But in the End one Needs more Courage to Live than to Kill Oneself~ Albert Camus

"Studies cited by the American Association of Suicidology (Holm-Denoma et al, 2008; Kaye, 2008; Keel et al., 2003) indicate that the suicide mortality rate of people with anorexia is one of the highest of all psychiatric illnesses. "

"Holm-Denoma et al. found that when individuals with anorexia decide to end their life, they typically use highly lethal methods, including jumping in front of moving trains, ingesting household chemicals, and self-immolation, indicating they truly wish to kill themselves and aren’t just sending out a cry for help."


"You knew this was going to happen.  You are not smart enough or pretty enough or interesting enough."

"Stop trying to believe that you are enough for him.  For anyone.  Men only want you for sex and then they leave.  You don't deserve any more than that, you ruined your family".

"It's all your fault.  You were weak and selfish.  You deserve to be punished."

"You will never be enough for anyone.  They will always leave you like you deserve.  Once they get to know you and what you did and then about me,  no one will ever love you.  You aren't lovable at all."  

"I am the only one who loves you.  I am the only one who will protect you from being rejected by others. Just keep doing what I tell you and people will think you are special."

"You can disappear.  Then no one can hurt you ever again."

"FAT!  UGLY!  WEAK! YOU TAKE UP TOO MUCH SPACE!  YOU AREN'T ENOUGH FOR HIM!  YOU NEVER WERE BUT IT JUST TOOK HIM AWHLE TO FIGURE IT OUT!  HE DOESN'T WANT YOU! YOU DON'T DESERVE LOVE! YOU DESERVE TO BE LIED TO! YOU DESERVE TO BE HURT! YOU DESERVE TO BE ALONE!"

After a dreadfully drunken phone-call that I can't even recall the slightest details from, I stumbled down the stairs whaling and desperate to make Olivia stop telling me what I already knew.  What I had just learned from my then-partner, whom I had been having relationship difficulties with both real and perceived.  

Not being able to tolerate even the slightest distress in my life, this was all too much to take.  I couldn't digest it.  I couldn't even come close to feeling the pain of rejection again.  

I was at my weakest, having disclosed my eating disorder to a trusted soul for the first time ever in almost 4 years of hell, and all I wanted to do was make all of the noise and the pain and the regret and the shame and the feelings of failure... and Olivia's brutal and unyielding derision STOP.  

Did I want to die?  No.  Honestly and truly, No.  Not at this point. 

I wanted to sleep.  I wanted to avoid the pain of being rejected, of discovering that Olivia was right and that I wasn't worthy or able to be someone that another could love solely.  Loyally.  Completely.

It was at this moment that I gave in and believed her.  It was this moment that I gave up the last shards of the healthy me who was sometimes able to emerge and save me from total self-destruction.  

I stumbled down the stairs and filled my coffee cup with more wine.  Then more.  Then more.  Then more, until the box (containing 4 750ml bottles) was nearly empty.  

I don't remember sending the unintelligible text messages to my dear friends who mobilized right away and came to my rescue.  I don't even know how I was able to send out the messages. 

Someone.  Something greater than Olivia and me took over and saved my life that night.  

I do know that I had not eaten anything substantial in almost three days, upon receiving an intolerable blow to my confidence in my relationship at the time.  

I do know that I did not tell a soul the pain I was in at that time, isolating and restricting, over-exercising and purging... drinking poison into a nutrient-deprived body, blocking my inability to calmly work out the bumps in my relationship that a clear-headed person would have been able to maneuver more gracefully.  

Putting on the false, familiar face that told the world I didn't need any help.  That everything was under control.  

"FAT!  UGLY!  WEAK! YOU TAKE UP TOO MUCH SPACE!  YOU AREN'T ENOUGH FOR HIM!  YOU NEVER WERE BUT IT JUST TOOK HIM AWHLE TO FIGURE IT OUT!  HE DOESN'T WANT YOU! YOU DON'T DESERVE LOVE! YOU DESERVE TO BE LIED TO! YOU DESERVE TO BE HURT! YOU DESERVE TO BE ALONE!"

I woke up in the ER, looking around at familiar, shell-shocked, concerned faces of the small army of support who left their own families in the middle of the night, to get me safely to care.  

Stephen, Peter, Erin, Karen, Felicity.  All there around my bed, as I faded in and out.  Shivering uncontrollably, having no idea that I should be thanking them or even grateful for their efforts.  

I had no idea where I was.  Or why I was there.  

I faded in and out.   I don't remember who stayed and who left.  I don't remember if I got there in an ambulance or a car.  

I never asked.  All I wanted was to sleep.  To make the pain stop.  

I do remember being driven home from the hospital in Erin's car.  Backseat.  Slumped over with my head in someone's lap.  Still drunk and woozy from whatever antidote I was most assuredly given for the poison I guzzled into my body.

It was morning now.  I was driven home in the daylight and I remember the buzz of voices in the car, planning the schedule of guards who would be sure that I was safe until I sobered-up.

None of them at this point, had any idea about Olivia or of the tumultuous events that were still to come.  

They didn't know that with the half-hour gap that they left open between when one of them left for work and the other could arrive to sit with me, that Olivia was working behind the scenes... remembering that there was still a second stash of wine.

Yes it was 8am.  It didn't matter.

"You are SO weak you can't even kill yourself properly!  There is more wine in the broom closet that no one found.  You can drink enough in a half hour to stop feeling this painful rejection.  It is starting to come back now.  You need to drink some more to make this pain stop.  We can't tolerate it!  You have to make it STOP!"

This I remember vividly.  I knew Stephen had left and that I had at least a half hour before Erin was coming because I heard them talking.  I wanted the pain to stop.  It was coming back with my lucidity.

