Sunday, November 30, 2008

I am, at times, so sensitive and raw and open to the subtlest things. I am laying on the couch after a day of writing a final, sitting inside a Starbucks while the rain poured down the windows. I emailed a professor to ask if it was okay that my final was 1 page over the 8 page limit. Given that I am a good student and that it was a page over and not a page under, I felt safe in the assumption that It was fine.
I got an email back saying that I would be allowed to turn it in that way, but If the rest of the class stuck to the page requirements, then I would be marked down.

I cried.

Moral of the story? I dont know... that crying is a great coping mechanism? That chosing to take care of yourself makes many of us sensitive?

Moving on..

Thanksgiving is generally a difficult holiday for anybody with food problems or in recovery, but this year was a bit insane for me. I had my almost 40 year old cousin staying with me. My roomate and I had decided to cook a whole Thanksgiving dinner and so, eventhough I hadnt seen her in 6 years, as the only other member of my small family on the east coast, I invited my cousin up to NYC.
I knew she cared about her figure, but I didnt realize just HOW disordered her eating was. If I had, I probably wouldnt have invited her.
From our first meal where she picked at a bagel, to our Thanksgiving dinner where she spoke about alcohol calories and carbohydrate calories and how they werent worth it, to the quick 1 mile power walk after thanksgiving dinner, to deciding to eat pie, only after I agreed to go to the gym the next morning, to then not eating until 4:30 the next day. I mentioned I was hungry and she said "Didnt you have that protein bar?" .... Well yes, I had one before we worked out at 11:30...
To then not eating dinner that night (I did....she didnt... I ate leftovers in bed... while she spoke about how annoying it was to hear people eat...)
To saying that the candy we ate ruined our workout and our walking.
To last night where she asked me what "that lump of sugar and butter" I was eating was (It was a crossiont, which I ate because I wasnt eating enough during the day.
She was also insanely judgemental of other people.

SO it was a hard weekend, but mostly it was just plain annoying!
At first, I had a complete body image breakdown, wanted to avoid Thanksgiving dinner and go to the gym, but I stayed and I ate and I made a conscious decision to pay attention to my own needs and followthrough. Ultimately, I could have run from them, but in the past, that has only led me down a road to miserable land and my body doesnt change much anyway.
I stayed with myself, I payed attention to my own needs and love for myself and focused on, not her body, but her self loathing and inability to love herself and care for her body and spirit and it got me through with more self love and strength than I had before.
Not to say it wasnt hard. I have some anatomical issues that are made worse by stress and anxiety that were flaring up a bit, making it really difficult to eat and digest food without it coming back up. There were two occasions where the food wasnt going to go down. While in the past, I have let this turn into purging or kind of binging and purging, I let it happen, then when I could, I ate more. I didnt want to feel like I was starting an ED cycle again.

So today, after she left... I am feeling a little raw.. a little sensitive... but cared for, loved and tender

Wednesday, November 26, 2008

Happy Thanksgiving Everybody!

Remember to stay with yourself and centered in love and everything will come and go with grace.

Let us all energetically wish eachother a year where Thanksgiving means being thankful, loving eachother, and feeding ourselves, both physically and soulfully.

Tuesday, November 25, 2008

The recent NJ decision was mentioned over at ED Bites and while I am glad for the families involved and those it will effect positively, I do have to say I have somewhat of a differing opinion about what the actual decision means.

