At any given moment

My friend posted a lovely quote on twitter earlier: “At any given moment, you have the power to say “this is not how the story is going to end”” (author unknown, despite ten minutes of googling). I replied: “I love that quote. Although the initial decision isn’t nearly as hard as maintaining the momentum of change!” and she agreed with me.

It’s a quote which has particular relevance in recovery. We are sold the story that we can have anything we want, including health and happiness, if we want it enough. To my mind it is both true and false, empowering and damaging in equal measures. Discovering that you have the power to save your own life is incredible, and many people do manage to recover from life threatening addictions, eating disorders and other mental illnesses. Many people are left with no alternative but to find some way to survive by themselves, as they are repeatedly let down by professionals, insurance companies and so on. But faced with the same lack of support, others struggle throughout their entire lives and die prematurely. I have no idea what marks out one group of people from the other – as far as I can tell from my friends it’s not severity or duration of illness, nor willpower. It’s a hugely complex subject, and one I hope research can eventually tease apart: the factors which combine to make spontaneous recovery possible or impossible. All I know is that some of the bravest, most determined, intelligent and generally wonderful people I know are still very unwell, despite their best efforts – and that others who came exceptionally close to death are now fully recovered. It’s completely bizarre.

So I can’t tell anyone how to recover, or even how I have managed to avoid serious relapse. I can’t relay the exact set of conditions, thoughts and exercises necessary to make a lasting change. I can’t promise that I have achieved a state of lasting change. I’m three years into recovery, and it’s still ridiculously difficult to maintain the progress I’ve made sometimes. If I’m honest, I’ve been hanging onto recovery by my fingertips ever since I moved up to Newcastle, eighteen months ago. It wasn’t the move that did it, it was the FIVE separate stomach viruses in two months I caught during summer 2010, coupled with my emetophobia. That’s what I got for moving in with two junior doctors, who brought a truly impressive collection of viruses home with them. After moving out, during the first half of 2011 I managed to stabilise things and make a little more progress on top of that – only to slip back again when I started work in June. It’s not like I’ve been losing weight consistently or even deliberately, it’s just that I have very gradually, over the last eighteen months, gotten closer to the bottom of my safe range, until now I realise that I’ve been maintaining right on the line for months. The line, this is, that I established in 2009, when I lost my momentum to push through the last few pounds to my target weight. I know in reality I am probably 10lbs under where a healthy 27 year old should be. My periods are regular, my cognitive function much improved even compared to a year ago, and I have no urges to binge, no cravings, no obsession with food. I eat intuitively, and the idea of having fear foods seems laughable considering the amount of chocolate I get through. It’s tempting to argue that this is where my body wants to be, even if it is a bit close to the wire. But those restrictive thoughts and urges will not leave me alone, particularly when I’m under more stress than usual. I can’t work out if this is because I could do with gaining a few more pounds or if it’s just because I’ve been under more stress than I can handle with for the last seven months, trying to cope with the job of doom.

I found working directly on my motivation to change invaluable during the early stages of recovery. I wouldn’t over-simplify things enough to say that this is what made the difference between life and death because that would be silly, but it was a big help to me. I used – as I told my friend earlier – just about every technique in the book, whichever book that might be. I wrote a letter to myself in five years time, first assuming I had not made any steps towards recovery, then imagining myself to be fully recovered. I neatly laid out lists of pros and cons, both of staying unwell and of recovering. I created two posters for my bedroom wall, of the physical, cognitive and emotional consequences of anorexia, and of all the reasons to recover I could think of. I duplicated those reasons to recover on a set of revision cards and carried them around in my bag, taking them out at least twice a day to remind myself why I was doing what I was doing – more on particularly stressful days. I kept myself accountable by being honest on my blog and with my family, to the extent of keeping a weight chart in my kitchen at home in Dorset for everyone to see. I kept problem solving and solution-focused approaches foremost in my mind: whenever I came up against an obstacle I identified what was happening, possible reasons why it was happening, and how I was going to stop it from happening. My aim was to change my default setting: from automatically responding to stress with eating disordered behaviours to automatically responding with healthy coping strategies.

I don’t do half of those things anymore. This is the danger of becoming complacent in recovery. The great thing about all of this is that I seem to have created room for error: in becoming complacent I haven’t relapsed entirely. There have been some dodgy moments and I could probably be doing better, but for three years in I’m still doing pretty damn well. I am at a technically healthy weight, even if I suspect it may be slightly on the low side. I am eating a little erratically, with my intake disproportionately weighted towards the evening (when I suddenly think oh crap, haven’t eaten nearly enough today), but I am consistently making the decision to catch up rather than letting it slide and promising to start eating more tomorrow, which I am well aware would never happen. And I’ve been through enough stress to lead to a full blown relapse in the last few months – yet all I am having to combat is cognitive, rather than behavioural eating disordered symptoms.

