‘Grounding’ and Other Complicated Words

This is a personal reference list for me, but perhaps it will help others. Overall I find quieting my mind or paying attention to my body (common suggestions for self-soothing) to be very unpleasant. At some point I would like to increase my tolerance for things on the second list, but exposure therapy is not how you relax.

Grounding:

1. weighted blanket
2. back breathing
3. fidgets, especially cold or heavy ones
4. hard hugs
5. hot showers/baths
6. square breathing

Triggering:

1. ‘body scan’ meditations
2. okay, really any meditation billed as ‘grounding’ [Example]
3. diaphragmatic breathing
4. mindful movement

[Advice] Eating & Endpoints

I’ve started answering questions…with questions. If you have a problem that might benefit from other angles of consideration, send it to donovanable [at] gmail [dot] com. 

I have an eating disorder. My therapist thinks it’s anorexia, but I don’t think I’m thin enough for that to be right (I’m just barely underweight) and I haven’t lost much weight either. I don’t want to recover ’til I’m thin.

Advice?

A first note, before the rest, is that anorexia both in the U.S. and abroad is classified by behavior and perception, leading to low weight, not necessarily a specific weight limit or weight change. Many people argue that the ‘low weight’ component of the DSM is still a poor criterion. (I am one of them). That being said, it is still possible that you may qualify for an anorexia diagnosis under the strict criteria.

kerikeri-sue-hawker1
Glass art by Sue Hawker

I have to admit, Letter Writer, I was not sure I could offer questions in response to this question. I could offer recognition—there is still a part of my brain that makes this argument to me, and another part of my brain that would like me to put it into action. Ultimately I think there always will be.

But if I could take myself out of this headspace, pause that part of my brain and interrogate it, these might be the things I would ask.

What does being thin mean in terms of other benefits? What values does it feel like it confers?
If you can, I would write this down, in a list you don’t have to keep or show to anyone else. If you’re like me—and you don’t have to be!—your answers might have little to do with appearance and more to do with things like ‘being acceptable to others’ and ‘moral purity’.

You don’t have to analyze these further or make decisions about them, just figure out what’s on that list for you.

What changes would it mean to how others see you to be ‘thin’?
Quotes because I mean what ever you mean by the word “thin”. What does your brain tell you about this?

How will you know when you’re thin? Specifically, is it a feeling internally or a specific measure?
I ask because I notice you said you’re a little underweight, by which I’m assuming you mean you’re under the weight recommended for your height. I think many, if not most people might be confused by hearing that you desire to be thin and also that you are underweight.

Do you have a specific, number-based stopping point in mind? If you do, do you think it’s one others would agree with? I’m not saying that other people are always great source of health information or bodily decision making, but I’m wondering what your anticipation of this answer is.

What does being not-anorexic mean for you?
It seemed like you were considering changing behavior (if I’m understanding you correctly) when you reached the ‘thin’ point. What would that be like? What would you do differently? What things is your brain telling you about what this decision would cause for you in terms of benefits and tradeoffs?

What would happen if you didn’t have access to reflective surfaces/measurements?
I ask because for me, I mostly got external information about my size (which then cued positive or negative reactions). As a sophomore in college, my dorm had renovations which accidentally removed all mirrors, except for four—one in each community bathroom. And nothing changed about my weight; I continued to have some disordered behavior and weight fluctuations, but not more or less than the previous year.

What did change was how distressed and impaired I felt by my body. I was less likely to skip class or social events due to seeing my body in the mirror on the way out the door. I could still go see myself if I wanted to, just by hiking down the hallway. But that little barrier? It did a lot to save my sanity.

I should say, I didn’t feel very positively about this. There is a quiet voice in me, one that was louder back then, that believes that I should feel shame and unhappiness about my body, that this is the correct penance.

But I wonder what you think would happen if you tried having less access to mirrors.

I don’t know, LW. I don’t know if this was helpful, or if a version of this would have helped me five years ago. I wish you happiness and health now and in the future.

 

Insane in Sane Places

I live in a tiny wonderful bubble where it’s (1) pretty unusual not to have a mental illness (2) public knowledge that I have an eating disorder. It’s a bubble where I am left out of conversations about diets and nutrition, where my figure goes unremarked upon, and I’m not the only one.

Work is not in that bubble.

It’s the first job since I started treatment where I kept an eating disorder from everybody, and I’ve fiercely protected that independence. (Independence? That’s what it felt like, and what I promised myself it would be.)

