Guest Post By Marjie Ruth - We're Still Where We Are!

I enjoy Marjie's posts.  Her offering each week or so always makes me think.  I thought this post was especially poignant since I just returned from the F.E.A.S.T. conference at which, of course, everyone was wondering where we are......

"Oh, Daddy, we're still where we are!"
~ young girl sitting behind me on the plane

Perhaps you're wondering about the unusual quote that I've started out with this week. As we were returning home from a trip recently, there was a young girl, probably about 5 or 6 years old sitting behind me. It was obviously her first flight, and she was understandably excited. When she first sat down, I had to chuckle as she announced to her dad that her ears were bothering her already. And this was while half the passengers had yet to board! She had obviously been told what to expect and in her excitement she was experiencing "anticipatory ear pressure". It was about 2 hours into the flight when she raised her window shade to look out once again, and upon seeing that we were still flying amidst the clouds she announced in exasperation, "Oh, Daddy, we're still where we are!". I smiled at her words and the succinct way she had managed to capture her perception so innocently and accurately in that phrase. By all appearances if one were to judge by the scene out the window, we had not made any progress at all in our travels . Flying along at 23,000 feet (or whatever), there were no familiar landmarks to help us determine where we were, how far we had gone, or in what direction we were headed. The more I thought about what she said, the more I was intrigued by the words.

We're still where we are! State it with desperation, and it becomes a cry for help. Where are things headed? When will we see progress? How will we know if things are going in the right direction? How do we get out of here? These are all questions that we ask at one time or another when dealing with a loved one and their eating disorder. It's foreign territory devoid of the usual landmarks. Perhaps that's why we often struggle so to keep the usual markers of progress in our lives. "Treatment is important, but let's not let it interfere with school (or career or family)," we think. These are things that define us and tell us where we are and where we're going. It may seem frightening to us to let them go. What with this horrible addiction already causing so much tension and anguish, we may find ourselves clinging to those "markers" in our lives. While the emotion is understandable, there may be some danger there. A person driven to such a self destructive behavior as a coping mechanism is most definitely experiencing some serious emotional pain in their life. It may very well be that the marker (school, career, friends, family dynamics, etc) we want to maintain is an integral factor in the mental turmoil they're struggling to deal with, albeit in an unhealthy way. The important guide here is to not let our own emotional needs become a detriment to therapy and recovery.

We're still where we are! Cry it with exasperation, and it is the voice of frustration. Why did this happen? What was the cause? How much longer will it last? Where can we find help? Why isn't she (or he) getting any better? Why can't she/he just eat? I don't think I can take much more of this! For sure, living with someone who is in the throes of an eating disorder is a very tough place to be. Just like the little girl who could hardly wait to get to her Florida destination and was frustrated when she looked out the window as it seemed that nothing had changed and she wasn't any closer than before, we are desperate and impatient for healing and a return to a more normal life. For the little girl, life was going to be very good when the plane landed. We find ourselves thinking in a similar pattern: if they can just get over this disorder, our lives will be good again. We may find that we think in terms of life before the disorder (the time before we knew that our loved one had become addicted), life as it is now with the monster that is the disorder creating such misery and havoc for everyone, and life as it will be (back to just like before hopefully or at least much better than now) after the disorder. Again, this is an understandable outlook but not necessarily a helpful one for at least two reasons. Just as the Zen philosopher would tell us that no man can put his hand in the same stream twice (because the water is always moving and changing, it is always a different stream), life in the future is always different from the past if only because we have experienced time in between. When dealing with something that develops at such a deep emotionally subconscious level and becomes both mentally and physically entrenched, even 100% recovery cannot erase the history of the battle. Nor should we want it to as it's the learning that occurs through successfully fighting for recovery that enables the victim to master the steps to maintain that recovery. Therefore, to put it in my own Zen-like words: better to not waste energy wishing for things to return to past; instead use energy to direct mind to learn from past, apply lessons to present knowing that it will become what is to be.

