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Archive for the ‘Restriction’ Category

One semester done, with many lessons learned (I hope) and implemented (even more hope).

Every student finds the first semester tough, away from home, new situations, routines, culture and environment. Not to mention a huge workload with conflicting assessment deadlines. It’s normal to feel overwhelmed and displaced.

Which is what I have been telling Sophie. It’s not her anorexia past that makes her feel all this, but it’s a normal thing, that everyone feels. It’s important to make sure she remembers she is NORMAL not the weird one. The important difference between her and others though, is her vulnerability. If she skips meals, gets depressed etc with the whole new uni life, she is more likely to fall into old restrictive habits.

Soph flatly refused to find a counsellor. She figured that after almost 5 years of full-on therapy it was time for a break. Whilst I understand the desire and the real need for that freedom and normality, in a totally new environment it wasn’t the time to do so.

She did get a doctor, did keep taking her medication, did get a good routine and did learn to care for herself. But in the depths of depression and being overwhelmed she needed a counsellor who could understand where she has been and how to help her through the bad times. There have been several bad times with the worst lasting a few weeks. It was only then she finally gave into getting a counsellor and realising just how good it was to talk to someone. Much better than dumping everything on her mum (who can’t really help).

It took a phone talk to her counsellor up here and several to me, to get her to turn this around. To take small steps and not look at the whole overwhelming big picture.

She also (FINALLY) talked to the uni and got extensions for two assignments and has a meeting with the disability unit to get her ongoing help.

From wanting to flee the whole situation (another escape plan), I think she has turned it all around and realised with the right help around her, she can cope much better than she was.

She is home in a couple of week for a while. Time to rest and get her mind around next semester. Time for me to check her weight (down) and make sure she is eating right. She also has appts with both the counsellor and psychiatrist whilst home as well.

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You can have all the help, support, treatment and therapists but the bottom line about recovery, relapse and healing is this:

To beat anorexia you have to eat

This isn’t the “just eat” type of comment. It is the deep, caring, understanding statement that in the end says “the only way to fully fight back is to eat”.

It means fighting against the voice of anorexia and the deep fears it has created in you – the food rules, the list of forbidden foods, the safe foods, the fat fears, skinny is best rules.

Eating is a normal activity. It is an essential activity for life and health. The mind and body need to be fully nourished for us to perform at our best. Eating is meant to be flexible, intuitive, fun, enjoyable, social, delicious.

Sticking close to the safe food list not only slows or stalls recovery, but it tells the anorexia that it is still in control and winning. Having a strict routine of counting calories, weighing food, using certain bowls and utensils, eating slowly, missing meals is also telling the anorexia it is still in control.

To beat anorexia you have to eat. You have to break down the rules and fears.

The rules and fears aren’t real. I think this is the hardest thing to realise. That other people do not have these rules and fears in their heads. It is the anorexia and only the anorexia that is making up these rules and fears. It distorts your thinking and your perception. It creates denial, smoke screens, irrationality and lies.

The biggest freedoms from anorexia are literally not having the rules, routines, fears and bondage that you live with on a daily basis.

Beginning to eat again is not an easy process. I truly know how hard it is. Sophie had so many rules and fears. It took months and in some cases years for her to confront the fear for each and every food. The fears are not a blanket approach – each food on the forbidden list had it’s own fears. For someone who only had 6 safe foods, Sophie’s forbidden list was formidable. For her it was a matter of finally deciding to choose recovery and be committed to it. It meant facing one new food at a time. Some foods were easier than others. But it did get easier over time. As the anorexia lessened it’s hold, Sophie found trying new foods and adding them to her diet was not as hard. Telling herself constantly that the fears and rules were all false also helped. It’s like reprogramming your mind.

Forever etched in my mind is her look of delight and amazement when trying a strawberry for the first time in years.
It was a truly magical and amazing moment.

Whilst you are confronting the anorexia and learning to eat again, this is where the therapy and support come in. Help to encourage you and let you know you are not having to face this alone. Treatment to help you unravel the hold the anorexia has on your mind. Meal plans to help you learn to eat again.

