Relapse

Someone in the program who’s been there only a week longer than I have had a lapse on Monday. I worried about her a bit on Saturday, knowing she was going to a wedding. On Sunday she didn’t turn up to the OA meeting we had talked about going to, and with no explanation, either. This morning I heard from her: They hadn’t been allowed phones at the wedding, so she didn’t get my text. She felt exhausted from the party – too exhausted to make it to the meeting – and then binged on Monday. I’ve been there so many time – getting through the worrisome event, only to fall down in the next 48 to 72 hours.

I confess I felt a little scared at the power of this problem – the sheer enormity of it. Usually I don’t binge when I’m being watched quite like this, and certainly not in the first couple of weeks. (And not when I’ve moved my life and spent an awful lot of money for treatment.) But there but for the grace of God go I, right?

I’m starting to think about extending my stay here until at least the six month mark, because that’s a point of freedom from bingeing I’ve never reached. I’ve made it to 100 days; I think maybe even four months. But then it all has fallen apart. There was a lecture at treatment today – more of which, shortly – about relapse. One of the things that struck me was that it’s not considered relapse if you do it after 90 days of abstinence – because relapse starts four to six weeks before the actual episode (in terms of thoughts, feelings and behaviors), you haven’t actually been in recovery long enough to call it relapse. It’s just that you didn’t recover.

Our homework this week is to come up with a list of quite-specific-to-us thoughts, feelings and behaviors that are signs we’re in the relapse zone. I know mine will be things like not cleaning the flat, eating while walking, isolating, staying up too late, and thinking I’m too busy to get to meetings or do recovery-type-stuff. Red flags, if you will. So far this lecture was by far the most useful and interesting, and certainly the most practical.

We also had the first (at least for me) life story, which went on for over an hour. It was a moving story – given by an alcoholic – that I don’t think is right for me to share here, even anonymously. What was terrifying (and fitting for today) about it was that she had 8 years of sobriety before her relapse. One thing she said that is a warning for me is that one of the treatment programs she did was in Arizona, and when she came back to London, she didn’t have any recovery friends.

Finally, I bought the Victoria sponge. Tesco sells them as two mini ones, so I’ve had one tonight and will have another tomorrow. Is this the best version I could have bought? No, but it was pretty good and didn’t require a lot of going into various bakeries and looking at things and wanting them all. Baby steps.

Ten Days

I’m feeling more like myself today than I have since I left New York. I went and worked in a coffee shop this morning (well, technically the lounge at Equinox) and it helped a lot to be out and about instead of stuck in this tiny flat. I had convinced myself I’m not good at working in coffee shops, but maybe that’s just a story I tell myself. (That said, I wasn’t really writing – just doing other types of work. And I certainly couldn’t do an interview there.)

Then it was on to an individual therapy session, and finally to beading, which struck me as the perfect group therapy for Brits, because everyone can focus on slipping beads onto strings (it’s jewelry-making) and not have to make eye contact with each other while revealing deeply personal things. Though there wasn’t actually much revealed. I wonder if it’s intentional to the therapy that beading is a deeply difficult activity for perfectionists, of which most people with eating disorders are? (I like to say I’m a perfectionist but bad at it, but that’s because I like to make light of my flaws.) We all struggled to make choices, struggled whether ours were “good enough,” and agreed about the need for perfect symmetry. One of the women was fussy even about beads that were all supposed to be the same – she wanted the ones that were the most exactly the same. Can’t say I really rated the person running the session, and the whole thing just felt more like a summer camp arts and crafts session, except for the smoking breaks (I might be the only person in treatment who is not a smoker.)

Did a couple more hours of work in another coffee shop, and probably should have gone to a meeting, but I had a several-thousand page deposition I was lugging around, the weather was terrible, and I just couldn’t face it, in part because it was located in such a way that it would take me 45 minutes on the bus but only about 55 to walk, and neither sounded appealing.

Today marks 10 days of neither bingeing or restricting. If I’m honest I’m resentful about the amount of time I spent thinking about and dealing with food – it seems like for all that I should get to lose weight, though I know that’s not the name of the game here. I still haven’t quite surrendered to it yet – I’m ok with 500 or 600 and in some cases 700 calorie ready meals, but I can’t go above that, and so there are a couple of things I haven’t allowed myself to eat. And today I wanted Victoria sponge (anyone got any thoughts on who in London does the best?) and stood in Tesco, holding a box with two small servings in my hand. I paused. Was I allowed to eat dessert and still have my nightly yogurt? I wasn’t sure. I know the idea is that nothing terrible would happen if I had both, but still I couldn’t do it. Nor did I feel like I could buy it and wait until tomorrow to have it, and so I put it back. It will be there tomorrow, along, I hope, with the ability to stop worrying about it all so damn much. I know, I know; it’s only Day 10. It will come.

