Tuesday, December 11, 2012

Recovery Week Day 2: Team Up Tuesday

Hey everyone--
Sorry this post is so late, but I have had a lot of meetings today with my team. Plus been doing a lot of thinking and have A TON of future blog post....so watch out...gonna be a lot of reading this week :) But for now let's focus on a treatment team...a vital part of recovery :)

Sometimes ED can get messy, need a team who can handle it

So the only way I know to describe a team is to talk about mine....currently I only have a nutritionist and therapist, but will be getting a new physician soon. Some people may have a psychiatrist as well...but my body can't digest medications and when it does it metabolizes them wrong and I get all the worst side effects, so no meds for me. So let's look at the parts I do have :)

So a nutritionist many times is the hardest person on the team to trust. They are taking control of the thing your ED seems to center around...food. It's hard to give over that control (it's something I still struggle with) but I have found as much as you dislike your nutritionist, they also become the person you love. They take away the panic of food, they push you farther than you think you can be pushed, but in the end all this does is bring you to a place of freedom you never thought possible. They are CRUCIAL to eating disorder recovery because they make you a meal plan that takes away your need to control your food.

So my nutritionist. Well, she is amazing. She really understands how my mind works, the ways I try to manipulate (even things I don't realize), and when I struggle she makes new ways to structure my plan more to help support me. I have had several different nutritionist and honestly it's about finding the one that gets across the information you need to hear in a way that you hear it. But, give them a chance. You are going to trust them at first and definitely won't like them at first, but don't use that as a reason to change nutritionist. For me it took a few months to get comfortable with Katherine, but now she is the best nutritionist I have ever had.

So it's important to know what you need from your nutritionist...for me here is what it is:

  • Someone who will call me on my bullshit and not let me get away with skimping
  • Someone who is tough, but not in a controlling I know better than you way
  • Someone who won't let me get my way, but will push me to do what is best for my body
  • Someone who will push me on freedom foods not just following meal plan
  • Someone who will let me voice my concerns as well and listen
  • Someone who is able to be contacted during the week
  • And the most important for me is my nutritionist doesn't focus with me on weight restoration (though that is a goal of ours) but instead on healthy eating and why it's okay to eat certain foods
Now when I first got into recovery I needed someone who would take complete control and not let me have a say, because I had no basis of healthy eating. That's something I have learned so my current nutritionist let's me negotiate a bit, but she has the final say and I know that. 

But really for me the last point is most important. I have been to several nutritionist where everything was about weight gain. If you lost, you lost exercise or other privileges. The appointments were just come in, weigh, get yelled at, and leave. No talk or conversation on food and goals, but my nutritionist now does that. She takes the time to console me when I gain and discuss why I lost when I did. Then we go on to discuss other parts of my intake like freedom foods and why I shouldn't be scared of certain foods. The reason for this I think honestly is because she doesn't specialize in eating disorders. But again, when I was first in recovery I needed someone who specialized in eating disorders and understood the crazy things I would try because I wasn't at the point now where I tell on myself when I struggle. 

I have been in therapy since I was 6....so this part of a team is one I am very used to. Basically this team member helps you deal with the real part of an ED, the emotions you are trying to escape. Therapy is rough but so freeing and definitely helps with the food, because emotions and food tie together so closely in ED. Now I have had several therapist with several techniques and again I needed different things different times. 

At first I needed a therapist who would dig into my past and the abuse I have endured. One that was more about the emotions and the reasons behind my eating disorder. The dig deep kind of therapist. Because I had never talked about a lot of the abuse or emotions. In fact I never allowed myself to cry with a person till therapy when I was 15. 

Also, at first I needed family therapy. It was the first time someone in my family had been to treatment for an ED and openly admitted to having one. My family needed to learn how to support me and I needed to learn to ask for support. There was also parts of my past I needed to talk to my family about. And I was under 18 so I was living with them and it was important to have this aspect of treatment. Now me and my family are in a different spot and I am in college, so we don't have family therapy anymore as I need to learn more about independence. But it is a good thing to look for when beginning to recover either for 1st time or after relapse. 

