"Healthy" Holidays

For those of us recovering from eating disorders, and, certainly, for those who've yet to start, holidays are like sweets-spitting dragons to be battled back, if not finally slain. It's primarily the Big Two that give us trouble - Thanksgiving and Christmas, or another holiday around the same time of year. In late November, tables shakily support the rewards of our self-congratulatory thanks, and, throughout much of December, they groan, Samson-like, beneath the weight of good cheer. These are occasions celebrated less with food than with FOOOOOD. The "overeater" and undereater alike struggle, but struggle in different ways.

It's a shame, really. Holidays tend to be built around the idea of friendship, family, and community. And friends, family, and communities like to eat. Food and drink are very basic, shareable resources (though, unfortunately, not always shared), and, sometimes, food and drink alone are enough to put people in a room together. My parents, still freshly divorced, now interact only on special occasions, and, while it's not just because of the food, the food helps. Their first real, extended post-divorcealyptic meeting came while visiting their anorexic son (that's me) at an eating disorder center. It was oddly fun.

On Thanksgiving, I didn't do so well. I went, along with the rest of the family, to my sister's; but I ate only a slight piece of the nutty coffee cake I purchased at the last minute, and I counted that as a supplement toward my meal plan. But I also took home some turkey (one of my "safe" foods), and, using it and other items, I ultimately met my meal plan for the day. Yet, it was and is clear that, despite my greater health, I still struggle. Not just with the food itself, but with the time of day at which I consume it and the amount of control I have over it.

Which brings me to Christmas. As I write this, it's 8:06 a.m. on December 25, and I am due at my sister's at 1:00 for Christmas lunch. On the advice of caring support professionals, I asked my mother to make her Christmas candies this year, something she hasn't done for the last couple. I can remember, years ago, looking forward to pies, cakes, rolls, macaroni and cheese, my mother's excellent sausage balls, her knee-weakening fudge, and her "buckeyes" - those chocolate-covered peanut-butter balls resembling the nuts of the buckeye tree.

Part of the bargain is that I have to eat them. And I shall. With relish. And I'll eat other things, too. 1:00 is a time I can work with, and I'm sure that the fare will include something safe enough for me to consume without Catholic guilt. I may not eat sausage balls, but I'll eat enough to substantially contribute to my meal plan for the day and to perhaps make me feel a bit normal this Christmas.

So, "healthy" holidays to all. To all, a good bite.

You Can, in Fact, Go Home Again

It may be a little weird at first.

It may not even be what you wanted to do, at least not at the time.

It's not so much that home is where the heart is -

Home is where the heart is welcome.

Last Supper

Today is my last day at the eating disorder center. I've known for about a week that I would be leaving, but the discharge isn't ideal and there was still some possibility of delay. Nevertheless, I'm just as subject to circumstances as the next person, and I tend to make decisions accordingly. Suffice it to say that I have major goals remaining, goals I'll need to meet. But I've improved beyond clinical expectations. I continue to. I must continue to.

But, more on all that later. This post is about last meals.

The nutritionist here usually asks departing group members to choose their final meal - most often a lunch, since that's our biggie. Today is Friday - Day of the Challenge Lunch (cue ominous music). So, challenge meal rules apply - namely that the meal must scare you, at least a little, and you must clean your terrifying plate.

I've struggled with various menu items over the past couple of months, and I will struggle with menu items when I leave. But that's a necessary condition for breaking free.

My last meal decision:  Beef. Particularly, lean ground beef.

More particularly:  A cheeseburger made with lean ground beef and a side of sweet potato fries (slightly "safer" than regular potato fries - perhaps irrationally so). I also requested a wheat bun option.

For dessert:  Whatever. Just not too heavy, considering the main dish.

Sure, my decisions might be based on eating disordered thinking. And they might not be.

It's so hard to tell sometimes.

A Damn Shame

All these bright, beautiful, talented, kind, wise, soulful people.

