Yes Trigger Warnings Do Help Me: Here’s How

I’ve talked before about trigger warnings, what they are, why they’re useful. It might seem like I’ve covered every element of the discussion possible. But there’s something odd that I’ve seen in discussions of triggers: no one is willing to say that they are the ones helped by trigger warnings.

I have many friends with a wide variety of mental illnesses, and many of them talk often and openly about their support for trigger warnings, but more often than not I see people say “I personally don’t find them helpful but I support them anyway.” Despite reading nearly every article about trigger warnings that comes across my radar, I can’t recall a single article that said “trigger warnings make my life easier.”

So I’d like to offer the perspective of someone who does find trigger warnings exceedingly helpful.

When I see a trigger warning, it’s very rare that I actually avoid the content it labels. I do not find TWs helpful as a way to curate my life into a happy little bubble that doesn’t include anything difficult or upsetting. First, that’s impossible and I spend much of my life dealing with things that are triggering anyway. Second, the point of the TW is ideally to allow people with mental illnesses to participate more fully in difficult discussions.

What IS helpful about TWs is that they let me know what’s coming. When someone talks about weight loss or self harm out of the blue it feels like I’m being smacked. Worse than that, because of the edges of paranoia that come with my depression and anxiety, it feels personal. It always, always, always feels like they’re talking about me or attacking me in some fashion, intentionally bringing up the things that make me feel the worst.

Now I realize that this isn’t rational and it’s something that I am working on fighting on my own terms, but the presence of the TW is enough to give me the space to realize that they want to have a discussion and also that they care about my well being. The TW is what lets me take a second to engage the more rational parts of my mind and lets me be gentle with myself.

In DBT there’s something called Wise Mind. It’s the balance between emotions and reason. When you’re in Wise Mind, you’re aware of your values and goals, and also capable of paying close attention to the facts at hand. TWs give me the space to try to be in Wise Mind. It’s that moment of mindfulness that makes me pull away from the strong emotional reactions I would have otherwise.

Sometimes when I see a trigger warning I choose to continue reading but I’m highly aware that if I need to close the window or go away for a while. that’s ok. It puts me in the mindset of self care rather than my typical mindset that sees disengaging as a failure.

Trigger warnings very rarely tell me that I should opt out of a conversation. Instead, they tell me that I’ll be safe if I try to engage. To some extent they’re a signaling mechanism that lets me know people care about my mental well being. But more than that they’re a reminder to me that I should be considering my mental health and engaging the skills that I have. And it gives me a heads up of what skills I’ll need to use based on what kinds of content will be there. If it’s weight related, I just skip all numbers. If it’s self harm related, I usually engage some kind of anxiety relief or self soothing (with a fidget or game).

When I don’t have the warning it hits suddenly and I don’t have coping skills at hand. It’s easy to get overwhelmed. It’s easy to let myself slip quickly into an anxiety attack, or even to use symptoms. TWs help me protect myself.

So when I see a TW, I feel safer. I know that I am safer because I take a minute to check in with myself and prepare for what might be coming. And I’ve found that I am almost never full on triggered by something that I’ve had warning for. It makes my life much easier and more than that it saves me from a lot of pain. Serious, real pain. That’s why trigger warnings are helpful to me.

Cooking and Grocery Shopping In Recovery

I recently saw an article of tips and tricks about grocery shopping when you have an eating disorder. Of course I clicked on the link, but I was surprised to find that almost everything on the list was exactly the opposite of how I prefer to approach food.

People’s strategies for recovery are as widely varied as they themselves are, and different people find different approaches to meal planning, shopping, and cooking helpful. So I thought I might throw out some of what’s helped me become more comfortable with the process of getting food from the store to inside my belly in the hope that others might find something useful in it.

I’d also love to hear other people’s tactics. The more we can share with each other what’s helped us, the less alone and confused anyone has to feel. So here are my strategies for the actual shopping and cooking processes while in recovery.

