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Eating Disorders in Recovery & our response to them

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National Eating Disorder Awareness Week (Feb. 24-March 2, 2013)

In 1990, I saw the profoundly disturbing movie Eating by Henry Jaglom. Prior to this, I was oblivious to eating disorders. The film was about a group of women cooking for a celebration. Throughout the film, they individually act out in their respective eating disorders. Watching their secrecy, shame, self-loathing, and powerlessness triggered an overwhelming sense memory in me. What they were feeling was no different than how I felt shooting coke in a locked bathroom. It made me realize how similar eating disorders were to addiction. Seeing this film helped me to feel empathy and compassion for my women friends who continued to struggle with bulimia even after years in recovery.

Our society isn’t very compassionate toward people who have diseases that manifest in self-destruction.  “How can I feel sorry for him? No one is putting a gun to his head forcing him to take heroin.”  While society is finally becoming educated in substance abuse and depression, eating disorders make people uncomfortable. It is cruel when adjectives such as lazy, greedy, and glutinous are used to describe over-eaters and those suffering from obesity. It is just as cruel to pretend there isn’t a disease affecting the health of a friend. People in 12-Step meetings become uncomfortable, even angry, if a member shares about vomiting after meals even if they share that this behavior makes them want to get high. The  whispering and dissing of the “skinny girl” is harmful and hateful. Eating disorders do not arise out of thin air. Childhood pain, violence, trauma, abuse, and sexual abuse are often at the core.

Recovering addicts and alcoholics with eating disorders are fortunate to already have a language to describe their experience. They have recovery tools and support. They know how to walk into a fellowship for their specific eating disorder and ask for help.  Yet, even with this leg-up, the road to ED recovery is riddled with potholes. I know many women with decades clean and sober whose recovery from bulimia continues to be two steps forward one step back. Binge eating relapses keep them trapped in a cycle of shame, self-berating, hopelessness, and despair even while they are role models of recovery in their primary 12-Step group.

Sustainable recovery from eating disorders is very difficult and painful and we (society as a whole and those of us fortunate to be in recovery ourselves) should be extending kindness, support, and compassion to anyone who is suffering so that they do not have to isolate in secrecy and shame. We can help by encouraging them to be honest and courageous, and by guiding them to professionals who can give them the help they need. Our generosity and love does not have to be insular. We have enough that it can be shared beyond the confines of our particular substance abuse group.

A dear friend in recovery became anorexic this past year. At first, I tried helping by applying what works to cut through the denial and arrest the disease of addiction but this was different. I realized she needed professional help and we found a therapist willing to work within her budget. After several months, it was clear that she needed a higher level of care – inpatient. Unfortunately, unlike drug addiction, there is very little help available in America for anorexics without financial resources. Anorexia Nervosa is a disease that leads to death – if not from starvation, it can cause a heart attack, fainting behind the wheel, shattered bones, and major organs shutting down. Many anorexics commit suicide before their bodies fail. Yet even with the high suicide rate statistics, there is very little help offered to people without $30,000 to spare or comprehensive health insurance. In my friend’s case though, it’s going to take more than good insurance or extra cash in the bank. Even after being discharged from therapy and told she needs a higher level of care, the denial continues to convince my friend that this disease can be self-managed.

No one could force me to get clean and I can’t force her into inpatient treatment. I hope she becomes willing. I continue to encourage her to not give up, to pray to whatever she believes in or doesn’t believe in, to blindly ask the universe or her own heart to guide her to safety so she can live. She asked me to dedicate this week’s blog in honor of Eating Disorder Awareness Week.

You may have friends in recovery living in shame, guilt and secrecy, suffering from an eating disorder they have not made public. These friends are your opportunity to practice empathy, compassion, tolerance and patience. Help them to feel safe enough to bring their ED out of the darkness. Eating disorders are not gender specific. Men this is your opportunity to bring your ED out of the closet so other men will not feel so alone. Together, in loving kindness, we can all recover.

For anyone reading this blog who may be suffering from an eating disorder, there is plenty of information online for local helplines, resources, 12 step groups. Not everyone needs to go to a treatment facility. Most eating disorders can be arrested and a healthy recovery can occur using a combination of 12 step meetings, therapy, trauma work (such as EMDR or gestalt therapy), and Dialectic Behavioral Therapy (DBT) groups, mindfulness (such as meditation, yoga, breathing exercises). Your life is worth it.

The following is a guest blog written by my friend who has Anorexia Nervosa. I asked her to write about her inner experience living with this disease. Perhaps next year she will be able to share her recovery from this illness.

eating disorders kill

 

Anorexia? WTF Happened?

During the course of this vicious anorexia cycle, I have confided consistently with one person. This alone may have saved my life— so far.

