One Year Down

October marks one year since I started treatment at Renfrew. I've been going back and forth between celebrating and feeling a little disheartened. I've heard different things about eating disorder recovery and most of them include years of therapy to be fully recovered. I don't know how long I will continue therapy. I don't know what fully recovered even means, but today I'm choosing to celebrate because of how far I've come.

One year ago I was sick. I was never eating breakfast, rarely eating lunch, and I was taking so many laxatives in a day that I could not be anywhere without having to be slave to the restroom. When I type those things out it doesn't feel like I'm talking about myself.  I was weak. I was tired. I was moody. I wasn't a good wife. I wasn't a good mother. I wasn't a good sister. I wasn't a good friend. So, I would binge at night to feel better.  But oh, that meant I needed to work out. Then I would wake up and do it all again.  

Today, I am not sick. I  eat three meals a day more often than not. I don't take any laxatives. When I have to go to the restroom, I can wait like a normal person until there is a bathroom available. I have energy. I am a better wife. I am a better mother. I am a better sister and friend. I work out sometimes, but sometimes I don't and that's ok. I may be a little bigger, but I like to think it's because my heart is so full. I fall asleep at night feeling tiny kicks from the sweet baby my body is healthy enough to carry. I wake up every morning to the sound of my precious son's voice asking "How was your sleep, mommy?" And I'm able to smile and say "It was so good. What should we do today?" because I'm no longer a slave to my eating disorder.

I still have days where I look in the mirror and wonder if I'm seeing what's really there. I have days when I don't really want to be around people because I feel fat. On those days I have to remind myself that life is so much more than worrying about a number on the scale or a clothing size. It's about the many blessings in this life and the hope within me for the life to come.

So, yes, I think I'll celebrate this past year. I don't know what's ahead, but I know what's behind and I'm never going back there.

Taking On The World

It's been a while since I've written. As I was writing about my journey through recovery I started feeling guilty. I had so many people write to me and tell me how inspired they were to see the process unfold. I was astounded to read daily messages from women (and men) who struggled with the same things or even very different things, but who found strength in reading the details of my struggles.

So, why did I feel guilty? Well, I just don't feel that inspiring. As I was recalling my experience in treatment, I was doing so several months after the events actually took place, and while writing was a wonderful reminder of the hope I found at Renfrew, it was also a reminder that the ease of my recovery was short lived.

K, whoa, let me back up. This is not meant to be a downer post and I don't want to break any hearts or let anyone down. Intensive outpatient is a wonderful way to go for quick and intimate therapy. I have no idea what shape I would be in if it weren't for my time at Renfrew, but I know it wouldn't be pretty. With that being said, here are just a few things that I have discovered since my time at Renfrew that have simply made my recovery harder:

The diet mentality doesn't work for long term weight loss (I plan to talk more about this in a future post so stay tuned). Not only does it not work, but it's not an option for me because I get all obsessive crazy and start using behaviors that aren't healthy. But, just because I feel this way, doesn't mean the rest of the world does. So, dieting, calories, and weight are all still a common topic of conversation. Don't get me wrong. It's not as if every time someone talks about calories or losing weight I am freaking out (only some of the time). I think I just came out of treatment expecting the 8 weeks to be enough to shield me from triggering situations, but the reality is that I was stepping back into the real world where all of the triggering factors are still present. I remember I was talking with my friend from group about how Renfrew veterans we met seemed tainted and discouraged. "That'll never be us," we both said. I'm so thankful that she and I experienced the "let down" around the same time so we could help each other through it. When I brought up this discouragement to my aftercare therapist, she explained it like this: IOP was a jumpstart to recovery. It gave me knowledge, skills, and techniques to cope with every day life. However, I am combating years of thoughts and behaviors and realistically 8 weeks (or however many weeks) isn't going to cure my disorder. Recovery is a journey and it takes time and work.

So, for a little update, time and work are what I have been putting in these days. Back in January, I starting weaning myself from my medication because we knew we wanted to have more children in the near future, and I wanted to make sure I could function without medication before getting pregnant. There were ups and downs during the weaning process, and lots of prayers, but I have now been off of my medication for over 8 months and am proud to say there have been minimal use of behaviors. It's hard. I have realized eating disorders aren't something that go away quickly or easily (I know, bummer, right?). There is debate on whether one can ever completely overcome one, but I choose to believe that there is hope of full recovery. Plus, I have even more incentive now to keep going (as if I didn't have enough before), since I am expecting baby number 2 in March!

So, to sum it all up, I needed to update you all so I didn't feel like an imposter. Everything I wrote was true. I had a wonderful experience in treatment and left feeling like I could take on the world. In my euphoric state I just didn't realize I would really have to do that!

