It’s not about what you are doing

Since I have a serious Dr. Drew Pinsky addiction (irony intended), I was really sad when his podcast was cancelled.  Thankfully, Celebrity Rehab 2 and Sober House came out shortly after the podcast ended, so I was able to watch those repeatedly for awhile. When VH1 stopped running CR2, I read his books.  Now, having exhausted all of those Dr. Drew resources, I am listening to Loveline.  This kills me a little bit, for several reasons:

1. It’s called Loveline
2. Half of it is sex talk
3. I have to pay $5 a month for it!

Still… It’s Dr. Drew, so I have to do it.  There are calls about addictions and psychological issues, and listening to his responses to those questions is worth my $5.

Dr. Drew had a particularly great quote today:

“It’s not what you’re doing, it’s what you’re missing – and you deserve better.”

The quote was not in relation to alcoholism or eating disorders, but it really hit home with me.  Yes, you need to get better because it’s important to take care of yourself, people care about you, you should care about you, you want to be healthy, it’s pathological, etc.  But also, when you are wrapped up in the ED you are missing life.  Maybe that’s semi-intentional; maybe you’re avoiding life.  You might think you’re just coping with life in an unhealthy manner, but you really are missing it.

You’re missing:

1. Close relationships with friends
2. Many normal social situations (getting pizza, going out for lunch, meeting for a drink, getting ice cream for no reason)
3. Good experiences (as well as bad experiences) that shape you as a person

I can think of a lot of things that I “missed”

1. Close relationships with HS friends
2. Trying anything new (for most of my life)
3. Getting ice cream with friends
4. A lot of summer cookouts
5. Trips I wouldn’t go on because there would be too much food or b/c I was depressed & wanted to stay home
   (okay, this is a depressing list so I’m going to stop here)

I think that eating disorders are as much about avoiding life as they are hurting yourself.  First there is all the time that you spend wrapped up in the disorder.  You’re isolating, avoiding events with food, and spending 90% of your day thinking about food and weight.  You have no idea what is going on around you.  And then there’s treatment, which takes up even MORE time… because along with the continuing disordered behavior (it’s not going to go away overnight), you now also have a dietitian, a therapist, a doctor, a psychiatrist (and this is assuming that you don’t really put your life on pause to go to a residential or partial hospitalization program).  You are spending your free time in treatment.  And I don’t know about you, but when I’m working on tough stuff in therapy, I have a harder time dealing with the rest of life.  When I’m upset about whatever my therapist said two hours ago, the last thing I want to deal with is a presentation that’s due tomorrow.  So yes, even in recovery, you are avoiding / escaping / missing (whatever you want to call it) your life.

It’s kind of ironic when you think about it.  You spend so much time in therapy trying to change behaviors, discussing why you are coping with life via your ED, identifying unhealthy aspects of your career and relationships, etc.  However… how much time do you spend talking about what you’re missing?

And for awhile, this is the point.  Maybe something in your life is not okay.  Maybe there is too much on your plate, maybe you are in a bad relationship, maybe you do need to change your job, maybe you are killing yourself trying to please everyone else in your life–whatever.  One of the best things about residential (I think) is that you don’t have to deal with the real world while you’re in treatment.  I can just focus on myself and what I need to be doing without the constant stress and anxiety of bills, relationships, responsibilities, work, money, and the list goes on.

However, I am not new to treatment, and neither are several of my friends.  And while I do worry about their health and their symptoms, what really makes me sad is what the ED takes away from them.  For one friend, it takes away time and energy that she would rather be spending with her children.  For another, it limits her career because work has to be planned around the ED and ED treatment.  Another friend has to put relationships, summer plans, and a lot of the life that she has created in the past year on the side right now to get more intense help.

All of these friends are making the right choices to work on the eating disorder and to get the help that they need!  Absolutely.  Friend #1 can’t take care of her family if she isn’t taking care of herself, Friend #2 won’t be able to put the energy and concentration into the job that career that she really wants until she is healthier, and Friend #3 won’t be able to maintain that life if she doesn’t do intensive treatment.  My point is, though, that what saddens me the most about these friends is not their concerning ED symptoms, but all the things that they are missing out on in their lives.  They’re such wonderful people and are meant to do so much more in the world than they can with this eating disorder.  They deserve so much more out of life than this eating disorder, and that’s why I hope they can get better.

