![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Racer on October 28, 2006, at 17:23:42
This has been a recurring issue lately. But, of course, it's complicated...
I don't know what I want, but I get to feeling so isolated sometimes, alone because people around me don't understand. It's much, much worse when they think they do, too.
Even my former pdoc, Dr CattleProd, told my current T (a specialist in eating disorders, CEDS, and she lectures on the subject all over the country) that she didn't need to worry about my eating disorder because my weight was just fine! People in my family seem to think that I must be "all better" because I'm not so thin. Even my husband doesn't have a clue about what's going on inside me.
Last night, I was invited out to dinner with some friends/acquaintances. I called my husband, to see if he wanted to meet me there, but he said no -- he wouldn't, but I should go. So, I came home. He thought it was because I thought I wasn't allowed to go, but really it was because the reality had hit me: if I went, I'd have to pick a food from the menu, in a restaurant I'd never been to, and then eat it. In front of people, no less. And I knew, if I picked something I felt safe eating, someone there would comment -- and probably pressure me to eat more than I felt safe eating.
I also find myself feeling completely at a loss in other ways. I don't really understand what it is that makes me anorexic. I know what it does for me, that makes it so seductive, but I don't understand how that happens. I do know that I can't get it just by not eating, though. Something has to switch in my brain for the good stuff to start. (I guess the "good stuff" is really starvation-related, so that's a bad name for it...) Whatever it is, though, I can't make it happen. It just does. Something changes, and I go back into it. It's distressing, because it's as though I'm taken over by something alien. Even while it's going on, I can watch, and say, "That's just not right..." But I still can't stop it, once it starts.
I've caught myself thinking, though, at times over the years, "Can't any of you *see* how badly I'm doing?" That does make me think that there's at least some part of this that is related to creating a visual representation to communicate my distress. Of course, that's why one motto common to ED treatment is "Use Your VOICE!" Use your voice to communicate that distress, not your body.
Anyway, one thing that brought this up was starting Zoloft. My experience on SSRIs is that I gain a huge amount of weight. I'm very frightened of that, and I'm also afraid that people will think that's only my ED making me afraid. It's not. Or, if it is, it's still a real fear, and it's not distortion that I've gained that weight. I didn't tell the new pdoc about my ED the first time I saw him, and I don't know why. I think, though, that part of it might have been my fear that he'd look at me, at my current weight, and think, "she's too fat to be anorexic, so she's either bulimic or delusional." (I don't think he did. He asked for three numbers: my lowest weight, my current weight, and what my goal weight had been. I was concerned, because I answered him honestly, that he wouldn't continue to prescribe Ritalin to me, but he did.)
After that, I got to sit in a room with people discussing mental illnesses, including bulimia. Now, I know bulimics. The group therapy for EDs that I go to twice a month is virtually ALL bulimics. (I'm once again the only restricting AN there...) So, I hear things that I can understand, even if I can't totally relate to them. Listening to that conversation, I felt so alone. I finally got up some courage and said, "I have a friend who's bulimic, and she told me..." But even that was misunderstood. (Dr CattleProd was kinda pompous when he said something like, "well, anorexia is only about control." Even trained mental health professionals don't necessarily know much.)
And there have been recent posts here that I have also felt upset after reading. I have been feeling as though what I'm experiencing is not considered real, somehow. That's a bad way to explain it, but the feeling is complex. I have been feeling kinda invalidated, I guess is the overall theme. I want to communicate my pain, but it feels as though no one out there really understands it, as though everyone I try to communicate it to is so sure they understand that no one really listens to me. That's it: I've been feeling unheard again. And you know what? Part of the anorexia is in response to not feeling heard.
OK. I learned something typing this. Thank you all for your patience...
Posted by sunnydays on October 28, 2006, at 18:30:54
In reply to Struggling about being misunderstood, posted by Racer on October 28, 2006, at 17:23:42
Well, Racer, I'm sorry. I can't understand what's in your head because I'm not there. But I feel tremendous empathy for you because I can feel the pain in your words. Some of what you describe about a switch in your head sounds like what I feel like about getting depressed sometimes. Keep trying to be heard Racer. It helps the rest of us get more practice at hearing you.
sunnydays
Posted by ElaineM on October 28, 2006, at 19:01:14
In reply to Struggling about being misunderstood, posted by Racer on October 28, 2006, at 17:23:42
Racer, I need more time to process your post and figure out what I want to say. Right now, I can only feel that I have something to say in response, feel the desire to inside, but can't pull it all out. So I'll definately be back.
