Ana-chan and Mia-chan
May 18, 2011 10:36 AM   Subscribe

What to expect in a PHP(intensive outpatient) program for eating disorders?

Hi guys,

Maybe I should have done this anon, but I used it recently and felt bad.

So, after suffering from various eating problems since childhood, I am finally seeking treatment. Although I've been in therapy for some time, I recently switched therapists to a private practice therapist from the one at my university, and she bluntly(in a good way!) said that I have BDD and a bonafide eating disorder and that I need to be in treatment now and for the long term. She wants me to make significant progress before I go to my doctoral program in the fall(and I want to, too!) especially since I will be living alone, and the culture of my department is that lunches are often taken together in the break room, which is triggering for me.

Since I have no real summer plans, she suggested that I go into a Partial Hospitalization Program that specializes in DBT. I have various manifestations of disordered eating, right now I am alternating between binging and 'purging' by restriction or fasting, and transitioning into a more restrictive manifestation.

When I was a child I would binge at every meal to the point of feeling nauseated. My father is a doctor and would regularly take away my plates of food after I had had "enough". I took ballet for 8 years and was teased about my weight and ostracized by the other girls in the classed. In highschool, I would skip lunch to read in the library, and only at 500 calories a day. Between highschool and university, I went to Japan for an exchange year and continued to restrict, fueled by not fitting into the Japanese clothes and needing a special plus sized uniform. I was almost sent home early from the program. Then college, the same thing, binging, purging by fasting, or restricting and drinking lots of diet energy drinks or soy lattes with 5 shots of espresso. And now after university I am only eating my "safe foods" which are broccoli and shirataki noodles and other low calorie things, or when I am being taken out to eat to celebrate graduating.

I do not doubt that I need help, and am relieved that after suffering so intensely my whole life I will finally take some steps towards recovery. But I almost don't believe that I will ever be free of these feelings, they've been my normal for my whole life.

So, what am I going to be doing? What are these programs like? Will I be eating the same food as the thin girls? I ask, because right now I am actually 20 pounds or so overweight(don't know for sure, I avoid seeing the number at the doctor and ask the nurses not to tell me) and I am afraid that I will just gain more weight. I am also worried about the thinness of the girls triggering me and making me feel worse about myself.

Sorry for the rambling. I just want to feel good about myself. Everyone thinks it's crazy that I feel this way because I bellydance, was the president of our troupe, did art figure modeling, and regular modeling. Everyone thinks I'm so settled and confident, when inside I am in pain, like almost physical pain and anguish from my disgust with myself every waking moment when I am not actively doing something else. I am on sertraline 50mg, and it has helped a little to ease the intensity of the "angst" but by no means is it gone.

tldr: What is my schedule going to be like? What are the mealtimes like? Will the other patients think I am gross because I am bigger, and how can I overcome being triggered by thin people, even when they are sick like me?
posted by lettuchi to Health & Fitness (1 answer total) 2 users marked this as a favorite
Best answer: Hi and congratulations for getting help!!!

I'm just going to comment on one aspect of this as mealtimes and schedules are always so different, but regarding the other patients thinking you're gross, that I can talk about.

Here's the thing about all of us with eating disorders. We all think we're disgusting. Those of us who are technically "overweight", those of us who are "normal" weight and those of us who are under weight. Doesn't matter. The person I became closest to in my very first program when I was having all of those terrible feelings you're talking about was the most underweight person there. I was terribly intimidated by her and was sure she thought I was disgusting but she would come over and hug me. I was super triggered by it but she wasn't at all! Surprised the fuck out of me.

Here's how I dealt with it. I spoke about it. Openly. I said, "I am super scared to say this because I think you all will hate me but I am triggered because I feel like I'm the biggest person here and you all think I'm gross."

It was SO hard to say, and I didn't say it until I really trusted the group, but it really got the discussion happening and I found out how supported I actually was.

As for you being triggered by the underweight, it will happen. You have to acknowledge it. Openly. Talk to your therapist about it in private at first if you think that will help, but group dynamics are set up to bring this stuff out. The therapist running your group is not afraid of dealing with this, she/he has most certainly dealt with it before.

I have been eating disordered since way before I can remember. I have been in recovery for about 10 years. I am still eating disordered, just to a far lesser extent. It is AWESOMELY freeing to not have the ties binding me as tight as they used to. You are going to get so much out of this if you go in being as honest as you can possibly be and as open to new ideas/change as you possibly can be. I entered recovery at my lowest. I would do ANY. THING. to feel better. It's a good attitude with which to enter recovery.

I wish you ALL the best and feel free to PM me if you have any questions, comments, etc.
posted by Sophie1 at 11:06 AM on May 18, 2011 [1 favorite]

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