Anorexia as a First Responder.
In my previous post I wrote about Anorexia showing up at the scene of the accident, along with the (alarmingly-young) paramedics, a couple police officers, and the man I believe was an angel who held my hand until the ambulance arrived and mouthed “You’re okay” over and over from the curb behind the paramedics as they put some serious stuff into different IVs.
I remember the paramedic guys pretty clearly because, when I woke from the strong stuff to find myself floating but thinking clearly, I asked them to please take off their masks and smile at me. I remember asking repeatedly if I would run again. And I remember that one of them had gigantic teeth. (I’m blaming it on the ketamine but his head turned into a that of a horse at one point.)
I remember knowing my husband was not there and must be in another ambulance. And I remember the awful receiving nurse with an attitude issue in the trauma center because she jammed a Q-tip up my nose so hard I thought it would give me a piercing way up between my eyes. (She got an earful for it.)
But it wasn’t until three days later that I realized an old caretaker has also come to my rescue. She had been quiet rather than frantic and alarming- her image even a bit blurry at times. Rather than overwhelm me like all the vampires who sucked out my blood three times a day, leave me more anxious like the doctors who scurried in and out “referring” my questions to others rather than giving me straight answers, or force me to take x,y,z every 4 hours, she was quiet and waited patiently…
Until Nutrition Services arrived on day 4 with a “liquid diet” menu I was supposed to survive on for the next few days.
And, of course, due to really messed-up legislation years ago (which has done far more harm than good… don’t get me started), exchanges were printed next to every item, and calories calculated and totaled at the end of the meal ticket like the balance on a bill. (“Who uses exchanges anymore? Do I trust a hospital that is creating meal plans based on theories from the ‘70s?”) Anyway….
The young man who handed me the menu (if it can be called that), stood by the door waiting for my selections. Needless to say, he was going to be there for a while, so I asked him to return later. Why? I don’t know. It’s not as if I had to choose between 6 Thai restaurants each with 32 menu items listed and each of those with 4 protein options. Scratch that- I do know. I had to make decisions about food. I wasn’t choosing between college electives or a shade of highlights; I was choosing between jello, broth, veggie soup, yogurt and no-sugar plastic pudding. That was enough for a game of ping pong to commence in my head.
Thoughts circulated in no particular pattern or order:
I haven’t eaten in 3 days.
I’m starving.
No I’m not.
This is all I get?
If I’ve managed for 3 days, why do I need food now?
I’m not getting any movement so why eat?
Wish I could have some real food.
Steak? Ice cream? An orange?
How will I heal on fake chicken broth!
Shit- she’s back (Anorexia)
No she’s not- I’m just over-hungry.
Is she?
As if things weren’t tough enough, a menu of less than ten liquid food selections started a war that would last for several weeks on the battlefield of my mind. I wrote more about how I came out victorious in a fight where the flag flying overhead seemed to change by the minute in my previous post The Art of Flipping a Coin.
Distressed, yes. Surprised? Nope- not one bit. Anorexia was my default go-to when the going got tough. Or at least she used to be. And she still faithfully shows up to offer her advice when I’m at a loss, lonely, stressed, afraid, feeling rejected, or in pain. Or…or…or… For much of my life she filled THAT void and made me feel safe.
Sadly, many of my readers will know exactly what I mean by all of this. You others will likely screw up your face in a sort of disgust-“you know better”-“you’re messed up” sort of way and retort “But she hurt you. Why would you go to her? Anorexia is evil.”
Maybe she is. I know she is. But she was also a necessary evil for a really long chapter of my life when I didn’t know how else to cope with the stresses of life. And my brain felt safe as long as she was around. Had anybody or anything topped that and filled her role in my life then, sure, I’d have loved not to wear her chains! But that’s not how things played out until a few years prior when I’d started to believe in myself again.
Life after I asked her to leave (Project Afterwards) without her wasn’t often easy. Sometimes it felt like it was never easy. And, ironically, it seemed like it just kept getting harder.
But here’s the thing. Most of us who struggle with eating “issues” of any kind are seeking some form of safety and control. It’s not unlike OCD and other kinds of anxiety in ways.
To brace the bridge I’m trying to construct for you I must first back up a little and clarify that my use of a personified Anorexia should not be simplified to the extent that one views her as merely a third party that can be asked to leave at any time like an annoying sibling or uninvited guest. It peeves me how often recovery communities depict her in this simplistic manner, even giving her and her sister bulimia the nicknames “Ana” and “Mia”. She’s a far more nuanced character than that- comprised of a enormous set of rules, values, standards, and ideals.
Any form of maladaptive coping strategy is typically established as an acquaintance by societal influences, family dynamics, emotional pressures (stress, anxiety, perfectionism), and hormonal and chemical deregulation. Constructs are formed by the individual that establish a sense of safety by the brain in the absence of other more sustainable and healthy means. And the feedback presented, whether physically or socially affirming, emotionally soothing, or intellectually gratifying, solidifies the approach as valid and “helpful”.
But at some point, new and adapted neural networks are formed after repeated behaviors and thought patterns have carried on long enough. These have, in essence, become the new “norm”. (In a post titled “Are You Seeing Clearly” I spoke to this phenomenon in detail.)
It is typically not until an individual recognizes the negative implications of the maladaptive brain wiring on his or her life that a driving discontentment and fear return once again. This time, however, it’s a double blow because not only is it recognized that the root issues were never in fact addressed and instead increasingly “buried” by the extra exercise, gambling, drinking, working, purging, organizing, (fill in your crutch), but it’s also likely that these new neural pathways created in the brain that have normalized a problematic strategy to regain safety and control have become so much a part of “how you live”, their intricate and many complications are difficult to identify, let alone revert or alter.
The desire for safety and control intensifies as the individual realizes that they are now trapped between maladaptive patterns of behavior and the underlying insecurities that brought about the coping in the first place. The only logical solution is an ironclad (albeit incredibly complicated) option number 3:
Discern the underlying distressing belief system(s) and face them head on to fully heal.
Replace false beliefs and challenge falsely-created fears.
Recognize and revert maladaptive coping strategies (typically through assisted recognition of behaviors and a CBT or DBT approach to altering them back to neutral and life/health-sustaining).
Bullet-pointing a recovery strategy seems so simplistic I’m almost embarrassed to have done so here. But for those of you who have ventured through a battle to take back your true life, you already know how tough it is. Taking back control over your life, future, and health (whatever that looks like and from whatever strongholds ensnared you) and in so doing working to find true safety through life’s suffering is the hardest thing you’ll likely ever have to go through. And it’s because of this that, when trial hits, and your version of Anorexia shows up as a first responder, you will know better than to seek her advice.
From my hospital bed I chose a few items on the menu and texted my husband a bunch of food to bring me from home to supplement and ensure I actually got enough. I looked over towards the window where I could still faintly depict a fading companion and, through tears, said:
“Thanks for staying with me. I’m glad you are there if I need you again, but I don’t this time. I’ve come a long ways. And I’ve got this. Bye for now. Love, Nat”
