Back to the future, again

[eating disorder, suicide including method]

My eating is out of control again. Sometimes I get wee thoughts like “at least I’m not eating until I nearly throw up”, “at least I’m not eating until I am worried about gastric rupture”, etc, as if it’s not that bad really. I am not logging my binges because I am not logging anything. I was always shocked when I logged them at how large they really were. I think “oh that wasn’t so bad” but I bet it was.

Now it’s 2-3 times a day which is back to its worst. I feel totally helpless in front of them. I say “no more” then the next thing I know I am binging. I feel like it is already decided and my attempts at stopping are just laughable.

I am piling on the weight. It’s everywhere. My abdomen, my breasts, my arms, my legs. I feel grotesque and huge. I feel like a monster. Wearing clothes two sizes bigger. Bits of me disproportionately distended and massive. Feel like discontinuous parts. Not human, anyway. I realise this will make me sound crazy but honestly, my body is shaped so wrongly now that it does not look human anymore. I think this is another one of those things that only makes sense on the inside of my head.

All this nonsense about a body a bit bigger. It’s not a few extra inches round various circumferences. It’s what it means. It’s means more and more people are starting to treat me like a fat person again which is not intrinsically or fundamentally a bad thing in itself. But here and now, where I live and who I know, it is unsafe. It’s men thinking I must be ‘easy’ or ‘desperate’ and not accepting no. It’s having “fat cunt” shouted out of cars. It’s fucking doctors. It’s people looking down on me.

Things are nowhere near as bad as they were when I was ‘morbidly obese’ but it’s starting. And I can’t bear it. Which makes me feel desperate which makes me binge. Round and round. (There’s a joke in there about me getting rounder. Can’t work up the energy.)

What do I actually want? If I disregarded everyone else’s opinions, what I want is to go back in time to the hotel and put the bag and elastic over my head with the noose and sink down and let it tighten. Actually do it. I want none of this to have happened. No traumatic hospital stay, not meeting the man on the ward, not thoughts getting even more batshit, not eating out of control again. Not all this relentless, overwhelming pain.

I have absolutely had enough.

Another list

After the list I posted earlier today, and because I like to torture myself, here is a list of things I could do to rebuild my life and try again:

  • Get a dog or some other pet for company and love
  • Do a second day at the charity project I go to for more structure and company
  • Alternatively, or in addition to the above, volunteer to do something useful and try and build some self-esteem
  • Get a private psychologist and really talk and open up (I am very lucky that my obsessive need to control my spending, after getting into the worst kind of trouble in my twenties, has had the beneficial effect of allowing me to build up some savings. I am the only person I know of that has been this lucky.)
  • Start running again and be brave and try new routes but cancel the gym and admit I never enjoyed it
  • Do the Open University Access course I have been eyeing up for… uh… years to give me a little hope that I could possibly have a future
  • Get a tattoo and do the other recommended things to start reclaiming my body and stop despising it

Comparing this list with my earlier list: there are major areas not covered. I don’t think those things can be solved or ameliorated. Which is why I am eating nutella and butter sandwiches and booking a hotel.

A nutella and butter sandwich.

Lists

[suicide]

I have so many bastard lists on the go at the moment as I try to get organised. My memory is hopeless just now so I am using lists for even the most basic things. Here’s a list from ten days ago that I am referring to frequently, for comfort, reassurance and to torture myself (impressive résumé for a list):

  • I feel guilty for the terrible things I have done which I can never fix or undo
  • I hate and despise myself; I am a terrible person
  • I have never achieved anything and I am intensely ashamed of that
  • I am a burden and I drag down my family and friends; I know for a fact that they will be better off when I am dead
  • I will never have someone to hug and hug me
  • I will never have someone to love and love me
  • I will never have someone to cuddle in bed with
  • I have feelings of intense loneliness which are very painful
  • I will never have someone I feel safe enough to have sex with
  • I am putting all the weight back on and everyone is laughing and looking down at me
  • I am ashamed that I can’t manage my eating
  • I hate my body and want to rip it apart and set it on fire
  • I am ashamed and horrified that I didn’t apply for the ordinary degree that I had credits for and so ruined even that faint hope for a future
  • It really hurts and I feel intensely ashamed every time I see someone talking about managing to be a doctor or medical student with a mental illness
  • I am a waste of the Earth’s resources; one less human is better for climate change
  • I am a waste of NHS resources
  • I am a waste of taxpayers’ resources
  • I am ashamed that I can’t manage my mental illness
  • I am ashamed that I so desperately want people to like me
  • I want to be free (though I don’t deserve that)
  • I want to be at peace (though I don’t deserve that)
  • I want to be finished and gone and in the past so that the harm I did can heal

It was hard to write but I felt better for it as my head felt clearer and emptied out. It is like cutting into raw, burnt skin when I expose this intense, overwhelming shame. If it wasn’t for the fact that I will be dead in a few days I wouldn’t be able to. I don’t know why I am publishing this. It eases something and makes these last days less painful, I think. I have no right to ask or hope for that of course. Also, it’s a kind of proof to myself. I would never, never, never talk about these things if I thought anyone I knew could even remotely possibly find out. There is always a possibility that you can be outed from an anonymous blog. But it doesn’t matter if you’re dead.

