Rationalizing

ER Season 14 Episode 5: Under the Influence

Janet: You drank? When? Last night. You want to get to a meeting?

Abby: I don’t have time to go to a meeting. I don’t need to go to a meeting. I just I had a bad day, a very bad day, and it was just one time. I’m not going to start drinking again.

Janet: Really? Are you an alcoholic?

Abby: Yes, but..

Janet: Yes, but? All those years that you were sitting in meetings, were you an alcoholic then? Yes or no? OK, keep drinking. Do the research, see what happens.

Abby: I can handle this.

Janet: Just let me know how it works out for you. OK, I’ve got a clinic full of patients.

Abby: Janet, Janet, you’re my sponsor.

Janet: I was your sponsor, but now it’s very simple. If you’ve decided you’re not an alcoholic, I can’t help you. If you are, I’ll be your sponsor again and I’ll support you in recovery. Let me know what you decide.

This conversation between Abby and Janet reminded me of an internal dialogue I have with myself a lot – debating whether or not I really have an eating disorder, and thus whether or not I really need to follow my meal plan. My therapist often likens restricting a few exchanges to an alcoholic having one drink. Much in the same way that Janet responds to Abby, if I restrict a little she tells me that I need to get back on track ASAP, that it is a slippery slope. Too often though, I rationalize, just like Abby is doing here. I say that it’s not a big deal, that it could be worse, and that I’ll get back on track tomorrow. Kind of like Abby, I say “yes, but…”. There is always a “but.”

Sometimes though, the rationalizing goes even further. I’ll convince myself that I don’t really have an eating disorder – I’m not underweight, I’m eating enough, I’m not overexercising or purging etc. Then, the logic goes, if I don’t have an eating disorder, why do I need to follow this meal plan? Why do I have to keep eating even when I’m full, or make sure to be diligent about meals/snacks? Normal people don’t eat the same amount every day, so why do I have to follow this meal plan?

The problem is, as Janet points out, this doesn’t end well. As she says, “do the research, see what happens.” Just like an alcoholic eventually starts drinking more than one drink, I start restricting more than one exchange. One exchange becomes two, two becomes three, and then those three never come back. I think Janet’s point to Abby is that she has to recognize that she has a problem and that she has to take certain steps (perhaps going to a meeting), to overcome it. In the same way, I need to stop rationalizing and accept that I need to follow my meal plan in order to achieve recovery.

To the Bone

I watched the new Netflix movie To the Bone, which is about a young women with anorexia. Contrary to what some people said about it, I don’t think it glamorizes eating disorders. I think they made her struggle look painful – they show her compulsively doing situps, running up and down the stairs despite being out of breath, and passing out in a train station. I do take issue with the fact that the lead actress, who has a history of anorexia herself, lost weight for the role, as it feeds into the stereotype that everyone with an eating disorder is underweight. However, when she goes to treatment, there are people there with a variety of body sizes, which hopefully helps to combat the idea that one needs to be severely underweight to seek out residential/inpatient treatment.

What I take issue with is the portrayal of the treatment process. I get that the place where is goes for treatment, a residential place run by a psychiatrist played by Keanu Reeves, is supposed to be “nontraditional.” However, I really doubt that any treatment place would employ some of the methods used by this place. For one, meals are completely unsupervised. The patients just sit at the table with a bunch of food, and are allowed to eat as much or as a little as they want. One patient almost exclusively eats peanut butter from a jar too. Although I know that some treatment places ultimately have patients practice intuitive eating or get to a point where they prepare their own food, most places have patients start out with supervised meals and meal plans. They basically make it look like treatment is living in a nice house, going on some field trips, and engaging in a group or two. I worry people who watch the movie will have an unrealistic view of just how hard residential/inpatient treatment is.

Furthermore, towards the end of the movie the main character has a revelation/near death experience, and then is shown going back to the treatment center, more willing than before. It is implied that now she will be compliant and get better. Although I have never had a near death experience, I know many people that have and continue to struggle. It’s not that simple. It is a daily, sometimes hourly, sometimes minute by minute, difficult decision to continue on the path to recovery. I wish they would make a second movie that documents her struggles now that she is going to be cooperative in treatment – because that’s when shit gets hard.

Although I did not personally find it triggering, that doesn’t mean that it is okay for anyone with an eating disorder to watch this movie. I know that others have found it triggering. If you are considering watching it, talk to your therapist or another professional first to make sure it is in your best interest.