We're still where we are! Now, try saying it with a bit of awe and wonder. "We're still where we are." Do you know where that is? If not, all the more reason to slow down and figure it out. A big issue dealt with in therapy is learning to stay in the moment. That's because either projecting into the future or clinging to the past has not been healthy for them. Looking ahead, especially if one is at all depressed, can be extremely frightening and debilitating. Can't understand that? Well, good for you as it means you're probably not suffering from depression, but please don't let that prevent you from having empathy for those who are not so lucky. It's common for those with an eating disorder to also be diagnosed with depression. (It's my hunch that often in such cases it was untreated depression that led to the eating disorder as a coping mechanism, but that's just my theory.) And for someone depressed, the future is just a black hole looming ahead. An unrealistic longing for the past is also a sign of trouble. This longing to be back in a safe time and place can trigger an irrational desire to remain childlike, thus avoiding the dangers inherent in dealing with "adulthood" in our society. This is part of why recovery encourages staying in the moment. Another reason is that the Eating Disorder (ED) likes to make things complicated, thereby insuring the need for its place in their lives, by making their thoughts all confused and anxious with worries about the future and painful reminders about a past they no longer live in. The ED wants life to seem very complicated and its disordered solution the only obvious answer. Staying in the moment is a way to help defuse the disorder by keeping life simpler, one moment at a time. And this is a strategy we can all gain from if we apply it to our own lives. Think about it: when your loved one does something that seems so very disordered, if we project that ahead in what we see as a logical progression, we can find ourselves in despair. But if we isolate that moment--take it as the single incident it is and admit that it's our fear that makes us worry about the future, and refuse to give in to the folly of projecting ahead--we cut that moment down to size and bring our own response in to scale. This "downsizing" to the reality of the moment can then help us to avoid contributing to the disorder through our own emotional acting out. We're still where we are, right now, whether we like it or not. And especially when we don't like it, life is easier to handle on a moment by moment basis. In this way we avoid being overcome by despair.

Well, we're still where we are, and maybe that's just where we need to be right now.

marjie Ruth
(727)244-9011 (c)

sruth1@tampabay.rr.com

marjieRuth1@gmail.com

As always, feel free to share this email with anyone who might have the least bit of interest in it. Keep my name and email address with it please, so that anyone who reads it will know who is responsible for the thoughts expressed here. If you are receiving this and would rather not be bothered, just email me and I'll take your name off the list. Thanks.

More on Responsibility

I have spent a lot of time this week thinking about responsibility, particularly in terms of what's mine and what's not.  Consequently, when Marjie Ruth's post arrived in my email box earlier this week, the timing was perfect.  Not only that, but this topic rose again during a conversation among a group of women on Thursday and yet again this morning at my meeting.

While reading Marjie's post, which is here on my blog,  I especially focused on the sentence I highlighted, which was: 

" ....For us, we may want success so badly for our loved one that we usurp their responsibilities."

I realized through a lot of work with my therapist these last two years and by listening to others dear to me and by listening to the experience, strength and hope of still others, that I usurped my daughter's responsibilities in many areas of her life.  I also know that others usurped her responsibilities, too.  I did not want her to be hurt.  I did not want her to continue to be ill and to decline.  I did not want her to die.  Of course not.  But I extended my reach into her world so much these past several years that she didn't have to face reality on several fronts to figure out what to do to fix things herself. 

Marjie wrote:

While parents readily desire to provide an environment for their children that will foster their success, they sometimes can't seem to bear having their offspring deal with failure. It's with good intentions that they'll jump in to avert an impending negative outcome from a misguided sense of helping. When they step in to rescue their child from the consequences of his or her own inappropriate actions, they're often teaching them that they can get away with it...that they're not subject to society's rules. Such actions engender a moral lack of personal responsibility, hardly the intended outcome but a very real one nonetheless. 

