Coincidentally, I wrote a letter last week to the woman who I ran into outside Sainsbury’s this morning. I almost didn’t see her, if she hadn’t stopped and said ‘Katie!’ I would have walked straight past her without realising. I stared at her blankly for five seconds before she supplied ‘Eve’ and I said ‘oh God sorry, I’m half asleep, I didn’t recognise you’. She’s grown her hair and I think she’s lost weight since I last saw her but that’s no excuse really – I sat opposite this woman for an hour every fortnight for eighteen months at the eating disorder service, I can’t believe I didn’t know who she was at first. She gave me a hug and I came out with ‘I sent you a letter last week’ in a rather dazed fashion. ‘I know’, she said, ‘thank you’. And although this was only eight hours ago, it took me by such surprise that the rest is pretty hazy. She was pleased to see me looking healthy, she said my skin looked a lot better than when I was sick. I suppose that it a pretty natural thing to say when you are an eating disorder therapist who has run into a client she hasn’t seen in a year. She asked if I felt I had any more direction now and I said not really, but I’m trying to just stay calm about it and see what happens, keep myself busy in the meantime. I thought about the contents of the shopping bag I was holding – four different types of beans and some tomato puree – and wondered if I had beetroot crisp crumbs stuck to the sleeve of my jumper, but then decided it probably didn’t matter if I did, because at least that would prove that I’m eating now.
The last time I saw Eve was on October 7th last year, when I was discharged from the EDU a few days before I moved up to York. When I left I had lost 3lbs from my highest weight of the year which I’d hit the previous month, barely a BMI of 18.5 to start off with, and I had already cut back from 2700kcals a day to 1600. The EDU is three or four miles outside of the nearest big town and I had gotten into the habit of walking to my appointments. On the day of the final one it was pouring down with rain, and I still walked. I remember wanting to cry while I was walking past the harbour with the wind, already wintery cold, whipping my hair across my face and driving the rain into my skin even through my coat, wishing I could get a taxi but telling myself that I couldn’t, that one missed walk might make my weight go back up. I turned up soaking wet and was still a pound down from my last weigh in the week before in my waterlogged corduroy trousers.
I sat shivering in Eve’s usual room, filling out questionnaires to determine whether I had made any progress with my eating disordered behaviours, body image, anxiety, self esteem and depression since I had been referred eighteen months previously. She read out my results afterwards. I laughed at the Beck’s Depression Inventory – when I was first referred I had been a patient in the main psychiatric hospital that the EDU is attached to and I was both manic and suicidal and climbing the walls, so it was hardly surprising that my score had dropped from about 60 to 40. The questions about eating disordered behaviour were probably not very illuminating either because when I first started to see Eve I was on quetiapine, and if I took it in the afternoon I would binge two hours afterwards almost without fail. The bingeing had stopped entirely after I cut the dose down a month or so later and there was not much point assessing me on just the anorexic behaviours, because I was totally in denial about the fact that I was relapsing. So she seemed pleased – all my assessments (bar the one on self esteem, which had actually gone down) showed some improvement. I gave her a card and matching necklace and earrings I’d made her and left. I only wanted to cry for a couple of minutes before I got caught up in working out how many calories I’d eaten so far that day and what I might be allowed for dinner.
When I came home from York in an anorexic mess four months later I was assigned to a different member of staff at the EDU. Every time I turned up for an appointment this spring I was so worried that I would run into Eve. I didn’t want to see her, I was so embarrassed at having fucked everything up when I’d left pretending everything was fine. I kept thinking about the card I’d given her when I was discharged, thanking her and saying that she had made a difference to my life. I meant it at the time even though I was relapsing but now I was in such a state I felt like I’d been caught out in a huge lie. And although this time around I was committed to recovery and started gaining weight almost immediately, at every appointment I still held my breath every time the door to the waiting room opened, hoping that it would be my nurse Kate and not Eve coming for another patient. I just couldn’t bear the thought of facing her again.
