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.

Being Ready

“It’s a terrible thing, I think, in life to wait until you’re ready. I have this feeling now that actually no one is ever ready to do anything. There is almost no such thing as ready. There is only now. And you may as well do it now. Generally speaking, now is as good a time as any.” ~ Hugh Laurie

I really like this quote, and recite it to myself often when I am having a tough time wondering if I am ready to take certain steps. For example, I am probably going to take a graduate class this fall. There are many days where I consider not going through with it because I do not know if I am ready or not – it has been a long time since I have been in school. However, if I wait until I really feel ready, there is a good chance I will never feel ready. While I think it is important to be realistic, I also think that the anticipatory anxiety is usually far worse than the actual experience, and waiting just increases this anxiety.

I also think that this quote is very powerful when it comes to recovery itself. Although I have definitely had moments deep in the eating disorder that are awful and really motivate me as far as recovery, often times those moments are quickly replaced by the eating disorder telling me to wait, that things “could be worse” or “are not that bad.” Despite that voice, I have chosen to go into treatment because, as Hugh Laurie says “now is as good a time as any.” If I waited until I was 100% ready to gain weight or follow my meal plan, well, that would never happen. I think recovery often involves a fair amount of “fake it ’till you make it.” It involves doing it even when you do not feel ready or feel that you want to give up the eating disorder. It involves doing it NOW, with the idea that eventually it will become the new normal and feel right.

 

Success

Hodgins: Sometimes it doesn’t matter if you have the whole world to support you, success can be just out of reach.

Bones: Then success must be redefined as that which can be accomplished.

From Bones Season 11, Episode 14 – Last Shot at a Second Chance

I was in an IOP group recently, and the group leader said something similar about goals. For this group we had to set daily goals. One time when someone was saying how she did not meet any of her goals, the group leader said that the stance in DBT is that if someone did not reach his/her goals, that does not mean the person failed. Rather, it means that it was simply the wrong goal. For example, let’s say someone set the goal of meeting her meal plan 100% every single day, but one day had a slip and did not meet 100%. From a DBT perspective, she did not fail. Rather, it just means that the goal should have been “eat 100% 6/7 days.”

Now I’m not saying that restricting is ok, nor am I saying that people shouldn’t set goals that are challenging. A big part of recovery is pushing yourself out of your comfort zone, and that means setting goals that are hard. However, I also think it’s important to be realistic and remember that recovery is all about baby steps. I know a lot of people, myself included, who tend to see one slip as a failure, or feel unsuccessful at recovery because it is such a slow process.

I think what Dr. Hodgins says is definitely true. Sometimes I don’t reach my goals because I don’t utilize supports or my skills. However, it is also possible to have all the tools and supports in the world, but still not reach the goal. With that in mind, I think it’s important to keep in mind what Bones says. Not reaching a goal doesn’t always mean you failed – maybe it means you need to redefine what it means to succeed.

Take the meal plan example. I could sit here and say that I am not succeeding at recovery because I have not met my meal plan 100% every single day since getting out of inpatient. However, I am probably doing the best I have done in a long time. That is not to say that I shouldn’t still continue to aim for 100%, or that restricting is ok. But, that doesn’t mean that I need to call myself a failure. If I define success with other markers, such as drinking an ensure when I can’t fit in a meal, or making sure to always eat a snack when driving home from work, then I am succeeding.

Again, I want to make it clear that I am not saying that restricting is ok, or that the goal shouldn’t always be to aim for 100%. Rather, I am saying that instead of getting caught up in a swarm of negativity, sometimes it is helpful to remember that you don’t have to be perfect to be successful.

Kimmy Schmidt – Putting Your Needs First

First, all of the quotes in this article are great: 14 Empowering Quotes From ‘Unbreakable Kimmy Schmidt’ That Will Motivate You To Take On The Day

I want to draw particular attention, however, to this one:

“Happy People Value Their Needs As Much As Others”

Putting my needs first is something I really struggle with. I have a hard time saying no to any request, especially when I’m doing so in the service of my own recovery. For example, if a friend asks for a ride somewhere, but giving her that ride means missing dinner, my eating disorder tends to do double duty and say “you can’t say no because that would make you a bad friend, and also this is the perfect ‘excuse’ to not eat dinner.”

