Homework, IOP, and Replacement Behaviors

I started this post DAYS ago.  Wednesday to be exact.  I just didn’t quite know what to say or how to say it.

I struggled with my homework for group this week.  I was asked to make a list of reasons to give up ED and reasons not to.  And honestly, it seemed like every single one of my reasons to give it up were still so mired in ED thoughts.  I kept coming back to things like “stabilizing my metabolism”.  I did finally manage to list a few that were legitimate.

Reasons for Stopping ED Behaviors

• Being a better role model for The Boy
• With my ED under control, I’ll finally be able to address the underlying issues.
• Honoring and respecting my body

Reasons against Stopping ED Behaviors

• I’ll have to start “feeling” again.
• I don’t feel as in control as I would like to when I’m not using behaviors.

So, I guess, even with that small amount, stopping wins by a slim margin.  But a slim margin is the only thing the rational side of my brain needs to grab onto and hold on for dear life during this fight.

Group this week went a bit better than last week.  Though I was incredibly anxious about the “experiential meal” portion of the evening, I went.  I sat and I listened.  I tried very hard throughout the group lecture to replace the words “overeating” and “binge eating” with “disordered eating”.   Those phrases just seem to trigger me into restriction and wanting to purge, which does me no good at all.  Still not fully convinced that the group is the right one for me, but it will have to do for now.

I ate dinner with the group.  It was incredibly hard, but a very nice guy that joined the group this week sat with me and really turned on the paternal instinct when he knew I was struggling.  He chatted with me about where I live, what I do for fun, fostering animals….and though it didn’t really help, it would at least distract me for a second or two, which was long enough to get a bite into my mouth.

As the week has gone on and I’ve done so well with “behaviors” at home.  I was eating three meals a day and a couple snacks if I needed them.  I wasn’t restricting.  I was feeling healthy.  But I started to notice that some of the other mental health issues that run through this big ol’ head of mine started getting a bit out of control.

OCD was searching desperately  for something to obsess about, and it found it in some mushrooms that refused to go away in my front garden.  I couldn’t stop thinking about them.  I was having trouble falling asleep at night unless I went outside and dug them up.  I couldn’t walk past the garden without kicking the mulch around with my foot to make sure there were no mushrooms hiding under the wood chips.  That crazy level of anxiety built up in my head every single day starting with the moment I walked out to the car to drive W to work and had to walk past the front garden and lasted until I drifted off to sleep plotting ways that I could pour gas on the damn things and not hurt the surrounding plants and grass.

I also deal with dermatillomania, aka chronic skin picking.  It’s a hard disorder to understand for anyone who doesn’t deal with it, but the wikipedia link there seems to do a good job of describing it.  It’s in the same disorder class as trichotillomania and is considered an impulse control disorder.  Essentially, I pick at my scalp.  In a effort to make the skin on my scalp perfectly perfect, I am constantly running my fingers through my hair.  Any swollen hair follicle or small imperfection gets picked into a gigantic wound and I continue to worry and dig at the sore, making it go from something that would normally heal in a couple days to something that stays for months.  I had been doing really well with controlling it.  I wasn’t perfect and still had a few times a week that I couldn’t stop myself, but it was moving in the right direction.  As soon as I started cutting all ED behaviors out, the derma got OUT OF CONTROL.  I’m currently nursing nearly 30 spots on my head and it hurts.

I realized in therapy that I was trying to move to quickly with the ED behaviors.  And by cutting out all of the control that ED allows me to feel, I was transferring that control over to other aspects of my life.  Controlling the fungus in the garden.  Controlling the “perfection” on my scalp.

Once again, I need to start trying to find my balance.

Discouraged, skeptical, and unsure

So, I went to the intensive outpatient group. And unfortunately, it ended up meeting a lot of the negative expectations that I had. I’m not planning on quitting, but I’m just frustrated.

It’s a BED group, and though I agree that I binge, I also have “compensatory behavior” given that I fast at least three or four times a week and severely restrict almost every other day. In other words, I don’t agree that the BED diagnosis fits me. I went into the group with an open mind that eating disorders, because they are not about food, can be treated with generally the same ideology and I would be able to benefit from the group. But I was a bit skeptical that I would be able to get the support that I was looking for from the group.

Tonight’s group felt more like recovery from Weight Watchers than anything else. There was a very large amount of talk about weights lost and gained, methods and diets followed, binge triggering foods (as in “Oh, I love XXX SO much! I could eat it by the gallon!”)

The therapist and nutritionist running the group kept redirecting it back to tonight’s discussion topic which was mindful eating, but the group was really driven to discuss the other stuff, so even during the mindful eating exercise, it was all jokes about how easy it was to just shovel the food in and no real observation of the concept.

I’m really starting to get concerned that if anything this group is going to be more triggering for me.

I know that I will go back next week, because I have made a commitment to myself that I will give this a shot.  I’m just really unsure about how effective it’s going to be for me.