27 January 2016

One Change of Routine at a Time...

When people describe recovering from an eating disorder as a journey, they really do mean it. Just when you feel like you have come to the end, you realise that there is so much further left to go. The hardest part about this is the fact that each stage of your journey means different environments, different responsibilities and different routines. As somebody that relies on organisation, structure and rigidity, the transition between these stages was quite difficult for me to deal with. The first change that occurred was when I was allowed to start going home on a weekend. After spending seven weeks in a hospital where meals were to be eaten at very rigid times, I found it difficult to break this habit at home. I would continue to set my alarm for 6:45am, so that I could shower and get ready in time for my breakfast at 7:30am. I would make sure that any activities that were planned, allowed for morning snack, lunch, afternoon snack and dinner to be at the exact same time as at the hospital. If these were not fulfilled at the specific times, I found myself becoming distressed and anxious.

However, it did get better! The first time that I realised that it was ok to be flexible about timings was when I went to London with my family. We had a variety of activities planned that would force me to challenge these rules that I had set around when I could eat. I am not going to say that it was easy, particularly because of the meal plan I was on, but I managed and learnt to adapt to the situation, without compromising on my intake. I found that after I had done this the once, each weekend at home became easier and so much more enjoyable. I found that I was engaging more with what was going on around me, as apposed to staring at the clock waiting for it to strike, signaling a meal or snack time. I do still find it difficult to imagine a time where I will be able to listen to my body in order to determine when I am hungry, but I believe that is just because I am still on a weight restoration plan. On the other hand, I am very optimistic about the fact that I will be able to recognise hunger and sustain a regular eating pattern when I am on a weight maintenance plan, I just know that this will take time.

Timings were continuously challenged throughout my ongoing recovery journey; particularly when I started to step down to the day service programme at Evolve. As my discharge date from hospital approached, I began a gradual transition onto the next stage of my treatment plan. At this point, I was living at or attending three different environments over a seven day period; Evolve on a Monday and Friday, hospital Tuesday-Thursday and then at home for the weekend. I found that this really challenged me in terms of my progression towards recovery, and tested how much I had learnt. Fortunately, because I had the mindset of embracing all aspects of treatment, I worked hard to make sure that I stayed on track. My weight restoration speed did plateau during this period due to increased activity, different food products and a wider variety of options for meals and snacks. Yes there were a few blips as well, and there still are, but you have to remember that for the past 3 to 4 years, my coping strategy to deal with difficult situations has been to control food, so habitually I found myself doing this, but soon pulled myself back out of it. Instead, I used coping strategies that I had learnt in hospital, such as playing with a hair bobble on my wrist, taking some time out for relaxation, but most importantly, talking. I was communicating my problems to my parents, which was something I had previously found so difficult, but realised that it helped me so much. Making these transitions was not only testing my understanding and confidence around food, it was testing how I use new coping strategies that are not damaging to my health. These are all seemingly small steps, but will have a huge impact on me as I reintegrate back into my new healthy life.

Starting at Evolve was a huge step in my recovery. I went from selecting a meal from a choice of three, to making completely new decisions about what meals I would like to eat. The hardest part was that I was, and still am, on a weight restoration plan, so creating a varied meal plan that included breakfast, two snacks, two main meals, two puddings and supper did prove to be quite a challenge. I was given a booklet to look at with plenty of suggestions, which did give me a few ideas. However, I found that I was unhealthily using this new freedom to entertain a lot of the rules that I had established about food whilst in the depths of my anorexia. I realised that this was a problem and so decided to approach the dietician to tell her about what I was struggling with. She alerted the other members of the team so that when I was meal planning, they would question whether I was still, excuse the pun, feeding into the anorexic thoughts. With time this improved, and I continued to challenge all aspects of the rules I had established, including the layout of food on a plate and the mythical guidelines I had set myself over which types of food groups I can eat in one day. I am sure people reading this will think that it is absolutely ludicrous that I have such rules, but in all honesty, they are literally just a few of the many things that circulate my head on a daily basis. Some days I wake up and wish that I could have a brain transplant, just so that I can scrap all of these beliefs that I have absorbed at some point in my life and cannot seem to let go of.

As well as the growing responsibility I was given over choosing what to eat, I also started engaging in Body Image therapy at Evolve. Although at this present time I can only do small amounts of the work, because I am working on weight restoration and consequently my body is changing, I have still found it beneficial. I explored my past and was able to take note of times in my life when I started to develop issues with my body. At first I found this quite difficult because I never thought I had an issue with the way I look and that my anorexia just started because of problems I had with food, but the more I investigated, it became quite clear that there were several triggers throughout my childhood. Seemingly small instances such as being categorised as small, medium or large for dance costumes; looking at images of models in magazines that were seemingly successful. It hadn’t yet began to effect my eating, but again the accumulation of several thoughts and ideas are what I believe assisted the development of this illness. I do think that the media have a lot to answer for in terms of how individuals make comparisons and connections between beauty and success. However, I think that the way a male or female is influenced by what is portrayed in the media does very much depend on their self esteem and body image at that time. Unfortunately because of the nature of my interests, I was looking at more than three fashion publications weekly, and was struggling with my body image, therefore was constantly absorbing everything that I read and saw. This started the ball rolling in terms of the food rules I established and now have so engrained in my mind.

At Evolve I could also explore more everyday challenges that I would be faced with. I had assistance from an Occupational Therapist who furthered my confidence in food shopping and eating out. These are scenarios that I would completely avoid in order to prevent unwanted anxiety, but I could not live my life like that. I have continually challenged these and consequently am now rebuilding my social life with accepting that eating out is a huge element of that. Every time I go it gets that little bit easier, but with nutritional information being displayed everywhere, I am still finding it a struggle to ignore the messages shouting out to me about what to choose. As with anything, as my own voice continues to get stronger, I know that it will soon drown out the other, but this will take time.

Throughout every stage of my treatment, I have tried to fully apply myself to what I was being taught. I didn’t want to take any opportunity for granted, as I knew how hard they were to come by. Each environment had its own challenges that did take a while to adjust to. Learning to trust the staff members was a huge thing for me, as I didn’t like to communicate my problems, even to those close to me. So after allowing myself to open up to the staff at hospital, I then had to establish new relationships with those at Evolve. I had to remind myself that if I don’t speak now to communicate my issues, then my 6 week placement would have been a waste, because I would have not have challenged everything that I was struggling with. Similarly to at hospital, I met some wonderful other ladies that were also receiving help. Even with everything that they were dealing with, they still managed to support me throughout, and I am so grateful for that. It was very difficult being the only person at Evolve who was still on weight restoration plan, so I felt like I was the only person constantly sat at the table. However, the other girls would make themselves a hot drink and come and sit with me as I ate my two course meals twice a day. They didn’t have to do that, but they did and that meant so much. At both environments, I genuinely felt like I was understood. I didn’t feel like I was going to be judged for saying what was on my mind or what I was finding difficult. I think everybody going through this deserves to have the opportunities that I was offered, it isn’t fair to be denied access to this life saving treatment, and unfortunately I am classed as one of the ‘lucky ones’ for having the chance to have another go at life.

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