However, that line of reasoning has resulted in nothing but countless admissions to the hospital, so I am really trying to do something different now. Specifically, when it comes to helping other friends who are in recovery, my therapist likes to remind me of how on an airplane they remind you to secure your own oxygen mask before assisting others. After putting everyone else’s requests ahead of my own needs for basically my whole life, it feels really weird to say “no, I can’t do that, I have to eat”, but I’m trying.

I’m also hoping that this quote from Kimmy Schmidt will help remind me that perhaps the way out of the depressive funk I am in now is not trying to keep pleasing others. I often think that I’ll be happier if I work more or do more for others, but maybe what I actually need to do is give myself that day off instead of taking on more work, or allow myself to curl up on the couch with my cats and watching Netflix instead of going out when I really don’t need to (although sadly I have now finished all of Season 2 of Kimmy Schmidt). It is a real shift in values/priorities, but here’s to hoping that Kimmy is right.

Talk To Someone

I have to give kudos again to Code Black for bringing up the important issue of mental health and therapy. The following exchange is from the Season 1 finale “Blood Sport”:

Angus: I killed someone, and now I can’t walk in here without thinking about it. The pills let me not think about it.

Mike: I made a mistake when I told you not to talk to anyone about this. I pressured you, and it made you think you could go around this problem. But you can’t go around it. You can only go through it.

Angus: How do I do that?

Mike: Well, for starters, we find someone you can talk to. Would you let me help you with that?

For the record, I have never killed anyone, but I can relate to what Angus says. I don’t abuse substances, but the eating disorder does the same thing – it allows me to numb out to things I don’t want to think about. No one ever directly told me not to talk to anyone about things, but for years I acted the way Angus has been acting – trying to go around the problem. I figured that if I just flew under the radar, that things would be ok. For many years, that strategy “worked” in that I stayed out of treatment, finished college, had a great internship, and started medical school. However, the eating disorder was always there, and eventually it caught up to me.

I have learned the hard way that what Mike says is true – you can only go through it. It really stinks, and there are many days where I feel like the “solution” is to quit treatment and go back to flying under the radar. But, when I am in a better place, I know that I can’t really live like that. I have to go through it.

Furthermore, I love what Mike says about talking to someone. I wish there was a pill that could fix the eating disorder, just as Angus wanted a pill to fix his mental health problems. But, therapy really is the way to go, and as hard as it is to talk about this kind of stuff, that’s what needs to happen.

Finally, the way Mike asks Angus “would you let me help you with that?” is just perfect. I think too often friends and family try to be the solution, rather than helping their loved one get help. Mike doesn’t judge Angus for using the pills, and he doesn’t try to fix him. He simply offers to be there and help him get professional help. Absolutely perfect.

You Feel Worse (At First)

From Code Black Episode 13 – “First Date”:

Dr. Rorish: Will therapy make me feel any better?

Therapist: Not if it’s working…Let me ask you something. Are you really ready to walk away from a job that is your whole life?

Dr. Rorish: That’s the very reason I’m here.

I know that I have blogged about this concept before, but I am writing about it again because it could not be more timely for me right now. I just finished a month of intensive treatment, and although I am nutritionally more stable than I was a month ago, I actually feel a lot worse. Physically I am nauseated, bloated, and exhausted. Mentally my depression and anxiety are far worse than they were when restricting was numbing me out.

I am very frustrated that I do not actually feel any better despite being objectively healthier from a nutrition standpoint, but my treatment professionals keep telling me the same thing that Dr. Rorish’s therapist told her – that the fact that treatment is working doesn’t mean that it is going to make me feel better. In fact, the very fact that I do not feel better actually means that it is working. Dr. Rorish was throwing herself into work in an attempt to numb herself from feeling all of the uncomfortable things that she did not want to feel in the same way that the eating disorder numbs me out. So, therapy is going to feel awful (at first).

Also, I kind of feel like I am having to do what her therapist asks of her with regards to walking away from something. The eating disorder is not my whole life, but it is a very powerful coping strategy. It is very hard to walk away from something that has seemingly worked so well or taken up a big chunk of your life. However, it is really the only way for me to move forward, in the same way that she needs to refocus her energy if she is going to get over her trauma.

On that note, everyone should start watching Code Black because as you can see from this post and past posts, it really has some excellent messages and writing 🙂