Taking the Semester Off

I'm getting to the time where everyone is asking me why I am not back at school. It's not winter break any longer, although it certainly is winter here. And I'm getting asked questions that I usually have no idea how to answer. Things like, "Are you going to school somewhere else?" or "What are you going to do now that you're home?" or "Why aren't you at school?" And I usually respond with the generic, I'm just taking the semester off to figure out some life stuff and I'm going back to school in the fall. It's a perfectly reasonable explanation, I think, especially after the advice that one of my professors gave me: 

"It is difficult to answer people's questions. They never mean any harm by them, yet its very awkward when you don't want to talk about it. You'll have to come up with a short, very generic answer. It is important to remember that people take time off from college for a variety of reasons... A semester off is nothing. I know other students who took off for medical leave, but some just want a break for a while to figure out their path. That is really mature (and wise) to do. So often young adults just jump on the path they think is 'correct' by their parents, friend, or society without looking at all of the options. You get the luxury of looking at your options!"

So I personally think my answer is really good. But then, some people ask me the dreaded question of all questions... 

WHY?

And it's not that I want to lie to people--I am not a liar (if I was a liar, I would probably still be at school right now)--but I don't exactly know how to read people and judge how they'll react to me telling them the truth. For example, some of the elderly people at church, what would they think? EDs weren't really a thing back then, besides, everyone knows that they all gossip and talk to each other and I don't want anything I say to get misinterpreted and rumors to be spread and whatnot. And a lot of times, people will ask and it won't be an ideal time to share that information because they'll be other people around who I don't want to overhear what I'm saying or there won't be enough time for me to explain the entire situation because you can't just throw it out there that, hey, I've had an eating disorder for almost 7 years and that's why I'm taking time off of school. It doesn't really work like that. 

Also, like my mom told me the other day--it really is none of their business. She was referring to a situation where someone who our family barely knows was asking about why I was taking time off of school. My business is my business and no one else's. 

I do, however, pride myself on being open about my ED because I want to change the conversation we have in society about EDs and the stigma that surrounds them. I am totally okay with speaking freely about my struggles and my illness, but there is a time and a place for it. I know that, and I try to do what I am most comfortable with in the moment. If that means talking about it, then by all means, I will talk about it. But if that means shrugging off the question with a generic answer, then that is exactly what I will do and if people aren't okay with that, well, that's just too freaking bad because it is none of their damn business in the first place. 

I am not selfish for putting my recovery before my education,
my family, my future, and everything else.
Putting everything else on hold to recover is not selfish.
You are not selfish for taking time out to heal.

But there are ways in which I am willing to share what's really going on--through an email, through a text, through a one-on-one conversation where there are no interruptions. Because as easy as it is for me to say I'm taking the semester off, it's a really challenging feat for me, one that I struggle every day to accept, to embrace, and to not judge. 

Most people don't get that I just might not be 100% okay with what I'm doing right now when they ask these questions. And again, they don't mean any harm by them, I'm sure. But every time that I have to look at someone and say that to them, another piece of my heart breaks. 

I sent an email to a high school teacher of mine the other day, sharing a really cool video that I thought she would find useful in her classes. She emailed me back and asked me how school and life were going for me, and I was very open with her about everything. She responded saying: 

"I hope that you can rest in the fact that it is all right to be at home right now.  My youngest also had to take time out from college to get her bearings back, and during that time I know that 'being out' was really hard for her, even though it was the right thing to do.  Life is bigger than our plans, sometimes."

I want people to think a little bit more before they ask questions and pry into people's lives, especially if they do not know them very well. I want them to think about the timing and the location of their questions, especially with something like this. Anyone who knows me well knows that I love school, especially Gettysburg, and that I hate quitting something or not finishing something, so anyone who knows me would know that me being home right now is 1) not a normal behavior for me and 2) not something that I would opt to do on my own free will. I also think people need to be aware of the degree to which it is acceptable to pry into the life of another person in a particular situation. I'm completely okay with telling everyone, in any situation, that I am taking the semester off of school. It's the questions that follow that are not always timed the best, and I'm not always comfortable saying that I don't want to talk about it in that moment. 

And again, I know that people don't mean any harm or hurt to come of their questions, and that usually they are just curious or trying to make conversation, which is fine. I just wish that people would be more careful about when and where they choose to ask things and that they would recognize that this taking a semester off thing isn't as easy as it looks for me, that it pains me to be sitting at home and not in my dorm room or in class and that I'm not just taking a break from school--I'm trying to rewire my brain. And that, my friends, is not easy or simple. 

Thoughts on Gaining: The Truth about Life after Eating Disorders (Part 1)

A few weeks ago, I finally finished reading Gaining: The Truth about Life after Eating Disorders by Aimee Liu. This is the second recovery book I've read, and coincidentally, the second book by Aimee Liu that I've read. It's taken me a while to get through. 