It was teaching a class on nutrition. How to eat healthily.
I’ve never followed any of the advice I gave—I am, after all, a cautionary tale in eating—but I will be endlessly proud of my rules for the lecture.

I will not discuss ‘bad’ foods and ‘good’ foods.

I will not shame.

I will not discuss weight loss as the sole goal for food consumption.

It was walking into a conversation about anorexia and how strange it was that teen girls do that. The crawling duality of being expected to theorize dispassionately for curious strangers about what makes crazy people do that. I walked back out again. I had forgotten…something in the other room.

It was five-thousand discussions about weight loss I stepped out of. A handful of ones I didn’t (that was a bad decision).

It was exclamations of how ‘good’ I was each time I refused offers of baked treats. The stupid bubble of happy feelings that rose up each time I heard it.

I’ve just almost done it—I’m talking with clients about what it means as my term at the agency ends, saying goodbyes, counting time in weeks.

But it was also eating my lunch in peace each day. Nobody policed whether or not I was eating ‘enough’. I wasn’t making people worried each time I refused food. People accepted ‘no thank you, I’m not hungry’.

I declined an offer for a going-away party this week (it means cake, see?).

It wasn’t appropriate to share, and this I know. Little practical gain for me, lots of guilt and uncertainty and worry for them.

But I miss my bubble.

Recovery Mutterings

1. I actually really just want that salad, without the large GUILT FREE sticker on it (see also: guilt free brownies, guilt free fruit cups (?!?!), guilt free kale chips, guilt free hummus). Remembering and then retroactively feeling bad for all the apparently GUILT CONTAINING salad is not a good road.

2. Find me a major holiday that does not involve food. I dare you. The trifecta of conversations about sweets, overeating, and diets that is Halloween, Thanksgiving, Christmas? Oof.

3. “I would like to go on a date with you. One that does not involve planning or eating food together.”

4. That thing which is memorizing the location of mirrors in every new location so that you can avoid them. My college has an unavoidable mirror in the women’s bathroom on the third floor, an avoidable mirror in the bathroom on the fourth. There is one path through the gym locker room that avoids all three (three!) mirrors.

5. Doctors offices. About a year and a half ago I sliced up my hand, deeply enough that I was concerned about the nerves for my left pointer and middle fingers. I also have a fairly strong phobia of injury and injection. In between passing out and attempting to find my insurance information for the doctor (I’d moved that day, everything was in a mess of boxes) I remember one continuous thought: what if they need to know my weight? What if they have to weigh me? I alternately promised myself that I wouldn’t beg them to avoid putting me on a scale and swore that I would just tell them: I had an eating disorder. Please don’t weigh me. I fought for that past tense.

6. I have met all but one of my partners during periods of anorexia or flirting with it. Someday I will believe this is not what caused the initial attraction.

7. Someday I will wear pants again/stop avoiding jobs that have a dress code including pants/stop giving up activities that can’t be done in skirts/sprawl/lounge with abandon

8. Someday I will be okay with the things are not going to happen someday.

9. Someday.


“The wounded woman gets called a stereotype, and sometimes she is. But sometimes she’s just true. I think the possibility of fetishizing pain is no reason to stop representing it. Pain that gets performed is still pain. Pain turned trite is still pain. I think the charges of cliché and performance offer our closed hearts too many alibis, and I want our hearts to be open. I just wrote that. I want our hearts to be open. I mean it.” -Leslie Jamison, A Grand Unified Theory of Female Pain

Some Things That Might Make Food Manageable

Post prompted by Brienne asking if I had a list of things that made it easier to handle food when food is hard. I did not! I should! Here we are!

This is a list of things I did in order to sustain momentum of recovery. At some point in college I managed to get to the point that I believed I should eat food regularly, possibly even in meal sized amounts. This sounds like it’s a flippant line, but was huge progress from high school, where I’d only managed to conclude that I should eat enough food to prevent dying and/or injury.

The list is divided into food-specific stuff, and other ways I changed my environment to make my symptoms less invasive.

These aren’t suggestions that are likely to cure your eating disorder, nor are they Official Therapist Advice. They helped me keep momentum in recovery and go about my daily life without melting down so frequently. The second half of the list might also help with gender dysphoria, body dysmorphia or related body badbrains.

