Loss

5 Ways To Deal With Weight Gain When You Are In Recovery From An Eating Disorder

/ bornwithoutmarbles / 14 Comments

If I had a penguin for every time I have heard someone say or have said myself “I want to recover from anorexia but I don’t want to gain weight”, I would have more penguins than exist on this planet and would therefore have to get the existing penguins to rapidly reproduce in order to make up numbers (which is why all the penguins of the world are probably grateful to hear that I don’t have to have a penguin for every time I have heard that sentence or else they would have a lot of egg hatching to do).
Admittedly, there are many sides to the Rubix cube confusing madness that is recovery from anorexia, both mental and physical, and there are a lot of fears revolving around all of them, but I think when it comes to recovery, probably one of the top three things most people worry about is the weight gain side of it all. Personally at least, I know that the fear of weight gain is certainly a big thing for me and is particularly relevant right now as in my current admission to hospital it is the forced and rapid weight gain that has ended up distressing me most of all to the point that I haven’t even been able to focus on any of the more long term mental health sides of the illness as I am too focused on the scales.
I know that to other people, my weight does not define me as a person and that the number that flashes up when I step on a little machine should not dictate the way I live my life but when you have an eating disorder, those thoughts are often automatic and knowing they are irrational doesn’t take them away.

Unfortunately, despite the fact that the weight gain side is incredibly hard, if you really want to recover from your eating disorder, the fear of weight gain is an unavoidable thing that will need to be tackled and that, if neglected, will never truly allow you to get back to a healthy mind and body again.
So how do you manage it? If you want to recover from your eating disorder (or even if you don’t and are in forced treatment at the moment…ahem), how are you supposed to deal with one of the most frightening challenges to face someone struggling with anorexia: weight gain. Well, if that question has been on your mind at all then welcome to a blog post containing some possible answers, because today I am here (wearing a bow tie no less because I am fancy and have dressed smartly for you on this occasion), with 5 thoughts to help you deal with weight gain when you are in recovery from anorexia. So without further ado, lets get into it *straightens bow tie and gets down to serious business*…

1. Weight redistributes – When you start the re-feeding process after depriving yourself of adequate nutrition for a long period of time, your body will have no idea what the hell is going on or what the hell to do (something I explain a little more in this post here: Five Things You Need To know About Re-feeding During Eating Disorder Recovery). Because of this confusion and deprivation, when your body first starts gaining weight, it will want to prioritise on life saving things first (handy that) and for this reason a lot of people find that weight gain in the early days primarily goes to the tummy area so that the body can focus on repairing things like a dodgy liver or an out of whack kidney. This has happened to me multiple times (including right now) and understandably it can be quite distressing as your body can start feeling out of proportion, but what I want to emphasise with this point is that even though weight may initially go to life saving organ places, it WILL redistribute and spread out eventually as long as you hang in there and give it time. Restricting your intake to lose the weight again will only make this process more dramatic, so the key is to stick with it and always remember that redistribution will happen!

2. You are gaining weight you shouldn’t have lost in the first place – Whenever you see or hear an advert for a weight loss diet club, the people will emphasise how good it is to have lost the weight they did with whatever weird low carb eat upside down with a pineapple up your nose (difficult task, would not recommend) diet they have been following and therefore the idea of gaining any weight back is automatically “bad”. Culturally this has then created this false idea that the act of gaining weight is a bad thing in itself however this is not always the case, especially when it comes to recovery. Thing is, when you are regaining weight you have lost through an eating disorder, you are actually not gaining weight but are regaining parts of your body that you should not have lost in the first place, so whenever you see that number go up on the scale remember, it is not weight gain in the negative way that the diet clubs claim it to be, it is just re-finding a little puzzle piece of the wonderful you that may have been lost to this terrible illness.

3. The alternative is worse – I will hold my hands up and admit it: weight gain is scary. Then again, if you think about it, isn’t the alternative, aka death (for anorexia is the mental illness with the highest mortality rate of all), even scarier? “I am not that bad” I hear you cry, “I am not going to die of anorexia”, but hey, that’s what they all say and in a lot of cases, it turns out not to be true. Anyway, even if you are one of the fortunate souls whose body somehow manages to survive the abusive nature of an eating disorder and live, what kind of a “life” is it to spend your days tortured and tormented by a beast in your head? Weighing things up then (no pun intended…actually screw it…with me the pun is ALWAYS intended), although weight gain is scary, when you are going through the process it is important to think of the alternative, and remember that that alternative is a hell of a lot worse.

4. Weight gain is not as visible as you think – If you are like me, when you stand on the scales and see that the number has gone up, you can immediately see where that extra weight has gone to. This however, in the nicest possible way, is utter nonsense because in actual fact changes in body weight are no where near as visible as we might think. I remember one week when I gained one pound and instantly I saw my physical appearance change into something unrecognisable to the person I had been before that pound. Know what everyone else saw? Nothing. I would be lying to say that no weight gain is ever visible (as someone who has just spent 5 months in hospital I can guarantee I do look very different now), but my point here is that weight that you gain every week at weigh ins is not as visible as you might think and if you think you can see that pound or two of extra weight then it is simply proof that your eating disorder is distorting your vision. Don’t listen to its lies I say!

