National Eating Disorders Awareness Week

The majority of this post was originally written in August 2018 and has been sitting in limbo, mostly unchanged since that time.  There were too many excuses not to post it... but it's time.  Because someone else may benefit.  Someone else may learn they're not alone with what they're going through.  Someone else may need a place to look for help.  And I have nothing to be ashamed of.  I have nothing to lose.  And it's National Eating Disorders Awareness Week.  And I'm home in Connecticut with my family right now.  And I've run out of excuses not to post it. And because of the treatment I've been going through, none of my pants fit.  So... let's have some awareness about Eating Disorders, RIGHT NOW, and then take a moment to love ourselves. Come as you are.

Maybe I'm wrong, but as an East Coaster, I feel like there is a stigma against seeing a therapist. Not a physical therapist like me... we're totally cool on both coasts... a mental health therapist...a psychiatrist or psychologist... a shrink.  The vibe just isn't the same from coast to coast. The only people in Connecticut who ever mention seeing a therapist (to me) were working through marital issues or recently had a significant trauma, and even then it was a hush-hush conversation. I still can't identify a single friend seeing a therapist at home. That doesn't mean it isn't happening, we're just not talking about it.  I can easily identify several friends who have experienced things they probably should see a therapist for... but after my own experiences, I realize that it only works if you're ready to face your own issues.

Things in Seattle are different.  Not only is therapy a common activity, but people talk about it freely!  I'd text a friend asking to grab dinner and they'd say, can we go at 7PM after my therapy appointment?  And then we'd meet up and sometimes discuss what happened at their session: new revelations, techniques to try this week, weird questions they were asked that were surprisingly thought provoking. It's amazing how removing the stigma makes it comfortable and so much less of a big deal.  Pretty much all of my favorite people in Seattle have seen a therapist at some time - and none have been shy with talking about their experiences.  

If you know me beyond this blog, you know I'm 100% extrovert.  At best, I tolerate solitude. I thrive on social interactions.  I'm jealous of friends who say they need alone time to recharge their batteries because I just don't operate that way.  I talk to people all day long at work and then want to keep being around other people because it's like a constant energy flow... or a way to avoid whatever is going on inside my own head.  So when I first moved to Seattle and didn't know anybody, I spent several months, night after night, and all my days off, alone without anyone to talk to over dinner or to go for a walk with and sit and watch TV together.  I was alone.  I was missing my family and friends who were insanely hard to reach due to the time difference and my work schedule.  All that time alone could have been an opportunity to learn about myself or find some hobbies, but what I learned was that I couldn't tolerate being alone, and instead turned to food for comfort.

Interesting how moving 3,000 miles across the country doesn't make binge eating go away. I didn't know before moving that I fit the criteria for an eating disorder diagnosis... I just thought I had poor self control.  I was living alone after spending three years with two amazing roommates who had delicious snacks around the house.  I stole their food and would replace it without their knowing... only to steal it again later on.  One time, one of them had taken a single bite out of a Snicker's bar and put the rest into the kitchen cupboard for later... I finished it, drove to 7-11, bought another one, took a bite out of the new one, and put it back in the spot I had taken it from.  I did it 3 nights in a row, finishing the partially started one and replacing it later on... she never knew.  When I told her about it, we laughed.  Then I cried.  Then I asked if she had half of a candy bar around for us to share.  Neither of them knew the kinds of things I did eating their food. I'm that good at hiding it.  So when I moved, I figured if I didn't buy the snacks and they weren't in my house, the problem would just go away. I was wrong.

It took almost a month for all of my stuff to arrive in Seattle from Connecticut.  I slept on a blow up mattress in an apartment with no furniture, enough clothing for one week, no dishes, eating rotisserie chicken with plastic cutlery standing over the kitchen sink.  I borrowed the money to move, so I didn't have much to spend.... but then I would find myself in Dollar Tree searching for cheap binge foods.  Trigger alert: Did you know they sell whole bags of mini Mr. Goodbars? And pints of ice cream?  And weird brands of chips?  And actual M&M's? Each for a dollar?!  I still cant make it out of the dollar store without buying foods I used to binge on... but now I can manage to only buy one instead of before where I would have bought a lot more.

I knew I did this for years in Connecticut... but it took me far too long to realize how much of a problem I was experiencing. I didn't know that it wasn't normal.  Other people don't buy a whole box of Cheez-Its and eat them in their car and then throw away the box so nobody knows it happened?  Nobody else walks to 7-11 with a spoon in their pocket so they can eat the whole pint of Ben and Jerry's and it never even enters the house?  Nobody else sees a coworker bring in a box of donuts and politely declines them all day long only to have the last three at the end of the day when the office has left and you've stuck around until the coast was clear? Anybody else feel like they've blacked out while they're eating only to realize the box of whatever you're eating is now empty... and not remember eating past the third bite?  Just me?  I was in the dark for a long time about what's going on in my head and what I've been doing to my own body.  Not any more.  It isn't just me.  

