2017 was the first year I sought eating disorder treatment since anorexia developed in 2011. My recovery prior to this was undertaken by myself, without input from any health professionals. This was not a healthy decision. I know of people who have undertaken their own recovery and weight restoration and done an incredible job, grown stronger and beaten their illness. I was not one of those people. Solo recovery was a struggle for me. Especially weight restoration. It took me under six months to reach my LW, where I remained for 18 months, and then it took another three years for that weight to be restored. I was severely anorexic. People didn’t notice / didn’t push hard enough / the nearest facility was 500 kilometres away and I was fourteen and determined to stay out of hospital. I was also dying, but mostly ignored this fact.
Anyway. Moving on to what this post is actually about. Eating disorder specific treatment. There were a few non-negotiables involved.
First, I had to stay safe. Truthfully, this effort was harder than reducing my engagement in behaviours. If I couldn’t starve my body or sabotage any positive progress through binge eating, or self-harm, how would I handle all the difficult emotions that would inevitably arise? With great difficulty, as it turns out. Second, I had to follow a meal plan. This was something I had tried in the past when working with a dietitian, but never something I had actually followed. Finally, I had to set goals.
There are a few reasons why I don’t like goals. I’m a perfectionist, so I often set unreachable and unrealistic goals that I simply cannot achieve, so that I have an excuse to berate myself later when I don’t meet them. I don’t like goals because they’re too much like resolutions, and resolutions mean new beginnings, and new years, and these never work so well for me, considering every year just brings with it a whole new plethora of mental health struggles. I’m not a particularly hopeful person, if that’s not any indication. Mostly, I don’t like goals because they require thinking about the future, and the future makes me suicidal.
Now I’m not sure exactly why this is. I’m not sure why the future seems so bleak that escaping it all together is the only possible solution I can conjure. I’m not sure why I have no hope, although I suspect it has something to do with the fun clinical terms “emotional abuse”, “guardian invalidation” and “psychological trauma”.
Goal setting makes me suicidal. Having this as a compulsory treatment aim in itself was very, very difficult. I made messes of weekly ‘homework packs’ because the goals I set simply weren’t right. They weren’t good enough, high enough, hopeful enough.
The truth is that good is good enough.
And anyway, that’s not the point of goals. Goals should be stars to steer by, not sticks to beat yourself up with.
I started simple. My first set of goals looked a little like this:
- Have calcium component of evening snack every day, even if I don’t feel like it. Actually buy calcium components so that I eat them. (Reminder to self – snack sized calcium component = one Up & Go, one glass of milo, 2 slices of cheese)
- When I feel the urge to self harm, phone a friend instead. If I can’t phone a friend, then I should go for a walk to remove myself from the sharp-object strewn environment – a short one, not a compulsive and purge-driven one.
- If I am working at the bakery, I shouldn’t do any additional exercise. If I must exercise for emotional regulation reasons, then I need to have 1.5 x my next snack.
I didn’t meet them. Not the first week, not even the second. Even now, I still struggle to meet goals. But they no longer make me suicidal when I don’t. If I don’t meet a goal, I re-evaluate why this was instead of immediately believing I’m a failure and the only possible solution is to disappear. Thanks BPD. The thoughts still come, but I’m getting better at the whole self reflection thing.
Why was I unable to take and eat my evening snack on the bus home? If I had taken it, I would have automatically eaten it to avoid waste. Why was I unable to phone a friend, and immediately reached for a sharp object? I no longer want to scar my body, but why was this action the only alternative? Why haven’t I been able to reduce the rigidity of my exercise? And why was it easier to stop in the park and turn around early than walk my normal full route but in the opposite direction?
And so on.
Recently, in my penultimate week of treatment at the day program I’ve been attending, I finally achieved some goals:
- I had not one, but two rest days
- I didn’t binge at work (I am sales staff at a bakery), but I also didn’t use the coping skill delaying as an ED excuse to restrict through the shifts instead
- I mostly met my meal plan, probably the most I ever have
- My weight has finally stabilised
As you can see from that proud little list, I’m getting better at goals. I’ve come a long way. But until I can set and meet all of my weekly goals, I don’t think I will be putting 100% into my eating disorder treatment. There are times when this may simply not be possible. There are times when mood will impact my efforts, or binging behaviours will sabotage all of the goals and set me back a whole week. But I have come leaps and bounds from the girl in the photos below. My weight is restored, and that’s the biggest treatment goal of all.
Trigger warning that shouldn’t be ignored like I’m sure you’ve done plenty times before, as have I, because you’re in the sort of headspace where you want to be triggered – I implore you not to ignore this one:
Please do not look at these photos if you’re currently recovering from anorexia nervosa or bulimia nervosa. They were taken in 2013-2014, at my most unwell. She is not a standard to compare yourself to, nor a goal to reach. She is sick, and she is not someone you want to be. But I am choosing to share them nonetheless – because they are a sign of the weight restoration goals I achieved, all by my screwed-up self. FYI – I’m the short one. The taller one is my big sister ❤