On Getting What You Ask For, or Thank Goodness It's No Longer Last Friday

Every Friday, all of us pitch in to prepare a "challenge meal" for lunch. Our nutritionist selects the menu, the recipes, the serving sizes, and then we mix all of the ingredients together in bowls and things. If needed, we heat the admixtures using an appropriate appliance. This is called "cooking."

The Rule: You must finish 100% of challenge meals.

We have two per week - a Wednesday breakfast challenge and the Friday lunch. I try as much as I can to think of these meals as caring but tough-minded dares, friendly but still-uncomfortable invitations to dual - with food, with staff, with the eating disorder, with myself. Although challenge meals are those things, I still brace hard for catastrophe before them, still brick up walls around me and ready the catapults within.

To be fair, challenge meals have been a lot less challenging than I've expected. Friday lunches have included entrees like grilled salmon with pineapple salsa, grilled chicken stuffed with feta and spinach, and some kind of pasta with a peanutty Thai sauce. Yesterday we baked tilapia. This is pretty healthy stuff. The vegetable and grain side items, while not usually on my Safe Foods List, have been safe enough for me to make it through the meals. Yesterday's sides, for example, included spinach and arugula salad, which I helped prepare, and a whole wheat roll, which is a departure from the whiter bread usually “offered” with challenge meals. Of course, there is always dessert, which is something I continue to struggle with. But, despite a good deal of irrational fear and unjustified resistance - neither of which seems to have anything to do with taste – I’ve even managed to make it through the dessert portions of the Friday lunches. I know that things could be harder, the challenges more severe. Besides, I didn't come here to coddle or enable my anorexia. I came here to get the help I'll need to kick its ridiculous ass.

But I wasn’t prepared for beef.

The previous Friday, we had taco soup with Mexican cornbread and, for dessert, cake bites from a local, high-end bakery. During meal prep, I was stationed at the cornbread bowl with another group member and didn’t really think much about the other menu items. While not thrilled about the cornbread, whatever its country of origin, I stirred the ingredients without too much anxiety. Indeed, it could have been worse. Why I didn’t think more about the taco soup or at least ask what was in it is a mystery to me. I suppose I was accustomed to being “challenged” with foods within my safe-zone or gradually moving toward it. Even fried fish or fried poultry might have been okay. Fried = 1 Fat in the language of our meal plans, all of which require fat exchanges. Fish and poultry themselves have been on my Safe Foods List for years.

When I started the program, the nutritionist asked me about food preferences and special dietary needs. She noted that vegetarians, even vegans, complete the eating disorder program without having to offend Gaia or sin against the animal spirits. However, she champions the benefits of red meat, primarily because it is the “best” (i.e., most abundant) source of iron and zinc. This may be a major selling point for the healthy and legitimately health-conscious, but, even now, I’m not sure I really care. I told her that I don’t eat red meat at all - just chicken, turkey and fish - mostly for “health” reasons, but that I also think of the exclusion as a step towards making a decision to give up meat altogether. And it’s true: I have thought quite a bit about becoming vegetarian.  But, I made the red meat decision at about the same time I increased deliberate exercise and eliminated most high-sugar, high-fat foods from my diet. I used “health” as an excuse for emaciation long after the eating disorder had taken root, well into the spring and summer of its bloom. It’s a common excuse among the more restrictive eaters in treatment.

Part of the challenge meal philosophy is to encourage you to face foods you have eliminated from your diet so that you might then reevaluate your decision to exclude them. Anorexia decided much of my diet for me. It does it still. This is one of its greatest benefits and one of its most severe punishments. So, realizing that my red meat exclusion was probably…definitely…eating disorder related in the beginning, I agreed to try it at some point while in treatment – just to see. The nutritionist assured me that she only includes red meat in challenge meals when she feels that someone is ready for that kind of challenge. And she generally uses only lean cuts. Of course, our refrigerator always has red meat on hand, in one form or another, should any of us choose to add it to a meal of our own design. Nevertheless, we run out of turkey much quicker.

The taco soup was made with ground beef. Granted, it was a very lean ground beef, but beef nonetheless. Granted also - beef is probably the most common meat found in taco soup. But you could just as easily use ground turkey or chicken or tofu or just go heavy on the beans. And you could even more easily mention the potentially terrifying ingredient to the people making the Mexican cornbread. I only realized what was in the soup when it and the cornbread were ready to eat. I saw the pot, noticed the meat, and asked, “What kind of meat is that?”  In unison, the nutritionist, other members of the treatment team, and one or two group members (fellow patients) answered:

“Beef.”