But I was just wondering if it would bother you to hear thoughts about stuff, or if that would just make you feel more unheard, if ideas clashed?...though I'm not sure what I could possibly say that would be so wildly different. I'd like to talk because it has been years since I've been around anyone else who's had an ED, nevermind someone who's also been a restricting AN. I'm curious to figure out myself more, interms of this.
But I also wouldn't want it to seem as though I was trying to explain you specifically, just because I've had, have, had, the same thing. I mean, you probably would never think that right? I don't know. Just thought I should ask just incase.
And then finally, I hope me asking the stuff in this post doesn't sound ....don't know what adjective I want....too soft-handed(?)
Anyways, you can let me know. thanks.
Posted by Racer on October 28, 2006, at 19:22:55
In reply to Re: Struggling about being misunderstood » Racer, posted by ElaineM on October 28, 2006, at 19:01:14
>
> But I was just wondering if it would bother you to hear thoughts about stuff, or if that would just make you feel more unheard, if ideas clashed?...though I'm not sure what I could possibly say that would be so wildly different. I'd like to talk because it has been years since I've been around anyone else who's had an ED, nevermind someone who's also been a restricting AN. I'm curious to figure out myself more, interms of this.It's funny you should bring that up. When I wrote my post, I was trying to be very careful to phrase everything in terms of my experience, my feelings, so that I didn't offend anyone else with an ED who might read it. Writing about it, talking about it, and listening to others who've experienced similar things helps me figure out what is going on for me, and I'd be -- well, I can't really say delighted, you know ;-} I'd be pleased, though, to share that process with you.
I've only ever met one other restricting AN who didn't progress to b/p. It would be interesting to hear your experiences, too.
Posted by Jost on October 29, 2006, at 16:51:08
In reply to Re: Struggling about being misunderstood » ElaineM, posted by Racer on October 28, 2006, at 19:22:55
I wondered, Racer-- and I don't mean to in any way invalidate or imply that the wrong answer would invalidate your feelings, or the reality or rightness of your perceptions or beliefs-- but could I ask one thing. It's a technicality, but it would help me orient myself in your world== a little
when you say that you gained a lot of weight on SSRIs, could you say how much, and over what period of time, and whether there were any clues you got as to why you did, or explanations that may be out there about why SSRIs cause weight gain.
I dont know much about SSRIs, except the most superficial things.
I definitely understand your not going out to dinner, for the reasons that you didn't. I wouldn't go to restaurants for years-- for those reasons. Still have the reaction, and still put a lot of limits and provisos on going.
I do think we can understand, and empathize, and not think you're "imagining" things-- or just deluded. It's more important how you perceive things, and maybe to some degree if there are other parts of your mind that perceive things differently, or could, in time, react to things differently--which could lead to different outcomes in how you managed things, and even in the ultimate way experiences turned out. That's hard to know, but I see that it's happened in certain ways for me/
Even though I see changes in myself along those dimentions-- I can't understand how they arose, or what the "truth" was or is about many things.
Jost
Posted by Poet on October 29, 2006, at 17:59:11
In reply to Struggling about being misunderstood, posted by Racer on October 28, 2006, at 17:23:42
Hi Racer,
I don't think it's a struggle about being misunderstood you're facing, but a struggle to be understood. Then again, I haven't had psychology since psych 101 in 1976 so what do I know? Strike that first sentence from the record if you wish.
I have told so few people about my bulimia that it is still Poet's Big Secret. My T knows, Dr. Clueless and expdoc know, a restricting anorexic friend knows and people here know.
My husband knows too, but thinks it was all done and over with long ago. So I get how hard it is for you that your husband doesn't have a clue what's going on inside of you.
I don't know what makes me bulimic either. I can't believe it's something I chose to be. I didn't decide one day to be depressed or have social anxiety and I don't accept that I decided one day that bingeing and purging was something I wanted to do.
I would not stay on a SSRI that caused weight gain. I lucked out that neither Paxil or Effexor XR did. I hope Zoloft does not cause any weight gain for you. I know how devistated I would be if something that's supposed to help me was helping my depression, but triggering the need to purge, like it would trigger your need to restrict.