For Families across the nation, paying for healthcare is both a fear and a struggle. With the costs of modern medical and mental health treatment, many middle class families can no longer afford to “get sick,” but what happens when somebody needs expensive longer-term care? With epidemic status, eating disorders afflict people regardless of age, race, class or gender. Eight million American’s face a daily struggle, and are more than not, denied the help they need by managed care providers (ANAD, 2008). Anorexia, once known as a “rich white girl’s disease” appears in every demographic and with the highest mortality rate of any mental illness, still only one in ten sufferers receive treatment and even less receive adequate treatment (South Carolina Department of Mental Health). Inpatient care averages at approximately $1,000 per day and with an average length of stay falling somewhere between three and four months, even middle class families are facing debilitating financial struggles to give their loved ones the care they need (Costin, 1999).
In Critical Care (Bennett, 2008), Bennett highlights several families with a member struggling with Anorexia Nervosa , and reviews the complications of receiving the costly treatment proven to produce positive results. Bennet further delves into the complications of cost, length of stay and ultimately the managed care that many American families rely on. As an example, the author highlights a class action lawsuit in which over 100 US families of eating disorder sufferers sued Aetna for inadequate coverage or in most cases, lack of coverage all together. Aetna’s argument was that in most states, managed care is only required to cover biologically based disorders and as the research has no conclusive evidence as to whether Anorexia is biologically based.
It touches on issues of mental health parity and its insuffiency or lack of existence in many states in the nation, but the average reader would have to do further research to understand the implications of parity and associated diagnoses. While three pages hardly affords Bennett the space to portray the complications Anorexia provide, she mentions the sheer time it takes to gain weight at two pounds a week, a speed generally considered healthy. Bennet further goes on to explain the settlement Aetna proposed and its insuffiency when compared with the lack of benefits and funds spent by the individual families.
In the article, Bennett introduces a recent policy initiative called the FREED act, which would “implement research and education initiatives, as well as require employers and insurers to cover eating disorder treatment the same way they cover physical disorders.” (Bennet, 2008). She further highlights two more bills aimed at New Jersey state brought about by senator Joseph Vitale, the first of which would add eating disorders to the list of mandated covered mental illnesses and the second would define them as biological.
One could glance at these initiatives and assume they would fix the problem of funding for a population so desperately in need, but they would miss out on the mass population of eating disorder sufferers. According to state parity in California and most states that, infact, have Parity for eating disorders, insurance companies are not required to cover the most common eating disorder, ED-NOS. (Harlick, 2006). Defined in the DSM-IV loosely, it applies to those who for one factor of another do not fit into the criteria for Anorexia Nervosa or Bulimia Nervosa. For example, an emaciated woman who fit all the diagnostic criteria for anorexia, but still had her menstrual cycle (either because she was on birth control or naturally) cannot technically have an anorexia diagnosis, as amenorrhea is a diagnostic criterion. A man, who threw up everything he ate, but did not eat more than any typical person in his situation beforehand, cannot technically have bulimia. These examples compose a vast majority of sufferers and Parity does nothing for them, other than to make them feel like they don’t deserve help (Lipton, 2008). Furthermore, the act proposed by Senator Vitale, while immediately helpful for those with Anorexia or Bulimia (as defined by the DSM-IV), has long-term ramifications that may be detrimental. If one classifies an intersectional disorder as biological, purely for immediate relief, they risk sacrificing much funding for experts to study the true nature of these disorders, which may lead to more accurate of comprehensive care down the line.
While policy surrounding eating disorders is lacking and often leaving sufferers and their families “out to dry,” policy initiatives need much more backing by the experts themselves and a holistic view would craft bills that help all those who suffer. With bills that effect only a small few, the oft question echoes in reverse, not “Can you afford to eat?,” but rather, “Can you afford not to?”

Citations:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental
disorders (4th ed.). Washington, DC: Author.
ANAD, Anorexia Nervosa and Associated Disorders Facts about eating disorders.
Retrieved September 18, 2008, Web site: http://www.anad.org/22385/index.html
Bennett, Jessica (2008). Critical care: Why even families with health insurance are
resorting to lawsuits to get coverage for the treatment of eating disorders like anorexia.. Retrieved Sept. 16,2008, from http://www.newsweek.com/id/142988/page/1
Costin, C (1999). The Eating Disorder Sourcebook.
Los Angeles: Lowell House.
Harlick, J (2006). Food fight: People suffering eating disorders have precious few
resources in the bay area. Retrieved Sept. 16,2008, from http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/01/06/PNGQEGF2TO1.DTL&type=printable
South Carolina Department of Mental Health, Eating Disorder Statistics.
Retrieved September 18, 2008, Web site: http://www.state.sc.us/dmh/anorexia/statistics.htm

Monday, November 24, 2008

Im being published!!!
You see that picture to your right? The one of me shoving my stiletto clad foot through a bunch of diet ads?
We Feel Fine is producing a book, and my photo is going to be included!
New Post soon!