I first bought Gaining when I was a senior in high school. I thought, A recovery book? Yeah. I'll read it and find out all the ways that I can look like I'm better, look like I'm recovered. I'll read it so I can find all the ways to hide my disorder. Before Aimee Liu, the only ED books I've ever read were memoirs or fiction--essentially instruction manuals for how to become sick, or in my case, sicker. Don't get me wrong--I love ED memoirs. I love that young adult authors are touching on EDs, which leads to conversations and early intervention. I just worry that sometimes they are too real. Too triggering. Too much of a how-to guide.

But Gaining wasn't like that. Gaining was research, put into real people terms, mixed with personal stories (shout out to Dr. Warren, who spoke on both of those sides and whom I've had the pleasure of working with for three years). Throw in Aimee Liu's wisdom looking back on her journey, along with bits and pieces of "You are not alone. There are others out there who feel exactly like you do," and you have a recipe for a very insightful and informative book for sufferers, researchers, loved ones, or the curious. However, this isn't a book review (okay... maybe it kind of is...), so I'm not going to go on and on about the value of Aimee Liu's work.

I am, however, going to go back through the book and highlight some of the important takeaways I got from each chapter--the things I've found helpful in motivating my recovery, the things that have been shocking, the things that have bothered me, the quotes that struck me, the times when she took the words right out of my mouth, all of it. Because I think in doing this, it will help me to figure out a better picture of what my recovery looks like, I think, going forward.

In order to overcome any problem, we must first admit we have that problem. We must face it, examine it honestly, and learn how to manage it. (p. xii)

Introduction--To Gain Is Good. 

To gain is good. We gain confidence as we grow, status and health as we prosper, and--so we hope--wisdom as we age. A gain of intimacy is essential for love, of toughness for survival. By definition, gaining is a source of pleasure and progress. Why, then, do so many women (and, increasingly, men) confound the meaning of this simple, satisfying word with shame and dread? [...] The greatest fear, however, is that gaining will expose some shameful inner truth. It's not about the numbers on the scale. Deep down, we all know that. (p. xiii)

It's true. Gaining is no longer about pleasure or progress, at least when it comes to weight. I remember being 12 and my dad saying something to my aunt about how I almost weighed as much as she did and all I remember is the incredible amount of shame that I felt around gaining. I was at an age where I was supposed to gain! And I was ashamed of it. It goes to show what value we put on numbers and gains in weight in our society. Look at Special K and their slogan, "What will you gain when you lose?" They are associating gaining with loss. What does that even mean?! It's a complete oxymoron. 

And that's not even about the numbers! It's about losing. EDs are not about the numbers. They become about the numbers, but they're not about the numbers. They're about what, exactly? I have yet to figure that out. Everyone is different. But my ED did not start from being about the numbers. I wasn't the least concerned with the numbers. I was concerned with feeling better and being better. 

Yet I now wanted to believe that gaining weight was enough to make me feel normal... What did "normal" even feel like? How did "normal" think? Anorexia had so distorted my perspective that I had no idea. (p. xx)

So let's talk about this one, because it's kind of where I'm at right now. It's not enough to be back in my weight range (which in this moment, I'm not yet in--so close!). Yes, the weight and the medical stability are part of it, but without normalizing food behaviors, without figuring out thoughts and triggers and everything else, relapse is basically inevitable. But what exactly is this "normal" thing? I'm at a place where my normal has, for almost seven years, consisted of being sick, and now, I have to reinvent normal from nothing, at 19. It's something that I'm struggling with as I'm seeking what recovery looks like for me. Which Aimee Liu goes on to talk about: 

Gaining back a full, healthy life in the wake of an eating disorder is largely a process of restoring these three realms of experience [inner self, relationships, experience of culture and society] to their rightful order. The first, most important, and in many cases ongoing challenge is to look beyond the surface of the person in the mirror. As University of New Mexico psychiatrist Joel Yager told me, "Know thyself in a very profound Greek way. What is your biology? What is your calling? How are you built? Study your temperament. Be respectful of it." The second stage involves reexamining and adjusting relationships with families, lovers, and friends. "You're not going to turn yourself into someone you aren't," Yager explained, "and nobody should try to turn you into someone you're not built to be." With enough self-awareness, we can rebuild or form new relationships around trust instead of judgment. Then, aided by this genuine support, we can renegotiate our responses to our culture and society from a position of personal confidence instead of emptiness. When what we do, want, and admire is shaped by a strong sense of self that operates from the inside out, we gain true power over our lives. (p. xxviii-xxix, emphasis mine)

Chapter 1--Connecting the Dots: A Genetic Link

The facts: 

• More than 2/3 of anorexics and bulimics have a lifelong history of anxiety disorders
• Typical anorexic qualities--perfectionistic, cautious, highly regimented, disciplined, suffer from self-perceived inadequacy
• Anorexia nervosa has the strongest correlation to temperament of any psychological illness
• Bulimia nervosa has a correlation but less so 
• Even years later, recovered patients will show abnormally high rates of anxiety and obsessive thinking, especially perfectionism

Dear everyone everywhere who ever thought that EDs were choices: they are not, in fact. So let's bust that myth right now. This at least makes me feel a bit better--knowing that this isn't my fault. In another of Aimee Liu's books, she writes that genetics form the gun, and it's true. Research has proved it. 

