Photo, not posted

Just now, I took a photograph of the upper half of my body, in just a bra.  I took the photo standing in a mirror.  It is the first time I have done this since 2005.  I choose not to post the photo.  I might, however, print it out, and put it in my notebook, for my records.  I felt that it was necessary to have this record on file.

I have all kinds of feelings about having done this.

Anorexia….

What I wrote tonight.

My blood pressure is low and my resting pulse is low. Dr K and everyone are really worried about me. She said, “I do not want to document your decline.”

I want her to document my decline. I relish in it.

I have spent the evening mulling over the fact that I will not beat this disorder. I can feel a sudden shift. I’m different now. It’s like I’m another person. She’s younger than me. She’s just a little girl. Just a skinny little girl walking a dog. I feel it in my body. I feel it in my face.  I feel it in my mind.

What my T said

I went to see my T Monday.  I had written a couple of e-mails to her that I never sent, but I printed these out and brought them with me to the appointment.  I read them to her.  It took a lot of courage to do this.

To refresh your memory, here is the text of the first e-mail I wrote, the day before, Sunday:

Dear T,

I am tired of coming to therapy and I don’t know what to do.  I feel like therapy is keeping me alive and I’m not sure that I really want this anymore.  I feel grateful that you do not want to give up on me.  But I feel like you are wasting your time and energy on me.

I feel very driven right now into a dark, dark place.  I feel that I do not want to be pulled from this place.  I want to be in this place and fall deeper into it and be comforted by it.

I am comforted by loud, raucous music these days.  I listen to it to drown out the world and not hear my ugliness reflected in it.  I sneak around my building, my neighborhood, everywhere.  It has turned into a complex web of actions all built for the purpose of avoiding humans.

I feel like I am slipping away from living.  I feel resentful that I have to go to appointments and get help.  I feel like The Three Musketeers–you, Dr. P, and Dr. K–are running around my body pecking at it and trying to steal it, and I am holding onto the tiny bit of it that I have left.  The part that is left is like a piece of straw, gasping for breath.

I feel like saying goodbye, and I don’t know what to do.

I’ve decided that I am not going to send this e-mail.  Instead, I will read this to you in our session.  See you tomorrow.

Julie

 

And here is the text of the second:

Dear T,

I wrote the last e-mail this afternoon.  I am writing this one while doing laundry Sunday night.  I will not send this one, either.

You know, I have things to live for. It’s just that I’m not living for life.  You, Dr. P, and Dr. K want me to gain weight.  You three represent weight gain to me, and I feel threatened by you, as I feel threatened by the world and its brightness.  You see, I fear weight gain more than I fear death.

I see an UP and DOWN arrow here and I feel that I am following the DOWN arrow.  It is the only arrow I follow right now because I cannot follow the other arrow.

So I follow the DOWN arrow into the DOWN elevator, and I am trapped in this DOWN elevator and there is no one else in it with me.  If it stops on any floors, my eyes are closed and I do not peek when the elevator door opens.  I have my headphones on and they are loud, loud, loud and do not want to see the world.  The elevator does not stop at the Lobby, but keeps going.  And going.  I don’t know when it will stop.  If the elevator were to stop at a floor and I were to open my eyes, I would see nothing but blackness and no people before me.

When I go to my appointments with Dr. P and go up the elevator, there is a canned voice that announces the stops.  As my DOWN elevator descends, its canned voice says, “No progress located on this floor” over and over.

That is the reason I question whether therapy is doing me any good.  That is why I wonder if I’m coming to therapy for the right reasons.  I like coming because I’m lonely and like having someone to talk to.  I don’t want to lose you.  Of course, it’s absolutely stupid to give you up–you, of all people, because you’re the best therapist I’ve ever had.  Dr. P will be pissed, and she’ll probably drop me as well.  It’s all in the cards.

But…I am asking you now for your opinion.  I value what you have to say at this point because I just don’t know what to do.  I will respect what you have to say.  I don’t know if you’re going to say, “I can’t continue with you,” or if you’re going to say something else.  I don’t know what your policy is regarding patients that don’t want to get better and in fact want to–according you YOU–want to descend into a downward slide.  So I’ll wait until tomorrow (it’s getting late and my laundry is done) and see.