Photo of starling murmuration from the BBC. It has nothing to do with this post; it’s just beautiful.

Self-destructive behaviours

[brief descriptions of self-harming behaviours]

I have a whole menu of self-destructive behaviours to call from when times are bad. I rarely do them nowadays and I think to the outside it looks like they are in my past and done with but they feel very much available to me whenever I need them. I find that a comfort and it makes me feel safe.

The Art of Self Destruction at NCH Collection, website currently bugged so can’t find out the artist.

I self-harmed a lot as a teenager. I drank problematically and took recreational drugs too much in my early twenties. I binge ate for two periods in my late twenties and late thirties though a large part of that was down to the physiological effects of dieting. I have comfort eaten/emotionally eaten (eating when not hungry but instead to relieve emotions; not binging) my whole life. Neglected my sleep despite knowing it was key to managing my mood. Not exercising at all for most of my adult life then over-exercising to the extent of injuries in my late thirties. Deliberately and accidentally socially isolating myself despite being the type of person that really needs social contact. Deliberately being horrible to people to push them away because I don’t deserve people being nice to me (it feels wrong). Fucking with my prescription medication (it’s going great). Deliberately not doing things I enjoy to punish myself. Oh, the list just keeps going on.

How I haven’t ended up with a borderline personality disorder diagnosis is a miracle and I think basically is because I am naturally a very personable person and was brought up middle class. I did four years of medical school and am pretty well read and get called “articulate” (I smile and try not to tell them to fuck off) so know the pitfalls of what healthcare professionals find difficult. I get on well with them and make an effort to do so. I wonder if that sounds manipulative. I bet it could be interpreted as manipulative. I see it as self-defence. They can literally decide where I sleep that night and whether I am dragged out in a cage of nurses unable to move properly. I think they are less likely to do that if they think I am an ‘easy’ patient. I never tell them if I have suicidal thoughts and answer only vaguely when directly asked which they don’t do very often. Healthcare professionals are a potential threat even when they are being nice to me. I would rather keep away from them, or at least keep them at arm’s length, and be safe even if I am alone. Does that could as a self-destructive behaviour? Not really engaging with psychiatric services? Or only engaging superficially. I don’t think they could do anything anyway. All I see is disappointment from my real life and online friends. Obviously this strategy is working out tremendously as you can see from how well my life is going.

In the post linked above, I was bragging that I hadn’t self-harmed in a very long time. Whoosh, gone. Have self-harmed several times in the last week. I don’t know if self-harm is generally seen as a kind of addiction anymore but to me it feels addictive. I feel like I want to do more and I have to exert effort to stop myself. My mood is fucking horrendous just now (bet you can’t tell from how articulate I am) and the self-harm was the most beautiful relief from the agitation. Better than any medication or ‘healthy coping strategy’. There’s the secret: it’s so addictive because it just goddamn works. But but but… It always escalates and always spirals out of control eventually. It isolates me from real people as it’s a barrier that they can’t understand and I can’t overcome. And it damages my poor, abused body that has really had enough. I can see that it is innocent and doesn’t deserve this. I do but it doesn’t.

Your body is not an object, not a sculpture based on some universal and enduring Platonic ideal of beauty — it is a living creature, an animal in your care that needs care and compassion, that suffers and dies if neglected. https://t.co/Q1lTdtI1or— Michelle Allison (@fatnutritionist) December 20, 2017

So going to have to knock this self-harm on the head again. I read this thoroughly compassionate article about self-destructive behaviours in Psychology Today. Cried but the soft tears when you feel like an awful, tight pain is unclenching and releasing. Then I read the follow up article by the same writer about how unhelpful shame is when trying to deal with self-destructive behaviours. And I sobbed for a while because I can’t deal with my shame. It’s too huge and overwhelming. I’ve self-harmed pretty severely (until it doesn’t hurt anymore; you either know what that means or you don’t and I’m not going to spell it out because I worry more about triggering the people who do understand than I worry about educating you) and shame hurts order of magnitude more than any physical pain I’ve experienced. The second article made so much sense to me. This is the key quote: “[D]o not shame yourself as an attempt to make yourself overcome the behavior. At best it will leave you feeling worse about yourself. At worst it will increase your dysregulated behavior.” I’ve heard that so many times before but the writer actually laid out her thinking here. It was like she levered some space in my head.