What completely freaks me out though, is that last point. Recovered patients will show abnormally high rates of anxiety and obsessive thinking, especially perfectionism. WHAT?!

The solution is not to eliminate these traits but to learn to manage them. So in treatment we try to move patients to a new framework, to enable them to accept growth and change. (p. 22)

I think this is what my therapist meant yesterday when she told me that I needed to learn how to be okay with ambiguity--that she really meant that I need to be okay with not knowing, with not being in control, with having my same temperament and not engaging in behaviors to make me feel better when my genetic wiring makes me feel like I need to. This is gonna take some time. 

Chapter 2--Portrait of a Hunger Artist: The Face of Fear

But the turning point, while critical, is not the same as a conclusion. [...] Virtually everyone who recovers from an eating disorder experiences such a moment. It might take a comment, a look, or the scare of a medical prognosis, but suddenly the obsession that just seconds before seemed all-powerful is revealed, like the Wizard of Oz, to be nothing more than the trick of a frightened mind. Once this truth is revealed it becomes safe to say, "I'm sick of this," or simply, "Enough!" (p. 28)

I reached my turning point. About three months ago. Check. However... 

Patterns of eating, thinking, feeling, and behaving that have taken years to develop and that may stem from inborn disposition are not going to reverse in a single afternoon. I know this now from my own experience. I also know it from Caroline Knapp, who at forty-one wrote, "I'm still prone to periods of isolation, still more fearful of the world out there and more averse to pleasure and risk than I'd like to be; I still direct more energy toward controlling and minimizing appetites than toward indulging them; I am one of the least spontaneous people I know." I know it from Marya Hornbacher's observation following her long battle with bulimia: "Always, there is an odd distance between you and the people you love and the people you meet, a barrier, thin as the glass of a mirror." (p. 29) 

Now that's depressing...

People who develop EDs tend to fall into three distinct and mostly lifelong temperamental groups: 

1. Overcontrolled

• Most restricting anorexics and a minority of bulimics 
• "Feel like they have nothing inside" 
• Avoid social contact
• Tightly control appetites for food and sex
• Limit pleasures 
• Withdraw from excitement, sensation, and risk

2. Perfectionistic

• Most bulimics and a minority of restricting anorexics
• Tend to be conscientious "good girls"
• Aim to please, excel, and conform
• Worry about details 
• So fearful of mistakes they can't get their work in on time 
• "Read an arched eyebrow as contempt, a frown as a stiletto through the heart" 
• Intensely self-critical

3. Undercontrolled 

• Split about evenly between bulimics and anorexics who binge/purge
• Emotions are intense
• Behaviors are impulsive
• Tend to fly into rages instead of expressing anger passively or turning it inward
• Desperately seek relationships to soothe themselves

(Crossover exists, particularly between the perfectionistic and undercontrolled groups, particularly during recovery) 

Lifelong?! Ughhh. That makes this SO MUCH harder. But is ultimately, good to know. Because now, instead of fighting my temperament, I can learn how to manage it, to work with it, to direct it in ways that allow it to flourish instead of wither and die. 

The question that must precede any meaningful or lasting change is, Who cares? Who cares whether you live or die, become a janitor or a rocket scientist, wear a size 2--or a size 20? The answer may seem obvious. Given the obsessiveness with which the eating disordered worry about their bodies, they clearly care a great deal. Just consider the language of these disorders. Though filled with self-loathing, anorexics excel at self-discipline and selfless acts of humility and generosity, which they often take to extremes of self-denial and self-punishment. Bulimics tend to be more selfish and self-motivated, but like anorexics, they are acutely self-conscious and riven with self-doubt and self-contempt. Both groups resist self-awareness even as they behave in ways that appear utterly self-involved. Eating disorders are all about the self--a self that somehow claims the center of attention while refusing to claim its own true needs and wants. Recovery begs the larger question: If I'm the one who cares so much, who, then, am I? Until we gain the courage to solve this complex riddle, the figure in the mirror--at any weight--will go right on tormenting us. (p. 39)

Melinda explained to me the other day that this phase of recovery is like me standing on the edge of a cliff and my team telling me to trust them and jump, when all that I can see below me is a giant black hole. Yep. Basically how I feel right there. It's terrifying. 

But I guess it's also exciting. Professor Barlett put it to me this way: 

"It is a time for you to figure out who you are and how that aligns with who you want to be. It's tough. You would think 'who you are' would be innate and we would not have to think about developing it, but that is why so many people just move along in life not questioning anything. It's hard."