Julie

I read both of these without waiting for her response in between.  There was a pause, and then she said that she would not stop working with me or “fire” me, that she has no policy about patients that do not want to get better and do not want to change.  She said that she would rather have me be honest with her, as I am right now, than have me “fake it” and pretend that I am in recovery when I am not (that is, lie and say that I am eating, I guess).  Obviously, both of us realized the futility of “faking it,” and knew that she would find out soon enough that I was trying to pull the wool over her eyes.  I told her that I live a very lonely, isolated, difficult life.  No one can reach me.

She asked me if I wanted people in my life.  I said, “Not really.”  She then made some suggestions.  One of them was some group associated with Gould Farm.  NO WAY!  I will not be involved in anything to do with that organization, or support it in any way.  Gould Farm is a slave camp and I am very sorry that I spent time there in 1984.  Then she made a couple of other suggestions, these not part of the mental health system.  I turned them down.  I am not interested in being with people, especially not other mental patients (I don’t call myself a mental patient anymore, actually).

She said, “So you want to be with your ED.”

“Yes,” I said.

“You want to be in this abusive relationship.”

“Yes.”

“Because that’s what it is.  An abusive relationship.”

“I don’t care.”

You know, people abuse, too.   I have been in many abusive relationships with people and some very bad abusive relationships with humans and there were no benefits to these relationships.  I guess I went running from humans to my ED because my ED was preferable.  Kinda says something about my feelings about people, and why I feel the way I do now.

So we talked some more, about getting weighed once a week and how it sucks, and a few other things, and then the session ended.  It was enough.  I was tired. I was exhausted.  I came home.

I see my T again tomorrow.  Mondays and Thursdays…it is endless, endless….

 

Another e-mail to my T while doing laundry

Dear T,

I wrote the last e-mail this afternoon.  I am writing this one while doing laundry Sunday night.  I will not send this one, either.

You know, I have things to live for. It’s just that I’m not living for life.  You, Dr. P, and Dr. K want me to gain weight.  You three represent weight gain to me, and I feel threatened by you, as I feel threatened by the world and its brightness.  You see, I fear weight gain more than I fear death.

I see an UP and DOWN arrow here and I feel that I am following the DOWN arrow.  It is the only arrow I follow right now because I cannot follow the other arrow.

So I follow the DOWN arrow into the DOWN elevator, and I am trapped in this DOWN elevator and there is no one else in it with me.  If it stops on any floors, my eyes are closed and I do not peek when the elevator door opens.  I have my headphones on and they are loud, loud, loud and do not want to see the world.  The elevator does not stop at the Lobby, but keeps going.  And going.  I don’t know when it will stop.  If the elevator were to stop at a floor and I were to open my eyes, I would see nothing but blackness and no people before me.

When I go to my appointments with Dr. P and go up the elevator, there is a canned voice that announces the stops.  As my DOWN elevator descends, its canned voice says, “No progress located on this floor” over and over.

That is the reason I question whether therapy is doing me any good.  That is why I wonder if I’m coming to therapy for the right reasons.  I like coming because I’m lonely and like having someone to talk to.  I don’t want to lose you.  Of course, it’s absolutely stupid to give you up–you, of all people, because you’re the best therapist I’ve ever had.  Dr. P will be pissed, and she’ll probably drop me as well.  It’s all in the cards.

But…I am asking you now for your opinion.  I value what you have to say at this point because I just don’t know what to do.  I will respect what you have to say.  I don’t know if you’re going to say, “I can’t continue with you,” or if you’re going to say something else.  I don’t know what your policy is regarding patients that don’t want to get better and in fact want to–according you YOU–want to descend into a downward slide.  So I’ll wait until tomorrow (it’s getting late and my laundry is done) and see.

Julie

 

An e-mail to my therapist, saved in my drafts folder, never to be sent

As per agreement, I do not e-mail my therapist except to schedule appointments.  I wanted to send this, though, but as I was writing it, it got so complex and dark that I decided it was wisest to put it on hold.

