stirring dull roots with spring rain

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on friday, my psychiatrist and i agreed some rules for april. unless i make what he described as significant progress by the start of may, he will suggest that we take a break from treatment and i consider my options. for the last few months, i’ve been stuck in a sort of half-recovery, doing just enough to avoid getting into serious trouble but not really trying as hard as i know that i need to.

the rules are simple. don’t lose any weight. three solid meals a day, totalling at least 1,200 calories. reducing the bingeing that has crept in to twice a week, max. no purging behaviours. basically all the stuff that ‘normal’ people do (except maybe the bingeing).

april needs to be the month that i crack this. partly because being kicked out of treatment (even if it’s done in the nicest possible way) will be (yet another) way in which i’ve failed but primarily because we’re hoping to start ivf this month. my missing period turned up over the weekend so i need to call our clinic tomorrow morning to get the ball rolling; a prospect which is both more terrifying and more exciting than i can put into words.

sadly, yesterday – the 1st april – wasn’t much of a success. it was perhaps slightly ambitious to try and stick to the agreed rules and host easter lunch for my in-laws at the same time. at the moment, any kind of social occasion – even one in my own home which i am firmly in charge of – generates a huge amount of anxiety which generally translates into all the behaviours that i’m not supposed to be engaging in.

it astonishes me that we’re in april already. the year is slipping past, lost in a blur of bingeing and restricting and purging. i don’t want to go on like this. today is going to be a better day. it has to be a better day.

{title quotation from the wasteland by t.s.eliot}

the beginning is always today (part ii)

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a couple of years ago, i decided to cultivate a little garden on our balcony. this turned out to be much more challenging than expected. we didn’t get much more than seven raspberries (which i turned into donuts, obviously). my mother-in-law made some valiant efforts to help but for the last couple of years, it’s been pretty barren out there bar a rosemary plant which i was assured was indestructible but which i’ve been doing a pretty good job of slowly torturing to death.

yesterday seemed like a pretty good day to get back out there and plant some things.

my best friend texted a couple of days ago to ask how my week had been. it’s been hard, i said, but they’re all hard. and they really are at the moment. for every few moments where i feel like i might actually beat this, there are hours of despair, self-loathing and shame.

this week has been even more up and down than usual (as evidenced by the fact that the number on the scales has been ricocheting around). we had an appointment at our fertility clinic and got the go-ahead to start ivf when my period arrives. which is great except my period is currently awol. my doctor thinks that the stress of the last couple of months and the extreme cycles of bingeing/purging/restricting have caused it to disappear. i need to get it back asap. for a little while, focussing on the needing to eat healthily for a potential baby give me some much needed motivation but i soon (ie within a day) slipped back into my old habits. this led to a difficult – but ultimately beneficial – session with my psychiatrist who put some firm ground rules in place as to what i need to do in order to continue with treatment otherwise he’ll discharge me. surprise surprise, i’m a perfectionist who likes structure and rules so i’m actually grateful to him for being ‘mean to me’ (his words, not mine).

there have been many new beginnings. i can’t tell you how many times in the last couple of months there has been a day 1 (after the official day 1) or an email from my therapist that ends with some form of ‘don’t worry, tomorrow is a new day’. but it does sort of feel that something has started to change over the last few days.

i was going to blog yesterday about how it was a fresh start and i was really committed to doing what i need to do (three meals a day, no restricting, no bingeing and definitely no purging) and everything was going to be different this time. but i decided not to because i wanted to see if i could actually do it or if it was yet another false start.

but i did it (just about).

for the first time in a long time, i did have three meals. and although i had a bit more chocolate after dinner than i probably should, i shared it with my husband (rather than bingeing in secret). every minute of the day was hard and i really had to fight for it but i managed it.

and then, i had a really good appointment with a nutritionist today. her enthusiasm and positivity was inspiring. for so long, i’ve been stuck in the past, re-living the night that everything changed. the idea of a future – and a happy one at that – has seemed so far away that it’s not something i’ve ever even been able to contemplate. but it feels a tiny bit closer this afternoon. i know this feeling won’t last forever and my capacity to self-destruct will kick in sooner or later but i need to believe that i can and will feel it again and every time that i do, i get a little bit stronger.