At the same time, though, I have this opportunity to figure out who I am. I have the chance to discover my likes and my dislikes, what I'm passionate about and what I couldn't care less about--EVERYTHING. But the sheer open-ended-ness of the possibilities, is, I think, what is so scary. 

Chapter 3--The Laws of Perfection: Obsession and Compulsion

The facts:

• Most people who have had an ED believe perfection is real and attainable and that it is their duty to reach it
• Perfection is by definition unattainable, leaving perfectionists perpetually frustrated and disappointed
• Perfectionism is innate--a function of the temperament one is born with
• Obsessive-compulsive personality--defined as one who is cautious, rigidly focused, stubborn, perfectionistic, convinced their way is right and everyone else is wrong, terrified of making mistakes
• Stress heightens perfectionism

“The greatest obstacle to perfection is our own inescapably human fallibility. The more we try to prove our infallibility, the more we are bound to fail.” (p. 47)

“The emotional promise of perfection is security: no one will criticize you, try to change you, or touch you if you have your universe in order. But perfection is impossible, frustration is inevitable and at times unbearable.” (p.53)

Guilty as charged. I am a perfectionist. I feel more secure when everything appears to be "perfect." It's true. I freely admit that. 

People with EDs, especially anorexia, tend to have high serotonin levels all the time, which heighten anxiety and lead to these personality traits--

• Organized
• Driven
• Somewhat compulsive
• Extremely obedient
• Overachieving
• Good at following through
• Sleep too much
• Rarely impulsive
• Rarely domineering
• Timid
• Risk-averse
• Need routine
• Do worse in novel situations
• Prone to depression

I mostly fit all of these characteristics. I also know that my serotonin levels are wonky, hence being on SSRIs. But. This is just super interesting to me (it also makes neuro easier because it gives me a real-life application! #psychnerd).

“Character is the real stuff of recovery because it consists of the traits we can change—unlike temperament, which is largely innate and permanent. If one thinks of temperament as the genetic wiring of personality, then character consists of the circuit boards that route, suppress, or maximize the currents flowing through that wiring. The three traits that comprise character—self-directedness, self-transcendence, and cooperativeness—are shaped less by genetics than by experience (how we are raised by our parents, for example, or trained by our culture) and free will (how we choose to interpret and react to experience).” (p. 61-62)

1. Self-directedness

• Measured by the degree of meaning and purpose we feel in our lives
• Less to do with what we want and more to do with why we want it
• Highly self-directed people: realistic about abilities, effective in choices, persistent in problem-solving, hold themselves accountable, take pride in reliability
• Not the same as self-sufficiency
• Allows us to work, play, and love others without fearing we’ll lose ourselves while doing it

 2. Cooperativeness

• Makes us feel part of society
• Benefits from self-directedness
• Highly cooperative people: personal passions and talents flourish in groups, high empathy, tolerance, and compassion for others, broad perspective on self

3. Self-transcendence

• Allows us to feel part of the greater universe
• Gives us faith
• Alleviates fear
• Measure of “the depths of self-aware consciousness, such as awareness of what it means to see the colors of a rainbow or the beauty of a painting….Individuals high in self-transcendence recognize the beauty and meaning of sensory experiences intuitively.” (p. 64)

I guess these are the things that I need to focus on right now--what gives me meaning and purpose, what makes me feel part of society, what allows me to feel part of the greater universe. Those aren't easy things to identify, for anyone, much less someone in recovery. But they are things that I can explore right now, things that I have the time to explore right now, and even though that's terrifying, it's pretty amazing. 

“The struggle between who we are and who we want to be is what motivates most human beings to grow….Unfortunately, what perfectionists strive to prove is impossible. No one is perfect, and everyone has limits. What kills us will not make us stronger or prettier or more lovable. A sense of purpose, connection, and perspective, however, can and will.” (p. 64)

Growth comes from struggling to get from who I am to who I want to be. Struggling. Not moving, not swimming, but struggling. It's not going to be easy. It's going to be difficult. It is a struggle.  And it will not be perfect.

“Error sometimes supplies the surprise that makes life interesting. Sometimes it opens up new opportunities. There’s a good reason why we rarely remember, much less tell stories about, the perfect landings.” (p. 66)

New opportunities. Different opportunities. Terrifying, but opportunities, which will lead to gaining things. 

Progress.

Pleasure.

Life.

(Stay tuned for part 2 of my review of Gaining! I don't want to overwhelm anyone--or myself--with an absurdly long blog post.)

Goal for 2014: Be Me-sponsible

It's a new year. And a lot of resolutions are being passed around with a slogan of "new year, new you." Most of these resolutions have to do with dieting, weight loss, exercising more... You get the picture. I for one am ridiculously sick of hearing and seeing all of those commercials advertising for these products "guaranteed" to change your life or the products that are shaming you for "indulging" over the holidays and convincing you that you need to lose those five pounds that you put on over the past month or so.