I walked~ no, I ran to the broom closet and moved the bags that were hiding the second box of wine and filled my cup twice while standing there, quickly emptying it into my body to feel the warm dulling of the sharpness that started to jab brutally again at my soul, as thoughts of the prior evening's conversation began to mockingly re-emerge.  Remnants of the prior evening's self-destruction still flowing  throughout my body, desperate to once again dutifully obey Olivia's orders to cure this life. 

By the time Erin arrived, ready for her on-guard stint, most assuredly unable still to process what had happened the night before, I announced that I was going to take a shower.  

Before she arrived, I had managed to move the box of wine to my clothing closet, trusting her desire to afford me the dignity of privacy (not understanding Olivia's presence) .  

I filled my cup twice more (at least) before disappearing to the shower, purging the calories of the wine into the shower, understanding that the alcohol was already absorbed into my long-deprived body.  

I emerged from the shower, and took my place, sitting on the kitchen floor while Erin dutifully absorbed herself into the task Olivia hurled at her to develop a list of things I could do in my "free time' to take care of myself.  

At this point, my dear friend Erin was interested only in keeping me safe.  Keeping me company...doing what normal people would do to help a friend  sober up after an unusual mishap with a bota box.  

I sat, dizzy, while she sat at the barstools writing on a yellow-pad, visibly relieved to have a task to distract the attention from what had gone on in the previous hours.  

I remember this like a dream... as though it went on for hours but in reality, I believe I must have slept, or passed out again...

Karen arrived at some point.  I don't remember when or how or why.  

I remember remembering that there was more wine in my clothes closet.  I remember the moment I remembered that I had a newly-percribed bottle of anti-anxiety medication and faster-acting Clonazepam  in my bag that no one knew about except for Ken, who was at work in another town pretty far away and unaware of what was happening.

I remember taking two anti-anxiety pills then two Clonazepams at a time, washing them down with the coffee-cup filled with wine I had smuggled into the bathroom with me.  Over and over and over.

I remember going into the kitchen and talking to Karen and Erin like it was a regular afternoon (I have no idea what time of day it was.  I have no idea how much time passed between my shower and taking the pills).  

I remember a moment of panic as the last moments of consciousness persuaded me to text Ken to tell him I had taken the pills.  I didn't want to die.  He had no idea of the happenings the night before.  Yet he mobilized quickly to action. 

He didn't even know at that point, that I had been in the ER the previous evening.   Olivia is a master at concealing the ugliness of this disease.   

I remember going back to the closet a number of times (I don't know how many) before Ken received the desperate texts from me, and somehow got in touch with Erin, telling her that I was taking pills.  

This is where it goes blank.   When I think about it, it is like what it must be to swim underwater for longer than one should.  Slow motion.  Unable to breathe.  Eventually drowning in the warmth of the quiet stillness that lets one's soul float freely of pain, of regret, of shame.

I woke up shivering.  Absolutely freezing under three heated blankets in the ER once again.  Faces around me of my dearest friends...fading in and out.   Is it daytime?  Nighttime? Is this a dream? How did Ken get here so fast? Isn't he supposed to be working? I thought to myself??  

I was in the ER again.  For the second time in less than 24 hours. 

After Ken arrived, I blacked out again.

I woke up in ICU later with Ken standing next to my bed in his paramedic uniform.  The sun was out.  Is it still today?  

Is it tomorrow? 

I have no idea how much time passed.  An hour?  A day?  A week?

Ken urged me to eat the breakfast that was in front of me.  I was shaking.  I was still freezing.  I was still drunk.  

I drank some orange juice and a nurse came in to check my IV and my vitals.  

I vividly remember the helpless, desperate look on Ken's face as I rejected the food brought to me.  

He knew why.  He didn't understand yet at this point, because who would?  But he was the only one who knew that I had Anorexia.   

When you land in the ICU as the result of what looks like two suicide attempts in less than 24 hours, the hospital sends in a crisis worker to assess your mental health.  

Unfortunately, something I am extremely good at, is convincing others that I am safe and solid and stable.  

I convinced the mental health worker (who would later become a pillar of support for me in the subsequent dark moments that ensued) that I was not suicidal.  That I simply wanted to sleep and that I would be safe if released into the care of Ken.  

Ken, at this point, had  little idea of how very sick I was and sided with me, agreeing to take responsibility for me until I could secure an appointment with my counselor, who knew of my eating disorder and my lack of desire to address it.  (I was the only one who knew that.  Well, besides Olivia).

"If they send you to a hospital, they will make you gain weight and stop restricting.  You CANNOT, under any circumstances, let that happen!".

"Tell Ken... tell everyone that you are FINE!  Go back to work, keep studying for your CPA, and stop being so weak that you end up in a hospital again.  You have come so far.  Just keep listening to me and I will protect you from rejection.  From pain.  

That is exactly what I did.  

I was dying inside.  But I made everyone sure that I was just fine.  that the other day was just a result of over-exhaustion from studying so much.  

It was too easy.  Not that people aren't astute or intelligent, but that they truly want to believe that those they care about are ok.  It's not logical or rational or usual to act in such a way.  

Everything went back to normal.  Everyone (so I thought) went back to their usual lives (including me) believing that I was back on solid ground~ frightened of what I had done to the point that I gave my medication to Erin to dole out 7 pills at a time, giving up alcohol so that I could focus on therapy with my regular counselor, contrite and remorseful for the upheaval I had caused. 

"Phew... that was close.  You are SO pathetic that not only do you not deserve this relationship with Ken, but now your friends and daughters know that you are weak and sick." 

"You can never be the partner that Ken wants."

"You can never be the mother that your daughters deserve".

"You will never be able to pass the CPA exam ."

"You are so fat and lazy, you only ran one time today.  How will you ever make up for the carrots you ate today? There is no way you purged all of them."

"You don't deserve to go back to your life."  

