Posted by ElaineM on November 20, 2006, at 18:16:33
In reply to Re: Spoke too soon. :-( » Racer, posted by adrift on November 19, 2006, at 16:33:57
I think you both gave some excellent advice. I'll toss my own piddly 2cents into the pile. Ideally, I think it's true that we should all be aiming towards one day being able to eat what is needed when we're hungry. The cr@ppy thing is that that's usually the very last thing to happen in someone trying to recover from disordered eating.
From only the programs I've done myself, (though it tends to be standard) the treatment and advice for anorexics, bulimics, and obese patients was the exact same - because there's only one way to eat normally. We were told that people who are actively symptomatic as restricters, bingers and purgers must adhere to pre-planned choice amounts (certain portions of different kinds of food are considered interchangeable, and you must have a certain variety of choice categories in a day) and strictly scheduled times (ie, meals and snacks). I found this maddening every single time I started -- Why am I "gorging" myself when I'm not really hungry?!. But the philosophy is that once a person has an active ED they've, not only mentally, but physically have lost the ability to recognize, obey and respect hunger and satiety cues. It's like they must be forcefully drilled into our heads again. Racer, did you find your dietician helpful with this? Eating "normal" snacks and meals often, is the best, if not the only, way to stop bingeing.
When you regimentize meals and take away the option of bartering/rationalizing... you take the control of food intake away from yourself and any ED influenced thoughts. Being anorexic, I used to get uncomfortably full on very little. I used to eat until I was nearly sick in all my programs (to be fair I was also on weight-gain). But I had to expand my stomach, retrain my head to realize that (eventually) they were feeding me normal amounts for an adult female my age and height (which they adjusted for). Unfortunately, that's what alot of AN (and B) are afraid of -- they don't *want* to get accustomed to eating normal amounts. I remember being terrified when being discharged that I had grown used to eating "so much" food. I used to blame the strict eating plans for making me obsessed with food, but the therapist said, "You were already obsessed with food. That's why you came to us". Of course it was true. Once I accepted that this type of eating was what I had to do, no choice whatsoever, it (eventually) took the pre-worrying out of it. Obviously the post-eating worry was still raging, but again, that may be with me forever -- it's learning to cope with that that's the crux of recovery. That's the long-term stuff. They used to tell us that it could take a good year before our own natural cues would be dependable (and that's only if you stay symptom-free). Part of maintenance is learning and planning (ironically enough) how to be spontaneous and flexible with the meal plan -- though that usually comes much later.
Also, in terms of avoiding binges, it's best to not have off-limit foods. Although, that would be where the huge amount of coping strategies comes in. Very early in her recover on her own, one woman's mother would have the "high energy" foods physically locked in a cupboard and give her one portion whenever the mealplan, that they had taped to the fridge, called for. After a few weeks, they worked on leaving the cupboard unlocked for certain lengths of time (gradually increasing that). Eventually, there was no lock at all -- some slips now and then, but that was expected, and something to work on too during meetings.
Adrift, your idea of leaving the house is exactly what many of the women did. Though if your urges are strong Deneb (especially in the beginning) you could have someone "in on your struggle" stay with you. It's best to get as many people helping with your pro-recovery side as possible.
Deneb, I just wanted to say that you did an amazing job those days that you binged but didn't purge. THe more you can make purging not an option, the more your anti-bingeing side will strengthen. Seperating the urge and the behaviour is one of the first things people trying to recover start working on -- so it's really great that you've started to do that on your own. To gain some confidence, try and see if you can equal or go longer purge-free. Keep trying. Your health is worth the hard struggle.
((((Deneb)))) [who's okay with hugs right]
*safe hugs* for (((Adrift))) [if you're okay with that.]
[By the way, you were having a hard time lately. How's it going these days?]encouraging tip of the head for Racer :-)
blove EL
poster:ElaineM
thread:703525
URL: http://www.dr-bob.org/babble/eating/20060628/msgs/705617.html