I didn't tell my T about being bulimic until my sixth session. I'm not in therapy for it so my T never asks and I don't volunteer. The only time she was concerned about my weight was during a major depression where I lost 10 pounds. I was seeing expdoc then, too and he would always ask about my weight and if I was actively bulimic.
You're brave for going to group to talk about your ED. I will never do group therapy (PERIOD)
Even braver for trying to get the people in that mental illness discussion to understand bulimia. Your quest not to be misunderstood is not in vain.What you're experiencing is real. Struggling about being misunderstood and to be understood is real.
Dr. Cattleprod was wrong. I question whether he understood any mental illness, not just anorexia.
One last thing, about dining out. I am afraid someone will think that I'm bingeing even though they don't know I'm bulimic. Eating makes me self conscious. Eat lightly and take the rest home. Anybody who dares comment on your not eating, look them in the eye and say I ate a huge lunch. Or I've gone vegan didn't you know? I have a vegan sister so I know how vegans eat and I've used that line more than once. I know it's denying my problem and denying who I am, but as I said I keep secrets.
Poet
Posted by ElaineM on October 29, 2006, at 20:07:19
In reply to Struggling about being misunderstood, posted by Racer on October 28, 2006, at 17:23:42
>>>>Even my former pdoc, Dr CattleProd, told my current T (a specialist in eating disorders, CEDS, and she lectures on the subject all over the country) that she didn't need to worry about my eating disorder because my weight was just fine!
I really hate that. If severe emaciation is required before intense monitoring or intervention seems to be called for then that’s like endorsing the belief that a person is only as visable their worst symptom – and that for anorexia specifically, weight is the only factor that merits attention. How are sufferers supposed to combat the belief that starving is counter-productive if it is the thing *required* to be taken seriously by treating professionals?! I guess it’s a touchy thing cause obviously diagnostic criteria does state an amount of weight-loss required, but I do think it’s important for professionals to realize that a danger zone doesn’t only exist from that one point and downwards – that it spans higher as well. I don’t often fault peers for not realizing that you can suffer side-effects from starving while being at a normal weight or higher. And I try to not get upset when they don’t really “get” any of it – I mean, if *I* can’t even understand all of it, how in the world can I expect them to. I often *wish* for it though. And I often forget everything I’ve been saying here and just react based on raw emotions – most often franic depression.
But I do get mad at professionals for not learning beyond the central basics. I mean, I can read a chapter on ED’s but does that qualify me to make treatment judgements, NO. I realize that even regular docs would do more than that, but it’s just very confusing when a doctor can be so skilled in treating some forms of mental illness but not others. I suppose it’s quite unfair of me to expect one person to know everything, and I don’t, unless they make claims of also being experts in the ED field, or do not claim that outright but continue to make unqualified treatment judgements regardless. Ooo, I could go on forever about this.Do you know what your T’s reaction to such a statement was? Not just to you, but what was her response back to Dr.CP?
>>>>>>People in my family seem to think that I must be "all better" because I'm not so thin. Even my husband doesn't have a clue about what's going on inside me.
It must be so frustrating – you sound separated from. For me, I think it makes any version or amount of closeness/understanding seem like a pseudo-closeness – cause if they can’t understand the part of me that hurts the most, impairs my life the most, the part I’m most proud as well as most ashamed of, then the other stuff doesn’t ever count for much at all. It makes it too easy for me to discount ANY show of understanding about ANYTHING that’s going on with me. I think that’s why I don’t like when people try so hard to say the right thing to me (not that there’s really anyone around to say anything right now). I’ve almost wanted to say, Can you please not say anything at all instead? (cause all it does is offer me repeating proof that, even when someone *wants* to help, even if they want to try to “get” it, they can’t. *sadness*) But then, when people don’t try I despair over that too. It seems to be an intense desire to not be alone within myself – but I also know that AN is often explained as both a desire and fear of dependency.