But my therapist now is different than all of this. Iain is the first male therapist I have had and he specializes in DBT. This kind of therapy is based more on the emotions driving behaviors and how to cope with them and stop the negative behaviors. It is awesome and exactly what I need. He is also amazing at what he does and we work very well together. Again the relationship is key here. 

For me here is what is crucial:
  • Someone who isn't stuck in their ways and will use a different style that works for me. First appointment with Iain he said: "I have no master plan. This is what you need." And in every session he asks what I need 
  • Someone who won't judge me. This is something I have felt from past therapist, but Iain always reminds me he isn't judging me. 
  • Someone who will call me on my bullshit. 
  • Someone who will push me further than I think I am ready to be pushed. 
Iain does all of these things. Our sessions are different than any therapy I have been in before and it's awesome. I feel like for once therapy is paying off. But really if someone taped our sessions they would think we were just fighting the whole time, but really we kind of "argue" in a way so I can counter ED. It works for me, but for others it may not. 

Also, as you all may have seen, Iain uses my creativity and visualization to help me. That's why we put ED in the corner, see him as a 6 year old, and something new is I am sending him away for the holidays. Like I am making a schedule for him and finding a hotel. For some people this would be silliness that had no benefit but for me its awesome and helpful. But other people journaling works, for me it doesn't. And so we tried journaling, it didn't work, and now we do the creative stuff. Iain has adapted to me. 

Something else is I really feel he cares about me. Even though he is really tough on me and reminds me this is my life I am fighting for (something I won't take from other people) I know it is because he cares. He also is available by e-mail and phone during the week and wants me to reach out...something I have never gotten from any other therapist. 

Iain doesn't specialize in eating disorders either, but I have found this has helped him be more open to using new techniques to beat my ED. But at first I think I needed someone who specialized in ED, because I needed someone to help me see what was behind my ED and why it still haunted me. Now I have a grasp on that and need someone who understands behaviors more. 
I know people can struggle to trust therapist and I struggled to trust Iain as well, but he was understanding of that and we worked slowly at first. But now that I trust him, he also knows that and pushes me farther than I thought possible (like I talk to him openly about food...something I've never done). 

With all the medical complications of eating disorders it is important to have medical doctor on your team as well. I currently am without one due to my University Health Center deeming me too much of a risk to work with. For me its important a physician understands eating disorders to some point and isn't judgemental and pushy as many can be. It's important they emphasize health and why I need the nutrients, without giving me a lecture about how I may die (which puts me on a guilt trip). So again its about the relationship

The Patient's Part
Something very very crucial to the team working comes down to us, the patient. We have to be honest. This is something I still struggle with because I don't want to let people down and don't want to lose my team, so sometimes I will go weeks struggling with a behavior before I tell my team and by then the tiny problem has become some cycle I can't break. This is probably why I have so many hard fast behaviors I struggle with, because instead of telling on myself RIGHT WHEN IT HAPPENED, I went weeks and waited. But now I have started to tell on myself right when it happens and it makes it so much easier (but still not easy) to stop the behavior. 

I will go more into this later this week in my mistakes post (Learn from Me or something like that will be the title), but really we have to be honest. ED craves secrecy, so letting go of that helps us to let go of ED and it becomes a great motivation. Before you do something ED related you realize you are going to have to tell your team, and for me that's enough to stop me in some situations. But again this took me being honest. Trust me, just like lying probably wasn't always easy for us, honesty isn't the easiest either. But the more you do it and see that nothing horrid happens and your team is still there, its easier to tell on yourself the next time. And then it becomes telling about urges you had, but the fact that you didn't act on them. 

So the team is important, but just like a meal plan, it's individual. You have to find the team that works for you and when one isn't working, find someone else. That can be hard to do to, but trust me changing from my old therapist and nutritionist (who I worked with for 4 years) to my new team (been with nutritionist for year and Iain for a few months) was crucial and the best decision I made. In the end, it's about doing what is best for you and worst for ED. So make the team that works for you...just like dodgeball. Choose the team that gonna peg ED the fastest and best way for you, and then rely on them. Trust them, be honest with them, and see just how far your dream team can bring you. 
Take that ED!

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