Silence.

Or, perhaps it was only me. A mere second or two following the reply, I drew in a very deep breath, tightened every muscle in my body, and held the breath inside. Those who tell you about the virtues of deep breathing intend for you to exhale. For awhile, I did not. Instead, I bricked up walls around me, fumbled with the catapult within. This is what happens when you let your guard down. This is what happens when you trust. This is what happens when you assume. This is what happens…

One therapist: “Justin, remember what we talked about yesterday during the group session, about challenging thoughts and beliefs…could you maybe use some of that?”

Me: “No.”

I took my bowl and sat at the table, in the chair where I usually sit. The nutritionist took the chair to my right, at the head of the table, where she usually sits. I wouldn’t even look at her. Nor would I look at much else besides the hideous table-cloth and the contents of my bowl. They tried to draw me out – the nutritionist, other staff members, fellow group members. They tried to get me to express my feelings as if I had any idea what feelings to express. Later, after having had some time to “process” the ordeal, I realized that these feelings were something like anger, resentment, fear, distrust.

The nutritionist: “I’d challenge you to eat this mindfully.”

Me: (thinking) Fuck you. (saying) “I don’t want to talk about this. You sprung this on me and now you want me to talk about it. I’m not going to.”

To make matters worse, I had agreed to a family therapy session with my mother via videoconference, which was scheduled to start less than an hour after the offensive lunch. I had been reluctant to do family therapy previously because 1.) I’m “too old” for that shit, and 2.) I’ve never been confident in my family’s ability to help.*

The nutritionist didn’t know about the session with my mother. Had she known, she might have saved the ground beef for another day. But I probably would have reacted just as unreasonably.
This is the main lesson I took from the experience: I still act unreasonably as a knee-jerk response. Some of those Cognitive Behavioral Therapy (CBT) skills that we discussed the previous day or the Distress Tolerance skills of Dialectical Behavioral Therapy (DBT) would have come in handy had I been willing or mindful enough to use them. One therapist had tried to point me in that direction, but, by then, I was too walled in to feel, much less accept, her gentle guidance. I refused to even see that it was gentle.

At the end of challenge meals, we have a “meal process group,” which is when we take time to discuss the meal, our feelings about it, and ways to deal with them. For the record, I finished the meal but didn’t really taste it. After the beef taco soup, I sure as hell didn't want to participate in the process group.

Alas, too bad.

So I begrudgingly played along. I talked about feeling as though the beef was “sprung” on me without warning. I talked about how I felt betrayed, my trust broken. I talked about these things while still unwilling to make eye-contact, especially with the nutritionist, who was the unlucky recipient of the worst of my reaction. (In the language of psychotherapy, this is called transference.)

The nutritionist: “Remember a couple of weeks ago, when I asked you if you thought you might be ready for red meat?”

Me: “I told you that I didn’t think I was ready yet but that I thought I would definitely need to try it at some point.”

The nutritionist: “I asked you if you would want me to tell you beforehand that we were going to have red meat as part of a challenge meal. I asked if you would rather not know, would rather be surprised. You told me not to let you know.”

She was right. I said that. I had given her permission to “spring” red meat on me.

This is the part where the anger, resentment, distrust, fear, and, now, embarrassment become too great to contain. But, because I fight emotion, try to hide it away, refuse to find my lion’s roar - which is just so much spring-loading - it all comes out in tears. And I fight these, too. I WILL NOT ALLOW THE WORLD TO SEE ME THIS WAY! I WILL NOT BREAK DOWN BEFORE YOU! IF I DO, I WILL DO WHATEVER NECESSARY TO SAVE FACE! I AM MACHO! I AM STRONG!

I am a mountain formed of papier-mâché. I am a 30 year-old child.


*After a few minutes alone with my thoughts and a cigarette, the therapy session with my mother went well. I let her know up front what I was dealing with, and she generously beared with. She's a pretty cool lady. 

Weight Weight...Don't Tell Me

We weigh first thing every morning. At least those of us on weight-gain meal plans do. Eating disorders range from binge eating ("too much") to anorexia ("too little"), with various combinations in between. So mandatory weigh-ins depend on the nature of your disorder and where you are in the process of recovery. The eating disorder center treats all varieties of eating disorder.