1. Plan ahead. I never ever go into a store without a list of everything that I need, and I try very hard not to buy anything that isn’t on the list (unless I look at it and realize I meant to put it on the list). This helps me to feel less out of control while I’m in the store, it ensures that my grocery trips take less time, and it means I can focus on crossing things off of the list instead of on all the food around me.
2. Buy in bulk. Some people really don’t like this one, and I understand. There are times that it’s overwhelming to me to have too much food in my house. But I really prefer to have fewer trips to the store, and so I buy lots of frozen veggies, grains that don’t go bad, and other things that can last me up to a month so I don’t have to venture back to the store for as long as possible. Again, your mileage may vary on this one, and if you feel really overwhelmed with having too much at once then it can be really helpful to start with a smaller store rather than a Cub or a Rainbow.
3. Produce and other things that go bad: approach with care. For a long time I wouldn’t buy anything that would go bad because it felt like too much pressure to eat it right this instant. If you have worries about things going bad then it’s actually possible to buy mostly long term things (frozen is your friend). My strategy has been to slowly introduce more perishables. I started with milk (because I need it for my mac and cheese) and have now worked up to such amazing buys as spinach. You don’t have to get a lot of any of these, or even a wide variety of perishables. You can make your basic diet one that doesn’t spoil and add on fresh things for more nutrients as you feel comfortable.
4. Recipes aren’t necessary but they can be helpful to come up with fast and easy things. You in no way need to follow recipes exactly, especially if there are more ingredients than you want to deal with. I recommend doing some brainstorming before going to the store for things that will be as easy and fast as possible. I find the longer I have to commit to cooking, the less likely I am to get my meals in.
5. Cooking in bulk can be great! I love to make extra pasta or rice so that I have a couple additional meals and don’t have to worry about cooking for a few days. Decreases stress, increases ease.
6. Eat things that taste good to you. I don’t buy frozen meals even though in many ways they would seem ideal for me. I don’t like how they taste. Instead I try to get things that I want to eat because that will increase my motivation to cook them and put them in my stomach.
7. With that said, also be aware of things that feel too anxiety provoking. I try not to have chips around too much because I eat them mindlessly and it causes me a lot of stress. That doesn’t mean cutting those foods out entirely, but rather being careful around them so that you can eat them with minimal stress (I only buy one bag of chips at my monthly grocery run so that I don’t feel overwhelmed).
8. If you’re going to go grocery shopping with someone else, communicate how you shop and what they can do to support you. There are lots of people out there who like to wander and browse in the grocery store, so don’t assume that everyone wants a list or can be in and out quickly.
9. I prefer to buy things that are not pre-portioned so that I can decide how much I am hungry for.
10. Eat before you go! Shopping when hungry means everything will look good and it can get overwhelming really fast. I also try to build in some downtime post shopping trips so that I can calm any stress that might have built up.
11. I prefer to have a few standbys for cooking that are as easy as possible and feel completely possible no matter how bad of a day I’m having. I always keep those around. For me it’s ramen noodles, mac and cheese, and chic’n nuggets.
12. I also try to make my cooking in general simple. I like to do variations on the same theme. Most of my food comes in the form of grain+veg+sauce all mixed together. That means I only have to figure out three choices for any given meal, but also allows me all kinds of different flavors.
13. When adding new things, don’t try to do too much at once. I never have enough protein in my diet, so I’ve been working on that, but I don’t try to do many things at once. This week I added protein smoothies to my diet. A few months ago I started adding fake meats to my basic meal template. One at a time is easier to keep track of, less stressful, easier to adjust if it starts stressing you out, and easier to grow accustomed to.
14. There is no need to be a perfectionist. For a long time I didn’t want to cook because I didn’t feel confident about it and I hate not being perfect. But my food doesn’t have to turn out like the food on Iron Chef. It just has to turn out like something I want to eat. It can be ugly, I can make mistakes, and I can experiment without being some kind of failure.
15. Spend money on food. I know that sounds privileged and stupid, but it’s an important shift of mindset for many people with eating disorders. For a long time I refused to budget any money for food because I didn’t see it as a necessity. But eating becomes much easier if you like the way your food tastes and if you can buy things that you enjoy, which means putting food as high on your budget priorities can go a long way. This is also part of why I allow myself to eat out more often than I probably should. My health is worth the money.

That’s what works for me at least. I hope some of it is helpful, and remember: if these things don’t sound useful for you then you don’t need to do them. Do what works for you.

 

Leaving the House in the Winter

It is winter, the time of low spirits, comfort eating, shitty body image, and “NOT THE HOLIDAYS” anxiety. For lots of people who deal with mental illnesses of any variety, winter is a time when it is incredibly difficult to leave the house. Isolation is the name of the game when it’s cold, dark, and you feel like crap that doesn’t deserve to see the outside world.

There are a few different brands of this kind of isolation, and each comes with a unique set of challenges. So here is Olivia’s Handy Guide to Leaving The House in Winter. These are my tactics for getting my ass out of my pajamas and into the great wide world when all I want is to sleep for another 12 hours.

Depression Isolation:

This tends to be the isolation that comes from having no energy. It’s dark, it’s cold, and I want to stay where it’s fucking warm thank you very much. I don’t care anyway, nobody likes me.

Ways To Fight It:

Bribe yourself. What sounds remotely good right now, other than being in bed? Make that thing happen outside of your house.

Make plans with people that you’d feel bad about canceling.

Keep your goals reasonable, and don’t get down on yourself for what “reasonable” means right now. Sure, in the summer you might be a machine of productivity, working from 8AM to 10PM nonstop. That is not reasonable right now. Is there one task that absolutely needs to get done today? Leave your house for that, and don’t expect more. Think you can make it to two? Awesome. Get to the bank and the grocery store. Set clear time limits of how long you have to be gone so that it doesn’t feel like a gigantic pile of “oh god not out there” weighing down on you.

Reward yourself! Yes this is hard. Yes it is easy to just be annoyed at yourself that leaving the house is a challenge. Yes it is easy to berate yourself for struggling so much with “basic adult tasks”. Secret: many, many adults struggle to complete “basic adult tasks” because they are annoying and emotionally draining and actually really hard in a lot of ways. If you manage to drag your unhappy self out of bed, put on adult clothes, and sit your butt in your adult chair at work for eight hours AND THEN still go out and be social like an adult is supposed to, or run your errands like an adult is supposed to, or whatever else it is that is calling you away from your bed, THROW A PARTY. If you like chocolate, eat that chocolate. If you like bubble baths, take that bubble bath. If you like not thinking, flip your brain into the “off” position for the remainder of the evening. You earned it friends.

Prepare before you venture out into that frozen tundra. This is actually just generally helpful, at least for me. Look up the location and hours of the places you need to visit. Have documents filled out and signed. You want to work out? Great, get in your workout clothes ahead of time so that the moment you hit the gym it’s sweatpants off and sweat on. This means less time stressing while you’re out and about and more while you feel mildly safe, comfortable, and warm.

And finally, a tip that is very personality dependent, so think carefully about it and how it might work for you before you do it. Do all of the things you possibly can in one go. This tends to work well for me because I feed off of accomplishment. Some people get tired. For those of us who get one burst of energy a week, when you have that energy and you’ve made it out, be the efficiency monster you know you can be.

Anxiety Isolation:

Everything is scary! I don’t know what I’m worried about, but it’s something, and so I should probably not speak to or see any human beings indefinitely in case there’s work I need to be getting done or I’m doing something wrong or I look stupid. People are scary, the world is scary, the cold is scary, the ice is scary, and there are so many things that need to get done I will avoid them all right here.

Ways to Fight It:

Start with a little bit of mindfulness, breathing, or other calming activity. You probably know what works best for you. If it’s at all possible to get your body and mind functioning in a way that’s more even-keeled, this will help you with getting out there.

