Missing things...

Despite the fact that I've been insanely busy the last few weeks and my anxiety is slightly increasing over my work facility actually opening, I've noticed I've just been missing things lately. I hate to admit it, but I'm still saddened by Baxter's passing away. I don't have gushing, all out tears anymore, but I still think of him often, like on a walk, imagine him doing his "Boxer burn" through the yard, barking to want to come in, giving me his paw to hold, bringing me the remote and dog bowls, laying his head right beside mine at night, and many other nuances he had and become teary. I don't fault myself for my struggle, but sometimes I think I should be further along than I am. Having his ashes wasn't as healing as I had hoped, so as spring is here, I will be making my own memorial to Baxter by planting an Eastern White Pine tree (one of his favorite) with surrounding wildflowers in my yard and making a photo/video montage to him. I'm hoping to complete it by what would have been his 11th birthday in June.

I'm also missing my old therapist whom I referred to as "C" here. The other day, someone posted a comment on the blog with her name, and just for a moment, I thought it might have been her. I doubted it but checked in my stats anyway. I wrote C. back in January but have not since then, afraid of appearing too needy or clingy. I've thought about seeing another therapist, but I'm not really sure what it would be for. My eating issues are more manageable these days (there' s always room for improvement), I no longer feel depressed like I once was, there isn't a "crisis" moment right now or a feeling that my life looks bleak,(still get moments of the whole existential anxiety though), my relationship with my family is better overall, I've worked through some of my trauma issues, so they no longer feel like a black cloud over my head, and begun dating again. This is all good, positive stuff that I once thought would never happen to me. This is what any therapist would want from their client--to move on, gain their wings and fly.

But yet, I still miss C. (and probably therapy too) I miss that interaction of talking to her about my deepest feelings, someone to counteract what I may be thinking, even if it was just for a moment, someone to make me think more about my actions/feelings, etc. I hope this doesn't come across as a transference thing, because that is not it. I'd known C. off and on for ten years, and this last round of therapy with her was one of the most meaningful (the other when I first saw her in college).

Maybe I'm just missing the safety of it all--the safety of therapy, the safety I felt with C., the safety of letting my guard down with no guilt or worries.

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On a happy note, I'm thinking about getting a bunny!

Note--*I've changed the blog template. I wanted something a little more bright. Unfortunately, blogger kept giving me errors with changing my font color, so I'm manually going through every post and changing it. Therefore, if you are looking through older archives, I have not gotten to changing it yet.

How beliefs are so hard to change

The next few posts will be on thoughts from my therapy appointments. Ahh, C., my therapist, says interesting words which always prove to be food for thought.

I've talked about how one of my goals this year was working on trauma-related issues from the past. It's a cognitive behavioral approach which I do think can be effective at times. We've put aside working on this since there were a lot of other issues which felt more pertinent to me at the time.

Currently, I'm working on the continuance of challenging my belief system through a series of questions/answers, exercises in ways of thinking differently, as well as going through emotional feelings, etc, you know all the CBT stuff. We went over my last assignment which I admit I probably should have worked on more. As I was reading my list of beliefs, saying them aloud, and answering the module questions, I suddenly felt very frustrated. At this point, I just wanted to shut my notebook, throw my hands in the air, and say how this was all stupid. I told C. "you know I know all these beliefs are irrational."

Her reply was, "Okay, this might be true that you know these beliefs are irrational, but how much do you really try to change them?"

Okay, I guess she got me there. That keyword of change. I don't know how much I am trying to do that, honestly. Well, I am, but right now my emotions don't feel as intense, therefore, there is a lackluster approach to feel the need for necessary change. And as horrible as it sounds, sometimes, I feel like putting myself in a situation where that type of trauma occurred, just so I could truly feel those emotions again. However, my logical side kicks in knowing that could be harmful and lead to possible irreparable damage. (this reminds me quite a bit of the parallels ED)

So going back to beliefs and change. How much do we do this with eating disorders? Obviously, that is part of the emotional point of treatment and recovery. I run across so many eating disordered individuals who all know so many things rationally, but I think have such a difficulty in really feeling and changing their beliefs about themselves. Most of them could tell anyone else how whatever feeling, behavior, etc, was irrational, but however, when it is about them, the rules somehow change, they are different (myself included here) A friend of mine often tells me when I am spouting out my justifications for ED this or that, "Do you hear yourself?" It actually does give me pause to think. Still though, why do we have to be our own worst critic?

I guess I'm feeling slightly frustrated with myself for having difficulty with this and not trying as hard as I could be, knowing that if I don't work on it now, it will only continue to bite me in the ass time and time again. :sigh:

Making therapy more useful

I recently read an interesting article by Scott Miller entitled Supershrinks: what is the secret of their success?
Though this is geared towards the professional psychologist/ therapist, there are examples in other areas of study in which he applies the same kind of thoughts.

So what is a supershrink? It's a term to describe the exceptional therapist. These are therapists who not only have a low drop out rate but are effective in helping their client make changes in their lives.

From various studies, Miller says:

We know that who provides the therapy is a much more important determinant of success than what treatment approach is provided. The age, gender, and diagnosis of the client has no impact on the treatment success rate, nor does the experience, training, and theoretical orientation of the therapist.

The article goes on to talk about what makes supershrinks and the formula for success.

This article reminded me of my therapy session a week ago which was the week where I mostly discussed eating disorder issues. My therapist C. is blunt and clear that eating disorders are not her specialty. I already knew this when I began seeing her again last year after a 6 1/2 year hiatus. (Side note: July 5th marked 10 years ago from when I first met her. Why I remember this date, I have no clue)

The appointment was slightly frustrating on both ends, because, well, that was what I wanted to talk about. C. has always let me take the reins of what to discuss when I first arrive. Lately the eating issues, anxiety over work, and family have dominated my mind much more than the trauma-related issues, so C. was very understanding and supportive of discussing these topics. I was honest with her, even telling her about my eye which you would have been blind not to notice.

When the session ended, she asked if this was helpful. It was but her reiteration of "my specialty isn't eating disorders" ruminated with me. After reading this article, it segued nicely into exactly what I wanted to say to her.