My initial motivation for changing back in 2009 was that I suddenly realised no one was going to force me to get better. While that might have felt like a godsend to the younger version of myself, I was twenty four and the illness had comprehensively destroyed my health, education, career prospects, relationships, friendships – everything related to my quality of life. I had this image of myself getting older and older and still living with the illness, repeatedly trying to sort my shit out and always having to defer to relapse and accumulating disability. And right then, living with the illness became more terrifying than the sense of horror I felt when I considered eating more and gaining weight. But even then, I could easily have become overwhelmed by the sheer amount of work I had to do to get anywhere with recovery.

I wish I had answers, both for myself and my friends who are still struggling.

Wishing isn’t going to help anyone at this point. I am facing several problems at the moment, mostly related to work and my mental health, and I think it is probably time that I started focusing on taking care of myself to build up my psychological resilience, so I can cope with more. That involves revisiting some of the principles I established in early recovery: working on my motivation, eating six times a day, not allowing myself to make excuses for undereating and reminding myself of the importance of maintaining a genuinely healthy weight range, not settling for the minimum necessary for health. It’s not a step backwards because everyone in recovery goes through crappy periods when their stress levels are through the roof and bad habits start to sneak in again. It’s tempting to ignore it and imagine that things will get better once those stress levels decrease, but I am reminded of life just before my most serious relapse, back in 2006. I had been at a healthy weight for a few months but had lost sight of the need to work on my recovery directly and instead become complacent. Gradually stranger thoughts, urges and eventually behaviours crept back into my life, until the hospitalisations and digestive problems of 2007 became the catalyst for a major relapse. If I started to experience similar digestive problems now I’m not sure I would be as resilient as I was even last year, in the face of all those stomach viruses. A year or more of being distracted by other stresses has left me vulnerable. I wonder where the Katie who was going to take the world by storm has gone. I can’t seem to put a finger on when she became so tired and ambivalent.

Considering the circumstances, I’m doing well for someone who has been in recovery just shy of three years, living independently for the last eighteen months, with no professional support and no one watching that I keep on eating. It’s not much short of a bloody miracle when I put it like that. But it’s still not good enough, not really. Not in any self-flagellating perfectionist sense; it’s just that if I want to avoid relapse long term, and if I want to find out if full recovery is possible for me, I’m going to have to do better. Not just hang around hoping things don’t get worse.

The initial decision, in February 2009, was terrifying. But I had so much possibility and potential ahead of me, and that kept me going. Now, when the stakes of life and death have receded into the distance and the step by step process of regaining weight and health is long past; when I have to cope with my pre-morbid anxiety and depressive tendencies without the numbing effect of restriction or the hope that weight restoration will completely alleviate them; when I am three years down the line and feel so under pressure to avoid relapsing when I’m approaching thirty and I’ve lost so much time already; when there is no immediate comfort in self destruction and yet so many different stresses associated with functioning as an independent adult – then, recovery is a different matter. I am past the time when any given moment could be a turning point. It’s a long game now, and motivation is more important than ever.

Advertisements

7 responses to “At any given moment

  1. This post made me a little sad, but also hopeful. I duno – maybe I’m just feeling vulnerable right now. Lack of sleep = one overly emotional Ellie.
    I don’t think this sounds like complacent recovery btw. Long term recovery shouldn’t be about constantly checking in with yourself and keeping motivations going. It’s kinda good that other stuff seemed more important, even if it wasn’t the best of stuff. It’s pretty active recovery if you don’t have to watch yourself, but are still able to notice the habits creeping back in before you get sucked into it so are able to address them before it’s too late.
    So now you motivate and you put the effort back in again until your comfortable again, knowing that you have the resources to cope with these difficulties when they pop up again.
    I hope things start to improve for you soon. It sounds like your having a really rough time right now, but hopefully everythings closer to sorting itself out so the stresses can lessen

    Hope you’re well x.

    • Ellie,

      No, one would hope that long term, recovery could eventually take a back seat to other concerns. However, I’ve been in *that* place before, and I know I’m not there now. There’s quite a big gap between being safe and stable in recovery and knowing that you are slowly going backwards but doing nothing about it because you’re under enough stress as it is and are hoping it’ll go away on it’s own. The former is healthy; the latter is complacency. And actually, I DO think that long term recovery should include checking in with yourself on a semi-regular basis and keeping your motivation going, especially when co-morbid conditions are involved, because otherwise this very thing can happen. You become more adept at avoiding accidental lapses as time goes on, but I don’t believe one ever outruns the biological predisposition towards anorexia, and so although you may be able to leave longer gaps in between check ins after a while, you really do need to keep working on recovery long past achieving weight restoration. It’s not something you’re done with in a year or two, and to be honest I’m not even in long term territory yet. Three years is less than a quarter of the time I spent being ill.

