10 September 2016

Looking back and thinking forwards

I'm not sure how to explain how it felt walking back to the eating disorders unit on Thursday, I actually made a 'Ughh' noise out loud heading up the driveway towards the outpatient department. Loud enough to wonder if anyone had heard me. It was a completely mixed set of emotions.

In some respects it felt familiar, like going back somewhere steeped in memories would, but in other ways it felt much more clinical and cold than before. I felt out of place and disappointed in myself. I didn't like how even knowing I was going there made anorexia louder, in a 'pride' sort of way. I didn't like that volume. Despite the residue of my eating disorder, I wouldn't say it was a voice which out-shouted my own for the past 18 months. I've been louder, which is why I've made the progress I have done thus far. 

My assessment was with a Dr. I'd not seen at all before, but whom I knew of. She also knew of me. 

I was weighed, measured, attacked by the vampire and had an ECG. The latter was fine, the bloods are pending, I seem to have shrunk 2cm in 2 year and my weight was higher than it was Saturday and lower than the last time they weighed me. 

Too low for them to be happy with. But not low enough to ring alarm bells. A BMI they're not happy with, a BMI which means I have been offered treatment. But I don't think it's my BMI which they're mostly concerned with. The lack of periods is one thing they're keen to change, as is my thinking about myself and  the food rules I still live by. 

It was a lot of the old questionnaires about self esteem, thinking, mood and emotion - the clinical side of things - and the therapy admin. We spoke at length about the care I'd had before - and how the service had changed since. Those people who have followed my blog from Day 1 will know that I have never defined the 'type' of therapy I had. Because I was never told. I ended up with a miss-match cobbled together careplan with no clear 'type' of therapy, no clear boundaries and no one style of work. That was partly because of the faults in the EDU, partly to do with my emergency admission in 2011, and my refusal for IP care, but need for serious support and finally, a little do with my quick move back to work - and ability to NOT focus on therapy. 

Things have changed. I have now been given two options. A course of CBT-E, with hardcore weight-gain, 20 sessions twice weekly and then 20 more one a week. With a focus on weight restoration, weigh-ins every session and then therapy to deal with all the anxiety OR CAT (cognitive analytical therapy) with an expectation but not a focus on WR, dealing with WHY I still think certain ways. Either 16,20 or 32 sessions. Obviously, the first is the one which is clinical proven to help anorexia best - the latter, a good option too. With the amount I have going on in my life, the latter is looking 80/20 most likely for me to go with. Plus, let's not bullshit. I'd be terrified of the first, but also, I have to keep my main focus on work and life. 

The one comment Dr. W made was "I think you owe it to yourself to finish off recovery"...and she's right. For as recovered as I am, I am not free. But what is hard to comprehend is being back there and not feeling like I belong. Being back there at all.  Although what is near-on impossible to get my head round and answer was the parting questions raised...."What do YOU want to get from going back? What purpose do my eating rules serve and am I willing to give therapy another go." 

Who knows? Probably. Maybe? Yes?


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  2. I just want to thank you for blogging your experiences; I get a lot of reassurance from knowing someone is going through a similar thing.

    In fact, our stories are quite similar; I have just been re-referred to an ED team (having walked out a year ago, chest puffed out, stating "I am absolutely FINE now and will never set foot in here again" ha) and had my assessments last week. Weight low-ish but not as concerning as my continued lack of periods and food rules. Shrunk 2cm since 2012 (you can imagine how my head took this news...). I was with this service from 2012-2015 and didn't receive 'proper' therapy either, having been part of some odd research trial then just bumbled along basically checking in with a psychologist every month rather than doing any real work. Hopefully that'll change now, although I felt so odd walking back into that outpatient department. I think the right emotion was 'shame', but how shocking to be shamed of my own mental health.

    I wish you all the best - as Ferris Bueller said, life moves pretty fast...
    S x