Saturday, 26 February 2011

Thoughts on recovery and treatment

I've been thinking about eating disorders and the fact that I haven't been 'in treatment' for quite a long time now; I'm five years out of hospital and I never had any kind follow up care, due to the fact that I went out of area and couldn't access their outpatient services because they were a private hospital and the PCT wouldn't fund any further treatment. Services back home slipped away as well, the psychiatrist I had before I went IP (and who I'd been seeing for the month or so before I got admitted to a NHS psych ward and the month between I got discharged from there and readmitted to Isham House) I never saw again.

I think I had a couple of sessions with a CPN that just didn't work out (family based therapy, bad idea!) but she eventually pulled out because 'I was the one making myself ill' and she literally told me that there was nothing wrong with me and that I was just being difficult for the sake of it and that I had 'behavioural problems' rather than mental health problems... (yeah, she was great <_<) she was also the same person who told me I'd be back in hospital within six weeks of being discharge so quite how two and two made four there I still don't understand...

So, I got discharged with nothing and it was over a year later that I went back to my GP's to be re-referred for my rapidly relapsing anorexia, she thought I was depressed and put me on Prozac and a few months later I went back to see the consultant who I saw right up until this summer. Unfortunately, he told me that despite the fact I was barely eating I wasn't in any real danger and didn't need treatment until my BMI was under 15... Even at my sickest literally dying point my BMI wasn't under 15 but these things tend to stick and affect the way that you think about yourself and your ED... I later had another relapse and pretty much begged to be referred to specific ED treatment and again got told that I wasn’t sick enough to ‘qualify’ for treatment, which is fair enough because treatment is limited, but at the time I did get treatment I really wasn’t ready to recover, I didn’t want to recover, and yet I got treatment from general psych and a specific ED unit and yet when I really did want to recover there was nothing out there for me...

Over the last couple of years under his care I have had quite a lot of treatment but it’s been largely focused on my Borderline Personality Disorder diagnosis; I went general psych ward a couple of more times for brief stays, did a mindfulness group therapy type thing, crisis house, day hospital, tonnes of different medication and Dialectal Behavioural Therapy. I had a care-coordinator who recently got suspended for malpractice, so working with her was nearly always counterproductive and often destructive, and I also had ‘regular therapy’ for about a year which I found fairly useful once I’d got into it but that was only really for the last couple of months before I finished with him. I did learn quite a lot from the sessions, about being good at other things than losing weight, and a lot of the day to day leftover crap that was good to talk about but I never really got to the bottom of my ED and lately I am wondering if it would be helpful or unhelpful to go down that road.

I’m doing a lot therapy wise right now, I really like the psychiatrist I see here in Leicester and find her incredibly easy to talk to and be honest and open with, I’m still in DBT (I finish at the end of April I think...) and I’m at rape counselling (thanks to said psych) and I know that the BPD stuff and the trauma stuff have some part to play on my ED but in all honesty, I see the BPD as a knock on effect of the trauma and my problems with food started years before any of that happened.

My gut reaction is that right now is that I wouldn’t benefit from dealing with what’s underneath the anorexia, talking about it would automatically make it a big part of my life again and I’m really growing to enjoy (Hell, fuck it!) LOVE the fact that it’s not a big part of my life at the minute. At least, it’s not unless it comes to my flatmate, it’s that that I seem to be struggling to cope with, rather than my own illness.

In all honesty, it has been getting on top of me but it's helping me enough to just be able to talk about it here; it's more about venting than anything else so that I'm not completely alone with this whole situation, and so that I’m not sitting with it all building up inside. I have had a couple of bad days, a few little slips, but think it just got a bit too much on those days and I feel like I'm in a better place to cope with it now because having that slip has completely reinforced why I want to keep on with recovery.

I've figured out a lot for myself over the last couple of years, I have a much better idea now of why I became sick, and one day maybe I will go back to therapy and resolve it, but for the moment I've made peace with it and that feels like enough.

Things really are so much better for me now than they've ever been. There is no way a few years back that I would have been able to live with another anorexic and not be jealous or compete but that thought hasn't even crossed by mind. I'm not happy with the situation but I am happy and proud of myself for the way I'm trying to deal with it. I guess I've got used to dealing with it on my own and in a way I feel like I have freedom and control doing it this way. I don't want to go back to the days where I would go to an appointment and it would all be about the ED... I know it's not perfect, I'm not in denial, I just want to keep its impact on my life to the absolute minimum, at least for the time being, but is that the best thing to do? Am I getting it all wrong?

I think I'm slowly learning how worthwhile recovery is and how pointless it is to go round in circles, bouncing from one behaviour to the next. In all honesty, there are still times that the only thing I want to do is lose a tonne of weight, and because I am overweight it can be easy to talk myself into it being a good idea but I really do understand how vulnerable I'd make myself if I devoted my entire life to losing weight.

It is something that I want, to get back to a healthy weight, but it's definitely something that I want to happen in the right way and for the most part I can cope with my body being the way it is. It's just much harder to rationalise the negative thoughts when you feel that they're justified ie I am medically overweight so I should lose weight or I eat too much so I should stop eating etc etc but I think I'm doing an okay job, it's been over a year since I used anorexic behaviours at all or bulimic behaviours regularly, and when I do slip and fuck up I feel awful about it rather than nostalgic and 'pleased' and since New Year I've even got a good handle on the binging, been eating regularly and get straight back up when I do fall down.

Seriously, there are things I want out of life that have nothing to do with food and weight and those things just keep growing all the time. I'm not denying that I still struggle to get that balance right and to have a 'normal' relationship with food but it doesn't impact the rest of my life like it once did. Food is food and weight is weight (whatever it is or isn't) and the everything else that's going on in my life is so much bigger than that.

Some days it gets me down or gets too much but most days it's just a small part of a much bigger picture.

1 comment:

  1. It is perfectly reasonable and realistic, to recognise that right now, you need more stability before you get under what caused the distress.
    DBT works on behaviours and stabilisation and then on the trauma.
    I also agree that services and lack of help to those who are not, literally, here, a BMI of even as low as 10 can be dismissed, it is shocking.
    I am proud of you Emma.
    I really am xxxx