Of course, I feel like I very much deserve my shame and deserve to be punished. Still have that strong push to punish myself and like that would be doing the right thing. But it’s nice to get that little unclenching and space for a while at least.

The truce

[self-harm, mention of sexual assault, suicidal thoughts]

I don’t really know why but I grew up hating my body. I hated how it looked and I hated how other people treated me because of how they thought it looked. I read somewhere when I was a young teenager that your body is just there to carry your mind around and that framing stayed with me. I never considered how it felt.

Black Truce by James Gleeson

I started self-harming when I was 14 years old. I mostly cut my abdomen with a razor blade. I also cut the tops of my thighs, my inner thighs, my hips, my left shoulder, my chest and my breasts; anywhere that was covered by my PE kit. I think I self-harmed because I didn’t know the words how to express my pain, frustration and anxiety from my untreated depression. I had also been extensively bullied at school for years. I had a lot of suicidal thoughts and plans too.

After eighteen months or so of self-harming, I finally went to my GP, was honest about my symptoms and I was given fluoxetine (Prozac) and weekly counselling (changed days to what people get today) which helped a lot. My GP was very matter of fact about my self-harm and focused on what I now know is called harm minimisation. I never felt even a flicker of shaming. I had been self-harming every day: every night in the bathroom before I had a shower. I always had wounds in various stages of healing. This is actually kind of horrifying me now to look at these memories from my current relationship with my body but it was so normal then. It felt like a logical and sensible response to my life. It fucking was a logical and sensible response to my life. But the self-harm just melted away as the depression melted away. I don’t remember any kind of fight to stop. It just naturally camed to an end. From the time I was 17 years old to now in my early forties, I have self-harmed less than a dozen times. When my mood is bad, thoughts of self-harm do come into my head but they feel miles away. It’s only in the worst of situations that I actually do go past thoughts and act on my body.

Can you only self-harm if you hate your body first? I don’t think that’s true. Sometimes things are just very desperate. There are no good choices available in some situations. But I did hate my body; almost as much as I hated myself. Those hatreds and despairs felt separate from very early on and remained separate until this year. Note that I’m not saying the hatred and despair has melted away but it feels like a frayed, stretched apart cloth between me and my body rather than a solid, impenetrable wall.

When I look down at my hands, there is still a tiny pause while I recognise them as mine. They don’t feel like mine but intellectually I know they must be. There is a much bigger pause when I look at body parts that I dislike more like my abdomen or my breasts (it still feels weird typing “my” there; my habit is to say “the abdomen” or “the breasts”).

That pause and the detachment were put there deliberately to protect my body from me. I can’t remember exactly what I read or what I heard that made me decide to pursue this detachment but I remember pushing it in my mind until feeling like I was quite separate from my body was a very natural state. It tied in well with my depersonalisation.

The next stage was a calling of a sort of truce between my body and myself. I think this happened in my early twenties. I had been sexually assaulted a few times by then though had convinced myself that it wasn’t affecting me. I was dealing with a lot of psychiatric medication side-effects. I was fat and finding that unacceptable to myself. My body didn’t feel like mine and I still hated it. I was reading about fat acceptance and I longed for the peace that the people I was reading about had found. It wasn’t this but I read something like this tweet from Michelle Allison (the Fat Nutritionist):

Your body is not an object, not a sculpture based on some universal and enduring Platonic ideal of beauty — it is a living creature, an animal in your care that needs care and compassion, that suffers and dies if neglected. https://t.co/Q1lTdtI1or— Michelle Allison (@fatnutritionist) December 20, 2017

It lead to a sort of ‘truce’ or ‘deal’ in my head: I won’t hurt you anymore and you will leave me alone. That was the basis of my relationship with my body for the great majority of my adult life. I did the basics to look after it, to some extent anyway, and the rest of the time I was free to ignore it. The best that can be said for this ‘truce’ or ‘deal’ is that it eased my relentless drive to kill myself which had been powered by my hatred of my body. The thoughts were still there but there was a distance too. I self-harmed very rarely. I gave up drinking alcohol entirely and I didn’t take drugs (I was very lucky in that I hadn’t developed addictions to either). I didn’t exercise and didn’t eat very nutritiously but I don’t think I had any disordered eating behaviours either. But it was a miserable, joyless way to live, I see now. Not taking any pleasure in my body, whether that was eating or sex or physical activity, etc, meant missing out on a lot of the experiences that make life worth living and make a human, human.