I learned very early to single-knot my shoe-laces when first tying them for the day, since this makes it quicker and easier to remove the shoes for the big event. When I arrive, I immediately take them off and empty my pockets in preparation. I feel a lot like I'm being booked in the county jail or passing through airport security. (I've only ever experienced one of these, and I'll let you guess which one.) I feel weird, a bit violated, childlike, distrusted, and angry. When finished with the scale, I tie the extra knot in my laces, reload my pockets, and then make my way to the kitchen for breakfast. Before I came here, my individual therapist back home weighed me similarly before each session. I may have felt just as uncomfortable, angry, or criminalized during those weighings, but I didn't see her five days a week.

We also weigh blindly, meaning that our backs are turned towards the wall opposite the scale, away from the digital screen and its electronic measurement. For someone who restricts their eating, this is not a terrible way to go about it. I stopped weighing myself years ago, because I knew that a pound gained would become two lost in the name of overcompensation. Except for when I initially began to "get healthy and into shape,” my eating disorder has never been about weight-loss. Rather, it has been one way to control something, anything, and I've used it more as a maintenance tool. My fear, on the surface anyway, has been weight-gain; my goal - constancy, predictability, security. Overcompensation is my gut reaction to a hike in the gravitational pull. This tendency can be more or less dangerous depending on how thin you are. Yet, now that I think about it, I've never overcompensated for weight-loss. Indeed, the lower weight has always become the new weight to maintain. I chase my tail only to let go once I've captured it.

So, maybe the eating disorder is about weight-loss - on the surface, anyway. Below the surface, prehistoric beasts are fighting to survive.

I worry that when I leave here...

...I'll find it hard to adjust to an unsupervised diet, to full weeks spent back home, to work - provided that my spot has been saved...

...because I also worry that I'll no longer have a job, that my first taste of "normal" life will be the bitterness of unlucky nose-to-grindstone, employment searches, interviews, bullshit résumés and bullshit job descriptions - an environment known well by so many people right now, an all-too-“normal” state of things...

...and I worry that, once left to myself, I'll succumb more easily to triggers, especially newer ones, like others noticing my more substantial mass, commenting on it with best intentions, but not realizing that stubborn, illusory perception often overpowers intention...

...for I further worry that, even if I maintain a healthy weight, I might also maintain an unhealthy tendency towards perfectionism, towards control, towards obsession and compulsion, towards both narcissism and pallid self-esteem – towards a much longer list of thoughts and emotions descending like stairs from surface to core – the same ones that got me here.

Worry may well be the parasitic worm of the mind. It does nothing for you. It takes much from you. Acceptance is its only effective exterminator. You can change neither past nor future. You can only change the now. And you can only change the you that is in it.

This is not original insight. So why is it so hard a principle to use, to live by?

Does anyone have Bobby McFerrin’s number?

Round 2: Me vs. The Cookie (Reprise)

Tuesday, we ordered boxed lunches again from the restaurant whose boxed lunch comes with a gigantic cookie. My anorexic mind thinks of it as the kind of cookie Godzilla might eat after an entree of human flesh. My reasonable mind thinks, "WTF is your deal, man?" Nevertheless, Round 2 of the epic duke-out goes to me. I ate the chocolate chip "treat" first - before sandwich or chips. I enjoyed its texture and taste (chocolate chip cookies were a favorite of mine in a past, less complicated life) but pretty well forgot about it once I moved on to the main event. That's right: Neither of us - my sugary opponent nor me - holds a title belt. No championships hang in the balance. We swapped our pugilistic licks before all your guests arrived for the marquis match, the one you dropped $59.99 to see. Our promoters still work nights at Publix; our trainers still bum cigarettes from the mothers with whom they live.

But, we're making our way up. I believe I am, at least.

The Saturday Evening Almost Post

I planned to post something yesterday. It had been a couple of days since the last dispatch, plus my mother was asking about the www.silence. I have a lot to talk about in general, but little to suggest where to start. So, yesterday I began to write about Jungian sand tray therapy, which is a little bizarre, sometimes off-putting (I broke down during one follow-on group interpretation...big, embarrassing tears), but kind of neat, too. I could have also written about how I became an unpaid (paying, with insurance help) music therapist. Or, I might have just written a little about the program's schedule, which even now I'm a bit sketchy on. Another topic fresh in mind was Thursday's attempt to down a milkshake without any ra-ra-ra group support (finished around 3/4 of a pretty large cup). These are all things I may eventually discuss.

