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.

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.