Myths and why CBT Did not Work for Me

 

No I am not a unicorn. But just like some people are mathematically inclined and others great linguists, the way my brain in not going to be identical to every other sufferer of an eating disorder, and vice versa.

Cognative Behaviourable Therapy (CBT) is a fantastic method. It helped me overcome a period of my life where the social anxiety was crippling, I learnt so much about my self and the way I thought and really often how irrational these thoughts and fears were. So when I was finally medically stable enough to attend sessions as an In Patient I finally thought I was going to be able to locate my daemons and deal with this whole eating disorder thing as easily as I had delt with my social anxiety.

Fast forward a to three months later and I was even more despairing of my situation. Week in week out I was failing to do as many 5 part models as needed. Spending hours trying to find positives and negitive from my day. Trying to locate the need that my disorder was fulfilling in my life. And then trying to write it all down. All the while getting more and more anxious that I didn’t understand it. I felt I was making it all up. I felt I was failing at therapy.

I couldn’t understand, it had worked so well before my therapist was gorgeous, we really connected and gave me so much time. So why was I relapsing? I haven’t been back since the end of August and I hate my self for it but it has been such a relief. Purely for how pathetic I felt after every session.

I was discussing with S in my session on Monday how I felt that all this time I had been searching for the root cause of my eating disorder, what it was a coping mechanism for and what need it was fulfilling in my life when really there was a simple answer to it all. I, Katie had always wanted to be thin, and at a certain point I dieted to a point that I was malnourished and from there my poor starved brain and my genetic make up and personality type meant that I had developed an eating disorder. That’s it. No deep trauma, no other reason. Just as with most cases and as portrayed in The Minnesota Starvation Experiment I had simply fallen victim to my own body’s symptoms of starvation and now that I was weight restored the only thing I had left was that niggling want to be thinner.

S was able to shed some light on the reason it did not work for me. You see treating mental illness is treating those who are not (albeit sometimes temporarily) coming from a place of reality. The thoughts, behaviours and compulsions of the patient are not coming from their developed brain, their true self. For example my social anxiety was based on a fear of being judged. My therapist at the time asked me ” when your having a conversation with some one new, what is running through you head? ” my answer was ” I’m worrying about how I look, is my make up okay, dose my outfit make me look fat? ” by seeing that I was thinking about my self and really in all honesty most people are worrying the same things about them self rather than judging me. So every time I had the thought I could successfully challenge it and my anxiety was reduced.

In those suffering from an eating disorder ( and I would say a lot of mental health issues) these thoughts are not coming from a place of reality. Sometimes the thoughts are so removed from what the individual is actually feeling and sometimes it’s hard to differentiate. Call him Ed, the voice, Satans dialogue what ever you want to call these thoughts and constant inner monologue, they are not coming from the real you. So can strike at any time, there’s no rhyme or reason for them so identifying the thoughts and then challenging them and changing your behaviour may work to deal with some aspects of the disorder but for me it was a bit like a game of Wack-a-Mole.

Its well documented that the personality type susceptible to developing an eating disorder is high achieving, goal orientated people pleaser with perfectionistic type tendencies. And I guess that’s why  the therapy with S is working so well, it’s not punitive. She doesn’t make me feel I’m failing when I have a tough week, she rationalises it for me. She said to me this week ” you don’t need therapy Katie, you need clarity” and that’s exactly what she gives me. And more importantly hope. Hope that one day my body will not be the be all and the end all of my life. She  is walking proof that remission can be achieved.

Ive also become increasingly aware through my recovery that many therapists still work with many myths surrounding eating disorders and I may do a few posts on the ones I have found most derailing.

 

 

For a Reason, A Season or a Lifetime

Going to an all girls catholic school till I was 16 ment I attended yearly religious based retreats and workshops. At the time really I was just chuffed as it ment a day off lessons and homework. Oo ooh and you got to wear your school track suit all day. Delighted.

As with a lot of my religious education and exposure, I absorbed a lot/most of it on a subconcious level ( I can see the argument that it was infact, indoctrination, but really I tend to look on it more fondly…). For instance I saw a new councillor last week and something she explained brought flooding back a particular retreat I did when I was fourteen, based on relationships and interactions with others. This councillor is fabulous! For the first time I feel like I may be able to work through this, she has had anorexia so has walked this path before, is fully in Remission for years and works on a more spiritual level as well as being a therapist ( let’s call her S). CBT was helpful at first but it didn’t, for me, feel as if I was understanding WHY I was using these coping mechanisms rather just trying to change them. It’s not to say it’s not great and will work for many but for me, on a practical level, I could not see my self sitting down every time I encounter a anxiety provoking situation and do a five part model. But definitely my therapist was a fantastic woman who helped me so much but I feel that it was not the right type for me at the moment.

sorry going off on a tangent there, it all how ever ties in to the title ( I promise!). The leader of the retreat introduced me to the idea that relationship changes are normal, the idea that people come in to your life for a Reason, A Season or a Lifetime and that no matter which category they fall in to each is as valid and important as the other. At the time I was struggling with changing friendships as the year before we had entered secondary school and friendship “cliques” had been separated and as an anxious person I hated the idea that my friends would think I was being rude, ignoring them or just not wanting to be friends anymore when really we were just, growing apart. That was a normal process and it did not invalidate the strength of that friendship, what it taught us and how we grew from it. It was about accepting that not everything is meant to last forever, change in relationships is normal and no matter the length of time people are in our lives they can shape, through our experiences together, who we are as a person.

