Wednesday, July 27, 2016

Training on Empty: Chapter 24 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

Chapter 24 – It’s All in Your Head

“The turning point in the process of growing up is when you discover the core of strength within you that survives all hurt.” – Max Lerner

Freud did nothing but further the plight of women’s rights. His theory of women and hysteria blatantly discounts the possible physical and emotional reactions to stress. When a woman goes to the doctor’s office, she is often discounted before she even announces her symptoms. If her symptoms are not detectable using a general blood test, it is often assumed she is faking them to get attention. If a doctor sees a patient with an anorexic past, the assumption is sometimes made before any tests are even run that the illness is not real. Even in cases where there is real illness, it is assumed that she brought it on herself, and getting proper treatment can be quite a challenge.

My last few years of college were a bit of a blur. After so many intense years of training on too few calories, my body was starting to tire. My immune system was shot, and I was continually without energy. Each day consisted of sleeping as late as possible, dragging myself to class, crawling to the library for an hour-long nap before practice, training and then heading straight home for dinner and more sleep. Though I longed to run, I no longer had the energy. With swollen glands and pallor that nobody could deny, I approached the head coach on one of our scheduled hard days. He told me to get through as many intervals as I could, so I continued to train through my illnesses as they got progressively worse. Over the course of one six-month period, I wandered from doctor to doctor complaining of great fatigue and a low-grade fever. Each time, I was given a routine blood test that showed I was on the low end of normal for everything. Several times, doctors suggested this sickness was in my head, and I slowly started to believe that perhaps I was, indeed, losing my mind and manifesting phantom illnesses. However, since the symptoms felt so real to me, I did not give up hope that a doctor might eventually find out what was wrong with me physically. Eventually, I saw an endocrinologist who found that my thyroid-hormone levels were very low. In fact, the gland didn’t seem to be functioning well at all, even when stimulated. I was officially diagnosed with hypothyroidism.

It was then that my doctor suggested I see a nutritionist. He felt that a better diet would help me feel better more quickly as I got used to the thyroid medication. After a few visits, the nutritionist asked me point-blank if I was over my anorexia. I told her that while my body weight was up somewhat, it was still an issue in my head. She thought it would be best if I could stay in a hospital specifically for eating disorders. My obsessive-compulsive lifestyle was all too obvious no matter how hard I tried to hide it. Exercise still took priority over everything, and I was holding the reins so tightly on my food intake that I constantly felt guilty for any crumb I consumed outside of what I felt I “should” eat. I had already read a great deal on recovering from eating disorders. Geneen Roth’s books were an inspiration to me, and I was trying to determine when I was hungry and also when I was full. The problem, it seemed to me, was that I didn’t always eat when I was hungry or stop when I was full. After much consideration, I entered the six-week eating-disorders treatment center with the full intention of breaking free from my addiction. I knew that what I was doing wasn't working, so I trusted that someone else might have some answers.

The first day in the hospital was miserable. I was told I couldn’t work out for the first three days. In addition, I had to eat everything on my plate at each meal. The other girls and I were fed three meals a day with an optional snack that nobody ever even considered consuming, except one girl, who had checked herself in for compulsive overeating. My metabolism started to kick in when I began to eat normally. The first two days I was starving. All of a sudden I worried that they weren’t going to feed me enough! The other girls watched me go through the struggles that they had recently endured. There was one girl who weighed 60 pounds when she first came in. She had edema so badly that her doctors made her wear stockings to help the circulation in her legs. When she first started to eat, her body didn’t know how to handle the food. She had to be watched 24 hours a day until her body could adjust. All of us were constipated, anxious, depressed and had digestive troubles. A single Ex-Lax tablet was part of every girl’s morning routine, except those who had abused laxatives outside the hospital. Normal elimination was something that would take many weeks to achieve. By the third day, my body began to adjust to the eating pattern and I was full. I ate three-quarters of my lunch and put my fork down. The other patients eyed me with a “this isn’t going to fly” look. At the end of the meal the counselors reminded me that I had to eat everything. “Yeah, but I’m full,” I replied. They told me I didn’t know yet what my body needed and that, for now, I had to eat what I was given. I could see that this was the “Goddamn egg” scenario with my mom all over again, only there was no way for me to throw up what I didn’t want to eat. I had to let go of my control, so I cried. I was angry as I forced the food down. It did not seem at all healthy, but I was also on a mission to become a model patient, so did as I was told – with one exception: I didn’t drink all of my milk. It was in a carton, so I could easily hide the fact that I left some every night. Somehow I had to retain at least some sense of control… in my mind, anyway.

Most of my time at the hospital was spent journaling or going to meetings. The days were very structured, with exercises and various kinds of therapy and lectures to attend, some mandatory and some optional. One exercise in which everyone had to participate was drawing a life-sized image of ourselves on paper. We all drew an image much larger than our actual size. It was clear we were all struggling with body-image issues, and nearly everyone was plagued with fears of failure and of getting fat. “I feel fat” filled page after page of the plain notebook paper I used as my hospital journal. The other girls and I shared “food feelings” after every meal, and again, “I feel fat” was my typical response. Feeling fat, I discovered later, was a blanket statement for any discomfort in my life, and while it’s true that I did see myself much heavier that my actual body size, I never resolved how to convert my feeling “fat” into the underlying emotion. What was worse was that I had no idea how to handle the real emotions once I discovered them, especially anger.