Food

-First and foremost, Recovery Record made the largest difference in my food pathology. A free app for iOS and Android, it prompts you to record mood, exercise, and food each time you eat, as well as prompting you at each meal time (customizable to when you normally eat). I was both able to notice what made for good trends (waking up early, lots of fruit) and what made for bad days and weeks (I thought anxiety was the issue; it turned out that guilt was a higher-risk emotion). If eating food isn’t something you will naturally be able to do, attaching a sense of accomplishment from checking it off your to-do list isn’t a bad solution.

-I listed all of the things that made food even slightly harder, no matter how silly, and then immediately stopped those things. I do mean even the silly things. To give you an idea, here is a partial list:

Eating food that was not served in bowls.
Eating food that did not come in single-meal sized amounts.
Consuming more than one type of food at a sitting (for instance, a sandwich and an apple)
Snack food.
Things that could not be eaten with a spoon.

….and then for nearly a year, every time I made food, I planned to avoid falling into any of these categories. Obviously, I started introducing more complicated meals later. Yesterday I had an apple, a sandwich, and snap-pea crisps for lunch, a meal which involves snack food, eating on a plate, several components, and no spoons. During no part of this my brain split asunder, nor did I consider that oh no, a multi-step, spoon-unneccessary, snack-food-including meal was occurring. But, the important part was that this was once I’d felt stable, and when things are more instable (during midterms, finals, and emotional crises) I revert to my spoon-involving, bowl-using meal plans.

-I told other people I was struggling with an eating disorder. This is advisable if and only if you expect this to result in support that is not emotionally draining.
Not supportive: friends and acquaintances who watch every bite you eat, continually push more food on you, and are vocally skeptical if you express a lack of hunger. This can very quickly make eating feel like performance art.
Supportive and worth their weight in gold: friends who offer to cook for you, make a standing weekly dinner/lunch/brunch date with you, are willing to tolerate that you will be suddenly hungry or full or eat at odd hours. (See also: longform tumblr writeup)

-Loved the everloving fuck out of foods that were not stressful to me, no matter how weird. At some point in my adult life, I ate a square of baking chocolate (that’s right, the kind with no sugar at all. It was probably eaten by accident.) and thought hunh, this is oddly tasty and reminiscent of chocolate bars. Since then, I keep baking chocolate around, because I can eat it without spending fifteen minutes calming myself down after.

Last week, I remembered that I like bread-and-butter pickles, and this week, my partner put two jars of them in the fridge. If it is 3am and I wake up hungry, it will take more brain power than any reasonable person has at 3am to talk myself into eating a protein bar or making toast, or pouring a glass of milk. Instead, I will go eat a few bread and butter pickles. Or maybe a square of baking chocolate. Is this deeply weird? Probably. But at 3am I will wake up and eat a very strange snack and then go back to sleep with exactly zero panic attacks whatsoever.

Environment

-Mirrors. Mirrors—well, really any reflective surfaces—were a huge problem. However, in one of the regular bureaucratic snafus of college, when I was a sophomore, my dorm complex was remodeled. Some how, in the construction, mirrors were forgotten. All the rooms had previously come with a full length mirror (on the back of the door, and thus, unavoidable), which disappeared. And this was amazing. Suddenly I could put on clothes or just be in my room with seeing my body, which meant far fewer cues for invasive thoughts about food and my appearance. In houses I’ve lived in since then, we’ve had the mirror in a hard-to-locate place, so that I had to be actively seeking out a view of my whole body.

-Related to the previous point, I cultivated the habit of taking routes which didn’t mean walking by reflective storefronts or buildings. Nanotechnology building had a glass front? Guess I was walking by the chapel instead. I framed the additional time as extra exercise, which made for near-compulsive motivation to take the safer routes. (Trade one pathology for a less dangerous one!)

-My object permanence for food is terrible. You know that game you can play with babies, where you put a cup or a blanket over their toy and they look confused, and then delighted when it appears again? (see also: peekaboo) At some point it stops being funny. That’s when the baby has realized that things that are out of sight have not suddenly stopped existing, and that you are not a magical toy-creating wizard. They have object permanence: things that exist do not cease existing because you can’t see them.

At some point, I noticed that I find food far less distressing when I can’t see it. Put a chocolate near me, and I’m caught in an endless (and distracting) loop of wanting it desperately and practically feeling as much guilt and horror as I would if I ate it. This can make it difficult to even focus on conversations at times. (Cue added guilt for being a bad friend.) So, particularly tempting food is quickly hidden. There’s a a plate of brownies on our dining room table…can I put a stack of textbooks in front of it? Is there a dish of candy at work? What if it was a dish of candy with a lid and a sign instead?

