mental health

Navigating Work and Recovering From an Eating Disorder.

Might work be an area that requires your attention in ED recovery?

If I was to ask you what one of your most challenging situations in recovery has been, I expect a lot of you will answer, navigating recovery and work.

What is it about work that makes it difficult to remain in recovery or on course with your goals?

Taking time off from our jobs/ school or college may not be possible for everyone in ED recovery. It wasn’t for me personally. There are times, where I know not being at work would have been really beneficial to recovery. Taking time out is beyond the scope of this blog and very individual.

I want to share some reflections regarding the relationship my work has had in my own eating disorder with the hope this may help you.

Considering many of us spend more than half our adult lives at work, it may be we need to put extra “work” in to maintaining our health in our place of work. Finding a way that means the two are not in conflict is vital. Both living with an eating disorder and recovering can be very stressful, managing this with the stressors of work can compound this further. It’s exhausting.

Ideally a person who is in the early phases of recovery wouldn’t be worrying about their career when the main goal at this time is to stay alive, yet because of a plethora of reasons, such as financial worries, stigma, access to care this is the reality for many. Many jobs lack the flexibility that is so needed to make progress in recovery.

Recently, I moved city and role in a new hospital.

Before we moved I told myself , “this was going to be an amazing fresh start in terms of recovery”. Before I go any further, I still have this view but I’ve had to shift my expectations and time line.

I came here with the mindset; people here don’t know my past which means I can start a complete fresh, ‘I will eat with people, eat all the foods I’ve not been able to in previous jobs and I will break away from the ED disorder identity’.

** To be clear, I ’m not ashamed of my background or struggles and if asked I will elaborate, however I want to recover, and not being tied to this ED persona is important to me.

My goal is to not be seen as the person who is ‘weird’ around food, or left out of social engagements that involve eating. I’ve missed out on this for years and my goal is to heal this relationship. Making connection with others, is recovery to me. To get to that, this for me means taking smaller steps.

Okay, so fast forward 6 weeks into my new job. I’ve felt completely perplexed by why my intentions hadn’t come into full fruition.

Let’s break this down, why might be harder than anticipated?

1. Firstly, let’s bin the notion you can ‘out run’ an eating disorder. I believed for years I could move and leave my ED behind. Time after time I proved this wasn’t a thing. I moved half way across the globe and my eating disorder followed. And so, let me save you the wasted time: YOU CANNOT OUT RUN AN EATING DISORDER.

2. People spend a lot of time at work. Sometimes people are afraid to share their struggles for fears of; discrimination, stigma or bullying. I was and to a certain extent still am.

3. Work can be a trigger for many. I’m not for a second saying certain occupations cause an eating disorder, however I strongly believe in those of us with the vulnerability to developing an ED, certain jobs may perpetuate them. Having this knowledge may be an asset in preventing and helping people to recover, for both employees and your employer. For instance certain occupations attract particular personality traits. Working in fitness, fashion, catering may draw specific trait’s. Working in the food industry may both be motivated by an ED or exacerbate. Certain careers like professional sports, fashion, entertainment and healthcare reportedly have higher incidences of people with eating disorders. Doctors’s may be at risk through; perfectionism, hard working, people pleasers and combine that with a culture where it’s praised if people forgo breaks, being vulnerable and speaking out against struggle is seen as a weakness. The stress of looking after others, exams, career progression, missing social events, It’s a perfect storm for those of us with the ED vulnerability.

4. Neural pathways take time to develop and naturally take time to deconstruct and rebuild new pathways. If your ED mindset and behaviours are entangled with your job, then it doesn’t take a rocket scientist to get why it takes time to resolve. (Though it’s taken me until now to realise this for myself).

5. Culture and societal pressures, “diet culture, weight loss, fad diets” are almost seen as a way of workplace bonding. People can fear being ostracised by speaking against this or simply excluded if they try to protect themselves from these otherwise seemingly innocuous conversations.

6. In the same theme as above fearing social engagements that involve eating with others can feel like it’s thwarting making connection’s and perpetuate this spiral.

7. Work place canteens may serve as a barrier to some people, the lack of options coupled with social anxieties may add a layer of stress.

8. Time pressure, work related stress may exacerbate eating disorder thoughts and behaviours especially when eating disorders have been the maladaptive coping strategies for stress.

9. Work may reinforce self esteem issues. If a person’s eating disorder is entwined with poor self esteem, a person who feels negatively about themselves at work or has poor confidence it’s unsurprising this may manifest in their eating disorder’s.

10. Imposter syndrome may be both perpetuated by an eating disorder and in some ways recovery. This is a big one for me, as I battle the eating disorder it can cause a imbalance of energy. I become anxious my focus on recovery is thwarting my career progression. I feel added stress and pressure, which can become a trigger in itself. However if I am not focusing on recovery, my work performance slips at the cost of my obsession with food and numbers. My anxiety can make me worry about losing out on promotions or career progression. Yet despite having to expend this energy, it will never impact upon my work in the same detriment that living with an eating disorder can. Being patient and kind to yourself here, I feel is the key. Forgiving for what is.

Now we can see some of the ways our eating disorder might be entwined in our work schedule, we have given ourselves insight and a place to focus our recovery goals.

I personally feel like identifying this, is a milestone in my own recovery, but I also feel frustrated by the fact it’s something I have to consciously focus on. It’s another hurdle when so much I want to be able to say; I’m free. Free to focus on anything but recovery from anorexia. However, I also fully embrace this is part of my healing journey.

Though I don’t claim to have this figured out, these are some of the tools I’m using to help me navigate this part of my recovery:

1. Make realistic goals. I am very much a black and white, or all or nothing thinker. Recognising my thought processes around recovering in the workplace has served as a catalyst to make changes. It’s not a failure if you can’t challenge everything all at once.

2. Be honest with yourself and importantly your support team. Make use of help anywhere you can get it.

3. Set yourself goals and debrief if they need tweaking. For example my initial goals were to eat with people every day when I started here. When that wasn’t working I needed to go back to basics and work out what was serving as the barrier. If eating with others is something that causes you a lot of anxiety, perhaps starting with smaller challenges first and building up to this might be a good one. I’ve been working on challenges like; making eating regularly non negotiable, practising eating different foods and buying the occasional meal or snack from the canteen. Something I have never been able to do until now. As I’ve become more comfortable in doing this I’ve then aimed to eat with others on occasion. I might not be in a place to buy foods and eat with others everyday yet, but that’s okay! I’ve often brought my lunch in and then gone and sat with my new peers outside or in the canteen. My point here is, you don’t have to achieve everything at once, take a step back from striving for perfect. Perfection is an illusion. Start with what feels achievable right now. I was focusing on the end goal rather than where I am right now.

4. Perhaps find a colleague you feel comfortable with, someone you can eat with (they don’t have to know about your eating disorder). I used to eat with a colleague in my old job, because she had a “fuck it mentality’ around food she was a great role model ( and she didn’t know how much she was helping me)

5. If it’s an option, sharing your struggles with a co-worker or employer. This is very personal and not for all. However having people around who know about your ED may allow other ways you can be supported: making time for breaks or allowing you to attend appointments etc.

6. Boundaries, boundaries and boundaries. Whatever boundaries you need to protect your recovery, whether it’s removing yourself from triggering comments, or carving specific times in your day that align with recovery. Boundaries are like a recovery superpower.

How can you, as someone without an eating disorder help a co-worker?

It’s highly likely you work with someone struggling with their relationship with food and body. You may never know someone is struggling ( kind of the nature of an eating disorder).

But you can be a real ally in someone’s recovery by:

1. Being mindful of how you talk about food and bodies around others. Don’t be that person who encourages the cheap diet talk. Keep the diet talk out.

2. Don’t comment on others eating habits, an innocent comment such as “ I wish I could eat that, or is that all you’re having or you’re going to eat all that” might just be the comment that serves as a barrier to a person eating.

3. If someone turns down an invitation to join you in social eating, don’t stop inviting them on other occasions. When someone feels excluded or isn’t given the opportunity to participate it may perpetuate the cycle that they cannot join in or they have to keep isolated. Eating disorders are extremely isolating.

4. Be kind. Don’t judge someone.

5. If you think someone you work with may be suffering from an eating disorder, share your concern with them in a non judgemental manner ( this may depend on your relationship). They may not open up to you, but you may have given them encouragement to talk to someone they’re comfortable with. It’s not your responsibility to make someone recover ( no one can do that) and so often a person won’t need advice but a supportive ear.

6. Educate yourself about eating disorders, some of the most harmful comments come from ignorance rather than a place of malice.