Focus on activities that are not anxiety provoking. Is socializing sounding really hard right now? I’m sure that there is an errand or two that you have to run that requires minimal human interaction. Try that for now. Is there someone that makes you feel more comfortable no matter where you are? Meet up with them for coffee. Leaving the house and seeing or hearing other people goes a long way towards keeping you out of the depression/anxiety spiral, so any way you can do it is a good thing.

See above: break things up into manageable tasks.

Give yourself an out, and try to remind yourself leaving early is nothing to be ashamed of. Let’s say you made it to that awful holiday party your parents throw every year, you’ve been there for an hour and the panic spiral is starting. First of all, you made it! Good job! You built up your social relationships, got into a new setting for a while, probably moved around more than you would lollygagging in bed, and got a bit of fresh air. Success! Now is there a friend who can say they desperately need you to come help them with something? Do you have important other plans that will interfere? Are you feeling unwell? Because you can skedaddle with any of those easy outs. If you have to talk to someone close ahead of time to set something like this up and develop a secret hand gesture that says “dear sweet Jesus, please let me go somewhere quiet and have a book for a while”, make that happen.

Despite its many downfalls, winter is a season of delightfully comforting things. Hot chocolate while watching snow fall outside. Soft, fuzzy blankets. Cuddling under said soft, fuzzy blankets. Good food, steaming hot. Candy canes and other Christmas goodies. Excuses to spend time with family/friends/people you like. Revel in these things and incorporate them into your “going out” routine as often as possible. This might be one of those seasons where you have to decide that spending money on your favorite coffee drink once or twice a week is what will get you through, and that means it’s worth it.

Body Image Isolation:

Ugh, I am a hideous beast of disgustingness and I should never, ever, ever leave my house. I can’t believe I ate so much at Thanksgiving/Christmas/that utterly arbitrary meal last night that I binged on because I was cold and lonely. Flee from my hideous mug, poor mortals!

Ways To Fight It:

Cover or dispose of your mirrors. And your scale. You better not have a scale. *glaring eyes until you properly dispose of the evil scale creature that tells you your worth is a number*

Pick one: choose clothes that feel comfortable. This is my personal preference. Oversized shirts and warm sweats are my uniform once I get home from work. I give a big ol’ finger to anyone or thing that implies I should have put more effort into my appearance because these pants are soft and I don’t like wearing bras. Option two: choose clothes that make you feel confident. Even on our worst body image days, most of us have one outfit that still fits just right. Maybe it’s a pair of boots. Maybe it’s a dress. Maybe it’s fancy earrings. Doesn’t matter. If it makes you feel confident, get it on.

Have you eaten yet today? I don’t care if you feel oversized, put some food in your body. Your emotions will feel more stable afterwards. It’s hard and it feels counterintuitive, but most of the time it helps.

Check out some body positive blogs, like Dances With Fat. Not everyone feels better about themselves after body positivity, but sometimes it helps to get a role model or some optimistic thoughts.

There is very often a correlation between low mood and bad body image. If your body image is being incredibly stubborn and getting in the way of your daily functioning, it can be helpful to circumvent that particular fight by focusing on raising your mood. All of the suggestions for anxiety and depression apply, as do any other techniques that you’ve found helpful in the past.

 

So there we are friends. Winter is hard. During this time especially make sure you’re eating well, sleeping enough, getting vitamin D, exercising a little bit, and treating yourself kindly. We will survive together.

 

The Reality of Chronic Depression

I’ve known for quite a while now that I have chronic depression. I first struggled with it when I was 14 or 15 and got hit with my first major bout at 17. What followed was a good five years of nearly constant depression, with some slight reprieve here or there. Depression runs in my family, as do a variety of other colorful diagnoses, making it more likely that my depression has genetic components and thus will not change with changes in circumstances. I’m not sure what other signals I would need to illustrate that mental illness will probably be a part of my life forever, but if I did then a diagnosis of a personality disorder and an eating disorder (both widely known to be stubborn creatures that never really go away) would do it.

But despite knowing all of these things for years, I’ve always had some measure of hope that things could get better. I mean they had to get better. There was no way I could continue living if they stayed the same. Some day my brain would switch back over into “not utterly unhinged” territory and I’d be able to make it through days at a time without bursting out into tears or struggling to breathe due to anxiety. There was another version of myself that I imagined, maybe not one who was ebullient and joyous and energetic, but one who was functional and content. That version was waiting for me if I chose to accept her.

This past summer, I finally knew what it was like to be her, at least for a while. Getting relief from depression is one of the most amazing feelings I’ve ever had. You get tiny realizations here and there: it’s been weeks since I last cried. I’ve laughed every day this week. I ate three meals yesterday and didn’t notice until now. Each one is a victory, a delight. I’d find myself giggling in joy over my life for no reason.

Last night I got hit with an attack of the jerkbrain. It’s been dark and cold lately, something that’s always hard for me. The day started out well enough, but somewhere in mid afternoon the undercurrent of worry that asks whether I’ve done enough today to be worthy of living started to swell. What if my life is not enough? What if I never do anything worthwhile? What if no one actually likes me? Behind the questions is simple despair. There are no words to make sense of it, and it comes from nowhere. It just hovers over me and trickles in when I have spare moments. Sometimes it brings its friend, panic, which takes up residence in the lowest pit of my stomach and bubbles up and over into my heart, just to keep me on my toes.

I know how to deal with these things. I talked to my boyfriend, I left the house, I gave myself permission to go out for dinner instead of cooking. I had some ice cream and played Dungeons and Dragons with my friends. I systematically listed all the things I needed to get done in the next week and ticked off all of the ones I had already completed, making it abundantly clear that I was not behind on anything. The feelings receded and today I feel average.

What I don’t know how to deal with, today, in the aftermath of that little depressive episode, is the reality of chronic depression. I knew before that it existed, but it has only been with the contrast of feeling good that I’ve internalized I am never safe from my own mind. No matter how much work I have done or will do, no matter how many wonderful people I have in my life, no matter how many things I accomplish or if I find my dream job, there will still be days or weeks or months during which everything will be a struggle.

