Wednesday, August 24, 2011

Actually, I Am Getting Better

I realize my previous posts might give the impression that I am improving little or not at all. Make no mistake: I am making progress. It’s slower than I had planned, but I usually ask more of myself than is healthy, regardless of how perfectly the planets must align for me to get even close. Unrealistic expectations, perfectionism, “black-and-white” thinking – these are all part of the anorexic mindset, which devolves even further into ridiculousness as the mind and body progressively starve. This is why treatment professionals tend to stress refeeding as the first task of anorexia recovery. Sure, you might simultaneously undergo psychotherapy, art therapy, group therapy, and more. But these require a patient’s cooperation and fairly active participation, both of which become likelier with increasing nourishment. Unfortunately, treatment professionals encounter a lot of patient resistance to refeeding. After all, the medicine they recommend is the very substance the anorexic patient fears and tries to avoid.
I have been meeting and often exceeding my meal plan requirements. I am steadily gaining weight, and I haven’t heard anyone recommend residential inpatient hospitalization (i.e., Anorexic Alcatraz) for me since I first enrolled in the program. I’ve been consistently gaining enough weight to keep the treatment team from pressuring me too much about it. The nutritionist usually adds more to the meal plan (which is a minimum) each week, and she has mentioned that, although consistent, my gains are occurring at a slower rate than she would prefer. But the gains have been large enough and fast enough to keep me here at the intensive outpatient program in relative freedom – between The Rock (residential inpatient hospitalization) and The Hard Place (minimal supervision, perhaps even self-directed recovery, if recovery at all).
Evidence of my progress: Despite continued fear and avoidance of some foods like cookies and similar desserts, I have occasionally eaten them anyway. Friday, I had banana pudding and can admit that it tasted really, really good. Afterwards, I felt a bit guilty and usually do after eating things I had given up to the demands of the eating disorder. That I can choose to eat fear foods and recognize that I enjoy their taste is proof that I’m committed to getting better and am actually doing so, even if I still need coaxing and sometimes still resist. I have also significantly reduced the amount and intensity of my exercise, which I previously used to compensate for or balance my caloric intake, and vice versa. While not totally compliant with the team’s exercise ban – i.e., no exercise for Justin except for the program’s thrice-weekly yoga therapy (which is great) – I’m getting there, becoming more and more comfortable at rest. The yoga helps.
Perhaps the best evidence of my improvement is that I’m willing to talk more about this and with an ever-widening audience. Q.E.D.

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