But, I posted nothing.

Instead, I spent the better part of Saturday afternoon and evening searching the web for an answer to one of those grand, cosmic, philosophical, humanity-in-the-balance types of questions:

What kind of milk does Starbucks use as a standard in its Frappuccinos?

My daily meal plan includes four supplements, which can be any combination of Ensure Plus/Boost Plus (or generics), Cliff-type bars, and "fun" foods, as the nutritionist calls them. Fun foods include cookies, muffins, cake, pie, ice cream, milkshakes, etc. The supplements provide "energy" in addition to what I get from the balanced meal plan. The plan is more structured and manageable than "Eat, Eat, Eat! Gain, Gain, Gain!" But, I'm quite aware of the broader goal and its fight song. (I'm actually sipping an Ensure Plus as I write this - Supplement #2 for the day.)

Yesterday, I decided to have a Caramel Frappuccino (not a Caramel-Lite) at Starbucks, but not before going to their website and looking at the nutritional info. I would count it as one of my supplements for the day, but I wanted to ensure (no pun) that it was within the caloric range of the other supplements I've been consuming (nevermind any caffeine cancellations). The website confirmed that it was, and I assumed that, since the milk selection defaulted to 2%, 2% milk must be the Starbucks standard if you don't request something else. I couldn't remember what milk we used when I worked in a Starbucks-affiliated Barnes and Noble Cafe years ago. But it didn't matter, since the Starbucks website defaulted to 2%. Right?

If only I could have stopped there. I actually did stop long enough to order and drink a Caramel Frappuccino, which automatically came with whipped cream drizzled with caramel sauce (not considered earlier). I drank the entire drink except for what whipped cream/caramel sauce I could keep from mingling with the base below. Afterwards, I went back to the Starbucks website (they love repeat visitors) to see what whipped cream/caramel sauce might do to a man's supplement. Turns out - quite a lot, but, even so, I was still only 40-50 calories ("energy") over what I would have gotten from an Ensure Plus. By no means an End-of-Times issue, even for a recovering anorexic. Yet, I began to question whether 2% milk is the Starbucks standard. There were, after all, other choices  in the drop-down menu on the website, and I remembered seeing loud ads encouraging Frappuccino "customization." So, I nosed around the site a bit to see if it mentioned a standard type of milk. I had no luck finding a definitive answer, even after several site searches and a close-reading of the drink FAQs.

What to do? Google, naturally. I spent a lot of time with this, only to turn up some statements confirming 2% milk and others declaring whole to be the standard Frappuccino ingredient. I won't list my specific sources, most of which I don't even remember, but they included several forums, question-answering websites, press releases, news articles, etc. Why didn't I just call the local Starbucks? (Seriously, if you know, please get in touch.)

Suffice it to say that I did not get a chance to do anything worth really doing in Birmingham last night. Suffice it further to say that I haven't done much worth doing over the last 5, 6, 7 years. I lose count. This makes me a bit sad.

But, treatment is changing this, just at a pace that makes it hard to tell. As with the condition itself, it might be futile for me to attempt explanation, so  I won't. I'm getting better - believe it or don't.

How did you spend your Saturday night? Doing something worthwhile, I hope. Do tell. I want gritty details, people.

Silly Smoothie Pictures

I took these Tuesday afternoon because:

1. Why not?
2. I wanted proof to show the treatment team, group members, and others that I drank a smoothie (chocolate/banana) - a small thing for most but a significant stride for me. 
3. I could think of little better to do. 
4. I had a smoothie and a camera at the same time. Only fools squander the gifts of the Fates.  

The official documentation.



The first sip. On another note: Should I get those moles checked out?

Yay. Smoothie.

Uh-oh. Look who's drinking a smoothie.

Really becoming aware of the camera now. This will not end well.

Pssst...over here...behind the smoothie.

Smoothie. What fun.

Hard to tell, but that guy is either some sort of Catholic monk or the drummer for a Neo-Medieval metal band.

Nearly finished and fascinated by the Starbucks Siren. Reminded of Odysseus' encounter during his decade-long trip home following the Trojan War. My return home should come sooner than that.



No smoothie experience is complete without the brain freeze.


So, that's that. The smoothie was tasty and I didn't freak out. Next step? Whipped cream? Do I dare?

Peace.