Tag Archives: recovery

Is social media causing more stress than it’s worth?

The idea behind social media is brilliant, it connects us. Initially it was that simple, maintaining connections between people who’re friends in real life or building virtual relationships between people who may never, otherwise, meet.

But it seems to have taken on a life of its own, making demands on us to present a specific “public friendly” version of ourselves, we get caught up in how many ‘likes’, ‘shares’ and ‘follows’ we’ve had and it makes 41%* of us feel lonely. That doesn’t sound right!

For Mental Health Awareness Week, PushON, an eCommerce agency, conducted a survey asking all about social media, how it makes us feel and how it impacts our mental health.

In 27 – 64%* of us, social media evokes feelings such as resentment, sadness, anxiety and jealousy and it makes 48% of us feel self-conscious.#

We’ve had to invent a word for that special photo that’s usually filtered – the infamous selfie!

We’re feeling awfully confused about social media, many feel concerned about being over monitored or ‘spied’ upon in the evolving technological world, yet we worry that no-one will pay attention to or ‘like’ what we post.

I’ve had a mixed relationship with social media. When I’ve been less inclined to leave the house (as a depressed introvert, it’s an easy place to end up!) it’s been a way of keeping in touch with the world and interacting with people at a comfortable distance.

Social media is great at connecting people with similar experiences, I wouldn’t have met these people without social media but I developed relationships that boosted my recovery as we were ‘in it together’!

28% of people say they feel motivated by social media and 43% feel happy while using it.*#

As I recovered from anorexia I had amazing support from the Berkshire Eating Disorders Service and their Support, Hope and Recovery Online Network (SHaRON!). I didn’t have to sit awkwardly in a room and do ‘group therapy’ – I just logged on whenever, wherever – not only getting the support (from therapists and fellow sufferers) when battling my way through a bowl of soup but also giving support – this 2 way process was important.

But at the same time, there are some negatives! How many of us can say our facebook statuses give an accurate picture of our life? At any given time, a Facebook wall could be covered in wedding, sonogram and baby pics – giving the impression everyone is either planning babies, having babies or caring for babies and all of this is shiny and happy. We all know this is no-where near the truth! Most people aren’t thinking about babies or children at all and those that are, are stressed out about it, rather than it all being smiles and laughter!

Mental illness is great at making us feel isolated, alone and completely incapable of doing life, the biased Facebook wall can compound these feelings. Don’t get me wrong, I’m not saying people shouldn’t share photos of their exciting moments. When unwell, it’s important to hold onto the fact that people do not write “struggled to out of bed today” or “washed my hair then watched TV”. Like good news rarely makes the newspapers, bad or neutral news doesn’t hit the Facebook status!

What’s more, while most of us are posting the edited highlights, 36%* of people admit they’re somewhere between ‘jazzing up’ their online profile and it being a complete lie.

Although social media can have a negative impact at times, 63% believed taking social media away would have a negative impact on them (with 1% believing they would feel heartbroken!)

There’s no debate, it’s here to stay, perhaps we all need to be careful, be clear about how we use it and don’t let it become a source of unrest or unhappiness – this is our choice to make!

*All stats from a survey of 1000 adults in the UK carried out by PushON, an eCommerce agency. (# Participants could choose multiple feelings). Survey carried in conjunction with Mental Health Awareness Week.

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When we stop talking about our pain

The other day, I read something that really struck home:

“You don’t learn to live with pain, you just learn to stop talking about it”

When an injury first occurs or before a chronic illness is diagnosed, we talk about our symptoms, if they’re worrying us, we have no problem saying “I’ve got a splitting headache again” or “My tummy ache’s not going away” or “The cold really affects my joints” but once you’ve got a diagnosis and are managing (with medication or otherwise) as best as you can, there seems little point to keep going on about it…this is something that seems to happen naturally but it’s a tricky thing that isn’t always the best thing.

One of my husband’s friends was having terrible back trouble a while back, as fellow Christians we were praying for him as he made decisions about treatment including the possibility of invasive surgery. After a while, I asked my husband how his friend was, he said he didn’t know – we didn’t know if that was because his back was better (unlikely) or he’d just stopped talking about it.

I have chronic pain in my neck, back and shoulders and have done for many years. This is due to spondylosis in my spine and fibromyalgia affecting all joints and soft tissues. Spondylosis is diagnosed with MRI and is a degenerative bone condition causing pain, including periods of inflammation and osteophyte (bone spur) growth, which press on nerves etc. Fibromyalgia is a condition diagnosed by ruling out all other connective tissue disorders which causes tender/trigger points and generalised pain and fatigue. I also have arthritis in my ankles which causes pain with every step I take.

I used to complain quite a lot, the conditions I have are difficult to manage, especially in someone “so young”, as my orthopaedic surgeon told me! I take regular pain killers, do physio, do regular exercise, get regular sleep and do relaxation techniques.

