Thinking my way to recovery from an ED

November 8, 2009 12:19 PM

Help me take control of thoughts that make me feel like an ugly giant.

I'm recovering from an eating disorder and I'm really struggling. I've been referred to a psychologist and had my first appointment yesterday (after a long wait), and I know it's going to take quite a long time to make any real progress there. In the mean time, I'm looking for any help I can get.

I've gained 7kg and am now at a "healthy weight" but sometimes I feel disgustingly huge, even though I can rationally tell myself that at my old weight I didn't have periods, my hair was falling out etc, despite the fact that I didn't feel that thin. Some days I look at myself and I look quite pretty and healthy and I feel great, other days I look absolutely massive and awful and feel embarrassed to go out, and then of course I can't bring myself to eat since I'm "already so big" and then I start getting physically weak and realise that I have to eat even though I don't feel hungry, but get really anxious about actually eating and don't want to do it, or feel really guilty when I do, like I'm a fat kid stuffing her face with cake, even though I'm only eating natural, whole foods. Often I regret having eaten and try to burn it off with excessive exercise.

Obviously my appearance can't be changing that dramatically from day to day, so I know it's got to be in my head, but it's hard to keep that in perspective when with my own eyes I'm seeing someone very large and lumpy. I've been trying to fill a blank book with resources to help me when I get stuck in that bad mental headspace. For example, last time I was too emaciated to get out of bed, I wrote a list of all the things I like doing that I can't do when I'm skinny, but can do even when i'm fat, so that's in the book, (as is that "fantasy of being thin" article), which I try to flick through when I start feeling yuck. I guess I'm looking to crowd out my unhelpful thoughts with other ideas so that sensible logic wins out and I can enjoy my life. When I cut down my eating my hormones go all funny and I get hot flushes and night sweats and disturbed sleep, and feel too exhausted to socialise/go to work etc - I don't want to live my life like this anymore!

Any suggestions for things I can tell myself, or that I can write down/print out for my book, would be much appreciated. In particular I'm looking for help in breaking the "you're disgustingly huge, why would you be needing all those calories?" line of thinking and help to see my appearance more consistently every day but anything you think would be helpful would be welcomed.

posted by anonymous to Health & Fitness (8 answers total)

I know exactly what you're feeling as I've suffered most of my life with a severe eating disorder and body dysmorphic disorder. Even though I am bigger than my previous ED self, I feel better now than I ever have. I don't experience the shame and guilt anymore that was always associated with eating. I can watch people eat without feeling sick and I can walk around a grocery store without having a panic attack. Things that helped me retrain my thoughts:

1. Eating is a necessary part of life, there's no way around that. Eating is not a choice, you have to eat. The choice you do have is what you eat. The more healthy foods I eat, the better I feel physically and mentally. It is imperative that you begin a healthy food regime and stick to it.

2. The "disgustingly huge" person you see in the mirror is not you. Repeat that to yourself every time you see this person. I know how easy it is to just stand there and look at all the things you hate about yourself. You need to stop doing that and begin to focus on what you do like about yourself.

3. No one is perfect, this includes you. You need to let go of this idea of reaching perfection because it will never happen. I have flaws, you have flaws, we all have flaws, that's just the way it is. Having flaws doesn't make you a bad or horrible person, it makes you a human being. And really, how boring would life be if everyone was perfect?

Please, please, please stick with the therapy. If you find you don't like your psychologist, find another one. This is a difficult journey and I wish you the best, I know how hard it can be. Feel free to memail me at any time if you want to talk about things.
posted by MaryDellamorte at 12:44 PM on November 8, 2009

I used to do mirror work when I was in active recovery and feeling very close to how you're feeling now. When you look in the mirror, try to look at yourself objectively, like someone studying a painting or statue. The goal is to keep your thoughts neutral. As soon as you catch yourself thinking something emotionally charged, step away from the mirror- you're done for the day. Your goal is to be able to look at your entire body objectively. I also began to dress myself with care- I bought clothes that fit my new body and sat well on my shape. I tried to be proud of my appearance. Believe it or not, I got way more compliments on how I looked then.
I found the books "When Women Stop Hating Their Bodies" and "Breaking Free from Emotional Eating" particularly helpful, along with Geneen Roth's writings. A therapist should help too. The Something Fishy forums online were another good source of support.
Good luck. Feel free to message me with any other questions.
posted by emilyd22222 at 12:47 PM on November 8, 2009 [1 favorite]

