October 30, 2008

"You should be on a Discovery Channel special."

M said that to me yesterday - and shockingly, meant it as a compliment!

Here's what she meant. She looks at my eating habits, and she can't believe how, um, normal they are. I eat when I'm hungry. I don't eat when I'm not hungry. I don't absolutely avoid "bad foods"; I just control my portions of those foods, but I still enjoy them. And, I simply love the feeling of enjoying food.

All of these are difficult / foreign concepts for her.

So she looks at my non-disordered eating with wonderment - like it's something on a science special on TV. I'm not sure whether to be flattered or not, but if having a positive role model for food is a good thing, I'm glad she's got that.


After months without one, M finally got an appointment with a new nutritionist. The nutritionist had a simple, intriguing suggestion for M: for the time being, focus more on when you eat than what you eat. So, M is supposed to eat breakfast between 8 and 9 am, lunch between 12 and 1 pm, a snack between 3 and 4 pm, and dinner between 6 and 7 pm. What she eats is up to her. The hope here is that this will free her from being paralyzed by debating whether or not to eat anything, so that she can start learning to trust and respond to her hunger more.

Through two days, the signs are pretty encouraging. She ate every meal on day one, and 2 good meals on day two. The bigger deal (in my mind) is that M seems less stressed by food than before. I've said it before, I'll say it again: the anxiety around food choices is almost as debilitating for her as the fear of food itself. This plan might help cool that pressure somewhat.

October 10, 2008

Busy M

M's been insanely busy recently with work. For the past two weeks, it's been work, sleep, eat (a bit), cook (she loves to do it), and yoga (once or twice a week). I'm not sure if the intense schedule has been good for her or not.

On the one hand, when she's crazy busy, she has less time to act on her eating disorder, and she has to stay focused on the task at hand.

On the other hand, she's stressed. Very, very stressed. And she does not handle stress very well. And I wonder if this schedule is going to drive her down the road of depression and disordered eating sometime soon.

Guess we'll find out - she's got one more week of this crazy schedule.

October 5, 2008

Trisha Gura

I had a chance to hear Trisha Gura speak recently. Trisha is a biologist and science writer by trade, but now focuses on writing about the personal and psychological aspects of eating disorders. Trisha recently completed a book called "Lying in Weight". I definitely encourage you to check out her Web site at www.trishagura.com. A couple of highlights from her talk:

* Trisha talked about the chemical differences in the brains of people with and without eating disorders. One of the effects of these chemical disparities is that they make it difficult, if not impossible, for sufferers to accurately visualize what they look like. In other words, self-image isn't a mental problem for people with eating disorders, it's a biochemical problem.

* Trisha discussed the importance of "discovery" to get to "recovery". This discovery is personal to each sufferer, and is basically the way (or ways) that they gain a better sense of self and something to anchor and grow the positive parts of their lives. This can be writing in a journal, or art therapy, or volunteering to help others. Trisha stressed that it's up to the sufferer to find and follow through on their discovery, and the role of loved ones is to encourage this path of discovery.

Lots more stats and insights at her site. Check it out.

September 19, 2008

Six things that haven't changed

I read somewhere this week that it's important to remember things about your loved one that haven't changed because of the eating disorder. I thought about what hasn't changed for me about M, and told her a few of them this week. Her reaction? Well, she glowed. I think it was huge for both of us, for different reasons. She needs to remember that she's more than just her disorder and her recovery. And I need to remember, through all the tough times, why I will not stop fighting for her - the many reasons I fell in love with her in the first place.

Anyway, here's my list.

1. Her laugh, which is the single most joy-inducing sound in my world.
2. She is so smart. I'll take five minutes to explain something I learned, and she'll say "Right, so you mean _____." And in six words, she'll make it obvious that she already knows more about this topic that I'll ever know. I swear this happens at least twice every week.
3. She has a great, wry sense of humor.
4. She hates unfairness or injustice, in any form, and she has the courage to let it be known.
5. She cares deeply about her brothers, and she's been such a great role model for them.
6. Her eyes. I still can't describe what color they are, because they're blue at times and green at other times. They're always spectacular.