The other day my husband asked how my pain was, commenting that I’d not said anything about it for a while. I said that it was ‘as usual’ – I hate complaining, and I hate lying so it just is what it is!

I have come to realise I may have a low pain threshold (ie I feel pain sooner than someone else) but I have an incredibly high pain tolerance – I can put up with a lot of pain and still go about my daily life, not that it doesn’t bother me, just that I don’t let it stop me. This, of course, take a lot of energy which contributes to the fatigue I get anyway!

I find it difficult to talk about my pain as most people, when they hear about it, want to help in some way, or at least say something useful, sympathetic or supportive. But there isn’t really anything anyone can say or do to help. If I do mention it, it generally feels quite awkward and I defer to lying, along the lines of “it’s fine, I’m managing ok” or “I have good days and bad days” – which is technically true but my good days are still about 5-6/10 on the pain scale…

Normal for me is pretty bad but who wants to hear that every time I see them?!

If I don’t talk about it, people don’t realise that I’m suffering, assume I’m fine and don’t understand when I need to leave events to go to bed, if I’m distracted or if I don’t offer to help (set up tables, move chairs etc). I worry that people won’t believe me because I ‘look normal’ or they will just think I’m lazy or a flake!

The thing is, I can act normal, as I did the other day in breakaway training at work, but I pay for it afterwards. That evening, I could hardly think, my head felt like it was completely split open, my shoulders and arms were stiff and I coulnd’t move them without excruciating pain. Hot pokers and crushing vices could probably reproduce the pain fairly accurately.

I have read some fabulous books by Paul Brand and Philip Yancy about how we’re meant to listen to our pain, not get angry about it or wish we didn’t have it – it tells us something is wrong, if we didn’t feel it we wouldn’t pull our hand away from the flame or take care of a brewing illness.

Unfortunately when it comes to fibro, the thing that’s wrong is the pain communication system – this means, I feel pain when I shouldn’t. Pain from spondylosis is due to physical degeneration or deformities – I listen to my pain and do not push my body beyond it’s limits too often but it’s incredibly frustrating when my brain is active and wants to be doing, but my body just can’t.

I’m not looking for people to feel sorry for me (that’s fairly pointless!) – I’m just saying it how it is.

So it’s a difficult balance, talking about the pain doesn’t solve anything and makes other people feel helpless or awkward, not talking about it means people don’t know the truth, may think I’m rude or acting strangely.

So, perhaps we should try to remember, if someone has a chronic condition, no matter what it is, diabetes, arthritis, mental illness, bowel or kidney disorders, they are managing it every single day. They may not talk about it but that doesn’t mean they’re fine, it doesn’t mean they’re not suffering just as much as when they do talk about it, all it means is that today, they’re not talking about it.

Sometimes I wish my conditions were more visible but most of the time I’m glad I can choose who I tell. I guess, my health is my business and I maybe I shouldn’t worry about what other people think.

Recovery from mental illness isn’t about staying within your comfort zone

Regarding mental health recovery, I just saw someone on facebook advise one of my friends to “take baby steps”- totally agree with this, but then she said “go at a pace you’re comfortable with” – this, in my humble opinion, is dangerous ground… let me explain.

Recovery from mental illness is going to be painful, it’s like physio, it ain’t gonna work if it doesn’t hurt! No pain, no gain and all that jazz!

The one barrier to recovery, I’ve seen over and over again is being terrified of change and needing things to stay the same.

There’s the old adage – no-one likes change and it’s true.

Yes, being mental ill is horrendous, no-one actually wants to be ill but, wanting to get better and wanting change are two very different things – I don’t think anyone would be ill if getting better was easy, straight forward and didn’t involve making massive painful changes to the way we think, feel and behave.

Unfortunately, the longer someone has been ill, the more comfortable the illness is, which makes change even harder. BUT there’s also the opportunity to use the feelings of frustration to motivate the change.

When recovering from anorexia, comfort, for me included, feeling hungry, saying “no” to food and making decisions based on consuming few calories and burning many. If I’d been told to “go at my pace”, I wouldn’t have gone anywhere at all. I’m not saying I wanted to stay ill but changing even the tinniest thing caused distress I couldn’t manage.

As odd as it sounds, depression can also be comfortable. I had my routines, I had people care for me, my thinking patterns were familiar, I believed the running commentary in my head… I was useless and trying was pointless – it was easier to stay in these patterns.

How could someone not want to break free?! Of course, I wanted to break free but I also didn’t want anything to change.

There’s a fear of failure, and let’s be honest, taking huge leaps increases the chance of failure, then confidence in one’s ability is knocked! So, it’s essential to take baby steps but I always found the tinniest step was uncomfortable.