"You are worthless and a failure.  You failed at being a wife.   You failed at being a mother.  You are going to fail at being a CPA.  You failed at being able to be in a relationship with Ken.  You didn't exercise enough today, you ate too many carrots today!  You didn't purge all of the carrots you ate today!  You are not enough....you are not enough... you are not enough....."

SHUT THE FUCK UP!!!!!!!

(to be continued)




"When the body weeps tears of blood, we need to wonder what terrible sorrows cannot be spoken. When food that had tasted good suddenly feels like poison and has to be purged from the body, we should wonder what traumatic experiences exist that cannot be contained, metabolized, and integrated. . . The body speaks of that which cannot be said in words, of secrets, lies, and trust that has been broken (Farber 2003, p.188)."

Red Flags for Relapse

I struggled with using this image.  In the end I decided to use it because I promised to keep things real.
I have been here.  Far too many times to count.  Heels, pearls and a pretty dress never kept me from purging or sadly, from passing out later in front of family and loved-ones.  This post serves to ensure that I never, ever feel so insecure that I resort to this measure to cope.
Ever again.

Relapse doesn't happen overnight.  

It is a series of decisions that I make in the face of stress or anxiety, to use eating disorder behaviors to cope with emotional pain.

The more consistently I choose them, and the more of them I employ to numb the emotions that I am determined to avoid, insecure of my ability to live through them, the more my Anorexia picks up steam and before I know it, I am back in Olivia's clutches~ biologically hog-tied and dragged back to a way of living that will only assure me a shortened version of it.

It is one thing for someone in recovery from Anorexia to look inside of themselves and take an honest inventory of what their own personal red flags are that would signal a slide towards relapse.

Sharing these embarrassing secrets with someone (or the entire blogosphere for that matter) is a step only one who is serious about staying in recovery would take.

It is in this spirit that I offer to you, an honest and uncensored list of behaviors I (used to) engage in that are clear (and sometimes subtle) signs I may be (am) relapsing.

Can it happen again? 

Yes, absolutely.

My recovery is still very much in its Spring Season.

But the likelihood of relapse decreases with each passing day that I choose not to engage in any of these self-destructive coping behaviors to deal with stress/anxiety, instead of the healthy alternatives that I am learning to employ in their place.

I have been doing everything differently this time.  I have never gotten this far in my recovery and I am nothing if not dedicated, tenacious and well...maybe a little stubborn.

I refuse to let my daughters down ever again.

I refuse to let my family and loved-ones down ever again.

I refuse to let myself down.

Ever again.

I am sharing this list knowing that people who know me will be reading it, building in accountability that one who lives without another adult isn't afforded.

I shared it privately with my co-worker who asked upon my return from treatment, how she could support me.

I shared it with my two running partners, one of which weighs me each morning to determine whether or not I should be allowed to exercise that day.  (If my weight dips even a few ounces, I will take the day off.)

I am sharing this list knowing that the people who love me will be on the lookout for any glimpses of a backslide, to keep me healthy and safe from the clutches of a potential relapse.

I am sharing this list knowing that some will shy away from me, or maybe even judge me a little after reading it.  I am not proud of any of these choices I once lived.  

I am risking sharing this list with all of you because I am serious about recovering.

For good.

1).  Skipping meals and snacks (even just one) claiming, "I'm not hungry" or "I already ate".

I might not be hungry, but this early in recovery, I have to eat on a schedule anyway.  I can't yet trust those internal cues.  They might be coming from a more sinister place.

2).  Messing with the timing of meals, saying that it is too late for dinner or putting off breakfast past 9am.

I need to stay on the following schedule:

7am-9am: Breakfast
2 hours later: Mid morning snack

12:00pm: Lunch
2 hours later: Mid afternoon snack

6-8pm: Dinner
(dessert is optional)

When I am pushing the timing of these meals and snacks, or skipping them all together, you can be certain that I am restricting and heading for relapse.  This is one of the biggest danger-zones for me.  

Red-flags numbers 1 and 2 will start the slide almost immediately, if I let these things happen even once.  

And if coupled with #8 (Exercising to the Extreme) these three behaviors are literally deadly to me.

3).  If the portions on my plate become increasingly smaller in size and/or I consistently do not finish what looks like a reasonable portion of food to you, I am beginning the road to restriction again.

4).  Avoiding entire food groups (i.e. carbohydrates, fats, sugar) stating that they aren't healthy for me.  

For many who don't have eating disorders, this is a logical thing to do.  For someone like me, with some very rigid food-rules, it is the top of the hill which slides quickly to relapse.  

In treatment, we learn that foods are not "good" or "bad", they are just food.  We are encouraged to eat a variety of foods, including those many consider "bad" foods, to face our fears and normalize our eating.

This is another one of the most certain signs I am relapsing.  It's tricky, because I love to eat healthy like most people, I just take it to the extreme.  One way to tell if I am engaging in this behavior is to watch that I am not cutting out the foods that I love (i.e. ice cream) again.  

It's an extremely slippery slope.

5).  Another sign of relapse that centers around food is that I eat the same foods for the same meals every day.  

Every single day. 

I do this because they are "safe" foods.  I don't fear them and since I have to eat, I gravitate towards foods I know the calorie counts for (because they are the lowest possible choices).

While this behavior doesn't represent restriction or purging necessarily, it serves to allow me to have one foot on the boat (recovery) and one foot on the dock (Anorexia).  

It's short living and it prevents me from living a full life of recovery.

It is the remnant of Olivia's voice whispering through the door, "just hold on to this one thing..."


6).  Leaving the table after a meal before 20 minutes have passed since my final bite.

If I couldn't purge within a 20 minute window, I wouldn't bother to do it.  If I get up from the table right after eating and make a determined dash to the bathroom, you might want to follow me.  