Friday, November 21, 2008

I have had such a blaringly amazing day!
At work this morning, I just had one of those uber productive and not overly exertive days. I saw two clients and did a ton of paperwork.
Client V is an Italian 59 year old man who had been in jail for 15 years, prior to his arrival at this facility. He has a history of herion addiction and alcohol dependency with severe anger management problems. Blah blah blah, long story short, I realize after the session that I have just had a conversation on tapping in to one's own intuition with this fella. In most ways I *should* be scared of him, but I really like the guy.
I have him doing my "Oprah assignment." Everyday around lunchtime, I asked him to think about One thing he knows for sure.
He really liked the assignment and asked if he could write it down for me.
I find my "airy fairy, uber yogini healer" style is insanely effective with people one would never think it would be with.
Then again, Ive learned to be authoritative in my healing love and light.
Client P is a 23 year old caucasian woman with 3 children, SEVERE ADHD and a history of opioid dependance. She walked in and asked if I had any candy or pretzels (many of the therapists keep stuff around because clients going through withdrawl or trying to quit smoking find sucking on things to be helpful). She sat in my office and pretty much binged while she was attributing her weight gain to thyroid problems. She keeps complaining of "getting fat," so I explored the idea that without drugs or old behaviors to turn to, sometimes we turn to the easily accessable things. I wondered if maybe she found herself doing this with food.
No. She didnt.
I asked her to get curious about her sugar cravings and look at when they happened. Did they happen when she would normally smoke? Also, I wanted to make sure the doctor was aware that she thought her thyroid was problematic.
Now I have an ethical question. The woman has been on adderall for 10 years. IN coming into this facility, they asked her to go off of it as it is an addictive drug. She agreed for a time, although she had never abused it in any way. Her behavior reflects her INTENSE need for it. The Psychiatrist has been hesitant to put her back on it, asking her to try less intense and non addictive drugs like Strattera first. She complains the Strattera is not working, but to dispense Adderall at this facility, a letter is needed from me, her therapist.
If I believe that a large part of her need/want for that specific drug is the appetite effect, what is the ethical thing to do?

Anyway, after all of that, I met up with a woman I worked on We Bite Back with for a year or two, but whom I had never met in real life. She lives in NJ but only 30 minutes away and is working on her Physicians Assistant Masters degree. We had a wonderfull time and braved the cold to meet up with Ai Lu of Avid Alegria
and Stephanie of 36-24-36 for a Latte and a recover(ing/ed) ladies Latte. It was so great to be amongst such strong women with a common denominator of hard times and huge growth.

After a lovely dinner, said friend and I went to SEE 36.24.36 with some of the girls of SEED (Students Ending Eating Disorders) at Columbia University.

It was an amazing performance where the true stories of the actors and the creative expression of what it is like to live, die and love someone with an eating disorder resonates deeply in the hearts of anyone touched by one. I am not personally a crier in movies or theatre, but I welled up with tears several times, relating deeply to what was being expressed. From leaning on eachother, to stroking eachother, one could visably see the audience supporting eachother through the performance and the hugs all around after showed the solidarity that is held among those of us who are recovered or in recovery and chosing to speak about it.

I came home and had some chocolate mousse.... because, you know what? I can!

Recap: Amazing day
Ive been noticed! http://acelebrationofcurves.com/2008/11/21/who-needs-help-learning-to-be-more-loving-and-less-condescending/

Wednesday, November 19, 2008

Somehow, perhaps because it was my world, I always assumed that therapists were all aware of eating disorders. I assumed they would know what might trigger an individual, what not to say to someone, populations that are/were more vulnerable than others.
I am not sure why I assumed this. As someone starting out in the field, I know very little about certain things. I know little about schizoaffective disorders. I do not know much about borderline or many of the personality disorders.