I don’t exactly remember when the idea had surfaced that I had an eating disorder.  At some point in late 2011 something started happening internally that resulted in an increase of anxiety, not sleeping, not eating, horrible leg cramps, night terrors, depression, anger, and hopelessness.  By April 2012 I had been in therapy for five months and remember feeling completely disconnected from my body. My mind was constantly spinning and I had 3 years clean from drugs and alcohol. I wanted to escape the screaming in my head and the pressure I constantly felt. Using and suicide bounced in and out of my mind.

I had slowly stopped eating. Well- I wouldn’t eat a couple days, but then would eat a few days and be fine. I didn’t really obsess over it and it was just one of those habits I think I had always had- since childhood. The idea of eating never really mattered to me much and the thoughts of over eating (or watching others over eat) grossly disgusted me. My frame is naturally small and the most weight I had ever gained was through both my pregnancies which I absolutely hated. Even though I had lost all the weight I had gained through my practically back to back pregnancies, my body was left with deep stretch marks which leave me with a strange self-conscience feeling I still have to this day.

Eventually, my first therapist kicked me out after about 10 minutes of what ended up being our last session. She looked at my sick body and advised me to come back after I sought help for my eating disorder. I hadn’t really talked much to this therapist but felt extreme anxiety when I knew I had an appointment that day and felt like I had been hit by a bus when I left. I don’t remember talking to her too much about anorexia.

Over the last year, I’m not sure why I have constantly denied that I could have an eating disorder. Most of the last year and a half has consisted of not eating, weighing myself obsessively, checking my BMI to see if I’m actually underweight (thinking that as my BMI is normal than I must not have a problem), puking every 3-4 days when I do actually eat, migraines, performing google searches about eating disorders, crying, punching walls, throwing chairs, anger, hiding out…

My health has been questionable. My digestive system feels fucked up. My heart rate and cholesterol are high. I’m almost positive I am anemic. I’ve passed out, lost track of time, been in four car accidents, fallen asleep at the wheel.  I have severe leg cramps every night which leave me falling down. I lost 30 lbs on my already somewhat small frame in the course of 4-5 month period and my weight was declining weekly. People were commenting on my body and it infuriated me when they questioned if I ate or if they told me that I’m getting too thin. I read articles and books about how to get help. I went to eating disorder meetings. I wrote letters to the fucking universe expressing my anger and pain and needing help.

Yet with all of the evidence pointing toward the clear fact that I do have an eating disorder problem, I continued to fight it (I still fight it).

I want help and I don’t want help. I want to fix my own problems and my own pain. I don’t want to let one more person close to me. I don’t want to become vulnerable.

I did eventually go to another therapist who specializes in eating disorders. I made as much of an effort as possible to kick this shit and feel better. I deactivated my gym membership, I gave up my scale, I wrote food logs. The terms were up front from the beginning with her. I had to stay honest. I had to do the work. If after a certain amount of time, no progress was made with my health, than she would recommend a higher level of treatment. This was and is one of my greatest fears. Needless to say, I was discharged in January of this year from my second therapist.

I actually made it to 4 years clean in January but feel like I am living my life in active addiction. I feel like I am in a downward spiral but not sure exactly what I am willing to do to get better. I still fantasize about all of this just disappearing on its own.  I feel like my mind is playing tricks on me. I tell myself things like this: I haven’t thrown up in a while now, I ate twice every day for 5 days in a row (only skipping two days of meals), I haven’t weighed myself since being at Publix two weeks ago, I am sleeping more than I had been sleeping, and that I haven’t lost any weight since my last therapy session. All of these things I tell myself eventually convince me that I can fix this by myself because I am obviously doing better than I was when this ‘eating disorder’ surfaced.

I absolutely hate everything about anorexia. I hate what is happening and feel trapped. I hate feeling like  there is something wrong with me and that I can’t control any of this. These are the same thoughts I have about addiction. I despise them both. I hate the internal fight of wanting to die and live all at once. And I hate feeling like I am being attacked by one or the other, if not both

Fuck addiction. Fuck anorexia.

Truth is- with all of my denial, anxiety, rage, depression, etc. –   I do hope that I continue to hold on until I get better.

 

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Eating Right & Feeling Better

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healthy-eating-vegetables

I’ve had food on my mind lately so it’s going to be the subject of this week’s blog. If you’ve just discovered this page and were hoping to read about recovery, don’t be discouraged. Food is an important component of the recovery process. How, what, and when we eat says a lot about where we’re at with self-care.

For example, when I notice I‘ve been leaning more toward sweets, carbs, white flour or extra caffeine and eating less protein, fresh fruits and vegetables, it’s usually an indication that something’s affecting me emotionally. Maybe I’m feeling depressed, lonely, frustrated, or angry. When I catch my diet moving in this direction, I can take stock of my life and my feelings and address them. I’m able to do this is because typically my daily eating habits are healthy and balanced.