Purging is one of the things that I got really good at.  I could be very sneaky/quiet. 

 I did it at restaurants, my office, your house, the side of the highway, etc.  

In the clutches of Olivia, if the urge struck, I had zero power over her and before I could even think about trying to talk myself out of it, I would find myself in a trance-like state, bent over the toilet, and bringing up whatever I ate by gagging myself with a toothbrush.

Note:  I DO brush after meals, but when I do that, you can hear me brushing my teeth...

This is almost always followed by 100 push-ups, right there in the bathroom on the often-dirty floor.

Look at my eyes when I leave the bathroom.  I really can't cover up the glossiness that ensues, the puffiness around my glands and the suddenly-missing eye-makeup.

I'll probably tell you I had a sneezing fit.  I might even fake one, to explain away the toll purging takes on my appearance.

7).  If I am in the bathroom and you hear the water running for an extended period of time, or I flush more than once, I am probably up to no-good.

8).  Exercising to the extreme.

If I start running twice each day, or doing a high intensity interval training workout in the morning and then a run in the evening, I am heading quickly and decidedly for relapse.

Exercise is my drug of choice.  

It is second only to restricting.  

It brings me to the state of negative energy balance faster than restricting or purging alone.

I can drop weight faster than you can read this blog when I use exercise to cope with anxiety.

If you see me in the gym in the morning and then running again in the evening,  I am running headlong, straight into the lap of relapse.

I cannot teach spin class any longer because it triggers me faster than any other exercise, including running.  I miss teaching because I loved it.  I had a reputation for being  a "tough" instructor, but in reality, I am lucky that my students weren't injured.  

I took it to the extreme and brought my students along with me.  

During treatment, I was given a compulsive exerciser test.  I "passed" with flying colors.

"Do you exercise even when you are ill or injured"?  YES
"Do you organize your day around exercise?"  YES
"Do you feel low or depressed if you miss a workout?" YES
"Do you miss or arrive late for important family events because you have to exercise first?"  YES
"Is exercise a chore?"  YES
"Do you exercise to compensate for calories consumed?" YES
"Do you exercise during (ridiculously) inclement weather?" YES

There were a few more on the list that I can't recall, but the Recreation Therapist at Mercy told me one was considered a "compulsive exerciser" if they answered "yes" to only three of the questions.  

I checked "yes" for ALL of them.

And in my true, perfectionist, enough-is-never-enough form, I added some bonus points that weren't the list: 

I exercised in the middle of the night.  

I exercised 2 or more hours at a time (more than once a day).

I exercised on a completely (700 calories the day before, all purged at some point)  empty stomach...to dull the pain of it.

I exercised to be someone special~ for it became my identity and took away my "softness" so that I could become intimidating or at least, invisible to men.  

I am a classic compulsive exerciser.

Of all of the red flags for relapse, this is the one I have to fight the hardest.  

The one that can take me down the quickest.  

The one I need my dearest friends to hold my running-shoe-clad feet to the fire without ever giving me an inch.  

9).  Drinking with the sole purpose of becoming intoxicated.  

Like I am on a mission.

Considering that I hardly ever drank anything at all until I began trying to numb the pain of what I had done to my family when I lived in Carrabassett Valley, this one takes even me by surprise.  

I only do this when I am restricting/purging/over-exercising.  

Or rather, the detrimental effects of drinking are exacerbated (for me) when I am restricting/purging/over-exercising.

Or, maybe I start to restrict/purge/over-exercise when I am drinking heavily.

I'm still figuring this one out.  

All I know is that each time something really, terribly awful happened in my life since I developed Anorexia, it was the result of a long chain of events that included restricting/purging/over-exercising AND drinking.  

When my body-weight is restored and someone else (who is a professional) decides it's ok for me to have a glass or two of wine with dinner again, I will consider it.

Or maybe not.  I haven't decided yet.

For now, I will keep abstaining.

10).  If I start treating meal-times like a mathematical equation (i.e. you find little pieces of paper or odd numbers scribbled in the margins of books or on the backs of envelopes), I am counting calories. 

I only do this when I am trying to restrict and be below the magic number that keeps Olivia's tirades in check.  

11).  Body-checking.

This is the process by which Olivia berates me for my appearance, or for being the "biggest" girl in the room... (or praises me for being the thinnest...depending on where I am in my recovery).  

It is accomplished by catching a glimpse of my body shape/size as often as possible, making sure that nothing has changed weight-wise, since the last store window, or car-mirror that reflected back the distorted image which threatens to catapult me back to subscribing to Olivia's corrective plan.

"Body-checking" is dangerous for those of us with eating disorders because we didn't see what you saw when we were at the height of our disorders and even less so,  once our weight is restored.

For now, it is best for me to check out my outfit in the morning (making sure I didn't stuff my skirt into the back of my hose) with a quick glance and a positive affirmation at the ready.  

For now, I fight the urge to look when I pass by a reflective surface, as often and as hard as I can, relying instead on the input of people whom I love and trust.

12).  Comparing.

Body-checking and comparing are difficult for you to notice because they are battles being waged inside my head.

However, now that you know I might be doing this, I might as well tell you that passing by someone who is naturally thin almost never bothers me.  

Passing by someone who is likely Anorexic is another story all together.  

You can tell when this bothers me because I cannot hide it.  

You will notice the change in my demeanor because it (can) cause Olivia to throw her sharpest swords directly at my resolve, desperately looking for a way back inside. 

You will see the stress on my face.

13).  If you continually invite me out to do things that I once loved to do, and you find that I am always busy (especially if it involves dressing up or eating), I am probably isolating because I am relapsing into old behaviors.  

I share these Red Flags for Relapse with you in full disclosure.  

I spilled all of them.  