On some level I always knew this, but feeling it is different. The randomness of a depressive attack is what hurts the most. It makes me feel childlike, dependent, incompetent. It reminds me that my mind isn’t really my own. It says that recovery is always temporary. This is terrifying. There is nothing more scary to me than the possibility of feeling the way that I did for the last five years. Nothing except for the sure knowledge that I will feel that way again, there is nothing I can do about it, and I don’t know when it will hit. Life is Russian Roulette.

And tied into all the fear is the inability to explain it to the people around me. Sure, they get it, but when they ask what’s wrong and all I can say is “I’m worthless”, they’re left trying to help an unhelpable situation. I’m afraid to inflict myself on other people.

I’m reminding myself today that the people who love me see something in my ability to continually feel like this and continue on that is worth caring for. I’m reminding myself that chronic does not mean constant. I’m reminding myself that the episodes are smaller and shorter now, and that I get so many happy days. I’m reminding myself that when I think about my own survival, I am in awe of my own strength. I’m reminding myself that writing that sentence is hard and I did it anyway.

The reminders help. I know that chronic depression doesn’t have to define my life. But under the reminders I’m scared for the next bad night.

The Role of Exercise in Eating Disorder Recovery

For people with depression, anxiety, or really any form of mental illness, a common refrain from well-meaning friends and acquaintances is often “well just exercise. That will help you feel better”. It’s true that there is good evidence that regular exercise can improve mental health (although there are many problems with simply prescribing exercise). However trying to incorporate exercise into a recovery and treatment regime becomes infinitely more complex in the context of an eating disorder. Over exercise is often a symptom of eating disorders, and for many people trying to recover it’s also a trigger for other self-destructive behaviors.

Because exercise is an important element both in healthy weight maintenance and improving mental health, but is also a triggering and potentially dangerous activity for someone with a history of overexercise, people in treatment for eating disorders must walk a delicate tight rope when it comes to their exercise regimes. This has been a particular struggle for me, and I’ve been looking for ways to bring exercise into my treatment in a positive fashion.

There are a few techniques that I’ve had some success with, but if anyone has more suggestions, please share in the comments. The first way that I’ve found to improve my relationship with exercise is to stop using the word exercise to refer to movement. This opens the way for all kinds of “exercise” that don’t involve going to the gym and using equipment that loudly announces your calories burned to you every time you look down. I swing dance and I rock climb and sometimes I just throw dance parties in my room and sometimes I try to just go for walks or have squirt gun fights with my friends. The more that I can find things that I enjoy which also happen peripherally to involve movement, the better.

The reason I try to use this technique is because the moment my brain is convinced that I am “exercising”, it becomes convinced that I need to hit certain markers of acceptability: burn a certain number of calories, exercise for a certain period of time, stick to a certain regime. If I don’t use the label “exercise” to describe what I’m doing, but rather focus on “fun activity, preferably with friends”, I get a lot more mileage out of the activity and don’t fall into a negative spiral that tells me I am not acceptably fit. Looking for activities that fit this mold also lets me double dip on my activities: not only do I exercise but I also find some depression fighting positive activities, and potentially social time as well.

Something else that has worked well for me is to accept that sometimes a complete break from exercise is necessary. I find exercise extremely helpful with anxiety and don’t like leaving it entirely behind (especially as I’ve been pretty active my whole life). However when I’m compulsively exercising every day, it can be much harder to try to slowly lower the amount of exercise that I’m doing while still doing some. In many ways it’s easier to simply say that I can’t be responsible about my exercising at this moment in time and I need to take some time off. This has the added benefit of giving me LOTS of extra time to do other positive things with my day.

There are a lot of ways that cutting exercise out of  your life for a time can backfire. How do you deal with all the anxiety you worked off before? How do you accept loss of muscle mass or increase in fat? How and when do you begin to add exercise back in without swinging immediately into over exercise mode again? Especially if you’re doing this while you’re trying to increase your caloric intake, it can take a serious toll on your emotions and your motivation to continue treatment. Unfortunately, this is one of those places I don’t have the answers: I’m struggling to find ways to begin incorporating exercise again without it becoming unhealthy.

One helpful way to deal with feeling guilty about not exercising or feeling extremely compelled to started exercising again is to find some friends who aren’t big on exercise. This doesn’t mean you have to dump your friends who are extremely fit, but there are people out there who aren’t particularly interested in physical fitness and are perfectly happy with their lives. I am a big proponent of distract until you’re in a healthier place, and finding people who will encourage you to do other types of fun and interesting things, model other versions of healthiness and happiness, and generally not bring up exercise as something you have to do is a great way to build a life that doesn’t circulate around exercise.

The final, and perhaps most difficult thing to do if you’re working on overexercise is to make sure that you’re not paying any money for exercise. What I mean by that is if you’re paying for a gym membership or classes or a personal trainer: stop. I’ve found that when I’m shelling out money I feel obligated to “get my money’s worth”. You can always go to the local rec center and swim some laps or go for a run or a bike ride. But those ongoing expenses are a constant pressure to get to the gym and make it worth it and I’ve found that pressure nearly unbearable.

Of course all of these are just suggestions that I have found helpful, and won’t work for everyone. I’d love to hear other suggestions in comments, especially from those who have found an exercise regime that works for them.

Hierarchies of Eating Disorders: A Spiritual Perspective

If you’re someone who reads lots about eating disorders, you’ve probably already seen this article by Maree Burns floating around recently. For those who aren’t enmeshed in the world of post-structuralist and feminist critiques of eating disorders, you may want to try to read it anyway. It’s a little long and at times jargon-y, but it’s also fascinating and makes important points about the hierarchies we set up around eating disorders. Similar to Burns, I will not be using this post to posit anything about the actual nature of eating disorders, but rather about how they’re constructed in the common conscience of Western society.