It's not about what you are doing

Since I have a serious Dr. Drew Pinsky addiction (irony intended), I was really sad when his podcast was cancelled.  Thankfully, Celebrity Rehab 2 and Sober House came out shortly after the podcast ended, so I was able to watch those repeatedly for awhile. When VH1 stopped running CR2, I read his books.  Now, having exhausted all of those Dr. Drew resources, I am listening to Loveline.  This kills me a little bit, for several reasons:

1. It’s called Loveline
2. Half of it is sex talk
3. I have to pay $5 a month for it!

Still… It’s Dr. Drew, so I have to do it.  There are calls about addictions and psychological issues, and listening to his responses to those questions is worth my $5.

Dr. Drew had a particularly great quote today:

“It’s not what you’re doing, it’s what you’re missing – and you deserve better.”

The quote was not in relation to alcoholism or eating disorders, but it really hit home with me.  Yes, you need to get better because it’s important to take care of yourself, people care about you, you should care about you, you want to be healthy, it’s pathological, etc.  But also, when you are wrapped up in the ED you are missing life.  Maybe that’s semi-intentional; maybe you’re avoiding life.  You might think you’re just coping with life in an unhealthy manner, but you really are missing it.

You’re missing:

1. Close relationships with friends
2. Many normal social situations (getting pizza, going out for lunch, meeting for a drink, getting ice cream for no reason)
3. Good experiences (as well as bad experiences) that shape you as a person

I can think of a lot of things that I “missed”

1. Close relationships with HS friends
2. Trying anything new (for most of my life)
3. Getting ice cream with friends
4. A lot of summer cookouts
5. Trips I wouldn’t go on because there would be too much food or b/c I was depressed & wanted to stay home
   (okay, this is a depressing list so I’m going to stop here)

I think that eating disorders are as much about avoiding life as they are hurting yourself.  First there is all the time that you spend wrapped up in the disorder.  You’re isolating, avoiding events with food, and spending 90% of your day thinking about food and weight.  You have no idea what is going on around you.  And then there’s treatment, which takes up even MORE time… because along with the continuing disordered behavior (it’s not going to go away overnight), you now also have a dietitian, a therapist, a doctor, a psychiatrist (and this is assuming that you don’t really put your life on pause to go to a residential or partial hospitalization program).  You are spending your free time in treatment.  And I don’t know about you, but when I’m working on tough stuff in therapy, I have a harder time dealing with the rest of life.  When I’m upset about whatever my therapist said two hours ago, the last thing I want to deal with is a presentation that’s due tomorrow.  So yes, even in recovery, you are avoiding / escaping / missing (whatever you want to call it) your life.

It’s kind of ironic when you think about it.  You spend so much time in therapy trying to change behaviors, discussing why you are coping with life via your ED, identifying unhealthy aspects of your career and relationships, etc.  However… how much time do you spend talking about what you’re missing?

And for awhile, this is the point.  Maybe something in your life is not okay.  Maybe there is too much on your plate, maybe you are in a bad relationship, maybe you do need to change your job, maybe you are killing yourself trying to please everyone else in your life–whatever.  One of the best things about residential (I think) is that you don’t have to deal with the real world while you’re in treatment.  I can just focus on myself and what I need to be doing without the constant stress and anxiety of bills, relationships, responsibilities, work, money, and the list goes on.

However, I am not new to treatment, and neither are several of my friends.  And while I do worry about their health and their symptoms, what really makes me sad is what the ED takes away from them.  For one friend, it takes away time and energy that she would rather be spending with her children.  For another, it limits her career because work has to be planned around the ED and ED treatment.  Another friend has to put relationships, summer plans, and a lot of the life that she has created in the past year on the side right now to get more intense help.

All of these friends are making the right choices to work on the eating disorder and to get the help that they need!  Absolutely.  Friend #1 can’t take care of her family if she isn’t taking care of herself, Friend #2 won’t be able to put the energy and concentration into the job that career that she really wants until she is healthier, and Friend #3 won’t be able to maintain that life if she doesn’t do intensive treatment.  My point is, though, that what saddens me the most about these friends is not their concerning ED symptoms, but all the things that they are missing out on in their lives.  They’re such wonderful people and are meant to do so much more in the world than they can with this eating disorder.  They deserve so much more out of life than this eating disorder, and that’s why I hope they can get better.

Do not pass Go, Do not collect $200

“I don’t want to play the rehab game anymore”

— Jeff Conaway, Celebrity Rehab 2

While I never thought I’d say this, on some level I can relate to Jeff (putting “treatment” or “recovery” in place of “rehab” in that statement). Treatment and/or recovery sound like a great idea–at least in theory. You go to therapy and talk about things that bother you. Get a dietitian’s input on what you’re eating. Relate to others with eating disorders in ED groups. Take a break from the other stressors in life to focus on yourself. Maybe draw some pictures in art therapy. Try yoga. Get medication that makes you feel better. Doesn’t sound too bad–right?