Once I’d decided I was going to tackle recovery and make it work, I had the right people around me, people who had faith in me, they presented me with challenges they believed I could achieve; every step was difficult, I had to fight my daemons and manage extraordinary levels of anxiety, but if I’d not gone through that, I’d still be at square 1 (or worse).

With all mental illnesses it’s important to make the changes stick, so, unfortunately, there’s no such thing as a day off! If you take your foot off the gas, chances are, steps backwards will occur.

Deciding to take a day off (as enticing as it is!) is dangerous territory!

So, baby steps – yes, even half baby steps, but as soon as you think it’s ok to stay comfortable, chances are, recovery will halt.

I DO NOT want anyone reading this to feel bad about taking steps back or not making progress, this is natural and (dear I say) ‘normal’! Recovery is exhausting – it’s seriously been the toughest thing I’ve even done, it’s so difficult to make the ‘right’ decisions days after day!

I’m simply pointing out, that in my experience (in myself and supporting people) recovery is about stepping out of your comfort zone, not staying within it.

I hope this will help supporters understand why linear recovery just isn’t possible!

Eating Disorders Awareness Week – Why Wait?

26th February this year is Eating Disorders Awareness Week. Beat (the UK’s leading eating disorders charity) are asking Why Wait? So I thought I’d try and answer!

Beat’s research shows:

“On average, 149 weeks pass before those experiencing eating disorder symptoms seek help. That’s almost three years, 37 months or 1,043 days.”

I’m going to be addressing this primarily from the point the point of view of having recovered from anorexia but some, if not all, of this will apply to other eating disorders too.

People with no experience of eating disorders would be puzzled by the delay in seeking and engaging in treatment but having been deeply entrenched in one for many years, I know recovery from an eating disorder involves a lot of ambivalent feelings.

The most prominent reason for waiting to recover is fear – saying ‘yes’ to treatment means saying ‘yes’ to change, saying ‘yes’ to stepping out of your comfort zone and most feared (when it comes to anorexia) saying ‘yes’ to weight gain.

Denial is also a problem, delusional beliefs about weight, shape, body shape and the extent of the problem lie square in the way of stepping up to getting help. Interestingly, I found, that even when my delusional beliefs were challenged, and I started to see and understand that my beliefs may not be entirely accurate, it was fear, again, that made me hold onto my inaccurate beliefs.

Some people hold on incredibly tightly to their delusional beliefs, no matter how gently or ferociously it’s challenged, there’s no budging it.

Fear and anxiety are helpful emotions – they tell us when something is dangerous, when something should be avoided. I’d be pretty grateful for the fear if I was being chased by a lion, my fear would be accompanied by a rush of adrenaline that would help pump blood to my muscles and help me run faster.

The fear of recovery from an eating disorder is pretty much on this level. Imagine everyday, feeling this fear, it’s not surprising that denial feels like a friend. Every time I was challenged about my weight, my restricted diet or my weight controlling behaviours, this fear and denial kicked in. It felt like I was being chased by a lion I was never going to be able to outrun, the fear was immense but accompanied by feels of hopelessness.

Fear of gaining weight is incredibly powerful – it’s a genuine belief that if you engage with professionals they’ll make you balloon to 100 stone, if you already think you’re overweight, it makes absolutely no sense that you should have to put on more weight…!

So, it’s pretty clear, there are some good reasons not to recover but now I’ll address some reasons why recovery could be a good idea, right now.

When I was struggling, I was advised to step back and look at your life as objectively as I could, as if looking at a friend.

Is there anything you’d change?

Do you want the daily fear to decrease?

Would you like to socialise more?

Do you want to feel less anxious?

Do you want people to stop worrying about you?

Would you like to stop thinking about food all the time?

Would you like to be able to find clothes that fit?

Do you want to go on holiday and just eat what you want?

Would you prefer not to be chained to the bathroom scales?

Do you want to enjoy exercise rather than flog yourself through it?

Would you prefer to be less deceptive and secretive?

Do you want to be free from the number on the weighing scales dictating your mood?

Do you want to try new foods?

Would you prefer to enjoy your food rather than fear it?

Do you want to stop feeling faint?

Do you want to eat your favourite food without fear of a binge?

Do you want to be free from numbers?

Do you want to satisfy your hunger rather than ignore it?

Even if it’s just one of these things, just think about it… Don’t immediately think – “but putting on weight/recovery” won’t do that for me, don’t worry about that right now. Just think, what you’re doing at the moment isn’t working, is it?!

The definition of madness is doing the same thing and expecting a different result.

Perhaps now is the time to try something new?

Recovery gave me all of this, and more!

If you’re watching a loved one battling an eating disorder, whether they’re in denial or fearful, perhaps direct them towards this blog, this maybe the first step for them to start the conversation about recovery.

I’m not offering all the answers, I’m just suggesting, recovery is there for the taking, but it has to be an active choice, the only thing that’s going to work is to find professional help and engage with it.