>>>>>>Last night, I was invited out to dinner with some friends/acquaintances. I called my husband, to see if he wanted to meet me there, but he said no -- he wouldn't, but I should go. So, I came home. He thought it was because I thought I wasn't allowed to go, but really it was because the reality had hit me: if I went, I'd have to pick a food from the menu, in a restaurant I'd never been to, and then eat it. In front of people, no less. And I knew, if I picked something I felt safe eating, someone there would comment -- and probably pressure me to eat more than I felt safe eating.This part is not so much a problem for me now (but not very much before either). Perhaps only during the original dropping down. But after that, I’ve never felt ashamed of appearing out of the ordinary when eating with or infront of others. I never hid any behaviours (maybe modified them slightly, but never avoided doing versions of them). I never even hid my body. I flaunted my bones like they were the best of me, while feeling that they were also the worst too. I did it knowing that it looked disgusting to everyone, knowing I would visually be indentified, unquestionably, as severely mentally ill. I almost think there was a masochistic side to it. I used to display the part of me that I considered the thinnest (hiding the parts that I thought were still fat or “fat” – I’m never 100% sure) knowing that it would prompt negative reactions. I used to like the sideways glances, the looks of disgust (I did not ever think the looks meant envy or anything like that, which some AN use to deflect confrontation or objection). Once I was walking past a group of grown women, and as soon as they were behind me I heard one of they say “Eww did you SEE how skinny and gross she looked?!” And I felt good about it. I felt more confident after hearing that than I did a second before. I could explain the etiology of AN for me and what it started out as, and what it changed into, but it would take up too much of your thread. But I kinda think a part of the anorexia for me was that I liked the idea of controlling what people would automatically think was the worst thing about me. I liked picking the reason for others to hate me. Almost like a “please hate me for this, instead of noticing this and this and this and….”
But, from the times I was attempting to blend in, I noticed that some people try to build a bridge in social situations by quickly searching through their own head for experiences that they think can relate to me, that seem “similar” to what I’m going through. Usually that amounts to talking about there own view of how dieting is bad or hard, how women shouldn’t have to, how they beat the feeling of a needing to lose 5-10lbs. Or if I’ve used the excuse of not feeling well (though alot of the time, when eating different or too much food, it’s not even an excuse, it’s real) they talk about stomach things they’ve gone through, or talk about when they had food poisoning…etc. I can know that they’re trying, that they only want to create a reassuring commonality, but despite recognizing that gesture, it only ends up making me feel more different, more far away from normal. I always end up thinking, “God help me, *that’s* what their biggest food problems are?! I’m gonna die from this.” It’s hard, I mean, bless them for trying but…..*sigh* Such a catch-22. But then of course there’s also completely ignorant people, ones who try and say smart-@ss things about stuff they that’s unfamiliar to them. I used to waitress alot and got my fair share of remarks. But I also learned that if you bounce around enough, crinkle your eyes and never stop smiling, people will accept whatever excuses you give them for being too thin, not eating, looking pale…. I think I really learned how to debate and defend as though my life depended on it – cause the life I had spiraled into kinda did.
>>>>>>I also find myself feeling completely at a loss in other ways. I don't really understand what it is that makes me anorexic. I know what it does for me, that makes it so seductive, but I don't understand how that happens.
I’d like to hear more about that part because I’m not quite sure I understand. For me the thing that the disorder does for me *is* the thing(s) that makes me anorexic. I don’t know if I’d ask you to write all the good stuff about having your ED here, cause I worry it could be mistaken as proof that it’s alright, but I assume you’ve done that exercise before, right? We had an entire group in treatment devoted to talking about the positive aspects of having the ED. (I don’t know if that would sound weird to someone reading who’s never had one, but the point is to recognize what deficits the ED fills, as a first step in working towards substituting healthy ways to fill those holes. It’s supposed to help you recognize what the actual “enemy” is, and not fat) I’d be interested in what makes it so seductive for you personally.
I’ve read a bit about the obsessive-compulsive disorders – alot of stuff fits in along the spectrum somewhere. I like the explanation that AN is a manifestation of OCD, but with added biochemical side effects that develop and worsen as the symptomatic defenses intensify. I realize its one of many paradigms but I like how it explains it to me. I’ve read that unlike non-ED obsessive compulsive behaviors, anorexia actually rewards its victims superstitious behaviors with tangible results – results that are usually only *felt* within for other types of rituals, and not *seen*.[SL]
This is an explanation that I like, “Anorexia is a form of OCD where malnutrition creates an organic mind syndrome that enhances obsessionality and offers its victims the secondary gain of assertiveness and aggression as she defeats those in her environment who mobilize in opposition to her disordered behaviour.” A little more to one part, a little less to the rest, but all in all I relate to what he says.>>>>>I do know that I can't get it just by not eating, though. Something has to switch in my brain for the good stuff to start. (I guess the "good stuff" is really starvation-related, so that's a bad name for it...) Whatever it is, though, I can't make it happen. It just does. Something changes, and I go back into it. It's distressing, because it's as though I'm taken over by something alien. Even while it's going on, I can watch, and say, "That's just not right..." But I still can't stop it, once it starts.