Dear T,

I am tired of coming to therapy and I don’t know what to do.  I feel like therapy is keeping me alive and I’m not sure that I really want this anymore.  I feel grateful that you do not want to give up on me.  But I feel like you are wasting your time and energy on me.

I feel very driven right now into a dark, dark place.  I feel that I do not want to be pulled from this place.  I want to be in this place and fall deeper into it and be comforted by it.

I am comforted by loud, raucous music these days.  I listen to it to drown out the world and not hear my ugliness reflected in it.  I sneak around my building, my neighborhood, everywhere.  It has turned into a complex web of actions all built for the purpose of avoiding humans.

I feel like I am slipping away from living.  I feel resentful that I have to go to appointments and get help.  I feel like The Three Musketeers–you, Dr. P, and Dr. K–are running around my body pecking at it and trying to steal it, and I am holding onto the tiny bit of it that I have left.  The part that is left is like a piece of straw, gasping for breath.

I feel like saying goodbye, and I don’t know what to do.

I’ve decided that I am not going to send this e-mail.  Instead, I will read this to you in our session.  See you tomorrow.

Julie

My eating disorder takes up all my time and energy and brain space and there is little left

I spend all day with it now.  I plot and scheme. I have charts that I work on.  I plan out every move.  I plan everything I will do all day long. This planning takes hours.  I spend a good part of the day working on the charts, deleting what I am not going to do, and putting up new stuff.  Of course, it contains food items–what I am and am not going to eat.  And I write my weight for each day.  I have a page for each day.  At the bottom of each page I write how well I starved myself for the day.  I “x out” the document when I leave the house, just in case someone comes upon my computer.  I keep these charts in a notebook titled “The Starvation Spreadsheets.”  I keep the notebook in my bookshelf.   Don’t touch it.

Must say, I’m getting pretty good at Excel.

Yesterday, I acquired some organizers for my desk, and neatened up my entire desk space.  This, I believe, is in the eating disorders spectrum behavior (I don’t know how else to say that).  I acquired a spice rack and took my spices out of the little bags I have and put them in jars.  They look nice and neat now, with big labels attached with post-its on eat jar.  You can’t believe how many hours it took to do these tasks.  Lately, my “organizing behavior” has concerned me.  It takes up so much of my time.  and it is getting worse and worse.  It is getting better and better.  I am just so preoccupied.

I spend hours every day cooking. I cook at night the meals I’m going to eat for the next day.  I eat a lot of vegetables.  Barely any calories.  There are very few foods I dare to eat, actually, so I don’t eat a huge variety.  I put my food in little containers, and label each clearly.  I recently bought a five-pound bag of carrots. I eat carrots every day.  I put each meal in a divided plate.  I don’t eat breakfast.  Well, I do.  But it’s miniscule. Given that the first bite of food in the morning gives me vertigo, I have to be careful.

I have a sad life.

I feel out of control.

I am desperate to keep everything just how it is.

 

I am resigned to the fact that my anorexia isn't going to go away anytime soon

I am resigned to the fact that my anorexia isn’t going to go away anytime soon.  Or should I say I am resigned to the fact that my anorexia most likely won’t ever go away.  Or mostly, I realized today the fear I have in my heart that my anorexia will kill me.  And although this emotion, which I’ve felt before in various forms, hasn’t always been sadness, I have felt sad all day.

Walking Puzzle is generally a joyful activity for me.  I can feel incredibly high while I’m in synch with my dog and we’re zooming down the sidewalks at top speed every morning and evening.  I get out before the dreaded vertigo starts, before the drudge of the day begins.  The vertigo wears off in the afternoon, and is gone by her afternoon walk, but I’m often not up to snuff for that walk.  It depends.  But the mornings are awesome.

This morning, however, was different.  I was listening to Evanescence.  This was not the best music to have on, it turned out, because it was what I listened to at the time that I was raped in 2008.  Whether I wanted it or not, I was brought back to this time, the time that the germ of my relapse was implanted into me, if you will, and life was never the same after that–I was dirty, contaminated, damaged goods.