I go to work everyday (okay, 3 days a week... im a grad student), and always ALWAYS end up walking into a conversation pertaining to food, weight and bodies. I do NOT work in an eating disorder facility, but rather a drug treatment facility that has many cooccuring dual diagnostic disorders present at any given time. We do have a few clients with eating disorders, but from what I can tell they go misunderstood and untreated beyond the occasional can of Ensure that is handed out and then it is left to the client to carry it around or decide what to do with it.

I hear coworkers talking to other coworkers about diets and food and weight and exercise. This bothers me, but not the extent it bothers me when I hear staff talking to clients about it. "Youve gained a lot of weight since youve been here"
"Maybe you should eat less"
"Your clothes are looking really tight"
Or even TO me referring to a client "Well, you know, she was pretty when she got here, but shes gained 30 lbs or so"
It is so maddening! I generally leave the conversations between staff, or between staff and clients. I have very little play room as to what I can or cant say to other therapist's clients. I refuse to participate, unless someone is lying about a physical mechanism such as metabolic function or something of the like.
I mentioned my history to my supervisor once, I believe, but she doesnt remember.
and frankly, it isnt that it bothers me because of my history... it isnt a trigger.... its just well...
UNENLIGHTENED and UNEDUCATED
and jesus christ... dont we have anything BETTER to talk about?
Maybe that were slowely losing government funding because of the economic crisis?
Maybe that so and so is getting married?
Maybe that (fill in your own topic)?

Thank GOD, I have other things to talk about and thank GOD that no matter WHERE I end up working, I wont be a therapist who cant see past a body.

Tuesday, November 18, 2008

Somebody pointed something out to me yesterday.
A recovered woman studying for her PHD in clinical psychology, she was afraid to reveal that she had once had an eating disorder for fear that it would discredit her in her field.
How odd this was to me, as I have always felt it obvious to say that I had had an eating disorder. Having been in treatment in a place run by recovered therapists, it seems almost beneficial to my professional career that I had suffered at some point. I know theory about self disclosure lays spans a large continuum of beliefs.

What is yours?
For those of you IN therapy, how much do you want to know about your therapists?
For those of you that are therapists, what are you comfortable revealing to your clients?
And also, how does becoming a therapist change what you want to know about your own therapist?