5. Getting bigger doesn’t mean you are big – If I ran a banana farm and after the harvest found that I had 1000 bananas, that would be a lot of bananas (and I would clearly be one hell of a good banana farmer). In that circumstance then, 1000 banana would be the definition of a lot of bananas. If the next year I then had 100 bananas would I think that I had hardly any bananas (trust me I do have a point here and am not just trying to send subliminal messages to you all about my secret dream to become a banana farmer). If however I had 0 bananas one year and then the next had 100, 100 bananas would be my definition of “loads of bananas” and that is what it is like with weight: aka all relative. Just because you are gaining weight and getting “bigger” it does not mean that you are big. You might think “I am huge” because the number on the scales has gone up but what I am saying is that just because the number has got higher it doesn’t mean that number is big. 100 bananas only looks like a lot of bananas if you previously had no bananas, just as a certain number of kilos only seems “huge” because it is bigger than the nothing you had previously and every “high” number you fear only seems high because you are looking at a lower one first. Getting bigger does not mean getting big therefore and if it was the other way round (aka the 1000 banana situation first) then your “high” number would be someone else’s low in a different situation. Whenever you see you have gained weight and feel like your weight is high, remember the bananas and the fact that a high number only seems big because it is bigger than the previous number and it is not that the number is big in itself.

SO there you have it! 5 thoughts to help you manage the fear and stress that is the weight gain side to recovery from an eating disorder! As always I am not saying that this blog post is going to solve the problem, nor will it probably make gaining weight any easier, but these thoughts are at least important and sometimes helpful/comforting things to bear in mind when the voices are getting a bit too loud for comfort and you have no arguments to fight against them. These thoughts are therefore your arguments against all of those bad thoughts, your weapons for the recovery battle, so take them brave soldier and use them wisely to outwit that cunning eating disorder who is trying to fool you into making weight gain seem like a bad thing.
In the meantime, if you are someone struggling with the anxiety ridden process that is gaining weight, please know that I really do feel for you as someone who has gone through the process multiple times myself (and is still going through it today), and I hope that this blog post has perhaps helped a little bit. Remember, recovery and weight gain is hard but losing your life to a cruel demon in your mind is far worse.

Take care everyone x

WeightGainFear

Five Things You Need To know About Re-feeding During Eating Disorder Recovery

/ bornwithoutmarbles / 11 Comments

Whenever you enter treatment for any kind of eating disorder, you will often be given about a million worksheets, pamphlets and photocopied passages from text books, about the mysterious topic of “re-feeding”.
Indeed, over the years I myself have been handed many of these scientific attempts to explain the various processes the body goes through during re-introduction of food after periods of starvation, and having been through those various processes multiple times, I thought I knew it all. I thought that when it came to re-feeding a patient with anorexia, I was an expert, an oracle of knowledge when combining my scientific genius (aka facts I memorised in text books) and personal experience. So arrogant and confident was I in my “know it all” attitude, that had I been asked to take part in the UK gameshow Mastermind, I would have chosen “the re-feeding process in treatment from an eating disorder” as my specialist subject and would have had a cabinet built for the trophy in my living room before I had even answered the first question. Luckily, nobody has ever asked me to be a contestant on Mastermind because if that had happened, I would have looked like a fool and would have had a very sad and lonely, empty of trophies, trophy cabinet.

Today then, rather than sit and mope with regard to my lack of trophies (and whopping great useless cabinet in my living room), I thought I would use my current situation as “person attempting re-feeding” to share with you the five things everyone needs to know about the re-feeding process when in recovery from an eating disorder.
This is not just the explanations that you get from the science books, this is the Born Without Marbles, real life, honest guide to get you through all the surprises that can happen during the re-feeding experience, even if you have been through it before and think you already know it all…

1. Taking it slow is important: I think there is often this misconception that the more food you can get into a person who has been starving for a long time the better, when really, that can be quite dangerous. When your body isn’t used to being given food, it sort of turns off and goes into a stand-by mode, so booting it up again is a process that needs to happen gradually. It is like if you had an out of work clown, to get them back into juggling you need to start again with 3 soft balls rather than going straight in with 10 flaming knives and a live alligator riding a chainsaw. When coming into hospital for example, people are often started off on half portions to build up from gradually over the space of a few days, to avoid the body going into too much shock and sending your electrolytes and cardiac functions all berserk. Now, this is not an excuse to let your eating disorder sneak in with “well, if it is dangerous to eat much even though you are in recovery, you should probably just eat a little bit of lettuce” because NO. All I am saying is that when you are getting back into the habit of giving your body food, you need to be gentle and start off slowly, preferably under medical supervision/working with a dietician to keep you both physically safe and to make certain you are gradually building up to the amount of food you need rather than sticking to the initial “half portions” of the first stage.

2. Any weight changes on the scales are not going to make any sense: In life, I think we treat scales a lot like calculators, machines that give us logical results and answers to various calculations of input and output made over the week. Unfortunately this is not the case, especially during the re-feeding process of recovery from an eating disorder, and instead of giant body calculators, I would encourage you to treat scales like a very drunk friend following a night out at the pub. This is not to say I advise taking your set of scales to the local takeaway for some cheesy chips and a lamb kebab (scales prefer pizza with a side of garlic bread), rather it is to say you should take everything they say not as fact, more as a vague approximation of reality/what is going on. I am not going into specific numbers here, but when I was admitted to hospital almost three weeks ago (my how time flies when you are in a mental institution!), I ate less than I had been eating at home, due to anxiety and because everything served to me was different and none of it was what I considered one of my safe foods. After a week of eating less than half I had been previously, I stepped on the scales expecting to lose weight. To my horror, I gained. A lot.
“Oh my goodness” I cried out dramatically fainting on the clinic floor. “What is this? My body is broken! Everyone says that when you eat more food you gain and when you eat less you lose weight but I am defying medical science. Someone send me to a laboratory for experimentation!”
When the doctors increased my meal plan, I was even more terrified than I had been before, figuring that if I was already gaining when I wasn’t eating, were I to eat more, my weight would spiral up and out of control. Therefore I continued to restrict in an attempt to lose the weight I had gained…and I gained again.
Soon enough, I had no choice but to start complying a bit and eating a little more, so on the next weigh day, I braced myself for another increase in kilos. You can imagine my surprise then, when I actually lost all the weight I had gained over the previous week despite having eaten double the calories. Logically, that made no sense to me, but, bodies and weights do not make sense during the re-feeding process. As food is reintroduced, chemical reactions explode like fireworks throughout the body, electrolytes get confused, the fluid levels go all over the place so when you get on the scales, any shifts you see are likely to be “false” weights due to all the internal changes going on. Thus, going back to the drunk friend comparison, when they show you a number aka tell you a story summarising the night before, though they will be able to give you a vague idea of what is going on/what your body weighs, they will not provide a logical accurate explanation of your situation/true body weight that you can gain any real knowledge or conclusions from.