I probably thought of sending Eve a letter last week because part of my brain recognised the date as being a year on from our final appointment. I discharged myself from the EDU in June this year when my BMI had come up from just under 14 to the mid-16s so I wanted to let her know that I have almost reached my target weight now, not relapsed again. I wrote that I feel like I have finally shaken off the anorexia, that I am studying again, looking for a part time job, am less isolated because I have a car, that things are still really difficult emotionally but now I don’t want to starve myself or use any other self destructive ways of coping. I wrote that the fact that I relapsed doesn’t make the things I put in her card were any less true – I do still use a lot of the things she taught me and she did make a difference to my life, she helped me through an incredibly difficult time in my life. I was trying to run before I could walk when I went to York so it was inevitable that it ended as it did, but at least it showed me that anorexia really IS an illness that I can’t control, and made me so angry with it for ruining my life that I fought back as hard as I could. Most of the time, everything I write gets photocopied or typed out so I know what I was thinking and feeling at a later date (the motivation for this being a mixture of dissociation and ‘book material’) but on this instance I sealed my letter in an envelope, posted it and tried to banish it from my mind. Thinking about Eve still makes me feel a bit messed up.
As I said, I was referred to Eve while I was in hospital. The evil effexor had stolen my appetite and I was so depressed and ashamed about being in the local psych hospital that I was capitalising on it and losing weight quickly. Eventually the ward asked the EDU for input and Eve came over to see me. I don’t really remember the assessment because I wasn’t really in at the time. I saw Eve every couple of weeks until I gained 15lbs on quetiapine and the appointments were cut back to once a month. But then my digestive system decided to give up on me and I started losing weight again. After a couple of months of not being able to eat or sleep, of feeling constantly dizzy and exhausted and terrified, I gave in and started starving myself on purpose again. Once my BMI was down to 15 Eve told me I could either do the INR – intensive non-residential programme, the day hospital – or wait until I’d lost another 10lbs and be admitted IP. I didn’t really care at that point, I didn’t want to get better but I didn’t want to end up in hospital either, so I grudgingly gave the INR a chance. But I’ve said this before. I gave it six weeks, quit, relapsed, applied to York in a desperate attempt to find something to live for. By July I had started gaining weight again, was more stable and had a definite discharge date of the week I was moving to York, so Eve said we could meet up every week until I left to work on the things that had caused the anorexia.
So Eve became the first professional I ever really talked to about the rape. She was also the first therapist I saw long term after Hazel, so I was incredibly anxious about the possibility of getting too attached and kept her at arm’s length as much as I could. This is probably why I didn’t make much headway with the anorexia or PTSD with her. The relapse that eventually forced me to leave York actually started the week I talked about the rape for the first time. That session over-ran and I didn’t have a chance to calm down a bit before I left, so I spent the week feeling incredibly unstable and scared. It freaked me out that I wanted to see her again to sort my head out – I thought that meant I was getting dependent on therapy again – so the next week I refused to talk about it and we started working on relapse prevention instead. I had a list of things I thought might make me vulnerable to relapse in York and we went through them all. It was useful, but…the whole time I saw Eve I never really engaged in therapy. I wanted to, I had been stuck on waiting lists for four years since being discharged from the adolescent services and I was so relieved to have some sort of regular support again – but I was terrified of getting too dependent on therapy and not being able to cope when it was stopped, so I refused to let go of the anorexia. I was convinced I would never survive without it, that it was the only thing keeping me sane.
Obviously things have changed now and I am glad I ran into Eve – I told her how well I was doing with the anorexia (including my current BMI) in my letter last week but now she has proof that I was telling the truth 😛 particularly since I was coming out of a supermarket and possibly had crumbs of beetroot crisps about my person. But now I feel all shaken up. It was weird, a little like when you are tiny and see your teacher in the shops and can’t quite get your head around the idea that they don’t actually live at school. Eve saw me when I was really ill and out of it in hospital, I talked to her about the rape, the anorexia, the worst of the self harm, and I still remember feeling so scared and ashamed at the thought of seeing her again this spring after I relapsed. Running into her today made me feel terribly sad and kind of exposed. I was already having a rough morning – I couldn’t stop crying from about 10pm-1am last night and I was only in town this morning in the first place to try and distract myself. Not so successful. After seeing Eve everything hurt even more. I felt so crap I actually thought of phoning Julie, but I thought calling my current therapist because I was freaked out about seeing my old therapist was probably a little weird even for me. So I finished my shopping, took it up to my car, bought lunch, walked to the park…and stayed there for three hours. I walked up and down, sat on the benches, read bits of Cosmo, did some people (and dog) watching. I do feel a little bit better now but still…I don’t know why this shook me up so much, but it did. Lets just hope I don’t end up spending half of tonight crying as well. It’s not much fun.
Three good things about today, other than the above, which is a good thing on balance:
1. X Factor in half an hour!
2. It was a really nice day, I didn’t even wear my cardi half the time I was in the park earlier.
3. IBS has been really playing up today so I had rice, eggs and a chocolate muffin for dinner 😛 works like a charm. I have odd comfort food.