Feeling Free

The first week of no laxatives was very hard physically. Emotionally and mentally, I felt wonderful. My body, however, had stopped working the way it was supposed to because it had relied on the laxatives to do the work. Every time I ate, I felt as if I were going to throw up. The bloating, reflux, and heaviness was not fun, but I got through it. And I didn't slip up, even though it would have been easy to do.  I kept telling myself if I took laxatives I would have to start this all over. God made our bodies to be so resilient. When I think about the abuse I had subjected my body to for over a year, and then how it healed in such a short time, I can't help but be thankful. There are still times I wonder if there is damage done that I can't see, but I have to give those worries to God and let Him heal me in the way He sees fit.

I went to my last session with my therapist and she gave me a sheet with a picture of a stop light on it. In the green circle she wanted me to write what continued recovery/no behaviors looks like. I wrote "No laxatives." In the yellow circle she wanted me to write down what it would look like to need to reach out for help. I wrote "Take laxatives or use other behaviors." In the red circle she asked me write what relapse would look like. "Laxative or other behaviors for a period of time" is what I wrote. It was hard at that stage for me to even picture going back to that place. I felt strong and confident and in my last week at Renfrew I decided I wanted to take in everything and make sure I wasn't checking out early. I did just that. At every exercise I listened, participated, and smiled, thinking of how far I had come. There were new ones joining the group, and I prayed that they kept going. I felt like a new person was emerging and it was euphoric. I was sad to leave the women who had become almost like sisters in that short amount of time, but so happy to be leaving because it meant I was well.

On my last night at Renfrew I went in feeling so happy. They had their usual ceremony when a woman finishes at Renfrew. They passed around a carved dolphin and each woman placed a "blessing" in the dolphin for me.  I had written something I wanted to read, and I only cried a little (can you believe it?).

When I came to Renfrew 8 weeks ago, I was in a dark place, and I didn’t even know it. “Oh, these poor girls who have eating disorders,” I thought to myself on the first night. It didn’t take long for me to realize that I was one of those girls and that I needed to be here. Over the course of my treatment I have been continually supported by all of you, and because of that support, I have found a confidence that I have never known. There has been something empowering about having a group of women listen to some of my deepest darkest thoughts and not pass one ounce of judgment. Each one of you has been such a big part of my recovery, and I won’t ever forget what your encouragement here has given me. I hope one day you are all able to see yourselves as I see you—beautiful inside and out.

I am leaving here, knowing that I am beautiful today, just as I am, because I am me. When I came here, I was in the grips of something evil called Ed. I am still a work in process, but he no longer has a hold of me, and I leave here today feeling free.

I thank God for my time at Renfrew. It really did save my life. I didn't know what life after Renfrew would entail. I felt strong and unbreakable, but I had not yet encountered the stresses of life without an outlet and safe place 3 nights a week. Adjustments were to come but the knowledge and support I got while in treatment was to be my saving grace every time I stumbled. It was almost Christmas and I couldn't wait to enjoy the holidays with my family and not waste time worrying about the demands of my eating disorder. And I didn't. I watched my son's face light up when he opened his presents. I held my husband's hand. I ate with everyone and enjoyed it. I felt like it marked a new beginning in my life, and I couldn't help but smile and say prayers of thankfulness for the life I've been given.

Dear Body, Love Self

At this point in recovery every day was starting to get easier. After my questioning/talking/crying/screaming phase I felt that my head was more clear than it had been in years. Each time I went to group a new light bulb seemed to turn on and my body was getting healthier too. I was taking less than half of the laxatives I was when I started and I was finding other ways to deal with my emotions.

I can remember my therapist giving me "coping techniques" for when I was feeling the urge to binge or take a laxative. One idea that has stuck with me is the idea of appealing to any sense but taste. For instance, when I was feeling urge to eat out of stress, sadness, loniliness, etc. I could choose to do something that appealed to sight. This didn't just mean to look at something. It meant to really look at something. So, I could find something that was appealing or interesting to look at and study it. Absorb it. Embrace it. Focus on that one thing for 5-10 minutes. I could listen to music, but I had to listen to every word and sink into the sound. This part of therapy was a huge help to me. By the time I did one of these things, my urge to binge or purge had subsided and I was able to move forward.

When I got down to three laxatives a day I was ready to be done with them. I didn't want to do it gradually anymore. I was just ready to say goodbye to them for good. So, at the beginning of December I stopped taking them completely and I felt insanely free. I had learned that I could survive without coping in that way.

One of my favorite memories from group was close to the end of treatment. One of the therapists was leading a Body Image group. She asked us all to write a letter to our bodies from ourselves. She gave us no other instruction. I was stumped. Everyone else was writing. I couldn't seem to separate myself from my body. My body was part of myself. Wasn't it? The therapist asked me if I was having trouble. "I just don't know what to say." I was finally able to write something. We went around the room and read our letters. I was last. It was emotional listening to these women I had come to love talk to their bodies. Some talked to their bodies negatively, some apologized, but all of them talked about how they wanted to love their bodies. I was last. It took me a minute to gather myself.

"When I started writing this letter my instinct was to write something negative about my body..."

I started to laugh and cry at the same time.

"...but i couldn't. For the first time in years, I had nothing negative to say to my body."