      I think maybe the misunderstanding is related to time scales. I’m not saying this feeling of stagnation has begun in the last couple of weeks and I’m hopping straight on it, I’m saying it’s been creeping up on me in parts for over a year, with some serious backsliding occurring since I started working in June, and it’s only now that I’m addressing it. It’s taken me so long in part because I HAD thought I was safe to put certain aspects of recovery on the back burner, and it hurts my pride a little to admit that I jumped the gun. Damn pride.

      I know how much some of my readers want me to be recovery superwoman and beat my ED into submission every time I run into a slight hitch. Unfortunately it’s more complicated than that. Life often is!
      x

      • I didn’t mean it that way – I don’t see you as a recovery superwoman. And also I do think you need to check in with yourself – I only said not constantly. Obviously you’d need to check in with yourself to keep track of where you’re at, but it can’t be all the time. My only point is that it’s not complacent if you notice it before it fully takes over your life and are able to work to get back on track. Obviously I don’t know the extent of this slide, but if you are able to go “well, this didn’t work/this does work” then use it to patch up the weaker aspects of your recovery, it’s not complacent. Of course you can’t escape the genetic aspect of so on some level, monitering progress is cruicial, but sometimes things are hard and sometimes they are less hard and recovery isn’t linear so old habits can come back at any point.
        Honestly, I don’t expect you or anyone elses recovery to be all good all the time, without any effort. I just think that admitting the problem and putting effort in to fix it doesn’t show complacency. To me, complacency would be the oposite of this and all I was trying to say is that I think that it’s selling yourself short to think of it this way. To me, it shows pretty active recovery if you can do this, regardless of how long it took or how much you let slide first. Part of long term recovery means learning when to worry and when to not, but you only get that through practice.

        Maybe its more of a semantic issue. Or maybe I was sloppily writing. Last night all my language skill got replaced by emotional outpourings in every aspect of my life lolz

        Sorry, I didn’t mean to make you feel like I was expecting too much from you or recovery more generally. I actually agree with all of your reply. I just don’t think I made my point clearly maybe x.

      • Okay, I’m a trainee counsellor and counsellors love to summarise 😛

        Basically I was saying that I’ve allowed myself to become complacent about recovery for the last seven months, while I’ve been working in my current job. I’m not saying that I’m being complacent NOW, in planning how to change this. I also find my hackles raised when I feel like people are disagreeing with me about things only I can know or not know about myself or my recovery. It makes me feel judged and patronised. However, sometimes when I write posts like this one I feel intensely vulnerable, and this can make me liable to misintepret things people say in response, so that might have been going on too.

        Probably just a case of wording and tone. The fact that there’s no tone of voice over the internet makes it all very easy to misunderstand!

  2. I actually see this as a positive post, in so many ways… You demonstrate insight, recognition of the problems you still face and the will to do things to help you get back on top again. I would be quite suspicious of someone who claimed to be ‘recovery superwoman’ in their third year of recovery from a longstanding ED…

    I look at it from this perspective: Those of us who develop EDs do so because we have an inherent vulnerability to do so, especially when life doesn’t treat us particularly kindly (for one reason or another). We need to first work on improving our eating behaviours and ensuring adequate and constamnt nutrition; then work on finding ways of developing ourselves and addressing some of the very things that make us vulnerable to developing an ED in the first place.

    I work at maintaining recovery every day, even though my weight rarely changes within a couple of pounds. Sometimes remaining recovered is easy. I get through the day feeling great and I eat with ease and consume well over 2,000 kcal per day. Other days I struggle. Sometime I struggle because of physical illness. At other times I struggle because I feel hopeless and have low mood (which can even be related to ‘time of the month’). I remain vigilant. I am glad you do too, Katie 🙂

  3. sanabituranima

    Good luck. I wish I had some helpful advice.

  4. I’m with ELT, Katie! I see you working diligently to slog through the hardest parts of recovery. Until you “test the fences” of how a non-ED life works uniquely for you, you won’t know how to maintain recovery or how to get more deeply into it. Life is a learning experience every day for everyone. The key is to make sure we don’t fall into patterns that become self-destructive, and I know that is much harder for someone with the predisposition to EDs, like you and my daughter, than it is for me. You seem to be doing it rather well, especially considering your history. Hugs!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s