Do you want to beat anorexia? Claim back you life? Finally have freedom?
Eating = healing

eating = healing

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To all the doctors, dietitians, medical professionals, and parents

Imagine you are in a dark, scary place. Your mind is playing tricks on you so you don’t know what is real and what is not. You have lost what truth means or write your own truth. You are terribly insecure, sad, and have no hope. You know you are sliding into a deep hole but are powerless to stop it. You hate yourself and feel so weird around others you isolate yourself. Your emotions and life are just numb and you prefer to just ‘disappear’. It would be better to hide. You have obsessions that you can’t control, that just take over your body and mind. It is like being on a treadmill that you can’t stop, but gets faster and faster. Until you are out of control and desperately want help, but are terrified to ask for it. Giving up on life completely seems a better option.

Would you like to live like this everyday for months or years?

This is the basis of what it is to live with an eating disorder. It is a mental health illness that needs treatment not ignorance.

How much educational awareness, media coverage, research etc will it take for you to realise eating disorders are serious. Or worse, they actually exist and will not go away just because you don’t want to understand or treat the disorder.

How many sufferers are condemned to getting sicker because you don’t believe they have an eating disorder or are not critical enough? Your brush off and lack of care or support silences the voice of the sufferer. Imagine having finally reached out to someone because you are desperate for help only to be told you don’t rate enough to get help.

Where do you get the idea that ‘just eat’ will work or ‘I know you can eat so get over this’. Why would you use medication to increase the appetite when you aren’t treating the mind or emotions? Who decides who is critical enough to warrant the attention of a psychologist or psychiatrist? Who decides that an eating disorder has ‘levels’ of diagnosis? Cancer is cancer not almost cancer. An eating disorder is the same and demands the same instant attention and treatment.

EATING DISORDERS ARE NOT ATTENTION SEEKING BEHAVIOUR

EATING DISORDERS ARE NOT A MINOR ILLNESS THAT YOU GIVE A BANDAID FOR

EATING DISORDERS ARE NOT A FOOD OR WEIGHT PROBLEM

EATING DISORDERS ARE NOT THE LATEST SOCIAL CRAZE AND MUST HAVE

There is no excuse apart from ignorance to treat people with an eating disorder as unimportant or stupid. Information is widely available including research. No one wants their loved one to have an eating disorder, but to bury your head in the sand and pretend it doesn’t exist will only make the eating disorder worse. It will get a stronger grip and you will end up with someone who is very sick. Early intervention and treatment is the key and so much research and statistics prove this point. And follow up support after treatment is also essential. You just don’t drop and run.

When you are an adult sufferer you can at least keep pursuing the challenge to find appropriate support/medical professionals to help you recover. It is a challenge that should NOT be there. Public health systems, medical insurers make the task of finding appropriate help a nightmare. Any other illness is a straight forward approach, but eating disorders still have not made even made it to basic level.

For those under adult age and are reliant on a parent getting them help they need it is heartbreaking. Not having a parent who understands or wants to take the time to learn what an eating disorder is only adds to the strength of the illness and the entrenchment of the illness. It won’t go away conveniently for you and yes it will cost money and time. Ignoring the illness and your child adds guilt, shame and denial of self to your child. They don’t need that – it just feeds the illness. I will be the first to put my hand up and say the journey over the last 4 years has been hell at times. But it has been worth it to see my daughter now.

I know I have vented before, and have said a lot of this before too. But I get sooooooo frustrated and angry when I get emails with desperate cries of help because families and the medical establishment remain blissfully ignorant.

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define normalAs the mother of two high functioning asperger children, I found the diagnosis of ‘normal’ for children so narrow and so unforgiving. Many mothers have found this across the board in many areas. The diagnosis of what is normal shrinks and it appears that most of us sit on the outside of ‘normal’.

Eating disorders is another area that normal gets confused. It is actually easier to say what IS NOT normal. The reason for this is that many industries tell us that it is normal to be thin, normal to exist on so many calories, normal to diet, normal to be underweight. The eating disorder itself distorts true normal anyway. Denial or rewriting normal is what the eating disorder will do – it skews your whole perception of normal.

I thought that instead of listing what is normal behaviour I would make a clear list of what is not normal. Stop the denial, stop the perverting of truth so you can start to hopefully see just how the eating disorder is controlling you.