I'm over all of it. I didn't stay up until midnight to watch the ball drop because I was in bed by 11. I didn't make any New Year's resolutions because I know that I will not achieve them because honestly, who does? Also, it's not necessarily in my best interests to make resolutions right now. I was reading this blog post the other day about how resolutions can be kind of iffy in the world of ED recovery and that “Resolutions can trigger perfectionistic behaviors and all-or-nothing thinking. Recovery is a reality when we are compassionate with ourselves and focus on the thoughts and behaviors that are in line with what is satisfying for us, deep in our hearts.”

In treatment, I'm beginning to focus more on what I ultimately want out of my life--where I see my ideal self, what makes my life a life worth living. As a group, we're going through life values and setting goals in all aspects of life. And through this process, I have learned that a lot of my goals in the areas that I value can and will only be achieved once I have reached a healthy and recovered place in life. So individually, I've been working on developing this idea of recovery--what it looks like for me, what it means for me, what it is on a very operational level. And I think that article put it well:

Recovery is a reality when we are compassionate with ourselves and focus on the thoughts and behaviors that are in line with what is satisfying for us, deep in our hearts.

At this time of year, everyone around me is making New Year's Resolutions, mostly around eating less and exercising more and losing X pounds, in hopes of making their lives happier or themselves more successful or healthy or thinner or what-have-you. And I'm stuck in this place of trying to figure out what I want my recovery to look like, what I want my life to look like, who I, in a world without an ED, want to be.

Right now, New Year's Resolutions are not even on my radar. Resolutions are so final and not malleable. You set them and that's it--you either achieve success or failure. There is no in between, no middle ground, no grey area.

I've been spending my time making goals for myself--goals that involve having what we refer to in treatment as a "life worth living." Goals that involve going back to Gettysburg in the fall, having healthy and deep relationships, being recovered and healthy and not eating disordered. Goals of pursuing a PhD program in clinical psychology and eventually becoming and ED therapist, researcher, and activist.

It's unrealistic for me to achieve all of these things in the upcoming year, even if I break them down into smaller, more specific goals.

Life doesn't go according to my plans, I've realized. I will set goals and not achieve them. I will make plans and not follow through. I will not live up to my expectations. I will have bad days and lapses and relapses in recovery. I will fail and I will make mistakes. Becoming a better person, developing my character, recovering--all of these things take much longer than year.

And although I have been and will continue to set goals for the upcoming days, weeks, months, and year, I have no expectations of what the year will look like. Will I be back at Gettysburg in the fall? I don't know. Will I be "recovered" by the end of this year? I don't know. Will I know who I am and how I fit into this world? I have no idea. The only thing that I can be certain of is that life is filled with uncertainty. And I can make plans and goals and dreams, but there is only a minute degree to which I can control the environment around me.

What I can control is myself. I can wake up every morning with a fresh start for a new day. I can learn how to be more caring and compassionate to myself. But most importantly, regardless of the situation, I can live each and every day to a degree that satisfies my soul.

-----
"I hope that in this year to come, you make mistakes. 
Because if you are making mistakes, then you are making new things, trying new things, learning, living, pushing yourself, changing yourself, changing your world. You’re doing things you've never done before, and more importantly, you’re doing something.
So that’s my wish for you, and all of us, and my wish for myself. Make new mistakes. Make glorious, amazing mistakes. Make mistakes nobody’s ever made before. Don’t freeze, don’t stop, don’t worry that it isn't good enough, or it isn't perfect, whatever it is: art, or love, or work or family or life.
Whatever it is you’re scared of doing, do it.
Make your mistakes, next year and forever."
-- Neil Gaiman

He's Feeling 22: 22 Things I've Learned from My Brother

Today is my brother's 22nd birthday. He graduates college in one more semester and then will start working full-time at Foursquare in New York City.  In my personal opinion, this makes him officially old and means that in one more semester, he will be a real adult.  It's hard to believe.

My brother and I at my high school graduation.

My brother and I, like all siblings, have not always gotten along.  In fact, we got into fights frequently, possibly much more frequently than other siblings, as kids.  We argued over whose turn it was to play the Game Cube, who got to sit in the front seat, and who had to do what chores with the rabbits.  We called each other names and got into physical fights on occasion.  I remember the time when he accidentally nailed me in the head with a saucer sled because he thought it would be a great idea to use it as a frisbee (I have a scar on my eyelid from that). But I also remember the times when we got along great.  The days we would spend playing Mario Kart together, the times we went sledding together in our neighbor's backyard, evenings spent snuggling with the rabbits.  I remember that he was the first person I went to when I slipped on a rock in the ocean and cut my foot open on some broken glass.

Being two years apart, we only spent a year in middle school together--Jacob as an 8th grader and me as a 6th grader. When my mom got sick, I remember all of the disagreements with my brother fading away as he stepped up to take care of me.  He protected me when the ambulance came by making me go out into the backyard and playing with the rabbits with me.  He let me pick the video game we played that night, made sure I got dinner, and didn't let me stay up past 10.  We didn't fight that week and I really gained a lot of respect for my older brother and his strength.