3. Your body is going to do some very weird things: When people talk about the re-feeding process they will often whip out phrases like “nourish to flourish”, as if the second you start eating again, sunlight will start shining from your eyes and you will find yourself skipping gaily in a field of daisies. Admittedly, one does need to nourish in order to “flourish” and become physically well, but again this is a gradual process, and at the beginning it is likely your body will do less flourishing and more random weird things that you never expected or understand.
You will probably get tummy aches and indigestion, feel full one minute and ravenous with hunger the next, your bowels may go to sleep or into overdrive, you may fall asleep all the time or even be unable to sleep at all, night sweats and drastic changes in temperature may occur, blood sugar levels will be unpredictably random (recently mine were highest after a day of very little food and then too low after the biggest meal of my admission so far – another reason why medical supervision in re-feeding is vital), and you may experience abdominal bloating as well as this weird thing called Edema. Edema is basically when your body goes through dynamic fluid shifts and parts of your body (mainly your feet and legs) may puff up.
This Edema thing has been especially bad for me this time and my legs and feet swelled up as if someone had thought I was a bouncy castle and plugged me into one of those air machines (during this time I learnt that life is hard when you are a bouncy castle as children are constantly jumping all over you. On the positive side, if you are business savvy you can charge them a few quid a time and make a tidy profit to buy yourself something nice/ice packs to soothe all the bruises made by violently jumping feet all over you).
I think the Edema one had me especially scared because naturally your mind will convince you that rather than water retention your legs are swelling with actual weight and fat, and as someone who is currently managing Edema I can hand on heart promise that is not true. Like I said, I swelled up like a bouncy castle, but after keeping my feet elevated for the past fortnight my legs and feet have started to deflate a little. It feels as if it is a disaster and going to last forever, but it DOESN’T. Me warning you of all these things is not to put you off the re-feeding process, far from it, as it is far more dangerous to remain undernourished with no chance of flourishing in the near future. Instead what I am trying to do here is let you know what might happen so that if it does, you are prepared and know that this kind of thing is totally normal and it is not an excuse for your eating disorder to convince you that it is your body and yours alone being weird and “rejecting food”.

4. Your mind is also going to do some very weird things: You would think that with your body off galavanting and causing mayhem, your mind might perhaps wait to kick up a fuss until after all the physical stuff is over, but no, your mind is going to go a galavanting as well and will also be doing some very weird things. The re-feeding process is very much like the descriptions of puberty I was given in a lesson by my primary school teacher (good Lord was that a terrifying conversation), in that your emotions are going to go all over the place. Like I said, when you are not eating, your mind and body go into standby mode and occasionally emotions shut down. When you start eating again however, the emotions turn back on at weird and unpredictably inappropriate moments. One minute you will be numb and feeling nothing at all, the next you could be laughing hysterically at your shoe, then you will be filled with rage for no particular reason before being overwhelmed with sadness and crying yourself to sleep…It is a lot more fun than it sounds…actually it is not, but again this is not to put you off the process, rather so that you know what to expect!

5. It is different every time: This is probably the most important lesson I am currently learning as I go through the re-feeding process and I imagine it will also be the most important one for people who, like me, have been through it several times before and may be reading this thinking “this is not new information, I know what to expect” much as I may have two weeks ago. I thought that because I knew how my body had reacted to re-feeding before, I would be able to predict how it would be this time round, but that was not the case. Every time you go through re-feeding it will be a different experience and your body will react differently. The longer you have been ill or the more trauma your body has been through, the weirder the experience may be. Like I said, I have really struggled with Edema this time round, and the reason I mentally struggled with it so much is because it has never happened to me before.
I knew all about it and had seen it happen to other people, but when my legs swelled up I was convinced that it was real weight rather than water retention, because my body hadn’t reacted like that on any previous occasion and therefore I thought that kind of problem could never affect me. Had I had Edema before I think I would have coped better with it, as well as the weird things I have noticed this time round on the scales, but it was the fact that “my body doesn’t do this usually” that had me frightened that something was going on and I was actually gaining and swelling with actual weight. Just because your body hasn’t done something before it doesn’t mean it won’t give it a whirl this time and if there is one thing I would want you to take away from this post it is that for all the preparations you make, this is still going to feel very random and very unpredictable…

…What a great final point to end on! Basically I have just told you a list of things to expect during re-feeding and then told you to go into it with no expectations because you cannot predict what will happen…hmm…Great advice…Good one Katie…

To be perfectly honest with you all, I have no idea what is currently going on with my body, what it will do tomorrow and quite frankly I don’t understand a damn word or second of this re-feeding malarky right now.
All I know is that it is scary, it doesn’t feel necessary to me, and I am still doubting the words of every doctor I come into contact with/struggling to accept or trust any of this.
Regardless of any of the mental rationale behind this admission or eating however, this is an honest account of what is and what can happen physically during the re-feeding process as I am trying to get through it, so if you have ever wanted to know what to expect or are going through similar things and are scared, you know that it is not just “your” body being weird and that there is someone else out there with swollen legs covered in the bruises of toddlers who have mistaken you for a bouncy castle.