There are many points in Burns’ article that I’ve spent time grappling with: the fact that anorexia is both held up as perfect control and derided as sickness and disgusting, the way anorexia and bulimia can be mapped onto the virgin/whore dichotomy, and the tendency to view anorexia as the ideal eating disorder. There is an hierarchy of eating disorders, one that is held up by nearly everyone. Anorexia is considered cleaner, more respectable. Many people even view many of its characteristics as positive, but simply taken too far. On the other hand, bulimia is considered disgusting, animalistic, and out of control.

Burns looks at this hierarchy from the perspective of post-structuralism. I’d like to take a different perspective that I think can illuminate some other elements of the hierarchy and the ways that eating disorders make a certain kind of sense. Spirituality is something that Burns does not touch on at all in her article, despite the fact that moral language runs rampant in descriptions of eating disorders, and in the past eating disorders often happened in religious contexts.

Throughout her article, Burns draws on the Western concepts of dualism. She looks at it particularly from a feminist lens, in which female is associate with body/disorder/evil/animal, and male is associated with mind/rationality/control/order. However there is a slightly different version of this dualism that may actually shed more light on eating disorders, which is the body/soul split. Burns points out that society (including pop culture, psychological professionals, and those who actually have eating disorders) makes negative judgments of only certain elements of eating disorders. This includes the behaviors of bulimia (especially purging) and the skeletal body of someone with anorexia.

She posits that these are different types of judgment: the judgment of bulimia is about actions that don’t fit into the appropriate feminine mold, while the judgment of anorexia is about a body that makes a mockery of the thin ideal.  She looks to how each of these “negatives” deviates from acceptable feminine roles and how that deviation results in judgment. In contrast, the behaviors that make up anorexia (self-denial and self-control) are often viewed positively as movements from feminine (bodily) to masculine (rational).

However there is another way to interpret the negative judgments we cast on those with eating disorders and the ambiguous position of anorexia in society. We can find a clue in the religious language used by starving saints in past centuries and co-opted by some people with anorexia today (including myself). Oftentimes this language circulates around dismissing the body completely and moving into a fully spiritual realm. The prioritizing of the next world over this one still holds sway in Western culture (despite frequent cries about our society falling into horrible materialism).

These criticisms of eating disorders reveal that bodies, particularly bodies that remind us that we are animal, mortal, and fallible, are what receives criticism. Negative judgments of bulimia often center around the corruptness of the body and through the body, the individual. The body is seen as the ruler in this situation, but the focus on the body is often given a moral meaning. People with bulimia binge, however the binging on food is often extended into other realms: they’re posited to be kleptomaniacs, sex addicts, or out of control. Most of these assumptions focus on impurity and the fact that binging and purging “taints” the individual. I’ve often heard them referred to as “failed anorexics”. This means that they have failed at the purity that those with anorexia achieve because they allow their body and its needs to overtake them. The obsession with “how much did you eat” and “how did you throw it up” reveal society’s dark obsession with the animalistic elements of bulimia and how it affects the body, rather than an interest in the inner lives of those with bulimia.

Burns suggests that the negative judgments of bulimia are made in contrast to the self-control (often interpreted as rationality) of anorexia. She says: “Self-starving is also paradoxically privileged as a signifier of those qualities that have historically been associated with ‘masculinity’, such as self-control, persistence, transcendence of the (labile feminine) body, and strength” However I would argue that this type of self-control is often associated with spirituality rather than any kind of rationality, as she suggests. People recognize the irrationality of anorexia in the context of the material world. However starvation, asceticism, and self-denial have a long history in the religious tradition of transcending this whole plane of existence.

Something that I’ve posited for quite some time is that the end goal of anorexia is to become pure spirit, to no longer be held up by worldly, finite things.This is why anorexia is often held above bulimia. However the reality is that people with anorexia do have bodies and their actions do impact their bodies. When their bodies begin to appear abnormal, we’re reminded again that they are human, finite, and mortal and that their bodies are falling apart. We are reminded of death (see: focus on the “skeletal” nature of the anorexic figure). And especially as Western societies move closer to secularism, this reminder of death is viewed as disgusting and disturbing, garnering criticism. The combination of heavenly motivation with dying body creates the mixed reaction of most individuals.

This additionally explains the feminine coding of anorexia. It falls in line with the tradition of women who fade away into martyrdom and make their femininity acceptable by rejecting their bodies unequivocally. It is part of the “pure” woman, the history of women as keepers of the spiritual well-being of their families, of women as more moral and in touch with religion than men. Part of the push/pull response to anorexia is the fact that the very deadliness and extremity of it is considered admirable by some. Not everyone can do it: it refuses to accept human limitations and so in some ways appears almost supernatural. The extreme refusal of finitude almost appears to be a martyrdom, especially for those who are trapped within the eating disorder. There’s even a kind of cultish interest in the fact that many people with anorexia suffer from ammenorrhea. Their bodies no longer even produce blood, one of the most obvious markers of human finitude.

On the flip side, bulimia reminds us of our more animal side. We think of the behaviors not as outstanding or amazing, but as mundane and slightly disgusting. We associate overeating with animals, with bodies, and we view vomit as wholly animal (because bodily fluids are gross ya know?). It’s very easy to view the dichotomy between bulimia and anorexia as a struggle between our lower natures and our higher spiritual calling.

And of course if we are considering female morality and spirituality, sex must be play a role. The connections between food and sexuality have already been identified, particularly in Burns’ article. Abstinence is a largely spiritually driven quest. Few secular people feel the need to be abstinent for moral reasons (of course there are some, but it’s not nearly as common as within religious circles). The drift of the spiritual meaning of sexuality into food also colors our conceptions of eating disorders. Just as the body is dirtied and corrupted by inappropriate or out of context sex, so it is by inappropriate or out of context food: a binge. An important part of this connection is the way that sexuality is used to dehumanize, animalize, and objectify women. When we use phrases like “orgies of eating” to describe a binge, we sexualize not only the food, but also the individual participating, and through that sexualization we objectify. It portrays people with bulimia as less human, as more animal. The objectification of women through hypersexualization plays directly into the ways that anorexia (anti-sexual) is viewed as humanizing, pure, and spiritual while bulimia is viewed as animalistic: those who engage in it are objectified just as others who are hypersexualized are.