I thought of my character in my novel, I am So Cold, and Hungry in My Soul, May, who tosses out her clothing after she is raped.  I did the same damned thing.  I scrubbed myself over and over in the shower to cleanse myself of the horror of the deed.

So I was thinking these things, walking Puzzle, just getting sadder and sadder about my life, while Aimee Lee sang the songs, “Lithium,” and “Lacrymosa.”  The music pushes and pulls against itself and twists and turns.  Her voice is full of turmoil.

You couldn’t say what I felt was turmoil this morning.  Just sadness, a deepening feeling that my life isn’t going to go on the way it would if I didn’t have anorexia, that I am already past the edge, and I am falling, falling into an abyss that I can’t get out of.  I see all the Fourth of July celebration around me and this makes me feel even sadder.

Last year, I walked past barbecues and drooled because I was so starved.  I am starved this July as well.  Now, though, I think the smell of burgers would make me gag.  I haven’t smelled any, though.  Guess I instinctively avoid big yards with  grills and picnic tables and toys and coolers full of beer of all types, and bags of chips, bags of corn-0n-the-cob, bags of burger patties, hot dogs, paper plates, cups, punch, coke, burger rolls, pickles, ketchup, mustard, spatula and tongs, and charcoal and lighter fluid.  Guess it’s any trace of family, friends, and celebration that I avoid.  Or should I say, someone else’s family, friends, and celebration.  I don’t want to see it, smell it, or taste it.

Yesterday, I went to a Staples store and shopped up a storm.  I put it all on my credit card.  I had coupons and a Staples card.  I carried it all home in my rolling backpack.  I bought mechanical pencils, two little boxes to keep things in, a three-ring binder, a little notepad, ink for my printer, a pencil box, a box nicely shaped for knitting needles, wipes for the computer monitor, and a box for 4×6 note cards.  I stopped at Petco for necessary dog toothpaste, three tubes of it, and three toothbrushes for Puzzle.  I bought a bunch of produce.  And this morning, after Puzzle’s walk, I was at it again, online, at Staples.com.  I went to CVS this afternoon and got two bottles of mouthwash, two thingies of soap, and dental floss.  I’m all set for financial ruin.

It was a comfort to me to have these little things.  To be a hunger-gatherer in this big, scary world.  Yesterday when I came home from my big shopping spree, I went on another spree: I cooked.  I cooked a zillion things that I didn’t eat.  I put things in tiny containers and labeled each container.  I think I spent three hours doing this.  Afterward, my apartment smelled of onion and peppers.  Everything I cooked was made only of vegetables.  When I chopped and stir-fried the onions, I cried.

As time goes on, I am becoming so organized, so compartmentalized.  I write down everything that I’m going to do for the day, and then I do it.  I write these things on a spreadsheet.  I write down everything I eat.  After the day is over, I print out the spreadsheet.  I write down how well I starved myself.  Of course, there’s a special place on the spreadsheet where I write my weight.  I thought about this, and I thought about the boxes I bought, and I thought about the databank watch I’ve owned for years, and I thought about the pop-up reminders I’ve set up on my computer for everything, and the labels in my refrigerator, everything organized, the post-its telling me exactly what to do, the way I get upset if I don’t follow my routine perfectly, how I eat what “normals” wouldn’t call meals but I do at the same time every day….This is getting damned scary.

Who am I becoming?  I think about my anorexia all the time.  I think about it from the moment I get up until the moment I go to sleep.  I thought about it the entire time I was walking to CVS today, and during the time I was shopping at CVS, and for the entire walk home.  I think of it while talking to people.  I even think about it during my joyful walks with Puzzle.  It never, ever leaves me alone.

I don’t remember this happening in all the years that I have had this illness.  I remember forgetting about it and thinking about my studies. I remember, even during this relapse, thinking about my thesis.  Now, I am lost, buried in it, and I can’t get out.

I am afraid that I will blurt it out.  I was afraid that I would tell the pharmacy person, while paying for my prescription today, “I am anorexic.”  I was afraid that I would lose control and say this.  I held my lips tightly shut.