When in treatment I was advised to read a book called ‘Feel the fear and do it anyway’ – I was very angry that I was being advised to read this book and I’m sorry to say I read the blurb and went no further. Every single day I felt fear (fear of going out, fear of being seen, fear of eating, I was afraid of everything) and I got on with my day anyway, I never let anything stop me. I was offended that this therapist didn’t have the first clue that I was ‘doing it anyway’ every single minute of every single day.

I haven’t read the book so I can’t be certain what it was about but I’ll hazard a guess that it would have challenged my way of getting through, the only way I could manage was to deny my fear. Yes, I was fearful of everything but I feared feeling that fear fully as I thought it would halt me in my tracks. I’m someone who pushes through regardless. If I’m worried about something, I don’t put it off, in fact, I’d rather get on with it, soon rather than later, I hate having worry gnawing away at me. I never avoid anything…except my feelings!

Maybe the book would have taught me that fear is ok (something I’ve grown to learn anyway) you don’t have to ignore or deny it, you can accept it, appreciate it, get to know and understand it…and then ‘do it anyway’!

Maybe we could all learn from this – if there’s something we’re fearful of, the fear is telling us to beware but it’s also giving us the energy to fight. As an eating disorder sufferer, when I worked out how to use that energy to fight, that was a big step towards recovery.

Why do we need rewards to look after ourselves?!

After my recent ankle arthroplasty I struggled with the expected pain, a lot of it but it was bearable. I was working hard at my physio and doing more, she told me I would obviously experience more pain but it really wasn’t feeling right, she told me to persevere but I don’t think she really understood how much pain I was in. I may have a low pain threshold but I have a very high pain tolerance. I experience a lot of pain, I just get on with my life but that doesn’t mean it’s ok or that I’m ok with it! It’s hard to know where to draw the line, how do you know, when you’re rehabilitating, how much pain is too much pain? I was pretty much told, I should keep exercising but absolute agony was the line at which I should stop!

Speaking to a colleague about his painful knee has had me thinking. He was injured 4 months ago and because he didn’t make a fuss when he first went to A&E he’e been through months of pointless pain, finally culminating in an MRI that concluded he needed surgery. He’s been thinking he should have made more of a fuss, if only he’d limped into A&E stating he was in agony, he would have had an MRI within days and surgery so much sooner. Those of us that don’t complain so often don’t get what we need.

I’ve been wondering if I was experiencing more pain than I should have been but my physio said it was fine, to be expected.

I was beginning to think I would be in pain for the rest of my life and I was beginning to get to used to the idea that I may never run again. Disappointed, doesn’t even begin to come close.

I saw my surgeon last week and he had a different opinion, I should NOT be in so much pain. Steroid and local anaesthetic injection on board and…I’m pain free, I can’t quite believe it!

When my physio said “repeat this exercise 20 times”, I do it 60 times and she says “good”, to be honest, I don’t think she was used to patients actually following through with their exercises but I’m so desperate to get better I thought the more I did the better…I can’t help wondering I shouldn’t have been doing so much exercise, I guess there’ll be no way of knowing.

Anyway! Today, on a totally pain-free ankle, I (with more measured advice from another physio) tried running for the first time in 5 months, it was for 1 minute at a time and I’m so excited that I didn’t feel any pain. This is the first time for many years I’ve run with no pain!! So excited, it’s unreal!

I have promised my husband I won’t push it. I will stick to 1 minute at a time for 2 weeks and increase it so slowly I’ll feel like I’m running backwards! But the hope is, I will be back running properly within a year!

My husband knows I’m likely to want to push myself. For starters, I got on the treadmill earlier and said to myself I’d to 2 x 1 minute stints, I ended up doing 5… it’s not don’t any damage and I’m still pain-free but I really cannot push it! I cannot risk needing more surgery.

We started talking about whether I need an incentive…for every week I’m “good” and stick to the slow build up plan, is there anything that would help me stay focused? We discussed all sorts of things but it occurred to me, what more incentive do I need than to look after my health?

Why do we always need incentives? When people are giving up smoking, it’s suggested they put the money they would have spent on cigarettes in a jar so that they can spend it on a big holiday or some new clothes, there has to be something to aim for. It’s the same with people trying to lose weight, for every pound, there has to be some material reward. Reducing the chances of long term life limiting illnesses just isn’t enough!

Our health gains are intangible and it’s like they’re just not enough.

I’m so proud of my 60-something mum who has just completed a couch-to-5k program and has done a couple of Parkruns, being one of the fastest women in her age category! That’s what I want to be doing in 30 years time, but I won’t be if I don’t look after my bones and my joints now, what more incentive do I need?!

Seriously, if I want the best chance of avoiding further surgery and to be running in my 60s, I need to take it slow and steady so that’s what I’m going to do, no other incentive necessary!