On Monday, I asked her if she was familiar with the article (she said it sounded familiar), pointing out that it was the clinician that made the difference, not the specialty or treatment intervention. I told her this, because in some bizarre sore of way I wanted to reassure that yes, she was still helping me even if her specialty wasn't eating disorders (and I wasn't exclusively seeing her for that anyway). She then told me why she felt she wasn't very good with ED people, mostly because she felt like she wasn't able to truly help them enough--that some behaviors would lessen but they still left unhappy. I understood this but pointed out that notoriously (and yes, I hate saying this, it's a horrible label) eating disorder clients are difficult populations, take many years to treat, (I'm truly not saying this in a mean way, just that it is often very hard to break through the mindset of ED individuals) but that lessening destructive behaviors is progress.

What was nice about this exchange we had was that it allowed for us to effectively communicate better. I finally got a better sense of why kept saying EDs were not her specialty, though I actually think she is more effective than she thinks (another college friend of mine saw her for awhile and also agreed). I learned that she felt perhaps by saying EDs were not her specialty that maybe she was closing me off from really discussing that area of my life. That was true after the session a week ago. I was really hesitant to bring up any ED-related topic at all in fear that she was going to ditch me and refer me to someone else. I should say this would be the understandable, ethical thing to do if I got to a state where she no longer felt comfortable in treating me.

The point of this post is about communication. I think there are many times we, eating disordered or not, have difficulty in discussing what might be working or not working in therapy. Or (if you are anything like me and worry immensely of what other people are thinking of you, including professionals who are there to help you), we are afraid of upsetting the therapist, not truly revealing what we feel even if there is a high comfort level already established. That session was such a fabulous reminder of this and why I continue to see C.

Note--*This post is not to say that you should see an ED specialist or not, but rather that much depends on the individual/ clinician and what the relationship is between therapist and client. Sometimes, more progress can be made with an ED specialist, while at other times there is no bearance whatsoever.

"Baggage"

My therapy session today was a bit interesting. Last week, we veered off and discussed work, career, and relationships, all of which was very pertinent (still is) and held my anxiety at bay. This week, we refocused on the trauma issues. I tried just talking about it versus writing it as C. felt this just distanced me from the emotions too much. Overall, I don't think it went the way she expected as I had a much tougher time thinking about my thoughts and feelings of the past and present.

There was one instance where I was recounting an event. C. asked a question about it, and I paused momentarily. So small, I didn't even think she noticed. But she did, and then asked a "what else" type question. I spoke of another instance which happened that I had given much less thought to over the years. It was significant, but like an afterthought, "oh yeah, and then this other time..." The funny thing with that incident is that I remember it much more clearly, with all those cues like what movie was on, that there was an interruption, that it was dark, how I felt before and afterwards, etc. This is highly different from the trauma incident that felt the most traumatic. Those details are all blurred with my recollections unclear, making me wonder about my own accuracies or inaccuracies.

After recounting the not so thought about incident, C. asked if there was anything else. And then, I said, there was this time and that time, etc. My first thoughts about this as I left was "shit, no wonder why I developed an eating disorder."

But aside from that point, what this also reminded me of was "baggage." We all have it. It's the skeletons in the closet we rarely like to talk about or show. It's the dirty laundry that makes us feel unlovable, unworthy, ashamed, damaged. For some of us, it feels like our Scarlet Letter A.

I was reading Jenni Schaefer's post on the Huffington Post about Dating real people (after and eating disorder). She said how she used to "air out the dirty laundry" early in dating someone as an attempt to see whether the other person really liked her. Personally, as a general rule, I've always been opposite in not revealing the "dirty laundry" until after I knew the person better. Of course, there were certain instances when I offered too much information as well. But mostly, I've always been afraid of my own "baggage" even if I was carrying my own bags. My thinking was more along the lines of, "if I'm afraid of my own baggage, what would someone else think?"

I've known many people in both circumstances. Some people want to get it all out there, while others feel like it'll just make the person run. Neither way is right or wrong but rather dependent on you. I think the thing that is more damaging is when you are so fearful of your own baggage that you never let go of the handles.

Blog writing and the connection of emotions

Some of you know that I've been working on some trauma-related issues in therapy (read here, here, and here). Currently, I'm on exercises five and six of this CBT approach my therapist and I are using. In the last two exercises, the assignments were to write in detail a traumatic incident, focusing on sensory perceptions, like sight, sound, and smell, as well as the feelings you felt. At first, I procrastinated the assignments (okay, still have a tendency to), but I find that once I make myself write, the words easily flow to the page.

During each session, I am supposed to read aloud my account. I think in some ways this causes me more anxiety than the actual writing bit. The first time I did this, I was incredibly nervous and read through it like some maniac in a speed reading contest. C. noticed this and asked if I could reread it and try to "feel" the emotions. The second time around, I still didn't really "feel" the emotions, but apparently, it must have affected me more than I thought. Right after I left, I had what I call mini panic attacks. It's not the first time this has happened when broaching this subject, and it will unlikely be the last.

At this last session, I knew I would have to read aloud what I had written. I had already warned C. that I didn't remember a lot of sensory type details, only the facts of what happened. After listening, C. said she felt like she was listening to a story. In essence that it really wasn't me, my story. This is very typical "dissociation"-like behavior that many of us do when we are hurt or something is too painful to cope with/discuss. And I'm certainly not immune to it. Even in the past, various specialists have told me that I talk about the ED in a third person-esque tone, despite using "I" statements. So obviously, I'm pretty good at this technique, albeit it is not the best at times.

Then, C. posed a theory, saying "I wonder if this could be related to your blog writing--that you're so used to that type of writing you aren't fully able to connect with the emotions."

In some ways, this could be a possibility. When I blog (though it is ultimately for myself), I am well aware that I am writing to an audience. Even though I talk about my feelings and emotions, there is still a kind of guardrail. This is improvement from a ten-foot tall wall which would have surrounded me years ago, but the guardrail continues to leave an element of distance, of protection of sorts. Sometimes, I wish I could be like other bloggers and be raw, intense, thought provocative, really displaying my emotions. I'm not saying that I haven't at times, because I'm sure if I look back through the archives, there are some that tug at the core. Most times, I think it is more due to insecurities, but that is a post for another day.