When I see my T on Wednesday, I will tell her about this writing.  Maybe I will read some of it to her (not all of it–or should I say I won’t read the majority of it).  I will tell her that I am going to die of this disease and that I may not make it to my next birthday.  Of course I don’t know this.  No one knows.  But it is her job to disagree with me.  It is her job to not let me die or resign myself to dying.  It is her job to help me find the will to live.  It is her job to help me find a way out.  I wish she wasn’t going to bother trying, though.  It isn’t worth it.  I am too far gone.

So I will see her  Wednesday, and tomorrow is the Fourth of July, and the next day is the fifth, and then Wednesday.  It seems far off because she’s been on vacation.  She’s been on vacation and I have lost weight.  Guess when the cat’s away, the mouse will play.  On a treadmill going nowhere.

What Dr. P said

She didn’t mince words.  She commented on my weight/appearance right away:

“You look sick.”

“You look emaciated.”

“You look gross.”

“You look like you just came out of Auschwitz.”

When she said, “You look gross,” I put my head down and giggled.  She asked me why I was laughing. She said that this was an unusual response.  I said, “No one ever said that to me before.”

She said, “Why is your voice like that?”  I realized that I was speaking in a tiny voice.

I don’t recall my response to this question.

I don’t know if her comments were rude, or if she was trying to wake me up.  Once, Dr. P said to me, “People stare at you, you know.”  So this kind of comment has come from her lips before.

If anyone else had said it, I would have been shocked.

Or maybe not.

When people say anything, anything at all about my weight, I feel like saying back to them, “Keep your comments off my body.”  My T thought that was a great thing to say.  My ex-neighbors, when I see them, talk about my weight every time.  Every time.  Geez.  I know it’s out of concern, but I really, really am sick of hearing it.

Just yesterday–actually, I think it was the day before–I overheard my current neighbors saying, “She’s so ugly!

Another thing Dr. P said was that she was driving home from work one day and saw someone that was obviously anorexic walking a dog.  She drove closer, and saw that the woman was me!  I asked her if she got a good look at Puzzle, and if I looked happy to be walking Puzzle.  Dr. P said that she didn’t pay attention to these things.  She said she was alarmed that it was one of her patients.

I don’t know how I feel about Dr. P’s remarks about my weight.  They were blunt.  I recognize that I am extremely thin.  I see my reflection in windows.  I make no attempt to hide my thinness anymore.  If my appearance makes people feel uncomfortable, well, so be it.  I don’t think it does.  People are too busy texting to think too hard about the skinny lady walking a dog that they see twice a day zooming around town.

I admit it.  I admit that I like looking anorexia.  I admit that I don’t want to change.  Even looking “gross” won’t change my mind, Dr. P.

I have never been one to care about my physical appearance.  One of my father’s biggest gripes about me was that I never cared for my hair.  It was a “rat’s nest.”  I always thought my mind was more important.  Well, ended up losing my mind….

I don’t know what to tell you, Dad.  You never understood my eating disorder.   Usually, you simply didn’t notice the weight changes.  When you did, you thought something was wrong with my metabolism.

Mom, you look at me and you don’t see it.

Brothers, you are mistaken and you think I’m doing great.

Last night, I cried while doing the dishes, wondering what would happen to Puzzle if she outlived me.  I thought I might want to contact the vet, or ask the vet when Puzzle has her shots in August, what kind of arrangements people make for their dogs if they don’t know anyone who can take care of their dogs “just in case something happens.”  I have vague instructions written in my refrigerator for her care.  These instructions are too vague.  I am 53 years old.  Puzzle is 4-1/2.  One of us is healthier than the other. One of us is normal weight: 15.1 pounds.

One of us could live many, many more years if only she would EAT.

It’s just so hard right now.

 

Something else I will mention to Dr. P

My sleep hasn’t been so good.  I wake up frequently in the night.  This isn’t because I have to pee.  This isn’t because of noise or anything else.  I just don’t sleep well.

Maybe she will recommend that I take Benadryl at night.  This helps me sleep and it’s safe to take with my other meds.