I was smiling so big but tears were streaming down my face and my heart was so full. The therapist and a couple of the other ladies cried too, and the therapist said, "This is why I love my job." This is what my letter said:

Dear Body,

I'm thinking about all you have endured.  I am thinking about the binges, the laxatives, the starvation, the dehydration. You haven't done anything to deserve the abuse I have given to you. You have kept fighting even when I gave you no means to do so. I have hated you so much even when you were fighting to give me a healthy home. I have loathed you even while you were doing beautiful things, like carrying my precious son. I'm so sorry.

I will look at you now with thankfulness, rather than disdain. I will reframe negative thoughts to remember the things you continue to give me. I will remind myself that you are a temporary vessel that is serving its purpose and doing it well.  I will take care of you. I will love you.

Love,
Self

I'm still trying to do these things every day. Some days are harder than others, but when I pull out this letter it helps me remember I am much more than just my body. It has done so much for me, but it's not who I am. I have bigger things to worry about than making this temporary shell look perfect and while I want to keep my body healthy, I want my first priority to be keeping my heart and soul healthy because those are the things that really matter.

Mourn. Accept. Live.

My therapist said she sees a lot of middle children with bulimia. By nature I am a nurturer, a lover, a feeler. I have always felt things very deeply. I can remember watching my little sister get spanked and crying my eyes out. I always wished they would just spank me because it would be less painful than seeing her be hurt.  I wonder sometimes if I just went around feeling everything for everything else and then stuffing it somewhere inside of me. Sympathy and empathy are such wonderful things to give, but I had allowed myself to give them in excess to the detriment of myself and my family.

Along with feeling things deeply, I also started caring way too much about what everyone thought about me. There are so many things wrapped up in this concept: the competition aspect of being one of three girls, being the daughter of a father who is incredibly fitness oriented, being part of a southern family who loves to eat, low-self esteem, moving in with my parents for two years while my husband was unable to find a full-time job. Without divulging ALL of my emotional baggage, there were a lot of dimensions to my eating disorder and they all started surfacing around this time.

It's still hard to decipher exactly how my eating disorder started taking control, but my therapist described it like this. "You're like a sponge. You absorb emotion, whether it's your own emotion or everyone else's. Eventually a sponge gets heavy and it has to be squeezed out." As she was saying this I could totally see the metaphor. Graphic, I realize, but the laxatives became a way for me to rid myself. It wasn't just about the food, or being skinny. It was about a release for all that emotional weight I had carried for so long. Okay, so what do I do about it? How do I stop caring so much? 

For the next couple of weeks I questioned. I questioned God. I questioned my life decisions. I questioned my reason for being. I addressed emotions I had never acknowledged. I cried. I yelled. I journaled. I mourned things I had never mourned. I shared with the group things I had never said out loud. I told them how I pictured things would be and how different they turned out. They cried with me. I dreaded every day. I knew the only behavior I could use was to feel every single thing and for so long I had learned to push those feelings away. It was exhausting. 

After taking time to mourn, cry and question, I learned it was ok for life to be different than I expected it to be. With the unconditional support of my family, my close friends, the therapists, and ladies in my group, I started to celebrate and appreciate things I had been too busy to think about. I had been so overloaded that I was not able to enjoy the blessings God had given me. Slowly, the realization of those things started to take the place of all of the negative things I had held on to for so many years. The more I talked about my feelings and things I hadn't been able to express, the more I was able to move on from those feelings and be the person I wanted to be. Sometimes we just have to step back and accept things in order to appreciate them. I was learning a day at a time that it was okay to have feelings. I learned to welcome feelings, keep some of them, and let some of them go. I started to live and not just survive and it felt good. It felt really good.

The Guest House

It was November. At this point in treatment I made a promise to myself that I was going to stop using behaviors. I was going to stop restricting and follow my meal plan. I was going to keep reducing laxatives. It has been 3 weeks of IOP and I was losing time. I needed to do what the therapists asked me to do to make sure I got better. I made this promise not realizing the challenges that lay ahead. I had no concept of how much I had come to rely on my behaviors to deal with my emotions. The first few meals were a breeze, but by the end of the second day eating all three meals and still reducing my laxative use, I felt like I was going crazy. I remember doing an exercise in an experiential group that was really eye opening. The therapist asked us to read this poem:

The Guest House

By: Rumi

This being human is a guest house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

As an unexpected visitor.

Welcome and entertain them all!

Even if they're a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice,

meet them at the door laughing,

and invite them in.

Be grateful for whoever comes,

because each has been sent

as a guide from beyond.

After reading the poem we were given a coloring page. It was a house. We were instructed to pick 5 colors to represent the core emotions: joy, sadness, anger, fear, love. We could color our picture any way we wanted to color it. I colored the sky outside yellow (joy). The house itself was blue (sadness), with a pink door (love) and green windows (fear). There was red smoke coming out of the chimney (anger). I didn't think too much about it as I colored away happily.