7. Be a role model, show people it’s ok to show vulnerability, to talk. You’re vulnerability may be the gift a person needs to feel safe.

8. If you are an employer, you can make your workplace a safer, more inclusive environment. Providing mental health training, awareness to make the workplace inclusive and reject stigma surrounding mental health.

I expect if asked, a lot of you would join me in saying one of the biggest threats to you recovery is work. Right?

With that, it makes sense a lot of our recovery energy needs to be focused on creating balance where the two are not in conflict. Perhaps talking with your support team can help you create a more symbiotic relationship.

What else would help you at work?

It’s OKAY to Talk About Suicide

It’s ok to talk about suicide. Suicide is not the solution.

CW discussion of suicide

Feeling suicidal is terrifying and if you have these thoughts please call the crisis line or someone you trust.

This is a difficult post to write, but it shouldn’t be. September is suicide awareness/prevention month. Really every day should be suicide prevention. For some reason, suicide continues to be a stigmatised, taboo subject.

Suicide is the second leading cause of death in young people aged 10-35. Yet it’s not talked about. Not nearly enough. 90% of people who die by suicide have suffered mental health symptoms. Marginalised communities have a 4-12x risk compared with the general population.

Anorexia is the most fatal of all mental health diagnoses, 1 in 5 anorexia deaths are from suicide.  27 people die everyday globally from eating disorders. Suicide is a large proportion of these. It shouldn’t be and doesn’t need to be.

We need to make society a safer place if we are going to reduce these stats, it starts with talking and normalising mental health.

When I was deepest in my eating disorder, I was haunted by thoughts of escaping, but this was not something I ever admitted, voiced. I was even asked many times by my team if I was depressed or had suicidal thoughts. The truth is, I wasn’t depressed, I felt hopeless, like there was never going to be anything else. The idea of living another day in this never-ending self-loathing, food obsessed brain was sometimes overwhelming. I used to say over and over in my mind- I wish I was dead. In those moments I believed it, I meant it.

The reason I want to share this, there were many times I felt like this when I was trapped in the ED. I felt so much shame for having these thoughts, I grew up in an environment that didn’t believe in mental health, I grew up believing suicide was selfish, cowardly or attention seeking. That’s so far from the truth.

Isolation was the worst part. I can hand on my heart say, it is none of the above. Suicide is a permanent solution to what I feel is a temporary problem and preventable with support.

Eating disorders are incredibly isolating. Not feeling I could talk about this added to the shame and perpetual cycle.  We often ask people “are you okay, how are you” but it’s an empty question. We don’t ask people how they really are, because as a society we are afraid of how to respond if someone was to really answer. Personally, I wouldn’t have wanted someone to have the answers. You can ask someone how they really are and not have to have the solution. You can offer support in many ways. Listening, not judging a person, advising they get professional help, letting them know their feelings are valid (even if you don’t truly understand). One of the biggest things is not perpetuate the rhetoric that suicide is selfish, cowardly or a choice. People who feel suicidal may be experiencing feelings of not wanting to be a burden, isolation, guilt. People who are feeling suicidal are living with pain and so many other horrible emotions. It is not selfish and making someone feel guilty or selfish is only going to fuel anguish and isolation. People are more likely to withdraw and not get the help they desperately NEED AND DESERVE.  Suicidal thoughts are a symptom and can be treated with help.

Raising mental health awareness, particularly in the healthcare profession is something I feel very strongly about. Healthcare professionals have higher rates than the general population of suicide. Female doctors are 2-4x at risk of ending their lives than the general population. It doesn’t surprise me, but it deeply saddens me. The medical profession is one of the worst for stigmatising mental health. It’s not a safe place to openly talk about mental health.  Not seeking help for our own mental health is a huge risk factor, that’s without all the other issues including making life or death decisions, giving up a large part of our own lives for the career and the fear of complaints. It’s not really surprising, is it?

Today, I started the first day of annual leave. Ben and I went for “afternoon tea” and as I sat there laughing at some of his silly jokes and we tasted the tiers, I felt grateful. I was so thankful that I could be sat here, laughing, and eating with ever increasing freedom. Not being trapped in an endless cycle of shame and torment. I would have called you a liar if you had have told me 12 months ago, I would be sat, relaxed and most of all HAPPY. I felt the happiest I have felt in, a long time. I’m so thankful to be alive, but I almost wasn’t. I never imagined this life for myself.

I don’t know why I am here and others are not so lucky. But I know this, I’m not prepared to continue the narrative that suicide is selfish, that mental health is not as important as physical health. Truly if mental health has the possibility to take a life, it’s about as serious as it can get and needs to be treated as such.

How can you recognise someone may be feeling suicidal?

Perhaps there will be no signs, but if you don’t ask someone how they are and mean it, it could be easy to miss.

  1. Isolation, withdrawing
  2. Expressing feelings of hopelessness, being a burden
  3. Talking about death, other self-harming behaviours
  4. Speaking negatively about themselves
  5. Talking about suicide
  6. Getting affairs in order, giving belongings away etc
  7. Access to means to harm oneself
  8. Mood changes
  9. Turning to substance abuse/ alcohol as a way of coping with feelings
  10. Drastic weight changes
  11. Appearing to have lost interest in things they would typically enjoy or life
  12. A sudden sense of calm, or appearing calm
  13. Ceasing regular medications

Risk factors for suicide;

  1. Prior history of suicide attempt/ self harm
  2. Depression, anxiety any mental health problem.
  3. Alcohol, substance dependence
  4. Bereavement
  5. Physical illness/ disability
  6. Knowing someone who has died from suicide
  7. Subject of violence
  8. Loss of self identity- loss of job, sexuality
  9. Major life events
  10. Relationship breakdown
  11. Financial worries
  12. Isolation.

What can we do?

  1. Making access to help easy, without stigma or judgement
  2. Don’t be afraid to ask someone, ask them how they are feeling in a safe space. It’s ok to ask about feeling suicidal. Let them know many people experience feeling suicidal and they’re not alone.
  3. If someone trusts you enough to confide in you, acknowledge this. “I’m glad you are telling me, you can tell me anything” “I am here”
  4. Be prepared to listen even if it’s difficult to hear and upsets you.
  5. Talking about suicide does not cause suicide but it may help prevent it.
  6. Listen to someone struggling. Don’t judge them, even if you disagree. Don’t attempt to fix their problems or dismiss them.
  7. Help someone find professional help, charities, organisations
  8. Small acts of kindness “saying hello to a stranger” you never know a simple hello may make someone feel noticed, loved.
  9. Actively seek help from mental health services for the person- call emergency services or crisis line if someone is clearly in danger.
  10. Offer them support by asking open questions like “you don’t seem your usual self, is there anything you want to talk about? Tell the person you’re concerned about them

If you are reading this and you can relate, are experiencing suicidal thoughts, you ARE NOT ALONE and YOU DESERVE TO LIVE. Please get help now.

It’s okay to talk about suicide. Start the narrative.

Help:

**these are my own experiences and are not professional/ medical opinion*

Lived Experience..in ED Recovery.

Lived experience is one of the most valuable assets to recovery.

You can read about eating disorders in as many text books as you like and on some level you will understand them. Cognitively you may get it, but unless you’ve walked in the path it’s difficult to “really get it”

When you have lived that experience, You get it on a whole other level. People in recovery “get it’ on a level that reaches them to their core.

This makes people with lived experience such important allies in a person’s recovery journey and can be crucial alongside treatment.

I will never be able to express the gratitude I feel for my therapist, I know she saved my life, literally. Therapy was huge in my starting recovery and breaking free from the ED. But the most transformative part in my own recovery has been through connecting with those who have lived it.

At all stages of my recovery lived experience has been influential and important in my own growth.

Reading blogs, listening to podcasts/vlogs and following pro-recovery accounts on social media has really assisted me in the process.

There’s a deep level of trust that develops, knowing that others who have fully recovered, or are in a strong place in recovery helps us to feel connected, validated and most importantly gives us HOPE.

I reflect on the times I listened to people like Jessica Flint, Tabitha Farrar, Mia Findley and Millie Thomas sharing their stories, their wisdom and experience and aspiring to reach many of the milestones in recovery. Believing through sheer faith in their stories that recovery IS POSSIBLE for everyone. Even in some of my darkest moments in the throes of the ED or difficult moments in recovery, trusting what those who have lived and come through the other side has felt comforting and at most motivating.