Secrets and Lies

A quiet weekend – I was supposed to see two friends in the evenings, but both got sick. One, frankly, I was relieved about. She’s not a close friend, but she’d invited me round for “wine and nibbles,” and I wasn’t sure how I’d handle it, since she is the type that likes a boozy midweek lunch (and in fact, I’d had one with her last summer, which stretched on longer than I would have liked.)

Saturday I had the first of what will be 8 Saturday sessions in this program. The first hour was a lecture about denial, which I didn’t find particularly useful, only because I’ve certainly been admitting I’ve had a problem for several years now, and that, in general, the only time I’ve ever managed not to binge is if I restrict instead. If there has been denial, I think it’s really only been in that I thought I could handle this without resorting to stronger measures. But who knows? Maybe – probably – I’ll discover more denial as I get farther in.

The second hour involved this exercise where you have to tell other people in the group their barriers to recovery (using a list) and what their strengths are, and of course, they do it for you. A bit difficult to do in the first week, since nobody really knows anyone else. I was pleased to have gotten one of my strengths was that I was friendly and open. One of my barriers was that I am self-pitying, which, hmmm, I’m honestly not sure is the right word for what the guy was trying to say – the choice of this, he said, was based on my comment in one of the groups about being ashamed of having an eating disorder; of wishing I could just claim I was an alcoholic, because really, an eating disorder sounds so unbelievably lame sometimes. Like I’m being chased by some cartoon slice of cake or something. (For sure I abuse alcohol sometimes, but I don’t think I’m an addict. I’ve never craved alcohol the way I’ve craved cake, that’s for sure. And I can put limits on it the way I’ve never been able to with food.)

I’m a bit impatient to get more into the sharing of stories, which, given that my favorite OA meetings are always the ones where someone tells his or her life story, isn’t a surprise. I’ve caught some very occasional glimpses, and it’s hard to resist pulling out a notebook and writing things down, because the details are so telling: the woman who’d put on a face mask so her husband couldn’t kiss her when she came home and smell the alcohol on her breath; another one who takes cabs on really hot days because she can’t bear to wear summer clothes and being on the tube fully covered would be unbearable. I have to keep reminding myself that I’m not writing a story here; that in some way, my constant analysis and the picking out of details is what keeps me not present, in the same way I use food to remove myself from the moment. This morning at an OA meeting (we’re required to attend at least one 12-step meeting a week) I listened to a woman share about standing at the bottom of a beautiful mountain only concerned about the size of her thighs, and I thought back to all the places I’ve been that I mostly remember through the prism of whether I was bingeing or restricting at the time. For example: Beijing (restricting), Venice film festival 2005 (binged so much the clothes I had with me didn’t fit at the end of the week and a half and I had to buy things from some Italian supermarket), Cambodia (restricting; grateful when Friend Bearing Chocolate was ill because it meant I could eat exactly as I pleased.)

I have to do some writing – actually, quite a bit of writing – before tomorrow’s session, about some of the worst episodes of this illness and the consequences of my behavior. Five episodes, at least half a page apiece. A couple of them have appeared on this blog, some quite nakedly, others more obliquely. For the most part, I struggle to pick out episodes, though, only because some I don’t remember in sufficient detail and didn’t cause sufficient harm – just the constant drip-drip-drip that eventually makes the sink overflow. I know I lied all the time to be able to eat/not eat/exercise. I refused dinner invitations (and lunch invitations and breakfast invitations) because I didn’t want to face eating at a restaurant, or because I was hoping that was the one day I’d be able to start a diet, or because it was the first week of a diet and I didn’t want to chance it. I lied to friends passing through town because I didn’t want them to see me at the weight I was at. It’s excruciating to write these things, but – so goes the theory, I think – less so than keeping them hidden.