The therapist asked us all to share with the group what each color represented. I always felt like the therapists were so wise and all-knowing and were sort of "tricking" us into recovery. I realize now they don't always know what we're thinking. Their jobs are simply to facilitate realization and change, and I appreciate that ability so much.

So, we're going around the room, every woman sharing her house, which really represents herself, and it gets to me. I've heard what the other ladies have said and felt sorry for them all. How sad to have all that sadness, anger, etc. I'm always really good at having sympathy for other people. Me, though? I was just coloring a pretty picture. When the therapist asked me to try to analyze why I chose to place the emotions where I did, I know I looked confused. I literally could not answer because I was so taken aback. It was Tracy who spoke up to analyze me. "I think the outside of your house is happy and joyful because that's what you want everyone to see. Your door is pink because you let people in very easily and show love right away. The main part of the house is sadness because I think you feel that way the most. Your windows are fear because you're afraid to look out and see what's really going on, and your anger sneaks out sometimes like the smoke." The more she talked, the more emotional I became. I was so confused. That wasn't me. Was it? I was quiet the rest of the group (rare).

On the way home I kept thinking about that picture. I didn't want to be only "outwardly" happy. Was I? If so, why? What was I sad about? What was that smoke seeping out? It was time to explore that house a little more and figure out what was going on in there.

The Beginning...Again

The night Grace came was the night Lucy finished at IOP. She held so much promise. Even though I wasn't that much older, she seemed so young, and full of life. I was so happy to see her go, only because I knew she was ready. I couldn't wait for her to go finish high school with the new found love for herself that I wish I had had during those years.

Around the same time, Lauren had to step down to day treatment where she could get more support. She just wasn't gaining the weight she should and still had a lot of anxiety around eating. Linda also left IOP. I was told she was "taking a break" from treatment. She seemed serious and hard to reach sometimes in group. It was obvious she didn't want to be there. I learned she had almost lost her life to her eating disorder and had been fighting it for many many years. She was tired. I wanted to tell her she was beautiful and that she deserved to live. I didn't get a chance to do that, but I still think about her from time to time and hope she's found peace.

I was feeling a little overwhelmed when the group I started with began to move on and new people were showing up. I had only just begun to get to know and open up to these ladies and now they were leaving. Two more new faces showed up after Grace. One girl, Julia, looked around my age. I liked her style and she had good taste in music. She was solemn, and I wondered what her story was. The other lady, Toni, looked late 40's- early 50's and she had such a warm smile. When the therapist asked the same question-- what would we like to tell them, Grace chimed in "It's safe here." I smiled, and was so happy after just one night she felt that way. There was solace there.

Grace still struggled at every meal. She could never finish, which always meant she had to drink a boost, which would make her even more upset. I felt for her. I wanted to fix it for her and to kick that voice out of her head and tell it to leave her alone. But, we couldn't fight each others' battles. We could only fight our own, and remind the others they were not alone. Sometimes that was enough to get through the day. Grace had to leave IOP shortly after joining because it just wasn't enough for her circumstance. She went to day treatment. I was so sad. I had come to love that girl in a very short time. But, it was best and I knew I would see her again. Some people you just can't forget.

I remember a night when one of the therapists asked us to write on a note card the first time we remembered having a negative thought about our body. Mine was at camp-- age 10. One of the boys called me fat and I remember being very aware of my body for the first time. On the other side of the card she wanted us to subtract that age from our current age to figure up the number of years we had been thinking about our bodies in that way. Thirteen years. That's how long I had been thinking of my body negatively. Thirteen years was too long. I was ready for a change.

When I met with my individual therapist in week 3, she asked me about my food journals. I had been filling them out, but very little. It wasn't because I was forgetting to, it was because I was eating very little. The fewer laxatives I took, the less I was eating. I didn't even fully realize I was making this change, but it was as if my Ed was telling me it had to be one or the other, because if I wasn't purging as much with laxatives I absolutely had to restrict. My therapist said that their first concern was my physical health. She recommended I step down to day treatment. I was devastated. Me? Step down? I have been fully participating. I have been putting my heart and soul into this. I have come to love these ladies and I am just getting to know the others.  "I can do this." I said. "I'm going to get my mom to just sit down with me at every meal and hold me accountable so that it's not so easy to skip meals. I'll have her initial my paper." My therapist said "Cool. I think you can do it too. We just want to make sure you have the support you need. If you think you can get it at home, then I trust you and we'll check in next week." I didn't realize it at the time, but that was the true beginning of my healing. Up until then I had a bag full of tricks (also known as behaviors) I could use when things got hard. Not anymore, though. The hardest times were yet to come.