C. thinks that maybe we should drop the writing a bit and try to "talk," that maybe that way I could feel more of the emotions. While this is true, this does lend to feeling more emotions in a sense, it also is very hard for me to talk about (10+ years of never really talking about it). The last time I tried, I went into a dissociation state, almost shutting down in therapy and then reverted to a bad ED cycle of restriction and what felt like effortless running.

So I don't know what to tell C. I'm really not sure how to completely "let go" if you want to call it that. Maybe dealing with this crap trauma issues is just not for me. Maybe I'll never really be able to be in a full, complete, intimate relationship with another human being. Or then, there is the theory that maybe I'm just unwilling to push the envelope, too scared to see what is inside.

Curious do any of you feel like blog writing deters you from connecting with your emotions, or does it do the opposite and enhance it? Or has it not changed a thing?

Note:--*image is from Garden State Highway Products, a company who supplies traffic signs and safety products. I liked this image since it shows a guardrail around a dangerous curve, something I can metaphorically speak of.

Procrastinating...and a favorite movie

What should I be doing? Working on my two weeks worth of therapy assignments. Yeah, just a little procrastination. :sigh: Not sure why, it's really not that tough: write at least one page on how your trauma has affected your beliefs. I've actually thought about it in my head, but that doesn't really count. Perhaps, putting it on paper, just makes it more real, similar to saying actual words. The second exercise is rather easy and based on thoughts and actions/consequences. I guess I should be good for that one after last weekend.

I know it'll get done before my appointment on Monday, I'm just upset with myself for procrastinating it and now feeling stressed. It's like school when you've procrastinated a much needed class project, except this time, there isn't a grade, no right or wrong answer, no judgment, no reading it aloud to class. Therefore, there shouldn't be this perceived sense of pressure. Come to think of it, I've procrastinated a lot of things I had planned to get done this week--working on my taxes, doing that edriving course a la speed ticket (registered for it and went through the introduction which I might add is incredibly cheesy--talking bobbledheads, hula girls, and tree shaped air refreshener), going to the bank, making eggrolls, and probably more. I guess my plan is to lump it all into Monday and Tuesday when I don't feel so time constrained. But then, it just becomes a vicious cycle. You plan to accomplish all these things, yet feel stressed. However, you know if you don't get all this done, you'll just feel unsuccessful for the day. Yes, this is how I make things difficult for myself.

Moving on.

wikipedia
I happened to catch one of my favorite movies last night: American Beauty (1999) For some reason, as dark of a comedy (if you can call it that) it was, I found it to be such a moving piece of work. Not only did it portray so many overlying themes, but each character had so much depth that it made it easy for me to identify with their various issues--feeling unsuccessful, wanting to be successful, trying to be perfect, fear of being ordinary, feeling different, feeling like a loser, trying to find yourself,, holding onto secrets, feeling powerless, wanting to change, trying to find happiness, seeing beauty, etc. I think one of the best themes it showcased was that you can never assume anything, you never know what goes on behind closed doors. During the time this movie came out, I felt like everything was for show, so this theme resonates with me closely. I know I've talked about facades before, but it makes me really think about the people I've encountered in my life, both past and present. How many others held a facade? Would knowing their back story cause me to be different towards them? Or if they knew my background, would they have felt differently towards me? I could probably talk more about this film, but I do want to mention a few other scenes I really like. The paper bag video is beautiful, and the last scene in the movie is quite moving, especially of Annette Bening grabbing Lester's clothes. I think that particular moment touches me so much, because it's a scene I can imagine so many others doing when there is profound loss. To end on a positive, random note, 8/9 books I ordered have come in this week.

Beliefs

Yesterday 's therapy session was tough, and I have a feeling it's not going to get easier. After I revealed my secret to C., I agreed to try to work on this issue, hoping maybe this time with concerted effort, I might be able to get past it. During the last few weeks, we've been working on trauma-related exercises.

The first exercise was to write rules prior to the trauma-related event and then see whether those beliefs were reinforced or different after the trauma. For me, since this trauma was over ten years ago, I had to think really hard about what I felt then versus now. It was much more difficult than I thought. C. could see how hard it was for me and pointed out how I was able to place the feelings but not the thoughts. This was an interesting observation, because with eating disorder issues, I'm Miss Rationalization and the feelings part become non-existent.

This is not to say that I don't rationalize with trauma-related issues either, it's just different. Often, it's with me wanting to continuously blame myself for everything. C. said something helpful which I thought might be helpful to some other bloggers who I know are having difficulties right now in dealing with both past and present issues.

She said it wasn't so much a matter whether you were right or wrong or that you had choice in the matter. What matters is how it affected your beliefs--the way you see people, the world, yourself.

This helped me to take less blame for the situation and reminded me that it certainly did change the way I view some things. Beliefs are an interesting thing. From childhood, we are taught certain beliefs. As we grow and have both positive and negative experiences, we decide to either change our belief system or hold onto it. The thing that is hard is when a belief you had is shattered. You don't know whether you'll ever able to see it the same way even though that way was healthy.

Existential anxiety

This week has been a fairly ho-hum kind of week. Of course, compared to revealing secrets last week, anything is considered more tame. Surprisingly, however, I've managed better than I anticipated. In my other attempts to get past this particular secret/issue, it would leave me headed for a downward spiral. So the fact that I haven't gotten too disorderly is a positive sign. But then again, maybe I have some of other issues that are stirring in my mind.

Last Friday, I had an interesting talk with a client who happens to be a former professor of mine. We got into talking about the new undergraduate degree in gender and women's studies which is slated for approval in the fall. I had been thinking of possibly getting this degree since I already have 12 hours in the department, just didn't finish my actual minor in college.

I expressed my concern to P. would be how could the degree help me for a future purpose. She rattled off some ideas, and then said, "if you were to close your eyes, how do you see yourself in the world? What is your purpose in the world?"

Although P. asked this in the nicest, thought provoking way as possible, it was still probably one of the worst questions to ask me. My simple answer is an "I don't know." This answer is better than a few years ago where I couldn't even envision myself in the future at all. Yet still, I struggle with what am I supposed to do with my life? What is my purpose? How do I really go about finding it? Where does my passion really lie?