While the role of male/female dichotomies plays an important role in eating disorders, we should also consider the dichotomy of worldly/heavenly and how that can explain some of the behaviors and attitudes we have towards eating disorders. The history of eating disorders (particularly the long history of female saints starving themselves to death) is a good place to start in this perspective.

I’m Afraid of Identifying As Asexual

This weekend was the fantabulous Skeptech, a conference about skepticism and technology. As per usual I had a great time and am currently quite exhausted (despite the fact that like a good little introvert I went home before midnight most nights).  I have lots of Thoughts spinning around in my head from the weekend, but for now I’m going to focus on one interaction in particular. In the Twitter feed I got into a discussion with Kate Donovan and Tetyana about asexuality and eating disorders in response to a panel regarding bias and science. Without really thinking, I mentioned that I was afraid my ED would turn out to be the real reason that I haven’t felt sexual in quite some time, and it grew into a conversation about why that would be a bad thing.

The topic was a bit too large for Twitter, so I’ve been pondering it a bit further and I’ve come to the conclusion that it’s a combination of fearing that I’m relying too heavily on my own privilege, and an internalization of many of the myths about sexual identity and the process of finding one’s sexual identity. I am tentatively taking on the label of “asexual” but I’m terrified that at some point in the future I will feel a wave of sexual attraction and it will turn out that I’ve been lying to everyone and that the real reasons I feel this way are medication, my eating disorder, and depression. Here’s why that seems so scary.

One of the things I worry about is taking the name and label of an oppressed group if I have not truly experienced the oppression that they live. It’s somewhat akin to a white person claiming that they’re racially oppressed. It’s an offensive concept at best, and at worst it muddies and obscures the real struggles that people of color experience, delegitimizing their words and stories and thus making it harder for them to make changes to improve their situation. While asexuality isn’t quite on the same spectrum, I am afraid that I will be claiming their oppression when I’ve existed in privilege. If I say that I’ve had those experiences, that I am oppressed in the same ways they are, but it turns out that I’m really allosexual, straight, cis, monogamous…how hard will it be for others to take the worries of the ace community seriously? I’m also afraid of calling on the resources that have been put together for asexual people because I’m worried I’ll be taking something from those who actually need it.

I believe that these are important fears to have, especially for someone who is as privileged as I am. It’s important to think about whether your future actions and identifications could have harmful repercussions for an oppressed group. I don’t want the ace community to be taken less seriously because I casually started identifying as ace and then nonchalantly went back to allosexual. Aces are already criticized for identifying as queer because they aren’t oppressed enough, because they are supposedly all white, cis, het girls who have privilege shooting out of their asses. I don’t want to contribute to this stereotype. These are important things to consider when thinking about whether to take on a certain identity or not. I don’t want to be the ace whose asexuality is actually a disease, the person that others can point to whenever someone else says “I am ace” as a way to remind them “but what if you’re really not”.

But there is a whole other level of worry that comes on a personal level which is fully wrapped up in the expectations that society has for a woman to be available constantly, for women to make perfect choices, and for sexuality to be a linear progression. If my “asexuality” were actually just a result of my eating disorder, I would actually just be a broken straight person, someone who wants to be able to have sex but isn’t interested because of trauma/disease/stupidity. It’s scary enough if I am asexual to look at the past 10 years of my dating life and think that I’ve spent all that time chasing after the wrong things. It’s even worse if I was just horribly broken and made choices that hurt myself because I am so disordered that I can’t find healthy relationships and wouldn’t even pursue something that would end up being good for me. It’s too cliche to be a girl with an eating disorder who can’t have sex because she’s too self-conscious.

There is a large part of me that is feeling imposter syndrome around this. It’s not necessarily that I think being ace is preferable to being allosexual, but rather that actually finding out who I am feels too good to be true. This can’t be right, I’m too screwed up, I’m too lost, I’m too confused to actually have found some small piece of identity that is truly me. I have spent so much of my life with no identity but my eating disorder that accepting something else as an integral part of me feels wrong in many ways. I suspect that others who are in the process of recovery feel this way when they start to find good things.

Partially it’s that I’m convinced I’ll never know who I am, partially it’s that if something is going to replace the eating disorder in any way it needs to be quite strong, and partially it’s a fear: what if I try to find something that’s really me and it turns out it’s just the eating disorder in disguise? What if every part of me is just my eating disorder in disguise? What if I can’t even trust something as basic as my sexual impulses? This is deeply tied to the mental illness. I’ve been told so many times that I can’t trust things like my hunger cues, or my desires, or the voices in my head. This one must be wrong too, especially if it’s something so out of the ordinary as asexuality. I think it can be really damaging to teach people as part of their recovery that they have to stop listening to things that feel perfectly real and important.

I’m also a rule follower, a big part of having an eating disorder. A perfectionist. Everything must be just so. I can’t make decisions until I explore every possible angle and even then I often can’t because there is no right or perfect answer. The idea that I might identify as something and then find out that it’s wrong is terrifying. I’ll have embarrassed myself, I’ll have gotten the WRONG ANSWER about something incredibly important. I won’t be doing things right, I’ll have screwed up. That would be the worst thing ever, even worse than that time in first grade I got time out that I still remember.

There’s also an element of internalized misunderstanding of how sexuality works. One of the things we’re taught is that you figure out what you are and then you be that thing. Usually you figure it out in high school or college: you “experiment” and then realize you’re gay/straight/bi/whatever. Then that’s your life. It’s fairly simple. You might make one mistake and date the wrong gender or try a poly relationship and realize it’s not for you, but then everything is figured out. This isn’t actually how sexuality works, in reality there’s some fluidity, there’s often a lot more confusion, you may think you’re one thing and then discover a new term or community that you think fits you. There’s absolutely nothing wrong with trying on different sexual identities to see which one feels the most like you.

