IOP: a fate more difficult than residential

By Thursday, I still hadn’t connected with my emotions, broken down, or processed the fact that I am on medical leave with mandatory (if I want to stay out of further treatment and continue school) IOP. I had so much on my mind that I couldn’t handle it. The time came when I was meeting with the new dietitian. I was randomly called out in the middle of AT/process after lunch. Being under the impression that I was able to continue with L made it a surprise, one that I never wanted. I finally broke over the change and lack of control in my life now. It was then that new L (to make things more confusing of course, ha) confirmed what I had already been thinking about, “this is going to be harder than residential.” We talked about how much of an uphill battle I’ll be facing these next few months. I cried from being so completely overwhelmed. This is a harsh reality to face.

This may seem odd to anyone who has never experienced multiple forms of treatment. Residential means being stripped of your freedoms, weeks or months away from home, and a complete overhaul of your behaviors. It certainly is hard to make an abrupt change and carve out the time to do so, however, one that’s just as cushy as it is drastic. You are stuck in this place that has all of the support you could possibly need, 24/7 to be exact. It’s actually pretty difficult NOT to experience at least some growth, even if that may be forced.

IOP is a 180 from residential. In my case, I will got 3 times a week (M, T, R) from noon until 5-5:30. We have 3 groups plus lunch/snack each day, along with weekly individual therapy and dietitian appointments. The entire rest of the week we are solely responsible for following meal plans, avoiding behaviors, and applying all we’ve learned. There is no one to check in on us multiple times a day or monitor our meals. If I didn’t finish a meal in residential I would only get a supplement. On the other hand, not adhering to my meal plan or otherwise slipping backwards now can lead to forced inpatient or residential and medical leave. I have major work to do and much to lose.

I always assumed my time at CFD would be the most challenging thing I have ever done treatment-wise. How could it not? I traveled across the country and gave up school. Adjusting to the new life that is residential was unlike anything else I’ve experienced. As much of a struggle this all was, it really was the best environment for recovery. In no way is recovery ever easy, but the amount of support in residential makes it significantly more attainable and manageable.

I can fully see how different IOP is. The effort to show up for my recovery is substantial. I have just 15 hours a week in treatment with 3 meals and 3 snacks. I need to make every single second count. The work doesn’t stop there. I cannot go home and just return fully to the ED. Motivation is key and if I fail to find it I am looking at IP or residential in the very near future. No one can make me recover now.

Where do I go from here? I could become consumed by fear and hopelessness, knowing of what’s to come. Giving up is absolutely the easiest option; however, it is not the one I choose to make. I am going to fight. I’ve been through years of struggle – times where I never believed I could make it through, but I did. IOP seems impossible right now and this may be my hardest battle yet. Even so, I will hold on to hope for a healthier future.

 

Alice all over again.

Well it feels like I have just woke up
In a world where down is up
And up is a long way from here
In the big wheels where they keep on turning
They don’t slow down they just keep on learning

Well my name’s not Alice but I know how she felt
When her world started turning into something else

Alice by Lisa Mitchell has been one of my all-time favorite songs since the summer of FV round one (so 3 years). It describes how I’ve felt during many transitions, both good and bad. You can read my post from last fall here.

Once again, I am listening to this song at least 5 times a day (10 times writing this post, oops). I have quickly managed to fall back into the pit that is anorexia. It’s so startling. Sometimes I do feel like I woke up and poof full-blown Ed thoughts and behaviors. This isn’t exactly true, but it’s why I relate so much to the lines “well it feels like I have just woke up in a world where down is up and up is a long way from here.”

A multitude of changes have occurred in a relatively short amount of time. I went from doing nearly 100% of my meal plan in the summer to 1/2 of the reduced meal plan. I’m not always having 3 meals per day. Honestly, I know this is a bad sign. My mind is occupied by disordered thinking all of the time. I lie about anything and everything, mainly as a way to keep my parents out of the loop. Slowly, I lose control of my life by handing it over to my eating disorder.

