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November 09, 2011

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Laura

Johanna... how do you stay okay when you work all day with people with eating disorders and, I'm assuming, some of them slipping at any given moment?

I am struggling so hard to stay emotionally afloat lately b/c someone I care a lot about is slipping again. This is a middle aged woman who I met in treatment. She was my guide. She helped me find my way through the meals. This isn't the first time she has slipped (she's had an ED for decades), but her recent slip is hitting me so hard. For about a week now, I talk to her on the phone every day and, when I hang up, I just sit on the floor and sob. I have such mixed emotions about her slip - everything from afraid she'll die to feeling angry that she's slipping and refusing to skype meals/snacks with me as a form of support.

I'm doing SO well with the food, but in the past 36 hrs I feel like it would be so easy to shrug my shoulders and just slip away... into the quiet, deadened world of the eating disorder. Why? Maybe it's biological (Maybe I really do need to be at a higher weight like my RD and T would prefer. Maybe going on that bike ride the other day with my dad put me in an energy deficit and this is the result). Maybe it's chemical (I take an OCD/anxiety med and I have forgotten to take my meds for like 4 days... not intentionally. I took them today). Maybe it's emotional - my friend struggling is taking a massive toll on me. Also, I am in the process of applying to insurance companies b/c my COBRA will run out soon and I am, predictibly, getting denied by everyone and even though I shouldn't take it personally I can't help it... I do.

I will not slip into restriction. For one, I have too much going for me. Two, if I slip now, I will start to not believe I'll ever recover and I can't afford that. Three, my friend who is slipping has the same RD as I do. If I start to slip then I'd be giving my RD more of a headache and I can't let her have two people who are slipping. So, I'll keep feeding myself. I have to.

It's just strange that I've been doing so amazingly and in the last little bit, suddenly I feel like it would be SO easy to shrug my shoulders and slip away - give up - settle into the quiet, sullen, deadened world of the ED.

Why do I want this? Is it a form of self care? Am I trying to care for myself with the ED by taking me away from what hurts (my friend's slipping?)? Is it a biological barometer? Like, oh, when I feel this way, it means I'm in an energy deficit and I need to get my food up to make my brain less restriction friendly? (Even though I haven't been restricting... but my weight has been minorly decreasing and my tx team is chalking it up to a metabolism change... so i have been eating more to try to account for this....)

I'm not fighting my emotions. I'm accepting them. I feel an incredible sadness and loneliness. I feel like I haven't had therapy in forever when I actually had it last week.

But how do you do it? How do you come to know that people are slipping and not slip yourself? (Not like slip as in get an ED... but slip as in... just feel so, so, so bad inside).

I feel like if my friend keeps slipping, I will just seriously quit recovery, quit life, quit it all. I will not be willing to handle it. If she dies, I feel like I will too. I know I won't, but that's what it feels like.

How do you stay okay when you care about people who are slipping? I mean, you do this all day long.... how are you okay?

sorry for this long and winded post. I just feel sad tonight and want to know how you don't crumble in the face of struggling clients of yours....

Laura R

Laura- sorry it is so hard. You have lost a number of people this year and I imagine that it's hard to tell yourself that this time can be different. Your friend sounds very special. I will keep you both in my thoughts. I am glad you listed all the reasons why you don't want to restrict. I believe you will honor them and continue to take care of yourself even if your friend can not take care of herself. BTW - When I miss my meds I feel like all my emotions are on overdrive and everything feels too much and I cry about everything. It gets better after I get enough meds on board. Hugs.

Laura

Thank you, Laura R, your comment helped a lot.

LeahV

I work with lots of victims and with lots of people with circumstance that I strongly identify with. Mental health is a hard field to work in. But the key, for me, is knowing that while so many that I care about are struggeling I have to maintain my joy and zeal. I have to continually nourish myself or I will be drained...and stuck at the bottom of deep well. An I never give completely ...I maintain a certain boundry that I do not cross nor do I let others cross...that is part of professionalism.

But when it comes to my friends..I still have remind myself of where my joy comes from..and that it is not dependant on the well being of those around me. I have lots of friends who struggle and when they fall it is easy be drudged in behind 'em. But I always put my emotional needs first.

It may sound a little cold but sometimes that emotional distance is healthy and protective.

