Sharing therapists

I’ve been in all different levels of treatment with numerous professionals and various treatment centers, and overall I’d have to say that both group and individual therapy are important (and beneficial) in recovery.  With group, there are several people who you can bounce ideas off of, get advice from, relate to, and rely on for support.  I feel like most of the real therapy work happens in individual, though, where you can focus on your specific issues, goals, etc.  I really do think it helps to have both individual and group components to your treatment plan, though.

This said… something that has always thrown me off is having my individual therapist as my group therapist.  This has happened to me a couple of times, in residential, IOP, outpatient, etc.  It changes the dynamic for me for a couple of reasons:

1. Every time I said something to the group I though, “has she heard this already?  did I tell her this before?”
2. I read (too much) into the things that she said
3. If I were having a bad day, she usually noticed
4. I wondered if there would be repercussions to the things I said (for example, I didn’t want to mention something in passing and have to spend the next two individual sessions processing it).
5. I worried that I’d treat group like an individual session and spend too much of the total time focusing on my own issues

These aren’t all bad things.  It’s good that my therapist would recognize that I was having a crappy day, since I likely wouldn’t have brought it up and the therapists who didn’t know me as well probably didn’t know anything was not right.  She also probably pushed me a little harder, since we did have a relationship and she could do that comfortably.  So, for the most part, it was good for me to have some groups with my individual therapists.

With all of this said, where things start to get a little messier is when other people in the group also share the same individual therapist.  I’ve been in some programs where everyone had the same primary therapist and others where there were a handful of individual therapists that also ran groups.  Both situations add that extra variable to the equation – sharing a therapist with another person in your group.

The therapeutic relationship is so unique that sometimes I think it can be challenging to “share” your therapist with someone else that you know.  I’m not concerned about the confidentiality as much as the dynamics of the relationship.  As the patient, you only have one therapist.  When you have a good relationship, it feels special.  You feel like you have this connection that maybe other patients don’t have.  It makes sense – every week you are confiding in this person, trusting him/her to guide you and to give you some insight.  This relationship and person mean something to you.  He/she is a part of your life.

Being in a group with your therapist and another one of her patients is a reminder that you’re not the only patient.  You know this logically, but the reminder can be kinda tough.  Sometimes it’s rough to see her concerned and focusing on someone else.  It can feel invalidating.  It can feel like a competition between you and the other patient.  It can be hurtful if you feel like you’re being ignored or that your interaction with the therapist is different.  It really adds a dozen additional variables into the therapeutic relationship equation.

There are a lot of things that make eating disorder groups tough.  Girls get competitive over eating, weight, exercise, etc – even if you don’t allow talk about numbers.  You have to be careful who you put in a group together, and even having one or two pretty anti-recovery people can change the whole atmosphere.   Sharing a therapist with several of the girls almost adds another thing to compete over.  Even if you refuse to participate in the competition to get the most attention or require the most concern (really, these competitions exist!), it can be hurtful to to feel neglected or uncared about.  I don’t think this is a topic that is often addressed in groups… but I think that sharing a therapist with other girls, and all being in the same group together led by your primary therapist, can be a little tricky…

Alternative coping – a tough sell

I thought that these quotes would be especially appropriate after my series on coping skills.

Dr. Meredith Grey: In the hospital, we see addiction every day. It’s shocking, how many kinds of addiction exist. It would be too easy if it was just drugs and booze and cigarettes. I think the hardest part of kicking a habit is wanting to kick it. I mean, we get addicted for a reason, right? Often, too often, things that start out as just a normal part of your life at some point cross the line to obsessive, compulsive, out of control. It’s the high we’re chasing, the high that makes everything else fade away.

Dr. Meredith Grey: The thing about addiction is, it never ends well. Because eventually, whatever it is that was getting us high, stops feeling good, and starts to hurt. Still, they say you don’t kick the habit until you hit rock bottom. But how do you know when you are there? Because no matter how badly a thing is hurting us, sometimes, letting it go hurts even worse.