But I’ve internalized that you figure it out and then that’s it, anything else is wrong or improper or a LIE. You might be repressing part of yourself if you ever end up changing. You’re probably misleading your loved ones. You’ve probably destroyed at least one relationship asking for something, setting boundaries when you really didn’t need to, trying to be something that you’re not: there was no reason to ask for space to try something new if you aren’t going to identify that way FOREVER, and doing so was really quite selfish. At the very least you’re just a really screwed up person who’s flip floppy and shallow and attention seeking because there isn’t any other reason to change. Obviously none of this is true. We all get to ask for whatever we need when we need it, but the implications for my relationships if it turns out I’m allosexual are confusing and frightening.

I think one of the things that makes recovery from an eating disorder so difficult is trying to suss out which parts of your life are you and which belonged to the eating disorder. For some reason coming to the wrong conclusions (even if you can change your mind later) feels like the end of the world. It seems as if more of your life has been stolen from you, as if you’re doing recovery wrong, as if you’re just too stupid to realize that your whole life was the eating disorder.

This is one of the reasons that I wish labels were both more common and less important. Reality is that people probably have some core identity but that they have some fluidity. For some reason taking on a label has reached a level of importance that people view it as All That Defines You. Particularly if you come out or have a few relationships in the mold of that label, you’re never ever allowed to change. If identity labels were more like career labels or relationships, something that’s important but that you can grow out of, it might be less scary to try some things on as you, then realize that you’ve grown into something else. That fluidity is hugely important in reducing the shame that people feel when they realize they might not be what they thought they were. I think we all deserve the space to learn.

 

NEDA Week: Writing the Experience

One of the things that I have often noticed about those in the eating disorder community is that many of the people in it often have difficulties speaking or telling their experiences, and that often they are far more comfortable with writing as their chosen form of expression (art is also common). As I think about eating disorder awareness, I’m really struck by the ways in which we write down what it is to have an eating disorder, particularly those pieces we conveniently leave out.

In particular, writing is a very different medium from speaking in that we have a lot of time to edit and only put down carefully crafted words. Oftentimes stories change a great deal when they get written down: certain parts are deemed unimportant or not fit for mass consumption, some parts are changed as we retell and rewrite, and we feel the need to create a coherent narrative. Who wants to read a story that ends “I’m still living my life and things are much the same. I learned a few things but I haven’t learned all my lessons yet and I’m still working the way I was through the whole story”?

Even as many of us find it easier to write, coming clean about the experiences of an eating disorder is still incredibly difficult. While the stigma and stereotypes are slowly being eroded, very few people actually want to hear the nitty gritty details of being on the inside of an eating disorder. No one wants to know about the puke you get on all your clothes when you purge. No one wants to know about the bizarre digestive problems and the sheer boredom of anorexia. No one really wants to know all the horrible things you say to yourself when you’re on your own. It’s incredibly difficult to pin down how honest is honest enough but not oversharing, and perhaps even more it’s hard to know how to frame your experience.

Eating disorders are your life. For as long as you have one, it tends to define  you, to take up almost every minute of your day, to affect nearly every decision. Imagine trying to summarize your life for the last year, being honest and giving someone the best insight into what the internal experience is like. This is the experience of trying to write what it is to have an eating disorder. To write it is in its very essence to try to pin down an entire life, to cut some things out, to forget, to choose a focus that may not wholly encapsulate who you are and who you were.

It is impossible to ever be wholly honest when you choose to write a piece about an eating disorder. As hard as it is to describe each individual experience that makes up the moments of an eating disorder, it is literally impossible to ever explain all of them. So what does it mean then to try to write an eating disorder? How do we choose which pieces to leave out?

In part, you define what it is to have an eating disorder by the pieces you choose to write. But you also choose how you want the world to view eating disorders (because as a minority, each one of us of course has to speak for all of us). You decide how to humanize eating disorders. Writing the experience is not telling others what your life personally has been: it is giving others a template for how to understand others with eating disorders. This may seem like a lot of pressure, but unfortunately many people out there will only ever hear one story of eating disorders and it may be yours. Most of us who write our stories know on some level that we aren’t just telling a story, we’re creating a narrative for People With Eating Disorders. This is part of why it’s so hard.

I believe that we’ve reached a point in eating disorder awareness where it’s become really important for us to start telling the ugly pieces. We took the time to write the narratives that show we can be positive and hopeful, the narratives that inspire, the narratives that people can relate to. But now we have to write our difference. No one will be able to help us until we’re willing to show them how we are not like other people, how our minds function in terrible ways, how we can spend hours debating a single bite, the mundane and disgusting and stupid parts of having an eating disorder.

Stories like this: last week my boyfriend was horrifically sick. It was something flu-like. He couldn’t keep anything down, he was miserable, he couldn’t leave the house because there was stuff coming out of both ends…and I was jealous because I knew he would be losing weight and I couldn’t.

I want our narratives to be whole and complex because we are whole and complex.

NAMI Week: Tropes and Strength

This morning on my way to work I was listening to NPR and I heard an interview with a woman who was in remission from breast cancer. She’d written about her experience, but unlike many other breast cancer stories, hers wasn’t bedecked in pink, she wasn’t painfully upbeat, and she didn’t have a story about how grateful she was for the experience. Instead, she spoke honestly about the fact that she wasn’t a breast cancer “warrior”, that it wasn’t about being strong all the time, that it truly sucked and she felt disgusted sometimes when she saw herself without eyebrows or hair, and that in the end her life went on in much the same way as it had before the diagnosis.

As she spoke, I felt some resonance with the experiences I’ve had of talking about eating disorders and the tendency to demand that those in treatment always remain upbeat, to turn the disorder into something you fight, and to gloss over the real and difficult elements of treatment and recovery that absolutely suck. No one honestly tells you how it feels to see yourself gaining weight, or how it feels to eat that first meal in your treatment program, or the circles you go in round and round in your own mind trying to decide what is healthy and what is good and what is right.