After some time, you hit a point where the “recovery game” isn’t so fun anymore. You are uncomfortable with your meal plan and with the weight that you are gaining. You don’t want to talk about certain things in individual therapy and the other people in group are triggering or frustrating. You’ve drawn the same picture in art therapy three weeks in a row. The new medications are making you drowsy, dizzy, irritable, etc. And most of all — You are missing things in your life that you want to be a part of.

I think that recovery can feel like a game at first because it is so different from the rest of your life. It’s nice to have others care about your wellbeing and there’s something about treatment that gives you permission to take care of yourself. Plus, there is so much positive reinforcement (gold star for following your meal plan over the weekend!). All of this doesn’t sound so bad… and I do believe you can make progress — even with this mindset.

When does the game end? Personally, I think this is when the disorder starts to feel threatened. There is something scary about recovering, and suddenly it doesn’t sound like a great idea anymore. I understand the panic that Jeff is experiencing.

However, because I do not struggle with a drug/alcohol addiction, it’s also easy for me to see that he has a long way to go in his recovery. His motivation to quit rehab is fueled by his addiction (and probably a lot of fear). It’s much harder for me to identify eating disordered thoughts. Treatment can be so tiresome–especially if it lasts for years. Jeff’s excuse for quitting is that he needs another back operation. I have plenty of excuses, too: I’m not underweight, I am so much better than before, I’m not getting anything out of therapy and need a break, I don’t think that therapy is the answer, there’s nothing that a dietitian can teach me (that I haven’t been told before), I have a life to get back to, etc.

I think that this is the point where you have to change your mindset and treat the ED as the life-threatening disorder that it is. Just going to appointments and sitting in groups isn’t going to make it go away — you are looking at necessary life changes. Your desire to quit is motivated by the eating disorder.

Treatment can feel like a never-ending game of Monopoly… and I don’t know about you, but Monopoly is not fun for me after the first couple of hours.

Dr. Drew should treat eating disorders

Just finished watching Dr. Drew’s Celebrity Addiction Special… and I’ll be the first to admit that I love Dr. Drew. I think that he is insightful, sensitive, non-nonsense, and passionate. I also think he has said one of the most true things about addiction: “You are as sick as your secrets.”

Eating disorders are different from drug / alcohol addictions, but there are definitely a lot of similarities. There are a lot of components of addiction treatment that I believe in and think are important, and should be applied to eating disorders:

Recovery is a lifelong, daily process — You may not struggle with food every day (heck, you could go years of being A-OK with it), but there’s always that risk. You don’t have the luxury of playing food games (and by playing food games, I mean even casual diets or schedules that don’t allow for normal eating). I would compare “I can have a couple of drinks” with “I can lose a couple of pounds.”

Denial, and not necessarily that you have a problem, but that you need help — Denial with EDs is particularly tough because they are not as black and white as other addictions… At what point does a lot of food become a binge? Where’s the line between health-consciousness and disordered eating? You may somehow know that your thoughts and behaviors aren’t completely normal… but not to a point where you require help. You’re still trying to convince yourself that you’re okay enough or that you can handle this on your own.

The importance of personal accountability — All the support in the world isn’t going to help you if you don’t take responsibility for the disorder. This means somehow sidestepping or pushing past the denial. No one is going to monitor your food intake forever, or follow you to the bathroom forever. If you’re not in a place where you can hold yourself accountable, then this means being responsible enough to arrange necessary help and support.

There’s no magic cure — 30 days of residential treatment doesn’t mean you’re recovered. Simply attending therapy doesn’t somehow fix things.

The disorder should be taken as seriously as any potential fatal disease — I really think that with eating disorder treatment, “slips” are much more tolerated and accepted than in addictions treatment. You can really get away with only putting forth a half-ass effort, because treatment isn’t necessarily your top priority. With drugs and alcohol, using once or twice is a big deal. With eating disorders… skipping a couple meals or losing a couple of pounds = not a big deal.

I personally find it interesting that you can dismiss so many little eating disordered things, because hey — people diet, you’re doing pretty well, it’s only a couple of pounds, purging every other month is insignificant compared to 3 times a day, etc. I respect Dr. Drew a lot because I always feel that he is saying, “no, these little things count — recovery is so important that any signs of disorderedness are significant.”

You are only as sick as your secrets…