Shelter From the Spoon

You say football, I say soccer. You say tablespoon, I say tablespoon… but apparently these are different things, as I learned in a very frustrating exchange with the dietitian today. How did I live here for 8 years and (a) not know a dessertspoon was a measure of anything and (b) that a tablespoon (which I guess some people call a dessert spoon) could be 2 teaspoons (if it’s the kind you use at the table) or 3 teaspoons (the cooking unit of measure)? Maybe I’ve got that wrong. I’m so confused and actually kind of annoyed, because all I want to do is try to eat according to plan. I realize an extra teaspoon of anything here and there isn’t going to make a huge difference, but the mess of it does my head in.

Tonight was another round of treatment: A small group thing that was a lot about processing feelings, and then another lecture that was more boring than the one on Tuesday, which was about cravings. This one was about service and sponsorship in 12-step programs, and not only did I know all of it, but frankly I thought the counselor did a pretty crap job of explaining it. (Lest you think I’m being critical, the woman next to me – who truly knew nothing about twelve-step programs – was thoroughly confused.)

Apparently there are more of us with eating disorders this time around then there have been in a long time – my friend who did it was the only one in her treatment group – so the counselors leading the group asked if the guys (both who are in for drug treatment) understood about eating disorders. It was both hilarious and embarrassing to listen to them try to explain it. I don’t think anyone who has an eating disorder has trouble understanding drug or alcohol addiction, but the reverse is definitely not true. One of the guys kept saying incredulously, “But what you do is natural.” (What it turned out he meant was that you have to go out and first try drugs or alcohol to get addicted.)

And because I’m trying to note things as I notice them, because they fade and become ordinary so quickly: Brits always seem to say something is “interesting” when they’re not sure what to say. Hmmm...interesting, right?

Hungry Hungry Hippo

A hungry day today, which terrified me and made me fear that I've irreparably damaged both my metabolism and my body's ability to regulate hunger.

My food plan isn't a diet and it's generous -- generous enough that I've already written about fearing gaining weight on it. And yet I felt hungry all day today. (And hungry a lot of yesterday.)

The only thing I can think/hope is that my body is adjusting to such regular intake of carbs (required at every meal and snack), except I've basically been eating carbs at every meal for several weeks. Or maybe it's just my adjusting to "normal" meals, as opposed to my "eat anything you want as long as it's not a binge" meal plan. I think I just have to get through two weeks and see how things shake out, but I'm not sure how.

Today was the dedicated eating disorders group, which felt like a relief after so much talk yesterday of drugs and alcohol, and feeling so separate from everyone else in the group. Much of the eating disorders group was young and anorexic, which usually I have trouble relating to (and, if I'm honest, and though I know it's wrong, wish were my problem), but I didn't have so much trouble with that today. S. was there and I felt acutely aware of worrying about whether this would ruin or strain our friendship or if it would be difficult for me to share honestly. I could feel myself wanting to be liked -- by her, by everyone -- which, of course, is all part of my problem.

And So It Begins

And so today was the first proper day of treatment, and I feel not much but frustration (and probably some fear.)

Frustration because everything seems to be focused on drugs and alcohol, and so I feel like a second class citizen. When I filled out the intake form, all the questions were about drugs and alcohol -- and they were not phrased in such a way that you could really talk about eating disorders. (And the counselor seemed annoyed when I pointed this out.) Frustrated because nobody told me there would be dinner available – I mean, nobody would put out a buffet of drugs and alcohol for this group. Frustrated because we are tested for drugs and alcohol, and yet there is no way to test for what I’ve got. And frustrated because the left hand doesn’t seem to know what the right hand is doing, which is where the fear comes in: I need this to work. I really need this to work. I can’t imagine I’ll be able to do something like this again, from both opportunity and actual cost.

This evening’s session had a group about food and feelings, which seemed to include not just those of us with eating disorders (there appear to be two others, one of whom has a problem similar to mine and the other of whom is an anorexic), but people who are recovering from other addictions but seem to have replaced those with some problems with food, or uncovered a problem with food. I think I much preferred that half to a lecture about cravings, which was the second half. (If I’m honest, I also was starving by that point, as I went out at the break with another woman with an eating disorder just to be friendly, and because I didn’t want to face the food.)

In the food and feelings one most of the women (there were four women and two men) were talking about how they didn’t even notice other people’s size because they were so focused on their own. And it made me feel so separate, because frankly, I do. I wouldn’t have guessed anyone in that room had a problem with food, and couldn’t help noticing how much bigger I was than all of them. I never don’t notice size, and despite it supposedly being a judgment free zone, I didn’t feel I could say it. Maybe at some point I will.