How do I get to the point where I want to recover?

Having written about being ambivalent about eating disorder recovery, this is a natural question to ask.

For people who don't understand why someone with an eating disorder wouldn't want to recovery, please read here.

It was my ambivalence to eating disorder recovery that got in the way of a lot of therapies that I tried. I would put all my energy into the therapy but recovery just wasn't happening because, underneath it all, I didn't want to recover.

I was very fortunate to come across a therapist who asked me "do you want to want to recover?" No-one had ever asked me this, no-one had ever said, no matter how long that sentence is, if you want to want to want to want to recovery, that's a good enough place to start.

So many people find themselves in limbo, they have a sort-of-life mixed with sort-of-functioning-anorexia. But still they wonder about recovery, what it is and what it could look like but remain stuck.

Ok, so if we establish that there's a small bit of you that's interested in getting to the point where you want to recover, it's about looking at what makes you want to get to that point?

I can only talk about my experience. I'll be honest, every minute of every day, while I was unwell, my interest in recovery fluctuated. It wasn't a smooth linear progression and there's no point in pretending it was, this wouldn't be fair.

I did a few things throughout my recovery:

I was honest about why I was holding onto my eating disorder:

  1. I rated thinness over everything else in life.
  2. Getting fat (restoring my weight) felt impossibly terrifying.
  3. I kept me "safe" – I could avoid social events etc.
  4. I could be excused from life whenever I wanted.
  5. It gave me a framework for making decisions (i.e. choosing foods on the lowest calorie content and doing activities that used the most calories).
  6. I liked the identity and I didn't know who I'd be without it.
  7. Recovery looks too hard.
  8. I'm such a bad/evil/fundamentally flawed person, I don't deserve recovery/happiness/freedom.
  9. I thought I'd done too much damage to myself and my life to bother trying.

Once we're honest with ourselves, we can start to be curious about what it all means.

I looked at the negatives of being unwell:

  • I wasn't taking a full part in life.
  • I was letting people down.
  • I experienced poor physical health (tiredness, coldness, lumbago, anaemia, aches and pains).
  • The only thing that made me happy was the number on the scale going down.

I thought about what professionals were telling me:

  • I was unwell (even if I didn't think I was).
  • I was damaging my body.
  • I was putting my life at risk.
  • Recovery was possible.
  • A better, more for-filling, happier life was possible and I deserved it.

I thought about how arrogant it was of me to rate my thoughts and beliefs above those of the professionals. If I ever didn't think I was sick enough or thin enough to deserve treatment, I thought of all the people who were sitting on waiting lists and realised the professionals wouldn't waste their time on me if I didn't need or deserve their help! I often checked out with professionals if they wanted to see me, probably sounds hideously manipulative but I needed to know they really wanted to help.

I imagined some positives of recovery:

  • I'd discover who I really was.
  • My physical health would improve.
  • I could enjoy "bad foods" – actually, maybe no food would be bad!
  • I could go on holiday/eat out and fully participate without fear.
  • I could help other people recover and believe what I was saying.
  • I'd choose a life I wanted rather than one anorexia dictated – this was really scary since I had no idea what I wanted but I had to have faith this would come

I looked at whether my reasons for holding on were valid:

  1. I'd be happy if I could rate something else over thinness (I didn't know what it would be but the possibility of valuing something else was appealing)
  2. The reality is, weight restoration is not about getting fat (even if Ana screams this everyday). Weight restoration is purely and simply about nourishing my body adequately for health
  3. What is "safe" about starting myself? (Yes, it feels psychologically safe but in reality it's killing me)
  4. I could learn assertiveness so I didn't have to use my eating disorder as an excuse.
  5. Learning my likes a dislikes could be exciting! Instead of choosing an apple due to it's calorific value, I could choose chocolate, just because I fancied it!
  6. As scary as losing the 'ill' identity was, the reality of people feeling sorry for me or treating me differently was tiresome. Recovery could give me the opportunity to choose an identity. I could be defined by my job, my achievements or my hobbies.
  7. Yes, recovery is hard but I had people offering help and they were telling me I was strong enough to do it.
  8. I had people telling me I did deserve recovery. If I was such a bad person, why would anyone stick by me?
  9. Continuing to think "what's the point of trying" just isn't sustainable. I tried this a few times, i.e. Disengaging with services etc but it doesn't have a happy ending.

It's very common for people with anorexia to feel they're not sick enough to start recovery. Sufferers feel they've not been a "good enough" anorexic if they've not been tubed or not reached a certain BMI, but everyone's experience is different. It's always worth considering what you'd say to friend in this situation. If they were saying "I'm not sick enough", would you say "yeah, you need to lose more weight, eat less, exercise more, then you could consider recovery"???

