Be Patient

House Season 6, Episode 3 – Epic Fail:

House: My leg’s killing me. Cooking helped for a while. I guess I got bored. My leg started hurting again, then I got worried, and that made the pain worse.

Dr. Nolan: What are you worried about?

House: That nothing’s gonna help. That I end up in the very dark place. I’m fine… Just not happy.

Dr. Nolan: I didn’t let you out because you were happy. I let you out, because I believe you had the skills to cope with that. You tried one thing. It didn’t work. So move on. Write. Play chess.

House: What if nothing works? What if nothing gives me more than a few days before my brain starts looking for the next fix, before my leg feels like someone’s shoving nails into it? What do I do then?

Dr. Nolan: If nothing in the world can hold your interest, uh, we’ll deal with that when we get to it. But you have to trust me, and you have to be patient.

I can relate a lot to how House feels here. Although the last several weeks I have been quite depressed, for most of this year I have been “fine…just not happy.” In fact, I have been pretty miserable. On the surface though, things are fine – I’m maintaining my weight, going to class, going to work etc. I have great friends and a family. But I’m not happy because my brain simply will not shut up.

Like House, I worry that nothing is going to work. In his case he is looking for a distraction from the pain in his leg, in my case I am looking for relief from the eating disorder, depression, and anxiety. I have a new treatment plan that seems to be working well, but it is very slow going and, well, I am not a patient person. Everyone keeps telling me that it is going to take time. After all, I have had an eating disorder for 18 years – it isn’t going to go away with a few months of recovery. I am trying to hang on and trust everyone, but it is definitely quite hard some days.

Advertisements

Hope

From House M.D Season 4, Episode 14 – Living the Dream:

House: “No, you’re afraid to change. You’d rather imagine that you can escape instead of actually try. ‘Cause if you fail, then you got nothing. So you’ll give up the chance of something real so you can hold onto hope. The thing is, hope is for sissies.”

I blogged about this quote previously as part of a longer entry on how the eating disorder serves as sort of a scapegoat for not meeting the high expectations I have for myself. However, I was rereading the quote the other night, and it spoke to me in a new way, so I wanted to touch on it again.

Specifically, this time the part about imagining the escape stood out to me.Often before starting a higher level of care, I feel hopeful. I imagine myself feeling better – not having headaches, not feeling so cold. Because I know I am not doing well with eating, I blame all of these physical symptoms on the eating disorder, and thus have hope that things can get better if I can stop the symptoms. However, I then start eating more and the reality is, I don’t feel better. My head is still pounding, often worse than before I started eating more (probably from the stress of eating more). I’m tired. I’m nauseated. I then lose all hope and get really depressed. I struggle to hold onto the hope that I will ever feel better. In turn, I start to lose hope that I can ever have a normal life.

What I take from this quote is that the hope I get from holding onto the eating disorder may feel good, but it’s at the expense of achieving something real – a life that consists of more than the eating disorder. Although it’s hard, I have to figure out a way to keep up the hope that things will change while I’m actively trying to change. Rather than focusing on how awful I feel and how things don’t seem to be improving, I need to remember that the alternative is not much better.

Rituals

House M.D.: Season 7, Episode 8:

Dr. House: We’re hardwired for answers…Problem is when we don’t find a logical answer, we settle for a stupid one.  Ritual is what happens when we run out of rational.

I’m not saying the eating disorder is a “stupid” answer, it’s not that simple. However, my experience does fir this quote. When I feel poorly physically, I immediately try to figure out a logical answer. For example, when I am I tired I try to figure out all the possible reasons – did I get too little sleep? Too much? Did I drink too much or too little caffeine? Nine times out of ten though, I can’t find a logical reason. I’m sleeping enough, eating enough, drinking enough etc. So, I “settle for a stupid” answer – I blame eating. I start to think that maybe I’m feeling tired (or have headaches or whatever) because I am eating too much. I somehow figure that if I eat less, I’ll feel better.

Along with that, while rationally I know that engaging in eating disorder behaviors is not helpful, they are so hardwired after seventeen years that it is fairly easy to fall back into the rituals. Rationally, I know that every time I start down that road, it winds up leading me away from life and into a higher level of care. I try very hard to stay in wise mind and counter distortions with rational responses. However, the process is incredibly exhausting, and often times the eating disorder just keeps pushing until eventually I just get worn out. Then when that happens, I turn back to the rituals.