I didn't do that the first time through, holding back the "special" ones like exercising in the middle of the night, body checking and doing push-ups in the bathroom because I was not fully-committed to recovery.

I (Olivia) didn't want you to know everything.

When I am starting down the path of relapse, I (Olivia) want(s) to do it without your interference.  

This is why I am sharing these secrets.  

I don't want them to be secrets anymore.

I want nothing short of full recovery.

Take that, Olivia.

Do Not Look Where You Fell, Look Where You Slipped.~ African Proverb

One of the most glaring omissions from treatment, having been through it twice in 7 short months, is the guidance and support offered by various programs to the "support people".  The very people charged with the task of taking on the voices inside of our heads that they cannot hear or understand or sometimes, even believe.  They are charged with loving us through an insidious disease that they likely never saw coming, nor fully understand.  They take the brunt of its aim when our illness takes us over, acting as though she speaks for us, ruining any chance of lasting relationships with people who mean the most to us.

People whom we need the most, to help us fight when we are so sick that we cannot.

People who are forced to fight for us, with one hand tied behind their backs, ever-changing rules and in a darkness that threatens even the brightest of lights in our lives.

Mercy Hospital's New England Eating Disorder (NEED) Program requires that each patient identify at least one support person, who's job it becomes to offer 24 hour supervision (including mealtime and bathroom activity) when the patient is at home in the evenings and on the weekends.  They are required to help with meal planning, shopping, meal preparation, portion-sizes and meal monitoring.  In addition, they are asked to provide tough-love style support balanced with loving care and concern when emotions are high, when our eating disorders are fighting the hardest and without any direction or preparation for the onslaught that comes their way.

In the beginning of the treatment cycle,  Olivia was stronger than me.  I was deep in my illness, and I couldn't fight her alone, yet she had the strength to fight me AND anyone who loved me enough to try and hold me up until I could take over.

Let's face it.  Most of us have never had personal experience with anyone with Eating Disorders until, well... until we DO.   If you have been reading my blog thus-far, it has probably become clear that the unpredictable behaviors, powerful emotions, myriad of triggers, secrecy, relapse potential, serious danger of suicide and contentious socio-biological explanations for the disease that contribute to a dizzying and chaotic atmosphere for the afflicted, as well as the people who care about us, make success an almost impossibility.

I remember so vividly, looking around the room on my first and then subsequent Monday morning check-ins during partial hospitalization,  acutely aware of the often perplexed and usually horrified expressions on the faces of our support people as we discussed the "voices in our heads",  "urges", "noise", amounts that we purged or over-exercised, restricted, hid food when our unsuspecting support people weren't looking,  or simply wanted to truly die.

I couldn't help them.

My support person couldn't help them.

Often, the treatment team, charged with the task couldn't help them.

The first time I was admitted to Mercy, I didn't want to help them.  I was still trying to decide how much I actually bought into the idea of full recovery myself.

And it was MY job to share with my support person, what he should be doing to support me.

This never made sense to me.

It's akin to leaving the fox in charge of the hen-house.

Further, once our weight is restored and we are no longer medically in danger, our insurances (if we are lucky enough to have it) declare that it is time for discharge.  Often, we are discharged back to the stressful and unchanged environments where we became sick in the first place, or without having enough time to absorb the new coping skills we were exposed to, to a new therapist who doesn't know us, for one hour per week.

I (Olivia) could do an awful lot of damage in one short week between visits.

Anyone who recovers under this scenario must use Herculean efforts to get there.  It's no wonder that the recovery rates are so dismal.

Since most of us chose those closest people to us for support while in treatment, it is my belief, that if the whole system was exposed to the treatment model,  we would have a much better shot at recovery, while preserving the most influential relationships in our lives.

My own personal experience with this break-down in treatment has inspired me to recover so that I can be a catalyst for change in this important aspect of treatment.  This has the dual purpose of helping my own healing in finding (another) reason to heal and to direct my energies for future work that means something to me.

To that end, I am asking my readers to share their experiences, to the extent that you are comfortable, as people recovering from an eating disorder, direct support people who have been involved with a loved-one during treatment programs, and family members or friends who care about someone with an eating disorder, in this aspect of treatment.

Please feel free to share whatever you feel is important regarding your own personal experience with treatment in whatever role you participated in.

Share your frustrations, insights, true gut-feelings about the process and ideas for change.  Please be candid and brutal in your honesty, even if (especially if) you were involved with me in some way.

Share in your own narrative form, bullets, lists, photographs, drawings, poems, ~ however you can best express yourself.

If you would rather have a framework for the discussion, here are some things to get you started:

Patients who have Experienced Residential, Partial Residential or Intensive Outpatient Programs to treat an Eating Disorder:

~ What did you wish that your support people understood about you (or your illness) that you feel they didn't or couldn't? (through no fault of their own)

~ What do you think, looking back, is the single most important thing your support person did/said/understood  (or you wish that they did) that helped support you successfully in your recovery?

~How is your relationship now with your support person, at whatever stage you are in at this point in recovery?

Direct Support People

~What was the most helpful thing you learned from the treatment facility in understanding how to help your loved-one in his/her recovery process?

~What do you wish someone told you about being a support person, that no one did?

~Did you feel supported by the program in your important role of "supervisor" of the patient when he/she was home?  Did you feel you had all of the tools and knowledge that you needed to be successful in your role?  Why?/ Why not?

~Share some of the feelings that you associate with the process you went through (or are currently going through) and any ideas you might have for systems or processes that can support others who will go through this

~How is your relationship now with your (former) loved-one whom you supported through treatment, at whatever stage you are in at this point in recovery?  If you are still involved, what do you need (for yourself) as an on-going support person as treatment progresses?