So I was alone in Seattle, no local friends, living alone, and starting a brand new career in a city I didn't know.  I'm working with a lot of youth athletes as well as with professional women's basketball players who are incredibly fit, strong, powerful, beautiful, and intelligent. I'm working in my dream job in the WNBA while morbidly obese.  How can I possibly survive this career promoting health, fitness, and exercise while I look like I do?  Who would choose a fat healthcare provider when they could have a fit one who looked like a healthy person?  I convinced myself on multiple occasions that any job I was not hired for that I applied to was because of how I looked.  Not because I'm a bit loud in personality.  Not because I was a new grad physical therapist.  I was certain it was because I was fat.  I tried to lose weight for the zillionth time in my life doing the Whole 30... but when I would reintroduce foods back into my diet, not only did I gain back the weight I had lost, but the binges got bad. Really bad. I go through cycles.  Out-of-control eating followed by a strict restrictive diet for a few months, lose weight, feel good about myself, and forget there's anything wrong only to lighten up a little on my eating restrictions and have it blow up in my face.  I'm not sure if anyone knew about my bingeing... certainly nobody confronted me or offered help.  I don't remember ever being caught.  I did it in private.  Correction: I do it in private.

I really wanted to fix this problem on my own, without ever discussing it or telling anyone else.  I was ashamed.  I'm still ashamed.  Though I'm starting to learn that there's no reason to be ashamed.  The Whole 30 was my last attempt at trying to go it alone before seeking help.  I didn't know what I was looking for.  For years I had told myself that I just needed to learn self control... restrict eating sugar, go on yo-yo diet episodes.  My best friend told me in college that I was happiest when I was on a strict diet. (She also told me I could make friends with a squirrel... isn't she the greatest?!)  But she's right.  Somehow, when I diet, I don't binge... until I stop the diet, and the binges take over. So I started googling online tests like "How do I know if I have an Eating Disorder."  I took about 7 of them.  (Here's one you can try if you're questioning this for yourself). They all said I did.  Every test said to get help.  They all recommended treatment. And then the creepy Facebook ads that read your mind started recommending the Emily Program.

So in February 2015, six months into living in Seattle, finally having made a few friends who all loved their therapists, I went to the Emily Program, a facility that evaluates and treats people with eating disorders.  They, too, have an online quiz you can take to see if you might need treatment on their homepage.  My intake paperwork took over an hour to complete with boatloads of tests asking me questions about eating habits, body image perspective, weighing myself, tracking my food, exercise routines... it was extensive and thorough.  I cried the whole time.  Not just tears streaming down my face... actual sobbing. I was so thankful I was in a room, alone, at a desk that was facing the wall.  I remember thinking... how does this place not have tissues? And why did this take me so long?  Not the paperwork... getting myself into an office where I could get some help.  

The intake specialist whose name I don't recall and whose face I could not pick out of a line-up diagnosed me with binge eating disorder that day. (Click the link and read about it.  This is National Eating Disorders Awareness Week, after all!). She told me I was not testing to extremes which meant I was unlikely to hurt myself beyond the damage of excessive caloric intake in short periods of time, and recommended some counseling.  I didn't need hospitalization or medication but was given a phone number to call in case I started considering self harm. So I set up some appointments with a therapist.... you know... one of those people we East Coasters despise...And I went.  And there was a couch in the room but I didn't lie down on it.  And I hated it.  Despised it. So I stopped going. 

I told my family.  I told a few friends. A few Seattle friends were recommending their therapists to try - maybe it had just been a bad fit.  But I was dead set against therapy and refused to do anything more than I had already done. Now I had an excuse.  I'd binge and then say - well, I have an eating disorder, so this is just going to happen. Then I'd do another round of the Whole 30 and lose the weight.

That was my cycle for the past three years.  A Whole 30, I'd feel amazing and lose weight, and then I'd have binge rages.  Despite the definition of insanity being "trying the same thing with expectations for different outcomes," I kept doing the Whole 30 because it made the binges stop, even if just for a month.  And I felt really, really good while I was restricting my diet.  I also read a book on mindfulness, a few about nutrition.  I tried the HeadSpace app for meditation... that one I really despised.  I started doing yoga - which I wrote about here - and which was the only thing I tried that I actually enjoyed and helped me channel my energy in a new way, but it wasn't changing my eating. 

All this to lead up to the fact that I had my annual physical in 2018 and my primary care doctor flat out told me to go see another therapist. For a lot of reasons.  She told me that I shouldn't feel like I needed to figure it all out on my own. And that's where this blog post came to be.  I'm sitting in the waiting area for my intake session with my new therapist, freaking out, and for some reason, I started writing what was going on around me to distract me from the fact that this couldn't possibly go well.

I had to fill out paperwork asking me questions about how frequently I'm sad or anxious or can't get out of bed or don't feel joy the way I think other people do, and what brought me to treatment and, as is typical for me, I was way too early, so I got stuck sitting in the waiting room feeling like I was running down a hallway naked. I'm holding a book on my lap but I can't possibly read it.  I'm wondering ALL THE THINGS. Can you talk to others in the waiting room of a therapist's office? (I wouldn't at the dentist... why would I think of that here?) I need to go to the bathroom, but don’t know where it is, and the lady that's also sitting here seems comfortable here, unlike myself.  I need to go before my session... oh she smiled at me I guess it’s OK to maybe ask. Thank you, kind stranger also working on your mental health for pointing to a door.  Walking around aimlessly didn't seem like the right approach...