I've read a number of books about overcoming your quarterlife crisis, trying to find what it is in life you enjoy, stories of other people recreating an enjoyable life for themselves that isn't stuck behind some CEO job, etc.

Yet again, I get lost in it all, feeling overwhelmed, feeling like I'll never figure it out at all due to some existential anxiety/crisis of sorts. I know I'm certainly not the only one in the same boat. So many people question themselves about this at one point or another in their life. Why is it even when you get to this point, you continue to feel like you are the only one who will fail at this?

Right now, P.'s question just keeps replaying over and over in my head like a broken tape recorder. I don't know which is better to be honest--thinking about horrible crap from the past which is depressing, shameful, guilt-ridden or thinking about the future which just creates loads of anxiety.

So that's where I'm at this week. The one good thing out of discussing this with P. was that she said she would try to help me in any way possible and that she is my cheerleader. What a sweet thing to say!

On another note, it's good I have a therapy appointment on Monday. I can't remember if I mentioned that I brought Tovah with me at my last session. She did stellar! This week, I'm bringing Baxter.

*Here is an interesting study on the Role of Existential Anxiety in Anorexia Nervosa. I don't necessarily agree with all of it but food for thought anyway.
Here is also a cyber sermon about existential angst from James Park at U. of Minnesota. Personally, I can relate to a lot of what he says in this prsentation, however, at the same time, it feels over the top too?

Revealing secrets

I've never been the type to reveal secrets but in instances where there might be harm. Okay, there was the one instance that my family never lets me down when I was very young and right before my mom opened her Christmas gift, I blurted out, "it's a blue shirt." But besides that, I don't reveal much. In this way, I've become the "keeper" of secrets, even my own.

Except for yesterday.

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When I decided to head back to therapy this time around, I told C. I really wanted to be as honest with her as possible. It's not that I try to be dishonest in therapy, it's just that I'm too afraid to say some things. I find when I get into these moments, I have to remind myself that I really want C. to know this, because it gives her better insight about me. By not being honest, how can she truly help me?

While it's true that sometimes it takes me a awhile to actually tell her whatever thing it is I am fearing, I do eventually reveal my secret. At my last appointment several weeks ago, I told her one small detail (okay big detail) why I was afraid of going on a medication. As always, she told me she appreciated me telling her and hopes that I can let go of my "safety net."

Yesterday's appointment, something similar happened. It was a gradual building. First, I talked about my blurred lines post, then about the babies post. The latter offered interesting discussion. In some ways, this was up C.'s alley, as women and pregnancies are one of her specializations. I told her how I had not ruled out the option to have children but was worried about passing on eating disorder genes. She understood all this and just said how the best you can do is be aware of it and if you see it, to intervene as quickly as possible.

Then I said, "Sometimes, I think if I had a child, it would...not necessarily make me more recovered but maybe...more normal."
C. replied with a simple "Yes, I think it would." This was a moment of direct eye contact, and it seemed we were both a little teary-eyed for a split second. It was quite a moving scene.

Then, she went on about how your focus is on something else other than yourself, etc. Later, she asked me whether I wanted to just have a child or have a male partner, husband, etc. My reply was I thought having some father, male figure would be nice.

C. asked, "so when are you going to open yourself up enough to have that?"

And then I found myself saying why I was this way.

**********

PSU

So that's how it all went down. When I walked into yesterday's session, I had not planned on talking about this secret. Most times it is just left in my distant mind, though it still lurks, reminding me of shame once again.

Although I don't regret talking about my deepest, darkest secret with C. which only very few people know, it leaves me scared, panicked, exposed, and vulnerable. Of all my issues, this is the one left virtually untouched. I say virtually, because in the past when I have tried to get past this, I go into a state of panic, feeling frenetic, feeling like I must run, thinking how fat I am, thinking how I don't really need this food. In essence, it leaves me a mess and easily headed down the relapse path.

Therefore, I've neglected it for both intentional and unintentional reasons. Intentionally, I know it opens a can of worms. I know I'd hurt all over again. Unintentionally, being out of mind, made it not seem so real. It made it buried at least in some shallow grave. But really, that grave is so shallow that no amount of dirt would ever really cover it.

I'm not always for rehashing your history or dwelling on the past, but this is a subject that's whittled at me for more than a decade. It's an issue that hinders me from ever having the life I really want, the life I used to dream about. I realize how much I'm missing out on things, because there is an intense fear.

This secret has left me emotionally scarred, and I want to learn to let it go. I want to learn to move on. I want to know that I won't necessarily be hurt again. But most of all, I want to learn to forgive myself. This is where I falter. I may let the secret out, but then, I don't know what to do next except panic, like some scared animal. The panic may eventually subside, but yet again, the remnants of the secret remain and I'm still left with myself.

What do I do? Where do I begin? Where does it end? Someone, please tell me I really do have the strength and ability to get through this, that I need to get through this healthily, because right now, I'm fragile like glass.

Dreams, perceptions, and reality

Before my power went out, I had wanted to write this post. A few weeks ago, I had this dream. I was at my old high school and mingling around. Maybe, this was a reunion but I'm not sure really. I came across this young woman who was a teacher. I did not recognize her but she somehow knew me. Her first words were, "You look too thin." I denied the answer and promptly left. I don't remember what happened after that.

Dreams are an interesting thing. There is such a variety in them. Sometimes, they depict subconscious thoughts underneath the surface. Other times, they are relevant to the present moment, becoming a way to suss out or mill over matters. Some are happy, some are sad and nightmarish, some are just in between, and some don't really have an emotion to evoke. My favorites are the dreams that make absolutely no sense, yet, you still try to figure them out anyway. Example: animals talking.

Then, in a category all its own, are the ED dreams. These are the dreams about food or treatment or your treatment team or the scale or your weight or your body image or the perception of yourself on others or illness or even death. I don't know about you, but these have always been some of the most vivid, memorable dreams for me. They tap into my fears and disillusioned perceptions and always ask "WHY" questions or leave strings unattached.

