Featured Image: “Artist’s Impression of Dust Formation Around a Supernova Explosion,” © EOS/M. Kornmesser. CC-BY-SA 4.0.
“So what I hear you telling me is that you’re still in a state of high anxiety from last weekend,” responded Kelly’s voice from the telephone receiver. It was just past noon on a Friday, and I was sitting at my desk in my little closet of an office, the door securely closed and my white noise sound machine swooshing steadily in the background. She was referring to a trip that I made back east over the Labor Day break. By Kelly’s estimation, based on my recounting of events, it was the most stressful and overwhelming situation I had encountered since my discharge from partial hospitalization nine months earlier.
I wasn’t exactly sure what made the weekend such a tsunami for me, but I knew that it was multifactorial. The result was that without even recognizing what was happening as it occurred, I found myself sucked into a pattern of psychological thinking, emotional numbing, and both mental and behavioral avoidance like I had not experienced since prior to my intensive course of treatment. My awareness didn’t awaken to this shift until the effects manifested in my eating. Kelly was adamant that I had not come anywhere close to binging when she reviewed what I refer to as my “Food and Emotions Diary,” in which I record how I am feeling both physically and emotionally before I eat, then write down exactly what I consume, and then reflect on how I am left feeling after I finish eating. My entries from the weekend were raw and uncensored. “WHAT THE FUCK DID I DO?!!!” lamented one entire, 3½ x 5½ inch page of the black, unlined Moleskine. Kelly declared it a success. “Are you kidding me?!” I challenged, sitting across her narrow desk on Tuesday morning. But she insisted, pointing out that even when I was in my worst mental and emotional place, blind to what was unfolding around me, unaware of my dangerous slide, unconscious of the need to even attempt to utilize the skills that I typically relied upon, I still didn’t really overeat. Use behaviors, yes. Overeat, technically no. I was still upset. I didn’t see the distinction as clearly as she did, apparently. Furthermore, my therapist seemed concerned… or maybe I was just mind-reading. One of the lingering repercussions of the weekend was that I was back to a stellar degree of over-thinking and over-interpreting every thought, word, and action from myself or others.
“I guuueeess…” I dragged out the vowels melodically, pleadingly, back in the present moment. Please help me! Why am I feeling this way? Make it stop! Tell me that everything is going to be OK!
How could I still be recoiling from the past weekend? No sooner did I plunk myself into a vinyl seat by the gate in the airport than I began processing what went right and what went not-so-right, searching for all the lessons I could possibly glean. I immediately returned to my basic skills and crisis survival strategies – the tried and true techniques that helped in the past. I called upon my mindfulness practices, rallied my support network, promptly followed up with both Kelly and my therapist, dove into my journal, and readjusted right back into my healthy routine as soon as the plane touched down. Back to work, back to my moderate exercise schedule, back to my safe foods and the reassuring comfort of my meal plan. It felt like I was back to “baseline,” so why, four days later, was I suddenly… not? It started shortly after I arrived at work on Friday morning. There was a familiar creeping feeling in my lower chest and upper abdomen that felt deceptively like an aching emptiness. It was coupled with a growing tightness in my chest, directly behind my sternum. My muscles tensed, my jaw set itself like cement. My heart skipped quickly and my breathing became shallow as my thoughts began to race. I’M HUNGRY!
That’s not possible, my Wise Mind said. I call it my Kind Voice, my Reassuring Responder. It quells the panicked internal exclamations that proclaim impending nuclear holocaust when I am stuck in traffic on my way home from the Biggish City and wind up eating dinner an hour later than usual. I just finished breakfast an hour ago, and last night I ate a very nutritious, very filling dinner. I am certainly eating enough, because I am meeting all of my exchanges on my meal plan, and I have not been overly active. This feeling is not real hunger. Whatever it is, it is not hunger, and it will go away. I know this feeling, I’ve had it before, and I know that I can tolerate it. It will not last forever. It is unpleasant, and I don’t like it at all, but I can get through this.”
WHY IS THIS HAPPENING?!! HOW LONG IS THIS GOING TO LAST?!! WHAT IS WRONG WITH ME?!! I CAN’T TAKE IT! The Reassuring Responder was compassionate and logical, but volume and intensity was on the side of Freak-Out-and-Panic. Back and forth they volleyed in my mind. I would feel relieved and at relative ease for a few moments, and then another alarming thought would race through my head as the hollow feeling in my stomach and chest expanded. What am I going to do? I started thinking about behaviors, and then I started to get really worried. As I fixed my lunch plate, I wondered what I would do after I ate. Would I go after the ice cream that was in the freezer in the break room, left over from the last pot luck? Would I hang in until tonight and then go out to a big restaurant dinner as an excuse to overindulge? It felt like I needed a miracle as I clutched my sanity, desperate to adhere to my meal plan while simultaneously searching for any possible loophole I might exploit. I can’t keep all this inside anymore, I decided. I need to share it. That was when I picked up the phone and dialed Kelly.
“I’ve been doing really well, though!” I protested, searching for some other proximate cause. “But…” I confessed to fears about gaining weight over the last several days. I admitted to thoughts about restricting, though I was not acting upon them. “Is this some sort of rebound from thinking about restricting?” I wondered.
“What ELSE is going on?” Kelly prodded. She always prompts me to dive deeper when I start thinking that I’m getting fat. “IT’S NOT ABOUT THE FOOD!” she declared to me just before my trip. Obviously, I knew that she was right… to some extent. My eating disorder is a deranged coping skill, basically. But sometimes it really seems like it’s all about the food. It is an eating disorder, after all. Her message at the time was that I was doing so well with food, with trying new foods and with eating in all sorts of different settings, that I would try to make it about the food when I was going into any sort of social environment, work function, or other place where I was uncomfortable or felt threatened. “Eating-wise,” she told me then, “you’re doing great.” I wasn’t doing so great anymore! Now it was about the food.
On the other end of the phone line, Kelly’s chipper voice wouldn’t relent. “Have you talked to your friend, yet?” she querried. The culmination of the weekend was that I finally managed (once I became aware that I had feelings and they needed to be released) to express my anger, frustration, disappointment, exasperation, and distress to one of my best friends, basically fleeing her house on Monday morning for the airport in tears. That was the last time we spoke… but we were planning to hash things out over the weekend… I admitted to Kelly that the conversation was impending. Could that really be it? Could I really be that worked up, as I anticipated speaking about the events of the weekend with the other person most affected by what happened? I was terrified of losing the friendship. TERRIFIED. I was terrified that I wouldn’t say the right thing.
In five minutes, Kelly diffused my anxiety. We reviewed my distraction techniques and distress tolerance skills. “What are you going to do this afternoon to tolerate this?” she asked me, and I ticked off my list.
“I’m going to dive into my work with all I’ve got, be present in the moment fully, I’m going to keep my hair appointment after work. My gym bag is in the car if I want to go for a (gentle!) swim. I’m going to read, color, journal, go for a walk, call a friend…” I’m going to be OK. I CAN do this. I’ve done it before. It doesn’t feel good, and it might not be pretty, and frankly, it might really suck, but it WILL get better…
…and it already is. Because it isn’t about the food.