PLEASE participate if you have ANY experience in these areas of Eating Disorder treatment, either as a patient or as a support person or family member/friend.  You can do so anonymously or if you are comfortable, feel free to sign your name.  If you happen to be writing about me, please know that you have my permission to share that fact, and any and all details that you feel are important.  I will not edit any entries (except for brevity and unless of course, they are not in the spirit of helping).

I plan to write a blog entry with all of your comments/input and will include all of the voices who take the time to share.

I think a candid discussion is the beginning to understanding how best to support the most important people in the lives of a patient with an eating disorder.  I anticipate with eagerness, hearing the experiences of all who are willing to share this important information.

I plan to collect your submissions for this blog entry through August 10th, 2015.

Please consider contributing!

Send your contributions to me at dori30c@gmail.com and be sure to include if you wish to be anonymous when I share the information.

P.S. If you plan to submit something, however big or small, please indicate that you will be, either in Facebook comments or the comments section below so I can get an idea of interest.

Please consider contributing! (Did I say that already??) :)

Whack-A-Mole, Wicked Witch of the West and Happiness

“In the midst of hate, I found there was in me, an invincible love. In the midst of tears, I found there was within me, an invincible calm. I realized that throughout it all, that…In the midst of winter, I found there was, within me, an invincible summer. And that makes me happy. For it says that no matter how hard the world pushes against me, within me, there’s something stronger – something better, pushing back.”

~Albert Camus

There is a reason (many, actually) why I have embarked on this journey back to my old self of 5 years ago,  whom I left standing at the corner of life as I knew it, and the detour I took to the place where someone, unbeknownst to me, removed the sign that read, "Bridge Out".  

It was time to stop the free-fall that ensued from crashing through the flimsy barrier of free will,  a dimly-lit passage lined with demons heckling me daily, that this was what I deserved.  That the only way out of the guilt, shame and pain was to continue the fall until I reached the bottom where eventually everything (everything) would end.

The stage of recovery that I am in presently, getting traction with feeling the feelings that I have been numbing or avoiding for so long, brings them all back with such extreme intensity for some of us, that we are vulnerable to relapse.  This is due in part, to the ability to be lucid and clear-thinking.  Being able to pay attention.  One has to brace themselves for it because with a cruel last look over her shoulder, Olivia's visage trots in each trauma one by one, as a last-ditch effort to gain her place back inside your soul.  

But this entry is about the best part of recovery so far.  Along with the pain that I didn't trust myself to manage, I also numbed the happy moments, not believing or even caring that I could participate in this emotion.  

I didn't deserve to and Olivia saw to that.  Anything (or anyone) that brought me even the smallest amounts of happiness threatened my eating disorder like fire to the Wicked Witch of the West, inciting Olivia's strongest efforts to cancel out its effects, digging in more fiercely to hold her ground.

We are told in treatment that complete recovery from Eating Disorders is possible, unlike that of drug or alcohol addiction, where many believe that once one is an addict, they must live out the rest of their days in recovery.  

The Psychiatric Doctor at Mercy explained it like this.  "Remember that rebel boyfriend you had back in high school or college...the one who was completely opposite of everything you ever really wanted but there was something about him that you just couldn't resist?  Then, when it ended, you thought you would never, ever, ever get over him until one day you woke up and thought, what the hell was I thinking????"  Recovery from an Eating Disorder is like that.  After successfully abstaining from all Eating Disorder behaviors for 3-5 years, people who once suffered can enjoy life like a normal person again, completely free from the illness.  

But it is hard work.

I'm not the slightest bit scared of hard work.

The very best part of this stage of recovery is that even though it is a little like "Whack-A-Mole" sometimes, with triggers lurking around every corner, I have lately been able to experience true and genuine happiness not only as I once did before, but even more intensely as I work through each trauma, releasing the masking pain that once served Olivia in stealing my right to it.

I have been able to truly be present, and experience the treasure that my daughters are to me.

I have deepened my relationship with my own mother, learning that allowing her to care for me conjures strength, not weakness.

I have embraced the gift of a quiet weekend, without the guilt of  "wasting" the time.  

I am learning patience.  (I know.  It's true.)

I have learned to acknowledge moments of extreme pain and sadness and to ride their waves  of crest and falls, without judgement, without action, peacefully letting them take their course.  Gaining the confidence that I can survive them with each success.

I have experienced the love of others who have reached out to me in a selfless and genuine desire to carry me over the rough patches, when I couldn't maneuver the path alone. And I welcomed it.

I remembered how much I freaking love to cartwheel.  Probably my truest and purest sign of elation.

I can handle what comes my way with confidence.  With capability.  With dignity.

I can look in the mirror in the morning and think I look pretty.

I believe that I deserve to be happy.

I believe that I deserve to feel love.  And that love will come to me again one day.

I can eat pizza with greasy pepperoni.  (And ice cream for dessert).

I can accept a compliment.

I have hope.

I love my life. <3

Meet Olivia

This has been the single most difficult blog entry for me to write to date.  In my effort to shed light on how one becomes open and vulnerable to the insidious promises of Anorexia Nervosa, I feel compelled to honor my promise in my opening blog post, to choose honesty over decorum, to show the parts that aren't pretty or dignified. But real.

One day early in my first round of treatment at Mercy Hospital's New England Eating Disorder (NEED) Program, I was listening to a young woman who has Anorexia Nervosa (Binge Type) explain that "Ed" was really loud over the weekend and that she couldn't make him shut up.  The young woman is a starting center for her college basketball team but she is in this program with me because her coach and Dr. both told her she can no longer play due to her extremely low weight and because of her last two suicide attempts, still freshly visible on her arms.

"Ed" was telling her to restrict all weekend, even though she was getting close to discharge and to her healthy weight.  Practicing with the team was on the table for her in the next weeks as long as she could maintain her weight.  I wondered to myself who this jerk, "Ed" was... her Father? Brother? Boyfriend?  And, why on Earth would he be telling her to restrict?  It made no sense to me.