It's not simple or easy but going through this sort of process might help when trying to get to the point of wanting to recover. Everyone's different and will have different motivations so it's important to go through the process for yourself, not comparing yourself to anyone else.

I found I had to choose recovery everyday. Some days this was harder than others and some days I chose to be ill but every new minute gives us an opportunity to choose recovery, to choose wellness, to choose to definite ourselves differently.

The ambivalence of eating disorder recovery 

It’s really hard for people who’ve not experienced an eating disorder to understand the pull towards destruction.

Ambivalence…the coexistence within an individual of positive and negative feelings towards the same person, object or actions, simultaneously drawing him or her in opposite directions.

When your life’s completely falling apart, you’re not able to hold down and job, you’re losing friends and you’re feeling physically unwell, how could anyone not grab hold of recovery with both hands and run with it?!

If, however, you’ve lost everything else, the only thing you have left becomes your identity and a place of safety. If you feel like your eating disorder is the only thing you have in the whole world, how could you possibly consider letting it go?

Eating disordered behaviour not only becomes habitual but it’s a compulsive addiction.

Weight restoration is a significant part of anorexia recovery and this, for me, was terrifying. Having spent years trying to lose weight, put my body through all sorts to try and obtain the unobtainable skinny body of my dreams, thinking about throwing all that work away is unbearable. All the professionals who claim they have my best interests at heart are trying to make me fat, how could they not understand that’s the one thing I can’t do?!

It feels impossible to understand when you’re told “you have to put on weight before you can engage with therapy”. Once your weight is below a certain level and you’re body is malnourished, your brain is not receiving enough energy to function to do everyday tasks, let alone process and absorbed any new understanding in therapy.

“But I can’t gain weight unless my head is straightened out”… this feels like an obvious plea as multiple professionals are telling you your medicine right now is food. “How am I mean to eta when every fibre of my being is telling me not to eat?”

That is what anorexia does, it takes over every fibre of your being, it infiltrates every cell and permeates every breath you take. It feels like you become anorexia. I didn’t feel like I existed beyond my anorexia therefore doesn’t it make sense that I wouldn’t want to let it go? That’s the impact it has, that’s what it makes you believe, anorexia is your identity, without it you are no one, you do not exist… 

Now, I didn’t want to exist, part if my anorexia was about losing so much weight that I would disappear but there was a tiny part of me hanging onto life. In an odd way, although anorexia was killing me, it was also enabling me to hang onto life. When i stopped and thought about my life and what a mess it was, ending my life was an appealing option but focusing on avoiding food and losing weight gave me a purpose.

The first step towards recovery is putting more faith in the people around you than in the anorexia that’s been with you for many months and helped you cope with all that life throws at you. This is quite a tall order. The leap of faith feels impossible.


As I started making progress towards recovery, it felt like the anorexia fought back, as though, it felt threatened. The voice I heard in my head began shouting louder, it continued to tell me I had to lose weight. How do you keep following the meal plan when day in, day out, you’re being told how fat you are, you’re eating too much, your greedy and you should engage in all behaviours to lose weight?

I had so many questions, if let go of my anorexia, who will I be? What will I do? What else will I think about? It felt like I would be nobody and I would be completely empty but as my recovery journey developed, I learnt who I was and things naturally became part of my life. 

How could I stop weighing myself multiple times per day?…then I wouldn’t know how much I weigh

How could I start eating chocolate?…what if I enjoy it?

How could I eat food if I didn’t know how many calories were in it?…then I wouldn’t know how much to restrict the next day

How could I stop exercising?…how would I know how much food I’d earnt?

I confess, when I was in a full blown eating disorder intense recovery programme, I would engage in searching for the web for hints and tips about how to “stay anorexic”, how to stop the hunger pangs without eating, what foods had the fewest calories, how to exercise when exhausted and on the verge of fainting, it’s all there and it’s down right dangerous.

The ambivalence is unbearable, desperately wanting to recover but also, desperately not wanting to recover. I could see the pain I was causing those around me, I honestly did want to recover so I could live a “normal” life but at the same time, I wanted to lose more weight and cling onto certain aspects of my anorexia.

The lack of energy you have when starving yourself makes the fight even harder. The recovery journey is tough and the tougher it gets the easier it feels just to stay indulging in anorexic behaviour. It gets even scarier when you get to the point when anorexic behaviours arent second nature anymore, what now? I thought, “if I’m not anorexic but I’m not recovered, what am I?”. At this point the feelings of failure are rife. Feeling like a “failed anorexic” is all too common but feeling like you’ve failing at life is also a tough obstacle to overcome. At this point, it feels like there’s no way back but the way forward feels equally impossible.