Connecting with others in recovery seemed terrifying to me when I first started. If I had have been offered group therapy or any form of treatment that meant connecting to others, I would have ran a mile. In fact, I did. I was so ashamed of my eating disorder and terrified my “sordid secret” would become common knowledge. But through listening to others, joining platforms or groups a lot of this shame began to disappear, because there was nothing in this community that was judged, hadn’t been felt, said or done before. I started to see I was NOT ALONE, that there were millions of us who have experienced eating disorders.

A common theme I began to understand was the level of shame we all suffered. The more I read stories, listened and talked the more the shame began to dissipate.

Things I felt I could never share with another living person, suddenly felt like no big deal in the recovery community. The nuances that we believe are so shameful and not to be brought out into the light of day, are everyday struggles we share and is part of non-judgemental wonderful conversations. They say shame is fuelled by secrecy, I believe this is so true.

Following other’s journeys enabled me to find my own voice. I refuse to be ashamed of something that has made me who I am and helping me to connect with my true self.

I used to say I wanted to recover to the person I was before the eating disorder. I no longer wish this, because recovery has made me someone else, someone bigger than I was ( pun intended), but the level of growth that comes from choosing to recover & surviving an eating disorder is such that I wouldn’t trade it for the world. I’m becoming more connected with myself with every recovery orientated decision and becoming aligned with who I want to be. I’m grateful to those who were brave enough to share their experiences, that motivated my own recovery and helped me keep faith.

People recovering from eating disorders have to do this in a world that still challenges many of the beliefs we have to unlearn and to be able to recover in this society is so hard. For some this society can be incredibly cruel and the more people who share their struggle, experience the better this will be one day, especially for those who cannot find their voice. Lived experience is becoming a much bigger part of recovery, with the ever increasing resources available, recovery coaches becoming mainstream and peer mentorships, this can only be a good thing alongside traditional recovery. These people have experienced the struggles, the up’s downs and navigated their way out and are so valuable in helping others do the same, with compassion and sensitivity that is as authentic as it can get.

I’ll share some resources that have been so imperative to my own recovery below.

  1. https://www.recoverywarriors.com/ From blogs, to podcasts and online community platforms such as the “Courage Club” this has been huge in my recovery. Jessica Flint is fully recovered from her eating disorder and has now founded a recovery community that has reached thousands of people in recovery. This has introduced me to some of the most incredible people I’ve ever met.
  2. https://www.instagram.com/lindseyhallwrites/?hl=en Lindsey Hall has herself recovered from anorexia and she shares incredible insights
  3. https://tabithafarrar.com/ Tabitha is a recovery coach, who has fully recovered from her eating disorder. She’s very direct in what she believes recovery is, but she has shared some amazing blogs, podcasts and now mostly posts video content on youtube. I followed her avidly when I first started recovery. She posts about things from “extreme hunger, weight gain, and neural rewiring”
  4. https://www.instagram.com/millietnz/?hl=en & https://podcasts.apple.com/au/podcast/end-eating-disorders/id1534539219 End Eating disorder recovery Podcast.
  5. https://www.beyondbodycoach.com/ Mia Findley- is an Australia based recovery coach, who has fully recovered. She posts videos and podcasts with her experiences.
  6. http://maintenancephase.com/ This is a great podcast that promotes HAES, diversity and is anti-diet
  7. https://www.instagram.com/drheatherirobundamd/?hl=en

Orthorexia

Photo by John Finkelstein on Pexels.com

Orthorexia- the “socially acceptable” eating disorder

My eating disorder like many, has been a shape shifter over the years, meaning at various times I would have met criteria for more than one diagnosis besides anorexia nervosa.

We are all human beings. Fitting into criteria or a neat little box isn’t congruent with being human. And so whilst diagnostic criteria can be useful to help identify or guide which treatments may or may not work for you, I think that’s where their relevance ends.

What is Orthorexia?

The Diagnostic & statistical Manual of Mental Disorders (DSM-V) does not currently hold a separate diagnosis for Orthorexia. Instead it technically fits under the diagnosis Avoidant Restrictive Food Intake Disorder (ARFID) , although not perfectly, we return to my point about us being humans and not fitting neatly under one set of criteria.

This is a disorder characterized by an obsession with eating “healthily” or “clean” foods. A person becomes fixated on eating only foods they deem to be “pure”, meaning they can adopt strict rules and restrictions around foods and how they are consumed. I called it the “socially acceptable” eating disorder because it can be hard to detect in a society that praises restriction and demonizes anything else. People often reward people for eating “cleanly”. No eating disorder is ok. Orthorexia is when a persons focus on eating healthily actually becomes detrimental to their health, as a result of the obsessions, restriction, nutritional deficiencies and effect on the body.

It wasn’t until I started recovery for anorexia I realised I needed to challenge this too.

Orthorexia complicated my recovery, as I mentioned eating disorders are shape shifters, my way of “coping” with recovery became focusing on nutrition for a short while. If you are trying to recover by eating only “healthy” foods, you need to challenge this.

You cannot recover from a restrictive eating disorder holding on to ANY rules around foods. My obsession with eating healthily also preceded my development of anorexia and at some points other ED symptoms.

It is generally accepted that people experiencing orthorexia are not always driven by a fear of weight gain or drive to be thin, unlike anorexia. It can result in body dissatisfaction but weight loss it is not the driving factor (usually). It is about feeling clean and pure. I have no doubt that it could lead to anorexia in those of us with the genetic susceptibility because it can result in energy deficit.

Some of the warning signs of Orthorexia may include:

  • Unhealthy obsession with checking ingredients or contents of food (not driven by a fear of weight gain)
  • Cutting food groups because they are deemed “unhealthy”
  • Rigidity, not being able to eat foods not prepared by themselves or consume foods they do not know the ingredients (again not as a form of intentional energy deficit)
  • Distress, obsession impairing well being

If you think you have a problem, any concern with disordered eating, it is always good to seek help. Talking to a GP, a health at every size aligned dietician or therapist would be a good place to start. You deserve to have mental freedom.

Helplines/websites:

Recovering from an Eating Disorder doesn’t Automatically Guarantee Life Will be Perfect..

But when life is challenging , you won’t have an eating disorder to contend with as well.

Rather naively, I think many of us hold this notion of “if I could just fix my ED, my life will be perfect”. So let me get in there early and save you the “aha” in months/years to come, set your expectations now, be realistic .

This is something I have come to realise throughout my recovery. The many times I’ve contemplated what recovery means, how I define it, what life will look like beyond my ED.

As I’ve gotten further into recovery and shifting away from my eating disorder, it’s become increasingly apparent that recovering from an eating disorder does not mean life will ultimately be all rainbows and flowers once the ED is conquered. No. That’s just not possible. But, life’s so much better, just putting this out there early.

But, the big thing here, the “aha” moment for me, was recognizing recovering from an eating disorder means we have tools to help us when life throws us a curve ball and returning to the eating disorder does NOT have to be an option.

Additionally when something in life happens out of our control, not having to contend with an eating disorder simultaneously, means we are better equipped to handle the stress.

An eating disorder is a big problem, not a solution. It may feel like it gives you control and comfort around times of difficulty but I promise you, that is the mask of the ED. It is definitely an added problem that you do not need.

Recovery will not mean that when you have a stressful time in your life, a loss or lots of change you won’t experience human reactions such as anxiety, low mood or whatever else we all feel according to life events. Recovery doesn’t make you some kind of super hero that doesn’t feel or get rocked by anything- but it does mean you don’t resort to dangerous/ maladaptive coping mechanisms that you have relied upon until this point. Learning to feel has been a skill I’ve developed in recovery and how to respond to these feelings.

It would be unrealistic to believe you will never have a day of insecurities, or god forbid a bad body image day. Because even people who have never experienced an eating disorder experience these human emotions. But if you’re recovered you won’t obsess over them, you will be able to deal with them and it won’t “ruin your day your week or even your year”! Yes I did just do that.

Recovery is a beautiful thing and it means something different to everyone. The recovery process is not the same for any of us, but I do believe it is important to consider your expectations of what it will mean for your life.

Personally, it has led me to an understanding that beyond ED Recovery work, in order to remain in recovery, l will need to put work into ongoing stress management, imposter syndrome and work anxiety. For me they are interlinked.

It is highly likely this will mean continuing with therapy of some kind to help me work with these issues, because I want to protect my health legacy.

One thing I know, life stressors are not something that are going away because it’s part of life, everyone has problems. BUT don’t let having an ED be one of them or believe that once you have recovered you will be a unicorn and NEVER have another issue.

Arrested State of Development…

Aka feeling stuck.