Later, when I met with my therapist in the program for the first time, she explained to me that the behaviors of our Eating Disorders start out for many of us, as ways of coping with something unbearable in our lives.  Later, they take on lives of their own and the disordered thoughts become our way of thinking and we are completely overtaken by them, often unable to distinguish between the disease's and our own wills.

She drew two circles, one on top of the other.  The first circle was the "me" that I used to be, with normal eating patterns and a healthy attitude towards food and exercise.  The other circle, which she drew over the "me" circle, was my Eating Disorder.  We had become so enmeshed that the Eating Disorder thoughts became my thoughts.  One important goal of recovery then, was to eventually disentangle myself from the Eating Disorder circle so that it was a separate entity from me again, and I could eventually eliminate it from my life.

She went on to explain that many people found it useful to give their Eating Disorder a name so that it had its own "identity" to help me recognize my thoughts from "It's" thoughts.  Before this moment, I was frighteningly and genuinely concerned that I might be crazy.  Having heard this "voice" in my head for so long and never telling a soul for fear that I was losing control and that others would certainly concur if I told them, I lived 4.5 long years in it's hell of twisted, painful and daily, self-loathing derisions.   After the suggestion from a therapist that I might try naming my Eating Disorder, I was certain that I was only a short distance now from that special room with the padding on the walls and that as I had, even the medical community had given up on me.

I wish that the story of naming "Olivia" was more memorable or exciting.  I hadn't really bought into the idea and honestly, felt a little silly doing it, so I asked the group to name it for me.  (This was not a condition of treatment... but I was willing to try anything to start feeling better so I took the suggestion).  Somehow, they arrived at the name and it stuck.

Like an abusive partner, my relationship with Olivia started 4.5 years ago all hearts and flowers.  Abusive partners are cunning and charming.  They draw their victims to them when we are at our lowest, willing to try anything to make the pain of what was happening in our lives, loosen its grips.

"Olivia" swooped in at that moment, promising that she knew how to stop the bleeding of my soul.

I was ready for her.  Open to the salvation she could deliver.

When she arrived,  my life was becoming unrecognizable to me, due in large measure, to my misguided weakening to the guileful encouragement of a poisonous man outside of my marriage, paying attention to my transforming figure, which I mistook for the love I craved.

You see, inherent in all extra-marital endeavors, I have come to learn, is a lack of foundation, trust and genuineness.  What I know now to be truth is that no action required to take place in darkness and deceit could ever lead to true intimacy or fulfillment.  

What I have also learned is that many people find themselves in situations that they never dreamed they were capable of.  I used to be one of those people.  Full of judgement and ready to scoff at the bad decisions of others, blaming them for their weaknesses.

Now I understand when people make decisions that hurt others.  I understand the faulty thought-processes that lead them there and make it plausible to do what others would consider unthinkable.

I don't judge people anymore.

In the beginning, Olivia was subtle, worming her way into my brain through the doors left open by a yearning to rectify the gap between what I valued (marriage, family, truth) and the unimaginable opposite actions I was engaged in (infidelity, lies and deceit).

"If you run a second time today it will help with the anxiety you are feeling about what is going on in your life.  You can make those feelings go away if you run more.  It's a healthy way to deal with your stress".

"You have to be the thinnest in the room to be special.  To matter.  I can help you get there and look at how much better you feel when you do what I tell you ".

"Look at what you can do.  I can help you be smaller, more perfect than anyone.  I can help you feel better.  Just do what I tell you".

This worked for awhile.  But as time went on, Olivia became more demanding.  My life was spinning out of control as my deceit became exposed to the light.

"You are disgusting.  You are weak when you don't listen to me.  You need me to get through this. No one else cares."

"I can help the pain go away.  Just listen to me.  Don't eat breakfast.  You are fat and disgusting and no one is going to love you that way"  (This was one of Olivia's favorite lines right up to my last ICU hospitalization this past May.   It hits me where it hurts.  She knew it).

Then, as my marriage began to unravel and my family and community became aware of the terrible decisions I had made, Olivia's quest for the ultimate cure for my life began.

"You can eat one meal today as long as you purge it after.  Make sure it is small and easy to bring up. I promise you that you will feel better."

"If you drink wine tonight, you will see that your hunger will stop.  Do whatever it takes to make it stop.  You are weak and fat.  Everyone knows what you did.  You have to be smaller.  You don't deserve to take up the amount of space that you do.  Throw.up.now"

"Yes, Olivia", I said.

To this day I remember with agonizing detail the first time I gave in to her demand to over-exercise, restrict my food intake to one meal a day, purging, and abusing alcohol at night.   I was both appalled and amazed at the ease with which I could make my own body betray me.  How I (Olivia) could take what was left in my life that was still good (nutrition and exercise) and use it against myself for her agenda.

I dutifully stood before the toilet.  Stuck two fingers down my throat and instinctively wiggled them around to cause the gag reflex to invoke the kind of violence within myself that when it strikes normally as the flu, makes people stay home from work/school for its discomfort.

When I was certain that I brought it all up,  I looked in the mirror and could see the damage I had done emerge instantly.

My eyes were bloodshot, my glands were swollen.  My face was puffed out.  But that wasn't the worst of it.

I felt better.

The calming that ensued for the next few hours, hunger subsided, anxiety and Olivia quiet, was like a fix for a junkie.  I was instantly hooked by this way to make the pain stop.  Even if only for awhile.

The next morning, I woke to a disturbing reality.  I had strained so much to forcefully expel the food that Olivia deemed my enemy, that where my eyes were once white,  a bright and demonic red had filled them.

The image looking back at me so startling, that I had to be sure that I was actually awake and not still dreaming.  I was frightened by it.