Fast forward a few weeks at my last therapy session. (I have another post on that in the works) Towards the end of the session, C. asked me how eating and exercising were going. I was honest, told her it was so-so. My exercising had decreased since I had Tovah and the visit with my parents--both good things for the most part. I told her I knew I had lost a little weight back in mid-late December. I only knew since I weighed myself at the fitness center. Of course, when I said the number which was not significant at all, C. claimed it was a lot. I told her I had probably regained most of that weight back anyway since I was exercising less and eating more.

Then, C. said, "You're thinner now than when I remembered you in college. Even today, you look thinner."

Seriously, I was quite shocked. I know my perception is skewed but I also know how my jeans fit around my waist, and they are not as loose as they were then. This should have been a victory for me--not falling down the rabbithole. (or is it pigeonhole?) But instead, it just made me question my perception of reality and wonder if I'll ever be able to see too thin, thin, normal, and fat, at least on myself that is. Has the eating disorder forever scarred my perception?

What's your take? For those recovered/in recovery, are you able to see the dimensions or your own body or the perceptions others see?

Related perception posts:
Perceptions and body image
Perceptions and our pets

So what awaits me at my next therapy appointment?

I have a therapy appointment this afternoon and feel a bit of hesitancy, an awkwardness of sorts. In my "Invasion of..." post, I mentioned that my mother would be tagging along at my therapy appointment. Beforehand, my mom and I decided she would meet with C. for the first ten minutes, and the remainder time was my session.

It's weird sitting there, because you of course know they are talking about you. Even through the muffled thing C. keeps by her door, you can still hear the voices slightly. I kept trying to tell if I heard sniffles, a tell-tale bad sign that things have gone awry. I heard none, so I took that as a optimistic sign.

The session itself was okay but surely I've had better. It's hard to cram a month's worth of stuff in 40 minutes time. C. first started by saying that what my mother had said gave her better perspective about my situation. This threw me for a loop. Though what my mom said was the truth, I had not expected it. It's the kind of truth that you really only reveal when it is evidently needed, otherwise, you just leave it be. Now, I wonder if C. thinks I just happened to have overlooked this, but really I haven't. So you ask why would I have not mentioned these details of my life? The simple answer is SHAME. :sigh: I still struggle with this issue in a variety of areas of my life--aspects that shouldn't even matter as they do not represent who I am as a person. Still, it leaves me overly pondering what someone else is thinking about me.

The rest of the session was mostly about my career and job more than anything else. I relayed to her the situation when my boss was gone and how I felt which was the motivation for the feelings in a bottle post. By the end of the session, C. was apologizing to me, feeling like she was conveying the message I needed to leave my job. I told her she was not but only saying what is the sad reality which I have trouble coming to terms with.

So I have this next appointment not knowing what to expect or feel. I'm already worried anyway since I learned that C. will no longer be taking my insurance, and I'm only approved for four other sessions. Deep down, I keep wondering if it is my fault as I know she had a lot of trouble with them and getting all my paperwork correctly filed. I know my mother would help pay for my appointments, but then there is just so much guilt tied in that, it makes me cringe and cry at the same time.

The anxiety medication dilemma

I had an appointment with C. yesterday. Like last week, she mentioned medications again. Not really so much for depression, but rather anxiety and to help me clear my brain.

It's an understandable suggestion. I've made some progress of my original goals in seeking her counsel, however, it's very slow. She knows and reminds me I only have ten sessions through insurance, and she wants to be able to help me. I can of course continue to still see her after ten sessions, it's just I'd have to pay out of pocket.

The last few weeks, I have not thought much about the whole future/career oriented decisions in my life. I'm sure part of it is avoidance (though I know I need to get a grip on it), but really it's that my mind has been more riddled with holiday stress and guilt. My father's wife even wanted to pay a plane ticket for me to visit at Christmas. I politely said no and responded that I may be able to visit at New Year or in January when things are less busy.

Even though I haven't had any more meltdown sessions, maybe that is part of my fear--that that will happen again. I know this issue isn't going to go away nor is it getting better. This is especially evident since my anxiety has increased which for me just ramps up my exercising habits. It doesn't even make sense, because I'm not really even thinking about it and my dad has surprisingly not brought up the issue in three weeks. That's a record for him since every conversation normally started out with "so have you thought more about your future? Have you put those applications in for grad school?" I told this to C. and how I knew it was really difficult for him not to say anything, and her reply was "so what," reminding me it was not of my concern.

In the past, I've been on anti-depressants unsuccessfully. No, I haven't tried every one in the book, but enough to feel hesitant about them. I've only had major side effects from one, but the rest didn't do anything for me. Maybe it was dosing, maybe it was impatience, maybe it was all the wrong psychiatrists. I know I could easily just go to my nurse practitioner whom I see for just routine check ups and ask for prescription A or B and she would hand it to me without any questions. That can be a good and bad thing--a) you get what you want, but b) it might not be what you need per se.

So righ t now, I'm sitting on the fence. I told C. I'd think about it--week number 2 here for that same line. I know she is hoping I give it a try, at least to perhaps speed up the process and let me think without such an overwhelmness if nothing else. However, with anxiety medications (not immediate ones like Xanax), they take 8-12 weeks or longer to kick in. My impatience with medications doesn't bode well for this fact.

Her goal for me, or at least what she feels like she can to do help me is to have all the information there (I've made a list of many options) and BREATHE, rather than having everything simply float around in my head which at the moment is where it is.

I told her that somehow I felt like I should be able to "tough" this out. Her reply, "I think you've already done that. You've toughed it out enough."

As I left and was still saying how unsure I was of medications, her reply was, "what I know is that you don't want to be in this place any longer." So the truth, but so hard to move out of the box.

Meltdown

I don't know how many of you are familiar with canine body language, but it's really quite essential for dogs and humans. Most times, people do not read canine body language well, and wind up miscommunicating with the animal. This can result in snapping , biting, dog fighting, and a number of other possibilities. The topic itself is way too much information to explain here, but there are many good dog books out there with photo illustrations. If anyone is interested, feel free to e-mail me for some titles.

But the one I want to mention here is FEAR, because that's how I'm feeling.