What is it about the starvation process? Is it the process for you, or the side-effects, the opioid effect…? (Jeez, it don’t know if it’s best to answer) Do you know *when* you tend to go back into it? The first time I really don’t know for sure what “caused” everything to converge. But for me, the original bout was very very different than the relapses. I can explain the relapses pretty “easily”, but it’s the first onset that I’m confused about. I’m mean, I’ve read theories that make perfectly good sense, not just theorectically ;-) but personally – seem to explain me quite well – but I never get that “yep I totally completely understand now” feeling.
Levenkron places a lot of significance on deficits of trust, dependency, and positive parental identity messages, which he says results in developmental emptiness. He says that, “The style of her struggle with others (disfigured appearance, ascetic willpower in depriving herself of nutrition, special thinness, eating rituals) will all coalesce to form a pseudo-functional identity that will alleviate her terrifying sense of emptiness.” [These are from notes I made for myself a few years ago while reading to understand myself better, so I don’t have all the page locations immediately. I’ll search them out and acknowledge them asap.] That being said, this all may meaning nothing to anyone else in the world but me, but I’m just sharing what I’ve come to believe.
>>>>>>>I've caught myself thinking, though, at times over the years, "Can't any of you *see* how badly I'm doing?" That does make me think that there's at least some part of this that is related to creating a visual representation to communicate my distress. Of course, that's why one motto common to ED treatment is "Use Your VOICE!" Use your voice to communicate that distress, not your body.
I think I use starving to deaden everything – to smother the anxiety I have at living the life I was…am…was -- to actually feel like death. Do you find it hard to use your voice to communicate distress? What is it about distressful feelings that make them need to be silenced and instead replaced with actions? (I’m asking that part cause that’s what I’m confused with myself.)
>>>>>>Anyway, one thing that brought this up was starting Zoloft. My experience on SSRIs is that I gain a huge amount of weight. I'm very frightened of that, and I'm also afraid that people will think that's only my ED making me afraid. It's not. Or, if it is, it's still a real fear, and it's not distortion that I've gained that weight. I didn't tell the new pdoc about my ED the first time I saw him, and I don't know why. I think, though, that part of it might have been my fear that he'd look at me, at my current weight, and think, "she's too fat to be anorexic, so she's either bulimic or delusional." (I don't think he did. He asked for three numbers: my lowest weight, my current weight, and what my goal weight had been. I was concerned, because I answered him honestly, that he wouldn't continue to prescribe Ritalin to me, but he did.)
Yes, this is something else I’m all too familiar with. But first, is it really a huge amount of weight, or a huge amount of weight for you? (not to say that it makes it any less disturbing) To me, I’d consider the amounts I lost, and the amounts I put on re-feeding, to be actually huge. But the part I could never make first pdoc understand was that for me, 5lbs seemed equally as devastating as XXlbs. Couldn’t understand that it was the act of gaining (not necessarily how much) that was hard to endure. Though, I’m not gonna lie, numbers did end up becoming extraordinarily important to me.
But I think it’s another tough dilemma. [It goes without saying that it’s mandatory to work on the emaciation first. Meds will just not work optimally or at all in someone quite malnourished and underweight. Weight must always be restored to a certain level first.] When weight-restored once, a doc asked me if I would trade maintaining at a slightly higher weight, for the possibility of giving a med the chance to take away a lot of my anxiety and depression. But that’s a tough question. I’ve never been keen on taking leaps of faith, of believing in “maybes” – is that just another reflection of an anorexics inability to trust in caregivers?….I don’t know. I have ALOT of issues with medication – perhaps even a mild phobia, but for ALL meds, like even vitamins and antibiotics. So it may be a slightly different additional aspect I’d bring to the med debate. If, for you, it’s not just only about the possibility of weight-gain, what else is it that you are worried about regarding the SSRIs?