Take care everyone x

Refeeding

How It Feels To Be Recalled To Hospital Under A Community Treatment Order

/ bornwithoutmarbles / 16 Comments

If someone had asked me what it feels like to be recalled on a Community Treatment Order (part of the Mental Health Act), before it had ever happened to me, I am not sure what I would have said. Possible guess answers that I might have offered would have probably included things like “scary”, “shocking” or “dramatic”. Probably one of the last answers I would have given, would have been “it feels like having your car stolen by a band of incredibly apologetic thieves who are very sorry for your loss”. However, as it turns out, that is exactly what it feels like…

As you will all know from the fabulous explanation of the Mental Health Act that I posted last year and linked to again last week (hint…it is right here: Demystifying The Mental Health Act…With Penguins), when you have a CTO, you have a list of conditions hovering over your head which must be adhered to if you want to avoid being legally recalled to hospital. Rather than conditions hovering like ominous wasps at a picnic who like a look at your jam sandwiches though, I like to think of them as “things that hold you accountable” or “reasons to do things”.
Every time I was scared to challenge my eating disorder and follow my meal plan I had an argument I could use, that being, “you have to do this because otherwise you will lose weight and go back to hospital”. It was a system that worked but admittedly I felt really trapped by it.
Every day I would wake up and force myself to eat a number of calories that made me feel depressed, knowing that it would keep me at my CTO weight which felt equally depressing.

All I wanted to do was give up, give in and lose weight but I felt I couldn’t because that would only involve being recalled to hospital which was simply not an option. My CTO weight was the border to a war zone and I was not taking a single step into no man’s land.
Then however, the recent hospital surgery medical drama, naturally led me to lose weight and I crossed that barrier without even intending to. Before, that CTO number had held a power over me, every digit had felt significant, like a law from the gods that I would probably find carved into one of those massive rocks at Stonehenge if I visited and looked close enough (a lot of people have theories as to why those mysterious stones are there including “for religious reasons” and “rituals”…My theory is that they were simply put there by some cheeky prankster who wanted to leave a pile of stones lying around so that future generations would ask “why the hell are those stones there?”)

When I went under the weight however, the power of that number and the spell was broken. I had thought that one step over the border would have resulted in guns and tanks sending bullets and bombs flying all over the place…but nothing happened. Of course it would have had the weight loss been “my” fault, but I had an excuse, my appendix did it not me, so it was almost allowed. Obviously the CTO weight still mattered and I had to get back to it, but with this medical “it isn’t my fault” get out of jail free card, I knew that I could take advantage and lose more weight without getting into trouble.

Thus it was that, as you know, I ventured further into no man’s land, and it was a sudden surprise when after all this “oooh this feels quite safe and allowed” turned into the previously expected “guns and tanks and swords and back to hospital for you”. Unsurprisingly, it was pretty distressing and traumatic, so a lot of people have been very sympathetic which has been lovely. I really appreciated comments from people online who were not directly involved in the situation because they felt genuine, but it is when we get to the words of the people closest to me that we get to this whole “I feel like I have had my car stolen”.

To use another analogy, I suppose you could view my body as a car that the garage have been keeping very strict rules on. I may have owned the car but there were restrictions as to what I could do with it, what colour I could paint it and how far I could drive. Then, when the CTO barrier was broken, I suddenly regained control over that car, so I grabbed that wheel, painted it purple and zoomed off into the distance (I suppose if we are combining this with the other analogy I zoomed it off into former no man’s land…just like people did with BMWs in World War Two…I may need to retake GCSE history).
With the car all to myself I set my speed limit, I pumped the tyres to a level that I wanted and I filled every seat with penguins because that is what I wanted to do. I could chose…until I was ambushed by bandits who seized the car and stole it, meaning that it didn’t belong to me anymore. Suddenly they would decide how much petrol went in, how plump the tyres were and how many miles it could run and my opinion was irrelevant (the bandits in this analogy being all the doctors and psychiatrists who recalled me to hospital).
Naturally, having just had my car stolen, I was not best pleased. Thing is, when you ACTUALLY have your car stolen you never tend to see the thieves who are the new owners enjoying a trip around the block in what used to be your very own automobile, and they are unlikely to be very apologetic.

Being in hospital though, I am not only seeing the “thieves” every day, I am living with them, and watching them abuse my car. The doctors and therapists decide what I eat now, when I sit down, where I can go and it is all very hard so I try to talk and work through it with them. I say how scared I am to eat, how scared I am to gain weight, how scared I am of everything and like many people online said last week, they say things like “I am so sorry you are in this position”, “this must be very hard and scary for you” but unlike when people online say it, it makes me angry, and all I can think is “WELL YOU CAN’T BE THAT DAMN SORRY BECAUSE YOU ARE THE ONE DOING ALL THIS. YOU STOLE MY CAR, I AM UPSET ABOUT IT AND CRYING AND NOW YOU ARE SAYING HOW SORRY YOU ARE ABOUT THE SITUATION BUT YOU ARE THE THIEVING, HYPOCRITICAL VAGABOND! VAGABOND I SAY!”

I don’t believe that they can really be sorry because they have what they want, they have the car and are legally allowed to do whatever the hell they want with it. I feel the same way about professionals as I do about close family members like my mum, which I know is terrible and I know I shouldn’t feel that way, yet still as much as I love our visits and I would not be able to get through this place without her, what I get out of them is entertainment, love, company, kindness and knickers (she brings in my clean washing…thanks mum). What I do not want from my mother, is sympathy because in my eyes she is kind of like a thief. Admittedly she did not do the legal act of stealing the car, but she gets something out of it, she now has a say over the car and the thieves will take her views into account. If my mum insists on yellow wheels and the thieves like that idea, those wheels will be the colour of sunshine within 24 hours. She could not have stopped the legal act from taking place but she has more say in it than I think she has used, I am sure if the next of kin kicked up enough of a fuss someone would have to listen, but no fuss has been kicked. On top of that, by me eating and being forced to stay in this hell hole gaining weight, she has benefitted from the thieving.
Again it sounds AWFUL to describe it like that, to compare my mum to someone who is in cahoots with criminals and joyrides around with lemon wheels, when I know she would argue that all she has actually done is not try to stop the people attempting to save the life of her offspring by their actions. She isn’t joyriding (my mum is not a joyful driver…especially if there is a cyclist nearby), she is finally offloading this nightmare she has been living with to professionals who can look after it instead and she can finally sleep rather than stay up into the early hours arguing about sweetcorn. She is benefitting because she gets a break, because as I gain weight she will feel safer and therefore I assume happier yet again, any “I know this is hard and horrible and I am sorry” inspires that same “WELL MAKE THEM GIVE ME THE DAMN CAR BACK AND WHY DID YOU PAINT THE WHEELS YELLOW” rage.