This is what I have learned..

wendy

Laura, I lead a couple of support groups for women and I love those women. Some have pain they are dealing with and some have ED's. I get the question you are asking and maybe some underlying questions that you didn't verbalize. When the ladies slip or even choose to quit the healing process or stay in ED, it does hurt my heart. But the way I get through it is to be careful not to use catastrophic thinking. Example, when one lady slips and says she is quitting our group, I could tell myself I can't handle it if she gives up or dies, etc. Or I can tell myself, you know, Wendy, this sucks and it hurts bad to see her walk away and know what may happen to her. But I can get through this. I can talk about my feelings, take care of myself in the mean time, and I can continue to show her compassion and encouragment. I can survive this and learn something in this pain. When I want to slip or do slip in my pain I tell my support team and ask for extra support. I can love and support, but I can't heal or force someone to recover. I can survive the hurts because I know I am not alone in them. I don't in any way want to trivialize your pain as I am familiar with it. But the way I deal with it is make sure I am telling myself the truth...I can survive it, espeically with the good support I have. I just have to be honest about what I need and acknowledge that connecting with others sometimes has pain and loss with it. But the joy outweighs the loss and...it makes me sad and sometimes angry at what people endured who are in my groups...and that is okay. Feeling means I am alive and well! I also realize that what is today, doesn't always mean it will be that way. Sometiems someone tells me they are quitting, and they show up the next week. They needed to feel some control, and now are back on track in a healthy way. The fact that you love her and care is one of the treasures of recovery! Hugs to you today!

Laura

Such helpful answers, thank you! Wendy, thanks for modeling what you say to yourself. I think I can speak to myself like you do

super egg

wendy, the egg has spoken...and i think u should go by WW 4 "wonderful wendy"

wendy

Super Egg, you crack me up and made me smile and brought tears of joy to my eyes! Laura, I have never gone into in patient treatment, but have several friends who have and because of the seriousness of people who have ed's there they have faced many more losses than I have and I want you to know I recognize how real and scary it must be that a friend is slipping! I am glad you chose to work so hard, because you have been a voice for us on here and eloquently have said things to which I could so relate and stirred me to try harder and to be more honest in my own recovery! Sometimes I think I should already be done with this, but as I read everyone's posts I realize that life, living and victory is about healing, recovering, growing, and and daily, moment by moment victories.

Laura R

Today in therapy I learned there is a part of me that really doesn't want to grow up (silly huh since I'm almost 47). This part of me says that being an adult is too messy and is all about pain and angst and misery. T says that this part of me is probably in her mid teens and all she knows about being a grown up is what she learned from my parents (life is hard and sad and scary). I think this this part of me is closely related to ED because tells me that I am unacceptable and that staying thin and rigid will help me not become the unhappy adult that my mom was. T wants me to get to know this part of me better. He says that I need to find out who I am as an adult and not assume I am becoming my mom. This scares me. Getting to know this part of me means letting it out of the place I've locked it away in so that she doesn't do anything unacceptable. I don't know if what I'm writing makes any sense. It's still pretty fresh in my head from this morning. Talking to T about it really shook me up and rocked my world.

Laura R

Laura - hope you and your friend are hanging in there.

wendy

Laura R, when i developed anorexia in high school that was once of my strongest beliefs. I can remember thinking and even saying that I didn't want to grow up. Its wierd, because at the same time I was assuming a lot of adult responsibilities that weren't mine to assume! What your wrote makes a lot of sense!

Laura

Laura R - Sounds like a good session and like you're onto something important. Keep up the brave work!

Also, thank you for asking about my friend and I. My friend is hanging in there, but I promised my T and my psychiatrist and my RD that I would stop sending encouraging texts to my friend all day long and I promised I would stop having these lengthy conversations with her all day because I'm "too enmeshed." My T did help me though by saying, "Laura, we can't save everyone. FRIEND may die, may keep slipping, and you will grieve, and you will deal with it, and you will also keep living and go on to become a great therapist, and continue on to have a family and to develop your own life." That was helpful to hear.


As for me... I'm frustrated right now. I feel so recovered in so many ways, but my weight is not cooperating. To try to give me a reality check, my team told me my weight b/c I wasn't taking them seriously when they told me my weight was slipping. I was pretty freaked out when I heard my weight, and I don't know how this happened. My team called my former residential place and my former php and iop place, and I've gotten all kinds of phone calls lately from a giant network of professionals basically saying, "WTF, Laura! You have to maintain your discharge weight. This is not okay!" It's frustrating b/c I'm so sick of being on everyone's "red alert list" permanently. I am frustrated b/c I truly don't feel eating disordered and I really feel like I'm not even restricting... My T is telling me about how we all have the responsibility to eat up to our metabolism, which is an individual thing. My T and psychiatrist and RD are all telling me that my body is still in refeeding mode (i swear it's been here for foreeeever) and I have to be patient with it and just accept that it needs more than someone not in refeeding mode. So, I don't "feel" eating disordered - so that's good. It just stinks that now i'm on the "red alert list" again. My parents of course are glad b/c it means my "red alert system" is working... Anyway, I'm willing to gain weight and I will. Now that I know my weight, I'm totally on board with gaining some back... it just stinks that i have to do this AGAIN. But, I have to b/c otherwise, I'm too close to Danger Brain Will Go Crazy zone.... I wish I could just press a button and be at my proper weight. So, I'm doing good but pretty bummed that i'm back on the red alert gain weight list.... especially when I don't even know how I got there in the first place. I swear I didn't restrict....

courtney

Laura. i heard you complaining a lot about this red alert list thing in your last post. Maybe you should be thankful to have so many people care enough about you to make a big deal about you. Not everyone had people who make a big deal about them.