I might say that when I had my knee injury, I slept well.  I needed a little more sleep during that time, as well.  Maybe I needed it to heal.

Occasionally, I sleep well.  I still get vertigo.  I still get swaying.

Ideally, I get 6-1/4 hours of sleep.  Ideally, I sleep through the night and wake up no more than once.  Sometimes I get 5-3/4 and I’m fine.  If I get seven, I’m groggy, except I got seven during the knee injury.  Occasionally, I take a 10-minute nap.  This is very effective.  If I sleep a solid 20 minutes, I’m extremely groggy for hours and hours.

I think I won’t read this list (the previous post also contains the first part of the list).  I’ll skim.  This is ridiculously lengthy.  Just for the Notebook.

Just for You.

What I will discuss with Dr. P today

I will be seeing Dr. P today.  Hopefully, she won’t spend the entire session lecturing me about my weight.  I think we have been over that a zillion times.  I will start the session by saying, “I have a list,” and hopefully this will start off the session without the lecture!

First of all, I will mention the vertigo I have been experiencing.  This is how I will present it to her:

When I wake up, I feel just okay.  I’ll tell you about that in a minute.  I shower and walk Puzzle.  Then, I feel fabulous.  My mood is really high.  I feel absolutely terrific.  I have a smile on my face.  I even feel good when I pick up the poops.  [I have more to say about this that I’m going to not say here–not about poops but about something else.]  Then, I come home and have the first morsel of food of the day.  Within ten minutes, I get vertigo.  Dr. K has confirmed that this is vertigo by the way I have described it to her.  I even feel dizzy while seated.

At this point, my mood rapidly drops.  Recently, the vertigo has started to become extremely distracting, and I have started to become mentally confused.  Fifty percent of me suspects that the vertigo is a sign of the return of “It,” given that so much of “It” was physical.  At this point, my day is ruined.  I can’t do anything for at least 2-1/2 hours, often more, waiting for the vertigo to end, and even after that, I feel crappy for hours, usually into the afternoon.  Every now and then, the vertigo has lasted all day.

Here’s what I want to say about the bingeing:

I have had maybe three bingeing episodes since I last saw you.  These happen two or three nights in a row, then I stop.  I’m not talking about two sandwiches.  I’m talking massive binges.  I do not throw up.  I repeat, I do not throw up. The binges have to do with self-destructiveness and sudden dip in mood.  As you know, I do not binge voluntarily.  They cause really bad edema.  I am extremely concerned about the health consequences of these bingeing episodes.  My list of physical consequences, in addition to the edema, is something I want to get into with Dr. K, but it’s serious, and I’ve got to stop.

Here’s what I’m going to confess about that Trileptal:

I cut back on the Trileptal back in April.  I halved it.  This immediately stopped the swaying.  I had to do this to enable me to run on the treadmill.  As you know, I have been diagnosed with arthritis in my right knee and have been advised to stop running and walking for fitness.  The treadmill is a thing of the past.  I chose to bring the Trileptal back to its original dose as of nine days ago.  The swaying returned.  A couple of things about the swaying that might interest you include the fact that if I don’t sleep well, the swaying is worse, and if I take a nap that’s too long and I’m groggy, the swaying is extreme.

She will ask, “How’s your eating?”

I will say, “Good and bad.”  Bad, actually.  “Mixed.”  Of course, my response means nothing.

I don’t know what she will say to that, except, “Your last weight wasn’t good.”

I will probably hang my head.  Not so much in shame but in hiding the fact that I am hiding the fact that I am hiding something.  Well, I am not hiding but leaving out the facts.  I am not ready to tell her.  I am not ready to tell any human all the details of my food problems.  Maybe, I will write them down and let it all spill out in this Notebook.

The session will end there.

As we speak, I am experiencing the vertigo I experience almost daily.  It’s pretty bad at the moment, and has been going on for about an hour and a half.  I am sitting here typing at the computer.  I am sitting here, discouraged.  As usual, except for Puzzle’s walk, it’s not a good morning.  I wish there were answers.  Maybe Dr. P will have some.