Fighting For Grace

“Oh the comfort, the inexpressible comfort of feeling safe with a person, having neither to weigh thoughts nor measure words, but pouring them all right out, just as they are -- chaff and grain together -- certain that a faithful hand will take and sift them, keep what is worth keeping, and with the breath of kindness blow the rest away.” Dinah Maria Mulock Craik

My third night in IOP was Lisa's last night there. She seemed like a kind person. She seemed like she had probably been through a lot. I tried to imagine what it would be like to leave Renfrew. I tried to guess how I would feel. Would I feel like a different person? Would I be "fixed"? I didn't know what it would mean, but Lisa sure did look happy. They asked her if there was anything she wanted to share with the group. She thought for a minute and she said "Progress not perfection." I thought about that phrase while she was gathering her thoughts. "I kept thinking I had to be perfect, but perfect isn't possible. Progress is though." She said some more things, but this concept has really stuck with me. Part of what an eating disorder does is "help you" cope with feeling like you've failed at, well, anything. Didn't finish your laundry? Here, have some cookies. Didn't stick to your daily Bible reading schedule? Oh here's some crackers for you. Don't like the way you feel today? Oh, don't you worry, I have just the thing. After several attempts at fixing my failures or problems with food, Ed liked to try to convince me that if food didn't fix it, laxatives would do the trick. But, Ed was wrong. After a binge/purge session all I would feel was guilt for eating and then taking laxatives. When I heard the phrase "Progress not perfection," I decided it would be my recovery mantra. That little phrase from an almost stranger got me through some of the hardest times of my life that were just around the corner.

It was week two of treatment. I was meeting with my individual therapist for the first time and I was a little nervous. When I'm nervous I talk too much, so that made me even more nervous. I stepped into her office and she started by asking me to tell her a little about myself and if this was my first therapy session. She asked me to tell her what I thought would make a good therapist. I started talking about myself and Stuart, and Camden. I told her I had briefly met with a therapist at the first treatment center I went to, and that it wasn't a great experience. I told her I would just like to talk to someone who didn't seem too therapisty. She laughed.  She asked me questions naturally and even though I know she had an agenda (all therapists do), she led the conversation in ways that made me feel as though I were talking with a friend rather than someone who was trained to listen. We made a recovery plan. She said she was most concerned at the time about the amount of laxatives I was taking. She asked if I would be willing to try taking 2 less a day for the next week. She also said it would be helpful if I started filling out food journals and eating the recommended exchanges. I agreed.  When I walked out of the door that day she said, "I like you." I smiled, and was able to genuinely say back that I liked her too.

That week was a breeze. I did take two less laxatives on most days. Food journals- eh, not so much, but I loved going to Renfrew. It became my solace. I took in every word and was fascinated with how much I could relate to these women who all had very different stories. At the end of the second week there was a new girl, Grace. She looked like she was early 20's, tall, thin. She looked nervous. The therapist asked if there was anything we would want to tell her about our group. "It's safe, I said. No judgement here." She nodded, and looked relieved. She volunteered for the first exercise in group that day and really put her heart into it. I was impressed. I was going to like this girl, I could tell. When we got to dinner it was apparent she was going to have a hard time. She poked around on her plate and ate a few bites. The therapist gently tried to encourage her to eat more. She started trembling and then crying and true fear was written all over her face. I had never seen anything like it. I moved my tray to the chair beside her and patted her back. "Your body knows what to do with it. Your body needs this food." She tried her very hardest, but just couldn't finish it. That voice in her head that was telling her not to eat was just too strong. She was a fighter, though, and I wanted to fight even harder now too- for Grace.

Realization

Night two of IOP. I was pumped. I was ready. I left the previous night feeling encouraged and excited to reach out and help those ladies fight their battles. I walked in and made small talk with the girls that were there. The nurse came and got me and said they had forgotten to weigh me and check my blood pressure the day before and could I come to her office. Panic. My secrets
is going to be out. They are going to know how big I am. I held it together. "Sure." I got to the office and they did blood pressure sitting down first. "You can step on the scale now." It sounded so...bossy. I started to step on and she corrected me "Oh, um, backwards." Wait. I'm not allowed to SEE how much I weigh right now? You get to know and I don't? This means I don't get to guess what you're thinking based on the number. This means I don't know how much I have lost using the laxatives in the last 6 hours. "Oh. Okay." She then took my blood pressure standing up. She told me I needed to drink a Gatorade because there was fluctuation in my blood pressure sitting down vs. standing up. She explained that if my body was deficient of certain things, it could cause this change.

So, back to group I went, Gatorade in hand. It felt like a trophy. The eating disorder voice (we like to call it the voice of Ed) was telling me I had succeeded. I had deprived myself enough that it was evident. Good job. 

The topic of the group was food rituals. "What are food rituals?" I asked after the therapist had been talking about them for a few minutes. Lisa chimed in. "You know, like, manipulating your food before you eat it to make it easier to eat. It can be cutting your food into little bites so it looks less daunting, or eating one thing at a time instead of taking turns with different types of food." I had never thought about this concept before. The therapist had everyone go around the room and tell one of their rituals. I was stunned. These poor women worry about eating so much. Every time they eat they worry. I wanted to hug them all. I went last. "I honestly don't think I have any of those. I just take laxatives." Linda looked up (she was usually looking down). "When do you take your laxatives?" I was caught a little off guard. "Usually, 3 in the morning 3 in the afternoon and 4 before bed." "Well, I know it's not when you eat, but taking 10 laxatives a day sounds like a pretty serious ritual to me." I didn't say anything for a minute. And then I just started crying (remember, it's what I do). I'm not talking about a little sniffle. I was pretty much sobbing. I felt the same reaction as I had the night before when I cried. Everyone offered their silent support through glances filled with empathy and lots of tissues. Tracy cried with me. I pulled it together.
"I'm so sorry. I think I just came into this thinking about how sad it was to be here with all of these women with eating disorders. I kept thinking I would help everyone get better. But, I need to get better. I really need to get better. I'm one of you."

