A blogger friend and supporter, Tina Klaus (dontlivesmall.com), recently published an extraordinarily courageous and honest post revealing that she would be resuming treatment for her eating disorder—a true challenge for her, because it is not her first round. Following her lead, I’m also writing about my decision to return to treatment. I hope that, like Tina’s post did, it helps to allay the shame many of us feel when we admit to needing help (again).
Pending insurance approval, I plan to begin an intensive outpatient program here in NYC as soon as possible. This particular five-day-per-week IOP program is part of a larger network that was started by a respected eating disorder professional who I admire very much. (Her book actually inspired my decision to seek treatment for the first time last fall.)
Some of my supporters were surprised when I told them the news. I seemed like I’d been doing so well, they said. On the one hand, their surprise comes from a classic misconception. Supporters often assume (usually out of hopefulness) that an ED sufferer must be doing well if she is at a healthy weight and/or is eating what she’s supposed to. Unfortunately, the outside offers no insight into what’s happening beneath the surface.
On the other hand, their surprise wasn’t totally unwarranted. I had been doing well, especially given that I’d only just finished my first course of intense treatment two months earlier. In recent weeks, however, the ED thoughts came back full-force and behaviors were starting to follow. I could sense the atmosphere in my mind becoming noxious. So, after several tearful discussions with my husband, my therapist, and my nutritionist, I decided to find a program.
But let me backtrack a bit. A few weeks ago, I told my therapist that I was spinning my wheels and getting nowhere. Sometimes I handled a food challenge—such as going out with friends for a slice of pizza—fairly well. But the experience would leave me so racked with guilt that I would eat less the following day to compensate. Restricting made me feel better about myself, so I would then reattempt “normal” eating—only to dredge up even more guilt. I was caught in a cycle of lunging at recovery and then drowning in anxiety.
To my surprise, my therapist asked why I felt I even needed to enter into this cycle. “I’ve been in treatment for eight months,” I said. “I should be better at this by now. I should be able to eat a slice of pizza and, even if it bothers me, remind myself there’s nothing wrong with it—that it’s just bread, cheese, sauce, and oil.”
(All you recovery folks are cringing at the “s” word…)
She disagreed. “You’re torturing yourself,” she said. “No one says you have to master pizza yet. If you’re struggling on a given day, then don’t push yourself. Instead of having pizza, have something that feels safer, like a salad—as long as there are all the necessary components (protein, starch, fat, dairy, and so on). Now is not the time to challenge yourself.”
A light bulb went on. I realized that my ardent desire to recover had eclipsed an important truth about the role of a recovery challenge. With the help of eating disorder professionals and/or a supportive community, it’s critical to identity “fear foods” and to gradually reincorporate them back into one’s diet. This will happen as slowly as it needs to happen, but it must happen. Hanging on to labels such as “unhealthy” or “fattening” keeps the door to restriction ajar.
But there’s a caveat to that process. Knowing how to challenge yourself has to be tempered with understanding when to challenge yourself. If you are feeling emotionally secure, or if you’re struggling but have adequate support, then take the plunge and eat that scone you’d banned from the breakfast menu. But if you’re not in a good place—if you’ve had a setback in treatment, or you’ve just received bad news, or you’re simply having a bad day—don’t challenge yourself more than necessary. I’ve found that doing so neither furthers my recovery nor makes me any stronger. Instead, I drain myself of energy and end up associating the challenge food or activity with negative feelings.
Recovery (and life in general) requires us to recognize and respect our limits. We have to be mindful of the line that divides healthy, constructive stress from toxic stress—and know when we are about to cross it. This means saying no to a task we can’t take on right now, or maybe dropping that extra class, or postponing a challenge on our to-conquer list.
For me, right now, this means recognizing that I need to put more supports in place so that I can keep moving forward in recovery. It means knowing that I’m almost ready to take on the challenge of managing recovery alongside work and school—but I’m not ready yet. It means staying patient with myself and respecting where I am in recovery. It feels like a drag; but I know that doing so will allow me, in the long run, to remain focused on all that I want to accomplish. And have a slice of pizza. And enjoy it.
Humor me for just one more paragraph—a memory has been bobbing across my mind as I’ve been writing this. A while back, I used to stop every morning in a coffee shop near my office. While I’d wait in line for my coffee, I would stare at the pastries and breakfast items, my stomach aching with hunger. I used to play a sadistic game with myself by imagining which item I would eat if I could have any one of them. What often caught my craving was a croissant with Brie, fig jam, and walnuts. I’d never wanted to eat something so badly. A few months later, when I began treatment, the croissant became a kind of emblem. I would know I’d reached recovery when I could walk into the coffee shop, order the croissant, and eat it joyfully.
Right now, I’m not ready to eat that croissant. And that’s okay. I’m learning to let recovery happen in its own time by listening to the quiet voice at the core of my being—the voice my eating disorder tried so hard to silence. That’s the voice that will guide me through this ordeal. It will tell me when to accept a challenge and when to take a break. It will let me know when I’m ready for that croissant.
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I'm a writer, a mental health activist, and a 20-something in recovery from an eating disorder. This blog chronicles my journey through the middle ground toward full recovery.
I see myself in your words. Thank you for sharing your experience. You are truly amazing. Peace and love to you on your journey. :))
Thank you Lily
Peace and love to you as well!
My son made me aware of your excellent blog post and I have to thank you for this nuanced and thoughtful approach to challenge foods. And I also appreciate your pointing out something our patients struggle with, both internally and externally: you cannot tell how much a person is struggling from their weight alone. I wish you well in treatment.
Thanks so much for the feedback. And yes, I think the relative non-importance of weight is one of the most difficult things for patients as well as supporters (and insurance companies…) to wrap their heads around. Of course weight is a key part of both the illness and recovery — loss or gain can have serious consequences, and you can’t recover without weight restoration. But there is just so much more to the disorder than the number on the scale. It’s something I still struggle with. And it sure as hell is something my insurance company cannot seem to grasp.
Thank you for reading! I think what all of you are doing at the Kartini Clinic is wonderful.
Peace,
Joanna
Hi Joanna,
Its Tina, thank you for posting this and for your support as I entered treatment back in august. I officially discharged after a 13 week Intensive Outpatient Program at The Eating Disorder Recovery Center of Denver on Friday 10/24/2014. It was a long and arduous journey that challenged me everyday. During that time also decided to shutdown Don’t Live Small as I saw how much I give parts of myself away and I started to feel uncomfortable with having my life splashed all over the internet. I’m still publicly speaking on eating disorders, creating my artwork and now starting a book with my therapist. So thats where my energies will be focused as I re-enter my life again.
Please keep in touch and I’d be happy to do some featured blog posts on Middle Ground if that is something you’d be interested in.
I hope you are well and on the mend. Keep up the good work with your blog!!!! And again thank you for all your support during my stay in treatment.
Tina Klaus xo
Tina! It’s so good to hear from you! Congratulations on finishing the program! That is no easy feat. I’m sure it took a lot of strength and courage to hang in there. I’m proud of you
And of course I can understand why you would want to shut down your blog. It does end up putting all of you out there — and it is quite time consuming. That’s a difficult thing to maintain alongside going through intensive treatment. But I’m glad to hear that you’re still engaged in other ways. You have such wonderful things to share. I hope you get as much out of those experiences as I’m sure your audiences do.
I would LOVE for you to do some featured posts for the blog! 100% yes. I’ll give you free reign over what you would want to write about — just send them along (I believe you have my email right? Just in case –> )
Take care of yourself and please keep in touch.
<3 Joanna
I have a daughter in recovery and would like to be added to your mailing list. Thanks