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.