About hiding your ED, I’ve thought of the same with my neurologist, of all people, and new PCP’s I’ve been calling (and recently, concerning something else I haven’t yet posted about). Cause when I told the Neur. about the anorexia, which I’ve been specifically out of intense treatment for for awhile, he asked “what medication are you on?” I said none. He asked if he could put me on one (before even addressing what I was sent to him for). I said no, and explained that, honestly, I didn’t want to gain weight, was aware that it was a known side-effect of what he suggested (not Zoloft), and didn’t think it had anything to do with the problem I was sent to him for – at least not without him examining and testing me first. At least he may have been slightly more believable then. He smirked though. And then I got that known sinking feeling, the one where you just know that someone else is not gonna look behind or beyond your psychiatric history. I just didn’t want to have to prove myself and my perceptions everytime I opened my mouth. If I’m always gonna be seen as that diagnosis, forever, then what was the point in recovering at all?! I don’t want to have to fight for my credibility – for the same benefit of the doubt that most others are given right off the bat. I realize that I was the one who starved it away in the first place, but when am I considered redeemed?! If I worked hard enough to gain the weight back, then give me a little credit in terms of how realistically I can perceive things now. It sounds like you may have felt something similar. But I remember that early on, during the first time, a pdoc said I didn’t have anorexia because I still ate peanut butter! It’s so important to work with specialists who know what they’re doing. I was so very lucky to be treated in the places I was.>>>>>>After that, I got to sit in a room with people discussing mental illnesses, including bulimia. Now, I know bulimics. The group therapy for EDs that I go to twice a month is virtually ALL bulimics. (I'm once again the only restricting AN there...) So, I hear things that I can understand, even if I can't totally relate to them. Listening to that conversation, I felt so alone. I finally got up some courage and said, "I have a friend who's bulimic, and she told me..." But even that was misunderstood. (Dr CattleProd was kinda pompous when he said something like, "well, anorexia is only about control." Even trained mental health professionals don't necessarily know much.)
Was it the members who were offended, or the facilitator who discounted you? I could say more, but I don’t know it would be relevant, cause I’m not sure where the misunderstanding occurred. But man, I don’t the sound of this Dr.CP. Only control? A big “Not quite!” Mr.Not-Knowing-Enough. Is this your current pdoc, or and old one?
>>>>>>>>>And there have been recent posts here that I have also felt upset after reading. I have been feeling as though what I'm experiencing is not considered real, somehow. That's a bad way to explain it, but the feeling is complex. I have been feeling kinda invalidated, I guess is the overall theme. I want to communicate my pain, but it feels as though no one out there really understands it, as though everyone I try to communicate it to is so sure they understand that no one really listens to me. That's it: I've been feeling unheard again. And you know what? Part of the anorexia is in response to not feeling heard.
If I describe my own version of your “not considered real” experience, I say that I fear that others may view anorexia as only a more extreme end of a “normal” behavior. I experience so much frustration and sadness when I think others are seeing EDs as only strict dieting. I think the "feeling invalidated" theme makes alot of sense considering what you’ve been writing here.
Obviously my favorite author on several psychiatric conditions is Steven Levenkron. The book I’m quoting from is "Obsessive Compulsive Disorders: Treating and Understanding Crippling Habits" He describes OCD suffers as, “Individuals who have descended into a ritualistic world because they’ve given up on others emotionally.” It sounds a little harsh without the rest of the long explanations (like what “giving up on” means) but I personally really get alot from his explanations. He included a whole chapter on ED in his book on OCD. The part that touched me the most was when he was describing the OCD patient saying:
“[it] very likely has been a long time since anyone’s voice calmed them down, since anyone’s advice relieved them, since anyone’s guidance made them hopeful….In discarding others they say, `No one else can understand. No one else can help me. No one else realizes how important all these ideas are to me. I have to do everything for myself. I’m the only one who can do them correctly. I’m the only one who can do things in a way that satisfies me….but the catch is that OCD sufferers *never* satisfy themselves.” [Pg 179]I realize that this is only one guys body of work but it’s one that had meant alot to me, so I included it. [I don’t know if I’ve gone into it before but I have BDD (not related to shape or weight), and the OCD diagnosis that that’s suggested has … influenced professionals opinions concerning my ED treatment. I had BDD for around 8 years (so they tell me) before anorexia or food issues appeared.]