My Brain Works Differently

I’m an alcoholic. I don’t have one drink. I don’t understand people who have one drink. I don’t understand people who leave half a glass of wine on the table. I don’t understand people who say they’ve had enough. How can you have enough of feeling like this? How can you not want to feel like this longer? My brain works differently. ~ Leo, The West Wing, Season 3 Episode 10 – Bartlet for America

I was watching this episode yesterday in anticipation of The West Wing Weekly podcast about it, and this quote really stuck out to me. Leo is talking about his experience as an alcoholic, but I can relate this very much to the eating disorder.

For most people, restricting their food intake is an adverse experience. They don’t have a chance to eat lunch or a snack one day, and they feel like crap and think “I am definitely going to make sure I have that tomorrow.” However, for me the opposite happens. I get this sort of high, and think “I want this feeling to continue.” I want to keep feeling that hunger, that emptiness. As Leo says, my brain works differently.

This is also why restricting is such a slippery slope for someone with anorexia. Just like Leo cannot have one drink, I cannot have one missed meal or snack. It just leads to more restricting. There are many days were I want to miss a little, and think it’s not that big of a deal. But if history is any indication, pretty soon that one exchange or one meal becomes two or three, and it just keeps on going. Why? Because as Leo says “My brain works differently.”

Being Alone

They found this guy in Maine who had been living completely alone in the woods for 30 years. They called him the last true hermit. 30 years without the warmth of human touch, without conversation. The hermit felt more lonely when he was out in the world, than he ever felt in the woods by himself. Surrounded by people, but drowning in solitude. That kind of loneliness can swallow you whole. ~ Grey’s Anatomy, Season 11, Episode 10

I am very lucky that I have a great support system. I have a great treatment team, a great family, great coworkers, and great friends. However, there are times when the eating disorder makes me feel completely isolated. I’ll be out to eat with someone or a group of people, and everyone else is laughing and talking, and I’m sitting there calculating how many calories are in what I’m eating/drinking. I’m sitting there drowning in thoughts of self-doubt, poor body image, and racing thoughts about calories consumed.

When I think of recovery, I think of being able to be fully engaged in these situations. I think of the eating disorder not making me lonely and isolated, even when surrounded by people. That would be true freedom.

Worrying

“We’re all susceptible to it, the dread and anxiety of not knowing what’s coming. It’s pointless in the end, because all the worrying and the making of plans for things that could or could not happen, it only makes things worse. So walk your dog or take a nap. Just whatever you do, stop worrying. Because the only cure for paranoia is to be here, just as you are.” ~ Meredith Grey, Grey’s Anatomy Season 6, Episode 3

I am a chronic worrier, and it is something that I have been working on a lot. I worry about everything, and often try to plan out my every waking moment. Even when I have a day off, I will plan out what I am going to do with each hour. I end up feeling chronically exhausted because I never actually have any time off from the constant planning and worrying.

Recently though, I have been trying to let go and stop planning. I will never be as spontaneous as some, and that is something I have to accept. But, I can do things like pet my cats or watch TV and not count the minutes that pass by, or worry about what I am going to do to pass the next hour. To be more technical about it, I have been trying to practice mindfulness. Just being present, and trying to focus on the sights and sounds around me. As the quote says, it’s impossible to plan for everything, so I should stop trying.

Keep Fighting

From Grey’s Anatomy Season 11, Episode 14 – “The Distance”:

Dr. Amelia Shepard: “The key, though, win or lose, is not to fail. And the only way to fail is not to fight. So you fight until you can’t fight anymore. Hold up you head and enter the arena and face the enemy. Fight until you can’t fight anymore. Never let go. Never give up. Never run. Never surrender. Fight the good fight. You fight even when it seems inevitable that you’re about to go down swinging.”

I actually don’t have a lot to say about this quote – I think it pretty much speaks for itself. The process of recovery from an eating disorder is grueling, and it’s easy to feel like a failure. I often actually feel caught in this vicious cycle of failure – if I make pro-recovery decisions, I feel like I am failing the eating disorder, and if I choose to listen to the eating disorder, I feel like I am failing at recovery. It sets up this impossible scenario where I just feel bad 24/7.

Every time I have to go back into more intensive treatment I feel like a failure too. I don’t feel that way when friends tell me they are stepping up treatment though. I think this quote is a good reminder that continuing to fight, even if that means having to go back to more intensive treatment, is not failing.

It also gets exhausting fighting so hard, day after day. Some days it feels like I just can’t fight anymore. But as the quote says, I need to “Never let go. Never give up.” Just keep fighting.