Growing Aches & Pains

I went to the gym today. I am this particular kind of sore—achy unevenly from an elliptical that wasn’t quite equally greased, sore in strange places from the leg press with the stuck seat-adjuster—for the first time in nearly a year.

Nine months ago, I banned myself from gyms without exceptions. Item 348 in a long list of stuff I’ve loved and given up because it made my mental illness that much more persistent. It, and several other concurrent changes, were good decisions.* They preceded the best nine months I’d had in eight years.

I stopped having that euphoric walk home after I’d exhausted my whole body. (I also stopped having to sit on benches because I was too dizzy or faint to walk the whole way)

I started having itchy/anxious feelings at night when my energy level spiked—I holdover from years of evening ballet rehearsals. (I also stopped having days of crawling, shaky panics because I couldn’t bear to be in my body but the gym was closed.)

I started needing to take long walks to burn off the jitters from the day. (I also stopped actively hurting my body…it’s quite hard to obsessively walk.)

Of course, when you write it out like that, it’s obviously worth it, right? But I missed the routine. After-school dance classes starting in first grade turned into ballet rehearsals six days a week, gave way to funky smelling gyms until I was good and sore and tired. And finally, a few weeks ago, I decided I might be well enough to give it a try again.


*yes, confounds, I know. Unfortunately, this case study used poor methodology due to time constraints.

Invasion of the Body-Checking

From the Eating Disorders Glossary:

Body checking refers to an obsessive thought and behavior about appearance. For people with eating disorders or body dysmorphia this may present as frequent weighing, looking in the mirror, and pinching or wrapping hand around stomach, waist, thighs, arms. Or they may ask others for such assurance: “do I look fat?”, “do I look any bigger,” etc. This can be done even hundreds of times per day; the reassurance may only be momentary followed by heightened anxiety and fear. Checking is a common symptom of obsessive compulsive disorders 

After years of ballet, which (as I’ve said before) is essentially paid mimicry, noticing movement — in both myself and others — is a firm habit. And, ever since I noticed how many of my natural movements are body-checking. Nervous habit of loosely wrapping my right hand around my left wrist during small talk? Body checking. Sitting cross-legged or with crossed legs in a chair? Done to avoid body-checking that got so bad while sitting that I couldn’t take exams. Hands on hips? Body-checking; poking about for boniness.

I wrote about Not-Just-Right-Experiences, and I’d describe the body-checking as being in response to NJREs. Something feels off, “have I possibly changed size??” leads directly to body checking. I calm down after I body check….only until the next NJRE.

And all of this is to lead up to this fascinating case study:

Thomas et al. (2012) describe the case of ‘Ms A’, who described herself as having ‘3% of full vision’: she could detect only high contrast, some colour, and large shapes under optimal conditions, but otherwise nothing at all.
[…]
Talking about her disturbed body image, Ms A described typical features of anorexia in the sighted, including checking behaviours, body avoidance (e.g. avoiding tight clothing), and comparisons with others. As she put it, ‘I do all of the checking, but without the eyes’. She, like other blind sufferers from anorexia, used tactile body checking – feeling for bony protrusions in face, ribcage, spine, and hips, and assessing how tight her clothes felt.  She would also try to engage in the ‘mirror checking’ that’s so common in sighted anorexics: she described how she would stand very close to full-length mirrors to use the patterns of light and dark to try to assess her shape. ‘I like to pretend I can see a form’, she said. Usually, because she could only see ‘a blob’, this kind of checking would simply confirm to her that her body was too large. When comparing herself with others, Ms A used changes in air pressure to estimate people’s body size, and auditory cues like voice location and pitch to gauge height and weight respectively – a practice common among the blind.”

I’d been foolishly assuming that body image issues depended on sight. This, even though the more distressing component of distorted perception is when my proprioception (knowledge of where my body is in space) is wrong. Even though body checking is prompted by an internal sense of distress, rather than seeing myself. Even though few people with eating disorders are able to recover just by seeing the evidence in front of them.*


*Eating disorders are not just for the already-slim (EDs: they’re for everyone!) and society makes it particularly hard to recover as a fat person with an eating disorder. I wouldn’t be surprised if the pathology and course of those cases is far worse, but of course we rarely manage to study them.