Often, I felt alone in the hospital. Though the other girls there were all going through something similar to what I was, it wasn’t until Julia stepped onto the floor of the unit that I felt that there was someone I could relate to there. Eventually, we became friends. Julia was admitted to the hospital by her parents because she was bulimic. Right away I could see that she wasn't exactly invested in her recovery. She had friends on the outside sneak Zingers into her room when they would visit so she could binge and purge. She was younger, but we became quite close. Both of us had a hard time with the long hours of the day, so we tried to make the best of it. We even tried to make it fun. In fact, on April Fool’s Day we tried desperately to come up with a way to order 12 large pizzas. We were convinced it would be hilarious to see some guy deliver a large number of pizzas to a room full of anorexic girls. Although we never did find a way to accomplish the prank, we had a good time coming up with the idea. She and another frail woman I met, Sarah, were incredibly supportive, and the three of us quickly formed a strong bond.

When Sarah first arrived, she was gaunt and exceptionally tiny. Her every movement was hesitant, yet she carried herself with elegance and grace. She looked far younger than her 30 years and had no problem associating with girls much younger. It was easy to see that she was terrified of eating. At her first group dinner, we were all served an unfortunate “oven fried” chili rellenos that looked like a mess of fattening cheese rolled into a greasy crumb coating. It was enough to intimidate even the most normal of eaters, and Sarah nearly broke down in tears just looking at the plate. I tried to reassure her that it got better, that she should just do the best she could to attempt to eat it. She was only able to manage a few bites before she completely broke down and confessed that her obsessive-compulsive disorder caused her to visualize things in her food. Not only was she dealing with the trauma of having the control taken away from her, she was dealing with phantom bugs running around on her already intimidating dinner!

As I got to know the girls on the unit better, we became like family. And just as every family has issues, we developed our own. There was one girl who was bulimic whom I found very intimidating. She never hid her anger and often blew up at a moment’s notice. When she stormed out of her therapy session in tears one day just before lunch, my first instinct was to go comfort her. Instead, I worried that she would lash out at me. I worried too that the counselors would not allow me to hold up the group when we were scheduled for lunch. Meal times were often anticipated, feared or dreaded, but they were always held at exactly the same time each day. None of us dared alter the strict schedule, so I followed the rest of the girls to the lunchroom, all the while sensing this girl’s increasing anger and sadness. She didn’t utter a word the whole time, but at the end of the meal she let us all have it, saying how shocked she was that not one of us came up to her in her time of need. I countered with the fact that her unpredictable nature did not make her very approachable, but deep down I knew she was hurt. I hated that I let my fear stop me from doing what I knew was right. We worked it out by simultaneously apologizing, and we eventually ended up as friends. I learned how important it is to follow one’s heart and go with initial instincts. I also found that ultimately, these girls were some of the most supportive, kind and caring people I had ever met. We all shared our weaknesses, fears and hard pasts with each other.

In one exercise we did as a group, all of the girls were supposed to go around in a circle and say one body part we liked on ourselves. I frantically went from head to toe eliminating every part for various reasons: too fat, too ugly, too oddly shaped, etc. When it came to be my turn, I was at a loss; I stared blankly and couldn’t bring myself to say anything. I looked from girl to girl and tried to utter something, but I just couldn’t lie. The silence became uncomfortable. Sarah blurted out, “Her eyes.” Oh, thank God, my eyes! Yes, that I could accept. “My eyes,” I agreed. It was the one and only body part I didn’t despise.

Probably the most important thing I took with me from my stay at the hospital was how to be honest. I had always tried to be fairly up-front with everyone around me. I never wanted conflict or to hurt anyone’s feelings, so I occasionally let slide a few minor white lies. In general, though, I considered myself an honest person. When one of the nurses gave a lecture on honesty and how it plays a role in addiction, she asked us all how honest we were with ourselves. I realized that not only did I occasionally blur the lines of truth when it came to explaining my eating habits and overtraining to others, but for a long time I had also been fooling even myself. Anorexia is a sly illness. It continually tries to creep its way back into one’s life. “Oh, it’s okay to skip a meal or cut back here and there,” it says, when in reality it’s a step closer to letting the dangerous malady back inside to consume the mind. I realized that being truthful with myself was going to be the most important factor in getting better.

When I left the hospital after my six-week-long stay, I was feeling more confident. I had a new diet plan and had already tested eating out at restaurants. Sarah and I kept in touch for many years after our hospital days. She continued to be plagued by compulsive behavior, but became much healthier and didn’t have to open 12 yogurts to find one she could eat. Julia and I hugged before I left. Something told me I would see her again soon. I was sad when, a few months later, we both relapsed and ended up back on the same unit. Julia had been rushed to the emergency room after fainting from not eating enough, and I was admitted after slitting my wrists and downing half a bottle of aspirin. We were both on large amounts of Prozac prescribed by our psychiatrist at the time. Seeing Julia there, hooked to an IV, made me wonder if it was possible to beat anorexia. I questioned whether I would ever recover or get better. I certainly didn’t think it could possibly get any worse.

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