In keeping with this quote, I think that I need to stop looking so hard for answers. I need to accept that sometimes I am going to be tired, or sometimes there isn’t going to be a perfectly rational response to the eating disorder thoughts. I think that if I can accept the uncertainty, or at least be less obsessed with having an answer, that might keep me from turning back to the rituals.

 

Rules

From House M.D. Season 2, Episode 19 House vs. God:

Wilson: Because when it comes to being in control, Gregory House leaves our faith healer kid in the dust…because if the universe operates by abstract rules, you can learn them and you can protect yourself. 

This quote made me think about all of the rules I have related to both the eating disorder and just life in general.

The first part of the quote uses the word control, and that kind of bothers me. I know that is a very stereotypical thing that people say – that eating disorders are about control. I have also heard a lot of people in treatment say that they turned to their eating disorder as a way to have control over one thing when other things were in chaos. However, I honestly don’t think my eating disorder has a lot to do with control. I actually never feel in control when I am engaged in eating disorder symptoms. I feel like I could always do a better job being in control – I could always eat less, I could always exercise more. So, I don’t really relate to the part about being in control.

However, I very much relate to the part that says “because if the universe operates by abstract rules, you can learn them and you can protect yourself.” For me, the eating disorder provides a set of rules that I can learn and use to keep out negative emotions. There are A LOT of rules – eat X number of calories, get X amount of exercise, weigh X amount of pounds, eat these certain “safe” foods, don’t eat these other foods etc. I don’t have anything or anyone in particular that I am trying to protect myself from, but as long as my primary focus is on these rules, I am protected in a way from having to experience uncomfortable thoughts and emotions. Rather than thinking about big questions like whether or not to get my PhD, I think about what to eat for dinner. Rather than feeling hopeless or sad, I focus on making obeying my eating disorder rules.

The problem is that while focusing on these rules makes me feel better in the short term, in the long term it does the exact opposite of protect me. It feels like I’m protecting myself from things that are uncomfortable, but all I am doing is keeping myself trapped in this eating disorder bubble that ultimately robs me of any sense of accomplishment or meaning in life. It’s hard to let the rules go, but ultimately being more open and will lead to better things that will in turn hopefully protect me from the lure of the eating disorder itself.

Being Miserable = Being Miserable

Dr. James Wilson to House: You don’t like yourself. But you do admire yourself. It’s all you’ve got so you cling to it. You’re so afraid if you change, you’ll lose what makes you special. Being miserable doesn’t make you better than anybody else, House. It just makes you miserable.

Ok, so I don’t admire myself, but I can relate to the rest of it.

When my eating disorder started 11 years ago, a lot of it had to do with being special. Growing up, I had always received attention for being thin – relatives or other people would comment on how skinny I was, or how I had “long and skinny legs” or something. As I hit puberty and started to gain weight, I freaked out that I was losing this thing that made me special. It wasn’t that I wanted lots of attention for being thin, it was just what I thought I needed to be in order to get the normal love/recognition that everybody wants.  Just like some people are special because they get good grades or are pretty, I thought that the only thing that could make me special was being thin.

But as I slowly came to realize, the eating disorder didn’t make me special – it just made me miserable and further removed from my friends and family.  Furthermore, it has now taken me further away from life goals that might actually make me feel accomplished.

So, if I no longer think that being thin will make me special, why do I still struggle with accepting weight gain?  I think now the issue at play is my fear of neediness and my guilt over being very fortunate in life.  With regards to neediness, I know that never needing anyone or anything doesn’t make me special, and frankly it is an unrealistic expectation.  However, I still feel bad when I can’t be 100% independent, and I think that relates to a bigger issue of feeling guilty for the fortunes I have been handed in life.

In my IOP group the other day we were talking about skills for dealing with a crisis situation, one of which is comparing yourself to others who are worse off than you.  This does not work for me at all because it only leaves me feeling guilty for all that I am blessed with in my life.  I am very lucky to be blessed with a very supportive family, financially and otherwise.  However, I find myself constantly feeling guilty for the fact that I don’t have to work right now, that I can live at home while doing treatment, and that I didn’t have to take out undergraduate loans.  As a result, I often find myself trying to compensate for this feeling by taking on lots of demands and forcing myself to constantly stay busy to the point where I am feeling really run down and miserable.