Anyways, feel free to disagree with anything I’ve said. I haven’t claimed to be an expert ;-) All this is only my opinions collected from my own experiences, my own thoughts, and select authors I’ve chosen to read (which is way more than just SL, but I'm kinda into him again right now). It’s definitely biased if not preachy, and if patronizing, I'm sorry. I know I’ve relied heavily on a single author, but hey, I never claimed to be a social scientist or researcher :) [Infact I’ll push the other books of his I have as well: "Anatomy of Anorexia"(a good beginners introduction) and "Cutting: Understanding and Overcoming Self-Mutilation". I know some criticize his books as self-aggrandizing and his tone pompous. But I think if he’s accomplished half of what he writes about then I actually find him too modest.] Just trying to figure myself out a bit. And I’m trying very hard to dance around language and a very sensitive subject here, but I’m sorry if anyone gets offended. Thanks for posting what you did Racer.
blove EL
Posted by Racer on October 29, 2006, at 22:13:40
In reply to Re: ...misunderstood (very long) » Racer, posted by ElaineM on October 29, 2006, at 20:07:19
> >
> How are sufferers supposed to combat the belief that starving is counter-productive if it is the thing *required* to be taken seriously by treating professionals?! I guess it’s a touchy thing cause obviously diagnostic criteria does state an amount of weight-loss required, but I do think it’s important for professionals to realize that a danger zone doesn’t only exist from that one point and downwardsAt the time he said that to her, I was within spitting distance of the goal weight he set for me. (That's all he did -- tell me how much I should be shooting for, and put a diagnostic code on his form.) My T, of course, laughed about it when she told me -- she knows better...
I wish, though, that doctors (and therapists, for that matter) would get over a few of their misconceptions about AN: that they can *see* it, for instance. When I was finally diagnosed, my BMI was about 14. Even then, I had to *tell* the doctor I had a problem! I'd asked for help in the past, only to have doctors say, "You don't look too thin to me." Another is that AN necessarily requires a lack of insight. Another doctor told me, "No, the fact that you're asking me tells me you're not anorexic. If you were really anorexic, you would lack the insight to know it." Hello? I was nearly 30 years old at the time, and had a lot of years in by then. If I didn't know *something* was wrong by then, I don't think I'd be suffering a mental illness -- I'd just be pretty dim-witted. Another doctor said something about my weight. I said, "well, I have an eating disorder and I don't know what to do about it. I've tried to eat, but it hurts too much." He nodded knowingly, and said, "ah... Food aversions. Well, I tell my patients who need to lose weight to avoid carbohydrates, so I guess you should eat more of them!"
Let's start out own medical school, teach them the part about patients being real people?
>
> Do you know what your T’s reaction to such a statement was? Not just to you, but what was her response back to Dr.CP?Honestly, I don't. She basically blew it off -- "that's how ignorant he is..." (This is the T whose two favorite phrases are "So what?" and "who cares?" remember -- she wouldn't bother to try to set him straight, I don't think.)
>
> I’ve almost wanted to say, Can you please not say anything at all instead?Ha! I have said it. I've told family members not to say ANYTHING AT ALL, EVER, about my weight. Ha! All they do is preface their remarks with, "Now, I know you don't want to hear this..." (I wonder why I have such trouble with setting boundaries?)
:^D
> >>>>>>I also find myself feeling completely at a loss in other ways. I don't really understand what it is that makes me anorexic. I know what it does for me, that makes it so seductive, but I don't understand how that happens.
>
> I’d like to hear more about that part because I’m not quite sure I understand. I don’t know if I’d ask you to write all the good stuff about having your ED here, cause I worry it could be mistaken as proof that it’s alright, but I assume you’ve done that exercise before, right?Nope, never done that.
Keep in mind, I've never gotten treatment as such: by the time I started seeing my current T, I had gained enough weight I was out of danger. What we work on is more related to depression and anxiety than the ED per se. Even the group therapy is less ED centered than I expected. Much more about feeling invisible than the issues around food, or even bodies.
In terms of what I meant, that's harder to explain. I guess it's got something to do with what throws the switch? I went nearly ten years at non-anorexic weights, mostly eating as close to normally as I ever have -- I honestly thought it would never happen again. And it did. There had been other times of stress for me, during which at times I'd stop eating, but it was never *restricting*, you know? Why does it happen? That's something like what I meant.
> >>>>>I do know that I can't get it just by not eating, though. Something has to switch in my brain for the good stuff to start. (I guess the "good stuff" is really starvation-related, so that's a bad name for it...) Whatever it is, though, I can't make it happen. It just does.