Girls and boys, women and men, young and not-quite-so-young.

For whatever reasons, unable to recognize, much less acknowledge and share, those electric qualities in themselves.

Qualities the world seeks, needs, but lacks in optimal proportions.

Qualities the world wants, though it might not always say.

The world hungers for completeness.

These bright, beautiful, talented, kind, wise, soulful people do, too.

Family Matters - Like it or Not

Friday, 9/30, was Family Day at the eating disorder center. The very idea of Family Day made me feel like I’ve been away at camp, though away at camp I’ve never been. There was a flyer announcement, an official-like agenda, a schedule. There was a boxed lunch, staff presentations to family and friends, Q&A, a keynote speaker.  There were flower arrangements on the tables, which we – the “campers” – designed and put together, bless our little hearts. The pomp and circumstance turned me off during the planning stages, and I argued a bit with the staff about the flowers, the new table cloths, the party napkins – even the normally-forbidden caffeinated beverages, some with calories and some without. Basically, I didn’t want Family Day to offer anything out of the ordinary, because that wouldn't be a true image of our daily lives. Rarely a flower arrangement and never a Diet Coke. Granted, the treatment team relaxed the rules for us on this "special" day, and I enjoyed the privilege of caffeine and the relative safety of the boxed lunch. It beat hell out of our regularly scheduled challenge meal, though the white sandwich bun and brownie were challenge enough for me (I overcame). Nevertheless, I wanted my parents, whom I invited, to get the full-on experience, to see how things really are. If I need permission to use the bathroom, why shouldn’t they?


For one, the eating disorder is mine, not theirs. A better question might be: Why should they be punished for it? Should the citizens of a "rogue state" suffer the consequences of sanctions on their leader? Although they may be complicit sometimes or tacitly consent, my parents are not, ultimately, responsible for my actions. They’re likely doing the best they can or, at least, the best they know how to do. This isn’t to say that they have nothing to do with the choices I’ve made. I lived with them for over twenty years, and their influence, along with the influence of my siblings, is pervasive. My influence on their choices is just as pervasive.  None of us fully understands the degree to which our lives and decisions are interlaced. Neither they nor I really know who’s in charge, or, as my individual therapist would say, who’s “leading the dance." No one person leads all of the time.
  
I do not make it easy for people to help me. I tend to sabotage potential support. Concerned family and friends probably get the impression that anything they might say to me is wrong. They would be right - I make it so. Telling me to “just eat” is bossy and betrays an overly-simplistic view. Offering me a salad or some other “safe” food is patronizing. Yet, silence is as good as encouragement. So, what’s a family member or friend to do?


Family Day!


I invited just my parents, because I wasn’t sure how many others I could handle in such a concentrated amount of time. Nothing against my brother, sister, extended family and  friends – but my parents are complicated enough. They divorced approximately a year ago, I guess (I don’t have copies of the paperwork).  In my opinion, the “official” split was long overdue. Until Family Day, they had spoken little to one another since the divorce and hadn’t spent nearly a full day together in the same building, much less the same room.


First, I was anxious about how my parents might behave, since I know there are many unresolved feelings between them. These are feelings that a court of law cannot adjudicate way. I’ve never known my parents to be happy together. Tolstoy’s famous first line rings eternally true. Even before the divorce, my siblings and I served as go-betweens for misaligned personalities. It isn’t that my folks consciously used us as middle boys and girls, now middle men and women.  It’s just that family systems have a way of doling out the roles required to maintain them. Eating disorders do the same. 


I was just as anxious about how deeply my parents and I might dive into my psychological state, particularly my feelings about them and about our relationship. While the eating disorder is “mine” alone – the identity it offers being part of its appeal – I use it as a way of dealing with the emotional “stuff” I’ve yet to consciously address with others. There is a lot of that, I think. Needless to say, I thought Family Day might get pretty heavy, and heavy is something the anorexic tries hard to avoid. It took me awhile to make the decision to invite either of my parents.