Friday, November 14, 2008

What do I enjoy in an internal/embodied way?
I enjoy sitting around a fire with friends and a guitar, singing and looking up at the stars.
I enjoy the shivers and shocks of cold that dart through your body when you realize that something in the world has shifted and that you were a part of it.
I enjoy massages and being tickled.
I enjoy the feeling of the sun my back. I enjoy the feeling of jumping out of a plane with a parachute, both in a symbolic and embodied way. I enjoy jumping on trampolines and the feeling of bouncing when you finally collapse. I enjoy rollercoasters. I enjoy singing and feeling my soul become one with my breath and my body. I enjoy the cocoon like feeling of laying in the steam room after a hard workout and the vague soreness the next day. I enjoy the coursing of shakti and surrendering and merging that happens when I meditate with my Sangha. I enjoy the feeling of a good hug.
I enjoy swinging on swings and wondering, like I did as a child, if I could go high enough to wrap around the top. I, finally, as an adult, enjoy hula hoping. I love riding a bike just at the beginning of fall and feeling completely free moving through space. I love horseback riding, although it is a lot scarier than it was when I was competitive as a kid. I love the synchronicity of dancing a tap dance that you already know and feeling a part of it. I love the subletly of a great Fosse number, where just a minor wrist curl makes everything sexy. I I enjoy a good arm wrestle, and knowing I'm strong enough to win 99.9 percent of the time. I enjoy the feeling of surrendering between the mattress and a duvet, but still being awake enough to curl up with a good book and a cup of tea. I enjoy the ultimate bath; bubble bath, tea, good music, candles and an Oprah Magazine. I enjoy rolling down hills. I enjoy spontaneous rock climbing. I enjoy music that makes your spirit groove. I enjoy the feeling of taking off a pair of heels after a night out. I enjoy a good Jacuzzi, especially outside at night with a glass of champagne.
But honestly, what I really enjoy, more than anything else, on a physical, spiritual, soulful, emotional level is sex. I honestly believe it is what saved me from absolutely destroying my body in the worst of times. It was something my body always did right. It was something I understood on all levels. It was the place in my life where I was the healthiest. It became what I studied, what I embodied, what I fought for. The experience didn’t rely on being at a certain weight. It had nothing to do with what I ate that day. Hell, there were MORE flavors than I could ever taste of ice cream. I never felt I should do it or shouldn’t do it. It was purely untouched by the negative factors that most of my life was barraged by. It was one way I could be in my body, love my body, let somebody else be a part of that, and celebrate something I would always have no matter what. Actually, before I went into treatment, the moment I knew something was really truly wrong was when I had bad sex for the first time and for the wrong reasons. I got out of bed and thought, “Okay, this isn’t me. Something is NOT okay.”
To me, it is similar to an amazing protest! Emotionally, there is an investment. You care about what you’re doing. It just plain feels good. You can feel the excitement in every part of your body. Spiritually, there is a connection to the divine, in a way that the universe makes more sense. It brings you into the moment, into yourself and who you are and how you are in relationship to others. It holds great power and can help free stuck energy, change old beliefs. Often people or types of people are involved that you never expected. Politically… well I just don’t do Republicans. No really. Size doesn’t really matter… its more about the noise you make. It hasn’t really started until somebody gets handcuffed. Hah! Just kidding.
Enough, enough ☺
But honestly, it is the most embodied experience I have a connection to on all levels. I do love the end of a yoga class, but holding things that hurt physically isn’t enjoyable. Spiritually, I love what it does, but physically? Not so much. And yes, I like how I feel about being in a gym, but does it FEEL good? No.

But really, there are a lot of things I enjoy. They
5 weird thing about being a therapist:

5) Your clients think you have no problems

4) Being youngest than your clients youngest child

3) Seeing GAF scores that are higher than your lowest was

2) Knowing things about clients that they dont know that you know

1) Being on the same meds as your clients.

Sunday, November 9, 2008

At times I ponder if it is possible for a soul to be too expansive for the capabilities of a singluar human form.

Perhaps my gemini nature is infact two souls in one mind.

I sometimes feel as if I crave more life than is ever possible, more experience than my self can encapsulate.

Who knows. What are others soul/body experiences?

Saturday, November 8, 2008

I knew it would hurt me eventually. I was sure it would catch up with me.
I was told by everyone that I had a problem. I knew I did, but I justified it as my last vice.
Everyone needs one, right?

Picture this:
Im walking home... or strolling... its a lovely day in New York City and I am in somewhat of a fog. I meander in and out of stores for about 3 blocks and feel a blister developing in my pink plaid vans. This blister is on my left foot. I dont know what is causing it, but I decide to leave it alone for the mile or so it would take me to get home.
I climb the 5 flights of stairs to my Manhattan Palace (aka a 2 bedroom apt). I throw myself across my bed.
"Whoa is me," I utter as contort myself into an odd yogi position in order to remove my shoes. I take off the one covering the blister distressed little piggy toe.

Do you know what caused it?
To my distress.... A packet of splenda fell out.
IT finally happened. My Splenda problem hurt me.

Thursday, November 6, 2008

I am feeling so insanely alone. I desperately need community of like struggle.
Half of me desperately wants to take good care of myself, love myself, nurture myself and half of me is afraid of breaking these patterns and giving up this identity that I have fallen back into.
I need somebody to hold me and say "aww baby girl, everything is going to be alright."

Wednesday, November 5, 2008

PRESIDENT OBAMA
thats all