What changed was I read two books this year that profoundly challenged my thinking. The first was Come As You Are by Emily Nagoski about female sexuality which explained a lot of my past experiences to me, not just about sex but also about emotions and the stress responses. The second was Intuitive Eating by Evelyn Tribole and Elyse Resch which explained a lot about eating, hunger and fullness. Both of these books talked matter of factly about taking pleasure in your body and of being connected to your body. It probably sounds ridiculous but I’d never considered that was possible. I kind of knew that some people had strong, solid relationships with their bodies but I didn’t think that applied to any of the people in my life and certainly not to me. But these books were arguing that yes, it was possible for me too.

So I stepped inside my body. Quite terrifying at times and very unsettling. These books made my thoughts safe enough and the meditation released my depersonalisation enough to make it possible. My medication and all the endless self-care I do controls my mood enough, at the moment at least. I still feel some detachment but I think that is fading as my new thoughts bed in. In some ways, I am convinced being connected to my body is a much better way to run things rather than my old detachment and ‘truce’ but in other ways, it feels riskier and more unstable.

I’m still afraid of my body and I still don’t like parts of it but the old hatred and despair has faded away mostly to nothing. I’ve seen it flare up a bit at times but not for long. Is this a new truce? Not really. This is very soppy but I feel like my body and me might be on the same side now. There is something very peaceful and lovely with that.

Weighing myself caught up with me

[weight numbers, suicide, brief mention of calorie numbers, eating disorder behaviours]

I continued with the intuitive eating in July but knew I wasn’t making a very good job of it. I was eating emotionally a lot and not stopping eating when full instead eating ‘to completion’, i.e. cleaning my plate. I had a rough plan of weighing myself every month after my period when my weight is at its lowest. This was to assuage my need for cold, hard data about the size of my body, because I find it very hard to tell what size it is, and in an attempt to prevent me regaining the weight I lost.

I weighed myself this week and was 4.8lbs up. I could feel that my abdomen and breasts were bigger but had been hoping that it was in my imagination like last time. I was horrified and felt very out of control. This is what I wrote in my diary at the time:

Weighed myself. 10st 7.6lbs so put on 5lbs in a month. Horrified and devastated. Didn’t think it would be this bad. How have I managed to fuck up so badly? Is it the binging? Had two moderate binges and one large binge plus started to binge but stopped a fourth time. That’s a lot. Is it the reduction in thyroxine? Body was bigger even before I went to visit my family. I hate this. I don’t know what to do. I want to diet. I want to shrink my stomach. I can’t stand this. If I diet then I’ll binge but I am binging anyway. Am I binging because I had the stress of going to visit family and of seeing the psychiatrist? Both of those were intensely stressful, before, during and after. I have to lose weight. I can’t have people see me like this. I’m going to have to diet but I really don’t want to. It’s so unpleasant and uncomfortable. Really the most sensible thing to do would be to kill myself and then I’d be free of all of this. Wouldn’t that be nice. I can’t do this anymore. I am so tired and stretched out.

Compared to what I wrote in my diary at the start of the month:

Weighed myself (yes, again): 10st 2.8lbs. Very good conditions: period finished, gut cooperating, nothing salty to eat yesterday (though not restricting salt either) and haven’t binged for over two weeks. Glycogen stores will be full though. Feel relieved, very happy, lightened. Stood in kitchen and said “I could live like this” and burst into tears. I would be okay living eating like this and at this weight I think. Not overjoyed at the size of my abdomen but I think I could come to terms with it. I think I might be okay.

Very histrionic response to weighing myself and getting a higher number than I wanted! As I’ve said here before, when I was fat I felt fundamentally unsafe due to the way people, strangers and family and friends, treated me. I felt profoundly unacceptable. Going back to that, which is statistically by far the most likely thing to happen to me, frightens me and makes me feel very desperate. Suicidal thoughts, even with some sarcasm, is an extreme reaction.

I was surprised at how unpleasant I found the thought of going back to dieting. I really, genuinely don’t want to. As recommended by the Intuitive Eating book that I am following, I had promised myself that I wouldn’t ever restrict/diet again. But I felt like I had no choice now. My body was just too big and unacceptable. Writing this down makes the situation seem so small and bizarre. How could I believe all these thoughts and just mindlessly follow them? How did a 5lb weight gain become so big? When did I become so dependant on other people’s opinion of my body’s appearance?