Spring break/Easter my junior year of HS
and his freshman year of college.

When we both got into high school, we were always fighting about what time we were leaving for school and how soon after the final bell we would head for home. We had countless arguments over this, and I always felt anger towards him because I was living in his shadow of brilliance--he is so much smarter than me, and I always felt I was never measuring up to his intellect and the reputation he had made for himself in our high school.  But in the midst of this, my brother was who I went to for advice on what classes to take, thoughts on how to get on a specific teacher's good side, and help with math homework when I just didn't understand it.  I wouldn't say that we were ever really that close, but we definitely grew closer.  When he left for college at the beginning of my junior year of high school, I realized how much I missed him.  Sure, he wasn't around to fight with all the time, but he was gone and that left a hole in my life.

In the four years since then, we have grown a lot closer.  I am now starting be able to talk to him about real things, like my eating disorder, depression, and anxiety problems.  Not a whole lot, but more than I used to be able to do.  And I think we've both started to enjoy spending time with each other, whether it's kayaking and going shopping together at the beach, watching a movie, or talking on the phone when we're both at school.  My memory is the time when we saw The Bourne Legacy together and then went for a walk on the beach that night.

Most recently, when I made the decision to come home and he made the decision to accept his job, we had a very brief text message conversation, during which he reassured me that my anorexia would not make me feel better in the long run and that he had faith in my ability to overcome it.  That's something that I've always found in my brother--a kind of strength that I am unable to find in myself.  Whether it comes from a simple text message, a strong hug when we finally see each other after being apart, him letting me hold onto him when I feel scared and lonely and sad at my grandparents' funerals, his ability to turn something I'm freaking out about into something very manageable... I could go on and on.  The past couple of days we have spent together, although they have been stressful for me, have been made better by his presence in our house.  We spent Christmas Day watching movies together (I saw Batman Begins for the first time!) and yesterday watched The Dark Knight.  He, without knowing it, is slowly helping me get out of my isolation mode and back into the real world.

Today, I celebrate the nearly 20 years that I have gotten to spend with my brother and I look forward to the next 20.  But most importantly, I celebrate a man who has no doubt helped shape me and mold me into who I am today, who gives me strength and courage when I need it, and who is always there for me, even though I sometimes feel like he's not (mainly because he always forgets to actually call me).  We don't have a perfect relationship, but no one does, especially not when you've grown up together.  We're siblings and because of that, we have a bond with each other that we cannot possibly have with anyone else, and for that, I am grateful.

I have learned so much from our relationship over the years. So today, because Jacob is turning 22, I would like to share 22 things, in no particular order, that I've learned from my brother:

1. To relax and calm down. 

2. That no one is perfect.

3. That being late is not the end of the world.

4. That I hate aquariums but should still go to them. 

5. How to kayak.

6. That Google is the best IT person.

7. To explore the world.

8. To go after what you want.

9. How to build a fire. 

10. That the world does not, in fact, revolve around me.

11. How to argue. 

12. How to stand up for myself. 

13. Humility. 

14. That a relationship will come when the time is right.

15. How to be strong.

16. To play video games. 

17. That family is important. 

18. That asking for help is okay. 

19. There's always someone who knows more than you. 

20. What not to do to avoid being in trouble with our parents. 

21. How a woman should be treated by a man. 

22. That one person can make a huge difference in your life. 

Happy 22nd Birthday, Jacob! Thanks for being the best older brother that I could ever ask for! I love you very much.

The most recent picture of my brother and I.

Christmas Eve.

I keep thinking back to last year, after the candlelight service at church, I was sitting downstairs watching some Christmas special with my family, writing a post reflecting on all of the growth that had taken place in my life that year.  I wrote about being recovered, feeling valued and beautiful and loved and worthy.  I wrote about being more than my past, about never being alone, about hope and healing.  I wrote about my complete faith in an all-powerful, healing, restoring God.

Christmas 2012 I was in a very different place than I was Christmas 2011.

And Christmas 2013 is no different. 

Tonight, I sit alone in my room, thinking.

Thinking about how my life has changed in the past year and has put me in a position that I never once thought that I would be in.  I dropped out of my first semester of my second year at college because I had a major relapse with my eating disorder, depression, and anxiety.  I took medical withdrawals from all but one course, in which I’m taking an incomplete and hope to finish up soon.  I’m taking the entire spring semester off from school.  I’m spending at least four hours a day in different kinds of therapy groups, with different psychologists and psychiatrists and doctors and nutritionists, trying to learn how to completely accept and manage life with an eating disorder, with depression, and with anxiety, trying to learn how to manage my life with this illness.

I never once thought that my life would go back to this, not even all those days I spent in treatment in high school, when I was so excited to go to college so that I could fully engage in my disorder and no one would notice.  I never once thought that things could get this bad again. I never once thought I would be in very intensive treatment again.

