Now I don’t know about you, but I found it incredibly difficult to relax in this scenario!
And without more than the reminder to lay still, keep calm, and DON’T get out of bed, they ran off. And I was left, alone, terrified, unsure what was going on, struggling to breathe because my panic had escalated to a point of terror, in a hospital bed. At least half an hour passed, and I remember calling my mom on my phone, sobbing, begging her to come up, telling her I was so scared, that I didn’t know what was going on, and that I thought I was dying or something.
It was only after my mom made the half hour drive to the hospital and badgered the nurses for a solid twenty minutes that someone finally told us what was going on. The heart monitor was showing irregular beats at 216 BPM, and they were scared my heart was stopping and I was having a heart attack, so they had to do an ECG. Turned out that the machine was glitching, which apparently was common, because the ECG came back totally fine. They just forgot to come and tell me that everything was good.
Thank you for leaving me alone in a bed panicking for two hours.
Moral of this story: As a result of this day, this episode, I have since developed horrible white coat syndrome. I PANIC when someone has to take my pulse. Blood pressure, fine, needles, fine, sew up my gaping hole I made when I sliced my hand at work, totally fine. But you try to take those two fingers and press them to my wrist or throat… NOT OKAY! PANIC. TERROR. Fear that they’re going to find 180, or 216 again, and we’ll have a repeat, except this time it won’t be a false alarm. It has taken years, literally years, to get a little better. I don’t turn into a complete basket case. But I still freak out.
Anyways, the day after that episode, the heart rate monitor that had caused me so much torment, the thing I’d been begging to get taken off for weeks because I was allergic to the tape and it was giving me the most painful welts, became my best friend. His name was Herbie, and I was chained to him. I was so scared I was going to have a heart attack and die, that I wanted to keep it on forever, so someone could always be monitoring me. So I wouldn’t die without anyone realizing I was going before it was too late. A few days before I was transferred to a bigger specialized center in Vancouver, my doctor wanted to remove the monitor. He was convinced I was now eating enough and had passed the risk point for refeeding syndrome and that my heart would no longer stop.
Side note: A wikipedia definition for those of you who don’t know about refeeding:
Refeeding syndrome is a syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished…Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications…
Refeeding increases the basal metabolic rate. Intracellular movement of electrolytes occurs along with a fall in the serum electrolytes, including calcium and magnesium. Levels of serum glucose may rise and the B1 vitamin thiamine may fall. Cardiac arrhythmias are the most common cause of death from refeeding syndrome, with other significant risks including confusion, coma and convulsions and cardiac failure.
This syndrome can occur at the beginning of treatment for anorexia nervosa when patients have an increase in calorie intake and can be lethal. The shifting of electrolytes and fluid balance increases cardiac workload and heart rate. This can lead to acute heart failure. Oxygen consumption is also decreased which strains the respiratory system and can make weaning from ventilation more difficult.
And I freaked out! I begged and pleaded with him to leave it on. My anxiety over it being gone when he insisted that it be removed was so high I compulsively checked my pulse almost every minute for almost a whole year, and they had to medicate me with benzodiazepines. And then I was left on them, became addicted, and then had to eventually wean off of them and go through med withdrawals. But that’s another story.
“There’s a reason why it has to come off,” he said to me while I was shaking and begging in my bed, “You don’t need it any more. This is a transference. You are transferring your anxiety about food, which you can no longer control, to something else. You have to cope with your anxiety, not just move it around.”
And (tada, roundabout point! I bet you were wondering where I was going with this!), this less lethal, but anxiety and guilt provoking situation is the same thing. In the pursuit of recovery, we become just as hyper-vigilant of doing the “right” thing, as I was with monitoring my heart rate, or as we all were when we were vigilantly monitoring /restricting our caloric intake. We still feel the need to be perfect, so we try to have a perfect recovery. We over-analyze things, and apply black and white thinking to our recovery mindset too.
I made the choice this morning to ignore the plan, set by a professional, and do an activity that for me has in the past been a known ED behaviour. Does this mean I did the “wrong” thing?
I don’t think so.
How do we know we did the “right” thing?
First, acknowledge/admit that there is the vast possibility that there is no such thing as a “right” or “wrong” choice. You didn’t do the “right” thing, anymore than you did the “wrong” thing. Recovery, just like the rest of life, is not black and white. In therapy we are taught to stop thinking in ultimatums. The same thing applies to this process.
Second, is it “okay” to go against the advice of a professional?
Of course. It’s your life. Your life, your rules. HOWEVER, this comes at a cost. I would say you can ONLY go against the advice of a professional if you are solid in your frame of mind and are completely aware of what your motivations and reasonings are for making a different choice. Stop making rules for yourself. You don’t have rules about brownies or burgers anymore, so stop telling yourself you need to make rules about everything. Everything we are told in recovery is a CHOICE. No one can force you to do anything. But you need to be aware of the choices you’re making, and you have to be just as aware of where they’re coming from, as you are of where they’re going to lead you as a result of making it.
There is a point in recovery where you are not aware of where your motives are coming from. You’re not yet at the point where you can separate that ED voice from your own. AND sometimes even those who usually can separate it, can’t. You need to be honest with yourself there. If you can differentiate, you can choose. If you can’t differentiate, it’s probably a better idea to stick to the plan.
For me, I knew this morning that it was me, and I was 100% sure of it. I made a choice, and it was one based on a message that my body was sending me from my HEALTHY SELF. This was even more evident to me when it was over, because I felt HAPPY, LIBERATED, and STRONG. Not guilty, conniving, anxious, or ashamed.
Did I question it? Of course. Did that questioning result in anxiety and second guessing? Yes. And this is where we need to draw the line. No ruminating. You made a choice, stick to it. Don’t rehash it if it doesn’t need to be rehashed. Chances are, what you’re rehashing is distorted.
What will they think?
Why does it matter? Screw it, let’s do it.
If you were solid in your decision making, there’s nothing to question.
Screw it, let’s do it.
Will it appease the ED? Maybe. But that’s not black and white either. Just because the eating disorder is happy, doesn’t necessarily mean it was the wrong choice. It just means that you have to be extra (but not hyper) vigilant in the decisions you make in the near future, because chances are ED will try to needle its way in because it’s active. You have to be able to once again analyze your motives before you make future choices.
Jenni Schaefer writes in her book Life Without ED that we have three selves: ED, anti-ED (always rebelling against ED), and our intelligent self. You could also look at this as black, white, and grey. Sometimes you got extremes, but almost always it’s some kind of mix (AKA, your intelligent self). Chances are a choice you make will have a ramification, and often times that choice will impact ED, but the more choices you make, and just because that happens doesn’t mean it’s wrong. We don’t want ED, and we don’t ALWAYS want anti-ED, sometimes we need the grey.
So if you find yourself questioning, if you need to make a decision, if you’re finding yourself frustrated, unsure, and trapped, sometimes you need to take a step out of the box. And sometimes, that step is unconventional. Sometimes, that choice breaks the “rules”, and sometimes it doesn’t. You do you.
And when it all comes down to it, sometimes you just gotta say:
“Screw it. Let’s do it.”