Last week I was setting my intentions for the New moon. Whilst beginning to manifest and set in place the foundations of those intentions, I had a realisation.

When we are experiencing an eating disorder we are living in a state of “arrested development”. Loosely this is defined as a cessation of growth, this can be both psychological and physical. Initially ALL of our focus and energy is used in sustaining our eating disorder, then it becomes recovery orientated, both requiring substantial energy and attention.

I’m in the process of some major life changes and upheavals over the coming months with a ton of uncertainty. I’d been ruminating over the fact I wasn’t where I wanted to be, in terms of the standards I’d set myself for my career, my life. I was feeling resentful to the time lost to my eating disorder and to some extent recovery.

It dawned on me, for the last two years I have been fighting for my recovery, fighting to have a life not dominated by and eating disorder and before that I was expending all of my energy on the disorder itself, leaving room for very little else. I was feeling frustrated that I was now “no longer considered the best doctor of my cohort”. This is an egocentric attitude I need to work on anyways, but I have always been a perfectionist and through uni I had never settled for second place. Now, academically I am viewed as “capable”, but not excelling. There is nothing wrong with this, it’s how my brain processes this that is the problem. Now, I’m the doctor who has the good rapport but hasn’t necessarily recalled every hazard ratio from every journal ever written, but this was me, a long time ago. Before my life priorities had to change.

I realised some of the standards I’d set myself had become external expectations and now I don’t match those either. Again, this is not a problem, it’s how you react to this. The thing is I have been trying to be “that standard”, but I’m not, I can’t be right now. I essentially took two years out. If I was a professional athlete I couldn’t expect to compete at the same level after two years out, it’s the same here. The difference is, the people with those expectations don’t necessarily know I have been trying to survive and recover again, this was because I kept my eating disorder hidden through fear of stigma and so why would they? It was only recently I felt able to be open about my journey.

It’s only now that I was beginning to feel “bored of having to be recovery orientated” and have so much more mental capacity I could see unmasked I had been living this state of arrest. It’s releasing, I’m ok with who I am. I’m proud of what I have overcome and where I am. Letting go of unrealistic standards and expectations is what’s helping me in my health legacy and provide my patients with care. I think it would be unhealthy and unrealistic to want to be the same person we were before recovery.

How can we develop and grow when our worlds are so minute and focused on such specific details such as weight or that grade. I didn’t have the energy or time to be reading the journals I now am, when I was merely trying to survive.

I worry about my colleagues, the pandemic will fuel burnout, but unless the healers have a place to heal themselves this won’t go away. I wish for the unforgiving environment that is the healthcare profession to become a more open and compassionate one. One that does not depict personal struggle as failure. I shared my struggle not so long ago, because this unrealistic image of what a doctor should be is harming those that look after you, the more we normalise the narrative the healthier the healers.

I do think recovery burnout is a thing, it’s emotionally, physically draining, it becomes tedious but for the days where recovery is not boring it’s important to keep recovery orientated.

Two years in recovery..WAKE UP CALL

TW and this may be difficult to read.

Yesterday a memory came up on my Facebook feed.

A trip we made to Sri Lanka in March 2019. My final wake up call before seeking help for my eating disorder.

It was not the wonderful experience that it should have been, or our pictures from our travels captured. They say “a picture paints a thousand words’, but most of what you see is what my eating disorder did for years, fake an exterior. It was this trip that I for the first time in 15+years, began to see how much of an issue my eating disorder really was.

For years my eating disorder had concealed the negative impact it was having on me.

My eating disorder was slowly killing me. If you are starving, you’re slowly dying. My friend if you need this sobering reminder, people die from eating disorders. We forget this when we are dancing with the devil. Or perhaps, we no longer care, when it’s painful to sit, or our body is covered in fine hair because we can no longer keep ourselves warm. We ignore message after message from our bodies until, if we are lucky we WAKE the FUCK up. It’s not just us that our eating disorders impact upon. Truthfully when engaging in behaviours and driven by the numbers, I didn’t worry about the effect each action could have on my partner, parents, brother, friends. But our actions do matter, If I had have continued I would have likely ended up as a stark statistic. Remember, YOU matter, your life matters and you affect many people’s lives. Please wake up.

That trip I felt completely lost and trapped in my relentless behaviours that had been by my side for years. I had no idea how I was ever going to step outside of the grips my eating disorder held on me. But I knew something needed to change or I would slowly but surely die.

What made me wake-up?

I realised I wasn’t living. If I wasn’t living, what was I? It became so obvious to me on this trip because Sri Lanka is full of beauty, but I felt nothing but cold.

I was done with the comments from peers and concerned looks. I hated it.

I was done with feeling nothing but bone cold, ALL OF THE TIME. Even in 30 degrees heat. I wanted to see past the brain fog and constant chatter.

I didn’t want to live like that anymore. I couldn’t live like it anymore.

This was not the first time I had had a moment of clarity, a few years prior I knew things were far from in control, but I didn’t seek help. I thought I could fix myself by eating a little more. Things got better for a time, but without support things soon descended back to the familiar chaos and calm of my eating disorder.

But this trip was different. Something needed to alter. I had reached “rock bottom” and I had to crawl out.

I wanted to be present, to share the experience but my eating disorder bled into everything. It was all encompassing. I was afraid for the first time. I was scared this was either going to be my life, or it would take my life.

It was the first time I realised how much stronger the eating disorder voice had become and how buried I was. I feared I had lost myself forever, I couldn’t recall when I was last in the driver’s seat of my thoughts. This was a sobering moment, at the same time I felt powerless to do anything about it.

These moments of clarity would pass again, and my eating disorder would begin to fool me once more that I was in fact fine, convinced me I wasn’t “sick enough” or that I even had an issue. However my healthy thoughts, were desperate to be heard and me listen. And so, it was this trip, I shared with my partner some of my story, although by this time it was hardly a secret.

Even though this trip was incredibly painful, I remain grateful for it, because it was like a wake up call and it kickstarted my true recovery process. Seeing pictures of the trip makes me sad for memories and experiences my eating disorder stole from me but I’m so thankful to be where I am now. Writing this.

If you’re in this dark place, THERE is always hope, It is never too late to seek help. And, you don’t have to go at it alone. You don’t have to have answers. Choosing to reach out of help is the biggest step, the rest will follow if you trust in the process and take that massive leap of faith.

There are stages we go through prior to starting recovery and then during recovery itself. I think we flip flop between them whilst we go to war with the two voices in our head. But we can all win, it is possible.

To me the stages look something like this:

◦ The “I’m fine. I’m just super healthy. I’m totally in control” stage.

◦ “Something’s not quite right with what I’m doing, but it’s ok right? I know I can stop if I want to. But I don’t want to” stage.

◦ The “Shit, I can’t stop. Well better just keep going. It will pass. It’s not that big a deal?” Stage

◦ The, “Ok, I think this is probably a problem. Not sure I want to do anything about it. But not sure how long I can keep going on like this” stage

◦ “Ok, I’m so done with this, I can’t keep living this way. But I don’t feel I have any control. I’m not sure I can stop” stage. This is the point I got to when I sought recovery. It’s one of the scariest decisions I’ve ever made.

◦ “Let’s try this recovery malarkey out. What do I have to lose? But I’m so scared of the thought of change”. Stage

◦ The, “Oh my god, this is way too hard. I’m never going to recover. Why even bother trying” stage. I think it’s common here, we often resort to old behaviours intermittently whilst making small changes in recovery. But the small changes matter and count.

◦ Then something clicks/ it’s like a switch. Recovery becomes easier. It’s still bloody hard but it’s less of a monster than the one that’s been dictating your life. This stage, you start to question your eating disorder thoughts, your own thoughts start to become clearer and in the foreground more frequently.

◦ It doesn’t take much for your ED to lure you back, a slip or relapse happens. But you learn from them and each slip you get wiser. Recovery gets stronger, you get stronger.

◦ Now you really want this, recovery feels achievable . You begin to see who you really are, what your life can be without this hitchhiker. You remain vigilant and know how recovery can look and you make it your mission to not go back. You’ve got this. Your actions and thoughts are all protective of your recovery, you have worked harder than anyone will ever know to be here.

Recovery is always possible, no matter how deeply trapped, lost or afraid you feel. Wake up, and rejoin the world, you deserve a full life and the world deserves to have you in it.

Check out the links below for seeking support/ starting the conversation:

  1. https://www.beateatingdisorders.org.uk/recovery-information/tell-someone
  2. https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/how-to-talk-to-a-loved-one
  3. https://www.ed.org.nz/getting-help/what-to-do/

OCD and anorexia…

OCD and eating disorders…

Statistically people with eating disorders are more likely to experience co-morbid diagnoses, such as depression, obsessive compulsive disorder, anxiety, borderline personality disorder. There’s a lot of research investigating whether they are biologically, genetically connected.