The picture of this puppy here is a good example of fear. If you look closely, you can see what we call the "whale eye" of a dog, similar to the white part of the eye of a whale. Dogs present this when they are fearful. They look through the sides of their eyes rather than turning their whole head which is the more normal response for dogs.

Yesterday's therapy session wound up being mostly about fear. This conference cemented the fact that I'm so fearful of the future, what to do, what not to do, etc. Much of this is my own doing I admit. It would be way too hard to explain here, but those of you who know me better, will probably understand. C. asked me about the fear, and I had the absolute hardest time talking about it. I sat there trying desperately to hold back my tears, quivering in the process of even trying to articulate anything. It was like a meltdown, one I have not had in a very long time. Even C. said she could see the massive amount of fear I had in my eyes which is surprising since I had such a difficult time even looking at her. I tend to get that way when I'm talking about really hard things.

I left with her asking me whether I wanted to come back which I found odd? I told her I did, and we set up the appt. for next week. She asked me to drive a different route again, but I just couldn't. I was very tired and wrecked emotionally. I could barely keep it together in the grocery store and just wanted to get home to cry in private honestly. I didn't cry, but wound up sleeping for several hours and then doing nothing the rest of the day but edit photos from the conference.

It's like I can make progress in other areas of my life but this one has a huge stop sign in front of me. Even when C. uses metaphors of being in a big pool and sticking your toe in before jumping all the way in, I feel like even when I do that, it still doesn't make me feel any more confident. And I don't know what will give me confidence.

Within the past several weeks, I've been digging around as to certain aspects of my fears and my job which is of course all good and well, but it's now finding a way to move beyond them. And this is where I falter. I honestly don't think it's because I'm stubborn, it really is about the FEAR. I know that may sound like there is an easy fix, but I think you can get to a point when it is much more complicated.

Right now, I'm just feeling so broken in many ways that it hurts so immensely. It's like I can see myself from the outside, and feel such sadness for myself (not in a pity way). I see many people around me capable of moving on with their lives even through many difficulties, so why do I have such a hard time with it?

:sigh: Every time I even think about this subject, all I want to do is cry, and I am seriously not a crier. Yesterday was a really hard day and today doesn't feel any better.

Sorry for the sad post. I'm just majorly down.

Mazeophobia

My therapy assignment was to drive another way home. It seems simple enough except if you have a fear of getting lost. Apparently, the technical term for this is "mazeophobia." This was one reason why I did not do the Portland Marathon which was my other option from the Wineglass one I just ran. My original plan had been to run the marathon, then go to Washington state for a few days. My main purpose was to visit Bastyr University and see Portland and Seattle. After I had everything figured out (and I had found a cheap plane ticket), I had a sudden panic of getting lost in a completely unfamiliar area. As C. said, "your fear got the best of you." So true.

After telling C. about all this, I also went into my other fears about the uncertainty of life, my future, etc. We talked about this, and then she gave me the assignment to drive a different way home. This threw me for a loop. I wasn't prepared, and I only knew a few ways to get home. She was like, so pull out a map and just see what happens.

I seriously wanted to give all these excuses as to why I could not do this. She wasn't forcing me to do this, just saying it as a suggestion. But me, who wants to show I am trying, was trying to convince myself that this was no big deal.

This exercise, however, was more than about just going a different way home, but about trusting myself. I had told C. that I have certainly gotten lost before many times and found my way. I didn't just sit by the side of the road boo-hooing. She agreed, but said, "but you didn't tell yourself that at the time. You didn't trust yourself or have confidence"

So after doing my errands, I did take a different way home. C. had wanted it to be a way that I had never been. Well, it didn't exactly happen like that, but I did take a route that I rarely ever take. This was the road that I had a bad car accident on six years ago. I had never driven the entire road from town back to my place, simply due to fear. I think it was overcoming a hurdle, knowing that I would be okay, that the road was really going to stay in place. I trusted myself to drive on that road again and remember the beautiful scenery of horse farms, trees, cows, the sunlight hitting the fields, etc.

Sometimes, I think we muddy our minds by focusing on the obstacles so much that we forget about the beautiful memories, creations, life, laughter, and love that has occurred. And in the process, we lose a little bit of ourselves too. So each time, we allow ourselves to be in a place of discomfort, we can grow, learn, and learn to trust ourselves again.

By the way, if you want to look at a list of other phobias, here is a lengthy list.

Recovery musings

Today's therapy appt. made me think about recovery and what my goals really are. Sure, it is to be ED-free, but it's not as simple as that.

I was telling her about my fear of "post-marathon" blues. You know it's kind of like the "post-vacation" blues, where you feel depressed and know that you're going back to your old life whatever that may be, except that it becomes worry about backsliding into eating disorder behaviors. I was truly honest with C. and told her that I think one reason why I've done "better" (this is in the context of the last few years) for the last ten months is because my eventual goals were to run marathons.

I felt so hypocritical after saying it, like recovery should be more than just about running marathons. I said to her half-tearful that "I don't want to have a marathon planned in order to allow myself to eat. I want it to be about being healthy and feeling okay with myself." She completely understood what I was saying, but then said and I'm paraphrasing here, "you know what, if it takes planning a marathon year after year to continue to eat, then maybe that's what you need right now until it becomes about health. I know you'd rather it (recovery) be for intrinsic reasons rather than external ones, but you're just not at that point yet."

I'm not sure how to feel about everything she said. On one hand, it's all true, but on the other, I just feel like I'm such a let down and loser. I know external validation from wherever it comes from can only go so far. You have to get to a point of wanting and creating internal validation or else, you'll continue to keep running in circles. Circles don't end, they're continuous. Lines, goals, and paths end, and that's where I'm hoping to eventually be--on the recovered end.

Text messenging as a therapuetic intervention in eating disorders

A raise of hands how many people use text messaging with their therapists? I haven't come across many that have. Do you think it would be helpful?

In this article out of Nursing Times, Amanda Hazelwood, a consultant nurse, uses text messaging as an adjunct therapeutic tool along with therapy for treating eating disorder patients. The idea of text messaging is to help clients express their feelings and emotions without enduring the face-to-face contact, especially for those who may have social anixety issues or feel guilt and shame. Text messaging can also help build trust in the therapeutic relationship as well as allow the therapist and individual to see the mind frame she or he may be exhibiting. There is also the aspect of being able to "save" a message or help in immediate crisis.