Back from the bathroom... are there any men here? I've been here 20 minutes and have only seen a few women.  Otherwise this place is too quiet and there aren't enough pictures on the walls.  Why is the music playing so loudly?  How was my previous sentence that the room is too quiet while also feeling like the music is too loud?  Awesome, they have coffee... oh wait, I don't drink coffee.  Oh... the other side has tea.  And that lady just stole 2 tea bags and put them in her coat pocket!  Seriously? Maybe one of the therapists here treats kleptomaniacs... should I admit that I'm a pen stealer?  Yes! A man! Oh, he works here. Figures.  Men never have problems.  Wow my sarcasm level is elevated sitting here.  I'm starting to sweat.

Checked the time on my phone. She's running late. I never run late. I already said that. I also don’t generally feel like I’m a nervous person.  When was the last time I was nervous?  Oh yeah - that was when when I had my work annual review.  My boss is my favorite person on the planet for 364 days of the year and 365 on a leap year... but then all of a sudden she’s a Dementor because we have to discuss my performance. I normally wear scrubs and a light shirt to work, but for that first review I chose to wear khakis and a long sleeve work jacket because I'm getting reviewed and maybe I should look a little bit professional... And then I was sweating and my heart was racing.  Yep... I can remember exactly one occasion where I was considerably nervous in the past year... until right this second.  I'm not sure which is worse.  Actually, that's not true.  I'd rather be sitting with my boss.  She already knows I'm crazy... this therapist does not yet know.

And then she brought me into her office. Of course she would also be thin and gorgeous...how can she possibly know anything about being fat? That's not going to make this easy.  I can't possibly like this therapist woman who looks like she's the same age as me and if we met at the bar, we'd probably get along just great. With my own new patients, I start with "What brings you into Physical Therapy today?" and then follow with "Have you ever had physical therapy before?" which, if they have, I ask, "how did it go - what worked and what didn't work for you?"  I didn't even give this therapist a chance to ask her usual questions, I just blurted out the answers to those from the very start in a stream of consciousness - kind of like this blog post has come pouring out of me:

"I come from a place where there is a stigma against therapy and that makes it hard for me to buy into this process. I know the impact of buy-in on outcomes and am willing to try to overcome this barrier. I never connected with my previous therapist because she was constantly saying 'I'm curious about...' and I would count how many times she said 'curious' in each session which was insanely distracting. I really need you to be receptive to what I'm saying until we get comfortable with one another and I need you to not be curious.  I know that if this relationship doesn't work out, there's no chance I would try this again with a third therapist, so basically you're my last hope. I don't want to do this... but I need to do this." Yes I sounded that desperate.  No I didn't cry.  She asked me to commit to six sessions and that we would re-assess then.  I'm certain now that she's the second best decision I've made living in Seattle... the first was working at Seattle Children's, which I celebrated two years at yesterday.  Thank goodness they somehow didn't notice that they were hiring a fat physical therapist... or if they did, it wasn't a barrier for them.  They do list Diversity and Inclusion as one of their workforce values... I'm not sure if obesity fits into that, but I'm happy to make the office photo look a little bit different.  To be honest, with some of the kids we see, it may be the best thing for them.

So now I'm telling all of you.... many months later.  Because making excuses means I can't move on. Because if I say it isn't that big of a deal that I see a therapist or that I have an eating disorder... then it can stop being such a big deal. Because I work with kids, particularly teenagers, and I sometimes suspect that they're experiencing similar issues to what I'm experiencing and they don't know what to do... so here's one more piece of noise on the internet that maybe they'll come across and ask someone for help.  Because I have a teenage niece and nephew who are surrounded by the pressures of middle school who I hope will grow to love themselves and be able to express themselves better than I am able to.  Because when I tell my therapist that something she's doing is bothering me - she stops doing it.  Just like I do with my own patients. And because of this, I now trust her.  Because I've been working on improving my "situation" - which is, I'm told, a disease - even though, until I knew I had it, I don't know that I realized how sick I really felt.  But truly, a lot of the time, I actually feel quite sick.

I'm learning a lot about myself and can see things changing, particularly my mood, which has actually gotten considerably calmer without so many extreme sugar-insulin spikes - but other things as well. Things got a lot worse before they got better.  They might get worse again... never know what that sneaky therapist might uncover. I haven't been on a diet in eight months.  Before that, the longest I think I've gone was three months without dieting for the past 20 years. I am out of my comfort zone.  No diet = weight gain = a lot of inner struggle.  I want to be on a diet.  I want to be off sugar.  I want my pants to fit. But I'm learning that I can't do that because in the end, it makes things worse.  So I'm going to try trusting the process and realizing that I have a crew of people lined up to help me now... there's a dietitian in the mix... is there a stigma against that, too?  And so what if my old pants don't fit... I can just buy some new ones.  Or wear scrubs.  They have an elastic waist band.

Come as you are.