I did make it though, I did put faith in the professionals, I started listening to my body, when it was hungry I would feed it, when it was tired I let it rest. The signals are mixed at first, hunger pangs are confused with feeling full, tiredness gets confused with a lack of motivation. I found it really hard, I’d spent so long ignoring my body I had a brain-body disconnect so initially trusting the professionals and going through the motions was all I could do. I had to trust that they’d been through this more often than I had! It does help when you hear it from people who’ve actually lived through it, when recovering I found it helpful to speak online to people at various stages of recovery.

For me, therapy was the most important part of my recovery but it couldn’t have engaged fully in it until I was nourishing my brain fully. I tried to kid myself that I could sort my brain out while still starving myself but I was wrong.

I may not be totally happy with my body but now I nourish my brain I’m able to think more objectively about it and see that now, my life is full of all sorts of other things that wouldn’t have had space if I’d not let go of my anorexia.

Confessions from a disordered mind

So, it’s eating disorder awareness week again and I fear, yet again, I will be “preaching to the converted”… not that I preach (I hope) but I fear my blog only reaches those people who already know about mental illness, those who are already interested, those who suffer themselves or who care for someone who is or has been mentally ill. People reading this do not really need their awareness raising, so…what’s the point?!

I’ve challenged myself to go a bit deeper this year. Maybe my audience are aware of mental illness, even aware of eating disorders and anorexia. But how many of you actually know what it’s like to be stuck on the treadmill of starvation where you beat yourself up because you wonder if you’ve chosen to be ill but when you try eating an apple, a voice tells you “if you don’t cut it into 36 pieces, you’ll put on 6 stone”?

Anorexia isn’t about choosing not to eat or just liking healthy eating. It isn’t sexy or glamorous. It isn’t about losing a bit of weight, being a moody teenager, being awkward or deliberately deceitful. It’s a serious mental disorder where your every waking moment is driven by a desire to lose weight and your nightmares are dominated by fear of fat. The interlinking of thoughts, emotions and behaviours and your interpretations of these is incredibly strong, it can feel impossible to break the automatic cycle.


The voice (I later called Ana) was with me 24/7, in bed, at the supermarket, while with friends, when I was alone, she never left me alone. I thought she was my friend as she gave me hints and tips to achieve my goal. She persuaded me to make trips to a supermarket that was further away because they sold products lower in fat and sugar. She kept me going when I slowed through exhaustion while out running, she made me run faster, harder, further. She helped me say no when I was tempted by cakes and biscuits. She made me walk instead of use the car, even when the weather was cold and wet. She gave me a buzz when I lost weight but didn’t let up, she made me strive for the next target.

With anorexia I was devious and deceptive. I’m ashamed of some of the things I did. This is common. My focus became losing weight, my aim was to consume as few calories as possible and use up as many as possible. Continuing with a vaguely normal life became difficult, impossible at times. I’d pour milk into a bowl to pretend I’d eaten cereal. I’d say I wasn’t hungry when my stomach was in knots. When offered food, I’d say I’d already eaten when the truth was I’d not eaten for days. On one hand I hated wasting food, on the other, I’d throw food away. I hated lying but if I was to achieve my goal I had to. Unfortunately, the more weight I lost, the more I had to hide. I also self harmed, I had to hide this as well.


Why was I so determined? I felt out of control of my body (during puberty) and of my emotions. I’m a highly sensitive introvert who felt like I didn’t fit in the world. I thought my food intake and losing weight was the only thing I could contol. As with any other coping mechanism we use to make ourselves feel better/happier (smoking, shopping, drinking alcohol) there comes a point where they stop helping and start becaming a problem in themselves.

The more weight I lost, the better I felt about my body, I got a pleasure, I felt a a sense of achievement. But each time I achieved my goal, I had to set a lower goal weight. The lower my goal weight, the harder it was to achieve. The harder I had to work at my eating disorder (yes, it’s hard work) the more unhappy I was. Anorexia is full of contradictions.

There came a point when I realised my goals for life weren’t compatible – I did not have enough physical or emotional energy to be the person I wanted to be and to continue losing weight. I had to decide which I wanted more. Unfortunately, it’s not as simple as just choosing to recover.


When trying to recover the juxtaposition of desperately wanting to get better with desperately wanting to continue losing weight (because you know you feel better lighter and feel worse heavier) is an impossible battle. It didn’t make sense to enter into a recovery programme, signing up to gaining weight, knowing this would make me unhappy. I was unhappy with my life dominated by thoughts of avoiding food, avoiding social situations involving food and constantly trying to use up excess calories, I knew I would be unhappy gaining weight and feeling excess fat on my body. This is a very difficult experience to explain.

As I wrestled with recovery, there were so many reasons to fight to get better but anorexia is powerful. I needed people around me with a lot of patience. Recovery is never a smooth journey and there were many hurdles and many set backs but it is possible.

When I tried talking about the voice I heard I was asked to give it a name (a well established therapeutic technique) but I insisted on calling it Frances because I knew rationally it was me… it felt like someone else but I knew this wasn’t actually possible. In an odd way, my insight was working against me.

