Hello darlings. I feel very grateful today as I sit down to write my second treatment entry, in no small part because of one person who has always, for reasons unknown, shown me such kindness. If you come here from t-central then you likely know who Calie is, and it’s this wonderful person who I’ve never had the pleasure to meet that continues to root for me. Again and again she (I hope she/her pronouns are correct, I apologize if they aren’t and welcome correction) has highlighted my entries on t-central, and more often than not leaves encouraging comments on those entries. Even as I am filled with doubt that anyone cares to read my words or that anyone supports my writing, Calie continues to surprise. I hadn’t posted in months, and yet, it was my entry that was recently highlighted. It gives me encouragement that maybe my absenteeism from the blogging world doesn’t mean that my writing days are over. So, Calie, thank you for you kindness.
Okay, on to the subject of this entry, my first week in eating disorder and substance abuse day treatment. I’m not sure if I will post weekly entries or more frequent ones, but for the sake of this week I think only one entry is probably needed. Before I get to what happened this week I promised to provide more exposition on what’s been transpiring over the past months, so I’ll begin there.
You might be wondering how I ended up with an eating disorder. The first entry I wrote about my experience with disordered eating can be found here: http://transadvent.blogspot.com/2018/01/1-17-2018-entry-updates-and-story-of-my.html but if you don’t want to read all of that this is the abbreviated version:
Several years ago I came down with the stomach flu to end all stomach flus, and was so sick for so long, that I ended up in the ER in pretty bad shape. Turned out that this flu was exacerbated by one large ulcer and a couple smaller ulcers, likely created from the almost non-stop vomiting that transpired over about 36 hours. I was put on medicine to help with this ulcer and while it did help the ulcer heal, it also made it nearly impossible for me to eat without feeling absurdly ill and ultimately vomiting my food up probably 50% of the time. This went on for a while and I lost a lot of weight until I figured out that it was the medicine that was making me more sick than the ulcer ever had, so I stopped the medicine. Things got better, but my heartburn issues returned and I went on another medicine thinking it would help. It did help the heartburn and for a while things seemed to get better, but not for long. After a couple weeks the same problems started popping up again and I found myself having to choose between being sick because of too much stomach acid or being sick because of the medicine. I stopped the meds, changed my diet to become a vegetarian, and went on weight watchers with my wife. Eventually the diet and the weight loss cured most of my heartburn issues, but it didn’t stop me from feeling sick after eating (because I was eating too much) and vomiting my food up. Another year or so of this went on until it stopped being about feeling sick and more about wanting to avoid adding points for the food I ate. I started to hide it and pretend it wasn’t happening, but despite my secrecy my wife started calling me bulimia queen until eventually she expressed a genuine concern that something was wrong. I knew enough about the DSM-V at this point to know that I definitely met the criteria for Bulimia Nervosa. Weeks later I told my therapist about it and she ultimately suggested that I get help for it. I embraced denial for a long time, thinking I could stop whenever I wanted to. Once I got to that magic weight I’d stop. Once I no longer felt fat or uncomfortable in my body, I’d stop, but I didn’t.
Then I got divorced and both my alcohol consumption and my eating disorder symptoms increased at an alarming rate. Things went spiraling out of control as I struggled with being alone and depressed. The psychiatrist put me on new meds to help me even out and they worked to a point, but with the alcohol consumption it was almost a moot point. I realized the drinking was going to kill me or cause me to lose everything so I sought out support in AA. My alcohol consumption stopped with some relapsing here and there, but the eating disorder didn’t. And then I was raped, and everything fell apart. I could barely eat and when I did I puked it up out of hatred for my body. After a visit to the psych ward I lost my job in a way that brought me a lot of shame, so much shame that I started to starve myself as a form of self-punishment for being so stupid. For a month I barely ate anything. Hunger was a constant feeling and I started to really enjoy the pain of it. I started to lose weight which just reinforced the behavior. Eventually with the help of someone I thought was a friend, I stopped restricting and started eating again, but I never stopped purging. Another year went by with periods of restriction, binging, and purging coming and going like a rollercoaster. I started to work with a girl at my job who had anorexia and it inspired me to pursue treatment. I went for the assessment and they suggested I do day treatment and take a leave of absence from work. I didn’t go back for 6 months, when things became intolerable.