That is why if you were to ask me “how does it feel to have been recalled on your CTO and sectioned back in hospital” I would tell you that it feels like some very apologetic thieves (some of whom are related me), have stolen my car.
Now I am just watching them all make the changes they want, implementing the modifications they have decided, desperate to run out and stop them but with my hands tied. I am just an observer watching people do things to my car, watching things happen to this body that I have had to disconnect from and pretend isn’t mine anymore for my own sanity. I guess a more accurate explanation/analogy then would be to say it is like having your car stolen and then having the thieves force you to be a mechanic carrying out every wish of theirs or risk being whacked on the head by a spanner, but that isn’t how it feels. It feels like things are being done to me, any movements I make are via the puppet strings that they hold, I have no say. When it comes to living with an eating disorder you don’t have much say or control either, but this feels different, this feels more stripped, more naked. This is not my body, it is just a body that I am trapped in, and I am witnessing it be torn to pieces every day. Every meal. Every bite.

CTORecall

How Physical Health Problems Can Trigger Mental Health Problems

/ bornwithoutmarbles / 17 Comments

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

The Frustratingly Illogical Existence Of Life With An Eating Disorder

/ bornwithoutmarbles / 10 Comments

A few days ago, I met up with a friend who I have not seen for 15 years. It was a friend I have known since the tender age of zero after we stumbled across each other at an antenatal class our parents had been attending in the hopes of learning what the hell to do with the new humans they were about to produce and were expected to raise without any prior knowledge of how to do such a thing.
We may have only been newborns but our connection was instant, we bonded over Thomas the Tank Engine and have been friends ever since (although like I said, we haven’t seen each other for fifteen years because when you get to senior school and puberty a lot of nonsense gets thrown at you and there isn’t any time left to discuss the wonderful intricacies of your favourite blue tank engine…senior school is cruel.)

Recently however, after reconnecting over the 21st century miracle that is “social media”, we decided to meet up, and thus it was that I found myself sitting opposite my oldest friend in a coffee shop several days ago.
I think when you meet up with anyone, either new to you or as old a friend as your life itself, there is always a tendency to compare yourself to that other person in some way. Frustratingly, even though I know that appearance and weight are the least important of all things, my eating disorder automatically compares my body to those around me and without fail will always manage to convince me that I am an inferior disgrace who should go home and hang their head in shame. Like I said, I know weight doesn’t mean anything and I quite frankly don’t care what other people weigh. The number of pounds shown up on someone’s bathroom scales does not matter to me in the slightest, nor does it affect my opinion of them, yet for some reason when it comes to me specifically and my body, weight is of the highest significance and summarises my self worth as a person.

When I saw my friend standing there then, I felt really embarrassed and had it not been for the desperation to see her after such a long time, I probably would have run out of the coffee shop and would still be hiding in a bin somewhere.
Eloise Unicorn McGlitterface (I may have added the “Unicorn McGlitterface” myself just for fun…she really likes unicorns…and glitter…), looked fabulous, and I wished I could look like her.
Immediately my eating disorder was triggered and the thoughts telling me to lose weight struck up their familiar bellowing.
I didn’t want to be thinking about these things at all, as I left I wanted to be thinking about how lovely it had been to see my friend, but as I got in the car to go home, my head was screaming at me to lose weight, and here is where I get confused.

I know for a fact, that my friend Eloise Unicorn McGlitterface, on paper, is a healthy weight, and even though I don’t believe the “facts” my psychologists tell me about me being “underweight”, I understand them, sort of like someone understanding the theory behind someone’s religion without believing in that religion themselves. Logically then, according to doctors and science, most people would conclude that in order for me to look as fabulous as my friend, I would need to gain weight. On paper and if talking to anyone else, I would easily be able to agree with this argument yet somehow, when it comes to me, even though I cannot explain the science behind it myself, I am convinced that the only way for me to look like someone who weighs more than me…is that I need to lose weight. WHAT KIND OF LOGIC IS THAT.
When I tried to explain this to my mum I couldn’t. Naturally she thought that I sounded irrational and like a lunatic (she would have a point), yet despite my inability to explain the science behind my thoughts, I remain utterly convinced of their truth without really understanding them…
I even thought that if I tried to write this blog post and tried to explain my theory I would realise how ridiculous I sound, how my thoughts make no sense and therefore cannot be true, yet still here I sit, unable to explain how my body defies science and needs to lose weight to look like someone who weighs more than me, yet utterly convinced that this is the case.

There are a lot of things I believe that make no sense to other people when it comes to my eating disorder, but at least I can see the logic behind them. I know it doesn’t make rational sense that I cannot eat unless my hair is tied up in a very specific way at a very specific angle, but I understand where that belief/behaviour comes from and the rationale behind it according to previous experiences. I know it doesn’t make sense that I cannot eat with forks, knives or plates and am only able to use spoons and bowls, but again I understand the reason I feel this way. There is no science behind it, but it makes sense to me and I could explain it to people.