Wow, the above paragraph strikes home for me, too.  There were times when I was able to step back and see the bigger picture and draw everyone who interacted into that picture to understand what was going on.  But more recently, I took myself over my own edge by somehow believing that I could change what was going on.  In fact, I certainly could contribute to the possibility of that change, but not actually change the situation.  That's what I had to learn.   That is truly up to her.

I continue to need to be reminded that I, as Marjie wrote,

.... all too often jump in to do it for our loved ones with the hope of getting them to a happy place more easily. And this, folks, is called enabling--doing something for someone else that they can and should be doing for themselves. When we help someone else circumvent accepting personal responsibility--when we make excuses for them, lie for them, do their work for them--we may actually be doing more harm than good by derailing that person's emotional growth. 

I did this, too.  I thought I was helping.  In fact, I was enabling.  Sure did take me a long time to finally "get" this:

Helping occurs when we do something for someone that they are incapable of doing for themselves. We feed and cloth a baby. We guide the blind person through traffic. We assist the elderly with housekeeping. The problem occurs when we are unable or unwilling to discern the difference between enabling and helping. And it is a problem because, ultimately, recovery is about accepting personal responsibility. 

No doctor, no therapist, no hospital, no residential treatment program can make an eating disordered individual well. They can support a person in their striving. They can offer training and tools that can be used by the person to recover. They can even point out they way. But in the end...or should I say, the beginning, because real recovery only begins and happens when the ED sufferer accepts the reality of their addiction and accepts personal responsibility for the tough road that is recovery. Successful recovery only comes with a price that entails many failures along the way. That is learning. That is growth. You may walk beside someone, but you can't walk for someone on the recovery road.

The most difficult step for me now is to simply walk beside her.  Yesterday I handed over a very important (to me) article that was published in Scientific American  (June/July 2008, pp. 60-67) by Trisha Gura titled, "Addicted to Starvation."

Many parents, including myself, have been to Family Week at residential facilities where we've been reminded that it's one thing to be able to recover from an addiction to substances like drugs and alcohol by abstaining and working, for example, a 12-Step Program but quite another to recover from an eating disorder when one needs to eat to live.  

The piece that must be reflected upon by many people is, I believe, that these illnesses are addictions that are evidenced by extreme disordered eating.  In the case of anorexia, the addiction is to the sensation of starvation.  How else can one starve oneself if not for some kind of reward, if only the reduction in anxiety that comes from eating?  How else does self-preservation fall by the wayside?  To put it simply, the person's brain sends a message that starvation is "feels good or at least better" and eating is "bad."  There are complicated explanations for this and more research is continuing in hopes of figuring out how and why.

Meanwhile, it seems to me, that the goal of the person who has chosen to live and fight (once they have been re-nourished enough to understand where they are and/or have reached a spot in their decline where their alarm bells are still going off) is to learn to immediately switch thoughts when they start to eat from "this is bad for me or feels terrible" (whatever form that thought takes) to "this is good for me.  I love myself.  I need to eat to show my love for myself.  I am worth it."

Getting to this internal language is hard.  It involves practice and practice and practice and repetition until the thought totally replaces the thoughts that are so harmful.  The voice of one so many of us call  ED.    Yet it can be done.  Although we read the alarming statistic (that may no longer be true and rather a myth because of lacking up-to-date information and better treatment modalities), the known statement is 80 percent survive these illnesses and 20 percent die.  The more we all know the more we can all work together in some role to increase that success rate.

My responsibility is to continue to shine the light and to love her, which I do.  So much.

Reflections on Taking Care of Myself - Signals that I'm Not

March 31 2019

My visits to my therapist have become less frequent for the most part.  I'm happy about that.  Her assessment with input from me is a reliable barometer of how I am doing in my battle (and it is a battle within) to separate myself from the what my loved one is doing without losing or demonstrating that sense of the unconditional love I have for my loved one.