A baby step forward, a wobbly step backward

First, the good news: M seems to be working hard to get more out of her sessions with her therapist lately. She's been with her psychiatrist (let's call him Dr. L) for a couple of years now, and her attitude about those sessions constantly swings between appreciative, challenging, and downright combative. M can be a wee bit stubborn, you see, and Dr. L is sometimes the only person in her life who calls her out and challenges her way of thinking. He pushes her to explore the root causes of her depression and eating disorder, even when that can be painful, and he challenges her to never silently settle for having this burden in her life, but to work towards something better. She doesn't always react well to that, but I think she recognizes that she needs that. When she wants to mope, I might let her, but Dr. L will press for more, for something that moves her forward. The fact that M is opening up to him more gives me real hope that the dark, latent demons could be flushed from her life sometime in the future - maybe months from now, years, whatever. How amazing would that be?

And then, all that flowery optimism gets walloped by the fact that M's started trying to occasionally numb her pain by turning to drinking.

Twice in the past 8 days, M has been drunk when I got home. Drunk, and crying her eyes out, reflecting on the horrible crap she's been through in her life. Mind you, she typically never drinks by herself - maybe half a glass of wine while she's making dinner, but that's it. Tonight, she had polished off a couple of glasses before I got home and was sobbing uncontrollably. She also had that "Chasing Cars" song playing on repeat on her computer (that would make me weep too - just kidding). Anyway, I just held her for about 20 minutes, and she started to calm down a bit. We talked about ways she could channel her anger and fear more constructively, and I thought everything was easing back towards normal.

Then I left the room for 10 minutes and she picked up the wine bottle again and took a few more swigs, before I finally came back in the room, saw what she was doing, took the bottle out of her hands (she didn't put up a fight - too drunk to object), and poured the rest of it down the drain. A few minutes later, she stumbled over to the bathroom floor, grabbed the toilet with both hands, and... well, you get the idea.

I told Dr. L the first time this happened, late last week, and he said to keep an eye out for it and see if it became a more frequent occurrence. Now that it has, I'm scared and despondent and hurt and more than a little angry. Somehow I have to find a way to talk to her about it tomorrow, while trying to turn that swirl of emotions into something firm but compassionate. I have to let her know that this is not an OK way to manage her pain, but not make her feel so bad about it that she goes off the deep end again.

Tiptoe firmly - that's my new motto.

August 17, 2008

Supporting vs. Enabling

Now here's an interesting conundrum.

When M isn't doing well, and is acting on her eating disorder, it's often difficult to know if I'm being a helper or an enabler. (Difficult for me at least.)

One example - she sometimes asks me if this eating disorder is her fault. No, it's not, I tell her, and that's perfectly true. She didn't ask to have this. It's just the result of a weird mix of bad experiences earlier in her life and genetics, and probably other factors as well. But at the same time, she is responsible for her reaction to this disease. She can choose how to respond when stress and anxiety begin to overwhelm her. She can choose whether to talk to me about it or shut down. But, I have to tread carefully here. I don't want to make her feel even more guilty than she already does. And I haven't yet figured out how to help her take on a healthy dose of responsibility without taking on a burden she can't (or shouldn't have to) handle.

Another example - we'll pass someone in a public place who's too skinny, at least to M's eyes. And M will ask me, "wait a minute, why isn't SHE in a treatment center?" If there's a more frustrating question than this, I can't think of it. How the hell should I know if this other girl is being treated for an eating disorder? How do I even know she needs any treatment? And most importantly, what does she have to do with you? I'm pretty sure the safest way to answer this question is to not answer it, but that kind of silence can make for a... curious conversation pattern.

So what do you do?