Overall, I think this is another tool, showing how our technology is evolving into treatment. I think my only gripe is the possible overdependence issue with some individuals. I'm sure the policies would be outlined beforehand, but the possibility is there.

I've actually always wondered how many therapists implement these types of tools or whether they feel it goes beyond boundaries. Though I'd consider myself more of an e-mail type, many of my therapists have not been. Or rather, they'd let me e-mail but just never respond or they had a disclaimer about how the internet wasn't private and e-mails could be lost. This is of course all valid reasoning. Most times, if I was e-mailing it was about things I thought about after the session or things I didn't say, and sometimes it would be brought up at the next appointment, other times not.

These days, I stick to my face to face appointments as I think my body language says a lot about how I'm really feeling. Therapy is probably the only place where I try to let go and forget about living behind the mask. It's not always easy as my natural reaction is to hide, but C. seems to pick up on this and ask about it. I'm still not sure whether I'd ever go the text route. It feels funny to me. I rarley text anyway, so maybe that is why. But I think for this new generation where texting seems all the rage, text messaging might be helpful as a part of therapy as long as the policies were told beforehand..

What's your reality?

This week is super busy, trying to get everything done before my trip. Since today was the only day I had off, I pretty much crammed a lot of errands. After my psych appt., my dermatology appt., my glove appt., and running around to various stores, I'm extremely exhausted. It didn't help that my eating and fluid intake were not so hot today either. I still have more to do, but I'm leaving that for tomorrow and Wednesday. Blogging this week may be a little light, but I still want to write a few posts.

My first appt. was with C. We talked a lot about my upcoming trip and my stress and anxiety of seeing my parents, as well as other catch-up stuff in my life. Something she said really sticks out.

"Remember, what your parents say do not have to become your reality."

She said she was saying this, so I had a different voice to hear, to put something else in my head. It was important that I heard that, because I think I do indeed hear my parents' voices a lot. And that tends to drown out my own voice, even when I don't exactly know what that is.

It reminded me of the different voices we hear--whether it is the ED voice, the voice of our parents, our friends, our relatives, a professor, etc. Sometimes, these voices can be overpowering, "controlling," and negative. In our vulnerability, we lose our own power, follow those voices, and try to make that our reality. And in the end, suffer because of it.

This is not to say that sometimes these voices are positive, encouraging, and supportive. Hopefully, we begin listening to that and finding our reality that way.

It's been a long day

I thought I'd give a quick update for those of you who might be interested in the lastest accounts of my oh-so-called-life. First, as I spoke about this weekend with my dad's and D.'s dog, Claude, the biopsy report was not favorable. He had two different types of cancer which metastatized and were ravaging his body. The decision was made to give him his wings. In the end, as difficult as it was for them, I think they felt better informed and able to "know" they made the right decision. Any situation like this gives me perspective of the time I too might have to make that decision for my wonderful four-legged companions. It's probably one of the only things that makes me cry and not many things do.

Secondly, I had my first therapy appt. with C. I was nervous and it felt awkward at first, but as I began to talk, there was a sense of comfort. The appt. itself was a normal intake type session, except that I tried to rehash the last six years of my life in 50 minutes. That really isn't an easy thing, and I'm sure she got a bit lost and confused. Hopefully, she got the basic idea. I'm sure as we go along, things will be clarified and better understood. One thing I did find sort of humorous was the fact she remembered meeting my dad. She said, "yes, and he did not listen just lik you said." My dad's impression of her consisted of "cute, Jewish woman--seemed nice" Hmm, slight differences in impressions.

The only catch to all this is my pesky insurance. I thought I had double the sessions allotted to me, and a mental health rider policy. Apparently, that is not the case, and I only have some horrible number of 10 sessions for a calendar year! I don't know what insurance companies think that you can really achieve on such a limited time. Besides that, my co-pay isn't really a co-pay but instead some co-insurance policy, making me pay half C.'s fee. I'm really unhappy about this and am now kicking myself for changing policies a few years ago. I could have sworn it was different. Everything would have worked out okay if I had met my deductible which is sky high. See folks, this is why you try desperately hard not to have an individual policy. They just run you into the ground with costs. So for now, I'm just going to have to work with what I've got and go from there. Sometimes, it feels unfair, but that's life for you.

Therapy call

A week or so ago, I mentioned To therapy or not. Yes, I have decided to go back, now I just had to make the call. I find calls like this to any professional very nerve-racking, at least initially. It's silly, all they ask is an appointment time, your name, phone number, reason why you want to be seen, etc. It's nothing earth shattering or explicit details (at least they shouldn't anyway).

So, shaking like a leaf and all, I called Therapist C. at the end of last week. I was secretly hoping to get her answering machine, but to no avail, she answered. I told her who I was, and she was very surprised. I don't know whether it was the fact that it was me or that I had somehow "found" her. She did ask that. Heck, she is on the web, it's not that hard. Plus, she's on my insurance list, and I've read a few pieces here and there about her over the years. She also asked if I'd seen Therapist A., the one who was too lackadaisical in her approach. I told her yes and that we just didn't mesh well and left it at that.

As we scheduled the appt. which is two weeks away, she reminded me of the fact that if it was about eating issues, her words were, "well, I'm not any better now than I was when you last saw me." This is the interesting part, at least to me anyway. I found myself saying, "I'm not completely recovered or anything, but I am better--more stable. I didn't want to work on eating issues as much as other stuff that I needed to address." She seemed to be okay with that. And I understand what she was saying--that there are other experts in that field which she could refer me to. But the thing is I chose her. I knew her expertise wasn't eating disorders, but because of the relationship I had with her.

After I said my statement about being better, I had one of those self-reflection moments of asking myself if I really was. Was I only justifying this to her, so she wouldn't be concerned and still see me? Logically, I really do know I am better behavior wise. When Therapist C. first saw me almost ten years ago (I saw her for three years), I was such a mess--depressed as ever, restricting, purging, overexercising, and just stressed to the max. So anything seems better than that. Still though, I have a tendency to be afraid to say when I'm better or happier or anything like that. It's like this fear of jinxing it--that once said, poof, it'll be gone in an instant, and I'll be left back at square one.

