Crisis Mitigation

It's been a long time since I've posted, and I feel like a lot has happened over the year or so that I have been absent. A lot of hopeful things and a lot of things that have left me feeling defeated. I want try to refrain from rehashing the last year unless it directly relates to what I am feeling in this moment.

Since February, I have been bouncing from treatment center, to psych ward, to treatment center, and so forth. I initially went into treatment feeling hopeful, feeling like this might be the time, this might be the LAST time I ever have to do this, this will be the time to not just learn, but to acquire the skills needed to maintain recovery. And then boom, three days into treatment I got taken by ambulance to a "Behavioral Health Unit" within a medical hospital. That was a pretty deep low for me, especially because at the time I could not recognize how bad things were. But looking back, even to just a few weeks ago, I apologize in advance for the language but I have been in a pretty fucked up place both behaviorally and emotionally.

Since then, I was forced into treatment, signed myself out against medical advance, was obligated to go into treatment again with the consequence that if I did not go I would lose my outpatient team, and then asked to leave after five weeks because the facility was ill-equipped to address my mental health concerns. And yes, they were concerns.

The most recent stint in treatment, I felt like I was well prepared to come out and "face the world." I knew from past experience that I can do treatment REALLY well, and still struggle at home. I had no doubt that this was a replication of the past. However, the difference this time is that I had received such inspiration from the small community I had become close with, that recovery could be possible. I became self-aware of the areas I needed to work on in my personal life. And most importantly, I had so much to lose. This fall will be my internship, and I can't risk ever having to go back to treatment; that would put my career at jeopardy. Because of what I had at stake, I felt like that would give me the motivation to make recovery work at home.

NEWS FLASH: Motivation isn't everything. I have written about this topic before, so I should know this. I got home and I crashed the first day. I have no doubt if I let this consume me that I will not be able to successfully make it through my internship. And I have no doubt that one small slip will really fuck up my world. But being motivated doesn't stop me from being afraid to eat all 8 starches on my meal plan.

Motivation gave me the ability to make a shopping list that contained all the exchanges I needed to meet my meal plan. Motivation helped me go to the store and put the items I needed in my cart. Motivation inspired me to label all of my foods with the product's exchanges so I would not have to go back to weighing out and measuring food that did not need to be weighed or measured, or obsessively counting calories. But motivation did not rid me of the debilitating fear of meeting my meal plan, or calm me down when I panicked and became frantic after consuming a "normal" dinner; motivation did not halt me from purging.

It's so discouraging to have the tools that seem to help others in their own recovery, to have practiced and succeeded at using them in treatment, and to come home and not be able to access them. It's discouraging to feel confident that I am prepared to do recovery outside of a facility, only to come home and crash and burn. It's discouraging to know that my passion is on the line, and to not have that stop me. It's discouraging that my summer is now going to be me going back into treatment, and that I am once again going to miss out on opportunities with my family and relatives.

It's hard for me to view recovery as sustainable. Right now treatment feels like merely "Crisis Mitigation." That is, I can be in a scary place both in my eating disorder or in my emotional health and go into treatment and be saved, but it will never completely take me to the staircase needed to get out of this hell. Maybe, just maybe, I can reach a happy place in recovery for a few months, but it is inevitable that I will always be susceptible to relapse. And it it inevitable that just the right concoction of triggers and stressors will set me down the spiral again.

Got to Step It Up

I've talked a little about this situation I'm dealing with that's causing a lot of stress and is impacting my recovery negatively. I can't go into details about it, or even say what it is, but I'm a little relieved because if things aren't resolved I have a back up plan in place. And not only is the back up plan going to be helping me out, but also a friend.

I don't think I mentioned it, but I started working at Children's National Medical Center yesterday as a volunteer. Ironically, I was told that many of the patients on the unit struggle with eating disorders. I don't think it's going to affect me negatively, at least at this point, because we don't really talk about the condition with the patients. I think the only thing that's going to be hard is not being like "I know this is hard, I can relate," or telling them that they don't want to live like this because an eating disorder in adulthood is nothing to be proud of and is such a barrier to living your life. If it does become a problem, I think I'll ask to switch units. But I think it'll be okay.

I'm meeting with my advisor this coming week, and I'm going to talk to her about taking an incomplete in two of my classes. I haven't talked much about the whole academic side of things, but it's been so overwhelming, and I'm getting so far behind I can't keep up. I'm missing assignments, and while I have a note from my psychiatrist to accommodate me, I feel guilty relying on that. I want to talk to my advisor about the possibility of taking some incompletes, and maybe working for my dad in the spare time I have to help with appointments.

I'm also trying to get myself back on track, because right now I'm on a really slippery slope. I talk a lot about how conflicted I am about recovery, and I am conflicted. But in the long run (I need to stop thinking about the now), I want to have a life. I want to work and be self-sufficient, and I want to enjoy my job and my life. I want to have a house, and maybe even a family. I can't do any of that with my eating disorder. I'm working on structuring my treatment team more, and creating my own "treatment program" outpatient, so that I'm getting daily support.

Right now I'm seeing my therapist every other week (which I should be seeing her weekly), dietitian every other week (again, should be seeing weekly), psychiatrist 1-2x/month, and my PCP once a month, and Dine weekly.

I'm hoping to step up my therapy and dietitian schedule to once a week, keep the dine monte nido, psychiatry, and PCP in place, but also add art therapy every other week, and meet with a Christian therapist as needed. I wanted to replace my current therapist with the Christian one, but I'm nervous about leaving my current therapist because she has done a lot for me and is great at advocating for me. But I feel like my recovery from my eating disorder largely relies on faith, and I struggle a lot with that.

I don't know. All of this is going to be hard to fit in, but I'm just considering it, and how I'm going to pay for it. But I think working for my dad will be helpful because he's currently looking for a sale's person, and I think I could help him out in the meantime while making some money to pay for things that I want to be responsible for.

Okay, now I'm actually flipping out (*tw* calories)

I have Dine tomorrow night The 3 hour program that includes dinner. Last week the meal was super easy, like I wouldn't have eaten it at home, but it's nothing I would have flipped out about.

But I got a text from Alex (leader) this afternoon saying we're going to Chevy's. Chevy's. I looked up the calories (which I know I'm not supposed to) and all the entrees are like 1000+ calories, not kidding. And we have to drink a caloric drink on top of that.

I texted Alex, "Hi Alex, sorry to bother you. I know I shouldn't be doing this, but I'm looking at the calorie count of the entrees at Chevy's and they're really high. Are we going to have to eat an entire entrée?"

To which she replied, "Hi Sarah. I know it's really really tough not to look up menu items beforehand and I know you may be feeling anxious. Try to remember, it's just one dinner. We can talk about this tomorrow before the meal too."

She's going to make us eat the entire entrée. Like, I don't know how I'm going to do that. That's a freaking shit ton of calories, and more than I eat in one day. Plus a caloric drink on top. Like I'm totally flipping out. I don't know how I'm going to do it. I don't want to do it, it's freaking me out. How can I eat all that in one meal???

I know it's not helping my recovery, but I'm seriously considering supplementing it (for those of you not familiar with treatment terminology, that means drinking an extremely highly caloric shake in place of the meal) because that would be less calories. And I know if I do that they're going to question whether or not I should be in the program.

But I can't do eat that much. Like I'm going to have to skip breakfast and lunch for this. I'm literally just going to fill up on coffee and diet coke tomorrow, and even then that's more than I'm okay with eating. I know I'm supposed to be moving towards recovery, but this is too much. I'd honestly rather eat pizza (which is a fear food).

I feel so immature right now, but I don't wanna do this. I can't.