I weighed myself again today and was down to 10st 6.2lbs. Somehow that seems more acceptable. It’s more under my threshold of ten and a half stone and 3.4lbs gained in a month doesn’t seem so horrifying. But, and this is the key point: my actual body is exactly the same. This is just laughably ridiculous that I am so affected by these numbers. The bad binge (3000+ calories) I had on Monday evening when I got home from my trip seriously fucked with my mood but these are long-standing patterns of thinking with me. I get overwhelmed so easily by these thoughts. Swept away and lost in them

So what I have decided to do, mulling it over for a few days, is to continue the intuitive eating but to aim to finish eating when feeling just full (6 on the hunger fullness scale), with occasional comfortably full (7), and to really focus on stopping the binge eating. I have been avoiding doing the chapter on emotional eating in the Intuitive Eating Workbook for weeks but will get that done. Would be a good idea to review earlier chapters too. Also, will make more of an effort with being consistent with exercise as have missed a lot in the last few weeks.

Hunger fullness discovery scale from The Intuitive Eating Workbook by Tribole and Resch

I am a little proud of myself that I didn’t slip back into dieting in response (to my overreaction) to my upsetting weigh-in. I had all these extreme thoughts, which, to be fair, I let swirl out of control around my head, but I didn’t actually take any action on them. I think I have been quite measured. I will see what effect my adjustment to intuitive eating has on my weight and whether this is sustainable. Fuck me, is this growth? Maturity? I just feel quiet and calm. Dieting was very emotive for me, which motivated me and drove me onwards, but god, did it hurt when it didn’t go to plan. This intuitive eating is much more about finding peace and just being okay. Sounds boring. It’s actually so lovely I could cry in relief.

Massage and the need to be touched

I remember as a child, maybe late primary school and early secondary school ages, having this desperate wanting to be hugged. Like something was physically missing from my body. It never even occurred to me to ask anyone in my life to hug me. My parents weren’t physically demonstrative and neither was anyone else so I just wasn’t touched for years until I started having romantic relationships.

I’ve had “low maternal warmth” written on my psychology notes now (see how they blame the mothers; not the fathers) and I’ve learnt how most (almost all?) people need a certain amount of physical touch and physical affection in their lives. The two times I’ve had long term romantic partners have been the times that I’ve had consistent touch and probably the main reason why I (mostly) remember those times fondly. I’ve not had a partner for a long time and that’s what I miss the most by far. But even just briefly imagining it there, I get strong thoughts that I don’t deserve it and that that will never happen again for me. Probably fair to say that I am too fucked up psychologically to be inflicted on another person. Anyway, the touch I am describing here is very different from sexual touch. I think it’s possible to meet all my needs for physical touch without any kind of sex.

I am a child of the MDMA (ecstasy) days, before ‘legal highs’/novel psychoactive substances, and one of the effects of that drug is that my friends and I got into the habit of hugging a lot. I remember that time fondly too. I still hug my friends to say goodbye and most of my family too. But these are quick hugs that don’t soothe my brain the way a long hug does. When my relatives’ children were small, I would hug them a lot. Partly because of my absolute fucking horror at the thought of them feeling like I did when I was a child and partly because it made me happy. I’ve had two long hugs in recent months. One from one of my oldest university friends and one from my sister and both because I was upset. They helped, and I am grateful for them, but they weren’t enough. I feel like I am this empty, insatiable pit of need when it comes to wanting to be touched.

So if you read the self-help articles and books then you are advised to try ‘therapeutic touch’ when you feel you don’t have enough touch in your life. I was given a voucher for a massage as a birthday present and I’ve had two and going to have a third today. They are very expensive. It feels intensely relaxing physically and my muscles feel liquid and released. But it’s for the psychological benefits that I am doing it. When my massage therapist moves round the couch to a different area she keeps a hand on my back or my shoulder. I am sure there is some what I’d disparagingly call hippy or spiritual (because it’s outside of my knowledge and experience) reason for this but what actually happens in my brain is that it suddenly starts thinking “I am normal” because she hasn’t taken her hands off me the second that she could. My brain starts thinking I might be okay and not entirely repulsive and repellent. Just a normal human body. A bit of detangling of my thoughts.

I grates with me that I have to pay someone to touch me and can’t find it naturally in my life. But, as previously mentioned, I am not in a position to have a romantic relationship and that seems to be the way that my society is organised to meet people’s needs for touch. I am lucky that I have this massage therapist that I feel safe with, and can occasionally afford to pay, and that I have my friends and family to hug. Maybe one day I will have more, and I would like that, but it’s okay just now.