Saturday, August 29, 2015

eating disorders

It's late. I should be asleep. I've been trying to stick to a schedule, I can see how much better life is in general when I simply ensure that I get 7-8 hours of sleep consistently. But I slept in today, and I could fall asleep but I don't want to.

I haven't written in a long time. I keep telling myself I need to do it more. It feels therapeutic - I guess this was one of my first coping mechanisms. I don't understand why writing a private journal doesn't give me the same feeling as writing a blog - addressing faceless, nameless strangers - but it isn't as satisfying or cathartic, somehow.

A lot is going on in my life.

I'm back home in AZ. My ex, N, wants absolutely nothing to do with me, and somehow that hurts more than I thought possible. The loss of our love. The loss of her friendship. The massive awkward of being in a very very tiny queer kink poly community and feeling like if I go to an event where she is, it's just going to be overwhelming.

I'm in a relationship, with J, the woman in Memphis. Very specifically an undefined relationship, although for convenience I sometimes say that we're dating, or she occasionally makes jokes that refer to us as girlfriends. She's a play partner. I don't actually know if she's a friend, but she's definitely a confidante. Does that make her a friend? If I trust her with secrets that no one else knows, because she asks questions no one else asks? I wrote about not holding walls well with her, or holding them selectively. I'm afraid that I'm still doing that. I worry that this will hurt her, when this ends, and that that will hurt me. Pushing it off, a worry for future me.

I'm starting intensive outpatient therapy this week. For "adults with eating disorders." I'm grateful that I won't be around a bunch of teenagers, but I'm trying to figure out what it's going to be like to be in a room, eating a meal, with people who might have very different struggles than I do.

Doing my 2 hour intake appointment was terrifying. But it was also a relief, in some ways. Out of habit I still lied on occasion, but I tried very hard not to, and most things were true and close to accurate. There were times when I couldn't quite believe the words coming out of my mouth - I sounded unhinged even to myself. My interviewing therapist was amazing and did a wonderful job of staying neutral and supportive and reassuring. It felt overwhelming to verbalize the extent of the problem - to hear my obvious attempts at control that still failed. It felt good to finally share this part of myself, to let someone see the piece of me that disgusts me the most and to have her react in a way that was reaching out and offering help. Not horrified, or guilty, or disgusted, or ignoring. Acknowledging that this is a problem, but not in a way that made me feel like it's insurmountable. Stating that she was proud of me for being there, in a way that felt genuine instead of patronizing.

I need to take lessons on patient interviews from this lady.

So that was yesterday. Today I got a call back to work out a payment plan (holycrapIcanonlyhopethishelpsbecauseit'ssoexpensive) and to tell me my group schedule. In theory it's an 8 week program. I'm going to be gone so often that if I did all of the sessions it would be a 13 week program for me, we'll see how that works out.

Either way, I'm telling myself that it's time.

I've told myself I can control it.

That works, until it doesn't (often the same day).

I've told myself that it's only temporary, until I lose the weight I want to lose.

That works, until binge/purging becomes the way I deal with food every single day to stay "on track".

I've told myself that this time, after (vomiting trace amounts of blood, getting symptoms of a sinus infection, vomiting in public restrooms/a bag in my car/in friend's houses/in the kitchen sink, having heart palpitations, feeling constantly nauseated, almost getting caught, reading about what I'm doing to my body in my textbooks, having to role-play a conversation with a bulimic patient) that it's over, I'm done, I'll never do it again. Even writing and reading that list I'm kind of horrified. I was horrified in those moments, swearing that this was the last time.

But it never was.

The last time I vomited was 3 days ago. I pulled over on the highway exit ramp, behind a semi truck, after binging on snack foods. I almost got the straw I was using stuck inside my mouth twice, which made me suddenly wonder if this was how I was going to die - chocking on a straw in my car in the hot New Mexico sun with a bag full of vomit in front of me. My mother would be appalled. I was appalled.

Instead of going home when I got to town, I went to my parent's house as I stuffed myself full of everything I could eat so that I could purge again without worrying about my roommates being home. Afterwards I found myself still eating everything I could get my hands on, but when I tried to purge again hardly anything came up - my gag reflex was exhausted. I freaked J out because she thought I should be home by then - when I didn't call as promised she panicked. I'd forgotten that I'd promised to call, because I was so single-minded in my focus.

The last two days I've actually been eating fairly well, possibly a little less than necessary, although I'm being quite sedentary. It's still regimented and limited, and something I count up multiple times during the day to ensure that I haven't gone over my calorie goals. Part of me suddenly starts to think "hey, maybe I've got this. I don't need their program, their embarrasing meals, I can do this on my own."

I know that's a lie. There's always a next time waiting, even if it's tomorrow, or in a week, or in 6 months, or in a year. If I don't want there to be a next time, I need help. My way hasn't been working very well so far, and I'm well acquainted with the definition of insanity.