Eating habits aren’t always dictated by emotional states. When the seasons change, my diet often changes with it. Winter it’s more soups, yams, winter vegetables and carbs and summer is lighter Mediterranean-style fare. One thing is certain – a healthy balanced diet helps me to deal with emotional turmoil better than if I ate poorly.

This blog Health Food and Heroin (part one and two)  will take you back to the roots of my becoming a vegetarian in the early 80’s and my interest in nouveau cuisine when it hit the culinary scene during my 20s. Keep in mind  that even with this information my last year getting high I existed mainly on vanilla cake mix with milk, chocolate chip cookie dough, and tortillas with sugar. Seriously, when I gave up on my life I gave up every bit of self-care I’d ever known. My bottom was complete abandonment of self.

When I got clean in the late 80s, one of the first things I did was join a gym and start eating better – but change didn’t happen overnight.  Late night espressos or ordering four or five Thai ice coffees while fellowshipping probably had a lot to do with the fact that I didn’t get a solid night’s sleep for my first six months clean (though I assumed it was some hold-over effect of drug addiction). The day my 1969 Dodge Dart was stolen I ate all the icing off a large sheet cake until I was so sugared-up I passed out. This seemed a better alternative to getting loaded (which was what I wanted to do). For fun, my recovering friends and I would come up with bizarre food combinations to create speedball effects such as high sugar/caffeine followed by heavy dairy and carbs. That would be our wild Friday night entertainment. Basically during my first year clean, we were taking as much pleasure as we could acting out with whatever was at hand without the use of drugs.

In spite of the insanity we encouraged in one another, we were still going to the gym, eating healthy food, and spending days off at the beach. Once I began experiencing the positive effects of the healthy side of my lifestyle, I lost my tolerance for sugar hangovers and junk food sluggishness.  A healthy lifestyle in recovery became a natural preference for one reason – I like feeling good. When my body felt good my emotions were also in balance.

I started this blog wanting to write tips for eating well in hot weather. If you are new to recovery you may walk away wondering how to create a food speedball. Hopefully you also are thinking “If I eat better maybe I won’t feel like shit”. It’s true – you won’t.

Here are some tips for your hot weather diet and grocery list:

Greek yogurt or cottage cheese with fresh or frozen fruit and nuts make a great breakfast. Until you eat protein you will stay hungry. This is why people who start the day with a couple donuts keep going back to the box until they are horrified to see they have eaten a half-dozen donuts before noon. Start the morning with a breakfast high in protein to maximize your energy and mental clarity.

Other protein you can keep around the house to throw into other meals on hot summer days – canned tuna/salmon/sardines, boiled eggs. Cook a chicken or turkey. The meat will stretch across numerous meals. If you are on a budget, split the cost of a turkey with a friend.

Meal-sized salads are perfect during a heat wave. It’s great to keep pre-cut vegetables in containers in the fridge. Stock up on cans of beans, nuts, feta or goat cheese, sun-dried tomatoes, a variety of dressings and anything else you want to add to create a meal salad.

Fresh fruit is delicious but buying frozen fruit is often cheaper and on hot days is a much healthier alternative to popsicles or ice cream.

Always throw a few apples, peaches, pears or your favorite fruit into a bag to bring with you when you leave the house.  Midway through morning and afternoon or during the long stretch between meals on busy days, a piece of fruit will help you maintain energy.  The same goes for unsalted nuts. I am not anti-salt but choose wisely. Without adding extra salt, most people get the amount they need in the course of a day through regular eating.

Stay hydrated.  Drink water. If you think 8 glasses of cola is the same as 8 glasses of water, think again. Water is water – don’t include the water used to make coffee or tea. Pure water helps flush toxins throughout your body. Cola doesn’t.  If water seems too bland, add a slice or lemon or lime. Once you start drinking water, you will begin to thirst for water.

This blog is not a diet plan by any means. When I work with clients, I insist on lots of water, fresh fruit and vegetables with every meal, and clean protein (meaning protein that isn’t hidden under mounds of melted cheese or deep fried). Changing a diet will happen naturally over time if you continue to lean toward healthy choices. Go online to educate yourself on the basics of nutrition. It’s possible to eat healthy and still eat cheaply.What about pizza, fast food, or dessert? Go for it but remember -it’s going to be the healthy fresh food giving you energy, better skin, mental clarity, alleviating depression, and aiding in sleep so don’t neglect one in favor of the other.

What you eat affects how you feel. Recovery gives us choices. Choose wisely.

 

first week clean

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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How can I tell if I’m heading toward a relapse?