When I was six it used to take me almost three hours to go to bed. I developed obsessive compulsive disorder (OCD). There are many overlapping features of OCD and eating disorders. I’m not sure that my OCD at times was separate from my eating disorder. I think it was like a shape shifter that adapted to fit my eating disorder.

The DSM-5 characterises OCD by negative repetitive thoughts that are intrusive and often result in compulsive behaviours to pacify the anxiety evoking obsessions. Common obsessions include ‘cleanliness, tidiness, numbers and many others.

My OCD was not your stereotypical “super clean and tidy” kinda picture. No it carried many similarities to my eating disorder compulsions but it did not relate to food. It began after several people close to me passed away before I was old enough to understand death or process emotions. I developed an intense fear of anyone else around me dying, or becoming sick. I began engaging in ritualistic behaviours. This involved counting, repeating certain phrases, running on the spot, avoiding certain numbers, turning light switches on and off and many more. I would perform these rituals or act out compulsions until I felt a sense of calm. The common denominator between my OCD and anorexia was the intense dread or fear of something happening if I did not perform X behaviour. (Fear in childhood death, fear from eating disorder weight gain). The only way I could silence my eating disorder voice was through compulsions and rituals.

It took a lot of child therapy to reduce these behaviours and challenge the thought patterns. Exposure therapy, similar to that in eating disorder recovery. I would cut a ritual a week until I was free. (A bit like reducing eating disorder behaviours). The exposures were ranked in order of fear and challenged with support.

But….. even though I was only six, I knew the thoughts were nuts. They were not ego-syntonic unlike the intrusive eating disorder thoughts where I believed my thoughts. For example, with an ED thought I truly believed my thoughts such as I “had to eat X number of calories or purge a chocolate bar” it wasn’t until these thoughts were challenged in therapy I could see they were disordered, I would not expect a friend to exist on the little I was eating, nor would I expect them to purge a chocolate bar. I could see after these challenges how distorted my thinking was around myself. I continue to use this, if I wouldn’t expect a friend to do something then why should I expect myself?

Another disparity between my ED and my OCD, I was far more resistant to giving up my eating disorder cognitions than I was my OCD thoughts and behaviours, even though I was just a child. I can make sense of this, neuroplasticity is much harder as an adult. But I do believe this is a distinction between my OCD and my eating disorder.

I feel it’s highly possible that having the predisposition and the appeasement provided to me by rituals definitely contributed to my developing of an eating disorder.

I believe they are both shape shifters. I can draw separations from the two disorders however there was some symbiosis within. For example, there were aspects to my anorexia that from the outside would be very difficult to draw a distinction from OCD. I had ritualistic cleaning behaviours “I had to engage in” to allow me to eat. I would clean the kitchen, from top to bottom prior to consuming anything. If I was interrupted I would start again. This may have been a part of my restriction, although I think more likely it was a separate entity to cope with the anxiety of eating. I don’t feel the thoughts surrounding this were related to the eating disorder.

Eating with very specific cutlery, is a completely different scenario. People with eating disorders often develop strange obsessions around cutlery. In my opinion (and I am only speaking from experience and talking to others who have had the same weird obsessions) this is very eating disorder driven. It serves several functions in the eating disorder. 1. Using a teaspoon (crazy) is a form of restriction. Small bowls, plates all the same. We have to stop. Using the same cutlery can feel “clean” this is an overlap.

My compulsive exercise is driven by my eating disorder. But personally I believe the compulsions and pathways were ignited and learned in my childhood. I would run on the spot or up and down the stairs for hours to feel my heart beating to feel alive. I imagine, my eating disorder reactivated this preformed pathway and used it. My drive to move when in the depths of my eating disorder was very different to when I was a six year old terrified of mortality but it still pacified my anxiety. The two disorders numb emotions that clearly I needed to find more constructive ways of coping with. My anxiety from my eating disorder was fear of weight gain, I was not afraid of this when I was six. The result of movement however, was the same, it appeased the discomfort short-term and clearly I had learnt this subconsciously as a child. This is just my simpleton thought and explanation. They both distract my brain, when I’m worrying about food or washing my hands, clearly I’m not worrying about the thing my disorders are protecting me from. But neither are healthy.

For me, overcoming my eating disorder has been so much harder than OCD. Again some of this will have been my easier to sculpt paediatric neural pathways, rather than my years of entrenched adult pathways. But I also feel it’s the eating disorder itself. We don’t want to recover, not initially from an eating disorder. This is very unlikely to be the case with someone suffering from OCD. I doubt there’s few people who decide that they want to keep their OCD, or that it’s a ‘friend’.

Cognitive behavioural therapy, has helped me with both. I guess that’s the good news about the two coinciding disorders, they are sometimes treated together. But I think it’s been more beneficial from an eating disorder perspective, because those of us with eating disorders have very distorted cognitions that can take some convincing. Whereas, I know that no one is going to die if I don’t wash my hands 37 times, I know it’s a ridiculous thought even though it causes similar anxiety. But I would have argued until I had no more breath that some of my eating disorder perceptions were not unhealthy. For the previous, it was more a case of changing my relationship with the thought- for example, when I get the thought “everyone is going to die if I don’t wash my hands 37 times” I have confronted not participating in the behaviour and “urge surfing, delaying or distracting” so many times now that I don’t feel the same anxiety and I am committed to not performing the action of washing my hands 37 times. No one has died. My brain knows this. For the latter, I have had to develop an extensive toolkit that is ever growing. When I experience a disordered thought, like; a food is “good or bad” and resultant anxiety I challenge the cognition, food does not carry moral value. And to avoid the behaviour I use a skill from the toolkit, self compassion, opposite actions.

Same same but different….

My eating disorder meant I had to eat the same things, same time, I would chew everything a specific amount of times (this was not OCD). It could easily have looked that way. I would eat in the same order. But these all served the eating disorder and were part of restriction.

I was extremely rigid with my rituals and compulsions. These were common to both.

My OCD did not cause my eating disorder but I strongly believe there is a connection, that is biological, genetic and psychiatric. I do not feel that my OCD diagnosis was important in my recovery from anorexia. I’m not sure I even really discussed it with my therapist but I think it is useful to understand the possible connection as not addressing co-existing disorders may make recovery more difficult. The treatments are similar but with variances. We are all complex individuals and so it’s possible for some not drawing a distinction may be ok in recovery but for others it may require addressing them together and with focus on specific aspects.

One thing I know for sure, the anxiety is never about the donut or the heart beating.

Check these out:

  1. https://www.amazon.com/What-When-Brain-Stuck-What/dp/1591478057 This is written for kids, but it has some really helpful principles
  2. “8 Keys to Recovery from an Eating Disorder” WORKBOOK by Carolyn Costin, this is so helpful it has lots of exercises, to challenge healthy self vs eating disorder self. https://www.carolyn-costin.com/books

Giving less F*cks

Giving less f*cks has been very important in my recovery. I feel giving less f*cks is liberating.

I do not mean, I don’t care about anything. Far from. I have learned that giving too many f*cks is part of my problem. So learning what to get rid of in my giving a f*ck bucket has been energy freeing. Freeing up the genuine give a “f*cks” like my family, friends, career, running, sketching, my cat, helping others.

I care a lot about my job, my career and everything it represents. However my profession is a breeding ground for perfectionism and comparison. Both things I have had to work very hard at challenging for my eating disorder recovery. Right now recovering from my eating disorder is priority so that my future self can be my best version in all areas of my life including my career. That has meant some things I have given too many f*cks about previously I simply cannot afford to anymore.

As part of my core values and self worth it is important to me to work hard, be good at what I do. But how that’s defined does not have to rely on single peer comments or being aware of every statistic from every journal ever. It comes from so much more holistically.

Another thing I have found to help me in recovery is to “let go of comparison”

There is a popular phrase, “compare and despair” which I believe is very relatable.

I believe it is innate in us all to compare ourselves to our peers. But what we compare is what I believe causes us harm and dis-regulation. It can come at a huge detriment in recovery.

Body comparison is common and meaningless. For instance, I recall early on in my recovery my therapist at the time challenging this very process. I used to compare my body to other people’s bodies all the time. She explained, that we carry biases. We tend to only see what our brain filters and we have a very selective attention. Therefore I remember one of my challenges was to walk through a crowded street, take notice of the diversity. Sure enough we all come in many shapes and sizes and our appearance is irrelevant.