I remember a nightmarish weekend filled with so much self-loathing, restriction, and purging after stepping onto the scale that I realized I couldn’t stop. I wanted to stop, I tried to stop, but it kept happening again and again, despite my efforts to lose weight I gained it instead. My friends could eat food just fine but not me. I had become obsessed with food, with my reflection (which I hated with a burning passion), and with my weight. I knew it was time to go back to the Emily Program. I started seeing a therapist, a dietician, and joined a LGBTQ group therapy. My relationship with food and my body, began to change, little by little, but I still couldn’t break my habits. I couldn’t get a solid grasp on my eating patterns or my urges to restrict or purge. Dating made things worse. Each time things didn’t work out or people would reject me because I was trans, I turned to alcohol… which has been the sad bedfellow to my eating disorder urges for over 3 years now.
So, there you have it, the (not so?) abbreviated version of my eating disorder history that’s led to me beginning day treatment. Now that we have that established I can write about my experiences this past week.
My first day of treatment was on Tuesday when I went in for orientation at 10:30 (treatment usually starts at 8am as an FYI). I met with a new dietician named Alisson (instead of my former Dietician Regina) and we went over some basic introductory stuff. She described how the program worked, gave me my information binder, a schedule for the program, took my weight (blind), and wrote out a basic eating plan. The eating plan is basically a grid that has tallies in different columns for the types of things you are expected to eat at each meal. There are three meals (breakfast, lunch, dinner) and three snacks on the sheet with probably 8 different columns of components. The columns are things like: protein, veg/fruit, fat, milk, grain, and desert. Each meal and snack has a different number of tallies required for any of the columns of ingredients. (don’t worry if it seems confusing, I still don’t really get it myself). Once we’d gone over the basics she told me that it was time to meet the other people in the program.
Now, I suppose I should note that yoga is part of this program, and while I enjoy yoga on my own, my single greatest anxiety about the program was having to do yoga in front of other people. I worried about how I’d look not only because of my weight, but also because I was afraid my anatomy would be more difficult to conceal. The last thing I wanted was for them to go from seeing me as Emma, the girl, to Emma the chick with a dick. XD
Want to guess what the first group I was supposed to attend was? If you guessed yoga then you are correct. I about had a panic attack when she told me we were going down to the yoga class. I basically begged her to let me skip it this time since I wasn’t prepared for it and was feeling very anxious about it. She begrudgingly acquiesced and said that after I was introduced to everyone that I could sit that group out for just that day. My anxiety dropped and I followed her down to the yoga room where I met several people and a very enthusiastic yoga instructor. Me and one other person dipped out of the group when they began the warm up process, and we both went upstairs. I thought this person might be sociable with me but she hardly acknowledged my existence and went a different way.
With nothing to do I sat in the lobby, waiting for lunchtime to arrive. The hour passed quickly enough and before I knew it I was joining my program mates for lunch. This experience would have been anxiety provoking enough on its own, but I had an extra helping of anxiety because I’d eaten breakfast late and was not hungry at all (least of all for the salad they were serving). Tapping into the ever obedient child I was growing up in an authoritarian home, I decided not to say anything about how I wasn’t hungry. I wanted them to know I was taking this seriously, even though I felt deeply conflicted about whether or not I actually needed IDP. So much of my mind was trying to convince me that we didn’t need to be there, that it was a waste of time, and that I wasn’t as sick as my program mates were.
With all of this swirling around in my head I cringed every time the dietician told me to add ingredients to my salad to meet my lunch tallies. Imagine, if you will, a sort of buffet line of salad ingredients with a dietician on the other side carefully and meticulously monitoring what food you had on your plate. By time I was done and my plate of food had passed her approval, I felt nearly sick looking at all the food I was supposed to eat, and yes, I was expected to eat all of it. I sat at the table with all my program mates, the dietician, and the program director and forced myself to eat the food. I hated it, I wanted to quit right there and then. I was an adult and didn’t need them treating me like a child! We were supposed to check in about how we were doing with the meal, what emotions were coming up, and difficulties we were having.
I lied when it was my turn, at least for the most part. I did confess that it was difficult to eat the breadstick because it didn’t taste very good and I wasn’t very hungry. The rest, I left locked away inside. My rebellious hatred of being in such a structured place was quelled by my desire and habit of being “a good little girl.”
The rest of the day was something of a blur. I met with the program director to go over the group norms and for him to ask me some questions. He seemed nice enough and I felt a little more at ease being there. I left that day still unsure of whether I wanted to go back the next day or not.