I guess I'm just feeling like this is pseudo-recovery right now, like it's not truly real, that I'm just a moment or step away from a relapse. That some traumatic, awful event will send me over the edge.

But then again, maybe I'm just afraid of opening a huge can of worms again in therapy?

To therapy or not

I've been thinking about going back into therapy for awhile. Whenever I decided to do this, it becomes an ordeal of analysis, and you'll see why below. However, I find writing it out gives me better success for follow through.

It's been almost nine months since I've been in any form of therapy, though that's not the longest I've been without therapy. Honestly, I feel a little pathetic that I feel this kind of need. It's not even really that but moreso in that it's the same issues--fears, anxiety, my future, my parents, and other issues as well. I guess I'd call them unresolved, though I've come a long way in learning the whats and whys.

So here I am trying to think of who I should see, and this is where my dilemma comes in. Do I want to see one who specializes in eating disorders or do I want a more general therapist? Do I want to see one I'm familiar with or start brand new with someone different? Do I want a passive approach or a more aggressive approach? Do I want one who is CBT-focused, psychodynamic, interpersonal, eclectic, or something completely different? So the run down of therapists are:

Therapist K. specializes in eating disorders and uses CBT and psychodynamic. I have seen her off and on for the last five years, so she knows me well. She takes an in-between approach of passive and aggressive but mostly gives you full rein of decision making which is sometimes not my forte. She is very knowledgeable about eating disorders and keeps up to date on the latest research which is something I really do like. She's probably the only therapist that has let me have my dogs there which I found helpful. Okay, that reason isn't a great criteria, I just thought it was cool, despite the fact she was allergic to dogs! Plus, I think she enjoyed seeing them a lot too!

A few drawbacks to Therapist K. are that she doesn't take my insurance and she has limited time.

My last therapy stint with therapist K. went okay, but we both became frustrated (she at me for not making progress and really wanting to recover and me just frustrated with myself). So we ended our time together with her leaving the door open for me. I took that break up hard and felt a sense of loss. I needed time to get past that. Though what she said was true and hard to hear, I still felt crushed and dejected.

Therapist R. also specializes in eating disorders and body image issues. She's currently the ED therapist at the main university here and has a small private practice as well. I've only spoken to her once on the phone which was awhile ago. She has told me she uses more of an interpersonal style of psychology and looks at a lot of relationship issues. Her approach is more aggressive than passive. I'm pretty sure she accepts my insurance and is willing to be negotiable with her schedule.

Therapist V. specializes in eating disorder and body image issues. She currently shares an office with Therapist R. I don't know too much about her style of therapy, but is more on the aggressive side. I haven't officially spoken with her. I chickened out at the last minute when I had originally thought about seeing her.

Therapist A. is a general therapist but also deals with body image issues. She was the ED therapist at the main university here (maybe five years ago) until she decided to open up her private practice full time. I saw her for about six months. It didn't go that well. We had different styles and didn't mesh well. She takes more of a passive approach towards eating disorders and therapy in general. We had many moments of silence! I terminated that one due to our differences. She understood and left the door open for me to come back if I so chose to.

Therapist C. was my therapist in college for about three years. I abruptly ended my sessions with her, because I took a medical leave of absence my last semester. It was an emergency session, and by the end of the week, I was gone. Her style is CBT and psychodynamic. She is more of a general therapist but specializes in working with fear as well as a few other things. Overall, my time with her went well, and she did help me through some very rough patches.

The one drawback for her is that she shares an office with Therapist A. Now, I know that that really shouldn't be an issue. I'm sure both are professional, it's just me and my paranoia. Therapist C. also knows several clients from my work. I did deal with a similar situation in that Therapist K. shared an office with a client whose dog I have taken care of many times. I dealt with it okay, but again, it's just that paranoia and six degrees of separation feeling.

Then there is Therapist D. I don't know much about her other than reading her website. She doesn't give specifications as to her style and seems to be a general therapist who works with eating disorders and sports performance as well as other issues.

There is also one other group in town with a variety of therapists. I don't know much about them but have heard good things.

Ultimately, I know I need to call these therapists and get information. I've been in therapy long enough to know what works for me and what doesn't. I know with a therapist who is more the passive type, well honestly, I'd probably just bullshit my way. And I don't mean that in a smart ass type of way, just that I'd have more trouble opening up, sharing my true feelings, and just not getting anywhere. I know I'm the type that needs challenges (I wouldn't necessarily call it "homework"), lots of food for thought, that type of thing. This doesn't mean just go read this book, it will make you feel better.

With Therapists K. and C. who know me well, what holds me back from seeing them is feeling like a failure. Logically, I know therapists are there to help you cope, deal with life, give new perspectives, etc. But sometimes I wonder if it is better for me to try someone completely different, kind of like having a "blank slate," though I despise the thought of going through my entire history again. A friend of mine would tell me make a pro/con list and decide what my factors were for therapists, but that just seems too logical. This is why I say therapist shopping for me becomes an analysis procedure.

The other thing for me to think about is WHY I would want to be in therapy now? It's really more about my life, getting over certain phobias, learning to move on, letting go, and gaining self-esteem than it is about the ED, although everything is essentially intertwined. Sure, I've talked about a lot of this in therapy in the past, but I know I can't keep putting these major life decisions on hold anymore. I'm 28 and not getting any younger. There are several other issues involved with my parents, expectations, social approval, etc.

I guess right now I'm feeling a bit "blue." I'm not sure whether it is the fact that three-quarters of the year has gone by, and I feel like I've accomplished nothing. Or that fall is coming soon and there is a hint of nostalgia. Or that I get tired of my father continually harassing me about graduate schools and moving closer to them. Or the sense of disappointment and inferiority I feel. Or the anxiety about my upcoming marathon which I feel very ill-prepared for. It's probably all of the above.

Sometimes I hate the fact of knowing these things but yet feeling so stuck that everything feels insurmountable.