IT.IS.NOT.NORMAL –

  • to exist on 1200 or less calories a day
  • to have a food/weight diary that is minute in detail that you are obsessed about filling in (a recovery food diary is different to this)
  • to have rules about food
  • to have strict routines, utensils or plates to eat food
  • to want to isolate yourself when it is meal time
  • to weight yourself every day (or more)
  • to feel guilty if you don’t exercise to the extreme each day
  • to feel guilty  (or worse) if you ate food
  • to have a list of good and bad foods
  • to have fears of certain foods
  • to feel fat, worthless, ugly, useless, stupid if you eat
  • to have a very real fear of weight gain
  • to feel depressed or worthless to the point of wanting to disappear
  • to think the only way to happiness is to be thin
  • to think that your thighs shouldn’t touch
  • to think your ribs (hips or collarbones) should clearly show through your skin
  • to restrict liquids (this is so dangerous – seriously)
  • to suddenly be vegetarian, lactose/gluten intolerant, vegan when there is no diagnosis or life commitment
  • to be cold all the time
  • to be in pain, weak, tired, dizzy or have heart palpitations
  • to think recovery means you are eating a tiny amount of  food not starving completely
  • to be addicted or obsessed with any kind of behaviour that consumes you all the time
  • to be intensely black and white (or rigid) in your thinking and approach to all areas of life (including food)

Got more…. Send them to me. I know the list can be added to.

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In eating disorder recovery either your psychologist and/or dietitian will introduce you to the concept of intuitive eating. It is an essential part of relearning how to eat – so that flexible, varied, normal eating patterns can be re-established. Below is one of the best information I have found on intuitive eating (http://www.intuitiveeating.org/content/what-intuitive-eating)

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Intuitive eating is an approach that teaches you how to create a healthy relationship with your food, mind, and body–where you ultimately become the expert of your own body.   You learn how to distinguish between physical and emotional feelings, and gain a sense of body wisdom.   It’s also a process of making peace with food—so that you no longer have constant “food worry” thoughts.  It’s knowing that your health and your worth as a person do not change, because you ate a food that you had labeled as “bad” or “fattening”.

The underlying premise of Intuitive Eating is that you will learn to respond to your inner body cues, because you were born with all the wisdom you need for eating intuitively. On the surface, this may sound simplistic, but it is rather complex.  This inner wisdom is often clouded by years of dieting and food myths that abound in the culture.  For example, “Eat when you’re hungry and stop when you’re full” may sound like basic common sense, but when you have a history of chronic dieting or of following rigid “healthy” rules about eating, it can be quite difficult. To be able to ultimately return to your inborn Intuitive Eater, a number of things need to be in place—most importantly, the ability to trust yourself!  Here is a summary of the 10 principles of Intuitive Eating, from our book, Intuitive Eating, 2nd ed, 2003. With these principles, comes a world of satisfying eating and a sense of freedom that can be exhilarating!

Intuitive Eating Principles

  1. Reject the Diet Mentality. Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily, and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight. If you allow even one small hope to linger that a new and better diet might be lurking around the corner, it will prevent you from being free to rediscover Intuitive Eating.
  2. Honor Your Hunger. Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honor this first biological signal sets the stage for re-building trust with yourself and food.
  3. Make Peace with Food. Call a truce, stop the food fight! Give yourself unconditional permission to eat. If you tell yourself that you can’t or shouldn’t have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing When you finally “give-in” to your forbidden food, eating will be experienced with such intensity, it usually results in Last Supper overeating, and overwhelming guilt.
  4. Challenge the Food Police. Scream a loud “NO” to thoughts in your head that declare you’re “good” for eating under 1000 calories or “bad” because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created . The police station is housed deep in your psyche, and its loud speaker shouts negative barbs, hopeless phrases, and guilt-provoking indictments. Chasing the Food Police away is a critical step in returning to Intuitive Eating.
  5. Respect Your Fullness. Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you’re comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?
  6. Discover the Satisfaction Factor. The Japanese have the wisdom to promote pleasure as one of their goals of healthy living In our fury to be thin and healthy, we often overlook one of the most basic gifts of existence–the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes much less food to decide you’ve had “enough”.
  7. Honor Your Feelings Without Using Food. Find ways to comfort , nurture, distract, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you into a food hangover. But food won’t solve the problem. If anything, eating for an emotional hunger will only make you feel worse in the long run. You’ll ultimately have to deal with the source of the emotion, as well as the discomfort of overeating.
  8. Respect Your Body. Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are. It’s hard to reject the diet mentality if you are unrealistic and overly critical about your body shape.
  9. Exercise–Feel the Difference. Forget militant exercise. Just get active and feel the difference. Shift your focus to how it feels to move your body, rather than the calorie burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk or hitting the snooze alarm. If when you wake up, your only goal is to lose weight, it’s usually not a motivating factor in that moment of time.
  10. Honour Your Health–Gentle Nutrition. Make food choices that honour your health and tastebuds while making you feel well. Remember that you don’t have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain weight from one snack, one meal, or one day of eating. It’s what you eat consistently over time that matters, progress not perfection is what counts.