One of the questions I'm always asked is something along the lines of "what are you doing for yourself?"

My list includes things like spending time with my husband, lunching with friends, taking a class, reading, working in the yard, not getting up at the crack of dawn to make an early morning board meeting, and seeing a movie.  The list used to include running but since a bad fall followed by x-rays of my neck that revealed a problem, I've turned to hiking/walking for my exercise.    Another activity is adding to this blog.

Since 1977 when I started running by putting on a pair of leather white and red swooshed Nike's, I've kept a running journal of sorts.  My entries usually included the miles I'd covered that day.  If I felt sick or sick enough not to run, I'd mention that.  If I was injured, I'd mention that, too (and not run).  I've had three injuries that got in the way of my running.  The first was a Morton's neuroma that was easily fixed with a wider toe box, lower dress heels, and inserts with a special pad.  I've successfully stayed away from surgery.  The second was IT band syndrome in 1981 that came about because I ran a marathon arranged to run in the direction of traffic so the cant of the road torqued my knee.  The third was more recent.  I wanted to run up Mt. Haleakala in 2001.  My training included miles uphill on the road up Mt. Lemmon here.  My plantar fascia rebelled.  We didn't go anyway because the run coincided with the awful events of that Fall and our flight was grounded.  

I worked very hard and continue to work to monitor my body in many, many respects.  As I've written elsewhere, my running brought me back to health.  I firmly believe that exercise, if incorporated thoughtfully and carefully, is very important.  I know I feel better having been out in the fresh air and sunshine.

Some folks will include things like the shoes they wore, the terrain they ran.  I'll usually note trail or a specific place like a nearby park that has a great walking path or the track when I used to do time workouts to increase my speed when I was racing. 

I've noticed that a great barometer of my focus on the exercise aspect of my life (which my parents ingrained in all of us at an early age as a means of keeping healthily fit) is not only exercising but also logging that exercise.  A member of the ultrarunning community (of which I used to be a member) created a challenge called the Million Mile Ultra and invited people to log their mileage.  I've been doing that since 1997 although I covered many more miles per year before that simply because I was always in training for an ultra or of our local trail runs that are calendared from September through May here.

One day, after first being startled to see that I haven't been keeping up with totaling my mileage in my journal,  I checked into the Million Mile site and was shocked to see that I had not logged a monthly entry since last August.  This lapse happened a few years ago when my loved one was failing rapidly and just getting out was an effort.  That lapse was three months.  This time the lapse was nine months.  I like making entries on this site because in the past it kept me motivated.   For me there's no competition involved; rather, it's a signal to several people on the list who I have known for a long time, that I'm still out there and somewhat kicking.

However this time, not only was there a lapse in logging, there was also a lapse in posting to my journal.  Fortunately, I am now am bicycling several miles once a week but thanks to many days of not posting in my running journal, there were weeks at a time when I might have put one or two entries if that.  Most lapses occurred early that year and recently I've gotten back on track.

So...... why?  I attributed some of the lapses to being on more celexa than I needed and therefore I simply got lackadaisical about it all.  This lackadaisical feeling over-ran several activities which is why I decided to reduce the dosage while working with my doctor about it.  I eventually quit celexa altogether and now take a low dose of buproprion.  Like many people who start to feel okay again, it's not clear to me that I won't feel okay if I go off the meds.  At least I recognize this fact.  There are those with anosognosia who don't recognize this fact and get into serious trouble when they quit their meds.  [

Reflecting on all of this, and I think my therapist will concur, I get sucked back into the life activities of my loved one when my loved one loses ground.

I've continued to be a member of the therapeutic team and appreciate their including me for I can offer insight on some of the behaviors everyone is observing.  I've been a welcomed member of the team now for ten years.  In the past it was a struggle to advocate effectively because it was so difficult to get key people to listen and take action.  Now the team is more tuned in yet their resources are severely stretched.  For me, knowing what is going on obviously has its pluses and minuses.  Good news is wonderful; bad news is so saddening. 