Recently though, I have been trying to say no to requests and take time for myself by reminding myself of what Wilson says.  People who have to overcome major adversity deserve all the admiration they receive, but in the same way that House is not any better than others because he is suffering, not having to overcome these obstacles doesn’t make me any less of a person.  The fact that I don’t have to work myself to death right now or that I can go to my parents for help with things doesn’t make me any less deserving of happiness than those who are not blessed like I am.  And making myself miserable to compensate for these guilty feelings do anything except make me miserable.

House M.D. Episode “Control”

I lam obsessed with the TV show House M.D., and in particular love the character of House.  There are so many great quotes from the show that I have used in treatment, and I hope to blog about them soon.  In the meantime, I am going to start with my thoughts on the season one House episode titled “Control.”  The basic plot synopsis is that Carly, the CEO of a major cosmetic firm, is admitted under House’s care with a blood clot in her leg. She then develops pulmonary edema (fluid in the lungs) and a bunch of other symptoms that make the team suspect that she has cancer, particularly colon cancer. She refuses to undergo a traditional colonoscopy, saying she “doesn’t want to be looked at” but agrees to a non-invasive procedure, which is negative. After this, House starts thinking about her psych symptoms, and eventually goes in while she is sleeping and realizes she cuts herself. He then deduces that she is bulimic and has been using Ipecac to induce vomiting, leading to the blood clot and heart failure. She needs a heart transplant, but the bulimia excludes her, so House lies to the transplant committee about that in order to get her the transplant.

I usually have a lot of issues with the representation of eating disorders in the popular media, but I actually really like this episode. Usually, the media feeds into stereotypes about eating disorders, always having people with eating disorders be extremely emaciated and eating about 10 calories a week. Then, they are all better once they gain weight (see recent episodes of Dr. Phil for a perfect example of this). Even when these shows feature a person who they refer to as bulimic because she bp, she is usually grossly emaciated.

However, this House episode does not do that. Carly is not grossly underweight – thin, but not visually underweight. And while her saying that she uses Ipecac to purge 3x a week sounds sort of like a writer looked up the criteria for bulimia and said “ok, the DSM says one has to purge 3x a week to meet the criteria for a diagnosis so let’s use that”, at least they don’t have her purging 30 times a day or something outrageous. Rather, this episode shows that eating disorders are serious illnesses even if the person only meets the minimum criteria and is of normal weight.

Going even further, I really like the way House talks to Carly and addresses her eating disorder. I have read a lot of reviews online where people say the opposite, but I personally like it. In short, he treats her with the same no-nonsense attitude that he treats everyone with. He tells her his diagnosis in the same manner that he uses with all of his patients – doesn’t treat her like some fragile being or give her sympathy. In doing so, he doesn’t let her get away with any of the bullshit that people with eating disorders often get away with; he doesn’t let her try and justify her actions. It isn’t because he doesn’t realize the mental issues of someone with an eating disorder, rather, he just jumps over all the stuff that is better suited for long therapy conversations and gets at the real heart of the matter – does Carly think her life is worth living? Does she care if she lives or dies? A lot of people think him asking her that question was overly harsh, but I think it was just what he needed to ask. He doesn’t have time to get into a whole therapy session with her, so he just jumps right to the end question – does she want to have a life? You can’t have both and eating disorder and a life, sorry, it doesn’t work like that.

My favorite scene though, is the last one where he visits her after the transplant, and makes a small joke about how she will now be on a strict diet, which is “exactly what someone with an eating disorder needs.” The way he delivers this line shows that he understands that the while the heart transplant fixed her physically, she still has a long way to go, she isn’t “cured.” She also asks him “why did you fight for me?” and he just says “because you are my patient.” But I think House, with his addiction, general depression, and nothing much in his life besides work, can relate to Carly. She turns to binge/purging to cope, he turns to vicodin.

The only thing I don’t like about this episode is the title.  That is the one sterotype that this episode fed into, that eating disorders are all about control. For some they might be, but not always. But, I can’t complain too much because I don’t really have an alternative title anyway 🙂