This exercise made this particular comparison easier to stop. Knowing the bias I harboured meant I could be accountable and when I found myself comparing, I could call myself out on it. Additionally challenging why I was trying to compare. Realising that what you see externally does not translate to what’s beneath the surface and so we are comparing to a false ideal we have created. How do we know the richer, slimmer person is any happier than ourselves.

Your eating disorder will never tell you you are as good as the person you are comparing to. Importantly, why would we want to be anyone other than ourselves?

Getting out of other people’s business..

I had a massive problem with comparing what I was eating to what everyone else was eating. I was in everyone’s business. But just as what I am eating is no body else’s business, it is of no relevance to me what anyone else is eating. I no longer could tell you what every single person at a social gathering did or didn’t eat because it doesn’t matter!!!

Comparing your eating disorder to someone else’s, completely futile and not comparable even within the same diagnostic label. Comparing others’ recovery and feeling you’re doing it wrong or not as deserving or vice versa. Just stop it, this is the eating disorder. Your recovery is your own. Your body is your own with it’s own requirements. Letting go of this has made recovery much more free.

There are many situations we can find ourselves drawing comparisons, status, aesthetics, character traits, possessions, families, sporting prowess, holidays, weddings, education, careers the list is endless when you think about it. It’s problematic when it’s black and white and impacts upon our thinking style. I’m not saying you will never compare yourself to someone again, I believe it’s ingrained in us all from an evolutional perspective, where historically it would have been a survival advantage. However there are ways I have learnt to lessen the unhelpful comparisons.

We live in a competitive society

We are told on a daily basis on many platforms to be the “healthiest’, richest, most successful. Women are made to compare themselves to other women constantly. It’s all external measures and rewards. Competition can be healthy, but recognising when it’s a problem is important.

For me, as long as I know am performing at my best, whether it’s at work or any other aspect of my life, I do not need to compare myself to my peers.

I know when I’m doing ok in this, because I don’t feel like I’m constantly striving and never achieving, I can feel grateful in little wins. This is not the case when perfectionism is in the foreground and unhealthy competition, then I never feel satisfied or recognise achievements big or small.

Gratitude:

Practising daily gratitude has really helped with this mindset shift. Seeing celebrations in the small things, there is something to be grateful every day, even on days where it’s hard to feel gratitude. This helps me filter my ‘Give a f*ck bucket”.

In my profession, I am yet to meet someone who in their final moments, talks about how much money they made, or how gorgeous they were in their youth. No they always talk about what matters, family, friendships and experiences.

Stop basing how you see yourself by comparing yourself to others. One thing is guaranteed is there will ALWAYS be someone who appears to be ranking better than you on some standard. You are good enough just as you.

Feel free to share

Things to remember on a bad day in recovery..

Iv’e been in recovery some time now, I can’t have a bad day right? Sound like a familiar thought? Bad days happen, shit happens.

Today, I was caught off guard. So I wanted to share for anyone else who had found themselves, feeling they “should be further than they are in recovery or should not have a bad day”

It was at a colleague’s farewell lunch which was a buffet to celebrate and wish her well.

But as I sat amongst my peers, the familiar thoughts and noise returned to, how am I back here again? How can it be so hard to put a piece of damn food in my mouth.

Panic swept over me, as the noise got louder and louder. The harder it became for me to pick up the single piece of sushi I had put in front of myself. Why couldn’t I just eat? “Seriously are we really back here after all this time? You should not be finding it this hard.”

Willing myself to pick it up and take a freaking bite. It became a battle. A battle I was all too familiar with but had felt very distant. I had almost forgotten what this absolute feeling of being overwhelmed and petrified of food was like. It was a battle.

The thoughts, “how are you suddenly paralyzed by a simple buffet? You look crazy, people are going to notice, you can’t eat that now it will look even weirder, pick something up, hide something”. JUST NOISE.

Everyone else had finished.

I realized if I was going to win this battle I needed to find and-listen to my healthy voice, the kind voice that was thinking about our future, where my life won’t be defined by moments like these, but what I will gain from listening to this voice. Not this “HH”.

Through the time in recovery, my voice is much stronger now than the noise of “HH” and can be found if I listen.

Another thing that has helped me move through today has been, accepting ok, I’m here today. It’s not where I want to be but it’s not where I was either. Before that I was criticizing myself for having “a moment of weakness”, feeling overwhelmed, but I realised, that’s not helpful or what got me moving forward and in tune with my healthy voice. This has taken practice and perseverance but it’s why I am here, now.

Finally, as we were clearing up I took some deep soothing breaths and I shoved the piece of sushi into my mouth. I picked up another piece and I repeated.

Beating myself up blaming myself for “not being further than I should” in recovery, is not serving my recovery. Some of life’s greatest lessons come from experiences and slips like this. So I am grateful for constant learning and growth.

Struggling is a standard part of recovery. I felt crushed when I was in that moment, it felt too acute and raw. I was terrified I was back to square one. Experiencing challenging moments doesn’t mean my recovery is “failing”. When we look past a particularly difficult experience, we can see actually how far we have come. We tend to focus on the negatives, what we do “wrong” and often get swept away in our unrealistic expectations. But if we take a step back and show ourselves kindness there’s something positive to be taken from every experience good or bad.

I have felt like I have been running along, but when we are running we often trip/ stumble at some point and that is normal. Recovery is no different.

I am grateful for this reminder how far I have come, but also that recovery really is a process of ups and downs.

So for anyone feeling they are failing at recovery for having a bad day, or should be further along, give yourself a break and see how far you have come. It’s ok to not be where you want to be yet.

Not playing the blame game is a game changer.

It’s been a shit day. I haven’t failed because tomorrow I get back up and carry on with recovery having gotten through a bad day, that much stronger.

Recognising small, subtle disordered behaviours, that keep us tied to our ED…

I cooked with my husband last night, various curry dishes. This in itself for me was a milestone, I have always felt the need to completely take control in the kitchen. This was largely so my eating disorder could make shortcuts or calculate everything that was going in. It normally caused me great anxiety to deviate away from my “known” and safe meal choices. This I know is very disordered. But sometimes behaviours and thoughts are trickier to identify and hide from sight.

Once we plated the dishes we had prepared my husband just mixed all his together. Partly because it was completely underwhelming in terms of taste (which in itself would have been devastating to me not so long ago). What I mean by this, if I had allowed myself to eat and then it did not meet the standards or expectations I had for it, I would truly feel irrationally gutted.

This is disordered. I mostly felt like this when I was deep in restriction and giving myself permission to eat was near impossible. I celebrated last night that this bland food that promised more gave me no more than a mild irritation that it took so long to be boring! But there was no emotional attachment or reaction.

However the biggest thing I recognised for myself, when he mixed everything together, you could pretty much say it blew my mind. When I considered doing it, the ED voice really kicked in. And I realised the reason why it has been hard for me to do this. Eating each food item separately, especially when severely restricting gives a false sense of prolonging eating, savouring the food.

It gives a sense of enjoyment of each food, feeling more fulfilled. Which I see now is really disordered. And so, I forced myself to mix my food together. This was probably the first time I have done this in nearly two decades. It felt wrong. But enlightening.

It told me, that there are small things, that often go unnoticed and don’t get discussed in ED recovery. Things we can identify ourselves. I feel now once I notice something is disordered I have to do the opposite. Even if it’s a tiny behaviour or “quirk” that to the outside wouldn’t seem like anything. For my ED recovery it’s the difference of staying in the ED vs eventually being out, free.

I can’t tell you what your own weird tiny disordered things will be, but once you do notice something that, either going against, or stopping causes you anxiety then it’s probably disordered and you can work to change it.

Shifting the narrative in eating disorder recovery….

Recovery is millions of little challenges

My husband and I were hiking yesterday. We had hours of trail ahead and in between goofing around, talking about our plans for the week ahead we talked about the last year, 18months. So much has happened in this time, like for many people. We talked about people missed. Career paths, life plans and we made jokes about previous events. One event, now an often feature of his jovial mockery and light hearted goading is one of our darkest moments. Often making a situation that was once very unfunny can flip it on its head, make it more bearable. You see that a lot in the healthcare setting, jokes that someone from a non healthcare background would shudder at, is often daily practice. Why? because it makes pain and darkness more bearable and shareable.