I never once thought that my life would do a complete 180 on me. But it has and that’s something that I’m just going to have to accept because even though I think that I've convinced myself that I've accepted this situation, I reach a moment where I get really pissed off about having been given these genes with this temperament and these personality traits and having been dealt this environment.  And then I’m back at square one, trying to accept it all just one more time.

But it’s never just one more time.

Looking back on my post from last Christmas, I can’t help but be a bit judgmental about where I am now and thinking that I’m in a worse place now than I was then.

This Christmas Eve, I’m not thankful. I’m not filled with joy and hope and strength.  I’m not feeling encouraged or blessed.  This Christmas Eve, I am filled with anger and bitterness and resentment.  I’m filled with depression and loneliness and insecurity. I’m filled with anxiety and distress and worry.  I’m filled with shame and guilt and regret.  

I’m filled with questions like “Why me?” and “Will this ever be over?” and “Will I ever feel and live a ‘normal’ life?” I’m questioning what my next steps are, where I stand with my relationships with everyone in my life, and how my faith fits into this.  I’m filled with questions about what my life will look like next Christmas and the one after that.

And something that I've learned in the past five weeks of treatment is that all of this is okay. Having questions and doubts and emotions—it’s all okay. Even during Christmas, when the expectation is joy and peace and contentment. My emotions are real and I am allowed to feel them, even now. Even at Christmas.

I guess what I’m trying to get at is that things change. People change. Lives change. And things don’t always go how you expect them to go. You don’t always end up where you want to in life. Sometimes the unexpected is exactly what happens and sometimes you take a giant leap backwards.

All of that is okay.

It’s life. And life doesn't stop for anyone.

Not even at Christmas. 

Reasons to Recover

I haven't written for a while, and frankly, I've just been so completely exhausted at the end of the day to even process what happened and very emotionally disregulated.  Things have changed rapidly for me in the past few days--my insurance company decided that since I have behaviorally stabilized (meaning, since I followed my meal plan for an entire week) and that since I'm mostly medically stable, that I needed to be stepped down to IOP (intensive outpatient), which is essentially the same thing as DTP, except it is only three and a half hours and not six. But initially, I was overcome with a lot of fear and anxiety that this is making me rush treatment, which will just put me back at CCED in another year or so. The other thing that this drop did was to completely invalidate how I felt about recovering from my eating disorder. Insurance companies are really good at doing that. They see a person simply as money, especially when it comes to mental health problems (but seriously, if I had cancer, this would not be how they would be treating me), and don't go by the guidelines for real healing. They just want to have to pay for as little treatment as possible and if the results are just barely in their checklist, then you are magically better and they will not pay for treatment any more.

Luckily for me, instead of dropping me completely, they allowed me to just step down into IOP, but even still, I don't feel okay with it. I feel fake because my actions and medical charts are improving, but my mental state is actually getting worse. Which is normal in eating disorder recovery world. But it makes me feel crazy because to normal people, I am getting better externally while internally I am feeling worse. It's a very frustrating process.


On the bright side, dropping to IOP, it means no more rush hour traffic, no more waking up at 6am, no more driving in the dark. It means no more exposure to one girl's defiance and protest to being in programming and no more exposure to another's hopelessness and desire to be the most pitied girl in the room. So I'm just trying to breathe through it and see how I feel at the end of the week.

One thing that has been the most helpful in getting me to this point where externally things are looking better is to remind myself continually why I am recovering. Why I want to get better. Why I need to get better. And at the beginning, I could not discern any of it for myself. So my favorite professor gave me a little help with why I need to get better, which got me following my meal plan all the time. And now in this time of change when I feel like my illness is being trivialized by my insurance company and I feel invalidated and like I need to get sicker to "prove" that I need the help, reminding myself of my reasons to recover helps me turn my mind from the distorted eating disorder thoughts to wise mind thoughts that allow me to continue following my meal plan. Here are the original 20 reasons to recover that my professor sent to me, which I keep coming back to as my base:

Reasons why you need to get better (which  means following your meal plan): so you can...

1. be HAPPY!

2. live normal again (whatever normal is) =)

3. come back to school and attend awesome classes

4. hang out with your Gettysburg friends

5. chat during my office hours

6. let your body recover

7. finish school and get a great job

8. get that job to help others

9. NOT let the disorder win

10. be that awesome success story that motivates others to get better

11. play with Eric and other little ones (because that is fun)

12. have your own kiddos someday (if that is of interest to you)

13. enjoy meeting up with friends

14. eat out in social situations and actually enjoy delicious food

15. go to church without anxiety

16. truly enjoy family gatherings

17. take back control of your emotional state

18. continue to help all of those friends that need you

19. use all of the potential that is waiting inside of you

20. simply live!

And as treatment has progressed, I've been able to add some more reasons to this list. I need to recover so I can... 