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I said a several posts ago that Sophie had banned junk food. It’s not really just that now. The weekend has brought out that it is now a hard and fast food rule. Just like in the beginning. No junk food – biscuits, cake, icecream, chocolate, hot chips, crumbed fish etc etc etc. All are BAD food. No reason, just BAD food. Hidden underneath I would guess the resounding ‘you are fat’ is drumming it’s beat, but Sophie is denying it.

food rules and anorexia

There is no SAFE ability to restrict any kind of food for someone with a history of anorexia. Whilst it makes sense to most of us to cut back or just treat ourselves with these types of food, those with anorexia are unable to do that. 

Sophie looked shocked I suggested having icecream for dessert when the yoghurt had run out. Looked at me like I was ‘losing’ it when I offered a piece of chocolate. This the girl who about 8 weeks ago would happily eat them and know it was OK. Everything in moderation. A slow sneaking change that can develop into something deeper.

How many times and how long it took her counsellor and dietitian to break down the rules and walls in her head, to accept that she could eat these foods. That she could be flexible, could swap foods around. A piece of chocolate today – enjoy it. To challenge herself. I sat in on just about all of these sessions.

On the weekend, she told me she actually had to fight the voice in her head, to enjoy a very small handful of popcorn at the movies. It become an effort, she barely won.

Safe foods are yoghurt, museli bars and fruit. She will eat what I cook within reason. Like I wouldn’t even begin to feed her fried foods. She eats well of the foods she eats and it is varied. So what is the problem, you say????

But and this is the BUT. Normal, healthy, intuitive food intake does NOT involve rules and fears.

Is she safe? Probably at the moment. After all there is a lot going on, and a lot of anxiety with HSC looming. It is only if this momentum keeps going and goes deeper. She has fallen several times, including on the way into anorexia, doing this particular food restriction routine. It is up to her how strong she is in recovery, to keep at this level and no deeper. But even pointing out the obvious to her at this stage, is met with denial.

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We are back to Sophie asking my permission to eat if she feels hungry. It is a common thing amongst those with anorexia in that they cannot give themselves permission to eat. The ED voice in their heads is so control of the whole person, that the simple decision to eat when hungry is impossible. Giving themselves permission to eat is beyond them. By asking me, Sophie sidesteps having to take not only the responsibility to eat but effectively silences the ED voice.

What frightens me the most out of all of this, is despite how far she has come, no matter what skills she has learned, the ease of slipping back into exactly the same ED behaviours is so total and quick. It is like the last 2 years of recovery is negated. Straight back into the same old. And what is also scary, is that even though Sophie understands what she is doing, she shrugs off the idea of standing strong.

I don’t think she will fall too far, I am still here and her team. If she does this next year away from all of this, then yes I am going to be very worried. It reminds both of us how insidious this illness is, how easy it is to slip back again and again. Perhaps it will always be like this for her. That is still something we don’t know. Recovery is still only young really. Yes, even though we are 4 years into this, we still have a long way to go.

So for now, she follows me around. To afraid to even ask me permission to eat sometimes, I actually have to say literally, you have permission to eat this food or have an extra yoghurt. We know each other so well know, I can tell the specific question in her eyes. Tonight I am trying a very healthy pizza. Pushing her buttons a little I know, but am trying to at least keep the evening meal varied, flexible and normal.

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