I continue to monitor myself closely.    I've kept close to my heart the expression, hope for the best; prepare for the worst.  The reader will notice which phrase I put first.

One day at a time.

To Name It Is To Tame It

Today’s Wall Street Journal (Tuesday, January 4, 2011) offers an article titled “Conquering Fear” written by Melinda Beck that can be summarized in a phrase:  to name it is to tame it  combined with the word mindfulness.

Over the past more than ten years, I’ve become increasingly acquainted with these two approaches through therapy, participation in the Something Fishy website, through readings such as books listed here on my blog, and in my weekly meetings.  When I started on this most recent journey to advocate for my loved one in the fight with the eating disorder beast, I truly was overwhelmed by the fear of loss and became so swallowed up by this fear that ironically I suffered the loss of a lot of precious time.  It is hard not to be overwhelmed when one’s loved one is on a sure path to death – many times – but I am learning that staying cool, calm and collected yields far greater benefits than obsessive worry.  Many different conversations and readings brought me to this place of greater calm and I know I will spend the rest of my life working towards it – a precious saying is progress, not perfection.

One of the mothers on the website introduced me to the phrase to name it is to tame it a couple of years ago.  How often do we ruminate incessantly over the what if’s and if only’s rather than to identify the underlying fear, observe it, and then step back and consider how to respond.  My daughter introduced me to mindfulness very simply by recommending the writings of the Vietnamese Buddhist monk, Thich Nhat Hanh, and more specifically two of his reliable volumes of commentaries, meditations, and stories that I keep close to me at my desk:  Present Moment Wonderful Moment (Parallax Press, Berkeley, CA, 2006) and Peace is Every Step (Bantam Books, NY, 1991).

By just opening one of these books and reading what is on the page brings wisdom and calm.  Just now, I randomly opened Peace is Every Step and came upon the sentence found in the short essay titled “The Roots of Anger” (pp. 64-65) “….If we genuinely try to understand the suffering of another person, we are more likely to act in a way that will help him overcome his suffering and confusion, and that will help all of us.”

Returning to the WSJ article, and pulling out a few quotes:

In reference to the third approach to cognitive behavioral therapy:  “….simply observing your critical thoughts without judging them is a more effective way to tame them than pressuring yourself to change or denying their validity.”

In reference to mindfulness:  “….paying attention to the present moment.  One of its key tenets is that urging people to stop thinking negative thoughts only tightens their grip – “like struggling with quicksand, “ Dr. Steven Hayes [a professor of psychology at University of Nevada-Reno] says. But simply observing them like passing clouds can diffuse their emotional power, proponents say, and open up more options.”

More on mindfulness by Zindel V. Segal, professor of psychiatry at the University of Toronto who devised Mindfulness-Based Cognitive Therapy to assist depressed patients:  “Part of what mindfulness does is get you to recognize that these critical thoughts are really stories you have created about yourself.  They are not necessarily true, but they can have self-fulfilling consequences.”

Many of those with eating disorders are overwhelmed by the internal critical voice or what is referred to as the Negative Mind by Peggy Claude-Pierre in her book The Secret Language of Eating Disorders (that I'm reading now and will talk about in a future post) and constantly beat themselves up in response to the messages they repeatedly hear about themselves.  By using these techniques they can learn to escape from these patterns of reaction and instead step back, think, and determine effective ways to respond.  This takes practice, but it does work.

A pioneer in all of this, I believe, is Marsha Linehan whose work has been so valuable in the treatment of those with Borderline Personality Disorder.  Dialectical Behavioral Therapy incorporates much of what is written here.

My favorite calming response is breathing slowly and deeply while concentrating on the feeling of stroking the side of my index finger with my thumb.  It has become a reflex action now and brings me to the present moment.  A calming place to be; a centering place to be.