It was the first of many realizations I came to while I was in treatment. Those realizations are what brought me out of the grips of something I had let run my life for way too long.

Right Where I Needed to Be

I've changed the names of the women in my groups out of respect for their own personal struggles.

After my trip to the emergency room I started researching other options for treatment. The first doctor I had seen was not a good fit. I needed to go somewhere that was more hands on and involved in my progress. I remembered  a therapist I had briefly spoken with at the first office mentioned she used to work at a place called The Renfrew Center. I looked them up and called to schedule an assessment. 

I hear a chorus of angels singing when I think of Renfrew. I like to think they saved my life. When I got to the office I was feeling brave. I had already done this. I had already told someone some of my deepest secrets. I probably won't even cry this time. The lady that came to get me was kind. That word doesn't seem quite right, but she embodied kindness. She took me through a labyrinth of rooms to get to her office.  We sat down and she started asking me questions she was reading from her computer. With every answer I gave, she demonstrated some type of movement or response that showed compassion. It was inevitable- I cried (it's what I do). I apologized and she handed me tissues and said, "It's okay. These things are hard to talk about." I felt comforted and like she understood. 

After the assessment was finished s she told me about the levels of treatment, and we concluded that IOP (intensive outpatient program) was the best option for me. It would mean me driving almost 2 hours 3 nights a week for 3-4 hours of therapy at a time. I would have an individual therapy session once a week, a nutritionist session once a month, and the rest would be group therapy. I would be eating dinner on site with a therapist present and then be prompted to talk about the emotions surrounding the food. It sounded a little daunting. 

3 days later...

It was the first night in IOP-- a Monday. I was nervous. I walked into the large room, which contained 3 couches, and four arm chairs. There was a lady across the room reading. She looked maybe late 40's, dark hair, thin. She looked up but didn't say anything. 

"Are you here for IOP?" I said. "Yep." 

"I'm Hannah." 

"I'm Linda." She kept reading. Two more girls came in together. They looked like babies. They introduced themselves. "Hi, I'm Lucy! I love your sweater."  "I'm Lauren."  . They were adorable and I was so sad they were there. These poor young girls have eating disorders. Another lady, Tracy, came in and introduced herself and said it was her first night too. She was late 40's-early 50's. She was going to be the mama, I could tell. She was outgoing and said she would be the crier of the bunch so to get ready. I was feeling more at ease already. 

The first session was enough to tell me I had come to the right place. After that, it was meal time. We all went to the kitchen and the other girls started instructing Tracy and I on what to do. I was a little intimidated. Each of us had our own tray with a sheet telling us how many exchanges we need (fruits, veggies, dairy protein, meat protein, starches, etc.) 

After getting our food, we went into the dining room where there were rules about not hiding food in our clothes and no "food talk". No going to the bathroom unaccompanied for 30 minutes after the meal, either. This was a whole new world. I was a little scared of what might take place. Another lady, Lisa, showed up during the meal and apologized for being late. She started crying and said it had been a really hard week. I was nervous she was going to lose it when she got her food, but the meal was pretty uneventful. After we ate, we went around the room. "On a hunger scale of 1-10, how full would you say you are?" The therapist went around and asked each girl these questions. "Is that an emotional full or a physical full? Are you feeling the need to use behaviors?" What in the world is she talking about? I thought. When it got around to me, I was confident. I answered quickly. "I'm about an 8. I feel good. I enjoyed the meal and I'm good." The therapist said, "Well good. Are you feeling the need use behaviors?" "Well, meals aren't that hard for me. That's why I've been so good at hiding this. The problem for me will come when I get home.." my voice cracked. "I will go home, and take laxatives to justify eating today." I started to cry. "That's why I feel good right now. I have an out later." 

I could feel every woman shift. It was almost as if they were sending me support without saying a word. Then there was Tracy. "I can't stand it! I'm a hugger! Can I hug you?" She wrapped her arms around me and patted me. "You're going to be okay, honey." 

I knew I was. I was right where I needed to be and I couldn't wait to go back.

Thank You, Friends

I want to take a minute to say thank you to anyone who has been following my story. I am overwhelmed with the amount of support I've received. The messages of encouragement and prayers being offered are a blessing and I just want to say how much it means to me.