I’ve talked about this before, but I think that wanting to want to recover is a big roadblock in eating disorder treatment. Meredith explains it very well — we get addicted for a reason. The ED plays a role in our lives. You don’t go seeking an eating disorder… but for whatever reason (I’m sure largely biological), coping via food / exercise works for you. Restricting did give me some kind of a high, but more importantly it did make “everything else fade away.” Of course it didn’t SOLVE any issues… but it did somehow mask them and make them less important to me.

The eating disorder doesn’t “work” for me like it used to. It doesn’t give me that relief that I’m looking for. It doesn’t make stressors go away. 10 years ago, I felt some kind of sick accomplishment from restricting. Like somehow not eating made everything better. These days, maybe it deadens things a little bit, but largely it throws off my blood sugar and makes me feel like crap.

I’ll admit that for whatever reason, in many situations it’s still my first instinct to use the ED to cope. All the coping mechanisms I mentioned are attempts to replace the disorderedness with something healthier. But really, it takes three “healthy” coping mechanisms to offset one unhealthy one. The kudos chart is an everyday thing and a bad day might require coloring AND card shops.

I think a lot of people struggle with feeling like they still need their ED. Even if it is kinda ruining their lives and not working like it did in the past, they still feel like they won’t be able to deal without it. If you’re trying to replace that disorderedness with bubble baths and crafts — well, that’s a tough sell.

I’m not saying it’s not worth it or that EDs are just unhealthy coping skills… I’m just saying that recovery takes a lot of coping skills.  You burn some of them out (for instance, reading does not help me like it used to) and have to be creative and come up with new ones.  And sometimes they feel ridiculous.  Heck, I’m in my mid-20s and googling “print complicated coloring pages.”  My kudos chart is remarkably similar to the sticker chore chart that I had when I was seven.  I’m not sure any of this is “normal,” but hey, it helps.  Ridiculous or not — just go with it.

Underrated coping skill: card stores

This is the second post in the Grey Thinking series, Five of the most underrated coping skills.

I don’t know why more people don’t hang out in card stores.  Just think about it… when you have a friend that’s upset, it’s not uncommon to send them some kind of “cheer up / feel better” card.  So, if you’re upset… doesn’t it just make sense to spend an hour in a card shop and read 100 of those?

I know that there is more to getting cards than the card itself (say… the thought behind it), but funny cards make people feel better.  I scan the aisles at Barnes & Noble nearly weekly for new stickmen cards and can’t help but laugh at Hoops & Yoyo.  Card stores are just a win-win for everyone.

A Treatment Refresher

While I do have several new posts on the way, I want to highlight a couple of older Grey Thinking posts (some are several years old!  I bet you were not reading GT two years ago) that talk specifically about treatment, your attitude toward treatment, recovery expectations, etc.  While there are a couple of people that I have in mind when it comes to the subject of these posts, I think that everyone can use the refresher.

You as your own case manager
Originally Posted: 01/01/2009

I wish that all these guys were going to stay clean, I really do. I’ve just seen it so many times that I can tell when someone’s really willing to do whatever it takes and when someone’s willing to do what they think it should take. And it’s just not going to work like that, unfortunately.

–Shelly, Celebrity Rehab with Dr. Drew 2

Wanting to want to recover
Originally Posted: 06/12/2008

Motivation to change implies an intention–weak or strong–to change one’s behavior. However, AN patients may at the same time both wish to recover and be highly resistant to change their behavior. Therefore, we suggest that assessment of motivation in these patients should include not only their motivation to change, but also their different wishes to recover which do not necessarily imply a behavioral intention.

Dr. Drew should treat eating disorders
Originally Posted: 07/01/2008

There are a lot of components of addiction treatment that I believe in and think are important, and should be applied to eating disorders:

1. Recovery is a lifelong, daily process
2. Denial, and not necessarily that you have a problem, but that you need help
3. The importance of personal accountability
4. There’s no magic cure
5. The disorder should be taken as seriously as any potential fatal disease

Do not pass Go, Do not collect $200
Originally Posted: 12/09/2008

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

– Jeff Conaway, Celebrity Rehab 2

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 don’t want to play the rehab game anymore”

– Jeff Conaway, Celebrity Rehab 2

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.