This however, I do not understand, yet like I said, this doesn’t make it any less compelling. I guess going back to the religious comparison, it is like being a devoutly religious person who can hear all the arguments against their beliefs but believes nonetheless and is convinced in their heart by pure faith. I don’t want to insinuate that my eating disorder is at all some kind of religious movement, it is a murdering mental illness that destroys lives, but I think this example goes to show that when you have an eating disorder your belief in your thoughts are held and driven mainly by a faith that you cannot explain the logic behind. In my experience at university studying theology and when talking to religious friends, if you ask them to explain “why” they hold their beliefs, any explanation will be secondary to the feeling they hold inside them. They can say “why” but when it comes down to it the thing that convinces them is a faith, an indescribable feeling that they have which means that they “know” what they believe to be true even though they can hear people arguing about why they might be wrong.

I don’t wholeheartedly believe my eating disordered thoughts because I am stupid and don’t understand science, somehow I believe them in spite of that understanding. This whole “to look like my healthy friend I need to lose more weight” thing is exactly like my obsession with green tea. I hate the stuff and over the years hundreds of people have told me that it makes no difference to your weight, I have read the studies and I know they are true and more scientific/rational than any thoughts I get from my eating disorder…yet somehow I am still convinced that if I don’t drink a certain number of millilitres of green tea I will gain several stone overnight. Consequently I drink that green nasty fluid that I am horrified is held in the same category as all other teas. WHERE IS THE LOGIC HERE EATING DISORDER? HMM?

I think what this really proves is the fact that eating disorders make no sense and that even if their thoughts don’t have a reason behind them, they are nevertheless believable. People with eating disorders aren’t stupid people who don’t understand how bodies work, they understand all of those things, often better than most, yet still the disordered thoughts are so strong and so compelling that they are convinced to follow them without being able to say why. Eating disorders have the power to make science sound ridiculous and nonsense sound like fact. I guess this example also proves the fact that eating disorders are flipping stupid and will always manage to convince you and tell you that you need to lose weight no matter what the facts of any situation.
Usually when I write blogs about eating disorders I do it to try and explain the reasoning behind
them to people who don’t understand, but clearly, sometimes life with an eating disorder is about not understanding a damn thing about your thoughts yourself and just basking in a frustrating confusion.

Take care everyone x

NonsenseBin

Why Are Eating Disorders Competitive?

/ bornwithoutmarbles / 9 Comments

Many people are aware by now of the dangers of eating disorders, the emotional inner turmoil, the isolation, and the potentially fatal consequences. However, one of the biggest dangers that isn’t quite as discussed is the fact that eating disorders can be incredibly competitive. It sounds odd and it is quite hard to explain how an illness can be competitive, but basically if anorexia was ever personified, it would be the person who becomes dangerous when playing board games and is prone to breaking valuable ornaments in the home over an unlucky roll of the dice in a game of Monopoly.

I think most people, often and unknowingly, see other homo sapiens as threats for many different reasons in every day life. At work you may feel in competition with someone to get a promotion, in a supermarket you might choose the best looking bunch of bananas so that yours will be better than those of whatever potassium craving customer comes after you, or in a car park you might discreetly race another vehicle to get the last available space. Maybe your competitive streak involves competing with your gaming arch-nemesis to be captain of the tiddlywinks championship team, whatever it is, at some point in every day, whether we realise it or not, most of us enter into little competitions with our fellow humans and in turn those people become threats.

It is rare however, for people to compete with another person’s illness, and I have often wondered why eating disorders are so different in that respect. Possible reasons I have come up with are things like the tendency for people with eating disorders to naturally be high achieving perfectionistic people, or that eating disorders are an illness that usually involve a lot of numbers and in turn, ways the illness can be “measured”. Obviously, in reality the severity of someone’s eating disorder is impossible to measure no matter how many scales you weigh them on or how many calories you see them eat, but no matter how incorrect the idea, people who do not really understand eating disorders to be a mental illness rather than a physical one, tend to measure the severity of an eating disorder by the physical effects they can potentially lead to. If people see a thin person they will wrongly assume that person to be more “anorexic” than their equally troubled neighbour who just so happens to be a healthy weight. With other illnesses though, this ability to gauge how ill someone is just by looking at them, however inaccurate the final judgement may be, is far more difficult in comparison. For example two people can have a liver disease but when they are walking side by side in a park, you cannot guess as easily who you perceive to be the sickest unless you take a few blood tests and maybe open them up with a scalpel (which would probably lead to them asking why you were wandering around a park asking people for blood tests and performing major operations).

When an illness is seen as focused around numbers then, comparison and thus competition tends to breed. Over the past decade I have met people whose eating disorders have led them (for I highly doubt someone’s individual personality would compete about such things), to compete with regards to numbers as to how much someone weighs, what their BMI is, how many calories they consume, even obscure things like who takes the longest to eat a meal, who has been into hospital the most times or who has the lowest white blood cell count. It is a disgusting, sick and twisted side to the illness since you are basically competing to see who can kill themselves the best, but I cannot deny it happens.
For this reason I actually think the more distanced a sufferer attempting recovery is from the intense eating disorder community, the better. If you are living in the middle of nowhere with a family of healthy people, you simply have your eating disorder to wrestle with (and lord knows one is still far too many). In hospital settings like inpatient eating disorder units, therapy groups, or even social media recovery accounts online, you are surrounded with other sufferers and thus other eating disorders to battle with. Don’t get me wrong, it is lovely to have people you can relate to, but the ability to relate to other people who are unwell and spending large amounts of time with them can lead to a loss of perspective.