This situation we were joking about was one of my biggest meltdowns, i’ve ever had. We were in New York exactly a year ago. I wasn’t really in recovery at this point, although I was fooling myself I was. We had been taking in sights all day, darting all over the place. I had done, what I did a lot at this time. Bargained with myself. I was “allowed” to eat whatever I wanted in the evening because I had been so active during the day. Fucked up beyond all reasoning, but this is how the eating disorder often works. Often that bargaining never actually leads to “eating whatever you want’ but we were looking for a restaurant that would suit us both. I didn’t have much input in restaurants at this point, so it was usually down to my husband to select somewhere. He talks about how incredibly stressful this was. I have no doubt, it must have felt like he was checking for poison for some medieval royalty. I would quash most selections before they had left his lips. However this particular day, it was 1 week from Christmas, we hadn’t booked. So the stress for him was ridiculous. Before he found a place, we spent an hour with us scanning menus, me rejecting. It got to the point where we retraced our steps and chose one at random that would allow us without a reservation. What came next, I don’t really remember. But he does very clearly.

It was a steak & lobster restaurant. There were no other options. There were chips and meat. That was it. After looking at the menu for all of 30 seconds, I burst into full blown tears, sobbing in a packed restaurant. I cannot describe what was going through my mind at this point. Except it was like the world had just ended. I had built the meal up, I was going to eat. Then I was presented with two things I hate, red meat and shellfish. I was petrified of chips at this point. A menu had reduced a 30 something to full blown tears. Inconsolable, snotty ugly tears. We stayed. ‘HH’ screamed that my opportunity had been ruined bla bla. I struggled through the dinner eating chips. Both of us shocked at how irrational I was. I had had moments like this at home but this was in the middle of New York. It’s obvious now, this was plain and simple fear.

But whilst cringing at this event, we chatted about the narrative now.

Eating disorders are not rational.

My world didn’t end. I didn’t die. I just looked totally mental. Now after lots and lots of little moments, challenges, meltdowns I can laugh at how absurd this moment was.

The point of this, recovery doesn’t happen over night. Recovery isn’t a case of going to bed one night and waking up recovered. It’s full of obstacles and challenges. If it’s not challenging it’s probably not recovery and doing jack shit.

Today, he asked me if I wanted an Ice cream. I heard myself say ‘no thanks’. This is a response ‘HH’ has trained to become my default. I am changing this narrative to ‘Yes, please’. Some days yes please is easier than others. But it felt uncomfortable, spontaneously having an ice cream. ‘HH’ certainly did not approve. This is another moment, challenge towards recovery. It was a world apart to the lobster joint. I felt uncomfortable, I got on with it and used to distraction techniques I’ve learnt along the way after. ( Today was repotting some of my veggies, other times breathing techniques can help) But if I’d said no thanks, it would have been a missed opportunity. Without challenges, nothing changes. In recovery discomfort is action. I don’t think I would sob in a restaurant now, unless the world genuinely was ending. I don’t bargain with ‘HH’ any more. There is no bargaining with an eating disorder, that’s an argument you won’t win unless you decide to do the complete opposite of what it’s telling you.

Useful breathing technique: https://www.cci.health.wa.gov.au/-/media/CCI/Mental-Health-Professionals/Anxiety/Anxiety—Information-Sheets/Anxiety-Information-Sheet—08—Breathing-Retraining.pdf

Food is more than just food.

Best biscuit ever……

Yesterday, I had a strange realisation. It’s taken me almost 30 years to get to it, but yesterday I realised food is not just fuel. Food has no rules, no moral value and no foods can be ‘good’ or ‘bad’.

Whilst reflecting about my relationship with food, I craved a chocolate Hobnob. I heard ‘HH’ stipulate, ‘but you’re not hungry’. It was this thought, I rewound and re-framed my life-time’s thinking. Food, although important for fuel and nutrition is also part of connection and ENJOYMENT. It’s always blown my mind that people have just been able to easily eat something, just because. But yesterday, I understood food can be eaten whenever. Whether we are hungry or not. If we want to eat something we can, without judgement, without compensating, because it’s just food.

I was feeling particularly reflective yesterday, because I felt really fucking sad. The fact the I felt sad, set off a whole chain of thoughts. But what made me grateful amongst it all, the fact I could acknowledge and identify that emotion. For years I have numbed my emotions, to the extent when I started to feel again, it took me a while to recognise what I felt. That’s pretty common I think amongst us who have eating disorders. I no longer associate with the nickname I have had for years and use to value, ‘the ice queen’. This is not me now. Nor do I want it to be. The fact it became at one with my identity is quite disturbing to me now, as I am a compassionate person. But in the depths of ‘HH’s grips I was an emotional void. I’d get angry, anxious & irritable if my routine was disturbed, or challenged but these were pretty much the extent of my emotions. Instead of returning to my old behaviours yesterday, exercising to the point of exhaustion, pain or restricting to the point of false euphoria, to numb out the events. Instead I went for a walk out in nature listening to a podcast and then had a cup of tea with a Hobnob.

I felt grateful. Grateful I have reached a point of mental freedom to enable me to feel. Being numb is not living. I was grateful I could feel sadness and sit with it. Feelings pass and are not permanent. But eating disorders are. Recovery although hard, is also temporary.

The next thing I’m working hard to reach, is body neutrality. There is so much talk about ‘body positivity’ at present. I believe the premise of this is great, but I also feel it’s a double edged sword. It’s general concept to love and accept your body, sure. Promoting acceptance by society of shape, size, gender or race is the main aim. But, I feel there’s pressure with ‘body positivity’ as a concept. It over values of the body image itself, rather than appreciation of the body’s functions. For me, I don’t know if I’ll ever ‘love my body’ but I love the things my body enables me to do. I think very few people eating disorder or no eating disorder love their bodies. So for me, getting to a point where I do not care, or have any value from my appearance will be sufficient, beyond that a bonus. But I feel it’s healthier to see our bodies as a vessel, a vessel that allows us to do what we desire. It does not matter what that vessel looks like. That’s what I believe the social media message should be, that’s what body positivity should be.

Interestingly my ‘negative body image’ didn’t truly start until I was in the depths of my eating disorder. Sure there were things I had insecurities with, but I think most people on this planet do have hang ups. But I can say, the negative body image spiralled and it took so much value. This value is incongruent with my own true values, i’m not a shallow person, I couldn’t give a rat’s arse what someone looks like if they are a good human being. But the world becomes so small, consuming and out of alignment with our own beliefs. I really struggle with this aspect of my eating disorder, because on a bad ‘body image’ day it still has far too much space. Space that’s not relevant or part of me. However this is part of the divorce from diet culture and unlearning so many untruths that are so engrained in society. Most days now fortunately I am neutral towards my body, but i’m not where I want to be yet. I’m not where I want the whole of society to be, where body image is as relevant as yesterday’s weather. But rejecting diet culture and accepting ourselves is a start towards remodelling society’s beliefs . Ultimately change starts with yourself.

‘Portion sizes’, re-learning to eat like a ‘normal human-being’, anorexia recovery..

Re-learning ‘normal eating’ ED Recovery

I say normal, loosely. Because the majority of the population has some form of low grade restriction going on. Whether they realize it or not, any diet behavior is restriction. This is not normal eating. But it is ‘societies normal’ This is not an option for us.

When we restrict, our body adapts, by lowering metabolism and a whole heap of other changes like disrupting hunger cues. (This is partly why diets don’t work, restriction leads to a response known as ‘hyperphagia’ (increased hunger) to counteract this unnatural behaviour. Our bodies function in equilibrium and so will adapt or correct the perceived famine. For anyone who is interested like me, in evidence or scientific explanations, the ‘Minnesota Starvation experiment, led by Ancel Keys’ is the closest we will ever get to depicting what happens to humans when starved, both physiologically and psychologically. It would never pass an ethics committee today but the evidence still stands. This was a practice changing study from the forties that still helps to shape nutritional rehabilitation. It provides explanation for experiences such as hyperphagia.

In early recovery most of us experience “extreme hunger”, hyperphagia. For me this wasn’t so much physical hunger, for the most part, but it translated more as mental hunger or feeling off. Regardless it’s still hunger, if we are obsessing about food it’s because our bodies are needing fuel. I was constantly thinking about food, when I was next going to eat, what I could eat, worrying about whether it was ok/ not enough, even dreaming about food, obsessing about food, reading recipes the list goes on. It felt relentless and really intrusive. It was hard to think about anything else. During this period, I would also find it hard to leave food on my plate, even if I felt full, I guess it was my brain freaking out, fearing that I was going to return to a state of famine again. I’d feel almost a compulsion to finish everything. I never felt satisfied early on, I would be painfully full but still thinking about food. This has gotten better with time. I don’t feel the need to finish everything in front of me. This obsession with food was different to that in the depths of my eating disorder, where I would obsess over food then. When under the grip of ‘HH’ I would control everything around it, I’d cook for others, but never eat what I’d made. I’d bake a lot at this point, now I bake if it’s someone’s birthday, I’m just not interested or obsessed like I was. This is common I think, now we have a rule in my house if I make it, I eat it. Some days, if I haven’t eaten quite enough, I find my extreme hunger can return the next day, but this is getting less and less.

