Regarding Eating Disorders “Treatment”: Today’s Reflections

There are many kinds of ED treatment available today.  People who develop ED’s in this decade are indeed fortunate that the knowledge and experience of professionals is much greater than it was when I first developed anorexia and subsequently binge eating disorder in 1980.

Those of you old enough may recall that Karen Carpenter died in 1983 of anorexia nervosa.  Some of you are young enough that you don’t even know who Karen Carpenter was.  She was one of the best-known singers of the 1960’s and 1970’s.  She had an angel’s voice.  All the money and fame she had did nothing to help her.  Her friends were desperate and didn’t know what to do, as nothing was known about the disorder.  She kept it hidden from the public throughout her career.  Her solo album was released posthumously.  I was in the hospital (for my mental disorder, not the ED, which doctors ignored) at the time, and was deeply affected by her death.  The nurses didn’t understand how I could be so devastated over some celebrity I didn’t even know personally.  But in a way, I did very much know her.

But I digress.  There are many treatments available today.  There are hospitals and various treatment centers that specialize in ED.  You can see a nutrition specialist.  There are therapists and psychiatrists that specialize in ED.  You can go to various levels of “step down” programs for ED, which include “residential,” which is like an ED halfway house, where you go to live.  There are ED evening programs, where you bring your dinner, and have groups.  These generally meet 6-9 at night several nights a week, and are designed for people fairly along in their recovery who work during the day or go to school.   These can be fairly long term.  There are “partial” programs, that get people back on their feet again after the hospital, which meet 9-3 generally.  You still have to take time off of work because six hours of the day are taken up by this program.  These have a “supervised” snack and lunch.  The rest of the time is taken up by groups.  It is short-term, just a few weeks.  Another form of ED treatment includes various types of independent outpatient groups that you can go to, generally run by a specialist.  There are also self-help groups and support groups that don’t have leaders, including 12-step groups.  I don’t think there’s such thing as ED long-term (over three weeks) day treatment in my area, and I don’t know if it exists anywhere as a treatment option as ED alone, but a general mental health day program, such as the one I tried to get into as an alternative to hospitalization…because, as I said before, I was desperate to avoid hospitalization.  But I have been successful at avoiding hospitalization…for now, anyway.  But I have told you this before, so enough of that.

Correct me if I’m wrong about all the details on treatments, also if I’ve left one type out, please let me know.

What is available to me: Therapy, with my therapist, twice a week, who has a lot of knowledge and training in ED but is not an ED specialist.  My psychiatrist, who is an ED specialist, and once headed up an ED program at a top hospital in the area.  I can see an ED specialist, but I don’t.  I saw a nutritionist and it didn’t work out.  I see my primary care doctor once a week.  I don’t go to a group, but I could, and in fact I saw one–an expressive therapy one (art therapy, etc) for ED–that interested me.  I tried to get into another group and got turned away because they said I was too sick for it and not “recovery-oriented.”  Imagine that.  Psychiatric day treatment–I was turned away.  I was reasonably certain it wouldn’t help anyway.  An ED partial is available to me, and I haven’t even bothered to tell my T that they take my insurance because I know it won’t help me.  Again, group programs have never helped.  They make me worse, generally.  Plus, what good will just a couple of weeks do me?  I heard from five or six sources–people that have been there–that the program is terrible, just not a very good program, and not really worth going to.  I’ll play this “wild card” only if I desperately need to–if I need yet another alternative to hospitalization.

What about these evening programs, and the halfway house?  Can’t do.  None in my area take Medicaid and Medicare.

Do I really want “treatment”?  Do I really want to get better, to rid myself of my anorexia?  Or do I want to stay in this hole I’ve dug for myself that everyone steps over, where no one sees me?  People walk around it sometimes, or try desperately to pull me out, and cannot.  The hole usually feels like a safe, warm place.  Often, though, it feels like my grave.

But do I bank on the knowledge that treatment, right now, isn’t helping?  Nothing is working, and that’s a fact.  Therapy isn’t making me eat.  Meds aren’t making me eat.  I am getting turned down left and right from other types of treatment that won’t work anyway.  No amount of statistics and physical symptoms I have seem to scare me into eating.  Do I like this?  Or do I desperately want help?

You know something?  I think I want help.  And as I write these words, I weep.  I want to be helped, gently, out of the hole.  I want to be invited, not pulled, out of the hole.  I don’t know what it’ll take.  Maybe it’ll be the faithfulness of my friends and all the love and caring they are giving me, and the way they listen to me, and I listen and share with them, and how we quietly spend time together.  Maybe it’s the satisfaction I get from making progress on yet another sweater for my beloved Puzzle, knowing I’ll keep her warm this winter.  Maybe it’s writing here, communicating, which I do with such desperation these days, knowing that people are actually reading my words and hearing me.

And maybe it’s the look in Puzzle’s quizzical eyes, when she tilts her head and wags her tail, and I remember, “Puzzle needs a mama!” and know that I must, must plod on, if only for one more day, and then maybe for another.   And  I am suspecting, believe it or not, that my faith in God, which was eradicated when my anorexia returned in 2008, may finally be peeking from behind the clouds, just a wee bit, and although I cannot catch it, and it may disappear again before I can grasp it, this hint of something–anything–gives me a sense that maybe, just maybe, something is going to happen.

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