When therapists and professionals talk about your eating disorder they talk about it being your friend albeit a toxic one. But the also talk about cutting ties with her, stamping her out, bulling her. The thing is I would never do that to a friend. Especially one I had been attached at the hip to for so long and was now trying to distance myself from. S explained that she doesn’t see this friend as purely toxic and actually that this disease comes into our life to teach us something. Not saying that we need to agree with her, infact she describes her as being like a friend who is a compulsive liar, but there is a reason she is in your life.

The way I see it is if you try to distance your self from someone who was once your best friend, confidant, boyfriend or anyone you allowed to be a major part of your life through anger, punishment or bullying you just end up enraging them and attempts to avoid them in social situations or indeed any unexpected future run ins become incredibly anxiety provoking. Or if you continue to try and cling on to a someone who is no longer enjoyable company, toxic or maybe you have just grown a part from, it can be distressing and prevent you from moving on in life and continuing your development.

By seeing my ED as something that has come in to my life for a reason, I’m accepting of the fact it stayed for a season but If I cling on to it for a lifetime, the friend that became my support system for a period of my life, would stop me from becoming who I could be. But that dose not mean I should stamp it out rather it will always be in my life I just need to figure out how do distance myself from it, create new support systems and figure out what I learnt from our relationship.

(however I still can’t forgive her for landing me in A&E, on my birthday weekend. But I’m working on it 😉

Never thought I would see you again

Ride this recovery wave. Sit with your feelings and eating what makes you anxious. There will be good days and bad. Your body image will be up and down yadahyahdahyah. Some days you can remind your self that it’s a process and “This too Shall Pass”. Other days you can’t even find those rational thinking in amongst the sudden re surge of disordered thoughts. Today was one of them, after catching sight of my now weight restored body in yoga pants and a sports bra I literally broke down, like didn’t want to go. Where once there was a defined four pack and defined arms are now a bloated belly with visible adipose tissue and arms with so much water retention it hurts to lift them above my head. I felt like a fraud. Undeserving of wearing gym gear and definitely not fit enough or skinny enough to attend a yoga class.

Okay so now I can see the ridiculousness of these thoughts, but at ridiculous-o-clock this morning not so much. Not to get all soppy but my mother came in and with what an only be mothers intuition ( or possibly because I looked like such a stroppy cow..) gave me a big hug and told me how much she admired me for getting up each day and just getting on with it. Things are so financially tight and after everything I have but them through the last few years, guilt pushed me out that front door this morning.

Then half way through the class I saw it. Lying on my back , one leg in the air, there it was. My ankle. We then changed legs. Amafagaaaaaad my other ankle. I joke not this is the first time since I started following my extreme hunger and loosely the minnie maud guidelines over TWO MONTHS AGO, that I have seen my ankle bones. Or indeed any thing that resembled a human ankle. Like I cannot express the excitement with which I am sharing this post I have even taken a picture.

I was so upset with the water retention in my upper body and my “Moon Face” that I had not even noticed my lower body. We see what we want to see in life and what meditation and yoga are teaching me is that, cheesy as it sounds, when we stop and breathe we notice the other things. And more often than not, I’m finding that those things tend to be the more positive ones. For example I’m typing this thinking ” great, another example of how backwards my body is. Only you could defy gravity and lose Edema from the feet up”. Being all fatalistic rather than enjoying the fact I have the ankles of a normal homosapian. Heck they could be gone by tomorrow.

Well I’m Bloody Glad one of you decided.

The Irish Mammy is a well documented species. The lesser know Irish Granny is an even more fascinating one. It could just be a trait of getting older but the irish Granny is not one to beat around the bush. Talking about how I felt my body had decided to recover and my brain was really not comfortable with it and there for could not take credit for my progress this was what I was greeted with ( lol at the fact my family now think of me as having 2 separate identities…). Not to mention that this conversation occourred in the cafe of a well known irish mental hospital. What is life?

I spoke about extreme hunger in my last post and how it has been vital to reaching near weight restoration. But today is one of those days the change is just too much. Body image is at rock bottom and fighting the urges both to restrict and binge is exhausting. And I guess I am struggling with the knowledge that I am now no longer distinguishable as being slim but yet my eating disorder still occupies most of my thoughts. Like what is on the outside dose not match how I feel inside. And any one watching me will now think I’m just greedy for the amount I am eating, and it’s getting harder to tell my self “you need this food” as I no longer see my self as ill.

This article is fascinating  https://www.psychologytoday.com/blog/hunger-artist/201011/starvation-study-shows-recovery-anorexia-is-possible-only-regaining-weight. But what I have feel is that now I’ve gained weight and the anorexic rituals and OCD tendencies have lessened, my ADHD, hyperactivity, Low mood and depressive tendencies have worsened and I haven’t yet lost the constant constant inner monologue. I guess that it’s just bringing to the fore the fact that my mental health isn’t great and many my anorexia was a coping mechanism for the dealing with them.