Wednesday was also something of a wash because I had work obligations that pulled me away from the majority of programming outside of breakfast and lunch. This time the meals went a bit better but I still found myself hating being there and wanting to leave. This got significantly worse after my therapy session where my therapist of 4 months told me she was leaving and I’d be transferred to another therapist. I cried for hours later that night, and even engaged in the new maladaptive coping mechanism of cutting. I didn’t want a new therapist. I didn’t want to start over with another person who knew nothing about my rape or my sexual abuse as a child. I didn’t want to have to talk about those experiences again… it was like having to live through it again. It took me almost 2 months to build trust with that therapist and now I had to do it again? I felt so abandoned, once again. One day everything is wonderful and we are doing really great work together, and the next she’s leaving? I couldn’t blame her for wanting to branch out from eating disorders, but it triggered so many emotions and memories of my divorce. I finally start to trust someone and start to believe they are there for me in a stable way and without warning the rug is pulled out from under my feet.
I didn’t want to go back. I was so over it. I was so ready to say fuck this shit to the entire Emily Program; IDP and outpatient. I wanted to be done, but despite the tears and the blood from my cuts, I knew I had to keep going. I knew where this went if I stopped going. I could see the future so clearly if I chose to give up. I’d break even more than I already have and I’d either drink or starve myself to death, if I didn’t commit suicide first.
Thursday was the first day I was at all 7 hours of programming, and it was a BYO food day. I had barely anything in the house to bring, so I did my best. What I brought more or less passed the dietician inspection and I ate my food with disappointment. It wasn’t enough, and I was left feeling hungry after each meal; which gave me a lot of anxiety. Since my ED has gotten worse feeling hungry or full has become a trigger for anxiety. If I feel full (not even over full) I immediately begin to have urges to purge. It becomes the only thing I can think about, the only thing I can focus on until the feeling either goes away, or I use symptoms (purge). If I feel hungry, I start to feel a very strong pull to keep that feeling and allow it to get worse. The pain of the hunger becomes both a mechanism of control and a mechanism of self-injury. The hungrier I am, the stronger the urges to not eat become. It becomes a battle inside my mind of whether or not to eat. My ED tells me to starve myself for days at a time, and my rational mind has to find a way to not listen to that urge.
On the outside everything seems fine. I talk as if the urges aren’t there, and to the untrained eye I’m probably pretty convincing. The benefit (and annoying part) of IDP is that they are trained eyes and they know that more is going on beneath the surface. They ask prying questions that require me to either lie, which I don’t normally do, or confess things I don’t want to talk about. My “fine” disposition, however, became something of a topic of conversation when a fellow program mate confessed feeling very self-conscious of how they weren’t fine and were actually struggling a lot. I realized then that pretending to be fine in treatment wouldn’t just impact me and my progress, but could impact the progress of others. That’s not to say I’m responsible for their recovery, but that if I’m not authentic and I don’t speak my mind, I’m doing them a disservice.
Friday was definitely the best day yet, if only because I decided that I was going to keep going to IDP, and that maybe if I made a big enough stink about which therapist I wanted, I could work with someone I trusted and felt safe with. More than just that, I started to get to know my program mates, and they started to get to know me (a more authentic me than Tues/Wed). I can’t say we’ve become friends or that we will be friends after treatment, but I think a bond is forming and we are all rooting for each other to get better. Friday was also the day I adhered most efficiently to my meal plan (even at home where no one was there to keep me accountable). I am actually looking forward to going back on Monday and despite how much work I need to catch up on because of this time commitment, I know this will be worth it.
Well, that’s all I have for this entry (I think 3000 words is long enough). I’ll either write another entry next weekend, or I’ll write one sooner during the week. There were a lot of aspects I cut out of this one that I want to address in future entries, so hopefully they won’t get too redundant.
If you have an untreated eating disorder or a close friend/family member of yours has one, please know that there is hope and things can get better. Unfortunately so many of us need to seek out therapy and treatment before that can happen but it does happen. If you or they live in MN, PA, OH, or WA I definitely recommend the Emily Program their website is https://www.emilyprogram.com/ and they have some really great resources for everyone at https://www.emilyprogram.com/resources/links
Otherwise https://www.bulimia.com/topics/bulimia-hotline/ provides information about hotlines you can call for help or support for anorexia or bulimia such as:
Operational Monday–Thursday, 9 a.m.–9 p.m. and Friday, 9 a.m.–5 p.m., volunteers are trained to provide support and connect callers to providers and treatment centers across the country.
An online chat is also available, and there is a text option for crisis situations: text “NEDA” to 741741.