Some have said I'm brave for writing about this. I don't know about brave, but I am tired. I'm tired of more importance being put on size and appearance, than kindness and inward beauty. Don't get me wrong. I have spent far too much time thinking about how I look. Those of you who know me well, know I like being a girl. I like to get dolled up. But, my eating disorder has been a rude awakening that life is so much more than striving to be pretty or be a size whatever (fill in the blank with your appropriate dream size). Would I still like to be skinny? Well, of course.  It's been imprinted on our brains since the time we are little girls that skinny=pretty=happy. But, what would happen if we were to start teaching our daughters that they are beautiful, because they are fearfully and wonderfully made (Psalm 139:14), that beauty doesn't really have to do with size, shape, or color. God made us. He loves us. That is what's beautiful. What if we were to teach them this formula:  love(for God, others, and ourselves)=beautiful=happy. 

Our culture is messed up. On one rack in the check out line we have the nakie magazines. You know, the ones where all the women are dressed in clothes that show off their awesome bods and we think wow, that'd be nice (after the shock of seeing too many tatas and and too little tact). On another rack we have the "healthy" magazines that contain tips about losing 10 lbs in a week, and having the perfect abs. On yet another rack we have Paula Dean's smiling face and the recipe for her butter, sugar, shortening, chocolate chip, heart attack dessert with whipped cream on top (which I'm sure tastes aaa-mmm-aa-zzz-ii-nnggg) and titles like "treat yourself." How confusing. 

We are obsessed with looking like models. We are quick to try new diets. On the other side, though, we are also fascinated with new recipes, trying the new restaurant, and figuring out how to eat our troubles away. How do we draw a healthy line? I'm still trying to figure this one out, but hopefully I can share some things I've learned throughout this journey that have helped me.  

But I'm Not Skinny Enough To Have An Eating Disorder

...This is the first thing that crossed my mind when I was heading home from Nashville on the day I received my diagnosis. How will I explain this? Girls with eating disorders are stick thin and look sickly. Wrong. Women with bulimia are typically average to over weight, which means it is easy for the disorder to go undetected. Not only was I misinformed about eating disorders, my family and friends were too. I was nervous about telling them what I had found out.

I was emotionally drained. It was a Wednesday night and I remember staying home from church and feeling completely justified because I was in no state to face anyone. Tears were hiding out behind my eyes ready to appear at anytime, without notice. I slept. 

The next day my mom and I had a talk about the appointment. I told her I felt better. I still felt a little strange about the way the appointment had gone, but the doctor made it sound so easy.  Talking to that psychiatrist helped and I can do this. You know what, I'm not going to take ANY laxatives today. And I didn't. 

Stuart had avoided the situation all together and because of his work schedule we didn't get to actually have a sit down until a couple of days after the appointment. When we finally did, it was uncomfortable. He seemed disconnected and unmoved by my diagnoses. He said he was glad I went and was getting help, but he didn't ask any questions and I didn't give him any more information (I wasn't sure what to say either). Day two of no laxatives.

Friday came around and I don't know exactly what went on in my head, but I was triggered. Maybe it was the awkward conversation with Stuart. Maybe it was the fact that I had not had a bowel movement in 2 days (which to me, meant I had gained at least 10 lbs). I started taking them early in the morning. More every couple of hours. I still don't know how many I took that day, but by 11 PM I was a sick girl. Everyone was in bed. I tried to lay down to ease the worsening pain in my stomach. You've been in pain like this before. Just suffer through it and be quiet so no one knows. I tried, but the pain was so intense I couldn't breathe. I woke Stuart up, gasping. 

"Stuart... I'm sick....I need help." I managed to force out of my mouth, while heaving. I could not catch my breath. My mom ran in. "Hannah, what's the matter?!" "I..took too many..laxatives." She asked me how many, but I couldn't remember, and even if I could, I could not speak. I honestly thought that was going to be the end of my life. Mom asked if I could walk, but without waiting for an answer she ran to my dad and told him I needed an ambulance. He came in my room and asked if I could walk. I shook my head and he carried me down the stairs. I pulled it together for a minute so he wouldn't see me that weak. Mom grabbed a trash can, helped me in the car, and Stuart drove us to the ER. I immediately started vomiting. Mom called them to tell them we were coming. When we got there, I was determined to walk in. I'm not that bad. I could feel my feet and legs moving slowly as if they were shriveled up, and my face felt strange. When I walked in, they looked at me like I was deformed. My mom told me later my face was drawn up, and I looked really scary. They took me back immediately, going before the people that had been in the waiting room. I don't remember much else, except they gave me a shot for pain and IV fluids. I was severely dehydrated and my stomach was working overtime to digest all of those laxatives. I woke up on the table when it was time to go home that night and the nurse said "You look so much better. I didn't know what you really looked like when you came in."

I will never forget the feeling of being completely helpless. I knew when I got home that night that I was ready to do whatever it took to get better. I had watched my mom and my husband cry and worry over my sick body, all the while, my sweet little boy lay sleeping at home in his crib. I was going to beat this. I had to. 

Why Laxatives?

Back it up...
October 2010.