{title quotation attributed to mary shelley}

it takes a village

20180212-IMG_1268normally i work from home on a tuesday because i have therapy first thing in the morning and i generally need a bit of solo time after my sessions. apart from when i’ve run away, this has been the pattern for the last nine months or so.

today, however, i’m in the office because not only do i now have a new psychiatrist but i also will have a new therapist after tomorrow.

i’m very grateful to my now ex-therapist. without him, i wouldn’t have got through the crippling ptsd that i suffered for most of last year. but there were also things that frustrated me about him and i felt that our sessions – or at least the overarching theme of our sessions rather than the individual sessions themselves – lacked a structure or focus. and in the short time that i’ve been under my new psychiatrist’s care (is it really less than three weeks?!), i think it’s become clear that i need more intensive treatment than i’m currently getting.

i’ve had some success with bringing my calorie intake up but that has resulted in some other unhealthy behaviours rearing up. behaviours that i thought i had well and truly left behind including, but not limited to, one of the biggest and most shameful binges i’ve ever had last night. my new psychiatrist said that he’s still happy that i can be treated on an outpatient basis (even that sounds so serious) and i’m not at the stage of needing day patient / inpatient care. but he’s also made it clear that it’s probably only a matter of a few weeks and that continued outpatient support relies on me actively participating in my recovery and surrounding myself with the best possible people. he has pulled some strings to get me appointments both with one of the top nutritionists in london and with a highly recommended specialist in cbt-e. i know the rest is down to me.

and, as much as i hate to admit it because i like to think of myself as independent and resilient and self-sufficient and everything else that a seemingly professional and pulled-together woman in her mid-thirties should be, i’m not really any of those things. i need all the help that i can get at the moment. because i want to beat this. i really do. and i can’t do it by myself. this is going to have to be a team effort.

this week is eating disorder awareness week (#edaw2018). already i’ve seen so many inspiring tweets, blog posts, articles and vlogs from people who are suffering, have suffered or have watched someone suffer. inspired by all of those stories, i’ve gradually told more and more people in my life what’s been going on and have been staggered by the generosity of spirit that so many people have shown me. most people don’t really know how to react or what to say – which is absolutely fine with me – but just knowing that they’re there and cheering me on is enough for me.

it’s yet another one of those strange paradoxes that anorexia is built on; i don’t think i’ve ever felt so loved at a time when i’ve never hated myself more.

{title quotation from an african proverb}

to reawaken us, to shake us from our lethargy

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today is pancake day. the day to feast before 40 days of restriction.

except 1) i am not religious and 2) every day is a day of restriction here.

no such caveats apply to my husband though and he has been mulling what to give up for lent. i suggested alcohol but, as he has just successfully completed a dry january, that didn’t seem much of a challenge. last year, he gave up all processed/added sugar and he was considering doing that again. he did pizza one year but has vowed never again. normally i join him in whatever he gives up, more for moral support than any other reason.

it’s been strange since i told him last week of my anorexia diagnosis. once he got over his initial confusion (‘is that the one where you throw up?’), he said he was sad. and that makes me so sad.

i can tell that he doesn’t know what to do or to say. this morning in bed, he had his arms around me and i could tell that he was feeling the bones which have gradually become frighteningly close to the surface. but i could also tell that he didn’t know what to say. we’ve had more arguments in this past week than we’ve had for the whole of our relationship, generally because he’s tried to make me eat something that i don’t want or – more often – can’t bring myself to eat. as much as i might be struggling right now, i think it’s even worse for him.

this morning, i emailed today’s weight to my psychiatrist. i’ve lost even more. his reply was stark. i’m heading for a hospital admission within a month. that’s not what he wants for me and that’s definitely not what i want for myself. i can’t even begin to imagine how it would devastate my husband. in order to avoid that, my psychiatrist has said we need a more ‘aggressive’ approach. i don’t know quite what that entails yet but i know it’s going to be fucking hard.

when i asked my husband earlier what he’d decided to give up and he said he’d decided not to give anything up. i think that’s his sacrifice for me; the last thing i need is more restriction in my life.

by the time lent finishes, on 1 april, i would love to have our first round of ivf underway. i’m not sure that’s a realistic proposition any more given where i am today but i have to believe that, 40 days from tomorrow, i’ll be in a much better place.

oh and whilst i can’t face our normal shrove tuesday pancakes, drowning in lemon juice and crisp with sugar, i’m not a total heathen so i’m planning a version of these alongside my latest obsession, broccoli roasted with garlic and a scattering of chilli flakes.