Gathering a group of people with eating disorders together, either physically or online, is sort of like gathering a group of wild gorillas in the middle of the rainforest (I would avoid both of these gathering activities if I were you as neither are particularly safe…if you are an avid collector or gatherer may I suggest gathering stamps or Pokemon cards instead).
There are probably a hundred reasons as to why gorillas sometimes stand on their haunches and beat their chests, but from my dedicated research and observation (I watched Tarzan), when a gorilla beats its chest in front of another gorilla, it can be interpreted as “look how big and mighty I am! Have you ever seen such a fine specimen of gorilla? Look at my hairy arms! They are fabulous! I am the best gorilla in all of the world and far superior to you! I am the best! Leave my forest or I will strike your hairy behind! Back off I say! Flee! Flee!”.
All the gorillas in the rainforest will naturally want to be best gorilla around to ensure their survival, establish their right to the most attractive mate or the biggest banana. They aren’t doing it for laughs (maybe the odd titter), but they are naturally born with that competitive instinct so that they can stay alive.
Similarly, when a group of people with eating disorders gather, their internal eating disorder gorillas perk up and start beating their chests to let everyone know that they are the best and strongest eating disorder around. Ironically though, unlike the real gorillas, the “winner” in terms of measuring who is the most physically ill from their eating disorder, the thinnest or the one who has gone the longest without eating, is the least likely to stay alive the longest.

If you are reading this as a healthy minded person you are probably thinking that competing as to who can lose the most weight is ridiculous and sick, and when it comes to that judgment, you would be right.
However I think people often forget how much competition there is with regard to weight loss even in “healthy” circles. On TV shows like The Biggest Loser, people compete to see who can lose the most weight with a cash prize for the winner, and though perhaps less extreme than competing with white blood cell counts, surely this is similar? What about in local weight loss clubs when people compete with their next-door neighbour to see who can lose more weight than anyone in their area in order to be awarded with the sash declaring them “Slimmer of the Year”. When you think about it, in our society, competing around food and weight is not as alien an idea as people with eating disorders can make it seem.

There is however one reason people often suggest as the answer to the “why are eating disorders competitive” question, that I strongly disagree with, and that is the idea that people compete purely because they want to be the “thinnest” and that the competitive drive is all about vanity and outer appearance. If anything, I think the drive is the total opposite to vanity, and more to do with insecurity and low self esteem regarding the internal self.
When you live with an eating disorder you basically live with a voice in your head telling you that everything you do is wrong and no matter how hard you try to please it, it will never be satisfied or see your “efforts” as enough. No matter what you eat, your eating disorder will tell you it was too much. Even if the portion was initially decided by your eating disorder, it will tell you that you could have left a bit or maybe it will tell you that you ate it wrong; too quickly, too slowly or with the wrong sized mouthfuls. Whatever you do, the voice will tell you you are not living up to the standards you should be, you are not good enough.
My drive to lose weight is not to see a nice patch of rib cage, it is to achieve something that my eating disorder tells me is “better” than my former self. Of course there is nothing “better” that can come from starving yourself and if I were talking to any other sufferer I would tell them that the “best” they can be is the healthy version of themselves who is able to nourish their bodies and enjoy a healthy relationship with food. Yet still when it comes to me, the eating disorder somehow manages to manipulate my thoughts in that direction that I am a “better” me, less repulsive, less annoying, less deserving of a punch in the face, if I stick by my eating disorder’s rules. I am constantly held up between my past self, current self and encouraged to compete against them to reach this “superior” future me. When you add another sufferer into the mix then, it is yet another person for my eating disorder to compare me to. No longer is it telling me to lose weight or starve because I am not good enough compared to the potential me I could become if I were to behave myself, now I am also not good enough compared to the person or group of people surrounding me. I don’t follow the rules to the standards my eating disorder would like in an ideal world, and when I am around other people it tells me that I am even more inferior because they are following these stupid rules better than me. I don’t feel competitive because I am vain and want people to admire my collarbones, I feel competitive because I despise myself, because behaving well and following all my rules gives me a sense of self worth, a sense that I am doing something right, so if I am not following the rules “the best”, then I am not good enough.

So why are eating disorders competitive? Well, there are many reasons from internal anorexia gorillas to self hatred, perfectionist personality traits or the ability to compare and misunderstand the importance that physical numbers have to play in a mental illness. Obviously this competitive undercurrent is wrong, needs to be tackled and is disgustingly disordered, but we are dealing with eating “disorders” so I suppose it makes sense. What I want more people to know though, is that of all the reasons, as sick and twisted and horrible as they are, they are not reasons that derive from vanity or any sense of bodily pride compared to the person in the next bed to you. If anything it is about desperation to be good enough in the eyes of a devil that is constantly telling you you are worthless, both in yourself, and in comparison to everybody else.

Take care everyone x

HairiestGorilla

The Difficulty Of Losing A Therapist

/ bornwithoutmarbles / 17 Comments

Over the past few weeks, I feel that I have been going through what is commonly referred to as “a break up”, one of those horrible experiences that, in popular culture, is often portrayed as a situation that can only be remedied by much crying into tissues and several tubs of ice cream. Now I know what you are thinking, “but Katie, how can you be going through a break up when you yourself admitted the day before Valentine’s Day that you haven’t been in any kind of romantic relationship for over two years” (alright don’t rub it in guys…Jeez).
Well if you thought that, you would be right, no, I haven’t been in a romantic relationship for a very long time (aside from the one I am in wth Helena Bonham Carter that she isn’t aware of…yet), but in the world of mental health there is a common experience that is very like a break up, that being the loss of a therapist.

Now, before I go on I would like to preface this by saying that I do not mean for this to imply that I am caught up in any romantic entanglements with the therapist I am referring to and who is currently in the process of “leaving me” for a new job.
Indeed our relationship is very much the standard “patient/psychologist” affair (perhaps affair wasn’t the best choice of word there…). However, what I don’t think a lot of people understand is just how attached one can get to a person who only hangs out with you every week because they are paid to do so.
It a very odd situation, and whenever a therapist leaves I feel I should deal with it easily, without being particularly bothered. This is after all not a new experience for me, as I have literally lost count of the number of therapists that have left me over the years, (seriously if you rounded them all up you would have more than enough of a cast to put on a performance of Les Miserables and trust me, from someone with a theatre background, you need a lot of people to perform that show). That said I know a lot of people find this a very difficult thing to go through, and rather than it mean we are clingy or weird, I think it makes a lot of sense.