21. enjoy the holidays and not fear or dread them

22. travel and visit new places and far away friends 

23. have an identity outside of my disorder

24. go grocery shopping on my own 

25. fully experience everything around me

26. not have my life ruled by food, calories, and weight

27. stop hurting myself 

28. care for myself in ways that are not self-destructive

29. live freely and be able to have spontaneously with food

30. tell others that recovery from an eating disorder IS possible and actually mean it

Last night, I was asked, "What are the things you DO want? The healthy things? To come back to school, right?" And I responded with, 

"Yes. And to play with kids and smile and laugh and not be self conscious while I'm doing it. I want to be fully alive and able to experience EVERYTHING--to travel. To not be afraid of the unknown. I want to have kids and a rewarding career where I get to help others. I want to love and be loved. I want to live."

Progress.

I Feel Alone.

A few days ago, I watched a video about how even though we are the most connected to others than we have ever been--thanks to social media like Facebook, Twitter, Foursquare, YouTube, Tumblr, Pintrest, etc and things like smartphones and texting that make anyone easily accessible--we are more lonely than we have ever been. I've linked the video here: 

After watching it a third time, it still makes my head spin when I watch it, but it also makes so much sense if you really think about the message it contains. 

Today, I was sitting in church next to my dad and he had his arm around me, like he usually does every Sunday we're in church together.  I was surrounded by a sea of people, most of whom had watched me grow from a first grader into a college sophomore.  I was surrounded, essentially, entirely by my family. 

And I felt completely alone. 

Right before the service began, I had a conversation with a lifelong friend about all that has been happening in my life, if being home was being helpful, how I was feeling, and it ended, like all of these conversations do, with her saying something to the effect of 'Let me know if you ever need anything. I'm here for you, and I love you.' 

So many people have told me that recently. And I very well know that I am not, in fact, alone. I have friends here who have tried to get together with me, but I've just been too tired or just not wanted to be social. I've received letters and care packages from school friends. I've gotten daily texts from some of my closest friends. And on the rare occasions that I have ventured out into the real world, one that is not my house or treatment, I've spent a couple quality hours with people who have been in similar situations. 

But I still feel alone. 

I don't know if I would say that I feel 'lonely,' because I don't think that's what I'm feeling. Lonely to me means missing people you care about, and although I do miss Gettysburg friends and home friends and extended family, that's not what is consuming me. It's the feeling of isolation, of not being understood, of not being fully known or heard, of people just not 'getting' me. The feeling of being alone. 

I know this has to do with my depression and my eating disorder. The two of them are not mutually exclusive from each other--experts still cannot determine a causal relationship between the two things, just that they tend to be highly correlated. But both add to this feeling of alone-ness, or isolation if you will. 

So even in those moments where I am not physically isolating myself, in the moments where I am not letting my social anxiety win, in the moments where I am not actually alone, the feeling of isolation and alone-ness is still there and it feels more present than it does when I am physically alone. 

Maybe this feeling of isolation and alone-ness has to do with my lack of vulnerability in these social situations.  All morning I was answering questions of 'How's school?' 'Are you glad to have had some time off?' 'Are you looking forward to winter break?' as if nothing were wrong. As if, in fact, I was making the five hour trek back to Gettysburg to have one more week of classes, a week of finals, and then over a month off for winter break. Maybe I need to be more vulnerable. 

Or maybe it has to do with the idea that I'm not constantly surrounded by my friends or that I can walk to class and pass four of my closest friends along the way. Maybe it is actual loneliness because some of those who know me best are not present, here, with me. 

Maybe it has to do with my being an introvert and not feeling fulfilled and cared for in large group settings, like church or like family Thanksgiving. But even in the one-on-one contact that I've had with people where I've been vulnerable and open, I have still felt alone. 

But mostly, my feeling alone has to do with the illness. The fact that I suffer from anorexia and depression and anxiety and that person sitting next to me does not. Or that person sitting across the room, although he or she may also suffer from depression, he or she does not also have an eating disorder and anxiety. The fact that I, alone, am being attacked by this specific illness and this specific combination of comorbid conditions makes me feel alone. 

Our culture puts such an emphasis on individuality, and I've been reading about it all semester in social psychology and how different psychological phenomena are experienced differently in collectivist cultures. If I lived in such a culture, would I feel any less alone right now? Probably not. 

Eating disorders are very individualized. Every person who suffers from any type of eating disorder suffers differently. That's why treatment must be individualized to the person in order for it to be effective. My eating disorder is not the same as any of the other people sitting in DTP with me or anyone else who has gone through CCED or suffered with an ED. 

I feel alone because psychologically, I am alone right now. 

This is one of those posts that isn't going to be wrapped up all nice and pretty and topped with a bow. This feeling of alone-ness is not going to go away just by placing myself in a room full of people, or a small group of people that know me well, or even in a room full of people who 'get it.' Because I will still feel alone. No matter how many letters I receive, texts and emails I get, words of encouragement I am told--the feeling of being alone remains.

And in this moment, sitting with this alone-ness and the discomfort it brings is just going to be something that I have to do. 

And maybe, one day, it won't be here anymore.