If the psychologist is one who does cognitive behavioral or dialectical behavioral therapies, it may not actually take a long time for you to gain some quick tools for dealing with the negative thoughts, although I do agree that major change may take some time (but it'll happen! you sound so motivated and ready, and that's a huge advantage!). Mention to the psychologist that you need some tools for the short term, because there are a lot of potentially helpful things you can work on together (if you need some relaxation tools, or some ways to combat the thoughts, please let your therapist know this--this is exactly what therapists are for). You could feasibly get some good suggestions for some relaxation and thought-managing tools in your next session alone (and if you don't, feel free to MeMail me and I can give you lots of things I use with ED clients). The struggles you're having are so, so, so normal and expected for your current state, and I know they can be so difficult. But you can get through this. (Side note: it sounds like a skills-based treatment like CBT and the like is well-suited to your needs. If your psychologist doesn't work in that treatment modality, consider seeking another therapist who does, maybe through NEDA or an online find-a-therapist directory like Psychology Today's listing.)

A quick suggestion I can give you is to try taking your negative thought and interrupting the cycle of negative thought -> negative feeling -> negative behavior with some questions (you can do this in your notebook or in your head, but I think writing it down is great):
- First, do a quick check-in about the thoughts/feelings: how much do you believe the thought you're thinking (I should not eat, I am already so big, I can't handle this), on a scale of 0-10 (try to separate individual thoughts and rate each independently)? You might also ask yourself what feelings are associated with the thought, and rate the intensity of the feelings individually, 0-10.
- What are some reasons to believe that thought may not be 100% true?
- What are other possible ways to look at the situation?
- What's the worst that could happen as a result of this? What will most likely happen as a result of this?
- What are my options for taking action right now? What is likely to happen if I try said course of action?

After that, use some of the self-care resources you know to be helpful in calming you down or refocusing your energy, or do some relaxation-inducing things like taking deep breaths for a count of 10, mindful meditation, guided imagery, alternating tensing and relaxing your muscles/body areas one at a time, etc., and then maybe check in again about the intensity of the thought and feeling. If it's lessened, but not enough, continue with the physical relaxation for a little longer, maybe, and check in again.
posted by so_gracefully at 12:50 PM on November 8, 2009

I like her:

http://www.geneenroth.com/

She gets at the core of emotional eating. Her books are excellent.
posted by DMelanogaster at 1:00 PM on November 8, 2009

One thing my therapist tried to make me understand, was that my menacing thoughts were partly a result of malnutrition. I had known all along that when you're not eating food, your body atrophies, but it didn't really click with me what kind of havoc that could wreak on my brain and emotional responses. Once I understood the self-perpetuation of the problem a little better, I was more able to fight it.
posted by sunshinesky at 1:30 PM on November 8, 2009

I won't claim to be a psychologist or anything, but this thought occurred to me: you seem to want to convince yourself that you don't look fat. But even if you're thin, it could be hard to make yourself believe it, because when you look in the mirror, "fat" is part of what you see there, not just an interpretation you add after the fact.

Instead, what if you tried breaking your association of fat with looking bad? Sure, not very many people find extreme obesity attractive, but keep in mind that lots of people are attracted to people who are a bit chubby or even moderately fat. And you're much less fat than they are. If you have someone who thinks you're good looking, it might help if he or she told you so. (You could also look at other people around you, most of whom are fatter than you are, and realize that nobody thinks they're "disgustingly huge.")
posted by k. at 3:15 PM on November 8, 2009

If you need support, these people are REALLY good at support.
Overeaters Anonymous
Don't let the name fool you, they are familiar with all forms of eating disorders. I'm guessing from your reference to kilograms that you're not in the states...I would assume that your psychologist will be able to refer you to a local equivalent.

I hope you find the support and strength you need. You're taking a good step to a healthier and happier "you".
posted by specialnobodie at 1:53 PM on November 11, 2009

Boo. HTML fail. www.oa.org is the link I was trying to post.
posted by specialnobodie at 1:54 PM on November 11, 2009