Yes, a relationship with a therapist is strictly professional and should, on paper, be the equivalent relationship to someone you have hired to be your private chef (who is paid for by the NHS because you are mentally unable to sustain yourself alone….I need to work on my analogies…)
The chef turns up at your house because it is their job just like my therapist turns up for our appointments, but when you are talking about your deepest darkest secrets and fears rather than how you like your eggs cooked, it can’t help but become more personal whether you intend it to or not.
In every other professional relationship you have with someone who is being paid to spend time with you, like a chef or a plasterer in your house, the reason for their being there is in reference to something separate, aka food or dodgy walls. With a therapist though, unsurprisingly, a lot of it is about talking about your life. How can that not be personal?
Ok other professional relationships have personal aspects to them as well, a private chef for example may eventually grow to know how much milk you like in your cup of tea without asking every time, yet with a therapist there grows a level of intuition that is less about knowing how you like your tea and more about being able to simply look at your face and know automatically that it is time to put the kettle on (although I would like to clarify that my therapist has never actually made me a cup of tea at all…if you are reading this dear therapist, maybe work on that in your new job). It is that deep connection of being understood as a person, and for that reason of course it can be like a relationship break up when a therapist retires or leaves to get a new job.

Again, of course I am not saying that it is in any way romantic and unlike romantic relationship endings we are not going to be left wondering who gets custody of the kids (we already decided in our first session that I get them Monday to Friday and then she has them over the weekend). Nevertheless I am left wondering what I will do without this person who is currently a big part of my life.
When you see a therapist for a long period of time, discussing your mental health problems/building a therapeutic relationship is sort of like building a house. In the beginning you have an empty plot of land and the patient has a hell of a lot of bricks (bricks that in terms of this analogy represent secrets/thoughts/things that make you as a person). The patient is standing in the middle of this messy pile of bricks without any idea of how to deal with it, so the therapist is there as a sort of builder/tidier to help sort it all out. Every week you both turn up at this plot of land and gradually, the patient hands the bricks individually to the builder. Together you try to construct something that is a little less of a mess, and a little more something you can work in. The more you talk, the more bricks that come out, and eventually the house is finished at which point you can go inside and start trying to make the place liveable. You try things out, experiment with fuchsia walls, checkered wall paper or new therapies and you see what works for you.
Then finally you get to the point where you can both walk into the house (aka brain), and know the insides and outs of it so well that one of you can reference something within the house and the other will know exactly what they are talking about. Refer to the “plant thing in the bathroom” and they know what that plant thing is as well as when in your life you bought it and why it is in the house, just as a therapist will eventually grow to know all about the way your mind works as well as any life events you simply reference to as “that time with the giant squid”. If anyone else comes in the house and you reference the plant thing, they don’t understand exactly what you are talking about. Even if you take them to the room to point it out they cannot have the same level of understanding as the person who helped you build the bathroom in that particular way and find that particular plant at the gardening centre. You can tell a new therapist about what happened during “that time with the giant squid”, but to them it will just be a story rather than an experience you have lived through together.
Getting a new therapist then is not as simple as the professional transition involved when you get a new plasterer for example (I have just realised there are a hell of a lot of interior design analogies in here which I think is in reference to my love of 90’s TV show Changing Rooms. I miss Carol Smiley. Where did she go. She was so Smiley). No, instead of a new therapist coming in to help you in the house you had made earlier, it is like having to smash all of that “brain internal understanding relationship” stuff to the ground and having to start again. Once again you need to start passing them all the individual bricks they have never seen before, so you actually have a long time of simply building up enough of a rapport/understanding before you can get on with any of the serious stuff.

Like the end of any romantic relationship you find yourself wondering if you will ever find someone you will get on as well with or who will understand the way you work in the same way, and the first sessions with a new therapist are very much like all the first dates you have to go on to try and find a new partner. Conversations go from deep personal investigations into the meaning of life to the cookie cutter “so what is your job”, “where do you live” standard statements that you have to go through before you can get to anything of real interest or value.
Unlike a first date of course, a new therapist will probably have all of your notes from the previous one and thus a rough knowledge of your history, but nevertheless, with or without these notes they will always say that they want to hear about your history “from you”. Admittedly this is a good idea. Obviously I can explain something that happened to me when I was eleven better than a therapist was able to jot down in a word document, but having to go through all that stuff is exhausting. Maybe if you don’t have a huge mental health history this “tell me about you” question can be answered relatively quickly, yet for me it is a question that is incredibly daunting. Tell me about your experiences with mental health services?! How can I do that? We have nearly 14 years of appointments to catch up on! I can’t get through all that in one hour!? DO YOU HAVE ANY IDEA HOW EXPENSIVE HOSPITAL PARKING IS?

This entire blog is probably just one long incoherent ramble so half of you reading will be probably wondering what the hell I am talking about and who the hell Carol Smiley is. I guess I just wanted to raise some awareness of how difficult it is when a member of your therapy team has to change and why it feels so much more impactful than a change in any other strictly professional relationship. If I was ruler of the world I think I would probably make it law that therapists are unable to ever get new jobs, retire, change jobs or go on maternity leave (sounds ridiculous I know but in terms of fair/rational leadership I would still be doing a better job than Donald Trump.)
Luckily as you will know if you have been around my blog for a while, I do have a whole team of therapists so it isn’t a total break down of my psychological support and only one person is changing. I also know and like the replacement very much so it is as “good” and manageable a “break up” as it can be. Nevertheless I can’t help but feel as though in a few weeks when it is time for our last session (on the 21st of March, put that in your diary folks), I will be losing someone very important, someone who I can trust and rely on, so naturally, this isn’t going to be easy.

Take care everyone x

therapistchange