You say that like it’s a bad thing

Chase: How would you feel if I interfered in your personal life?
House: I’d hate it. That’s why I cleverly have no personal life.

If you replace “personal life” with “personal issues,” I could have written those lines (although much less eloquently and using three times as many words).  It’s much harder to be hurt when you just don’t have issues–right?

Along the same lines, Chase and House have another conversation later in the show:

Chase: Why does everybody need to know my business?
House: People like talking about people. Makes us feel superior. Makes us feel in control. And sometimes, for some people, knowing some things makes them care.
Chase: I’d tell you my dad left, my mum drank herself to death… you gonna care about me more?
House: Cameron would. Me, I just like knowing stuff. [pause] I know you hate your dad, but I’m gonna tell you something –
Chase: I don’t hate him. I loved him until I figured out it hurts a lot less to just not care. You don’t expect him to turn up to your football match? No disappointments. You don’t expect a call on your birthday, don’t expect to see him for months? No disappointments. You want us to go make up? Sink a few beers together, nice family hug? I’ve given him enough hugs. He’s given me enough disappointments.

If you don’t care — or can dismiss anything unpleasant as being a nonissue — then it’s much harder to be hurt.  Isn’t that convenient?

However, notice that House does not have many friends (…and poor Wilson!).  He’s semi-miserable and no one can ever make him feel better.  Even the drugs aren’t doing it.

Okay, so I’m not House, but I am pretty good at always being okay.  I hate the thought of others suspecting that there’s something wrong.  I told my therapist the other day that it literally HURTS to be not-okay in front of someone else.  It’s hard for me to explain why, but I just hate it.  I would respond just like Chase: “Why does everybody need to know my business?”  My mantra is, “If said person is not really in my everyday life and is not someone that I need to turn to for support, then why do they need to know if I’m struggling?”

“I don’t care” is in a way an ugly way of saying “I’ve reset my expectations.”  Chase’s dad was never going to be reliable.  He wasn’t going to play the father role that Chase needed.  He learned that and adapted.  Personally, I think that’s a relatively healthy response (especially if the alternative is continually being re-upset every time you dad doesn’t show up, for the rest of your life).

I think that it’s important to find support in other places if you can’t get it from your parents.  That said, I also don’t think you can get over the loss of that relationship 100%.  He still wishes that things could be different between them, and he was bothered by his dad’s being there because it is still a sore spot for Chase.  Having a hundred caring friends is still just not the same.  You try and get the support that you need from other people, and that does help.  And you grieve the loss of that relationship, which sucks, but also helps.  But…. still, that longing does not completely disappear (okay, clearly I am talking about myself now and not so much Chase).

My point of all of this (which I am not doing a good job of expressing) is that just not caring does have its advantages.  Life is much simpler when everything is “okay.”  You’re not disappointed if you set the bar low.  However, by lowering your expectations like this, you are also isolating yourself more.  It gets lonely and frustrating when you won’t let others in.  Because I can’t stand the thought of struggling when out with others, I am left to deal with all of the emotions on my own.  By eliminating the possibility of being disappointed, I think that I also eliminate my chances of feeling better.

When I think about all of the people that I care about, the ones closest to me are those who know what’s going on in my life.  We talk about more than just coffee, the weather, our pets, television, work, etc.  It’s that humanness of NOT always being okay that makes us care about one another.  While it is definitely adaptive in some circumstances to re-evaluate what realistic expectations for that relationship are, I personally can’t turn that caring / trusting thing on and off.  Chase did have an honest conversation about the relationship he has with his dad (albeit, the conversation was not his idea and it was with House…), and they clearly left on a better foot than they started on.  I think he feels at least a little bit better.  House, who has “no personal life,” though, likely went home and sat his couch by myself, popping vicodin.   Having no personal life is not that clever.

You say that like it's a bad thing

Chase: How would you feel if I interfered in your personal life?
House: I’d hate it. That’s why I cleverly have no personal life.