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caution_relapse

Last week I had the fun experience of being a guest “speaker” on a Twitter addiction chat. I had no idea how I was supposed to be a  “speaker” in 140 characters or less. Luckily it turned out to be a Q&A. The final question  “How can a person tell if they’re starting to relapse and how can they stop themselves?” seemed like a good topic for this week’s blog post.

The interesting thing about a relapse is that afterward the addict will swear, “I made the decision to use” when really, “I made the decision a while ago and using was the anticipated outcome” is more likely the case. When we’re clean we always have a choice. By the time the “decision” to use comes along, we’ve already given up that choice by not recognizing and correcting the behaviors that were leading us toward a relapse in the first place. When we are in the disease clean, the window of opportunity to choose recovery gets smaller and smaller until our disease is stronger than our recovery and we use.  We forget we are powerless once we use. Almost every addict who has relapsed tells me immediately afterward, “If it gets bad, I’ll get clean again”. Really? If it was that easy to get clean, why wouldn’t I use one day a year?  They get amnesia about what it took for them to ever have had the desperation to get clean in the first place.

So what are these behaviors we need to watch out for and take seriously that have the power to eventually lead us back to using?

We start to come up with reasonable sounding reasons to start missing meetings (or IOP or whatever support group you are part of).

We start finding our recovery/sober friends annoying. We don’t feel like being around people and are much happier when we’re alone.

We feel a general crankiness toward everything.

We feel an endless hunger for anything (food, shopping, money, power, sex, attention, caffeine, tattoos, seductive pain) outside of ourselves to make us feel better, to feel excited, to feel alive. We long for euphoria.

We stop doing things we used to enjoy in our fellowship such as service, group activities, fellowship, stop working the steps (usually after step 5), stop talking to our sponsor/sponsees. In fact we start feeling judgmental toward both.

We start acting out in asshole behaviors without noticing such as gossip, anger, deceit, and righteousness. We nurture our resentments and start keeping secrets. Consequences include shame, remorse and guilt yet we do not talk about these feelings or their source to anyone.

We’re Hungry, Angry, Lonely, Tired.  We take no action to remedy it.

We start hanging out with people who are not in recovery more often than people who are. Watching our friends who are not addicts use and drink starts making us have thoughts that we can do it too. We tell no one this.

We hang with using addicts and alcoholics and enjoy it. We believe it is not affecting us. We make less time for friends in recovery.

We act out in self-destructive behaviors such as cutting, eating disorders, sexual compulsion, unsafe sex, compulsive Internet cruising and tell no one.

We isolate in abusive or unhealthy romantic relationships wanting someone who doesn’t want us yet going back time and again expecting different results.

If you are doing ANYTHING that your head says is nobody’s business (not even the person you trust most with your recovery) LOOK AT IT.

I really believe that if an addict stays in emotional pain long enough the only solution guaranteed to bring relieve will be using.

A relapse can usually be traced back to a combination of these behaviors occurring over a period of time. If you see any combination of these happening in your life, start taking the opposite action. This can be as simple as removing yourself from the situation, recommitting to meetings, service, reconnecting to your support group and being thoroughly honest about devious thoughts and actions.

 

 

 

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Tips for Staying Clean through the Holiday Season

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Increase (not decrease) your meeting attendance.

Find out what is happening in your fellowship – marathon meetings, dances, social events. Whether you are seeing family or alone for the holidays, stopping by these events is an excuse to leave an uncomfortable situation early (if you have to be with family or in social situations where there is alcohol) and for newcomers it is an opportunity to meet members on a more social level and make new friends. Remember – volunteers are always needed and welcomed.

Ask around and you will hear about social gatherings and parties various members of your group will be having in their home. Usually someone is having a party or members are organizing group activities.

It is better to be tired from too much fellowshipping than rested and alone at home.

Pay attention to HALT (Don’t get too hungry, angry, lonely, or tired)

Don’t bottle up feelings. Tell people what is going on inside of you. (No one is sick of hearing it).

Be of service – Google volunteer organizations in your area. If you have free time, helping others will lighten your mood and energize you. Many places are happy to have one-time-only volunteers.

If you have to spend time with people who push your buttons or be in an active environment, prepare an exit strategy. Plan ahead to meet someone from your support group afterwards. Be accountable to someone.

If you are leaving town, get a meeting list for that area. Find an alternative place to stay so you have options if you need them – put the info in your phone (local taxi and hotel).

If you are newly clean/sober, stick close to your new friends in recovery. One holiday season away from your using and drinking friends won’t destroy the relationships that matter. Put yourself and your recovery first.

Keep phone numbers of your fellowship friends handy and use them to check in and stay connected.

Get fresh air and exercise daily to keep the blues away.

exercise

 

Don’t over-indulge in caffeine or sugar and drink plenty of water.

Set aside time to meditate or reflect on the positive changes you are making.

Gratitude is a mood changer.

be grateful

 

 

 

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