You might imagine how awkward their reunion was. I saw and spoke with them briefly before things kicked off (they did not ride together, of course). They greeted one another, but their tone, manner and facial expressions betrayed their discomfort. They were cordial enough, but I still saw the chips on their shoulders. The chips are there, regardless of what either of them might tell you.


During the first half of the day, family and friends were occupied listening to the staff’s presentations on eating disorders, their psychological and medical complications, the nutrition required to sustain normal human beings and effectively battle disordered thoughts and behaviors. My fellow group members and I went about our morning as usual, away from our visitors. We had heard it all before and would almost certainly here it all again. We practiced yoga as scheduled, and yoga – when you willingly and generously submit to the practice – has a way of putting things into perspective. At heart, yoga – and life – is about the breath. You can breathe through your anxiety. You can recognize your breath. You can focus on it. You can live with it, in it, through it. You are it. Without it, you are not. Breathing, you can essentially eliminate a lot of your worry about the horizon, because you no longer seek what might be on it. You are breathing. That is all. That is enough. This helped me get through a lot of my Family Day anxiety. It may sound to you like corny self-help juju, but yoga –  the breath – is just as much metaphor as actual practice.  It's taken me awhile, but I’m finally beginning to heed our instructor’s advice about letting yoga - the breath, the metaphor - inform the way I live out the other aspects of my life.


To their credit, my folks had agreed to set aside their own grievances for Family Day and try to be present for me alone. So, I would trust them. If I got burned, I could inhale the flame. Then I could blow it out.


Part of me wishes I had an action-filled climax to spice up my Family Day account, but I don’t, really. We – the campers – reconvened with our family and friends for lunch. My parents – sitting and eating together with me – spoke directly to one another, complete sentences. They undertook the conversation gingerly but with greater comfort than at the day’s start. They had learned a lot more that morning than I would have been able to objectively teach them.


After lunch, everyone got together in a room and sat in chairs arranged in a circle. Breathing or not, I felt a tinge of anxiety about this. I let it go. First, a former patient  – a fellow dude (represent!) – spoke about his personal experience at the eating disorder center and his continued recovery. Gender aside, his story was very much like our own stories. I took away a lot from his retelling, and I admire and appreciate his courage to tell.


Earlier in the day, the staff had given everyone – campers and visitors alike – a worksheet to complete.  This worksheet had four sentence fragments printed on it, all of them the same: “I wish my family member(s) knew…”

The staff asked us to complete the sentence – four times, fewer than four times, more than four times, whatever we could do. We would not have to read these aloud, they said, but there would be an “opportunity.” Yay.

We closed Family Day in our circle, group members sitting with their family and friends, me sitting between my parents. The worksheets  were out, the “opportunity” provided, the initial silence excruciating. I agreed to read some of my statements, but not all four of them. But then, as I began to read, I thought:  Fuck it. This isn’t supposed to be easy. To be effective, it has to be hard.

So, I read all. This, more or less, is what I said: 

• I wish my family member(s) knew…that I do not want to be this way, to have an eating disorder.
• I wish my family member(s) knew…that, most of the time, I feel uncomfortable around them, but that I wish this were not so.
• I wish my family member(s) knew…that I often worry about what they might think of me and am not always honest about my feelings with them.
• I wish my family member(s) knew…that I love them but often find it hard to do so. I harbor resentments that would best be addressed and which have grown stronger because they have not been.

Family Day went better than I expected, perhaps because I expected. It was a good day, regardless. I am glad that my parents came. I am relieved and thankful that they came in the spirit of the event and that they appeared to take some of that spirit home with them. We’ll see where this takes us.

Until then, I’ll keep breathing.

More to Come...

Forgive me Blogger - it's been over a week since my last post.

I feel like I'm slacking, and I probably am. I've been "processing" Friday's Family Day at the eating disorder center and hope to post something about that soon. Short version: Went much better than I feared it would. Lesson: Don't believe your hype.

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.