If you replace “personal life” with “personal issues,” I could have written those lines (although much less eloquently and using three times as many words).  It’s much harder to be hurt when you just don’t have issues–right?

Along the same lines, Chase and House have another conversation later in the show:

Chase: Why does everybody need to know my business?
House: People like talking about people. Makes us feel superior. Makes us feel in control. And sometimes, for some people, knowing some things makes them care.
Chase: I’d tell you my dad left, my mum drank herself to death… you gonna care about me more?
House: Cameron would. Me, I just like knowing stuff. [pause] I know you hate your dad, but I’m gonna tell you something –
Chase: I don’t hate him. I loved him until I figured out it hurts a lot less to just not care. You don’t expect him to turn up to your football match? No disappointments. You don’t expect a call on your birthday, don’t expect to see him for months? No disappointments. You want us to go make up? Sink a few beers together, nice family hug? I’ve given him enough hugs. He’s given me enough disappointments.

If you don’t care — or can dismiss anything unpleasant as being a nonissue — then it’s much harder to be hurt.  Isn’t that convenient?

However, notice that House does not have many friends (…and poor Wilson!).  He’s semi-miserable and no one can ever make him feel better.  Even the drugs aren’t doing it.

Okay, so I’m not House, but I am pretty good at always being okay.  I hate the thought of others suspecting that there’s something wrong.  I told my therapist the other day that it literally HURTS to be not-okay in front of someone else.  It’s hard for me to explain why, but I just hate it.  I would respond just like Chase: “Why does everybody need to know my business?”  My mantra is, “If said person is not really in my everyday life and is not someone that I need to turn to for support, then why do they need to know if I’m struggling?”

“I don’t care” is in a way an ugly way of saying “I’ve reset my expectations.”  Chase’s dad was never going to be reliable.  He wasn’t going to play the father role that Chase needed.  He learned that and adapted.  Personally, I think that’s a relatively healthy response (especially if the alternative is continually being re-upset every time you dad doesn’t show up, for the rest of your life).

I think that it’s important to find support in other places if you can’t get it from your parents.  That said, I also don’t think you can get over the loss of that relationship 100%.  He still wishes that things could be different between them, and he was bothered by his dad’s being there because it is still a sore spot for Chase.  Having a hundred caring friends is still just not the same.  You try and get the support that you need from other people, and that does help.  And you grieve the loss of that relationship, which sucks, but also helps.  But…. still, that longing does not completely disappear (okay, clearly I am talking about myself now and not so much Chase).

My point of all of this (which I am not doing a good job of expressing) is that just not caring does have its advantages.  Life is much simpler when everything is “okay.”  You’re not disappointed if you set the bar low.  However, by lowering your expectations like this, you are also isolating yourself more.  It gets lonely and frustrating when you won’t let others in.  Because I can’t stand the thought of struggling when out with others, I am left to deal with all of the emotions on my own.  By eliminating the possibility of being disappointed, I think that I also eliminate my chances of feeling better.

When I think about all of the people that I care about, the ones closest to me are those who know what’s going on in my life.  We talk about more than just coffee, the weather, our pets, television, work, etc.  It’s that humanness of NOT always being okay that makes us care about one another.  While it is definitely adaptive in some circumstances to re-evaluate what realistic expectations for that relationship are, I personally can’t turn that caring / trusting thing on and off.  Chase did have an honest conversation about the relationship he has with his dad (albeit, the conversation was not his idea and it was with House…), and they clearly left on a better foot than they started on.  I think he feels at least a little bit better.  House, who has “no personal life,” though, likely went home and sat his couch by myself, popping vicodin.   Having no personal life is not that clever.

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.

Positive self-help or self-hurt?

I’ve written several posts on the negative aspects of therapy as well as my disdain and frustration with positive self-talk, so I was pretty excited to see this headline: Study Shows The Negative Side To Positive Self-Statements In Self-Help Books

“…individuals with low self-esteem actually felt worse about themselves after repeating positive self-statements.”

“…paradoxically, low self-esteem participants’ moods fared better when they were allowed to have negative thoughts than when they were asked to focus exclusively on affirmative thoughts.”