Laura

That's a really really good point, Courtney. Thank you for reminding me to be grateful. That's such a great perspective. Good point, and point taken!

Laura

Also, I'm sorry for being so thoughtless and inconsiderate. I was worked up in the moment and bitter about *still* being an "ED patient,* but no excuses...

Laura R

Laura - At the same time that I see Courtney's important point about being thankful, I can also understand why being on the "red alert" list would be really frustrating. Especially because you were doing all the right things. I know having people trust you and acknowledge that you are an independent adult has been something that you have been longing for as part of your recovery. I think you have been doing an awesome job in your recovery with all your new experiences and you have been showing all of us that you are a responsible adult. I believe you when you say you didn't restrict. Maybe this is just your body's way of trying to compensate for all the new activities you've worked in to your life. Way to go for being "totally on board with gaining some back". BTW - I love your idea about the push button :) I'll take one too!

Laura R

Laura - I forgot to ask..."refeeding mode"...is that when your body is still trying to get healthy and your metabolism is fluctuating? Since I haven't been in any type of treatment program I am still not up on all the terms. One thing that RD keeps telling me is that I am not yet at the bottom of the BMI for my height. I thought BMI was not a very accurate way of targeting weight. I keep hearing about IBW but don't know how the two compare. Maybe it doesn't matter and I just need to stay focused on eating right? Every time I go into the hubby's bathroom I have to by-pass his scale (I put mine away a long time ago) and usually it doesn't bother me but today I thought about using it for a mere second. Then I thought about how ashamed I'd when when I had to tell you guys!

Traci

I haven't written in awhile, because I feel like I am always long-winded and way too negative . . . but I was thinking about everyone here and all the amazing support I get here - so I'm sending some virtual (((HUGS))) to everyone - love you guys and so greatly appreciate your honesty and wisdom.

Laura R

Traci - I want to hear how you are regardless of whether it's positive or negative. I always learn from you. I care how you are.

Ann

Hi all, feel like I need to check in. Life has been crazy busy and I feel like there's never enough time in the day.

Johanna, thank you for answering my question!! I found it very helpful. I do have follow-up questions, but too tired to ask tonight.

I hope everyone takes a moment tomorrow to breathe and notice the beauty of the world around us..

Laura

Hey Laura R.... good questions and ones you could ask your RD for better answers. I don't really want to get into a discussion of BMI and IBW on this forum b/c I think it could be triggering. I think my pervious post about the red alert list was walking a thin line of being triggering already..... But, seriously, these are questions that you should get to ask, so try asking your RD.... that would be my suggestion...

Traci - hello! Glad to "see" you! Be long, be short, be positive, be negative (talk about that for black and white, all or nothing language), it's all good for me! i'm glad you checked in :)

courtney

I totally agree Laura.

Laura

Hey Court... yeah, I really am sorry about my red alert post. I wish I could delete it. I am someones who feels heated up and not necessarily triggered but really bothered by low weight comments, and I realized I just contributed to that type of comment. I really do regret it. I'm sorry. I always feel a big call to remind everyone that not everyone with an eating disorder needs to gain weight. I hate the stereotype of the skinny girl who has the ED. Weight loss is not necessarily a sign that someone is doing worse. Severity of ED really cannot be only measured in weight. And hearing people talk about their EDs purely in the form of their weight super bothers me. Again, I'm really sorry for contribution. I really am. By the way, given what I think I know about you based on some comments you've made here, I have a pretty sure opinion that, if we met in person (which we could since we live in the same area I think), I think we would actually have a lot of similar opinions, thoughts, etc.

Laura

Courtney... something else... and I probably shouldn't even say this on here. But in the comment right above, I wrote that I get bothered, too, by "low weight comments." I felt that might have given you the impression that my weight is really low. In case if you read my Red Alert List post as me being like "i am so underweight! poor me!"... I wanted to just tell you that I am not officially underweight and it wasn't my intention to convey anything different. Anyway, weight is just a tricky and sensitive topic and it's a topic I probably should just stay away from. I really am sorry.

Laura R

Sorry guys. What was I thinking. I think my ED is acting up a lot because I've been pushing it w/T and also I've brought a bunch of foods back into my life that I hadn't eaten for a long time. It's good because I like these foods but it also scares me because it feels out of control to have more food choices. I've learned that I can either work on "more" or "new"...not both at the same time. Anyways, I'm having lots of thoughts about compensating and I think that triggers the obessesive thinking. I'm ashamed to say that I sat in front of the computer last night and googled about the topic that I asked Laura about. It's hard to take risks and manage ED.

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