This is terrifying when it first happens. If it is happening to you, or someone you know, extreme hunger is normal, it’s a healthy response to energy deficit and reintroducing nutrition. It showed up for me months later in recovery, after I got back on track from a relapse. I didn’t experience it prior. Bingeing is normal in this setting. It’s distressing, it feels it’s going against everything the eating disorder believes. But the only way I found it improved was to listen and respond to it. Restriction remains the enemy for this.

Some-thing I still find difficult, is what’s normal. I also think, there probably isn’t actually a normal, because what’s normal for one person is not for another. However serving sizes is a tricky one, I can under-eat some times because I have done so for so long and my perception of what a ‘normal portion’ is warped.

I have found asking for help with this, although humiliating as an adult and at time unbearably uncomfortable, I often run my lunches past my husband and if he tells me it’s not enough, I don’t argue, I add more. I am trying to re-learn normal eating.

Another thing that helped me, although at the time I hated it and argued until I was blue in the face was relinquishing control around food. By this I mean, I was lucky my partner took complete control of what I ate, when I could not make healthy decisions geared towards recovery without ‘HH’ sabotaging. I was not allowed to cook, prepare meals, or enter the kitchen when meals were being prepared. It was one of the most humiliating experiences of my life and there were times when I would argue, shout, cry, throw, he would force me to eat what was in front of me. I was like a child. But worse, I was an adult having a meltdown. But this role was necessary for a short time, because if left alone, I would skip ingredients, make smaller meals, substitute ingredients ‘for healthier’ alternatives etc.

But it was important for me to regain independence quickly (for me and my partner) and the only way I could was to suck it up.

I cannot express the grattitude I have for my partner, I think people who support a person through eating disorder recovery are saints, they see the worst side of a person imaginable, because a caged animal will always lash out. I have apologised more times than I wish I’d ever have to in a life time. I think this is where it’s useful to seperate the person from their eating disorder. We are not our eating disorders, and the non-negotiations are with the eating disorder, not the person being over shadowed by it. This does not give a free pass to be a dick, it’s just to help understand why you have to keep fighting for recovery. Thankfully this wasn’t needed for long.

For a short while, I followed the principles from Gwyneth Olwyns, homeodynamic recovery. I like evidence and this is evidence based. I will link this below. I do not count calories and find doing so to be detrimental, however this principle sets minimums and it helped me for a short period when trying to become independent again.

One thing I’ve accepted is, comparing what we need to eat in recovery to someone who has not just waged war on there body is never going to be helpful. We need more than most people to heal. Healing doesn’t end at ‘weight restoration’, we still have a nutritional rehabilitation, inner repair, mental healing beyond this. Who knows how long this will take. This, Is hard for someone with a restrictive eating disorder, but I believe it’s true and giving yourself permission to eat whatever, whenever and often ‘more’ than people around you is an important step. Letting go of the judgment. I’ve only recently gotten to this point, I used to find it really really hard to eat in front of, or with others. That’s isolating and something a lot of us have to overcome. So ignoring comments about food is important, hard but totally achievable.

1. The Minnesota Starvation experiment: https://archive.wphna.org/wp-content/uploads/2016/01/2005-Mad-Science-Museum-Ancel-Keys-Starvation.pdf

2. Gwyneth Olwyn, Homeodynamic Recovery Method: https://edinstitute.org/blog/2013/3/31/homeodynamic-recovery-method-guidelines-overview

Navigating recovery…recovery beyond Eating disorder “treatment”

Navigating anorexia recovery

I believe there are many milestones in eating disorder recovery. For starters the first day of entering recovery, this is always going to be the biggest. Monumental. Then after that there are thousands of milestones (some more like marathon check-points). Like the first time we conquer a fear food, and then reach the check point of there not being fear foods. So many. Getting your first period (if you lost it/never had), then its recurrence becoming so normal and boring and moaning about it like the general population. But what about when ‘our formal support’ becomes less required?

For those of us fortunate enough to have quidance, follow a treatment plan or having a coach etc, maybe it helps path the way. But, regardless for the most part, your recovery belongs to you. Own it!

I graduated from “regular recovery support” today. Feel like I have my big girl pants (pun very much intended). I have completed CBT-E, MANTRA and have now reached a point with my therapist (OT) to move to “check-ins” rather than scheduled, regular sessions or following some kind of plan.

I know for some people navigating the world beyond regular support, is scary and daunting. I get it, it means YOU are accountable for the ongoing recovery process. But that’s pretty cool right? You have gotten far enough into recovery to be able to make healthy decisions for your recovery. You’re moving towards full recovery and this is another check-point smashed!! That’s the way I’m viewing it. Part of recovery is learning to “cope” in an informal way, that’s life.

Just because my ‘regular’ sessions are finished does not mean I can’t continue growing my support network or learning. One of the things I’ve recently found to be instrumental to my mental shift is connecting with others who have had similar struggles, are struggling or recovered. There is tons of support, whether it’s real connection, following people’s blogs, podcasts or joining a support group, they all help to validate how we feel and strengthen our healthy self. So I’m not nervous about not having regular appointments. I’m proud I’ve gotten here. I’m grateful. If I can get here, I believe anyone can, because I never believed it at the start.

However, I am anxious regarding the next challenge in my life. Something I think for anyone who hasn’t had an eating disorder finds challenging anyway. That’s getting pregnant, becoming a parent. This is another area I think in medicine that doesn’t get spoken about or shared much. What happens when someone in recovery gets pregnant? Is it wise? Should O&G teams be aware? Do they ask or look for history of eating disorders?

I wanted to wait until I was solid into my recovery and even still I worry. I worry if the child will be small, pre-term, miscarry. Will I stay on track?

For my partner and me, having a family has been something we have always wanted. For reasons not related to my eating disorder, fertility is a difficult issue which I won’t go in to.

We are about to embark on IVF. This is something I haven’t entered into lightly, I’m all too aware of what’s required in the IVF process, the follicle stimulation, multiple hormones. This I’m sure is hard in a normal setting, but for those of us with significant body image issues to begin with, these issues need to be factored into planning. Hopefully help prepare the person for the changes and enable them to remain accountable. Support, hopefully can help to prevent slips.

Next issue, if we are fortunate enough to get pregnant… avoiding energy deficit. Some people experience nausea (both during fertility treatment and then in pregnancy). Hyperemesis gravidarum (aka morning sickness) this is not a good situation for someone with a restrictive eating disorder. Breast feeding post-partum.

Our bodies change throughout pregnancy. This is a fact. Something I am trying hard to prepare for. I feel going through the weight-restoration phase of recovery helps this, perhaps. My body has changed beyond any prior recognition and that’s ok, and I don’t even have a baby to care for and love. Or to explain my pregnant looking belly, aka recovery belly. I like to think that having a child will mean that none of the ‘HH’ thoughts will matter, because that child will be the most important, most amazing achievement I will ever have. But I wanted to share this because people with eating disorders go through pregnancy. It never gets spoken about and I don’t know whether we look for it in medicine. I think people could have help and support. I expect there are many people with eating disorders too afraid to share their struggle with the medical team, for fear of judgement, lack of understanding. What will I do?

Not really sure what the point of this post is, other than I’m happy to be here. I hope if you’re reading this and perhaps your treatment has just ended and you’re freaking out, or you’re starting recovery alone or with help, you can just know that there’s support available. Support doesn’t have to be formal or structured and remember celebrate the milestones. Navigating this is like an ultra-marathon but with no clear finish line.

Some online support groups and resources….

1. Beat eating disorders UK: https://www.google.co.nz/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjxuaHD3a7tAhX2yDgGHUGiCXcQFjAAegQIAxAD&url=https%3A%2F%2Fwww.beateatingdisorders.org.uk%2Fsupport-services%2Fonline-groups&usg=AOvVaw2LpFetlZFjVyKJ6Sg1WWaX

2. Recovery warriors (Australia):eatingdisordersqueensland.org.au

3. Various options US: https://centerfordiscovery.com/groups/

4. EDANZ: New Zealand. Various resources. https://www.ed.org.nz/parent-carer-support-groups