Now, I don’t think I’ve ever claimed positive self-talk caused anyone to feel worse… but personally, I’ve never found it helpful as a coping mechanism. The results of the study do make some sense to me, though. Saying completely untrue statements like “I accept myself completely” make me feel further from that as a goal. I start to think, “Will I ever really accept myself completely? What’s wrong with me that I can’t right now? Does it matter if I do? Will I really feel better if I do?”

Also, the article makes a good point with being “allowed to have negative thoughts.” I think that often only positive affirmations are used in treatment in recovery. Things like “Everyone can get better,” “I know that you will beat this, you are such a strong person,” “You have too much potential to struggle with this forever,” “You’re making amazing progress,” etc. are all meant as motivational compliments. Maybe for some people they are… but again, I am backwards and actually feel a little invalidated when I hear how awesome I am doing in recovery. I don’t mind my therapist telling me I’ve made a lot of progress, but I do mind being told that I am doing great when I am feeling crappy. Additionally, sometimes I do worry that I will never get over this or that I will be considered “recovered” once I am 100% ideal body weight, regardless of whether or not I feel mentally/emotionally okay. I’d rather be told that she (therapist) knows that I am struggling and that she is there to support me, and that those fears are understandable becuase people do die from this illness or suffer from it their entire lives, but that I’m in treatment and working for something better than that.

I would love to see if there is a difference between others giving you affirmations vs. you creating them yourselves. I have a letter from an old therapist that says “you are more than enough” as well as a card from a different professional that says, “there are people who care deeply about you.” Both of these are comments that I could tell myself (I am lovable, my family and friends love me, etc.) but they are only significant because I care about and really look up to the people who gave them to me. I guess that’s what makes it so different from positive SELF-talk.

Numbers – a Catch 22

I read this post on Dads and Daughters With Eating Disorders: Eating Disorders – Weights & Scales

To summarize:

Because her health is directly related to her weight.  Measured by scales.
Her recovery is directly related to her weight.  Measured by scales.
Her life is directly related to her weight.  Measured by scales.
Weight matters.
And scales matter because they measure weight.

I posted a comment on this post, which hasn’t been approved yet, but I decided that I wanted to discuss the issue on Grey Thinking anyway.

Yes, weight is inexorably tied to health and to recovery.  Weight restoration is vitally important to recovery.  You can’t be recovered and still be below the healthy weight range.  Professionals need to monitor weight.  Some treatment decisions need to be made based on weight.  In short, I am not at all arguing that weight is unimpotant for recovery.

With all of that said… I find a lot of diagnostic criteria and treatment approaches to be contradicting and frustrating.  In therapy, you’re told that you are not a number.  That you are lovable regardless of what the number on the scale says.  That coping with food / weight is not okay.  That eating should be mindful and emotional eating is unhealthy.  You don’t have to be sick to deserve care.

But think — how is your health measured?

• weight, BMI, % of IBW
• calories, exchanges, % of meal plan completed
• heart rate, blood pressure, potassium, electrolytes
• # of binges / purges, # of laxatives, # of diet pills
• hours exercised

… see my point?  Everything is measured in numbers.

I have an issue with your mental health being measured in numbers.  From this point of view, gaining weight = a good week and losing weight = a bad week.  That has just never been a linear relationship for me.  I have bad weeks and gain weight, and vice versa.  Sometimes I follow my meal plan and lose weight, and other times I restrict and gain weight.  The system reinforces the necessity of communicating through your eating disorder.  If you’re feeling crappy but follow your meal plan, then obviously you weren’t really feeling bad — if you were, you would have restricted.  Plus, when you are at a healthy weight — ta da, end of treatment!  You’re all better!  Even if you feel as crappy as ever, you’re not sick anymore, so…..

Thankfully not all professionals practice this way, but measuring your progress in recovery by numbers is not unusual.  I feel strongly that weight is just a piece of the puzzle… and while weight and eating are core components to eating disorders, by basing treatment on just these factors you are really limiting treatment.  There are people who will stay sick because the system inforces that they need to be to get help.  And that’s unfair…