I've never been one to discuss toilet issues, but I had them. So, I took a couple of laxatives. It was an easy fix for an uncomfortable problem. No big deal. It helped, so I took a couple more the next day. And the next several days. And well, I started  liking the idea of being able to eat and then "get rid" of the calories with laxatives (which I now know was a misconception). So, I continued taking them. In addition to believing laxatives were magic and could make me look like a super model, they also became an easy way to distract from the stress of life. Can't control your current living situation? Oh, here you go, have a laxative or 2. That will help. After a while, though, the daily dosage of 3 laxatives just wasn't cutting it anymore. My body started needing more to function, and I needed more to distract. So, just a few more, I thought. This continued for several months. Eat what you want, then purge with laxatives. You will lose weight, and life will be wonderful. 

I didn't lose weight at first. It wasn't until I added restricting that I lost weight. And well, I just couldn't keep that up consistently so weight fluctuation was ever present. For a bulimic, looking at the scale and seeing weight gain is reason for more destructive behavior. In my case, the destructive behavior was actually causing the weight fluctuation so it was a vicious cycle. It went like this: "diet" or restrict for a day or two. Give in. Lose control. Eat too much. Feel guilty, disgusting, like a failure, etc. Purge with laxatives. Start over. While I didn't lose the weight I wanted to lose, I did lose energy, hair, a normal period, and most importantly giving my undivided attention to my family who needed me. My eating disorder consumed me. I could not be alone or with people without constantly critiquing myself.  Three laxatives went to 5 then 6, then before I knew it I was taking 10-12 a day. This went on for a solid year before it was addressed.

We were living with my parents at the time, which I firmly believe was providence. My mom had noticed laxative packages from time to time. She asked me about them.

"Are you okay? Having stomach trouble?" 

"Yes," I said. :"I can't really have a bowel movement without taking laxatives." It was true. My bowels were lazy. They had gotten so used to having the work done for them that if I stopped taking laxatives for even a day, I was miserable.

"Oh, that's concerning. Maybe you should go see a doctor. You don't want to mess around with that. It doesn't sound good."

"Yeah, I know. It's kind of crazy. I'll make an appointment." 

My mom was seriously concerned for my health. It never occurred to her that I had an eating disorder. Really, it never occurred to me either until she asked questions. It wasn't until I felt the guilt and shame involved with answering questions about my behavior that I realized something was seriously wrong. I didn't want to tell her how many I was taking and she didn't ask. I went home and googled laxative use and long-term effects. I was startled. I made the appointment that day and I remember feeling relieved that it was going to be coming to an end. Little did I know it was just the beginning. 

The Diagnosis

It was October of 2011. I wasn't sure what to expect. I thought back to the conversation I had when I called to make the appointment. 

Me: I need to make an appointment.

Desk person: Ok. Do you have an eating disorder? 

Me: Well, I don't know. That's what I'm kind of trying to figure out.

Desk person: Well, what brought you to us?

Me: I take a lot of laxatives. 

I got to the office 5 minutes early. As I walked in, I found myself critiquing every person I saw. That nurse is overweight. The man working at the front desk is big too. I'm the healthiest person in here. I saw a tall, thin, man with round wire glasses walking into a room and I knew it was him. He would be the one analyzing me. I waited for what seemed like a ridiculously long time before he stepped back out and called my name. I walked toward him and he turned around and walked back into his office. I assumed I was supposed to follow him. "You can have a seat in that chair right there," he said, all the while looking down at his notebook. It wasn't a couch, but it was couchesque. I felt very self-conscious. 

"What brings your here today?" His voice reminded me of kermit the frog. 

"Well, I have been taking excessive laxatives for about a year now, and I feel like that's probably not normal."

"Hm, well, about how many do you take?" He wasn't looking at me, just writing and nodding. Very psychiatristish. 

My voice got a little quieter. "About 10-12." It sounded strange coming out of my mouth. He didn't raise his head but he looked at me over the top of his glasses. I'm pretty sure I probably laughed nervously. 

He had a lot of questions for me, several of which made me cry. He never acknowledged it. After an hour of these intense questions ranging from had I been sexually abused to would I like to kill anyone (I answered no to both, just in case you were curious), he was finally finished.  He sat up straight and took his glasses off. 

"Well, um, it looks like you have bulimia nervosa and I also believe you have depression and anxiety disorder as well." 

I wasn't sure what I was supposed to say. "Okay." My voice cracked. 

"I'm going to recommend you take 2 less laxatives a day this week and 2 less the following, and so on and so forth and that if you can, join our intensive outpatient program 3 nights week. I'm also upping your dosage of zoloft to 100 MG." It was a lot to take in. I felt so exposed. I had just told this man intimate details about my life (some of which I know sounded crazy) and all he could do for me was a diagnosis? I don't know if I expected him to hug me or what, but definitely did not feel right leaving there with a total stranger knowing so much about me and my life. 

On my way home I thought Really? All I have to do is just take more zoloft and less laxatives and show up to some group therapy if I can? Yeah. I can do this. 

I was wrong.