Looking back, I should have seen the symbolism so evident to me now.  Food was not my enemy.

It was Olivia, now inside of me, looking back at me that morning.

I quickly googled "red eyes from vomiting" for a reasonable explanation more palatable for my family and the children I worked with as the K-8 librarian than what actually caused them.

I found one.  I told everyone that the freakish look that I now was stuck with for the next two to three weeks was caused by the strain of attempting pull-ups for the first time in the gym.

To my astonishment, everyone bought it.

It got easier over time to bring up the food that Olivia forced me to expel from my body anytime I was given to eating it.

My eating disorder began the day I crossed the line of infidelity.

My marriage ended and I moved away from the place where I could no longer stand the haunting.  The shame.  The real and imagined pointing and sneering as I attended my childrens' sporting events.  "Home-wrecker".  "Bad Mother".  "Selfish Bitch".

Please understand.  I was not a victim in this.  I have owned my part in how my marriage ended and take responsibility for my part in it.  But in so doing, I also took on all of the judgement and guilt that people who once loved or respected me, heaped onto my already burdened soul, without regard for the heart that was breaking quietly behind their view.

I moved away from the area, but all of the pain came with me, packed in between my belongings, and hopes for healing, with Olivia carrying whatever didn't fit in my boxes.

She turned up the heat.

"You are a bad mother.  You left your life where you should be.  Where you should stay and endure the pain.  You have to be a perfect mother.  Everyone knows now that you aren't."

"You don't deserve to eat.  Purging and exercising are good but you don't deserve to eat.  You don't deserve the space you are taking up.  Be small.  Restrict."

After purging two and sometimes three (and sometimes more) times per day for 2 years, my body began to turn on me.  What was once so easy to do, bringing such perfected and predictable calm to my burdened life, now began to elude me.  At first I thought it was a fluke.  Just some strange malfunction in the reversal I had trained my body to so efficiently execute at my (Olivia's) command.

But the task became a chore.  Surely my body's attempt at survival.  To try and take back some semblance of calm, a fleeting moment that my healthy self perhaps recognized that I (Olivia) was trying to kill myself slowly, and its attempt to halt the demise.

"You're such a failure you can't even throw up right anymore.  What's wrong with you!"  You have to eat less.  If you can't throw it up, you have to eat less.  We are getting so close to your goal.  You can't stop now.  You are so fat and disgusting to look at.  You don't deserve to eat." 

Later, after restricting with great success, and purging anything I might have eaten for another two years, failing at any attempt to start or maintain a relationship, exercising to the extreme of exhaustion, unable to think clearly anymore for a lack of nutrition, Olivia added,

"You don't deserve to live".

And I believed her.  That's a story for another day.

What I now believe, after being a slave to Olivia's daily and relentless noise , is that I gave her the power over me.  I created this "other" and then later even gave her an identity by affixing a name, further inviting her to stay and be a part of my life.

Was this helpful to my recovery?  I'm honestly not sure.  While it probably helped me to separate from the eating disorder itself at times, I think it also distracted me (and others who tried to help me) and took valuable energy to "fight" Olivia.  "Fight" my eating disorder that I could have used to build my healthy self instead.

Fight.Fight.Fight. Until I was exhausted and defeated from the fight, and wanted to give in.

I almost did.  On the way to treatment for the second time, Olivia was telling me,

"You are not going back there.  Drive off the road.  You will not go back to treatment where they are just going to make you eat and get fat.  You will be miserable again.  You will lose all we have worked for.  You are at the lowest weight you have ever been.  You are special now."

"You can do things other people aren't willing to.  They admire you for being able to have so much self-discipline.  When you start to eat again, you are going to be fat and disgusting and miserable. No one will ever love you."

"Drive off the road".

I didn't drive off the road.  I reached out to a person who had seen me at my lowest.  Whom I had let Olivia drive out of my life with mean and hateful behavior.  I don't know how or where I got the strength to do so, but I am certain that a Power Greater than myself had a hand it it.

And this person, who had every right to ignore my cry for help, who had every right not to respond, told me that Olivia was trying to kill me.  That it is her end-game.  That I had the strength to beat this and that in spite of all that had happened, he believed in me.

I made it to Mercy that morning.  Determined.  Dedicated to healing.  Scared as hell to be back at square one again.

It was here that I was able to finally enlist the support of my family, including  my daughters and my mother, who I essentially left out of the process the first time around.  It was here that I was able, in spite of (or because of) all I had lost and still stood to lose, that I started to understand.

It was here that both of my daughters expressed both verbally and with their support, that they had forgiven me.  Long ago, my ex-husband had forgiven me.  My own family had forgiven me.  It was time for me to forgive myself.

It is not an accident that my daughter's high school graduation occurred the day after I was released from the Partial Residential program at Mercy, into the less-restrictive Intensive Out-Patient program.

Everything happens for a reason.  This was no exception.  I told my counselor at Mercy that my eating disorder began in Carrabassett Valley, and that I intended to leave it there after the festivities were over.

And that is exactly what I did.  In a very un-ceremonial quiet prayer to forgive myself for what I had done and to dedicate myself to healing this wound.

Once I said this prayer, I fell into the deep and peaceful sleep that had been eluding me for years.  A sign that it was the time.  It was the right thing to do.

Now, as I have reached a point in my recovery where I have never been before, with more days of choosing to honor my healthy self over my eating disorder self, it is time to say good-bye to Olivia.

What I believe truly, is that it is time for me to take back the power I gave to Olivia because it is mine to take.  It is time to tip the balance of power, with all that I have gained (quite literally) back to my healthy self.

It is time to put Olivia to rest.

Not violently, not ceremonially, but deliberately, as one who has a broken leg once requiring crutches to aid in its healing puts them away when she no longer needs something to do the work that her own healthy self can once again take on.