Down the rabbit hole I go once again… but this time, it’s tempting. I know what I’m getting myself into since I’ve been here before. I have dealt with my problems through restriction, exercise, self-hatred, body checking, etc for years. In that way, embracing Ed thoughts feels much more comfortable. In a disordered way I feel at home. Anorexia is home. How messed up is that?

No matter how stuck I feel, I am not a permanent resident, or at least I don’t have to become one. I do have the power to turn around and climb back out. The Ed thoughts are strong, very strong; however, there is the healthy me still there. She is reaching out, seeking more treatment, and fighting every single day.

I am not alone. My treatment team, although all are new, will be here to bring me up. I have the option for more intensive options if I feel unable to handle this on my own. The few amazing supports I have will always be there. I am not alone even though it seems that way.

I have to decide: is it worse/scarier seeing how I’ve slipped into relapse, or is this false comfort and hope anorexia gives me enough to continue this downward spiral?

 

Right now I feel like Alice and I don’t have to accept this new reality when I am able to turn it around and come out of this stronger.

 

I knew this was coming…

I met with S today, most likely for the last time. At first it didn’t seem that way. I was honest about how I’m doing and began a writing assignment. She had me write what has changed, pros/cons of my behaviors now, why I feel it’s happened, and how/if I wanted to change it. I’ll share a little bit of this but not all since it may be triggering and I definitely want to avoid that here.

  • what’s changed: restricting more, lying, fear foods, eating the same few things, increased ED thoughts, isolation. On and on and on.
  • pros: feel better emotionally, I feel more in control, these behaviors will make me like my body more
  • cons: doing worse in school, no energy, hurting my family/friends, where I’m going scares me

While I was working through that, S read my food diaries and meal thought logs. I glanced over a few times and her face killed me. That’s when I knew for sure what would happen but didn’t want to believe it.

I only got through half of my answers before she spoke the dreaded words: “you need more help than I can give you.” Her schedule is basically full up until we leave for winter break. I would probably see her once until the 2nd week of January. As of now, this doesn’t mean IOP, PHP, inpatient, or residential, but I need to see a new therapist. Specifically she is recommending/telling me I need once a week or more.

I tried to argue and make excuses. I still want so badly to get out of it. Of course she doesn’t buy any of the ED’s bullshit though. Basically I had 2 choices: go get the extra help now or be forced to go inpatient within a month (at the rate I’m going). God I didn’t want to hear that. I cried a little as I realized this was what I’ve come to. I’m supposed to be doing better. I know this is chronic and relapse happens but all I wanted is a good semester/year.

Once I left her office I couldn’t hold myself together. She’s been there for over a year. I hate change, especially when it means leaving someone I know works into the unknown of a new therapist. I’m terrified of what lies ahead. Part of me, the very sick part, sees this as proof that I am doing “well” in the eating disorder. It finds a twisted satisfaction.

Part of me wanted to lie to S, tell her I called and got an appointment when I didn’t. Maybe I would just skip therapy altogether. The thing is I have hope. S told me that maybe this is God’s way of providing me with someone who will help me exactly how I need. The real me is holding on to that.

So reluctantly, I called. I’ll be going to the same practice where my old dietitian was. They specialize in eating disorders and offer all types of outpatient treatment. I talked to the director and have an appointment set up with my new therapist, R, on Dec 1st. This is two weeks out and in the meantime I will attend group therapy on Tuesdays. I have fears on both fronts: Will I be the largest one there? What if I hate my new therapist? Will it even help? What if I can’t do this at all?

I am sick. This is something I need if I want any chance of getting back on track before I hit rock bottom. I am too sick to see S anymore. I cannot do this without more help. I am going to be okay, I hope.

Giving Thanks – Nov 3

Today I am thankful for: MY DIETITIAN.

I met with my new dietitian, L, for the second time today. It makes the ED part of me want to run, but that’s the point. She is exactly what I need, what the healthy me needs.