{title quotation from pope francis at the start of lent in 2014}

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the beginning is always today

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i’ve just eaten lunch.

i can count on one hand the number of times i’ve eaten lunch in the last six months. the last time i ate lunch was on 1 january when we went to visit some friends and i couldn’t really think of an excuse not to go (not least as i’ve been so self involved recently that i’ve been a terrible friend).

a lot has happened this week. on tuesday, i agreed with my therapist that the advice from the nutritionist i saw was both unhelpful and dangerous. he also was happy for me to not go back to the psychiatrist i’ve been seeing since september so long as i found an alternative and, preferably, one that had a slightly more than basic understanding of eating disorders. i emailed both the nutritionist and psychiatrist later that day. my psychiatrist’s pa confirmed that my next appointment had been cancelled and that’s the only follow up i’ve had from either of them. i’m slightly staggered that, given the psychiatrist claimed to be very concerned about me a few weeks ago, she hasn’t bothered to get in touch. at least it allows me to draw a line under both of them and move forward.

by thursday, i’d found a new psychiatrist and had an initial appointment. he changed some of the aspsects of my diagnosis (it’s now formally anorexia nervosa rather than the hodge podge it was before), tweaked some of my medications and, before my session had even finished, emailed me a ‘day 1’ plan.

yesterday was day 1.

day 1 involved eating breakfast which i haven’t done for a very long time. it was a struggle but i managed to eat some plain yoghurt. it also involved telling my husband the truth about my diagnosis which i somehow managed to do. and there, in black and white, is my acklowledgement that ivf and having a baby is more important to me than having an eating disorder. i’m still trying to make myself believe that this is true.

day 1 also involved telling my boss at work what was going on. i thought it would be a shock to him. unfortunately, it wasn’t and before i even said anything about eating disorders, he told me that a number of people had expressed concerns to him about my weight loss.

having it out there in the open does feel better. the more people that know, the more people there are to let down and the more i have to recover.  having a definitive plan with targets and all the support i could want to get there feels better. my psychiatrist has said he will be in daily contact with me for the moment while we get through this ‘crisis’ (ie that i’m steadily losing weight). at the end of every day, i have to email him with my weight, what i’ve eaten and how i’ve felt throughout the day. it’s so far removed from the ‘help’ i’ve had previously (“go and see this quack nutritionist and then we’ll consider if you need to go to a residential clinic thousands of miles away which will pay me a nice referral bonus”).

it’s so unbelievably hard though and i really don’t think i can do it.

i left my session on thursday feeling really positive and strong but that’s waning, minute by minute. last night, i saw my dad who commented on my weight loss and ‘how well i was looking’. he doesn’t know about the eating disorder (still can’t bring myself to call it anorexia; i feel such a fraud having that diagnosis when i’m still so fat) and i’m sure he wouldn’t have said anything if he did. but all i can think about is how i have to keep losing weight and how great it felt this morning when i saw a more than acceptable drop on the scales from yesterday. and now i feel so full and bloated because i’ve already eaten twice today even though it amounts to <250 calories and was nothing more than yoghurt, a piece of sourdough bread and some fruit/veggies. the actual eating was less of a struggle than i anticipated. but just knowing how much i’ve eaten and seeing it written down and feeling it just sitting in my stomach is so much worse. the anxiety and panic is slowly rising up and threatening to consume me.

i bought this bracelet a few days ago. the rings represent my husband, me and the reason that i’m doing this. i need to focus on that with all my strength if the beginning really is going to be today.

{title quotation attributed to mary shelley}