There are certain tropes in the eating disorder community about the right way to recover and the right way to seek treatment. The right way is with a positive attitude, with a desire to recover, with a strong inner motivation that turns you into a warrior against the eating disorder mind. The right way is following your meal plan and with mantras and with finding the joy in your life again so that you have the strength to battle on. The right way is by finding your inner beauty, by struggling through mechanical eating until you find love again, by having the very best family ever that you always rely on and always open up to. The right way is by learning the world is huge and beautiful and you are too, by realizing you would never judge others the way you do yourself, by finding your authentic self.

The right way to recover is to hold on to your eating disorder until you’re hospitalized repeatedly and nearly die, realize the importance of your life and then throw yourself into treatment, never looking back despite how hard it is. The right way is with breakdowns on the shoulders of those you love and moments of clarity.

These things are great for some people and I would never tell someone that they can’t hold on to these tropes or strategies if it works for them. Unfortunately there are many, many, MANY people for whom these things just aren’t their reality. Many people get dragged into treatment kicking and screaming, but that doesn’t mean that treatment will always be 100% useless for them. Many people don’t hit that moment of rock bottom and get a burst of clarity and momentum to move forward. Many people don’t find new joy or fun in life again, they simply have to remember how to manage in a contented way as they used to. Many people slog through years of treatment under different programs and therapists without a clear sense of where they’re going until they’ve finally found they have many of the pieces they need to do better.

It can be a wonderful thing to hold onto something positive. It can be inspiring to see that someone else has made it through and is in a better place than they used to be. Many of these tropes seem to have grown out of the idea that we can be strong and we can come out the other side better, the idea that we are not less than others or weaker than others or in need of pity. These are wonderful things to hold on to. But just like anyone else in the world, we also must be allowed to have difficulties and struggles. We must be allowed to have the complex experiences of being human.

Just as it is cruel to deny people of a certain group hope or happiness, it is just as cruel to deny them the experiences of being afraid or anxious or hurt. Part of what I would like to see in the awareness of eating disorders is the portrayal of real and complex people who have eating disorders: people who are sometimes hopeful and sometimes broken, people who work through each day like anyone else but who happen to have a few more things on their mind, people whose lives and trajectories aren’t a straight line down and then a straight line up. 

True awareness is not statistics or cut and dry stories that end just so. True awareness is a conception of how eating disorders fit into the real and messy lives of real and imperfect people. It is listening to someone speaking openly of what it’s like in their life. It’s not leaving out the parts that are hard or scary, or painting the illness to recovery journey as one of black to white. I would love to see more of this awareness.

Seeing Progress

Last night I had my final session with my individual therapist for DBT. After almost two years of 5+ hours of therapy a week, I’m starting to get really burnt out, and so after my full year commitment of DBT was up, I decided it was time to be done. I have one more group meeting, then I’ll be leaving. I don’t entirely feel ready to be done with DBT, but I am fairly certain that it’s the right decision at this moment. I need some breathing room and I really need more time to be able to do things that I enjoy. Right now my schedule is a fairly large stress in my life, and I feel like I’m often choosing between committing to therapy and committing to work, something I absolutely hate. So overall, I think that it’s a good choice, although I do wish I could keep learning more about DBT.

Part of moving on when I don’t feel entirely ready is that I feel I haven’t made any progress. It’s easy to do. Since change in mental health often comes slowly, we rarely notice the differences. Often it’s a lack of anxiety or depression that is a big change, and those are also harder to notice than something actually showing up (as an example, I made a phone call yesterday without anxiety, which is a huge change for me, but I didn’t notice it until I brought it up in therapy). Mental health is rarely a straight line upwards, and so there are peaks and valleys. Again, this can make it hard to see an overall upwards trend.

So as I’ve started moving out of DBT, I’ve been feeling a little down on myself. Anxiety’s been high lately, I feel I haven’t excelled at the treatment, and my perfectionism is high. But last night as I was talking to my therapist for the last time, she mentioned repeatedly how far I had come. She pointed out specific skills that I had become much better at. She pointed out my grasp of all the skills and my ability to figure out which skill is the right one to use in a given situation. I was surprised when she first said I had grown, and at first I thought she was simply saying it because that’s what a therapist is supposed to say to a client who is moving on. But the more I thought about the more I realized that I have been more level-headed in the last year, that I’ve made it through some really tough situations with little to no meltdown or target behavior, that I’ve figured out how to think critically about my feelings without invalidating myself.

By no means do I feel recovered or entirely healthy. I absolutely have struggled with a few bad bouts of depression and anxiety in the last month that have interfered with work and relationships. However with the help of someone else pointing it out, I can say that I have grown an amazing amount over the last year and made some serious progress towards healthiness.

I know many people who feel like they can’t find clear landmarks of their progress. Some can, and those things are wonderful, but many people wonder how they’ll ever get better and don’t see how far they’ve come. I think an important element of taking care of your mental health is checking in. Others are far more likely to see how far you’ve come than you are. Of course no one can define how you’re feeling but you, but if you haven’t thought about progress or how you’re doing in the larger scheme of your life for a while, it can be really helpful to have an outside perspective who can reassure you that they’ve seen changes and that they’re proud of you.

When in treatment, you often periodically check up on treatment goals or talk about whether you need to introduce new treatment. It’s great that this kind of check in is often built in to therapy. But I wish that it was just part of our relationships too. I wish that like getting your annual check up, each of us would periodically go through the inventory of our mental health with someone we love and trust to see how we’re doing and if there’s anything we should be worried about. Not only would this make it easier to talk about mental health in general, but it can be incredibly grounding when you’re trying to sort out your mental health by yourself.

I can’t say that I feel I’ve hit any big landmarks in my treatment. I still restrict. It hasn’t been a particular amount of time since I last purged or over exercised or self-harmed. I haven’t weaned off my meds (if I ever will. Still not even sure I’ve found the right ones). But despite all of that muddiness, it can be incredibly validating to see that someone else can point out what it is I’m doing better. What tricks do you use to measure progress and keep yourself motivated?