>
> What is it about the starvation process? Is it the process for you, or the side-effects, the opioid effect…? (Jeez, it don’t know if it’s best to answer) Do you know *when* you tend to go back into it? The first time I really don’t know for sure what “caused” everything to converge. But for me, the original bout was very very different than the relapses.The first time for me was not the best. It came on after I'd been sick, and had lost a lot of weight in the hospital. My mother was always very thin, and used to criticize me for being chubby. I was 13 -- it was baby fat, puppy fat, not a weight problem, just a growth pattern. I came out thin, and I wanted to stay that way. And so... The rest is history, right?
Each time, though, my weight goes lower. I think it's partly that the only reason I've ever stopped is the antidepressants. Not that they "cured" it, but that they caused so much weight gain for me. (and I'm talking about gains of over 50 pounds each time. By the scale, not my eyes.) Sometimes, I would catch myself thinking, "This isn't enough -- when I have to start ADs again, I'll gain so much, I have to have a little room so I won't get so fat..."
>
>
> I think I use starving to deaden everything – to smother the anxiety I have at living the life I was…am…was -- to actually feel like death. Do you find it hard to use your voice to communicate distress? What is it about distressful feelings that make them need to be silenced and instead replaced with actions? (I’m asking that part cause that’s what I’m confused with myself.)When I'm actively restricting, and successfully thin, I feel so strong -- SuperRacer! I feel better. And I definitely use it to control feelings that distress me. No question there. As for why I can't use my voice to communicate them, it's probably because no one has ever listened to me...
I do have to go, but I'll write more in response later. I really appreciate sharing this with you, Elaine. You may not be an expert on my eating disorder, but you certainly are an expert about your own. Other people's stories do help me work out my own issues sometimes. If nothing else, sometimes I learn new questions to ask about it...
Posted by NikkiT2 on October 30, 2006, at 13:15:17
In reply to Partial response... Holy Guacamole! LONG! » ElaineM, posted by Racer on October 29, 2006, at 22:13:40
This sentence of Racers triggered a thought off..
"Let's start out own medical school, teach them the part about patients being real people?"
(Racer will know where I am going at the moment)
The only way to change doctors opinions, and to stop them forming, is to go there and give training!
Contact your local hospitals, especially training ones, and ask if they do this kind of thing.. give service user training.. If they don't ask why.. tell them they should. If they do.. ask how you could get involved.Only with service users going in and telling thm what is good and what helps.. and also explaining what doesn't, and why..
You both speak so elequently, I know you could make a difference.
and, take my word for it, a difference can be made.. and it feels so so good!!
Nikki
ps - Elaine, if by any chance you are in the UK, I can help with the getting involved side of things.. *s*
Posted by ElaineM on October 30, 2006, at 21:48:25
In reply to ElaineM Racer.., posted by NikkiT2 on October 30, 2006, at 13:15:17
NikkiT2, that's one of the most touching compliments I've ever had. And it's one of the few that I've ever actually felt good accepting. Thank You.
I'd be way too afraid to speak to people in person. And I really don't know much beyond my own experiences and witnessing those of others in treatments with me. I was asked once to write an info sheet for adolescent sufferers about what treatment is like. Just cause the staff ended up knowing me, and I have a written voice like a kid myself. It meant so much to me to be asked - I'd give anything to help anyone else feel better about recovery and programs. They're such scary things, whatever your age. But of course, the fact that I was *asked* and not given too much of a guideline, I got so anxious that I couldn't write a single thing. I mean, it wasn't a big deal or anything, but it was something that I had *wanted* to be able to do.(oh well)
Thanks again. I smiled.
EL
Posted by Racer on November 3, 2006, at 14:41:30
In reply to ElaineM Racer.., posted by NikkiT2 on October 30, 2006, at 13:15:17
I talked to my T about it, too.
She did say that she thinks I'd need to be farther along in recovery before I did it, but she also thought it would be a good idea in future. She gave me some ideas about how to go about it, too.
And I've been encouraged elsewhere to write about it, although I want to catch up in my math class before I think about anything like that.
Just as an open question, what aspect(s) do(es) anyone think would be a good topic for writing about?
OK, maybe I might get excited about it, at least enough to do some writing...
This is the end of the thread.
Psycho-Babble Eating | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.