There is so much I can and will share about this experience so far. For now, 3 reasons I already feel blessed beyond measure:

  1. Two parter: she came in today specifically for me and had our session go for and hour and 15 minutes. This is only our second session yet she cares enough to give me the time and scheduling I need.
  2. She is beyond willing to work with where I am. She doesn’t expect change overnight and listens to me fully. The goals we have set are what both of us feel comfortable with. Also, I still get to use my CFD meal plan which is comforting and familiar.
  3. She will push and give new ideas. A good chunk of our meeting today was spent with her asking me the hard questions and digging deeper into why I have been doing poorly. A goal for this week is a technique I haven’t used in almost two years, but I feel like this is a good chance for a second go around.

God put L in my life right now for a reason. I cried out for help and He answered. She is a part of my recovery now and I am already grateful for it.

“How do you have an eating disorder?”

It was my first night inpatient at Forest View. I was more than terrified. I stood nervously in the hallway near the nurses station. Why I was standing there I can no longer remember, although it may have been waiting for the 6th, 7th, 8th, or 9th blanket. Maybe I was afraid of being alone in such a scary place. I don’t honestly know because I was completely stuck in the ED, my mind fogged by all of the restriction from the majority of the past year.

Either way, there I was in the hallway, wishing I was anywhere else. I would have rather been at MCC eating in the cafe, back in high school, at work, or stuck in PHP since I would be able to go home then. I knew I was supposed to be there, I knew I wouldn’t do college if not. I knew that this was a chance to stop behaviors for a week and hopefully head into the school year in a better place. Of course, I was wrong about that. After my encounter that night I was so upset that I considered just signing myself out AMA.

A girl around 20 came up to me in a wheelchair. She had announced why she was in the hospital many, many times: she drank bleach with the intent to commit suicide/self harm as well. I had no reason  to judge her. In fact, I never felt anything but compassion and understanding for any other patients. All of them, myself included, were seeking help for mental illness. We had no right to say someone is worse off, that you are better than them, they seem “happy/just fine”, or that there’s no reason for them to be inpatient. Despite these unspoken rules, she did anyways. It hurt me in more ways than she would ever know.

Right away, she told me why she was at Forest View (only the 10th time I’d heard it) then proceeded to ask me, “why are you here, you seem fine?” This worried me right away. I could have lied, maybe I should have. Instead I admitted that I’m suffering from an eating disorder and that I’ve been very bad this whole summer. This primed her for one of the most hurtful comments I had ever received in regards to my ED: “How do you have an eating disorder?” If that wasn’t enough (trust me, it was), she started telling me I was way too large and compared me to another girl who had a BMI in the low teens, which I know because said girl told me in a bragging way :(. She claimed I shouldn’t be here because I’m not *that* bad. Then, she laughed at me and gave me a terrible look. I walked away because I could barely hold the tears in and found nothing else to say that would make her see I wasn’t just a fraud.

I went straight to my room and cried in the comfort (well, not really but it was better than being out in the common room) of my own bed. I couldn’t stop the thoughts that only multiplied following her words. I tried to muffle the sound as much as I could, but the nurse doing rounds heard me anyways and became somewhat concerned. She asked if I was just scared given it was my first night. I shook my head yes so she sat with me for a minute and gave a little pep talk. After she left I knew I should quiet down. I did, and tried my hardest to push her remarks out of my head.

I would love to say that her words haven’t affected me since that day. She questioned the validity of my illness and assumed I shouldn’t be in treatment. I have always dealt with these fears on my own but she only intensified them. I still struggle with that. When I entered residential I was convinced they would tell me I wasn’t really struggling, that nobody would believe me since I wasn’t emaciated and had no physical changes due to my ED. I waited for someone to not take me seriously. Thankfully, that never happened and I was continually supported by everyone. Her comments have also made me hyper-vigilant when I tell others I have anorexia. My automatic expectation is to have a repeat of what happened that night in inpatient. I imagine them saying I’m too fat, too happy, attention-seeking, etc.

I am working past that 2 minute conversation. The most important thing is to know that I am sick. I cannot mull over everyone’s reactions to determining whether I am or not, because in the end, I do have anorexia.

Next time you see or learn of someone with chronic illness, please treat them with dignity. What’s on the outside doesn’t reflect how they truly feel. Any “how do you have ___” questions do nothing but harm.