Once I gave in and called her Ana, it became easier. Instead of blaming myself, feeling angry at myself, beating myself up etc…I started aiming all my anger and frustration at Ana and started fighting against my illnesses instead of against myself.


Is life plain sailing now I’m recovered? No, of course not! But, although I may never love my body, it is what it is and I make my own decisions now, I’m not dictated to by disorered thinking.

The truth about ECT

Is this barbaric treatment still carried out?!

Electroconvulsive therapy (ECT) is a controversial treatment but the stigma relates to early treatments where high dose electricity was given to patients without anaesthetic.

What is it?

A general anaesthetic and muscle relaxant is used to ensure the patient remains as still as possible. Electrodes are used to pass a small electrical current through the brain causing a brief (20-50 second) seizure. It can be given uni-laterally (to one side of the brain) or bi-laterally (to both sides). Very small movements of the limbs will be seen to signify a seizure has taken place. It re-aligns the brain chemistry altered by certain mental illnesses.

Why is is given?

Mental illnesses are treated with medication and psychotherapy but when certain illnesses are severe, life threatening and resistant to these treatments ECT can be used.

Severe symptoms may include:

  • Suicidality
  • Refusal to eat and/or drink
  • Risky/life threatening behaviours associated with mania
  • Psychosis involving severe loss of touch with reality
  • Catatonia

ECT is also given if it has been successful in the past and the patient presents with similar symptoms. The decision is usually collaborative, between patients and prescribing psychiatrist, however, the patient may lack insight or have lost touch with reality, then consent is encouraged but not necessary.

Are there side effects?

An electrocardiogram (ECG) and blood tests will be taken to ensure the patient is physically fit enough to undergo the general anaesthetic and receive the treatment. However, side effects may occur.

Short term (minutes-hours):

  • Headache
  • Confusion/feeling out of sorts
  • Muscle aches
  • Memory loss
  • Sickness
  • Affects of general anaesthetic

Long term (days-years) reported in a minority of cases:

  • Memory problems
  • Personality changes
  • Loss of skills

Death or serious injury can occur in 1 in 80,000 treatments, about the same as with having a general anaesthetic for dental work.

Side effects can be reduced by given unilateral placement of the electrode on the non-dominant hemisphere rather than bilateral stimulation.

Does it work?

ECT is usually given in blocks of 6 treatments twice per week. Improvement in symptoms is usually reported after 2-3 treatments. If small improvements are seen after 6 sessions, up to 12 treatments are given. Treatment is stopped as soon as adequate improvement is seen.

A study of 1895 courses of treatment showed:

  • 1712 reported improvement (‘minimally’, ‘much’ or ‘very much’)
  • 113 reported no change
  • 28 reported feeling worse.

Bilateral and high electrical current is shown to be more effective at treating symptoms but will increase side effects.

There is little evidence for continued or “maintenance” ECT.

A personal story

Mental illness can strike anyone at any time. I have had long standing mental health issues but a few years ago, I became extremely unwell, lost insight and required sectioning under the mental health act to keep me safe. I was unable to control my suicidal behaviours and although medication was tried, it was not effective in the time scale needed. I could not engage with psychotherapy due to severely distorted thinking.

I had lost hope. ECT was offered as a last resort. Due to my distorted thinking I did not know why people were bothering to keep me alive but consented feeling as though I may as well give it a go. (Although, my consent was not necessary as I was section under the MHA.)

It was quite bizarre to be offered it, I had horrendous images of old movies where you’d see the patient’s brain electrocuted and they’d have a violent fit but I was reassured I would have an anaesthetic and muscle relaxant to reduce jerking. It was still hard to understand I was agreeing to my brain being zapped.

After each treatment I would feel muzzy and a bit dazed for the rest of the day but compared to the severity of the symptoms of my illness, this was manageable. I was initially given bilateral ECT we saw a slight improvement in my mood but I was getting severe headaches so we continued with unilateral ECT for 12 more sessions until my mood improved enough for me to engage in psychotherapy.

Long term, I have lost a few chucks of memory but this happens with severe mental illnesses anyway so who’s so say it’s due to the ECT? Without it, I’m in no doubt my suicidal behaviour would have continued and probably ended my life so it truly was a life saving treatment.

Conclusion

ECT should not be given lightly. It is a serious treatment for a serious illness. There are side effects, just like there are for any treatment but since it is reserved for the most seriously ill who’s lives are at risk already the benefits by far outweigh the risks.

If you or someone you care for is offered ECT you will have gone through numerous other treatments unsuccessfully which can lead to feelings of helplessness and hopelessness. ECT is an unusual treatment that can offer hope.

Useful links:

NICE guidelines

Royal College of Psychiatrists

Mayo Clinic